how do we treat the sick?

There’s been quite the flurry of noise on the Internet about the American Health Care Act that was passed in the House of Representatives today. Something that caught my attention is an interview with Mo Brooks (R, Rep. AL), in which he said:

‘People who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy. And right now, those are the people — who’ve done things the right way — that are seeing their costs skyrocketing.’

Source: CNN Interview with Mo Brooks by Jake Tapper (around 3.20 of the clip)

His statements imply that people who lead healthy (‘good’) lifestyles don’t have pre-existing conditions, which also implies that people who do get sick or have pre-existing conditions somehow did something to deserve their poor health.

Brooks does immediately add, ‘Now, in fairness, many of the people who have pre-existing conditions have those conditions through no fault of their own.’

It’s the earlier statement that is getting the headlines and the attention, and for good reason. The problem here is in placing a moral value on a person’s lifestyle — whether they exercise regularly or diet or eat well — which is what the first statement does: people who lead ‘good lives’, who have done things ‘the right way.’ How, then, do you reconcile the second statement, that those with pre-existing conditions are not at fault for having them, with the first? You have already established the premise that ‘good people’ don’t have pre-existing conditions. So how can someone have a pre-existing condition and not have done something to deserve his or her condition?

This is not a new question. I am reminded of the disciples asking Jesus when they see a man blind from birth: ‘Rabbi, who sinned, this man or his parents, that he was born blind?’ (John 9.2) We might not express it as outright as that, but we still sometimes have that sentiment that if something bad happens to someone, then they probably deserved it: this idea of, ‘Well, they had it coming.’

But we need to remember Jesus’s answer: ‘Neither this man nor his parents sinned; but this happened so that the works of God might be displayed in him.’ (John 9.3)

Granted, in the gospel, the work of God is Jesus restoring the man’s sight, which isn’t exactly something we can expect to happen today (it wasn’t common then, either). That doesn’t mean we can write off Jesus’s answer, though.

Neither this man nor his parents sinned; but this happened so that the works of God might be displayed in him.

Often I see the focus of this passage placed in the following sentence or in the events after the miraculous healing, to the point that this sentence is overlooked. If this sentence is evoked, it’s usually done after some misfortune or tragedy, along with the platitude, ‘All things happen for a reason’ (with which I politely disagree, but that is another subject).

What are the works of God and how might they be displayed? What does that look like today? Right now, in the wake of the AHCA passing the House, this is what I hear from that passage:

The works of God are displayed in how we treat the sick, the poor, and the needy.

Our words, our thoughts, and our actions: what are they when we encounter someone who is ill? What are they when we encounter someone who is chronically ill or differently abled? Not just how we treat that person as an individual; but how do we treat them as a group when we shape our ideas about health care and when we vote? Are we treating the sick, the poor, and the needy in such a way that it displays the work of God?

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on commercial healthcare

Yesterday I went to the ER (A&E for my British readers). I had been doing some DIY work on the patio/catio and the step-ladder I was standing on inexplicably folded out from underneath me. I immediately retrieved frozen vegetable bags from the freezer to put on my bruised and blindingly painful left foot, peeled off the sock, and saw that it was bleeding. I swallowed some painkillers and hobbled my way to the bathroom to wash my foot. The cut, once I could see it, was far deeper than I knew I could manage alone. Hastily, I bound it with tissues and medical tape, maintained pressure on the wound, and phoned a friend to ask about going to the ER.

surgical shoe 14-03-17

It looks more dramatic than it really is.

I had only been to the ER twice before, and only once in the U.S., more than a decade ago and only because I needed to see a doctor on the weekend. Since then, the number of independent urgent care centers have proliferated, in part encouraged by competition. Was there some trick to know which one to go to? Were some covered by my insurance and others not? My friend assured me that I could go to any of them, so we located one closest to me and I drove myself there. I was the only patient and was seen to immediately.

The commercial quality of healthcare in America was apparent by the sign announcing, ‘Highest rated on Yelp!’ on the entry door, and was highlighted again when I was checking out: not only was I asked to fill out a customer satisfaction survey, but I was also given a gift bag, the contents of which were all branded with that urgent care center’s logo. Today the center phoned to check in on how I was doing and to ask again for a customer survey.

The entire commercialization of healthcare part of the experience leaves me baffled and repulsed. That healthcare is to be so commercialized and run for profit is antithetical to my belief that access to basic healthcare is a human right, especially in a country that claims to be so far advanced and civilized as this one, and to my general distaste for excessive accumulation of wealth, particularly at the expense of others. In terms of customer satisfaction, what does it matter beyond competent and correct care and that everyone involved behaves professionally? I don’t need a gift bag or be pampered by the staff. I don’t understand the mindset that equates patient with customer.

(The cut was deep enough to need stitches, but its placement and clean edges meant that they could use a ‘super-glue’ for skin instead. It hardly hurts at all; in fact, my bruises and the tension headache that followed hurt worse once the foot was bound up. I’m lucky that it wasn’t worse, considering that I landed on concrete with various bricks and wooden planters around me with sharp edges.)

On patriotism, travel

Today, as many will be aware, is the 4th of July and it is the seventh I have spent in Europe. Being overseas during this very patriotic, American holiday brings to focus how living outside of the USA has given me a different perspective on American patriotism.

I’m not one for patriotism, really. You probably wouldn’t find me at a “Freedom Fest”, even if I do enjoy fireworks. I don’t buy into the concept of “American exceptionalism”. The United States of America is one of many great countries on this planet, and like all countries and cultures it has its own faults and virtues. I do think that American culture — though this in itself is a tricky subject — is unique, but unique does not necessarily equate with “best”. British culture is unique. Austrian culture is unique. Thai culture is unique. No one system has the perfect government, perfect social system, perfect education, perfect anything. Some countries might provide better quality of life than others, but even that is a sliding scale. To be honest, the USA does not always rank highly in these lists, not when it comes to health care, maternity leave, or work/life balance.

At the same time, American culture is fascinating because it is simultaneously diverse and homogenous. Put a group of Americans in one room — some from southern California, some from northern California, from Florida, Texas, Main, Massachusetts, Kansas, Colorado, Alaska, Hawaii, and Ohio, for instance — and some will instantly hate each other…while also bonding over shared music, favourite television shows, how they all love Mexican food (and then the Californians and the Texans will argue over whose Mexican food is better). In a country as large as the United States, it can’t help but be a mosaic of diversity, and yet a shared language and shared media acts as the mortar linking these different groups together.

As I was discussing this with my friends in Vienna, a German and Icelandic couple, I thought also about how it is the 4th of July and here I am attempting explain “America” to two people who have never been there. I do think it is a shame that many Americans don’t own a passport and have never travelled abroad. Even so, I am often embarrassed by the Americans I do see travelling abroad. Why? Not only because travel is educational, fun, mind- and eye-opening, not just because American tourists come across as brash, loud, ignorant, and rude, but because Americans themselves can be America’s best ambassadors. What better way to counter the international reputation that Americans are stupid than to provide an example of an intelligent American traveling abroad?

In this way, perhaps, I am patriotic, and I would encourage other Americans to participate in this form of patriotism, too.

The future is now

I am currently watching the Venus transit via the NOAA Mauna Loa live webcast, though I will soon be going to bed. Ros and I stayed up to watch Venus make it to second contact because, well, this is a once-in-a-lifetime event. The next time Venus makes a transit across the sun will be over 100 years from now. Worth staying up for, even if I will be tired tomorrow.

One of the (many) things Kelly and I discussed was the future of science fiction as a genre; particularly, how to continue to depict things that are unfamiliar to our contemporary audiences. The previously recognisable ‘science-fictiony gadgets’ are now our reality: communicators and tricorders are smartphones and iPads. We have lasers, we have robotic sand fleas, we have the Internet. Sixty years ago, television was limited and still in black and white; today, nearly every home has one, digital and in colour, and here Ros and I are, watching a live webcast on my computer from a telescope in Hawaii while we sit in our pyjamas in Scotland. The future is now.

The next Venus transit will be in 2117: 105 years from today. What brave new world will watch the next transit, then?

And, thinking as a science-fiction writer, are we on the brink of a revolution in our own genre, a break from previous canon as we try to envision something new?

Musings

My coworker and I both exclaimed in surprise when a bird dropped from the sky. It landed head first right in front of the museum doors. We watched it, at first thinking it was dead, but then it moved. Our doors are automated and open outward, and the bird wasn’t making to go anywhere. As a result, we were worried that the doors would knock it and hurt if further. So I went out a side door, scooped up the bird by sliding a couple of ‘Wet Paint’ signs under it, and carefully transferred it to the bushes. It merely looked up at me, dazed.

I was wondering just now, since I was planning on checking on the bird when I go out for my lunch break — what other animal would do this? Any other large predator would have either killed and eaten the bird or ignored it. Could we say that compassion, not just for fellow members of our species but for other creatures as well, is one of the qualities that separates humankind from simply being another kind of animal?

And if compassion is a quality that defines one as human, how then do we cultivate that quality in our lives?

Giants, dragons, & bears…

A friend of mine asked to hear more about my creative writing and another asked me to write about how powerful medieval literature is. Here is an attempt to answer both, quoting the illustrious Helen Cooper:

‘[Romance motifs’] quality as memes, with their generous capacity to latch onto the mind and replicate, is wonderfully caught by one of the last authors to use medieval texts in an unbroken line of transmission, John Bunyan, in the later seventeenth century. He misspent his youth reading cheap prints of romances, not least the perennial favourite Bevis of Hamtoun: a work that owed much of its popularity to its density of the simplest and most colourful of such motifs, dragons and giants and grim prisons and healing balms. […] Bunyan realized that a good story composed of motifs that are already familiar is the most mind-engaging form there is, and that romances are the very best such stories. It is no coincidence that the authors who kick-started the modern equivalent of the romance, C. S. Lewis and J. R. R. Tolkien, were two of the leading medieval scholars of the mid-twentieth century.’ (The English Romance in Time, pp. 3-4)

As I continue to read The English Romance in Time I find more and more quotes I would like to use from Cooper, but I shall refrain. The romance genre — not to be confused with the modern romance novel — was the most popular form of secular literature for at least five hundred years. Though there is family resemblance across these texts, no one definition fits all of them. But their popularity lies in their appeal to the imagination and to entertain, their relevance to current society whilst being placed ‘far far away, long long ago’, and their use of familiar motifs and ideas — and not only the faithfulness to various motifs, but their adaptation of them. The beautiful woman met beside a fountain might very well be expected to be a fairy, but in the case of Melusine, the fairy becomes all the more compelling because she loves her husband, raises many sons, and desires a mortal, Christian life instead of a life with other fairies. Romances were not only used to entertain, but also to educate, and opened themselves consciously, and sometimes not so subtly, to debate the actions, motivations, and morality of the characters. In short, medieval romance is exciting to not only read but also study because in addition to the giants, dragons, quests and adventures, they are also mirrors through which we can glimpse the preoccupations, concerns, desires, and ideals of medieval society, albeit darkly.

And so it should come as no surprise that I find myself writing ‘modern medieval romances’, fairy tale retellings in the mode of medieval romance. The Pooka novels make use of motifs found in fairy and folk tales, Classical myths, and medieval romance. The knights and princess go on quests, encounter strange creatures, and have many adventures along the way. Like my medieval predecessors, it is not only the appearance of standard fantasy and fairy tale motifs, such as dragons, a damsel in a tower, etc., that make my stories fun to read (or so I hope), but the reworking of those motifs, the blending and reinterpretation of them into something familiar, yet unique.

This is, of course, a rather poor answer for a very rich subject, and yet I hope it has proven interesting…

Our Garden, Part 8

Last night Ros, Charly, and I heard that it might be possible to see the Northern Lights, so around midnight the three of us went out to the end of the long pier. It was mostly cloudy, and though there was a suspiciously bright patch of cloud over the bay, and an oddish colour blue between the clouds to the north, we mostly saw the northern lights of Dundee from across the Tay. But it was not a venture wasted. Dark as it was, we could see ribbons of white and silver on the tips of the waves. Between the patches of clouds were swaths of stars, so rarely seen in summer when the days are so long. I was mesmerised by how far light can reach in the darkness: a flash of headlights sparkled on the waves from a car turning down a road across the bay, a bonfire at the base of the castle cliffs where someone was juggling fire, and even Jupiter cast a faint gleam on the sea.

This morning, after a much needed lie-in, I was grateful that it was another sunny day. After brunch I went out to work in the garden. The task today was to clear up the area around the blackcurrant bush and apple tree so that we could get to them more easily. One thing I appreciate about gardening in Scotland is that I need have no fear about getting amongst it in weeds and bushes, because I don’t have to worry about spiders that can kill me. I always forget to take before and after photos of my renovation work in the garden (renovation is the best term for it, since we inherited the garden with the house and it has suffered who knows how many years of neglect). But here you can see how our fruit area looks now.

Of course, having now made the blackcurrant bush easier to get to, I then promptly stained my hands purple harvesting a bucketful of fruit.

One of the first time I encountered blackcurrants was when I was traveling around Britain with a group from OBU, and I poured myself a glass of what I thought was grape juice one morning at breakfast. After that first misadventure, I was wary of blackcurrant flavoured things. Then I tasted blackcurrant jam, though, and it’s been a good relationship since.

With my very own blackcurrant bush, I can make my very own blackcurrant jam. Just look at that bubbly, fruity goodness. Blackcurrants, like most native British berries, are really quite tart. But add just enough sugar and it becomes a delicious, delightful jam. I was pleased to end up with four jars as the fruit of my labour. (I know, the tray behind them says cherries. But I like it.)

Of course, one must always have a piece of toast with the left over jam in the pot.

I spent the afternoon attacking the weeds around (and beneath) the courgettes and the pumpkin plants. Imagine a garden where it gets just the right amount of sun, good fertile soil, and lots of rain, and then let it be neglected for three or four weeks. Yes, I have quite a lot of work ahead of me.

In other news: C is for Courgette: