Len Zwelling

I have been thinking about why I am so upset by the images coming from Ukraine as opposed to similar images that have come from Africa, Afghanistan and the Middle East. This is not the first modern war of aggression where a native population has been uprooted and terrorized. We just saw it in Afghanistan less than a year ago. We have seen mothers and children running for their lives before and fathers trying to resist. Heck, we saw it when we were the aggressors in Vietnam. Why then does this one hit so close to home?

In 1978, a four-part television miniseries called “Holocaust” was broadcast on American TV. It was very controversial as it depicted the beginning rumblings and the ultimate results of the Nazi’s Final Solution through the eyes of a German Jewish family that was victimized and a Christian one whose members supported the Nazis. I have only the vaguest of recollections of the show other than it was both star-studded (early Meryl Streep) and powerful. But I remember one thing more. For some reason I was watching an episode with my visiting parents in our home in Potomac, Maryland. In that episode the son in the Jewish family runs from the Nazis to join the resistance. The rest of the family perishes. My mother turned to me and said, “Remember that. When you can. Run!”

Readers of this blog know that I have championed the rights of transgender people especially after my experiences as the Chief Medical Officer at Legacy Community Health, a health care haven for the LGBTQ+ community in Houston. When I walked into the men’s bathroom at Legacy and saw what was apparently a woman adjusting her make-up and retreated to the door thinking I had entered the wrong room, but had not, I got it.

It’s a thought I had had myself, but was articulated by former Australian Prime minister Tony Abbott in an op-ed in The Wall Street Journal on February 28. Why didn’t NATO and especially the United States throw up a no-fly zone over Ukraine to keep Russian planes out of Ukrainian skies as soon as Russian troops began amassing on the Ukrainian border?

After all, the great mistake of the Iraq War was when President Bush stopped relying on a United States imposed no-fly zone over Iraq to protect the Kurds and instead marched in. We had Saddam in a box, just like we had the Iranians in a no-nuke box, then we opened Pandora’s Box and now we are the worse for it.

This title comes from the great Thomas L. Friedman’s op-ed in The New York Times on February 27. This piece is titled “We Have Never Been Here Before” and Friedman describes why the current Russian aggression in the Ukraine is unique in world history. In short—it’s on the Internet. Friedman makes a compelling case suggesting that if we had had smart phones and the Internet in Vietnam, that war might have ended with the burning of the first Vietnamese village by American troops or the first use of napalm. The horrors of war are being beamed around the world in real time for the first time in history.

I am clearly missing something.

The United States has a huge military and a huge military budget. That’s the American people’s tax dollars being spent on troops and equipment aimed at only two things—defending the nation or advancing American interests when the weapons of war are needed. Are those weapons needed now and if so, why haven’t they been deployed?

Because we have used these weapons unwisely in recent years—in Afghanistan, Iraq and Vietnam—American presidents have insisted that military action is a last resort to extend the interests of the nation. Why? Just because you did something stupidly before doesn’t mean that that action is always stupid. Smacking someone in the face for no good reason is unwise. That’s what we did in Afghanistan, Iraq and Vietnam. Our intelligence was inadequate so using the military in all three instances was premature. We were never going to uproot the Taliban, Viet Cong or Iraqi nationals even if we had initial success. We weren’t playing long ball in any of these instances and our enemies were.

It is difficult to decide what to do about the Russian aggression in and around the Ukraine now that it appears to be a full-scale invasion.

Bret Stephens does a great job in The New York Times on February 23 explaining why.

To come up with the right decision on the Ukrainian incursion by Russia requires first that President Biden put himself in the shoes of Vladimir Putin. Given that Biden usually sounds like he’s not in his own shoes, this may be asking far too much.

Let’s say our adversaries (e.g., Communist China) placed offensive weapons or even defensive ones near our borders—let’s say in Cuba. What might we do? Hmmm—

I am not at all sure that either Dr. Kleinerman (the Beautiful Wife, BW) or I really found our life purpose completely until we got to Houston and to MD Anderson in 1984.

Genie had been a tenured faculty member at the NCI’s Biologic Response Modifier Program in Frederick, Maryland. That’s where she started her collaboration with the late, great Josh Fidler. They both knew that the immune-stimulant therapy he developed in mice and which she examined in human systems, liposome encapsulated muramyl tripeptide, was ready for clinical testing, but the leaders at the NCI would not allow her to do the trials there. No problem at MD Anderson. Come on down! And to make a thirty-year story short, she, Dr. Fidler and Norman Jaffe did exactly that and proved that this new adjuvant in combination with conventional chemotherapy could prolong the lives of adolescents with osteosarcoma, actually curing some. One of the “kids” Genie cured is an oncologic orthopedic surgeon in Pittsburgh with kids of his own. Genie had accomplished the measure of clinical excellence determined to be the gold standard by none other than J Freireich. She had developed a cancer treatment.

One of my favorite descriptions of anyone in academic medicine whose reputation exceeded his abilities and accomplishments was that he or she was a photon—all energy and no mass. Photons have no gravitas and leaders need to have gravitas. This is well elucidated in the attached op-ed from The Wall Street Journal on February 14 by Joseph Epstein. Epstein was talking about President Biden. And, I agree. I am never impressed with Biden and he’s gotten worse with age. At least when he was bullying Anita Hill he seemed to have some political weight. Now, he seems like a bumbling, dressed up elderly gentleman who mumbles platitudes and tells stories about his childhood, that illustrate nothing. In the end, Biden is a product of a life in the Senate—making deals, pumping hands, slapping backs and inappropriately smelling the hair of the nearest female. He’s no chief executive as the past year has demonstrated.

David Axelrod wrote an informed op-ed on the website of The New York Times on February 14. In it he begged Mr. Biden to use the platform of the State of the Union Address to express his empathy for what Americans have gone through in the past two years. Rather than do what most of his predecessors have done with this time before the Congress and the American people, laud his administration’s accomplishments and paint a rosy picture of the future, he should acknowledge that the state of the union is not great although better than when he took office. Then he needs to spend a little time convincing us all that he gets the problems—the virus, inflation, immigration, crime—and has concrete ideas for how to make progress on these issues in real time.