After Stephon Clark Shooting, Sacramento Protests Grow More Diverse


One protester was struck and injured by a police car in the fifth night of protests in Sacramento, Calif., following the police shooting of an unarmed black man.

Family Of Stephon Clark Releases Findings Of Independent Autopsy


The family of Stephon Clark, an unarmed black man shot and killed by Sacramento police officers, released the results of an independent autopsy at a news conference.

White Evangelicals Discuss Intersection of Faith And Political Leadership


On Easter Sunday, NPR's Sarah McCammon talks with Johnnie Moore, an evangelical advisor to President Trump, Liberty University professor Karen Swallow Prior, and evangelical activist Shane Claiborne.

Donald J. Trump, like his followers, erroneously believe that the United States will be better off without African Americans.  So that having its version of the Waffen SS, the militarized US police forces nationwide killing unarmed black mean will make America Black-free by mid-century.  Just as Judeophobia was popular in Germany in the 1930s, Negrophobia has increased since 2010 when the Tea Party was folded into the GOP, and took it over in July 2016 resulting in the election of Donald Trump as President of the United States--who will finally fulfill their dreams of an all-White America.  But I caution, be careful of what you wish for.


Kentucky Lawmakers Limit Black Lung Claims Reviews Despite Epidemic


Radiologist Dr. Brandon Crum reviews an X-ray of the lungs of Mackie Branham, who suffers from advanced black lung disease. Dr. Crum is among the Kentucky radiologists now barred from assessing X-rays in state workers' compensation cases filed by coal miners seeking black lung benefits.

Howard Berkes/NPR

A measure signed into law in Kentucky this past week would prevent federally-certified radiologists from judging X-rays in state black lung compensation claims, leaving diagnoses of the disease mostly to physicians who typically work for coal companies.

The new law requires that only pulmonologists — doctors who specialize in the lungs and respiratory system — assess diagnostic black lung X-rays when state black lung claims are filed.

Up until now, radiologists, who work in evaluating all types of X-rays and other diagnostic images, had been allowed to diagnose the disease as well.

Just six pulmonologists in Kentucky have the federal certification to read black lung X-rays and four of them routinely are hired by coal companies or their insurers, according to an NPR review of federal black lung cases.

The two remaining pulmonologists have generally assessed X-rays on behalf of coal miners but one is semi-retired and his federal certification expires June 1.

Among the radiologists excluded by the law is Dr. Brandon Crum, who helped expose the biggest clusters ever documented of complicated black lung, the advanced stage of the fatal disease that strikes coal miners.

"I do believe the coal industry is writing this bill to exclude certain doctors that they don't like," said Phillip Wheeler, an attorney in Pikeville, Ky., who represents coal miners seeking state black lung benefits.

Experts in reading X-rays

The changes are part of sweeping reforms to Kentucky workers' compensation law, known as House Bill 2. Workers' comp provides medical and wage replacement benefits for miners suffering from black lung.

Dr. Crum is the most visible of the excluded radiologists. His clinic in Coal Run Village, Ky., was the focus of a 2016 study by epidemiologists from the National Institute for Occupational Safety and Health (NIOSH). They verified 60 cases of complicated black lung that had been diagnosed in a period of about 20 months in 2015 and 2016.

NIOSH had previously reported 99 cases nationwide over a five-year period.

At the same time, NPR and Ohio Valley ReSource reported nearly 1,000 cases across central Appalachia, prompting NIOSH epidemiologists to declare it the worst epidemic of complicated black lung they'd ever seen. Our ongoing survey of black lung clinics and law offices has the current count of advanced black lung diagnoses at more than 2,200 since 2010.

"Throughout the United States, I know of nowhere where radiologists are taken completely out of the evaluation for potential black lung disease," Dr. Crum said. "That's what we're primarily trained in."

Physicians who read chest X-rays for work-related diseases like black lung are known as "B readers" and are certified by NIOSH for both federal and state compensation claims. B readers do not specifically have to be pulmonologists or radiologists, though they can be both.

Radiologists, on the other hand, focus entirely on reading multiple types of X-rays and other diagnostic images.

The law also bars out-of-state radiologists who are both NIOSH-certified B readers and medically-licensed in Kentucky. That includes Dr. Kathleen DePonte, a radiologist in Norton, Va., who has read more than 100,000 black lung X-rays in the past 30 years.

"It is curious to me that the legislators feel that the pulmonologist is more qualified to interpret a chest radiograph than a radiologist is," Dr. DePonte said.

"This is primarily what radiologists do. It is radiologists who receive all the special training in reading X-rays and other imaging."

Dr. Edward Petsonk, a pulmonologist at West Virginia University with decades of experience and research focused on black lung, points to a 1999 report of pass-fail statistics for physicians taking the NIOSH B reader examination. Two-thirds of the radiologists passed, while the success rate for pulmonologists was 54 percent.

A comparison of a healthy lung and a lung ravaged by severe black lung disease on display at the National Institute for Occupational Safety and Health in Morgantown, W.  Va.Howard Berkes/NPR

Relying on the expertise of industry

Radiologists, pulmonologists and other physicians don't necessarily read X-rays the same way. Those who work for coal companies tend to be conservative in assessing black lung because the coal companies or their insurers pay black lung benefits. Those reading X-rays on behalf of coal miners are often accused of being too liberal in their assessments.

Judges often decide which assessments count most.

This seemed to frustrate Rep. Adam Koenig, a Republican from Erlanger and the primary sponsor of the changes in the law.

During the House floor debate on the measure, Koenig said one B reader finds black lung 41 percent of the time while another's rate is 91 percent.

"Obviously we do not have a standardized process so we are trying to standardize it," Koenig said. "No one here is trying to deny anyone who does that work from getting their black lung claims."

That's precisely what the new law will do, argued Rep. Angie Hatton, a Democrat from Whitesburg.

"When we're finding increased amounts of this illness it seems to me that this is when they need us the most," Hatton said. "Why are we making it tougher for them to prove their illness?"

In an interview with NPR, Koenig said he "relied on the expertise of those who understand the issue — the industry, coal companies and attorneys."

He'd heard "anecdotal stories," he said, about lung cancer being misdiagnosed as black lung.

Early stages of lung cancer and black lung can leave similar masses on lungs, according to West Virginia University's Dr. Petsonk.

But Dr. Petsonk also noted that coal miners exposed to silica dust "are at an increased risk of lung cancer. They do get lung cancer. Silica is a carcinogen."

Severe black lung disease deeply scarred the lung of a 61-year-old West Virginia coal miner, which was removed as part of a lung transplant. Courtesy of NIOSH

A miner reacts

Former coal miner William McCool believes he would have been denied state black lung benefits if the new law had been in place when he applied for compensation.

"It'd be pretty much impossible," McCool said. "I've had lung doctors tell me I don't have black lung."

McCool said it took two years to win his state claim because the doctors working on behalf of a coal company were conservative in assessing his disease. But the 64-year-old from Letcher County ultimately prevailed and has been diagnosed with advanced disease.

The federal black lung compensation program continues to rely on all NIOSH-certified B readers, whether they are pulmonologists, radiologists or other physicians. But seeking federal benefits instead of state workers' compensation is not necessarily an easy option.

Dueling assessments in the federal system mean that some miners have waited more than a decade for decisions on federal benefits. Some die before receiving them. State benefits have traditionally been quicker and more generous to miners.

That seems to be changing, said Evan Smith, an attorney at the Appalachian Citizens' Law Center in Whitesburg.

Smith said the new state law "keeps Kentucky coal miners from using highly qualified and reliable experts to prove their state black lung claims [and] looks like just another step in the race to the bottom to gut worker protections."

Koenig insisted that's not the case.

"All we're doing is making sure that qualified doctors are making these determinations," Koenig said. "And if this process doesn't work, I'll be the first in line to figure out how to do it better."

Ronald P. Formisano in The Tea Party: A Brief History (2012) illuminates that Tea Partiers are less favorably disposed to African Americans and Hispanics than most Americans, according to a 2010 University of Washington survey of whites in five states who approved of the Tea Party.  Similarly the CBS News/Times poll found that 52 percent of Tea Partiers believe that too much has been made of problems facing black people, compared to 28 percent among all adults.

A follow-up University of Washington survey of twelve states yielded similar results.  The researchers regarded as most striking a divide between "mainstream" conservative Republicans and Tea Party Republicans.  Significant differences also appeared between the two groups on the question of whether Barack Obama was a practicing Christian: 27 percent of Tea Partiers believed that the president is was a practicing Muslim [an idea reinforced by the Birther Movement led by Donald Trump], compared to 16 percent of other conservatives, and 26 percent of Tea Partiers did not believe that the president had a valid birth certificate.

That polling took place before April 2011, when the White House, seeking to quiet a new flurry of attention to the birth issue raised by potential candidates for the Republican presidential nomination, released the president's long-form birth certificate from Hawaii.  Fox News Rush Limbaugh, and others [except for Donald Trump] who had stirred the birther pot quickly backed off.  In the space of about two weeks, the percentage of Republicans who believed the president was definite or probably born in another country dropped from 24 to 13 percent.

For a recalcitrant minority [especially Trump], however no document suffices.  Their quarrel is not with the absence of certificate but with the presence of the man himself.  [Suave, Harvard educated, and well liked and respected around the world, and whose sheer force of personality held the country together during the Second Great Depression/Great Recession.]  Savvy Tea Partiers reorganized this as well as the likelihood that birther agitation can damage their image, [as President-elect Trump came to understand].

Trump has displeased the Kochs (Kochtopus) on many levels, especially the tariffs on steel and aluminum, which threaten to bring on trade-war or a redux of Smoot-Hawley, and for his war on immigrants--legal or otherwise.  This along with his firing of Rex Tillerson, who as ex-CEO of Mobil-Exxon is an alumnus of the Kochtopus.  The Kochs have never liked Trump and would not support him in 2016, instead supported Tea Party Congresspersons down-ballot.  Trump with his New York bigotry, superstition, and ignorance, does not understand what has united the United States and what and who have made America Great.  Dan Rather & Elliot Kirschner in What Unites Us: Reflections On Patriotism (2017) issues values that make America great prior to Trumpism.

Rather and Kirschner write that we often hear about how we need to be more tolerant: to make room for people, ideas, and actions with which we may not agree.  This is a prerequisite for a functional democracy.  But tolerance alone is not sufficient; it allows us to accept others without engaging with them, to feel smug and self-satisfied without challenging the boundaries within which too may for us live.  A society worthy of our ideals would be a much more inclusive one, a more integrated one.  It would be a place where we continually strive to create a better whole out our many separate parts.  This is a sentiment that itself stretches back to our founding.  Our first national motto was E pluribus unum, "From many, one."  From many states, we are one nation.  And from many peoples, we should be one society.  Under this framework, building tolerance is a worthy way station to a much grander destination of inclusion.  This is a journey that is in our power as nation to make.  I know this to be true, because as journey from intolerance to tolerance to inclusion is one that many have made, myself included.

Trump has never crossed the bridge toward tolerance because of his narcissism prevents empathy.  He believes the world revolves around him.  He has the personality of an old-time slave master who must be loved by his slaves beyond the slave's own self-interest.  He is a character straight out of Fredrick Douglass' Narratives.


President Trump must study the military history of the United States instead of listening to a war-hawk like John Bolton.  There has never been a war fought by the American from colonial times until the present in which African Americans as soldiers or sailor have not participated.  Soldiers like Colin Powell, who fought in Vietnam, when Trump chose to op-out, rose through the rants from private to general and into the government as, in my opinion, the best Secretary of State since George Kennan.

Trump is a great admirer of the military and its lore, and glorifies in weapons of human-destruction.   This is why he still valorized Lt. General Michael Flynn and the tale Michael Ledeen ghost wrote for Flynn, Field of Fight.  However, Trump does not understand that the United States has not won a war against a worthy opponent, since it won the War in the Pacific in 1945 against the Japanese.  Being Third World ill equipped armies in the Caribbean, Asia, South America and mounting third party wars such as in Africa and Syria, don't count.  The Russians won World War II in Europe.  Trump trash-talks about North Korea to his rural White supporters while insulting the Blacks and Browns who make up the grunts of the military.  How does a leader in the 21st century, the Social Media Age, make war among the internally diverse population, while making war on external populations?  If there is no united front on the inside, the war is lost on the outside.  This is the lesson of Vietnam, but Trump has fired General McMaster, the man who wrote the book on Vietnam, and replaced him with Pompeo, "the Man From Koch," in order to please the Kochs.

African American, although only 12 percent of the population, were 25 percent of the dead and wounded in the Vietnam War.

Rather & Kirschner write that we live in debt to those who have served [in wars] and died, a debt tallied in blood.  And too often our political leaders who commit our young men, and now young women, into war do not take this truth into account with a adequate fullness of measure.  Over the years, I have been to many military commentaries, and I am always overcome with waves of emotion.  This is especially true of the cemeteries that are filled, not with the tombs of long-lived veterans who earned a military burial for their service, but with the graves of the young who perished in battle.  For me the most striking hallowed ground is the Normandy American Cemetery in France.  I defy anyone to walk through its more than 170 acres of green grass and white crosses and stars and not feel deeply moved.  All told, 9,387 Americans servicemen are buried there, with uniform grave markers, regardless of the rank they held in life.  Death strikes us all with the same finality.

Trump Nominates Veterans Affairs Secretary Replacement, Speaks In Ohio04:02

President Trump flies to Ohio Thursday, where he's delivering a speech on infrastructure. It's his first public appearance in an eventful week: On Wednesday, he nominated White House physician Rear Adm. Ronny Jackson to replace Veterans Affairs Secretary David Shulkin.

Here & Now's Lisa Mullins talks with NPR's Tamara Keith (@tamarakeithNPR).

This segment aired on March 29, 2018.

Fired VA Secretary says White House muzzled him

Politics Laurel Wamsley , Scott Neuman · · Mar 29, 2018
Ousted Veterans Affairs Secretary David Shulkin demurred from pointing a finger squarely at President Trump but described a VA riddled with political pressure and conflict.
Ousted Veterans Affairs Secretary David Shulkin demurred from pointing a finger squarely at President Trump but described a VA riddled with political pressure and conflict. Getty Images

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Comment by mary gravitt on April 2, 2018 at 1:07pm

Trump has a choice to be President of All the People or President of none.  There is no White America; Black America; or Brown America.  There is only one America that all Americans are willing to die for.  Patriotism is more than slogans and waving flags and trash talking.  The United States is as close to heven as most of US will ever get.  We will not allow a narcissitic bully to dis-unite US.  My spelling is bad, but my intent is good.

Comment by J.P. Hart on April 4, 2018 at 9:18am

mary gravitt,

God remains as he gave us morning.

At least the (P)?resident has not called our First Amendment fake.

Fifty years and a decade at least already and I am thinking of that day mom and dad had gone for groceries. At the front door bell a man in a white helment uniformed like a motorcycle cop told me he'd a petition to change the name of my street. "...there's a communist agitator, colored guy, named King ... y'll know?"
"How'd I find my way home?" I asked.
Then my older sister who'd goldy-locks hair ran up behind me, sacred, angry, yelling, "NO! WE LIKE MARTIN LANE! Jimmy! - - - is the screendoor locked?"

And to borrow one from Roy Orbison: I close my eyes . . . and I drift away . . .

Comment by mary gravitt on April 4, 2018 at 1:44pm

Karma will catch up with Trump, but Pence is even worse because he believes he was sent by God to rule the US.  Why don't the Right-wing want to seperate themselves from US sinners like they used to?


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