The growing acceptance and popularity of cosmetic surgery brings with it some real concerns and dangers. Altering one’s physical appearance with surgery is not something to be undertaken lightly. Surgery is always irreversible to some degree, if only due to the scar(s). Cosmetic surgery is real surgery and carries all the potential risks of any operation: infection, bleeding, injuring to structures near the surgical site, poor healing, unsightly scars, and anesthetic complications. Then there are the potential life-threatening complications such as blood clots leading to embolism in the lungs, heart attacks, strokes, pneumonia, and more. There are books written on surgical complications.
The weighing of risk versus benefit takes on special significance in cosmetic surgery because it is medically unnecessary. Patients undergo cosmetic procedures because they wish to, not because they need to. Ideally, cosmetic surgery would be free of risk, but that is not reality. It is incumbent, however, for surgeons to do everything in their power to minimize the risks for any cosmetic procedure for every patient. Enter the Brazilian Butt Lift, popularly known as the BBL.
I consider myself a reasonably intelligent person, a man of science, possessing of a degree of common sense, and one who attempts to rationally think through things before expressing opinions. With that in mind, I have a few questions.
1.Why do we allow over 2 million illegal aliens to enter through our southern border without any documentation, vetting, or requirement for testing for Covid yet I, as an America citizen who leaves this country on vacation or business, cannot re-enter without proof of a negative Covid test?
2. Why does the US Supreme Court disallow vaccine mandates for private businesses yet permits them for federal employees and employees of any institution that receives Federal funds? Are those persons more at risk? Do they not deserve the same freedom of choice as private business employees?
3. Why are we acting as though Omicron is the latest apocalyptic plague when all the indications, ALL the indications, are that it is not much worse than a bad cold? Why do we ignore numbers that encourage the country, such as minimal rise in hospitalizations and a decline in Covid deaths, and focus on those, e.g. rising cases, that justify continued draconian measures to “save even a single life?”
I cannot think of a better way to begin 2022 than to speak truth to power because 2021 and the year that preceded it were almost entirely about power over truth. It has been the power of government over the individual citizen; about power of wealthy, elite progressives over the working class; about power of the media, both mainstream and social, to censor and cancel citizens and even entire institutions that did not adhere to their explanation of events; and even the power of a few, elitist, politically motivated scientists and doctors over clinicians on the front lines of patient care. It has been the power of an ideological narrative over facts. It has been the power of gaslighting wherein we are told to believe the media spin rather than our own eyes.
As the year draws to a close, thoughts inevitably become reflective. I reflect on the year just past and on the one to come. There were big changes for me, both personal and professional. This year I celebrated the 30th anniversary of my 39th birthday. I recovered from Covid. I also celebrated 40 years of marriage to the woman of my dreams, my true soul mate. Next year, I will begin the seventh decade of my life and I foresee big changes, retirement or at least a major slowing down of clinical practice being one of them. It has been a good run.
If a cold is a organ grinder monkey, influenza is King Kong, and Covid is King Kong on steroids.
R. T. Bosshardt
I have known Kurt for over 53 years. We have been best friends since high school, are now both physicians (he a family practitioner and I a plastic surgeon), and still maintain weekly contact. He is my workout partner at the gym. He is also my personal physician. I take his medical advice seriously.
Kurt and I sit down once a week for an hour to just talk about things- our lives, medicine, the craziness of the world around us. Recently, our conversation has focused a lot, of course, on Covid. Our takes are a bit different. He is a pragmatist and focuses on what works and what doesn’t. He calls me an idealist but, on reflection, I would qualify that by calling myself a cynical idealist. By that I mean that I see the world in ideal terms but also accept that it just isn’t that way, largely because people are imperfect and unpredictable.
Our conversation this morning turned on vaccines. He received his vaccination with the Pfizer product in December. I chose to wait for the Novavax vaccine and planned to treat myself using the FLCCC protocol in the event I became ill before it was available. I weighed my risks and elected to chance Covid given that my risk of dying was less than 1 %. He has not been ill all year despite repeated exposure to Covid patients. I came down with Covid in July. I followed the protocol and came through it, but it was a miserable experience, on par with a severe case of influenza for my wife and me. (go to page 2 below)
I am not an academic. I am simply an American who happens to be a white male, arguably the most maligned group in America today. I have never believed, or acted as though I believed, that someone is in any way inferior to me simply because of their race. I am not colorblind. I have eyes to see every human being for what they are. I also believe that immutable characteristics should be irrelevant in judging persons. Critical Race Theory purports to explain inequites seen in society and correct them. It claims to be the answer to racism. I am skeptical and here is why.
Critical Race Theory sees everything through the lens of race and racism. Racism underlies all of human history. All motivation and actions are, at their core, race-based. There is no such thing as altruism or just doing the right thing for its own sake as race underlies all behavior. Critical Race Theory advocates speak incessantly about race until one begins to give in to its ridiculous propositions through sheer exhaustion and desire to just make them and the issue go away. It is not unlike a whining child to whom adults give in just to shut them up. One of the most vile aspects of CRT is that it defines American history by its worst racial moments. Slavery, Jim Crow laws, red-lining, and scattered incidents of inter-racial violence or injustice are proof positive of America’s systemic and structural racism and sufficient justification to take down the entire edifice of American jurisprudence, social programs, and education. It completely ignores the abolitionist movement in which blacks and whites fought slavery, often at great personal risk. It ignores the Civil War in which over 620,000 white, military-age males, or one in ten, died to end slavery. It ignores the 13th, 14th, and 15th Amendments to our Constitution, the Civil Rights Movement, legislation such as Brown vs Board of Education, and well-intentioned, but flawed, efforts to equalize opportunities for black and other non-white Americans such as affirmative action. It ignores the tremendous progress made in correcting the wrongs of the past and efforts to insure equal opportunity for all going forward. We still have a long way to go, but CRT acts as though no progress has been made at all. CRT pushes the virtues of diversity, equity, and inclusion or DEI. Let’s look at those.
Diversity- CRT claims to promote diversity but it is one-dimensional sort of diversity. The diversity of CRT is restricted to those non-whites that agree with the premise of CRT. All whites are racist unless they agree with CRT. Even then, they must declare and acknowledge their intrinsic racism before they are accepted into the CRT family. Blacks and others of color who disagree with CRT are excluded as racists. Diversity of thought is not tolerated as all who disagree with CRT are de facto racist. CRT promotes the false dichotomy that there is only white and non-white. You are one or the other. Skin pigmentation is everything, ignoring the fact that nearly all of us, if you go back far enough, are of mixed heritage.
Equity- This is where the roots of CRT in Marxism are most evident, perpetuating the Marxist view that divides mankind into one of two groups: oppressor or oppressed. The goal of CRT is not reform or an attempt to further humanist or Judeo/Christian values, as did the Civil Rights Movements. CRT advocates repudiate the leaders of that movement, including the Rev. Martin Luther King himself. The goal is revolution and a total destruction of the current “system”, which is intrinsically racist. This includes values such as meritocracy based on ability and hard work, the nuclear family, and free enterprise capitalism, which CRT claims simply perpetuates white privilege and white oppression. In its place will be some vaguely envisioned utopia in which whites (bourgeois) will be put in their place and everyone will share equally in the spoils of society, according to their need, not their contribution. This is nothing more than equality of outcomes and is Marxism, pure and simple. All that has been done is replace the bourgeois and proletariat with white and non-white, respectively. Every attempt in human history to transform this ideology into reality has resulted in enslavement of the population and the deaths of tens and hundreds of millions.
Inclusion- CRT elevates group identity above all else. It is not even enough to be white or black, although these are the foundational identities; you must subscribe to CRT ideology. This is why CRT advocates can call blacks who do not agree with CRT “Uncle Toms” as exemplified by President Biden’s comment to black interviewer, Charlamagne, “If you have trouble deciding between me and Trump, you ain’t black.” Individual identity does not exist in CRT. Acceptance into the CRT family requires either the right skin pigmentation or subscribing to its racist ideology. Whites are only accepted if they deny their “whiteness”, accept their undeserved white privilege, apologize for their intrinsic, universal racism, and subscribe to CRT’s premises. CRT is inclusive only to the extent that all adherents to this ideology must agree on specific tenets. These include the belief that America is systemically racist, i.e. that our laws are geared to maintaining a white privileged status quo. It maintains that individuals are defined by the group they are in, according to skin pigmentation and that being white is sufficient proof that one is racist. Ibram Kendi goes so far as to assert the self-contradictory position that to claim one is not racist is, in and of itself, a racist statement. That claim is not allowed in CRT. You are either racist or antiracist. Antiracism is a term coined by Kendi to exemplify the false dichotomy of CRT. The two are inseparable and indistinguishable, despite the assertions of some who do not understand this and believe that antiracism is simply another way of denouncing racism.
Rather than unite us, CRT will perpetually divide us according to immutable characteristics such as skin color, which is the definition of racism. According to CRT, we are judged solely on skin color and found wanting, regardless of how we may think, what we say, or how we act. Nothing matters except our skin color and willingness to accept CRT ideology as gospel. It is telling that the originator of the term “antiracism”, Ibram Kendi, will not accept any challenge to defend his position in a debate with another person of color who disagrees with him because, to disagree with him is racist, and he will not debate racists. That alone should tell you something of the intellectual bankruptcy of CRT.
After 28 years as a Fellow of the American College of Surgeons, I am done. Although it breaks my heart, I will no longer be Richard Bosshardt, MD, FACS. If you want to know why, read on.
When I was in my surgical training, I first noted that some of the attending surgeons had the initials, FACS after the MD behind their name. I learned that this stood for Fellow of the American College of Surgeons (ACS). The ACS represents all surgical specialties.
Fellowship in the College was more than just a matter of applying, paying a fee, and getting a certificate. To be considered, you had to have an unrestricted medical license and be board-certified in a surgical specialty by a member board of the American Board of Medical Specialties. You had to have been in a full-time practice in one location for at least one year. You had to have unrestricted hospital privileges and no reportable actions against you. You had to have references from two Fellows of the College. Once you were elected to Fellowship, there was a ceremony at the annual meeting of the ACS, very much like a graduation ceremony, in full cap and gown, at which new Fellows pledged to always adhere to, and uphold, the highest standards of surgical practice and always place the care of their patients first and foremost. (Please continue to page 2- see below)
The year was 1984. I was a chief resident in general surgery at the US Naval Hospital, Oakland, CA. I and my two co-residents were finishing the last of five years of training in general surgery. By now, we were functioning as nearly independent surgeons, operating on our own patients and helping train the residents behind us. We were allowed to operate without an attending surgeon present most of the time, but were expected to request assistance if we needed it on complex or difficult cases. By this time, we had enough knowledge and surgical experience to feel fairly confident in our capabilities.
Surgery is a strange amalgam of confidence coupled with humility. Confidence is a must in a profession where you are cutting people open as a matter of routine. Humility is equally important. People and the human body are simply too complex to be approached without some trepidation and with great respect. There has to be a balance, however. The over-confident surgeon is just as dangerous as the overly-timid one.
One of the traditions of our program, indeed, of most surgical training programs, was to send off the graduating residents with a banquet. It was attended by all of the residents and attending surgeons and their spouses. The graduates were toasted and roasted in equal measure in funny and, sometimes, embarrassing ways. For that evening, the general surgery service at the hospital was covered for emergencies by one of the other surgery services so that we all could attend and the day’s surgery schedule was shortened as well. For the graduating residents, it marked the transition from resident to attending surgeon and was highly anticipated.
“With Covid-19, we have thrown caution to the winds.”
I am no virologist, infectious disease specialist, or even a family physician, just a lowly plastic surgeon. Even so, friends, family, and even my own staff turn to me and ask what they should do about the Covid vaccine. Should they get it? Am I going to be vaccinated? I have reviewed this issue for a while to try to formulate a reasoned, evidence-based approach. Finally, I am ready to provide an answer. Happily, it is a validation of the approach I had already chosen for myself.
To begin, let’s review a little about vaccines in general and the Covid vaccine(s) in particular. My source? Dr. Paul Offit https://www.paul-offit.com/about-paul-offit-md, a pediatrician with impeccable credentials in the area of vaccines and co-discoverer of the rotavirus vaccine (more on this in a moment). My information came from a recent interview with Offit on the Peter Attia, MD podcast https://peterattiamd.com/pauloffit/.
The anti-vaccine movement stems from a fraudulent paper published in Lancet in 1998 by Dr. Andrew Wakefield and retracted soon thereafter, when it was proven that Wakefield falsified his data https://briandeer.com/mmr/lancet-paper.htm. The entire story can be accessed in the book, The Doctor Who Fooled the World, by Brian Deer. Suffice it to say that, despite a few residual outliers who simply refuse to accept the facts, it is a medical certainty that autism is not caused by vaccines, specifically in the case of Wakefield’s paper, the measle/mumps/rubella vaccine.
Offit worked for 26 years to develop a vaccine against rotavirus, which causes fever and diarrhea in children between 6 and 24 months of age. Before the vaccine, nearly every child in the US was infected by age 5, with 75,000 hospitalizations, mainly for dehydration, and 60 deaths annually. Worldwide, rotavirus killed 500,000 children per year. Offit made the point that a rotavirus vaccine that pre-dated his had a severe side effect that could not have been predicted, even by extensive studies, and was taken off the market within 10 months. This becomes important later, when discussing Covid vaccines.
To understand the unprecedented nature of the available Covid vaccines, you have to understand how vaccines are developed.
If you are like me, you are probably exhausted from all the discussion regarding the virus, SARS-CoV-2 and Covid-19, the illness it causes. A lot of discussion had understandably focused on the rate of serious illness and death from Covid. The rates of both have been frightening (although the true rates are not really known for many reasons not germaine to this post) and served as justification for unprecedented measures to end the pandemic. If it were not for that, Covid would have been regarded as just another annoying seasonal virus, little different from the other coronaviruses, rhinoviruses, RSV (respiratory syncytial viruses), parainfluenza, and others we have not yet identified. We live with those as a matter of course. We now have enough experience with the “novel” virus unleashed on the world by the Chinese Communist Party to know that it uniquely spares children, poses relatively little risk to healthy adults, and is most dangerous to adults over 70 years-old and those with certain chronic medical conditions.
Those conditions are medically termed co-morbidities and include illnesses such as cancer, heart disease, asthma and other lung problems, obesity, diabetes, immune-related conditions of every sort, kidney disease, and so on. Among them are four that are noteworthy because they are so common and so commonly associated with serious illness and death from Covid. These are obesity, type II diabetes, hypertension, and metabolic syndrome. The last is basically a melding of the first three. In addition to having in common the fact that they greatly increase the risk of serious illness and death from Covid is the fact that they are all largely preventable.