Aloha, everyone, this is Think Tech Hawaii, and this show is the Politics for the People, and we're weekly on this day. We have guests joining us to be a panel to discuss the topics of this show, which as you may have guessed, politics. All right, I'd like to welcome Jay Fidel to this show and also Tim Appichella and Winston Welch. We are ready to talk about the politics and the activities of yesterday and all those that affect them. So Jay, I wanted to start with you by asking, we all know about the disappointing outcome of the Senate's vote yesterday for the voting rights bill. And I'm wanting to know if you think in contrast to the fact, to the matter that it was a disappointing result, what are the positives about it? What is an advantage of having had that vote? Is there any advantages? It's like getting beat to with an inch of your life for exactly what are the advantages in that? And I don't see any advantages, Stephanie. Maybe these other guys see an advantage. I see only defeat. And the newspapers, especially Winston's links that he sends around, are trying to make a silk purse out of what is a sow's ear. What happened yesterday is a sow's ear. On the other hand, I have to say that it was entirely, completely predictable. And you had all these commentators saying, no, no, no, something will, a miracle will happen this, be some miraculous turn of events. No, no, mansion and cinema, our item together, they voted with the GOP and that was very clear. That was gonna happen and it did happen. And so no voting rights bill for us. The notion of breaking it all down both in Biden's build back better and in voting rights is really a long shot. I think he's lost credibility, he's lost power and influence if he had any anyway in the Senate, he's never gonna get anything through. They wanna embarrass and humiliate him, they wanna make him look foolish and impotent and they've done that. So I don't know what's left, maybe these guys have a better idea, but I don't know what's left for him to do. And then he gets up yesterday and talks about Ukraine and he makes this sad sack statement about, yeah, Russia's going to invade Ukraine before you know it, everybody is back peddling on what he said and then he tried to backpedal on what he said. It was an era, it was an era of judgment and era of thought process era, I think. And so what we have there is you take all these things together, it was a bad day for Biden. And I think people are really wondering if he can make it through. Well, thank you, Jay, that is what we saw. But what we also heard was that even though we knew, they knew, those engaged that the Senate was not, that the vote was not gonna be happy. And nevertheless, Schumer decided and the Democrats to go ahead and have it anyway. So there were some discussions about that tactic and I'm just trying to probe into what it was that they saw was positive about it. So Tim, can you dig in and see why they went ahead with it given the absolute assurance that they were gonna fail? Well, the official line was we want everyone to go under record on how they vote for this voting rights on the record rather than commentary, rather than statements in the hallways of Congress. So they got that, they got on the record exactly who wanted it and who didn't. And so how will that be used? Hard to say, maybe become an election time, they'll use that against them. I didn't say I'm out of word because that's the only purpose it served. So you think that it might be, Tim, something to draw on during the election to show that they, what? That they belied their previous vote or that they're bad people or what is that? Well, yeah, basically that's why they wanted to go on the record. You know, if it was Donald Trump, he, you know, have these conversations either on the open microphone or behind doors saying, I'm gonna primary you. If you don't vote my way, I'm gonna primary you and you wish that you hadn't crossed me. You know, the old President Johnson way of getting things done. It's a bad look to say that you've got the house in your palm, you've got the Senate in your palm and you're the executive and you can't whip two votes to get some landmark legislation done. What did that say about the administration? And it says that you're weak and ineffectual. And that's exactly how he's come off. So, okay, now we have the record of who voted which way and will that be used against them during the primaries? Who knows? I mean, Joe Manchin is so popular with the Republicans in West Virginia, probably doesn't really matter. And cinema is probably gonna be on the way out. She will probably be primaried and not be successful but we'll, time will tell about that one. Interesting. Okay, thank you. All right, Winston, this question is one that looks to who it was that was gonna gain from having this vote. And that title of this program is, you know, what the Democrats plot next steps, you know, after this disastrous vote. So I'm gonna try, I'm gonna ask you for your agreement or disagreement or if you see some other facts here that we're looking on the question of why did they do this? Why is this strategy, why did they stick the strategy and didn't come to terms with reality? And I'm not exactly sure because we knew the outcome of it before it was going to happen. Apparently they put Kamala Harris in charge of the Senate just in case it was a tie breaking vote. But I think it was a foregone conclusion that it wasn't going to be. So I think perhaps it was just to show that this was pure obstructionism on the part of the Republicans. I'm not sure why other than that, what the purpose of this was is to just have people go on record saying they're against this, that and the other. What it does point to now is the need for many articles that have said, you know what Joe Biden is, and yes, as Jay says, I might tend to be a little bit polyannish or happily naive, that's okay. When we're looking at what he has accomplished in the last year, just Google, what has Joe Biden accomplished in the last year and look for the positive articles. We got enough of the naysayers where it's like it says, you know on, I was looking at something that's, you know, Fox and Donald Trump saying, you know, they're lockstep and saying how terrible it is and how awful it is. You know, the reality is, where most jobs created under any president in his first year, unemployment's at 3.9%. He said some major bills passed. We have a sane, calm, wise person. Has he made failures? Yes, has he made missteps? Yes, but he also said, you know what? And he's frank with the people. This is one thing that even Fox News carried in an article on their website, which we should be looking at all new sources and seeing what they're saying by Kevin Walling, which came out today. He says Biden gave a command performance at his press conference. He was forceful, direct, self-deprecating and earnest on Wednesday. He says that is, and their commander-in-chief, someone willing to speak with the American public like that. And he said as longest press conference from a president in recent history and he went over what he, you know, where his failures were and where his successes were and then outlined a new strategy. I mean, he was also pretty frank on Ukraine, which I thought was welcome. He, it says that basically this is what he needs to do. And we talked about this yesterday. He needs to take his case directly to the American people in the weeks and months ahead as he's indicated. He's still here. He's not going anywhere. He's got three years more in his term. And I think this first year, given the enormity of the difficulties that he faced when he took office, you know, he's also, let's not forget, trending above where Donald Trump was a year into his term. I think Donald Trump was at 35% or 38% or whatever it was. This gentleman is maybe at 45%. But do we really need to pay attention to the polls that much on this for something, you know, does he need an hourly blip meter to see how he's doing? I think we can take him on the whole of how he has stabilized our nation and made it at least a place where we can have discussions where, you know, I'm remaining hopeful and optimistic. Despite some, you know, missteps in his first year, I think that we have a lot to go yet. And I think that Joe Biden is reassessing what he needs to do. He's gonna come out with a lot of different ideas and strategies from now working across the aisle. He doesn't have any other choice. I mean, and across the aisle, I mean specifically also to Joe Manchin and Kristen Sistema. Okay, yeah. Well, thank you for calming the waters here. I meant getting a little balanced in the view of him. And I wanted to go over to Jay to ask about this coming out and talking more with the people and showing himself as Winston's saying as a unifier peacemaker and trying to tout the accomplishments, get those in people's heads. But Jay, do you think that's a good idea for him with his agent-ness and the slipperiness of his speech sometimes or do you think there's other ways he should be communicating or promulgating, you know, his successes? What do you think? Is that gonna get him anything more? Well, to answer that directly, I was thinking about this in anticipation of the show and my gut is that Joe Biden doesn't have an organization. He doesn't have a national following that acts on his command. Now, Trump did, maybe it says on the extent he does now. He does now, but Biden doesn't.  And I think the solution is to get other people, millions of other people to speak for him to develop a national effort among the Democrats. There are plenty of Democrats who need to be activated, who need to get into the media, into the legislatures, into the courts. And I don't think he's doing that. It's like a one-man band and that doesn't work. And not for him, it doesn't work for him. The other thing, you know, I wanted to say is that, you know, Joe Biden has, you know, he has to, I've written a commentary about this. He has to figure out who's gonna be in the ticket next time. Now, right now it's kind of this shuffling toward the end of his term with these vague suggestions that maybe, you know, he'll run and he does not instill confidence, I'm sorry. And I was gonna say in response to Winston that, you know, it's not what you did for me last month or months ago, it's what you did for me yesterday. It's your trajectory. And I'm afraid to say that Joe Biden's trajectory isn't good. It's trending down, not only in the polls, but in his success factor. He's been less successful every time you look. He's made more, you know, chess move mistakes, strategical mistakes. I don't understand, he's got only smart guys, but he's nevertheless making what are identifiably mistakes. So I don't think we have a president who can hold it together. I'm afraid to tell you that. And of course, he's a decent, honorable, honest man and he should have our support. But the political reality is, what have you done for me today and are you strong? And can you sustain the effort and do you have an organization or people shouting for you from the bleachers? Answer no. Well, one take is that he had advised Obama and he saw that in the Obama administration, there hadn't been enough going out and telling people about what they've done and that he may be, you know, trying to make that up in his presidency. But your points are very good and he needs to do exactly what you're saying. And can he do that through the circuits? He has, like, that can't... Well, you know, now you know David Brooks. David Brooks appears on PBS The News Hour for years now. David Brooks has been a star reporter for the New York Times, a columnist for decades, okay?  He doesn't jump to conclusions. He's not shrill in any way. Sometimes it bothers me to listen to him because he's so soft. But David Brooks wrote an article, a commentary, an opinion piece yesterday, which was something along the lines, you know, let's look carefully at how this country is doing. And this is not his words, but it was very similar. It's coming apart. And he talks about aggressiveness. He talks about the divisiveness. He talks about violence. He talks about insurrection-minded people. People have no faith in the government or in Joe Biden or in democracy. That's the article he wrote. That's a real chakaroo from David Brooks. So, you know, you can argue with David Brooks and say, no, what is he talking about? It's not like that. It's much better. There have been successes in the Biden administration and so forth. And there's, you know, more jobs and less unemployment and all that. But David Brooks' article, to me, is the canary in the coal mine. And we all want to take a look at that and see, you know, what's really going on in this country. And it points to the kind of thing that we have been, we here on Think Tech have been talking about as a possibility of connecting the dots. It is not a good future. Every metric I can think of, every meaningful metric I can think of is consistent with David Brooks. Well, Jay went to the big time, what's the next steps for the Dems and recommending that that ticket question be resolved soon. But moving on to Tim, do you think that the voting coming up in 22 is gonna be affected by the legal shade or, you know, the growing civil suits against the former president? Do you see that having? I can see the Democrats trying to position it that way because they think that's gonna get them votes. It's almost like the criticism of Donald Trump. That doesn't get you anywhere anymore. It's like Jay would say, that's old news. You've gotta show what we've got around the corner, what's on the immediate horizon that it's going to improve the lives of Americans or establish, you know, voting rights again, democracy, but to focus your efforts on elections and the winning of seats in the House on the horrible things that occurred for January 6th is a really bad strategy. Again, show us what you're for, not what you're against. And I think if they follow the January 6th formula and all the horrible news that will come out of that and all the proof that finally has been ascertained, it's not gonna win seats, it'll lose more seats. So if I was the Democratic Party, I'd say, we've gotta get something done with Build Back Better. Okay, forget it, 1.75 trillion done, gone. Can we get it done for a trillion? Can we get it done for 900 billion? What will Joe Manchin support? What's the dollar amount? What's the programs?  What will he support and let's get it done? Yeah, it won't be anything like the original $3 trillion that we wanted. But at least it's something, same thing with the voting rights. What can we strip out of this thing and break it up so that we can get Republicans to come over to the other side and vote for it? Again, Mitt Romney made it pretty clear that he was interested in trying to work something out. So let's quit being so partisan. Let's be bipartisan, break it up and find the compromise that we need to find. Those will be accomplishments for the Democratic Party. That will help preserve seats in the 2022 election. But if they don't do that and they don't find new accomplishments, they're doomed. Well, I noticed you said that if they do that January 6th strategy, that that will lose. That'll lose. It's not a winning strategy. It's just not winning. And you're saying these other strategies are positive in showing what they've done. Show me accomplishments. Yes, show me accomplishments. Show me what this administration can do and how it's gonna make my life better. Or give me some assurance that we still have a democracy. But tell me, you think there isn't going to be reaction or anger or discontent when all of that information comes out about this insurrection? And this- Of course.  Yes, the answer is yes. But if that's your primary strategy, it's a losing strategy. It's an ancillary strategy as far as I'm concerned. It will help voters get motivated because they'll be, I hate to say it, but they'll be pretty upset. They'll be angry. But we already know what we know already in the news of what all the different points that Donald Trump and his henchmen took to try to overthrow a free and fair election. We know what that is. It's now old news. Now we're just trying to prove that, which we already know. And so it won't be new news. Well, that is interesting. Thank you for helping us see how to strategize for something like this. I mean, you're still saying that that bad news from the January 6th can support that- Yes, but support a winning strategy, not be the sole strategy and think that's gonna win the day for you and you save seats in the House of Representatives. It won't. All right. Well, do you think anybody's telling Biden that? Where's he getting this information? Do you have any sense of it? You know, I don't know where he's getting this information. Where's the DNC and all this? Where's their policy ideas on how to win the 2022? I don't know what's really taking place behind closed doors of what President Biden is hearing or not. I would hope that he's hearing a voice of reality and maybe think tech alike and call him up someday. Do that someday. Let's give it a try. Okay, for some news that is new, we hear from the January 6th committee that they've decided to nicely invite the past president's daughter, Ivanka, to come in and tell them all about what it was he was doing that day when we had it in a direction. Winston, do you think this is a winning strategy? Do you think she's coming? This is the lady that orchestrated the Bible showing in front of the church and clearing out the square with tear gas. She carried the Bible in her handbag. I don't think she's probably gonna show up willingly and she'll probably be held in some sort of contempt. But what will that do? I don't know. I mean, what's interesting though, and is that while we talked about the courts and everybody wants it's an activist court if it's doing what you don't want it to do. Yesterday though, they rendered a decision that says Donald Trump has no right to exert executive privilege over those documents and they ordered the National Archives to turn over relevant documents to the January 6th commission. So, there's another opinion that was in the Washington Post, six ways to counter-authoritarians ahead of the midterms. We're gonna see a lot more articles like this. This is where civil society kicks in, where we say, and that can be done in tandem with a sane unified Congress, as unified as it's going to get and say what are common sense things that we can do so that we don't have chaos at the end? Now that assumes that you have good people on the other side, but their first oath is to the Constitution of the United States, not to their party. And while they might twist something and say, well, this is the only way we can see this, Tim is right. We've got to strip down these bills to what is supported by everybody. And the Democrats came in with some very ambitious and progressive ideas, when the nation was in the middle of reeling from COVID, reeling from four years of Donald Trump and all of the chaos that that had. It was probably too big of a two at the time. And I think that's what we've been shown. Apparently Joe Manchin went to the White House in December and said, this is what I'll support. And surprisingly, a lot of it was a lot of money for climate change initiatives, which did take me by surprise. So he may not be as easily pegged as we think. And I know Jay has said he thinks he's a bad actor, but let's assume that he's not. And then we go back to him and we say, okay, you write the bill, like Tim said, maybe it's 900 billion, whatever it is, let's get it through. The same for voting rights. What is it that we can all agree upon that just it's not voting rights that are so much the issue is how we count the votes at the end of the day and how we certify them. And to make sure that the people who are counting and certifying are following standard rule of law that is laid out clearly right before them. And any challenges that need to be made to these laws that have been passed across the country need to be made right now. There's not waiting till tomorrow. So if Joe Biden's administration doesn't do it, then let other organizations in the civic sphere take on these challenges before it's too late. And it's in some ways already too late, but I think they can show more than just cause to get involved in this. He can do that with cinema and mansion that they would go along with these new rules. I don't think he doesn't need to. He needs to ask, or maybe his Justice Department probably is already looking at this. I'm not, we don't hear a lot from Merrick Garland or a lot of people in this administration. And I think that's what Tim was saying and Jay is let loose these great communicators that you had. Let loose the Pete Buttigiegs and all the folks that Amy Klobuchar is in and have them be more noisy than not. Let's get AOC out there again. Her message deserves to be heard. So then people are thinking, oh wow, that sounds pretty far out there. So maybe, Amy Klobuchar sounds pretty reasonable to me when you're says, okay, well, we're gonna have you. And that's the type of thing that we need. We need, where's the DNC? Great question Tim. We need to see a concerted massive PR campaign that lets us know we're way better off having a sane, stable, accountable government led by a president who's the same. All right, thank you, Winston. Jay, I wanted to go back to the strategy question. We already have discussed that with regard to Schumer and the Dems and what they did yesterday. But it so happens that of course, in all of these legal concerns about Trump and the civil suits that are developing, his response to that is to be oppositional and deny and say he's innocent. And so this is the constant rant across all of everything that he's been charged with. And is that still a winning strategy? What is that strategy? And how is that supposed to be helpful to anybody? Tell me what that means. You bet it's a winning strategy and you forgot the other D word delay. I mean, this is a well orchestrated plan. It's a war against the Democrats. It's a war for power, for insurrection, for coup. We can never forget that. And if you assume some sort of goodwill, good faith among the GOP, it's not there. It's not gonna be there. That's why I say, well, you can break these bills down on the assumption that reasonable people will vote for a part of it. Okay, well, they're not reasonable people. They're at war. And even if their inclinations are not to do that, Trump has got them counted to this primary threat. So we're not gonna see any real cooperation from them on anything. As a group, as an organized group, they don't care about the future of the country or the democracy. They're only interested in beating the Democrats, taking complete power and elevating Trump or some other autocrat into a position where he can do what he wants. The Reichstag, ladies, is burning right now. So I don't know if there is a strategy yet. As I said before, I think that Biden has to develop a national effort with the DNC. He's supposed to be the leader of the party, right? Among other things. And I don't think he's leading the party. And there's some kind of chair or president of the party. He's not doing anything either. And I don't necessarily mean that you get up on TV and you make some statements and try to whip people up on national TV. That's what our politics has become. Statements on national TV, try to make a good speech and talk to all the people all over the country at the same time. That's not the good strategy. You gotta get into the communities, the neighborhoods. You gotta talk to people who you might convince otherwise. I mean, the liberals, they're gonna do the same thing but they're not motivated. And the people in the base, they're really hard to change their minds. But that's what's gotta happen. This politics has to go back to what Tip O'Neill said. All politics is local. And the Biden administration has to find the interland and talk to them and not let them off the hook and explain to them that the country is slipping down the proverbial slope. And if you ask me what the strategy should be, I think that's what it should be. But it's a long shot whether this administration or the Democratic Party as it presently exists can pull this off. So send your money to Switzerland. What can I say? All right, Tim. I had one more question I wanted to ask. We've got a little bit of time left, not much, but there's a little specific. But what did the January 6th committee think that Ivanka would do? Would that person as a witness are coming in to talk? Is she gonna turn her father over? What do you think? Well, you know, before you could subpoena someone, you've got to show that we asked them nicely. You don't go directly to a subpoena. You know, it's a multi-step process. So you ask them nicely. You know, they're gonna say no. And then you go to the next step. That's a check, you know, it's a check mark basis. Thanks. All right, well, Winston to finish up here in your comment, is it likely she would ever say anything against her father? I mean, I'm questioning the expectation of the community that they can get anything out of it or put her in that position. What do you think? I think it was the same as the vote taken yesterday. It's a foregone conclusion. They just want to say no one's cooperating for the betterment of the nation. You know, one thing, when Jay lays out his case, it's very compelling. David Broder, yeah, the Canary and the Colmar. And that was for our gentle viewer, January 13th, America is falling apart at the seams. I'm sorry, David Brooks, article. And, you know, what we have with Joe Biden, he's never been the great communicator. He needs to unleash that communication force that he has all around him. He can sit back like he said yesterday. They don't, he's been too, too senatorial. He's been too, too much fighting his own party just to get scraps. And he said, the people don't expect him to be president senator. They expect him to be president. And I thought that was, that's a great admission from somebody who could step back and say, yeah, I'm not really succeeding in this area.  And I think we can look out for some changed tactics in the weeks and months and years ahead because we do have them for years. And we can help by continuing our discourse at Think Tech and in our living rooms and with our friends. But Jay does make a compelling case, I have to say. And when I'm at my pessimistic point and assume that the other forces here are reasonable actors, I sometimes question my, you know, optimism. But nevertheless, I still want to hold out hope that things will turn out for the better. And as we plod along and these revelations are made, we will collectively regain our sanity as a nation. No, yeah, we'll close, okay? Thank you Winston. And thank you, Tim Apichella and Jay Feindahl for being on the panel and contributing to this show. I'm Stephanie Stull Dalton, your host. And we will be back next week, same time, same day. Thank you very much for viewing in Aloha.


This three-year-old child presents with diabetes insipidus. Let's have a look at the imaging, a sagittal non-contrast T1, and a sagittal contrast-enhanced T1-weighted image. Have a gaze for a moment. I'm going to move on to the questions and begin with question number one. All the following produce stalk involvement and contrast enhancement except A, LCH or Langerhans cell histiocytosis B, hematoma the tuber scenario C, sarcoidosis D, lymphoma E, metastasis Question number two. Which of the following stalk lesions is most characteristically associated with age under 10? A, germanoma B, lymphoid hypothesis C, Langerhans cell histiocytosis D, helicitic astrocytoma E, sarcoid Question number three. Which of the following regarding LCH or Langerhans cell histiocytosis is false? A, neurohypophysis is normal B, males greater than females C, often presents with diabetes insipidus D, thickening of the stalk E, formerly known as histiocytosis X Let's go back and look at our three-year-old. The sagittal projection shows involvement of the pituitary gland by a mass with stalk involvement that enhances. In fact, both enhance. There is no subarachnoid space enhancement but there is enhancing tissue in the sino nasal cavity which can be a manifestation of this disease which has low-grade, intermediate-grade and advanced high-grade areas of involvement that might include the viscera when it is a high-grade aggressive form of the disease also previously known as letteracye disease. Let's go back to our questions. Question number one. All the following produce stalk involvement and contrast enhancement except is hamartoma of the tuberous scenario associated with behavioral disturbance and gelastic seizures. Hamartomas have little to no enhancement but the other choices do enhance or cause enhancement of the stalk such as LCH, Langerhansel histiocytosis, sarcoid and abnormality usually seen in adults. Lymphoma, also adults, and metastases especially from breast and lung, also adults which leads us to question number two. Which of the following stalk lesions is most characteristically associated with age under 10? Well, it's not germinoma. That is not a characteristic stalk lesion although it can involve the stalk. Typically, germinomas occur in boys and young men in the pineal region. Lymphoid hypothesis associated with pregnant women. Langerhansel histiocytosis is the correct answer. While astrocytomas of the pilocytic variety could involve the stalk, especially in NF1, this would not be characteristic of either the tumor or the disease NF1 and sarcoid is seen in adults, sometimes young adults, but not under age 10. Question number three. Which of the following regarding LCH is false? The correct answer here is, and it's a tough one, the neurohypophysis or the posterior pituitary gland is normal. That is not the case. In fact, the majority of individuals with LCH or Langerhansel histiocytosis may be missing the posterior pituitary bright spot. But the other choices are true and you might have to come to the answer by eliminating the rest. You may or may not know that males are more often affected than females, but you should absolutely know, even from residency in medical school, that this condition often presents with DI. Thickening of the stalk is a characteristic manifestation. You should know that from your radiology training and everyone knows that this was formerly known as histiocytosis X. So your choices really should boil down to A and B and you just have to know B, males more commonly affected than females, and therefore by process of elimination the correct answer is A. This concludes our discussion of LCH or Langerhansel histiocytosis with discussion of the pituitary stalk. Let's move on, shall we?