Month: February 2024

This month brings more good news. It's sort of trivial, but that's never stopped me before.

In January I told you that my cancer levels had dropped to a level that qualified as a "complete" response. But there's an even better category labeled a "stringent complete" response that has to do with something called the serum free light chain ratio. This is the ratio of kappa and lambda light chains, and this month mine was both measurable and normal:

Now, it so happens that the latest medical thinking on this matter is that the free light chain ratio doesn't actually matter very much. But it matters a little bit, and that's good enough for me.

In other news, my immunoglobulin levels are starting to recover. My IgM level is now normal and my IgG level appears to have bottomed out and is (just barely) starting to turn up. This is good for two reasons. First, immunoglobulins are better known as antibodies, and having a normal level of antibodies is an excellent thing. Second, the fact that they're recovering suggests that the CAR-T might finally be finishing up. Obviously I'm glad it kept working long enough to kill off lots of cancer cells, but I'd also like it to eventually call it quits so that I can recover from the procedure and start to feel better.

That's the latest. No big changes, but basically all good news.

Sometimes it feels like you need a PhD in Trumpology to figure out what the guy is blathering on about. But it's not so hard! Let's go through a few examples. First up is this:

This is Trump in his standard amoral asshole mode. As everyone knows, Michael Haley is an Army major who's currently deployed overseas in Djibouti. Trump also knows this but doesn't care.

Next up is this:

Surprise! This is not Trump in forgetful mode. It's Trump in revenge mode. He gets confused about who's president all the time because he doesn't really have anything against Joe Biden. But Barack Obama made fun of him once and Trump has been furious about that ever since. He is obsessed with Obama, which is why he thinks Obama is now and forever president.

Then this:

This is Trump in woke warrior mode. He's reacting to press reports from a few weeks back that the Park Service planned to remove a statue of William Penn in Philadelphia. This decision was reversed within a couple of days, but it's still stuck in Trump's craw. He is implying here that if Biden wins the election, the woke mob will insist on changing the name of Pennsylvania.

And of course this instant classic from last month:

This is Trump in plain old doddering mode. Nikki Haley has offended him by not dropping out of the primary, so everything bad is somehow her fault. Plus Nikki and Nancy both start with N, so they're easy to confuse.

And this:

This is Trump in lying braggart mode. He's inventing a conversation that obviously never happened to make the point that he's a tough guy who told Europe that America is the boss.

So that's that. We have several modes of Trump:

• Asshole
• Revenge
• Anti-woke
• Forgetful
• Liar

When you're not sure what the hell he's talking about, just go through this list and eventually it will become clear. You're welcome.

I've already said that Special Counsel Robert Hur was out of bounds in his final report when he made derogatory remarks about President Biden's memory, which had nothing to do with the actual case he was investigating. But it turns out it's much worse than that. Marcy Wheeler lays out the problem at length here. I'll summarize.

Hur says that his case rests primarily on a single folder of classified documents related to Afghanistan that he found in a "badly damaged box surrounded by household detritus" in Biden's garage. This by itself suggests the documents were there by accident, but Hur argues otherwise by citing a snippet of a conversation Biden had with his ghostwriter just after leaving office in 2017:

So this was—I, early on, in ’09—I just found all the classified stuff downstairs—I wrote the President a handwritten 40-page memorandum arguing against deploying additional troops to Iraq—I mean, to Afghanistan—on the grounds that it wouldn’t matter, that the day we left would be like the day before we arrived.

The most natural interpretation of this is that Biden had just found his copy of the memo he wrote to Obama. This was classified, but since it was a handwritten recollection—like Ronald Reagan's diaries—it was OK for Biden to keep it.

Instead, Hur repeated that bolded 8-word phrase 23 times and concluded that it referred to the Afghanistan documents in the garage—the ones that looked like they hadn't been touched in recent memory. Without this, Hur has nothing, and it really should have been the end of the investigation. Biden had kept some personal records, which was OK; some minor stuff no one cared about; and a single folder of classified information that gave every sign of being forgotten about.

But Hur chose a different direction, insisting that "context" showed Biden was referring to the Afghanistan folder. He then spun a long, tortured story about why Biden might have deliberately kept this folder even though he had returned everything else. Remarkably, it contained language like this:

Like many presidents, Mr. Biden has long viewed himself as a historic figure.... Mr. Biden collected papers and artifacts related to noteworthy issues and events in his public life. He used these materials to write memoirs published in 2007 and 2017, to document his legacy, and to cite as evidence that he was a man of presidential timber.

It's astonishing that a special counsel would use snide language like this. It's especially astonishing when it's there solely to back up a convoluted theory about why Biden would have kept one (1) folder of classified information that he obviously didn't need since he had a copy of the 40-page memo based on it.

And this also explains Hur's editorializing about Biden's memory. There was no case to make against Biden because Biden had done nothing wrong—but Hur didn't want to admit that. So instead he was forced to come up with other reasons for not recommending charges, and one of them was that Biden's faulty memory would persuade a jury he was a sympathetic figure who had just forgotten they were there.

The more likely truth, as Hur himself notes, is that reasonable jurors were unlikely to accept a single vague aside—never repeated and never acted upon—as evidence of anything. Especially since, again, as Hur himself points out:

• Biden said this shortly after leaving office, when he was routinely surrounded by classified documents and they were no big deal.
• Biden was accustomed to having staff handle details of box packing and so forth.
• The classified documents were from 2009 and "concern a conflict that is now over, in a country where there are no longer any American troops, about a subject (the 2009 troop surge) that has already been widely discussed in books and media reports."
• Biden cooperated completely with Hur's investigation and never seemed concerned that the FBI would find anything damaging.
• Biden returned every single classified document he had. This single folder in an old box was the only exception.

You can, as Hur did, invent a long, circuitous story that (a) Biden's aside referred to the Afghanistan folder, (b) he was desperate to keep those documents in order to write a book that had nothing to do with Afghanistan, and (c) even though he was keenly aware the folder was in his garage, he left it in plain sight in an old box instead of hiding it or filing it or tossing it out when the investigation started.

This is Glenn Beck territory. It's ridiculous.

Yesterday I put up a chart showing that average GDP growth under Donald Trump was 4.1% while Joe Biden's has been more than double that at 8.3%. How come no one ever shows this comparison?

The answer is simple: it's not adjusted for inflation. Here are the real numbers:

I had two points to make. First, always adjust for inflation!

Second, journalists routinely print whatever figures they're handed. In the case of GDP, the Commerce Department always reports real GDP growth, so that's what they show us. In the case of, say, wage growth or the S&P 500, the headline numbers are nominal so that's what they show us.

There's no good reason for this. A journalist friend of mine asked me the other day why I thought reporters were reluctant to routinely adjust for inflation. My guess: because it means adjusting the "official" numbers and that suggests the reporter is manipulating things instead of reporting them straight. Maybe. In truth, I don't know. Maybe they don't know how? That seems unlikely since it's pretty easy: just divide your series of numbers by the inflation index and then multiply by the current index.

There's no need to overthink this. Always adjust for inflation. Use CPI unless it's a long series, in which case use PCE and make a note of it. That's it. Easy peasy.

If this is confirmed it's big trouble for UNRWA:

Hidden deep below the headquarters of the United Nations’ aid agency for Palestinians here is a Hamas complex with rows of computer servers that Israel’s armed forces say served as an important communications center and intelligence hub for the Islamist militant group.

....Israeli military officials assert that people working at Unrwa would have been aware of the tunnel complex, either from activities during its construction or by what they said would have been a jump in electricity usage when the complex started operating.

....Next to the room with computer servers, which was air-conditioned, was an electricity-supply room fitted with massive batteries, apparently to serve as a backup if power was disrupted.

The electricity room and server room were beneath the Unrwa compound’s own electrical supply room, the officer said. He said wires snaked down into the underground base from the Unrwa compound, allowing Hamas to steal electricity from the U.N agency to power its underground facility.

UNRWA is the main UN aid agency for Gaza, and it's been under pressure forever. Both Israelis and American hawks have long claimed that it's heavily infiltrated, if not outright controlled, by Hamas, and Israel recently released evidence that 12 UNRWA workers were Hamas members.

That revelation didn't mean much. UNRWA employs about 30,000 people, and it's inevitable that some of them will be Hamas members. I'd be pretty shocked if the number were as low as 12.

But a big, air conditioned tunnel complex and server installation right under UNRWA headquarters? It's a little hard to believe they didn't know about it and actively allow it to keep operating.

UNRWA is in a tough position in Gaza. Yes, Hamas is a terrorist group, but they're also the government of Gaza. It's all but impossible to operate there without dealing with Hamas on a regular basis. That's just reality. Still, accepting reality and working with them where you have to is one thing. Looking the other way while they operate a secret tunnel complex powered by UNRWA electricity is quite another.

My memory has always been the Sargasso Sea of storage devices, but I got a disturbingly concrete reminder of this a few days ago.

Like many of you (probably) I enjoyed Cixin Liu's trilogy The Three-Body Problem. So when I saw that Amazon had made a series out of it I headed right over. It turned out to be 30 episodes long, which seemed reasonable for a three-volume set. But no: it's 30 episodes for just the first book. Yikes. It's also in Chinese. That's OK too, but fair warning: the subtitles come and go pretty quickly. Pay attention.

Anyway, I finished watching it a few days ago. My verdict: OK, but not great, and boy did they take a lot of liberties with the book. So many liberties, in fact, that I was prompted to reread the novel.

So I did. And it turns out they took no liberties at all. It was the most literal page-by-page adaptation I've ever seen. And yet my memory told me completely differently. This is for a book I read only five or six years ago.

Meh. I'd like to gripe that this is the price of getting old, but I've always been like this. It's a wonder I remember how to get out of bed in the morning.

You've heard endlessly that the Fed has raised interest rates by five percentage points since 2022. And that's true. But remember: always adjust for inflation!

There's a big difference between 5% interest rates when inflation is running at 9% and 5% interest rates when inflation is down to 3%. The Fed effectively raised rates nearly ten points over the course of a year, and the real rate is now almost four points higher than the pre-pandemic average.

Aside from inflation, I'm a bug about monetary policy having lags. So the question is not whether a real interest rate of 2.6% is appropriate for today's economy. It's whether it's appropriate for the economy a year or so from now. I very much doubt it.

The best way to assess Joe Biden's mental condition would be to sit down and have a talk with him. Unfortunately, most of us never have that opportunity. White House staffers do, but obviously they're biased and can't necessarily be trusted.

But it turns out that "most of us" doesn't include Paul Krugman:

As it happens, I had an hourlong off-the-record meeting with Biden in August. I can’t talk about the content, but I can assure you that he’s perfectly lucid, with a good grasp of events. And outside of that personal experience, on several occasions when I thought he was making a serious misjudgment — like his handling of the debt ceiling crisis — he was right, and I was wrong.

It's instructive that, as far as I know, not a single person who has interacted with Biden personally has ever reported any kind of cognitive decline. This includes Republican leaders who have visited him in the White House, even though they have every incentive to leak dirt on Biden to the press. In fact, I've never come across a comment from anyone, even on background, that describes him as anything other than attentive, engaged, and detail oriented.

If we're going to keep this up, someone needs to describe a conversation with Biden—just one!—where he exhibited any kind of intellectual deficit. Anybody?

You may be surprised to know that opioid use hasn't increased in recent years. SAMHSA has tracked overall opioid use since 2015, and the number of regular users has declined 26% since then:

Most of this is heroin and cocaine. Fentanyl use in 2022 was only about 10% of the total.

The reason drug overdose deaths have skyrocketed is not because opioid use has boomed, or even because fentanyl use is all that high. It's because fentanyl is so damn dangerous. My rough calculation suggests that fentanyl users die at 12 times the rate of ordinary opioid users.

Both the New York Times and Washington Post reported today on a $2 billion Medicare scam. The way it worked was simple:

• Scammers buy a few small medical supply companies (seven, to be exact).
• The companies send Medicare bills for millions of phony catheters.

That's it! But how did they get away with it? The Post explains:

Urinary catheters made an appealing target for potential scammers because orders for the low-cost products — small tubes often made with latex or silicone — could escape some of the scrutiny that accompanies billing for expensive equipment, surgeries and other high-cost claims, fraud experts said.

Huh. The Times provides this chart of catheter billing:

I'm a big proponent of being patient until all the facts are in, but this truly looks insane. Catheters were billed at a steady $50 million per quarter, and then, in one quarter, it jumped to $600 million. And Medicare has no systems in place to flag that? My credit card company flags my account if I spend a thousand dollars in a different time zone.

But apparently nothing like this was in place. The scam wasn't even uncovered by Medicare, despite skyrocketing billing and lots of complaints (the scammers submitted bills using real customer and doctor names). It was uncovered by a private organization.