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Our Dangerous Fear of Pain Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=52396"><span class="small">James D. Hudson, The Washington Post</span></a>   
Sunday, 01 December 2019 09:25

Hudson writes: "One of the first things I learned about pain was its value."

Hank Skinner and his wife, Carol, are no strangers to pain, having collectively experienced multiple illnesses and surgeries. Hank relies on a fentanyl patch but is now being forced to lower his dosage. (photo: Salwan Georges/WP)
Hank Skinner and his wife, Carol, are no strangers to pain, having collectively experienced multiple illnesses and surgeries. Hank relies on a fentanyl patch but is now being forced to lower his dosage. (photo: Salwan Georges/WP)


Our Dangerous Fear of Pain

By James D. Hudson, The Washington Post

01 December 19


We used to know how to manage discomfort. Our quest to banish it brought on the opioid crisis.

ne of the first things I learned about pain was its value.

I was a third-year medical student in 1976. My first clinical rotation was in general surgery. The chief resident explained that a patient’s abdominal pain was the most useful tool we had in distinguishing the life-threatening condition of acute appendicitis from a more benign ailment such as stomach flu or constipation. He warned us not to treat that pain before the attending surgeon had a chance to place his hands on the patient’s abdomen. We were also encouraged to listen carefully to the patient’s experience of pain, the timing, the duration and any factors that made it better or worse.

Forty years later, our concept of pain couldn’t be more different. Instead of learning from pain, we now regard it as an illness in and of itself. Insurance companies, health-care providers and drugmakers have all worked to increase the public’s fear of pain, leading us to see it as something to be treated, eliminated, banished — never lived with or accommodated or managed — lest it destroy us. They turned our natural fear into big business; our fee-for-service system has multiplied treatments based primarily on the financial rewards for pharmaceutical companies, doctors and hospitals. That attitude shift is perhaps the most overlooked explanation for an opioid crisis that kills tens of thousands of Americans every year.

It’s good to have a healthy fear of pain. It protects us from injury and reminds us to allow time for healing. Acute pain can be made more tolerable by a short course of opioid medication (the Centers for Disease Control and Prevention recommends only three to seven days, even after major surgery or injury). And there is a good case for using opioids over longer periods to treat end-stage cancer and other terminal ailments that can bring unbearable suffering. Palliative care in those situations is almost always necessary and compassionate.

But otherwise, the fear of pain, and the belief that a pain-free existence is optimal or even possible, has been a catastrophe for patients. Before the opioid revolution, doctors understood that pain was important to keeping us safe, to be lived with and managed. Even if this meant we bore frequent episodes of discomfort, that was better than the nationwide crisis America faces today. Life isn’t “pain free.” If we want to end the epidemic of addiction, we need to relearn that lesson.

Early in my career, I worked at a chronic-pain rehabilitation program in Grand Rapids, Mich. Here I was exposed to patients with incurable pain, most commonly in their backs. Many had undergone multiple operations; others suffered with neck and extremity pain; some were victims of auto accidents or work-related injuries. Then there were those with less-understood maladies such as phantom limb pain, fibromyalgia or complex regional pain syndrome. The treatment focused on helping people get their lives back despite the pain.

In those early years, some patients came in with pills, but they tended to be relatively mild pain relievers like codeine and ibuprofen, and in rare cases a drug called Percocet (one of the first formulations of oxycodone, approved by the Food and Drug Administration in 1976). Then things began to change.

In the 1990s, Jack Kevorkian, a Detroit pathologist who had previously advocated harvesting organs from death row inmates, began using his lethal-injection machine to assist “clients” in ending their lives. His medical license was revoked, but before he was finally convicted of second-degree murder in 1999, he had assisted more than 100 people in ending their lives. He argued that this was compassionate assistance for patients with intolerable suffering, igniting a national debate about the wisdom of “death with dignity."

He challenged our profession, saying doctors did not care enough for people in agony. The implication of his argument was profound, equating life with pleasure and health care with an escape from pain and suffering. And the publicity Kevorkian received — news coverage, books, a “60 Minutes” profile — had a dramatic impact on the practice of pain medicine. In 1995, the president of the American Pain Society started a campaign to begin treating pain as a vital sign and an illness in its own right, instead of a symptom of an injury or an underlying condition. State legislatures were lobbied to ease restrictions on opioid analgesics, and enforcement was relaxed. Opioid manufacturers started aggressively marketing their products to physicians and, according to a study in the journal JAMA Network Open, this marketing correlated with overdose deaths. The CDC has thoroughly documented the rapid rise in opioid prescriptions and deaths since 1999.

Many doctors listened to the marketing campaign. In our hubris, we began to think we had the capacity to banish chronic pain. Pharmaceutical companies were developing ever stronger and longer-lasting opioids, and surgeons were replacing more and more worn-out joints. New techniques meant that pain anesthesiologists could block nerves, sever the signals to the brain, and insert catheters or electrodes into spinal columns and brains. Pain was to become a thing of the past, conquered by modern medicine.

As part of the push to defeat pain, “physician experts” compensated by drugmakers hawked these medications at conferences, telling doctors that the new and more potent analgesics were not addictive when prescribed for pain. They told us that there was no upper limit on dosing, that patients would develop tolerance to the medication and that some would need extremely high doses to control their pain. But not to worry; this was normal: A new, unsubstantiated ailment called “pseudo-addiction” was offered as an explanation for the patients who ran out of pills early and borrowed more from friends and family or got them on the street; this wasn’t because they were addicted but because their doctors were under-prescribing. In at least a few cases, physicians lost court cases accusing them of undertreating pain. (No empirical evidence has ever shown that pseudo-addiction is real.)

This evolving outlook on pain created a flurry of new business opportunities. Physicians and health systems benefited from an explosion of diagnostic testing with CT and MRI scans, for which they could bill insurers, and which led to a rapid rise in invasive treatments, injections and surgical procedures without adequate scientific proof of their long-term benefits. Incidence of spinal fusions, for instance, varies twentyfold depending on the area of the country you live in. Unethical medical practitioners were opening “pill mills,” often taking only cash for almost unlimited amounts of addictive medications with no real attempt to make a diagnosis or assess the need for such prescriptions.

Fear of pain can also be aggravated by pain specialists or surgeons. Patients have told me that some practitioners planted the seed of fear as soon as their treatment ended: Warning them that they would eventually need another surgery or shot. That they should never lift more than five pounds unless they wanted the pain to return. Or, if patients declined treatment, that they would end up in a wheelchair. Patients are not in a position to regard such recommendations skeptically, and second opinions are expensive, time-consuming and unlikely to countermand recommendations made by a surgeon who has operated on the patient.

Insurance companies also bear significant blame. They reimburse interventional pain treatment so handsomely that these practitioners have become some of the highest-paid specialists in the country. The Medical Group Management Association reported that anesthesiologists who specialize in pain management earn almost $530,000 on average annually, making this a lucrative specialty. In comparison, primary-care providers make less than half this (while the average physician makes $300,000), and most end up working for large health-care systems that pressure them to see more patients, a pattern correlated with an increase in prescriptions and a decrease in time educating patients about lifestyle changes and self-management.

The American public is not benefiting. Life expectancy, which had been rising for the past century in the United States, began falling in recent years because of increases in suicides and opioid-overdose deaths (400,000 fatal overdoses between 1999 and 2017). According to the National Institutes of Health, 21 to 29 percent of patients who are prescribed opioids for chronic pain “misuse” the drugs, and there is no evidence that we have any less pain. The Midwest, where I practice medicine, saw opioid overdoses increase 70 percent from July 2016 through September 2017. Meanwhile, our country spends more on the treatment of chronic pain then on cancer, heart disease or diabetes.

To this day, we have no objective way to measure a person’s pain or suffering. It is a subjective experience, and fear of it can lead patients to feel it more acutely. Research has shown that disability is driven more by fear of pain than by the degree of pain itself. Making pain a vital sign and judging the quality of medical care by how often we ask someone to rate their pain, and then treating it aggressively, have paradoxically increased both our fear and our experience of pain.

Patients with chronic pain syndrome often find that things that shouldn’t hurt do, and things that should hurt a little hurt a lot. Their pain doesn’t remain in just one area. It moves around and spreads. They suffer headaches, irritable bowel syndrome, interstitial cystitis, fibromyalgia, insomnia, and sensitivity to light, sound and smells. Their arthritis is more painful. The simplest daily activities hurt, and they become afraid to move. They often take a long list of prescription medications and supplements, and undergo multiple injections and surgeries, all in a futile attempt to feel better. Their pain is real, and the vast majority of them are not addicts. They take their medications as prescribed, but the drugs just aren’t working anymore.

None of this is predestined, and if we want to reverse the opioid crisis, a new approach to pain is a good place to start. American medical schools do a poor job of teaching the latest in pain science. Many are still teaching the 1965 “gate control theory,” which treats pain as a localized physiological phenomenon, but that concept has been supplanted by the superior “neuromatrix model,” which regards pain as a holistic experience (shaped not just by biology but also by psychology, stress, sleep and other factors) and goes much further in explaining what we see in our chronic-pain patients. Most of what is taught to medical students and residents is how to prescribe medications for pain — and almost nothing about the complexity of the body’s pain system or the ways that non-pharmacological treatments can help control it.

Patients, understandably, don’t come to the doctor wanting to learn how to accept pain. They want to get rid of it. Whenever reasonably possible, that is what doctors should do. But it comes at a cost: Our present system overpromises and underdelivers on relief, fostering dependence in the process.

One way of reorienting patient thinking along these lines comes from the multidisciplinary pain clinics pioneered by the late John Bonica, a pain specialist at the University of Washington. Bonica proposed that we look at the whole person. Doctors who follow his lead examine a patient’s physical and mental health, their medications, how they think, move and behave. They look at a patient’s passions and how their current life stacks up to the life they really want to live. Education is a cornerstone: They teach patients how their nervous system can either calm their pain or amplify it, then give them the skills to direct that system.

New approaches hope to teach self-management by educating patients about their bodies and nervous systems, reducing fear of pain, and treating depression and hopelessness — partly by getting them back to exercise and normal activities. Helping patients resume their lives rather than focusing narrowly on eliminating pain changes their outlook. Instead of taking pills and awaiting their next epidural, they calculate the costs and benefits of getting up and engaging in life again. They invariably fear that the pain will be too great and their ability to tolerate it too limited, and this is where caring professionals can help lead them through a step-by-step management program. Patients learn how the thoughts they have, the words they use and the beliefs that underlie them can either increase or decrease their nervous system’s danger signals.

In many ways, learning to live with chronic pain is like learning to live next to the El in Chicago. This aboveground transit system is old and loud. It roars past homes and businesses. Nearby residents feel the vibrations; it can be so noisy that they pause their conversations while the train goes by. Yet those who think a lower rent is worth the annoyance report that the sound soon ceases to be disruptive. You get used to it. Getting angry every time a train passes is a sure way to obsess over it. Our body’s pain system works the same way. The more we learn to calm it down, the less it bothers us; the more we try to be pain free, the more it takes over our lives.

Fixing our health-care system isn’t as easy. Financial incentives are set up to increase health-care delivery, not the overall health of the population, and Medicare-for-all wouldn’t address this problem. But one fix is for insurers to scrub the rules that make it cheaper for patients to continue failed pain treatments, surgeries, injections and medications. Instead, they should push for conservative care, such as physical therapy, pain neuroscience education and multidisciplinary pain rehabilitation programs, which are low-risk, high-reward enterprises that focus on improving a patient’s function. These interventions require an intensive period of treatment, but they’ve been shown to be cost-effective, giving patients a shot at becoming the people they used to be.

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Giuliani Claims He Has Evidence Linking Biden to Obama Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=9160"><span class="small">Andy Borowitz, The New Yorker</span></a>   
Saturday, 30 November 2019 14:25

Borowitz writes: 'In what could be his most explosive allegation to date, Rudolph Giuliani claimed on Monday that he had 'mountains of evidence' linking the Democratic Presidential candidate Joe Biden to former President Barack Obama."

Barack Obama and Joe Biden. (photo: Cheriss May/Getty Images/NurPhoto)
Barack Obama and Joe Biden. (photo: Cheriss May/Getty Images/NurPhoto)


Giuliani Claims He Has Evidence Linking Biden to Obama

By Andy Borowitz, The New Yorker

30 November 19


The article below is satire. Andy Borowitz is an American comedian and New York Times-bestselling author who satirizes the news for his column, "The Borowitz Report."


n what could be his most explosive allegation to date, Rudolph Giuliani claimed on Monday that he had “mountains of evidence” linking the Democratic Presidential candidate Joe Biden to former President Barack Obama.

Appearing on “Fox & Friends,” a visibly excited Giuliani said that he had stored the evidence of the Biden-Obama ties in his office safe and was prepared to reveal it “at the proper time.”

“This isn’t a case of the two men sharing an occasional phone call or meeting,” Giuliani charged. “For eight years, they were basically joined at the hip.”

Giuliani argued that Obama and Biden had a “secret understanding” that, if anything happened to Obama, “You know who would take his place? That’s right: Joe Biden.”

Their corrupt deal enabled Biden to “feast at the teat” of the federal government, the former New York mayor said. “Biden took military aircraft around the world and got free housing in Washington, all with the seal of approval of his best pal, Barack Obama,” he said.

In his most serious allegation, Giuliani said that all of these “lush perks” amounted to a “payoff” for nefarious services that Biden had rendered to Obama.

“In both 2008 and 2012, Joe Biden meddled in the U.S. elections to benefit none other than—you guessed it—Barack Obama,” Giuliani said. “Talk about a quid pro quo.”

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Today's Socialist Revival Began on the Streets of Seattle 20 Years Ago Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=43501"><span class="small">Daniel Denvir, Jacobin</span></a>   
Saturday, 30 November 2019 14:22

Denvir writes: "The global justice movement exploded onto the scene in protests against the Seattle WTO meetings twenty years ago today. The movement was far from perfect, but its anarchist, direct action-oriented politics were crucial learning experiences for a left that has today finally found its footing."

Seattle police use gas to push back World Trade Organization protesters in downtown Seattle on November 30, 1999. The protests delayed the opening of the WTO conference. (photo: Eric Draper/Daylife/AP)
Seattle police use gas to push back World Trade Organization protesters in downtown Seattle on November 30, 1999. The protests delayed the opening of the WTO conference. (photo: Eric Draper/Daylife/AP)


Today's Socialist Revival Began on the Streets of Seattle 20 Years Ago

By Daniel Denvir, Jacobin

30 November 19


The global justice movement exploded onto the scene in protests against the Seattle WTO meetings twenty years ago today. The movement was far from perfect, but its anarchist, direct action-oriented politics were crucial learning experiences for a left that has today finally found its footing.

n November 30, 1999, just a few weeks after turning seventeen, I witnessed another possible world taking shape in Seattle as tens of thousands of protesters took the World Trade Organization by surprise. I wasn’t near the West Coast, but I was on Indymedia. The site first went live to document the Battle in Seattle, aggregating activist-generated stories, photographs, and videos for turn-of-the-century left radicals, and received 1.5 million unique visitors that first week alone.

It was the dawn of the anti-globalization movement. Or the global justice movement. Or, perhaps, the alter-globalization movement. Whatever you called that movement, it was suddenly clear that an alliance between labor, youth radicals, environmentalists (hundreds of whom marched in sea turtle costumes), and countless others contained incredible power that we had not known we possessed.

We knew what we were against and, in broad strokes, what we were for. Most of all, we asserted that the world could be very different. This all seemed extremely radical after years of Bill Clinton’s carceral neoliberalism insisting that it was the left wing of the electorally possible.

Margaret Thatcher is said to have remarked that Tony Blair and New Labour were her greatest achievements. Bill Clinton was the same for Reagan, consolidating neoliberalism’s power by aligning the Democratic Party behind it. The Cold War’s end promised a new world drawn together by trade under Washington’s benevolent guidance. Instead, bipartisan consensus spawned the demonization of undocumented immigrants, mass incarceration, and an anti-union onslaught as corporations with an increasingly global reach decimated worker power.

The loudest voices of dissent before Seattle were failed presidential candidates Pat Buchanan, a far-right extremist, and Ross Perot,  an ideologically-incoherent crusader against corruption. The global justice movement finally gave us an alternative. It was an incipient left-wing rebuttal to the idea that we were living in the best of all possible worlds.

We saw that a cutthroat capitalism that destroyed the environment and exploited workers everywhere could only be confronted by people everywhere uniting. But though we believed this struggle would be the movement of our lifetimes, it soon disappeared. Twenty years later, however, we can see that we were right. Today’s left revival in the United States began that Tuesday morning, when radical protesters—organized by the Direct Action Network and trained by the Ruckus Society in Earth First!-style tactics—linked themselves together at strategic intersections and successfully blocked delegates from entering the WTO.

“Those who were arguing they were going to shut the WTO down were in fact successful today,” Seattle Police Chief Norm Stamper lamented.

The WTO meetings finally got started thanks only to fierce police repression: tear gas, pepper spray, rubber bullets, concussion grenades, a 25-square block “no protest zone,” and hundreds of arrests. “We will clear this intersection,” a Seattle cop, captured in the classic activist-made documentary This is What Democracy Looks Like, told the group blocking it. “We will clear it with chemical and pain compliance. If you do no move, you will be the subject of pain.” Steelworkers President George Becker told the “youngsters who were peacefully demonstrating who weren’t doing a damn thing to hurt anybody,” who he saw facing down “jackbooted, helmeted, club-holding” cops: “This is where you belong, right here with the labor movement.”

And then, inside, negotiations reached an impasse and the summit collapsed. The dramatic coincidence of external protest and internal dissensus suggested that neoliberal globalization was no fait accompli.

The direct action that shut down the WTO meetings was led by young people. But it was the presence of organized labor from across the United States and around the world — “a logistical feat that has never been repeated since,” in the words of longtime Oregon labor journalist Don McIntosh — that set the stage for a historic confrontation with global capital. As McIntosh writes,“The Oregon AFL-CIO mobilized an estimated 1,600 union members, including fifteen busloads and a specially chartered 350-seat Amtrak train. In Washington, every central labor council sent at least three busloads, and Tacoma sent over thirty. Forty-two busloads crossed the border from British Columbia.”

Twenty-five thousand gathered at an AFL-CIO rally at Memorial Stadium, including representatives from abroad like Barbados Workers Union head Leroy Trotman. “Brothers and sisters, keep the struggle going. Make sure that the leaders of the governments around the world will never forget this day,” said Trotman. “This demonstration is not a demonstration of United States, it is a demonstration of all working class people all over the world.”

Many broke off from the AFL-CIO’s permitted march to support direct action in the streets. Members of the International Longshore and Warehouse Union, a bastion of radical organized labor that survived the Red Scare, shut down ports along the West Coast.

Protest attendance was not limited to the remnants of the labor left. Unions seemed ready to mount a counteroffensive after decades getting beat down and losing membership under neoliberalism. After long years of fighting against free trade on their own and losing, the AFL-CIO, under newly progressive leadership, saw the power of coalitions. Even Teamsters President Jimmy Hoffa Jr did.

“We’ll keep the pressure on,” said Hoffa. “We want the message to go out that the WTO is in trouble; the citizens are revolting.” One protester held a sign that became shorthand for this new sentiment—Teamsters and Turtles United at Last—and the exciting possibility of a union and environmentalist alliance.

The media unsurprisingly fixated on a group of anarchists who smashed store windows, with Starbucks CEO Howard Schultz complaining that “for us to have to close our stores during the peak season, the holiday Christmas season just beginning, really is an injustice.” The movement obsessed too, engaging in endless debate over what we called “diversity of tactics.” We denounced police repression, and we also eagerly courted it. Physical confrontation, while undeniably effective in Seattle, became an end unto itself. As did the photographic and video evidence of it, the circulation of which among activists became criticized as “riot porn.”

We were developing a sophisticated analysis, but our political strategy had become spectacle, operating on the same superficial level of imagery dominated by the corporate brands we hated. The failing was understandable, though. Seattle had been the first thing that had worked for the left in a long time, and it seemed necessary to stick to it.

Comrades Everywhere

It was a heady time to be a teenage radical leftist; it seemed like I had comrades everywhere. I joined a budding mass protest circuit, traveling to the Summit of the Americas in Quebec City to fight the proposed Free Trade Area of the Americas (FTAA), to Washington D.C. for the IMF-World Bank meetings in April 2000 (“A16” in movement parlance), and to Los Angeles to denounce the proceedings of the Democratic National Convention and the nomination of Al Gore. The book Al Gore: A User’s Manual by Alexander Cockburn and Jeffrey St. Clair was my go-to reference source; my souvenirs were a rib cracked by an LAPD officer’s club and memories of hiding from rubber bullets after police shut down a Rage Against the Machine protest concert.

We consumed abundant documentaries, teach-ins, magazines, and books that laid out the problems in detail. One of my favorites: Whose Trade Organization? A Comprehensive Guide to the WTO, written by the consumer watchdog Public Citizen, which played a lead role in organizing the Seattle protests.

At the height of neoliberal hegemony, the very possibility of coordinated left-wing opposition to corporate rule was shocking, to ourselves and our many critics alike. “Is there anything more ridiculous in the news today then the protests against the World Trade Organization in Seattle? I doubt it,” wrote Thomas Friedman in the New York Times. “These anti-WTO protesters — who are a Noah’s ark of flat-earth advocates, protectionist trade unions and yuppies looking for their 1960’s fix — are protesting against the wrong target with the wrong tools.”

We did indeed have a problem with our targets and tools, though not the ones Friedman had in mind. We struggled to move from opposition to offense, and we quickly came to deride our own dedication to “summit hopping.” Hop we did: mass protests met the World Economic Forum in Davos, the IMF and World Bank in Prague, the G8 in Genoa, Italy, the Republican National Convention in Philadelphia, and beyond.

We wanted to repeat the Seattle miracle. But it always failed, because the cops weren’t to be fooled again. “The actions were powerful, but it felt like a slogan — shut it down — had dictated our strategy, and defined our success,” activist and writer L.A. Kauffman recalled.

The WTO and other international financial institutions symbolized a system of corporate globalization that protected the economy from democratic control. The popular chant “this is what democracy looks like!” spoke to the disconnect between ordinary people in the streets and elite decision-making behind closed doors. But the movement couldn’t quite grasp what democratic government might actually look like, let alone taking power to make it a reality. This was due in part to the pervasiveness of anarchism. We also didn’t get how to make our opposition to global trade pacts and international financial institutions a part of a broader fight against neoliberalism — and maybe even capitalism — rather than the fight in and of itself.

Summit protests were, with some exceptions, concentrated in the Global North. But the movement had global reach and understood itself as representing a global public. We looked to the indigenous people in Chiapas, where the 1994 Zapatista uprising against NAFTA and the Mexican state had become a major reference point. No Logo by Naomi Klein introduced us to a global majority in struggle to which we tried to connect through groups like United Students Against Sweatshops. Noam Chomsky and Howard Zinn sketched out the contours of US empire.

The World Social Forum, first held in Porto Alegre, Brazil in 2002, signaled the movement’s global linkages and, not coincidentally, a new emphasis on concrete alternatives. Later that year, Workers’ Party candidate Luiz Inácio Lula da Silva won Brazil’s presidency in a landslide. Latin America’s Pink Tide of left governments and the social movements that brought them to power made it seem like another world was not only possible but actually being built.

The protest in Seattle and its reverberations comprised the most militant mass street movement in the US since the 1960s. As Subcommandante Marcos of the Zapatistas put it: “After the Cold War, the fourth world war has started.” This war, however, had barely commenced before the September 11th, 2001 attacks and George W. Bush’s declaration of the War on Terror ended the movement as a sustained force and transferred much of what remained to anti-war activism. As Kauffman writes, “the handful of sizable street actions against corporate globalization that took place in the ensuing years were dispiriting affairs, notable mainly for police repression.”

Instead of a global insurgency from below, we had a clash of civilizations imposed upon us from above. It was a resolution to neoliberalism’s growing legitimacy crisis in the United States, if only, in retrospect, a provisional one.

After the Flow, the Ebb

The anti-war movement failed to stop the invasion of Afghanistan, which was protested by a depressingly small number of people. We then failed to stop the invasion of Iraq, which was opposed by the largest worldwide protests ever. Antiwar demonstrations continued but grew smaller and petered out even as the wars continued and public support for them plummeted.

Opposition fed into the Democrats’ 2006 midterm election victory and then, in 2008, Barack Obama’s ostensibly anti-war candidacy. Neither Democratic victory, of course, stopped the forever wars that continue to this day.

The Global Justice Movement’s only bid for power was Ralph Nader’s 2000 Green Party presidential campaign. People drawn to Nader’s social-democratic platform packed in “super rallies” at arenas like Madison Square Gardens. I threw myself into volunteering, though I was too young to vote. We correctly diagnosed the problem as neoliberal Democrats using the two-party system to capture left votes while sticking to corporate politics. But our best guess at a solution was to win Nader 5 percent of the votes so that the Green Party could get federal campaign funds.

As the race between Bush and Gore approached election day, however, nervous liberals fled to Gore, and we failed. Two decades later, what most sticks out about that campaign is that we never entertained winning the presidency as a goal because it seemed — and likely was — entirely impossible.

The Bush Administration was a low point for left-wing politics. It was the era of the Daily Kos and liberal blogosphere, a situation so dire that even Howard Dean, entirely unremarkable save for his vocal opposition to the Iraq War, was deemed an insurgent. One very notable exception was the mass immigrant rights protests of 2006, which among other things reclaimed May Day as a worker’s holiday.

But even as the system that we had challenged in Seattle continued to lose credibility, no significant left opposition emerged to confront it — even after the 2008 financial crisis.

The response to Bush’s wars and Wall Street’s crisis was Obama, whose candidacy and election was greeted with a messianic glee that feels so bizarre looking back from 2019 that it’s nearly incomprehensible. Obama promised to heal a divided nation. Voters wanted not revolution but redemption. What passed for class politics that election was John Edwards’ declaration that there were “two Americas” or, more in a more reactionary register, Hillary Clinton’s comment that Obama lacked support among “hard-working Americans, white Americans.” The Left as it existed was mostly dedicated to non-electoral work, if cautiously pleased that Obama had defeated Clinton, who represented everything we hated about the Democratic Party.

The Obama presidency promised to reconcile the contradictions but of course only accelerated them. As foreclosures mounted and the recovery saved banks alone, the left was nowhere, even as the Tea Party broke out in 2010. Occupy Wall Street’s eruption in September 2011, then, provided a welcome respite: first in Zuccotti Park, and then in cities everywhere, people sat in to declare their opposition to financier rule. It was inspired by, of all things, a staple of late 90s left activism that I didn’t know still existed: the magazine Adbusters. To communicate, protesters used the human mic (“mic check!”) — another Seattle throwback.

But Occupy likewise suffered from the Seattle era shortcoming of defining left politics by a single tactic. After Seattle, we had attempted to shut down one major summit after another. Likewise, Occupy occupied.

When police evictions ended Occupy, however, a radicalizing, immigrant-youth led anti-deportation movement carried on. Then, in 2013, Black Lives Matter took off, indicting state repression and the unequal social order it held together. Militant left politics were back and, unlike those years following the WTO, they maintained a consistent ferocity. But still, the idea that we might and must win state power didn’t become clear until Bernie Sanders’ 2016 Democratic primary challenge. That run shattered the decades-long presumption that the left would be a protest movement and not a governing force, and with it, our self-righteousness, the belief that our very marginality signaled our correctness.

I remember reading about Sanders’s announcement in May 2015, buried deep within the newspaper. I knew immediately that I would vote for him, though with the clear presumption that he would badly lose to Clinton. At age 18, I would never have voted for a Democratic presidential candidate. Two decades ago, though, such a candidacy wasn’t possible. From Nader, we learned that the two-party system was well defended against third-party attacks from the outside; with Bernie, we discovered that it was vulnerable from within.

Twenty years later, I’m resistant to criticism of the Global Justice Movement failings. I don’t see them as shortcomings so much as inevitable learning experiences as we in the US left slowly fought to break neoliberalism’s imaginative bonds and expand our political horizons. In Seattle, we saw Green New Deal politics in rudimentary form: that labor and environment united was the only way forward. Occupy indicted finance; immigrant rights activists and Black Lives denounced state repression within and on the border.

The massive growth of Democratic Socialists of America as an organization would never have happened without so many experiments in radical horizontalism. As a result, DSA remains notable in the history of US socialism for its decentralization and relatively flat power structure (a matter, of course, of significant contention).

In Seattle, tens of thousands of militant protesters reminded us that another world was possible. In the years since, the Left sketched out what that might look like, in fits and starts and under extraordinarily difficult conditions. Today, we can clearly name our politics: we’re fighting for socialism, and we know that the point is to win.

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FOCUS | Cornel West: There Is 'a Neo-Fascist in the White House' Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=51483"><span class="small">Al Jazeera</span></a>   
Saturday, 30 November 2019 12:27

Excerpt: "This month it emerged White House senior adviser Stephen Miller promoted white nationalist literature and racist propaganda to conservative news website Breitbart in the run-up to the 2016 election."

Professor Cornel West. (photo: VICE)
Professor Cornel West. (photo: VICE)


Cornel West: There Is 'a Neo-Fascist in the White House'

By Al Jazeera

30 November 19


We discuss racism in the United States through the lens of Trumpism with philosopher and activist Cornel West.

his month it emerged White House senior adviser Stephen Miller promoted white nationalist literature and racist propaganda to conservative news website Breitbart in the run-up to the 2016 election.

According to the Southern Poverty Law Center (SPLC), which obtained the material, Miller pushed racist immigration stories in hundreds of emails to the website.

The SPLC's findings have thrust the racist and white supremacist tendencies of Donald Trump's presidency back into the spotlight.

According to a recent Pew Research Center survey, about six-in-10 Americans (58 percent) think race relations in the United States are bad, and 56 percent think US President Donald Trump has made race relations worse.

Many lay the blame at Donald Trump's door, pointing to his anti-immigrant rhetoric and hardline policies.

American philosopher and activist Cornel West says the era of Donald Trump is distinctive because of the escalation of white supremacy, he describes Trump's presidency as neo-fascist.

"You have white supremacist perceptions, sensibilities and practices coming from above in a neo-fascist moment with a neo-fascist in the White House," West says.

West also believes Trump himself is racist, "if Donald Trump is not a racist," West says, "then I don't know what a racist is."

"He's a narcissist, he's a racist, he's a xenophobe, he's patriarchal, he's homophobic … he's a sign and symptom of a spiritually decadent culture that allows someone like him to have that kind of power."

West says the US has always been white supremacist, just like it has always been male supremacist, and capitalist, but says this neo-fascist moment is distinctive.

"And this is why I think so many people are depressed, especially on the left and in liberal circles, because they think that somehow this is so new that it might be impossible to overcome."

West says the only way to get through this "neo-fascist moment" is through tremendous struggle and solidarity based on a commitment to poor and working people.

"We have to have real, real examples of integrity, honesty, decency, courage and hope," West says.

In this week's UpFront special, we discuss racism in America under Donald Trump with academic and activist Cornel West.

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FOCUS: Trump Has Begun the Process of Selling Out Rudy Giuliani Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=11104"><span class="small">Charles Pierce, Esquire</span></a>   
Saturday, 30 November 2019 11:53

Pierce writes: "And, right before the holiday season officially begins, the last piece of the puzzle locks into place, and the last alibi falls apart like an overcooked turkey."

Rudy Giuliani. (photo: Drew Angerer/Getty Images)
Rudy Giuliani. (photo: Drew Angerer/Getty Images)


Trump Has Begun the Process of Selling Out Rudy Giuliani

By Charles Pierce, Esquire

30 November 19


It might not make a difference, but anyone still arguing for the defense on Ukraine now looks even dumber.

nd, right before the holiday season officially begins, the last piece of the puzzle locks into place, and the last alibi falls apart like an overcooked turkey. From The New York Times:

Lawyers from the White House counsel’s office told Mr. Trump in late August about the complaint, explaining that they were trying to determine whether they were legally required to give it to Congress, the people said. The revelation could shed light on Mr. Trump’s thinking at two critical points under scrutiny by impeachment investigators: his decision in early September to release $391 million in security assistance to Ukraine and his denial to a key ambassador around the same time that there was a “quid pro quo” with Kyiv. Mr. Trump used the phrase before it had entered the public lexicon in the Ukraine affair.

Now we have the whole thing. The president* used military aid money already appropriated by Congress to shakedown the government of Ukraine, an ally, in order to get Ukraine to help him ratfck one of his prospective opponents in the 2020 presidential election. As last week’s testimony confirmed, everyone in this massive loop knew this at the time. Then someone, and we still don’t know who, took a complaint to the intelligence community’s inspector general. This was at the end of July. And, by August, they had briefed the president*, who, having been caught borscht-handed, released the aid in early September. Every episode in that chronicle is an impeachable offense, and the entire timeline is one very big one.

Remember what Rep. Adam Schiff said last week, when the Republicans on the House Intelligence Committee tried to argue that nothing untoward had happened because the president* eventually released the aid?

"My Republican colleagues, all they seem to be upset about with this is not that the president sought an investigation of his political rival, not that he withheld a White House meeting and $400 million in aid we all passed in a bipartisan basis to pressure Ukraine to do those investigations. Their objection is that he got caught. Their objection is that someone blew the whistle, and they would like this whistleblower identified, and the president wants this whistleblower punished. That's their objection. Not that the president engaged in this conduct, but that he got caught.”

Now, even that most threadbare irrelevancy is denied to all but the most fervent members of the cult. The president* released the aid because his lawyers told him he’d been caught. On this matter, at least, the case is airtight, and there is no daylight to be found. The president*, among others, is stone busted. That may matter. It may not. But anyone arguing for the defense on the Ukraine matter is bound to look like even more of an idiot than they already do, and those people look like the succulent, ripe fruit of the Stupid Tree already. That’s something, anyway.

As this news was breaking, the president* was having another one of his traveling wankfests, this one in Sunrise, Florida. His trolley left the track early and never returned. From NBC News:

"The same maniacs are pushing the deranged impeachment. Think of this. Impeachment. Impeachment. A witch hunt. The same as before," he said referring to former Special counsel Robert Mueller's report. "And they're pushing that impeachment witch hunt. And a lot of bad things are happening to them. Because you see what's happening in the polls? Everybody said: that's really bullshit.”

He looked awful and sounded worse. There’s something hinky about one of his arms. His voice was raspy. I’m beginning to think it was a bad idea to let the story of his Midnight Ride to Walter Reed fade as quickly as it did. Before the rally, the president* did an interview with Bill O’Reilly in which he began the process of selling out Rudy Giuliani. From The Daily Beast:

Asked point-blank if Giuliani was acting on his behalf in trying to dig up dirt on former vice president Joe Biden—an issue now at the heart of an impeachment inquiry—Trump said, “No, I didn’t direct him, but he is a warrior, he is a warrior...I know that he was going to go to Ukraine and I think he cancelled the trip. But Rudy has other clients, other than me. He’s done a lot of work in Ukraine over the years.”

That’s his story and he’s sticking to it. For now, anyway.

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