* * Rob Solomon wants everybody to have health care

Robert Solomon, MD, is a mensch.

Mensch is a Yiddish word meaning a person with integrity, honor, and empathy. Rob is my general practitioner, an internal medicine doctor in Blacksburg. When people in this country can’t afford the treatments they need – and let’s be clear; at some point in our lives, everybody gets sick – it’s heartbreaking not only for them but for doctors like Rob, too.

When we met recently to talk about the problem from his perspective, he said, “When I was in the Army, the environment was basically socialized medicine. Everybody I took care of had health care provided. It made it easier for me, as I didn’t have to worry about the money. If a patient needed a test or a drug, I could prescribe it without worrying about whether they could afford it.”

Originally from Roanoke where we met as kids at Temple Emanuel, Rob got his medical degree at Eastern Virginia Medical College on a scholarship from the US Army, and then did his residency in the Army, treating patients in Panama and in Germany. He was in active duty for 6 years, before returning to Virginia to set up a private practice in Radford in 1990.

“My biggest adjustment going into civilian medicine was that often people couldn’t afford what they needed. At that time, 40 million Americans didn’t have health care; it’s an astronomical number! The percentage was probably higher (locally) than the national average. More people are now covered, but the costs have gone up dramatically.

“When a patient can’t get proper care because they can’t afford it, it’s sad. It’s very important for me as a doctor to look at the money aspect. I have to look at whether the patient can afford treatment, what their insurance covers if they have it, what their deductibles and co-pays are. Doctors shouldn’t have to do that. If my patients can’t afford it, they won’t get treatment. People have to eat.

“Here’s an example. There is an effective vaccine for shingles, a painful and potentially deadly disease that may affect as many of fifty percent of people by the time they reach 80. It is two shots, $180 or so each. Most Medicare doesn’t pay for it, without a supplemental plan. Some people can’t afford it.

“Insulin is another example. It’s gone up dramatically in recent years, as much as 100-fold.”

I noted that the insurance companies contribute nothing to human health, but still have their hands in the till.

Rob agreed, “Insurance companies take $504 billion annually out of the health care pie. It is a for-profit industry making money off health care while really not providing anything. I believe in a (government administered) single-payer system. This type of system is used throughout the industrialized world and is not a new idea here. President Eisenhower proposed this type of system, as did President Nixon. They were both Republicans. There is a strong conservative case to do this.”

The beauty is we already have a system, Medicare, that is working for millions of Americans and simply needs to be expanded to cover everyone. Anyone who hates wasteful overhead and bureaucracy should love Medicare for all.

From my experience traveling overseas where citizens enjoy universal health care plans, their reaction is two fold: First, they can’t believe a great country like USA doesn’t cover everybody, and second, they’re astonished that anybody in the USA believes our system is better.

Another advantage is that people are not dependent upon their employer, so coverage is transferable if they want to switch jobs or start a company.

Rob said, “I just want people to have basic care. I want to be able to prescribe the best treatments and the best medicines and know that my patients have access to them and can afford them. If someone gets a catastrophic illness, they can be decimated (financially), even if they’re insured.

“Some people don’t even come to the doctor when they’re clearly sick. What if a person who has no insurance develops a breast mass? She’s scared to see a doctor because she fears the costs. It may cost hundreds of thousands of dollars. So she doesn’t go. The mass becomes metastatic before any doctor sees her. Then she dies.  Many deadly diseases can be treated if discovered early.

“With Medicare for all, everybody will be equal on the same system. Administrators of a single-payer system could better negotiate prices from drug companies.

“We spend far more than any other country per capita on health care,” he said, “but our outcomes are not near the top. We have been prejudiced by powers that gain from the current system. With a single-payer system, I’m confident I could practice better medicine. I think we can change it. I’m optimistic.”

* * Deep hate

Rose Mallinger died last week at age 97 in Pittsburgh, Pennsylvania. During her working years, she was a secretary in her school’s office. Friends described her as “spry,” “vibrant,” and the “sweetest, lovely lady.” Ordinarily her passing wouldn’t be newsworthy other than to her family and friends. But she was one of the eleven people – the oldest – who were shot to agonizing deaths in their synagogue, the Tree of Life. She lived a rich, full life until a fusillade of bullets, fired from a high-powered weapon, pierced her wrinkled, aged skin and obliterated her organs. How deep must a man’s hate be to murder a 97 year old woman?

Ms. Mallinger and the other slain Jews were not the only victims during a terrible week in America.

A few days before Robert Bowers allegedly murdered these people – we will say “allegedly murdered” because here in America we all have the presumption of innocence until proven guilty – but there is no doubt about his guilt, Cesar Sayoc from Florida mailed at least 12 pipe bombs to prominent Democrats and media personalities who have been critical of Donald Trump. Fortunately nobody was injured. And a few days before that, white supremacist Gregory Bush, after failing to enter a predominantly black church, murdered two people at a store in Kentucky simply because they were black.

These horrific incidents follow the shooting of a Republican congressman at a baseball field and the white supremacist rally in Charlottesville that left a counter-protester and three policemen dead and scores injured in 2017. Back in July, Jarrod Ramos murdered five people in a newsroom in Annapolis, Maryland.

Americans are devastated, heartsick, and frustrated with the rancor and violence.

Bowers, Sayoc, Bush and Ramos were all middle-age white men, who reveled in righteous anger and were determined to vent their animosity in heinous, murderous acts. While not all acts of domestic terrorism have been carried out by Trump supporters, these and a disproportional number of others were, and it’s predictable that it will continue, given the President’s use of incendiary language. Public statements like “I’d like to punch him in the face,” “If you do (hurt him) I’ll defend you in court. Don’t worry,” and “I could stand in the middle of Fifth Avenue and shoot someone and I wouldn’t lose any votes,” embolden and legitimize those who are likely to be violent.

Trump has publicly vilified blacks, Muslims, Mexicans, gays, refugees, and many other minorities who have enjoyed otherwise peaceful lives in America. He has repeatedly called the media, “enemies of the people,” and blamed them for inaccurate and fraudulent news, rather than accepting responsibility for his vitriol. If the media are indeed enemies of the people, who would be surprised if those in the media were attacked by defenders of the country? Shouldn’t the words “enemies of the people,” be reserved for those who maim, kill, and terrorize us, rather than those who bring us the news? We can expect more assassination attempts towards prominent media figures to come.

So angry are Jewish leaders in Pittsburgh with Trump’s asperity that they have signed an open letter asking him not to visit their city until he denounces white nationalism and stops targeting minorities for scorn and derision. As I write this, 16,000 people have signed the letter, and more by the minute.

So here we are, living in a nation – tragically unique in the world – where mass murder, often racially motivated, is part of everyday life. A mass shooting is generally described as having four or more individuals being shot or killed in the same time and location, and we’ve had over 300 so far this year. Shootings that only involve two or three victims don’t even make the evening news any more. Most killings involve semi-automatic rifles and pistols. Opinion polls suggest that majorities of American favor stricter restrictions on purchase and ownership, but nothing seems to ever change.

Recent events are particularly hurtful to those of us here in the New River Valley where our image of a benign and peaceful area was shattered in April, 2007, along with the lives of 32 Virginia Tech students and faculty. And to me because of my Jewish heritage.

Trump callously suggested that if the synagogue had an armed guard, “results would have been far better.” Listen, if you have to have armed guards to practice your freedom of religion, then you don’t have freedom of religion.

Fair-minded Americans are fed up. I’m fed up. You’re fed up. The madness needs to stop. Individually and collectively, we need to decide whether a second civil war is the right path for our nation or whether we will respect our common humanity and chose peaceful, harmonious paths to solutions to our vexing problems.

* * Bringing passenger rail back to Christiansburg

Discussions are underway to bring passenger rail service back to Christiansburg after a 50 year absence. I’ve taken an acute interest in this, as my most recent book, Chasing the Powhatan Arrow, is about trains, and specifically how the railway presence has affected the communities through which they run.

Recently I got together with John Tutle who is on a volunteer committee to coordinate efforts between the various municipalities, stake-holders, and AMTRAK to try to make that happen.

“They’re seeing good ridership numbers in Roanoke,” he told me, regarding the new service expanded from Lynchburg in October 2017. “That’s crucial, because if they don’t get the good numbers they need in Roanoke, we won’t see it here. But they’re getting good numbers and they’re pleased. They’re going to see around 40,000 passengers in the first year.”

At this stage, Roanoke is the end of the line; you can only go or come from the east, through Lynchburg. John’s group hopes to change that, with the end of the line extended into Christiansburg and potentially to Bristol.

“If they can continue to have enough ridership in Roanoke, and if they feel they can expand, they’ll come here. It makes lots of sense and is getting good support here. Virginia Tech is strongly in favor, as is the CRC (Corporate Research Center). The town of Christiansburg has proactively bought property alongside the tracks near the Aquatic Center in anticipation of building a platform or station there. They’re putting in a parking lot that can be used now as overflow for the Center, but later used for train patrons.”

At this stage, Roanoke doesn’t have a station at all, merely a platform, near the Winston Link Museum, the Hotel Roanoke, and the Farmer’s Market. According to Tutle, Christiansburg would like to “jump a little bit more, and get a station as soon as possible.”

Tutle was personally not a train aficionado. But for years he’d been involved with the Montgomery County Chamber of Commerce and its economic development efforts, serving as a board member for many years and chairman in 2013. “I began to see (renewed passenger service) as an economic driver for the region.”

I envisioned more people leaving than coming, with local folks going to Washington, New York, and Boston on holiday visits. But Tutle felt that many people would use the train to come here, for graduations, football games, and recreation. “It will be a great way to bring people here, especially on the weekends.

“And it’s a great, relaxing trip. The train has WiFi so you can be connected and get work done. It’s 5-1/2 hours to DC, but there is no traffic and no stress.

“With I-81, we’re averaging five wrecks per day from Winchester to Bristol. Last Thursday, there were two traffic jams that turned several sections into a parking lot that lasted for hours. Trains certainly have the chance to be more reliable.”

During research for my book, I spoke with the station master in Lynchburg who told me that on weekends, especially prior to holidays, the train from there to Charlottesville, Washington and beyond is filled with students from Liberty University, Longwood University, and University of Lynchburg going home in a safe, affordable, traffic free way, making it almost a party scene. There’s nothing more fun (for college kids) than riding a train filled with college kids!

 “I was hesitant when I first got started in this,” Tutle admitted. “But I think passenger rail will make a comeback. I thought it was a fad. But I don’t believe that any more. It’s been eye-opening, how many people want to ride the train and how many people are riding now. Transportation to and from the station will be easy with services like Lyft and Uber. Hotels will offer service the way they now offer shuttles to airports.

“My committee started with the Blacksburg Partnership. I’m on the marketing side. I’ve done a couple of presentations where people have said they’ve been on trains and want to go again. They want to see a ballgame or show in New York, Baltimore or Washington.”

Personally, I’d like to see greatly expanded railroad service in America. We subsidize our highways and our airports and air traffic control. Why are we not willing to subsidize railroad service?

“I’d like to see a shuttle train from Blacksburg and Christiansburg to Roanoke,” Tutle said. “It would really tie the area together.

“I’m really impressed by how many people want to ride the train. It’s not a whim. It’s not a passing fad.”

* * Ron Angert is getting out of ‘Dodge’

Ron Angert recently had an experience that seems destined to alter the trajectory for the rest of his life. Ron walked the famous pilgrimage called the Camino de Santiago in Spain. That five week walk was a profound event for him. “I am moved by spiritual content, and it was a spiritual experience. So my wife Ann and I are planning to move to Spain.

 “I’ve always been focused on loving people. I saw the movie The Way a few years ago. It’s about a man who walked the Camino to deal with the death of his son who had attempted the same walk. Ten minutes into the movie, I knew I needed to do it myself before my 70^th birthday. I knew I needed to be retired first as I could never go back to work.”

In the cathedral in Santiago de Compostela, Spain, is the shrine of the apostle Saint James the Great, where his remains are thought to be buried.

“For many who walk, it is a challenge like hiking the Appalachian Trail. It’s 500 miles and the physical part affects everybody. Foot pain. Back pain. Leg pain. But you get over that. It’s not as challenging as the AT because at the end of the day, you stay indoors, you may choose to get a nice meal with great wine, and you get a shower and a warm bed. But it’s still hard.

“Then there’s the emotional aspect. For months before I went, I got online and read people’s accounts of their experiences. Some were homesick. Early in the trip, every day at around 11 a.m., I gave up. I decided I couldn’t do it, but I further decided nobody could do it. I thought it was a lie, that it was impossible, to get to the end. Yet 270,000 people do it every year. Pilgrims have been doing this walk for 1000 years!

“The third aspect is spiritual. Not all, but many hikers realize a more profound relationship with creation, that they never understood before.”

I asked about the seed of that spiritual transformation.

Ron said, “I can only speak for myself. I fell in love with hundreds of people, including many with whom I shared no common language. Eventually all the walkers naturally build relationships with others. I called mine my ‘Camino family.’ For example, I met Stephanie, who became my Camino daughter and her aunt Janice who were walking together. We met one day leaving a hostel early in the morning, in the dark. We walked along on a mountain trail while she had told me about two suitors who wanted to marry her, about their pros and cons, and her feelings for them. As the sun rose, she asked for my advice on her decision, to which I responded, ‘I have a wife and a daughter and I’ve never had this intimate a conversation with either of them,’ and at that point I didn’t even know her name.

“I became bonded to this group of people. It was middle-school, gushy, love, inappropriate love. I loved them so much.”

It’s fair to say that everybody who walks the Camino is changed is some ways by the experience. But Ron and Ann are planning to go to the next step. Their home in Newport is on the market and they’re planning to move to the town of Astorga, on the Camino.

“There are many reasons,” Ron said. “I’m devoted to health, and the food is amazing there. We have introduced the concept of ‘Farm to table,’ where food is grown locally. That’s the norm there. Many restaurants have their own gardens producing the vegetables they serve.

“Second, we Americans are hyper-competitive. Fastest! Best! Tallest! Over there, it doesn’t matter. (On the Camino), you walk every day, but at your own pace. Every day is new sights, people, towns, and experiences. It’s very healthy.

“I see lots of hatred in this country, and that really bothers me. We have elevated lots of hateful people. In business. In government. Even in grade school, with the bullying. You don’t have to be ashamed of being hateful it seems. You can brag about it.

“Still, I’m not so much moving away from something but to something. Our friends have expressed that it’s an outlandish thing to do. But for us it makes sense.

“In the community we’re moving, people spend time together at cafes, reading the paper, sipping tea and coffee. They’re not too busy and not competitive. We want that.

“I encourage everyone to live in another culture, either as a volunteer or worker. Getting out of ‘Dodge’ is a really mind expanding thing,” he smiled.

* * Norway is Amazing

The first thing you need to know about Norway is that it is haltingly, startlingly beautiful, with crystalline lakes, enchanting fjords, rugged mountains, and pastoral farms. I’ve always wanted to go and time has been marching on. Finally my wife and I decided to make this old dream come true.

In Norway, there is a new wonder around every bend in the road. The fjords are simply magnificent, indescribable. I’ve heard it said that the whole country is as grand as Yosemite. Our 3000 km loop from Oslo across to the west coast to Stavanger, then Bergen and Alesund, then back through Lillehammer, proved that to be true.

Speaking of roads, the only straight ones are in the many tunnels, and some of them are curvy. Their highway engineers know how to go underground, and it’s a good thing, too, because above ground is marvelously corrugated.

There are many toll roads. There are no toll booths. Every car is required to have a chip on the windshield which is periodically scanned by sensors and an invoice is simply applied to stored credit cards.

Incidentally, speaking of credit cards, in Norway people use them to pay for EVERYTHING, mostly via hand-held readers that print receipts. Your credit card pays for meals, ferries, parking, and groceries. The one place we found pay toilets (in the tourist area of Bergen), no cash or coins were accepted; only credit cards.

Speaking of toilets, most communities of any size have free public toilets. As do the convenience stores, which are all modern and immaculate. Even remote villages had public toilet facilities, and all had running water, electric hand driers, and lights. And they were spotless.

There were pedestrian and bike paths everywhere, and people of all ages used them frequently.

The default intersection was the roundabout, and they worked great, moving significant levels of traffic smoothly and with little problem for anybody. I’m home now, immediately frustrated with the wasted minutes and fuel at every one of the countless signalized intersections we have around here.

Driving in Norway takes a level of skill, attention, and especially cooperation that I doubt most Americans are able or willing to provide. The roads, even the major highways, are almost always two-lane affairs, often 1.6 lanes or narrower. Some country roads lack room for oncoming cars to pass, and each must cooperate to use sporadic wide passing zones. Lorries (tractor trailers) navigate even narrow highways with an astonishing level of aplomb. Most of the cars are new and small, and we never saw one with crash damage. Norway has taken to electric cars in a big way. Driving is a full time job and nobody is on the phone.

As I alluded, above, they use the Metric system, like seemingly everybody else (but us). My rental car, a six-speed manual Ford Escort, used 5.5 liters in 100 kilometers. Can you do that conversion?

Overall, Norway is highly energy efficient and pollution conscious. There is zero roadside trash and no billboards. Did I mention it is astonishingly beautiful?

The federal government plays a huge roll in the welfare of all Norwegians. They pay high taxes. In return, they get government sponsored higher education and universal medical treatment. Minimum wages are high. Waitresses make $22/hr and don’t rely on tips. They love their health care system and are gobsmacked learning ours leaves millions uninsured. They can’t believe Americans are brainwashed to believe theirs is terrible. Get this: when they get sick, they go to the doctor and get treatment AT NO CHARGE.

Speaking of America, they are deeply vexed by what’s happening politically in our land and are far more educated about us than we are about them. One AirBnB host said, “We’ve hosted lots of Americans and not a single one approves of Donald Trump.” They see him as unstable and dangerous.

If there is any poverty, we didn’t see it. Even the most out of the way hamlets seem prosperous. The tourist trade is booming. Did I mention that Norway is beautiful?

Scenic landscapes. Lovely, well-educated, relaxed people. Fascinating history. I don’t think we’ve talked to anybody here who doesn’t love it.

Finally, Norway is a resource rich nation, primarily oil. Norway has invested the money reaped from taxes and exploration fees in their Government Pension (Oil) fund, currently around $1 trillion, an astounding $195,000 worth per citizen. It has holdings in stocks, real estate, and energy reserves throughout the world. America is a resource rich nation, in oil, coal, natural gas, and minerals. The American corporate owned government has channeled most of the wealth generated from those resources to an unfathomably wealthy elite, and America is now approximately $21 trillion in debt, an astounding $65,000 debt per citizen.

Which nation do you think will have a better future?