What to do while you are dying

It’s a little more complicated than that title suggests. Not a great deal, but a little. [1]

It will simplify things a great deal to make the distinction between “it,” the body that serves us well or ill by turns, and “I,” meaning the sense of myself I have. This is a crude distinction, of course, but I am relying on your own knowledge of your life in which on some days “you” are just fine, while “it” is acting up; then there are other days when “it” is entirely free of any symptoms at all and “you” are miserable.

I live in a Continuing Care Retirement Center (CCRC) and when I moved here a year and a half ago, I told friends I trusted that I was coming here to die. It was only the phrasing, not the idea, that was open to misunderstanding. That phrasing could be understood “coming here for the purpose of dying” as if it were a hospice. The friends to whom I trusted that phrasing knew I didn’t mean that. What I meant is that I wouldn’t have to move—or be moved—to any other place when either “it” or “I” neared the end. [2] It was a very comforting thought to me and still is.

Death as a commonplace

So…where I live, a lot of people die. That means that I get to see all the paraphernalia that goes with all those deaths. A lot of ambulances pull up to this address. There are lots of notices on the front desk that someone died yesterday. There are lots of memorial services, some of them here in the Penthouse. [3] The families of the recently deceased residents show up, the grandchildren and great-grandchildren having no clear idea what is going on.

death 1The same thing happens on the social side. A resident I have gotten to know in my brief time here shows up in the little coffee nook where world problems are hashed out every afternoon [4] and today, he has a cane. Tomorrow—or some tomorrow or other—it is a walker. Then a wheelchair; then a wheelchair with oxygen. Then he doesn’t come all the time; then he doesn’t come at all. These are perfectly ordinary signs that “it” is failing.

And that brings us to the meaning of “you” in the title. Nothing I have said bears at all on the “you” of that resident and friend who kept coming to Drasko’s Seminar. He may very well continue to be as cantankerous or irenic or liberal or conservative or as disciplined or dilatory as ever. It’s harder to be cantankerous when you’re on oxygen, but aside from that, everything is the same.

This person is the best answer I know to the question of what to do while you are dying. Living. That is the best thing to do while you are dying. You keep going to the places you can go; you keep hanging out with the people you used to hang out with. You keep on pointing out to them that they missed the whole point of movie by failing to appreciate the fundamental contradiction in the character of the eldest son. You keep hoping the Steelers can figure out a way to beat Jacksonville.

It should be pretty easy to nod your head affirmatively as you read through that paragraph. Maybe not the part about the Steelers. But because of where I live, I see it every day. There is nothing subjunctive about it for me, as if I were trying to imagine what it would feel like to be running with the bulls in Pamplona. It is subjective for me; it is experiential. I get to see these amazing people living fully—to the full extent of their capacity—even as “it” declines. It is a powerful experience for anyone with the eyes to see it and I count myself as one of the fortunate ones in that I have learned to see it for myself.

I had no idea when I moved here that you could continue to express all of who you are, subject only to the limitations of what “it” will allow. It sets a standard I can aspire to.

death 3The other side of that dichotomy is harder. The other side is when “you” begin to suffer losses so that you are “no longer yourself.” That’s the way they say it, but, of course, you are “yourself;” you are precisely the self you now are. You are not the self you used to be, of course, which is what everyone who uses that phrase is understood to mean. [5]

I have declined a good deal, myself, in what I would call “peripheral” functions. I don’t remember names and faces as well as I once did; I forget authors I have cited effortlessly for decades, and so on. These are “peripheral” not only because they allow more important functions to continue unimpeded, but also because quite a few of the people I live with are experiencing the same decrements of functioning. These deficits are something we share and that makes it easier to treat them as a standing joke at no one’s expense.

There are more fundamental losses, however. I don’t know what those are like. You can’t tell by looking and you can’t find out by asking. I am hoping that I could feel that I was doing my best under difficult circumstances, but I don’t know if dementia really allows you to feel that way. When the “you,” not the “it” declines, your standards for understanding what is going on decline as well.

Maybe it’s like this. When my father was well into his Alzheimer’s phase, he was visited by my brother Mark, a physician, and his wife, Carol. When they came into the room, Carol went over to him and kissed him on the cheek and said, “Hi, Dad.” Mark and Dad made conversation of some sort. I am sure it was generous and situationally appropriate because that is the way Mark would do it. When the visit was over, Mother asked Dad if he knew who that was who had visited. The question presumed the answer, “My son, Mark.”  The answer was, “His wife kissed me.”

I think the gift Mark gave was every bit as good as the gift Carol gave. For many years, Dad had been appreciative of the gifts Mark had to give, in part because they were so much like Dad’s gifts. But he wasn’t able to appreciate that kind of gift any more; he was still able to “understand” the kiss of an attractive and warm-hearted woman. Maybe that’s what it’s like.

Death as a brief interruption in the community’s life

The other thing I have noticed here, being a participant in a community that sees so many deaths, is how brief the period of public reflection is. I take great comfort in that.

There is always grieving when there is death, but grieving isn’t always the most death 4prominent response. When a person has lived a long and successful life, it is perfectly appropriate to celebrate that life as a whole and at the same time to mourn the loss the the person.

Then there is the question of the setting in which those emotions are noted. I, myself, have lost a wife I adored and I now believe that you never really get done grieving. It just comes and goes and you call it for what it is when it comes and you say a gentle goodbye when it goes. That personal level is one where grief doesn’t “go away;” it just comes and goes.

But there are smaller communities of friends—people you always went to the movies with or played bridge with or served on committees with—some of which should really have come with combat pay. The occasional return of the conversation to the member of our group who is no longer with us may continue for quite a while. But if the other members of the group keep on living—actively investing themselves in their lives—the death of that one member begins to recede. Other complicated events take up part of the space it once took. Also, the group that was once the “community that knew him” is itself reduced in number over time.

The public grieving is remarkably short. There is an equanimity that characterizes community life here. The death of one of us causes a ripple on the surface of the pond which we all notice. Some are able to comment more than others, but I have never seen the topic linger at this level—at the most general level—for more than a day or so.

We appear, as a community, to have made our peace with the loss of a friend. The death is most often not a surprise. It is on some occasions a relief for everyone—the person, his family, and all of us who knew them. If the effect of the death of a member were given in points of a Richter scale, I would say most deaths here are well below 3.0. That is what I hope for my own death. I would want to say, after the formal notice has been paid, “Go on with what you were doing;” meaning, “I know you were all busy living and I know that is what you should be doing. Please continue.”

There are people who have known me well and loved me dearly. I think I would hope for them the kind of grieving I have had for Marilyn. It comes and brings with it most often some really sweet memory, and then it goes and you smile with the memory. And then you go on living.

[1] Throughout, I will be distinguishing between things that are complicated, i.e. hard to understand, and things that are grievous. I am going to be thinking in this essay about how to understand things, not about what it might cost to endure them..
[2] “Nearing the end” gets more complicated when some parts of you are mechanical. I could hardly stop laughing when they told me last year that the battery in my pacemaker was guaranteed for ten years. It was hard to avoid the sense that I had just been given a warranty.
[3] I would like mine to be at our church because I understand my own life in fundamentally Christian terms, but if the setting were all that mattered to me, the Penthouse is a lovely place for a memorial service.
[4] For the sake of convenience, I will all it Drasko’s Seminar. That is what everyone else calls it, in honor of Drasko Jovanovic who, just by his presence, convenes the daily mix of attendees, of whom I am sometimes one.
[5] Just when “once” was is a little more complicated. It might mean “what I was like at the height of my powers.” More often, it seems to mean, “what I have been like in recent years.” But you still see once-beautiful women yearning for the effect on men they used to have and the same thing goes for once-authoritative men. That seems unnecessary and sad to me.

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Posted in Getting Old, Living My Life, Love and Marriage | Tagged , , , , , | 5 Comments

Lent and inconvenience

If only we had more time, right? If only. If we had more time, we would…um…we would… OK, what would we do with more time?

A professor of mine at Wheaton College [1] once told a story about himself that madeTime 2 him look bad. I’ve been grateful to him ever since for being willing to do that. His notion of living the Christian life was that around him in the world were people he was called to serve. He didn’t have a narrow or a specifically religious notion of what “service” was. He did have a sense of how those people were to be identified to him, however. He counted on the Holy Spirit to move him toward those particular people he was being called to serve. Not only is that resolutely orthodox; it was not even unusual at Wheaton when I was there.

Quite a few times, he said, he had to defer acting on that inner urging because he didn’t have the time to comply with it. So he tried an experiment. He would set aside fifteen minutes each day specifically to do the things God was asking him to do that he would otherwise have said he didn’t have the time to do. God, I’m giving you fifteen minutes for free! WooHoo!

Then he told us that in several months of trying this experiment, he never—ever—used up the fifteen minutes. He stopped using the excuse of not having enough time to do the things God was pointing out for him to do and discovered to his amazement that doing those things took almost no time at all. [2]

I want to get to Lent in a little while. Christians are urged to “give up something” for Lent. Sometimes that is treated as if giving up something for awhile was good all by itself, but at other times, the idea is that you will have more time for a special spiritual emphasis or practice if you give something up. I don’t think the odds are good on either of them and I’ll tell you why.

Let’s start from another place and see if we can get back to that question. Tim Wu has a column in the New York Times in which he argues that “convenience” is a double-edged sword. Let’s begin with “housework.”

However mundane it seems now, convenience, the great liberator of humankind from labor, was a utopian ideal. By saving time and eliminating drudgery, it would create the possibility of leisure. And with leisure would come the possibility of devoting time to learning, hobbies or whatever else might really matter to us. Convenience would make available to the general population the kind of freedom for self-cultivation once available only to the aristocracy.

Let’s take the time, now, to imagine a family of a husband and a wife and two kids where the “work at home”—that includes all kinds of housework and all the various forms of childcare—engages husband and wife equally. This would become another kind of essay in another kind of family.

time 3Now let’s go back and look at the sequence. “Eliminating drudgery” creates the possibility of leisure, which in turn creates the possibility of self-cultivation in a way that was once possible only for aristocrats. With these new household “conveniences,” everyone can be “like an aristocrat.” [3]

And how did that work out?

Betty Friedan looked at what household technologies had done for women and concluded that they had just created more demands. “Even with all the new labor-saving appliances,” she wrote, “the modern American housewife probably spends more time on housework than her grandmother.”

And this isn’t only historically true—as if it applied only to dishwashers and vacuum cleaners—but it is persuasive as a principle. It might be nice to think it is only the drudgery of doing the dishes that keeps me from mastering the Greek epics, but when the drudgery goes away, what takes it’s place? Some new drudgery, like protecting all your internet passwords from being compromised or a new higher set of standards—your glassware is clean, but does it really “sparkle?”— that requires all the old work but at a higher level?

The only thing that is going to really work toward your mastery of the
Greek epics is a really strong desire to learn Greek and master the best stories written in that language. That’s what’s stopping you. It isn’t the housework and the childcare—at least not in the family I created for this example. What is missing is the strong desire for the project and the willingness to do whatever it is that needs to be done to achieve it.

Tim Wu points out, correctly in my view, that when “convenience” gives us more time, we tend to spend that time on more conveniences.

Convenience has the ability to make other options unthinkable. …After you have experienced streaming television, waiting to see a show at a prescribed hour seems silly, even a little undignified.

I know a lot of people who “binge watch” TV because they can. It isn’t that the show isn’t good enough to wait for. It isn’t that you don’t feel any need to discuss it. It is that you subordinate other desires—desires that would make much more sense if they took more time—to “the most convenient option.”

Of course, that gets political too.

When you can skip the line and buy concert tickets on your phone, waiting in line to vote in an election is irritating. This is especially true for those who have never had to wait in lines (which may help explain the low rate at which young people vote).

Time 4If it were formulated as a rule, and there is no reason to think anyone would really do that, the rule would be this: if it takes either work or waiting, I will choose something else. Political reform? Takes too long. Providing infrastructure? Way too long. Slowing the rate of climate change? [4] Not every worth thinking about. Easier just to deny the reality of it.

It takes too long. End of story. Let’s do something “more convenient.” Playing Wu’s argument out in the political arena—that’s not what he does with it—would mean that choosing systemic projects, no matter how important they are, would fail to occur and we would choose instead projects that require an election cycle or less. Voting for someone who is angry on the grounds that you too are angry, for example, is immediately gratifying.

So the time I clear for myself by “labor-saving conveniences” is not at all likely to be used for hard work. It will not be used, following the logic of Wu’s argument, for time consuming or onerous tasks or for the pursuit of goals that will not mature quickly. Conveniences don’t lead us in that direction.

Here’s a possibility. How about a driving desire to prioritize our lives so that the most important things receive our commitments first? That sounds pretty good. And now we have arrived back at Lent.

For Lent, that would mean some new study or reflection or emotional openness or behavior that evokes this special period—the last painful phase of Jesus’s ministry. [5] I am going to be reading Raymond Brown’s study, The Death of the Messiah, again. That has been my practice for the last ten years or so. Every year, as I read, I remind myself of things I already know and learn some new things. And then I learn to wonder about things I never wondered about before.

This year I am going to be working on understanding the use of genre (my word for it) by the evangelists. It’s hard to say exactly what that means, but it isn’t hard to illustrate. Several years ago, I proposed this “quotation” for the readers of this blog.

All men are created equal, that they are endowed by their Creator with certain unalienable rights. Therefore, Workers of the World, unite! You have nothing to lose but your chains.

The first question is simple: Is it reasonable to get from first part of this quote to the second part? My answer is, Yes, it is. The second question is more difficult: Is it even conceivable that any document could use a quote like this without taking a substantial part of its “meaning” from the fact that the first part comes from our Declaration of Independence and the second from the Communist Manifesto? My answer is, No, that is not possible.
The “meaning” of this misshapen quote is that part A comes from here and part B comes from there. That is the “meaning” over and above what the words mean. That’s what I mean by “genre.” So what on earth does Matthew mean when he says (27:51—53, New Jerusalem Bible) this?

51And suddenly, the veil of the Sanctuary was torn in two from top to bottom, the earth quaked, the rocks were split, 52the tombs opened and the bodies of many holy people rose from the dead, 53 and these, after his resurrection, came out of the tombs, entered the holy city and appeared to a number of people.

I don’t think that’s reporting things that happened. I think it is citing a scripture or some scriptures (a genre) and that “where those accounts come from” will be a big part of their meaning, just as Thomas Jefferson and Karl Marx provided the largest part of the “meaning” in that fake quote by being the authors.

And if the source is the meaning, what meaning does it have? I don’t know because I don’t know the source. I think I will know that when I find out what the source is; I think I will know then what they meant to Matthew and/or to his church. And when I know that, I hope I will be able to reflect constructively on who this Jesus is that Matthew is trying to make present for us.

And that seems worth doing for Lent.

[1] Not the Wheaton Crusaders, as they were when I was there in the 1950s, but the Wheaton Thunder now.
[2] There are lots of ways to criticize this instructor’s experiment. You could question the mechanism by which he was to be directed; you could question the tasks to which he was called, and so on, but I have benefited so much from the conclusion he drew that I am not inclined to.
[3] Just to remind us all, the English aristocracy comes from the Greek aristos, meaning “the best.” You see immediately, I am sure, that commoners with household conveniences can be “aristocrat-like” without being “the best people in the society.”
[4] In Kim Stanley Robinson’s dystopian novel 2312, the period of life on earth where we are now is dated from 2005—2060 and is called “The Dithering.” New York City is entirely flooded and people get from building to building on skybridges.
[5] That is not a random or casual list of approaches. If you think it is, try grouping the middle two and contrasting them with the first and last.

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Racism and Sexism, treated by The Good Doctor.

If you were here, I would dearly love to turn to you, as I did to Bette, and say, “What just happened?” Here is what I think happened. In the first season of The Good Doctor, they have developed a racism subplot and a sexism subplot to supplement the handicapped theme—the “good doctor” is autistic—which is the main driver of the show.

In Season I,  Episodes 10, 11, and 12, one of these two plot developments absolutely floored me and the other followed a very familiar pattern.  It is the racism subplot that has turned strange; the sexism subplot is thoroughly predictable.

The Sexism Subplot

We are going to have to do some plot now. I’m going to be using a lot of pictures because most of the characters are non-white and that matters in this account.

Step 1 Dr. Coyle (Eric Winter) inappropriately propositions Dr. Browne (Antonia Thomas) in one of the operating rooms racism 6of St. Bonaventure Hospital in San Jose. Here are Dr. Coyle ANTONIA THOMASand Dr. Browne. She reproves him as she should and reports him as she should. But Dr. Kalu, her boyfriend, (that’s a gross characterization, but it’s good enough for this small turn of the plot) is angry and physically assaults Dr. Coyle. And then he gets fired for having done that.

Step 2 Dr. Kalu wants his job back, so he hires a lawyer to make the case that his punishment is much greater than the punishment of several white doctors who were reproved for having done the same thing Dr. Coyle did. [1] The severity of Dr. Kalu’s punishment is said either to be racism or to be something that will look like racism when Dr. Kalu’s lawyer takes the case to court when he sues the hospital.

race 2This requires a confrontation between Allegra Aoki (Tamlyn Tomita),  who is Chair of therace 3 St. Bonaventure Foundation—that means she presides over the sources of the money that fund the hospital—and Jessica Preston, (Beau Garrett) who is Vice Chair of Risk Management. You see them here.

Step 3 Ms. Aoki agrees the settle the case rather than to allow it to go to court, the result of which is the Dr. Kalu gets his job back. That means he returns to his position as surgical resident under Dr. Andrews, who is furious with him for doing what he had to do to get his job back. Here are Dr. Andrews and Dr. Kalu. Keep this picture in your mind when you see the line, “It sets us (us!) back two steps.”

Step 4 Dr. Coyle has been “punished” by being transferred to a different hospital at a higher salary, but that is not enough for Dr. Browne. She complains to Ms. Aoki that the punishment is not severe enough. Ms. Aoki agrees, but says that all Dr. Browne has, from a legal standpoint, is a case of he said/she said, which is not a strong case. So Dr. Browne heads out to round up other women who may have been abused by Dr. Coyle (#me too!) and in the last scene of these three episodes, finds one.

A familiar problem with a familiar solution

Let’s take the harassment problem first. Dr. Coyle is a creep. He is not a racist, but he is a creep. Dr. Browne complained about his behavior and he was punished, but not severely enough to satisfy Dr. Browne, who is pretty sure that Dr. Coyle is going to continue to operate [2] in the way he did at St. Bonaventure. So Dr. Browne goes out looking for other women who may have experiences inappropriate advances from Dr. Coyle.

This is the #me too moment. We are led to believe that if this subplot is continued, Dr. Browne will find a bunch of women—fellow victims—and that Dr. Coyle will finally get what is coming to him.

This is the most common of the current plots. The man is evil and the women are victims, but when they join together, the evil man can be punished appropriately. I’m not making a judgment either about the real world events or the TV drama events that follow this path. I am saying it is the most common current path of the shows I watch or hear discussed. In fact, I might go so far as to say that as a plot device—not as a real life event, but as a dramatic convention—it is trite.

A familiar problem with a twist

The race question goes a different way, although it doesn’t appear, at first, that it is going to. Up in Step 2, I said that there was a clash of sorts between Ms. Aoki and Ms. Preston. Here’s what that looked like.

Preston: The chief oncologist—this is before I came here in December of ’14—Dr. Marshall shoved a scrub nurse during a post-op discussion of some sort. So you remember that?

Aoki: I do.

Preston: Your response was to settle with the nurse while Dr. Marshall was let off with a warning. There’s another almost identical instance later that year. In both cased, the doctors in question were white. They were censured. Dr. Kalu was fired.

Aoki: Do you think this was a racial matter. Do you think I’m racist? That I favor white people?

Preston: Then why the leniency then and not now?

Aoki: They’re stars that happened to be white. Doctors like Dr. Marshall allow St. Bonaventure to compete with other West Coast institutions.

Preston: So that’s our defense. We’re not racist. We just allow our doctors to assault people as long as they bring in enough donors.

Aoki: They were reprimanded and there were no further incidents.

Preston: And how do you think all of this is going to play out in court?

Aoki [pushes the file across the desk to Preston] Settle.

Preston: OK

Neither Ms. Aoki or Ms. Preston thinks that the way Dr. Kalu was disciplined had anything to do with his race. [3] Both look at the damage that can be done to the hospital if Kalu’s case goes to court and Ms. Aoki makes the prudent choice. Settle this out of court.

I think that is not quite standard. The charge is standard. You treat white offenders different than “dark” (Caribbean, maybe?) offenders. But neither of the women in this discussion thinks that issue really is race. They agree that it will look like racism if it goes to court.

The Racism Subplot

But then something blatantly non-standard happens. Not only was I unprepared for it; I found myself nearly speechless when I saw it. I went back and watched that part again to be sure it really happened the way I thought it happened. It did. Here it is.

Dr. Andrews, Chief of Surgery, (Hill Harper) is just leaving for the day when Dr. Kalu (Chuku Mood) catches up to him and tries to engage him in a conversation about what happened in surgery that day at the hospital. Dr. Andrews isn’t having any.

Dr. Kalu Dt. Andrews. Good evening. I…uh…checked out the twins’ file…it’s an amazing case.

Dr. Andrews: To be clear, Jared, I don’t want you here.

Kalu: What we presented to Miss Preston was the truth.

Andrews: I understand that. And those problem doctors and the ways we police ourselves will be dealt with, should have been dealt with a long time ago. But you stepped over a line.

Kalu: I fought for my job.

Andrews: You compromised your integrity. The incident with that jerk Coyle had nothing to do with black or white, but that’s what you and your lawyer sold for leverage. And when you misrepresent racism for something it’s not…it sets us two steps back.

So how is the racism question being dealt with here? Very differently that the sexual harassment question certainly! I said that development of the harassment theme was trite as a dramatic narrative. This one is pathbreaking.

race 1Dr. Andrews, the black Chief of Surgery, (on the right) reproves Dr. Kalu, the dark race 4surgical intern, (on the left) for playing the race card inappropriately. Kalu defends himself by arguing that the case he made—white doctors in that situation have been treated differently than he was—is true. Andrews says that isn’t a good enough excuse. “You stepped over a line,” he says. He doesn’t say what “the line” was, but he is about to.

Kalu defends himself again. He was just doing what was necessary to get his job back. He is right about that. Nothing less that threatening an embarrassing and unsuccessful appearance in court would have caused the hospital to settle. But that isn’t the line Dr. Andrews is talking about. He says that Kalu compromised his integrity. That is not something you ordinarily hear a victim of racism accused of, and very probably no one who is not black and not his superior at the hospital could have said it.

What did Kalu do wrong, according to Andrews? Kalu knew that the discipline he received had nothing at all to do with race, but he and his lawyer used race anyway, just as leverage. Then come two really important final steps. The first is this: “When you misrepresent racism for something it’s not….” Your punishment had nothing to do with racism and you knew that, but you said it did and you said that for your own advantage.

The second is this: “…it sets us back two steps.” Us. The differences between Dr. Andrews and Dr. Kalu, so far, have been that Andrews is Kalu’s immediate superior. Andrews is Chief Surgeon. Kalu is a resident in surgery. Kalu is a hothead and romantically involved with another resident. Andrews is not a hothead, and in his position, he couldn’t afford to be. And he knows the risks he runs by having a hot-tempered resident on his staff. We know about those differences. They have been clearly shown to us in previous episodes.

“Us” has not been clearly shown. “You and I,” Andrews is saying, “are people who have been and who will continue to be, subjected to racism. We have been making progress; slow and painful, step by step progress. And you have just set ‘us’ back two steps.”

Andrews here addresses Kalu as a fellow black man. That’s what “us” means. It is hard enough to make any progress in undoing the knot of racism without some of the victims playing fast and loose with the truth. “The truth” here is given a very high place. “Making a dent in racism” is given a lesser place. If one is to be sacrificed to the other, is the the crusade against racism that is the give way and the truth of the matter to be preserved and it is especially the work of the black victims of racism to demand it.

Sexism and Racism

So…I don’t know. I’ve never seen these two liberal subplots running along side by side and then watch one change direction drastically while the other keeps on going. I suspect the marketing department at ABC knows something I don’t know. Do they have a liberal fan base and a conservative fan base and decided to give one subplot to each? Do they have one tribal fan base—racism, anti-racism, sexism, and anti-sexism are all tribal affiliations—and one judicious, let the facts speak for themselves fan base?

Surely not. If I were in marketing for ABC, I would certainly argue that the network is going to make more money pandering to the tribal affiliations–either one, let alone one for each– than to the judicious, above-it-all group.

Any ideas?

[1] This is a plot problem of sorts. No one is accused of having done what Dr. Kalu did, which was to physically assault another member of the hospital staff.
[2] The notion of “a smooth operator” in a hospital-based show is really asking for trouble, but there it is. The language will stand only so much twisting and bending.
[3] There is a nice moment, though, when Aoki, who is Japanese, asks Preston, who is white, if she really thinks Aoki is racist. Really?

 

Posted in Communication, Movies, Paying Attention, Society | Tagged , , , , | Leave a comment

My next job

This is a fantasy. If you don’t know me, you might wonder why I would write about what my next job will be. I have retired several times already and my final retirement was five years ago. If you do know me, you know very well that I am not going to take on a new job and would certainly not be writing about it.

And it gets worse.

My “next job” is doing whatever I would be doing in C. S. Lewis’s notion of what Heaven new job 5is like. [1] In The Great Divorce, Lewis gives a very interesting account of the Spirits who are in Heaven and who belong there. In Lewis’s version, the Ghosts come up from Hell as visitors—there is a bus every day for that purpose— and are met at the bus stop by the Spirits who are there to help them.

I have spent a lot of time on the Ghosts in The Great Divorce. In 2011 and again in 2014 I taught an Adult Ed class based on it at our church, here in Portland. To give you a little of the flavor, the course was called Seven Characters in Search of Damnation. [2] The Ghosts are quite different from each other superficially. One is an artist, one an Episcopal priest, one a mother (ONLY a mother), one a tough guy employer, one a world-weary cynic, and so on But radically—at their very root [3]—they are the same. They have come to Heaven to try to use God for some purpose of their own.

But I have begun to think recently about the Spirits who meet the several Ghosts at the bus stop.  The work each does is different because each Ghost has a different reason for preferring Hell to Heaven, but deep down—“radically”—they are broadly similar. They offer the same kinds of service.

  • They offer a personal apology, if that is one of the reasons they were chosen. That is true in the case of the Spirit who was sent to meet the Rights-monger, as we will see below.
  • They clarify any misunderstandings about what is real and what is not.
  • And they offer their services if the Ghost decides to stay in heaven (only one does).

So if I wound up in C. S. Lewis’s Heaven, those three things would be my job. I would be traveling  up into the mountains, because that is that is the hope and desire of every Spirit. I would interrupt my trip—all those miles would have to be traveled again when I returned—and come back to the bus stop to meet someone to whom I had to make personal amends or whom I was particularly well equipped to help. And I would offer my services to that Ghost for as long as he needed me or, as in the case of the Spirit who was sent to meet the Rights-monger, longer. [5]

Those three things. They would be my “next job” in the world Lewis has built. And if I started in Hell, my first job would be to get on the bus and get off in Heaven and to choose to stay. I guess that’s really three jobs. So it is easier to start in Heaven.

The Rights-monger

The clearest example of this relationship is the interaction between a Spirit who, on earth, was called Len, and a Ghost who is not given name, but whom I call “the Rights-monger.”[6]  He knows his rights, or thinks he does, and demands that they be honored. [7] In Heaven, where only the grace that God offers matters at all, this is a very costly demand.

new job 1It is also true, in this fantasy, that the Ghosts are completely insubstantial. Picture a column of smoke in the shape of a person. The Spirits are substantial—“real” Lewis says—because Heaven is “real” (substantial) and that difference in the two places mimics the spiritual condition of the two kinds of beings.

One of the characters, whom I have called “the Cynic,” describes the difficulties of Heaven this way.

“That’s all propaganda [that you can stay if you want to]. Of course, there was never any question of our staying. You can’t eat the fruit and you can’t drink the water and it takes all your time to walk on the grass. A human being couldn’t live here.” [8]

In fact, Heaven is the kind of place that you can adapt to if you stay long enough. You solidify as you stay and the result is that you actually can eat the fruit and you can drink the water and the blades of grass no longer pierce your feet—as they did when you arrived because those blades of grass are real (substantial) and you are not. Every Spirit tells every Ghost how that works. It doesn’t work for the Cynic, of course, because he doesn’t stay. “It’s all an advertising stunt,” he says in dismissing the possibility.

Len, the Spirit who was sent to the Rights-monger, has some explaining to do. Once, back on earth, he had killed a man named Jack and Len’s crime looms very large in the Rights-monger’s mind. Here is Len’s account of why he was chosen to come to the bus to meet his former employer.

That’s why I have been sent to you now: to ask your forgiveness and to be your servant as long as you need one and longer if it pleases you.

That is the “job” of this particular Spirit. “Servant” in this context means a lot of very new job 8physical tasks. The Rights-monger cannot simply wander around Heaven on his insubstantial feet, much less begin a journey to the mountains. He will need quite a bit of help and Len is offering it to him. It means spiritual tasks as well, as in asking for forgiveness for the evils Len had done on earth.

On the other hand, one of the conditions in Heaven is that you know a very great deal that the Ghosts do not know and about the previous life on earth, they seem to know everything. Here are some examples.

Rights-monger: What about poor Jack?

Spirit: Here is here. You will meet him soon if you stay.

And there is sure knowledge about Heaven.

Rights-monger: That may be very well for you, I daresay. If they choose to let in a bloody murderer all because he makes a poor mouth at the last moment, that’s their lookout. But I don’t see myself going in the same boat with you, see? Why should I? I don’t want charity. I’m a decent man and if I had my rights, I’d have been here a long time ago and you can tell them I said so.

Spirit: You can never do it like that. Your feet will never grow hard enough to walk on our grass that way. You’d be tired out before we got to the mountains.

And it isn’t exactly true, you know.

Ghost: What isn’t true (sulkily, Lewis adds).

Spirit: You weren’t a decent man and you didn’t do your best. None of us were and none of us did. Lord bless you, it doesn’t matter. There is no need to go into it all now.

The Spirit who used to be Len the Murderer knows quite a bit. He knows about Heaven—your feet will get accustomed to our grass if you stay—and he knows about life on earth. He knows the Rights-monger was not decent (even in the way the Rights-monger himself defines it) and he did not do his best. And he knows that in Heaven, it doesn’t matter at all. And finally:

Spirit: You made it hard for us [employees] you know and you made it hard for your wife and for your children.

Ghost: You mind your own business, young man….I’m not taking any impudence from you about my private affairs.

Spirit: There are no private affairs.

This is another aspect of what the Spirit knows. Heaven is a huge and joyous commons, but nothing is private. In Heaven, there is no walling off of the “business decisions” and the “political decisions” and the “family affairs.” Everything is known and grace is available for the acceptance of every act the Ghost is willing to own. When the Spirit says that none of them had done their best, he is referring to a state of knowledge he now has. He is not repeating some especially dour philosophy he held on earth.

The Rights-monger isn’t having any of it. He knows his rights, he says, and he demands what he deserves. Unfortunately, he deserves damnation, which is why he gets back on the bus and goes “home” to Hell.

Lewis has a “guide” in Heaven for the purpose of explaining things he cannot show us by the actions of the characters. In fact, Lewis himself is one of the characters. He is the one to whom the spiritual infrastructure of Heaven and Hell is explained and George MacDonald is the guide. [9] MacDonald puts it this way.

new job 6

[1] You might be wondering whether I have not skipped a step or two in assigning myself to Heaven, even C. S. Lewis’s heaven, but in fact there are no jobs to do in C. S. Lewis’s Hell, so I had no choice.
[2] Apologies to Luigi Pirandello, author of Six Characters in Search of an Author.
[3] “Radical” comes into English from the Latin radix = root. I often think of “radical” and “superficial” as the alternatives if you have only two alternatives. For reasons that are easier to understand, our word “radish” also comes from radix.
[4] I have half a suspicion that this extra service, service that depends only on the whim of the Ghost, has something of restitution in it. Lewis never says that, but I have my suspicions.
[5] “Monger” is not a combining form used much in American English, although we still say “rumormonger.” A monger is a trader in something. In England, we would know what a fishmonger does. But you can’t trade in “rights” in exactly the same way you trade in fish.
[6] He is, in that respect, very much like the “prisoner of war” in The Mouse That Roared who demands that his food be brought to him on a tin plate at least 10 inches in diameter. He does not know that they have prepared a banquet in his honor and his tin plate functions as a refusal to go to the banquet at all.
[7] Notice the function of “you” in this complaint. It means “one” as the Cynic uses it. “No one,” in other words, can eat anything or drink anything. But obviously, it is the Ghosts who can’t and the Spirits who can. So the use of “you” as the Cynic deploys it is entirely rhetorical.
[8] C. S. Lewis, the author, not the character, credits the writings of George MacDonald as being an important part of his own conversion to Christianity, especially Phantastes, and Lilith.

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Living with Seniors

That’s what I do. I live in a Senior Center, being old myself. [1] But when I was an undergraduate in college, I lived with Seniors, too. And Juniors and Sophomores and Freshmen. I just thought of that today. It changes the sense of “living with Seniors” entirely and not only that, it also offers a very useful new idea about them.

Now imagine that I was about to take a three course sequence. At Portland State, these courses would be called AGE 199, 299, and 399. And let’s say that I was worried about my GPA. [2] I might very well locate a Senior who had taken that sequence and had done very well with it. And since he had already had the experiences I was about to have, I might ask him to share what he could about how to do that particular piece of work well. Furthermore, to the extent that “doing well” involved any way of mastering academic material generally, I might ask if I could hang around and see what I could learn from watching him.

OK, the Senior Center where I live is…actually…rich in Seniors. And quite a few of them—there is no way of knowing in advance which ones—have already taken AGE 199, 299, and 399 and some of them did very well in them, metaphorically speaking. Is there any reason I couldn’t choose the ones I think have done best and listen carefully as they say just how they managed? I think that would be the smart thing to do and I live at the perfect place to try it.

Here at Holladay Park Plaza, the real life equivalent of AGE 199, 299, and 399 are challenges of two sorts. For reasons I will explore below, I am calling them KM and non-KM challenges. The KM challenges are those that you can’t beat—there is no way to beat them—but you can keep them from beating you. The second, non-KM challenges, are ones that you actually can beat if you are willing to develop the skills that are required.

Kobayashi Maru (KM)

Star Trek is famous for the Kobayashi Maru test. The purpose of this simulation is KM 1
“to cause the cadets to ‘experience fear in the face of certain death and learn to remain in control of themselves… despite that fear.” [3] Of course, everybody faces certain death. That is, as Ursula LeGuin’s Archmage, Ged, says, “a consequence of living.” But here, I see people for whom that death is not all that far off. A diagnosis has been made and a probable time line established. If that isn’t “in the face of certain death,” I don’t know what is. And yet many of the Seniors I live with, live absolutely radiant, other-centered lives. [4] They are passing Kobayashi Maru and everyone around them is benefiting by it.

It is said, in Star Trek, that you can’t beat the Kobayashi Maru test. But you can, keep it from beating you. You can remain in control of yourself despite your fear. I see people doing that all the time. It is said, in Star Trek circles, that Captain Kirk “passed” the Kobayashi Maru test. We find out, by the end of The Wrath of Kahn, what that expression means (he cheated), but the fact is that Kirk did not pass the Kobayashi Maru test. He didn’t take it.

Where I live, everybody takes the Kobayashi Maru and nobody cheats. Some pass and some don’t. I get to live with many who have passed it. And I don’t want so much to learn their tricks as to be strengthened by their resolve.

It is easy to say, sometimes, that you just cannot bring yourself to do something that is difficult or unpleasant. But it is harder to say that when you live among people who do, in fact, bring themselves to do extraordinarily difficult  or unpleasant things and manage them with a certain flair.

Non KM Tests

The Kobayashi Maru is about self control in the midst of fear. The collection of challenges I am going to consider now are not about self control. They are about achievement.  I have several kinds of achievement I want to tell you about and then I would like to tell you a story.

KM 2There are people here, for instance, who manage to stay in touch with their biological family—that ordinarily means siblings and children and grandchildren—and also to build stable friendships with the other residents. I wasn’t all that impressed at the beginning of my time here, but now that I have given it a try, I know how hard it is and I want to learn how they do that. I don’t want to copy them—the differences also need to be taken into account—but I want to learn how they see the field of play and how the decide what to do.

There are also people here who have descended from one level of physical ability to another. And sometimes to yet another. And these people—not all of them, but the ones who have done it best—have managed to rise to the top of each level of physical capacity. They find a way, in other words, to get the most out of whatever level of ability they currently possess. One of the skills that requires is not getting lost in lamenting the earlier levels. Another thing that requires is not giving up the abilities you now have on the grounds that further decline in in your future.

Let’s just put those two skills into the scale of a single week to help you see what an achievement they are. It is Wednesday and you are capable of all the actions in Set B. You give yourself fully to those actions. You master them, you implement them; when necessary you work around them. And all this without dwelling unduly on Set A, which you were capable of last Monday or on Set C, which is all you will be capable of by Friday. You put Set A aside, remembering it but not lamenting it. You put Set C aside, predicting it but refusing to be prematurely constrained by it. That leaves you Set B and you do Set B for all you’re worth.

Telling Stories

These are Seniors who passed AGE 199, 299, and 399 with flying colors and I can only profit by getting to know them. Let’s deal with something more concrete.  I said I had a story to tell you.

There are people here whose spouses are no longer good company. Most, but not all, of these spouses are men, so I am going to shift over to “husband” as a convenience. The story I am going to tell you—“lightly edited,” as they say now—takes place in the Holladay Park Plaza dining room.

Bette and I had dinner with one of these couples recently. The wife was bright and KM 5chipper; the husband was quiet, but he could say things that made sense on their own and that contributed to the conversation. Sometimes. And sometimes not. When “sometimes not” happens, the wife has a decision to make.

He said, “So…I used to play basketball at a little high school in Texas…” And she said, “You just told that story.” And he said, “Well, I want to tell it again.” And she said, “You go ahead and tell it. That’s a really good story.” And she looked at Bette and me and winked. That’s the story.  And I’ve been thinking about what it means.

This story could be told a hundred different ways. I know that. Even being at the table, I realize that I could interpret it an several ways, myself. Here is how I interpreted it at the time and, having reflected on it for a week or so, how I still interpret it.

The husband could be really incompetent. He could deny that he has a responsibility not to tell the same story over and over, knowing also that he can get away with it. I don’t think that was what was going on. I think he didn’t remember that he had told it and the “rule” that you don’t tell the same story over and over again [5] seemed remote to him.

The wife could act as if she were the only real person at the table. I see that sometimes. She could, for instance, say, “He just keeps telling the old stories over and over” as if her husband were not at the table at all. This woman didn’t do that. She kept in touch with her husband on one side and Bette and me on the other. She helped us understand that this was something he did from time to time, even when he was reminded, and that it didn’t have anything to do with us in particular.

The wife could take the husband’s side, explaining to us how good the story was or how significant it was and implying that we ought to be happy hearing it over and over again. She didn’t do that either. She affirmed him, seeing that she couldn’t dissuade him, and she affirmed us as well. By saying to him, “You go ahead and tell it…” she touched him warmly and by winking at us, she touched us warmly. She made us part of the audience along with herself and promised us her help in moving on to a genuinely common topic after the story was over.

This is the only time I have had this experience with this particular husband and wife, but I have had a lot of experience with that particular dilemma and I don’t think I have ever seen it done better. She facilitated the conversation and affirmed every person in it. I don’t know what it cost her to do that, but I admire it and it helps me to aspire to do it myself.

Conclusion

So the really good thing about Senior Centers is that there are people here who have already done very well on “courses” you haven’t taken yet, but which you will take as you proceed through this particular curriculum. Seeing what the best of them do and, when it is appropriate, asking them how they do it, is a great advantage. We are, in fact, going to be taking these courses and watching people who are passing them with flying colors is almost like Cliff’s Notes.

[1] It turns out that when you say “senior center” to yourself in just the wrong way, you come up with something like this. Jake Hanson is, in fact, the center on the Duck’s football team, and if he keeps his grades up and stays out of trouble and doesn’t go pro, he will be a senior center in just two short years.Screen Shot 2018-01-18 at 6.28.14 AM.png

[2] True confessions. MY undergraduate GPA was so low that there was no point at all in worrying about it. I was admitted to graduate school on probation.

[3] It is true, of course, that Captain Kirk “defeated” the Kobayashi Maru challenge. He cheated. And he did so on the grounds that there shouldn’t be tests like that. “I don’t believe in the No Win scenario,” he said. That means that we never find out whether Kirk could have passed the test; that he could have remained in control of himself in the face of certain death.

[4] To help lessen the risk that you will conclude that this essay was written by the Holladay Park Plaza marketing folks, I need to find some place to say that there are fair to middling seniors here and some I would call failures. Just like college. The fact that this essay selects the best of them as my mentors is not meant to imply that all the residents are like the ones I am focusing on here.

[5] This suggests another kind of spouse problem. Bette and I have been meeting a lot of new people over the last year or so and I have had occasion to tell the same story in Bette’s hearing over and over again. And I hear her stories over and over again. There isn’t any other way for us to be together for a long time and to keep meeting new couples and not run into this problem. A good solution, I think, is for the spouse to assess the performance itself. The setting demands that the story be told and the spouse could say, “Well done. You tell that story better every time I hear you tell it.” Or if it is not well told, he or she could say nothing. Given the setting, it isn’t really fair for the spouse to say, “Oh no, not that story again.”

 

 

 

 

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Horizons

All my life, I have been a sucker for horizons. “Horizons,” I once thought to myself, “are just the earth in profile.”

With a horizon, you get beyond the welter of particular features and see the broad horizons 1incontestable outline of things. And after that, and without losing any awareness of it, you can attend to a good deal of complexity without losing your sense of the vision as a whole.

Back when I was studying humor more systematically than I am now, I ran across this from Max Eastman’s The Enjoyment of Laughter.

The mind should approach a body of knowledge as the eyes approach an object, seeing it in gross outline first, and then by gradual steps, without losing the outline, discovering the details.

I was so excited I just put the book down and went for a walk. It said a great deal about me that I had never heard that said before and it may or may not be true that, as Eastman says, “the mind should.” I think it is most certainly true about my mind and that I why I call myself “a sucker for horizons.” It is that “gross outline” that always grabs me.

I have recently been grabbed again and that I what I would like to think about today.

I have recently been grabbed by the level of generalization that Peter Stearns routinely uses. He provides the kind of horizon I seem to crave. I recently wrote that he is “my guy” on gender relations , referring to his excellent historical analysis of gender relations in the West. [1] Lately, I have been heading and listening to [2] his course on world civilizations. All of the world civilations, not just ours.

horizons 3And it isn’t just history. In preparing for a Bible study course that begins in September, I have been studying the Old Testament prophets. And all of a sudden, it occurred to me that there were three major categories of those prophets. Only three. There were the pre-Exilic, whose message was that God is going to punish (“discipline” in some of the prophets) you for your godless ways. And then there were the Exilic prophets, who said to Israel, “Your sentence is almost up. God is going to restore you to your homeland.” And there were the post-Exilic prophets who, with the exception of Jonah, said, “The holiness of the temple and the city and the worship of Yahweh have all been compromised while you were gone. Put things back to the way they should be.” [3]  This is someone’s notion of what the prophet Amos looked like.  He was one of the pre-Exilic prophets.

Three kinds. No more. Each with a characteristic message. I will get a good deal deeper into a study of those prophets before next September, but I will always have that horizon available to me. Which kind of prophet—and therefore which kind of message—are we talking about? Given that there are, you know, only three kinds.

horizons 5When I hit my first communitarian sociologist, Frank Hearn, I was fascinated by his allocation of all kinds of “social problems” to one of three places. His own preference as a sociologist is that most problems be considered as “social problems,” by which he means problems rightly referred to communities using their own local institutions. But that means that he has to have a nasty name for the practice of referring those social problems to other places, where they really shouldn’t be. [4] Problems that are rightfully social, but that are referred to the polity instead, have been “politicized.” Problems that are rightfully social, but have been referred to the economy instead, have been “commodified.” Three places to put problems: no more. Horizon.

Recently in the New York Times, David Brooks in his column and Ross Douthat, in his column, referred to a book by Patrick J. Deneen, a political theorist at Notre Dame. Deneen’s book is called Why Liberalism Failed. Note the past tense of the verb. Deneen says that of the three systems active and plausible in the 20th century, communism and fascism have already failed. The third, liberalism [5] is failing right before our eyes. Why is that? Notice again the three and only three. Horizons again.

In Deneen’s view, liberalism is not a sustainable system. Here are three small clips from his work. [6]

The ancient claim that man is by nature a political animal and must…through the … practice of virtue learned in communities, achieve a form of local and communal self-limitation–a condition properly understood as liberty–cannot be denied forever without cost.

Note the identification of “local and communal self-limitation” as the meaning of “liberty.” That sounds odd, certainly, but if the alternatives are distant and bureaucratic limitation, on the one hand, or unrestrained individualistic excess on the other, then it is a definition worth taking seriously.

If my analysis is fundamentally accurate, liberalism’s endgame is unsustainable in every respect: It cannot perpetually enforce order upon a collection of autonomous individuals increasingly shorn of constitutive social norms, nor can it continually provide endless material growth in a world of limits.

I think this quote is truly helpful. It puts the two requisites down together. Liberalism has to be able to do one or the other, he says. Then he says that we cannot enforce order on individuals who have no access to “communal self-limitation” (see the previous paragraph). That is not sustainable. Nor can we provide endless material growth, which Deneen sees as the other alternative. There are, in short, only two ways out of our current dilemma and we can’t do either of them. That is his point.

If I am right that the liberal project is ultimately self-contradictory, culminating in the twin depletions of moral and material reservoirs upon which it has relied even without replenishing them, then we face a choice.

Here he points to the choice we have. If we can’t do the one (communal self-limitation) or the other (endless material goods), then we have a choice to make.

Ross Douthat’s complaint is that Deneen doesn’t go on and say just what choice that implies, but I think that is more up Douthat’s alley than Deneen’s and I imagine that Douthat—and very likely, David Brooks as well—will get around to it.

As dismal as this may seem, I find it refreshing. We can swim in or drown in the horizons 4complexities of today’s policy proposals. DACA or not? Amnesty or not? Enhanced legal immigration or not? But all of these questions take the present political system—the old classic post-medieval Liberal system—for granted. And Deneen says that system is running out of fuel and can’t be saved.  I’m sure this picture is an ad for a business of some kind, but note the similarity to Deneen’s communalist picture of liberty.

That means that all such questions are really just one kind of question. That question is, “Can we find a way to undo either of the limitations Deneen sees and if not, to what kind of system do we go as an alternative?” Is there a post-Liberal system?

Liberal or post-Liberal. Horizons.

[1] I think it is unfortunate that the title is Be a Man! A much better notion of what he is writing about is conveyed by the subtitle: Males in Modern Society.
[2] His Great Courses title is A Brief History of the World. Does that suggest “horizons” to you?
[3] Oh, and kick the squatters off of your ancestral lands.
[4] And in a stroke of wit, he made these names not only pejorative, but also ugly.
[5] Liberalism in this very historical use refers to the political and economic institutions that replace the feudal system. All modern liberals and conservatives are “Liberal” in this sense and so is capitalism and so is democracy.
[6] I used to run out and by books that look as interesting as this one. Now I search the electronic storerooms for an article-length version of the book’s argument. I am quoting here from an article he contributed to the journal First Things: A Monthly Journal of Religion and Public Life, back in 2012. It is called “Unsustainable Liberalism.”

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This is your id speaking. Listen up!

I’ve been thinking about healthcare recently. I’m going to say some things I haven’t heard anyone else say. That is often not a good sign. As usual, I am going to start at several apparently unrelated starting points and as usual, I am going to try to bring them within speaking distance of each other.

Psychiatry

I don’t know much more about Freudian therapy than you can easily get from books andid 1 movies. [1] The picture I am relying on here is the patient lying on the couch free-associating in the presence of a fully present therapist. The “free” of free associating means, in part, that the little boxes in which we keep the thoughts and feelings that contradict each other are all opened at the same time in free association. And they associate with each other, not in the dark safety of the mind but in the public space between the therapist and the patient. Both hear the patient say things neither has ever heard before. [2]

Now I want you to picture President Trump as the therapist and the conservative core of his support as the patient. The patient is being encouraged to say, out loud, feelings and beliefs that have been publicly frowned on for many decades now. But instead of thinking that exposing them will rob them of their insidious power over the patient, the idea here is that it will reformulate them as public policy and give them a great deal of power over everyone. In fact, it will give them the power of law.

Federalism

Since the Great Realignment began around 1970, the two major parties have become much more internally consistent that ever before. [3] Now we have, not two parties, each of which has a right-ish wing and a left-ish wing, but a left wing party and a right wing party.

That is easy to see in a red state and blue state map of the United States. And year after id 3year, red states want to do red state things and blue states want to do blue state things. And every year, each color has to put up with federal regulations that requires them to be much more similar than they would really like to be. This tension between the national administration of national systems and the state preferences which express the political culture of their own states, is the heart of the federal bargain.

Healthcare

For example, some states think that “welfare services,” thinking particularly of medical services at the moment, need to be earned. This the the cri de coeur of the red states. “Working” is good. Receiving benefits apart from working is bad.

The red states have been slapped on the wrist for many years now by the Great Father in Washington, who says that their hearts can cry out all they want, but their Medicaid administrators may not withhold medical benefits by enacting a work requirement. Note carefully that this is a constraint on the behavior of healthcare administrators in red states. It has nothing to do with what I called earlier, the cri de coeur of those states.

So the first thing to notice is that those states want, year after year, to do this. They want it when the economy is booming and they want it when the economy is busting. Only the rationales change; the desire stays the same. During liberal administrations and conservative administrations, they want this. And because it is a federal requirement—you may not, however much you want to—make the availability of medical services contingent upon “work” or “looking for work.” [4]

And why do they want to do this? One answer is that it is the right thing to do. They hold a view of “working” that is essentially moral. Work is what establishes your full membership in society. [5] Work establishes the income that will allow you to purchase medical services or at least the insurance that will pay for the medical services. And if it doesn’t, you will still have done your part and therefore deserve the additional money the state contributes to your care. That’s what I mean when I call this stance “the moral view.”

And I mean to distinguish this “moral view” from the practical view. If you wanted to design a system that provided medical care to people who need medical care, this is not the way you would do it. What might be called “the red state prescription” will not only withhold medical care from many who need it, but it will also cost more than it would cost of offer treatment. Here’s an excerpt that explains why. You can see the whole article here.

Other states [in addition to Indiana] are considering similar proposals, but a recent redesign of West Virginia’s Medicaid program offers reason for caution. In 2007, West Virginia asked Medicaid-eligible individuals to sign a personal responsibility agreement to qualify for enhanced benefits. The agreement required beneficiaries to keep medical appointments, take medications, avoid unnecessary emergency department visits, and participate in health screenings.

Those who didn’t sign it — or couldn’t hold up their end of the bargain — had their benefits cut, and were enrolled in a basic plan that restricted prescription drug coverage, limited access to mental health and substance-abuse services, and excluded weight management or nutrition education programs. Both children and adults were subject to the agreement, which raised a basic fairness question: Children might be at the mercy of unreliable parents or guardians to follow the rules.

Less than 15 percent of those eligible signed the agreement, and more than 90 percent of children with Medicaid had benefits restricted. A central motivation of the program was to reduce emergency department use, but over all, people were more likely to visit the emergency room. There was no clear improvement in health or healthy behavior. The experiment was scrapped in 2010.

I’m pretty sure that this predictable ineffectiveness is not known in these red states, but I wonder if it would make any difference if it were. “Morality” as the source of public policy really doesn’t lead to “effectiveness” as an outcome. Here is the pitch, as I understand it.

If it’s the right thing to do, then it’s the right thing to do.

And besides, the people who will be harmed by it are not morally worthy people. Weid 4 know that because they aren’t working. Further, they are not working because they choose not to work and in that choice, they forfeit their claim to society’s help.

And the federal requirements that we fund their chosen inactivity are now being rescinded by a conservative administration in Washington which “gets it.” This administration understands how resentful we are that we have had to fund all this laziness in our states and now we get a chance to do it our way. [6]

Nothing I have seen in federal policy has taken any account of the persistence of this red state desire. I have heard it criticized as cruel and also as ineffective. But eventually, some account is going to have to be given of why they continue to want to do this. Decade after decade, they have the same policy preferences. Does federalism mean that eventually, they get to do what they want to do? Or does federalism mean that the citizens in those states are protected against their governments by national programs that constrain them?

Conclusion

After many years of national administrations hostile to “work requirements,” the redid 5 states are finally being allowed to do what they have wanted to do for so long. It is this “permission,” that called to mind the image of Dr. Trump as the therapist and “the red states” as the patient. Dr. Obama kept telling them how they should feel—compassion, for instance, toward those not able to find work—and made them feel ashamed of how they did, in fact, feel. Dr. Trump is allowing those states to say out loud what they have felt for so long and is giving them permission to build systems tying work to medical service.

I think the red states will find, as Khular says in the excerpt above, that it doesn’t really work. But I’m not sure they will care.

[1] It isn’t that I haven’t studied it. It is that the climate at the University of Oregon when I was there was actively anti-Freudian. The Rogerians and the behaviorists and the cognitive therapists were all opposed to it, although for different reasons.
[2] I can see why that would be helpful. I get some of the same jolt less expensively by talking candidly to friends who routinely disagree with me and with each other.
[3] I think of Paul Ryan as the true exemplar of the Republican consensus, not Donald Trump.
[4] I am fully aware of the difference. When I moved to Oregon, I received unemployment compensation for awhile and the requirement was that I continue to “look for work.” So I did. I applied for and had interviews relating to jobs I wouldn’t have taken if they were offered to me. And side by side with those, I spent time getting to know the people who knew people who would eventually open the door for public policy work. So I do actually know the difference.
[5] “Real work,” that is, not being “a paper pusher.” The prejudice in favor of physical or at least difficult work is very common among the working class whites who form the hardest of the hard cores of Trump support. See Joan C. Williams, Reshaping the Work Family Debate: Why Men and Class Matter’ .
[6] Even if it hurts good people to punish the shiftless in this way, there is a theoretical perspective that sheds some light on it. It is called “altruistic punishment.” See the piece by James H. Fowler of UC Davis in the Proceedings of the National Academy of Sciences, 2005.

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