Paul Pelosi, the 82 year-old husband of the Speaker of the House of Representatives, was struck on the head by an intruder in his San Francisco home on Friday, Oct. 27, 2022 at just after 2:00 a.m.  The intruder struck Pelosi with a hammer and fractured his skull, rendering him unconscious. Pelosi was hospitalized with a depressed skull fracture and required emergency surgery.  Press releases issued after the surgery indicated that he was expected to make a full recovery.  Political rivals of Pelosi’s wife found this incident very amusing.

The son of the former President posted a picture of a hammer and underwear and joked that this would be his Halloween costume. He subsequently posted a picture of a hammer suspended in a work belt and labelled it “Open carry.” Presumably this was meant to convey the absurdity of a hammer as a deadly weapon. A gubernatorial candidate elicited protracted laughter from a campaign crowd when she referenced problems with security at the Pelosi home. The new owner of Twitter speculated that the real incident was a falling out between Pelosi and a male prostitute that Pelosi had hired. To these and innumerable additional purveyors of stupid jokes and conspiracy theories, I recommend you leave attempts at humor and slander to the professionals.

What has been described by police on the scene and revealed by the alleged perpetrator is neither amusing nor salacious.  The man apprehended at the scene and allegedly observed by the police to strike Pelosi on the head provided a detailed account of his motivation and plan. If these reports are accurate, the perpetrator’s plans were malicious and his actions, unequivocally criminal. The incident should alert all Americans that the venomous political rhetoric that is accepted as the norm today has tragic consequences.

In my medical opinion Paul Pelosi is not likely to make a full recovery, despite press releases to the contrary.  Indeed, if he survives this assault, it will be with permanent neurologic impairments and substantial risks of seizures (post-traumatic epilepsy), recurrent bleeding over the brain (subdural hematomas), and persistent fluid accumulations in the brain (hydrocephalus). An 82 year old man with an acute, traumatic, depressed skull fracture is likely to die within days, weeks, or months of the injury. The force of a blow sufficient to fracture the skull is necessarily substantial. The skull is a helmet designed to protect the exceedingly delicate brain material, and it will not fracture unless it is subjected to a potentially fatal impact. The energy of a blow sufficient to fracture the skull is transmitted to the brain tissue and routinely causes bleeding in the brain and in the membranes overlying the brain.  A depressed skull fracture also disrupts the protective linings of the brain and renders the victim of the assault susceptible to infections, spinal fluid leaks, and a variety of other potentially lethal complications.

Why are people laughing? Why are morons proposing conspiracies? How did we arrive here?

Social media has played a major role. Twitter and its mimics have elevated gossip into an art form. It has degraded self-examination into exhibitionism. We rarely discuss good or evil: we are beyond that.  All that matters is whether an event, a book, a speech, a historical fact is amusing or disconcerting.  The disconcerting is pushed aside by conspiracy theories. The amusing is trivialized. The assault on an 82 year old man becomes a punchline.

We have entered an age in which the discomforting is banned, and those who insist on mentioning it are dismissed as troublemakers. We must not teach the horrors of slavery because it may upset the descendants of slave-holders.  We dare not recount the social devolution that led to the Holocaust for it may be viewed as a criticism of our current political leanings. If we discuss sexual orientations, our children may be traumatized. If we suggest that environmental destruction must be addressed now, we are obviously radicals.

Many Americans yearn for a long-gone era that never was, when everyone carried a six-shooter or a rifle and no one paid taxes. In this imaginary time, every law-abiding, God-fearing, hard-working citizen enjoyed the simple pleasures of family and community. There were no pandemics, racial strife, religious extremists, or social injustice. The poor were poor because they were lazy, and the rich were wealthy because they were smart. Many of our politicians insist that we can get to this imaginary condition if we put our trust in a strong leader who will fix the economy, suppress the troublemakers, expand our prison populations, eliminate the barriers between church and state, ban the immigration of poor people, and take other steps that require an effective dictatorship.  If these politicians had read “unsanitized” history books, they would have realized that they are espousing solutions already toyed with in the 1930s, solutions that nearly converted the United States into a fascist, totalitarian oligarchy. For those Americans who are unfamiliar with these terms, I refer them to the politics of modern Russia.

Samuel Clemens, aka Mark Twain, responded to people who rejected the need to be familiar with America’s past missteps by joking, “History never repeats itself, but it does often rhyme.” We have a political climate that unfortunately “rhymes” with one our nation navigated nearly a century ago. Back then, America had Charles Lindbergh, Father Charles Coughlin, and Henry Ford praising the accomplishments of fascist dictatorships in Europe and urging America to follow the leads of Italy, Germany, and Spain. America’s problems were blamed on the Jews, the immigrants, and the Communists. Members of Congress and other government officials were financed by foreign governments attempting to control America’s foreign policy.

What history has taught us is that political violence is no joke.  One old man suffering a skull fracture may seem inconsequential in a nation plagued by inflation, homelessness, racism, and school shootings, but it is symptomatic of a disease infecting and affecting our politics. Embracing the modern messages of hate and personality worship is not the cure.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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