Bridge Makeover

Golden Gate district seeks public input on five suicide-barrier designs



The Press Democrat reports:

The Golden Gate Bridge is one step closer to a historic safety makeover as public comment begins on a project intended to stop people from taking their lives by leaping over the iconic orange railings.

"This is a milestone," said Bridge District spokeswoman Mary Currie. "This is something that has been discussed since the first suicide the year the bridge was built."

But with current costs for the project estimated to be as much as $50 million, the barriers are still far from a reality.

"From here it will be about fund raising," Currie said.

The district released an environmental impact report Monday that shows five possible barrier designs.

Four of the five designs would use additional fencing along the bridge's walkways to dissuade potential jumpers and get in the way of those who might try.

A fifth design places a retracting net 20 feet under the bridge, to catch and restrain jumpers.



With an estimated cost of $25 million, a stainless steel cable net is the least expensive of the options studied in the report. The other designs are in the $40 million to $50 million range.

Costs of all possible designs are expected to grow in the time leading up to construction because of the rising costs of steel, Currie said.

Currie said the possible designs all meet specific standards, including maintaining the bridge's cultural and historic status.

But that does not mean they would not have an impact on the bridge's appearance.

Four of the designs -- those involving taller railings -- could significantly alter views from the bridge, a major draw for tourists.

A fifth design -- the netting -- alters the profile of the bridge from viewing points on either side.

"We are introducing new elements, a big railing or a big net," Currie said. "We are changing the visitor's experience."

Tourists taking in the sights Monday were cautious of any plans that would impede their views and photo opportunities.

"Any barrier would dramatically change the charm of the bridge," said Jimmy Castillo, visiting from Los Angeles. "And I doubt it would prevent them from committing suicide another way. They should keep the bridge as it is, a historical site."

While camera-toting tourists bristled at the thought of a changed bridge, suicide-prevention advocates cheered what they saw as a momentous move toward addressing a major safety issue.

"Anything that gets in someone's way buys them time and saves their life," said Eve Meyer, executive director of San Francisco Suicide Prevention. "Suicide in the entire area will drop."

This year, 10 people have committed suicide by jumping off the bridge, and 29 people have been stopped in the process of attempting to jump. Thirty-eight suicides were committed last year, 31 in 2006 and 23 in 2005, according to the bridge district.

Eighty barrier designs were originally proposed and tested for various factors. From those, five designs were chosen, including a sixth "no build" option. The report, completed by DMJM Harris Inc. of Oakland, does not include any recommendations to the district.

The report is available online at www.ggbsuicidebarrier.org, and public comment is open through Aug. 25.

After public comment is collected, bridge directors will hold hearings on how to proceed.

Currie said the district's desire is to select a locally preferred plan, vetted through public comment, possibly by the end of the year.

Fund raising the millions needed for construction would be the next goal, Currie said.

In the past, board members have resisted the idea of a barrier, saying such a project would cost too much, would alter the majestic crossing and might not work.

Barrier supporters hope attention from a 2006 film "The Bridge," which featured the startling images of people jumping from the Golden Gate Bridge, might change their opinions.

Governors Oppose New Medicaid Rules

The New York Times reports:

Governors of both parties strongly objected on Saturday to a half-dozen new federal Medicaid regulations that they said would shift billions of dollars in costs to the states, forcing them to consider cutbacks in services.

The rules, scheduled to take effect in the next few months, would reduce federal payments for public hospitals, teaching hospitals and services for the disabled, among others.

State officials voiced their concerns as they arrived here for the winter meeting of the National Governors Association.

Federal health officials said the new rules were needed to end creative financing techniques that states had used to obtain excessive amounts of federal Medicaid money.

But governors said the Bush administration was unilaterally reshaping Medicaid in ways that would harm some of their most vulnerable citizens. Moreover, they said, the rules are taking effect at a time when the national economic slowdown is cutting into state tax revenues.

“Governors strongly oppose the changes,” said Gov. Jim Douglas of Vermont, a Republican who is chairman of the association’s Health and Human Services Committee. “The timing could not be worse.”

One of the rules would ban the use of federal Medicaid money to help pay for the training of doctors, a use that has been allowed since the inception of Medicaid more than 40 years ago. Another would set new limits on Medicaid payments to hospitals and nursing homes operated by states, cities, counties and other units of government.

A third rule would limit Medicaid coverage of rehabilitation services for people with disabilities, including serious mental illnesses.

Federal officials estimate that the rules will save the federal government $15 billion over five years. But that figure may be low. California alone says it could lose $12 billion over five years.

Congress delayed some of the rules last year, but they will soon take effect unless Congress intervenes again.

Gov. Arnold Schwarzenegger of California, a Republican, said the rule changes “would effectively end the federal government’s participation in many crucial components of the Medicaid program.”

Dr. Rhonda M. Medows, commissioner of the Georgia Department of Community Health, said: “We understand the need for financial safeguards, but these rules, taken together, would have a tremendous adverse impact. They would undermine the health care safety net for the entire state of Georgia, reducing federal Medicaid payments for hospitals, nursing homes and school clinics.”

The National Conference of State Legislatures joined governors in criticizing what it described as “the regulatory activism” displayed in the new rules.

The federal government and the states share the cost of Medicaid, which provides health insurance to more than 60 million low-income people, including 30 million children.

Dennis G. Smith, director of the federal Center for Medicaid and State Operations, said the rules were needed to “protect the fiscal integrity of the Medicaid program.” Since 2003, he said, federal officials have persuaded 30 states to end “questionable Medicaid financing arrangements.” The purpose of such arrangements is to maximize the use of federal money while holding down the use of state and local revenue.

Although the most blatant problems have been corrected, the administration says, many states still use federal Medicaid money for purposes unrelated to Medicaid.

“We believe that paying for graduate medical education is outside the scope of Medicaid’s role, which is to provide medical care to low-income people,” Mr. Smith said. “There is no explicit authorization under the Medicaid statute to subsidize the training of physicians.”

Robert M. Dickler, chief health care officer at the Association of American Medical Colleges, said, “It’s a little surprising that the federal government would just now discover that there’s no legal basis for the Medicaid payments it’s been making for medical education since 1965.”

Stan Rosenstein, the Medicaid director in California, said the payments were justified because “interns and residents provide a tremendous amount of care to Medicaid beneficiaries.”

The federal government says this rule would save $1.8 billion over five years. But New York, which trains 15 percent of the nation’s doctors, says it would lose more than that alone. State officials are also concerned about a rule that would eliminate federal contributions for a whole category of public spending on health care for the poor — specifically, spending by autonomous units of local government like the Denver Health and Hospital Authority.

“As a result of this rule, we will lose $60 million a year,” said Dr. Patricia A. Gabow, chief executive of the Denver agency, which operates a 477-bed public hospital, the city’s public health department and its ambulance service. “We were part of the city government for more than 130 years. In 1997, we became an independent governmental entity, but we don’t have taxing authority. So we don’t qualify as a public provider, and we can’t draw down critically important subsidies for services we provide to the entire community.”

Larry S. Gage, president of the National Association of Public Hospitals, said the rule’s importance went far beyond Medicaid because it would compromise the ability of public hospitals to provide vital services like trauma care and burn treatment.

New York City Health and Hospitals Corporation, the largest municipal health care system in the country, which gets 60 percent of its budget from Medicaid, said the rules would have “a potentially devastating impact” and could force cutbacks in services.

A group of 17 states, including Connecticut, Michigan and New Jersey, told the administration that the new restrictions were “simply awful public policy.” Senators Jeff Bingaman, Democrat of New Mexico, and Elizabeth Dole, Republican of North Carolina, are fighting the rule on public hospitals.

The rule “would have a devastating effect on North Carolina’s Medicaid system, costing our hospitals hundreds of millions of dollars annually,” Mrs. Dole said.

The Medicaid rules were overshadowed last year by a battle over insurance for children.

“We can have a legitimate discussion about expanding the Children’s Health Insurance Program,” said Governor Douglas of Vermont. “But the Medicaid rules are different. They renege on commitments already made.”

In Vermont, Mr. Douglas said, “we’ve come to rely on Medicaid to help pay for special education and other services to children with disabilities.”

Medicaid is a crucial part of the foundation on which many states were planning to build coverage for the uninsured.

Deborah S. Bachrach, a deputy commissioner in the New York State Health Department, said, “The new Medicaid rules make it difficult to pay for current programs and nearly impossible to expand coverage to all.”

Love in the Time of Dementia

So this, in the end, is what love is.

The NY Times reports:

Former Justice Sandra Day O’Connor’s husband, suffering from Alzheimer’s disease, has a romance with another woman, and the former justice is thrilled — even visits with the new couple while they hold hands on the porch swing — because it is a relief to see her husband of 55 years so content.

What culture tells us about love is generally young love. Songs and movies and literature show us the rapture and the betrayal, the breathlessness and the tears. The O’Connors’ story, reported by the couple’s son in an interview with a television station in Arizona, where Mr. O’Connor lives in an assisted-living center, opened a window onto what might be called, for comparison’s sake, old love.

Of course, it illuminated the relationships that often develop among Alzheimer’s patients — new attachments, some call them — and how the desire for intimacy persists even when dementia steals so much else. But in the description of Justice O’Connor’s reaction, the story revealed a poignancy and a richness to love in the later years, providing a rare model at a time when people are living longer, and loving longer.

“This is right up there in terms of the cutting-edge ethical and cultural issues of late life love,” said Thomas R. Cole, director of the McGovern Center for Health, Humanities and the Human Spirit at the University of Texas, and author of a cultural history of aging. “We need moral exemplars, not to slavishly imitate, but to help us identify ways of being in love when you’re older.”

Historically, love in older age has not been given much of a place in culture, Dr. Cole said. It once conjured images that were distasteful or even scary: the dirty old man, the erotic old witch.

That is beginning to change, Dr. Cole said, as life expectancy increases, and a generation more sexually liberated begins to age. Nursing homes are being forced to confront an increase in sexual activity.

And despite the stereotypes, researchers who study emotions across the life span say old love is in many ways more satisfying than young love — even as it is also more complex, as the O’Connors’ example shows.

“There’s a difference between love as it is presented in movies and music as this jazzy sexy thing that involves bikini underwear and what love actually turns out to be,” said the psychologist Mary Pipher, whose book “Another Country” looked at the emotional life of the elderly. “The really interesting script isn’t that people like to have sex. The really interesting script is what people are willing to put up with.”

“Young love is about wanting to be happy,” she said. “Old love is about wanting someone else to be happy.”

That’s one way to look at it, at any rate. And it’s not just that relationships are seasoned by time and shared memories — although that’s part of it, as is the inertia the researchers call the familiarity effect, which keeps people from leaving a longtime relationship even though he nags and she won’t ask for directions.

It’s also that brain researchers say older people may simply be better able to deal with the emotional vicissitudes of love. As it ages, the brain becomes more programmed to be happy in relationships.

Researchers trying to understand aging and emotion performed brain scans on people across a range of ages, gauging their reactions to positive and negative scenes. Young people tended to respond to the negative scenes. Those in middle age took in a better balance of the positive. And older people responded only to the positive scenes.

“As people get older, they seem to naturally look at the world through positivity and be willing to accept things that when we’re young we would find disturbing and vexing,” said John Gabrieli, a professor of cognitive neuroscience at the Massachusetts Institute of Technology and one of the researchers.

It is not rationalization: the reaction is instantaneous. “Instead of what would be most disturbing for somebody, feeling betrayed or discomfort, the other thoughts — about how from his perspective it’s not betrayal — can be accommodated much more easily,” Dr. Gabrieli said. “It paves the way for you to be sympathetic to the situation from his perspective, to be less disturbed from her perspective.”

Young brains tend to go to extremes — the swooning or sobbing so characteristic of young love. Old love puts things in soft focus.

“As you get older you begin to recognize that this isn’t going to last forever, for better or for worse,” said Laura L. Carstensen, director of the Stanford Center on Longevity and a research counterpart of Dr. Gabrieli’s in the brain imaging research. “You understand that the bad times pass, and you understand that the good times pass,” Dr. Carstensen said. “As you experience them, they’re more precious, they’re richer.”

Of course, not everyone would show the emotionally generous response that Justice O’Connor did. As Dr. Cole said, “I have many examples in my mind of people who are just as jealous, just as infantile, just as filled with irrationality when they fall in love in their 70s and 80s as she is self-transcendent.”

And it still is possible to have a broken heart in old age. But in general, Dr. Carstensen said: “A broken heart looks different in somebody old. You don’t yell and scream and cry all day long like you might if you were 20.”

In one of the few cultural examples exploring old love — the film “Away From Her,” based on an Alice Munro short story and released in the spring — the starting point is similar to the O’Connors’ story. A man who cannot imagine life without his sparkling wife of some decades watches her slip into Alzheimer’s and then a romance with another patient in a nursing home. In the fictional example, the spousal devotion is such that he arranges for her new boyfriend to return to the nursing home after seeing how crushed she is when the man moves away.

But the story is more complex. The husband had a series of affairs years earlier, so what seems like devotion is also a desire to pay her back and to ease his own remorse.

For Olympia Dukakis, whose mother had Alzheimer’s and who played the wife of the other man in the film, that wrinkle explains the resonance of Ms. Munro’s story.

“She was very aware that contradictory things live together,” Ms. Dukakis said. “You can’t look at it and say he did it purely for love. It’s a complicated issue, because there’s a lot of life that has been lived. It’s not going to be simple.”

Still, for all those kinds of complications, those who study aging can only smile at young lovers who say they never want to become like an old married couple. Despite the popular preference for young love, the O’Connors’ example suggests that we should all aspire to old love, for better and for worse.

“Young love is very privileged, and as a culture that may be a mistake,” Dr. Pipher said. “If you want a communal culture where people make sacrifices for each other and work for the common good, you would have a culture that privileges the stories of older people.”

Those stories would not be without their troubles. But nor would they be without rewards. “If you stay married,” Dr. Pipher said, “there’s riches in store that nobody 25 years old can imagine.”

Seized by Alzheimer's, Then Love

Sometimes Alzheimer’s disease means losing a loved one twice.

The NY Times reports:

As the disease ravages the brain and erases memory, patients who have been married for years, even most of their lives, may stop recognizing their spouses. And sometimes, in a phenomenon rarely discussed, husbands and wives find they must watch helplessly as patients fall in love with someone entirely new.
The romantic lives of Alzheimer’s patients made headlines this week with news that the 77-year-old husband of retired Supreme Court Justice Sandra Day O’Connor, John Jay O’Connor III, has found companionship with a woman in the nursing home in which he lives. The two patients reportedly spend time together and hold hands, even in the presence of Justice O’Connor.

Although no research has tracked how often people with Alzheimer’s disease develop new romances, doctors say it’s not particularly unusual for married patients to bond with someone new. Although the disease may steal the memories of past lives, it doesn’t take away the desire for love and companionship.

“Imagine if all the people you know and loved disappeared,’’ said Dr. Richard Powers, chairman of the medical advisory board of the Alzheimer’s Foundation of America. “Wouldn’t you want to find someone who was your friend, who would hold your hand and watch old television shows with you? The person with Alzheimer’s still searches for joy.’’

Family members often aren’t sure how to regard such a liaison. The children of Alzheimer’s patients often find the adjustment difficult, said Dr. Powers, while many spouses actually are heartened to see a husband or wife comforted by a new friend. Although Justice O’Connor hasn’t commented, her son was quoted as saying that the family is happy that Mr. O’Connor seems to have found rays of contentment in the darkness of his disease.

“It’s not uncommon at all for families and spouses to allow this to go on, because it sustains a person’s happiness,’’ said Dr. Powers. “Those of us who have had this disease in our families know you just have to roll with these changes. Let them have a friend, if it buys them a day of happiness.’’

Dangers of a Cornered George Bush

From Consortium News/Editor’s Note: As the nation and the world face 18 more months of George W. Bush’s presidency, a chilling prospect is that Bush – confronted with more defeats and reversals – might just “lose it” and undertake even more reckless military adventures.

In this special memorandum, the Veteran Intelligence Professionals for Sanity (VIPS) collaborated with psychiatrist Justin Frank, author of Bush on the Couch, to assess the potential dangers and possible countermeasures available to constrain Bush.

Veteran Intelligence Professionals for Sanity & Dr. Justin Frank write:

Recent events have put a great deal more pressure on President George W. Bush, who has shown little regard for the constitutional system bequeathed to us by the Founders. Having bragged about being commander in chief of the “first war of the 21st century,” one he began under false pretenses, success in Iraq is now a pipedream.

The “new” strategy of surging troops in Baghdad has simply wasted more lives and bought some time for the president. His strategy boils down to keeping as many of our soldiers engaged as possible, in order to stave off definitive defeat in Iraq before January 2009.

Bush is commander in chief, but Congress must approve funding for the war, and its patience is running out. The war – and the polls – are going so badly that it is no longer a sure thing that the administration will be able to fund continuance of the war.

There is an outside chance Congress will succeed in forcing a pullout starting in the next several months. What would the president likely do in reaction to that slap in the face?

What would he do if the Resistance succeeded in mounting a large attack on U.S. facilities in the Green Zone or elsewhere in Iraq? How would he react if Israel mounted a preemptive attack on the nuclear-related facilities in Iran and wider war ensued?

Applied Psychoanalysis

The answers to such questions depend on a host of factors for which intelligence analysts use a variety of tools. One such tool involves applying the principles of psychoanalysis to acquire insights into the minds of key leaders, with an eye to facilitating predictions as to how they might react in certain circumstances.

For U.S. intelligence, this common-law marriage of psychoanalysis and intelligence work dates back to the early 1940s, when CIA’s forerunner, the Office of Strategic Services commissioned two studies of Adolf Hitler.

We call such assessments “at-a-distance leader personality assessments.” Many were quite useful. VIPS found the 2004 book Bush on the Couch, by Washington psychiatrist Justin Frank, MD, a very helpful assessment in this genre. We now have two more years of experience of observing Bush closely.

As we watched the pressure build on President Bush, looked toward the additional challenges we expect him to face over the next 18 months, and pondered his tendency to disregard the law and the Constitution, we felt very much in need of professional help in trying to estimate what kinds of decisions he is likely to make.

Dr. Frank, it turned out, had been thinking along the same lines, when we asked to meet with him just three weeks ago. What follows is a collaborative Frank-VIPS effort, with the psychological insights volunteered by Dr. Frank, who shares the imperative we feel to draw on all disciplines to assess what courses of action President George W. Bush is likely to decide upon in reacting to reverse after reverse in the coming months.

Parental discretion advised. The outlook is not only somber but potentially violent—and includes all manner of threats born of George W. Bush’s mental state (as well as the unusual relationship he has with his vice president).

Things are going to hell in a hand basket for this administration, and Bush/Cheney have shown a willingness to act in extra-Constitutional ways, as they see fit.

While Bush and his advisers make a fetish of it, he is nonetheless commander in chief of the armed forces and the question becomes how he might feel justified in using them and is there still any restraining force—any checks on the increasing power of the executive in our three-branch government.

We have a president whose psychological makeup inclines him to do as he pleases. Because Congress has been cowed, and the judiciary stacked with loyalists, he has gotten away with it—so far.

But the polls show growing discontent among the people, especially over the war in Iraq. Congress, too, is starting to challenge the executive, as it should—but slowly, slower than it should. The way things are moving, there is infinite opportunity to diddle and dodge—in effect conducting business pretty much as usual over the next 18 months.

Could Start Another War...

Meanwhile, the president may well feel free to start another war, with little reference to the Congress or the UN, against Iran.

The commander of CENTO forces, Admiral William Fallon is quoted as having said we “will not go to war with Iran on my watch.” Tough words; but should the president order an attack on Iran, chances are Fallon and others will do what they are accustomed to doing, salute smartly and carry out orders, UNLESS they show more regard for the U.S. Constitution than the president does.

There is an orderly remedy written into the Constitution aimed at preventing a president from usurping the power of the people and acting like a king; the process, of course, is impeachment.

The usual focus on impeachment is on abuses of the past, and a compelling case can surely be made. We believe an equally compelling incentive can be seen in looking toward the next 18 months.

In this paper, we are primarily concerned about what future misadventures are likely if this administration is not somehow held to account; that is, if Bush and Cheney are not removed from office.

Unless Checked

If the constitutional process of impeachment is under way when President Bush orders our military to begin a war against Iran, there is a good chance that, rather than salute like automatons and start World War III, our senior military would find a way to prevent more carnage until such time as the representatives of the people in the House have spoken.

This administration’s capacity for mischief would not end until conviction in the Senate. But initiating the impeachment process appears to be the only way to launch a shot across the bow of this particular ship of state. For it is captained by a president with a psychological makeup likely to lead to new misadventures likely to end in a ship wreck unless the Constitution is brought alongside and a new pilot boarded.

We are grateful that Dr. Frank agreed to collaborate with us and to issue under VIPS auspices the psychological assessment that follows.

Discussion of the three scenarios after his profiling of President Bush was very much a collaborative exercise aimed at applying Frank’s insights to contingencies our president may have to address before he leaves office. Our conclusions are, of necessity, speculative—and, sorry, scary.

The Assessment of Dr. Frank:

If a patient came into my consulting room missing an arm, the first question I would ask is, “What happened to your arm?” The same would be true for a patient who has no guilt, no conscience. I would want to know what happened to it.

No Conscience

George W. Bush is without conscience, and it would require a lengthy series of clinical sessions to find out what happened to it. By identifying himself as all good and on the side of right, he has been able to vanquish any guilt, any sense of doing wrong.

In Bush on the Couch I gave examples illustrating that remarkable lack of conscience. From his youthful days blowing up frogs with firecrackers to his unapologetic public endorsement of torture, there has been no change.

Observers are gradually becoming aware of this fundamental deficit. For example, after watching the president’s press conference on July 12, Wall Street Journal columnist Peggy Noonan wrote, “He doesn't seem to be suffering, which is jarring. Presidents in great enterprises that are going badly suffer: Lincoln, LBJ with his head in his hands. Why doesn't Mr. Bush?”

No Shame

George W. Bush seems also to be without shame. He expresses no regret or embarrassment about his failure to help Katrina victims, or to tell the truth. He says whatever he thinks people want to hear, whether it be “stay the course” or “I’ve never been about ‘stay the course.’” He does whatever he wants.

He lies—not just to us, but to himself as well. What makes lying so easy for Bush is his contempt—for language, for law, and for anybody who dares question him.

That he could say so baldly that he’d never been about “stay the course” is bone chilling. So his words mean nothing. That is very important for people to understand.

Fear of Humiliation

Despite having no shame, Bush has a profound fear of failure and humiliation. He defends himself from this by any means at his disposal—most frequently with indifference or contempt.

He will flinch only if directly confronted about being a failure or a liar. Otherwise world events are enough removed from him that he can spin them into his intact defense system.

This deep fear helps to explain his relentlessly escalating attacks on others, his bullying, and his use of nicknames to put people down. There is fear of being found out not to be as big in every way as his father.

What a burden to have to face his many inadequacies—now held up to the light of day—whether it is his difficulty in speaking, thinking, reading, managing anxiety, or making good decisions. He will not change, because for him change means humiliating collapse. He is very fearful of public exposure of his many inadequacies.

Contempt for Truth?

Contempt itself is a defense, a form of self-protection, which helps Bush appear at ease and relaxed—at least to big fans like New York Times columnist David Brooks.

The president’s contempt defense protects his belief system, a system he clings to as if his beliefs were well-researched facts. His pathology is a patchwork of false beliefs and incomplete information woven into what he asserts is the whole truth.

What gets lost in this process is growth—the George W. Bush of 2007 is exactly the same as the one of 2001. Helen Thomas has said that of all the presidents she has covered over the years, Bush is the least changed by his job, by his experience. This is why there is no possibility of dialogue or reasoning with him.

Sadistic

His certitude that he is right gives him carte blanche for destructive behavior. He has always had a sadistic streak: from blowing up frogs, to shooting his siblings with a b-b-gun, to branding fraternity pledges with white-hot coat hangers.

His comfort with cruelty is one reason he can be so jocular with reporters when talking about American casualties in Iraq. Instead of seeing a president in anguish, we watch him publicly joking about the absence of “weapons of mass destruction” in Iraq, in the vain search for which so many young Americans died.

Break It!

Bush likes to break things, needs to break things. And this is most shockingly seen in how he is systematically destroying our armed forces.

In the early days of the Iraq invasion he refused to approve the large number of troop the generals said were needed in order to try to invade and pacify Iraq and acquiesced in the firing of any general who disagreed.

He turned a blind eye to giving the troops proper equipment and cut funding for needed health care. Health care and other social programs have one thing in common: they are paid for by public funds.

It may well be that, unconsciously, the government represents his neglectful parents, and those helped by the government represent the siblings he resents. If George W. Bush wanted to destroy his own family, he could scarcely have done better. Thanks to him, no Bush is likely to be elected to high office for generations to come.

Where Does This Leave Us?

It leaves us with a regressed president who needs to protect himself more than ever from diminishment, humiliation, and collapse. He is so busy trying to manage his own anxiety that he has little capacity left to attend to national and world problems.

And so, we are left with a president who cannot actually govern, because he is incapable of reasoned thought in coping with events outside his control, like those in the Middle East.

This makes it a monumental challenge—as urgent as it is difficult—not only to get him to stop the carnage in the Middle East, but also to prevent him from undertaking a new, perhaps even more disastrous adventure—like going to war with Iran, in order to embellish the image he so proudly created for himself after 9/11 as the commander in chief of “the first war of the 21st century.”

Iran would make number three—all the compelling reasons against it notwithstanding

* * *

Contingencies:

We will now attempt to put flesh on the discussion by positing and examining scenarios that would force Bush to react, and applying the observations above and other data to forecast what form that reaction might take.

Outlined below are three illustrative contingencies, each of which would pose a neuralgic threat to George W. Bush’s shaky self-esteem, his over-determined efforts to stave off humiliation, and his unending need for self-protection.

These are not seat-of-the-pants scenarios. Each of them is possible—arguably, even probable. The importance of coming up with educated guesses regarding Bush’s response BEFORE they occur is, we hope, clear.

Scenario A: Destructive Attack on the Green Zone

The U.S. military is out in front of Defense Secretary Robert Gates and other policymakers in Washington in seeing the hand of Iran’s government behind “the enemy” in Iraq.

On July 26, the operational commander of U.S. forces in Iraq, Lt. Gen. Raymond Odierno, blamed the recent “significant improvement” in the accuracy of mortar and rocket attacks on the Green Zone on “training conducted inside Iran.” Odierno also repeated that roadside bombs are being smuggled into Iraq from Iran.

Last week, Gen. David Petraeus warned that insurgents intend to “pull off a variety of sensational attacks and grab the headlines to create a ‘mini-Tet.’” (Tet refers to the surprise country-wide offensive mounted by the Vietnamese Communists in early 1968, which indicated to most Americans that the war was lost.)

Attacks on the Green Zone have doubled in recent months. Despite this, the senior military appear to be in denial with respect to the vulnerability of the Green Zone—oblivious even to the reality that mortar rounds and rocket fire have little respect for walled enclaves.

Anyone with a mortar and access to maps and images on Google can calibrate fire to devastating effect—with or without training in Iran. It is just a matter of time before mortar round or rocket takes out part of the spanking new $600-million U.S. embassy together with people working there or nearby.

And/or, the insurgents could conceivably mount a multi-point assault on the zone and gain control of a couple of buildings and take hostages—perhaps including senior diplomats and military officers.

Given what we think we know of George Bush, if there were an embarrassing attack on U.S. installations in the Green Zone or some other major U.S. facility, he would immediately order a retaliatory series of air strikes, and let the bombs and missiles fall where they may.

The reaction would come from deep within and would warn, in effect: This is what you get if you try to make me look bad.

Scenario B: Israeli Attack on Nuclear Targets in Iran.

This would be madness and would elicit counterattacks from an Iran with many viable options for significant retaliation. Nevertheless, Sen. Joe Lieberman (D, Conn) and his namesake Avigdor Lieberman, Israel’s minister of strategic affairs, are openly calling for such strikes, which would have to be on much more massive a scale than Israel’s bombing of Iraq’s nuclear reactor at Osirak in 1981.

For that attack in 1981, Cheney, a great fan of preemptive strikes, congratulated the Israelis, even though the U.S. joined other UN Security Council members in unanimously condemning the Israeli attack.

Five years ago, on Aug. 26, 2002, Cheney became the first U.S. official publicly to refer approvingly to the bombing of Osirak. And in an interview two and a half years ago, on Inauguration Day 2005, Cheney referred nonchalantly to the possibility that “the Israelis might well decide to act first [to eliminate Iran’s nuclear capabilities] and let the rest of the world worry about cleaning up the diplomatic mess afterwards.”

One thing Cheney says is indisputably—if myopically—true: Bush has been Israel’s best friend. In his speeches, he has fostered the false impression that the U.S. is treaty-bound to defend Israel, should it come under attack—as would be likely, were Israel to attack Iran.

With the U.S. Congress firmly in the Israeli camp, Cheney might see little disincentive to giving a green-light wink to Israel and then let the president “worry about cleaning up.”

Reporting from Seymour Hersh’s administration sources serve to strengthen the impression shining through Bush’s speeches that he is eager to strike Iran. But how to justify it?

Curiously, a National Intelligence Estimate on Iran’s nuclear capability, a study scheduled for completion early this year, has been sent back several times—probably because its predictions are not as alarmist as the warnings that Cheney and the Israelis are whispering into the president’s ear.

Senior U.S. military officers have warned against the folly of attacking Iran, but Cheney has shown himself, time and time again, able to overrule the military.

But What if Impeachment Begins?

Is there nothing to rein in Bush and Cheney? It seems likely that only if impeachment proceedings were under way would senior officers like CENTCOM commander, Admiral William Fallon, be likely to parry an unlawful order to start yet another war without the approval of Congress and the UN.

With impeachment under way, such senior officers might be reminded that all officers and national security officials swear an oath to protect and defend the Constitution of the United States—NOT to protect and defend the president.

It was a highly revealing moment when on July 11, former White House political director Sara Taylor solemnly reminded the Senate Judiciary Committee, that as a commissioned officer, “I took an oath and I take that oath to the president very seriously.”

Committee chair Patrick Leahy had to remind Taylor: “We understand your personal loyalty to President Bush. I appreciate you correcting that your oath was not to the president, but to the Constitution.”

The most senior officers, military included, can get their loyalties mixed up. And this is of transcendent importance in a context described by Seymour Hersh: “These guys are scary as hell...you can’t use the word ‘delusional,’ for it’s actually a medical term. Wacky. That’s a fair word.”

One does not need psychoanalytic training to see that Bush and Cheney do not care about facts, treaties (or the lack thereof), or other legal niceties, unless it suits their purpose. This gives an even more ominous ring to what Hersh is hearing from his sources.

If Israel attacks Iran, President Bush is likely to spring to Israel’s defense, regardless of whether he was inside or outside the loop before the attack; and the world will see a dangerously widened war in the Middle East.

Psychologically, Bush would almost certainly need to join the attack, mainly to sustain his illusion of safety and masculinity. And Cheney, knowing that, would be pushing him hard on U.S. energy and other perceived strategic interests.

Scenario C: Congress Cuts War Funding This Fall

We posit that Congress finally grows weary of the increasingly obvious bait-and-switch, the “we-need-more-time” tactic, and cuts off all funding except for that needed to bring the troops home.

The talk now is about getting a “meaningful” progress report in November, because September is said to be too soon. The Iraqi parliament is behaving much like its American counterpart by taking August off. But our soldiers do not get a month-long hiatus from constant danger.

It is clear even to the press that the surge has simply brought more American deaths and an upsurge of insurgent attacks. What is less clear is why Bush remains so positive. It is probably not just an act, but an idée fixe he needs to hold onto tightly.

Since doubt is dangerous, we see a compensatory smile fixe on the face of the president and other senior officials, dismissing any trace of uncertainty or doubt.

If Congress cut off funding for war in Iraq, Bush might well cast about for a casus belli to “justify” an attack on Iran.

Would the senior military again go along with orders for an unprovoked, unconstitutional war on a country posing no threat to the U.S.? Hard to say.

In this context, an ongoing impeachment process could provide welcome evidence that influential members of Congress, like many senior military officers, see through Bush’s need to strike out elsewhere. Military commanders might think twice before saluting smartly and executing an illegal order.

In such circumstances, Dick “it-won’t stop-us” Cheney, could be expected to try to pull out all the stops. But if he, too, were in danger of being impeached, uniformed military officers could conceivably block administration plans.

There is only a remote chance that Defense Secretary Gates would be a tempering voice in all this. Far more likely, he would smell in any restrictive legislation traces of the Boland amendment, which he assisted in circumventing during the Iran-Contra misadventure.

Petraeus ex Machina

With “David” or “General Petraeus” punctuating the president’s every other sentence at recent press conferences, the script for September seems clear. This is one four-star general with exquisite PR and political acumen—pedigree and discipline the president can count on.

And with his nine rows of ribbons, he calls to mind the U.S. commander in Saigon, Gen. William Westmoreland at a similar juncture in Vietnam (after the Tet offensive when popular support dropped off rapidly).

It is virtually certain that Petraeus will press hard for more time and more troops. Potemkin-style improvements will be used by Bush to justify continuing the “new” surge strategy, with the calculation that enough Democrats might be overcome by the fear of being charged with “losing Iraq.”

In the past Bush seems to have bought Cheney’s “analysis” that increased enemy attacks were signs of desperation. Hard as it is to believe that Bush has not learned from that repeated experience, it is at the same town possible to “misunderestimate” one’s capacity for wooden-headedness, particularly with respect to someone with the psychological makeup of our president.

He is extraordinarily adept at finding only rose-colored glasses to help him see.

With Cheney egging him on from the wings of the “unitary executive,” but Congress no longer bowing to that novel interpretation of the Constitution, Bush will be sorely tempted to lash out in some violent way, if further funding for the war is denied.

To do that effectively, he will need senior generals and admirals as co-conspirators. It will be up to them to choose between career and Constitution. All too often, in such circumstances, the tendency has been to choose career.

Impeachment hearings, though, could encourage senior officers like Admiral Fallon to pause long enough to remember that their oath is to defend the Constitution, and that they are not required to follow orders to start another war in order to stave off political and personal disaster for the president and vice president.

Justin Frank, M.D.

With,

David MacMichael
Tom Maertens
Ray McGovern
Coleen Rowley

Steering Group
Veteran Intelligence Professionals for Sanity

Virginia Tech Shooter's History Raised Red Flags Wherever He Went

Virginia Tech teachers attest lonely figure could be a menacing classroom presence

The
Washington Post reports:
They met across the professor's desk. One on one. The chairman of the English department and the silent, brooding student who never took his sunglasses off.

He had so upset other instructors that Virginia Tech officials asked if she wanted protection. Lucinda Roy declined. She thought Cho Seung Hui exuded loneliness, and she volunteered to teach him by herself, to spare her colleagues. The subject of the class was poetry.

Roy, other officials, investigators, acquaintances and neighbors Tuesday helped fill in a dark portrait of the bespectacled young South Korean citizen who had sought bizarre expression in literature and then massacred 32 fellow students and teachers here Monday in the worst shooting rampage in U.S. history. As police closed in, he shot himself and was found on the floor of a classroom building with his weapons nearby.

Cho, of Centreville, Va., the son of immigrants who run a dry cleaning business, and the brother of a State Department contractor who graduated from Princeton, was described by those who encountered him over the years as at times angry, menacing, disturbed and so depressed that he seemed near tears.

He often spoke in a whisper, if at all, refused to open up to teachers and classmates, and kept himself locked behind a facade of a hat, sunglasses and silence.

Authorities still are not sure what set him off Monday, and what propelled him as he stalked the halls and classrooms of Norris Hall with two semiautomatic pistols, chaining doors closed and murdering and maiming as he went.

Authorities found two three-page notes in his dorm room after the shootings. They weren't suicide notes and provided no clue about why he did what he did. Instead, they were expletive-filled riffs against the rich and privileged, even naming people who he thought had kept him down, federal and state law enforcement sources said. Two government officials said he had been treated for mental health problems.

Police also are uncertain why Cho stopped, shooting himself to death in Norris Hall, where most of his victims lay scattered around him.

Any comprehension of what happened seemed to come only in hindsight.

Cho appears first to have alarmed the noted Virginia Tech poet Nikki Giovanni in a creative writing class in fall 2005, Giovanni said.

Cho took pictures of fellow students during class and wrote about death, she said in an interview. "Kids write about murder and suicide all the time. But there was something that made all of us pay attention closely. None of us were comfortable with that," she said.

The students once recited their poems in class. "It was like, ‘What are you trying to say here?' It was more sinister," she said.

Days later, seven of Giovanni's 70 or so students, showed up for a class. She asked students why the others didn't show up and was told that they were afraid of Cho.

"Once I realized my class was scared, I knew I had to do something," she said.

She approached Cho and told him that he needed to change the type of poems he was writing or drop her class. Giovanni said Cho declined to leave and said, "You can't make me."

Giovanni said she appealed to Roy, who then taught Cho one-on-one. Roy, 51, said in a telephone interview that she also urged Cho to seek counseling and told him that she would walk to the counseling center with him. He said he would think about it.

Roy said she warned school officials. "I was determined that people were going to take notice," Roy said. "I felt I'd said to so many people, ‘Please, will you look at this young man?' "

Roy, now the alumni distinguished professor of English and co-director of the creative writing program, said university officials were responsive and sympathetic to her warnings but indicated that because Cho had made no direct threats, there was little they could do.

"I don't want to be accusatory or blaming other people," Roy said. "I do just want to say, though, it's such a shame if people don't listen very carefully and if the law constricts them so that they can't do what is best for the student."

Cho wrote poems, a novel and two plays, acquaintances and officials said, in addition to the rambling multi-page "manifesto" directed against the rich, the spoiled and the world in general, which police found in his dorm room.

Paul Kim, a senior English major, said Cho was so withdrawn on campus that he did not know "we had a Korean person who was in the English department and was male until I met him in class."

"He never spoke a word," Kim said. "Even when the professor asked questions, he never spoke. He constantly looked physically and emotionally down like he was depressed. I had a strong feeling to talk to him on the first day of class, but I didn't get to talk to him because he sat right beside the door and as soon as class was over he left."

For Kim, one detail stood out. The classroom was rectangular. The class was split in half with one half of the class facing the other. "I always sat directly across, looking directly at him," Kim said. "He never looked up."

Kim said he might have seen signs of Cho's deterioration: He disappeared from class.

"For the past month, he stopped coming," Kim said.

Charlotte Peterson, a former Virginia Tech student, said she shared a British literature class with Cho in 2005. On the first day, when the instructor asked students to write their names on a sheet of paper and hand it up, Cho wrote a question mark.

"Even the teacher laughed at him," Peterson said. "Nobody understood him."

Brooke Kistner, 22, a senior English major from Chester, Va., said she had three classes with Cho.

"He would keep his headphones on a lot," she said. "I remember one instance where the teacher had addressed a question to him and he really just stared off into space. He didn't even recall acknowledging that she was talking to him. We were like what are you doing? The teacher said, ‘Will you please see me after class?' and he still didn't even acknowledge her. It was an awkward silence, and then she went back to lecturing."

In his Centreville community, residents recalled him as strange young man.

"He just seemed odd," said Greg Kearns, a neighbor who tried unsuccessfully now and then to strike up conversation with Cho.

Kearns recalled seeing Cho in front of his parent's townhouse a few years ago. Kearns was walking his dog. When he said hello, Cho turned his head and shoulders away. "It was like he was carrying on a conversation with himself," Kearns said.

Abdul Shash, who lives next door to the Chos, said Cho never seemed to have any friends over the years.

"If you walk and you come close to him, he'd walk away," Shash said. "I have kids and he never talked to them."

Shash described Cho's parents as quiet, modest and hardworking people, who seemed devoted to helping their son. During his years at Virginia Tech, his parents regularly shuttled him to and from Blacksburg, more than four hours each way.

"Nobody knows him really," Shash said. "He's always quiet. When I talk to him, there's no response."

Cho graduated from Westfield High School in Chantilly in 2003. He turned 23 on Jan. 18 and had lived as a legal permanent resident since entering the United States through Detroit on Sept. 2, 1992, when he was 8 years old, according to the Department of Homeland Security.

Cho held a green card through his parents, and he renewed it Oct. 27, 2003, according to Homeland Security. He listed his residence as Centreville.

Cho's sister, Sun Cho, graduated from Princeton University with a degree in economics in 2004 after she completed summer internships with the State Department in Washington and Bangkok.

A State Department spokesman said Sun Cho currently works as a contractor specializing in personnel matters.

Investigators said Cho procured one of the guns he used in the rampage, a Walther .22, on Feb. 9 from a pawnshop on Main Street in Blacksburg near the Virginia Tech campus.

On March 16, he bought the second gun, a 9mm Glock 19, from Roanoke Firearms, a gun shop on Cove Road in Roanoke.

He used his driver's license as identification and had no problem buying the guns because he was complying with Virginia law, which permits the purchase of one gun a month, investigators said.

The Glock was used in two shootings, first in a dormitory and then in Norris Hall more than hours later, officials said. A surveillance tape, which has now been watched by federal agents, caught Cho buying the Glock, sources said. Both guns are semiautomatic, which means that one round is fired for every finger pull.

Cho reloaded several times, using 15-round magazines for the Glock and 10-round magazines for the Walther, investigators said, adding that he had the cryptic words, "Ismale Ax," tattooed on one arm. Although there are many theories, sources said, no one knows what it truly means.

As the university mourned Tuesday and the identities of the dead were made public, more details of Monday's tragedy emerged.

One of Cho's suite mates in Harper Hall said the killer began the day looking like he had every other day since moving in. Karan Grewal said Cho's face was blank and expressionless. "He didn't have a look of disgust or anger," Grewal said. "He never did. There was always just one look on his face."

In August, when Grewal, Cho and four others moved in, Cho's suite mates tried to talk to him but never got a word in return.

"My impression was that he's shy," said Grewal, 21, a senior accounting major who lived in a room across the hall. "He never looked anyone in the eye. If you even say hi, he'd keep walking straight past you."

The six students lived two to a room in a three-bedroom, one-bathroom suite. The others never saw Cho with any women or friends. He would turn his head away to avoid conversation. His room had the typical college dorm look, strewn with cereal boxes and clothes, Grewal said.

Recently, Cho had started going to the gym. Beside that his suitemate had been behaving exactly as he always had.

"He had that blank expression," Grewal said, "nothing else."