Offline: Looking forward to Donald Trump

Lancet, Volume 388, No. 10061, last 2726, 3 December 2016

Richard Horton

Perhaps we should be more relaxed about Donald Trump as America's next President. First, he will likely serve only one term. It will be over before you can say Hillary Clinton. Second, if Nigel Farage was to become Her Majesty's Ambassador to the United States of America, it would exclude a particularly disagreeable voice from British politics. We might be grateful. Third, Mr Trump is not a Republican. He may find he has two parties opposing him in Congress, instead of one. Gridlock plus plus plus. Fourth, the world is already on a path to solving its most intractable predicaments—for example, climate change. Whatever President Trump thinks, says, or decides will not derail the direction of travel for 194 other nations. Fifth, Mr Trump realises that inciting hatred during an election campaign doesn't translate well into policy. He will not implement even a fraction of what he has so far promised. And sixth, we must thank Mr Trump for galvanising a generation to engage more energetically in their futures. His words may have divided America. But they have also mobilised a resistance of surprising proportions. The next 4 years won't be nearly as bad as you might think.

But this guarded optimism was not the prevailing mood during last week's Global Health Lab, held at the London School of Hygiene & Tropical Medicine. The question concerned the implications of the US election for global health.

Sophie Harman is a political scientist at Queen Mary University of London. She implored her audience to 'ignore the dead cat'. By which she meant, ignore the distractions that Mr Trump will throw at you. His Twitter feed is already redirecting your attention away from what really matters.

Focus.

Domestically, Americans should be worried about the survival of all that is good in the Affordable Care Act.  Women should be anxious about how they might protect their reproductive rights. A renewed permissiveness towards racism will worsen the mental and material health of African-Americans and other minorities. Xenophobia will encourage violence. And Mr Trump's tax and welfare proposals will harm health. The global implications of Trumpism were barely an election issue. His assault on reproductive rights at home will be mirrored abroad. His isolationist foreign policy will diminish the US voice in global health policy making. His protectionism means that he will likely not take on big pharma. His administration's choice for Director-General of WHO will have lasting effects on the agency (his anti-globalism will weaken its role).

And the allegations he has fomented against the Clinton Foundation could damage an institution that has won many victories on behalf of the poorest.

Harman disagreed with The Lancet's assessment of a Trump Presidency. She argued that our suggestion for rational engagement was mistaken. The Trump team is not going to engage on a rational basis, or at least on any rational terms we might propose. Instead, she suggested that those opposed to Mr Trump should join or support organisations representing issues they cared most about. You might amplify your resistance through social media. You must vote. And, above all, you should be kind.

 'Interesting and challenging', was Stefan Elbe's understated view of Mr Trump. Elbe is Director of the Centre for Global Health Policy at the University of Sussex. He praised President Obama for strengthening America's leadership role in global health. A third of the world's development assistance for health comes from the US. And this despite the financial crisis of 2007–08. Obama has left a 'clear, significant, and meaningful legacy'.

Regarding Mr Trump, he predicted 'dark clouds'. America first, economic nationalism, manipulation of the weak, populism, and a coercive approach to power. These are the Trumpian traits we already know about. So the question one must ask is not will Mr Trump be bad for global health, but how bad will he be for global health?

The fact that we have no idea shows how much he has already undermined democracy in America. But Elbe did offer one tactic for negotiating our way through the next 4 years. Mr Trump sees power as a commodity to be used and traded in a hard, quasi-military style. There is another way of viewing power—as a quality distributed through networks. Mr Trump is one small node within this network, a network that contains many nodes channelling and influencing forces that shape our lives and futures. It is therefore simply too soon to say that the liberal—and global health—order has been lost.

   [ - emphasis added and some minor paragraph editions made.  - MV]

How a Southern White Gun-Owning Male Figured He Would End That Clinton Child Sex Trafficking Ring Run Out of a Pizzeria Once And For All, Rescuing All Those Chil'ren

Mike Victor

To all my friends on the right (both of you) who told me that Clinton's 2.5 million popular vote victory was reality slapping us Liberals in the face to remind us how little we know about Real Americans (read:  white, gun-owning, Christian country folks with less than a college education):  allow me to remind you what reality REALLY looks like when the universe is trying to teach us a lesson.  This is no slap in the face but a 2x4 upside the head.

28-year-old Edgar Maddison Welch, of Salisbury, North Carolina, who drove across the country with at least 3 firearms, 2 of which he used inside the premises of Comet Ping Pong, believed by right wing conspiracy theorists to be the front for a child sex trafficking ring run by the Clinton family after a fake news story was misunderstood to be true.  

Our instructive tale could start anywhere, but let's keep it simple and fast forward through slavery, the Fugitive Slave Act, Dred Scott, secession, the Civil War, Reconstruction, the Lost Cause mythology, Jim Crow, Brown v. Board of Education, the lost cause for segregation, Little Rock, Selma, the Voting Rights Act, and the election of our first African American as president.   

Although we kind of need that last part because the election of a black president fueled the seething rage that spilled over against Democrats in general among Southern males in particular, a rage best expressed through (what else?) a surge in gun sales.  

Gun manufacturers were more than happy to play upon Southern white male paranoia that Liberals were going to come for their guns (just as soon as we could find a truck big enough to also hold their bibles (no sense making two trips, especially by a CO2-obsessed administration duped by that Chinese global warming hoax).)  

Reality just gave us all the ingredients for another mass casualty event (this one luckily averted):

- Southern white male gun owner +

- Easy availability of weapons of war on demand without background check, weapons that all other countries reserve for their military +

- Lax gun laws that allow stockpiling of ammunition and transport of weapons in an unsecured private vehicle across state lines +

- Mass media AWOL as an instrument of education or truth-telling since infotainment is so much more profitable +

- A white male racist candidate telling other white males that they are a persecuted minority whose cause he will bring to the Oval Office while locking up his dastardly opponent who is "evil", "such a nasty woman", a "liar", "criminal", and "corrupt" +

- Years of far right partisan news (Fox, hate radio, "Christian family" radio) stoking outrage and paranoia, lowering the bar as to what dastardly plots would be believable about Clinton or any other member of the Massive Left Wing Secular Humanist Conspiracy, intent as it is to bring science into your kid's school and ISIS to a Walmart near you (because, you know, there are few things that secular Western feminists love as much as a far right, misogynistic, militant theocracy) +

- Fake news (AKA maliciously fabricated lies to stoke hatred of a woman who by all rights should be our first female president) +

- Her opponent openly inviting the Russians to hack her emails (which they did, then selectively released to a gullible public) +

- Social media acting as an echo chamber of Really Bad Ideas  +

- Gasoline cheap enough to allow a private citizen who is either unemployed or marginally employed to drive across the country to conduct his own private investigation and deliver his own vigilante justice to a child sex slave ring Clinton was running from a Washington state pizza store.

Luckily, the North Carolina gun owner was a bad shot or lost his nerve while executing his Second Amendment remedy, and his first intended victim fled as soon as he leveled one of the two weapons he brought into the store (a third was in his vehicle).   The police intervened and arrested the would-be mass shooter alive (he is white, after all).  

I know I keep saying this, but you really, really, really cannot make this stuff up.  If you did, no one would believe you.  

The Hollywood Movie Pitch

I actually did imagine what might happen if someone in Hollywood tried to pitch a movie with the above plot.  You're welcome.  

WRITER: Yeah, so this guy makes up this crazy, wild-ass story about a major political candidate, a former Secretary of State, and her husband, a popular former president, accusing them of -

PRODUCER:  Let me guess - peddling their influence and access for money?

WRITER:  No, no, no!  Too boring.  Of running a child sex trafficking ring.

PRODUCER:  [Pausing, not knowing if he is part of some elaborate practical joke.]  A sex trafficking ring?

WRITER:  A CHILD sex trafficking ring.  

PRODUCER:  [Shaking his head.]   This doesn't make any sense at all.  Why would a high profile family, scrutinized by the press, one excoriated by a hostile Republican Congress, investigated by the FBI (and exonerated in all cases) do something so crazy?  These are now very wealthy people.  They're not short of cash, so where is your motivation for them throwing away everything they have on this sort of scheme?  And why in Washington STATE?  Are you sure it should not be Washington, D.C.?  

WRITER:   I don't know, I haven't worked all that out yet, but in my screenplay, the Clintons are going to come across as diabolical, arrogant, aloof, absolutely convinced they can get away with anything.  Why, if she could get away with having 6 classified emails on a private email server with no charges brought against her, she could get away with ANYTHING!  Don't you see?  

PRODUCER:  No, not at all.  This sounds like dog shit.  What other ideas do you have?

WRITER:   Please hear me out.  There is more.  

PRODUCER:  [Looking impatient.]  I was afraid you would say that.

WRITER:   The Clintons figure that they can get away with it by using a legitimate business as a front for their operations.

PRODUCER:  So now it's a mafia movie?  A legitimate, family-owned olive oil business?

WRITER:  Close - a pizzeria!

PRODUCER:  A pizzeria?  

WRITER:  Yeah.  Crazy, isn't it?  

PRODUCER:  There are other words to describe it, but who the hell would believe such an idiotic plotline?  

WRITER:  [clapping his hands with delight]  EXACTLY!   And that brings me to my big plot twist.  

PRODUCER:   To have a plot twist, you first need a plot.  

WRITER:  None of this is really true.  

PRODUCER:  You don't say.

WRITER:   No, I mean in the script.  The child sex trafficking ring fronting as a Washington state pizzeria is all a fake story.   A plant.

PRODUCER:  And an idiotic one at that.   You got nothing here.

WRITER:    But you haven't heard it all.

PRODUCER:  What - some lunatic hears the story, thinks it's true, then tries to kill the Clintons?

WRITER:   Better than that!  He hears the story -

PRODUCER:  Let me guess - he's gotta be a white guy, a Southerner maybe, with a huge gun collection.  A Trump supporter?  Do I have the stereotype complete?  What other clichés will you throw in - a picture of him posing for Facebook with a cocky look on his face, dressed all in black, holding up his assault rifle with a banana clip locked and loaded?

WRITER:  [looking encouraged]  You read the script?  

PRODUCER:  No, I didn't read it and I don't intend to.  It's borrowed from so many movies and caricatures of the South, always created by people who never lived there.  People who live in the liberal bubbles on either coast.  

WRITER:   I can scramble some of the demographics then, make him from Oakland, California, or something.  

PRODUCER:  No, you would have to make him from Mars to believe this horseshit.  It's just not believable.  

WRITER:   Well I'll work on it.  Maybe he's psychotic or something.  

PRODUCER:  So then it's just a movie about some lone psychotic guy.   The story, the guns, the Clintons, none of it matters.  Boring.

WRITER:   [plowing through]   So he's not psychotic.  Maybe just gullible.  Listens to talk radio all the time and watches Fox News.  Everyone in his trailer park is convinced the Hillary Clinton is the anti-Christ.

PRODUCER:  You're just piling it on thicker.   There are a lot of folks who live in trailer parks who DO think Hillary Clinton is the anti-Christ and I got news for you - they buy movie tickets.  But not for this excrement.  [holding his head in his hands]  Just out of morbid curiosity, how does it end?  Put me out of my misery.

WRITER:    Well, our shooter is so mad, he hops in his car and -

PRODUCER:  Drives to New York to confront the Clintons.

WRITER:  No, no, no!  He drives to Washington.

PRODUCER:  D.C.?

WRITER:  No, Washington STATE!  Haven't you been listening?  

PRODUCER:   So you want me to believe that some random guy hears a fake news story that is so absurd that even I don't believe it - and I'm in a business that makes movies about kids who can talk to dead people or kill death eaters with a magic wand - loads up his truck with his arsenal then drives across country not to kill the ringleaders of this dastardly scheme but to have a shootout with some poor pizza delivery guy who probably doesn't even know about the terrified kids locked up in the back of the store?  

WRITER:  [uncertainly now]  Yes...

PRODUCER:   [Sighs deeply.]  When is the last time you talked to your shrink?

WRITER:  Ah, c'mon, this story has everything - guns, politics, the Clinton, fake news, pedophilia.

PRODUCER:   It's terrible.  Only an idiot would believe it.  There's no there there.   We're trying to market our shit to a mass audience.  Including a lot of gun owning white males in the South who won't take kindly to being made to look like gullible idiots who reflexively believe the most patent nonsense about the Clintons.  These folks might not always be the sharpest knives in the drawer, but they are not THAT dumb.  I have a dozen right wing groups who already say this town is too damn liberal and doesn't get Southern gun owners - if I turned this script of yours into a movie, they would form a lynch mob.  An antisemitic lynch mob, I might add.  And this puddle of dog vomit isn't worth dying over.  

WRITER:  [looking dejected]  Maybe you're right.  

PRODUCER:  Of course I am.   [laughing]  Child sex ring run out of a pizzeria… who ever heard of such a thing?  But just out of curiosity, in this script of yours, what enemy of the Clintons fabricated this story?   The Pakistan intelligence service?  The Russians?  Bernie Sanders' people?

WRITER:  [shrugging]  Nah, just some guy in his pajamas.  He did it for shits and giggles.  And to make a little money off of all the clicks he got.  

PRODUCER:   You've got to be kidding me.  All this trouble caused by some random person who didn't even have it in for the Clintons?   None of this is tied together.  It's too random.  How much money did he make from it?

WRITER:  I don't know.  What difference does it make?  A few thousand bucks, if that.  But it will all be chewed up in legal fees after the lawsuits and maybe some criminal charges.  

PRODUCER:  The only crime here is the minutes of my life you stole from me and that I can never have back.  So what else you got?

WRITER:  [with a deep sigh, closes his manuscript and pulls out another]  OK, I'm not as excited about this, but here me out.  We start with a talking blender.

PRODUCER:  Like the kitchen appliance?

WRITER:  Exactly.  

PRODUCER:  [now excited]  Who talks?  

WRITER:  Of course.  But only when the homeowner isn't around.

PRODUCER:  And that's why we never see them talking!

WRITER:  You got it!  So this blender comes to life and leads all the other household appliances - who can all also talk when the homeowner isn't around -

PRODUCER:  [spreading his hands]  Of course!

WRITER:  - to launch a revolt, this campaign to get the manufacturing company not to discontinue his model.  

PRODUCER:  [his eyes narrowing]  I like it.    

WRITER:  [nervously]  Yeah.  I was thinking Robert De Niro as the blender's voice.  

PRODUCER:  [snapping his fingers]  And Danny De Vito as the toaster's!

WRITER:   You're a genius.  

PRODUCER:   No, you are a genius.  You had me scared for a minute, but you still have the touch.  Now THIS audiences can believe.   Polish it up and I'll start making some calls.   

[Writer leaves.  Producer shakes his head one last time and chuckles.]   Fake news pizzeria child sex ring run by the Clintons.    As if.  

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