The Reaper Chronicles

Every aspect of the health insurance "debate" makes me purple with rage. This morning's AP story quotes Sibelius' claim that the wretched Obama is willing to drop the public option in favor of the useless co-op nonsense.

There are no words to describe my complete disgust with Obama and the rest of the Washington Democrats. Their gutless incompetence has in all likelihood doomed real health insurance reform for another generation. Actually, a humane, civilized health care system is probably impossible in the U.S., given our hostility to doing anything to help our fellow citizens -- especially those who aren't white -- and the opposition of a loud, easily manipulated plurality of stupid Americans. Yes, there is a significant percentage of American citizens who are proudly ignorant, gullible dolts. These are the kind of people who give Democracy a bad name.

The Rabid Right's latest cri de coeur -- "Obama Death Panels" -- has been scooped up and amplified by an equally stupid and irresponsible media class. So far, Obama has been singularly ineffective in countering the hysteria. As Maureen Dowd writes in today's NYTimes:

Sarahcuda [Sarah Palin] knows, from her brush with Barry on the campaign trail, that he is vulnerable on matters that demand a visceral and muscular response rather than a logical and book-learned one.

Okay, here's a visceral response to the idiotic notion that Obama will pull the plug on Grandma. Here's the story of a real Grandma, my husband's Grandma.(All names have been changed.)

Louise had metastatic cancer. She had survived breast cancer many years earlier but now, in her eighties, the cancer had returned. One bout of chemotherapy was enough to convince her that she didn't want to spend what was left of her life enduring painful torture. I think it was the right decision. She lasted another two years and was relatively healthy until the last three or four months. The "cure" would probably have killed her far more quickly by weakening her with poison and pain. And it is those last three or four months that concern us now.

Harry, my husband's grandfather and Louise's husband, was in his mid-eighties. He was amazingly vigorous and sharp as a tack, but old age had amplified his peculiarities. He was a miser and a hoarder. And he was totally paranoid about having strangers come into his home. That, in itself, wasn't unreasonable. The elderly have good reason to feel vulnerable to strangers. As his wife's health deteriorated, however, he insisted on coping with caring for her by himself and then, when he could no longer lift her to change her soiled bedding, he enlisted his daughter Joanne's help. My husband's mother was well into her sixties and not in great shape herself.

The combination of ignorance and despair was determinative. Joanne called me one day to ask, amazingly, for my advice. She didn't know what to do, how to proceed, how to handle an increasingly untenable situation. Her stubborn, paranoid father refused to allow anyone into the house -- no nurses, no home health workers, not even Meals on Wheels.

I advised that she convince Harry that he must allow her to have professional help. At no point, I said, should she allow her father to hospitalize Louise. I told her that once her mother was in the hospital, her agony would be prolonged. She would have the tubes inserted, the machines hooked up, and she'd be kept alive as long as possible, in misery. I advised her to contact someone about home hospice care.

All Louise needed at that point was to be kept clean and comfortable. At home, she could spend her last days with family in familiar surroundings with a view of her lovely garden outside.

Harry was an autocrat and would have nothing of it. Joanne, even in her sixties, was still a cowed and impotent child when facing her father. So Louise was taken to the large hospital nearby. She was hooked up to a feeding tube, IVs and monitors. Her view out the window was of a brick wall.

Louise spent the last forty-two days of her life on her back in that hospital. No one asked about alternatives. Standard operating procedure was to prolong her life through any and all means.

There's also a dirty little secret that nobody in this health care "debate" talks about: Doctors are paid by the procedure and there's nothing like a helpless, elderly patient for the opportunity to pile on the tests and procedures. During a patient's last days in the hospital, doctors come out of the woodwork to peek in the door, glance at a chart, order an expensive test, and walk out to bill Medicare accordingly.

When Louise wasn't staring out the window in pain, she was being hauled all over the hospital for tests and x-rays for -- what, exactly? There was no question that she had terminal disease and that the end was very near. Did they think this blood test or that x-ray would tell them something they didn't already know? Did they expect to predict the exact day and hour of her death?

So for forty-two days, Louise was mindlessly kept alive while her body was being eaten to death by the cancer. Her bones had become so fragile that some time in the last week her hip broke merely from lying in the bed. Her guts had turned to putrid goo. Finally, she died.

The hospital bill was, of course, stratospheric. Miserly Harry didn't care, though. Medicare picked up most of it and what they didn't cover, supplemental insurance did. And it was all totally, utterly unnecessary. Harry was rich enough that he could have paid for round-the-clock nursing at home. There would have been no feeding tube, no monitors, no IVs. Louise would have died weeks sooner, in her own bedroom, and been spared what passes for "care" in America's modern hospital system.

But no one in a position of authority spoke up. Louise wasn't given the chance to choose her own fate. Every day in the hospital, she begged to go home. Instead, she had a husband more concerned with money and his own paranoia, a willfully ignorant man happy to have someone take the problem off of his hands for free. She was left to a system that has perverted its mandate for mercy into a soulless, hypocritical exercise in milking the helpless for every penny that can be squeezed from Medicare.

So don't talk to me about "Obama's Death Panels." Don't talk to me about "pulling the plug on Grandma." Don't pretend to care about people when all you care about is demagoguing and demonizing humane health care reform to score political points.

I'm in despair that any real reform will ever be enacted. I'm sick of a country informed by brutality and stupidity. I wonder what all those imbecilic "Town Hell" screamers would be screaming if they found themselves in Louise's hospital bed.

(Cross-posted at The Broad View.)