Hi Thom - I plan to keep reading your work, HCR, Snyder. As a family doc who is very concerned by the incoming public health, HHS, and CDC leadership, I plan to speak up when truth is bent to power as it pertains to good primary care. I won’t obey in advance, and yet I’ll try to find ways to engage with “the other side” and bring them back from the authoritarian, anti democratic, big lies as big litmus test beliefs. For example, I wrote this deep dive on how to approach patients, family and friends who have let the anti-vax movement undermine their own trust in science and medicine:
Thank you Dr. McCormick for your comments and actions. With RFK Jr., likely to be the head of HHS you and other like minded docs will need to speak out loudly and often with truth and commonsense.
Federally, I am urging friends and colleagues to choose one perhaps two areas to advocate in/fight in.
It remains to be seen whether demonstrators will be shot if they protest. That possible/reality will help direct what we can do and how. Our warming/changing climate will be one of my choices.
Otherwise, even more than usual - calls and emails to my reps and perhaps all in the House and Senate for a variety of issues.
On the state level, there are several fights I will be involved in with a hearty and informed group of activists.
Missing from my plan is how I will rejuvenate on a regular basis,
Thank you. As a Californian, calls to my Reps and Senators are good, but it's the red State GOP folks like Joanie Ernst etc who know better than always go along with 45's outrageousness, who need to hear from us All. You are not forced to say where you live when you call these folks. -- I don't lie but I do skip answering that question and still get my message across loud and clear. Chances are whoever answers will think we just forgot to state which State we live in, and hence tally our opinions anyway. Messages make a Big difference with these folks, -- especially those who know better. (Ie, skip the MTG types who do not!) Thom never advocates for this for excusable reasons --- but Congressional laws and decisions affect All Americans. It is a bit absurd that doing the right thing by US Congress persons is only determined by being voted back in by one's local constituents or not!
I understand why people are checking out. I, along with half of this country, feel so powerless. I also lack much hope that this will be gone in four years. If "the other half" ever realizes the wealth is not going to flow their way, it could likely be too late to reverse the flow.
For Monday, my plan is to have a massage and not turn on the news. For the next few weeks and months, I will work with others at our church to organize in support of our immigrant members. I also plan to keep speaking out--today I'm going to the People's March with my walking buddies. One day at a time.
So much will depend on the economy and resources that I will have at my disposal. My current plan is to retire in April 2026. My house is paid off, so I would ideally sell it and buy a house and land, at least 20 acres in the mountains, with a well. I would upgrade the outbuildings for housing guests, and offer it as a refuge/intentional community. I have friends who do not have robust retirements, and perhaps I would be able to help them out. My background is in the environmental area, so I would be managing the land to support native plants and wildlife, but would grow a vegetable garden. If that is not possible, I will sell all my belongings and move to a tiny old cabin that I have in the mountains. Last time around I marched and wrote and donated, and it all seemed to backfire, as if drawing attention to the things we care about made them more likely to become targets. I imagine the Eye of Sauron rotating and fixed on us. This time I will wait and watch, build community and focus on local needs, then do more if the opportunity presents itself.
I live abroad, but have family in the US. Even abroad, of course, I understand how affected we will be...cost of goods, retirement income, VOTING RIGHTS..
When in the US, and talking to friends, I will continue engagement on such things as the outrageous healthcare system. Here, in Panama, I was recently hospitalized for two days following knee fracture surgery. The incredible level of care and attention I found here no longer exists in current US hospitals but reminds me of the care in the late 60's, early 70's when I worked as a student in a Boston hospital.
Beyond that, I wish there were some level of civic engagement with young people starting out involving lessons of citizen duties and understanding of constitutional freedoms.
Wow Deb, I lived three years in Panama, spent weekends in Santiago de Veragus, Chiriqui and Volcan. I had a cervical hemilaminectomy performed by a Dr Pinilla, the best neurosurgeon in the world.
Is the charity hospital St Joseph still in operation. I drove the Avenida Balboa from the edifico Gusromares every week day for almost three years.
I would shop at the market at the end of the Avineda at the punta, buy a whole tenderloin for , to me, nothing, huge camerone's, freshest vegetables ever, and on the way to Santiago, just outside the Zona del Canal, there was a panaderia, that sold fresh hot bread, and the freshest hot queso fresca ever,it smeared like butter.
I learned to make ceivche from a vendor near Panama Viejo., I make a fresh batch every week.
I hear that it has become quite expensive, since Citigroup's successful campaign to convince the people to have credit carfds. Debt is the cause of inflation.
The bank of Panama used, in 1978, American dollars as a medium of exchange and its coins are minted inthe Philalelphia Mint of the same stock as American coins,only the designs ae different.
If they still use American Dollars then Panama is not really a sovereign country, as its cental bank is a branch of Citigroup, as authorized by the Edgeact of 1919.
The CIA had it's ownbank, Midland Merchant Marine on Ave Balboa, next (of all things) to the Vatican.
Bring me up to date please,Panama is my first choice in my go to,I love the people,the culture, the country and it's excellent medical care.
When I was there the most popular occupations were abagado and medico/doctoro/
It is more expensive here than when you were her, but still MUCH LESS than most, if not all places in the US. And the quality of life is excellent.
I just spent two nights at Mae Lewis hospital in David following surgery for knee fracture repair. The care and attention to detail from the medical and nursing staff are at a level I have not seen in the US since the late 60's, early 70's when I worked in one in Boston as a student
Thanks. Glad to hear that. I don't care about the expense, it has to be cheper than America.
What worries me is the attitude of Panama towards American ex pats, with Trump making insane threats.
I really do like Panama, fond memories, and the culture, though I have witnessed some entertaining events.
When I was there Torrijos, would not permit the mechanization of cane cutting as it would result in unemployment. I would watch cane cutters going through the fields and whooping. The whooping was to let others also wielding machettes that they were nearby.
I also met a dude who had is arm cut off below the elbow. He had been bitten by a fer de lance while cutting cane, and his coworker whacked off his arm to save his life.
Since you have been to David, have you been to Volcan. That was quite a surprise to me, houses were Bavarian style, they had propane heated water, and I saw a lot of blue eyes and blond hair. To be expected as Volcan was settled by Baviarian and Swiss immigrants.
Sadly, everyone I seem to know is "going back to art and listening to music." Im very disgusted. I wait for the great awakening and to hear "Im ready to fight!" Meanwhile, your writings and others keep me buoyant. Thanks. My hope for the coming years (doubtful its limited to four) is to continue to counter the hopelessness I hear all around me from the comfortable, and to try to find ways to support the targeted members of my community.
Even on the cloudiest days, some light breaks through. Let’s keep the faith and press on. Some stormy weather ahead to be sure. But in my heart, what Trump & company offer is contrary to the American character. No amount of lipstick will change the MAGA pig.
I am turning my attention to State Politics. It is more important than ever that State politics reflect the morals and values of the majority of its residents.
The horns of a dilemma. On one-hand, the sight or sound of the orange turd talking ravages my mind.
To maintain health - i have to give that poison up to a higher power. I know how bad this next four years will be - we have a baseline. I distinctly remember being the camp of having a tiny bit of hope for decency prior to humpty dumpty taking office in 2016. It lasted 11 days. From Jan 20 - Jan 31st in 2017 - that was all i needed to see (check out the headlines from those 11 days).
More recently, i had hope that the Dems could get it done. Our leadership failed to get the job done. We're so bad at messaging - that we lost.
And we now understand how the lack of intellectual capacity required to even be intellectually curious - is missing throughout the land. The dummies have gotten what they voted for.
On another hand, I am watching for a less ideological / more centrist Dem leadership to sharpen messaging to continually show exactly how unfair these losers are. Not a sign of that yet from party leaders so far - sad to say, it may take the old style dems failing a couple more times before change occurs - i hope not - but i do have to say - my certainty of how bad the orange turd really is - is actually greater than knowing if the dems can find a way to win.
Two things keep it on balance for me personally. 1) Don't listen to the orange turd, and get active in a couple ways: Physically - keep your hippocampus healthy with yoga, exercising, taking saunas, steam baths, cause a re-set of your vagus nerve as many times a week as possible. And get involved locally. I just aint gonna let them win.
I am struggling to learn how to deal with the next 4 years. I know I have to follow the news to be sure that I am present as I am needed. Although I have participated in protests in the past [Iraq war, for example, I am now in my early 80's struggling to maintain my health and manage family matters.
How to cope? Stay engaged. Use your voice. Vote. I am concerned,like many, we will lose our voice as the media kowtows to the Orange Man. I understand, they want to remain in business; a choice between conscience and paycheck isn’t easy. So one area to get the straight skinny (with a pinch of salt too) is the Substack. It is why I have signed on (payed) for Hartman’s blog, and others too. But the caution to blogs and MSNBC (assuming they remain) is the message must be more than woe. It must also propose action to address our quest to continue a socially caring and inclusive society. It must carry the message that our security rests in large on world security. It must enforce the reality our economy is inextricably linked to the world. And we must communicate with our Congressional leaders to make our voice loud and clear in our government. To that point, I note even in the minority the GOP still got their message out. And they regained office. We can learn too Tea Party and MAGA. Hopefully without developing a kool aid cult.
"Feel free to offer your thoughts on the best way to make it through...."
This is dja vu. The last time, I retired. Sat out most of Trump I, although I witnessed the carnage.
Yesterday I was on a zoom with an organization of federal administrative law judges, hoping they had some superior knowledge about those pending executive orders. There are pending lawsuits challenging judges' authority, and at least one challenging the consitutionality of the NLRB. https://www.shrm.org/topics-tools/employment-law-compliance/supreme-court-boosted-chances-of-successful-constitutional-chall They didn't have anly clue, but they know they have to read up on the law of rifs and unemployment.
I don't have any good advice. Keep low. Duck and weave. Kelar clothing is too expensive. Claymore mines and recoiless rifles don't seem to be obtainable. Living in a condo, I can't grow my own.
My wife and I hope to survive, although based on age, according to the statistics, the odds are not good. .
The world be a changing. Expect female rage to burn down the old belief structures. Old things that are fear based will not survive into the future Earth. There simply is no energy in them and the crumble is coming. This will surprise the nuts but its been in the air for decades predicted by the psychics.
Thom, what to do, live my life is what. I will focus on the future as it happens. Positive attitude will help as well. We are now living in TrumpASTAND LAND! The thing is this ride is not going to be fun. Kamala said once just do you and I am with her on that. I am going to remain and be happy because to be anything else is not what Martin Luther King would I think would have wanted. Celebrating a man who really knew all these things could happen to us as well, Oligarchy. Thank you Thom. Black and I’m proud. I ain’t gonna let nobody turn me round. Nobody! Don’t forget the man and what he stood for. I know i won’t.
I believe we are all correct in our assessment of the nature of things to come. But nothing is real until it is fact. I have no idea of whether tariffs on Canadian clothing are actually going to happen, or even of Chinese clothing will be tariffed. It could be scare tactics and bluster and bullshit, which is not uncommon for Trump. I terrorize myself about that, but frankly, there's not a damned thing I can do about it. The yes or no of that example is serious enough to be life or death, and all I can do is wait and see.
The primary thing is the direction the DNC takes. If the party itself doesn't just allow itself to give a nod to progressive, there will no coming back from dystopia in the flesh. There are some voices that appear to be leaning that way, and that means nothing. This, too, is wait and see.
MY expectation is that as much as humanly possible will have been done within six months, and that we are going to see a blitzkrieg of true assault on what most of us have experienced as America. I am feeling real dread about Christian Nationalism in particular, but the laundry list of action items in Project 2025 (the thing that Trump has no knowledge of) is offensive and long.
I already support direct to reader journalism, and any organization that smacks of Bernie Sanders' platform in 2016 will get my financial support as well. I expect to keep track of what goes wrong and how it does so. I expect to share my opposition in print. We'll see, though.
At any rate, it is Saturday. In just two days we will get our first glimpse of an ACTUAL very different America, and actual events, not fear and dread of expected things, will determine how I handle things inside and outside of this head.
Hi Thom - I plan to keep reading your work, HCR, Snyder. As a family doc who is very concerned by the incoming public health, HHS, and CDC leadership, I plan to speak up when truth is bent to power as it pertains to good primary care. I won’t obey in advance, and yet I’ll try to find ways to engage with “the other side” and bring them back from the authoritarian, anti democratic, big lies as big litmus test beliefs. For example, I wrote this deep dive on how to approach patients, family and friends who have let the anti-vax movement undermine their own trust in science and medicine:
https://mccormickmd.substack.com/p/so-do-you-want-to-talk-about-which
Thank you Dr. McCormick for your comments and actions. With RFK Jr., likely to be the head of HHS you and other like minded docs will need to speak out loudly and often with truth and commonsense.
Federally, I am urging friends and colleagues to choose one perhaps two areas to advocate in/fight in.
It remains to be seen whether demonstrators will be shot if they protest. That possible/reality will help direct what we can do and how. Our warming/changing climate will be one of my choices.
Otherwise, even more than usual - calls and emails to my reps and perhaps all in the House and Senate for a variety of issues.
On the state level, there are several fights I will be involved in with a hearty and informed group of activists.
Missing from my plan is how I will rejuvenate on a regular basis,
I need to start working on that!
Rev Penny Greer
Lincoln NE
Thank you. As a Californian, calls to my Reps and Senators are good, but it's the red State GOP folks like Joanie Ernst etc who know better than always go along with 45's outrageousness, who need to hear from us All. You are not forced to say where you live when you call these folks. -- I don't lie but I do skip answering that question and still get my message across loud and clear. Chances are whoever answers will think we just forgot to state which State we live in, and hence tally our opinions anyway. Messages make a Big difference with these folks, -- especially those who know better. (Ie, skip the MTG types who do not!) Thom never advocates for this for excusable reasons --- but Congressional laws and decisions affect All Americans. It is a bit absurd that doing the right thing by US Congress persons is only determined by being voted back in by one's local constituents or not!
I understand why people are checking out. I, along with half of this country, feel so powerless. I also lack much hope that this will be gone in four years. If "the other half" ever realizes the wealth is not going to flow their way, it could likely be too late to reverse the flow.
For Monday, my plan is to have a massage and not turn on the news. For the next few weeks and months, I will work with others at our church to organize in support of our immigrant members. I also plan to keep speaking out--today I'm going to the People's March with my walking buddies. One day at a time.
The plan is to remind everyone I know that direct democracy is the engine that runs our local and state governments. Get something done THERE.
Build, grow, and fix things. Spread love to family, friends, and the environment. Stay true to yourself, and don't forget to LAUGH!
So much will depend on the economy and resources that I will have at my disposal. My current plan is to retire in April 2026. My house is paid off, so I would ideally sell it and buy a house and land, at least 20 acres in the mountains, with a well. I would upgrade the outbuildings for housing guests, and offer it as a refuge/intentional community. I have friends who do not have robust retirements, and perhaps I would be able to help them out. My background is in the environmental area, so I would be managing the land to support native plants and wildlife, but would grow a vegetable garden. If that is not possible, I will sell all my belongings and move to a tiny old cabin that I have in the mountains. Last time around I marched and wrote and donated, and it all seemed to backfire, as if drawing attention to the things we care about made them more likely to become targets. I imagine the Eye of Sauron rotating and fixed on us. This time I will wait and watch, build community and focus on local needs, then do more if the opportunity presents itself.
I live abroad, but have family in the US. Even abroad, of course, I understand how affected we will be...cost of goods, retirement income, VOTING RIGHTS..
When in the US, and talking to friends, I will continue engagement on such things as the outrageous healthcare system. Here, in Panama, I was recently hospitalized for two days following knee fracture surgery. The incredible level of care and attention I found here no longer exists in current US hospitals but reminds me of the care in the late 60's, early 70's when I worked as a student in a Boston hospital.
Beyond that, I wish there were some level of civic engagement with young people starting out involving lessons of citizen duties and understanding of constitutional freedoms.
Wow Deb, I lived three years in Panama, spent weekends in Santiago de Veragus, Chiriqui and Volcan. I had a cervical hemilaminectomy performed by a Dr Pinilla, the best neurosurgeon in the world.
Is the charity hospital St Joseph still in operation. I drove the Avenida Balboa from the edifico Gusromares every week day for almost three years.
I would shop at the market at the end of the Avineda at the punta, buy a whole tenderloin for , to me, nothing, huge camerone's, freshest vegetables ever, and on the way to Santiago, just outside the Zona del Canal, there was a panaderia, that sold fresh hot bread, and the freshest hot queso fresca ever,it smeared like butter.
I learned to make ceivche from a vendor near Panama Viejo., I make a fresh batch every week.
I hear that it has become quite expensive, since Citigroup's successful campaign to convince the people to have credit carfds. Debt is the cause of inflation.
The bank of Panama used, in 1978, American dollars as a medium of exchange and its coins are minted inthe Philalelphia Mint of the same stock as American coins,only the designs ae different.
If they still use American Dollars then Panama is not really a sovereign country, as its cental bank is a branch of Citigroup, as authorized by the Edgeact of 1919.
The CIA had it's ownbank, Midland Merchant Marine on Ave Balboa, next (of all things) to the Vatican.
Bring me up to date please,Panama is my first choice in my go to,I love the people,the culture, the country and it's excellent medical care.
When I was there the most popular occupations were abagado and medico/doctoro/
It is more expensive here than when you were her, but still MUCH LESS than most, if not all places in the US. And the quality of life is excellent.
I just spent two nights at Mae Lewis hospital in David following surgery for knee fracture repair. The care and attention to detail from the medical and nursing staff are at a level I have not seen in the US since the late 60's, early 70's when I worked in one in Boston as a student
Thanks. Glad to hear that. I don't care about the expense, it has to be cheper than America.
What worries me is the attitude of Panama towards American ex pats, with Trump making insane threats.
I really do like Panama, fond memories, and the culture, though I have witnessed some entertaining events.
When I was there Torrijos, would not permit the mechanization of cane cutting as it would result in unemployment. I would watch cane cutters going through the fields and whooping. The whooping was to let others also wielding machettes that they were nearby.
I also met a dude who had is arm cut off below the elbow. He had been bitten by a fer de lance while cutting cane, and his coworker whacked off his arm to save his life.
Since you have been to David, have you been to Volcan. That was quite a surprise to me, houses were Bavarian style, they had propane heated water, and I saw a lot of blue eyes and blond hair. To be expected as Volcan was settled by Baviarian and Swiss immigrants.
https://homework.study.com/explanation/is-the-republic-of-panama-a-u-s-territory.html#:~:text=Answer%20and%20Explanation%3A,Panama%20on%20December%2031%2C%201999.
Sadly, everyone I seem to know is "going back to art and listening to music." Im very disgusted. I wait for the great awakening and to hear "Im ready to fight!" Meanwhile, your writings and others keep me buoyant. Thanks. My hope for the coming years (doubtful its limited to four) is to continue to counter the hopelessness I hear all around me from the comfortable, and to try to find ways to support the targeted members of my community.
Even on the cloudiest days, some light breaks through. Let’s keep the faith and press on. Some stormy weather ahead to be sure. But in my heart, what Trump & company offer is contrary to the American character. No amount of lipstick will change the MAGA pig.
I am turning my attention to State Politics. It is more important than ever that State politics reflect the morals and values of the majority of its residents.
State and local involvement is one of the best ways, imo👍👍. HCR hammers that point repeatedly. Just showing up, showing your presence
The horns of a dilemma. On one-hand, the sight or sound of the orange turd talking ravages my mind.
To maintain health - i have to give that poison up to a higher power. I know how bad this next four years will be - we have a baseline. I distinctly remember being the camp of having a tiny bit of hope for decency prior to humpty dumpty taking office in 2016. It lasted 11 days. From Jan 20 - Jan 31st in 2017 - that was all i needed to see (check out the headlines from those 11 days).
More recently, i had hope that the Dems could get it done. Our leadership failed to get the job done. We're so bad at messaging - that we lost.
And we now understand how the lack of intellectual capacity required to even be intellectually curious - is missing throughout the land. The dummies have gotten what they voted for.
On another hand, I am watching for a less ideological / more centrist Dem leadership to sharpen messaging to continually show exactly how unfair these losers are. Not a sign of that yet from party leaders so far - sad to say, it may take the old style dems failing a couple more times before change occurs - i hope not - but i do have to say - my certainty of how bad the orange turd really is - is actually greater than knowing if the dems can find a way to win.
Two things keep it on balance for me personally. 1) Don't listen to the orange turd, and get active in a couple ways: Physically - keep your hippocampus healthy with yoga, exercising, taking saunas, steam baths, cause a re-set of your vagus nerve as many times a week as possible. And get involved locally. I just aint gonna let them win.
I am struggling to learn how to deal with the next 4 years. I know I have to follow the news to be sure that I am present as I am needed. Although I have participated in protests in the past [Iraq war, for example, I am now in my early 80's struggling to maintain my health and manage family matters.
How to cope? Stay engaged. Use your voice. Vote. I am concerned,like many, we will lose our voice as the media kowtows to the Orange Man. I understand, they want to remain in business; a choice between conscience and paycheck isn’t easy. So one area to get the straight skinny (with a pinch of salt too) is the Substack. It is why I have signed on (payed) for Hartman’s blog, and others too. But the caution to blogs and MSNBC (assuming they remain) is the message must be more than woe. It must also propose action to address our quest to continue a socially caring and inclusive society. It must carry the message that our security rests in large on world security. It must enforce the reality our economy is inextricably linked to the world. And we must communicate with our Congressional leaders to make our voice loud and clear in our government. To that point, I note even in the minority the GOP still got their message out. And they regained office. We can learn too Tea Party and MAGA. Hopefully without developing a kool aid cult.
"Feel free to offer your thoughts on the best way to make it through...."
This is dja vu. The last time, I retired. Sat out most of Trump I, although I witnessed the carnage.
Yesterday I was on a zoom with an organization of federal administrative law judges, hoping they had some superior knowledge about those pending executive orders. There are pending lawsuits challenging judges' authority, and at least one challenging the consitutionality of the NLRB. https://www.shrm.org/topics-tools/employment-law-compliance/supreme-court-boosted-chances-of-successful-constitutional-chall They didn't have anly clue, but they know they have to read up on the law of rifs and unemployment.
I don't have any good advice. Keep low. Duck and weave. Kelar clothing is too expensive. Claymore mines and recoiless rifles don't seem to be obtainable. Living in a condo, I can't grow my own.
My wife and I hope to survive, although based on age, according to the statistics, the odds are not good. .
The world be a changing. Expect female rage to burn down the old belief structures. Old things that are fear based will not survive into the future Earth. There simply is no energy in them and the crumble is coming. This will surprise the nuts but its been in the air for decades predicted by the psychics.
Thom, what to do, live my life is what. I will focus on the future as it happens. Positive attitude will help as well. We are now living in TrumpASTAND LAND! The thing is this ride is not going to be fun. Kamala said once just do you and I am with her on that. I am going to remain and be happy because to be anything else is not what Martin Luther King would I think would have wanted. Celebrating a man who really knew all these things could happen to us as well, Oligarchy. Thank you Thom. Black and I’m proud. I ain’t gonna let nobody turn me round. Nobody! Don’t forget the man and what he stood for. I know i won’t.
I believe we are all correct in our assessment of the nature of things to come. But nothing is real until it is fact. I have no idea of whether tariffs on Canadian clothing are actually going to happen, or even of Chinese clothing will be tariffed. It could be scare tactics and bluster and bullshit, which is not uncommon for Trump. I terrorize myself about that, but frankly, there's not a damned thing I can do about it. The yes or no of that example is serious enough to be life or death, and all I can do is wait and see.
The primary thing is the direction the DNC takes. If the party itself doesn't just allow itself to give a nod to progressive, there will no coming back from dystopia in the flesh. There are some voices that appear to be leaning that way, and that means nothing. This, too, is wait and see.
MY expectation is that as much as humanly possible will have been done within six months, and that we are going to see a blitzkrieg of true assault on what most of us have experienced as America. I am feeling real dread about Christian Nationalism in particular, but the laundry list of action items in Project 2025 (the thing that Trump has no knowledge of) is offensive and long.
I already support direct to reader journalism, and any organization that smacks of Bernie Sanders' platform in 2016 will get my financial support as well. I expect to keep track of what goes wrong and how it does so. I expect to share my opposition in print. We'll see, though.
At any rate, it is Saturday. In just two days we will get our first glimpse of an ACTUAL very different America, and actual events, not fear and dread of expected things, will determine how I handle things inside and outside of this head.