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John Galbraith Simmons studied philosophy at Northwestern University, graduating with honors, and also holds a degree in developmental studies from Long Island University. His newest book, written with Justin Zivin, is tPA for Stroke: The Story of a Controversial Drug. The book, which will be published in November, looks at the history of tPA which can drastically reduce the long-term disability associated with stroke if it is administered within the first three hours after the event occurs. In the original article below Simmons looks at Beau Biden’s recent stroke.

Details around Beau Biden’s “mild stroke” on Tuesday, May 12, remain unclear, although his reported symptoms were paralysis, numbness, and headache. He and his family, and his political entourage, currently are limiting their contact with the press while portraying him as alert and in possession of “full motor and speech skills.” Stroke is a genuinely disorienting event, so some initial reluctance to disclose may be understandable — for now.

But Beau Biden, 41, may help put a public face on the larger issues around stroke, a disease much neglected in terms of public awareness. Stroke is the leading cause of adult disability and third leading cause of death (after the sum of cancers and heart attack) — and receives little attention relative to its importance. Most germane are two issues. First is whether Biden’s stroke was appropriately treated as an acute emergency. Second, but no less significant, is whether his stroke was ischemic (due to a blood clot or blockage) and if he received the FDA-approved drug for stroke, known as tPA.

At present, indications are that Biden or family members made the right call — which, for stroke signs and symptoms, always means 911. He was taken by ambulance to Christiana Care Health System, one of the largest hospital systems in Delaware. Christiana Care is a certified primary stroke center that would in effect insure that if he were eligible for treatment, and if tPA was appropriate, he would have received it. After suffering his stroke on Tuesday morning, Biden was later in the day transferred to Thomas Jefferson University Hospital in Philadelphia. No explanation for the transfer was forthcoming but reports continued to be positive for a full recovery.

tPA, which stands for tissue plasminogen activator, is the only approved treatment for ischemic strokes, which are caused by blood clots or blockages and account for about 85% of all strokes. A “clot-busting” drug, tPA is not difficult to administer but must be given within four and a half hours after symptoms start, and a computerized brain scan is first required to rule out a bleeding, or hemorrhagic, stroke. Although approved by the FDA for stroke in 1996, tPA has had a long and difficult road to widespread acceptance among physicians, while potential victims remain for the most part disturbingly unaware of it.

For the present, Beau Biden’s “mild” stroke is worthy of headlines because he’s young, the son of a U.S. vice president, and a rising political star in his own right. Although strokes are more common in older people, Biden’s problem is not rare.  But the genuine story, it may turn out, will be to enhance public awareness of stroke as a hyperacute event. From Biden and his family, we will be waiting to hear better and more detailed news.

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By Edward Zelinsky

In recent remarks to the leadership of the AFL-CIO, President Obama and Vice President Biden affirmed their support of the Employee Free Choice Act. The Act is a priority of labor unions, a central element of the Democratic coalition. If enacted into law, the Act would effectively eliminate union recognition elections. Instead of secret ballot elections in which workers choose whether to belong to unions, the Act would amend federal law so that unions can achieve recognition based solely on public “card counts.”

Ironically, at the same time unions disfavor secret ballot elections in the workplace, many unions and their Democratic allies have aggressively advocated expanding the voting rights of corporate shareholders.

A similar paradox befalls the Republican Party. While the GOP has been stalwart in supporting workers’ right to vote in confidence on whether to join unions, the GOP has defended with equal fervor the efforts of corporate management to neuter shareholders’ voting rights. These efforts have been particularly troubling as corporate managers and quiescent directors have moved executive compensation packages into stratospheric levels and have denied shareholders the ability to vote their shares in protest.

No one has done a good job of explaining why workers should vote but not shareholders or vice versa. The underlying issue in both contexts is the same: the right of persons to vote confidentially on matters of importance to them. The secret ballot is the accepted method by which Americans exercise self-determination. Both as shareholders and as workers, Americans should enjoy a robust right to vote.

Just as President Obama’s endorsement of the Employee Free Choice Act highlights the issue of workers’ right to vote on unionization, the American Recovery and Reinvestment Act of 2009 (known to most Americans as “the stimulus bill”) underscores the question of shareholders’ voting rights. Under this Act, firms receiving federal funds from the Troubled Asset Relief Program must permit their shareholders to cast advisory votes on managerial compensation. But why just these firms? And why just advisory votes?

The limited voting provisions of the stimulus bill reflect the Obama Administration’s marked disinterest in giving shareholders the ability to vote on important matters, including questions of executive compensation.

Plausible arguments can be advanced both by those who would deprive workers of the right to vote on union representation and those who oppose shareholders’ right to vote on corporate policy. The procedures of the National Labor Relations Board, we are told, are so cumbersome that employers can delay union recognition elections inordinately and can create coercive environments when such elections are finally held. Shareholders, we are similarly told, often focus on short-term profits, rather than the long-term welfare of the corporation.

In the spirit of bi-partisanship advocated by President Obama, federal law should be amended to affirm the rights of Americans, both as workers and as shareholders, to vote. In the work place, unions seeking to represent workers should be required to obtain a majority vote by secret ballot of such workers. Similarly, important issues of corporate policy, most obviously the compensation packages of corporate managers, should be subject to binding shareholder votes by secret ballot.

While affirming the voting rights of workers and shareholders, Congress and the President should also address legitimate concerns raised by opponents of these voting rights. In response to the complaint that employers inappropriately delay votes on union organizing campaigns and create coercive environments, Congress should adopt administrable rules to prevent such delays and coercion and should appropriate the resources to enforce such rules effectively. In response to the complaint that shareholders ignore long-term corporate interests, Congress should similarly restrict voting rights to those shareholders who have owned their stock for a reasonable holding period and have thereby demonstrated a concern for the corporation’s long-term well-being.

With these protections in place, Democrats and Republicans alike should simultaneously affirm the rights of all Americans, both as workers and shareholders, to vote.

Mr. President: At the most basic level, the secret ballot is the American way.

Harm de Blij is the John A. Hannah Professor of Geography at Michigan State University. The author of more than 30 books he is an honorary life member of the National Geographic Society and was for seven years the Geography Editor on ABC’s Good Morning America. His most recent book, The Power of Place: Geography, Destiny, and Globalization’s Rough Landscape, he reveals the rugged contours of our world that keep all but 3% of “mobals” stationary in the country where they were born. He argues that where we start our journey has much to do with our destiny, and thus with our chances of overcoming obstacles in our way.  In the post below, written for National Geography Awareness Week, Blij looks at America’s geographic illiteracy.

The election of Barack Obama to the office of President of the United States revealed once again that American society is capable of revolutionary self-correction. The state survived a Civil War that brought an end to human-rights violations of the most dreadful kind. The Civil Rights Movement, a century later, completed a long-dormant cycle of American transformation on the basis of a Constitution whose terms, as Presidents Kennedy and Johnson proclaimed, had not yet been met. And now, two generations on, the unimaginable has happened. My mail from all over the world over the past several days has one common theme, amazement – and a second thread, admiration. People who usually went to bed before the polls closed in their own countries’ elections stayed up all night to watch the drama unfold in America. November 4, 2008 was Global Awareness Day – global awareness of America and its continuing importance to the future of this planet.

But from the American side, the two-year-long preoccupation with electoral politics took its toll on U.S. awareness of the world, and revealed some geographic illiteracy among the candidates that gave cause for concern. Even those news media still committed to some global perspective shrank their international coverage in the face of the demand for, as CNN put it, “all politics all the time.” And it was not just a matter of diminished attention to Iraq, Afghanistan, and other headline topics. Right next door to us, Mexico is becoming the Colombia of Middle America, but the drama – and it will have huge repercussions in the years ahead – barely makes it into print. In our hemisphere, enormous changes are occurring in Brazil, with China strongly in the picture, but the geography of this emerging superpower hardly makes the headlines. Even Russia’s growing belligerence (how soon Moscow’s portentous actions toward Georgia faded from view) only made the news when its president failed to congratulate president-elect Obama on his victory and used his acknowledgment of the event to threaten missile emplacement in Kaliningrad. Let us hope that National Geography Awareness Week 2008 will mark a renewal of attention to global concerns.

On the matter of geographic literacy, it was disturbing to hear one presidential candidate refer to the Iraq-Afghanistan border and another suggest that you can see Russia from Alaska (to be sure, there are places where you can, but not as her assertion intended). Anyone running for the highest or the second-highest office of the United States ought to know what NAFTA means and realize that Africa is not a country. As to Kaliningrad, let’s not even go there.

So long as we have national leaders (as has recently been the case) who are not adequately versed in the environmental and cultural geographies of the places with whose peoples they will have to interact, and which they seek to change through American intervention, we need to enhance public education in geography. Whether the world likes it or not, the United States still is the indispensable state of the twenty-first century, capable of influencing nations and peoples, lives and livelihoods from pole to pole. That power confers on Americans a responsibility to learn as much as they can about those nations and livelihoods, and for this there is no more effective vehicle than geography. It is a matter worth contemplating during National Geography Awareness Week.

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com.  In the article below he reflects on last week’s vice-presidential debate. Read his previous OUPblogs here.

Obama supporters were surprised that Sarah Palin didn’t trip up in her debate with Joe Biden; but they nevertheless thought that she was incoherent through most of it. Palin’s supporters were thrilled that she came back after multiple setbacks with her interviews with Katie Couric with a slam dunk. We have become so divided as a nation that we can’t even agree on which is night and which is day.

The reason, I think, is because Sarah Palin did not answer Gwen Ifill’s questions. When a student refuses to take a test, we cannot meaningfully compare her performance with another.

Right at the outset of the debate, Palin announced her contempt for the debate format: “I may not answer the questions that either the moderator or you want to hear, but I’m going to talk straight to the American people and let them know my track record also.” Palin’s opponents cried foul, but her supporters applauded her contempt of the media and Washington’s rules.

Here was Gwen Ifill’s first question: “The House of Representatives this week passed a bill, a big bailout bill … was this the worst of Washington or the best of Washington that we saw play out?”

This was Palin’s first non-answer: “You know, I think a good barometer here, as we try to figure out has this been a good time or a bad time in America’s economy, is go to a kid’s soccer game on Saturday, and turn to any parent there on the sideline and ask them, “How are you feeling about the economy?”

Biden did a classic debate pivot, but he did try to answer the question, saying “I think it’s neither the best or worst of Washington, but it’s evidence of the fact that the economic policies of the last eight years have been the worst economic policies we’ve ever had.”

Consider Ifil’s third question: “Governor, please if you want to respond to what he (Biden) said about Sen. McCain’s comments about health care?” and Palin’s petulant non-reply “I would like to respond about the tax increases.”

Or Ifill’s seventh question: “What promises have you and your campaigns made to the American people that you’re not going to be able to keep?” Sarah Palin tried her hand at the pivot trick too: “I want to go back to the energy plan, though, because this is — this is an important one that Barack Obama, he voted for in ‘05.” By pivot I mean, tangent.

In her closing statement, Palin again made clear where her priorities were. “I like being able to answer these tough questions without the filter, even, of the mainstream media kind of telling viewers what they’ve just heard. I’d rather be able to just speak to the American people like we just did.” Speak to the American people she did, but answer these tough questions she did not.

We should stop pretending that debates really happen in American politics; even the four organized by the Commission on Presidential Debates no longer qualify. Masquerading for debate, all we get are solipsistic televised addresses delivered to us in alternating segments. Last Thursday, Gwen Ifill was little more than a two-minute time keeper with no control of how Biden and especially Palin used their time.

Let us remember why we care for debates. Because meaningful exchanges between alternative voices stand at the heart of democracy. By controlling for question, we can see how candidates measure up to each other substantively. Instead, American politics today is deluged by speeches and not debates, asymmetric communications in which politicians talk past each other rather than to each other.

Avoiding the questions and eschewing a debate may be good for a candidate but it is bad for democracy. And we should not allow Sarah Palin or any other candidate to tell us that democracy is only about connecting with people and not also debating the issues. Only demagogues insist on trading directly with the people without the watchful eye - Palin calls it the “filter” - of the media or a dissenting interlocutor. Democracy is best served by reciprocity and deliberation, not one-sided assertions to one’s base with no follow-up questions.

While Palin connected last Thursday, she hardly debated. As supporter Michelle Malkin revealingly put it: “She was warm, fresh, funny, confident, energetic, personable, relentless, and on message.” Seven ayes for style, an aye for substance, and nay to debate. The nays have it.

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Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com.  In the article below he Palin’s nomination. Read his previous OUPblogs here.

John McCain’s campaign has turned a 7 point deficit into a 4 point lead according to the new USA Today/Gallup poll. This post-convention bump did not come from McCain’s acceptance speech, which only received an “excellent” rating from 15% of those polled, compared to the 35% Obama received. The bump came from Sarah Palin. Here is the poll’s most important result: before the convention, Republicans by 47%-39% were less enthusiastic than usual about voting. Now, they are more enthusiastic by 60%-19%.

The new McCain campaign message is that change is about reforming Washington, aided in no small part by a Number 2 that has developed/created quite a reputation for reform. This new configuration appears to be overshadowing Obama’s definition that change requires a change in party control of the White House, because it has tapped into the anti-Washington sentiment felt among the Republican base.

Palin is running not as the back-up plan (as most vp candidates have), but as right-hand woman, and this is why Barack Obama took the risk of appearing unpresidential today by attacking Sara Palin directly himself. But Obama’s response - “You can’t just make stuff up” - sounded like a petulant kid crying foul rather than an effective counter-punch. As the campaign fumbles for a working riposte, it will become clear that the answer was always right before their eyes. By an ironic twist of fate, Hillary Clinton, though unsuccessful in her own presidential bid, has become the queen and kingmaker. Sarah Palin would not have risen from political obscurity into national prominence but for the schism generated by Clinton’s candidacy within the Democratic party. Yet Joe Biden cannot perform the role of attack dog as viscerally as he would if Palin were a man, and so ironically, Clinton will have to be dispatched to play this traditionally vice-presidential role. The question is whether the media will give Clinton the time of day now that the primary season is decidedly over.

Safe for the October surprise still to be discovered, the tectonics of the match-up are now mostly settled. With the VPs now selected, two previously toss-up states have moved into the “leaning” category: PA has moved in Obama’s direction because of Biden, and MO has moved in McCain’s direction because of Palin. The only vice-presidential debate sceduled on Oct 2 will be more critical than the first of three presidential debates on September 26. There’s been a lot of talk of Gallup polls conducted immediately after the conventions only getting it right fifty percent of the time, but less acknowledged is the fact that by the first week of October - the week the vp candidates shall debate - these polls have gotten it right almost every time since 1952. On October 2, Biden and Palin will have their one chance to get it right for their respective campaigns.

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Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com.  In the article below he looks at Senator Barack Obama. Read his previous OUPblogs here.

The talk of town these days is that Senator Barack Obama is either just too cerebral, or refreshingly so.

Assessing the Senator’s weak performance at the Saddleback Faith Forum, Michael Gerson wrote in the Washington Post, “Obama was fluent, cool and cerebral — the qualities that made Adlai Stevenson interesting but did not make him president. ” Yet to others, cerebral is good. “Obama’s cool, cerebral style may be just what we need,” wrote Eleanor Clift of Newsweek.

It has occurred to me that people who agree or disagree with my thesis about The Anti-intellectual Presidency have tended to be divided on the question of whether or not a president’s political judgment should be based on intellection or intuition. This division may appear to some to map crudely along partisan lines: some liberals and Democrats tend to value reliance on the intellect; some conservatives and Republicans prioritize instinct. I think there is more agreement than meets the eye.

Insofar as there is a partisan disagreement, populist Republicans are probably right that as a general political rule, visceral trumps cerebral. The Obama campaign is starting to recognize this, with their choice of vice-presidential candidate Joe Biden, someone who speaks with passion and sometimes, apparently, without much prior thought.

But I don’t think many people are against intellection as a method for decision-making. It is surely a strawman argument that President Bush does no thinking and that Karl Rove was the brain behind his decisions. The key is that Bush pulls off the semblance of intellectual diffidence, even though he must do a lot of thinking behind the scenes. Like others have said of President Dwight Eisenhower, President Bush has mastered the highest political art that conceals art itself.

Now, there is still an argument to be made for judgment to be based on intuition rather than intellection, but it is a weak one. “Go with your gut” may be a familiar refrain, but even if intuition is less error-prone than intellection, there is one reason that recommends against its excessive use. Intuition is non-falsifiable. No one can prove what he feels in his or her gut. So when President Bush told us that he looked into Vladamir Putin’s eyes and saw a soul, we could only take his word for it that he saw what he saw. We couldn’t test the claim; we couldn’t even debate it. This can’t be what democracy is about, because democracy is conducted with the deliberation of public reasons, not the unilateral assertion of private emotions.

If I am correct, then no one disagrees with the importance of intellection as a decision-making method, even as there is disagreement on the political utility of projecting or hiding such intellection. The disagreement is about the image, but we can scarcely deny the importance of the process of intellection. Because they have failed to make this distinction between image and process, those who disagree with the appearance of intellection have also wrongly concluded that the process of intellection should have no place in leadership.

Anti-intellectualism is politically powerful, but it is in the end self-defeating. Suppose I feel in my gut that intellection is key to decision-making. How will someone who disagrees with my gut instinct prove my intuition wrong? Only by argument, debate, intellection.

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