The buzzword that nobody can grok in Washington is LEAN.  LEAN just means having a process that performs only the action for which it was intended.

After being churned through the Washington mindworld, it looks like this diagram on Lean Six Sigma.lean_six_sigma_structure_pyramid-svg There is a mental process of sucking the meaning out of every management process so as to make it ridiculous.  Many corporate pinheads manage in this way.

Corporations once were a bit more like the prototypical IT companies.  They were guided by humans. An individual would get an idea, and would build a way to do it.  Do just that one thing, no more, no less.

There is a mental process, or philosophy or culture in America, that is absolutely poisonous.  It turns the slightest proposal into a monstrous effort, requiring huge amounts of capital, personnel and energy.  Many of our older and larger corporations live in this Weberian hell.

Mr. Trump may be enough of a self-centered asshole to be impatient and intolerant of things not getting done.  If so, the great battle is on – will Washington bring him down, or will he bring Washington down?

Ron Reagan pretended to be going in to DC to scrub out the barn.  But that was only how the script read.  Only the most devoted or psychotic actor mixes their identity with their character.  When the red light goes, off, they go back to being Joe the Actor.  Actually, Ronnie was extremely damn charming, and he fit right in.  Washington hated his predecessor – the dour, un-charming and rigid Jimmy Carter (who was the last President, by the way, to have shut down a bureau.)  Jimmy Carter was SERIOUS – ALL THE TIME.  He was the kind of Navy stick-up-his a** guy that Hyman Rickover loved.  (Admiral Rickover hired him.)  Jimmy Carter did not do nice, or give out attaboys for just trying.  He was a demanding, unforgiving prig.  After he was run out of the White House, things actually got kinda fun for the Washington set.

Jimmy Carter was especially dickish about not using the White House as the Main Party Crib of DC.  He never threw parties, turned the lights down, cut the food and liquor budget (!!!!) and generally acted like it was some sort of Government museum that he lived in.  Ron got the boogie goin’ again, and the high-cut champagne started flowing for the DC set.

If Trump loses, it will be not so much that he is beaten – rather, that he is co-opted.  The forgotten people in Flyover Land fade from the memory once the business of government gets down, and within the Bubble, there is a whole different sense of meaning.

For instance, a Deputy Secretary wields immense social power, can speak to cabinet officials, get a table at the best restaurants, has a Government car and a parking space – and perhaps a driver.  The Department of Homeland Security has its own electronic FONT, created by an electronic type foundry and copyrighted SOLELY to DHS.

Power inevitably brings nonsense.  Ron Reagan is idolized, but what he really discovered was if you lift any limits on raising the deficit, the economy turns all robust and fancy.  It’s been continued for the last thirty years – and sucked the US down the drain.  But it worked for a while.

Ron did not overthrow the bureaucracy; he entrenched it.  What will President Trump do?

DOING requires a subjective sense of quality.  If there is no individual capacity to tell sh*t from Shinola, people just buy what’s ladled onto their plate in the cafeteria line.  Corporate Medicine means giving people stuff, and TELLING them it’s high-quality medicine.

Here, I swear, is a true conversation in my clinic.  I offered a sixtysomething diabetic patient immunization against Pneumococcus.  I mentioned that it’s a nasty infection that kills people, especially diabetics.  He demurred. He said “I’ve never heard of it, so I don’t think it’s important.  I want that Terry Bradshaw vaccination!”  meaning, of course, the shingles vaccination.

I regret that I never offered Terry Bradshaw coaching advice during his career.  He is the voice of authority regarding medical vaccination practice, though.  I’m going to hire some bobbling head to recommend SAYLENE 0.9% as a life-saving shot.  If you’re SALINE DEFICIENT, you will die.  No questions.