We are doomed - 103 reasons why

 [Ed note - this was written a few months after Trump's election, with occasional editing in brackets since then to update and add more reasons!  It started with 99 reasons.)

103 reasons we* are doomed in America (and I fear for other democratic countries, too.

(For the optimists out there, please give me your 103 reasons we are not doomed! Specific to America, not things like "the sun", "the earth", etc. ) Bless the optimists...

After the first ten, the list is random.

1. Capitalism - it just isn't sustainable in any way, but boy does it lead to a lot of great stuff and some really scary stuff. And way too much trash and waste. (Which totally relates to number 2 and 3 below which are certainly the most scary outcomes of capitalism.)

2. Climate Change (ocean rise, glaciers melting, heat, cold, flood, droughts, stronger hurricanes, more intense fires, et. al. and refugees in the tens of millions)

3. The rise of the AI - 3.  massive disruption and we are not aligned! (This is totally integrated with #1 and should probably be in the #2 position now since Chat GPT 4 came out.)

4. Supreme Court is going down - particularly that the Republicans stole a seat (and also stole about 50 appellate court seats) [edited to add - and another one]

5. The electoral college

6. Gerrymandering brought by the right (and occasionally the left)

7. Congress: particularly the Republicans refusal to compromise on most everything important

8. Trump/Republicans and the fact that so many Americans - about 43% - think Trump is great

9. The coming refugee crisis (as if the one that exists isn't already very bad) as climate change forces migration

10. Voter suppression efforts of the right

11. Most people thinking they have the truth and do not want compromise - left and right

12. Fake news - left and right (and see #23)

13. The internet: GAFA (google, amazon, Facebook, apple) - the dystopian future described in sci-fi works has arrived - the death of privacy, the rise of social media bullying, easy-as-pie mass surveillance, deepfakes, hacking - Russian and malicious, malware, ransomware, ad nauseam.

14. Seeing the past through today's eyes - this is particularly strong tendency on the left. The logic of this will lead us to reject every single person in the past for being "not woke". This thoughtless ahistorical perspective warps the entire past and, more so, the present.

15. Overuse of toxic chemicals like pesticides - and they are everywhere

16. Big pharma

17. NIMBYs

18. Death of public education as we used to know it

19. Bail, traffic tickets, payday loans, parking ticket/impound, lack of access to inexpensive food, decent housing, health care, etc. for poor people - which helps to keep them poor.

20. Fear of black people, particularly black men - which has warped our criminal justice system. A very significant portion of black Americans who are incarcerated are there because of prosecutorial misconduct and mistaken identity.

21. Prisons in America - way too many people incarcerated, way too little rehabilitation

22. College debt

23. Stupidity - remember 100 is the average on IQ tests.

24. Tribalism left and right

25. Guns and gun laws

26. Planned obsolescence

27. Consumerism

28. Smart phones being way too important in too many people's lives

29. Household debt - there is more than there was before the 2008 crash.

30. The increasing threat of violence, right and left

32. The criminal justice system is really the criminal injustice system where truth and fairness take a decided back seat to prosecutors zeal for winning - particularly against the marginal in our society.

33. National flood program makes it worst (and insurance companies benefit.)

34. Critical thinking is not part of our K-12 system in general

35. Paranoia and conspiracy madness (Sandy Hook isn't real, [edited to add QAnon] et. al. - though JFK was killed by our govt! Trust me on this.)

36. Fox news, Breitbart, Drudge and talk radio like Limbaugh.

37. Nuclear capability in crazy hands - and hey, just nuclear capability.

38. Testosterone (it's always been both a blessing and a curse; I think the curse portion is winning now)

39. Racism, sexism, xenophobia and homo and trans phobia

40. Religious extremists of the Muslim, Christian, Buddhist, Jewish, et. al. variety

41. Extremists of the right and left who are not motivated by religion, but by some belief that they have "the truth".

42. The coming pandemic [edited to say: one came; more are on the way]

43. Public transportation infrastructure

44. Our horrible tort system

45 The fact that we have not come to terms with, apologized for or made amends for our history (slavery, genocide and land theft of Indians, imperialism, overturning regimes we don't like, supporting horrible regimes, theft of land from Mexico, Hawaii, and others, et. al.)

46. The decrease of social mobility

47. The sixth extinction is nigh

48. Crazy, crazy amount of spending on defense

49. Bureaucracy

50. Scientific ignorance

51. Factory farming, processed food and the whole industrial food complex

52. Anti-vaxers

53. Cops getting away with murder

54. The fact that human beings often seem to love or need revenge

55. The split of the Democratic party into two warring factions, which is why we have Trump today (and it is going to get worse before it can possibly get better - remember the 60s and 70s people???) To put it another way: The left is cannibalistic. They eat their own. The right somehow manages to come together while the left doesn't.

56. Reality shows

57. The rise of China (authoritarianism seemingly working as well as - perhaps better than - democratic capitalism)

58. The Putin rise in Russia (horrible provocateurs even if their country is screwed)

59. Mental health/ mental resilience getting worse - and few resources to help

60. The feeling of entitlement on the left and the right

61 Housing prices in desirable weather/ cultural areas going crazy. Homelessness exploding. Not enough housing in many markets in the West and South.

62 The inability of so many to delay gratification

63 Internet and gamer culture (it's horribly sexist even though many, many folks who are into the internet and gaming are just fine, of course)

64. The decline of unions

65. The already existing, but soon exploding, pension crisis

66. The death of employer-sponsored pensions and health care without good alternatives

67. No way to die easily when your time is done (adding to our huge debt and a lot of unnecessary suffering)

68. Income inequality and, yet, the richest 20% want even more even though they already have 76% of American's wealth. [edited to say 86% in 2022]

69. Lobbyists

70. Lack of campaign finance reform - rich people buy what they want.

71. Blue state white folks are generally fat and happy so they aren't going to be rising up

72. Red state folks don't seem to give a damn about having competent leaders

73. A nation of immigrants is increasingly anti-immigrant (though other times have been like this.)

74. The insect apocalypse.

75. Violence, sexual assault and disrespect against women

76. Addiction to various things

77. The left not supporting free speech

78. Massive overuse of plastic

79. Venezuela is one precautionary tale

80. Brexit is another precautionary tale

81. People hating and fearing refugees - and there are going to be millions of them

82. The fact that leftists can't tell rightist apart (and think they are all Nazis or white supremacists)

83. The fact that rightist can't tell leftists apart (and think they are all Venezuela-style socialists or communists)

84. The left equating physical violence with language violence – giving intellectual justification for physical violence against verbal violence

85. The fact that the right has all the guns and physical power: the left will be crushed in a civil war

86. The lust for power and money

87. The fact that neither the left nor the right can take a joke

88. Over-regulation

89. Anti-science and anti-intellectual movements

90. The rise of Dominion Christians like Pence and Moore

91. The fact that, increasingly, people stick to their own kind, read their own kind, live with their own kind, marry their own kind, get entertained by their own kind, etc.

92. Coral bleaching, mercury in fish, a huge amount of plastic in the ocean, overfishing, etc.

93. The health care mess in America

94 The infrastructure mess in America

95 Drought in the West, the draining of aquifers many places, dried wells and land subsistence.

96. Medicare/social security crisis - aging boomers

97. Identity politics on the left, which serves to divide us - plus all the over-sensitive stuff like cultural appropriation, trigger warnings, safe space - the left as victims.

98. Republicans cutting taxes - particularly on those who can easily pay way more taxes so all the messes can't be fixed

99. The overdose crisis

100. Nuclear waste - fear Hanford.

101. Too many people with too little resources. (I actually think there will be many less people in a few generations so the population will top off and and, through water scarcity, pandemic disease, famine, refugee death, flooding, heat waves, etc, it will actually start decreasing but still! However, Africa's population is booming. Nigeria is projected to overtake China in population by 2100, with a size 10x smaller. )

102. Soil erosion.

103. Resistance to chemicals - whether antibiotics or pesticides - in which the problems explode exponentially as new ones can't be made fast enough - or are too toxic - to help.

104. Multiple issues with the press!

• "We" is defined here to mean those who feel we are the sons and daughters of the enlightenment. While I think we are doomed, I do think America and Americans have many fine qualities. This is just not that list. Feel free to make that list!!

Colonoscopy tips plus should you even have one?

PART ONE

On my Facebook page, I said I had some tips for colonoscopy prep. So I will start with the tips in Part One. But, in Part Two, I want to give you info on an easy, inexpensive and effective alternative - the FIT fecal-test.

For context, the last time I did a colonoscopy, I used Moviprep and had to drink it all in one day. I became very bloated and got worried that it would NEVER work. It did, finally, but it was a pain, physically and mentally.

I changed to Kaiser this time, and their prep is longer, but way easier - WITH ALTERATIONS. (Their instructions are here if you want to read the full thing.) The idea is that you switch to low-fiber - aka low-residue - foods three days before the procedure. You have a liquid diet the day before and drink half a gallon - Gavilyte-g was the stuff I used - starting at 6 pm. Then, the next morning, you drink the rest of the half-gallon.

I think preparing over three days really made it much easier, but I wasn't looking forward to the all-liquid diet for a full day (though I did know that as soon as I drank the stuff, my appetite would be gone...)

Tip One: Screw the all-liquid diet on the day before. You can eat low-residue food in small amounts. There are a whole lot of scientific studies about this that have come out in the last few years, and they all agree: the all-liquid diet is not necessary, and absolutely not better. Here is an article about one of those studies. Therefore, I ignored Kaiser, and ate two eggs and some toast in the morning the day before the procedure. That was enough for me to feel good until I drank the stuff. Basically, medical organizations haven't caught up to the science on this one. Here is an article on low-residue diets - though there are abundant articles about them on the internet.

Tip Two: Do your own timing of when to drink the stuff. I used their timing on the day before - that is to drink it at 6 pm - but that is a stupid time for me. It took until about midnight to get rid of the first wave. I would have liked to gone to bed earlier. Clearly, I should have started at 4pm - and would have been ready for bed by 10PM.

Similarly, the next day they wanted me to start 5 hours before, have the second gallon done by 3 hours before - and take no more liquids after. I totally ignored that and started about 7 hours before, and drank about half the remaining stuff. Within three hours, I was "piss-pooping" clear (and slightly yellow, which is what they expect) and threw the remaining prep down the drain. Yes! If it hadn't been clear, I still had another hour to drink more.  I then drank clear liquids until the three hour mark.

If you have an early morning colonoscopy, they expect you to wake up in the middle of the night to do this. If you are a rule follower and want sleep - truly you should get a mid-afternoon appointment with this regime (as I had). Or, decide to make changes based on the time...

Tip Three. Drink it down fast and make sure it is chilled! This is one that most people know - and manufacturers of the stuff advise.  I didn't flavor it - but lots of people swear by that. But whatever you do, have a chaser. The taste (which isn't all that bad) only lasts as long as it takes to drink your chaser. I used tea sometimes and chicken broth other times. But anything you like will work that is in the ok-liquid column.

Others can feel free to put other tips below in the comments. You can do so anonymously if you like.

PART TWO

In the United States - unlike any other place in the world - colonoscopies are the go-to for colon cancer screening beginning at the age of 50. The rest of the world uses much less expensive but, perhaps, just as effective screening techniques such as the fecal-test FIT. This test must be done every year to be effective.

The fact is that colonoscopies - as yet - haven't been proven to be more effective (or as effective, for that matter) than this test in detecting cancer or reducing mortality. Now, the logic is that colonoscopies should be the most effective - after all, you get rid of the polyps before they have time to become cancerous. But, the fact is there has never been a randomized controlled trial - the most rigorous type of study - of colonoscopies to see if they, in fact, reduce colon cancer mortality more than other methods. (Though there are three studies in process, and in about seven years we might know for sure!) That does not mean there haven't been other types of studies that are very encouraging about them, such as Baxter et al.  and Nishihara et al 2013, which certainly indicate a colonoscopy is pretty darn good, though it has risks such as perforation of the colon, infection, and bleeding.

But, there is no proof, as yet, that it is better - or as good as - a simple, inexpensive fecal test.

So, if they haven't been proven to be better, scientifically, than the alternatives, why are we so colonoscopy-crazy in the United States? Could it be $$$$? Check out this NY Times article on this.

Bottomline: you don't have to get a routine colonoscopy for cancer screening - unless the fecal test shows a problem. For most people, it's probably the best way to go. Kaiser, for instance, emphasizes FIT tests as the basic screening test, and colonoscopies are only recommended for people in a higher-risk group, such as people who always get polyps - like me!  

Anyway, as they say - ask your doctor if the FIT test is right for you instead of doing this rigmarole. Colon cancer is the second leading cause of cancer death in the United States. So whichever screening method you use - don't skip it!