Coffee heat rising

A Voice of Reason

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Yesterday the boob cancer flap flared up again! And I got REALLY exercised this time.

The surgeon’s nurse called to report the new pathologist’s report. In short, once again the surgeon “didn’t get it all,” to use the old-fashioned terminology. Surgeon wants to see me again, ASAP.

Then she informed me that said surgeon has left town. The soonest I can get in to see her is next Wednesday! And again, I’ll have to trudge through godawful rush-hour traffic to the Mayo Clinic’s offices halfway to freaking Payson, endure another stress-making talk with the doctor, and watch this whole mess go from bad to worse.

Damn!

So I got pretty upset. When this woman called, I was flaked out on the bed with ice packs on my boob, and believe me, I do NOT want to go through this again!

In discussing the path report, she said that the pathologist noted that the tumor has “spread throughout the breast.” I said, “Well, then you’re saying it’s NOT a DCIS, but that it’s metastasized throughout the breast?”

She now says “We don’t use that word.” (Yeah: your doctor doesn’t call it “cancer” — she keeps saying it’s a “precancer” — but you and all your nursing colleagues and every underling who gets on the phone or ushers me up a hallway call it “cancer,” a fact that does little to engender confidence!) and that it IS a DCIS.

Uh huh. Well, to my mind a tumor that has “spread throughout the breast” is not something one would characterize as “in situ.”

This is beginning to spell “complete mastectomy” to me. And now I’m starting to freak totally out.

By mid-morning I was just beside myself. So I called Young Dr. Kildare’s office, just because the man has the deepest fund of common sense of any man I’ve ever met and I wanted a sane shoulder to cry on. He agreed to see me in the early afternoon.

My son wastes his lunch hour, poor guy, to come over and try to calm me down, but he succeeds only in making me feel he’s speaking to me as though I were a ten-year-old, which gets me even more upset. Can’t blame him: I used to do the same thing to my mother when we all thought she was a hypochondriac. That was, yea verily, while her innards were merrily filling up with columnar tumors.

On the way out the door to YDK’s office, I printed out a 2010 article summarizing and commenting on research suggesting that DCIS lesions known to be “indolent” (i.e., slow-growing or possibly not growing at all, as mine is) should a) no longer be designated “carcinomas” at all and b) should be left alone, in favor of a “watch and wait” approach.

2010, mind you. This isn’t exactly breaking news.

He was startled to see it — he said he’d never heard about it. Well, YDK is a kind of GP — basically a door-keeper who tries to guess whether patients need specialized care and who refers or doesn’t refer based on his somewhat educated opinion. He’s certainly not an oncological specialist…on the other hand, this controversy hit the news in 2010; I get my news almost exclusively from Google and The New York Times, and even I had heard about it back then. So it was sorta surprising. Anyway, he said he would read the article and look up the actual science, so that was nice.

By the time I got to his place, the Mayo had faxed the pathologist’s report over to him. So he sat down and translated it, as follows:

The new excision showed the carcinoma coming right up to the inked margins, meaning she did not remove enough papilloma-free tissue to leave any margin of normal flesh. The term “metastasize” is used only to designate cancer that has spread outside of the organ where it originated. If it has not left the organ, it is not said to have metastasized. Where the pathologist says “spread throughout the breast,” YDK believes he means the tumor has grown large enough to fill most of the breast. The good news, though, is that there still is no sign of any invasive cancer.

Well, of course, this raises as many questions as it answers. For example, if the tumor is that large, why would that not have been visible on the umpty-umpteen mammograms and sonograms I’ve been subjected to? If it’s that large, why would it not be visible to the surgeon’s naked eye? And how many more of these time-sucking, stress-inducing, hair-pulling, life-disrupting, painful surgeries am I going to have to endure????? More to the point, are we looking at a complete mastectomy here? And of course, that’s all before we bring up the question of why, if as early as 2010 experts felt it was safe to simply leave a low-grade, indolent item in place and watch it, why we’re doing all this in the first place?

Arrrrrrrgghhhhhhhhhhhhhhh!

Well, he said that no matter what, at this point the best thing to do is to get the abnormal cells OUT, since what’s begun is begun and it would be unwise to leave the job unfinished. He did think a full mastectomy is entirely possible, but, said he, so what? Better to be rid of the boob than to keep cells that may or may not turn into invasive cancer. It will not, he observed, be the end of the world. He said he believes this is the best approach because, given my overall health, it’s likely I’ll live at least to 85 or 90. Since I’m just pushing 70 now, that means that even a very slow-growing entity could cause some very serious problems or death before a heart attack, stroke, or other issue carries me off.

Then he said, “Look, what you really want to know is how to bring a stop to the repeated surgeries, right?”

Yup, yup!

“So here’s what you’re gonna do, and you’re gonna use these words: When you see her, say to her ‘If we are going to do another surgery, I want that to be the last one. What can we do to make that happen?'” That, he believed, would elicit an effective response.

At any rate, a half-hour or forty minutes with YDK calmed me down some. But I am still not a happy camper!

Another Country Heard From…

And to complicate matters, SDXB’s daughter, an RN who has been a military nurse for decades, e-mailed her advice from Germany:

There is no excuse for a doctor not to get a mass and have the margins clearly defined on the first go, let alone the second try.  Did he pick any nodes to determine if the cancer has spread to the lymphatic system?  Did he determine the cancer type?  Did he grade the cancer?  If she doesn’t know the answers to these questions then she is not informed.  Also, Every time he is there fucking around and cutting on her he is stirring up the cancer and increasing the chance he is going to spread it. It takes one seed to get into her blood stream through her lymphatic system to become metastatic cancer,   Fire his ass and get her PCM to write a referral to MD Anderson.  You have a great MD Anderson in Phoenix.  This is a no brainer.  Why would you go to McDonalds if you want French food.  Yes, they serve French Fries, but they aren’t French.  This guy may call himself an Oncologist, but he sure isn’t acting like one.  I am surprised they haven’t removed both breasts.  Seriously.  With her family history…as her friend I would be encouraging her to get someone better. .  See list below:

We know that it’s an encapsulated papillary carcinoma, DCIS. So far, no evidence of invasive cancer has appeared in any of the path studies. When we believed we were looking at two lesions, the surgeon assigned a grade of 0. After excision revealed that it was really one entity, it was upgraded; because it’s still noninvasive, we’re at grade 1. Because EPCs are extremely indolent, it was decided that sentinal node biopsy is unnecessary, and so no; no nodes have been removed & biopsied. I’ve thought about MD Anderson…on the other hand, the Mayo isn’t exactly McDonald’s. 😀  I have no family history of breast cancer, ovarian cancer, colon cancer, or BRCA mutation; my mother died of what apparently was a gastric cancer, probably related to her 6-pack-a-day smoking habit. There’s no indication of any neoplasms in the other breast, and the chance that a another papillary carcinoma will arise in that one is set at .3%. In the first one, though…hmmmm…

1.  Get all medical records copied and sent to MD Anderson.  Their fax number is online. (Just call each doctors office and give them MD Anderson’s fax number). Give them a suspense date of 3 working days. Stay on their ass and make sure they comply.

2. She needs the hard copies or discs of all X-rays, mammos, ultrasounds, and labs done on her breast.  Gather them together…again giving each place a suspense of 3 days and hand carry or overnight them.  Some offices will do this for you.  Stay on them and make sure they comply.

3.  Have primary doctor write a referral to MD Anderson and fax it over to them.  This has to happen before they will see her so definitely push this to the max.  Be concerned if her doctor says..”.I just don’t think we are there yet.”  That just means you have probably saved your friends life.  He doesn’t know what he is doing.  Tell him you just want a second opinion.  Lie.  Just get the referral.

4.  On line there is a self referral form…the patient fills it out.  You explain what is going on…the basic history of her disease.  Your family history and past medical history. They will want to know pawn at her doctor has done up to this point and why she wants to go to MD Anderson.

After all this is done, the whole team at MD Anderson will review the chart, tests and her letter and determine if they can help her.  I got Joe Senior to go for his prostate cancer.  He was amazed at the treatment he received.  Here is the wonderful thing about MD Anderson…you don’t lose control of what is happening.  You are part of the team deciding how things are going to go.  You have the best doctors finding out the best plan of treatment, nurses finding out the best diet to support you through treatment, pain specialist to ensure your quality of life is not affected by the drugs, and a pharmacist reviewing all treatment to ensure that no medication interactions happen and chemo doses are correct, and psychiatrists to ensure that depression doesn’t kick in and your outlook is positive.  But, you have the final say in all treatments.  There is no judgement.  And, for once in a lifetime, you will be treated like a person in a doctors office.

Get her into MD Anderson now.  Seriously.

To coin a phrase: Holy shit!

Lies and Prevarication

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PinocchioWe’re told — I forget where, offhand — that the present generation receives the word “lie” as unforgivably rude. So, to spare any Millennial blushes, let  us discuss the Art of Prevarication.

Isn’t it amazing, what people get away with? They get away with it so frequently and so sublimely that they regard it as part of life, their natural privilege.

Ms. Neighbor — the one who was prevented from boarding my ship because my son had the cojones to go across the street and tell her “no!” — called the day before yesterday to wish me luck in the surgery and mumbled some sort of apology that I didn’t hear fully because I didn’t want to listen to her voice and so hung up on the answering machine. However, my son, a born diplomat, had told me that I should go over there and tell her how sorry I was that he ordered me not to take her in and extend my sympathies on her predicament.

He’s so polite.

So this morning I returned her call and reached her at her house, soon to be her former house. Said she, “Oh, dear, oh dear, I would never have suggested it if I had known you were going to have surgery yesterday!”

Say what? REALLY?

Does she think I don’t recall saying, “But I’m going to the hospital tomorrow for a second round of breast cancer surgery”?

Does she think I don’t recall her saying, “Oh, but I can be of help to you! Now my refrigerator can fit right here…”

Well, of course she does. Or she thinks she can make me think I don’t recall it, not quite like that anyway.

One of the things that accomplished liars prevaricators understand is that most people tend to believe the most recent thing they’ve heard. You can kind of “overwrite” a previous conversation or fact by saying something different with enough confidence, especially if your listener is elderly or not too bright.

I guess she thinks I’m a little bit of both. 😉

She must be an accomplished manipulator. That’s prob’ly why her relatives don’t want her moving in with them.

It wasn’t until I was in my 40s that I became aware of the number of people who lie as easily as breathing. So repressed was I as a child that even to this day I find it uncomfortable to fill in a fake name, phone number, and email address on a form to get another nuisance “member card” for some retailer. So it seems to me that an awful lot of people are very, very good at lying, and they do it as a matter of routine.

When I was about 45, I met and befriended a young couple who practiced insurance fraud. The ways they collected would beggar your imagination. They awed me. I’d never met anyone like that. Interestingly — or, hell: maybe “not surprisingly” — their professional prevarication slipped over into their personal lives. You really couldn’t know for sure when some story one of them told — whether it was an episode of ordinary daily life or some High Drama — was true or not.

There’s an art to prevarication. It’s like acting: you have to practice at it. Method prevarication, as it were.

The result of coming to know people like Ms. Neighbor and the Insurance Fraudsters is unfortunate: most of the time I don’t believe anyone. When a student comes up with some excuse for why she can’t turn in thus-and-such a paper, I assume she’s lying. When a salesman claims he’s required to tack on thus-and-such a chargeable service, I assume he’s lying. Today I question the truth of just about anything anyone says. And about a quarter of the time, I’d estimate, that’s justified.

Maybe that’s just Life in the Big City?

Image: Pinocchio. Enrico Mazzanti (1852-1910). Public domain.

 

 

 

Never Rains but It Pours…

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damNAtion! Is this EVER going to stop????

So, having been rescued from a potentially bottomless fiasco, come yesterday afternoon I’m sitting here staring into the computer, trying to decide whether to start on the client’s latest barrage of chapters, whether to try to figure out what my own character is going to say next, whether to give up and just cruise the Web for awhile, or what…when the phone rings.

It’s the brand new English Division chair. “We have a problem with your online course,” says he.

“Which one?” I ask. I figure the 235 section hasn’t made and he’s calling to say he’s canceling it.

“The 101.”

“I don’t have a 101 section,” I say.

“I mean the 102 class. A student called…”

…Ohhh SHIT!!!!!!!!!!!!!!!!!!!!!!! I think…

“…and said she couldn’t figure out why your assignments don’t jibe with the textbook. We realized your syllabus was written for the 10th edition. But they’ve bought the 11th edition.”

“WHAT?”

“Yes, we’re using the 11th edition. The admin says she gave you a copy.”

“No. I never got a copy of the 11th edition. I had no idea.”

The mailboxes in the departmental mailroom (needless to say, adjuncts do not have offices or even a corner of a desk in a bullpen) are set up so it’s hard to tell whether your name refers to the slot above it or to the slot below it. People often take mail for the wrong person, and so probably what’s happened is some other adjunct took the book out of my slot, months ago, and since of course I rarely go out to the campus, I had no clue. Chances are I wouldn’t have had a clue anyway, but I might have noticed a new text sitting in someone else’s mailbox.

I would know if a new text had been foisted on me, because every time that happens — which is about every two or three years with the damn Seyler book — I fly into a soaring rage. It invariably means I have to COMPLETELY rewrite my syllabus, a time-consuming, hair-tearing nuisance. Seyler doesn’t just throw in some new “selected readings.” She jacks the entire textbook’s organization around, so you’re forced to re-do everything.

The constant churning-out of new textbook editions has to do with the used-book industry, which exists solely because textbook publishers, seeing a captive audience, gouge students ridiculous amounts of money for their products. Seyler’s Read, Reason, Write is a prime example. At the high end, the thing is worth about $30, new. But as we scribble, Amazon is selling the damn thing for $116.84. Or you can rent it for a mere $87.99.

When a book is sold and re-purchased in the used-book market, the publisher earns nothing on the resale and the author earns no royalty. Since profits and royalties on a required textbook that costs $120 are significant (especially when it’s written for an almost universally required course like freshman comp), naturally publishers and their authors resent this commerce. To get around it, they cobble together new editions every two or three years.

So in the first year after publication, they make a bundle. Second year, they make a little less. By the third year, they’re going broke, as they DESERVE to be doing given the way they rip off the students.

At any rate, what this means on the microcosm is that the instant I regain consciousness from today’s fucking medical misadventure (as my friend Harriet pointed out, even though the doctor probably did what she was supposed to do in following the new DCIS excision guidelines, nevertheless the result is an unnecessary second surgery for me), I’m going to have to spend the better part of a day rewriting the syllabus. Actually, it won’t be the instant: the department is snail-mailing the book to me, so presumably it will arrive toward the end of the week. That will blow away my weekend.

Meanwhile, though, it develops that SOME of the classmates have the 10th edition! They presumably read the syllabus and also happen to order their books online instead of at the rapacious campus bookstore. So, students who a) were sharp enough to read the syllabus closely up-front and b) are smart enough to figure out that you can get these things a lot cheaper at Amazon and waypoints ended up with a textbook that works with the syllabus. Students who, as students are wont to do, simply went into the campus bookstore and purchased all their texts in one swell foop have the 11th edition.

I’m reluctant to make students who had their act together at the outset go out and buy an outrageously overpriced new text. If I’m to resist this shearing of my little flock, I’m going to have to create an adjusted syllabus for the people who have the 11th edition and let the ones who have the 10th edition use the existing syllabus.

Just imagine the grading nightmare that’s going to create.

I could deep-six the reading reports — that would get rid of 11 busywork assignments for them to have to write and us to have to read. But then I have no source of steady interaction in what is a 100% online course! So that’s not going to work.

There are only so many things you can say about how to write a freshman comp essay. And so really, there’s no good reason for them to buy the 11th edition (except that we as faculty are required to make them do so, by way of enriching the bookstore and the publisher).

[And, to make everything perfect, after I paid Luz $80 to make my floors glow in the dark yesterday, the dogs just frolicked through the mud and ran into the houses. Doesn’t matter: When my son comes to babysit me, he;s bringing Charley, whose snowshoe-sized feet will track in three times as much mud.]

So what I’m leaning toward is to keep the present 11 busywork projects (the so-called “reading responses,” which ask students to synopsize a chapter and then apply the chapter’s principles to one of the chapter’s selected readings) for those who already have the 10th edition and to create 11 new busywork projects for those who bought the 11th edition. The projects are essentially the same: synopsize the content/show how it works. It probably doesn’t MATTER what the chapter number is and what new reading selections Seyler has substituted for the old ones.

Except for the enormous hassle of trying to figure out which chapters in the new edition correspond to the chapters in the 10th edition, it may not be that difficult to simply let them write their “reading responses” on 11 chapters, any 11 chapters. It WILL be a hassle: this bitch of an author revises chapters by moving contents from Chapter A to Chapter B, so you end up with a new text whose chapters don’t correspond reliably with the old text’s. It will be a confusing, time-consuming, INFURIATING headache. But once that’s out of the way, it shouldn’t be that hard to score the busywork.

Isn’t teaching “fulfilling”? Isn’t it “rewarding”?

PBPHBPBPBPBTTTTTTT!!!!!!!!!

Bizarre Day on Wisteria Lane…

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Yesterday was bizarre. That’s about the only word for it. I swear, we no longer live in a Monty Python Show. We seem to have moved to Desperate Housewives’ Wisteria Lane.

I’m racing around trying to get out the door to meet my friend and business partner in Tempe for lunch at the fancy restaurant we favor, there to celebrate her birthday. The doorbell rings. The dogs go batsh!t.

It’s my neighbor cattycorner across the street. She’s sold her house and is moving out, apparently having fallen on hard times. The sale closes on Friday, the 29th.

As it develops, she has not found another place to live. She had arranged, she says, to stay with a friend who was going to put her up for a month while she looks for a new place. But said friend went on vacation to Puerto Rico and just returned to the states — with a Boy Toy in tow! This guy is moving in with the woman, and now Neighbor is dis-invited to stay there. Would I do her a favor and let her move in here? Otherwise she doesn’t know what she’s going to do.

Holy sh!t.

A month or two ago, when the house sold (it was underpriced by about $30,000 and so got snapped up instantly), while the three neighbor ladies on this end of the block were out in front yakking, she mentioned that she hadn’t even looked for a place, and I said, jokingly, that if push came to shove she could move in here.

That was before I had the last surgery and long before I was told I have to have MORE surgery tomorrow.

Caught point-blank and face-to-face, I didn’t see how I could say anything else than “uhhh….ohh-kayyy….” The puppy is squirreling around. I pick her up and put her in her X-pen to get her out of the way.  Now suddenly Neighbor is planning where she’s going to put her bed (meaning I have to move furniture out of one of the rooms) and talking me into letting her put her refrigerator in my garage (do you know how much a fridge running in a 110-degree garage will run up a power bill?!?) and saying words like “one to three months” and going on about how she’ll start looking for a place to stay after she gets her money from the sale (while I’m thinking…don’t you get your money on closing day? the kids aren’t moving in for a month because they want to do a bunch of renovations…can’t you ask if you can rent the place for a week or two while you look for an apartment?)

She wants to start moving in on Thursday. That’s the day after tomorrow: when I’ll be recuperating from surgery!

This conversation goes on until I say I have to leave because I have to drive to the far side of town. Neighbor is shoveled out the door.

Now I’m running late. I fly around the house trying to finish getting dressed and write a check for the  editorial work my friend has done, which I intend to pay her for over lunch, and get ready to shoot out the door. Last task is to stick the puppy in her crate so she can’t defile the floor. And…and she’s GONE!

I call and call, search and search, and I can’t find her. I figure she slipped out the door when Neighbor left. So next thing I’m out in the street screaming like a fishwife for Ruby. Neighbor comes over; they look around. Finally she explores the house and finds Ruby in her X-pen, where of course I’ve  forgotten that I stashed her. This is what happens when old ladies get distracted by unexpected and potentially hassle-laden new developments when their lives are already disrupted by repeated cancer surgeries.

I thank Neighbor, pick up Ruby, and shovel Neighbor out the door. Ruby, squirming in a frantic effort to get out the door, too, hooks a hind claw in my shirt — my favorite shirt — and tears a hole in it.

Shit.

Lock up the dog. Change my clothes, fly out the door. Meet my friend.

Have an amazing meal, as usual, at Tricks. Then we go over to The Shoe Mill, the single best shoe store in the Valley, where I need to buy a couple of pairs of the expensive Europoean shoes that don’t hurt my feet. There I buy two pairs of Naot sandals, all my sandals having simply worn out, and we each buy a pair of Pikadillos, actual shoes of the sort grown-ups wear. None of these are cheap: my tab is almost $600.

Well, I figure since I buy good shoes about once every four years, that works out to $150/year, so I don’t feel too bad about it. And I wear those kinds of sandals almost every day, since I live in jeans. One pair is a little dressy-looking and will be perfect for church (we’re required to wear black shoes to process), and another is an amazingly cute and astonishingly comfortable platform.

But meanwhile, as time has passed and discussion has been had, the whole idea of Neighbor moving into my house at all, to say nothing of one day after I get my boob cut open again, sounds worse and worse. I didn’t like the idea much at the outset but now I’m getting worried. I’ve lived alone for 20 years, and I like it that way! If I wanted someone living with me, I’d have someone living with me. Notice that I live with dogs: they can’t kipe my food, they don’t talk back, they don’t leave their makeup on the bathroom counter, and they don’t want to watch mindless television into the middle of the night.

I discuss this with Wonder Accountant, also a Wisteria Lane resident and friend/acquaintance of Neighbor. She suggests a written agreement and points out a number of pitfalls, not the least of which is “what are you going to do if she doesn’t want to move out after three months?” I want her out after one month, not three months.

Discuss with Insurance Broker to see if taking rent money from this woman will affect my homeowner’s insurance. He says not but is concerned about liability if one of the dogs bites her. He suggests I require her to take out renter’s insurance, about $15 a month. He asks what I’m going to do if she doesn’t want to move out after three months…

Discuss with Realtor Pal, to see if he can help find her a place to rent — he says the rental market, especially in the “reasonable rent” category, is impossibly tight right now and it could be difficult to find her a place to live. Because she’s getting so little from the house sale, it’s not going to be easy to get her into a condo or patio home, either:  she underpiced to begin with and then she agreed to give huge allowances to rereoof the place ($10,000) and do the pool repairs and apparently some other things, and then she discovered the house had a $45,000 lien against it to cover the care of her crazed father, Carlos the Knife, as he descended into his final dotage. He says that she should get her money on Friday when the deal closes and in fact if she asks they should cut her a check on the spot. By the way, Realtor Pal asks, what am I going to do if she doesn’t want to move out after three months?

Now I’m feeling behind the barrel.

Phone rings: it’s my son, wanting to see how I am and, while he’s standing in line at a deli to buy his dinner, to lay plans for the next Surgery Day. I explain what’s going on. He says, “I’ll be right over.”

He arrives, riding his white charger.

This man is an automobile insurance adjustor. His job is to spend the whole damn day, every day, listening to people’s sad stories, fielding their demands for compensation, and telling them “no.”  He pours a bourbon and water. I tell him the story with all its convolutions.

He says, “You stay here. I’ll take care of this.”

Mounting his white charger and taking up his white lance, he gallops across the street and presents himself at Neighbor’s door. Drawing from deep wells of testosterone-fueled swagger (God, but men are amazing creatures!), he informs her that he has unilaterally decided that his mother is not taking on a roommate one day after she has breast surgery. He tempers this by claiming that I’m actually a great deal more fragile than I look, and says he has decided this is all a very bad idea.

She says no problem, she’s sure she can find someplace else to stay.

So. Thank God and my doughty son, I’m out from under that. What a flap!

Today, then, all I have to do is deal with the plumber, deal with the cleaning lady, deal with the new 102 class, deal with new copy sent by paying client, prepare for surgery, and call in to the hospital after 4 p.m. to find out when it’s scheduled. Doesn’t that all sound like jolly fun?

At least I won’t be moving furniture out of the spare room…

$4333 an Hour??

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So along comes an itemized statement of charges from the Mayo Clinic, for the surgery, the anaesthesia, the this, the that and the other. Are you ready?

Are you sure you’re ready?

Be forewarned: it may not be possible to be ready.

Okay, so you’re really ready…

Thirteen thousand dollars.

That’s right: $13,000.

Think of that. The whole adventure from start to finish took about three hours.

$13,000/3 = $4,333.33 an hour

{sigh} Reminded, once again: we’re in the wrong business.

The Worst Threat the World Has Seen Since WW II

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The Guardian is running a story titled “‘Apocalyptic’ Isis beyond anything we’ve seen,’ say US defence chiefs.” Now, it’s true, The Guardian tends to exaggerate. But lemme tellya: this one is no exaggeration.

I lived in Saudi Arabia for ten years, in one of the remotest parts of a remote kingdom. We lived among the local people, who, during the 1950s, were still dwelling in conditions Europeans would think of as medieval, culturally and materially. No love was lost on Americans among the Saudis, and let me assure you, the murder of an innocent victim such as James Foley as a device to express hatred, vengeance, dominance, and menace was culturally acceptable then and it remains so now.

The West in general and the United States in specific have made so many bone-headed mistakes in the Middle East that it is impossible to keep track of them. Those stupid moves are coming home to roost now. With the ascendance of the kind of people who make it a religion to hate the West — to some degree with good reason — and the suppression of ruthless dictators who had a vested interest in keeping the peace, we do indeed face an apocalyptic threat. The Moslem extremists who are fast seizing power are fully capable of and feel justified in exploding nuclear bombs, releasing poison gas, and spreading engineered disease in cities filled with civilians, in any country on the planet. And sooner or later they will do so.

The most serious recent  mistake the West has made was to support the overthrow of strongmen like Saddam Hussein and his ilk. That is because we operate under a fundamental error: we believe, as though it were a religious tenet, that because democracy works for us it must therefore be best for everyone else in the world. And that is not true.

Democracy does not necessarily fit every culture. That is especially so for cultures that spawn groups capable of the atrocities we’ve already seen — atrocities that, you may be sure, are just the beginning. We need to butt out of the governance of other people’s countries. If a dictator is what’s needed to keep extreme jihadists under control, then a dictator is who should be in power. But stupidly, we failed to take advantage of the strongmen who were in a position to do that. When we should have continued to cultivate them, we dethroned them, or encouraged the locals to dethrone them. This was exceptionally stupid.

Our longest-running mistake in the Middle East has been to build dependence on the region’s oil supplies to support America’s enormous, spendthrift energy needs. This forced us to intertwine our economy and our politics with cultures that are not our friends and never have been our friends. Surpassing exceptionally stupid. We would have been better off to dig up all of Alaska, Canada, the Dakotas, the Pacific Ocean and the Gulf of Mexico than to establish the kind of dependence that we have now and have had for decades. When you compare the two evils, the former would have been less harmful to the United States as a nation and to the West as an alliance of technologically developed nations.

Our second-oldest mistake — hang onto your hats, folks, because I’m about to surpass myself in political incorrectness — was to support the establishment of Israel and maintain an alliance with it.

Think about Israel from an Arab point of view: This is a Western sovereignty populated mostly by people with European cultural roots that was forcibly planted on soil stolen from Palestine. Western allies supported its development shortly after the Second World War for a simple, truly evil reason: no one wanted to provide homes and safety for the millions of Jewish refugees from European tyranny. Instead of opening our borders to the beleaguered victims of a murderous time, we exploited a specious religious belief that a plot of territory on the Mediterranean was a God-given “promised land” to the Europeanized and Americanized descendants of an ancient nomadic tribe. After all, we persuaded ourselves, the Jews were there first.

Well. Maybe. But consider an American analogue. Let us suppose the European Union decided that Virginia should be removed from the governance of the United States and returned to the Pamunkey and Mattaponi Indians, on the theory that they were there first and Virginia is, after all, their land. Imagine how that would go over! It’s just about as rational, though, as ripping out a chunk of Palestine and handing it over to the descendants of the Hebrew tribes.

Given that Israel has systematically oppressed the local Palestinians and as we scribble is in the process of killing hundreds of civilians in its own defense (2000 Palestinians vs. 68 Israelis), it’s not surprising that Arabs feel a certain resentment toward the West.

In my opinion, ISIS is the worst threat to Western civilization that we have seen since Adolf Hitler. We need to crush this outfit NOW, even if it means dropping plutonium bombs on Syria, Iran, and Iraq, killing innocents along with the criminal extremists, and letting God sort them out. We cannot allow ISIS to gain any more power, territory, weapons, or political influence — period. If stopping ISIS means killing everybody in sight, that’s what we need to do.

We need to go all-out in building an energy infrastructure completely free of any association with any Middle Eastern country, even if it means despoiling our lands, raising the price of gasoline, building more nuclear plants across the nation, and perforce limiting the amount of power we expend.

We need to quit sending military aid, economic aid, and political support to Israel, even if it means evacuating every person of European ancestry and Jewish heritage and finding homes and jobs for them in Western countries. How about Virginia for starters?

My mother was not an educated woman. But she was perceptive. Sometimes she said things that amounted to metaphor. Once, she remarked, in so many words, that “Armageddon will come out of the Middle East.”

It sounds extreme. But she was commenting on an extreme situation.

World War III will come out of the Middle East. And WW III, given the kinds of weapons we have now and the fanaticism of our opponents, could very well be the Western world’s Armageddon.

Postscript, 8/23/2014: Don’t believe me? Well then, take a look at this authoritative article by Ed Husain, a senior fellow at the Council on Foreign Relations and a senior advisor to the Tony Blair Faith Foundation. It appears in this morning’s New York Times. What Mr. Husain describes exactly reflects my own experience of a decade in Saudi Arabia.