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Healthcare
3 days ago
Sunday, February 28, 2010
Pass Health Care Reform
The key to understanding the politics of health care reform is to observe the Republican desperation in trying to stop it. Today, Eric Cantor was predicting a Democratic electoral debacle if reform is "rammed" through. If so, he should be chomping at the bit for the Dems to pass a bill. He should be like Clint Eastwood: "Make my day, pass the bill". But he knows somewhere deep that the American people will support the insurance reforms. Smart Republicans know that if Obama passes health care reform he will be seen as a major president, achieving something many others have tried and failed to do. Republicans fear health care reform for political reasons, and are going to the mat to stop it. It is not just ideology that is driving them. From DeMint and his Waterloo analogy on, the right has understood that serious health care reform, passed by this president, will solidify his mandate and marginalize them even further. Republicans have been brilliant at throwing everything they have to demonize the bill. They have played every angle and so confused their supporters with crap that the cry "keep your government hands off my Medicare" makes perfect sense. Democrats need to pass meaningful reform, and let the political chips fall where they may. My guess is that they will be playing the winning hand by doing the right thing.
Unparsable Path to Freedom - AA.
The below passage from the novel, Infinite Jest, by David Foster Wallace found on page 350-351 (of 1079 (including 388 footnotes)) about the process of recovery, in this case specifically through AA, but maybe it's also about Recovery more generally not just from Substances and maybe not just through AA meetings in Boston.
"The process is a neat reverse of what brought you down and In here: Substances start out being so magically great, so much the interior jigsaw's missing piece, that at the start you just know, deep in your gut, that they'll never let you down; you just know it. But they do. And then this goofy slapdash anarchic system of low-rent gatherings and corny slogans and saccharin grins and hideous coffee is so lame and you just know there's no way it could ever possibly work except for the utterest morons ... and then Gately seems to find out AA turns out to be the very loyal friend he thought he'd had and then lost, when you Came In. And so you Hang In and stay sober and straight, and out of sheer hand-burned-on-hot-stove-terror you heed the improbable-sounding warnings not to stop pounding out the nightly meetings even after the Substance-cravings have left and you feel like you've got a grip on the thing at last and can now go it alone, you still don't try to go it alone, you need the improbable warnings because by now you have no faith in your own sense of what's really improbable and what isn't, since AA seems, improbably enough, to be working, and with no faith in your own senses you're confused, flummoxed, and when people with AA time strongly advise you to keep coming you nod robotically and keep coming, and you sweep floors and scrub out ashtrays and fill stained steel urns with hideous coffee, and you keep getting ritually down on your big knees every morning and night asking for help from a sky that still seems a burnished shield against all who would ask aid of it - how can you pray to a "God" you believe only morons believe in, still? - but the old guys say it doesn't yet matter what you believe or don't believe, Just Do It they say, and like a shock trained organism, without any kind of independent human will you do exactly what you are told, you keep coming and coming, nightly, and now you take pains not to get booted out of the squalid halfway house you'd at first tried so hard to get discharged from, you Hang In and Hang In, meeting after meeting, warm day after cold...; and not only does the urge to get high stay more or less away, but more general life-quality-type-things -- just as improbably promised, at first, when you'd Come In -- things seem to get progressively somehow better, inside, for a while, then worse, then even better, then for a while worse in a way that's still somehow better, realer, you feel weirdly unblinded, which is good, even though a lot of the things you now see about yourself and how you've lived are horrible to have to see -- and by this time the whole thing is so improbable and unparsable that you're so flummoxed you've convinced you're maybe brain-damaged, still, at this point, from all the years of Substances, and you figure you'd better Hang In in this Boston AA where older guys who seem to be less damaged -- or at least less flummoxed by their damage -- will tell you in terse simple imperative clauses exactly what to do, and where and when to do it (though never How or Why); and at this point you've started to have an almost classic sort of Blind Faith in the older guys, a Blind Faith in them born not of zealotry or even belief but just of a chilled conviction that you have no faith whatsoever left in yourself; (foot note 135) and now if the older guys sat Jump you ask them to hold their hand at the desired height, and now they've got you, and you're free.
Footnote 135: A conviction common to all who Hang In with AA, after a while, and abstracted in the slogan "My Best Thinking Got Me Here.""
"The process is a neat reverse of what brought you down and In here: Substances start out being so magically great, so much the interior jigsaw's missing piece, that at the start you just know, deep in your gut, that they'll never let you down; you just know it. But they do. And then this goofy slapdash anarchic system of low-rent gatherings and corny slogans and saccharin grins and hideous coffee is so lame and you just know there's no way it could ever possibly work except for the utterest morons ... and then Gately seems to find out AA turns out to be the very loyal friend he thought he'd had and then lost, when you Came In. And so you Hang In and stay sober and straight, and out of sheer hand-burned-on-hot-stove-terror you heed the improbable-sounding warnings not to stop pounding out the nightly meetings even after the Substance-cravings have left and you feel like you've got a grip on the thing at last and can now go it alone, you still don't try to go it alone, you need the improbable warnings because by now you have no faith in your own sense of what's really improbable and what isn't, since AA seems, improbably enough, to be working, and with no faith in your own senses you're confused, flummoxed, and when people with AA time strongly advise you to keep coming you nod robotically and keep coming, and you sweep floors and scrub out ashtrays and fill stained steel urns with hideous coffee, and you keep getting ritually down on your big knees every morning and night asking for help from a sky that still seems a burnished shield against all who would ask aid of it - how can you pray to a "God" you believe only morons believe in, still? - but the old guys say it doesn't yet matter what you believe or don't believe, Just Do It they say, and like a shock trained organism, without any kind of independent human will you do exactly what you are told, you keep coming and coming, nightly, and now you take pains not to get booted out of the squalid halfway house you'd at first tried so hard to get discharged from, you Hang In and Hang In, meeting after meeting, warm day after cold...; and not only does the urge to get high stay more or less away, but more general life-quality-type-things -- just as improbably promised, at first, when you'd Come In -- things seem to get progressively somehow better, inside, for a while, then worse, then even better, then for a while worse in a way that's still somehow better, realer, you feel weirdly unblinded, which is good, even though a lot of the things you now see about yourself and how you've lived are horrible to have to see -- and by this time the whole thing is so improbable and unparsable that you're so flummoxed you've convinced you're maybe brain-damaged, still, at this point, from all the years of Substances, and you figure you'd better Hang In in this Boston AA where older guys who seem to be less damaged -- or at least less flummoxed by their damage -- will tell you in terse simple imperative clauses exactly what to do, and where and when to do it (though never How or Why); and at this point you've started to have an almost classic sort of Blind Faith in the older guys, a Blind Faith in them born not of zealotry or even belief but just of a chilled conviction that you have no faith whatsoever left in yourself; (foot note 135) and now if the older guys sat Jump you ask them to hold their hand at the desired height, and now they've got you, and you're free.
Footnote 135: A conviction common to all who Hang In with AA, after a while, and abstracted in the slogan "My Best Thinking Got Me Here.""
Sunday, February 21, 2010
Essay of the week - The Things I've Lost...
... in which the idea of loss as a "slow ascent that some might refer to as maturation" is explored by the writer Brian Arundel:
THE THINGS I'VE LOST (EXCERPT)
By Brian Arundel
Fleece hat and gloves: in the backseat of a Boston cab in 2002, before driving back to Maine. Round, purple sunglasses: in an Atlanta pool hall over drinks with Ashby, whose wife was determined to save their marriage by having a baby. A measurable dose of self-skepticism: at about 14, when I realized I was very good at both playing violin and baseball, while not necessarily everyone else was. A school-wide presidential election in sixth grade, after I was drafted to run by Mrs. Sticoiu, the most frightening teacher in the school, while I was out of town. A copy of The Little Prince, in Mrs. Sticoiu’s class the previous year. A floppy disk that contained my paper on ideological subversion in Wendell Berry, the first essay I’d written after returning to graduate school following a four-year respite. A black scarf from Pigalle: somewhere in Maine before moving west.
The chance to kiss Leslie Wertmann, and, later, that redhead in seventh grade with a smile that could buckle steel—Kim, Christine, or Kathleen maybe—and the blonde at the freshman dance because I couldn’t recognize flirtations, even when told that I looked like Bruce Springsteen. My virginity: in 1980, a couple weeks short of 16, in a ritual so brief, awkward and forgettable that I have, in fact, forgotten it. My heart, or so I thought, in 1985, when Susie dumped me; my naivete, three months later, when I learned that she’d slept with at least three other guys I knew while we’d been dating.
Belief that my mother was somehow more than human: in 1972, the first time I saw her fall down after getting drunk. Belief that my father was more than human: a few months beforehand, after learning that he’d had an affair and was being thrown out of the house... A ten-dollar bill on a DC subway in 1985, on my way home to my friend Tommy’s, where I was staying after leaving my father’s house—after he’d moved back in, once my mother remarried and moved south.
The chance, in 1986, to meet Raymond Carver: the only person invited to sit in on an interview, I instead drank all night with friends and overslept... My shit, figuratively, that same summer when Bob Weir sang “Looks Like Rain” just as my acid trip was peaking at a two-night Dead stand in Roanoke, Va. The Buick a friend had given me as a tax write-off in 1996, which I let someone take for a test drive without holding collateral.
The thought that officials were somehow more evolved than those who elect them: in 1972, listening to my father explain the Watergate burglary. Faith in politics—particularly a two-party system relegated to fundraising contests perpetuated by shallow sound bites, mudslinging and outright lies for the Mindless American Voter so that each party can pursue a majority with which to repress the other, with complete disregard for actually trying to improve the lives of citizens: gradually over time, culminating in 2000. Fundamental hope that Americans really would overcome their vacuity, fear and greed to evolve beyond sheep determined to re-elect George W. Bush: 2004.
The ability to drink until late at night and go to work the next day without feeling like I need to be zipped inside a body bag: sometime in my early thirties. General insecurity and inadequacy: during the past seven years, as I’ve tried to allow myself to be loved without guilt or judgment. Self-pity and -importance, at least most days, while striving to look beyond the borders of my own desires in a steady ascent that some might refer to as maturation... A black beret: in a Minneapolis bar, just a few days before relocating to Georgia in 1993. A taste for soy sausage patties: inexplicably, sometime in the past six months, leading up to a Saturday brunch three weeks ago.
-----------
Brian Arundel received an MFA in creative writing from Louisiana State University, and his fiction and nonfiction have appeared in numerous journals, including Mid-American Review, Under the Sun, The Strange Fruit and Bryant Literary Review. He works as an editor in Seattle, where he lives with his wife, Manuela.
(ESSAY FOUND ON THE ON LINE JOURNAL, BREVITY WHICH PUBLISHES ESSAYS OF NOT MORE THAN 750 WORDS)
THE THINGS I'VE LOST (EXCERPT)
By Brian Arundel
Fleece hat and gloves: in the backseat of a Boston cab in 2002, before driving back to Maine. Round, purple sunglasses: in an Atlanta pool hall over drinks with Ashby, whose wife was determined to save their marriage by having a baby. A measurable dose of self-skepticism: at about 14, when I realized I was very good at both playing violin and baseball, while not necessarily everyone else was. A school-wide presidential election in sixth grade, after I was drafted to run by Mrs. Sticoiu, the most frightening teacher in the school, while I was out of town. A copy of The Little Prince, in Mrs. Sticoiu’s class the previous year. A floppy disk that contained my paper on ideological subversion in Wendell Berry, the first essay I’d written after returning to graduate school following a four-year respite. A black scarf from Pigalle: somewhere in Maine before moving west.
The chance to kiss Leslie Wertmann, and, later, that redhead in seventh grade with a smile that could buckle steel—Kim, Christine, or Kathleen maybe—and the blonde at the freshman dance because I couldn’t recognize flirtations, even when told that I looked like Bruce Springsteen. My virginity: in 1980, a couple weeks short of 16, in a ritual so brief, awkward and forgettable that I have, in fact, forgotten it. My heart, or so I thought, in 1985, when Susie dumped me; my naivete, three months later, when I learned that she’d slept with at least three other guys I knew while we’d been dating.
Belief that my mother was somehow more than human: in 1972, the first time I saw her fall down after getting drunk. Belief that my father was more than human: a few months beforehand, after learning that he’d had an affair and was being thrown out of the house... A ten-dollar bill on a DC subway in 1985, on my way home to my friend Tommy’s, where I was staying after leaving my father’s house—after he’d moved back in, once my mother remarried and moved south.
The chance, in 1986, to meet Raymond Carver: the only person invited to sit in on an interview, I instead drank all night with friends and overslept... My shit, figuratively, that same summer when Bob Weir sang “Looks Like Rain” just as my acid trip was peaking at a two-night Dead stand in Roanoke, Va. The Buick a friend had given me as a tax write-off in 1996, which I let someone take for a test drive without holding collateral.
The thought that officials were somehow more evolved than those who elect them: in 1972, listening to my father explain the Watergate burglary. Faith in politics—particularly a two-party system relegated to fundraising contests perpetuated by shallow sound bites, mudslinging and outright lies for the Mindless American Voter so that each party can pursue a majority with which to repress the other, with complete disregard for actually trying to improve the lives of citizens: gradually over time, culminating in 2000. Fundamental hope that Americans really would overcome their vacuity, fear and greed to evolve beyond sheep determined to re-elect George W. Bush: 2004.
The ability to drink until late at night and go to work the next day without feeling like I need to be zipped inside a body bag: sometime in my early thirties. General insecurity and inadequacy: during the past seven years, as I’ve tried to allow myself to be loved without guilt or judgment. Self-pity and -importance, at least most days, while striving to look beyond the borders of my own desires in a steady ascent that some might refer to as maturation... A black beret: in a Minneapolis bar, just a few days before relocating to Georgia in 1993. A taste for soy sausage patties: inexplicably, sometime in the past six months, leading up to a Saturday brunch three weeks ago.
-----------
Brian Arundel received an MFA in creative writing from Louisiana State University, and his fiction and nonfiction have appeared in numerous journals, including Mid-American Review, Under the Sun, The Strange Fruit and Bryant Literary Review. He works as an editor in Seattle, where he lives with his wife, Manuela.
(ESSAY FOUND ON THE ON LINE JOURNAL, BREVITY WHICH PUBLISHES ESSAYS OF NOT MORE THAN 750 WORDS)
Tuesday, February 16, 2010
Saturday, February 13, 2010
What if there really ARE only two kinds of people?
"What if heredity instead of linear, is branching? What if in fact there were ever only like two really distinct individual people walking around back there in history's mist? That all difference descends from this difference? The whole and the partial. The damaged and the intact. The deformed and the paralyzingly beautiful. The insane and the attendant. The hidden and the blindingly open. The performer and the audience. No Zen-type One, always rather Two, one upside down in a convex lens."
-- David Foster Wallace, Infinite Jest, page 220.
Tuesday, February 9, 2010
Things you can learn traveling...
The hotel I stayed in last night has three prices 160, 200 and one room for 220 (local currency) per night. I grabbed the 220 (If my math is right that would be U.S. $9.) Notwithstanding the high end claim that the highest price room ought to fulfill, it was frightening. The mold on the shower ceiling which is quickly growing to more than just the ceiling is almost scientifically interesting. The two towels were the size of kitchen hand towels and when I went down to ask for a third "management" said "only two towels per room". I insisted and got them to give me a third. But the best part came when I turned off my light to realize that there is an internal window above the bed that opens onto the hallway. Of course the hallway light stays on all night and sufficiently lights up the room for the occupant to be able to read in bed (which in a way is good since there is no bedside table lamp). When I mentioned this to management the next morning they did agree with my suggestion that a curtain might be a good idea but said that is one of the details that they have not gotten around to because it is always so busy. (I seriously question the too busy argument but thought better of challenging the assertion). I could go on with other details, like the fact that the main desk does not even have a local phone book (which would have come in handy when looking for certain supplies) or that after I had checked out but had come back to pick up my bags I asked if I could use their bathroom and they said it is only for staff; but you get the idea. Remind me to send a letter to the Lonely Planet folks to ask them what kind of tequila their reviewer was drinking when he wrote that "despite the price the rooms (at said hotel) sparkle". (Maybe that sparkle was the light from the hall way reflecting off the glow-in-the-dark mold growing in the bathroom?)
2. That in way too many places outside the U.S. Kellogg's products are ubiquitous and sort of jarring.
3. That any hotel that costs under $15 per night will be horrible notwithstanding the Lonely Planet's claim (of said hotel) that "despite the price the rooms sparkle".
3. That any hotel that costs under $15 per night will be horrible notwithstanding the Lonely Planet's claim (of said hotel) that "despite the price the rooms sparkle".
4. That staying in a horrible hotel can be really fun.
5. That the NY TImes travel suggestions of things to see and do and places to stay and eat are all pretty obvious and/or lame but somehow about right if that is what you are into.
6. That many young men look a bit like Mark Wahlberg.
Friday, February 5, 2010
Born In A Cave...
02/02,03,04/10 (UNOFFICIAL) Field Report from Guapalayna, Mex. (pop. 420)
Rain, two days now, no sign of letting up, it's a cold rain. At first it cuts the dry dust then it makes a lot of mud. Surrounding the town are the mountains (the largest of which is "Cero Blanco") where the Raramuri live (exact pop. unknown, estimate is 2,000 on Cero Blanco and immediately surrounding mountains; total pop. throughout region est. much higher).
This morning we (Omar, a local health care worker - in whose mother's (Anita) house we are staying - Suzy, RN and MPH candidate who is here for six months to begin a maternal and neo-natal health care training program among the Raramuri, and me) hiked up the mountain (In the rain) to do a health check on a few families.
Footnote No. 1: In order to provide health care delivery to the Raramuri who live in the mountains, Omar has to hike up the mountain to do home visits. The average distance is about a 6 hour hike. He is on the mountain for 20 days per month.
Footnote No. 2: I am reserving bragging rights for the hiking which is pushing my fear of heights and for that matter general fear of injury to the limit - today's hike began at 8:00 AM and finished at 2:20 PM - 1,500 foot ascent - if you fall it's all bad run out (i.e. nothing to stop you if you go over the cliff).
Footnote No. 3: Anita's house could (maybe) be described (paradoxically) as "plush primitive" meaning it is both more plush and at the same time more primitive than one would expect (e.g. the house has toilets but no toilet seats.)
On the hike-in-the-rain we visited three families: One family lives in a one room adobe house, they sleep on the dirt floor on a blanket. The next family we visited live under two tarps with an outdoor fire-pit around which they were sitting (in the rain). The third family live in a cave (they have many children; the youngest a new born - one month old). These are not homeless people - these are their homes and they are not small families. The adobe house was dry and filled with smoke; the tarp home was useless against the rain; the cave was dry. The main apparent characteristics of the general living conditions of the Raramuri on the mountain are (a) inadequate basics (food, shelter, sanitation); what appears to be a very serious and extensive alcohol problem and what is called in urban America "babies having babies".
Footnote No. 4: The Raramuri make their own corn based alcoholic beverage known as "Tesquino". It is basically grain alcohol and it is everywhere.
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