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Effect Measure

Given the usual response to terrorist threats on airplanes, we expect the latest move to protect us will be to require us to travel nude. OK. Probably not. Republicans are too skittish about public nakedness. They prefer it in the privacy of their mistresses’ beds. What we will see, instead, is yet another attempt at a technical fix, spearheaded by high priced security and aviation “consultants.” I saw one of them, Mary Schiavo (former inspector general of the Department of Transportation) the other night on the PBS Newshour. She was hawking expensive explosive sniffers for airport check-in, as well as the scanners that undress you without undressing you. That apparently works just fine for prurient Republicans.

I’m not an expert on airport security (although I am an expert victim of airport security theater), but I do know something about statistics and probability and can recognize a classic fallacy when I hear one. And I heard one, not only from Ms. Schiavo (an attorney) but also her “counter-point,” David Schanzer, director of the Triangle Center on Terrorism and Homeland Security at Duke (one Newshour correspondent, who shall remain nameless, once wryly described to me the format of the show in this way: “And now for another view of the Holocaust . . . “). Here are the relevant parts of the segment:

GWEN IFILL: David Schanzer, is there — is there a technology in place that could have avoided this kind of failure?

DAVID SCHANZER, director, Triangle Center on Terrorism and Homeland Security: Well, the full body scan machines can do a better job, and they can improve the likelihood of finding something like that.

But there’s no 100 percent screening device that’s going to be able to pick up everything. And I think you have to ask yourselves before you deploy a multibillion-dollar technology whether or not you get more bang for the buck out of things like intelligence enhancement, watch-listing, more international cooperation.

GWEN IFILL: Let’s back up a minute. You said there’s no 100 percent guarantee. And the president, in fact, said that himself today. But wouldn’t people be satisfied if — knowing that, since 9/11, we were at 75 percent, 80 percent?

DAVID SCHANZER: Well, it’s all a bit of — it’s all probabilistic.

The question is, though, that we have an adaptive adversary, that whatever technology we deploy, they’re going to take steps to try to circumvent it. And, so, the problem is, if you invest huge amounts of money in these technologies, they might become obsolete when the next type of threat comes up six months or a year from now.

GWEN IFILL: What do you think about that, Mary Schiavo?

MARY SCHIAVO: Well, that’s — that’s really not the way I would approach it at all.

Obviously, we have to invest in the technology, because it’s the technology that can spot so many of these threats. Not 100 percent? Well, it could be very close to 100 percent, because there are four different machines with four different technologies that can spot explosives and explosive materials and components of bombs.

And, here, we can’t say we rely on profiling and intelligence, because that’s what we were relying on, on September 11, 2001. We don’t always fit the profile. There have been young beautiful North Korean women to someone over Indiana in 1933 blowing up planes. We cannot rely on profiling and intelligence, because we have proven that, over the last 70 years, it has failed. Hardware is our last line of defense, and it can be pretty close to 100 percent.

[snip]

GWEN IFILL: David Schanzer, it seems like there a lot of costs that we’re talking about here, the costs of actually the physical equipment, of getting the money, the costs of what you give up once you agree to this sort of — of what some people consider to be an invasive technology.

What would you say the costs are?

DAVID SCHANZER: Well, you have named some of them. The fact of the matter is, we live in a world of limited resources. So, we have to make trade-offs and choices about which set of policies and which sets of technologies we want to deploy.

Your other guest mentioned four different types of machines. Well, I don’t think we’re going to be able to deploy four different new types of machines, not only in the United States, but we would need to deploy these things globally to truly protect us.

I’m not saying we shouldn’t have screening devices. We — absolutely, we should. All I’m saying is that you have to consider the full package and figure out what set of policies is going to do the best at reducing the risks that we all face.

GWEN IFILL: Mary Schiavo, we saw you saying, yes, we are. You know, those four machines can be deployed.

But let me ask you this. At what cost in terms of civil liberties?

MARY SCHIAVO: Well, the cost in civil liberties, the great thing about machines is, they treat everyone the same. The machines don’t violate our civil liberties.

What violates civil liberties, when you say, well, we’re going to pick out this person and look at them, or this person and look at her, et cetera. The machines treat us all the same.

The only civil liberties issue so far that makes any sense is where it reveals the shape of the human being. But even that, the machines have gotten better. And the private parts can be shaded or — or not shown. And those machines have improved as well.

[snip]

DAVID SCHANZER: Well, just to make one point, the privacy protections that your guest mentioned might have made it more difficult to detect this particular device.

I just think that, when you have limited resources, you have no choice but to make these risk trade-offs. Maybe some types of devices would be useful, but, again, this device, the body scanner, is used in secondary screening. It isn’t used for everybody.

So, at some point, you are picking who is going to go through that device and who isn’t, unless you’re, again, willing to deploy it and have everybody in the world who’s traveling at that point be screened. So, that is a very expensive endeavor. And, again, the adversary is just going to simply adapt and try to find a different way to attack us. (Transcript, PBS Newshour segment on trade-offs between security and civil liberties)

Schiavo has made the basic error. Schanz is essentially correct that it’s a cost issue, but he ratifies Schiavo’s mistake by picking on the least problematic part of her analysis, how good the technology is in picking up explosives and ignores the fallacy that would strongly support his point. Since he didn’t do it, we’ll do it for him.

The basic error is this. Schiavo is citing the probability that someone carrying explosives will be detected by these expensive machines. She claims it is essentially 100% and Schanz’s retort is that this is unlikely. Actually it is not unlikely. I can easily design a machine that will identify every single person carrying explosives onto an airplane. It is a black box with a red light on top of it. When someone with explosives walks past it, the red light is on. Now all I have to do is wire it so that it is always on. That way it picks up 100% of all explosives carrying passengers.

This is a classical screening problem in epidemiology and we know how to solve it, although most doctors have faulty intuitions because they make the same mistake as Schiavo. We’ve discussed the medical version here already, so let’s stick to airport screening. The probability of detection isn’t the relevant probability. The question we want to answer is not the probability of picking up a terrorist carrying explosives (the question Schiavo posed). It is the probability that a “detected” passenger will be carrying explosives. To address that we also need to know the probability that the detector will go off if someone is not carrying explosives (a false positive) and the probability that any passenger is carrying explosives.

First the false positives. The problem with my 100% sensitive machine is that it also says a lot of people who don’t have explosives do have them. You don’t want those cases, but if you want 100% or close to 100% detection ability, as Schiavo claims, you know you are going to have to accept some. The simple RFID anti-theft devices in stores have them all the time and that’s a relatively easy problem compared to explosives detection (NB Sciavo cites a combination of four different kinds of machine required because explosives vary and all it would take is a new kind of explosive or some other non-explosive that had a similar signature to one to screw things up). Those “minor” quibbles aside, let’s assume that by investing a gazillion dollars we could deploy some sophisticated technology at every airport within our borders and coming to and from the US that was so accurate it only had a false positive once in 100,000 passengers, i.e., it was 100% sensitive and 99.999% specific. I doubt we can make a machine that accurate, but let’s just suppose we could.

How many false positives would that produce? According to the Department of Transportation, during the last year there were about 710 million enplanements (US carriers, October 2008 – September 2009; excludes all-cargo services, includes domestic and international). That would produce 7100 false alarms, about 20 a day. How many passengers carrying explosives would the technology pick up? Well, we’ve had exactly 2 since 2001 (Richard Reid the shoe bomber and the current underpants bomber), or .25/710,000,000 enplanements (it’s actually less because enplanements have decreased substantially since 2001). So the probability of an alarm being correct is about 1 in 30,000 or .000033. For that yield there is the cost of research and development of the technology, acquiring and installing it, operating and maintaining it and the extra time of all the passengers. There will also be an effect on air travel generally, stressing an already economically desperate industry. To the extent that increases miles traveled by road, we have to add that cost and the cost in lives of motor vehicle accidents into the mix.

Of course there will be those who say it’s worth it, whatever the cost in dollars (direct cost, only, estimate of $100 billion; why “no cost too high” should be true for air travel and not health care reform baffles me, but human psychology isn’t always rational). But the “worth it” argument is only valid if it worked. As others have said, including Schanz on the PBS Newshour segment, this is essentially a reactive strategy. There’s almost always a way — often an easy way — around technological fixes like this. They usually involve human engineering exploits, not technological ones. Yet we are the proverbial generals always fighting the last war. Nor is it irrelevant to the cost accounting that there have been two examples in 8 years of passengers carrying explosives aboard airplanes but zero examples of successful detonation. Even when you get the stuff onboard, there seems to be a substantial gap between paranoid fantasy and actual practice. It’s just not that easy.

So as we head into the new year, I am expecting air travel to be even more unpleasant and as a consequence I will be even more eager to avoid it. That means I will be encouraging more videoconferencing and conference calls and less face to face meetings. There’s always something lost when you don’t meet in person. But what is gained is not having to deal with the utterly stupid, pointless and unnecessary response that is sure to come.

Happy New Year everyone!

Comments

#1 IanW
December 31, 2009

I agree with you 100%. Since the Police departments cannot possibly prevent 100 percent of crimes, and cannot catch 100% of perps, and since serious crimes are such a small number compared with the millions in the population, why even bother with a police department? We coud save billions by dismantling them all with no ill effects.

And of course, if we don’t bother trying to weed out terrorists when people board airplanes, there’s no way that those two incidents over the last eight years would ever have become significantly more than two.

I don’t see any fallacy at all in your argument.
#2 Rose Colored Glasses
December 31, 2009

The devices could detect explosives only if the material is not properly sealed.

Proof?

Simple. The ammunition in the firearms of airport police contain double-based powder, which is a mixture of nitroglycerine and nitrocellulose. Since the cartridges are sealed, no moisture leaks in, and no fumes leak out. With all this ammunition moving around the airport, surely the detectors would give a false alarm every time a cop got near a detector, but that never happens, not even once.

Thus a pound of PETN, properly sealed with something as simple as two coats of shellac, would escape detection.

Another problem is specificity. Even if the detector could go 100% on detection, never missing an explosive which is there, it will not be 100% specific, finding lots of things that are there that aren’t explosives. If we screen a million passengers, figure fifty thousand false positives and one single true positive. As we secondarily screen those 50,001 people, we will get so used to clearing them that it will become a habit, so that unless the one true positive is among the first dozen or hundred, he is virtually guaranteed to get a pass.
#3 revere
December 31, 2009

IanW: Unfortunately you don’t understand the fallacy of Schiavo’s argument (another way of saying it is that you are committing the same one). You focus on the sensitivity of the detectors, which can always 100%. But then you lose specificity. Even with 100% sensitivity and an unrealistic specificty of 99.999% you wind up with extremely unfavorable probabilities that a detection alarm will be a terrorist. Your logic leads to the idea we spend unlimited amounts to save a life, which I assume means you want to put a lot more into health care (I’m with you there, although “unlimited” isn’t my notion since resources are always limited). Just to lay it out for others (since you didn’t really bother to read or follow the post), the fallacy in your police department argument is that the prevalence of police appropriate crime is much higher than terrorist incidents that alters the balance dramatically. At the same time we have constitutional and other leal safeguards to handle the false arrest problem and that doesn’t work that well for police.

Rose colored glasses: You obviously get it. It’s not a political but a practical and technical argument.
#4 Phillip IV
December 31, 2009

Given the usual response to terrorist threats on airplanes, we expect the latest move to protect us will be to require us to travel nude.

Absolutely. In addition, for the last hour before landing, everyone will be tied up. To prevent people to get too excited, all on-board movies will be about baseball.

Seriously, though, I think the main point a lot of people are missing in regard to the airport security debate is the fact that air transport is solely a target of opportunity for terrorists. They like to attack passenger planes due to their fragility, allowing them to kill a lot of people and cause a lot of property damage with a small amount of explosives – but even if there was a way to forestall all such attacks, that would not solve the problem of terrorism itself. The terrorists would simply switch to a different type of target – as long as they have people willing to kill innocents and die in the bargain, they’ll always find a way to do damage. Even if all venues where people congregate in larger numbers would be secured to the point of paranoia, that would at most reduce the bodycount – if nothing else works, the terrorists could still move from mass killing to serial killing.

In the long run, there is no way to deal with terrorism anywhere else than at the source – which are the societal structures in the countries of origin.

but human psychology isn’t always rational

But that’s the other side of the issue, and probably the reason why politicians support tightened airport security even when they are aware of the issues I pointed out above – it’s less about security, and more about calming down nervous air travelers. While the chances of falling victim to a terrorist attack are minuscule, every new attack still has a psychological impact, and the airline industry is already doing badly enough – so after every attack, they need to institute some new harassment or inconvenience, just to give travelers a hands-on experience of ‘tightened security’.
#5 P J Bryant
December 31, 2009

Out of interest, why are we only worried about bombs going off in the last hour? Surely the terrorists will be happier with a plane going down mid Atlantic, than not at all?
All bloody theatre.
#6 revere
December 31, 2009

PJ Bryant: Of course. It’s stupid.
#7 Richard Hendricks
December 31, 2009

In my opinion, it gets even dumber. We have a terrorist attack (attempted or not, doesn’t matter). So what do we do? We require extra screening, which, realistically, is one of the worst things you can do, because now you have a large concentration of people gathered where they are easily accessible to anyone who has not been screened. It’s all security theater until the TSA wises up and makes ALL lines fast enough that there aren’t any large groups, anywhere in the airport, including check-in and baggage claims.
#8 M. Randolph Kruger
December 31, 2009

The other part of this is airport security. If the idea is kill passengers and create transportation havoc then you dont attack the airplanes… You attack the terminals. You would get a shit load more of them from that and no one would come near the place afterwards. Lets face it, our school buses and schools are much more vulnerable. Its an opinion poll world that we live in. So after all of these security interdictions and the money spent, they simply let the mofo onto the plane?

If the idea is to bring down airliners then there are plenty of places to get weapons on the black market that will do the trick….Why bother with the terminals if thats the case? Here is a picture of some farm machinery that was picked up in Miami two years ago at the ocean port. Thirty of them and it was pure dumb luck that they found it. State run media ensured that it only got a few lines in the local papers.

http://iraqthemodel.blogspot.com/uploaded_images/Strela-706590.jpg

Lets spend some more money. Chaff/flare dispensers on the planes and the like really wont matter at the speed and altitude these things operate at. Its the equivalent of our older Redeye handhelds and has been upgraded now. The Ruskies only made at last count about 11 million of them.

But its about the layering of the protections and yes the four scanner system would likely pickup just about all of the things on your body. But its a recognition gig too. So you do what when you find it. He knows he is caught and with a scream of Allah Akbar he takes out a terminal? Shit and just as I was slipping my shoes back on too. Didnt have a chance to run.

Here is something at the airport that we are all watching for now down below. Detroit fame-Binaries. But we have really been looking for a long time. You should see the security procedures I have to comply with now. If it has wires I have to look at it by hand and visually inspect every shipment. In a few years I doubt that there will be air cargo on pax aircraft because of this stuff. Think it costs a lot to fly now? Wait til that offset is gone.

Reveres suggestion that he could design a machine that would detect this is laughable…as is Sciavo and the other one. 100% or nearly so? You put in a billion dollars of equipment and then its rendered useless when something else comes along thats better and cant be detected. And you find it the hard way. But the simple procedures of screening were not met on the flight into Detroit and Big Sis and Obama are being excoriated for it. Good, I said they were both putz’s and thats really beginning to show. There will be more of this. If a plane is jacked or blown up then you can bet that Big Sis will go (have to have a goat to sacrifice) and Obama will just order more bureaucracy to cover his ass. It will of course do NOTHING FOR SECURITY but anything to get them butts into the seats.

But, again,you have to go to the source on the threat and not to the ACLU. This is what this guy was trying to make up over Detroit ten minutes before touchdown in the vid. It apparently didnt go because of the lack of drying, so it fizzled and burned instead. Must have been a helluva crotch fire. If you travel, always be aware of the people around you on a plane or a train. If something starts up, dont wait and dont hesitate to remove them from the planet. Thanks to the Dutch.

The Detroit bomber? He isnt talking so where in the hell is my waterboard?

http://www.break.com/usercontent/2008/6/Binary-Explosives-519240.html
#9 RedPete
December 31, 2009

As always revere, a very clear explanation of a complicated issue.

One area where screening for people carrying explosives is different from medical screening however, is the idea of deterrence. I would imagine that some terrorists will be deterred from bombing a plane knowing that there are screening procedures in place. Not that I feel this effect materially changes the benefit-cost analysis.
#10 Jubal
December 31, 2009

Banging on Republicans is tiresome and alienating. You may have had a good point in your article but I quickly went on to something that might not be a partisan diatribe. Please try to keep to “Public Health Discussion and Argument.” FYI, it seems many Republicans don’t have a hang up about nudity.

http://www.bostonherald.com/track/inside_track/view.bg?articleid=1197778

http://www.huffingtonpost.com/2009/06/27/mark-musselwhite-former-g_n_221844.html
#11 Kevin
December 31, 2009

The assumption is all passengers are equal risks. This is obviously false. Data mining of the manifest (AKA profiling) would allow sorting the passengers into risk groups and subjecting the highest risk percentile to the most extensive measures. It would be easy, in IT terms, to have age, travel history, country of origin, gender, payment information, for example, available and used to screen passengers into risk groups and apply appropriate measures to each group. Of course not 100% effective but a much better use of resources than blanket measures.
Even low tech measures such as thorough questioning of high risk passengers appear to have worked for El Al.
#12 revere
December 31, 2009

Kevin: Note that this is the assumption put forth by Ms. Schiavo, the aviation consultant, and which I was addressing. With other assumptions, then the trade-off issues she was denying come into play.
#13 dhogaza
December 31, 2009

Out of interest, why are we only worried about bombs going off in the last hour? Surely the terrorists will be happier with a plane going down mid Atlantic, than not at all?

All bloody theatre.

Why the last hour? No idea. However … blowing up a plane over land means that the cause of the loss will be determined.

Remember Lockerbie? The girlfriend whose luggage was spiked with a tape recorder packed with plastique? The endless years following of being asked if you packed your luggage yourself, if you’ve had it in your possession, etc?

If it had been blown up in the mid-Atlantic, and the cause never understood, these weak countermeasures would’ve never been imposed on the flying public.

Think of the shoe bomber … if he’d not been caught and had blown up the plane over the mid-Atlantic, we’d still be walking through security with our shoes on.

In terms of screwing up air travel, if I were in that business I’d rank blowing up the plane over land where the cause is likely to be determined as being the best outcome. I’d rank having the perp caught and the resulting chaos (as we’re seeing now) as being second best. Lowest? Blowing a plane up over the ocean where it might never be determined that it was brought down by a terrorist attack vs. something else (think Air France’s from Brazil that disappeared most likely due to weather and bad pitot tubes but … hmmm … could it have been a bra bomber? We don’t know …)

We’re so pathetic the terrorists are winning by getting caught.
#14 dhogaza
December 31, 2009

if I were in that business…

I meant I’d assign that ranking if I were in the business of planning (not preventing) such attacks…

(and I’m not, despite my Arabic-sounding handle
#15 GeorgeT
December 31, 2009

“There’s always something lost when you don’t meet in person.”

You only say this because you haven’t gotten really good at virtual meetings. I’ve been doing them for years and have gotten to the point that the enormous time saving and productivity gains easily makes up for whatever is lost. To be honest, if you have video conferencing, very little is lost. Eliminating wasteful travel due to worthless meetings is one of the biggest things you can do to help the environment.
#16 dhogaza
December 31, 2009

This, on the other hand, is sensible …

Washington (CNN) — The State Department on Thursday is directing its embassies around the world to include information on whether a person has a U.S. visa when they send special cables to Washington containing information on potentially suspect individuals, CNN has learned.

Daddy tells embassy “my son scares me and I think he might be dangerous”. Embassy notes that they’ve issued the kid a tourist visa. Maybe you pay more attention to him when he boards the plane.

Though my guess is they would’ve missed the codpiece bomb regardless.
#17 SusanC
December 31, 2009

In the meantime, the Canadian government in their infinite stupidity, is requiring all US bound passengers to travel with no carry-on BAGS. I know because my DD just traveled on such a flight.

She (and fellow passengers) was told she was allowed EITHER her laptop OR her camera, plus documents and essential meds, but not books or just about anything else. Which leaves out the question of what if you have BOTH laptop AND camera (and iPod, and cellphone, and etc) – are the airlines going to compensate for ruined electronic items if you put them in the hold? After much argument, there was of course nowhere for such a policy to go except bust – she was allowed both items.

But the most stupid part of the charade was that they all had to carry these individual bits in their HANDS, with no BAG, not even transparent shopping bags to put everything in. My DD had 5 different items which she managed to consolidate into 2 by cramming some of them into her laptop ‘sleeve’, but I can imagine many others (eg with kids) with many more bits and pieces (all essential items, mind you) and nothing to hold everything together. Such stupidity!!!

So here’s what I don’t get – a guy tries to blow up a plane by putting explosives in his UNDERPANTS, and they respond by banning BAGS? What gives??

Now, you all know the standard announcement at the end of a flight, about taking care when opening the overhead bins as items may have shifted etc. Just pause for a minute and consider this – imagine a whole plane full of passengers all with numerous loose bits and pieces of essential, fragile, and/or electronic items, all of which have to be put (unprotected) in the overhead bins during takeoff and landing. What do you think happens at the end of that flight, as everyone scrambles to retrieve their items, which of course would have shifted BIG TIME, in the overhead bins??!!

Anyone want to take a bet on how long they can sustain such a policy???
#18 glock
December 31, 2009

“Well, we’ve had exactly 2 since 2001 (Richard Reid the shoe bomber and the current underpants bomber), or .25/710,000,000 enplanements (it’s actually less because enplanements have decreased substantially since 2001). ”

Unless there were other undetected malfunctions or would-be bombers that had an epiphany en route and discovered they had a better shot at the hottie in 27b than the 72 virgins and decided to wait…… Or just lost their nerve.

Needless to say this is a dynamic evolving deadly serious game of cat and mouse that we
hopefully get better and better at.

dhogaza is right,
I think efficient and effective sharing of intelligence would be a force multiplier for the current screening technology and procedures, regardless of their effectiveness.
#19 pft
December 31, 2009

So over 9 years, hundreds of millions of flights, 2 attempts to blow up a plane, both failed miserably. Both passengers flew out of international airports where the privately owned ICTS was the security company (also in charge of UAL’s security on 9/11). So in response, the government (TSA) must purchase a bunch of body scanners for use in the US? Who benefits? Certainly whomever builds these machines, and those who operate them outside the US, ie, and the security industry in general.

Terrorists of course, knowing that a body scan is ahead of them will either take the path of least resistance (change target) or use their body cavities, or maybe just check the bomb in using a mule like the drug dealers do.

Why isn’t anyone looking at ICTS? Is it too hard to imagine AQ infiltrating a security company to allow their guys on board planes?.

I sometimes wonder if such events are orchestrated by those who will profit. For example I have always suspected that anti-virus software companies have an incentive to create said viruses (or their employees). I mean, how does a guy from Nigeria with a 1 way ticket, and according to one account without a passport, whose father, a former economic minister of Nigeria, had reported him to the US embassy as being an extremist, get a chance to do this. And of course, those parts of the Patriot Act due to expire today have been extended and will be renewed, most certainly a coincidence.

And lets at least focus on what we are trying to prevent. On 9/11, the main damage was due to planes being used as weapons. This causes an order of magnitude more terror and damage than a plane blowing up at 35,000 ft. I mean, tough for any passenger on board, but planes used to crash or blow up in mid-air on a more frequent basis than today and people still flew, and if it happens more than once every 10 years, which it has not, then maybe you have to do soemthing.

To me the effort on trying to prevent a passenger from killing himself and others on board is worth it, and it has worked thus far. But at some point you look at the cost-benefit ratio, and the cost, both in terms of money and inconvenience, exceeds the benefit, since no planes have been taken down via this manner w/o the cost.

The sheep of course request protections, perhaps they will stop short of “take my babies if it will keep us safe”, but I mean, enough is enough. Besides, these draconian measures give a victory to terrorists, because the purpose of an attack is not just to kill, it’s to terrorize, and such actions as being proposed promote terror (fear of inconvenience among others). I can only imagine some bearded guy in a cave on a dialysis machine giggling with glee as he watches on CNN how another failure is turned to victory (the shoe bomber cost us our water, this idiot costs our dignity and time).

Maybe he has stock in the security industry and is profiting to boot.
#20 Joe
December 31, 2009

re IanW at #1, it’s well-known in criminological circles that police have very little effect on the level of crime. And of course everyone now knows that the effort police put into crime is massively ill-directed, since most of the harm done by criminals is caused by white-collar criminals.
Given the way the airlines are going (Alitalia nearly broke in 2008, JAL nearly broke last week), I reckon we won’t be having many problems in five years or so, there won’t be too many planes flying.
#21 BostonERDoc
December 31, 2009

I am with Jubal. You seem to have forgotten your mission statement posted on top of the blog page. Is this an Afghanistan blog or a public health blog? It is ok to have other stuff, and I do enjoy the occasional political statements, but 50-60% of the topics lately have been on Afghanistan and that is over the top my dear doctor. Maybe the Reveres should consider changing the mission statement. Writing outrageous remarks about republicans, you behave like a flaming self agenda ridden person rather than an educator. I know it is your blog, but you have a responsibility I respectfully remind you of. You are representing to the public medicine and public health–remember that. I thank God I am an independent not stuck in such a rut.
#22 revere
December 31, 2009

BostonERDoc: I am also an Independent and have been one longer than you. We have a public health mission and war and peace fall in that mission (we wrote a series of 5 posts about this on the old site, so this isn’t new). Moreover, if you will look at the posts over the last year or so you will see that they average one a day (we used to do two) and that the Afghanistan posts are add ons at the ned of the day. They do not displace other posts. They are there for the reason we stated a few days ago. Our outrage and dismay over this (our engagement on war and peace issues are defining elements in our lives and of a piece with our public health perspective) and the spate of Afghanistan posts began with Obama’s announcement of escalation. It did not come out of thin air. Our goal is to remind our readers about what is happening, whether it is in the news or not, and to express our feelings about it. Like the TV remote, you have the ability to skip them. Since they are not taking the place of public health posts you are losing nothing. You can go on with your life in the ER and not have to think about it, or at least not have it intrude on your time here reading our blog.

We’ve been doing this for may years, now, and periodically we have this complaint from a newer reader. Either you’ll get used to it and accept who we are and take the rest to the extent it is useful or you won’t. But we do it out of sense of conviction, obligation and conscience. And because we are Independent and that means we get to say what is true for all to see, that the Republican Party has sunk to a uniformly low level of credibility and worth and deserves all the derision it gets. And that there are plenty of rotten Democrats who deserve the same contempt. The same is true for lots of Independents. And I’d be happy if there were a party that represented my views and I’d no longer be an Independent (it’s not a particular virtue). But there isn’t. So we are also Independents. Remember, it is Democrats who are waging this war, with the enthusiastic chicken hawk cheerleading of the Republicans.
#23 microdot
January 1, 2010

Now it’s normal procedure to remove shoes…
The full body scans appeal to my inner exhibitionist, but then perhaps that’s my problem.
You fly and you take a risk, terrorism or not. A plane is a complicated piece of machinery and they work great, most of the time. The odds of terrorism curtailing you flight make flying just a little riskier than it already is.
The most interesting thing about human intelligence is the ability to improvise. That’s a good thing and it is a bad thing…but it is what makes us so very interesting.
#24 M. Randolph Kruger
January 1, 2010

You guys dont understand it to the logical conclusion. This IS healthcare. I emphasize that. Revere is completely correct. All of this stuff that we are paying for could be ended with just a few strategically placed high volume kill shots. We wont because its in some little pissant country that is close to toppling…Pakistan. Its in worse shape than Afghanistan. Either this gets interdicted at the point of conception, or you will have to wheel real shit asses out like me later on who would use tactical nukes on them. You really do want to make sure that I dont get in charge of their health in Pakistan or Afghanistan.

I didnt agree with Cheney and what he was doing in the back rooms of the White House but the bottom line is clear….They are actively trying to kill Americans and any moderate Muslims out there. Subversion of those moderates by threat and killings. Saracen book of conquests-101.

Either we stop them now or when they do come onto the radar, they will come in force and they will be getting a lot more than they have recently. 2 bombing incidents indicate a low level of competence. They will work to fix it. But, do I advocate the use of WMD’s against civilians and combatants? Yes-First though define what is a civilian and what is a combatant. Its time to ante up, squat or get off.

WE had better damned well start hitting the strongholds and forget this Miranda bullshit or you will have to cowboy the entire US of A. Legal to carry guns on the plane kind of thing. Cap them where they stand. As for the combatant/civilian issue. We can fix that by making a declaration that attacks of this manner are military in nature. They arent political prisoners with a bent then, they are combatants and they can get the rights of Geneva and not Miranda. Lock them up until the cessation of hostilities. You know, about 100 years. We can launch attacks on strongholds with impugnity. We can hit whole villages and kill them all. Declare the garb of a Muslim to be combatant dress IF activities are hostile in a village and that collaterals are a non sequitur. E.g. they are all combatants then and how we handle it is up to the military.

That settles the issue of whether they are criminals or combatants. It would give you the right to shoot without saying drop it. You could kill them without Miranda and it speeds up the decision processes.

If one of them tags another 9/11 event there aint gonna be any bullshit about Bush blowing it up, cutter charges and the like. WE are going to be 2nd quarter and 2 minutes to the whistle for half-time and they are going to have the ball. Ultimately as we get more and more enraged we will end the need for health care in a number of places on the planet, improve the condition of the living by taking these bastards out and only because we have finally had enough and resorted to EXTREME violence. Most of you have no idea except from films what we could do and if it ever gets out of the box, its a bitch to put it back in. Give me a wing of Bones, half of an air cavalry division and I would make sure that they didnt come back for two generations.

Shit, Revere ought to be supporting the efforts in Afghanistan because if we back out then the shit asses like me will get their big bomb request eventually. I want to do it now to prevent MORE casualties between now and the politically correct “Big Decision.” If we dont do it, then the extremists will get one and do it to us. Its inevitable that this WILL happen now unless we take extreme measures.

Everyone, everyday should review the BDA’s from WWII up until Nagasaki and look at the differences between weeks of bombings and 30 seconds of drop to point of detonation and then 1 second for a nuke. The millisecond to 8 milliseconds timeframes are very enlightening. I fear the day that this will happen, but it will and you can bank on it.

Either put them in to win, or pull them out and then wait for the day that we move to DEFCON-1.
#25 revere
January 1, 2010

Randy: Just do a global search and replace of Taliban or Iranians or Iraqis or Afghanis for Americans and you’d sound just like them.
#26 Alex
January 1, 2010

Out of interest, why are we only worried about bombs going off in the last hour? Surely the terrorists will be happier with a plane going down mid Atlantic, than not at all?

All bloody theatre.

Well duh. It’s called terrorism for a reason.

MARY SCHIAVO: Well, the cost in civil liberties, the great thing about machines is, they treat everyone the same. The machines don’t violate our civil liberties.

What violates civil liberties, when you say, well, we’re going to pick out this person and look at them, or this person and look at her, et cetera. The machines treat us all the same.

Schiavo would therefore see no civil liberties problem if the government (say) threw us all in the gulag, so long as it’s everyone thrown there.
#27 JerryM
January 1, 2010

I’m continually amazed at the lack of effectiveness of these terrorists.
And glad. And afraid they’ll eventually get the same ideas as I have when I see yet another foiled attempt.

It’s that I don’t have the money, time, or religion and, what was it, oh yes, my moral code, that I don’t go round killing people.

Oh, and I’ve already disappointed my mom enough.
#28 tymbuktu
January 2, 2010

“Randy: Just do a global search and replace of Taliban or Iranians or Iraqis or Afghanis for Americans and you’d sound just like them.”

I am anti-war but no pacifist. However, one has to admit that the Bomb did the trick. It’s not quite as clear cut now because we had sole possession of the ball. The whole thing was a massive mistake from the get-go and brings up hard questions of where does our responsibility for screwing up a country (Iraq) while taking our eye off the ball when we actually had a chance end and self-interest and preservation start.

As far as airline security goes, while everyone’s focusing on the pax coming through the front door, nobody’s watching the back door — the miriad of airline/airport employees who have access to the planes passenger compartments and cargo holds. Take a baggage handler’s family hostage at gunpoint and have him place whatever wherever you tell him to. Then there’s the mail…
#29 tewthman
January 6, 2010

But if you limit scans to probable perps ie Middle Eastern males ages 20-30, you tremendously improve the specificity, selectivity, and cost effectiveness.
#30 revere
January 6, 2010

twethman: You mean like Timothy McVeigh or Richard Reid? More to the point, Ms.Schiavo was saying you shouldn’t do that because it would be a personal liberty issue, so that is what I was commenting on. The failure to understand probability.

BTW, you don’t affect the sensitivity or specificity at all. You might possibly affect the prevalence, which in turn affects positive or negative predictive value. But that’s a technical point.