On Having Heart Disease, Part II

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The discovery that I have coronary artery disease and the resulting two stents has been, in some ways, a great blessing. Now I know why I have had symptoms for fifteen years—the calcium buildup was narrowing three of my coronary arteries. The stents have helped me feel better, and I have been eating lots of veggies, fruits, and nuts, with the only meat being white meat from chicken or turkey. Exercise on my treadmill is now up to four to five days a week, and distance and calories burned have been steadily increasing.

One of the strangest benefits for me is that when I was in the cath lab, I knew there was a slight risk of death, but I was ready for whatever happened. For a few moments I was not afraid, and I trusted in God. While I still have my moments of fearing death is annihilation, those moments do not come as often as they did before my hospital stay. There are too many coincidences not to believe that God was involved in my recovery. I have tried to pray more, though the discipline is difficult, and I particularly like the early morning “Lauds” service on the Common Prayer I consciously think about God much more often and see God’s handiwork in the beauty of nature—even in this fallen world.

There are, of course, negatives. I know that coronary artery disease is chronic and that the battle against its spread must be thorough and constant—and there are no guarantees that more blockages would never occur or that my 50% blockage will never grow. There is also small vessel disease. My heart, the organ that keeps me alive in an immediate way more than other organs, is utterly contingent. Will a new blockage form? Will a clot form in a coronary artery and cause a myocardial infarction? Will the blockages already present make my heart electrically unstable and throw it into a fatal ventricular arrhythmia? While I work out and am not afraid, in the back of my mind I know these events are possible, and I keep my nitro handy in case I need it—hopefully I never will.

A few years ago, I read a memoir of a man who had suffered a heart attack—I do not remember his name, but the book was well-written. He said that his MI was a blow to his ego, especially to his sense of sexuality—he felt “less sexy” for having a heart attack. Perhaps it is the myth that a man has to be strong, and his heart attack seemed to reveal him as weak. In me, the effect was stronger due to some peculiarities of personality, most likely related in part to my mild autism (Asperger’s Syndrome). Now these are personal matters (read no further if you want to avoid sensitive topics) that I explored in my novels, End of Summer and Unpardonable Sin.  I have always been fascinated with the heart, and when Daddy brought a stethoscope home (he was a dialysis technician), I was mesmerized when I listened to my heartbeat or to other’s heartbeats. With the onset of puberty, the sound of a woman’s heartbeat became a fetish of sorts (actually “of sorts” puts it almost infinitely too mildly) for me. I also liked a woman to listen to my heart. Having a strong heart for me was part of my sexuality, and when this current situation with my heart took place, I felt (and still feel) very unsexy, even though there was no heart muscle damage. It is like a flaw in my manhood. This is irrational, I know, but given that it is tied to such powerful feelings, it is almost impossible to shake. But I am willing to take this small negative for the positives, especially the continuation of my life, for which I thank God every day. I trust that He knows what is best for me, in life or death.

On Having Heart Disease, Part I

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I knew my genetics sucked, but I thought that somehow I would avoid my family’s scourge of heart disease. For twenty-plus years I jogged regularly until arthritis slowed me down to a brisk walk. For most of those twenty years, I did not eat too much unhealthy food—but unfortunately that had changed lately, with too many trips to the fast food joints. For years sudden exertion had made me breathless, but since I could walk at a brisk pace for 45 minutes on a treadmill I thought my shortness of breath was from getting older. Last month woke me up big time—I felt chest pain on exertion. I passed a stress test with flying colors in June, so the cardiologist thought my problem had to be something other than heart disease. I had to be sure, so I hooked myself up to my portable EKG, got on the treadmill, and started walking, keeping an eye out for the S-T segment depression that would reveal a lack of oxygen to the heart muscle. It did not take long for that to happen—within three minutes there was deep S-T depression. I stopped and foolishly waited for my wife to get home. I did not reveal any alarm in my voice, so she told me to call the doctor’s office to talk with a nurse (this was in the evening, and the office had a nurse manning the phone). The nurse told me to get to the ER immediately, so Karen took me to Cape Fear Valley Hospital in Fayetteville, North Carolina, where I was seen. All the tests came out normal—EKG, cardiac enzymes, and the rest of the blood work, though my bad cholesterol was too high and my good cholesterol was too low. I showed the EKG to a cardiac physician assistant, who had enough doubts to get the staff to admit me to the chest pain unit. This was on a Sunday, and Monday I chilled out with a heparin drip and waited for the angiogram scheduled for Tuesday. The cardiologist did not expect to find anything other than, perhaps, small vessel disease which is treated medicinally. I remember how cold the room was where the test was done and the skipping of my heart (probably a short run of ventricular tachycardia) when the dye was injected. It took only seconds for the doctor to say, “You have three major blockages: a 99% blockage in the right coronary artery, a 75-80% blockage in the “widowmaker” (the left anterior descending [LAD] coronary artery), and a 50% blockage in one of the circumflex arteries. Initially the doctor wanted to do bypass, but I told them when my mother had bypass surgery all her bypasses failed. The doctors ran the statistics, and stents vs. coronary bypass had about equal results. Of course I chose stents. The first stent was put in later that day (Tuesday afternoon) in the right coronary artery. The doctor was brilliant in cutting through hard calcium with the “roto-rooter” to clean out the artery. He had great difficulty, and I think any other doctor would have given up, but Dr. Daka is an extremely skilled interventional cardiologist, and I thank God for his fine work. My chest hurt for about thirty minutes, and my body went into mild shock, causing me to sweat through my pillow. The right side of my heart had adjusted to low oxygen, and with the vessel open it asked, “Where the hell is all this oxygen coming from?”

The second stent was put in on Thursday. It was much easier to place, and I slept through most of the procedure. I returned home Friday to rest and allow my arm and groin to heal. After I was able to walk, I found that I could handle sudden exertion. I could walk up the stairs at the university at which I teach without getting out of breath. I feel so much better.

I am grateful most of all to God for working with the doctors and nurses to save my life. Dr. Daka and the staff at Cape Fear Valley Hospital were excellent, and even the hospital food was good. There was no heart damage, and my ejection fraction is a high normal of 60-65%. I have made major changes in my diet and exercise for an hour almost every day on my treadmill. As of today I have lost 24 pounds. So many things had to work out perfectly to get me into the chest pain unit, to get the cardiologist to order an angiogram, to get a master interventional cardiologist to do my stents, to avoid a myocardial infarction despite the 99% blockage. I was probably hours away from a major heart attack, and God spared me. My faith is stronger than before, and I thank God every day for saving my life.

Part II will deal with some of the emotional reactions I have had to living with heart disease, both positive and negative.

The Great Splitting of the United States

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“Splitting” has a number of meanings, but what they have in common is the notion of dividing something that was formerly not divided. In psychiatry and psychology it refers to a tendency, often seen in people with Borderline Personality Disorder, to shift between total admiration and love for a particular person and total disgust and hate. Election Day, 2016 was a time in which the cultural splitting of the United States became full-grown. It had been conceived in the 1960s by Tom Hayden and others in the “New Left,” one of whose catch-phrases was “The personal is the political.” Politics, once the domain of rational (though often heated) discourse became irrational, and those opposite to the New Left’s political views were demonized as evil people.

This splitting spread in the 1970s, the decade in which the values of the mid and late sixties permeated down to the rest of society. There was always a large swath of middle America, primarily in rural areas and small towns, who opposed the new wave of Leftism. However, in universities, the media, and Hollywood, the views of the 1960s left grew until a coalition between those three groups dominated elite society. They won victories in the courts such as Roe v. Wade on abortion and later, the legalization of homosexual marriage. They are pushing a transsexual agenda and a fluid notion of gender that is increasingly being publicized and supported by many in those three elite groups. These values are in sharp contrast with those of much of middle America and mark major differences in world view.

Donald Trump became a symbol of the cultural war in the United States. Hated by the left, parting for running a right wing campaign and partly for not being part of the establishment, supporting him resulting in his supporters losing friends, getting in arguments or fights, and even losing their jobs for being conservative. Conservatives, resentful at their voices being silenced, have reacted, and some, though a minority, have ended their friendships with liberals and consider them all evil. Election Day 2016 marked the Great Splitting of American, a division so deep that it recalls the situation before the War between the States. While violence thus far has not come close to the 1967-71 period in the United States, the threat of violence looms over us. I have lost lifelong friends. As a novel writer, I know my sales and publicity have been hurt by my openness about my conservative positions, which makes me a demon to many leftist writers. I have had people who know me, who in the past told me people can disagree and still be friends, change their minds during and after the 2016 election. Did I suddenly grow demon horns in November 2016? Do my eyes glow red? Have I turned mean since then? Of course not, and neither have those who have rejected me due to my positions. Why can’t we agree to disagree again, if for nothing else, to avoid the world ending, as it does in T. S. Eliot’s writings, with people shooting each other in the streets.

Satan, Pride, and the Denial of the Goodness of the Body

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Traditionally the fall of Satan was due to pride. Often this pride is portrayed as anger at God for granting such favor to human beings when the angels, according to Satan, were the only ones worthy of being God’s children. I would further speculate that Satan was jealous of God granting such favor to an embodied, material being. Matter could not possibly rise to the level of spirit, and Satan bristled at the prospect.

I have been reading some writings of Aleister Crowley, who was alleged to be a Satanist but who actually was more of a Gnostic. Like the ancient Gnostics and like some contemporary New Age writers, he constantly disparages life in the body, labeling it as an illusion that will be replaced one day by a higher spiritual consciousness without the body. I hear similar views at meetings of parapsychological groups, not as much from the scholars but from laypeople who support the field. While I believe parapsychology and psychical research to be legitimate, some of the people who follow the field are de facto or de jure Gnostic. They believe that one day human beings will transcend the physical body and ascend to the realm of pure spirit.

Now if Satan hates the idea of bodily life ascending to God, would it not be logical for him to disparage life in the body for human beings? Would it not be logical for him to deny the bodily resurrection of Christ and the general resurrection of all human beings? He may believe these things intellectually–after all, Satan is theologically orthodox, but in his temptation of human beings he would deny those beliefs. He would try to get them to deny the goodness of matter and the goodness of the body. He would try to get them to believe that only by rising to the realm of pure spirit can a human transcend bodily limitations. He would work to spread the notion that humans are pure spirit, part of God, and that matter will never inherit the Kingdom of Heaven. This is not to exalt human beings, for Satan knows that human beings are irreducibly bodily. But if he gets humans to deny that fact, he has them in his cloven hoofs–exactly where he wants them. When they are surprised after death at the resurrection of their bodies, then they will face the God who made them and loved them as body-soul unities, with the body just as essential to their identity as the soul. If they submit, perhaps God will save them by His grace. But if they refuse, following Satanic advice, and claim that they could not possibly live with a material body and be truly glorified, it is difficult to see how God could save them and let them go to Heaven. Denial of the goodness of matter–and of the body–is the fruit of Satan, not God.

The Scope and and Methodology of Philosophy of Religion

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Philosophies-of-disciplines, while not a return to the ancient and medieval view that philosophy encompasses all knowledge, allow philosophy to “invade” other disciplines and discuss their foundational principles. The philosophy of science, for example, discusses such topics as the nature of theory change, the nature of scientific explanation, scientific realism vs. nonrealism, and the demarcation of science from nonscience, among others. Its complexity has grown amidst the recognition that scientific methodology differs from discipline to discipline, and the “unity of science” thesis seems dead for now.

A similar growth in complexity has affected contemporary philosophy of religion. The initial struggle in the establishment of philosophy of religion as a subdiscipline involved separating the field from Christian theology. To what degree should philosophy of religion be tied to a particular religion. After all, if it is the philosophy of religion, rather than the philosophy of the Christian religion, its scope would be broader than a philosophical examination of Christian belief and practice and broader than monotheistic faith in general. However, Western philosophy of religion is dominated by examination of monotheistic claims about the existence of God, the attributes of God, the problem of evil, and life after death. Take most undergraduate (and graduate) texts in the field in the United States and in the UK, such issues dominate the textbook. If someone wants to study the philosophy of East Asian religions, the student usually takes courses in a religious studies department.

Strangely enough, methodology seems to fit such divisions. For example, analytic (or Anglo-American) philosophy of religion focuses on monotheistic claims. This has been consistently the case since the 1955 publication of the anthology edited by Antony Flew and Alasdair MacIntyre, New Essays in Philosophical Theology. This anthology marked the rebirth of philosophy of religion in Anglo-American philosophy after its short sleep when logical positivism dominated analytic philosophy. The trend of focusing on traditional monotheistic claims continued in an influential anthology edited by Baruch Brody, Philosophy of Religion: An Analytic Approach (first edition 1974) and later anthologies and textbooks as well as most articles in the field. Following Alvin Plantinga’s lead, some analytic philosophers of religion used analytic methodology in the study of Christian theology; examples abound, including Plantinga, Richard Swinburne, and Eleonore Stump. Sometimes this approach is labeled “philosophical theology;” and sometimes it is classified as “philosophy of religion.” Neo-Thomists, from the analytic tradition, more traditional Thomistic positions and Transcendental Thomism, followed this focus as well. For those interested in a broader philosophy of religion, the later Wittgenstein offered them the opening of classifying religions in terms of language games. D. Z. Phillips held that religious language does not make truth claims about reality but functions in particular expressive ways within religious communities in guiding worship and practice. The process philosopher Rem Edwards used such a Wittgensteinian approach in his classification of religious beliefs and practices in his 1972 text, Philosophy of Religion.

Continental philosophers of religion took a broader approach and generally did not limit their study of philosophy of religion to monotheistic traditions. Their use of the phenomenological approach to the study of religions allowed them to discover both similarities and differences between disparate world religions without dealing with religious truth claims. A good example is the widely used textbook by James C. Livingston, Anatomy of the Sacred, now in its sixth edition. Even though Livingston’s book uses phenomenology, a well-established philosophical methodology, it is generally classified as a book in religious studies and not as a book in the philosophy of religion.

Process philosophers who work in philosophy of religion are interested in religious truth claims and often focus on similarities between world religions. Recently prominent have been meetings between Christian process philosophers and Buddhist philosophers in order to foster interreligious dialogue.

In 2014 a book by the Eastern Orthodox philosophical theologian, David Bentley Hart, was published, entitled, The Experience of God: Being, Consciousness, Bliss. His own methodology could be called eclectic, and he finds similarities between Hindu and Christian conceptions of God, an interesting conclusion for a conservative Eastern Orthodox scholar. His book could be classified as Christian theology, philosophy of religion, or philosophical theology, given the fluidity of such terms in the West.

My question is, “Is such apparent narrowness in Western philosophy of religion necessarily a bad thing?” I do not believe so. Areas of contact between Hindu, Buddhist, Jewish, Muslim and Christian philosophers are growing, even among traditional Christian thinkers. In addition, India has a rich tradition of Hindu philosophy of religion, which is difficult to separate from religious studies—a similar situation to that in the West. Although American society is increasingly diverse, and religion is in rapid decline, the dominant cultural force religiously remains Christianity and to a lesser extent, Judaism. The inroads Muslims are making only introduces another monotheistic faith into the fray. Students should be, in my judgment, exposed to Western ideas first and then to ideas from other traditions so they can make accurate comparisons between traditions.

Methodologically, in the field of philosophy of religion, pluralism should be welcomed. Whether a philosopher of religion uses analytic methods, phenomenological methods, or the careful but not mathematical logic dominated approach of traditional Thomists—each method has its uses. It would be a positive development if analytic philosophers would study East Asian and African religions using that approach. Another positive approach would be more dialogue between phenomenologists and analytic philosophers. Each should be more familiar with the other’s methods.

My own approach to methodology in philosophy of religion is eclectic. I approach the field as a traditional Scholastic with affinities for both Thomas Aquinas and Duns Scotus. I tend to keep my arguments in English rather than putting them in symbolic form, so I do not share the emphasis of analytic philosophy on formal logic. It seems to me that analytic philosophers are often unaware of the limits of formal deductive logic. It does not, by itself, capture well inductive and abductive thinking and ignores intuitive knowledge and what Scholastics label “connatural knowledge.” Phenomenology is useful in describing religious experience, although eventually I will get to evaluating truth claims. I am not sympathetic with postmodernism with its tendency toward epistemological relativism. Subject-wise, I focus on Christian beliefs, although I am open to insight from other religions if they help solve a problem on which I am working. My first philosophical love is metaphysics, and I tend to approach problems in the philosophy of religion from that standpoint, although I realize that metaphysics influences epistemology and vice versa. Overall, I could pigeonhole myself as a “pragmatic eclectic Scholastic,” although I would never expect or want other people who work in the field to follow that particular approach. Any philosopher of religion, regardless of method or focus, should be willing to learn from anyone, no matter what method he or she uses.

Your Brain is Trying to Kill You

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[I am open to correction in any point of the post below].

….all diseases may, in some sense, be called affections of the nervous system, because in almost every disease the nerves are more or less hurt; and in consequence of this, various sensations, motions and changes, are produced in the body.

–Robert Whytt (1714-1766), Scottish Physician

 

One of my obsessions as a child (and as an adult) is probably related to my having Autism Spectrum Disorder, Level 1 (in my case, what used to be called “Asperger’s Syndrome). I have always been fascinated by the heart and death and why a particular medical condition caused the heart to stop beating, especially if the condition was not itself a heart disease. I’d wonder about how a gunshot that missed the heart could sometimes cause rapid (or in the case of certain head wounds, nearly immediate) cardiac arrest. I would see Daddy shoot a rabbit, and it would run for ten or twenty yards, then collapse, dead. Why did its heart beat strongly enough to support its running, then suddenly stop. Or, in another scenario, why can a human being hold her breath over three minutes (and for free divers, close to ten minutes), yet someone who slips underwater or chokes on a piece of meat suffers cardiac arrest, in some cases, in a minute or two. Recently I heard of a case of a twenty-eight year old man who choked on food, and when rescue arrived two minutes later, his heart had already stopped. He was revived and had no neurological effects—but what caused his heart to stop so quickly.

Now I am not a medical doctor; the furthest I got in the medical field was as an EMT-Basic who was not even certified to give IVs or advanced cardiac life support. However, I can read, and over the years I learned that people shot often bleed out and that people who drown in fresh water can suffer cardiac arrest within a couple of minutes from electrolyte imbalances, but what about the choking victim. In the case of the gunshot victim, why does the loss of 30-50% of blood volume arrest the heart? Surely that is enough blood to stretch the sarcomeres enough for systole to continue.

I used to blame the heart—it was strong, yes, but also very fragile—too fragile, and stops too easily or too quickly for doctors to halt the underlying cause of the arrest in time to avoid brain damage or death. It turns out that often the real culprit is not the heart, but the brain.

The brain responds to bodily trauma in a way that is often destructive to the body. True, there is the diving reflex that diverts blood flow to the heart and brain that allows some drowning victims to survive. However, the rapid release of neurotransmitters in trauma or asphyxia or even in a myocardial infarction (heart attack) can result in stoppage of the heart. In effect, the sympathetic nervous system which speeds up the body, with its neurotransmitters, conflicts with the parasympathetic nervous system, which slows the bodily functions, and this conflict can lead to cardiac instability and a fatal arrhythmia. While the electrical instability of the heart itself can cause a fatal ventricular arrhythmia during an MI, often the big straw that breaks the small camel’s back is a massive release of stress hormones that is “ordered” by the brain. In the case of severe bleeding, such as occurs in gunshot wounds, a nervous system mechanism causes the heart to slow down (“brady down”) and stop after 30-50% of blood volume is lost. Some head injuries, such as bullet wounds that affect key areas of the brain associated with the brain stem, cause, according to a military medic with whom I talked, almost immediate Torsades de Pointes (a chaotic heart rhythm) which progresses to ventricular fibrillation and death. The military uses pharmacological blockers to cut off sympathetic and parasympathetic signals to the heart, and sometimes that buys extra time to treat the patient. A recent animal study published by the National Academy of Sciences found that it is the release of neurotransmitters with conflicting effects on the body that leads to cardiac arrest, and when such parasympathetic and sympathetic signals are blocked, it buys several minutes in which the heart continues to beat until oxygen is totally exhausted. Yet this time could allow doctors to reverse the asphyxia without going through the (far more often than not) unsuccessful CPR and advanced cardiac life support in the face of cardiac arrest. Some scientists are not suggesting that in cases of asphyxia cardiac arrest, animal studies be done to determine whether pharmacological blocking agents to stop both parasympathetic and sympathetic signals from reaching the heart during asphyxia crises will keep the heart beating longer. Apparently there is a pattern to the course of dying in such cases, and knowing the pattern can help the timing of intervention. If blocking agents work in animals, this may be an option for human treatment.

Thus I should stop blaming the heart for early cardiac arrest in these conditions, at least in most cases, and blame the brain instead. A person with the strongest heart in the world could go into cardiac arrest quickly from asphyxia or blood loss if her nervous system effects cause the arrest.

As a philosopher of religion, this raises some issues for intelligent design arguments, at least those in the British natural theology tradition. Animal bodies are filled with examples of poor design; Francis Collins, who is a devout Christian, mentions some of them in his attack on intelligent design arguments (one of the design flaws is that instead of a totally separate, two-tube system for food and air, we have a system in which a flap closes the airway while we eat so that air goes into the trachea rather than the esophagus. Collins points out that any human engineer would have enough sense to avoid such a flawed design. The fact that our brains “try” to kill us during severe disease, trauma, or asphyxia does not suggest intelligent design—it suggests that some of the so-called protective mechanisms of the brain can make cardiac arrest occur more rapidly, resulting in less time for doctors to focus on underlying causes and resulting in the deaths of many people who would not otherwise die. Give me a good cosmological contingency argument any day over an intelligent design argument. Now I am not calling God incompetent; I believe it is possible that evolution became flawed due to an angelic fall (as we see in J. R. R. Tolkien’s mythical account, in which Melkor (or Morgoth) and his allies damaged nature itself in their rebellion against Eru (God).

I suppose the satisfaction of curiosity is a good feeling, but I am also frustrated with the slow progress of medicine in this area in which very few studies have been done. I am glad some scientists are working in this seminal area of science and medicine and hope that their efforts result in lives saved from an early death.

Mr. Trump is Right about Monuments

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I watched Donald Trump’s news conference yesterday (August 15, 2017) and agree with most of what he said. The only disagreement I have is that I do not believe that economic growth in itself will improve race relations. However, he is correct that it is hypocritical to take Confederate monuments down and still support monuments to George Washington and Thomas Jefferson. The Left, big business, and establishment Republicans like Mitch McConnell are doing their best to turn people into rootless, homeless machines who work for the technocratic state. If history is erased except for a whitewashed history that supposedly is non-controversial, this helps produce the robot-like, echo-chamber world they desire. I have ancestors who fought on both sides in the War between the States. I am a member of Sons of Confederate Veterans. I find the removal of monuments to Robert E. Lee and others who were involved with the Confederacy to be a travesty, an act of historical vandalism fueled by corrupt “history professors” and other members of the Academic Left, the radical Left in general, and the corporate Right to destroy the heritage of an entire group of people. The sheer hypocrisy of such people is astounding. They ignore the fact that most people in the North supported slavery because it kept blacks from moving into their states. They ignore the racism of Lincoln–even most of the Abolitionists were racists. They ignore the fact that one of their most hated figures, Nathan Bedford Forrest, supported full civil rights for blacks in his old age. They ignore the fact that many of the Founding Fathers were slave owners, including those mentioned above, Washington and Jefferson. They ignore the fact that General Ulysses S. Grant owned slaves and refused to release them after the war until the Thirteenth Amendment was passed. Related to that, they ignore the fact that Lincoln’s Emancipation Proclamation only applied to the Confederate States, not to the other states that remained part of the United States. They pay attention to the Succession Documents of the deep South states, ignoring other motivations for war in the middle South in which states opposed Lincoln’s unjust and illegal invasion of the South. They ignore the brutal war crimes committed by the Union Army, especially but not exclusively under General Sherman. They bring up atrocities in Andersonville yet ignore greater atrocities and a higher death toll in Union POW camps. They ignore the fact that many blacks fought for the South as attested by newspapers covering the war. They ignore the stirring up of the former slaves by corrupt Northern agents during Reconstruction.

Their hypocrisy is bare for all to see, yet the elites–both Democrat and Republican–have power and use that power to suppress dissent and destroy monuments. Organizations such as the SCV and United Daughters of the Confederacy can work to buy up private land on which to put the monuments, but that will not help in places like Baltimore, where the mayor desires not only to remove the monuments in that city, but destroy them. In Durham, North Carolina, a mob destroyed a Confederate monument. These actions are fundamentally evil, and some of the people in Virginia were opposing the removal of the statues and were not part of any white supremacist group. But lumping legitimate groups together with racists such as Nazis is a favorite–if dishonest and unfair–tactic by the Left (and by Mitch McConnell).

Yesterday when I heard Mr. Trump, I felt proud to have him as President of the United States.

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