View 846 Friday, October 17, 2014
“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”
“Transparency and the rule of law will be the touchstones of this presidency.”
President Barack Obama, January 31, 2009
“We had been told, on leaving our native soil, that we were going to defend the sacred rights conferred on us by so many of our citizens settled overseas, so many years of our presence, so many benefits brought by us to populations in need of our assistance and our civilization.
“We were able to verify that all this was true, and because it was true, we did not hesitate to shed our quota of blood, to sacrifice our youth and our hopes. We regretted nothing, but whereas we over here are inspired by this frame of mind, I am told that in Rome factions and conspiracies are rife, that treachery flourishes, and that many people in their uncertainty and confusion lend a ready ear to the dire temptations of relinquishment and even to vilify our actions.
“I cannot believe that all this is true, and yet recent wars have shown how pernicious such a state of mind could be and to where it could lead.
“Make haste to reassure us, I beg you, and tell us that our fellow citizens understand us, support us, and protect us as we ourselves are protecting the glory of the Empire.
“If it should be otherwise, if we should have to leave our bleached bones on these desert sands in vain, then beware the fury of the Legions.”
Centurion Marcus Flavinius, Second Cohort, Augusta Legion to his cousin Tertullus in Rome. No date given.
The premise of the liberal philosophy is that good intentions are the most important qualification for government office, and government is more competent to solve social problems than any other institution. Today President Barrack Hussein Obama appointed a political operative to be “Ebola Czar.”
Obama to Tap Former VP Chief of Staff Ron Klain as Ebola ‘Czar’
President Barack Obama will appoint Ron Klain to head up efforts to address the Ebola threat, a senior administration official tells NBC News.
Klain is a former chief of staff to both Vice President Joe Biden and former Vice President Al Gore. He left the vice president’s office in 2011. He is now the president of Case Holdings and serves as the general counsel for Revolution, an investment organization.
"It’s not solely a medical response," White House press secretary Josh Earnest said. "That’s why somebody with Mr. Klain’s credentials — somebody that has strong management experience both inside government but also in the private sector; he is somebody who has strong relationships with members of Congress; and obviously strong relationships with those of us who worked with him here at the White House earlier in the administration. All of that means that he is the right person."
I cannot resist wondering whether his association with Al Gore was thought to be qualification for a post involving scientific observations. Chief of Staff to Al Gore and Joe Biden.
Ebola Scare at Pentagon After Woman Who Was Recently in Africa Vomits on Tour Bus
Around 9:10 a.m., a woman began vomiting in the Pentagon parking lot while on a bus tour, according to Pentagon spokeswoman Lt. Col. Valerie Henderson. The woman indicated she has recently traveled to Africa.
DC Dept Health Director says woman who got sick on bus had been to Sierra Leon.
That one, at least, is not a problem: she has since confessed that she has not recently been in Africa, and physicians are confident that she does not have Ebola. Of course the Pentagon would not be a target of Ebolized jihad.
Belize Confirms Patient With Ebola Symptoms On Cruise Ship Off Its Coast
Six Reasons to Panic
As a rule, one should not panic at whatever crisis has momentarily fixed the attention of cable news producers. But the Ebola outbreak in West Africa, which has migrated to both Europe and America, may be the exception that proves the rule. There are at least six reasons that a controlled, informed panic might be in order.
(1) Start with what we know, and don’t know, about the virus. Officials from the Centers for Disease Control (CDC) and other government agencies claim that contracting Ebola is relatively difficult because the virus is only transmittable by direct contact with bodily fluids from an infected person who has become symptomatic. Which means that, in theory, you can’t get Ebola by riding in the elevator with someone who is carrying the virus, because Ebola is not airborne.
This sounds reassuring. Except that it might not be true. There are four strains of the Ebola virus that have caused outbreaks in human populations. According to the New England Journal of Medicine, the current outbreak (known as Guinean EBOV, because it originated in Meliandou, Guinea, in late November 2013) is a separate clade “in a sister relationship with other known EBOV strains.” Meaning that this Ebola is related to, but genetically distinct from, previous known strains, and thus may have distinct mechanisms of transmission.
Not everyone is convinced that this Ebola isn’t airborne. Last month, the University of Minnesota’s Center for Infectious Disease Research and Policy published an article arguing that the current Ebola has “unclear modes of transmission” and that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.”
In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it.
Yet what’s really scary is how robust the already-established transmission mechanisms are. Have you ever wondered why Ebola protocols call for washing down infected surfaces with chlorine? Because the virus can survive for up to three weeks on a dry surface.
How robust is transmission? Look at the health care workers who have contracted it. When Nina Pham, the Dallas nurse who was part of the team caring for Liberian national Thomas Duncan, contracted Ebola, the CDC quickly blamed her for “breaching protocol.” But to the extent that we have effective protocols for shielding people from Ebola, they’re so complex that even trained professionals, who are keenly aware that their lives are on the line, can make mistakes.
By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published.
(2) General infection rates are terrifying, too. In epidemiology, you measure the “R0,” or “reproduction number” of a virus; that is, how many new infections each infected person causes. When R0 is greater than 1, the virus is spreading through a population. When it’s below 1, the contamination is receding. In September the World Health Organization’s Ebola Response Team estimated the R0 to be at 1.71 in Guinea and 2.02 in Sierra Leone. Since then, it seems to have risen so that the average in West Africa is about 2.0. In September the WHO estimated that by October 20, there would be 3,000 total cases in Guinea, Liberia, and Sierra Leone. As of October 7, the count was 8,376.
Given that this is in the neoconservative magazine Weekly Standard I doubt if Mr. Klain has read it, but perhaps someone on his staff with access to the Czar will encounter it. The rest of the article is worth your time. Five of the 58 medical professionals involved in the Science Magazine study died of Ebola before the paper was published.
U.S. Soldiers Get Just Four Hours of Ebola Training
As the U.S. military rushes to combat Ebola in West Africa, soldiers are receiving on-the-fly instructions on how to protect themselves against the deadly virus.
American military operations to fight Ebola in Africa are unfolding quickly—forcing the military to come up with some procedures and protocols on the fly.
Soldiers preparing for deployment to West Africa are given just four hours of Ebola-related training before leaving to combat the epidemic. And the first 500 soldiers to arrive have been holing up in Liberian hotels and government facilities while the military builds longer-term infrastructure on the ground.
For soldiers at Fort Campbell and Fort Bragg preparing for their deployments to West Africa, Mobile Training Teams from the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), based out of Fort Detrick, have been tasked with instructing them on Ebola protocols.
A team of two can train as many as 50 personnel over that four-hour time frame, USAMRIID told The Daily Beast. The training includes hands-on instruction on how to put on, remove, and decontaminate personal protective equipment, followed by a practical test to ensure that soldiers understand the procedures.
“All training is tiered to the level of risk each person may encounter,” said USAMRIID spokeswoman Caree Vander Linden.
The training process sounds daunting: One USA Today report described soldiers being told that Ebola “basically causes your body to eat itself from the inside out” and that Ebola is “worse” than what soldiers encountered in Afghanistan. Others reportedly heard that the disease is “catastrophic” and “frightening… with a high fatality rate,” though the chances of contracting it are low.
“I’ll be honest with you,” one soldier told the newspaper. “I’m kind of scared.” [emphasis added]
* – * – *
Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands.
The military maintains that American service members have only limited interactions with locals on the ground. But some American soldiers are working with the Armed Forces of Liberia on a day-to-day basis, and others are training health-care providers on how to combat the virus.
Further, the military acknowledges that it is currently sharing hotels and businesses with foreign nationals.
"We are here with the permission of the Liberian government and we do not clear out local hotels and businesses during our stay," said an Army spokesman. "We chose hotels with the safety of our service members in mind, and the hotel staffs monitor all employees and guests and allow us to conduct safety inspections of their facilities to ensure they meet our safety criteria."
Instead, the military spokesman focused on the precautions that they are already taking: Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands. They are also are required to frequently wash their hands with a chlorine solution. Some locations even employ chlorine mats that service members are required to wipe their feet on in order to enter.
“The facilities that we’re in have been vetted by our doctors. [They] have gone through the facilities to make sure that they’re safe for our soldiers,” Army spokesman Lt. Col. Michael Indovina said. “We’re very confident. We’ve had very good luck from the time when we’ve arrived on the ground.”
Congress has been slow to give the green light to funding for military operations combating Ebola in Africa, in large part due to initial skepticism over whether there was a sufficient plan for protecting American service members in Liberia.
In mid-September, the Obama administration submitted a $1 billion request for Ebola funding. The request was for a movement of leftover funds from an overseas war spending account, requiring a sign-off from several key congressional figures.
When the Obama administration briefed staffers of the Senate Armed Services Committee on Sept. 19, it was criticized for not adequately explaining what steps the military would take to ensure soldiers’ health.
“If they had bio-security procedures in place, they weren’t adequately articulating them to Congress,” said an aide to Sen. Jim Inhofe, the top-ranking Republican on the Senate Armed Services Committee. “When they first came over, they were not able to answer a lot of questions about what procedures were in place.”
Of course it was not long ago that high government officials assured us that any decent hospital in the United States would be able to care for Ebola patients. Yesterday Nina Pham, the first American known to have contracted Ebola in the United States, was taken out of her hospital where, as a nurse, she contracted Ebola, and was sent to Bethesda. Her condition, previously reported to be “good” has now been downgraded to “fair”. Unlike typhus and cholera, Ebola basically turns internal organs to liquid and expels them through diarrhea. There is no known treatment, although there is empirical evidence that the plasma of Ebola survivors can be effective. Experimental drugs but not plasma was given to Mr. Duncan, from whom Ms. Pham contracted Ebola; he subsequently died.
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Once the Sixth Grade Reader of what was considered the world’s best public education system: California in 1914. Recommended to home schools up to 9th grade.
Nine Doctors Without Borders physicians, all equipped with the best of isolation and prophylactic gear, have died of Ebola. Of the physicians and nurses who have died of Ebola in this epidemic, most (more than 60%) had what was considered more than adequate protective gear and were instructed in its use. The US Military being sent into the plague zone have had four hours of instruction.
The U.S. military’s plan to deal with Ebola in Africa
The U.S. military is prepared to provide up to 3,000 troops to help deal with the Ebola crisis in West Africa.
There are 547 U.S. troops there, primarily in Liberia though some are in Senegal, according to the Pentagon. Their assignments include building 17 treatment centers in Liberia, training local professionals in how to handle Ebola patients and conducting tests to verify diagnoses of the virus.
U.S. forces will not treat Ebola patients directly, but medical personnel will be trained to care for and transport American service members back to the USA if they contract the disease.
All branches of the military contribute to the effort:
•Navy "Seabees" (Construction Battalions) build the treatment centers, and Navy medical personnel conduct lab testing.
•Army soldiers from the 101st Airborne are being sent to West Africa, and others are already on hand, performing civil engineering and logistical duties.
•Airmen coordinate military flights in and out of the country.
Thursday, President Obama signed an order allowing reservists to be called into active duty to support the Ebola effort. "The authorities that have been invoked will ensure the Department of Defense can properly sustain the military operations required in this effort," Obama said in a letter to House Speaker John Boehner.
The Pentagon said the order allows flexibility to draw on the reserve force for specialists in areas of technical engineering, communication systems, logistics, comptroller duties and religious specialties.
The reservists provide special skills not available among active-duty forces and can augment or replace personnel sent to Africa, the Pentagon said.
The military is good at breaking things and killing people. They are not particularly well trained for managing contagious disease outbreaks.
Kobani may fall to militants, top U.S. officer says
WASHINGTON — It is "highly possible" that the besieged Syrian city of Kobani could fall to Islamic State militants, the commander of U.S. military forces in the Middle East said Friday.
Army Gen. Lloyd Austin, who leads Central Command, said Islamic State fighters have made Kobani their "main effort" in a move to expand the territory they hold in Syria and Iraq. Austin said attacks by the militants on Kobani have given the U.S.-led air war opportunities to blast the terror group — also known as ISIL or ISIS.
In his first remarks on the air campaign that began in August in Iraq, Austin said progress is being made and called for "strategic patience." The U.S.-led effort is designed to allow security forces to secure Iraq’s borders, then retrain, re-equip and retake ground lost to Islamic State fighters, he said.
A regiment of Marines with air support could accomplish wonders in this battle. For that matter, selected units of the 101st Airborne could, on 24 hours notice, completely change the course of the war against the Caliphate. Whether that would be a good use of the troops can be debated; but if saving Kurds is an American goal, this would be a more appropriate use of troops than sending them into a plague zone.
The question is not the competence of the troops, nor of their officers; but one can question the competence of their civilian controllers, both civil service and political. And perhaps our new Ebola Czar can reconsider whether sending them into a plague zone is the best use of our Army. No, that won’t work. But he reports to Susan Rice, National Security Advisor; perhaps her expertise as a diplomat has determined that sending soldiers to Liberia and not sending help to the Kurds is good national policy.
After all, the premise is that government is competent.
But I do wish I heard a bit more about objectives, not merely in Syria/Kurdistan/Iraq, but for control of the Ebola outbreak in the United States.
Lawmakers urge an Ebola travel ban, Obama opposed
House Dems side with Obama, oppose Ebola travel ban
I remain unrepentantly in favor of quarantining dangerous contagious diseases. I hope the new Czar shares that belief, but I have no real hope that he will.
The author is correct, "boots on the ground" is a capability. Thus, US troops in Iraq could be used much as the 1st Marine Provisional Brigade was used in defense of the Pusan Perimeter during the Korean War; as a ‘fire brigade’ to shore up, reinforce, and exploit successes of the Iraqi army/militias.
Colonel, U.S. Marine Corps Reserve, Retired.; Former Governor of Wasit Province, Iraq; Righter of Wrongs; Wrong most of the time; Distinguished Expert, TV remote control; Chef de Hot Dog Excellance; Avoider of Yard Work
What Could US Boots on the Ground Do in Iraq and Syria?
In discussions of America’s current conflict with the Islamic State of Iraq and the Levant (ISIL)—which, like the Vietnam conflict, Washington does not consider an official war—a phrase heard frequently is “boots on the ground.” It is a direct challenge to those who believe wars can be won by airpower alone. Critics of the current air campaign in Iraq and Syria argue that boots on the ground—the physical presence of soldiers on the battlefield—is a prerequisite to military success. But how many?
There are currently somewhere around 2,000 American military personnel deployed in Iraq, protecting the U.S. Embassy, helping the Iraqi forces coordinate military operations and assisting the air campaign. They have no direct combat role, although some may engage in special operations, such as attempting to rescue hostages. Strategists outside of government have suggested the need for 10,000 or 25,000 American combat troops.
Boots on the ground represent a capability, not a strategy. The question is, what would 25,000 American ground forces do that nearly 300,000 Iraqi soldiers cannot do?
They could bolster local defenses in critical areas, reinforcing Iraqi or Kurdish forces that are hard-pressed by ISIL fighters. This is not just a matter of added firepower. Their presence on the ground could also enhance the effectiveness of the air campaign. And with American combat units at their side, Iraqi units might fight harder—or they might fight less, leaving it to the Americans to do the bloody work.
American combat forces could also be used as a mobile strike force to follow up the bombings or destroy concentrations of enemy forces. In this kind of deployment, the combat units would be moved from place to place to exploit opportunities, rather than to hold terrain.
A more ambitious and costlier task for American forces would be to drive ISIL forces out of the cities and towns they now hold. Urban warfare, especially against dug-in defenders, chews up armies. As we have seen on numerous occasions, from the battle of Hue in 1968 to the second battle of Fallujah in 2004, urban engagements can become ferocious fights. More than 13,000 American, British, and Iraqi forces were engaged in Fallujah, and they suffered nearly a thousand casualties.
There is considerably more, all worth your time if the subject interests you. Needless to say the point of the story is you must have objectives in mind or choose them when you have assessed the situation; simply putting forces into an area doesn’t accomplish a lot. Armies are good at breaking thing and killing people. They are also good at building roads and temporary bridges. In disasters military people are useful at first because they are versatile: but their primary skill is in breaking things and killing people. It’s what they do. The important thing, then, is to choose wisely the things to be broken and the people to be killed. That is usually known as strategy, and the first principle of military strategy, at lest as taught at West Point for decades, is The Principle of the Objective. Before you break things, it is well to have a good grasp on what you will gain from having them broken.
Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much, although some of you pay that, and have my gratitude. How to subscribe is described here: PAYING FOR THIS PLACE.
So my earlier research was correct — this is indeed a separate strain of Ebola from the Zaire strain some have claimed it to be. Which also explains the different level of fatality percentages. And if it happens to be more like the Reston strain, then it may well transmit airborne.
…Oh $#!^. And it’s mutating. Fast.
"In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it…By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published."
"The latest WHO projections suggest that by December 1 we are likely to see 10,000 new cases in West Africa per week"
Epidemic: (of a disease) affecting many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent.
Pandemic: (of a disease) prevalent throughout an entire country, continent, or the whole world; epidemic over a large area.
"In September, the CDC ran a series of models on the spread of the virus and came up with a best-case scenario in which, by January 2015, Liberia alone would have a cumulative 11,000 to 27,000 cases. That’s in a world where all of the aid and personnel gets where it needs to be, the resident population behaves rationally, and everything breaks their way. The worst-case scenario envisioned by the model is anywhere from 537,000 to 1,367,000 cases by January. Just in Liberia. With the fever still raging out of control."
Liberia’s population is only about 4.3 million. Worst case, that’s 12.5-32% of the total population.
"…if the four pillars—contact tracing, case isolation, safe burial, and effective public information—fail, no one seems to have even a theoretical plan for what to do."
I have an idea or two but it isn’t pretty, nice, or politically correct. It may wind up being expedient.
Who the hell ARE these people?!?
"A travel ban is not the right answer. It’s simply not feasible to build a wall—virtual or real—around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.
When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else."
That is EXACTLY what you do! A quarantine confines people who may or may not be infected, to keep everyone ELSE safe, until it can be determined if they ARE infected, and what to do about it! And you don’t go in to extinguish a wildfire! You set up FIRE BREAKS — effective WALLS around the fire — to deprive it of fuel!
I’ve just located a paper studying Ebola’s susceptibility (when dried on surfaces) to UV. There’s a lot of people out there believing that if the victim, e.g. throws up on the sidewalk, if you just expose it to the sun for a day, it’s safe. I have my doubts, especially if it is capable of staying around for 3 weeks. I’ll pass on the paper in a minute; I’m trying to get the gist of the important parts.
Interstellar Woman of Mystery
I would have thought that avoiding the importation of new infection sources would be a first order of business. It’s hardly sufficient, but I would think it necessary.
Quick Tests Versus Effective Procedures
Earl misreads my statement that quick tests "are an essential part of any effective Ebola entry-prevention policy"
My point in emphasizing the need for such tests, since it apparently wasn’t obvious the first time, is that cheap, quick, local finger-prick tests are far more useful (far easier to use early and often, and thus more likely to be so used) as part of an overall entry-screening process than current tests that require drawing a vial of blood, sending it to a lab, then waiting two to three days.
I had not been aware that Ebola virus detectability could lag visible symptoms by days; my thanks to Earl for pointing that out. CDC seems to think that the lag is "up to three days" for their tests (see
and I’d be interested in pointers to any info on the reasons for this delay and on how likely it is to apply to the new fast tests. But yes, this would obviously complicate screening procedure design.
Worth noting here is that one study I previously cited on asymptomatic Ebola infections (http://www.ncbi.nlm.nih.gov/pubmed/10881895) clearly indicates that both the antibodies and the viruses themselves can be tested for and identified in asymptomatic individuals. The problem may then not be fundamental, and some possibilities may exist for higher-sensitivity quick initial screening tests.
My understanding is that other viral initial-screening tests tend to go for extremely high sensitivity, and deal with the accompanying high false-positive rate with more precise follow-ups tests. If such an approach is currently difficult for Ebola, I’d be curious to see more about why.
This is not really the place to debate specific procedures and quarantine practices. Those are generally left to be decided by locals familiar with their resources and the people involved: the best may not be good enough, and in fact often the best is the enemy of the possible. Developing and employing such procedures is truly a matter for experts, which does lead me to wonder what led to the appointment of the current Czar; I would have thought it better to appoint a technical expert and someone like Klain as his/her chief of staff.
Anyone willing to put down odds on an Ebola quarantine being put into effect just in time for the first deployed US military Ebola case to become the political football "proving" that we need to have an open door policy to let in Ebola patients? I ask because the lack of training and cavalier attitude the govt and CDC has towards Ebola pretty much guarantees multiple Ebola infections among our troops deployed to the Ebola zones.
Newt Gingrich pointed out on Hannity something that I think is in one of the articles you linked – Of the 25 Ebola specialists who authored a thoroughly comprehensive medical paper about Ebola, 5 of them are already dead from Ebola. Think about that. In a group of 25 doctors who may be regarded as the most knowledgeable experts in the world on Ebola, who can be expected to have 100% adherence to ALL protocols and safeguards, 20% still contracted and died of Ebola. Only an idiot would say we shouldn’t be terrified by this, even if our govt was doing everything right.
It is the height of arrogance and ignorance for ANYONE to say "we got this", expecting that the magic of American medicine is an effective and reliable countermeasure against Ebola.
The question remains, why would our govt, in the face of global astonishment at how childishly ignorant and dangerous our Ebola response is, continue down this path of suicide. One cruise ship has already been denied port rights due to a single American on board, because Belize things we’re a bunch of suicidal idiots and they don’t want to have anything to do with anyone from the US who has had anything to do with Ebola, symptoms or not. Belize is utterly correct – we’re dangerously incompetent and any government who cares about its people probably ought to implement a 100% ban on travel from the US because we’re the only country on the planet who thinks its ok to transport Ebola patients around the globe as if its nothing worse than the common flu.
Plus, the update from the world health organization… 70% fatal, 42 day incubation. That’s horrible, but why is that more scary than 50% fatal and 21 day incubation given that you can travel around the world 5-6 times and interact with thousands of people in dozens of countries in 21 days, let alone 42? The world has every right to be terrified of American travelers at this point.
The fact that President Obama named Ron Klain as "Ebola Czar" rather than fill the empty post of Surgeon General tells me he wants not a medical solution but a political solution.
Live long and prosper
h lynn keith
Ebola and Luck
In Ringworld the Puppeteer Nessus tells Louis Wu that the Puppeteers have bred humanity to be lucky as they saw no other hope for the long term survival of humanity. And, they did like humans.
After reading about how we are dealing with Ebola and this link
I wonder if the puppeteers haven’t started earlier than documented in Ringworld.
God protects fools, drunks, and the United States of America. Of course we were a much more devout nation when Bismarck made that observation.
Freedom is not free. Free men are not equal. Equal men are not free.