Thursday, March 31, 2011

Fetus Versus Child

I have two friends with whom I have frequent political debates on Facebook. Actually, I guess Friends isn't exactly the right word for people you know only through FB, especially when your only link is a passionate interest in politics and more especially, when you violently disagree on every issue. I don't know a better term though so I'll stick with friends.

My two friends are both rabidly conservative while they consider me idiotically liberal. I accuse them of wanting to go back to the days of aristocrats and peons. They accuse me of yearning to live in a Nanny State. At least one of them believes Barack Obama, Kenyan, pulled the wool over our eyes about his place of birth to get elected.

None of us pull any punches. We all have thick skins and can take the heat or we'd have headed off into the sunset with our wounded feelings by now. We range the gamut of subjects from Libya to taxes to gay marriage to health care to Sarah Palin to unions.

In our most recent exchange, one of them stated with anger that if I had my way, a stranger could take his 12-year-old daughter to have an abortion without his knowledge.

Our of curiosity, I asked what he would do if , say, his 12-year-old was molested and got pregnant as a result. Would he insist she have the baby?

His answer was: "of course, would a grandfather murder his grandchild simply because of the circumstances of its conception?"

I backed off because we were starting to venture into a realm too personal for even barely dispassionate discussion. Our beliefs in this matter were so far apart that we could never find even a shred of common ground. If I had responded, I doubt I could have kept my horror at his attitude from showing.

I find it stunning that this basically good man would be willing to sacrifice the life of a living, breathing, feeling, thinking human being, his own daughter, for the sake of an unconscious fertilized egg. He would judge the value of a small blob of tissue higher on the scale of deserving consideration than a little girl who can laugh and cry and feel pain and confusion and love.

Can a man even have any clue how traumatic nine months of pregnancy and then the birth of a baby can be, even for mature women, even for women who were happily pregnant, much less a child who is barely out of babyhood herself? Can he even begin to imagine what being pregnant would mean to this little girl? The physical shock of your formerly lithe and obedient body turning on you, becoming heavy and unwieldy and slow when you should be out there twisting and turning on the volleyball court like the pre-teen you are? Or the emotional upheaval? The jeering and/or teasing by other kids (and even some thoughtless adults) at the sight of pregnant 12-year-old? A little girl forced to face womanhood too soon, not only psychically wounded by a molester but who must now cope with the additional burden of carrying and giving birth to a child. And what about afterwards? Can a 12-year-old simply forget, ever, that she's a mother. Let Mom and Dad raise the child or put it up for adoption but that doesn't alter the fact of its maternity. Can she ever overcome the memories of being victimized when she produced a living reminder? Her abuser will be inextricably tied to her forever, no matter how much she'd like to escape his awful presence.

This father seemed so cruelly blase to me, as if what I see as a negatively cataclysmic event in a child's life was just something that has to be be got through, like a sprained ankle.

Truly, if you put a 12-year-old child on one scale and a fetus on another, do they have exactly the same moral weight? If the child and a test tube containing a fertilized eggs were in a house on fire, would you even have to hesitate for a moment about which to save first? Can you look at a petri dish and have the same feelings for your "grandchild" as you do for your daughter when she winds her arms around your neck and says, "I love you, Daddy?'

I suppose my friend's stance is based on religion but it seems like a form of sexism to me, as if a female is, first and foremost, a child-bearing vessel, regardless of how she came to be with child. God's will, don't you know, and if she has to suffer, so be it.

We're so far apart on this issue, we can't even glimpse each other from where we're at.





Monday, March 21, 2011

Should We Ration Medical Care?

I will be 65 in August and that means Medicare. I get information in the mail almost every day regarding Medicare, mostly from companies that want to sell me a supplemental health insurance policy. I know, first-hand, that Medicare is not as generous as it used to be because I have a 91-year-old mother and I've been told a number of times by doctors - "Medicare won't approve that test/treatment." Or Medicare won't pay for your mother staying in the hospital any longer."

Even though I'm almost 65 and soon to be on Medicare - and even though Mom is 91 and has been on Medicare for decades - I actually agree with rationing health care. To tell you the truth, I've always thought it was odd that, as a country, we chose to cover all of our elderly people instead of all of our children. In effect, we invest more in the past than in the future.

I know the rationale is that old people, yes, like me, have worked hard all their lives and at a certain age, they are on fixed incomes and helpless to earn enough to pay for their own health care so, as a society, we owe them. But if senior citizens are helpless, children are even more so.

The fact is that we pay the most medical costs for seniors in the last years of their lives. We spend those dollars on people who aren't going to get well and return to active living. My father-in-law is an example. He was in the nursing home with Paget's Disease, an extremely painful and incurable condition requiring lots of specialized and expensive treatment. He was rushed to the hospital with an aneurysm. He was stabilized in the emergency room, then transferred to Intensive Care where he spent several days. Eventually, he was returned to the nursing home where he lived another agonizing a cost of many, many tens of thousands of dollars to the taxpayers.

Should we have gone the extra mile to save him? I don't think so. I would say the same if it was my mother. I hope I'd be courageous enough to say the same if it was me.

Mom and I both have living wills that will hopefully prevent that kind of situation. No heroic efforts to prolong life. No feeding tube to keep us hanging on indefinitely if we're unlikely to return to a life worth living.

What we should be able to expect is comfort care. We shouldn't have to endure intolerable pain.

Mom was in a wreck a few weeks ago. She was taken to the emergency room where tests were done. "No broken bones," they told us, "no internal injuries." Just extremely deep and severe bruising. "She'll be sore for a while."

And she was. I had to help her turn over in bed, assist her to the bathroom. She didn't complain. After all, we'd been warned what to expect. Two weeks later, the pain was as bad as ever and she was plagued with constant vomiting. She was crying in despair. "I just can't go on hurting so bad and being so sick."

I took her to the emergency room again. They patted her on the head and essentially said, "now, Honey, we told you you'd be sore." But they did more tests. The doctor came in looking rather sheepish. "No wonder you hurt, you have four broken ribs. We missed them the first time around."

He gave her stronger pain medication and sent her home. It didn't help. I could see her going downhill. I took her back to the emergency room and this time I threw a fit.

"I can't get her to eat or drink anything. I think she's getting dehydrated. I want her in the hospital where professionals can take care of her!"

He said she didn't meet Medicare's criteria for keeping her. I told him, "then find whatever hook you need to hang it on, just do it!"

They admitted her for a 23-hour observation. They hooked her up to intravenous fluids. They put pain medication and anti-nausea medication in her intravenous tube. By the time, I brought her home 23 hours later, she was in good spirits. Her suffering had been alleviated; her vomiting had stopped. She'd been re-hydrated. She'd gotten a good night of rest.

That's what I mean by comfort care. Not only is it kind but it is cost-effective. I'd asked the doctor, "what happens if she gets completely dehydrated and the vomiting continues."

"Bring her back. If she gets that far down, we can admit her."

"Won't she be here longer if that happens? Why not admit her now and prevent that from occurring?"

The way we do it now is ass-backwards, waiting until a patient is so far down, desperate measures are required.

It used to be that people got old and then they died of what we considered then, natural causes. Now, we make extreme efforts not to allow people to die of natural causes. We put them in acute care and hook them up to unnatural tubes and machines. My father always swore he'd haunt me if I allowed him to be put in that position. Fortunately, he died of a massive myocardial infarction at home in his own bed. I hope the same thing happens to Mom but if it doesn't, what I want for her (and me) is to be able slide away from this earth pain-free.

Medicare is one cause of our huge national deficit. I don't go as far as putting our old people on ice floes to die as the Eskimos used to do but I think commonsense dictates that we stop spending so much money we can't afford on people who aren't going to return to good health whatever we do.

The Republicans hate national health care but one of their big gripes about Obama's health care plan was so-called Death Courts. They ranted and raved about the immorality of judging who deserves to live or die. (Myself, I think the medical community is perfectly capable of making that decision). I guess the Republicans believe the moral stance is to do without healthcare altogether and let God decide....even if that means untold suffering prior to death. They can't make up their minds. They want the Terri Schiavo's to be kept alive forever but they evidently don't want to pay for it. So which is it?

My vote is for directing more of our scarce healthcare dollars to the early years of life and fewer of them to the final years. Those of us who are of Medicare age have had the opportunity to live our lives. Children still have their futures ahead of them.



Thursday, March 10, 2011

Enablers R Us

I'm freakin' sick of hearing and seeing Charlie Sheen. He's no different than a thousand small-time addicts I knew while working at the Sheriff's Department and the Prosecutor's office. They all had enablers without whom they couldn't function at even a minimal level. The only difference is that Charlie is a celebrity so his level of being enabled is so much higher, and that's to his detriment rather than his benefit. People like Charlie (see: Elvis, Michael Jackson, Anna Nicole Smith, Lindsay Lohan.....) are surrounded by sycophants whose success is tied to their own and so, cater to their every whim - mansions and luxury cars and twin Goddesses and new roles and publicity and as much alcohol and as many drugs as their addicted little hearts desire (often right unto death).

Most alcoholics and druggies are anonymous to all but law enforcement and the judicial system and what family still sticks with them and the few friends who tolerate and/or share their addiction. Unlike Charlie, the only times their names are in print is in the "Arrests" section of the local paper. Unlike Charlie, no interviewer records their every raving word, allowing them to humiliate themselves for all the world to see.

But those penny-ante addicts do have their own enablers. When siblings and employers and friends give up, it is often Mom who makes excuses for them and bonds them out of jail yet again, sometimes to the resentment of her other children who don't understand that, in her eyes,  it is her black sheep who needs her the most. If not a parent, then it is a partner who puts money she can't really afford into his commissary account and stands waiting in the lobby to take him home when he's released, even though she may still have the bruises from his last bout with drunkenness. He loves her, don't you know, it was only the booze that made him do it.

So, with every drunk driving arrest and overdose, the addict loses a few more former supporters who tried over and over to get him to see the light, but there are always the enablers who hang in there no matter what, allowing him to carry on. There was a movie line once - "love is never having to say you're sorry". But I think love is more likely to be "sorry, but saying your sorry isn't enough".

Alcoholics and other addicts tend to be charming and creative. I often wondered if charming, creative people were more prone to addiction or if the addiction taught them to be charming and creative as a survival technique. In jail, they could construct tattoo needles out of radio parts and weave cigarette wrappers into elaborate picture frames and braid a thousand strands of dental floss into a rope strong enough to pull a baggie of marijuana in through the screen of the exercise yard. They drew beautiful pictures and wrote wonderful poetry and sculpted perfect figurines out of  dampened bread. They devised elaborate hiding places in the bare space of a tiny jail cell and made hootch out of bizarre combinations of unlikely ingredients. They could spin funny, colorful stories as long as you would listen.

They were all a little bit Charlie Sheen and it was hard not to warm to them even when you knew that all you could ever ultimately expect from them was betrayal. Not betrayal to you so much as to themselves and their own potential.

I know of what I speak because I was married to an alcoholic. An addictions counselor once illustrated for us enablers what we were doing. She had someone stand on a three-legged stool while another person placed themselves in front so the person on the stool could rest their hands on her shoulders. With this support, the one on the stool was able to keep from falling.

"Now step away," said the counselor.

When the person in front moved away, the one on the stool immediately fell.

"That's you," the instructor said. "You allow your addict to remain on the stool but he/she won't get better until they fall and have to learn to stand on their own."

But if the addict is addicted to drugs or alcohol, the enabler is addicted to the addict. They can't bear to step away.

The best thing we could all do for Charlie Sheen is step away....but, of course, that won't happen. For some he's a meal ticket, for some he's worth his weight in entertainment value, for some getting his story is a job, for some he's a loved one. Whatever our reasons, we'll probably just watch as he continues his spin into self-destruction - the old, sad dance of addict and enabler.




Thursday, March 3, 2011

Ho-Hum Obama

I'm sorry, but I think Barack Obama is a boring president.

I know the executive office promotes caution. Your enemies are ever on the alert to twist your words and to provide a sinister context to every action but still.....what is the point of making it to the pinnacle of American politics if you don't act with courage. That's what it's all about, isn't it? Leaving a legacy stamped with your own individuality?

Of course, Barack Obama has already secured his place in history in a way no one else will ever be able to match, being the first African-American president. Maybe he doesn't want to take a chance on doing anything to tarnish that Wikipedia achievement. Or it just may be that he is a man naturally characterized by caution. Somehow, though, timidity doesn't match the change mantra on which he campaigned. Change is inherently daring.

I understand that presidents are limited by our political system so that they are not able to single-handedly put the country on the path they believe it should go. But, their greatest advantage is the bully pulpit. They can at least encourage, urge, cheerlead their people in the right direction. Their words can resonate across the world stage and possibly change the course of history. If nothing else, there in more honor in going down fighting for principle than standing fearfully in the shadows.

I was not at all a Ronald Reagan fan, especially in regards to his domestic policies, but could any American not feel a thrill of pride when they heard Reagan exhort - "Mr. Gorbachev, tear down this wall!"  No beating around the bush, no fear of offending,  just four words that told the world exactly where America stood. And the wall did come down and Ronald Reagan will forever get the credit for at least punching a hole that allowed the flood of freedom to begin rushing through.

John Kennedy told us we were going to the moon and we went. Lyndon Johnson told us we were going to become a country where civil rights meant something and we did, although he wounded his party for decades by doing the right thing.

Harry Truman desegregated the military and  fired the soldier/hero, MacArthur, for not following orders, both unpopular stances, but he had the courage of his convictions.

Bill Clinton's first order of business was to try to end discrimination against gays in the military even though the old Bull Democrats in his own party defeated his effort in the end and stuck us with the perversion, that is Don't Ask, Don't Tell.

I wish our current president would make a statement similar to Reagan's about the Middle East. I don't know enough about the delicate house of cards on which our foreign policy rests to know what actions could lead to detrimental consequences. (I'm aware that Libyans protesting Khaddafi don't want us to intervene militarily) but President Obama should at least head the freedom march by making an inspiring statement of solidarity with people, wherever they are, who are risking their lives to overthrow the repressive regimes. No pussy-footing around power gluttons like Mubarak and Khaddafi.

And speaking of solidarity, I wish Obama would make a trip to the Wisconsin Statehouse in a show of support for the workers in their efforts to retain their right to bargain collectively. God, isn't this the very heart of what the Democrats are supposedly all about, ensuring that working people have a level playing field on which to negotiate with their corporate (and in this case, governmental) bosses)?  My Grammie used to say she was a Democrat because they were the party of the Little Guy, while Republicans were the party of Big Business. I think it has been a long time since the Dems were the party of the Little Guy but they used to make a gesture in our direction every now and then.

I wanted Obama to make a grand plan to rebuild New Orleans as one of his first acts. If we could go to the moon, we could certainly reconstruct a city! I wanted him to say that allowing a great American treasure to remain on its knees simply wouldn't be tolerated. I wanted him to give us updates on progress being made until, before the end of his first term, he could triumphantly declare that New Orleans was back as good as it was before Katrina with stronger levees now in place to keep it safe.

I wanted him to forcefully assert his heartfelt repudiation of Don't Ask, Don't Tell.

I listened to Obama's speech about the budget this week. Not carefully. I was on the computer and heard it in snatches via the television in the kitchen so maybe it isn't even fair to make a judgment but from what I did hear, it sounded bland. Nothing I heard made me want to go listen more closely-  "shared sacrifice...blah, blah, blah....bipartisanship...blah, blah, in our future....blah, blah, blah."

Presidents can't always unilaterally act but it is their grand responsibility to speak for America, to let the world know in soaring words what elemental moral principles they believe our country stands for, not in timid tones, but boldly.