I have been a Fellow in good standing in the American College of Surgeons (ACS) for over thirty years. Founded in 1913, the ACS is the oldest and largest organization representing surgeons in the world. Its mission used to be to further excellence in surgery and support surgeons and our patients. This is no longer the case.
In 2020, the ACS leadership declared war on surgeons and surgery. It claimed that the ACS is structurally racist, that surgeons- especially white surgeons are racists, and that surgery itself is racist. No evidence to support any of these shocking claims has ever been provided. This messaging by the ACS leadership goes so far as to support the unbelievably toxic claim that patients do better when operated on by a surgeon of their own race. You cannot find any claim more poisonous to the relationship between surgeons and their patients. Imagine meeting your surgeon who is of a different race than yours and worrying whether their implicit racism will prevent them from giving you the best care. This is an insult and a slap in the face to all surgeons who go to work every day committed to the best care of the patient before them, regardless of race, ethnicity, gender, sexual orientation, or any other irrelevant characteristic. We all take the same oath to serve every patient to the best of our ability.
Twinkle twinkle little star How I wonder what you are? Up above the world so high Like a diamond in the sky
Twinkle, twinkle, little star How I wonder what you are?
The year was 1980. I was the medical office aboard the US Navy replenishment ship, USS Wabash (AOR-5). We had completed a six-month deployment to the Western Pacific and were docked in the Naval Base Subic Bay, Phillipines preparing to return stateside when we received word of the takeover of the US Embassy in Tehran, Iran. Our operational plans made a 180 degree turn as we loaded up on food, ammunition, and aviation fuel in order to ship out to the Indian Ocean in support of Naval operations to deal with the crisis. A few weeks later, we were on station, making regular round trips from Diego Garcia, a tiny island in the Maldives, to the Persian Gulf and back.
There is not much for a physician to due on a ship with 500 healthy young men, so my clinic duties rarely took up more than a couple of hours in the morning. Besides reading, writing letters, and doing health inspections in the galley and engine spaces, I had lots of down time. It was during this period that I discovered the night sky for the second time in my life.
The first time was on a European trip with a high school classmate in 1971. In our travels, Kurt and I hiked across the Oberer Grimwald glacier and up the lower slopes of the Wetterhorn to a small lodge with a detached dormitory. This was as far as we went, but for many others, it was the jumping off point for some serious alpine mountaineering. We had a simple, but delicious dinner of split pea soup and crusty bread and slept in the dorm with dozens of hikers and climbers. Late in the evening, I went outside and walked a short way from the lights of the lodge. I lay back on a rock and looked up at the night sky. I had never seen such clarity. I have never pursued astronomy as a hobby and cannot identify constellations, stars, planets, and such, but the sky was spectacular. Over the next hour, I saw more stars than I imagined possible, constellations, and meteor showers. I was impressed for the first time by the magnitude of the universe around us and I remember feeling very small. The experience was profoundly spiritual as I contemplated the vastness above and the miniscule place occupied by our planet and me. It was profoundly humbling as well.
“If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them if a large millstone were hung around their neck and they were thrown into the sea.” Mark 9:42
A quick perusal of the news on any given day will convince you there is a war on children, our most precious resource. This, the next generation will inherit whatever legacy we leave them, for good or ill. We are given children for a very short time, to raise, nurture, encourage, teach, and protect before sending them into the real world. We have a God-given obligation to protect them from those who would do them harm and exploit them for dark purposes.
The enemy today is the woke progressive agenda. This stands on three legs. One leg is race, the second is gender, and the third is climate. These activists are the shameless purveyors of critical race theory, systemic racism, and white privilege as the source of all of society’s ills. They deny gender as a biological reality and regard it as a construct in which feelings trump facts. They have given us 70-100 genders and counting. They push the idea that we are in a climate crisis demanding radical solutions, including abandoning fossil fuels, radical restructuring of agriculture, and depopulation. The primary target of their efforts to advance these causes is our children.
It may surprise most of the general public to know that the American Medical Association is not the representative of physicians. Only 15% of MD/DO’s are members. The AMA does not require member dues to survive because it was granted a monopoly by the Federal government on the Current Procedural Terminology (CPT) coding books used by all insurance companies over thirty years ago. Between the sale of these books and other related royalties, the AMS has non-dues income estimated to be over $100 million dollars annually. The AMA failed physicians during the negotiations about the Affordable Care Act (Obamacare), and did not involve itself in the deliberations for this in a quid pro quo for repeal of the Sustained Growth Rate, a payment algorithm that continually cut back payments to physicians, even though the SGR repeal already had bipartisan support and needed to be repealed in any event. This was the last straw for me and I quit the AMA for good in 2010.
Since the Covid pandemic and George Floyd killing, the AMA has gone full woke. It claims that medicine is systemically racist and has embraced critical race theory in the guise of diversity, equity, and inclusion. It has supported gender-affirming transitioning of young children and adolescents with puberty blockers and cross-sex hormones.
Now, the AMA claims that the body mass index (BMI) scale is racist because of its “historical harm” and “use for racial exclusion.” What it comes down to is that the BMI charts were developed with data from non-hispanic white patients so, of course, it must be racist.
I recently received a form letter from the Surgeon General. This is my reply.
9 June 2023
Vivek Murthy, MD, MBA
Surgeon General of the United States
200 Independence Avenue, S.W.
Washington, DC 20201
Dear Dr. Murthy,
I am responding to the letter you mailed out regarding Covid -19. I assume this was sent to all practicing physicians in the U.S. The gist of the letter was a thank you for our efforts in dealing with the Covid pandemic and encouragement to vaccinate “all” patients including administration of bivalent boosters as well as treat with Paxlovid those who currently present with Covid symptoms.
I was not a frontline physician in the pandemic as my specialty is not primary care, but I have many colleagues who were, and I share your gratitude to them for doing all they could to prevent and treat illness in their patients, often under impossible circumstances and at risk to themselves. I had Covid twice and recovered uneventfully both times. My first bout was with the Delta strain and that was unpleasant, but I and my wife (I am 70 and she is 67, both in excellent health) remained at home for the duration. The second bout was with Omicron and was as mild a cold as I have ever had. I remain unvaccinated and plan to stay that way for the foreseeable future. I am not an “anti-vaxxer”, take the flu vaccine annually, and encourage appropriate vaccination in my patients. I chose not to get the mRNA vaccines when they were rolled out as I had concerns about the speed of development, inflated efficacy and safety claims, and absence of long term data on them. I was waiting for the Novavax vaccine, the rollout of which was continually pushed back until I came down with Covid in June 2021. After that, I chose to rely on my acquired immunity, which time and subsequent studies have shown to be as robust and durable as vaccination, if not more so. This was borne out with my second bout June 2022.
My reason for writing to you is to express my dismay and disgust at the public health response to the Covid pandemic. From an unprecedented nationwide quarantine of healthy individuals to Draconian measures such as school closures of a year or more, lockdowns that devastated small businesses and our economy, and relentless pushing of measures with no proven efficacy, such as universal masking and “social distancing,” I believe that our public health sector failed miserably and the Covid response will be viewed as one of the greatest failures of modern medicine. The dismissal of expressed concerns by experts who opposed many of these measures, e.g. Great Barrington Declaration, was unscientific and undeniably politicized what should have been a reasoned scientific discussion and debate among scientists and physicians. Demonizing physicians who were striving to do their best for patients using repurposed drugs, before vaccines were available, and ostracizing those who chose not to get vaccinated was truly appalling.
More than the initial missteps in managing the pandemic was the inability or unwillingness of the public health establishment, from Dr. Fauci on down, to adapt to change, especially that seen as the virus mutated and changed to a less virulent strain. The failure to admit and accept acquired immunity was inexplicable. The relentless push to keep schools closed and to vaccinate young children with a novel vaccine when it was clear that children were uniquely spared by this virus will be viewed down the road as unjustified experimentation on those who could not speak for themselves. Shame on those who did this.
Even now, the CDC pushes vaccines for children and boosters which have almost no data to support them. I fear that we have set a dangerous precedent for future pandemics.
I am astonished that, in the face of incontrovertible evidence of the complicity of the CCP in the origin and spread of the pandemic, the World Health Organization, governments, and physicians worldwide have not demanded that the CCP be held to account for the deaths of millions.
The Covid response by the public health experts in the U.S. was an embarrassment, probably cost more lives than Covid itself, and was responsible for destroying generations of trust in our public health institutions. I no longer trust the CDC, NIH, FDA, or those who head these organizations when it comes to Covid information.
I would suggest that one of your goals as Surgeon General should be to reform or dismantle these organizations so we do not see a repeat of this debacle in the future.
So create something that doesn’t exist in nature and see if you can kill it.Steven Quay, MD, PhD
Until well into the Covid pandemic most people had never heard of “gain of function” research in viruses. Now, it seems everyone has at least a vague understanding of the term. The public knows it has something to do with making a natural virus more dangerous to humans in some way and that this may have played a role in the origin of SARS-CoV-2, the virus that causes Covid or, as I personally prefer to call it, the Wuhan virus, for its origin in Wuhan, China. Since that seems offensive to some people, I will use the politically acceptable Covid.
Gain of function involves several things. It may involve one, several, or all of these. These include the following:
Creation of a virus that does not exist in nature.
Taking an existing virus and modifying it in several ways:
Make it more transmissible to humans, especially if from an animal source.
Make it more infectious, i.e. easier to spread.
Make it more virulent, i.e. deadly.
Make it able to evade detection by our immune system.
Make it able to spread without prelimimary symptoms, i.e. asymptomatic spread.
No’s. 6 and 7, are regarded by many countries, including the US as impermissable. Oddly, the others are not. I have seen this mentioned with references in the past, but my search for these sources has been a failure. I cannot but wonder if they were not taken down.
Jay Battacharya, MD is Professor of Medicine at Stanford University where he received his MD and a PhD in Economics. He is a senior Fellow of the Hoover Institute at Stanford. He has published peer-reviewed papers on public health policy since long before Covid. Dr. Battacharya carried out the first population serologic studies of Covid to determine its penetration in the community. The results of this, which were available as early as April 2020, showed that the virus would not be, could not be, stopped by lockdowns, a conclusion that the next few years confirmed unequivocally.
Martin Kulldorff, PhD is a biostatistician, epidemiologist, and Professor in the Department of Medicine at Harvard Medical School. He is a member of the FDA’s Drug Safety and Risk Management Advisory Committee, and a former member of the CDC’s Vaccine Safety Subgoup of the Advisory Committee on Immunization Practices. He developed the software used by the FDA and CDC to monitor drug and vaccine safety.
Sunetra Gupta, PhD is an epidemiologist in the Department of Zoology at Oxford University and heads a team of infectious disease epidemiologists. She has published multiple papers on the transmission of infectious diseases and is on the Scientific Advisory Board of Collateral Global, an organization that studies the global impact of Covid-19 restrictions.
It is entirely another thing when physicians begin to question biological reality to advance a narrative that has nothing to do with science and everything to do with ideology. In this case, it is the relatively recent movement to abolish sex and gender as anything other than social constructs that are fluid and infinitely variable. This has given us an ever expanding number of genders, including the best one, which is non-gendered (does anyone have a clue what that means, including the people who claim this?). Basically, you are whatever you say you are, or feel you are, or think you are. Emotion rules the day. Your gender can change as often as you wish and, what’s more, everyone around you is required to accept and approve of whatever gender you are at any particular moment. No dissent is allowed unless you want to be labeled a “hater”, “transphobe”, or other pejorative.
She claims that there is some general consensus on the part of doctors regarding definitions of biological sex or, should I say, lack thereof. “For decades scientists and physicians have agreed that there is no sufficient way to define what makes someone a woman, and that there is a myriad of variation. No true physician or scientist would claim to be able to distill the intricacies of this into a simple binary.” I love how, to be true, you have to accept her premise. This is typical progressive wokeism in medicine. Either believe as I do or you are delegitimized and have no place in the discussion.
This e-mail exchange with the Florida Society of Plastic Surgeons took place in May 2022. Nothing has changed. If anything, things are worse. Below is the original e-mail and responses that followed.
Dear FSPS Member,
I know many may have strong feelings about the AMA but when politicians consider legislation impacting medicine, they look to what they consider a trusted source, the AMA.
The Aesthetic Society is approximately 52 members shy of regaining our seat at the AMA House of Delegates. If we are not represented, we cannot advocate for our patients, our specialty and the safe practice of medicine.
To regain our seat, at least 20% of Aesthetic Society members must also be members of the AMA . Membership also counts for our other societies as well.
The American Board of Cosmetic Surgery has delegates and is certainly voicing their opinions to the AMA.
Please join the AMA today so we may keep a seat and a voice at the table and can provide important input regarding decisions that impact us and our patients. The deadline is May 31st so the sooner the better!
David Halpern, MD
Below is my reply:
This presents me with a dilemma. I do not believe the AMA any longer represents the interests of physicians if, indeed, it ever did. I dropped my membership in the wake of the failure of the AMA to voice the concerns of physicians in the passage of the ACA in a quid pro quo to eliminating the SGR. Now, the AMA has gone fully woke, adopting critical race theory and race essentialism, as well as other progressive, unscientific positions vis a vis gender dysphoria. I simply cannot, and will not, join this organization, the demise of which cannot come soon enough for me.R. T. Bosshardt, MD, FACS
The media’s new narrative that a lab leak scenario has only recently become more likely, because of the emergence of new information, is false. The information on a lab origin was always readily available and shows that, from the very beginning, the lab leak theory was the only viable theory.
Hans Mahnke and Jeff Carlson
Real fatigue at the end of a long day of surgery in the West Bank in 2005.
If you are like me, you are tired of hearing about Covid. I get it, truly I do. I wish we could go back to before the pandemic when all we had to deal with was Trump derangement, hyper-partisan politics, impeachment hoaxes, systemic racism in America, and impending climate doom. Happy days for sure.
Unfortunately, we can’t just forget Covid and shouldn’t. Why? We owe it to the millions who died directly from the virus and to the even more millions who died indirectly from the catastrophic mismanagement of Covid by our public health authorities. We owe it to children and young adults who may never make up the loss in education from school closures that went on long after science showed they were unnecessary and harmful. We owe it to those who lost jobs and businesses that some of them had spent a lifetime building. We owe it to all who suffered in some way and need to hold to account those who were responsible in some way for the devastation of our country and the world by their actions and inactions.
Despite the seemingly back-to-normal appearance of life around us, we are still dealing with Covid related issues and probably will for the next generation. A major health system still has social distancing signs and floor stickers telling patients where to stand. Signs in the lobby request those who are unvaccinated to wear masks despite the fact that science, real science, shows these measures to be essentially worthless.