An Obsession (un)Worthy of Munchausen, Griffith and Palissy

This coming Saturday, April 29, 2017, marks a dubious historic milestone: '45's first One Hundred Days in office. And unlike the first One Hundred Days of FDR - or JFK, LBJ, GWB or the rest of the presidential gang - '45 will have next to nothing to show for it -- save the confirmation of a new Supreme CourtJustice which is, in his inimical terminology, simply yuuuge. Absenting this one achievement - which never would have happened without a historic, ill-considered change in Senate rules - absenting this, what do '45 and his administration really, truly have to show for their first One Hundred Days?

A humiliating withdrawal of their signature "repeal-and-replace" health care proposal? An abysmal fracturing of the GOP? A passel of Executive Orders - the lion's share of which are meant to bend, fold, spindle and mutilate Obama's legacy? Picking fights with the very people whose support he needs? A whole bunch of policy about-faces? A series of incomprehensible phone conversations with various world leaders? A record number of weekends playing golf in Palm Beach? The telling of more fables, lies and outright bullsh*t than ever attributed to the real or fictional Baron Munchausen (that's him on the left, as imagined by Gustave Doré)? Not precisely the kind of First One Hundred Days historians are going to remember favorably.

In the midst of all this wibble-wobble, there are precisely two things '45 has maintained a rock-solid, obsessive consistency about: increasing the nation's military budget by no less than 10% and building his cockamamie wall on America's southern border. Of course, where he originally promised ad nauseum that Mexico would pay for that piece of useless architecture, '45 is now pruning every last dime he can out of the federal budget so that we, the taxpayers, can pick up the tab . . . until the time when he, Mr. "Art of the Deal" can finally, finally convince our neighbors to the south that it is in their best interest to pay back the $12 - or $20 or $50 billion - this monster will wind up costing. And of course, '45 is obsessively, compulsively constant in his insistence that the purpose of this wall is to preserve American lives, protect American jobs and defend American honor.

Two of the most egregious and dangerous cuts being made in order to pay for '45's Maginot Line are those aimed at the National Institutes of Health (NIH), and the Food and Drug Administration (FDA). The proposed N.I.H. cuts amount to 20% of the agency's $30 billion budget, while the proposed FDA cuts amount to 21%. The N.I.H. helps fund breakthrough medical research, creating new drug treatments, medical devices, and therapies for an unbelievably wide range of diseases and medical conditions. Without adequate financial backing from NIH, projects researching various forms of cancer, Multiple Sclerosis, heart disease, autism, diabetes, migraines, sleep apnea, infertility and tens of dozens of other potentially fatal medical issues and conditions - including so-called "orphan diseases" (such as Acromegaly, Tourette Syndrome and Job Syndrome - will have the scientific carpet pulled out from underneath them. This doesn't even begin to take into account all the scientists, doctors, statisticians and bio-engineers who would be out of jobs. This is a horrifying prospect - especially in light of just how close the medical community is to discovering actual cures for many heretofore fatal diseases, syndromes and conditions.

Without adequate FDA funding, that agency will have to cut hundreds - if not thousands - of positions, which will inevitably lead to a severe lessening of regulatory oversight. In truth, this is precisely what '45 and his billionaire buds want; a"streamlining" of the regulatory process for new drug applications. This streamlining, they argue, will "prove to be beneficial in reducing the end consumer price point on new therapeutics and drugs, decrease the cost of research, thereby effectively bringing new products to market much sooner."

The question is, at what price? Writing as one who has spent nearly a quarter century vetting somewhere between 1,000 and 1,200 medical research proposals, I wish to state a truism learned through experience: that while FDA rules and regulations may tend to slow down progress a bit, it is both well and good. Jumping through FDA "regs and hoops" helps insure that the risks-versus-benefits ratio inherent in any clinical trial puts the safety, efficacy and tolerability of new medicationsand therapeutics ahead oftheneeds and perquisites of industry. Simply put, it places people and patients ahead of profits.

For the past many years I have spent, on average, two days a week vetting medical research proposals -- that is, making sure that the research in question is ethical and then turning medical terminology into understandable English. The goal is to insure that those who become test subjects in various medical research programs fully understand what they are agreeing to. This is the process known as "informed consent." Its origins go back to the "Doctors Trials" held in Nuremberg in 1946. This trial considered the fate of twenty-three German physicians who either participated in the Nazi program to euthanize persons deemed "unworthy of life" (the mentally ill, mentally retarded, or physically disabled) or who conducted experiments on concentration camp prisoners without their consent. As a result of the trial's findings, it was determined that from that date forth, no one would ever again participate in medical experiments without their knowledge and written consent. For the past 70 years, those who practice medical ethics (myself included) take this very, very seriously. A significant cut in the FDA budget puts this process - informed consent - in serious jeopardy.

And for what? To insure putting aside several billion dollars with which '45 can fulfill his obsession with increasing the military budget and constructing his own Great Wall? History records the exploits of any number of obsessive-compulsives who went to insane lengths in order to fulfill their dreams. Back in the 16th century, French Huguenot potter Bernard Palissy became so obsessively committed to recreating ancient Chinese porcelain that he burned his furniture and even, it is said, the floor boards of his house in order to feed the fires of his furnaces (That's him above on the right). Then too, 102 years ago, movie director D(avid) W(ark) Griffith spent, borrowed and mortgaged every dime he could find in order to create a film called The Birth of a Nation. Although it did earn tens of millions, it eventually bankrupted him. (n.b.: That movie's star, Lillian Gish, would become my mother's mentor. That's a newspaper photo of mom and Miss Lillian from 1939 or 40 at left).

Griffth's and Pallisay's obsessive compulsive manias may have been considered both insane and excessive in their own time, but at least lead to immortal works of artistic brilliance; the product of their obsessions have a place of honor to this very day. One wonders whether '45's obsession - denuding the federal budget in order to build a wall between Mexico and the United States - will be applauded a century from now . . . not to mention in the midterm elections of 2018.

'45 really, really ought not defund the NIH or FDA. If he really, truly wants to preserve American lives, protect American jobs and defend American honor, he couldn't do better than fully funding ethical medical research. Erecting wall or medical research between disease and good health will save many more lives than one constructed of concrete.

And who knows: perhaps one day medical science will discover cures for Obsessive Compulsive Disorder and Pseudologia fantastica.

97 days down, 1,364 to go . . .