Race: Danger or Distraction? Bomb or Bomb Scare? [UPDATED AGAIN]

September 11, 2009 at 12:54 am (By Amba) (, , , , , , )

Tonight on MSNBC I heard a parade of Democrats, including Ron Reagan, saying solemnly that they thought Joe Wilson’s “outburst” last night was about race, that such incivility would not have been directed at a white President.  (Bush II was booed in the same chamber.)  I had to turn it off.  I blew my stack on Twitter, because it seemed to me they had all received their talking points and were setting up a story line in which opposition to Obama’s health care plan could only be motivated by racism.  Makes me nuts.

(UPDATE II, Sunday the 13th:  James Pinkerton nails Maureen Dowd doing her duty for the cause:  “Some people just can’t believe a black man is president and will never accept it.” Pinkerton comments:

The cultural elites can’t have it both ways: They can’t simultaneously trash the middle class–labeling reasonable skepticism of Obamacare as “racism”–and then expect that same middle class to simply take the elites’ word for it that Obamacare is a good idea.

And I agree with Pinkerton’s terse prognosis:  “bad politics. It’s not going to work.”)

This led to a fascinating conversation with my brother David (True Ancestor), that I’m reproducing here, starting with Twitter.  (Still can’t bring myself to say “my tweets.”  I’d prefer a George Carlinesque “brain farts.”)

Sometimes I wonder if Obama was elected largely because his race is such a convenient way of ending an argument and silencing debate.

Tremendous barrage of “it’s race, it’s race” on the Left’s pet channel MSNBC today. A concerted campaign–this is how they plan to pass HC??

To get back to the subject of liberal Dems browbeating on “race” theme–I am disgusted beyond measure. This is exact flip side of Birtherism

My own bro falls for & perpetuates the “it’s race” meme re: Joe Wilson http://tinyurl.com/ljsvnt I bet a very liberal white prez wd get same

Here my bro’s so right tho: “I see signs all around me that people are pissed off and paranoid, self-righteous and self-absorbed.”

Please pause here and read David’s post.  It’s a very good and very thoughtful expression of the alarm that is the theme that has sincerely gripped many liberals (and David, as you can see, is no ultraliberal), just as alarm at loss of freedom to an overweening State is the theme that has sincerely gripped many conservatives.

I would have been astonished no matter who called the President a liar, and no matter who the president happened to be. But because Barack Obama is an African American man, in a room populated mostly by white men, it seemed to me that a little bit of mob mentality spilled over the decorous bounds inside of which presidential speeches have always been safely held. The fact that Joe Wilson hails from South Carolina added to the chill in my blood.

I don’t consider rough politics out of bounds. I don’t consider Barack Obama beyond reproach. I don’t consider all Republicans bad people (I vote for them sometimes). But moments like this disturb me deeply. It makes me wonder anew whether the animus against Barack Obama is heightened because many cannot stomach the thought of a black man being president.

I commented:

On the other hand, Obama’s race is very convenient for Democrats. No one can criticize his policies without being suspected/accused of racism. (I’m not suggesting that Joe Wilson’s incivility was legitimate criticism. I doubt it was a spontaneous outburst either. More likely it was a bid to be on the 2012 ticket.) That’s THE big theme on MSNBC today (as much a propaganda organ of the L as Fox is of the R). That so sucks — it’s one of the tactics that makes people feel like something’s being put over on them by trickery, thus aggravating the paranoia.

A lot of conservs on Twitter, and NOT crazies, are saying Wilson shouldn’t have apologized (in their wishful fantasies at least), because they believe the president WAS “lying” (illegal immigrants WILL be covered de facto because there’s no test) and somebody had to say it. These people are in a sincere (if well-fanned) panic about “statism,” and I think THAT has zero to do with Obama’s race.

David responded:

First of all, saying that Obama’s race is convenient for Democrats takes nothing away from the very real peril of racism, and the very real possibility that it may be playing a role in the way Obama is confronted, and the way he was confronted last night.

Furthermore, all leadership, in all eras, in all countries throughout time, have sought to take advantage of the convenient. That this is no different doesn’t make it less real or any less ominous. To merely view it cynically is to deny that racism occludes sensible judgment of Obama — judgment that could help mount a more effective opposition, that could lead to better legislation, and that could do less damage to the perception and the effectiveness of leadership in Washington. Racism is a flame that can be fanned. Last night, I felt the heat. Like a fever, it was a heat that chilled.

My concern was not aroused by any talking head on any network with an ulterior motive or an agenda; it arose as I watched the event unfold in real time, unadorned by commentary. Not only that, in what little commentary I watched afterwards (a bunch of talking heads on CNN, followed by Larry King’s interview of John McCain), the issue of race was never brought up.

Second, the non-crazy conservatives to whom you refer believe the president was lying; I believe they are wrong. There are reasonable interpretations on both sides, pointing to the fact that weaknesses in the legislation could allow illegal immigrants to be insured. Most of the CNN panelists I saw, and stuff I’ve read today, said they felt that could and likely would be addressed in upcoming negotiations. Whether or not Obama was lying does not make what Wilson did OK, any more than yelling invective at Bush, Bush II or Reagan at a similar (or any) occasion would have been OK.

If “somebody had to say it,” that somebody could have done much more good for their cause by saying so in a more intelligent way at a more propitious time. I don’t mind that somebody had to say it; I strenuously disagree that that was the forum and the moment in which to do so, and there seem to be many — including about $300,000 worth of South Carolina Democrats, and virtually every leader on both sides of the aisle in both the House and Senate — who agree with me.

I answered (warning:  I get a little vulgar):

To merely view it cynically is to deny that racism occludes sensible judgment of Obama — judgment that could help mount a more effective opposition, that could lead to better legislation

It’s not a matter of viewing it “cynically.”  Of course there is racism out there.  What’s frustrating is that no one can criticize Obama without being accused of it!!  That makes him, in a weird way, bulletproof (I know how ironic it is to use that metaphor, and I’m still worried about assassination attempts myself).  And he and Democrats are willing to take full advantage of it.  It means that his being black is, after all, an obstacle to his being an effective president, because of variants of race-ism on both sides.

I believe that while one edge of the hysteria about Obama is racist, much more of it is ideological, and that part would be much the same directed at a white liberal.  Christ, look at the insane attempts to destroy Clinton, who wasn’t even that much of a liberal.  Just a Democrat.

Which leads to the insight that Republicans are just as willing to fan fringe racism to get power back as Democrats are to fling accusations of it [to hold on to power].

In this climate, those who are, in fact, trying to mount a sane and civil opposition (Gingrich, Pawlenty, some of the others with counterproposals to the public option) can hardly even get heard.  Everyone’s walking around with a (metaphorical) hard-on, with adrenalin in full flood.  It’s very scary.  But Democrats are fanning the flames in their own way, because it will let them off the hook if Obama fails.  You must consider how creepy it is to have legitimate policy disagreement blamed on racism.  Wouldn’t that make you paranoid if the roles were reversed?  It would look like a diabolically clever way of silencing debate and ramming through an agenda.  Even if you believe in that agenda, getting it done that way will have too high a cost.

I’m scared sick too, I just think there’s blame to go around.  Dangerous times.


If “somebody had to say it,” that somebody could have done much more good for their cause by saying so in a more intelligent way at a more propitious time. I don’t mind that somebody had to say it; I strenuously disagree that that was the forum and the moment in which to do so, and there seem to be many — including about $300,000 worth of South Carolina Democrats, and virtually every leader on both sides of the aisle in both the House and Senate — who agree with me.

Jeez, I’M not arguing that “somebody had to say it,” or that the president was lying!  I’m trying to tell you why Wilson might have been angling to be on the 2012 ticket!  Some people were saying he was a hero (until he apologized), and that’s not about race at all!  The hysteria about immigration and “statism” was in full cry on the Right before Obama was a gleam in the Democratic party’s eye.  The point I’m trying to make is that the Democrats are so fixated on getting the public option (and I’m not sure Obama is, but he’s captive of the base) that they are going about this in a way that feeds into it and aggravates it, as extremes so often do incite each other.

David replied, in response to my first just above:

Yeah, you hit on it. It’s the whole hard-on for battle that’s got me a little on edge. It seems there’s almost a bloodlust. How can you can negotiate when you just want to murder the person across the table.

Do you really feel that “no one can criticize Obama without being accused of” racism? I feel like he’s been roundly, and in large part justifiably, criticized for his handling of this issue, among others. His approval ratings haven’t been bulletproof, nor should they have been. I don’t read as much as you do, but I simply haven’t seen any “legitimate policy disagreement based on racism.” In either direction. (Remember when Clarence Thomas referred to his confirmation hearing as a “high-tech lynching,” and the opposition just withered on the spot? That, to me, was a classic example of what you’re referring to.

I’m still naive enough to believe that if you have real debate, you will not be able to stymie it with fear. But you don’t have to look too far back in history, or too far afield, to see how naive that belief might be.

And in response to my second:

I see your point. And I’ll predict this right now: he’ll [Joe Wilson] narrowly lose his reelection bid; he’ll claim to have been bullied by Emanuel into making his apology; he’ll become a champion of the victimized right; and he’ll wind up on the 2012 ticket. It may all have been choreographed, soon after Obama became that gleam in the eye you mentioned.

So I said:

Wilson’s already claiming that his own party’s leadership made him apologize, that it wasn’t from the heart!  “Grassroots” Republicans are as mad at their own party’s elite as they are at Democrats.  People like Peggy Noonan who disdained Sarah Palin are toast, with them!

No, I don’t mean that no one legitimately criticizes Obama without being accused of racism, but if you listen to MSNBC (the left’s Fox), today they paraded one person after another pushing that line — including Ron Reagan.  It’s as if they got their talking points/marching orders, just like on the R when everyone starts parroting whatever Rush said that day.  Wherever it’s coming from, it’s a stupid ploy, because it makes reasonable people feel like they’re being had.  It’s a huge diversion/distraction from the question of what kind of healthcare policy we should have, and what better kind we can manage to get to given our disagreements.


Remember when Clarence Thomas referred to his confirmation hearing as a “high-tech lynching,” and the opposition just withered on the spot? That, to me, was a classic example of what you’re referring to.

Oh, definitely!  Definitely.  Nothing was more cynical than his appointment.

There are people who are doggedly (blue doggedly?) trying to have a real debate; they’re just being drowned out.  Too many people don’t have a taste or a hunger for substance any more, only for emotion.  To continue the hard-on metaphor, lots of people are looking to be jerked off.

And David (thankfully changing the metaphor) said:

That’s what happens on the eve of a conflagration. The tinder is dry. A few sprinkles here and there are no match for the lightning.

UPDATE: The plot thickens: David sends “more on Joe Wilson” (presented as evidence for the prosecution?):

Allegedly member of a far-right group called Sons of Confederate Veterans, and one of only 7 SC Republicans who went against his own party and voted to keep the Confederate flag flying over the Statehouse.

(If you follow the link, you’ll see that the SCV is actually split into two warring factions, one that is innocuous and one that is virulent.  No word on which one Joe Wilson is or was a member of.)

Does that change the equation?  It does change the 2012 equation, I think.

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Does the VA Nudge Seniors Toward Death?

September 2, 2009 at 3:13 pm (By Amba) (, , , , , )

I didn’t buy the “death panels” rhetoric, but based on this, I’m reconsidering.

Note that neither Hot Air nor the WSJ actually links to the VA booklet.  When you do, the first thing you get is this disclaimer:

Your Life, Your Choices was officially retired from use in VA in 2007, and an expert panel was convened to review and comment on an online module version of this document that was under development at that time.

Ha!  So there are “panels.”  Expert panels.  Doesn’t that make you feel better??  God, I’m so sick of the fucking “experts.”  What does that word cover anyway?  Psychologists?  Economists?  Are there any combat-disabled veterans on the panels?  The only “experts” on this subject are the patients and families who’ve been there, and the good doctors and nurses who’ve been in the trenches with them.

The Your Life, Your Choices online module is currently being revised based on suggestions from the expert panel members and from chaplains representing eight different faith groups.  The revised online module is scheduled to be released on the My HealtheVet Web site in the spring of 2010.

Please note that portions of this document have been interpreted by some to be negative in tone and insufficiently balanced. The revision process is addressing these concerns.  Also note that some of the links contained in the document are no longer active.

Hey, wait, I found the Expert of Experts!  His name is Robert A. Pearlman, he’s the author of the VA booklet, and in this photo at least he bears an uncanny resemblance to Tim Geithner.  (Purely rational Vulcans all?)  He studied ethics at Harvard.  How much more expert does it get?

He received post-residency training as a Robert Wood Johnson Clinical Scholar, a Fellow in the Ethics and the Professions Program at Harvard University, and a Faculty Scholar in the Project on Death in America. He joined the [National] Center [for Ethics in Health Care, apparently part of the VA] in the summer of 2000. His interests and expertise pertain to empirical research in clinical ethics (especially end-of-life care) and organizational ethics. His research has explored euthanasia, the role of quality of life in decision-making, the validity of life-sustaining treatment preferences, medical futility, advance care planning, physician-assisted suicide, and relief of patient suffering. He is the author of two books and over 100 publications in medical journals and book chapters. His most recent book, entitled Your Life, Your Choices, is an interactive workbook to help patients and family members with advance care planning. Your Life, Your Choices will be available to veterans through MyHealtheVet in 2007.

Forget Ezekiel Emmanuel:  is this the government’s Dr. Death?

But now I’m really confused.  The preface to the online booklet now says “Your Life, Your Choices was officially retired from use in VA in 2007.”  Made available and retired in the same year??  Or am I misunderstanding?

Here’s Jim Towey, creator of what he calls “the most widely used living will in America,” “Five Wishes” (not unlike Your Life, Your Choices, “introduced in 1997 and originally distributed with support from a grant by The Robert Wood Johnson Foundation”), being vague about exactly when the workbook was instated (I’m trying to figure out whether the dates need to be jiggered to make Democratic administrations solely to blame for the thing and Republican administrations the blameless heroes who questioned it):

Last year, bureaucrats at the VA’s National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, “Your Life, Your Choices.” It was first published in 1997 and later promoted as the VA’s preferred living will [VA “Fact Sheet” rejoinders that it is “not an advance directive or a living will.”] throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. [VA “Statement” says “The document was developed under a federally funded research grant over a decade ago and in 2007, the Veterans Health Administration convened an outside panel of experts to review the tool and assess its merits. Overwhelmingly, the panel of experts, which included a diverse group from the faith based and medical communities, praised ‘Your Life, Your Choices’ and endorsed its use.”] Unfortunately, under President Obama, the VA has now resuscitated “Your Life, Your Choices.”

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

Here’s a perfectly decent handout on advance directives which, however, refers people to Your Life, Your Choices at the end.

So the booklet was “developed” with federal money during the Clinton years; it’s unclear when the VA began using it; and it’s unclear what happened to it in 2007 and whether its use has now been reinstated without input from “faith panels.”  (The booklet encourages its users to consult religious advisers.)

Looking at the booklet, it certainly hits you right between the eyes with some gruesome though not unrealistic scenarios, and there is certainly a none-too-subtle bias in the discussions against taking heroic measures — or even antibiotics — to prolong a life clearly near its natural end:

Chris Larsen [age unspecified] never told his family what kind of medical measures he’d want if he became critically ill.  He is in a nursing home after having suffered a severe stroke 9 months ago.  He is paralyzed and unable to take care of himself or communicate in any way.  Now he has pneumonia and will probably die unless he goes to the hospital to receive intravenous antibiotics.  He also may need to be  on a breathing machine for a week or so.  The doctor says that his chances of returning to normal are remote, but that he has a fair chance of getting over the pneumonia.  His family members disagree about what they should do. His son Bill says, “Dad was never a quitter.  He’d want to fight to the very end, as long as there was the slightest hope.”  His daughter Trudy disagrees. “Sure, Dad wasn’t a quitter, but he wanted to die naturally—he would be horrified to be kept alive this way.”

In fact, Trudy’s views were the closest to Mr. Larsen’s true opinion. But the family never had a way to find this out. They treated his pneumonia and he lived another year in the nursing home without recovering his ability to communicate or care for himself.

This is on page 5.  It’s offered as an example of why you need to think and talk about these issues while you can.  The trouble with such hypothetical scenarios is that not only do people differ in their values and beliefs, but each case is unique and often unpredictable in its particulars.  After we got to Chapel Hill just about exactly three years ago, J declined both mentally and physically, until in December 2006 he ended up being taken to the hospital with pneumonia.  He certainly would have died if he hadn’t been treated.  His doctors and I agreed that a DNR order (do not resuscitate, i.e. no ventilator or defibrillator) at least was appropriate, and a woman resident asked me if I didn’t think it was time for “placement outside the home.”  However, IV antibiotics was all it took to resurrect J — in a matter of hours, he went from virtually comatose to sitting up in bed talking coherently on the phone to my mother — and it turned out that most of his steep mental decline over the autumn had been due to incipient pneumonia, not accelerating dementia.  The rest is history.  If he were in a late stage of neurological disease, contracted in a fetal position, uncommunicative, and uncomfortable, IV antibiotics would not be appropriate.

(No, he doesn’t have a living will.  Probably the best course for him is to ask him to sign a health care power of attorney.  Though actually, I just learned from this very booklet that if you trust your spouse, that’s who will be consulted in the absence of a POA.  Either way, it will someday be up to me, who knows J best, to decide whether, based on his mental status, responsiveness and awareness, he who loves food so much would want to be kept alive by a feeding tube.  J is also the kind who might well look me in the eye someday and say lucidly, “Let me die.”  But if something happens to me first?)

Naturally, the VA booklet is being quoted selectively by conservative culture warriors.  (The exercise on “What makes your life worth living?” on p. 21, however, doesn’t need selective quoting to be every bit as bad as they say it is.)  Towey in the WSJ notes that “There is a section which provocatively asks, ‘Have you ever heard anyone say, “If I’m a vegetable, pull the plug”?'”  In full, that section merely notes that people sometimes do actually say things like that without being very clear about what they’re talking about:

Have you ever heard anyone say, “If I’m a vegetable, pull the plug”?  What does this mean to you?  What’s a vegetable?  What’s a plug?  Even people who live together can have very different ideas about what the same words mean without knowing it.  When you say, “pull the plug” it could mean a variety of things:
•Stop the breathing machine
•Remove the feeding tube
•Don’t give me antibiotics
•Stop everything

The booklet’s central question is, “For you, is there such a thing as unacceptable quality of life?  Where would you draw the line?”

It’s not that these are bad questions.  It’s, why is the government asking them? (A far more important question than “Did a Democrat or a Republican administration ask them?”)  Or, for that matter, why is an insurance company asking them, or a nursing facility which makes money when patients’ lives are prolonged?  All of these parties have classic conflicts of interest — as, for that matter, can family members eager to be rid of a burden or to collect an inheritance.  Families are not always havens in a heartless world — as Your Life, Your Choices rather ghoulishly acknowledges when it invites you to check “Yes,” “Not Sure,” or “No”:

I believe that my loved ones should take their own interests into consideration, as well as mine, when making health care decisions on my behalf.

I believe that it is acceptable to consider the financial burden of treatment on my loved ones when making health care decisions on my behalf.

The ultimate question is rather like that about sex education:  is this a private matter, even if it inevitably means some kids will be kept in barbaric ignorance or misinformed?  Do you really want some nanny bureaucracy with a “rational” agenda to impose its one-size-fits-all values on the intimate lives of your kids?  Can the transmission of information about such issues ever be value-free?

It’s doctors who should be educated, in the most humane possible way (I mean they should read the humanities, philosophy and literature, as well as psychologists and other “experts”), on these issues, and doctors, together with trusted family members and chosen religious advisers, who should be working out the decisions.  Family doctors used to do this, and no doubt plenty still do.  Yes, it’s a priestly function.  People do look up to their doctors that way in life-and-death situations, so doctors might as well live up to it.

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At Ground Zero, Coffee and Jokes. [UPDATED AGAIN]

August 19, 2009 at 8:46 am (By Amba) (, , )

I wake up from vague political nightmares and turn on Twitter and find everyone cheerful, as if nothing happened.

Actually, I guess the Obama admin’s reversal and threat to ram through public-option health care with 51 votes (by the tactic called “reconciliation”) makes a lot of people happy.  It merely confirms alarmism on the right about O’s and dems’ “tyrant” instincts — that inflammatory argument will no longer have to be rammed through, it’ll slide right in — while it has immensely cheered up the moping warriors of the left, who’ve wanted him to seize this opportunity to do just that all along.

Here I was stupid enough to think things were actually working as they should and that the minority had managed to slow the majority juggernaut almost to a standstill, forcing everyone to think and talk and work out a compromise that incorporated the best of a range of views.  It looks to me as if the administration is reacting with wounded pride — urged on by its “base” — rather than trusting its own second thoughts or its flimsy (as it turns out) reconciler fantasies.

Didn’t they learn anything from the Hillarycare fiasco?  They have handled this SO badly.  Inconsistent, incoherent, chaotic, driven, it seems, by vanity and petulance rather than chastened sobriety and eagerness to learn.  Nothing new will be allowed to emerge.

The Democrats may have a political majority, but that can’t paper over the deep crack almost right down the middle of the body politic.  To force a solution on the country that close to half of it doesn’t want will give a fatal blow to the splitting wedge.  We’re going to be a crippled country.  When it’s all over we’ll be remembered for being so spoiled by success that we squandered our strength on the luxury of fighting each other, turning our birthright into the spoils of a political Super Bowl.

I’ll admit my own myopia.  When you have a hammer everything looks like a nail, and when you’re a centrist partisanship, not “socialism” or “wingnuts,” looks like the force destroying the country.  It goes back to the Republicans trying to destroy Bill Clinton (who, after the stumbles of his first year, is looking better and better, though rogue’s luck played a part) for no better reason than that he was a successful Democrat who’d “stolen” some of their ideas about fiscal prudence and welfare reform.  (Granted that Bill put the weapon in their hands — and it was in his own pants — but it was wanton and self-indulgent of the Republicans to grab it.)  It goes back before that to Democrats, including myself at the time, despising Ronald Reagan because he was a hawk and not an environmentalist, failing to appreciate how much the freedom we ourselves enjoyed depended on living in a strong country.

I think we’re in terrible trouble, and I’m really scared for the first time.  I must have been naïve:  hardly anyone seems concerned or even surprised this morning.  It’s just another day for you and me in paradise.

UPDATE: From the other side, Philip A. Klein agrees with Maxwell that using reconciliation to pass healthcare reform is an empty threat — and little more than a bluff.

UPDATE II: Randy finds the best links!  If I’d seen this by Clive Crook in the Atlantic sooner, I’d have just quoted it instead of trying to write about the issue myself.

This struck me as a non-story if I ever saw one.

Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s co-operation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks.

Oh please. It isn’t Republican support they lack, it’s public support. And this is not the way to go about getting it. Democrats are technically right that they can get a bill through the senate even with one or two defections on their own side, using a special procedure to prevent a Republican filibuster. But with public opinion, previously well-disposed to reform, now leaning against the Democrats’ proposals–a result of the White House’s dismal failure of leadership on the issue–it would be political recklessness of a high order to pass reform by means of a ruse. Not least because the purpose would be to disempower dissenting Democratic senators, not just Republicans. What would centrist voters make of that? The go-it-alone threat surfaces every few weeks. Though complaints about Republican obstructionism are justified, the idea looks less credible now than before.

It goes on.  Key passage, in my view:

The administration should drop the public option. Politically, the disappointment of the Democrats’ hard-liners would be a plus for the administration, not a minus: their protests would reassure moderate opinion. Substantively, it would subtract little or nothing from the considerable virtues of the other aspects of the reform proposals, around which a broad popular consensus can still be built.

And from the Financial Times editorial Crook links to:

The sooner he ditches [the public option], the better. …  In signalling that he might be ready to do so, Mr Obama has said that comprehensive reform is still possible without it. He is right. A broad consensus supports new rules that would stop insurers from denying coverage because of pre-existing conditions, cap out-of-pocket expenses (so that illness would no longer mean bankruptcy), and make affordable insurance (with public subsidy where necessary) available to all. Those changes are transformative in themselves. Dropping the public option in order to get that done would be a triumph by any sensible standard, not a defeat.

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