Posts filed under 'Healthcare'

Democracy Now!: More Health Care Professionals Involved In Design, Structuring of Torture Than in Providing Care for Survivors

Sometimes, with all I’m involved in, I never get around to posting something I’m intending to post. So, belatedly, here is a September 28 Democracy Now! interview with Doug Johnson of the Center for Victims of Torture and bioethicist Steven Miles. The chilling title makes clear the central importance of fighting health provider, including psychologist, collaboration with the torturers wherever it occurs, including in US detention centers and “black sites”:

More Health Care Professionals Involved In Design, Structuring of Torture Than in Providing Care for Survivors
Friday, September 28th, 2007

“In today’s world there are more health care professionals involved in the design and structuring of torture than there are involved in providing care for survivors,” said Douglas Johnson, executive director of the Center for Victims of Torture in Minneapolis. We also speak with professor Steven Miles, author of “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.” [includes rush transcript]


As we broadcast from Twin Cities Public Television in St. Paul, Minnesota, we turn now to the issue of torture. Minneapolis is the home of the Center for Victims of Torture of Torture - an organization that works to heal the wounds of torture on individuals, their families and their communities and to stop torture worldwide.

Today, we are joined by the center’s executive director Douglas Johnson. Doctor Steven Miles is also with us. He is a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is the author of the book “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.”

But before we turn to our guests, we play an excerpt from Wednesday’s Democratic debate at Dartmouth College. It aired on MSNBC and was moderated by Tim Russert.

  • Excerpt of Democratic debate on issue of torture.
  • Dr. Steven Miles, author of “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.” He is a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is also a practicing physician.
  • Douglas Johnson, executive director of the Center for Victims of Torture and the past president of the National Consortium of Torture Treatment Programs.

AMY GOODMAN: We turn now to the issue of torture. Minneapolis is the home of the Center for Victims of Torture, an organization that works to heal the wounds of torture on individuals, their families, their communities, and to stop torture worldwide.We’re joined by the center’s executive director, Douglas Johnson. Doctor Steven Miles is also with us. He’s a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is the author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror.

But before we go to our guests, I want to play an excerpt from Wednesday’s Democratic debate at Dartmouth College. It aired on MSNBC and was moderated by Tim Russert.

    TIM RUSSERT: I want to move to another subject, and this involves a comment that a guest on Meet the Press made, and I want to read it as follows: “Imagine the following scenario. We get lucky. We get the number three guy in al-Qaeda. We know there’s a big bomb going off in America in three days, and we know this guy knows where it is. Don’t we have the right and responsibility to beat it out of him? You could set up a law where the president could make a finding or could guarantee a pardon.” President Obama, would you do that as president?

    SEN. BARACK OBAMA: America cannot sanction torture. It’s a very straightforward principle and one that we should abide by. Now, I will do whatever it takes to keep America safe. And there are going to be all sorts of hypotheticals in emergency situations, and I will make that judgment at that time. But what we cannot do is have the President of United States state as a matter of policy that there is a loophole or an exception where we would sanction torture. I think that diminishes us, and it sends the wrong message to the world.

    TIM RUSSERT: Senator Biden, would you allow this presidential exception?

    SEN. JOSEPH BIDEN: No, I would not. And I met up here in New Hampshire with seventeen four- — three- and four-star generals, who after my making a speech at Drake Law School pointing out I would not under any circumstances sanction torture, I thought they were about to read me the Riot Act. Seventeen of our four-star and three-star generals said, “Biden, will you make a commitment you will never use torture?” It does not work, and it’s part of the reason why we got the faulty information on Iraq in the first place, because it was engaged in by one person who gave whatever answer they thought there were going to give in order to stop being tortured. It doesn’t work. It should be no part of our policy ever. Ever.

    TIM RUSSERT: Senator Clinton, this is the number three man in al-Qaeda. We know there’s a bomb about to go off, and we have three days. And we know this guy knows where it is. Should there be a presidential exception to allow torture in that kind of situation?

    SEN. HILLARY CLINTON: You know, Tim, I agree with what Joe and Barack have said. As a matter of policy, it cannot be American policy, period. I met with those same three- and four-star retired generals, and their principal point, in addition to the values that are so important for our country to exhibit, is that there is very little evidence that it works. Now, there are a lot of other things that we need to be doing that I wish we were: better intelligence; making our, you know, our country better respected around the world; working to have more allies. But these hypotheticals are very dangerous, because they open a great big hole in what should be an attitude that our country and our president takes toward the appropriate treatment of everyone, and I think it’s dangerous to go down this path.

    TIM RUSSERT: The guest who laid out this scenario for me with that proposed solution was William Jefferson Clinton last year. So he disagrees with you.

    SEN. HILLARY CLINTON: Well, he’s not standing here right now.

    TIM RUSSERT: So there is a disagreement?

    SEN. HILLARY CLINTON: Well, I’ll talk to him later.

AMY GOODMAN: That was an excerpt from Wednesday’s Democratic presidential debate at Dartmouth College. We are joined now in St. Paul, Minnesota by Douglas Johnson of the Center for Victims of Torture and Dr. Steven Miles, author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror.

Dr. Miles, let’s begin with you. Your response?

DR. STEVEN MILES: What Joe Biden said was that he would not ever order torture. What Ms. Clinton said was that we would never have a policy for torture, but she did not rule out the possibility of an executive order for torture in a specific circumstance. And Barack Obama was very hard to read on this matter. So the only clear statement came from Joe Biden, and I think that further clarification on this needs to be addressed.

It’s not just that there’s no evidence, but the National Intelligence University, in a huge analysis of this last year, in two thousand — well, actually, earlier this year, that there is no evidence that torture works, and furthermore that it leads subjects to provide misinformation and to become recalcitrant to cooperation with providing information that we need.

AMY GOODMAN: How did you get involved with this issue?

DR. STEVEN MILES: Well, when I saw the pictures of Abu Ghraib, I was stunned. And the question was: where was the prison medical staff? Why didn’t they blow the whistle on it? And I figured that what they’d done is that they had attempted to blow the whistle on it and that their reports had been suppressed. And what I found was that the Armed Forces Institute of Pathology was suppressing information about deaths from torture and that the medical staff, including psychiatrists and psychologists, were actually integrated into the system of devising course of interrogations.

AMY GOODMAN: And so, you wrote this book Oath Betrayed. When we were doing the Burma segment, you made an interesting comment.

DR. STEVEN MILES: Well, you take the speaker that you had. He was talking about the use of dogs, close confinement in crowded cells, meal deprivation. All of these are techniques which are currently approved against the use of prisoners that we’re holding, which, by the way, I’d point out, as in Burma, 85% in Iraq are innocent or ignorant of insurgency activity. And it is very difficult for us to say to Burma, “Don’t do these techniques,” when we have set as a matter of national policy that in national emergency, given national sovereignty, that we can embark on torture.

AMY GOODMAN: The ticking time bomb theory that Tim Russert posed?

DR. STEVEN MILES: I’ve looked at every instance of a ticking time bomb that’s been proposed in the war on terror. All of them are not what the government has said they are. In fact, basically there is never a circumstance where you know that a particular prisoner has a particular information and will yield with a particular amount of pressure. In fact, gathering intelligence is a matter of pulling information gradually from a number of sources, who you recruit through rapport building.

One of the fascinating things about the ticking time bomb scenario is that it has elicited bad information, which has sent our troops on dangerous and fatal missions, as they go and chase down wild goose chases to get bad — chasing down bad information. And furthermore, the sole source for the information that bioweapons were being developed jointly by Saddam Hussein and al-Qaeda came from a guy that we kidnapped in Sweden, took to Egypt and tortured, and that made it to the UN and was part of the authorization to go to war.

AMY GOODMAN: We have been doing extensive coverage of the debate in the American Psychological Association. They, this year, ultimately did not pass a moratorium on psychologist involvement in coercive interrogations. Can you talk more about what is going on there and the contrast with the American Medical Association and American Psychiatric Association?

DR. STEVEN MILES: Essentially, what the American Psychological Association has said is that psychologists may work with interrogators to break persons down. And it turns out that that was the specific agenda all the way from the beginning, including when military people were stacked on their interrogation policy committee.

The directive from then-President Koocher, as expressed in his emails, said as follows: the goal of such psychologists’ works will ultimately be the protection of others, innocents, by contributing to the incarceration, debilitation or even death of the potential perpetrator, who will often remain unaware of the psychologists’ involvement.

And then, a month later he said to that same American Psychological Association policy committee, “I have zero interest in entangling the American Psychological Association with nebulous, toothless, contradictory and obfuscatory treaties that comprise ‘international law.’ Rather, I prefer to see the American Psychological Association take principled stand on policy issues where psychology has some scientific basis for doing so.” Well, the irony of this is that the scientific evidence weighs against course of interrogation, and the psychologists should have put the brake on the CIA, but in fact they worked with the CIA to develop these techniques, which then spread through the Army, and it resulted in enormous damage.

AMY GOODMAN: How did you get that email of the former president of the APA, Gerald Koocher?

DR. STEVEN MILES: What happened was that there was a task force that was set up to do this. Nine out of the twelve members were related to the military; three weren’t. One, Jean Maria Arrigo, has made the email correspondence to that committee available. And this is being — currently being posted up on various websites.

AMY GOODMAN: We’ve interviewed Jean Maria Arrigo on Democracy Now!

Doug Johnson, your thoughts on this issue? You are the head of the Center for Torture Victims here in Minneapolis. It’s very unusual to have such a center. There are only a few in the United States, is that right?

DOUGLAS JOHNSON: Well, unfortunately, there are over thirty now.

AMY GOODMAN: Oh, over thirty.

DOUGLAS JOHNSON: And we all work as closely together as possible to learn from each other. And I think the experience for all of us is that we care for people who the rest of the community would consider innocent victims of torture, but all of those survivors would tell you that they would have said anything, anything at all that was wanted of them, eventually, to get the torture to stop. And so, they’ll confess, they’ll give the information that’s fed to them, because the person who most needs a confession is the torturer. Without that confession, the torturer has no justification for what they’ve done. And the only way that torture states manage the dissidence and the moral — morale and the minds of their torturers is that a confession emerges. And that’s one of the key reasons why truth doesn’t emerge from torture. Anything could emerge. Sometimes it’s a danger.

But one of the big problems of the focus on the ticking time bomb is it’s really an enormous distraction. The focus on just what’s happening in the interrogation center and the tactics of interrogation have obscured, for most of us, and especially our policymakers, what the strategic results of torture are. And one of those key strategic results is this: I spent some time with Alberto Mora, who had been the Navy legal counsel who fought against the torture policy, someone you should have on your show, when we were visiting members of the Senate Intelligence Committee, and he emphasized that the reason we have the Geneva Accords, of course, emerging from the way Allied troops were dealt with by the Nazis and the Japanese prison camps, was the notion that if a soldier knows that they will be treated humanely, when they are trapped and they have no place to go, they have at least the opportunity of surrendering, but if they know they will be treated cruelly, if they will be tortured, if they will be otherwise treated without dignity, then the total incentive for them is to fight to the last man.

And under those circumstances, and under the circumstances we now have in Iraq, when we are overpowering a group with firepower, we have given them the total incentive to fight to the last man. And that endangers American troops right now. Americans die from this policy, because we have falsely thought that the creation of fear keeps us safe, rather than endangers us.

AMY GOODMAN: How do you treat victims of torture at the center?

DOUGLAS JOHNSON: Well, we have a multidisciplinary team.

AMY GOODMAN: How many victims are there now?

DOUGLAS JOHNSON: Well, we believe there are about 30,000 just in Minnesota, at least a half a million in the United States. They’ve come from so many countries. We’ve provided care for people from almost eighty countries.

AMY GOODMAN: And how many are in your center now?

DOUGLAS JOHNSON: We only have the capacity for about 300 a year, which means we have a hundred years of work sitting in the state right now. So one of our key roles is to be the learning center, to learn the impact of torture and what we do about it, and try and engage the broader mainstream healthcare program to do what ought to be done in the healthcare system. That’s an enormous struggle.

So, in addition to our care, we have major programs with as many resources as we could put together to train mainstream survivors. We also have a contract to provide the technical assistance to the other centers in the US, and we work with seventeen centers in parts of the world where torture is used to try and reinforce them and really broaden the capacity in the world to work with people.

AMY GOODMAN: I think when a lot of people think torture, they think other countries. In our headlines, we read the story of what’s happening in Chicago and the exposes around one of the top police for years, Jon Burge, and his torture victims. What is your response to that?

DOUGLAS JOHNSON: Well, our friends at the Kovler Center in Chicago have been engaged in this case, and one advantage of the treatment centers is also to be able to begin to develop forensic evidence in these kinds of cases. So our colleagues in the human rights community have been really the impetus behind this investigation.

Torture occurs everywhere, and including the United States. What has distinguished us, for the most part, is that in the US, when it does occur, we have active investigations and intervention. And that this occurred over a decade in Chicago really indicates a very high level of corruption, which, I would have to say, in the world, where we see torture occurring, there is a very high correlation always with corruption.

AMY GOODMAN: Professor McCoy, who wrote the book A Question of Torture, said psychological torture is worse than physical. Is that true?

DOUGLAS JOHNSON: That was a surprise to me when I arrived at the center nineteen years ago, because, again, I had the imagination that it’s the physical. But our clients tell us that the physical, they don’t always remember. I think it’s sort of like a woman who gives birth. Why would she give birth again? There’s something about the actual pain of the event that fades. And what they tell us is that the subject of their nightmares are the psychological forms of torture, the mock executions, observing other people being tortured. But what we have seen is that the processes of psychological torture have become much, much more utilized and more highly sophisticated over the years.

AMY GOODMAN: Professor Miles?

DR. STEVEN MILES: There was a terrific study that was done of Bosnian survivors, came out last year, and what it found was that in terms of causing post-traumatic stress disorder, that physical torture, emotional torture and sexual torture, or the intensity or duration of torture were not associated with a greater or lesser likelihood of PTSD. And so, that emotional torture, such as, say, being forced to witness the rape of a loved one or a mock execution, is just as likely to cause long-term disability as physical torture.

AMY GOODMAN: What about the ones that the US military, CIA, etc., have engaged in, like isolation, sleep deprivation, sensory deprivation?

DR. STEVEN MILES: The means that we have used basically resemble those used by all other countries, with the single exception that we have not used mutilation — that is, cutting off hands or ears, which have been done in some countries. But in terms of the range of physical abuses, from electrical, thermal, hypothermic, beating and various forms of emotional trauma, they look exactly like other countries.

AMY GOODMAN: What do you think of the APA debate, what’s been going on, why the APA hasn’t passed a moratorium?

DR. STEVEN MILES: Well, I can’t really speculate on why. There is a fair amount of speculation, but I think it’s just that. Certainly, when the psychiatrists said that we will not participate in this, they got blown off of these interrogation panels. The APA current position is essentially dovetailed to continue substantial involvement with the Central Intelligence Agency. And furthermore, they very specifically stated that physicians — or psychologists could work in secret prisons with an option of leaving if they wanted, but not with an obligation to call attention to the abuses within secret prisons. And so, the APA policy is fundamentally designed to work with a secret prison system, which is the worst form of danger to prisoners.

AMY GOODMAN: Doug Johnson.

DOUGLAS JOHNSON: I think it’s important to understand — and this is an example of it — that currently in today’s world there are more healthcare professionals involved in the design and structuring of torture than there are those who are involved in providing care for survivors.

AMY GOODMAN: Say that again.

DOUGLAS JOHNSON: There are more healthcare people involved in the design and the instrumentation of torture than there are involved in providing healing for the survivors.

AMY GOODMAN: In this country.

DR. STEVEN MILES: No, around the world.

DOUGLAS JOHNSON: In the world.

AMY GOODMAN: Around the world.

DOUGLAS JOHNSON: In the world. And it is, in many times, because healthcare people get engaged and confused by the same ticking time bomb theories that fuel 24 and other fantasy programs, which have unfortunately seem to be the basis of learning for many of our policymakers. It’s fantasy-driven, and it causes people to do stupid things.

AMY GOODMAN: Dr. Miles?

DR. STEVEN MILES: About 130 countries torture, but of the survivors, somewhere between 20% and 50% report seeing a health professional directly involved in supervising the torture. And that doesn’t count the ones who never see the physician who falsely certifies the cause of death as natural causes. So it’s actually around 40% of survivors actually see the health practitioner involved in the torture. And, you know, as Doug said, about 1% of the torture victims in Minnesota are actually getting treatment.

AMY GOODMAN: And finally, Doug Johnson, your view of the whole controversy within the American Psychological Association? And have you taken a stance on this, your center?

DOUGLAS JOHNSON: Well, we see ourselves as a technical and professional organization, and we try and feed people the information that comes from our work. I have to say, though, that in my view there’s a strong parallel here with what happened in Uruguay at the height of the repression in Uruguay. And here, you had really a struggle between two groups of psychologists. The dominant group in Uruguay were psychoanalytic; the emerging group were behavioralists, and they were second-class citizens in the psychological world. Therefore, they allied themselves with the military in designing systems of torture, of designing the whole structure of what was called Libertad prison, so that it became an ongoing instrument of torment and disruption and psychological dissonance within the minds of the prisoners, a situation that was so bad that it was the very first report from the ICRC that was released to the public, the second only being what we know about in Guantanamo. And so, it’s hard for us not to see those parallels, that there may be a bigger struggle in the way psychology is going, and some are aligning the wrong way.

AMY GOODMAN: Well, I want to thank you both very much for joining us, Steven Miles, author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror; and Doug Johnson, head of the center for torture victims here in St. Paul, Minneapolis. The specific name is the Center for Victims of Torture. Thank you so much.

Add comment October 14th, 2007

Sicko: Michael Moore on Oprah

Michael Moore was on Oprah yesterday. They, along with a healthcare economist and an insurance industry publicist, had the deepest discussion of the healthcare that crisis that I’ve ever seen in the corporate media. You can watch it here:

Parts 2-6 after the break.




Add comment September 28th, 2007

Michael Moore Open Letter in response to CNN/Sanjay Gupta hatchet job

Micheal Moore replies to the CNN/Sanjay Gupta attack on his movie Sicko. Make sure to read the detailed line-by-line rebuttals cited in the letter:

An Open Letter to CNN from Michael Moore

7/14/07

Dear CNN,

Well, the week is over — and still no apology, no retraction, no correction of your glaring mistakes.

I bet you thought my dust-up with Wolf Blitzer was just a cool ratings coup, that you really wouldn’t have to correct the false statements you made about “Sicko.” I bet you thought I was just going to go quietly away.

Think again. I’m about to become your worst nightmare. ‘Cause I ain’t ever going away. Not until you set the record straight, and apologize to your viewers. “The Most Trusted Name in News?” I think it’s safe to say you can retire that slogan.

You have an occasional segment called “Keeping Them Honest.” But who keeps you honest? After what the public saw with your report on “Sicko,” and how many inaccuracies that report contained, how can anyone believe anything you say on your network? In the old days, before the Internet, you could get away with it. Your victims had no way to set the record straight, to show the viewers how you had misrepresented the truth. But now, we can post the truth — and back it up with evidence and facts — on the web, for all to see. And boy, judging from the mail both you and I have been receiving, the evidence I have posted on my site about your “Sicko” piece has led millions now to question your honesty.

I won’t waste your time rehashing your errors. You know what they are. What I want to do is help you come clean. Admit you were wrong. What is the shame in that? We all make mistakes. I know it’s hard to admit it when you’ve screwed up, but it’s also liberating and cathartic. It not only makes you a better person, it helps prevent you from screwing up again. Imagine how many people will be drawn to a network that says, “We made a mistake. We’re human. We’re sorry. We will make mistakes in the future — but we will always correct them so that you know you can trust us.” Now, how hard would that really be?

As you know, I hold no personal animosity against you or any of your staff. You and your parent company have been very good to me over the years. You distributed my first film, “Roger & Me” and you published “Dude, Where’s My Country?” Larry King has had me on twice in the last two weeks. I couldn’t ask for better treatment.

That’s why I was so stunned when you let a doctor who knows a lot about brain surgery — but apparently very little about public policy — do a “fact check” story, not on the medical issues in “Sicko,” but rather on the economic and political information in the film. Is this why there has been a delay in your apology, because you are trying to get a DOCTOR to say he was wrong? Please tell him not to worry, no one is filing a malpractice claim against him. Dr. Gupta does excellent and compassionate stories on CNN about people’s health and how we can take better care of ourselves. But when it came time to discuss universal health care, he rushed together a bunch of sloppy — and old — research. When his producer called us about his report the day before it aired, we sent to her, in an email, all the evidence so that he wouldn’t make any mistakes on air. He chose to ignore ALL the evidence, and ran with all his falsehoods — even though he had been given the facts a full day before! How could that happen? And now, for 5 days, I have posted on my website, for all to see, every mistake and error he made.

You, on the other hand, in the face of this overwhelming evidence and a huge public backlash, have chosen to remain silent, probably praying and hoping this will all go away.

Well it isn’t. We are now going to start looking into the veracity of other reports you have aired on other topics. Nothing you say now can be believed. In 2002, the New York Times busted you for bringing celebrities on your shows and not telling your viewers they were paid spokespeople for the pharmaceutical companies. You promised never to do it again. But there you were, in 2005, talking to Joe Theismann, on air, as he pushed some drug company-sponsored website on prostate health. You said nothing about about his affiliation with GlaxoSmithKline.

Clearly, no one is keeping you honest, so I guess I’m going to have to do that job, too. $1.5 billion is spent each year by the drug companies on ads on CNN and the other four networks. I’m sure that has nothing to do with any of this. After all, if someone gave me $1.5 billion, I have to admit, I might say a kind word or two about them. Who wouldn’t?!

I expect CNN to put this matter to rest. Say you’re sorry and correct your story — like any good journalist would.

Then we can get back to more important things. Like a REAL discussion about our broken health care system. Everything else is a distraction from what really matters.

Yours,
Michael Moore
mmflint@aol.com
www.michaelmoore.com

P.S. If you also want to apologize for not doing your job at the start of the Iraq War, I’m sure most Americans would be very happy to accept your apology. You and the other networks were willing partners with Bush, flying flags all over the TV screens and never asking the hard questions that you should have asked. You might have prevented a war. You might have saved the lives of those 3,610 soldiers who are no longer with us. Instead, you blew air kisses at a commander in chief who clearly was making it all up. Millions of us knew that — why didn’t you? I think you did. And, in my opinion, that makes you responsible for this war. Instead of doing the job the founding fathers wanted you to do — keeping those in power honest (that’s why they made it the FIRST amendment) — you and much of the media went on the attack against the few public figures like myself who dared to question the nightmare we were about to enter. You’ve never thanked me or the Dixie Chicks or Al Gore for doing your job for you. That’s OK. Just tell the truth from this point on.

2 comments July 14th, 2007

Michael Moore takes on Wolf Blitzer

Add comment July 10th, 2007

An interview with Steven Miles

Bioethicist Steven Milesis featured in the University of Minnesota alumni magazine [Taking on Torture]. A few excerpts:

“Early on, I would wake up in Abu Ghraib,” says Steven Miles (M.D. ’76), describing the toll his most recent research project took on him. “That was not a pleasant place to wake up in.” After seeing the leaked photographs of abused prisoners at the Abu Ghraib prison in Iraq in May 2004, Miles, a professor in the Medical School and the Center for Bioethics at the University of Minnesota and an attending physician at the University of Minnesota Medical Center, Fairview, wanted to know where the prison doctors were while these abuses were taking place. So he began to dig, reading through tens of thousands of pages of declassified government documents obtained by the American Civil Liberties Union (ACLU) and posted on its site.

“I’m not a professional historian,” Miles says. “I’m a doc, and so I have a special kind of expertise like, for example, the ability to read death certificates that a historian doesn’t have.” What he uncovered was extensive evidence that medical professionals in the prisons in Iraq and Afghanistan and at Guantanamo Bay were often participants in abusive interrogations, concealing and enabling torture and issuing fake death certificates. He read accounts of sodomy, pulpified legs, deaths by asphyxia and beatings, and doctors examining torture victims and then medically discharging them back to the guards who tortured them….

What kinds of changes do you want to see? We have to harmonize the AMA’s policies and the other medical associations’ policies with international law. That is, it’s no longer enough for the medical associations to say, “We oppose medical participation in torture.” The medical associations must say, “We stand by the Geneva Conventions, and, furthermore, we stand by the legal accountability of health professionals to the Geneva Conventions.” We can’t just say that these documents are moral aspirations. We have to insist that they are accountable, legal, and professional obligations….

Print ViewPrint View

Taking on Torture

MN-July-cover1
Steven Miles, photo by Mark Luinenburg

By Shelly Fling“Am I naïve in believing that medicine is still a noble profession, upholding the highest ethical principles? For the ill, doctors still stand for life. And for us all, hope.”

—Holocaust survivor Elie Wiesel, writing on prison medicine in Iraq in the New England Journal of Medicine in 2005.

“Early on, I would wake up in Abu Ghraib,” says Steven Miles (M.D. ’76), describing the toll his most recent research project took on him. “That was not a pleasant place to wake up in.” After seeing the leaked photographs of abused prisoners at the Abu Ghraib prison in Iraq in May 2004, Miles, a professor in the Medical School and the Center for Bioethics at the University of Minnesota and an attending physician at the University of Minnesota Medical Center, Fairview, wanted to know where the prison doctors were while these abuses were taking place. So he began to dig, reading through tens of thousands of pages of declassified government documents obtained by the American Civil Liberties Union (ACLU) and posted on its site.

“I’m not a professional historian,” Miles says. “I’m a doc, and so I have a special kind of expertise like, for example, the ability to read death certificates that a historian doesn’t have.” What he uncovered was extensive evidence that medical professionals in the prisons in Iraq and Afghanistan and at Guantanamo Bay were often participants in abusive interrogations, concealing and enabling torture and issuing fake death certificates. He read accounts of sodomy, pulpified legs, deaths by asphyxia and beatings, and doctors examining torture victims and then medically discharging them back to the guards who tortured them.

“This is easily the saddest and most disappointing academic project I’ve ever done,” Miles says. “Not just because docs were involved, but also because this is not a U.S. military that I recognize and it’s also not U.S. intelligence services that I recognize. I’ve had experience with both, and this is just outside of our history.”

Much of what Miles read—about the abuse of women prisoners and of children, the pouring and igniting of lighter fluid on the backs of prisoners’ hands, and other atrocities—he set aside if he didn’t find evidence of a medical professional involved. That material was not included in his article on medical complicity in torture, published in the British medical journal The Lancet in 2004, that received worldwide attention or in his subsequent book, Oath Betrayed: Torture, Medical Complicity, and the War on Terror, published by Random House in 2006. This past spring, with a grant from the University’s Office of Public Engagement, Miles organized, indexed, and cross-linked the material he used in his research—an estimated 60,000 pages of documents, including documents pertaining to the deaths of 160 prisoners—into an online archive on the Human Rights Library site at the University (it may be accessed through www.umn.edu/humanrts).

Miles says he’ll continue to add to the archive as documents are declassified, including approximately 500 recently released pages about the mental health of the guards at Abu Ghraib. But his job is otherwise complete, and he says he’s searching for his next project—something else around “the idea of engaging medical ethics in a broader social debate.” His past research has addressed—and often helped shape policy around—end-of-life care, reducing bed-rail accidents in nursing homes, universal health care, and the treatment of victims of AIDS in Africa and of refugees in camps.

Whether Miles’s work leads to new anti-torture policies and regulations by medical associations and licensing boards is yet to be seen. Meantime, he points to the lasting value of the sort of archive he has created—one that is a model for transparency and accountability in government.

What follows are Miles’s characteristically frank answers to questions about his research.

Are prisoners in U.S. custody being tortured right now? One of the problems is that we’re working with a telescope that goes out two light years; that’s how long it takes to declassify materials. I think that the situation in Guantanamo may be better from the standpoint of physical abuse, although there are still substantial abuses of due process at Guantanamo—habeas corpus, fair trials, arbitrary detention, and so forth. But I think that the question of physical abuse in Afghanistan and Iraq remain a huge issue, although it’s impossible to quantitate because of the way the Freedom of Information Act works [including that obtaining information from agencies close to national security, such as the CIA, can be impossible].

Is torture ever justified if it could save lives? Every time a nation has decided that torture can be justified, it’s wound up misusing it. They’ve taken a singular case and they’ve gone to a general practice. So I don’t think that the technology of torture works. It doesn’t produce reliable information. It can’t be targeted just to people who would pop that information. And we don’t have a way of using that information in real time. And so I’d answer the question no.

What do you hope for this archive—how it will be used, what it might forward? I know it’s currently being used by human rights groups and by major media. The ACLU deserves great credit for putting this stuff up, but it’s largely categorized by the date that they were able to post it. And so by organizing it, indexing this material, it made it more accessible for other people to do research. So, my hope is that this will be used to that end, and, in fact, the work so far has resulted in changes to the policies of the World Medical Association, the AMA [American Medical Association], the Royal College of Psychiatrists, the American Psychiatric Association, the American Psychological Association—and it’s changed at least three Defense Department policies. So it is having an impact, but I think we’re still at a relatively early stage in terms of getting the final impact from this whole episode of treatment of prisoners.

What kinds of changes do you want to see? We have to harmonize the AMA’s policies and the other medical associations’ policies with international law. That is, it’s no longer enough for the medical associations to say, “We oppose medical participation in torture.” The medical associations must say, “We stand by the Geneva Conventions, and, furthermore, we stand by the legal accountability of health professionals to the Geneva Conventions.” We can’t just say that these documents are moral aspirations. We have to insist that they are accountable, legal, and professional obligations.

What was the AMA’s reaction to the allegations of medical complicity in the torture? The AMA initially, right after the Abu Ghraib pictures came out, turned down an invitation by the British Medical Association to call for an independent investigation. The AMA did strengthen its anti-interrogational abuse policy a click, but they have not called for an independent investigation. They took an extremely low-profile position with regard to the McCain Amendment [of 2006, prohibiting the inhumane treatment of prisoners]. And although the JAMA [Journal of the American Medical Association] is separate from the AMA because of an editorial firewall between the two, JAMA [as of mid-June] has not editorialized on this issue at all. So, I think the AMA’s position has been one of silence.

You’ve spoken to some medical professionals in the prisons. Did they talk about the pressure they were under to participate in abusive interrogations? There was pressure. And some of the pressure can be seen in the documents as well. But what I don’t see in the documents or in their personal stories is the type of pressure that is brought to bear against health professionals who protest torture in countries like Chile or Uruguay or the Soviet Union or Turkey, and risk being disappeared or tortured or killed or having their family members killed for that resistance. The pressure that was brought to bear was peer pressure, in some cases the threat of a transfer. But when I look at my colleagues in other torturing countries, I see them taking absolutely heroic and in some cases suicidal risks to protest torture. So I don’t accept—I simply do not accept—the notion that the pressure was of a degree that should have caused them to be silent or complicit….Would you knowingly go to a doctor as your personal physician who’d been complicit in torture? I remember a wonderful teacher I once had who had been an S.S. officer. He teaches at a local college. His insights into how he wound up becoming an S.S. officer and the historical warnings that he gave his students, and, indeed, the academic community at large, were really important. So, I guess I wouldn’t want to go to a physician who practiced torture who didn’t take from it some kind of wisdom about why that was such a terrible idea and have a willingness to share about how to avoid taking that path.

Do you think that complicity by medical professionals makes torture worse? Yes, I do, in a couple respects. Jacobo Timmerman, who was a prisoner in the Argentine junta, described it this way: The doctor’s “presence was terrible because he was the symbol that a scientific instrument is with you when you are tortured by the beasts.” When you look at torture victims, around 60 percent say they’ve seen medical professionals supervising it, and that doesn’t include the ones who are buried with a fake death certificate. I think it makes it worse in terms of its demoralizing impact on the person undergoing torture, but also because it winds up roping in a larger medical community on behalf of a torturing society….
And, perhaps most relevant to myself and my colleagues who have been fighting to change American Psychological Association policies for quite a while:

How did you read the torture documents day after day without losing your sanity? I went down to the Dakota Jazz Club in Minneapolis a fair amount, which was a very good thing to do. I actually learned a lot about jazz during this project, which had a major saving effect. And I don’t think that’s entirely coincidental, because since so much jazz is related to the African American experience, which is an experience of torture, I think there is an interesting redemptive theme to jazz. But this material is toxic. Robert Jay Lifton, who wrote on the Nazi doctors, said the same thing when I was talking to him about this. It’s not something people should work with for a long period of time. It’s not just taboo material, it’s material that will transform you into a nonhealthy state. So part of putting up the archive was to turn the process over to others.

Add comment July 6th, 2007

Doctors telling personal anecdotes to patients aren’t doing the patients a favor

As a long-time researcher and proselytizer among my clinical colleagues for the value of research, I love examples where researchers start out with an hypothesis only to be told by the data that they were wrong. Yesterday’s New York Times provides one of these examples.

Those concerned with improving doctor patient interaction have encouraged doctors to loosen up how they talk to patients, in order to build a relationship that can facilitate communication and compliance with medical advice. Some thought that doctors being willing to reveal personal details about themselves might contribute to improved communication.

Researchers studied doctors in Rochester who agreed to have two unidentified pseudo patients come to their office and surreptitiously record the consultation. the researchers were surprised by the results. When the doctors revealed personal details, rather than aid communication, it seemed to hijack the discussion to the doctor’s concerns and away from the patient’s.

June 26, 2007

Study Says Chatty Doctors Forget Patients

by Gina Kolata

A new patient comes into a doctor’s office weighing 204 pounds. He’s six feet tall. The following conversation ensues:

Doctor: Is that up a little bit for you, weightwise?

Patient: It might be up a few pounds. I used to jog and I just haven’t …

Doctor: See, ’cause I’m weighing more like 172, 173 and I’m six foot. And I’m still running. I’m doing the 5 and 10 and 15 K’s. The half marathons and …

Patient: So, I’m 30 pounds heavier than you?

Doctor: Right now, yeah.

That, a group of researchers say, is part of an actual conversation they recorded in the course of a study that showed that many doctors waste patients’ time and lose their focus in office visits by interjecting irrelevant information about themselves.

Their paper, published yesterday in The Archives of Internal Medicine, involved 100 primary-care doctors in the Rochester area. As part of a study on patient care and outcomes, the doctors agreed to allow two people trained to act as patients come to their offices sometime over the course of a year. The test patients would surreptitiously make an audio recording of the encounter. The investigators analyzed recordings of 113 of those office visits, excluding situations when the doctors figured out that the patient was fake.

To their surprise, the researchers discovered that doctors talked about themselves in a third of the audio recordings and that there was no evidence that any of the doctors’ disclosures about themselves helped patients or established rapport.

Nor, in the vast majority of cases, did the doctors circle back to the personal conversation or try to build upon it.

“I think all of us on the team thought self-disclosure is a potentially positive aspect to building a doctor-patient relationship and that we ourselves were quite good at it,” said Susan H. McDaniel, a psychologist who is associate chairwoman of the department of family medicine at the University of Rochester and lead author of the study.

“We were quite shocked,” Dr. McDaniel added. “We realized that maybe not 100 percent of the time, but most of the time self-disclosure had more to do with us than with the patients.”

Dr. Howard B. Beckman, medical director of the Rochester Individual Practice Association and an internist and geriatrician who was an author of the study, analyzed conversations before and after the doctors started talking about themselves.

“I’d been saying for many years that disclosure was a form of patient support,” Dr. Beckman said. “If someone says, ‘I have a problem,’ and you say, ‘I understand because I have it, too,’ that would be comforting.” But, he added, “in truth that never happens.”

Patients were not comforted, he said, and conversations got off track. Four out of five times when a doctor interjected personal information, the doctor never returned to the topic under discussion before the interruption.

“We found that the longer the disclosures went on, the less functional they were,” Dr. Beckman said. “Then the patient ends up having to take care of the doctor and then the question is who should be paying whom.”

The researchers studied the conversations looking for any hint that patients were helped when the doctors talked about themselves.

“We looked for any statement of comfort, any statement of appreciation, any deepening of the conversation,” Dr. Beckman said.

They found none.

Dr. Jeffrey Borkan, who is a professor and chairman of the department of family medicine at Brown University, said it was easy to see why doctors thought it was helpful to talk about themselves. Doctors are told that they must make a connection with patients. But, Dr. Borkan said, “the instruction is often imprecise — how do you make a connection?” Many think the way to do it is by talking about themselves.

“What’s shocking about this article is how often they moved from the patient’s concerns to their own,” Dr. Borkan said.

But Dr. Richard Frankel, a professor of medicine and geriatrics at Indiana University, hopes that doctors do not conclude that the best course is to clam up completely about themselves.

Patients, for example, may ask a female physician who is pregnant when she is due or whether she is having a boy or a girl. “It would not be appropriate not to say anything,” Dr. Frankel said.

The Rochester researchers, though, say their results opened their eyes to their own transgressions and made them change their ways.

They also made them see that they, too, had been the victims of doctors’ time-wasting disclosures.

Dr. McDaniel said, “I went to my doctor recently, and I realized after I left, when I was in the parking lot, that I had only asked one of my two questions because my doctor was telling me about his trip to Italy.”

But not all doctors informed of the results saw themselves in the data.

Dr. John K. Min, an internist at the Kernodle Clinic in Burlington, N.C., said he had always been circumspect when he talked to patients.

Then, however, he recalled a patient who came to see him five years ago for a physical exam. Dr. Min is avid about building furniture and the patient was skilled at furniture building. The patient spent 40 minutes with Dr. Min. When he left, Dr. Min looked at his notes.

“I realized that I didn’t even examine him,” Dr. Min said. The man, he added, was gracious when Dr. Min called to apologize.

“He said, ‘We’ll just wait for next time,’ ” Dr. Min recalled.

This study has potential relevance for psychotherapy as well. In the therapy world, as in medicine, there has been discussion of whether therapist self-disclosure might facilitate an improved therapist-patient relationship and increased patient sel-disclosure. This study would suggest that examination of this possibility should carefully distinguish between cases where the therapist makes brief personal comments in an attempt to further patient talk and cases where the therapists ends up hijacking the conversation.

2 comments June 27th, 2007

New list for info on medical operations in the war on terror prisons

Bioethicist Steven Miles, who maintains an archive of materials on medical roles in the war on terror announces a new email list:

I am getting many requests for the URLs of new government documents that pertain to medical operations in the war on terror prisons. Accordingly, as I add documents to United States Military Medicine in War on Terror Prisons I will send each of you copies of the relevant information.

Those wishing to be put on the list should contact Dr. Miles at miles001@umn.edu

Here is an example of the first item sent out:

=================== New Document ===========================

Issuing Body: Author: Intelligence Science Board
Title: Study on Educing Information
Date: December 2006
Note: This 400 page report is the current gold standard report on what is known about the science of interrogation. Of particular interest to this site is
Chapter 2. “Approaching Truth: Behavioral Science Lessons on Educing Information from Human Sources page 17-44)

Link: http://www.dia.mil/college/3866.pdf

Title of document in Archive: Intelligence Science Board 2006

Add comment May 30th, 2007

Iraq health declining. Les Roberts cited by NYT as expert

According to the New York Times,, the World Health Organization reports that public health is deteriorating:

As a result of these multiple public-health failings, diarrhea and respiratory infections now account for two-thirds of the deaths of children under five, the report said. Twenty-one percent of Iraqi children are now chronically malnourished, according to a 2006 national survey conducted by Unicef, which puts them at risk for both stunted growth and mental development.

And, in what may be a first for the New York Times, they quote Les Robert, of the Lancet Iraq mortality study fame, as an expert, without any language dismissing him as crazed or politically biased:

“There has been so much violence for so long that the result is inevitably this kind of complete social decay,” said Dr. Les Roberts, a principal researcher in a series of public health surveys on mortality among Iraqi citizens whose controversial results have been published in the British journal Lancet.

He says he believes that some of the new data vastly underestimates the human tragedy. “The W.H.O. has done a great job in walking a tightrope,” said Dr. Roberts, who was formerly at the Johns Hopkins Bloomberg School of Public Health and now heads the program on forced migration and health at Columbia University. “They are telling the world that the Iraqi health situation is really bad and likely to get worse, but doing it within the political constraints of respecting government numbers.”

He said, for example, that the report of 100 deaths a day from violence was “a gross underestimate,” placing the probable tally at several times higher.

The health situation continues to decline :

Dr. Khalid Shibib, of the W.H.O., said that most of the public health figures were “better a few years ago” because “loss of electricity and displacement of people have led to a deterioration of our public services and lack of access.”

“If the environmental situation continues to deteriorate, there will be increased diarrheal diseases, such as cholera,” he said. “Also, if there continues to be so many displaced people who are crowded together — maybe living with relatives — there will be a great rise in respiratory diseases, maybe even tuberculosis.”

And health care is declining as doctors and nurses flee and ethnic conflict infects health facilities. As a result:

The report cites the Iraqi government as saying that almost 70 percent of critically injured patients die in the hospital because of lack of staff, drugs and equipment.

Add comment April 19th, 2007

Psychological defenses and abusive detainee healthcare

Nancy Sherman, former teacher of military ethics at the U.S. Naval Academy and author of Stoic Warriors, has a new piece, From Nuremberg to Guantanamo: Medical Ethics Then and Now, in Dissent exploring the defenses used by the health professionals at Guantanamo to those used by the Nuremberg doctors.

She was, I believe, on the same visit in 2005 in which American Psychological Association President Ronald Levant as well as American Psychiatric Association President Steven S. Sharfstein participated. Naturally, her account is not quite so gushing as that of President Levant:

Though we were invited as observers, we saw none of the 505 inmates during the whole day, save for one stolen glimpse of two bearded prisoners in white tunics and loose pants behind screens and barbed wire. Still, two scenes involving inmates made my moral worries concrete.

Seven detainees were on hunger strike, a steep drop from the escalated numbers over the summer. We were assured that the hunger strikers were being treated humanely. The commanding doctor at the time, Captain John Edmonson, showed our group (which included U.S. Surgeon General Richard Carmona, Army Surgeon General Kevin Kiley, Joint Staff Surgeon Joseph Kelly, as well as top civilian physicians who work for Undersecretary of Defense for Health Affairs William Winkenwerder) a tube used for feeding�a thin nasogastric tube, a 10-French Dobhoff�and explained that lubrication and anesthesia were routinely used before insertion. The senior military and civilian doctors listened attentively as they were told that there was overall �complicity,� in that most strikers did not forcibly resist insertion of the tubes or remove them once they were in place. Not one doctor asked about the consequences of not acquiescing to the tube; none openly worried that acquiescence might not be the same thing as consent; none voiced the concern that pulling out a nose tube funneled down the back of one�s throat to the top of one�s stomach might, in some circumstances, be painful, and that failure to do that might at best be a weak form of consent.

The scene is disturbing in light of confirmed reports, just four months after my visit, that striking detainees had been strapped into restraint chairs during and immediately after force-feeding in order to prevent, according to officials, purging and asphyxiation that might result from being fed in a prostrate position. Some detainees alleged that while in the chair they were force-fed not only nutrients but also diuretics and laxatives. The result was that they urinated and defecated on themselves. The allegations raise serious questions about the role of doctors in authorizing the procedure. If diuretics and laxatives were used, who approved their use? I raised this question with a senior medical official in the Pentagon, but have not received an answer.

A SECOND SCENE has returned to me often. We were taken to the psychiatric wing of the hospital and introduced to two young female army psychiatrists. The presiding commander of Guantánamo at the time, General Jay W. Hood, praised them highly for their dedication in the face of resistance from detainees.

Five months later, I replayed that scene as I listened to the account of a detainee lawyer, Joshua Colangelo-Bryan. Colangelo-Bryan is a young lawyer who, in his own words, is �cynical by nature� and takes all his clients� reports with �a grain of salt.� When he took on the representation of several Bahrainee detainees at Guantánamo in 2004, he took their concerns with an even �bigger grain of salt� than he would in a typical case of commercial litigation. One of those detainees, Jumah al-Dossari, had been in Camp 5, the maximum-security facility, for extended periods. The blocks in Camp 5 have solid walls, with the only access to the outside world being a food-tray slot on a door that opens to a hall where large industrial fans drown out any attempt at conversation. Not surprisingly, al-Dossari suffered from the psychological stress of isolation. During their consultations, al-Dossari said that in interrogation sessions he was wrapped in an Israeli flag, chained to a floor while a female interrogator put on his face what he believed to be menstrual blood, and beaten unconscious by guards. The attorney was initially skeptical of some of the statements until he later read FBI memos and a book by a military officer that detailed exactly the same interrogation techniques his client had described, including the menstrual blood tactic.

In the spring of 2005, while al-Dossari was still in Camp 5, he asked his attorney in a quiet voice, �What can I do from going crazy?� On October 15, 2005, Colangelo-Bryan went down to Guantánamo to consult with him. During the interview, al-Dossari said he needed to go to the bathroom. Colangelo-Bryan called in the military police so that they could remove the shackles holding al-Dossari to the floor in the meeting area. The attorney then walked out of the room and the MPs took al-Dossari to a small cell with a toilet, located on the other side of the meeting area and separated from it by a steel mesh wall. A couple of minutes went by, and then a few more. The attorney had a sense that something might be wrong and peeked into the door to the meeting area. There he saw a pool of blood. He looked up to find a gaunt figure hanging from the mesh wall on the cell side, face covered in blood, body limp, eyes rolled back in his head, his lips and mouth swollen and protruded. He called in the MPs who cut down al-Dossari from the mesh wall and, at the attorney�s request, began CPR. Colangelo-Bryan was ordered to leave, but as he left he heard al-Dossari gasp for air.

Al-Dossari survived this suicide attempt, but during his time at Guantánamo he has tried to commit suicide eleven other times. (There were three successful suicides at Guantánamo by other detainees in June of 2006.) After al-Dossari�s October 15 attempt, his attorney asked for transfer to a less isolating camp, some meaningful social interaction, a few books, and one telephone call with his family. All four requests were denied. Al-Dossari then filed a motion with the court that was also denied. The Court argued that he was not isolated because he had been interrogated twenty-nine times over the past two years��a novel legal position,� his attorney commented (though perhaps in line with the notion that rapport building is, as I was told by Hood, the preferred method of interrogation at Guantánamo). Because of the Graham-Levin Amendment stripping detainee cases of habeas corpus (upheld recently in the Military Commissions Act), al-Dossari�s team has not been able to obtain legal relief.

Legal issues aside, the case raises concerns about the role of psychiatrists and behavioral therapists at Guantánamo: in particular, were mental health workers involved in decisions about al-Dossari�s isolation and restrictions? Are they typically involved in such decisions?

Add comment March 12th, 2007

Frank Rich, on General “Coverup” Kiley

In today’s New York Times column, Frank Rich gives a cameo role to General Kiley, Surgeon General of the Army. Kiley, of course, has become notorious in recent weeks for his total inaction as we was repeatedly told of the horrible conditions at Walter Reed. Those of us involved in the psychologists-interrogations issue know of Kiley as the man who addressed the 2006 APA Convention in defense of the psychologist participation in the Behavioral Science Consultation Teams (BSCTs) at Guantanamo and Iraq. These antics have led reporter Art Levine to refer to the Surgeon General as “Coverup” Kiley.

In today’s column, after describing why it is a certainty that Bush will pardon Lewis Libby, to keep him quiet about all the secret machinations of the administration that he was privy to. Rich then devotes a few paragraphs to General “Coverup”:

A particularly vivid example of the extreme measures taken by the White House to cover up the war’s devastation turned up in The Washington Post’s Walter Reed exposé. Sgt. David Thomas, a Tennessee National Guard gunner with a Purple Heart and an amputated leg, found himself left off the guest list for a summer presidential ceremony honoring a fellow amputee after he said he would be wearing shorts, not pants, when occupying a front-row seat in camera range. Now we can fully appreciate that bizarre incident on C-Span in October 2003, when an anguished Cher, of all unlikely callers, phoned in to ask why administration officials, from the president down, were not being photographed with patients like those she had visited at Walter Reed. “I don’t understand why these guys are so hidden,” she said.

The answer is simple: Out of sight, out of mind was the game plan, and it has been enforced down to the tiniest instances. When HBO produced an acclaimed (and apolitical) documentary last year about military medics’ remarkable efforts to save lives in Iraq, “Baghdad ER,” Army brass at the last minute boycotted planned promotional screenings in Washington and at Fort Campbell, Ky. In a memo, Lt. Gen. Kevin Kiley warned that the film, though made with Army cooperation, could endanger veterans’ health by provoking symptoms of post-traumatic stress disorder.

The General Kiley who was so busy policing an HBO movie for its potential health hazards is the same one who did not correct the horrific real-life conditions on his watch at Walter Reed. After the Post exposé was published, he tried to spin it by boasting that most of the medical center’s rooms “were actually perfectly O.K.” and scapegoating “soldiers leaving food in their rooms” for the mice and cockroach infestations. That this guy is still surgeon general of the Army — or was as of Friday — makes you wonder what he, like Mr. Libby, has on his superiors.

[Emphasis added.]

Add comment March 11th, 2007

Next Posts Previous Posts


Pages

Calendar

November 2008
M T W T F S S
« Oct    
 12
3456789
10111213141516
17181920212223
24252627282930

Posts by Month

Posts by Category