11.19.21

the bodhi tree

Posted in Uncategorized at 7:17 pm by Administrator

every morning that i drive to my clinic, i am distinctly aware of the way that i feel about the day ahead. it is always the toughest day of my week. sometimes, i feel that it comes so close to breaking my spirit. even after nineteen years of seeing patients, the job gets no easier for me, and sometimes it drives me to despair. and this is without a doubt due to the nature of the work: spending time with poor, suffering people, absorbing their anger and pain, managing the secondary trauma that i accumulate on account of joining their life journeys. the secondary trauma in primary care is unique and unlike the experience one might have with acutely ill patients in the hospital or as a paramedic in the community. it is the grind of seeing patients relentlessly suffer through the many intricate and stubborn barriers that our healthcare system erects to block their access to the people that can most help them. it is the steadily building frustration and futility of absorbing the anger of patients that we cannot save. it is the grueling experience of disappointing their hopes and watching them deteriorate on account of innumerable inimical factors that one cannot control.

my drive to my clinic takes me down a stretch of road lined with beautiful trees. there are two trees in particular, planted on a median strip, that are magnificent, framed as they are against the backdrop of the mountains in the distance. i never fail to be struck by the view. and as i drive under their boughs, i never fail to feel touched by the essence of those living trees and the leaves that they surrender in the fall season. lately, i have come to sense the great awareness of those trees, a quality that builds upon but is not limited to the uncountable invisible interactions those trees have with the air and with the soil deep in the earth where their branches silently and profoundly extend. but this contemplation is for another time. it suffices to say that the trees have extended great kindness to me over the years, and they have reminded me that consciousness is not as human or fleeting as i have been led to believe. there is a grand consciousness pervading this universe, and even after this suffering form that i call myself ceases to exist, the consciousness that i think of as myself will not cease to be connected to everything here.

in their season, these trees shed everything that we think of as their beauty and grandeur. we look at this and feel both awe and sadness, because it looks like death of a kind. but the trees have told me that they are not the leaves, and the passage of the leaves does not signify sadness or loss for them at all. every year, they surrender their leaves and become bare, twisting, dark, and solitary, because it pleases them to do so, and because it demonstrates a profound truth that resonates throughout the universe: that form does not fully capture what life is, and that emptying oneself of form is how the living experience the truest connection with other life. when i consider this, in the context of the daily ritual of observing and sharing in the suffering of human beings, i am reminded that i am not the complete and intact being who is being assaulted by the complaints and feelings of lesser people; rather, i am the one who will be simple, aware, and without direction. i will hold up my leaves and all the beauty and wisdom they might appear to represent; then i will surrender those leaves and be as nothing, and i will be no less of myself for it. giving, receiving, living, dying, prospering, and suffering—these are words and ideas that we put to the very simple process of growing these leaves and then surrendering them. it is without necessity or meaning, but it is all that living is

11.16.21

NFL Mock #4

Posted in Uncategorized at 7:03 pm by Administrator

i think that over the past week i’ve landed on a new understanding of what the eagles should do with their three first-round picks in the 2022 draft. Here are the relevant developments that have influenced my position:

1. garrett wilson really is that good. his domination of purdue was impressive on so many levels, and as if expectations weren’t high enough, he seems to be taking his game to even higher levels. don’t look now, but wilson is putting himself on the same level as top-10 receivers in recent years—and i think he merits the hype. meanwhile, the eagles are enjoying a breakout season from devonta smith but so clearly lack any legitimate 2nd receiver on the roster. never mind the recent wasted picks on jj and jalen; the eagles owe it to jalen hurts to upgrade one of the worst wide receiver groups in the NFL.

2. jalen hurts is improving. now that we’re past the midpoint of the season and can judge him for the highs and the lows, it should be obvious to everyone now that jalen hurts is solid, sometimes spectacular, and never out of his league. he’s a stronger bet to succeed than any of the quarterbacks coming out in the 2022 draft, and he’s also making russell wilson and deshaun watson look like unnecessary risks for a team that’s on a good trajectory. we should use our picks to support hurts, not to replace him.

3. our defensive ends are looking less and less impressive by the week, and there’s absolutely no doubt now that derek barnett cannot be a candidate for an extension. we have no replacements for him on this roster. we have to draft our defensive end of the future. the 2022 defensive end group isn’t just thibodeaux and everyone else. it’s a potentially elite group at the top that features blue chippers like aidan hutchinson, george karlaftis, and kingsley enagbare—guys that each might have been highly acclaimed pass rushers in other draft classes.

so with that all that in mind, here’s where i’m landing with the eagles in the 1st round: a defensive end, a defensive back, and a wide-out to complement devonta smith. we’ll get our o-lineman in round 2, when plenty of exciting talent (i.e. zion johnson, andrew voorhees, sean rhyan) will still be on the board, and i imagine we’ll take a safety or linebacker in round 3 or day 3, wherever there’s value.

2022 Mock Draft: 1st Round

1. Detroit: Kayvon Thibodeaux
2. Houston: Derek Stingley
3. Jacksonville: Evan Neal
4. NY Jets: Aidan Hutchinson
5. New York Giants: Kyle Hamilton
6. Philadelphia (from Miami): Garrett Wilson *
7. Washington: Malik Willis
8. Carolina: DeMarvin Leal
9. New York Giants (from Chicago): Ikem Ekwonu
10. New York Jets (from Seattle): Kenyon Green
11. Philadelphia: George Karlaftis *
12. Minnesota: Kingsley Enagbare
13. Denver: Matt Corral
14. Atlanta: Jordan Davis
15. Philadelphia (from Indy): Kaiir Elam *
16. New England: Chris Olave
17. Pittsburgh: Carson Strong
18. Kansas City: Drake Jackson
19. Miami (from San Francisco): Treylon Burks
20. Las Vegas: Tyler Linderbaum
21. Dallas: Myjai Sanders
22. New Orleans: Ahmad Gardner
23. Cincinnati: Charles Cross
24. Tennessee: Nakobe Dean
25. Green Bay: Jameson Williams
26. Arizona: Trent McDuffie
27. Cleveland: Drake London
28. LA Chargers: Andrew Booth
29. Baltimore: Sean Rhyan
30. Tampa Bay: Darian Kinnard
31. Detroit (from LA Rams): Isaiah Spiller
32. Buffalo Bills: Roger McCreary

11.10.21

Mock Draft #3

Posted in Uncategorized at 11:46 pm by Administrator

i’m still betting that the eagles will close this season on a 6-2 tear and make playoffs, then beating the cowboys in the wild card round to cap a season of spectacular surprises. jalen hurts will develop touch and accuracy in the passing game, jalen reagor will emerge as a viable 2nd receiver, and davion taylor and k’von wallace will break out as legitimate defensive starters in the latter half of the season.

however, in this mock draft, i assume for arbitrary reasons that the eagles underperform down the stretch and end up 7-10, good for 11th in the draft order. i have them picking 6th (courtesy of miami), 11th, and 15th (courtesy of indy). i think this is a reasonable estimation of where the eagles will be drafting in april, as miami is unlikely to be a bottom 5 team based on projected wins, and as indianapolis is likely going to post a losing record over their very difficult final stretch of the season. regardless, eagle fans do not need to worry about the colts yielding us a pick worse than 18th, as it is nearly impossible to see them getting past all of las vegas, new england, kansas city, and pittsburgh for that last AFC playoff berth.

here’s the 1st round, and i’ll get into details about our picks afterwards.

2022 Mock Draft: 1st Round

1. Detroit: Kayvon Thibodeaux
2. Houston: Derek Stingley
3. Jacksonville: Evan Neal
4. NY Jets: Aidan Hutchinson
5. Washington: Matt Corral
6. Philadelphia (from Miami): Kyle Hamilton *
7. New York Giants: DeMarvin Leal
8. Carolina: Malik Willis
9. New York Giants (from Chicago): Chris Olave
10. New York Jets (from Seattle): Kenyon Green
11. Philadelphia: Kingsley Enagbare *
12. Minnesota: George Karlaftis
13. Denver: Sam Howell
14. Atlanta: Jordan Davis
15. Philadelphia (from Indy): Ikem Ekwonu *
16. New England: Garrett Wilson
17. Pittsburgh: Carson Strong
18. Kansas City: Drake Jackson
19. Miami (from San Francisco): Kaiir Elam
20. Las Vegas: Tyler Linderbaum
21. Dallas: Adam Anderson
22. New Orleans: Ahmad Gardner
23. Cincinnati: Charles Cross
24. Tennessee: Myjai Sanders
25. Green Bay: Drake London
26. Arizona: Trent McDuffie
27. Cleveland: Treylon Burks
28. LA Chargers: Andrew Booth
29. Baltimore: Jaxson Kirkland
30. Tampa Bay: Darian Kinnard
31. Detroit (from LA Rams): Isaiah Spiller
32. Buffalo Bills: Noah Daniels

this is the second draft in which i have the eagles taking ikem ekwonu, the 6′4″ 320 pound absolute bully of an offensive lineman coming out of the wolfpack. he’s going to continue to have a featured place in my eagles mocks, for a variety of reasons. first, he’s one of 10 players in this draft that i consider to be transformational players; he has a shot at being a pro bowler in the NFL. second, the eagles continue to struggle with continuity and consistency at the guard positions on the line, and we really owe it to landon dickerson to stop using him as a rotational guard. third, we need to move on from brandon brooks, who is overpaid and no longer reliable.

i think that the eagles need to come out of round one with a premiere defensive back, an effective edge rusher, and a dominant interior o-lineman. i put those three positional needs ahead of linebacker and wide receiver (the 4th and 5th most imminent draft needs) because of the intersection of need with value in this draft class. to put it simply, i’m not sure that the quality of linebackers and receivers in this draft class warrants a day one investment, particularly when the top linemen in this class are so notable. kingsley enagbare in particular looks like a prototypical fit for the eagle offense, based on his measurables and his play style. pound for pound, he will exceed derek barnett in power, speed, and skill and amp up a philadelphia pass rush that has been inconsistent and sometimes pitifully bad. one could legitimately point to cornerback and linebacker as more obvious deficiencies on this roster, but i’d argue that our edge group has never looked so bad, and in the absence of pressure we will never have a chance at a lock-down defense.

if the eagles pick 6th or 7th and both stingley and hamilton are off the board, demarvin leal will be a popular projection to the eagles, but i’d sooner trade down from that pick than take leal. we already have a hybrid 6′3″ 290 pound athletic freak on the d-line in milton williams, and demarvin leal would simply be a redundant and difficult fit for our d-line group. i might even prefer drake jackson for the eagles to demarvin leal for this very reason.

i’m still a fan of nakobe dean, but when it comes down to it, a potentially elite interior offensive lineman is more important to the future of the eagles than a solid linebacker. if we end up taking hamilton, enagbare, and ekwonu as i’ve projected here, then my picks on day two would focus on linebacker and receiver. i’d have my eyes on alabama’s #1 receiver jameson williams in round two, and i’d look for demarvion overshown in round three

10.29.21

Mock Draft #2

Posted in Uncategorized at 11:40 pm by Administrator

starting early with the mocks, which tells you where i’m at as an eagles fan. in this draft, i abandon my naive optimism about a late-season run and place the eagles 10th in the draft order.

here’s my 1st round mock, and i’ll go through each eagle pick afterwards.

2022 Mock Draft: 1st Round

1. Detroit: Kayvon Thibodeaux
2. Houston: Kyle Hamilton
3. Jacksonville: Evan Neal
4. NY Jets: Aidan Hutchinson
5. Philadelphia (from Miami): Derek Stingley *
6. New York Giants: DeMarvin Leal
7. Washington: Matt Corral
8. Carolina: Malik Willis
9. New York Giants (from Chicago): Chris Olave
10. Philadelphia: Treylon Burks *
11. Atlanta: Jordan Davis
12. Minnesota: George Karlaftis
13. Denver: Sam Howell
14. New York Jets (from Seattle): Kenyon Green
15. Philadelphia (from Indy): Ikem Ekwonu *
16. New England: Garrett Wilson
17. Pittsburgh: Carson Strong
18. Kansas City: Kingsley Enagbare
19. Miami (from San Francisco): Kaiir Elam
20. Las Vegas: Tyler Linderbaum
21. Dallas: Adam Anderson
22. New Orleans: Ahmad Gardner
23. Cincinnati: Charles Cross
24. Tennessee: Myjai Sanders
25. Green Bay: Drake London
26. Arizona: Trent McDuffie
27. Cleveland: Drake Jackson
28. LA Chargers: Andrew Booth
29. Baltimore: Jaxson Kirkland
30. Tampa Bay: Darian Kinnard
31. Detroit (from LA Rams): Isaiah Spiller
32. Buffalo Bills: Noah Daniels

pick 5:

i think there’s a strong probability that one quarterback will go in the top 5, but i’m not sure which qb and which team (whether detroit or houston). if either the texans or lions decide to take a chance on a promising but raw quarterback at the top of this draft, then philadelphia will have an interesting question at pick 5: take a qb, trade down with a qb-hungry team, or take the best player available right here and never look back.

i don’t have enough faith in either malik willis or matt corral to take a QB at #5. even if the eagles end up being the 10th worst team in the league this season after a series of face-plants by jalen hurts, this is not the year to go all in on a rookie quarterback. i’d prefer taking the best player available at #5 and giving gardner minshew a full season to sink or swim with sirianni before potentially moving on from them both in 2023.

i think there’s a decent chance that derek stingley will fall to #5 because of his injury and because of the rapid ascension of aidan hutchinson, who may or may not be the next nick bosa. i would also be happy taking kyle hamilton here if it’s hamilton, not stingley, who falls out of the top 4. the eagles must get a sure thing in the secondary in this draft, and it has to be either stingley or hamilton with our first pick.

pick 10:

if the eagles get their cornerstone defensive back with pick 5, then the question facing them at pick 10 is whether to go with wide receiver or defensive end. even if we move on from derek barnett at the end of this season, it’s getting harder for me to imagine the eagles would lean toward an edge player at #10, even though it’s a premium position and unfortunately an emerging weakness for this floundering defense. kingsley enagbare would be very tempting here and might instantly be our best pass rusher in his rookie season; but the fact is that the eagles have invested too much money and recent draft capital in the defensive line to splurge yet again. josh sweat, milt williams, terron jackson, and patrick johnson may not be a very inspiring rotation next year, but at some point we’re going to have to give the dubious class of ‘21 a chance to prove themselves.

obviously we’ve spent an embarrassing amount of draft capital on the receiver position, but the situation at WR is cut and dry regardless: we have almost nothing to show for three straight years of 1st and 2nd round picks at the position, other than the slim reaper. the eagles could try to see if gardner minshew is able to tap into jalen reagor’s ever-elusive potential, but this offense is bad enough that i think jump-starting the quest for a legitimate #2 receiver will be too tempting to pass on at pick 10. i’m certain chris olave will go in the top 9, leaving the eagles with a choice between garrett wilson and treylon burks. i’m betting that they will choose burks for his unique size-long speed dimensions. 6′3″ 225 pounds with sub-4.5 speed would appear to project well to the NFL, though all bets are off for wide receiver projections when it comes to the poorly coached and idiotically schemed eagle offense.

pick 15:

again, the eagles could invest at edge here, but i think they’ll pass again on that opportunity given their more imminent need to establish an offensive identity. it will, after all, be nick sirianni’s last chance to salvage a once-promising coaching career that is rapidly devolving into futility.

brandon brooks has been nothing but a disappointment for the past couple of years, and i don’t think it’s remotely reasonable to imagine that he can stay healthy for more than 2-3 games next year. he has a lot of guaranteed money thanks to howie roseman’s largesse, but it still may make sense to ship him off along with a late round draft pick just to get the majority of his contract off of our books. we desperately need youth and power on the interior of the line, and few things can turn around our offensive identity faster than a potentially dominant offensive guard to complement our core three guys in mailata, johnson, and dickerson.

i don’t see the eagles waiting until round 2 to buff the interior line because ikem ekwonu and darian kinnard really are head and shoulders above the rest. pick 15 is not early for either guy; and i see the eagles locking onto ekwonu, whose power and skill set him apart as a potentially elite lineman in the NFL. a starting five of mailata, seumalo, dickerson, ekwonu, and johnson (with driscoll and herbig in reserve) could be the best in the league, and for an offense that really needs to start running the ball with aggression, this is a line that could easily bully nfc east defenses week in and week out.

2nd round:

the eagles absolutely need to get a linebacker on day two this year. in this draft, i didn’t project any inside linebackers going in the first round (a testament to how strong the defensive talent is overall in 2022), so that means that the likes of devin lloyd, nakobe dean, christian harris, and demarvion overshown will fall to the 2nd round. of these, i like nakobe dean the best.

3rd round:

it’s a better safety class than you’ll find in most draft years, and i’d be looking for a guy like jalen catalon, brandon joseph, or tykee smith in the early 3rd. one could argue that we should be looking to draft depth at edge in round 3, but the safeties late in day 2 should be good enough to warrant the investment. i’m not a fan of our strategy in recent years to almost completely ignore the position, particularly in light of our poor tackling and consistently leaky coverage. receivers don’t fear hits over the middle from our defense. that has to change. we need to build a safety group that will deal punishment with impunity

10.26.21

eagles: early season thoughts, and mock draft #1

Posted in Uncategorized at 9:31 pm by Administrator

it’s seven games into the season. the eagles have lost to five good teams; they’ve beaten two fairly bad teams. if they prove capable of beating the woefully bad teams remaining on their schedule (the lions, jets, giants, and redskins) then they’ll actually have at least 8 wins on the season and a legitimate shot at a wild card game. by my estimation, an 8-win team is going to take the 7th NFC playoff berth, and it very well may come down to one of three very mediocre teams: the vikings, the 49ers, and the eagles. if the eagles end up taking advantage of a very easy schedule down the stretch, they’ll be a playoff team, and the massive outcry against sirianni and gannon may quiet down just a little. i hope for their sake that they find a way to beat some very bad teams down the stretch.

all that being said, i think it’s not too early to determine that jonathan gannon is not a good defensive coordinator. under his coaching, most every defender on this team has put in a career-worst effort, with the exception of javon hargrave. the defense is unacceptably soft in coverage, painfully unaggressive with pass pressure, and ridiculously sloppy in run defense. in other words, there isn’t a single thing that this defense is doing competently. it won’t be a good look for the franchise to cut ties with a young coach who just recently seemed to be on a stellar trajectory, but one can’t dispute the results on the field. there’s probably no consensus on anything regarding the eagles except for this: they have a rotten defense. i’m particularly sad about this because i had high hopes for gannon and this veteran unit.

as for the offense, i think there are still many important questions to be answered in the latter half of this season. can hurts improve? is there a legitimate second receiver on this offense? are lane johnson and brandon brooks officially in decline? can nick sirianni come across as anything but a doofus? i think it’s too early to give up on jalen hurts, and i hope the team gives him the full 17-game slate to judge what he’s got. granted, there’s gardner minshew, and perhaps sirianni has something to gain by winning with minshew and implicitly scapegoating hurts. but we already know enough about gardner minshew from his history in this league. he may be many things, but he’ll never be a top-10 quarterback in this league. the eagles shouldn’t be quick to move on from hurts this year.

it’s truly terrible as a fan to transition to lower expectations. for four years, i got up on sundays expecting my team to win every game—and of course i was frequently disappointed. now, i don’t even watch the games. i expect us to lose (and to look very bad while losing), and yet still i find myself capable of being crushed. there is no adequate way to prepare oneself for the tragic fall of a franchise. in retrospect, it was a series of mishaps that conspired to derail our hopes of a repeat super bowl: wentz’s knee injury, mcdaniels’ sudden flakiness with the colts that led to reich’s unexpected departure, an epically bad 2019 draft, and spectacular regressions from both doug pederson and carson wentz.

the silver lining of course is the 2022 nfl draft, which most eagle fans are expecting howie roseman to botch again. i might point out here that many of my pre-draft favorites (kristian fulton from 2020; j-ok, greg rousseau, and paulson adebo from 2021) have shown flashes, while eagle draft picks that i have not liked (i.e. andre dillard, jj arcega-whiteside and miles sanders from 2019; davion taylor from 2020; and milt williams and zach mcphearson from 2021) are showing poorly. i try to give credit to roseman for his high points, but there are too many low points to pick at nowadays, and if he’s at the helm of our 2022 draft, i would expect more wasted opportunities.

in any case, here’s what i think the eagles should do in 2022 with what i project will be the 5th, 15th, and 23rd picks in the draft.

2022 Mock Draft: 1st Round

1. Detroit: Kayvon Thibodeaux
2. Houston: Derek Stingley
3. Jacksonville: Evan Neal
4. NY Jets: Kyle Hamilton
5. Philadelphia (from Miami): Aidan Hutchinson *
6. New York Giants: DeMarvin Leal
7. Washington: Matt Corral
8. Carolina: Malik Willis
9. New York Giants (from Chicago): Kenyon Green
10. Atlanta: Jordan Davis
11. Minnesota: George Karlaftis
12. Denver: Sam Howell
13. New England: Chris Olave
14. Seattle: Tyler Linderbaum
15. Philadelphia (from Indy): Kaiir Elam *
16. Pittsburgh: Carson Strong
17. Kansas City: Kingsley Enagbare
18. San Francisco: Ahmad Gardner
19. Las Vegas: Alec Lindstrom
20. Dallas: Adam Anderson
21. New Orleans: Treylon Burks
22. Cincinnati: Charles Cross
23. Philadelphia: Nakobe Dean *
24. Tennessee: Ikem Ekwonu
25. Green Bay: Garrett Wilson
26. Arizona: Trent McDuffie
27. Cleveland: Drake Jackson
28. LA Chargers: Andrew Booth
29. Baltimore: Nicholas Petit-Frere
30. Tampa Bay: Jaxson Kirkland
31. Detroit (from LA Rams): Drake London
32. Buffalo Bills: Derion Kendrick

after a not-so-shocking late season run that puts the eagles in the playoffs, philadelphia ends up upsetting the dallas cowboys in the wild card round before losing in the divisional round.

we take aidan hutchinson with our top pick because edge rush will be a primary need going into 2022, after we cut ties with brandon graham, derek barnett, and ryan kerrigan. we’ll need hutchinson to step in with josh sweat and book-end a front four that still has the potential to be very good next season. demarvin leal is also a legitimate option at pick 5, but we already have a hybrid inside/outside lineman in milt williams that we’re having trouble integrating right now. hutchinson is the more explosive guy and the more straightforward fit with our d-line guys.

kaiir elam is a no-brainer at pick 15 because our cornerback group is unproven (outside of slay) and utterly lacking in depth.

at pick 23, the question will be whether we take garrett wilson or nakobe dean. obviously i think we need to take the game-changing linebacker in nakobe dean, who excels in all phases of the game and can immediately inject physicality and coverage skills into our league-worst linebacking unit. i’ll admit though that garrett wilson (or treylon burks, should he fall to 23) will be tempting, as we need a solid receiver opposite of devonta smith.

10.24.21

dune: a vision of woke america

Posted in Uncategorized at 11:12 pm by Administrator

no can deny that denis villeneuve’s dune is a visually striking film. we could leave it at that and declare the movie a tour de force exhibition of desert landscapes, luxuriant indoor spas, and neo-brutalist architecture. but underneath all the expected flourishes one would expect from villeneuve, there is of course the story that he is telling—the story that he chose to tell through the trappings of frank herbert’s mind-bending novel. and the story that villeneuve is telling through this movie is probably one that he is completely unaware of, as much a product of his subconscious as it is his sincere effort to interpret a source material that begs interpretation. i would characterize villeneuve’s dune as a story of enlightened whiteness: a progressive, purposeful, and passionate whiteness, steeped in the traditions of western empire but tempered and colored by a deep awareness of the toll it has inflicted on colonized people of color throughout the world. dune resonates with us because it is a vision of woke america, ruled by whites who earn their privilege by winning our loyalty rather than simply demanding it by force.

let’s be clear that there is no mistaking that the movie is steeped in racial and ethnic stereotypes that are impossible to dismiss. unlike david lynch’s dune movie, denis villeneuve’s dune sports a racially diverse cast, which affords the movie an opportunity unavailed to david lynch: the opportunity to formalize a racial hierarchy. and oh does villeneuve relish this task. we have our heroes, the atreides, white to the last man with the exception of their whipping boy thufir hawat (endearing, black, and slapped around a little by duke leto after not properly tending to his house duties) and the physician wellington yueh (chinese, because asian doctors are obviously the best). the harkonnens and the sardaukar are russian mafia types, with the requisite accents and facial tattoos to remind you that these guys are from a little east of the civilized side of the european continent. and then of course, there are the fremen, who aside from javier bardem are predominantly black. and the fremen aren’t incidentally black, in the way of being heavily tanned by all their years in the arrakis desert. they’re stereotypically street—technologically primitive, ignorant of the world at large, and physically intimidating. in frank herbert’s book, jamis never struck me as a black man, but in denis villeneuve’s movie, he’s the science fiction version of marlo stanfield—a gangster who believes that only the strong should survive. he won’t bow to a weakling, he won’t respect a woman, and he sure as hell won’t surrender a grudge. the climactic scene of the movie is street fighter jamis in hand to hand combat against our fresh-faced progressive white boy paul atreides. want to guess who wins that fight, in this allegory of our present times?

it’d be one thing if this dune were self-aware in its perpetuation of common stereotypes and myths of white privilege. but it’s downright serious in its adherence to all of our ways and forms, down to the scottish bagpipe ceremony that welcomes our enlightened british conquerors as they supplant their nazi/russian/mafia predecessors in the crudely undeveloped but resource-rich lands of arrakis. it’s not tongue in cheek. it’s not ironic. the story is written this way to resonate with us, the american audience, because it tells a story that we have already learned from school, from the media, and from every story about the greatness of western civilization and its enlightened heir in modern times—the united states of america. make no mistake, we gravitate to this version of paul atreides, who is the descendant of a british mother, who dreams of interracial romance with an exotic ethnic woman, and who willingly steps into a prophetic narrative in which he is the one who will end the oppression of a downtrodden race while bringing dignity and power to his gilded family line (a mayflower family, no less). paul atreides is the vision of a woke america, saving black people from enslavement while maintaining authority, power, and rule. it’s not a medieval colonialism anymore; it’s progressive, benevolent, and persistingly privileged whiteness, updated for the palate of the 21st century.

i can’t judge a film like this on its own merits because the premise is a non-starter. it’s like trying to judge the phantom menace without remembering the original star wars series, or without noticing the obviously jamaican jar jar binks and the painfully asian neimoidians. it’s like trying to offer a legitimate critique of a movie that depicts adolf hitler through a sympathetic, human lens, so to speak. i don’t buy that this version of dune is a faithful rendition of frank herbert’s book. this kind of racialization can never be a faithful rendition of anything that is worth being rendered. like i’ve written previously, every artist in these times bears some responsibility for what she depicts and ultimately inculcates into her audience. a film like this is unconscionable. it can’t exist in the america of our times. it can’t be made in this manner. and yet it was. and that strikes me with deep and awful sadness, because the movie is an exquisite and elaborate homage to a narrative of white privilege and colonialist oppression that our generation is so ardently trying, through blood, sweat, and many lost lives, to dismantle forever

10.22.21

a perfect day in primary care

Posted in Uncategorized at 11:31 pm by Administrator

my clinic days are a perfect picture of our broken healthcare system. but instead of describing just what tortures me (and my patients) on those grueling days, i’ll describe what i think would be a perfect clinic day with my predominantly medicaid population in the underserved urban environment i work in.

1. the local and county hospitals all use the same electronic medical record we do, which means all the ER and hospital records are fully visible to us on every post-discharge visit. this is almost never the case, and of course they do not take the initiative of sending the records to the PCP, so i am constantly trying to guess what happened and for what reason. sometimes it’s interesting playing at detective. but it’s never good for the patient.

2. all the specialists in our network use an integrated electronic medical record, so i have instant line of sight to their notes and results. this is universally never the case, which means that when my patients come to me complaining about the painfully brief and uninformative encounters they had with the GI doc or the ENT specialist, i cannot help them make sense of the experience. some of our specialists still hand-write their notes—and they’re completely ineligible! is this or is this not the 21st century?

3. the patients all speak english. i’m moderately proficient in medical spanish, but that doesn’t mean that language isn’t still a barrier. i have to put more effort and time into encounters with speakers of other languages, and on rare occasion, this really bothers me. i know that a lot of my spanish-speaking patients actually do use english in society, but after hearing my spanish, they expect me as their doctor to exclusively communicate with them in their language of preference. it’s a legal requirement and it’s the right thing to do, but sometimes i just don’t like it at all.

4. a skilled medical assistant does the clinical documentation for me, as a scribe. having doctors type is a waste of time and incurs repetitive stress injuries that are totally unnecessary. i spend way too much time on the computer. approximately 20% of that time is important, and the rest is wasted on typing, clicking, and navigating an EMR that brings little value to my life.

5. specialists are located in my office or just a quick phone call away. it’s nice to get curbside consultations; but in reality, medicaid primary docs don’t work in multi-specialty offices, and there are layers and layers are health plan-imposed barriers to prevent reimbursable communications between PCPs and specialists about common patient issues. that hurts quality of care and is just plain stupid.

6. administrative staff are well-trained in billing codes and referral workflows so that they can independently handle coding and specialist referrals with minimal input from the physician, outside of the clinical note. this strikes me as straightforward and simple; but of course our health care bureaucracy prevents any straightforward and simple solutions. health plans make their money off of restricting PCP practice, and we can argue about the ethics of that all day, but at least i’d like someone else pushing the paperwork for me.

7. i eat what i kill. pay me for the patients i see and the complexity of their problems. make a substantial portion of my earnings contingent upon what i produce. i’d go into private practice if i didn’t have to worry about practice management and overhead costs. and i’d be a much more energetic and productive physician if my daily earnings hinged on what i actually produced from day to day.

8. i have total control over my schedule, so that i can give as much time to the patients as i think that they need. in the context of 7 (productivity-based compensation), no one has anything to lose by giving me that flexibility. i as the pcp will earn more if i create more access; but at the same time, i will have the freedom to work outside of a standard schedule to give my patients the level of service that will keep them coming back to me.

10.17.21

eagles: we’re looking for variance, not the mean

Posted in Uncategorized at 3:50 pm by Administrator

after game 6, plenty of eagle fans are giving up on the team. fans are openly mocking the play-calling at the stadium. didinger called sirianni’s offense “off the charts dumb” after the home loss to the bucs, and in the same post-game show seth joyer repeatedly labeled the scheme a “high school offense”. while nick sirianni is taking the brunt of wrath from the fan base, jalen hurts, jonathan gannon, and individual players on the defense are also taking their licks. you would think from the outcry that this was supposed to be a team with established superstars in their prime and imminent super bowl aspirations. obviously, neither is the case.

in the preseason, i projected a 9-8 finish and a wild card win for the eagles, and i still don’t see a reason to doubt that prediction. i think we will gut out wins against the raiders, lions, saints, and giants before the bye week, and i’ve predicted a 3-1 finish against divisional opponents to finish out the season. back in august, i stated my belief that the eagles’ defense would prove to be good this year and that after a rocky start, this offense would rally behind hurts and his big-play ability. the D has been highly inconsistent but also formidable for stretches, and hurts has shown me enough to warrant my belief in the stretch run.

here’s the challenge i want to put out to eagle fans. look at the positive variance, not the average performance of this team. this is a rebuilding squad, and the most important question we have to answer this season is what the team’s potential can be within the next season or two with jalen hurts at the helm. while sirianni’s offense has struggled with the run-pass balance and too many 3 & outs (two issues i predicted we would experience in my 8/4 entry), it has already put up more explosive plays than we had in 12 games with carson wentz last year. more importantly, jalen hurts has already proven this season that he can play under pressure, lead the team late in the game, score in the red zone, and win with his legs. the average level of play that we’re seeing on the field might raise questions about whether we have a quarterback and a coach worth sticking with beyond this season; but i think that the upside is impossible to dispute. based on the range of results that hurts is showing us at the week 6 mark, i am optimistic that we will see growth (and wins) over the remainder of the season.

that’s not to say that the team’s identity on offense right now is anywhere close to figured out. sirianni’s RPO offense produces too many non-positive plays. the screen game and the running game have been predictable and easy to stop at the line of scrimmage, and hurts’s drop-backs too often result in extended plays where hurts has to improvise outside the pocket. the eagles’ two best weapons thus far this season have been runs by hurts and long passes downfield, which reflects how little the eagles are getting from their short-intermediate passing game. these are scheme issues. i have to believe that sirianni can adjust the plays to help hurts get rid of the ball faster. no, i’m not happy that we’re barely running the ball, but i think that in the tampa bay game in particular, the pass-heavy game plan should have been entirely predictable. we have a starting running back in miles sanders who still struggles to see open running lanes, has suboptimal ball security, and lacks the basic game IQ to stay in bounds when he needs to, which limits any up-side we can expect from a run-oriented offense.

the defense’s inability to stop the run has been galling, and it’s resulted in plenty of long scoring drives for opponents this year. teams playing the eagles know that the pressure up front from hargraves, cox, sweat, and barnett will be fierce, and they’ve been using runs and screens routinely to pick up chunk gains on us. gannon’s defense was supposed to be schemeless and unpredictable, but unfortunately we’ve been predictably bad at covering gaps and tackling the runner. our lack of a defensive field general and a legitimate playmaker at linebacker have never been more exposed. this is not an excuse for gannon necessarily, but on the other hand i don’t know how he is supposed to scheme a run defense when his best guys to work with at the second level are alex singleton (overachieving but not a star), eric wilson (who can’t cover), davion taylor (still learning how to play football), and genard avery (playing out of position). oh and by the way we have no legitimate nickle or dime playmakers to work with, much less a functional rotation at safety. as i’ve mentioned previously, i think howie roseman is a better GM than he’s recently gotten credit for being, but our league-worst linebacking unit is an eyesore he has to take full responsibility for, and the team’s struggles right now illuminate the flaws in our draft strategy for 2021—a year that saw us pass on jeremiah owusu-koramoah and nick bolton in the second round.

overall, we’ve lost to four legitimately good teams (the 49ers, cowboys, chiefs, and buccaneers), and we’ve beaten two teams that we were supposed to beat (the falcons and panthers). it’s too early to call the season a disappointment, and it’s too early to give up on our quarterback or our coaching staff. the fan base can certainly cry foul, as it so frequently does, but a little perspective might go a long way this early in the season. the fact is that we’ve got a much more exciting team right now than the one we had a year ago, and we’ve got at least seven winnable games on the calendar that could pave the way to a playoff berth. i still have no idea of what nick sirianni is capable of; but i think that jalen hurts is up to the challenge. i’m really interested to see what kind of team we end up with by week 18.

sad to see zach ertz go like this. but i like tay gowan. did i mention that he’s the cornerback i wanted us to take in round 4 of the ‘21 draft?

GO EAGLES

10.15.21

why we fight about israel and palestine

Posted in Uncategorized at 7:57 pm by Administrator

like many married couples i’m sure, my wife and i have a good hearty debate about israel and palestine every few months. this past week in fact, we had a heartfelt discussion over several hours about our conflicting views on the region, and i daresay that it got emotional. but as we usually do, we found our way to a detente. beyond simply agreeing to disagree, i think we got to a place of mutual understanding.

i’ll avoid categorizing my wife’s views, because they are nuanced. but i think i can say fairly that she feels great sympathy for palestinian arabs, the refugee crisis they are experiencing, and the suffering they continue to experience as a result of israeli military action and israel’s systematic settlement expansion into the occupied territories. she views the ethno-nationalistic nature of the israeli political state as the underpinning of the ongoing conflict in the region and very much wants to see not only social equality for palestinian arabs but also a deconstruction of the nation-state that arbitrarily pits jews against arabs in the entire region. colonialism, in other words, is the force that is continuing to incite the violence of invasion, eviction, and displacement throughout israel and the occupied territories.

while i agree with many of these points, i continue to enter the conversation with a vastly different point of reference: the right of israeli to exist. to many of my countrymen, including our past three presidents, this continues to be an important and non-negotiable conversation starter when it comes to approaching the demands of the palestinian authority. to me, it is irrational and provocative for regional leaders to deny israel’s right to exist, whether as a jewish homeland or otherwise. and the fact that israel’s legitimacy as a nation continues to be rejected by its neighbors directly reflects the imminent threat to national security that continues to inform israel’s policy of settlement expansion. whether they like it or not, israel is at war in the face of an existentialist threat. their policy of disproportionate retaliation may be unpalatable and even patently immoral, but it is nevertheless their tactical approach to war—against an enemy that infiltrates the occupied territories and uses palestinian arabs as human shields.

while the holocaust isn’t generally relevant to the substance of these debates, it was actually the issue that triggered our discussion on this occasion. my wife sent me a link that horrifyingly described a texas county’s newfound interest in “representing both sides” of the argument over the reality of the holocaust. i responded by saying that this school system might take its lead from palestinian classrooms, where the holocaust is entirely ignored. this comment triggered the broader debate that predictably ensued. holocaust denial is incredibly galling to both my wife and me, and we both take anti-semitism very seriously. but while i view the arabic world as monolithic in their anti-semitism (and holocaust denial), my wife believes that this is unfair stereotyping and that in fact the holocaust is fairly viewed as one of the main factors that has driven jewish settler colonialism of palestine.

i’ve realized through these debates that perhaps the main thing that distinguishes our viewpoints on the middle east is our faith in human beings. my wife believes that the religious and cultural roots of enmity between jews and arabs can be interrogated and ultimately transcended, in the interests of mutual peace and understanding. i on the other hand believe that we are stuck in tribal thinking—and that particularly when it comes to palestinian muslims and jews, the impact of their religions and the consecration of land will continue to plague the middle east for many generations to come. while my wife blames european colonialism, i blame allah and jehovah for all the unresolvable hatred and violence, and as such, i see no clear path to a deep reconciliation between these peoples. a two-state solution that validates the legitimacy of both israel and palestine is the only solution i can foresee, and the best that these two political entities can hope for is detente.

we fight about israel and palestine because the mutual cruelties are impossible to ignore and reflect what is most base about humankind: its obsession with religious mythologies, its incessant susceptibility to causes of conquest, and its egoic commitment to the oppression and subjugation of others. we want to believe in a different kind of humanity: enlightened, unbiased, and compassionate. but while that hope enlivens my wife, it embitters me, because i cannot believe

10.12.21

chappelle’s problems with transgender people

Posted in Uncategorized at 5:01 pm by Administrator

i’m a big fan of dave chappelle, and i think he’s unique as a comedian of this era. his wit, his instincts, and his capacity to infuse deep feeling into his content have all really set him apart from others in his trade. chappelle’s opening monologue for SNL the weekend after trump’s election in 2016 was one of the most moving and important things i’ve ever heard, and i credit him for being a voice of reason in that season of fury and confusion.

i think that it’s chappelle’s underlying and profound sensitivity to the crowd that so informs his particular approach to stand-up. he’s at his best when he’s had time to observe and analyze society’s idiosyncrasies and hold his own visceral reactions to them. he’s shocking when he shoots straight from the hip, usually out of anger, and some of his more memorable sets are those moments of outright passion. when he’s on stage, chappelle is always walking that fine line between exquisite vulnerability and impenetrable passion. and for every time that he’s spoken truth to power with immaculate articulation, he’s had a time when a heckler or a critic utterly derailed him.

the latest furor over his anti-transgender comments is derailing dave chappelle. and it’s not because the mainstream audience refuses to accept a transphobic black comedian. if anything, transphobia is the rule, not the exception, in our brutally heteronormative society, and i think that it’s hardly likely that the protests of the transgender community will dissuade chappelle’s extremely loyal audience from their obstinate loyalty. no, transphobia is derailing dave chappelle because he’s allowing the controversy to get under his skin. it’s painfully obvious that he’s obsessing over the feedback that he’s getting on-line about his transphobic comments. the majority of his set on netflix’s “the closer” (released just last week) was a bizarre and circuitous defense of his position on transgender sexuality, and during his show at the rose bowl last thursday, he was evidently affected by what he called his “cancellation” by transgender proponents—even though there’s no evidence whatsoever that he’s being cancelled. in fact, dave chappelle has never been more popular with his audience. the contrast between chappelle’s reality and his self-perception is striking and perhaps should be concerning for his fans.

i think that chappelle has been so deeply affected by the transgender community’s negative reaction to him because he knows that his position is untenable. he might not feel that his blatant transphobia is wrong; he’s on record saying that he feels that biological gender is fact, and in “the Closer” he appeared to defend JK Rowling, whose comments about transgender females have provoked much grief and rage among transgender advocates. but chappelle perhaps understands that his public transphobia is untenable because it does not align well with his consistent and passionate rhetoric about racism, particularly racism against blacks. chappelle in his own way has become an important figure in the evolving national conversation on police violence against black men, and he’s proven to be both comfortable and confident in engaging in the general social discourse about social justice. in this context, his transphobic content past and present has to be a thorn in his side because it demonstrates a gnawing inconsistency in his treatment of privilege and discrimination in america.

and for what it’s worth, his transphobic content really is profoundly transphobic. these aren’t one-off jokes that touch on superficial stereotypes about the transgender community, comments that can easily be passed off as tongue-in-cheek or inherently ironic. chappelle’s content gets deep into the stuff of transgender identity, when he directs the audience’s attention to transgender genitalia, transgender bathroom behavior, and the inherent deceptiveness of transgender dating behavior. unlike chappelle’s roasts of people of various races and ethnicities, his attacks on transgender people are inherently dehumanizing; with the power that the podium gives him, he encourages his audience to share in his patent disgust for the preferences, behaviors, and basic dignity of people of this community. moreover, in “the Closer”, chappelle bizarrely stereotypes transgender people as whites, implicitly nullifying the experience of transgender people of color, while justifying his parallel narrative on white privilege. it’s flimsy and doesn’t hold up in present-day discourse.

the definition of privilege is a lack of understanding the other, a lack of interest in understanding the other, and furthermore an entitlement to blatant ignorance of the other. dave chappelle, in his treatment of the transgender community, clearly exhibits all three, and thus he presents to us a singular intersectionality of our times: a black man who combats white privilege, while himself embracing heterosexual privilege to punch down on a deeply marginalized, traumatized, and persecuted transgender community. i still think dave chappelle is a wonderful human being and a very funny man. but i regard his transphobia the way i regard the ugly underbelly of this grand nation we are a part of. it is an imperfection, a hypocrisy, and a failing that can be only be described as human

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