Curing the Ill – Should We?

There will always be the sick among us and it is a basic premise of ethical and religious systems that it is our responsibility to care for them and, where possible, to cure them. Even ignoring morality and focusing on self-interest, most people would be willing to expend the resources necessary to care for others in exchange for the guarantee that they will, themselves, receive such care when they are sick. It's likely, however, that they would express their support of the concept of caring for the ill in moral and ideological terms rather than self-interest.

While there have been, from time to time, some who would leave their sick and disabled on the side of the mountain to die, this has been viewed, by and large, as an aberration, and most civilized societies make health care a high priority. We see provision for the needs of those less able than ourselves as an obligation which is not lightly disregarded. In this country there is a sophisticated mix of medical and social programs which are addressed at these needs. In the medical field they involve private insurance, Medicare and Medicaid, “Obamacare,” as well as some institutions supported by governmental funds to provide service for those not otherwise covered. While it would not be accurate to suggest that the level of care is equal for all of our citizens and non-citizen residents (including undocumented aliens), the means exist for provision of some service for everyone.

That condition, however, does not always obtain. Situations can arise in which providers are forced to "ration" care by one system or another in order to function in a satisfactory manner. The paradigm of this situation is the triaging which takes place at the time of a disaster or a military engagement, when the number of individuals requiring attention is greater than can be handled by the system. At such a time a sorting of patients is made according to preset guidelines to determine who is in greatest need of attention or who is most likely to benefit from it. Those who do not meet these criteria would only be seen when, and if, resources later become available.

And there isn't unanimous opinion that tax money is the appropriate source for the costs of medical care – especially terminal care. Notwithstanding the moral strictures, they feel that people should pay for their own medical care, either directly or by the use of private insurance. Some acknowledge the inability of the poor to afford such care, yet many would deny them public funds to get it. They view such as charity, and maintain that charity is the responsibility of the individual, not the government.

It has, however, become a “given” that health care is a right. It's not explicitly in the Constitution, but our nation – indeed, many nations – consider it a state responsibility to ensure the health of all those living within their boundaries, whether or not they are citizens. It is decreed by medical ethicists and accepted by those on both the left and right (though with different degrees of enthusiasm) that some form of guaranteed care be available to all. The Republican Party assures us all that they'll repeal Obamacare and replace it with a “better” version of health insurance. Even they agree that some plan is necessary. (I don't know if, by the time this is published, changes will have been made.)

But is it? Would the knowledge that each of us is responsible for his own health care, and the government won't pick up the tab for those on welfare, help to encourage some of those who aren't doing so already to seek employment? Similarly they reject care for those here illegally. And those who are interested in the most efficacious use of health care dollars and other resources may consider it reasonable to deny care to those either deemed “unfit” or unsalvageable.” Another group that might approve are those who (secretly) might want to “pull the plug” on suffering family members, but would feel guilty if forced to make the decision themselves. I personally don't subscribe to all of those ideas, but we're burying our heads if we don't recognize that they exist.

I won't be subtle or deceptive. I want to be sure that, when the time comes, I receive the best available care. I've been paying for it and I want it. Ideally it should come from my own funds and insurance, or be provided by charity. However I don't trust my fellow man to care about anyone but himself, so, if the “crunch” should ever come, I'd rather rely on the government. Not that I trust the government and politicians. I don't. But I know that the prime goal of politicians is to be elected, so they'll do everything they can to guarantee the safety and health of their constituents. They care about themselves, so they care about me and every other voter. They're sure to vote for health care – especially since the voters will wind up paying for it.

It's not a matter of curing the ill. But they want to be elected and I want to be cured. Whether my life is worth anything to others – whether the use of medical resources on me would be justified in their eyes – I agree that it is society's obligation to care for the ill. Especially me.

March 5, 2017

Mixed Grill N+5 +

Mixed Grill N+5 +

Even more of the wurst of Sir Oracle.

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Tie one on – New Asian cocktail.

Anachronism –Ohioan.

In the twinkling of an I –Yours truly is really fast.

Snarky – Sneaky, with shark-like wit.

Skycap – Gin over the clouds.

Opioid – Garfield's favorite pizza topping.

Five easy pieces – KFC. Actually five greasy pieces.

Tit for tat –Fetish exposed by psychological test.

Niagara Falls –Frosted (or washed) wigs

Shorts – Sons of britches

Trump – Overvalued clubs defeat POTUS's ace of diamonds

Social media – Pleasant talkative ladies who pass along the fake new you want to hear

O tempora o mores –Watered down paint

The more the marryer – Reverend Moon

Starbucks – Cost of a cup of coffee.

These are the mimes that try men's soles – Cobbler's Indians.

Reign, rain go away – Après moi le déluge.

Pig Latin – Ainkoi.

Quack –Walk like a doc.

Good night. Sleep tight – Drank too much vodka

El Cid – Bright new Spanish light bulb.

Panty hose – Cure for hot pants.

Budget Gap – No concessions in this passage

Old navy – Russia

Soulmate –He's a heel but I love him.

Sumer is icumen in – Elam better watch out.

Mother of Pearl – Let's get down to basics. Who's the father?

William Tell Overture – Better an overture than an underture.

Especially with an apple.

Homeopath – Hermit.

Phenobarbecue – I love the taste, but I seem to get sleepy after most meals.

Till death do us part – After that go to St. Pete's Hair Salon.

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Worst? You be the jury – and we know where you live.

Que Será, Será

Bottom line. There's nothing new here. However I feel like discussing the subject and this is as good a place as any. Actually it's better than some. It's especially better than places where people can speak back and express views with which I might disagree.

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Would you rather lose your sight or your hearing? (“No” is a cute answer, but not useful for this purpose.) It's a question that, I suspect, has crossed the minds of many people. And I'm one of them. I'm a radiologist, and I've always been visually oriented in everything, so I guess I'd rather give up my hearing than my sight, but I love Bach and I'd hate to lose the chance to hear good music.

Of course my preference is irrelevant. I may lose neither, one, or both. It's not up to me. In the words of Josephine McKenna (Doris Day and her “son” – Christopher Olsen as Hank McKenna – in “The Man Who Knew Too Much”), Que será, será – “What will be, will be.”

The whole issue came up when I was thinking about my treatment for a tumor I have. The side effects of one of the drugs I take include a neuropathy, and I have tingling in my hands, feet, and ears as well as a funny feeling in the back of my throat and some compromise of the front of my tongue and my palate. Things don't taste as good as they used to. That's what got me thinking. I suspect I'd trade my symptoms and tolerate a little more tingling for improvement in my taste. But it's not up to me.

For most of us, the best approach to life is to play the hand we're dealt. It's not a new idea and it's been paraphrased on many occasions. “If life deals you lemons ...” Another allusion from the world of cards. Which particular game is not the issue; any one suggests that what happens is a matter of chance. Rather than “chance,” some would use “fate,” “predestination,” “G-d.” “kismet,” or some other terminology, but it all boils down to the same thing – we have no control over what will happen. We might as well “lean back and enjoy it.” Que será, será – “What will be, will be.”

That's fine for most of us, but humanity has progressed because there are people who haven't been satisfied with business as usual, and the acceptance of things as they are. Rather than play the had they're dealt, they try to improve it. Generally this refers to scientists looking for answers to questions that most of us ignore, but it would equally well apply to explorers, authors, academics of many varieties, and others for whom some kind of advancement is the goal. The status quo may be comfortable, but it's not good enough for them. So they draw to an inside straight, and every now and then they make it. No, now and then we make it, for their accomplishments improve all our lot – or at least they'll improve the lots of those who will follow us.

Not all their efforts pay off, but every now and then they win the pot. Every now and then they learn or accomplish something that we never dreamed of. In fact we never even thought about it. It takes imagination or, as rocket scientists say, thinking “outside the envelope.”

And that's where most of us fail. No, “fail” is too strong a word. There are too many things we can't control, so playing the hand we're dealt is fine for getting us through our lives, and we're primarily interested in doing just that. And no more. Perhaps we'll try to improve our hand marginally – who wouldn't – however the changes we seek to make our lives, and those of our families, better, deal with what we know, and are limited by our lack of imagination.

But our imaginative brothers and sisters have upped the ante. They get what they play for. And that's our challenge. To think big; to look beyond the hand we're dealt to the hand we want. To devise a way to get there. It's fine to make the best of circumstances, but it's better to improve on them. Most of the time we won't accomplish what we want. They don't. But they keep trying, and so should we.

What will be, will be. Only if we're willing to accept it.

February 26, 2017

Mixed Grill XVIII

The suffering never ends.

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Fender bender – Eddie Van Halen

Mourning becomes Alexa – Do you hear me now? Are you plugged in?

Satan doll – Rejected chant by Ellington, Strayhorn, Mercer, and Bondye

Funeral costs – The best things in death are very expensive

Buxteyehude – Danish Jewish composer of the 17^th Century

Money hop – Bottom line dance

Rembrandt van Rhine – Large-nosed Dutch artist

Bill book and candle – There's no such thing as a free candle

Rodeo drivel – Beverly Hills small talk

The last time I saw Paris – He was involved in some kind of dispute with Philoctetes

Finiculi, finicula – Can you top this?

The meaning of life – Philosophy yields to Python

Sailing over the bounding Maine – Now I remember

Redeemer – Religious issue or can it be solved at an S & H site?

Hip hop – Hopeless

Causus belli – Lite beer

Little scirocco how do you do? – No good. No good. No good. No good. ...

Strawberry fields forever – Christian ministers don't mostly deal with fly balls but there are some on the ground we won't hold that against him, but forever … ?

No, we don't have any bananas – Nor do we stereotype

Ages of rock – From the 1950s on

Words are the small change of thought (Jules Renard) – I have no idea what this means but it seemed very erudite when I saw it.

Joy Børge (Rosenbaum) – Victor not victorious in Culture Club. There's no piano

The Velvet Frog – Kemit

Trump – Current possessor of the bully pulpit

He said, she said – Marriage counseling for fun and profit

Meltdown – Severe problem in Pennsylvania. No, not Three-Mile Island, Hershey.

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More to come.

Say It Again

If I've said it once, I've said it a thousand times. And I suspect that my wife secretly rues the fact that she's heard it a thousand times. Maybe more.

Speaking of facts, that's a fact of life. It's a common – perhaps universal – “malady” that increases with age. And it's not a disease, but a reflection of the fact that humans, like other forms of life, are predictable.

But first, let me take a quick digression into “habit.” We're all, as the cliché says, its “creatures.” There are many acts we perform without thought. Whether it's nail-biting, smoking, grabbing the banister when climbing or descending stairs, or sitting in a particular chair in the living room; whether it's self-imposed or taught by others – like parents, for example – habits are situational responses which aren't accompanied by conscious thought or decision making. You just do them at the appropriate time.

In this instance I'm referring to is the way we verbally interact. And in many situations we do so based on a kind of habit – an automatic response to some verbal (or other) stimulus. Social occasions follow certain highly superficial rituals. They begin with an introduction and early “ice breakers” to get the conversation started. You know they're coming, and the responses – at least to the initial inquiries – are factual and forgettable. For the most part they're thought-out, although they often don't require much thought. They're not particularly annoying to those around you, because they tend to be brief and factual. “I come from Sheboygan.” “It's in Wisconsin, on Lake Michigan.” “Chicago? About 140 miles south.”

So far so good. But then you hear yourself singing Mention my name in Sheboygan It's the greatest little town in the world. (For those who don't know, it's a song from 1947.) It's not been asked of you, and you didn't think about it, but it always seems to come out when you're discussing the place in which you grew up. Perhaps it started as an affectation, a “clever” way of hiding your anxiety. But now it's automatic – virtually Pavlovian. The circumstances of the discussion of your home town are irrelevant. Somehow or other you begin singing. And your spouse, standing next to you, has heard it so many times before.

Or someone mentions employment in a widget factory, and the work there. “That reminds me of the time ...” and a long, boring story follows. It may even be true. But the words never vary. You've told that story too many times already and you/re not going to change it now. It's easier than actually participating in the conversation, so when you realize that you're in the midst of “an oft-told tale” you simply continue. If it's a shared memory some corrections may follow, but they won't be included the next time you reprise it. You'll do it the same way.

Perhaps you see or hear something that brings back a memory and you launch into the same thing you've said so many times when facing the same stimulus. It may not be a conscious act, but the unconscious association is likely to initiate a fixed and predictable response. Much to the dismay of anyone around.

Such personal responses and stories inhabit all of us. Each of us has a stock of stock stories or comments that anyone who has heard them several times can recite for us. Even the trigger for the telling is apparent to that “anyone,” who knows, before you start, what your reply will be. (“Not again. Can't you say something different? I'm gonna' get a drink. Maybe I'll get drunk.”)

There's another variety of “normal” repetitive speech, one usually saved for your children. “Clean up your room!” “Don't pick your nose.” Turn off the TV and no texting either. It's bedtime.” “If I've told you once I've told you a thousand times (and that's not always hyperbole).” But it's different. It's more a command than a response, and so it will probably be ignored by your spouse. (Often by your child as well.)

Last week I discussed repetitive speech which was pathological and often condemned (rightly or wrongly) by society as requiring therapy. Annoying as the repetition of smart remarks and anecdotes may be, it's normal. And as we get older we'll wind up hearing them more and more often. So if you want to get older, and want your spouse to do so as well, turn down your hearing aid or just don't pay attention. (But if don't turn it down and you pay attention I hope you tell and hear such stories for many years to come.)

But the best strategy is to avoid cocktail parties and any contact with people.

That's my approach.






February 20, 2017

Society And The Rest Of Us

I started this essay between six and seven years ago, but I never finished it. The time has come, even though the slant now may be different from what I originally intended. I've edited it to conform to my current philosophy.

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Someone repeats the same sentence several times. He is getting older and his children are tired of hearing him. What's to be done? Perhaps the affliction is pathological and requires a remedy.

A man goes around the room straightening every picture – some only a millimeter or two off his mark. He has obsessive-compulsive disorder. It clearly abnormal. Everyone agrees he needs to be treated.

A child looks out the window every time a teacher starts speaking. It must be attention-deficit disorder. Such a problem is clearly detrimental, and the proper medicines and counseling must be instituted to alter this behavior.

A woman talks incessantly, not leaving an opening for anyone else to talk, and apparently unaware of what anyone else has to say. Though irritating, it's normal and requires no professional intervention, although someone may say something.

No, this isn't a misogynistic or any other type of rant. My target, rather, is the way we set standards of what is normal and what isn't. I'm a little put out by the way we decide what falls outside the range of the acceptable, in speech and in behavior, and what we should – or is it what we can – tolerate. I'm concerned because I view our standards as being based on politics or some kind of imagined correctness and not on any objective criteria.

Let me give an example: A “pin-up” calendar in a men's locker room would be viewed as provocative and unacceptable, while lush wallpaper in a ladies' lounge, wallpaper that includes images of virile Greek gods, would not merit mention. How this attitude entered our society isn't clear, but there are many men, in addition to women, who agree with the view. Somewhere along the line society has conditioned us as to what's acceptable and what's not.

So our comfort is what counts, and the man with OCD needs treatment because it's bothersome to others – not necessarily to himself. And it's easier to diagnose a child as having ADD, and possibly put him on drugs, than to look for any other reason for his behavior. Perhaps the elderly individual who cannot remember what he said would benefit from therapy, but the problem is most striking to the listener, not to the one repeating himself – though he may be judged by the courts to be incapable of making decisions and forced to undergo therapy that others choose.

Most of the problems for which we have devised solutions derive from what society has taught us. And society's dictates vary from time to time. To the point that we no longer accept the Constitution of our country as it was written. Extensive interpretation is necessary. Free speech is nice unless it offends someone. And if it bothers someone we've designated as a member of an “oppressed” group it may constitute hate speech. “This is your punishment for deviating from the Bible. I pray that you are forgiven.” Though the speaker may sincerely wish for the benefit of the person he is addressing, said to a homosexual it constitutes deplorable hate speech. The concepts of free speech and freedom of religion, and religious views, are less important than the feelings of the listener. (Often it is a non-involved party whom it offends more than the one to whom it was directed. No one will find it offensive if somebody accuses you of being a gun supporter, though it may be accompanied) by more hate than the biblical remark.)

And words that were perfectly acceptable in the past are no longer to be used. Euphemisms must be substituted. A child who was once said to be retarded is now “special.” But if everyone knows what the euphemisms mean, they're no different from the words they replace. Except to the “sensitive” among us. Meanwhile other words, anatomical designations or expletives once forbidden in public discourse, are used freely and without disapproval.

There's no solution to the problem. Some people will insist that only the way they speak is acceptable, and those who disagree should be silenced. But, as Benjamin Franklin said, “Whoever would overthrow the liberty of a nation must begin by subduing the freeness of speech.” Or, in the words of George Orwell, “If liberty means anything at all, it means the right to tell people what they do not want to hear.” The freedom to express ourselves any way we want is paramount (although those who see their nation's flag burned, or who see Nazis protected by the government while marching through the streets may want their representatives to revisit the issue). And our behavior as well. Forcing us to obey the rules of the intolerant is contrary to any ideas of freedom. Making us fit into societal norms is tyranny.

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I said then, and I still believe that what we say and what we do (as long as we're not physically harming others) is our own business and should be protected by society, not controlled by it. Limitations on free speech are only rarely justified, and such action should be taken only after careful consideration of the consequences. As for forced, or pressured, therapy, we went through the tragedy of eugenics early in the last century, and we should know by now that no one should be treated for any real or imagined disease unless he chooses to be.

The United States was founded with the intent of offering freedom. Destroying that freedom in order to soothe the majority must not be tolerated.






February 9, 2017