Mitt Romney crushes Newt Gingrich in Nevada...

...but the dog-whistling Gingrich refuses to quit the race.

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Money and religion are the reasons Mitt Romney won Nevada on Saturday, his second straight victory since losing to Newt Gingrich in South Carolina. Romney outspent his rivals five-to-one (in fact, he's spent more than John McCain did during his entire 2008 campaign) and enjoyed the backing of a sizable Mormon bloc, which made up 26 percent of the electorate. In another instance of political ecumenism between differing faiths, Romney, a Mormon, appealed to nearly 50 percent of Nevada's white evangelical voters.

Poor Newt Gingrich has been losing ground since his come-from-behind win South Carolina. In Florida, Romney quit focusing on Barack Obama and began focusing on Gingrich; he crushed the former House Speaker with tsunamis of attack ads. Some say those ads caused poor voter turnout in Florida. That only got worse in Nevada. Compared to 2008, about 25 percent fewer voters came out.

Gingrich may be cash-poor but he's always been calumny-rich. In Florida, he said Romney, as governor of Massachusetts, had prevented Holocaust survivors on public assistance from eating kosher. That was kittenish compared to his latest. In creating distance between Romney and the hardline conservative wing of the GOP, Gingrich called him "Obama-lite" and a "George Soros-approved candidate." In dog-whistle-speak, that translates roughly to: He's like an uppity black man and a rich Jew.

Gingrich said voters "want a candidate who represents Americans who work, pay taxes and believe in the Declaration of Independence, not somebody who is clearly against the American ideal." Gingrich cashed out on his political connections for Fannie Mae and Freddie Mac, the government-backed mortgage lenders. He's now a millionaire.

Gingrich held a press conference after the Nevada results that sparked speculation that he may be pulling out. No such luck. Instead, his staff announced a "delegate-based" strategy. That means what we've known since Florida. The new rules of the Republican Party mean states are no longer winner-take-all. Instead, candidates win a proportion of delegates. Gingrich has reason to stay in the race, which is what he said he'd do.

Of course, the longer Romney has to fight, the more banged up he will be in November. He's said that a prolonged battle will better prepare him, and maybe that's true. The real damage may be self-inflicted and at this rate, who knows what condition Romney will be in.

In January, Romney took heat, somewhat unfairly, for saying he likes to fire people. That was taken out of context, but still. He said it. After winning in Florida, he told CNN that he's "not concerned about the very poor." That line is unfortunately the same in context or out.

A long fight for the GOP's heart has Romney worried insomuch that he's made secret deals with Ron Paul, the libertarian candidate. They have agreed not to savage each other. A partnership like this brings the promise of Paul's energetic and young followers, and also the potential for reviving Tea Party fanatics who love Paul but yawn whenever Romney enters the room. The upside for Paul is that he might get a speech at the convention and therefore pave the way for his son, the truly weird Rand Paul and his nascent presidential ambitions.

That may backfire if Gingrich can hold on. Paul is the guy most people believe could lead an insurgent third party but Gingrich, in his quest to peel away every delegate he can from Romney, may be positioned just for that. His biggest problem, however, isn't money. His biggest problem is that so few people like him.

John Stoehr is a lecturer in English at Yale University.

 

 

John Stoehr teaches writing at Yale. His essays and journalism have appeared in The American Prospect, Reuters Opinion, the Guardian, and Dissent, among other publications. He is a political blogger for The Washington Spectator and a frequent contributor to Al Jazeera English.

 

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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