Wednesday, December 12, 2007

From Silent Spook to All Kiriakou All the Time - Something Doesn't Smell Right

Cross-posted at Raising Kaine

Is it just me or is there something fishy about this Kiriakou guy? Just last week we learned out of the blue that the CIA destroyed hundreds of hours of videotape of detainee interrogations, some of which included torture such as waterboarding. Within a few days of these revelations a new face suddenly appeared on the scene, that of the earnest and articulate John Kiriakou, who claims to have been intimately involved in the apprehension of Abu Zubaydah and his interrogation, but not his waterboarding. Yet in spite of claiming to have not been on the scene when Zubaydah cracked, Kiriakou talks about it as he were. Moreover, he repeatedly asserts that Zubaydah cracked after only 38 seconds and immediately provided information, really good information, that saved a lot of lives.

Okay, call me suspicious, but something's off. Kiriakou makes me wonder if he's leading us all down the primrose path. He claims to have been an important factor in the CIA's apprehension and interrogation of the suspect, but has he actually offered any proof of his claims? How do we know what his position was within the agency? Why is he suddenly hitting every talk show in town, blabbing as fast as his tongue can move and asserting simultaneously that waterboarding is torture, which is bad, but that it worked really well and really fast on Zubaydah, which is good? Does anyone else think there may be a little disinformation campaign going on here?

My suspicion that maybe there is something contrived at work here deepened after I read Red Wind's diary at DailyKos Who Are You, John Kiriakou? Red Wind points out that up until Kiriakou started describing Zubaydah as an extremely high value detainee most people in the know did not regard him as such, and moreover, most or all of the information Zubaydah provided was either already known or was discredited:

In fact, much of the interview, and much of the tone of the ABC tape, goes to great ends to inflate the importance of Abu Zubaydah. To watch the report, you would believe that Zubaydah was the linchpin to breaking open the whole 9/11 conspiracy, and you would also believe that the crucial information was first divulged by AZ as a direct result of the waterboarding.

Ross and his colleagues do little to undercut this contention. It makes for an exciting exclusive, but not for very good journalism. The truth—if we can ever truly get there in these hyper-secret times—about Abu Zubaydah and his importance seems much, much hazier than Kiriakou or ABC leads us to believe.

Though I don’t have time to post a complete point-by-point (I’m a little under the weather today), I have read numerous major reputable publications on this subject, and I can safely say that for every bit of information that Kiriakou (or, for that matter, George W. Bush) claims was revealed by AZ after his torture, there is credible evidence that the US knew the intel before Zubaydah was even captured. The Washington Post and New York Times have covered this, and even the Report of the 9/11 Commission makes note that the supposedly key information that Kiriakou and Bush like to attribute to AZ—the “nickname” of Khalid Shaykh Mohammed—was known to the US before the attacks of 9/11/01.

Ron Suskind, in his book, The One Percent Doctrine, calls Zubaydah a low-level logistics guy, responsible for making minor travel arrangements, who knew nothing of al Qaeda’s inner workings. Suskind also notes that AZ was, in the words of one intelligence analyst, “insane, certifiable, [a] split personality.”

Given all this how is it that Kiriakou is allowed to go around, unchallenged, asserting that Zubaydah's information was so spectacular? Why isn't the CIA moving to stop him from revealing its activities and supposed secrets? The CIA seems unfazed by his garrulousness, not even denying or objecting to what he's doing, yet he paints himself as somehow being in opposition to the CIA.

Here's what I think. Kiriakou can be only one of two things. Either he was a low-level CIA functionary who likes to pretend he was far more important than he actually was and his prattlings are just the rambling boasts of a little man; or he is a sandbagger. All trial lawyers know that the best way to handle detrimental information about a witness or evidence is to lead with it before the other side can. When a witness has a serious flaw the attorney presenting that witness will often ask the witness about his flaws instead of waiting until opposing counsel raises the issue in cross-examination. This is sandbagging. I've listened to Kiriakou. A day or two ago I heard him say that he has decided that waterboarding is wrong and we shouldn't do it, but in the same breath claiming that it had such salutory effect on Zubaydah he could not deny its efficacy. His whole conversation was a resounding endorsement of the practice once you look past the BS feeble protests against it. I suspect that Kiriakou is being allowed to say what he is saying because it's setting up the administration's defense - sure, waterboarding's probably illegal and all, but look how many lives it's saved, they'll say. And yet ... and yet there is no showing that it saved lives. There are only Kiriakou's claims that it did. No one else in the administration can actually admit having been involved in waterboarding because they could be prosecuted. But they can sandbag the opposition. They can plant the idea that Zubaydah cracked after half a minute, had a vision of Allah that night, and the next day commenced to spill his guts and name every Al Qaeda cell from Peoria to Peshawar. How convenient. Half a minute of discomfort for all those lives? What a great bargain. Sure, it's the devil's bargain, but it's not like we hurt the guy, and he was really only discomforted for half a minute. No biggie, right?

Yesterday I listened to the interview where Kiriakou claims that he cracked after only 5 seconds of waterboarding and was amazed at Zubaydah's ability to resist for a whole half minute, but then I remembered journalist Kaj Larsen's endurance of 25 minutes of waterboarding before the session was stopped. How to explain the disparity between Kiriakou's claim that half a minute is an extraordinarily long time when Larsen underwent almost half an hour? Could this be a deliberate attempt to minimize the torture in the minds of the public?

I'm just saying, we should stop taking this Kiriakou at face value.

Monday, November 05, 2007

Finally Free of Photons - Fabulous

Here's my last post from the Parotid Tumor Patients' Forum. Of all the things I've lost it's my mind I miss the most, and look forward to renewing its acquaintance after a few days or weeks off the radiation. Let's hope it missed me and wants to come home.

Finally Free of Photons - Fabulous!

Posted By: CarlaFW
Date: Monday, 5 November 2007, at 1:01 p.m.

It finally happened. The day I thought would never come arrived and on Friday I issued forth from Radiation Oncology on a couple of hugs, calls of congratulations, and clutching my freakish souvenir - the much-maligned "autocast" - my mask. It still bears tape with little "x-marks the spot" inkings and one long and carefully drawn "V" along the lower left quadrant (with a tip of the lizard skin to Jodie).

My emotions are mixed. For three months the Radiation Oncology unit has been a regular part of my daily schedule. I've gotten to know the wonderful women who are the backbone of the unit; have listened to the gentle teasing of its outnumbered male, Mr. C; have enjoyed my conversations with Dr. L over everything ranging from my treatment plan to mutual acquaintances to the latest depredations of the Demon Spawn, also known as Arlington County's Parking Enforcement.

For three months I've plopped into the unit's comfortable chairs, chatting with patient and staff alike, phasing through as all radiation patients do since treatments never exceed a few weeks or months at most, and quite often may be as brief as one or two visits.

What can I say about this strange science? Every day at RT is a voyage on the SS Paradox, a sophisticated balance of hair of the dog with what bit you and destroying the village to save the village. Now my ship has come in and I can resume my life, wait for the infernal itching on my neck to go down, and find other things to occupy my mornings.

I took the mask to work and horrified all the claustrophobes by modeling it with commentary. My children were astonished when they saw the thing. I think they thought I was got up in something like a hockey mask every day.

My appearance at work on Saturday turned into a little bit of a reality check as I was there for only two hours before being overcome with exhaustion and driving home to spend the rest of the afternoon and evening on the couch. The cat took up her position on my chest and the dog his position on my legs, and my 16 year old and I watched "Jaws" as I told him of the summer of my own 16th year when the movie was released and my sisters refused to go swimming with our family off the shores of Massachusetts. Normalcy is nice.

Today I went to work and felt a little less fatigued, but forgot the name of the restaurant up the street when suggesting to a colleague that we go there for lunch, and forgot a copy of the code section I needed for court today, and forgot the name of the client on my walk from the office to the court. Radiation does that, I think. Its effects ripple like the pond into which the rock has been dropped, and it will take a while for the waters to recede and for the silt to settle and the depths to clear. I'll just have to be patient.

So that's it. My little adventure is done. It's been almost a year since I went for the physical that set me on this course. Let's see what 2008 brings.

Friday, October 26, 2007

Photon Freakout

Another couple of weeks have gone by and with them seventeen photon treatments; seemingly endless treatments. It's hard to remember what it was like not to report to the hospital every weekday. I'm there walking the hallways so much that not only have I found all the shortcuts to the cafeteria, but my presence in areas usually traversed only by maintenance and other staff goes unremarked. A familiar face, I blend into the surroundings. After including x-rays over the last few days I had hoped to be told that today was the last treatment. It was not to be so. My reassessment is on November 2nd.

Anyway, the latest installment of my Parotid Tumor Patients' Forum Journal is done, so I'm posting it for whatever it's worth to whomever might wander by. Here it is:


Photon-a-Palooza: Radiation Cogitation

Posted By: CarlaFW
Date: Friday, 26 October 2007, at 9:34 p.m.

To everyone waiting with bated breath for last week's posting which never came, I'm sorry. You can breathe now. The fact is that I fired up the old computer all ready to type away, a copy of Moby Dick beside me AND a re-run of Star Trek, Next Generations on the telly for inspiration, and I just ran out of steam. Crashed. Too pooped to pop, I ended up lying on the couch (a real couch with bouncy cushions, the decorative afghan, etc., not that thing at radiation oncology some comedian named a "couch" and which is actually a hard narrow table not made for large middle-aged women with dicey backs and plump thighs). Lacking any cat-themed throw pillows I instead propped a real cat on my chest and a Jack Russell terrier across my hips. The cat lay there for hours, gazing into my face with disconcerting feline opaqueness and occasionally pricking me awake with a single, casual claw to the top of my sternum or sticking her bewhiskered nose into my open, lightly snoring mouth. Glad to know there are some things which can make me more uncomfortable than the mask.

Before proceeding I must congratulate Jodie for somehow managing to weave the mini-series "V" into a discussion of Hannibal Lector by way of offering a cogent explanation of why the mask makes us look like cannibalistic reptilian pseudo-aliens. Liver with fava beans! Sounds, um, not too good, but the man's a cannibal and there's no accounting for taste.

Now, as for the last seventeen days of photon goodness, anyone can get used to anything if it's reduced to a routine. It's just very tiring and a little unnerving.

I've spent the last few days pondering WHY it's unnerving. It's not the staff, the facility, or even the process itself. The staff is just wonderful. I couldn't say enough about how helpful and kind they've been. The facility is modern, well-lit, with good chairs and lots of reading material and water and strategically placed baskets of crackers. The process, too, is non-threatening and mundane, a routine during which a friendly technician usually opens a door and tells me to go on down the hall to the treatment room, where I am always greeted by one or more of the personnel, usually a technician and/or a nurse and/or a dosimetrist and one of their new interns. The interns are always young and enthusiastic; cute, but competent, who remind me of my own dear 21 year old daughter. An old hand, I stroll into the treatment room and wait for them to complete setup so I can lie down.

Setup changes from patient to patient depending upon the treatment ordered. If I enter the room after a breast cancer patient has been in there I'm likely to see two stirrups off to the side, and a little round stand for the patient's head. The stirrups are for the patient's arm, which must be placed out of her way while the breast is irradiated. This setup is of a piece, with that portion of the table being removable, stirrups and all, and another, flat portion of table laid down in its place. The setup for a head and neck patient like me consists of a rod containing little pegs placed in grooves on the table, upon which a sort of tray is dropped into place on the pegs, and which itself may have some pegs for placing in the table's holes, for stability. Near each corner of this tray are latches: round buttons with flat metal prongs on them which can be turned to hold in place the clear plastic headrest. The misnamed couch is in fact like a Lego pegboard on which many setups can be erected, or maybe it's just a big game of Battleship.

I lie on the couch and arch my head back a little for the mask, which is placed over my face and firmly strapped down. I can move my face inside of it a little bit for comfort, but comfort is a matter of perspective. To me, comfort means that I feel constricted, but not so constricted that I think I'm suffocating. Staring upward at the blue sky ceiling panels through the gauzy fuzziness of the mask I feel the couch slide silently under the collimator. Treatment rooms have these things - blue sky ceiling panels and walls with scenes of flowers and gardens - an effort to alleviate the claustrophobic sensation of a room without windows. Talking is impossible - probably not a bad thing - and I can only stare upward at the machine. I've memorized the innards of the collimator, trying to guess the depth of the hole through which the white light comes (maybe 18 inches?), and noticing the tell-tale wedge formation of large MLCs just below the light. Much of the structure looks like the inside of an SLR camera lens.

At some point during the treatments we decided to dispense with the hospital gown and instead treat me in my work clothes. Some mornings the shirt has to be taped down to reveal my clavicle and the little tattoo dot next to it. Considering the difficulty of lining up something as round and irregular as a neck and shoulder, the crew works very fast and efficiently. Reflected in the machine I sometimes see the green laser line tracing down my clavicle. Sometimes an ink dot enhances the underlying tattoo. Sometimes the green laser light isn't on, and I can see reflected the piece of tape, a line carefully marked down it, which courses down the left side of my mask. The reflections are obscured when someone slaps the MLC wedge into its slots on the collimator and I read the legend: "30 cm x 40 cm 15 degrees steel".

Happy with their work the techs walk out the door, a huge 12-inch thick door with a red radiation caution sign on the outside, and leave me alone on the other side of it. Sometimes I hear a "poomf" noise as the door softly closes. I have often wondered whether this sensation of being left alone is what is so disquieting, but think not. I've never minded being alone. As a child I used to hide in closets and under beds, avoiding parental scrutiny and reading voraciously by the light of my Girl Scout flashlight. Nope, solitude for me can be comfort.

Alone in the room there is nothing to do but wait, with an odd sense of anticipation, for the treatment to begin. No announcement precedes it, just silence and a sudden buzzing noise from the left which goes on for over forty seconds. The buzzing stops, and the collimator rotates to my left. Someone enters the room and removes the wedge, then leaves again. Another soft poomf and the collimator rotates all the way under me. Sometimes the green laser light is on and I watch two narrow lines of green chase each other across the ceiling, and then the bottom section of the machine is above me; a flat, gray mass with a piece of masking tape across it with "Do not rotate beyond this point" written on it. I wait, and another buzzing starts, this time for 30 seconds or less. One day last week the buzzing stopped after only a few seconds, and I lay there confused and wondering if I should move, until it started up again and completed the dosage. Somehow a switch had been accidentally hit.

A few days ago as I lay on the couch after a session I glanced up and noticed a surveillance camera in the corner. A technician told me the camera shows each patient in the room, and all that is necessary if I am ever in distress is to raise my arm and they will come running. This is good to know. Perhaps I will work up the nerve to start flashing gang signals or make little animal shapes one of these days.

On top of the treatments there are x-rays. Lots of x-rays. Maybe this is the source of the disquiet, the sensation that on top of the unnatural amount of radiation I receive each day there are additional rads coming through my x-rays.

Maybe the disquiet is related to physical reaction to the treatments. In the mornings I receive a treatment and sometimes upon getting up from the couch I feel a blocked sensation in my ear, or a coarse static. Sometimes I feel a delayed electric sensation swelling my throat or lips for hours afterwards, like an overdose of sun at the beach. My voice comes out croaky sometimes, sounding like the eternal teenage boy on The Simpsons. My gums hurt and my teeth are sensitive. My neck is red on the left side and I think of how appropriate it would be to have Gretchen Wilson singing Redneck Woman just once in the treatment room. I'm tired and my brain is foggy. How many times have I had to explain to people that if it is not in front of me I may not remember it? Or that I cannot quite recall things which normally would be at my fingertips? A natural chatterbox from whom words normally gush unimpeded and heedlessly, I suddenly find myself groping for words at times, reaching across the radiation-induced drought and stumbling over pebbles of thought as I grope for pools of my former loquacity.

So, perhaps the disquiet is this; the feeling after decades of being warned of the dangers of radiation, of being taught to "duck and cover" in the early sixties at my grade school, of living through the Cuban missile crisis at ground zero in the DC area, and through the no-nukes movement of the late seventies, that being on the wrong side of the danger sign on the blast door is abnormal. It's a cognitive disconnect to be on the wrong side of that door, in a room with false windows, and next to a machine which is giving me the equivalent of dozens, or maybe hundreds of x-rays every time I'm there, not just from the front but from the back, also.

Notwithstanding this disquiet, every day I report for treatment, and every day walk from the room unimpeded and generally unscathed but for the minor complaints put forth above. There is nothing here from which I will not recover. The disquiet is in the end like the monster under the bed, unsettling but not real. It is tolerable, and as I embark on the next week of treatment I understand that I will feel a bit worse before I feel better, but that this will be but an interesting topic of conversation at dinner one day, a set of experiences out of which I might weave a tale, its tone either somber or amusing or informational, but something which will be in the past. My future does not include this disquiet. All is well.

Saturday, October 13, 2007

Radiation Update - Parotid Tumor Journal

Thank you to those who've expressed their concern about my situation. I feel fortunate in that my condition is not cancer, and I will not require chemotherapy, and that I live in an area where there is easy access to cutting edge modern medical treatment. For those who may have stumbled onto this site while looking for information about parotid tumors, you cannot do better than to look at the superb Patients' Forum on Parotid Tumors run by RoxanneM at this link.

Unfortunately, I am not yet done with treatment. I've been through five weeks of electron RT and am now embarking on about three weeks of photon treatment. During these past weeks I have been posting a journal of my experiences on the Patients' Forum, going by the screen name CarlaFW. I've reproduced the journal in its entirety, unedited and complete with minor errors, below. The biggest error is that I am not in IMRT radiation therapy, but straight-up photon treatment. The later entries tend to be more accurate than the early ones due to the information I've gathered during this period. Maybe by the end of this little episode I'll actually know what's going on. In the meantime, I would like to extend thanks to the Radiation Oncology staff of the Virginia Hospital Center. They are the best.

Starting Radiation Treatment Next Week

Posted By: CarlaFW
Date: Thursday, 2 August 2007, at 10:27 p.m.

Well, I've gone and done it. After dillydallying, ducking, and diverting myself for the last few months since my April surgery I've finally started preps for radiation treatments. After five recurrences during the last 34 years it's clear something a little more drastic than waiting for the next pleomorphic adenoma to grow in is called for, so I'm ready to roll.

I've been to see the radiation oncologist twice this week. He's very comfortable to be around and his office is efficient yet lowkey. On Tuesday I showed up to have my mask made. This is the thing which will be placed on my face to keep me immobile during the treatments over the next few weeks. I'm curious about others' experiences of this rather bizarre process. I'm not claustrophobic, but having a large, warm, rectangular, meshy, waxy thing placed over my face like Saran wrap and strapped to a table was a bit unnerving, especially when it began to stiffen. However, the reality is it wasn't too bad. You can actually see and breathe through the thing. There was a lot of marking of things with green magic marker, bits of masking tape being torn off and slapped onto it, and various terms being tossed about. Hard to follow for this math-phobe, but they answered all my questions to my satisfaction.

Today I went back for a bit of tinkering. This time my doctor greeted me with flat piece of pink wax upon which had been crudely drawn an ear outline. He snipped and worked it and kept fitting it over my ear. Once he felt it was sized right he picked up a lead disk, traced an outline of the wax onto it, and more snipping and shaping ensued. Come Monday I'm assured this thing will have a wax coating. It's to protect my ear and ear canal from the radiation. After that I had to lie on a table for about 15 minutes while more measurements were taken, and then two tiny tattoo dots were put on my temple and front of my ear. They're hardly noticeable.

I'm told treatment will be mostly with electrons, calculated to appropriate depths at a strength of 9 million volts(!?). Electron treatment is supposed to be far less destructive than photon treatment since electrons are particles and photons are rays. It's possible that due to some earlier involvement of my lymph nodes in my fourth surgery that I may have to have photon radiation on the nodes, but we'll cross that bridge when we get to it. Right now it looks like we're just doing the electrons. My doctor wants to review my ancient file and make a final determination. He told me that my record makes me a little bit of a medical anomaly and he and my surgeon are planning to present my case to some meeting next week. Sounds like fun.

My friends' crazy senses of humor are a help. Some of them are planning to get my mask after we finish the treatments, cast some molds, and create "cargoyles" for various places like their gardens and maybe my office. The kitschier/tackier, the better. We wouldn't want to leave me with any shreds of dignity, would we? Maybe we'll fashion a "twin" for me for the high occupancy vehicle lanes.

Anyway, Monday's the big day. We'll see how things go.

First Week of Radiation In the Books

Posted By: CarlaFW
Date: Friday, 10 August 2007, at 10:38 a.m.

Well, I've finished the first week of radiation. It's 9 million volts of electrons every morning at 8 a.m. It's just a regular appointment I keep every morning, after which I proceed to work or sometimes home if I feel like a little nap. So far, so good.

As to side effects, yesterday I got the shock of my life when I accepted a spoonful of Italian ice. The right side of my mouth felt like I'd just broken a tooth and slapped ice on top of it. Ouch! My tongue feels slightly larger. The left side of my head, which is the treatment side, has been stiffening up lately. Yesterday my jaw felt very stiff on the left and I found myself working it and stretching it like the Tin Man after a rain. Last night I couldn't sleep due to the ache in my shoulder radiating down from my neck. But aside from this irritating tightness I haven't got much to complain about. I feel more tired than usual, but have been able to work. There is a sense of ditziness that hits right after the treatment - where I have trouble finding words and completing thoughts - but that sensation burns off after a little while, and part of that may be related to menopause. Or maybe I'm just ditzy and never noticed it before. Who knows?

Last night I did a little research and found some reference to hearing loss related to electron radiation, so am planning to ask the doctor about that on Monday. My last tumor was so large I had impaired hearing, but after the surgery my hearing improved. I'd hate to lose it again, but sometimes you can't make an omelet without breaking a few eggs. More on this later.

Anyway, now I have two days before I have to go back again, a welcome respite, and then back into action on Monday. It helps enormously to have such a friendly, helpful, responsive staff. I've seen pictures of their children and favorite pets, heard anecdotes of family adventures, and gossiped about hair care and favorite foods. They're downright neighborly.

Second Week of Radiation Complete!

Posted By: CarlaFW
Date: Friday, 17 August 2007, at 9:32 p.m.

Another week has passed and another week of radiation is done. There's more fatigue, but that may be related to the fact that my teens don't seem to understand that I need a lot more uninterrupted sleep these days. They're used to their insomniac night owl mother prowling the house at all hours and so think nothing of starting conversations or calling me from their friends' houses at 1:30 a.m. Today, my business partner finally called my daughter and asked her to read the riot act to her brothers since I'm walking around with bags under my eyes large enough to shutter a window.

With the exception of a small computer problem which caused my treatment to be postponed until Thursday afternoon there have been no problems. As for side effects I've noticed a stiffness in my jaw and next to my ear, and a mildly bruised feeling on the side of my head. I have started to see a diminution of my sense of taste, especially along the left side of my mouth, and my teeth and gums are increasingly sensitive. This problem I am treating aggressively with high fluoride prescription toothpaste and Sensodyne after every snack or meal during the day. The sense of scattered thinking remains, although maybe that's the fatigue more than anything else. I continue to pause to grope for words, probably to the relief of colleagues who needed a break from my constant prattling.

Looking forward to my little weekend break.

Third Week of Radiation Done

Posted By: CarlaFW
Date: Saturday, 25 August 2007, at 8:04 a.m.

After three weeks of radiation I have to say that electron's definitely the way to go.

This week the doctor increased the thickness, by one centimeter, of the bolus, the gel-filled thing resembling a mousepad which they place over my ear after taping the ear shield to my head and hair. The idea was to get closer to the surface of my skin, and I noticed an immediate increase in the sensation of a sunburn within a day or two. I was surprised at how much heavier the bolus felt with the added thickness. Like lead. I also asked why, after counting off the seconds during each treatment, there is as much as five seconds variation in treatments. The technologist told me that she measures the barometric pressure, humidity, and temperature of the room every day and the readings are input into the computer, which then adjusts the time to allow for the proper dosage. The dosage determines the amount of time the treatment is administered, not the other way around. The doctor gave me an appointment for Tuesday to review my treatments. Several weeks ago he told me he must decide whether to "go deeper" after my lymph nodes, and I got the distinct impression this meant switching to protons. Can only hope I'm reading this wrong.

So here we are, after the third week and fifteen zappings, and the worst side effects I can report include increasing fatigue and an ear that feels sunburned. The fatigue is a real drag. For a self-employed person no workee equals no eatee, so I've been trundling off to work every day after radiation. Yesterday one of my colleagues dropped in and told me she'd seen me leaving skid marks on the sidewalk from hauling my rear to the courthouse. I feel just as I did in college when I came down with mononucleosis in the last month of my last year and had no choice but to continue going to class, writing papers, and taking exams. Brutal.

Intense feelings or aggravation or agitation can bring me down in a hurry. I'm usually a very energetic, some say hyper, person who feels energized by debating or generally dealing with people. The other day I was arguing with a prosecutor over disposition of a minor case and actually started to stagger with exhaustion. I had trouble finding words and that really scared him. Poor guy made me go sit down until I could pull it together. Looks like I should avoid taking on any jury trials or anything requiring intense preparation.

Other than fatigue I'm feeling more pain and sensitivity in my teeth and gums, the side of my head feels stiffer, food is looking less attractive, and I've opened up a sore right above my earlobe which bleeds occasionally. Every day a technologist marks my head with either a green magic marker or a red magic marker (depending on the technologist) prior to treatment. The red has leeched into the gray hair surrounding the site, which when added to the green on my face gives me a slightly Christmasy look and opened up a lot of good natured ribbing.

Fourth Week of Radiation Done!

Posted By: CarlaFW
Date: Saturday, 1 September 2007, at 10:49 p.m.

Well, another week's gone by and other than even more fatigue I'm still feeling pretty darn good.

The skin on the left side of my face is taking on a very sunburned look and my ear feels increasingly as if it's blocked or full of ear wax or something. Though unpleasant these feelings are not terrible and I have been able to continue working, albeit with a reduced schedule and frequent little catnaps. I definitely require more rest.

The doctor and I met briefly on Tuesday, during which he told me he's very pleased with my progress thus far and anticipates the treatment concluding about two weeks from now. Happy news. Two days later his assistant stopped me and asked if I understood the doctor was talking about current electron treatments for the area next to my ear and not necessarily about the lymph nodes. D'oh! If he decides to go after the lymph nodes it'll be no more nice electrons and hello photons. As I told the techs, no one ever hears Captain Kirk telling Scottie to arm the electron torpedoes, and anything that can blow spaceships out of orbit, like photon torpedoes, just can't be good for your body. Didn't hear any disagreement there, although the girls did ask if I always think in popular cultural allusions. Um ... yes?

Anyway, I'm still able to sort of taste things and beer and wine have not lost their charm (hooray), thus allowing me to continue swilling at baseball games and Bar functions. And I can't begin to express my gratitude at being able to drink coffee in the morning. Have to be careful not to burn, but boy do I need the caffeine. The aggressive prophylactic treatment of my teeth also seems to be helping. I floss and brush several times a day and use fluoride treatments. Still no major complaints about them.

So that's it. More of the same, with no big surprises, and that's fine. One can get used to anything if one does it enough.

Fifth Week of Radiation Done - and Over?

Posted By: CarlaFW
Date: Friday, 7 September 2007, at 9:23 p.m.

Today I was told that my last electron treatment will be on Monday - just one more day. Then, after a rest of about a week to ten days we're going to move on a brief session of IMRT photon radiation - to take place between a week and a half and three weeks.

My ever helpful friends have suggested that we find a Star Trek costume for me so we can get in the mood for the "photon torpedoes". I can't see any downside. I suggested that I take the Lieutenant Uhura role, but these same friends say that I simply don't have Nichelle Nichols's legs and maybe I should stick to a Captain Kirk/Scottie scenario.

Overall, I cannot complain about the electron treatments. Despite periods of extreme exhaustion I'm able still to work and even go out with friends or to a ball game. Part of this is probably due to my natural high energy, but a lot is due to the fact that electron radiation is a much more superficial type which does not cut through everything in its path.

So, after five weeks I can report a sore ear, slightly impaired hearing which will probably resolve itself over time, pervasive fatigue, and a rather sunburned looking side of my face. I've lost my sideburn, the radiation leaving a smooth edge to the hair almost to my temple, which looks as if I went after it with a razor. My hair is shortish, but long enough to easily cover the missing little hank of hair.

All in all, not a bad experience.

Sixth Week After Radiation Started

Posted By: CarlaFW
Date: Friday, 14 September 2007, at 9:03 p.m.

I did my last electron radiation treatment on Monday. Nice to have a break from the festivities before I start on the IMRT ... now with more photons!

The staff warned me that I would continue to feel the effects of the treatment for days afterwards. I think I walked out of there expecting to be completely normal (to use the term loosely) by Friday. Instead, my skin continued to get flaky and irritated and I started to drag quite a bit by today. But come to think of it I've been working late and intensely, and my drama prone family has had more than the usual share of crises this week. The only thing for the flaking/itching is keep slathering on the Alra Therapy Lotion. Great stuff. It really does help. My doctor called me out of the blue today, told me that he does this each Friday with everyone who's completed a course of radiation, and asked how I am. He told me all sounds normal and is looking forward to seeing me next week for a review and the simulation for the IMRT. Since I spend most of my time listening to other people's complaints and dealing with their problems it was gratifying to have someone ask me how I am.

I used the extra time granted by my lack of a regular RT meeting to search the web for an appropriate picture of Captain Kirk and Scottie to present to the girls at Radiation Oncology in honor of the "photon torpedoes". The dialogue goes like this:

"Arm the photon torpedoes, Scottie."

"Cap'n, ah cannae do it. She's a menopausal woman, dangerously unstable. One wrong move and she's likely to blow."

"Never mind that, Mr. Scot. Give me those photon torpedoes."

Cue cheesy 60s Star Trek music.

Might as well have a little fun with this.

Send in the "CAT"

Posted By: CarlaFW
Date: Wednesday, 3 October 2007, at 7:44 p.m.

Well, it was off to the radiation oncologist today for evaluation and review. Fresh from a triumphal five week tour of electron world (Now, with more linear acceleration!), I am now preparing to embark on a three week course of photon therapy, which I like to refer to as breaking out the photon torpedoes.

Before we start it's necessary to get a "CAT" Scan tomorrow. Yes, yes, I know, it's actually a CT Scan. Boring! I'd much rather have it done by a cat. I can see it now (scene goes all misty into black and white):

"Okay Carla, we're going to do a 64-slice CAT Scan to map your head and neck. Here kitty, kitty, kitty ..."

"Mrrrowwwwrrr, pfst!"

"There you go, kitty. Come on over to Carla."

"Nice kitty, do your damage. We need 64 slices."

"Hey, are you sure this is safe? That cat looks angry ... no don't ... mreowwwrrrhhhrrowwww ... pfsssttt! Ow, for pete's sake, what are you doing?"

"Come on, kitty, just 4 more and we're done."

"Rowrr!"

"Ackkk, I'm bleeding!"

"All done, Carla. Don't you just love our brand new 64 slice CAT scan? It's the latest in medical technology."

"Hackk, spft, hackck ... "

Ooh, a hairball. These technical problems happen sometimes ..."

The "CAT" Would Have Been More Fun

Posted By: CarlaFW
Date: Friday, 5 October 2007, at 12:01 a.m.

Today I went for simulation in preparation for photon radiation starting next week. All in all I think my idea about using a "CAT" scan was more fun than today's adventure.

I was ushered to a back room, where once again all my idiot questions were answered fully and completely. This bunch is unstoppable.

A radiation tech, or maybe she's a dosimetrist, told me she was going to assist in making another mask for me. Ruh roh! Now, for those who've been following my adventures you know that I was actually fitted for a mask about two months ago, and then when I showed up for my electron treatments they just had me tilt my head, placed an ear shield and a bolus on my ear, and zapped away for five solid weeks. No mask, just a warm, electric sensation.

So I asked: "Why no mask before?" Turns out a mask can't be used in electron treatments because the poor little sensitive electrons just get absorbed right into the mask and lose their effectiveness. This makes them sound sort of wussie, albeit rather soft and cuddly.

Now the photon torpedoes have no such problem. They're a leaner, nastier form of RT; sort of like the kids in my old neighborhood growing up. Photons are gangsta to electrons' wannabes, so they'll go right through the mask and pretty much anything else in the way, impeded only by the MLCs. The way the dosimetrist explained it the MLCs are dozens of tiny lead leaves which can adjust and flutter to block and direct the photons, which allows them to do their work while avoiding damage to surrounding tissue.

Still awash in the glow of new-learned useless information I was directed to sit on a table next to the CT scanner. The doctor, the physicist, and dosimetrist all gathered around and started talking in tech speak and numbers at each other. Always at times like this the magic markers come out and before I know it there are multi-colored circles, slashes, and little exes on my face and neck. Everyone's got a favorite color it seems. After rendering me suitably ridiculous looking the team decided it was time to mask up. Mr. C., the physicist, cheerfully declared that they were going to make my neck hurt now. Hey, the man was being honest.

The table had a little plastic stand for my head. Apparently these stands are labeled "A", "B", and "C" depending on size. They tried the B, then the C, then the B, then finally the A. I felt like Goldilocks choosing a bed.

Everything was fine until they asked me to tilt my head back, then farther back, then pretty much all the way back while perched on the stand. Oy! I was handed a big ring to hold between my hands.

The ever-cheerful Mr. C approached with a large round yellow frame across which was stretched a hot, gauzy, waxy-looking membrane, like a thick piece of Saran wrap, and without further ado pressed it down around my face and locked it into the table.

This can be a startling, confining experience. The waxy stuff is very warm, but starts immediately to cool, and as it cools it hardens. You can breathe through it, and see through it, but as it dries you feel it adhering to your forehead and chin. In my case the tech speak kept right on going, with the dosimetrist and Mr. C marking pieces of masking tape and slapping them onto strategic parts of my mask. Occasionally the magic markers came out again.

Eventually all the scribbling and tech speak was done and the machine was turned on and I was sent into the scanner, then back out again. There seemed to be a lot of this in and out stuff, with the dosimetrist, Mr. C, and the doctor occasionally wandering back into the room to fuss over the mask and speak in anagrams and numbers some more.

At one point Mr. C started poking my chest, as if he was looking for my sternum. It turned out that my surgeon had what my radiation oncologist regarded as an obsession with my chest - not the good kind of obsession, mind you - but a concern that tumor cells may have migrated there. I was sent into the scanner yet again to take pictures almost to my waist. Then the dosimetrist tattooed two little marks on my clavicle, which she laughingly called the "vampire bite", and we were done.

By this time I'd been almost an hour with my neck locked into an unnaturally tilted position and things were getting uncomfortable. All you can do in such a position is stare upward, which in my case meant watching the two green laser lights on the ceiling, then the blinking red lights as I entered the scanner, then the whirring thing inside its frame inside the machine.

Finally the dosimetrist came out and unsnapped the mask from its base. By that time I was stiff as a board. The doctor explained that everything was clear and it was nice to hear there were no masses lurking in my lungs or shoulder. The area to be irradiated is about 15 centimeters, from the mastoid process down to the clavicle.

So that's it. The dosimetrist showed me all the pictures and the area to be treated. I told the doctor that I'm not claustrophobic, but after an experience like that was considering taking it up, and he laughed and replied that he has a lot of angry friends who insist on entering the machine feet first or even sedated.

I toddled off to work, which is where I discovered the criss-cross pattern of the mask still on my face, where it remained for a solid hour and a half before fading.

So, the long and short of it is that the mask can be annoying and confining and a little unnerving, but even an hour in the darn thing does no real harm, and for my treatments of course I will be in it at most for a couple of minutes. No big deal, but I still would have liked a cat in there with me.

Arm the Photon Torpedoes, Mr. Scott

Posted By: CarlaFW
Date: Saturday, 13 October 2007, at 1:20 p.m.

Well, I've started my latest round of radiation, this time with photons. Except for the incredibly confining mask, the length of time spent getting zapped, the direction in which I'm being zapped, the multiple zaps, and the difficulty of lining up my uncooperative shoulder with my equally uncooperative neck, it's exactly like electron treatment.

When one hears that one is going to get two different types of treatment one assumes that there will be two different machines. However, now I'm back in the old room with my good buddy the Clinac21EX/23EX linear accelerator. It turns out that linear accelerators are used for multiple purposes, making them the Ronco kitchen tools of the radiation world. Darn things have more diversity than a New York street festival.

With nothing better to do I slipped into toddler mode this week and asked a lot of stupid technical questions. The main machine is called the gantry. That it rhymes with pantry makes it all the more kitcheny to my ears, and the fact that it strongly resembles a gigantic '70s era Sunbeam mixer doesn't help. The mixer head is referred to as the collimator, which sounds suspiciously like colander. The collimator is very versatile and has a number of grooves and locking mechanisms for the insertion of various implements to assist in the administration of the radiation. In my case there is a metal tray called an MLC wedge which slides and locks into place, and helps to shape and direct the beam.

On Tuesday I reported for what I assumed would be my first treatment, but it was actually another picture taking session. I got on the table, technically called a couch (a really hard, flat, narrow couch without any fluffy cat pillows, decorative afghans, or bouncy cushions), and the mask was strapped over my face. It is extremely snug, but does not hurt. With my head tilted pretty far back the edge of the mask butted up against the top of my throat, and with inhalation I felt the jugular pulsating against it. Ick. I found myself delaying taking a breath just to avoid the sensation. I was then elevated pretty high, and the couch slid under the collimator. I mumbled a request through my mask for a doughnut (mmm, doughnut!), which is the ring I hang onto with both hands so my arms don’t slip down my sides and ruin the setup. The doughnut is a wonderful invention, especially for those of us who may be a bit over-nourished.

My vision from the mask is somewhat obscured but good enough to see the flat metal of the collimator, and the rectangular hole through which I could see more metal layers of varying shapes, and a white light. In the ceiling there is a cross-shaped hole out of which comes a green laser light. For this session I could see my reflection from the glass covering the hole in the collimator, and saw reflected a green line which traced the line of my clavicle. The technician and dosimetrist fussed over me with a green magic marker and started the usual routine of speaking in jargon and numbers. The technician carefully drew a line (green ink this time) from the top of my throat through the tattoo marker and to the next tattoo marker, then traced the green light down my clavicle and then up to my shoulder, following the line of light from the rectangular opening above me. The result was an incomplete rectangle, with the top open. Then they inserted the MLC wedge and the light was bent by the presence of a series of ridges, like little steps, in effect creating a step-shaped shadow on my skin. This too was carefully traced and the blocked area colored in a little. It ended up looking like a diagram from a kid’s science fair project on how waves create sand dunes. Charming, especially after I couldn’t get the ink out completely, even with a shower the next morning.

Then commenced the picture taking. It seems to me we do a lot of this. At times I feel like a celebrity fashion victim what with the technician running into the room with her digital camera for another shot of the hospital gown-clad plump lady strapped to the couch, and then the x-rays from the gantry. They took a series of x-rays from the top, then rotated the gantry upside down and took more pictures from beneath me. I hadn’t noticed before, but the couch is actually just a big grid with a kind of plexiglass covering it.

After the session I asked a lot more stupid questions. It seems I am receiving 176 cGys (they used to be called rads, but are now called grays after a British physicist, and designated by Gy) on the top shot, and 117 cGy on the bottom shot. At my first treatment on Wednesday I went through the first zapping, then lay there perplexed and wondering if I should try to move, when the gantry suddenly rotated upside down and they administered the second dose. The first dose is always around 40 or 45 seconds by my count and the second is about 25 to 30 seconds. The doses are administered by 100 monitor units, or M.U.'s. As with the electron treatments the time varies for each dose based on environmental factors.

So far I’ve had three sessions. Setup is more complicated than it was for electron treatment. The mask has to be strapped on and my shoulder has to be lined up just so, and then the lights have to line up exactly before they commence. I’ve already noticed a nasty stiffening in my shoulder and will have to ask about possible physical therapy or exercises for the problem. After my third session on Friday I went off to court and while standing in a hallway felt a wave of fatigue rise from my ankles and swell over my head. My voice is starting to feel a little raspy, and I expect that I might have a sore throat by the end of next week. Given a choice I would say that even a free week at the beach inclusive of admission to the seafood buffet would not induce me to stay at Club Rad, but sometimes we have to do what we have to do. It’s not jail and it’s not permanent, so I’ll keep on trudging to the Radiation Oncology office every morning until they tell me to stop. It beats having yet another doggone surgery.

At any rate I can still work, and so I do, and last night a good friend took me to the National Italian American Foundation gathering in D.C. with a show by Neil Sedaka. My friend did the whole radiation thing for breast cancer, plus chemo, which I don’t have to have, so I’m still coming out ahead. We went and had a great time and met some charming Canadians and found out that Neil Sedaka is at least part Italian and in fact can sing and speak in Italian. Who knew? Life goes on.

Thursday, August 02, 2007

Radiation Therapy Follies

The last few months have been a whirlwind of weird medical issues and elderly relative caretaking responsibilities. Oh, and there's also running the business and all that. I haven't posted in a very long time, but I've missed my blog.

Starting next week I begin radiation treatment for my little parotid tumor problem. Although the April surgery came back with a benign pleomorphic adenoma diagnosis, the fact is that without drastic measures I will have another - sixth - recurrence, and that each recurrence increases my chances of developing a malignancy.

Accordingly, I agreed to radiation treatment. On Tuesday I went to my radiation oncologist and was fitted with a mask. A large, rectangular, waxy, gauzy, heated thing was pressed down over my face as I lay on a CT Scan table and strapped down. As soon as it began to cool it started to stiffen. Not a painful experience but a bizarre feeling. For a fleeting moment I thought "I have to get out of here" as I considered ripping the damn thing off and fleeing. It passed, but I realized then that for the truly claustrophobic it has to be a miserable experience.

As the thing cooled they huddled next to me, drawing on it with a green marker and sticking marked pieces of masking tape in various spots on the mask. The two doctors worked companionably with each other, and it felt oddly like we were all involved in a grade school science project together with me as the test subject.

They told me they planned on using electron radiation primarily and hoped to avoid using photon radiation. To me radiation's just whatever is likely to make me glow in the dark, so I had to ask the difference. Well, it seems that electrons are delivered by a particle beam which can be tweaked and calibrated to a very subtle degree. They can be programmed to a great range of intensity and depth, and upon reaching their calculated depth they dissipate. Photons, on the other hand, are rays and keep going past the point of their original focus. They are necessary for deeper, more radical treatments. I asked if this is why Star Trek features photon torpedoes but no electron torpedoes. "Sure," replied one doctor.

After about 20 minutes the mask was removed and I was left with green marks down the left side of my face which came off readily with an alcohol wipe.

Today I went back for some tweaking and discussion of my case. The oncologist sat next to me with a wax slab upon which was a crudely drawn outline of my ear, and he snipped and shaped it to fit the ear, then traced it onto a lead sheet and cut that out. Again, he and the other doctor, his assistant, chatted companionably, exchanging little pointers and comments. "He's been with me for 23 years," he said of his assistant. "Since he was a kid." There was much happy talk about how well the ear shield turned out, with compliments all around from assistant and staff, and this I somehow found comforting. There is much to be said for making a patient feel as if she's participated in a joint effort rather than like a project to be worked on.

By Monday morning the shield will be coated with wax and I will wear it for each of my treatments. It feels strange but beats having stray electrons rattling down my ear canal and wrecking what's left of my hearing on that side. Given my history - five recurrences over 34 years, the oncologist told me that he was considering photon radiation of my lymph nodes. Ick. I'd much rather deal with the kinder, gentler electrons, but I'm not the expert.

The ear shield done it was time to take more measurements. Once more I ended up on a table, which was moved around and situated under a boxy looking machine so close it almost touched my face. The table moved smoothly and swiftly, like the beginning of an amusement park ride. Both doctors seemed inordinately pleased with the ease of their measuring and calibrating and more drawing on my face ensued. Then a tiny tattoo point was made on my temple and another on the scar directly in front of my ear. The one on my temple hurt and bled and made me wonder, not for the first time, why anyone would volunteer to be tattooed. The second one I hardly felt at all since the nerves are so deadened there from five separate surgeries over the same spot.

As I prepared to leave the office the oncologist told me he and my surgeon are going to present my case to a roundtable of doctors. It seems I'm a medical anomaly with my early onset of parotid tumors and my recurrent and never fully effective surgeries. Having hung out at the extremely useful Parotid Tumor Patients Forum online I know of situations a lot stranger and certainly more serious than mine, but that's a worldwide forum. I don't imagine they've seen that much of it on their little patch.

So there it is, the little problem that's been occupying so much of my time and attention these last few months. Now that it's getting underway maybe I can stop fretting over it and fret over more important stuff, like this stupid war and our equally stupid administration. Now there's a real problem.

Tuesday, May 15, 2007

Death of a Soldier

Just read this powerful article about the life and death of Army Staff Sgt. Darrell Ray Griffin, Jr. E-Mails Reveal a Fallen Soldier's Story. Sgt. Griffin was killed by a sniper in Sadr City on March 21, 2007 while standing in the hatch of his Stryker vehicle. Embedded journalist Alex Kingsbury had met with and interviewed him extensively just a few days before.

Sgt. Griffin sounds like an extremely bright individual who approached seriously the question of who he was, and why he was there, and who struggled to reconcile the horror of his war experience with his vision of what he should strive for in his own life. He deserves to be remembered.

Sunday, April 29, 2007

The Good That We Do Ain't Doing So Well - Iraq Reconstruction Projects Going Down the Tubes

A common complaint of Iraq war supporters is that the MSM "doesn't tell the success stories" of projects built and progress made. Setting aside for a moment the story of those projects which never made it off the ground thanks to rampant corruption, contractor incompetence, and diversion of funds to other "purposes", what has happened to the projects which did get built?

According to the Office of the Special Inspector General for Iraq Reconstruction (SIGIR), nothing good.

The New York Times reports that a sampling of eight Iraq reconstruction projects shows that

in a sampling of eight projects that the United States had declared successes, seven were no longer operating as designed because of plumbing and electrical failures, lack of proper maintenance, apparent looting and expensive equipment that lay idle.

According to the SIGIR
At the [Baghdad] airport ... inspectors found that while $11.8 million had been spent on new electrical generators, $8.6 million worth were no longer functioning.

At the maternity hospital, a rehabilitation project in the northern city of Erbil, an expensive incinerator for medical waste was padlocked — Iraqis at the hospital could not find the key when inspectors asked to see the equipment — and partly as a result, medical waste including syringes, used bandages and empty drug vials were clogging the sewage system and probably contaminating the water system.

The newly built water purification system was not functioning either.

Additionally
inspections found numerous instances of power generators that no longer operated; sewage systems that had clogged and overflowed, damaging sections of buildings; electrical systems that had been jury-rigged or stripped of components; floors that had buckled; concrete that had crumbled; and expensive equipment that was simply not in use ... most of the problems seemed unrelated to sabotage stemming from Iraq’s parlous security situation, but instead were the product of poor initial construction, petty looting, a lack of any maintenance and simple neglect ... that kind of neglect is typical of rebuilding programs in developing countries when local nationals are not closely involved in planning efforts ...

Only recently has the SIGIR been allowed to come into its own as a source of rigorous audits and on-the-ground accountability for U.S. funds expended in Iraq. In early November 2006 Senator Duncan Hunter slipped language into an appropriations bill seeking to cut off the SIGIR's funding as of October 2007. Fortunately, this was reversed when the new Congress took over in January 2007, but how characteristic of the Administration to seek to squelch criticism by shooting the messenger.

Friday, April 27, 2007

So Are They Prisoners of War or Criminal Detainees?

For a brief period on Thursday, April 26th, Senator Patrick Leahy became a witness and testified before the Senate Armed Services Committee on the rights of Guantanamo detainees.

Leahy described the indefinite detention of hundreds of individuals as "un-American". Senators skirmish over Gitmo detainees. Thank goodness for people like Leahy and Senator Levin, who point out the hypocrisy in a system which professes the rights of the accused and yet holds them indefinitely without the right even to demand probable cause. As Levin said:

"America at its best is a beacon for human rights and human liberty, and that's how we like to see ourselves ... but much of the world sees us in a very different way when we fail to live up to the standards we profess."
The government has released well over 300 of these detainees, the so-called "worst of the worst" according to Cheney, yet the continued detention of the remaining detainees is considered justified by the nature of the accusations against them. What a crock.

We hear it over and over again: We're in a "global war on terror". Really? It's a war? Then why aren't the rules of war being followed? Why aren't the people we're detaining being considered prisoners of war and subject to the protections of the Geneva Convention?

They're not soldiers but terrorists? Well aren't terrorists criminals? Why can't we subject them to the criminal laws of this country as we used to do before the Bush Administration decided to create this legal limbo where people are neither soldiers nor criminals but something in between? How is it that we were able to try and convict terrorists like the blind sheik and his co-conspirators after the first World Trade Center bombings without sending them to an island with no recourse to the legal system? Didn't we try and convict Tim McVeigh without taking away his right to an aggressive legal defense? The law is not the enemy. Legal protections and standards of evidence and fairness are not the enemy. Again, what is our government afraid of?

Thursday, April 26, 2007

Bush Administration Continues Its Attack on Gitmo Lawyers

Cross-Posted to Raising Kaine

Here's an article from the New York Times describing the latest in the government's efforts to curtail and obstruct Guantanamo detainees' attorneys in their pursuit of fair hearings on the evidence for their clients. Court Asked to Limit Lawyers at Guantanamo

The government has proposed some teeny-tiny adjustments to the way Gitmo detainees are represented, to wit:

the government would limit lawyers to three visits with an existing client at Guantánamo; there is now no limit. It would permit only a single visit with a detainee to have him authorize a lawyer to handle his case. And it would permit a team of intelligence officers and military lawyers not involved in a detainee’s case to read mail sent to him by his lawyer.
The attorneys have been accused of "causing unrest" at Guantanamo. Well we all know how happy the detainees were to be there until all the pesky lawyers showed up. The government's hatchet man, Cmdr. Patrick McCarthy, says defense lawyers have
gathered information from the detainees for news organizations. Commander McCarthy also said the lawyers had provided detainees with accounts of events outside Guantánamo, like a speech at an Amnesty International conference and details of terrorist attacks.

“Such information,” his affidavit said, “threatens the security of the camp, as it could incite violence among the detainees.”
Give the government the right to review all communications between lawyers and their clients? How could that possibly be seen as impeding the relationship between attorneys and clients? The government guys will keep their secrets and won't use the information gleaned to seize unfair advantage in their cases. Honest!

And one visit to initiate representation? Sounds reasonable. After all, the detainees have been locked up for years by generally white, non-Muslim Americans who don't speak their languages, and the lawyers are generally white, non-Muslim Americans who don't speak their languages, either, so no reason for the detainees to be suspicious of any lawyer who shows up - sometimes sporting a Jewish name - and says "let me help you. And by the way, if you do allow me to help you this is the only time we're going to talk about your case so I need to know everything. And by the way, everything you tell me through correspondence or meetings will also be told to the government's lawyers. But I'm really on your side. Seriously. Trust me. So come on, start talking."

Of course the attorneys deny that they have done the things of which they're accused. No proof offered, just the usual speculation and hinting at dark things to come. These people are wasted in the law. They should all be in Hollywood writing scary screenplays for a revival of the Goosebumps series.

I have an idea. Let's distribute the detainees around our federal prison system and CLOSE Guantanamo. Let's let their attorneys see them the way they see their non-detainee clients.

This issue is yet another "sky is falling" assertion by elements of the Bush Administration bound and determined to continue stacking the deck against the Guantanamo detainees. Here's another suggestion. Why not drop all the bulltwaddle, gather the evidence and put it out there, and hold some damn hearings with real rules of procedure and rules of evidence? Or is that just too scary a prospect for the likes of Alberto ("I know nothing, I see nothing, I hear nothing") Gonzales and this Administration?

Tuesday, April 24, 2007

How Do I Scandalize Thee? Let Me Count The Ways.

Cross-posted to Raising Kaine

For all the people who wished me well during my recent parotid tumor surgery - Thank You. The surgery turned out far better than anyone could have predicted, and I face the world today with a normal (albeit not very striking) face and a renewed sense of purpose.

From Tom Raum of the Associated Press comes a story of just how many scandals we've seen out of the Bush Administration. Bush Administration Awash in Scandals. Tom Raum points out that

Campaigning in 2000, Texas Gov. George W. Bush would repeatedly raise his right hand as if taking an oath and vow to "restore honor and integrity" to the White House. He pledged to usher in a new era of bipartisanship.

The dual themes of honesty and bipartisanship struck a chord with many voters and helped propel Bush to the White House in one of the nation's closest-ever elections. Americans re-elected him in 2004 after he characterized himself as best suited to protect a nation at war.

Now, with fewer than two years left of his second term, the Bush administration is embroiled in multiple scandals and ethics investigations.
Mr. Raum highlights the Administration's dirty little secret, which is that unquestioning loyalty to President Bush and his neocon ideology trump technical competence, trump effectiveness in government, trump the independent nature of every position from the Attorney General on down. Mr. Raum highlights
Some recent incidents:

- World Bank President Paul Wolfowitz, one of the architects of the Iraq war as deputy defense secretary, acknowledged he erred in helping a female friend he is dating to get transferred to a high-paying job at the State Department while remaining on the World Bank payroll. The revelations fueled calls from the bank's staff association for him to resign.

- Matteo Fontana, a Department of Education official who oversaw the student loan industry, was put on leave after disclosure that he owned at least $100,000 worth of stock in a student loan company.

- Lurita Doan, head of the General Services Administration, attended a luncheon at the agency earlier this year with other top GSA political appointees at which Scott Jennings, a top Rove aide, gave a PowerPoint demonstration on how to help Republican candidates in 2008. A congressional committee is investigating whether the remarks violated a federal law that restricts executive-branch employees from using their positions for political purposes.

- Julie MacDonald, who oversees the Fish and Wildlife Service but has no academic background in biology, overrode recommendations of agency scientists about how to protect endangered species and improperly leaked internal information to private groups, the Interior Department's inspector general said.

Today I spoke to a client who started to complain about the Bush Administration, but then remembered that she was speaking on a government phone from her government agency. This life-time employee has had drilled into her head the separation between political advocacy and the performance of her duties as a government employee. She breathes, thinks, and channels the Hatch Act. You couldn't say the same for Lurita Doan and the other high ranking Bush appointees who have turned their agencies into private sounding boards for and advocates of Bush Administration policies. Wherever one turns there is evidence of undue influence, overreaching, and cooptation of the most essential regulatory federal functions. And then there are the scandals. Does Paul Wolfowitz have a sense of shame? A sense of limitation on his endless sense of right to self-gratification and self-aggrandizement? Is his only qualification to hold his office his unquestioning loyalty to the Bush Administration and the policies which flow therefrom?

What of Alberto Gonzales, the chief apologist for and architect of the Bush Administration's torture policies? Does he have any sense of shame? Is he aware of any obligation other than his unquestioning loyalty, repaid by Bush's bottomless boosterism, to the Bush Administration and its Bill of Rights curtailing Constitution crushing policies?

Today I read of the defection of Pete McCloskey from the Republican Party. He left the Republican Party, to which he and his family had been founding and sustaining members since the time of Lincoln, and joined the Democratic Party, complaining that
it seems that every Republican presidential candidate is now vying for the support of the Pat Robertsons and Jerry Falwells rather than talking about a return to the values of the party I joined nearly 59 years ago.
Traditional conservatives who value the philosophy of the original Republican Party should indeed be worried. They have been replaced by neocon ideologues and members of the new Inquisition and America is much the poorer for it.

Sunday, April 15, 2007

Living With A Parotid Tumor

I've been pretty busy working lately, which accounts in part for why there haven't been any new diaries, but there is also the knowledge that in a few days I will be having surgery for the fifth recurrence of a medical oddity known as a parotid tumor. For all the normal people out there who have never heard of the parotid gland, it is the largest salivary gland in the human body, a matching set on each side of the head, and is perilously close to the facial nerve and nerves controlling things like eyelids and ears and whatnot. Four times I have had a form of tumor called a pleomorphic adenoma, a benign and largely painless thing which just keeps growing until it is taken out. My four surgeries took place starting in 1974 and continuing to 1983, with varying degrees of success. After nine years of surgeries just about every other year I decided to simply ignore the next recurrence, which started when I was about 26 years old and when my family and career were just getting started, and has been growing inexorably to this, my fiftieth year. Time for it to go.

The problem with parotid tumors is that sometimes they can "go south". In other words it is possible for my benign pleomorphic adenoma to become a carcinoma ex pleomorphic adenoma. This, and the fact that the darn thing is really sticking out of my head now, covered only by a hank of my graying, thinning hair, means it is time to take out the trash. The surgery is on April 19th. In a few months I will undertake radiation treatment, whether or not the biopsy is bad, in order to try to prevent or at least delay another recurrence. Each recurrence increases the possibility of a malignancy developing. The problem with radiation treatment is that there is some research indicating that a recurrence after RT is more likely to be malignant than it would have been if the RT hadn't been undertaken, but by the same token that is only if there is a recurrence. At this point the likelihood of a recurrence if I do not have the RT is 100% and if I do have the RT it's more like 50%. I'd rather take a chance of a bad recurrence for the opportunity to have no recurrence, instead of sitting around waiting for the inevitable next recurrence without the RT.

So the tumor's coming out in an outpatient procedure. If all goes well I'll be up and running around after a few days. If not so well, then I may have some problems with my eyelid - the transgenital nerve which controls the eyelid runs through the tumor - and my eyelid would not be able to close. There's always a danger of facial paralysis, but for some reason this does not bug me as much as the thought of having a Pinkerton eye (we never sleep!). If my lid is affected then it may affect my sight, which will in turn affect my ability to do close work. If the facial nerve is damaged I may look like I have Bell's Palsy, but as long as I can talk, see, and swallow I can live with the idea. It no longer frightens me, as it did when I was a young litigator starting out, that my looks could be so affected. Guess we'll know after Thursday.

Thursday, March 22, 2007

Confessions of a C-Span Junkie - Two Callers Show the Way

Every morning I watch the news until the fake bonhomie and pressing stories of how to make the best fashion decisions or adopt a shelter animal get to me and I feel compelled to change over to C-Span's Washington Journal.

This morning, as I got ready, then left the house and started my usual drive around town, I heard interviews with Dem. Rep. Crowley, and a Texas Republican (blanking out on her name), and finally Rep. Maxine Waters. The call-ins were particularly uninspiring, and in the case of the Texas rep. no less than three callers in a row called in to express support for the war and to say that if "we don't fight them there they'll come over here", the Bush Administration's favorite reason for staying in Iraq forever.

Thankfully, the quality of call-ins changed radically as soon as Representative Waters came on board. The first caller was an older man who said he was sick of all the talk about "get them there or they'll come here" and recalled that back during the days of Vietnam this is exactly the justification used to keep the Vietnam war going. It was all about stopping communism "before it comes here" he pointed out. Then he said "how many terrorists are they talking about coming here? Fifteen, twenty? Where's their army, their air force, their navy? What heavy artillery are they bringing with them? I'm tired of hearing that we have to keep this war going on over there because a handful of terrorists might come over here." Wow. Great comments.

The very next caller stated that he is a Ronald Reagan Republican who believes in the principles of shared responsibility and shared sacrifice. He said "I make $450,000 a year. I have two children in college. In the past few years I've received tens of thousands of dollars in tax relief. I have not been required to sacrifice anything and I have sacrificed nothing. The only two times President Bush asked people like me to make a sacrifice for the war he asked me to go shopping." This caller said he is disgusted at the selfishness of an administration which calls upon only a small portion of the population to make a real sacrifice while refusing even to ask the wealthy to pay their fair share of taxes to make it possible. I think this same caller then commented on the massive government growth under Bush and flagrant violations of civil liberties.

It's callers like these who keep me listening to C-Span although many others cause me to yell at my radio as I drive, much to the consternation of passing drivers.

Sunday, March 18, 2007

Jim Webb on the Incarceration Crisis

Cross-posted at Raising Kaine

This comes a little late, but a week ago Senator Jim Webb was on the ABC show This Week with George Stephanopolous and said something which took me by delighted surprise.

We've -- this is a chance to put a lot of issues on the table. One of the issues which never comes up in campaigns but it's an issue that's tearing this country apart is this whole notion of our criminal justice system, how many people are in our criminal justice system more -- I think we have two million people incarcerated in this country right now and that's an issue that's going to take two or three years to try to get to the bottom of and that's where I want to put my energy.

Yesterday I had the chance to thank Senator Webb in person for bringing up this virtually invisible issue at Brian Moran's pancake breakfast and told him how grateful I am as a criminal defense attorney to see a United States Senator calling attention to this enormous crisis. He immediately (and impressively) off the top of his head started reciting the facts and figures of incarceration and expressed dismay that an entire segment of our sociey, the young black male, is growing up incarcerated or under court supervision. He said "it's terrible that you can make a mistake when you're 18 years old and have it follow you around for the rest of your life. We have to change that." He added that this issue is as important as the war and economic fairness. For information on some of those facts and figures see this New York Times article Plight Deepens for Black Men, Studies Warn

Senator Webb mentioned an article he wrote for Parade Magazine in 1984 on the Japanese prison system. What We Can Learn From Japanese Prisons. While I would never endorse the Japanese practice of interrogating prisoners and having them sign confessions without a lawyer present, we could learn something from the Japanese sense of fairness and honesty in dealing with prisoners. An American former prisoner told Webb
he prefers Japan's legal system to ours. Why? "Because it's fair," he says. "They never tried to trick me, even in interrogation. They were always trustworthy. I could have got five years and they gave me two. The Americans who were helping them wanted me to get 20. The guards at Fuchu were hard, but they never messed with you unless there was a reason. You didn't have to worry about the other prisoners coming after you, either. And the laws of Japan are for everybody. That's the main thing. The laws in this country depend on how much you can pay. I'd rather live under a hard system that's fair."

Having represented dozens of people suckered by detectives and private security personnel into confessing, usually on the promise of release or of lenient treatment, I say a change would do the entire system good. The bitter fact is that the police lie. They lie all the time. Their lying is trained into them at the academy and accepted by the courts with nary an eyelash batted. They lie about the evidence; they lie about the statements of suspected co-defendants; they lie about the legal effect of a conviction; they lie about their power to affect the outcome of the case once it has gone to the prosecutor. Having been forbidden to use force on criminal suspects they resort instead to interrogation techniques designed to elicit confessions, but not necessarily the truth, and they have little understanding of just how their techniques can in fact result in injustice. It is the poor and uneducated who are most susceptible to these techniques, which can account at least in part for the feeling among many of my young, poor, uneducated, and minority clients that their involvement with the system is an inevitability, perhaps even a rite of passage. Moreover, there is a sense among them that the only difference between their dishonest approach to life and the government's is that the government has power and that is why cops can lie to get what they want while the suspect is punished.

On top of this is the acceptance within our society of brutality and rape of prisoners within our prison system. People talk of such things with a smile and a wink instead of as the appalling thing it is.

Added to this are the extraordinary rates of incarceration, often for decades, for crimes which often involve only dishonesty or non-violent drug offenses. I asked Senator Webb to look into the skewed results produced by mandatory minimum sentencing in which all the power rests with the prosecutor - who chooses what charges to bring against defendants in order to bring about particular dispositions - and reduces the judges to mere clerks imposing sentences based on worksheet calculations.

I asked the Senator to consider the problems of the mentally ill. Few services are available for the mentally ill and they are often incarcerated for crimes committed while in the grip of their delusions or their compulsions. Many of them have fallen through the cracks and are off their medications when they commit their crimes. Don't get me started on how much of this is related to unavailability of mental health treatment services even in so-called "good" health benefit plans. We are warehousing the mentally ill in our jails and prisons.

Last, in a zero-tolerance state like Virginia, where possession of any drug but marijuana is a felony, I have seen long time resident aliens and undocumented aliens either deported for their drug felonies (one ecstasy pill is all it takes for a felony conviction) or denied the ability to apply for citizenship because of their status as felons. Senator Webb replied that he hopes some day soon to hold hearings on this issue and I wished him success.

Looking back, I realize I piled a lot on his plate in a two minute conversation, but at least he's willing to pay attention to this crisis. Once again, thank goodness that Jim Webb won that election instead of George Allen.

Monday, March 12, 2007

Surge Scandal - Army Deploying Medically Unfit Troops

Cross-posted at Raising Kaine

Mark Benjamin of Salon.com reports that the Army is deploying troops to Iraq who have well-documented unfitness for duty (read here).


Is it any surprise that commanders are feeling the pressure to activate as many of their troops as possible to meet the demands placed on them by this surge? Benjamin reports that

a unit of the Army's 3rd Infantry Division at Fort Benning, Ga., is deploying troops with serious injuries and other medical problems, including GIs who doctors have said are medically unfit for battle. Some are too injured to wear their body armor, according to medical records.
Soldiers reported being ordered to attend a meeting on February 15th at which
Master Sgt. Jenkins and 74 other soldiers with medical conditions from the 3rd Division's 3rd Brigade [met with] with the division surgeon and brigade surgeon. These are the men responsible for handling each soldier's "physical profile," an Army document that lists for commanders an injured soldier's physical limitations because of medical problems -- from being unable to fire a weapon to the inability to move and dive in three-to-five-second increments to avoid enemy fire. Jenkins and other soldiers claim that the division and brigade surgeons summarily downgraded soldiers' profiles, without even a medical exam, in order to deploy them to Iraq. It is a claim division officials deny.
Eight soldiers described being summoned to a perfunctory meeting with "Lt. Col. George Appenzeller, who had arrived from Fort Stewart, Ga., and Capt. Aaron K. Starbuck, brigade surgeon at Fort Benning."
In direct contradiction to the account given by the soldiers, Appenzeller said physical examinations were conducted and that he had a robust medical team there working with him, which is how they managed to complete 75 reviews in one day.
The article does not detail who besides Appenzeller and Starbuck were on this "robust medical team", but it is hard to imagine that a thorough review could have been done in less than a half hour at the least. At the rate of two soldiers per half hour for, say, a ten hour day, that still makes only twenty doable in one full day, doesn't it? Also, there's no information about whether this "robust medical team" contained more than one surgeon.
it is hard to imagine there is not some desperation behind the decision to deploy some of the sick soldiers. Master Sgt. Jenkins, 42, has a degenerative spine problem and a long scar down the back of his neck where three of his vertebrae were fused during surgery. He takes a cornucopia of potent pain pills. His medical records say he is "at significantly increased risk of re-injury during deployment where he will be wearing Kevlar, body armor and traveling through rough terrain." Late last year, those medical records show, a doctor recommended that Jenkins be referred to an Army board that handles retirements when injuries are permanent and severe.


A copy of Jenkins' profile written after that Feb. 15 meeting and signed by Capt. Starbuck, the brigade surgeon, shows a healthier soldier than the profile of Jenkins written by another doctor just late last year, though Jenkins says his condition is unchanged. Other soldiers' documents show the same pattern.


One female soldier with psychiatric issues and a spine problem has been in the Army for nearly 20 years. "My [health] is deteriorating," she said ... "My spine is separating. I can't carry gear." Her medical records include the note "unable to deploy overseas." Her status was also reviewed on Feb. 15. And she has been ordered to Iraq this week.

Other medically unfit soldiers selected to continue our mission of spreading democracy to Iraq include a captain whose back was "corkscrewed" in a Humvee accident there last year, and a female soldier who had part of her coccyx removed after an accident years ago and suffers from
degenerative disk disease and has two ruptured disks and a bulging disk in her back.
This soldier is now already in Iraq. Another soldier, whose military occupation is truck driver, developed sleep apnea after his return from his last deployment. As a result of his condition he now has narcolepsy and actually fell asleep during his interview for Salon. Nevertheless, he has also been ordered to Iraq, apparently to drive trucks.


These medically unfit soldiers are not only at extremely high risk for injury or death, but pose enormous risk to their healthier comrades. A medically unfit soldier is a burden to his or her unit. This situation should be investigated and the medically unfit personnel already sent overseas called back home before they or their units suffer any losses as a result of their conditions and appropriate sanctions handed out to those who have put them in this position.


UPDATE!! Have just discovered a diary on this very subject at dKos and posted by paddykraska. Visit paddy's diary here and check out her recommendations for ways to draw the attention of elected representatives to this issue. Everyone should be outraged.

Monday, March 05, 2007

Habeas Corpus - Why Congress Must Act

A great article from Aziz Huq, found on the Thomas Paine website, Habeas Corpus Can't Wait

Delay in the day of reckoning occurred not due to the detainees’ lawyers, but through a series of increasingly reckless maneuvers by the administration and its lawyers to avoid any review of the factual grounds for detention. First the government argued that Guantánamo was not part of the United States, and the president’s sweeping judgment that anyone picked up by the CIA from Bosnia to Pakistan via Thailand must be an “enemy combatant,” and therefore undeserving of any judicial solicitude. Then there were legislative efforts, in the form of the 2005 Detainee Treatment Act and the 2006 Military Commissions Act, to stymie review.

It is important again to emphasize that what the government has sought to avoid is not simple “release.” What the D.C. Circuit held last week was that the Military Commission Act stripped the courts of power even to hear the detainees’ pleas. And at best the Supreme Court will determine that the detainees have a right under the Constitution to be heard. None will necessarily be released. None will even immediately get a day in court. The best case scenario is that the mere prospect of review will push the government into moving forward with releases.

But this is not enough. To understand why, look at the section of Guantánamo called Camp Six. Camp Six is the “more comfortable” facility in which detainees who have been “cleared” are held. As James Cohen’s recent account for the National Law Journal makes clear, detainees in Camp Six are kept in cells with walls, floors and ceilings of solid metal for 22 hours a day, denied natural light or air and have virtually no contact with human beings other than guards. Conditions are worse than any Supermax facility in the United States.

Thus, it is not sufficient to ensure that the detainees have their day in court. Even those who the government concedes to be innocent of any terrorist involvement are still kept in brutalizing and inhumane conditions. A comprehensive solution to the Guantánamo problem requires much more. And, acting alone, the courts have only limited capacity to that end.

So Congress too must act, and there is much that it can do now. The court proceedings are no cause for delay. A comprehensive solution necessarily involves multiple branches of government, and the sooner legislators act, the sooner America can remove the moral stain of Guantánamo from its plate.

I can only concur.

Sunday, March 04, 2007

GMU! GMU! GMU! Lookout VCU, we're coming for you ...

Sorry, very excited right now after watching GMU dismantle ODU in the Semis at the CAA tournament. Great game, terrific defense, and great teamwork. Congratulations to Coach Larranaga and his team.

Saturday, March 03, 2007

Iraqi Insurgency in a Nutshell - Or Why We're Up the Proverbial Creek

Kevin Berger of Salon.com, recently interviewed Evan Kohlmann, founder of GlobalTerrorAlert.com, "a clearinghouse of virtually every communiqué -- video, audio, Internet, printed -- issued by insurgent groups in Iraq." The Iraqi Insurgency for Beginners

Kohlmann has ... emerged with a clear-eyed view of who is fighting whom in Iraq and why. Given his insights, Kohlmann has been put to work as a consultant by the U.S. Department of Defense, the Department of Justice, the FBI and the CIA.

Some highlights:
You have to be careful when you say "insurgency." You have to distinguish between the Shiite militias and the actual insurgency, which is the Sunni groups. Most of the Shiite militia activity is not directed at the U.S., it's directed at the Sunnis. The Sunni insurgency, meanwhile, is directed at everyone -- the U.S., the Iraqi government, the militias.

The best way to divide it up is into three camps. You have Sunni nationalists, initially a large portion of the insurgency; the moderate Sunni Islamists, who use Islamic terminology and talk about establishing a government based on Sharia law; and you have the Salafists, like the group Al-Qaida in Iraq. To them, the fight is not about preserving the borders of Iraq, it's about revolution, about rebuilding something completely new on the basis of some kind of idyllic Muslim empire.
Kohlmann describes the evolution of the Iraqi insurgency from nationalist groups seeking to expel the invader from their midst to increasingly radicalized elements who feel they have no choice but to join forces with Al-Qaida.
Has the U.S. invasion, in fact, strengthened al-Qaida?

Definitely ... The hardcore true believers of al-Qaida at one time were probably 10 percent of the insurgent groups. Now they're 50 percent. Al-Qaida is growing in places it shouldn't. You have groups ... that have transitioned from being traditional insurgents to extremist ones. Or take a popular insurgent group called the 1920 Revolution Brigades. The very name of the group has a nationalist, not Islamist meaning. And yet ... people from the 1920 Revolution Brigade [are] now fighting alongside al-Qaida. The U.S. is failing miserably at containing the spread of al-Qaida.

Why are the more moderate Muslim groups siding with al-Qaida?

They have no choice. There's a group called the Iraqi Islamic Resistance Front ... They ... were also the subject of a flier that was being posted around in Ramadi. The flier was signed by al-Qaida and said the Front was working with the Iraqi Islamic Party, the Iraqi government, and so is no longer a legitimate group. The Front ... issued a statement saying, "We're not working with the government, we're with you guys ..." So there's a lot of pressure to work with al-Qaida or be targeted by it.
Kohlmann notes that those who work for the Iraqi government or for U.S. forces in Iraq are targeted by Al-Qaida and if those who work for anyone else are targeted by the Shiites.
Would al-Qaida have blown up the mosque if the U.S. wasn't in Iraq?

There wouldn't be an al-Qaida in Iraq if the U.S. wasn't there. The story of al-Qaida in Iraq begins in 2003. We handed al-Qaida exactly what it was looking for, a real war in the Middle East where it could lead the way. Al-Qaida is like a virus. It goes for weak victims and it uses conflicts to breed. Iraq gives al-Qaida a training ground, a place to put recruits in combat. If they come back from battle, you have people who have fought together, trained together, you have a military unit. As Richard Clarke has said, it was almost like Osama bin Laden was trying to vibe into George Bush the idea: "Invade Iraq, invade Iraq." This was an opportunity they seized with amazing alacrity. As brutal and terrifying as what they've done is, you have to acknowledge they capitalized on an opportunity that we handed them. (Emphasis added)
And as for democracy:
What happened to the U.S. message of democracy?

It totally failed. The idea of Western-style democracy in Iraq doesn't appeal to anyone. It was our own myth. We thought that if we get rid of Saddam Hussein, people would come together and celebrate and democracy would reign throughout the Middle East. The people who thought that up are people who think Iraq is like Texas ... To Iraqis, tribal affiliations, religion and family mean a lot more than saying, "I'm from Iraq." You know we're doing a bad job of communicating our own message when we're losing the propaganda war to people who cut other people's heads off on camera. Think about it: People in one of the most Westernized countries in the Middle East would rather trust al-Qaida than the United States. That's a terrible sign of things to come.
Of course, now the U.S. is fighting people on all sides of the partisan divide in Iraq.
The U.S. is fighting both the insurgency and Shiite militias, right?

Right. But the Shiites aren't a simple group either. They have divided themselves into two factions: the pro-Arab Shiites who are Iraqi nationalists and the pro-Iranian Shiites. There have been some incidences involving the Shiite Mahdi Army and the U.S. and British military. But the scope of activity between the Mahdi Army and the U.S. military is minute. The militias pose less of a day-to-day insurgent problem and more of a problem in the way they have infiltrated the Iraqi police force and other Iraqi government services, particularly the Interior Ministry, and how they arranging the murder of Sunnis through those agencies. They are creating instability, and that's the main reason we're going after them. It's also the No. 1 reason why Sunnis fight and are upset: The Shiite militias have essentially taken over the law enforcement and are using it to murder Sunnis.

We invaded Iraq to rectify crimes by Saddam Hussein against the Shiites, right? We wanted to bring him to justice. What the Sunni groups are saying is, "How come there's no justice to people who are drilling holes in people heads right now? Never mind 20 years ago." ... So the Sunnis are saying to the U.S. "... we're going to take matters into our own hands." And the Shiites are saying the same thing. They're saying, "You can't protect us from al-Qaida's suicide bombers. Your idea of strengthening security is to crack down on the Mahdi Army, who are the only ones preventing suicide bombers from coming into Sadr City. Why should we trust you? We should rely on ourselves. You can't trust anyone but your own people."
Kohlmann dismisses the Administration's ratcheting up of hostilities toward Iran for its alleged complicity in the deaths of 170 American servicemen while Saudi Arabia is not even criticized for its support of the insurgents
Money and weapons and personnel have been coming across the Saudi and Syrian borders for four years and have been directly aiding Sunni insurgents, who are responsible for the lion's share of U.S. casualties. It's the height of hypocrisy to attack Iran and not criticize Saudi Arabia ... if you want to know who is responsible for the fact that al-Qaida is succeeding in Iraq, it's Saudi Arabia. The most common nationality of foreign insurgents in Iraq has been Saudis. Where do you think all the money comes from to pay for these operations? It's from Saudi donors. I'm not blaming this necessarily on the Saudi government. But they have made some very provocative statements about the idea that if the U.S. withdraws from Iraq, they're going to actively aid Sunnis in their war against Shiites. If we're going to put pressure on Iraq's neighbors, let's put pressure on all of Iraq neighbors to stop contributing to the violence.

Kohlmann is opposed to withdrawal from Iraq due to his fear that it may become a situation akin to Rwanda, and he describes the Iraqi government as a "joke".
So what's the solution?

We have to give people a reason to stop supporting al-Qaida. And the only way to do that is to punish the people who are harming them. We have to show that democratic forces can also hold up justice. Right now, democracy for Iraqis amounts to Shiites in control of the police force and running everything. The things that might convince Sunnis to move back in the other direction would be a real step at trying to reform the Iraqi police force, the Interior Ministry, and try and bring some of the individuals in those places, which have committed gross crimes, including crimes on the scale of Saddam Hussein, to justice.

Does the Bush administration have the smarts to figure that out?

I'm not sure they do. I thought perhaps, in invading Iraq, they had some long-term view that nobody else could see. But that hope faded very quickly. The Bush administration didn't reach out to anyone credible when they were asking about, for instance, the connections between al-Qaida and Saddam Hussein. Anybody with any real knowledge of the region would have told them there are no connections between Saddam Hussein and al-Qaida. The only people who believed that nonsense were lunatics.

Kohlmann's bleak assessment concludes that the "best solution is not to have invaded at all." There are no good options in Iraq, just some options which may be worse than others, and each with its own disadvantages. General Odom is on record as saying that we should leave Iraq because it would remove us as the irritant driving the Iraqi nationalists and perhaps force the warring parties to step back and decide whether they want to continue their downward spiral into mass murder or come to some agreement with each other.

Any solution here would have to include the countries in the region which are using Iraq as their proxy for political jockeying, and even more clear is that the surge will not work. This problem cannot be solved by military force but by diplomatic pressure on neighboring countries and direct pressure on the corrupt and Shiite dominated Iraqi government, police, and Interior Ministry.