SERENA - THE TALE OF TWO AMERICAN SISTERS

The US Tennis Open, which has to be the greatest spectacle in sport with its gladiatorial contests that can go on late into the night and early into the next morning. A single shot can decide a game, a set, a match and a Championship and will be accompanied by roars that echo into the heavens. Fittingly the major battles are played out in the Colosseum like stadiums named after Arthur Ashe and Louis Armstrong. Ashe was the first African American to win the US, Wimbledon and Australian opens, a victim to Aids via a blood transfusion and a winner and pioneer in so many arenas. Louis “Satchmo" Armstrong was a beloved native of New York and one of the trailblazers of jazz and arguably its greatest exponent.The whole tennis complex with its numerous courts was recently christened the Billie Jean King US Tennis Association Center in honor of yet another tennis great this time renowned for her struggle for equality for women’s tennis, gay rights and her tireless efforts for these and other causes. So this battle for world tennis supremacy has as its backdrop a gigantic complex that celebrates excellence as well as championing the underdog and those who have overcome adversity. The screaming fans, no polite clapping here, whose support oscillates between the excellent and the underdog reflect this culture.

All this by way of introduction of the hype and near hysteria that this year surrounds the number one women’s seed Serena Williams and to a far lesser extent her elder sister Venus Williams. Serena at the time of writing is on her way to history. If she wins the US Open she will have a calendar slam, having won the Australian, French and Wimbledon Opens this year. This last calendar slam was achieved by Steffi Graf in 1988. In addition Graf has won the most open slams in the “Open Tennis Era”, 22. And if somehow you have been in a coma these past two weeks if Serena wins this 2015 US Open she will equal Steffi’s magical number.

THE MEDIA BLAST

The blast involves all the media from the internet to the published media of all sorts all backed by a flood of advertisements featuring the Golden girl Serena. Chase Manhattan have featured her almost incessantly on TV and the Internet while Gatorade commissioned twenty one murals in Brooklyn NY featuring her winning each one of her slams to date accompanied by a touching advertisement tribute. She has been featured on several magazine covers. To give some idea of the coverage that Serena has evoked let us look at the reportage of Day 5 of the US Open in the media and internet:

Firstly there is extensive reportage of the previous days match such as “Serena loses first set but rallies to beat Mattek Sands" and ” Serena reaches her third step to history - four more to go”.Then there were articles as to how ok it was to be nervous and articles as to why she was nervous. (Maybe she had just been following the media who to date had not commented as to what the world would be like if she didn’t win - presumably fearful of the emptiness the hopelessness that such a catastrophe would evoke.) Then there were at least 10 videos on the internet on highlights from game three the round where  64 players had entered. In addition it was thought appropriate to run videos of previous slams.

The headline that put it all into perspective was run on the ESPN website - “ Day Five - Five developments not involving Serena”.

WHY THIS MEDIA FOCUS?

Before we go much further Jay H. Ell agrees with the unanimous assessment that Serena is not only the greatest women tennis player ever but the greatest women athlete. The question that needs answering is why the most comprehensive wall to wall coverage is being meted out that is usually reserved for the issue to du jour such as a hurricane disaster, a mass school/cinema murder, Shandra Levy’s disappearance, 9/11…. .  No sports event ever amasses this type of continuos coverage - not the baseball or basketball play offs and sometimes the Super Bowl. Jay H. Ell was around when Steffi not only won the calendar slam in addition she triumphed with the Wimbledon Gold Medal and while the media covered this feat appropriately it was still considered very much business as usual. So why this frenzy?

THE CAREERS OF VENUS AND SERENA AS COMPARED TO FEDERER

Could it be the greatest record in tennis that has unleashed the floodgates?

Since 1997 to this day one or other Williams sister has dominated the women’s tennis scene. Serena has won just in case you missed it earlier in this piece, 21 Grand  Slams and Serena 9. As partners they have 13 Doubles Grand Slams. While for the large part Venus dominated the earlier part of their careers their victories have been interspersed, The first of their trophies was the 1997 US Open won by Venus and Serena won in 1999. Venus last victories in Slams were at Wimbledon in 2005, 2007 and 2008. In the latter tournament she beat Serena and in 2005 and 2007 Serena was on the injured list. A large part of both their pilgrimages have been punctuated by illnesses or injuries.

All in all pretty impressive but if you were seriously looking for a feature on the basis of performance it would had to have been Federer. Federer is also pushing the mid thirties has had two main rivals, every step of the way of his career, Nadal and Djokovic who between them have won 23 Slams. Venus and Serena’s most serious rivals were each other. In fact over the past three years when Serena has won 8 of the 13 Slams she has played a host of opponents and along the way her challengers have been shortlived.  Federer’s consistency over the decade and a half has been amazing having been World number one for the longest period of any player and has the highest recorded number of slams in mens tennis 17. In addition he has won the World Tennis Championship 6 times and has won a record 295 Grand Slam matches and been in more consecutive semifinals 23 and quarter finals 46 than anyone else. He has been consistently ranked first, second or third spot for nearly his whole career. Serena’s rankings over her nearly twenty playing years have been all over the place. There is little doubt that he is the greatest tennis player of all time and arguably one of the greatest athletes of all time. He is playing the best tennis having just won the US Open dress rehearsal in Cincinnati beating Murray and Djokovic. The tennis world, for what it is worth, is watching his progress in an extremely tough mens field with greater interest.  By contrast Serena’s best competition in this open was Venus. For the rest they are in and out with no one but no one stamping themselves as a great.

So as impressive as Serena’s record that is not the reason for getting the Katrina like treatment.

THE AMERICAN STORY

As Jay H. Ell has blogged American aristocracy derives from money, and those that are cheered and revered are regarded as winners and or victims. Celebrities from the entertainment world, especially where a ball is involved, are adored.  The Williams’ have all these attributes in addition to a story that is remarkable. It is their rags to riches log cabin bit that brings tears to everyone’s eyes. Even more important Serena is American and her supportive, loyal and friendship relationship with her older sister is endearing - apple pie and mother’s milk.

In the beginning daddy Richard Williams trained his two phemons on public courts. With virtually no tennis experience in a world where there are tennis academies and high priced coaches he did it all from scratch. He wrote a seventy eight page plan for their training and future and carried it out. As Serena opined with only two players he produced 30 Grand Slam wins a feat rarely achieved by the most prestigious coaches with several proteges. John McEnroe,  marveling at his achievement, questioned incredulously, “How does he do it?”   Richard kept them out of the Junior Tournaments as he felt there was racial prejudice so they were robbed of early acclimatization to competitive tennis. When finally they entered the professional ranks the young girls were not part of the club and kept very much to themselves. In 2001 at a time when there were repeated unsubstantiated accusations of match fixing by their father, an injured Venus pulled out of the prestigious Indian Wells Tennis Tournament in her semi final match against Serena. The angry crowd booed and jeered Serena throwing out racist slurs. A shattered and frightened Serena never returned to Indian Wells till 2014 when under the influence of Nelson Mandela’s philosophy of the power of forgiveness returned. Over the years in spite of a few high profile court incidents she carved out for herself a resume of charity foundation work and a reputation for guts and perseverance and ultimately serenity. 

Venus, too, gaining in confidence with every year on the tour, became a much admired role model, an activist for women in a quiet and dignified manner. Both of them had other interests and become more and more admired for all their activities. Most significantly their touching supportive relationship and friendship when on the court they were fierce competitors has been featured more and more in the media. Both of them endured ongoing injuries and long periods away from the game. Serena suffered a life threatening pulmonary embolus and Venus was recently diagnosed with an energy sapping autoimmune disease. Yet both of them publicly express gratitude at their blessings. Both of them have come to terms with their tennis points of compass - Venus  - that Serena is the better player - Serena,  - as Victoria Azarenka has observed, that unlike everyone else rather than wanting to win, - just refuses to lose! 

They are moneyed winners who have overcome adversity and Serena shows unbelievable guts and tenacity having won 10 of 11 grand slam matches when she was a set down. They operate on a world stage and as Americans they have dominated for 15 years. 

THE AMERICAN STORY CONTINUES

At the time of writing the story is ongoing. As if scripted, Serena, in the quarter finals, beat her only realistic competition, 35 year old Venus, in this the 2015 US Open. She did this after losing the second set to Venus, 6 -1. The two hugged endearingly at the net after the match played to a packed crowd in the crucible of the Arthur Ashe stadium. Donald Trump having been bumped off the media focus by Serena, also as if scripted, arrived to watch the Serena  - Venus quarter final. Donald also is a quintessential New Yorker and why shouldn’t he bask in the Williams’ limelight, especially as he is running for President?  Maybe he is a tennis fan? This all adds up to be show business which is makes zany America tick. And New York, where The Donald is unlikely to garner too many votes, included him in on the night that belonged to them.The drama is being enacted in the stadium where the Williams sisters love to play, in their own American Open which is their favorite tournament where they are embraced by all Americans - as everyone witnesses the Great American Dream come true. If the masses needed any assurance that the Dream was not a myth they are once again being reminded by the fairy tale story of the Williams’ playing out before their very eyes. 

Serena is the leading lady in a sensational heart tugging story that whichever way it ends the ending has been declared happy. To join in the metaphorical madness she has two more mountains to climb in her seven step journey to history. The nation watches stroke by stroke to the beat  of the commentaries of icons of former years, John McEnroe, (how can anyone not take it all in when the maven McEnroe tells you how privileged he is to watch Federer again), and Chris Evert  both of whom are willing history on. To keep in the idiom just watch when Serena crowns her achievement on Saturday. The very private Steffi Graf, now an American citizen, will be persuaded, if she hasn’t been already, to present Serena the trophy and we will all go ballistic because we will know that all is well in the USA and therefore the world…..

And finally if Serena wins the Founding Fathers will at last have something to celebrate ............

BREAST CANCER MAMMOGRAPHY - WHY THE CHAOS?

Women have to be confused with the plethora of papers that seem to question the value of mammography as a screening technique in symptomless patients and those not at increased risk for breast malignancy. While there seems to be very little controversy over the management of clinically detected breast cancers there is a continuos swirling debate around preventative mammograms that gets more and more intense every day. Ductal Carcinoma in Situ, (DCIS), where the cancer cells are limited to the breast ducts and not in the breast tissue, and which entity is predominantly diagnosed by mammography, is the most recent breast disease to have its management strongly challenged. How can this all be? Surely scientific medicine has certainty?

HOW DO DOCTORS DECIDE TREATMENT?

To understand it all one has to analyze how medical knowledge is obtained and how the discipline of medicine decides on treatment options. Some therapeutic choices in the not so distant past such as blood letting and leeches were based on belief and nothing else. One would dearly like to believe that medicine has progressed beyond that, which it has, but it has not nearly the scientific precision that some of its practitioners pretend it has. The dream that Flexner had when he revolutionized the study, practice and education of medicine has not fully materialized. His report, which had the imprimatur of the American Medical Association, was published at the turn of the twentieth century and had as its objective to make medicine a purely scientific discipline. To effect this he had the medical schools that had no scientific emphasis to medicine shut down. The reformer never took into account the variables of doctor and patient that go into defining disease and its management. 

EMPIRICAL DIAGNOSES

So to return to what predicates medical decisions. A large number of treatments, especially surgical, are pragmatic and commonsense. These are deemed to be empirical and have not been subject to rigorous scientific assessment. For example, the field surgeons in war learned pretty fast if you didn’t amputate a highly compromised limb, gangrene would set in and result in death. So that is what they did with no scientific trials to prove them right. That principle holds to this day although with modern medicine and anesthesia one can battle more successfully to save many limbs. Likewise surgeons did not have to stand around and watch too many appendices burst with subsequent death to realize that removal of the appendix was the way to go with symptoms and signs of that condition. 

Other medical disciplines also got the message through observation or obvious commonsense. Anesthesiologists didn’t need too much cajoling to use chloroform as opposed to alcohol and holding the patient down in surgery. The penny dropped in obstetrics when they finally put two and two together noting that puerperal sepsis was occurring in mothers that delivered in the hospitals and not in the community. Semellweis who made this observation linked it to hand washing. He was spurned by his colleagues as he had no scientific basis for his theory but he was proved right. 

But not all instances of empirical, intuitive and commonsense approaches turn out to be correct.

LIMITATION OF INTUITION, COMMONSENSE AND EMPIRICAL MANAGMENT IN TREATMENT SELECTION.

Two examples where practical commonsense and intuition have failed dramatically in management options relate to the prevention of coronary heart disease. Working on the assumption that women do not suffer from Coronary Heart Disease till their menopause men were given female hormones as a prophylaxis with disastrous results. Likewise it was the conventional wisdom that females after menopause should be put on supplemental hormonal therapy as they would be cardiac protective and decrease cancers. After years of comparative research studies the consensus was that coronary artery heart disease, breast cancer, stokes and thrombotic events were all increased. So intuition and logic is not enough to advocate a medical treatment. 

So we see that empirical treatment plays a big role in medical management. However except in obvious situations the empirical hypothesis needs scientific evaluation otherwise the outcome cannot only be of not be any use it can do harm.

The two commonest ways to scientifically evaluate an empirical management or any hypothesis for that matter is either by an observational trial to see outcome of treatment over a long period of time or a comparative study to compare the new management with either nothing or another established approach. There are several variations to these two types of research and this is not the place to discuss them other than to state that the more rigorous the study is the more reliable the result. 

THE ROLE OF MAMMOGRAPHY IN THE PREVENTION OF BREAST CANCER AND HOW WE GOT THERE.

Let us look at the current controversies on breast cancer management and see how we got there. Breast cancer is the commonest female cancer occurring in one in eight women during their life time with over two hundred and thirty thousand women diagnosed each year. Even today empirical intuitive treatment still plays a major role in management decisions and this to a certain extent has created the dilemma that has occurred in the recommendations for mammogram screening and treatment of DCIS. 

Introduction of Mammography.

Mammography is a relatively new concept that was introduced in the 1960’s. It was based on the logical assumption that if one was able to diagnose breast cancer, early, before it became clinically evident, then one would be able to treat it earlier and thereby prevent the spread of the cancer and therefore death. The introduction of routine screening of women throughout the world has been tremendously successful with in some areas nearly an eighty percent success rate. This tour de force has coincided with the introduction of more and more sophisticated and powerful mammography of the breast tissue. Like so many medical interventions the compelling nature of the rationale of the approach resulted in wholesale adoption before scientific evaluation had taken place. Not only was the actual concept not assayed neither was the sophisticated technology, with the latest being the 3 - D mammogram, evaluated as to its impact on the disease. The more sophisticated the screening technique the higher the detection rate of cancer or DCIS.

Evaluation of  Screening Mammography.

The impact and outcome of mammography screening has now been extensively and scientifically evaluated. The results have been to put it kindly, disappointing. The number of breast cancers diagnosed have increased but the number of deaths from the disease have almost remained constant. The Cochrane Collaborative Group, which is the most prestigious group for evidence based medicine maintains that there is no quality evidence that mammography has decreased the death rate from breast cancer. They have taken their argument one step further and maintained that it is uncertain whether the screening does more good then harm.

Four types of cancer types have been recognized:

1. Slow growing so even if detected late does not impact outcome.
2. Fast growing so that even if detected early it cannot influence outcome.
3. Cancers that are so slow growing that should be left as patients will die with them.
4. A small number of cancers detected that benefit from earlier detection and treatment. 

It appears that there is a positive impact of screening mammography in the age group of women between 50 and 74 years of age where cancers are detected that will benefit by early treatment.  In a review article in Medscape in 2009 it was cited that mammograms in the age group between 50 to 74 would save 1.8 lives of a 1000 women screened over a period of 15 years. The Canadian Task Force had similar results starting that screening 720 women for 11 years would prevent 1 breast cancer. 

That respected Cochrane research group stated that if screening mammography started at 40 years of age, 50,000 women would need mammography over 15 years to save one life at an additional projected financial cost of $6.5 billion. 

Risks of Mammography Screening

Assuming the Cochrane group is more or less on the money and cost isn’t taken into consideration, why wouldn’t society want to save one life in 50,000 screened over more than a decade? It boils down to the risks. David Newman in his book “Hippocrates Shadow” argued that, on balance, the mass screening produces cancer phobia and unnecessary surgery and treatment. The anxiety and even panic that mass screening produces is immeasurable but a constant as any practitioner will relate. However there are a number of measurable side effects such as false positives, over diagnosis and radiation.

1. Over diagnosis is rated as the biggest hazard of mass screening. In effect this relates to operating on patients that do not need surgery. The number in this category varies according to the study but in 2012 the UK Cancer Research Group stated that 1 in 5 breast cancer cases were over diagnosed. A much higher figure, one in three, was quoted in s study published in the British Medical Journal in 2009. Analysis was from several countries including the UK, Canada, Australia and Sweden. The American Cancer Society rates the figure between 0% to 30%.
2. False positive results occur when the initial mammography screening results indicate a cancer and further tests such as a biopsy prove them wrong. According to the American Cancer Society that of the ten percent of women who are diagnosed as positive on mammography a half to three quarters have not got the condition on further testing. This results in unnecessary anxiety and expense all over the whole board. 

3. Radiation is really a big cancer risk in the younger patients. Above 50 years it is minuscule. 

MAMMOGRAPHY SCREENING AT THE END OF THE DAY

There appears to be a consensus that mammography is most cost effective when performed every second year in women between ages 50 to 74. The US Preventive Services Task Force, (USPSTF), are in line with this approach but this is such a hot political potato that Congress overrode their 2009 recommendation insisting that insurance companies pay for annual screenings from forty till death. As a public health economic issue the cost with 70% of eligible women participating is $7.8 billion per year. If the target 85% screening rate would have been achieved the tab would have been $10.1 billion. (Annals of Internal Medicine 02/04/14).

Several studies lead the USPSTF in 2009 to change their recommendation as to who  should be screened and how often. Their principal recommendation was for screening for women between ages 50 to 74 every second year. This would bring down the cost to $3.5 billion a year. Bearing in mind that 50,000 women over 40 years of age screened annually will save one life but leave in its wake all the morbidity and even possible mortality that are adverse effects of the screening must surely make the medical world and the Public Health authorities relook at the current strategy of routine annual screening of all women over 40 years of age.The additional cost of including the 40 to 50 year old sector is $6.5 billion.

MAMMOGRAPHY’S DISEASE - DUCTAL CARCINOMA IN SITU. (DCIS)

With the introduction of routine mammography screening a new disease DCIS was defined. The latter rarely presented as a clinical entity. Put another way, in by far the majority of cases there is no mass in the breast, no nipple discharge or skin changes so without routine mammography the diagnosis of DCIS would not have been made. The irresistible inference was that DCIS, where the cancer cells are just in the ducts and not in the breast tissue, was the precursor to invasive carcinoma. With more and more sophisticated technology being developed the diagnosis was made more and more often. About 60,000 cases were diagnosed in 2014. The treatment of DCIS is essentially the same is Stage 1 invasive carcinoma. That includes lumpectomy, (removal of the area where DCIS is with wide margins), mastectomy, radiotherapy with or without lumpectomy or unilateral or bilateral mastectomy. This is pretty radical treatment to institute on the basis of “intuition”.  

Now the radiologists make this diagnosis on the basis usually of patterns of calcification. As there is no mass in the breast the most efficient way to do the biopsy to confirm DCIS is by stereotactic core needle biopsy. The latter uses x-ray equipment and a computer to analyze pictures of the breast. The computer then pinpoints exactly where in the abnormal area the needle tip needs to go - a complex and costly procedure. Up to three quarters of biopsies are negative.

MAIN FINDINGS OF RECENT DCIS STUDY.

With the scientific studies now emerging the intuition on DCIS has been challenged in a number of areas. A major study published in the Oncology Journal of the American Medical Association involved the follow up of over a 108,000 women who had been diagnosed and treated for DCIS. The follow up was for 10 to 20 years and yielded many important findings: (Whether these will change doctor or patient behavior is another matter). 

1. Regardless of the management of DCIS, which ranged from bilateral mastectomy to simple lumpectomy with or without the radiation, the outcome was the same.

2. While the risk of death from breast cancer was higher in the DCIS group the significant predictors of mortality were women under the age of thirty five and black ethnicity. The women under thirty five were obviously not diagnosed by screening and must have had clinical indications for the mammogram. The risk of dying was greater at a young age being 17 times greater in women under 35 as compared to 1.4 in those over 65.

3. Prevention of invasive carcinoma in the breast with treatment did not prevent death from breast cancer. However the deaths were due “secondaries” just as if these DCIS were invasive carcinomas to begin with.

DILEMNA ON DCIS

This paper has evoked responses across the board ranging from DCIS must be treated like Stage 1 invasive breast carcinoma, (which for practical purposes it currently is), to it should not be treated at all and just watched with repeated mammograms. Bearing in mind that DCIS has the same prognosis and natural history as invasive carcinoma and treatment of DCIS did not prevent the latter there is a strong argument for the wait and watch approach till if and when the invasive carcinoma presents. This would prevent the vast majority of DCIS patients being treated unnecessarily. Close on sixty thousand women are diagnosed with DCIS and the majority could be being over-treated, at great cost with endless morbidity, as a result. It is apparent as well that there a subgroups with DCIS that must be at more risk than others and while age and ethnicity have been identified studies of those with hereditary predisposition, estrogen receptors status and histology for example need to be evaluated. Surely all workers must agree if this group is to be treated that all radical treatments must be out.

AT THE END OF THE DAY

* The death rate from breast cancer has remained virtually static for decades. What improvement there has been is generally accepted to coincide with a decrease in hormone replacement therapy which had been shown to be a cause of breast cancer. It is thus obvious that all this activity needs a dispassionate review and scientific assessment rather than continuing these visceral judgements in the management and screening of breast cancer.  Society has to decide whether they wish to modify the criteria for these costly and radical treatments that show little benefit and high adverse effects. 

* The problem is that standing in the way of the rethink is doctor and patient behavior - two variables that are never taken into account yet it is doctor bias that has got into this mess in the first place. The medical profession now sanctimoniously argues that the pros and cons of treatment should be discussed with the patient so they can make an informed choice in situations they probably would not have been in if there had been the appropriate studies in the first place. On the other hand patients don’t see the necessity of scientific studies either if they are persuaded by the “logic” of the treatment. When, in 2009, the USPSTF made its recommended changes for routine mammogram screening at the age of 50 years there was an outcry second to none. The US Congress had to step in and decree that medical insurance companies regard 40 years as the age that would recognize and pay for.  Society swallows buckets of pills, with only anecdotal evidence of efficacy, that they intuitively believe will help. Recently pressure groups even influenced the FDA, society’s gatekeeper to keep science in medicine, to reverse their decision to register a medicine that supposedly increases a female’s libido. In studies the medicine has shown doubtful effectiveness coupled with unacceptable side effects and its registration had twice been denied by the FDA. 

* Costs do matter. If one recognizes that Planned Parenthood that performs over 10 million women services per year do so at a  cost of about $200,000,000 then $6.5 billion is a lot of money. They perform 10 million services and a million of those are for breast and cervical cancer testing that otherwise would not be done. They diagnosed 85,000 cancers, provided 4 million birth control encounters and 2 and a half million sexually transmitted screenings or treatments.

* As far as mammograms are concerned the US Preventive Services Task Force’s recommendations on mammography which include routine screening of symptomless between 50 and 70 years of age should be reconsidered. With regard to DCIS found on screening a study needs to be designed to evaluate the difference between watchful waiting with repeated mammograms versus lumpectomy versus lumpectomy and radiation. 

To quote Dianne Rehm on her influential Public Radio morning show, where she was trying to make head or tail of the experts’ opinions on the recent DCIS study, that should she be diagnosed with the DCIS at this stage of her life she would do nothing.

MICHAEL JORDAN - THE ENTITLED VICTIM

Americans are predictable: money is the arbiter of success, (It is very simple money is aristocracy, the more you got the higher up you are - a millionaire is a mere Sir and a billionaire is a Prince); they cheer a winner regardless of his or her behavior; they support a victim regardless of the circumstances; they just worship entertainers, - of any variety but particularly those involved with a ball of any sort and they are entranced by the drama of the courtroom, having a touching belief in the justice system. These cultural characteristics have taken over from more humble tokens like log cabins, mother’s milk, Davy Crocket hats and apple pie as the bedrocks of the American value system. Often a notable can encompass more than one of these  characteristics and can then set the world on fire. Witness Donald Trump an unashamed boor and braggart but a billionaire winner none the less. That coupled with his entertainment skills and he is off to the races - Presidential races that is. 

Top entertainers in sport have an incredible following and it is fair to say are the most admired of all the American icons.  Good or bad off the field they capture the imagination and admiration while the public never give up on them. Witness the sudden return to form of somewhat scandal tarnished Tiger Woods in a golf event last weekend. The ticket sales went up dramatically. Now if one these champions with a ball appear in a legal drama the nation sits back spellbound day after day watching each play in the court of another sort. Just remember how the nation paused while the O. J. Simpson trial played out while each infringement of a National Football League Player garners all the attention in the world. Nothing engrosses a celebrity hungry society as much as a tragedy to an all conquering hero such as the affliction that baseball great Lou Gehrig had. In tribute he then had his lethal neuronal disease named after him. A victim not only evokes empathy, sympathy and compensation but is somehow admired for bearing his cross and this too is seen as emblematic of the Great American psyche today. 

I WANNA BE LIKE MIKE

The above are examples of top dogs that had encompassed a few of the attributes that epitomize the great American society. What if one champion exhibited them all? Enter Michael Jordan the most accomplished sportsman/entertainer in Jay H. Ell’s lifetime. Now that is saying something because there have been the likes of Pele, Federer, Nicolas and Gretzky. 

Now none of these displayed the all round talent, skill and determination of the famous Chicago Bull, MJ, who is as internationally well known as anyone. It is that much harder to stand out in a sport that relies on teamwork than a pastime that you either compete as an individual or where your own performance is not dependent on anyone else. Jordan was not only the greatest star n his own right he took a team to the dizziest heights that only had one other luminary and elevated the play of everyone else. To just cite one example, Dennis Rodman who was an absolutely unpredictable individualist who danced to his own drummer and MJ integrated him into the team building him up to be the rebound king. Jordan would take the responsibility for all key plays and although everyone knew the ball was coming to him he still converted. Then when everyone read his game and double and even triple teamed him he changed his style totally - no more knifing his way to the hoop, either drawing the foul or scoring - rather shooting from the three point line and or drawing defenders and passing to players that had been left unmarked in the pursuit of him.

All in all the Bulls won 6 championships in the 1990’s. There would have been more had there not been the punctuation in the maestro’s career after the first three when Mike went off to play baseball. In addition, Gerry Reinsdorff, the greedy Bull’s owner, knew he had sold all the tickets for a new stadium so he would no pay all that money to keep that Dream Team intact after their sixth Championship. In short Mike was a phenom and left at the top of his game. He played for another year or two elsewhere but the light had gone out. His legacy was ensured. He was known as “Air Jordan” and “His Airness” but more significantly MJ, his initials, are better recognized than JFK or LBJ by today’s generation. The NBA website acknowledges that he was the greatest basketball player of all time and in Jay H. Ell’s opinion the greatest sportsman in history. 

MIKE THE BUSINESSMAN

After he had finally stopped playing he went into business. It made sense that he invested in a basketball team but the basis of his massive fortune became public as a result of litigation, that he initiated and that played out in Federal Court Chicago last week. But more of what that is all about later. 

MJ is the only sports billionaire. His investment in a basketball team is said to be worth about $500 million and he has an annual income of well over a $100 million a year that comes from branding his name. A decade after he had called it quits he obtains over $80 million a year from Nike. Nike of course collect billions from sales from MJ’s named sneakers. This franchise is growing and growing. “His Aireness” makes millions from every other company that he is connected with. This includes Hanes underwear and a memorabilia company, Upper Deck. This explains why MJ is never prepared to sign autographs - he was reportedly under contract not to do so. So 12 years after shedding his Nike sneakers he limits his signature and it fetches higher and higher amounts. 

JORDAN’S LITIGATION

With all this as a background we proceed to the litigation that took place in the Dirksen Federal Court in Chicago last week. MJ sued, Safeway, the holding company of a grocery store, Dominick’s, that had gone bankrupt, for $10 million dollars. The basis of his claim was that Dominick’s had sent out a flier congratulating him on his election to the Hall of Fame in 2009. The flier also offered two dollars off on a meat product on presentation of the flier. Two customers took advantage. Jordan maintained that his number and likeness had been illegally used. (MJ who fancies himself as American aristocracy had a request denied by the Judge that he enter the court via a special security entrance). 

Jordan on the witness stand admitted that he was doing just fine but he argued that the use of his name was worth $10 million. His counsel argued that his name brand had to be protected. Safeway, the defendants who had owned the now defunct grocery store produced experts that maintained that at most the compensation for this flier should have been a $150,000. So the great MJ the greatest sportsman of the twentieth century was a victim. Someone had used his name congratulating him in a flier and had as a result had $4 worth of coupons redeemed . MJ believed that as his name had been unlawfully abused he was entitled to $10 million.

The sickening part of it all is that the jury, made up of the likes of you and Jay H. Ell, instead of telling this megalomaniac to go jump into Lake Michigan awarded him $9 million dollars! It seems that MJ, the winner both as an entertainer and a businessman, was a victim as well being a central character in a drama played out in court. Do the jurors believe that these awards to a billionaire are not without cost to the man in the street? Does the pompous MJ warrant having the cost of groceries increased because he has delusions of grandeur? If he could have shown that Dominick’s had profited by this gesture he would have well been entitled to a share. But that was not the case.

“His Airness’s" argument that this is not about the money - ostensibly it is about him being used and being made a victim - is hollow. Nobody even knew about the whole incident till MJ made it public. It is blatant greed. Whenever anyone says it is not about money it is about money unless they actually don’t get any money. 

 So the leading billionaire entertainer and a winner too in business, successfully persuaded his peers, that is us, that he had been victimized and was entitled to win the lottery. In addition he used the opportunity to punt his restaurant but more significantly to obtain tens of millions of free advertising for his brand in addition to the nine million he didn’t really want. Besides there was the message to all potential sponsors of his worth as determined by his peers, (the buyers) - this not in a poll, but in a court of law. 

THE ALTERNATIVE?

Could the outcome have been any different. Now if MJ would have ignored the whole tepid event no one would have been any the wiser. The little congratulatory flier from the dying store would have just floated away into nothingness. It was not accompanied by media headlines, “His Airness taken for a ride” or “MJ’s brand abused” . So Air Jordan could have let it fly away.

Then the jury, that is us, had an opportunity to inject some reality into this unashamed greed. They were asked to choose between two conflicting theories. On the one hand it could be argued that how could MJ’s brand suffer if no one even knew of the alleged slight. Likewise the defendants had gained no profit from the exercise so how could there be monetary damages? At most according to the defendant’s experts the damage suffered was about a $150,000. The other theory put forward by Jordan, a real expert on himself and who values himself really highly, said the "loss" was $10 million. Mumbo jumbo arguments were used to get to this number in relation to the Dominick case. It is all very well if firms that get billions in sales award him $80 million a year but “His Airness" was asking $10 million for the sale of two pieces of meat. The jury cruelly lobbed off a million and only awarded $9 million never - the- less, in so doing, laid down what they thought societal values should be. In Jay H. Ell’s opinion he should have been awarded a cent. He had suffered no real damage all he was doing was pumping up his own self importance and claiming even though there had been no real damages because he was MJ the victim he was entitled to it.

The belief too that no harm is done by making a rich grocery holding company pay out $9 million is a myth. What will happen is that the consumer will pay a little extra for each item as the company’s bottom line never suffers. But victim Jordan claimed that winner Jordan would donate all the money to charity so good is coming out of it. Be that as it may it would have been far more impressive if “His Airness” shelled out his own money. As for us when we pay an extra few cents for a loaf of bread we have to know its going to a good cause.

AT THE END OF THE DAY

Jay H. Ell is of the old school he believes that society deserves better. Those who are blessed to be winners in every field should be role models not unashamed uncaring megalomaniacs who are winners at any cost. They have a responsibility to those who are giving them these outrageous sums of money for their G-D given talent, however hard they work. MJ should take a leaf out of Federer’s book. He should listen to his acceptance speech delivered  after winning the Connecticut Tennis Open for the seventh time. There was no false modesty, “His service worked well today” and in addition plenty of humility. His team and family were acknowledged for their contribution and sacrifice and every one down to the ballboys were thanked. Then unlike Michael he patiently signed every exited young fan’s hat, tennis ball or photo. Then without any publicity Federer ususally donates a chunk of change to his Foundation which to date has provided finances to assist in the education of nearly a quarter a million children in Africa. In fairness to MJ he has a Celebrity Golf event once a year and he has raised over $7 million in the past 15 years.

MJ was the greatest ever and brought unforgettable entertainment to so many but apparently thats what he did for a living and should not be rewarded for it anymore than anyone else who does an honest days work. At the end of the day he is not really an icon who one can enthusiastically reminisce with one’s grandchildren as someone you would like them to emulate.

IRAN CONGRESSIONAL DEBATE OVER THE TOP

Everyone involved in the Iran congressional debate agrees that the Iranian nuclear threat should be curtailed. The question is how. Obama and the rest of the world clearly believe that the painstaking diplomatic efforts backed up by all sorts of military, nuclear and scientific support in reaching the final Joint Comprehensive Plan of Action, (JCPA) is the best shot. Bibi Netanyahu, under daily genocidal threats from the Ayatollah, doesn’t. To a certain extent where one comes down depends on the context that the debate is framed. (Blog: The Great Iranian Debate Divide). 

Broadly speaking there are those that believe that Iran is such an existential threat that negotiations themselves represent “selling out” to the theocracy. At the other end of the spectrum there are those who argue that the alternative to the JCPA is war. While Jay H. Ell is of the opinion that the deal is a mistake and has repeatedly blogged that Obama is misguided in his judgement on this issue, (Blog: Why the Iranian Deal), the politics and vitriolic rhetoric that have accompanied the debate as to whether the United States Congress should accept or reject the plan of action is quiet frankly dangerous, over the top and counterproductive.

CONSENSUS THAT THIS IS A DONE DEAL

At the end of the day it is agreed that whenever there is evidence that Iran is on the nuclear path the sites will be bombed to smithereens. That much is obvious and is inherent in Obama’s policy as well as how else could you explain his bombast that the alternative to no understanding is to go to war. So there is consensus on what would happen to Iranian nuclear facilities should there be evidence or intelligence that they are in the nuclear weapon way. All this should to a certain extent reassure the opponents of the plan, but needless to say it doesn’t. 

At the end of the day, too, this accord will survive and Congress will not override a Presidential veto. Jay H. Ell has blogged that the GOP really support it and if any further indication is needed as to their real attitude it was provided by their Senate leader, Mitch McConnell. At a speech to a Chamber of Commerce in Kentucky he confided that, “The President had every likelihood of success”. He further hoped for a “Respectful uplifting debate”. Not the fighting words expected to garner support to overturn a presidential veto. McConnell knows and wants this to be a done deal. The world is behind it and it cannot be undone. Over ninety percent of the American, military, nuclear and security experts agree that the nuclear agreement should be signed. McConnell can still have it both ways knock Obama and not have to take the responsibility of kiboshing the accord and then have to take the flack if it all turns sour. 

Also the American electorate, in general, favor the plan by 2 to 1 according to the latest WashingtonPost/ABC poll. Even moderates and Independents are 60 percent onsides while Republicans are equally divided. Not that it is that important to the broad mass of the electorate who rate Foreign Affairs low down on the totem poll.

So on the crucial issues - curtail the nuclear threat, if Iran sets on the path of creating a nuclear weapon it will be bombed and that the JCPA is a done deal - there is very little congressional dispute - it is all just for the record.  The electorate are generally disinterested but when polled favor it.  So why the hysteria and unprecedented lobbying on both sides? Also there are accusations flying around that Obama is genocidal sending the Jews to the oven and more recently that he is invoking the notorious anti semitic Protocols of Zion. 

The climate is being created that anyone for the agreement is an anti semite. This is lunacy and can only help the true anti semites who would be only to happy to welcome former Israeli Generals and security personnel as well as their American counterparts into their ranks. On the other hand Obama creating this as a test of loyalty to him and pressuring the Democrats off the charts is overkill as well.

NETANYAHU AND CONFLICTING JEWISH OPINION

While there is plenty of blame to go around Prime Minister Netanyahu has worked hard at being able to claim the number one spot in creating this hysteria. In an unprecedented intervention into another country’s internal affairs he connived with the Republicans to attack the “bad deal” that hadn’t even been announced yet. The argument that Churchill did the same is poppycock. While it is trite to say that Bibi is no Churchill, the real issue is that the British Bulldog did not come to Congress to oppose the Administration. He rather argued that the UK and the US had common cause to engage a common enemy that threatened our civilization and way of life .The GOP gleefully aided and abetted Bibi in his impertinence and then forty - seven GOP Senators followed up by sending a letter to the Ayatollah Khamenei, treasonously stabbing their own President in his back by telling the mad Mullah that Obama had no final say in the matter. The Ayatollah for once interpreted the missive correctly pointing out that the letter reflected the deceit and dysfunction of the American political system. 

King Netanyahu has not let up, not satisfied at making Israel a partisan issue in the US Congress and socking one to his nemesis Obama he has carried on as if the Jews in America and the rest of the world are part of his constituency and owe him undying loyalty. This when most of the Israelis don’t afford him blind loyalty so why he should expect it from the diaspora hebrews only he knows? In the wake of Congress’s upcoming vote on the matter he has implored the Jews of America, whom he claims to represent, to canvas and lobby against the deal. Three hundred and forty rabbis defied him and urged Congress to accept the deal. Twenty five Jewish Organization leaders urged acceptance in a full page advertisement in the New York Times. Doubtless there are another three hundred and forty rabbis that are against it that will surface very soon in the company of twenty five Jewish Organization leaders that are for it. But so what?

Now there are a plethora of lobbies in America including a number involved in “Jewish” issues. Chief among these are AIPAC and J Street. The former lobbying for the axing of the pact and the latter are for it. As a matter of a fact there are several other groups lobbying including The Center For American Progress and Plough Shear and the Black Churches to name a few. 

While Orthodox Jewry and the more influential Jewish lobbies are against the understanding, polls show that a majority of those who regard themselves as “Jewish” are in favor of the accord. Netanyahu has focussed attention on the Jews instructing them to not make a decision on its merits but rather to do so for what he defines as being in the Jews best interests. Implicit in that argument is if you don’t you follow Netanyahu you are betraying Israel and the Jews in general.

Netanyahu’s own retired top army brass and security intelligentsia are not ad idem with the Likud Prime Minister. Forty seven of the latter wrote to him urging him to support it. These included a Former Chief of Intelligence and Chief of the Israeli Security Agency, Scores of admirals and generals, the lead scientist at the Dimona Nuclear Reactor and members of Mossad joined in.  An unprecedented position paper, entitled IDF strategy, published by the Israeli Defense Force and authored by its Chief of Staff Lt. General Eiskenot barely mentions Iran. This missive surfacing at this time is being interpreted by Israeli cognoscenti as a not so subtle message from the military to Netanyahu that they disagree with him on Iran. (For what its worth Jay H. Ell disagrees with these military and security personnel because he sees the JCPA in a much broader context).

The question still remains for those that are screaming that supporters of the Iran deal are anti semites as to whether they include most of the Israeli military and security establishment and the majority of jews in America?

IRANIANS AND THE DEAL

The Iranians could do all these activists a big favor by nixing the agreement themselves. The Iranian parliament has solemnly given themselves 60 days to decide. Not that they really have any say at the end of the day but let them have fun. The Ayatollah has irreversible veto power. You cannot override his veto and live. Now it has been published by some guy who is said to be very close to the head Mullah that he is not happy with the pact. Khamenei refuses to even call it an agreement he only dignifies it with the term “text”. He stated that it has to be scrutinized through legal channels. One wonders what they have been doing for the past few years while the “text” was being negotiated and agreed upon. Then from Iran there are the regular outpourings of disgust at the American process ,the objections to the alleged insults to the Iranian people coupled with reassurances from Khamenei downwards that the Iranian Revolution will still continue, that is code for death to America and Israel. Incidentally other than the latter statement Jay H. Ell does not believe a word they say - all cultural he supposes as he has been told they just talk in hyperbole and mean the opposite of what they say . 

STOP IT!

It is time to hone down the rhetoric and stop defining this as The Dreyfus Trial or Kristallnaght. Someone needs to get a sense of proportion. This is about a tactic to control a common threat to nearly all of the world, including the Sunni Muslims. (Blog: Iran - Not About Trust But About Avoiding War). It has been acknowledged by all concerned that with or without the deal the Iranians will still scream death to America and Israel. One has to  believe that Netanyahu and Obama’s personal animus has plenty to do with this. Jay H. Ell already fears that the damage has been done. Is AIPAC or J Street trying to prove the anti semites right that the Zionists control the world? Mercifully not too many people in America are taking too much notice of the protagonists in this unseemly fight, both of whom claim it will be armageddon that will herald the end of the world if the other side triumphs. Just as well everyone around here is watching the Donald Trump reality show. The Donald is one of the apprentice contestants for President and in passing has mentioned that he is against the agreement. His priority however is deporting eleven million aliens, stopping the legals sending money home and changing the constitution so as to create more aliens to deport. He does acknowledge that if he becomes President it would be too late to reverse the Joint Comprehensive Plan of Action.

Maybe everyone should just listen to Mitch McConnell and have a "Respectful uplifting debate".