Author Archives: oinsketta

The Patient Protection and Affordable Care Act

The New York Health Exchange, which determines the metallically designated (platinum, gold, silver, bronze)  level of PPACA insurance coverage your income qualifies you to have, has no ombudsperson.   It has no meaningful appeals process to correct things like an error that deprives a patient of health coverage for a few months.   The name of the director of the New York State of Health, if you ask, figuring you will contact that office directly, is none of the public’s business, although the enterprise is a wholly public one.  

It employs practices that fit the definition of “arbitrary and capricious” but would probably not be so deemed in a court of law.   You can hire a lawyer to bring an Article 78 proceeding, under NY State law, if you have a few thousand dollars lying around, but, there is zero chance of recovering any kind of monetary damages, so why go there?    

The Patient Protection and Affordable Care Act could, as accurately, have been called the Health Insurance and Pharmaceutical Industry Profits Preservation Act, but while the name would have been more truthful, it would have been a harder, and more embarrassing sell for the president.

But, let’s leave all that aside for now.    

Now you have health insurance assigned to you and you pay your premium. You liked the doctors you’ve been seeing for years, and were promised you could keep them, but that was not a truthful promise by the president.  No problem, and don’t get all pissy about it.  You find new doctors and you can have medical records sent to them for free by your old doctors, provided you send the proper authorizations to each previous doctor’s office.  Not really much of a problem, as anyone would agree.  

Except when you try to find out who will pay the new doctors for their services.  Then it becomes the patient’s sole responsibility– and you’d better be smart and patient as hell, preferably a trained lawyer, too — to figure out what you have to do so that you won’t be left holding the often shockingly unaffordable bill.

Although there is no requirement in the law that the patient be informed of the price of any medical service until after it is rendered (and therefore, purchased) it turns out to be possible, if not simple or straightforward, to research which services and providers are covered by insurance under the Patient Protection and Affordable Care Act.  

All you need, in the end, is the provider’s NPI number.   You call the provider (in health insurance jargon doctors and hospitals are called ‘providers’) request and write down the ten digit NPI number for that provider. Then you call your insurance company where you can usually speak to a representative within less than twenty minutes, since they are generally busy assisting other “customers”.   You give the person who answers the NPI number and then go back on hold while they connect you to someone who knows what an NPI number is.  

Do not get overwrought when the ads you are listening to while on hold are suddenly in Spanish, or in Mandarin.  You can never be sure, from a marketing point of view, which language ad will be the most ‘impactful’ even if the customer did not oprime el numero dos when given the choice of languages.  It is best to remain free of judgment while on hold.  

One must not be unduly disturbed by the thought that every health-related transaction is driven by the imperative to maximize corporate profit.  It is also important to keep in mind that any aggravation you may experience while on a long hold has nothing to do with any active desire to make things harder for patients trying to get medical treatment.  The health insurance company keeping you on hold to speak to customer service is only trying to keep costs down, for your ultimate benefit.  

“You didn’t get the provider’s NPI number?” the representative may say, throwing up her hands.  If you had the foresight, and got the NPI number, it is only a minute’s work for the insurance company representative to look up the doctor, determine if the provider is “in network”.  If you have not made a prior call to the provider to learn the provider’s NPI number you create additional work for a representative who does not get paid very much to do the patients’ work for them.  

You may learn, to your great surprise, and only 51 minutes into your customer service experience, that one provider may have multiple NPI numbers, each corresponding to a specific office location and associated telephone number.   Call the wrong office, or even the right one picked up at the wrong location, and the NPI number and provider are no longer “in network”– even though it’s the same provider, it’s a totally different NPI number, which should be obvious enough.  

From the insurer’s point of view, why would you expect to have insurance pay for a provider who you think is in network, even if the insurer itself told you so, if you do not have the correct NPI number for the specific service delivery situs you are making an appointment to see that provider at?

I understand that the bottom line in our global economy is corporate profit.  I get that, I really do.  I don’t like it, particularly when applied to health care, but I understand we live in a materialistic world and that corporations are legally constructed psychopaths the Supreme Court has us pretend are living human beings for purposes of their right to have a say in the government that makes and enforces the laws they must “live” by.  I get all that, I do.  

I get that all presidential candidates lie, that all presidents disappoint, that Mr. Obama was no worse than most in either of those areas.  He was better than some recent ones, certainly.  If you’re going to be fleeced by a predatory corporation, or killed by a drone without charges or trial, or have your phone and email records secretly collected, or be denied a Freedom of Information request, or threatened with the death penalty for being a diligent journalist, or anything else Mr. Obama or any other American president might do, you might as well get that treatment from someone who is thoughtful, funny, smooth, cool, calm, who knows how to sound like his heart is always in the right place.

I don’t begrudge B.O. the hundred million in speaking fees he will get in the next couple of years.  He’s brilliant and very talented and deserves the handsome fees much more than most of the famous and infamous speakers who get paid obscene sums to inspire corporate audiences.  God bless America and God bless his freedom to make those hundred million in the next few years.  Couldn’t happen to a nicer guy, as far as I can tell.

That said, I have limited patience for statistics-spouting, blindly partisan defenders of a deeply flawed,  perhaps fatally compromised, solution to a long-standing problem that afflicts millions of our most vulnerable, especially if that partisan defender has had no personal experience with the day to day niceties of the Patient Protection and Affordable Care Act.  

The outgoing president, taking his bows now in a last well-measured victory lap, has to get some of the blame for the many flaws of the monstrously complex, profit-driven health industry-favoring law that bears his name.  

You want to point out that he’s been surrounded from day one by detractors, many of them racists, snarling, unreasonable, petulant obstructionists who have done nothing to fix the flaws in the complicated, problematic law, outside of trying to repeal it countless times?  Fair enough. But the solution the president put on the table at the start of negotiations was designed, before anything else, to ensure that health insurance and pharmaceutical company profits were kept as healthy as possible.    It was drafted, after all, by experts who went back to work for those industries after the bill became law. 

And, as in any zero sum game, the weaker party, regrettably, wound up, inadvertently and completely unintentionally — and we’ll stipulate, out of respect, that it was done with only the best of intentions — burdened, scammed, coerced, unaffordably billed and, in many cases, simply fucked.  

But, hey, would you rather have a preexisting condition?   Or die in an E.R. with the 45,000 other Americans who died every year for lack of health insurance?   Thanks to Obamacare the number of Americans who die in Emergency Rooms for lack of decent preventive health care is certainly much lower now.   Though statistics are hard to find, I’d wager that terrible number has been cut in half.

As the president said when signing the flawed law “don’t let the perfect be the enemy of the good.”  Or, as a patient protected by the PPACA might say, “don’t let the good be the enemy of the fairly crappy.” 

Creativity as a solution to problems

Creativity is only a solution to a real-world problem, like poverty, if it generates capital.  That’s an iron law of capitalism.  Even an excellent idea that could help millions, unless it can be monetized, is worth the weight of the abstract brain cells that spawned it.

“You are one bitter motherfucker, son,” said the skeleton of my father respectfully.

The Framers’ Intent and the Electoral College

“There’s been a lot of whining about the Electoral College since, for the second time in the last five presidential elections, the winner of the popular vote, a Democrat, lost in the Electoral College to the Republican, who went on to become president according to the Constitution,” said the skeleton breezily, sitting up alertly in his grave.  

“That’s arguably by the intent of the Framers’, Elie.  American democracy was based on a series of compromises between wealthy white men whose wealth was not based on slave labor, and those whose wealth was.  Fair is fair, Elie.  In the Northern states manufacture and, to some extent, in places like New York, the slave trade (but not slavery itself, God forbid) were sources of wealth.  In the South it was labor intensive monocultures, cotton and tobacco.  To make those crops really lucrative, it was best to have a slave labor force to pick it.   So keep your cotton pickin’ hands off our slaves, son of a bitch. 

“To ensure the deal, and make sure popular opinion, that might be eventually be revolted by something as inherently repulsive as chattel slavery, did not get the final say, safeguards were put into place to make sure the wealthiest Americans did not have to resort to dirty tricks or violence to keep the populace in line.  One of these ‘compromises’ was the Three-Fifth’s Compromise that is so famous today, and rightfully so.  

“For purposes of apportionment to Congress, and to give more power to the more sparsely populated southern states, each slave counted as 3/5 of a man.   So if you owned 500 slaves, your district got a boost of 300 ‘citizens’ for purposes of apportionment and say so in the Electoral College.   In effect this manipulation of the electorate– using slaves, who were neither citizens nor voters, to increase the voting power of their masters  — equalized the playing field for the rich of the North and the genteel, slave holding Planters of the South.  

“All this to say that it’s no surprise a media-star billionaire who lost the popular vote by more than ten times the margin JFK beat Nixon by is the president-elect of the United States today.  It is as the Framers intended it, you might say, if you were the smug skeleton of, say, Antonin Scalia.  

“You want the punchline?  Alexander Hamilton was very proud of the Elector College, he thought it the most ingenious part of the Constitutional scheme, because… wait for it…. it would protect the new republic from ever being taken over by a demagogue.   You can’t make this shit up, seriously,”  the skeleton nodded, jaws clacking.

“Have a nice day, Elie,” said the skeleton, “I’ve got to sleep this one off.”

Thoughts while falling asleep

I think of my father’s dire childhood, it actually is unthinkable.  How often was he hungry growing up?   Phrases to describe the poor kid’s misery pop into my head in the middle of the night, too perfect not to get up and write down, though last night I didn’t, needing sleep more than phrases.   Now I’m left with shards, like the ones on my father’s eyes and over his lips when they opened the coffin for me to do a positive I.D. at the cemetery.

Here is a thing that was impossible for my father:  turning off the brooding anger.  My sister said it right: the loss of a dime from the change he had received and put on the counter was the same to him as the loss of his entire family in Truvovich.   Every indignity equalled every other indignity, every tragedy, no matter how small, carried equal weight. Every disappointment enraged him.  Then we have the next logical step.  

“Nothing you ever tell your sister, no amount of praise you can give her, ever sinks in,” said the ‘dumbest Jewish kid in Peekskill’ on his deathbed, almost 81 years old, after a distinguished life as an intellectual who was half a dissertation away from a PhD from Columbia.  

“You had a temper tantrum at the rain,” observed my father when I was a boy.  He shook his head with one cheek creased in a smirk to underscore the idiocy of this tantrum.  Something I’d been looking forward to, possibly a day at the ballpark, had been washed away by a deluge.  I apparently ranted at the rain.   “You stood there hollering at the rain, you were inconsolable,” my father said sadly.

I’d like to think the skeleton of my father has the insight to reframe these two remarks.  

“I know what you want me to say,” said the skeleton, “‘Your sister, I’m ashamed to say… your mother and I never gave her the emotional support we should have, all we did was undermine her confidence.  Every kid needs to hear that she’s bright, and capable, and cute.  Your sister was all of those things, at the top of the scale for each.  We never gave her any credit, filled her with self-doubt at every step.  It’s a testament to her will, independence and intelligence — her character, really– that she has done all she’s done in her life.  It’s not something we like to dwell on– we were simply wrong and we fought like devils to convince you two we were never wrong.'”

Couldn’t have said it better myself.  

“Well, but that’s not how it works, Elie.  You can’t just rewrite all my lines and pretend I was ever capable of the insights you ascribe to me posthumously.”

Actually, as the living party of this partnership, I get the final say on how it works, though I take your point.  I don’t know that you’d be capable, even now, of saying the words I just put between your jaws.  Still, they are the right words for you to say.  Just like you could have said this about my bitter disappointment as a young boy, when I was, as you say, inconsolable and you just shook your head about it. 

“Look, Elie, I know how much you were looking forward to this and how disappointed you are that it got rained out.  Any kid would feel the same way.  I know it hurts.  We’ll do it next week.  Life is full of disappointments and one of the biggest challenges anyone faces is remembering that they are only momentary set-backs.  Everything will be fine later, you’ll see.  Come on, let’s do something now to take your mind off it, you want to go see ‘Son of Flubber’ today?” said the skeleton, grimacing to pronounce the fifty-two year belated words of consolation.  

“But, of course, much as you’d like to hear it, I would never fucking say any of that.  You really expect anyone to believe that just because I felt guilt and remorse as I was dying that I would have held on to the insights I had then throughout eternity?”  

I prefer to think that, yes.  

“Jesus fucking Christ, that’s not how the world works,” the skeleton squinted like Clint Eastwood, if you can picture it. “Prefer away, then, but it changes nothing, your preference.  You want to believe in a world where people are not self-interested pricks out for their own advantage over everything else?  

“Go ahead.  Believe that 75% of your fellow Americans did not vote for this American Mussolini you got in the last election.  Statistics may show you’re right, numerically, but there’s a lot of hate out there.  You think Germany in the twenties was some kind of historical anomaly?  The height of western civilization plunged to the depths of barbarism over the course of a few years.  Your boy Frank Zappa had that track in the late sixties, ‘It Can’t Happen Here’ with the guy asking pointed questions, rat-tat-tat, in a German accent.  Hey, even the Germans are alarmed by this guy you have now.  

“Any nation that could enslave millions for centuries and then persecute the ancestors of those slaves for over a hundred years after a bloody civil war led to the abolition of said ‘Peculiar Institution’… well, all bets are off for the grandchildren of the little kids who ate cotton candy and cheered as black men were jerking at the end of a rope.  I know you don’t need me to draw this picture for you, Elie.  It doesn’t matter what you believe, what you need to believe– it matters how you live, how you use your limited influence, the example of your life.  And even those things hardly matter.”  

You’re a warm fire of inspiration on a chilly grey day, dad.  

“Homo sapiens is distinguished by one thing, domination over others, over nature.  If dolphins ran the world, maybe there’d be a chance to save the planet.  But killer apes in charge?  Good luck, Elie.”  The skeleton looked around, that eerie smile/yawn on its face.  

“You want a happy ending here, a nice bow to tie this into today?  Sorry, Charlie.  No can do.  That’s not how this shits how works, you dig?  Get on with your life, make those six medical appointments you listed yesterday, meet the new doctors, do what you can to protect your life going forward.  

“God knows this motherfucker you have now is not going to do anything to protect anyone, except perhaps his reptile children, the heirs of his hideous DNA.  Didn’t you love his son, speaking to his bloody mouthed followers, describing how his father came from ‘nothing.’  I guess to a billionaire’s son a few measly millions, even forty or a hundred of ’em,  really are nothing.  A plague on them all, Elie.  Take care of yourself today.”  

You have a nice day too, dad.  We’ll talk again soon.

Pants

The hospital room was quite cool and they didn’t seem to have enough blankets for some reason.  Down in the E.R. they’d brought me a heated blanket, which was delightful.  But once I checked in, put on a hospital gown, began shivering, the nurse told me they had to look for a blanket for me.  Meanwhile she covered me with several sheets, which almost did the trick.

A couple of hours later a guy came in to wheel me to the room where they do the stress test.  I told him I wanted to grab my pants, since I was cold.  He assured me I wouldn’t need pants.  

As we rolled I told him I wouldn’t need them if I was getting right on a treadmill to start running.  He smiled, doing his only job, pushing the patient in the wheelchair.  I noted idly that he had pants, and so did everyone else we passed in the chilly  corridors on the way to the echo room.

In the refrigerated suite where they do the stress test, I was the only person without pants.  I asked a worker there if he could get me some pants.  I pointed out that everyone else had pants and that’s probably why nobody else was particularly cold.  He assured me he’d find me some pants, then twenty minutes or so passed and I still had no pants.

“I’ll be right back,” I announced, getting out of my wheelchair, “I’m going back to my room to get my pants.”  

The original pants promiser called out that he’d bring me pants, and a few moments later came back with a pair of blue cotton hospital pants with a drawstring at the waist.   Perfect, thank you.  

I felt much better having pants.  Something as simple as a pair of fucking pants sometimes can make all the difference, if you know what I’m saying.  

Four or five hours later, when my twenty minute stress test was finally complete, I called out as I was being wheeled away “and thank you for the pants.”  The man who brought them to me smiled, the circle of small kindnesses now complete.

Gratefulness 101

It’s an often annoying cliche: we are happier and healthier being grateful for the good things we have than being bitter or anxious about the things we don’t have.  No less true for being an annoying cliche, of course.   I am grateful today, for breath going smoothly and deeply in through both nostrils, quietly out the same way.  

Pain in the chest, radiating down the left arm, numb hand suddenly tingling with pins and needles.  Doctor told you months ago the left atrium, one of four chambers of your heart muscle, is very weak, need to see a cardiologist, who will call.  No cardiologist calls, instead promises: two weeks, one week, any day.  No day.  Then one day, amidst payment denials from agents of the Patient Protection and Affordable Care Act, pain in the chest.    Directly over where the left atrium would be, here we go…. just to be safe, a trip to the Emergency Room.  

Twenty thousand dollars in state of the art medical testing and a day in the hospital later — a relatively clean bill of heart health.   Cleared to resume strenuous exercise.  

Bike ride the next day with two friends who have not fallen out of shape in fear of heart attack.  A pleasure, even if I was sweaty and gassed after a relatively short and not very strenuous ride.  I cannot describe to you the crispness of the world, the trees, the people, the deliciousness of cold water, of each deep breath, the miracle of the entire enterprise of being alive.  

It’s all a cliche, of course.  You really had to be there.  But I am one grateful dog today, still.

Found Obituary

My father always had a tall, tottering pile of New York Timeses next to his side of the bed.  His filing cabinet in the basement was a dust covered mess– he really had no discernible filing system.   The steering wheel of the Buick Regal he drove into the ground before giving it to me as a gift was blackened.  I had to scrub it with some kind of solvent before I started driving it, and nobody would call me a fastidious man.

“Your father is pretty much a pig,” my mother would observe from time to time.  A much better housekeeper herself, the surfaces of her kitchen, bedroom and other rooms were always clear and clean.  Her drawers and closets were crammed with a jumble of things, but that is another story.

“You got that letter today from fecal bronze Obamacare, soon to be terrific, actual shit-bronze Trumpcare, about denial of payment to two of the doctors you were referred to and you’re taking it out on your dead parents?” said the skeleton.  

No, I was just giving a bit of meaningless preface for my uncle’s filing system, which was, by contrast, quite meticulous.  

“Yes, he was definitely the anal-retentive of the two of us,” said the skeleton.  

After your brother died my cousin and I were going through his neatly organized filing cabinet and spotted a file with your name on it.   I took that file back to New York, after flipping through it. There were receipts from the hotel in Peekskill where we stayed for the funeral and another one where we stayed a year later for the unveiling.  There were car rental slips, paid toll slips, restaurant receipts.

“Nobody ever claimed my brother wasn’t mad as a hatter,” said the skeleton.  “In fact, you could make a case he even looked a bit like a rabbit.”

In that file folder, toward the back, I saw the other day, was a copy of the draft obituary he’d handed me to place in the New York Times the day after you died.  I placed it not in the New York Times, but on a nearby coffee table, and never saw it again.   Trying to clean one of the cluttered surfaces at her farm the other day Sekhnet came across the file folder with your name on it.  

“Mazel tov,” said the skeleton, “now, get over the galling inadequacy of the fecal bronze health insurance you have, and call one of the two New York City nephrologists in the network, Dr. Wooin Ahn or Dr. Qais Alawquati, call one or both, find out where their office is located and go have a covered kidney exam, before it’s too late.   You don’t want to fuck with your kidneys, look what happened to me.

“And either try to forget about the odd numbness in your left arm, and the stiffness and flickers of palpitation in your slightly dilated left atrium, or find a cardiologist in your network, demand a referral and go see the fuck, it’s been literally months now.    

“But don’t forget what happened to me, with my genius team of specialized medical experts.  Like your friend’s father used to say: doctors and lawyers don’t think for you.  You have to ask all the right questions.  You might start with ‘What the fuck, yo?'”

The Uncleansable Palate

“Sometimes there’s just no sorbet, even industrial strength sorbet, to cleanse the emotional palette,” said the skeleton of my father from his grave in Cortlandt, New York.  “Certain tastes are just too distasteful to stop tasting, sickening as that also is.   How’d you like that nice whiff of Hitler and his handiwork you had at eight years old?”  

I did not like it at all.  On the other hand, it’s not as if he killed my entire family, obviously.  Several of the dozens did survive.

“Well, you’ve always been a hyperbolic crybaby.  Look, obviously, this recent election, more than any in our memory, evoked that great image of Lewis Black’s that you and your mother laughed about not long before she went to her reward.   ‘When was the last time you went into the voting booth and voted for someone you really believed would do a great job, had integrity?   No.  You pull that curtain in the voting booth and– it’s two bowls of shit!  And you have to pick one!

“Your friends clearly found one to be a bowl of complete and reeking excrement and the other a bowl of some kind mildly inspiring, distasteful but edible sustenance, perhaps not the thing you’d choose to eat if there was any real choice in the matter, but something you could live with, something that would kill you much less brutally than trying to choke down the contents of the other bowl.  

“Hell, you might even have been pleasantly surprised at the weight loss benefit, since you would only have eaten as much as needed to keep you alive.  But that option is, sadly, now off the table, thanks to the skillful manipulation of popular anger and fear.

“On the other hand, Elie, the times now call out, in the most strident possible voice, for what Howard Zinn held out as those irresistible moments of human progress, like the end of slavery, the end of child labor, the vote for women.  At one time each of these institutions was considered just part of the immutable landscape of our great democracy.  A factory owner could make a killing employing kids instead of adults, or locking women in to prevent them from taking unauthorized smoking breaks on the fire escapes.

“Sometimes it takes a horror like the Triangle Shirtwaist Factory fire to move the heavy thumb off the scale of justice.   The image of all those dead women, their burnt corpses laid out in rows, poor women just trying to eke out a living in a brutal sweat shop, 146 dead to save the owners a few copeks?  Really, this is what you are, America, land of the free and home of the brave? 

“This guy you have now looked directly at the camera and claimed, with the confused look of a sincerely lying child, that he had no idea who David Duke was — no idea who the guy smiling with him in the photo was– then unconvincingly denied that he was coyly and steadily courting the enthusiastic endorsement of the Ku Klux Klan and their troll friends of the German hate-phrase adapting ‘alt-right’ lügenpresse.  

“Now that he’s elected, one of his first moves is to appoint Steve Bannon as his so-called chief strategist.  Bannon is the gauleiter and CEO of Breitbart, the white supremacist website that is the go-to cesspool for the ‘alt-right’– people who find guys like Rush Limbaugh to be tightrope walking pussies who lack the moral courage to call out the real reasons for our nation’s struggles:  non-whites, immigrants, Muslims and the fucking Jews. 

“The ADL said Bannon presides over a group of ‘unabashed anti-Semites and racists.’   The Southern Poverty Law Center said something similar.   Would they prefer a group of abashed anti-Semitic racists?  I mean, really, Elie, the world can be so judgmental toward men who stand proudly by their hatreds.  Plus, Bannon’s defenders do actually appear abashed when they defend their man and deny he hates anyone, even those groups who richly deserve it for being enemies of our freedom.”

Your skeleton’s sense of humor is not very funny to those of us who still have to walk, alive, through every day of the next four years.

“Only if you’re not struck down first.  You people just assume you’ll keep living, in spite of billions of cases you can look at to show the idiocy of that supposition.  All I have is this kernel of possible good news: this may be a tipping point in American history, the election of an American Mussolini.  Many of the people who voted for him wanted to blow up the system, and it’s about to catch fire.  

“You know that old saw, long debunked, about the Chinese word for ‘crisis’ being ‘danger’ plus ‘opportunity’.  That may be a cause for hope as much as a cause for fear.  Fear never got anyone anywhere– except out of direct danger, I suppose– but you know what I’m saying.”

Sure. I just don’t know how much longer I can ride the bones of this dead horse of talking to my dead father.  You know, the hard work, Brownie, the hard work… I dither here bullshitting with you instead of rolling up my sleeves and getting to it.  

“Well, it’s worked for you this far,” said the skeleton of my father, tartly puckish as he ever was sitting across the battlefield from me at dinner.

Clarifying the Skeleton’s Character

Best to be as clear as possible, for my sake, for the sake of the skeleton of my father, and for the sake of anyone trying to make sense out of any of this.  

My father fought, until literally the last night of his life, the idea that people can change anything fundamental about themselves.  My position was that we can make many crucial changes for the better, with sufficient effort, and that the question of “fundamental” was not something that should shut down the whole vital enterprise.

“Without fundamental change you’re left with scraps and window-dressing, superficial, essentially meaningless tokens of change,” said the skeleton.  “You’re a student of history.  Are you going to argue for incrementalism in a time of existential crisis?”

You get points for consistency, dad, but we’re talking about meaningful, positive individual change not vast, intractable institutional ones.  Without hope of change, you have nothing but the unyielding misery that is.  Is this the legacy of your life you want for your children, your message to your grandchildren? 

I’m not talking about learned helplessness by itself, that shit happens, like passing on a genetic disposition to cancer, as you said the other day.   Our general powerless over many terrible things aside, do you really want your final position on working for change to be that no matter how fucked up things are, there is no hope for change?

 “Clearly not,” said the skeleton, “however it may otherwise appear.  Look, I told you that last night of my life how much I regretted not taking you up on your many attempts to start a real conversation with me, how bad I felt for not reaching back across the flaming no-man’s land I kept idiotically burning between us.  

“I told you how I could not forgive myself for having been too weak and rigid to realize how insane my intransigence was.   You know all this.  Yes, I waited until hours before my death, but yes, I also died with unbearable regrets that only faded as my kidneys finally gave out and I expired with one last short breath.”  

If I was a praying kind of person, I’d have been praying for you in those last moments, dad.  As it was, I did my best to make you feel loved and wished hard for your end to be as peaceful as it seemed to be.  

“I know, Elie,” said the skeleton.  

I want to make it very clear here that you are not some idealized version of your ungenerous, angry, bullying self now, all wise and Buddha-like just because you died with regret and are now a fucking skeleton.  

“I know that,” said the skeleton, looking absently to the left and the right “who the hell are you talking to here, anyway?”

I’m making it as clear as I can, in a world that’s often based on lies, sometimes called myths, sometimes called advertising, propaganda or the cost of winning a business deal.  You are not, even in death, fundamentally changed, so you can take some solace, if you like, in being right about that.  

At the same time, in many other ways, you were significantly changed by the insights you had as you confronted your rapidly approaching death.   Your character now is informed by the hurt you finally allowed yourself to feel at the love you denied yourself and your loved ones during your life.  What you learned in your painful death is not lost on you, or on me.

Sure, like anybody else, you wake up on the wrong side of the grave sometimes and take it out on the only person who talks to you.  But you are also capable, in a way you could only have dreamed of during your embattled life, of having a real, sustained, mutual conversation with your own flesh and blood.  

“You are having the conversation, not me,” said the skeleton.  

Nah, I may be writing it down, it may seem to be in my head, but it is a real conversation between us nonetheless, the kind you wished we’d had fifteen years of, as you found me quietly listening to your regrets as you were expiring.  

“Well, all anyone really wants in a conversation is to know they are being listened to,” said the skeleton.    

That’s all I was ever trying to say.  It meant a lot to me that my father, the abused infant, the eternally enraged two-year old, finally came to that position too, even if it was on the last night of his life, or even eleven and a half years after his death.   You understand what a crucial door that single realization opens?  

Your fundamental nature may have been warped by the nightmare you endured for your entire childhood, but there is also a deeper nature, a more fundamental one than the one you identify as your baked-in personality.  

That deeper nature is the miracle of the human personality, it has the resilient ability to believe in and work for evolution, even a kind of rebirth. Being listened to by someone you care about can make all the difference between belief or pessimism and despair.  

“Well, I never felt I ever had that growing up, Elie,” said the skeleton.  

I feel sorry for you, but, at the same time, when you were a grown man, going forward, it was your own fucking fault that you never figured out how to learn that.   

“I know that, Elie, believe me,” said the skeleton.  “Fostering mutual conversation between adversaries was part of the most exciting years of my professional life, for fuck’s sake.  You’re supposed to have some fucking sense…”  

Learned Helplessness

“Let us clarify, at the start, that the title of this is not ‘learn-ned helplessness’, that deeply reasoned, well-informed, intellectually robust helplessness that comes at the end of a long course of diligent study of the methods and materials of helplessness, complete with the philosophical underpinnings,” said the skeleton, unaccountably wearing what looked like a dented motarboard.  

“We are talking about the natural, seamlessly transmitted lack of hope passed like a genetic predisposition from one helpless generation to the next and endlessly reinforced on the tilted playing field we are all frolicking on.   Your mother and I passed on our learned helplessness to you and your sister, after receiving it from our parents.  Today, more than half of this deeply divided country woke up experiencing the all-too-familiar horror of this feeling of bottomless despair.”

You know, now that I’ve had time to get over some of the initial horror, I realize I was unfair the other day, having you rail against the white haters who voted the bullying president-elect into office.  Many of the people who voted for him, it is only fair to admit, were not motivated by hatred at all, only strong dislike and fear, at worst, and in some cases these voters were the nicest people in the world, they were just protecting their wealth, trying to pay as little tax as possible by having a billionaire president.  

“You can spin it however you like, I’m just making the point about that infantile terror that strikes when you are forced to confront your own helplessness, against death, against those, armed to the teeth and seething with ill will, who come to kill your loved ones, against those who threaten the air you breathe and the water you drink.  It’s a dark day in America and millions woke up with a dry mouth and that feeling in the pit of the stomach that signals you are irremediably fucked.”  The skeleton sent his odd, flat-topped hat frisbeeing down the hill, almost reaching Eli’s grave sixty yards below.

“Take Yetta, your grandmother, for example.  She was bright, talented, entrepreneurial, idealistic, ambitious– and a vodka drinker with a hollow leg.  When she was a teenager she had a dress-making business in Vishnevitz– she employed several adult women to sew the dresses she designed, dresses that were in great demand in that small town.  

“This would have been around the time, right after the Russian Revolution, that the Communist youth movement was flourishing in Kremenetz, in that whole area of the Ukraine.  Young Yetta and her friends were thrilled to believe that the world was changing for the better, towards a world of universal decency for the poor, the end of exploitation of the many by the few, a new era of international worker solidarity.  Or so it seemed.

“She made her way to America, the land of opportunity, while the forces of counter-revolution battered away at the forces of worldwide worker justice.  She joined the International Ladies Garment Workers Union, made a decent living all through the Depression and then learned that all the women she’d employed in her dress-making business, and all her former customers, and all six of her brothers and sisters, and all of her nieces and nephews, and her parents, and every other Jew in the town had been murdered.   Imagine what she must have felt to get that news, at the age of forty-three, with a teen-aged daughter of her own.”  

You pick up the vodka bottle, try to feel happy or optimistic somehow.  Even if you have to be drunk, it’s better than the alternative, I suppose.  

“Well, there is no way to process the end of all your dreams, the death of everyone back home you loved, the end of the dream of international peace and cooperation — the end of everything good in your life.  

“Except for your life itself, an infinite good in itself.  You recall how fiercely grandma clung to life at the end?” the skeleton stared at me intently, with empty eye sockets.  

You’re really cheering me up, dad.  

“I’m not meant to cheer you up, Elie.  I’m meant to wake you up.   Whatever despair you are feeling right now, forget about it.   There is hard work to be done, and nobody else to do it.  You need to marshal your talents and put them in the service of convincing people of the need to organize, educate themselves…. ah, who am I fucking kidding?   You can marshal all the talent in the world…without funding… who am I fucking trying to convince?

“When I was in my thirties, around the time you were born, I went to speak to parents and teachers at schools that would one day be effected by the Supreme Court’s landmark Brown v. Board of Education ruling, schools that had to be racially integrated with ‘all deliberate speed’.   I spoke well, and passionately, and what I got for my troubles was a police escort because the parents and teachers were hostile to someone, in New York City, delivering the self-evident American message I had: Negro kids have the same right to opportunity in America as everyone else.  

“That was sixty years ago, Elie.   The only big change in that time, outside of a small very rich black upper class that has emerged and a much wider range of black celebrities in the media, is the banning of the word that those audiences who threatened me used to refute my talk about equality.  They pelted me with ‘nigger’ every time I spoke about freedom and equality and our Constitution, and the right of all Americans to a good public education, to become knowledgeable citizens, assemble, express themselves, and participate in our democratic system.

“I can see some of those faces I spoke to, talk about ‘twisted and contorted with hate’.  Sixty years ago, Elie, and the schools in New York City are as racially segregated as they were before the Supreme Court found segregated education unconstitutional.  Most citizens have no idea how crucial the Supreme Court is in setting the law they will live by for a hundred years or more. 

“You’ve got to tell them, Elie, about the string of Supreme Court cases in the decade after the Civil War that reduced the thirteenth, fourteenth and fifteenth amendments to meaningless footnotes for a century. All that is required for an evil status quo to continue is a Supreme Court that champions that evil status quo.  You’re about to have that for the rest of your lifetime, believe it.”  

Dude, you really have to shut up now.  This is all bad enough without the historical perspective.  

“The cancerous, zombie chickens coming home to roost, Elie, that’s all this is,” said the skeleton, with unaccountable cheerfulness.  

Well, as an old country boy, I have to say, the cancerous, zombie chickens coming home to roost is something I welcome– to paraphrase Brother Malcolm, before he was executed by a small team of hired n-words in the Audubon Ballroom.  

“Elie, you’d better get outside and go for a walk,” said the skeleton with what appeared to be genuine concern.