The Followspot

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.)

Michelle Obama channels Alice Waters

The New York Times reports that there is soon to be an organic food garden at the White House.

This is Alice Waters' dream come true. On last Sunday's Sixty Minutes Lesley Stahl interviewed Waters. This was part of their exchange:

STAHL: Now she has her sights on a new project and we would like to warn President Obama that the steamroller is on its way.

"You have been pushing for a vegetable garden at the White House for years. Rose garden? Forget that. You want a broccoli garden?" Stahl asked.

"I have been talking nonstop about the symbolism of an edible landscape at the White House. I think it says everything about stewardship of the land and about the nourishment of a nation," Waters said.

Asked if she thinks she'll achieve such a garden at the White House, Waters told Stahl, "Well, I'm very hopeful. I've always liked the idea of doing press conferences at the compost heap."

I'm not sure if Waters intended something deeper with her "compost heap" remark -- but that aside, her message seems to have resonated loud and clear. Not that Mrs. Obama and her people wouldn't have come up with the notion on their own. It's a natural for this First Family.

I'm sure some Republican jerks will find a way to make a negative out of this terrifically positive news. For those of us who live midst food stands and grocery stores selling fresh-picked locally grown produce, we know what a treat such unadulterated fruits and veggies can be. We knew that the Obamas know it too, and we're thrilled that they will be giving the "locavores" a bully, er, pulp-it.

P.S. The spinach recipe that Tristero wrote about (see the post immediately below) came from the White House kitchen!

A bargain

I don't take particularly good care of myself -- I smoke, and I hate exercise. Somehow, in spite of those failures and of the fact that I'm nearly 70 now (you don't know how little sense that number makes to me) I've never been a hospital patient overnight except when I had my two babies. I do eat a pretty healthy diet, because (as faithful readers will know) I prefer the "Mediterranean" style of dining, with particular emphasis on the grand foodstuffs of Italy. But using olive oil in cooking instead of butter and eating salads instead of Big Macs can only take you so far. Luck and genes, I suspect, are more responsible than anything I do or don't do. Thanks, Mom. Thanks, Daddy. And all the begats.

There is, however, one pesky problem that I've had for years -- with my back. A muscle on the lower left side gets knotted, and then I can't sit or stand straight, which means that all the rest of me gets progressively twisted and tortured. I can usually fix things up with a couple of days of bedrest, a heating pad and Advil. When those remedies don't work -- and in the last week they hadn't -- there is a chiropractor in town who offers deliverance.

Dr. Adams is one terrific lady. She doesn't seem to have aged a day since I first met her, nearly twenty years ago. She and her husband, who are in practice together, have raised five children. They both are -- there's no other word for it -- merry. They have a positive attitude about life that they convey, simply, with their own body language. It's a delight to know them. Best of all, they are completely non-judgmental, even with people like me who cavalierly break all the rules of a holistically healthful lifestyle that they themselves cherish. 

What a relief it was yesterday to receive Maria's tender ministrations. When she was finished, I fairly hopped off the table, filled with the bliss of being pain-free. I then had another pleasurable moment. Instead of the usual $50 fee, I needed to fork over only $6.42. 

Now...I pay something over $3,000 in annual premiums for Medicare and the Part J supplement -- the latter is known as "Medigap," for you young 'uns out there who aren't yet ripe for the program, and covers a significant portion of the fees that basic Medicare doesn't. In light of the hefty premiums, $6.42 may not seem like that much of a bargain. But I think it is, if only to remind me of how fortunate I have been, of how a government program can soften what otherwise would be a hard financial landing if indeed something more catastrophic than a sore back strikes. And to remind me, in a visceral way, of what a rocky road this life is for so many people who have inadequate health insurance or none at all. 

It's not cheaper by the dozen, or for 14 either

When are we, as a species, going to grapple with the fact that perpetuation of our time on Earth will probably require a whole lot less of being fruitful and multiplying? When will we, as Americans, see that the cult of "LIFE" at all costs will mean more unneccessary death and suffering?

I thought the news earlier this week that a California woman had given birth to octuplets (8! Count 'em! 8!) was a testament to everything that is both right and wrong about our health care system. As the story has developed, I think it's also an alarm warning of our inability to adapt to changing circumstances.

Only the physicians' skills and superior facilities commonly available in America enabled the safe delivery of what can only be termed a litter. The babies were nine weeks premature and range in weight from one pound, eight ounces to three pounds, four ounces. One is still receiving assistance breathing. Before the birth, the mother had been hospitalized for bed rest for seven weeks. A team of 46 doctors, nurses and hospital staff prepared for and attended the birth.

And therein lies the problem that we're all paying for: Forty-six medical professionals were needed for one pregnant woman. That woman required nearly two months of hospitalization before the main event. For an undetermined amount of time, eight premature infants will be hospitalized in intensive care.

The almost universal response in the media is one of celebratory joy. A few get to interviewing fertility experts about the questionable wisdom of such a high-risk pregnancy -- way down at the end of the piece. None that I've seen question the morality of burdening society and the planet with such flamboyant fertility.

Yet there are still women in this country who can't get adequate prenatal care. There are infants in this country who suffer and die because they don't have health insurance and the first time a doctor sees them is in an emergency room.

But this stupid, selfish breeding machine is praised for having the damned nerve to hog so many medical resources. She declares that she's "ecstatic" about the "miraculous experence." There is nothing miraculous about in vitro fertilization and implanted embryos. It's technology.

Yesterday it was reported that mega-mom already had six children before she had the embryos emplanted. What the hell? Is there any combination of human genes that deserves that much representation in the pool? On top of that, she lives with her parents. Call me old-fashioned, but is there a father/husband around?

What do doctors say?

"Who am I to say that six is the limit?" said Dr. Jeffrey Steinberg, medical director of Fertility Institutes, which has clinics in Los Angeles, Las Vegas and New York City. "There are people who like to have big families."

Dr. James Grifo, professor of obstetrics and gynecology at the NYU School of Medicine, added: "I don't think it's our job to tell them how many babies they're allowed to have. I am not a policeman for reproduction in the United States. My role is to educate patients."

"There are people who like to have big families." Yes, there are, and nobody is saying that it's time to re-examine our priorities, particularly not the doctors running the lucrative fertility clinics.

There are infertile couples desperate for children that can't afford fertility treatments. There are children languishing in the foster care system who desperately need parents. Yet there is a doctor who thinks it's ethical to give a mother of six, living with her parents, implanted embryos.

We all love our own. Perhaps, though, it is time to start loving not just well, but wisely. If we human beings can't learn to limit our collective and individual fertility, nature will do it for us. Wars over resources, new plagues spread by globalization, widespread famine, environmental degradation -- isn't it time we used our so-called "big brains" instead of our lemming-like tendencies to overpopulate? Must we applaud such selfish, extravagant rights to reproduce until the inevitable population collapse?