The Politics of Rage

I, like many Americans, spend much of my psychic energy every day trying to keep the top of my head from blowing off.   This happens when a person is placed in a psychological pressure cooker of one kind of another.  In my case the present pressure cooker, primarily, is the near impossibility of seeing a recommended doctor to treat my serious kidney disease– an eventually life-threatening difficulty I’ve been stuck in for two months now as unknown damage may or may not be occurring in a vital organ/organs.  

Solving this vexing health problem would only relieve so much stress, of course.  I would still face the many frustrations of living in a competitive pressure-cooker of a society where people are pitted against each other in a zero sum war, while ugly partisan battles rage daily and the earth itself is becoming uninhabitable due to the incomprehensible greed of a few already immensely wealthy people.  We watch problems that should be intelligently discussed and solved go unaddressed, except for the televised bickering of well-dressed two year-olds spouting talking points, talking past each other to score meaningless points with those who support them, year after year.

The result of enforced powerlessness is resignation and rage.  These things sound at first like opposite reactions, but they are not mutually exclusive, they are two sides of a coin.  You feel hopeless and resigned, you brood about why you are in the situation you are in and you feel rage.   Your rage leaves you hopeless again, but it is building in the background for the next wave.  The rage and hatred at least provide a surge of energy, a phantom feeling of some kind of power.

In my case, I find myself hating frequently deadly American Corporate Health Care and the culture of personal greed that justifies countless preventable deaths as an acceptable cost of doing supremely profitable business.   When corporate medical providers and corporate insurance companies blame each other for the medical predicament I find myself in, I turn my hatred to the corporate “person”.   I understand that this legally created person is a psychopath, it exhibits every one of the DSM’s characteristics of the psychopath.  Callous unconcern for the feelings of others, reckless disregard for the safety of others, deceitfulness, repeated lying and conniving against others for profit, incapacity to experience guilt, etc.    

I can defend my hatred with countless examples.  It doesn’t help me solve the immediate problem, avoiding death by American health care, but critically analyzing the faceless entity that is nonchalantly and impersonally trying to kill me offers momentary relief from the feeling of being sodomized.  The confirmation bias comes into play.   Every time I see another example of corporate psychopathy, and there are many, I am confirmed in my view that the practices of these poisonous institutions should be tightly regulated instead of corporations being the omnipotent rulers of the “Free Market” that is the democratic world order.   I dismiss ads by Koch Industries that tout the wonderful, creative, life-sustaining, people-friendly company they are as the work of an amoral public relations agency making a shit load of money putting a good face on the hell-bent moral equivalents of Nazis.

Here’s the larger point, though:  

We live in the stubbornly gridlocked political dysfunction of a divided nation of self-interested partisans, bigots and haters of bigots, barking past each other, each side howling catch phrases to its base.  This hideous farce is currently presided over by the personification of unearned privilege and the idiocy that is marketed to Americans as success.   This “winner” was born rich, sought endless attention, finally attained it as an abrasive, wildly popular ‘reality-TV star’, and, through an aggressive, divisive campaign narrowly won the Electoral College (designed to protect slavery from the whims of the democratic voters) and took on his dream role of the most powerful man in the world.   His presidency is a symptom of the miasma of rage most Americans live in.

Everything I have said above about my hatred of the corporation can be said, in one form or another, by anyone who hates.   We do not believe anything without being able to justify it 100%.  As I can make my case against corporate psychopaths, someone who hates immigrants can make their case, someone who hates Muslims, or Jews, Blacks or homosexuals can make a case as tight as a noose.  The analysis may not be as convincing in each case, but a case is made and an undying belief confirmed.  

Trump appealed to the rage that millions and millions of white Americans feel, having been told over and over they are “privileged,” as they watch brown and yellow people, many who don’t even speak English, pushy women, transsexuals, foreign-born secret Muslim presidents, etc, moving ahead and “winning” while they are not, and worse, as they lose they are being held guilty for wrongs done long ago, wrongs they had nothing, personally, to do with.    It’s not hard to understand why many white people would be angry, watching the American Dream slipping away from them.

It’s hard to dispute that most Americans are worse off than we were a generation or two ago.  Certainly in terms of hope for a better life for the next generation.   Adjusting to that reality is maddening.  As the super-wealthy increase their wealth, the vast majority of Americans grow more economically insecure in our casino capitalist system while a government of millionaires performs disgusting theatre in a pay-to-play system that does not act in the interests of the screwed majority who voted them  into office.  

The candidates in the recent presidential elections spoke to that injustice to varying degrees.  Millions, particularly the young and most directly screwed, supported Bernie Sanders, who analyzes the situation astutely, speaks plainly and proposes humane solutions based on crucial systemic changes.   Millions who hated Trump did not bother voting for Hillary Clinton, the second most hated political brand in America, because she spoke the language of a corrupt insider, promising incremental change, the rising tide that lifts all boats, and empowering little girls to grow up to be rich, powerful women.  Trump, meanwhile, spoke nakedly to hatred and rage, making an emotional appeal to a mythical past when everyone knew their place, demonizing immigrants and angry minorities, and promising things he had no intention of delivering to suckers he correctly said would have supported him if he shot someone on Fifth Avenue.

Not all analysis is equal, of course, but the confirmation bias means we will select data that supports our thesis, ignore data that contradicts it.  Particularly, and this is worth noting again, when we are angry.  When we are angry, we feel perfectly right to be angry, there is no question abut that. Virtually everyone who voted for Trump still believes they were right to vote for him, that he is doing his level best to carry out his promise to Make America Great Again, in spite of being surrounded by traitors, liars, leakers and other cowards.  Trump is regularly throwing red meat to them, directly to their phones, confirming over and over that he is their man, working for them, no matter what.

Consider this example.   Black kid sneers at cop, or menaces him,  cop shoots black kid to death.   There is a big difference, legally and morally, if the cop felt disrespected or was in actual danger, or protecting others from imminent danger, but that is a question for a jury of one’s peers.  That is, if you can get a Grand Jury to indict a police officer who kills in the course of his duty to protect and serve.  Depending on who the jury is, we will have two very different outcomes.  

A jury of poor blacks will know other families who have lost a son to an angry cop, may have their own experience being treated badly by the police.  A jury of policeman will know other cops who have been killed because they hesitated to defend themselves with deadly force.  Conviction or acquittal, in a system based on ‘reasonable doubt’, will come down to where the trial is held and the composition of the jury.  Lawyers are paid big bucks to get the right venue for trial and pick the best jury.

That is not to say, of course, that everything is relative and depends on your point of view.  Something happened right before Michael Brown was shot to death in Ferguson, Mo.    Cop told him to “get the fuck out of the street.”  Brown may have said “back atcha, you fucking racist cunt.”  Brown may have moved menacingly toward the cop, punched him and made a violent move to reach into the car to grab the officer’s gun, as the cop said, justifying the six shots that killed the young man.   Just because we will never know exactly what happened does not change the fact that something objectively happened.  Here is one account  trying to piece together what actually happened.

If the officer had been wearing a body camera, and it had not been switched off, the entire incident could be viewed.   That video could have exonerated the policeman in short order, if the kid actually did reach into the car to grab his gun.

There will be Americans who sincerely believe that an angry black kid who curses back at a cop deserves whatever he gets.   Death sentence is fine with them.  They will be outraged that a black person would respond to “get the fuck out of the street” by cursing the cop, or making a menacing move toward him.  Unthinkable that anyone could curse at a police officer,  no matter what the cop may have done to the citizen, let alone shove or punch a cop.   I suspect  Trump got the vote of virtually every American who feels that way.  

We live in a culture of systematic manipulation, driven by the profit-motive, which never sleeps.  It is no surprise that the most toxic notions in the world are routinely sold here in America.  Millions here believe “Climate Change” is a hoax dreamed up by prosperity-hating commies like propagandist Al Gore.  No amount of evidence can change a view that is baked in and confirmed by everyone they trust.

A psychopath has no limitations on what he will say or do to get his way. That’s the liberating beauty of being a psychopath, or a corporation, for that matter.  If you truly have no regard for others, outside of taking their money, and no shame, you have a great advantage in a society that teaches there is only one measure of success:  unlimited fame and vast fortune.  

As for me, I continue to try not to let my powerlessness and hatred destroy me, and to keep the top of my head from blowing off.

Death by American Healthcare (part 2 of 22,000,000)

I won’t even mention Obama, except to say “fuck that charismatic sell-out punk and the whores he rode in on.”   I buy my health insurance through the New York State exchange under the immensely complicated compromise scheme crafted under his watch.  I suffer from a serious kidney disease.   I am unable to get an appointment with a recommended nephrologist who accepts my insurance plan, one of fifty or more sub-plans offered by the corporation that provides my health insurance.  

The insurance company has now listed three doctors, each one highly recommended, as  participating in my specific plan.   You call and eventually find out, oops, devil is in the details, they don’t actually participate.  The insurance company blames the providers for not keeping them updated.   I blame corporate medicine for fucking people to death with a tireless mechanical dick.  In fairness to them, there is no regulation of their practices, so why blame them for taking advantage?

Nothing I can write here will ease my frustration or rage one bit.  I might as well bang my face against the wall until I black out.  That is probably a better bet than anything else I can do at the moment.  

I just note for the, hahaha, record, that the theory of Obamacare is that doctors are fungible, interchangeable, any doctor is as good as any other doctor.   Relationships between doctors and patients, and trust, are irrelevant.  Better to pick a name out of a hat and see a doctor than to have no doctor at all, goes the theory.  Sometimes that goes badly, as when a doctor does not believe in sharing diagnostic information with a patient with too many questions.  “I am expert,” says the doctor, “you deal with side effects from chemo,” and that should be answer enough.  You want another doctor?  Dip your hand back into the hat, motherfucker, maybe you’ll do better this time.  

Or maybe you will run full force into a wall, over and over again, until you lose consciousness.  That is probably a better bet for you today.  Have a nice day, your business is very important to us, please continue to hold.

 

Shame-based orientation

Shame is a killer.   It can turn an abused person into a violent criminal, a tortured neurotic, or both.   Shame spins a web of secrecy, to be guarded tenaciously.  My father fought shame his entire life, the shame of growing up in “grinding poverty”, the shame of being whipped in the face by his religious mother from the time he could stand.  Any other shames thrown in there on top of those were just gravy.  He would not, could not, consider opening the door to examine this deep shame, possibly find some relief from it.   As a result, he lived as the “Dreaded Unit”, bullying his wife and children, and died with many regrets he only got to confess due to chance.  

“I did what I thought I had to do.  I wish I’d had the insight to understand how fucked up that was, how much richer my life, and your lives, could have been if I’d only had some fucking insight, some fucking courage,” he concluded tragically on the last night of his life. 

Two people subjected to the same shame may have different responses.  One response, like my father’s, is never to speak of shame, to angrily attack others whenever they get close to the source of your shame.   It is a response that leads to a defensive, sadly circumscribed emotional life.   You are constantly wary, blame yourself for being ashamed, which increases the shame.  

Another reaction is to understand that what was done to you, the thing that causes you shame, was not your fault.   This was portrayed beautifully in the movie Good Will Hunting, when Robin Williams as the psychiatrist, tells Will, during a breakthrough moment in therapy, that Will’s shame is not Will’s fault. He hammers gently at the tough kid, saying it over and over, “it’s not your fault”, until the boy breaks down in the shrink’s arms.   The truth of this kind of moment, Hollywood screenwriting aside, is hard to dismiss.  

My father’s shame about being whipped in the face was truly not his fault. He was powerless, at two and three, to do anything but endure it.  The shame was his mother’s, not his.  He was too terrified to go near the subject, so he tried to act like the toughest man in the world and lost much of the richness that could have been in his life.

Shame is generally imposed by somebody else, it is almost never the result of a conscious act of our own.  Shame is deeply scarring, traumatic, it is not the same as regret for a mistake we have made, a misguided action we feel badly about.  We may feel ashamed of ourselves, but that is not the same as shame that is imposed on us.

A young woman is swept off her feet by a handsome, charming, athletic older man.  He tells her he is separated from his wife.  They begin a love affair.  It turns out he was possibly not separated, but really, really wished he was.   He eventually gets a divorce and they marry.   He impresses her with how large he lives, unlike her frugal father, this man will casually leave a $50 tip in a diner if he loves the service.  

She notices he is not always truthful.  The lies begin to add up.  He didn’t lose his job due to a mistake, as he said, he’s been fired from his job for stealing from the company, as the boss, a former friend, calls to inform her.   They move to another town.  He loses his next job for something similar, announces they are broke.  

They move again, to live near their parents.  They plan to buy a house, schedule the closing, he borrows ten thousand from his father-in-law towards the downpayment.   At dinner two days later he announces that he has declared bankruptcy.  

His father dies, he takes the wallet from the bedside table and maxes out all the dead man’s credit cards.   He pretends, for over a year, to be going to work and bringing home his pay.  He leaves the house at 8:30 every morning, hangs out in strip clubs while his wife is at work and his children are at school.   He returns on payday with cash advances drawn from his dead father’s credit cards.   One of the three credit card companies eventually catches him, his wife repays a large sum of money.  

He gets another job from a friend, embezzles from the friend, is fired.  Tells his wife business has been slow and he was let go.  A call from the former friend, and a threat to press charges, makes the wife arrange to pay back the thousands her husband has stolen.   Then he is immobilized with crippling back pain, can’t get out of bed, suffers on oxycodone for three or four years.

Through this all, the woman keeps everything mostly to herself.   She is frequently angry, as anyone would be, but her children must never know the reason, it would cause them all shame.  She is ashamed, on one level, to have married a person so lacking in character.  How badly does the choice reflect on her? she wonders.  

On the other hand, he is a keen student of her psychological weakness, nobody understands her better or is better able to reassure her.   He is calm where she is wracked with worry.   Their children know they can count on her, but are drawn to their loving, always accepting father.   He is playful and affectionate and never blames anyone while, mom, as they all know, can be critical.    

I watch this unfold and ask how it is possible to live with a demanding husband (he still yells downstairs to find out what is holding up his dinner) who hasn’t worked for years, with a storied history of lying, criminal activity, road rage and many speeding tickets, “borrowing” money from friends and family he never repays, manipulating, never apologizing,  someone who threatened to kill the kids, her parents, and both of them…    

“He only did that once,” she protests.

And someone who fucked every willing skank that moved.  

“He never did that!  If he ever did that I’d leave him in a second!”  

Well, as you said once when I asked how he was doing “how would I know?” I say to you– how would you know?  He does have a long and impressive history as a manipulator and liar. 

The thing about shame is how insidiously it replicates itself.  The children grow up watching mom frequently enraged at dad, the most laid back man in the world.  Dad throws up the palms of his hands and says “well, you know, mom has a hard time forgiving anyone who isn’t perfect.  I may have made a few mistakes, but you know mom…”   The kids know this is sometimes true, mom can be a hard-ass.  

The sensitive kid wonders about this far too simple explanation, something is intuitively wrong with this glib over-simplification.  The mother worries about the daughter’s road rage, occasional bad choices, the son’s dark moods.  But shame ensures that the shameful truth must never come to light.  

It makes me want to cry.

Death by American Healthcare

Richest country in the world, blah, blah, blah.  Only wealthy country that lets thousands of its citizens die every year, deaths that would have been prevented but for lack of access to affordable health care.  Only country in the world where basic medical services are a commodity, administered on a profit-based model by corporations whose sole mandate is to increase profits for shareholders.  Blah, blah, blah.    The Devil, as always, is in the details.   Death by American healthcare is not always as straight-forward as it seems.

 I vented to Sekhnet’s long-time doctor about American Corporate Medicine, and the externality that, to keep profits as handsome as they are, 50,000 Americans dying preventable deaths every year is reckoned an acceptable ‘cost of doing business.’  

“Where did you get that number?” the doctor asked.  

“The number I always hear is 45,000, but I’m hopped up because I haven’t been able to see a new nephrologist for my progressive kidney disease, so I added 5,000.”

“You can add a lot more than 5,000.  Those statistics are deaths based on documented ER visits when the disease is discovered in its final stage.   Many more Americans than that die preventable deaths every year.   You can probably multiply that 45,000 by some factor to get the actual number of Americans who die for lack of access to affordable basic health care.   How many more die without ever getting to an Emergency Room?  Those dead Americans don’t even get to be statistics,”  the doctor said.    I don’t dispute the good doctor’s point.    

As a man who has now had to change nephrologists so far three times (in less than a year), and is currently without care for my kidney disease as I look for a fourth nephrologist,  as a result of Obamacare’s immensely complicated private insurance scheme, I take Obama’s famous “if you like the doctor you have, you can keep your doctor” lie personally.  That poised, principled, hilarious, smooth-talking bitch looked me sincerely in the eye and lied to my face.  

I’d have liked to have stayed with the second nephrologist very much, instead I was forced, by income-based insurance laws, to visit one who was arrogant, defensive, insecure and argumentative.  As a result of her healthcare inexpertise, and the intricacies of the government-private insurance partnership, I am now more than two months without medical care for my progressive kidney disease, kidney disease the final nephrologist labeled an emergency case.  My kidney disease is of unknown origin, though all studies seem to agree that stress makes it worse.

“You mustn’t take these things personally,” says a random anal sphincter, passing by.  

Of course, it is absurd to think that Mr. Obama lied to me personally, offensive for me to refer to him with the gender insensitive “bitch” rather than as a dick or corporate shill.   He did his best to make positive change, President Hope and Change.   Mr. Obama was certainly a much better president than his predecessor, a limited man run by a cabal of psychopaths, and his successor, a man who needs no introduction.  

By the same math, of course, Mr. Mussolini was much better than Mr. Hitler and Mr. Stalin.   That is just hyperbole talking, a gratuitous rhetorical flourish, snapping snappishly.   Nobody is comparing any American president to these maniacs, it is a grave national insult to do so and it removes history and morality from the equation.  These were dictators, for one thing, our leader is democratically elected.   The tens of thousands, perhaps as many as a million, killed by the three most recent American presidents are not comparable to the millions killed by brutal dictators like Hitler and Stalin.  Collateral damage deaths in war zones are not the same as deliberately mass murdered civilians, even when they are the direct result of an errant smart bomb or a mistaken “signature” drone strike, or they are children who die as a result of an embargo of food and medical supplies.   A fine point to the families of the dead civilians, perhaps, but a discussion for another time.

The problem with assessing the real world effects of our presidents is that we don’t even have the language to talk about it.  Without a frame for the discussion, it is hard to understand how someone like Obama, who spoke eloquently from his heart on many matters of great public importance, at the same time steadily supported the powerful forces that run our pernicious status quo and ensured that any change proposed would be incremental, at best.  

Obama campaigned on “Hope and Change” with a slogan of “Yes We Can!”.   Campaigns and their tag-lines are pretty much PR bullshit, we all know that.   Reagan used “Make America Great Again” along with “Morning in America” and a bunch of other glittering, meaningless phrases.  Anyone who voted for Obama truly hoping for the advertised hope and change was clinging sadly to hopes inspired by a very successful marketing strategy.  Obama himself repeatedly told the people who voted for him that it was their responsibility to push him to keep his promises, though he phrased it more flatteringly to himself. 

Let’s take a glance at Obama’s presidency.  Before he was in office very long he was awarded the Nobel Peace Prize, for things he said as a candidate, presumably. When he accepted the prize he spoke eloquently about war, poverty, racism, but asked us to recognize that while he stood on Martin Luther King’s shoulders, his hands were somewhat tied.  As president, he reminded us, he would have to authorize the ongoing war on Terror, order extrajudicial killing by weaponized drones and engage in other violent policies Reverend King might not have approved of.   He humbly asked us to remember that there is only so much an American president can do about the institutional violence of militarism, racism and poverty.

“Everyone knows you don’t mess with the American war machine.   War is deadly serious bucks, man, it’s a powerful, lucrative industry with unlimited clout and, truly, if we’re completely honest about it, you cannot separate the American war machine from racism and poverty, and if I tried to, particularly as the first black president, I’d be a dead man, I promise you,” is something he didn’t need to add.

The reason my disgust for Obama exceeds my disgust for Dubya is that I expected nothing from the strikingly incurious Dubya and I expected something from Obama.  Obama might have come into office and turned the page back towards a world order based on international law, as most of the world was keeping its fingers crossed he would, for example.   This was the direction international law was headed when Mr. Bush took office in 2000, pursuant to a one-off Supreme Court decision declaring him the winner of a close and disputed election.  The Bush administration went on to flout international law, create a novel doctrine called Preemptive War, commit war crimes (with full preemptive legal immunity for the perpetrators), and serially violate the Geneva Conventions and other international treaties against torture and inhumane treatment.  

Obama took the high road, promising to look forward, not backwards, refusing to hold anyone accountable for the atrocious state policies carried out in our name.  Eventually he had the personal courage to publicly acknowledge that, in those confusing days after 9/11, and with the best of protective intentions, “we tortured some folks.”   Good speech, bro.

The term we are searching for is neoliberal.   Bill Clinton was a neoliberal. He was liberal on social issues: a woman’s right to choose, freedom from discrimination, protection of civil rights and the social safety net, proactive policies on Climate Change and environmental protection, gay rights, pubic education, access to affordable health care, freedom of speech and expression, etc.  He was neoliberal when it came to economic policies that disfavored corporate power– he took action during his presidency to ensure that large financial interests prospered.  He smiled as he reported great economic growth on his watch and claimed that a rising tide lifts all boats.  

He also signed several key pieces of right-wing legislation that did a lot of harm to the poor and swelled the bloated U.S. prison population, disproportionately with people of color.   He had the charisma to carry it off and to be remembered as a popular liberal president.    Until Obama, many called Clinton our “first black president”.   He was a neoliberal, a social liberal capable of forming alliances with the extreme right in the interest of promoting the continued growth of the “Free Market”.

President Bush didn’t have much to do, from an economic point of view, when he took over in 2001.   He cut taxes for the very rich, as anyone in his position would have, but Wall Street was humming, as it had been under Clinton.  Clinton signed off on the repeal of Glass-Steagall, which freed the biggest financial institutions to make risky, highly leveraged bets, backed by federally guaranteed money.  This led directly to the great scam that ended in the multi-gazillion dollar losses to Americans in concerted, industry-wide fraud by businesses too big to fail and the bailout of these crooked institutions by those same taxpayers.  

Obama presided over the aftermath of this, but nobody was ever prosecuted for the massive, coordinated fraud, the vast transfer of wealth to the wealthiest.   No serious policy changes were instituted to prevent a repeat, as Wall Street stabilized itself.   Obama’s financial brain trust was from Goldman-Sachs and the other top beneficiaries of the taxpayer bailouts.  Everybody who really mattered did very well under Obama, who also continued most of Cheney’s secretive policies, while giving moving speeches about the need for government transparency in a true democracy. The disgruntled masses who got a little poorer?  They are always belly-aching.

Neoliberalism, in matters of basic profit-making by corporations, the entities that are said to create all wealth in the “Free Market,” is identical to neoconservatism.    Their interests meet in their central belief that corporate freedom to thrive in a Free Market is essential to our way of life. For the market to remain free, government policy must give these corporations many protections, such as subsidies to oil companies, payments for agribusiness not to grow certain crops, no-bid emergency contracts, tax incentives, right to unlimited campaign contributions, a revolving door between industry and government to influence policy, financial bail-outs when their scams go south and so forth.  

Why is it called the “Free Market” if the government has to play such a key role in its operation?  

Because, if we told you the truth, the whole truth and nothing but the truth, it would make you want to rise up and smash our faces.  It really would.  

That’s why.

Insidious detail

Count on the New York Times to zero in on the big story, as it gives its sober, measured take on sometimes outrageous things.   Its piece detailing how the current president is doing everything in his considerable power to undermine and destroy Obamacare (and in fairness to him, Obama, a secret Muslim, was not even born in this country, SAD!) so that it can “implode,” contained this nugget:

The Department of Health and Human Services, which is in charge of administering the Affordable Care Act, has also been circulating bad news about the program.

I love that this is an aside, it reminds me of that throwaway line in the Bible about Onan’s brother: “the Lord slew him, also.”  The new administration is using taxpayer money to fund a campaign against the law passed by the previous administration.  Kudos to the Grey Skank for bringing this out!  

The rest of the short article is quite detailed in describing this quiet horror-in-progress, you can check it out here.

 

“Trying to suck his own cock”

There is the famous joke that explains much that is unexplainable in human affairs, most strikingly in the area of law.   How, for example, did an evil genius like Antonin Scalia do as much unappealable damage as he did, with no consequence to himself, outside of the eternal love of right wing extremists?  Here is the joke that explains it, an old one I’m sure you know.

“Why does a dog lick his balls?”

Because he can.

Nothing is illegal, absent a law that makes it so.  Things are evil, immoral, unethical, despicable, disgusting, infuriating, wrong, etc. but, unless there is a specific law against the hideous practice  — not illegal.   About these things judges and lawyers look at each other and say “de minimis non curat lex“, “the law does not concern itself with trifles.” 

Speaking of trifles, a frivolous lawsuit was recently brought by a blustering bully who owns a coal mining company.  This bully, named Bob, is a big Trump supporter and is almost as litigious as the man he supports for president.  He filed a lawsuit against a comedian who critically covered Bob’s shady practices and had a man dressed in a squirrel suit holding a sign that said “Eat shit, Bob”.   Here is what the ACLU filed in that case, as a friend of the court.  Scroll down to page two, the table of contents.  It will be the best hundred or so words you read all week.   The rest of the brief is a delight to read as well, Bob.

But I came here not to speak of fucking Bob Murray, CEO of a coal empire and man, from all appearances, bent out of shape from constantly trying to suck his own inconveniently located appendage.   I didn’t even come here to complain about the steep and disgusting decline in civil discourse since crude talking cock-suckers, ass-dickers and pussy-grabbers took over the West Wing, as well as the increasingly inclusive lunatic fringe of one of our two major political parties.  I am here to vent just a tad about a trifle that the law does not concern itself with.  

The law in question is the Patient Protection and Affordable Care Act, everybody’s favorite whipping boy.  It does not provide for very much regulation of the insurance industry, though the regulatory scheme for the consumers it protects is rigorous.  Uninsured consumers who qualify financially, for example, are mandated to participate, and to sign up during a single, very short annual enrollment period.   Insurance companies, on the other hand, can stop participating in the ACA program any time they fear their profits will be adversely impacted.  Like during times of increased profit uncertainty.   Like during times when the current president uses his bully pulpit to fulminate, Birther-style, against his predecessor’s signature law while cutting funding to the ad budget of the ACA and using tax payer money to run ads attacking the government program.   Like, now.  

There is no regulation, of course, of the practices of the state “marketplaces,” the exchanges where qualified people are required to buy their health insurance if their employer does not provide it.   Because the “free market” was given priority over “health care” to Americans (note the estimated 27 million of us still uninsured under the ACA), as an individual without employer subsidized health insurance you either jump through the exacting hoops of the PPACA or wind up without insurance of any kind.    Jump through all the hoops perfectly and you may still wind up screwed, with no recourse but a several months long line for an “appeal” at the marketplace that screwed you in the first place.  No need for state regulation when the marginally competent government agency itself is able to provide all the due process necessary.

My dealings with three different insurance companies, at three different income levels, and my ongoing nightmares with Donna Frescatore’s New York State of Health Go Fuck Yourself Self-serve Marketplace, have demonstrated over and over the need for state regulation.  Today I called a second replacement nephrologist on my health plan, this one recommended to me by a doctor friend (what happened with the prior one, recommended by another well-respected doctor, is yesterday’s news).  Today I learned, once more, that just because the insurance company has the doctor listed as a provider does not mean the doctor is actually a provider.  Strike two, get back in the batter’s box, motherfucker, before we call you out for delay of game…*

Mistakes are made, the passive voice used.   Humans are only humans.  Corporations have feelings too, they are called “profit” and “loss”.   Why am I so judgmental?  Why can’t we all just get along?  Why don’t I just shut the fuck up already instead of venting about this de minimis inconvenience to my hypochondriacal kidneys?   Who do I hope to influence by writing these words?   Why do I insist on seeing the glass of syphilitic piss as half full, instead of half empty?    Why am I not pouring all these incendiary details into my letter to the Attorney General?  Why so many questions?

Anyway, now it’s Friday evening, at long last.   Why is nobody pouring me a cold glass of beer as foamy, and richly golden, as a beaker of my own protein- rich urine?  It’s Miller time, is it not, Mr. Stephen Fucking Miller?  … if that is your name.

 

 

*    Sports fans will note that, under the rules of baseball (where balls and strikes come from) a batter cannot be called out for “delay of game” (in the National Football League it can result in a five yard penalty, a complete non sequitur in baseball).  The footnoted sentence is what’s charitably called a mixed metaphor.  If I told the ump to go fuck himself, that the threat to throw me out for delay of game is ridiculous, and not in the rules of baseball, the ump could call me out for “arguing balls and strikes,” a rule giving ample grounds for my ejection.  As always, de minimis non curat lex, baby.

 

Informed Consent

We live in an imperfect world, a point that needs no belaboring.  We like to believe that Reason governs human affairs, but most often we can trace the behavior of societies, groups and individuals, to fear, hatred, hopelessness, greed and other mostly non-rational impulses.  The great democracy we live in, for example, is currently presided over by a person who is not a clown as much as a menace.  He was put into office by the galvanized forces of fear, hatred, hopelessness and greed.  He cannot seem to control his impulse to lie.  Here’s Amy on a recent presidential lie the White House just admitted was a lie.  

You can go mad watching the news, dominated by this stubborn attention seeker, unless you believe, as up to 33% of our voting populace seems to, that we live in a time when minorities and poor people are completely out of control, rich job creators are being tortured by our government, the media lies constantly and that only good old fashioned law and order can “Make America Great Again.”  

Going mad is not the best option, at least not as far as I can see.  I’ve made it my daily practice to try not to go mad, no matter how tempting it may be to go there.   One form of this daily practice is writing, in detail, to make whatever I am dealing with as clear as possible, to myself and to anyone reading.  

Transparency, and its deliberate denial, has long been a big issue with me.  It comes from a childhood where blame was shifted on to the children for the problems of adults.  Perhaps my father was incapable of answering my anguished question about what happened to grandma and pop’s twelve siblings (shot in the neck in a ravine, as it turned out) but it was wrong of him to blame me for being anxious about it.   If Reason is to guide us in trying to live reasonable lives, we have to have the information we need to consider things fully and make reasoned choices.  

We have that great phrase from the Author of Liberty, about ideal government: “deriving their just powers from the consent of the governed.” That has been changed slightly in practice, if not rhetorically.  A more accurate statement in 2017 would be “deriving their indisputable powers from the acquiescence of the systematically manipulated.”   Our elections are decided by a plurality of voters casting votes after watching fantastically expensive advertising campaigns.  The winning product is the one with the most effective attack ads on the rival product.  The government that results from this process hardly amounts to one ‘deriving its just powers from the consent of the governed’.  

It is a mark of patriarchy to rest on its right to simply be right.  No discussion is required, if one party has all the power and the other party has none, when the powerful party declares “because I said so.”  You cannot give informed consent if you are not informed.  There is nothing mysterious about this formula.  

As in the larger society, so it goes in individual interactions. If patriarchy is the final word, from top to bottom, and you have a problem with that, you are the one with the problem.   The impulse to be right is a powerful one, and we are all conditioned to argue that we are right whenever we feel challenged.   There is a more merciful orientation, true, and the world would be better if more people operated under it, but that is not the problem of patriarchs.

I called the National Kidney Foundation’s helpline.  Marjorie was great, though, in her own words, not very knowledgable about anything but the basics.  She’d never heard of my idiopathic kidney disease, for example.  She was pleasantly surprised to learn that up to 40% experience a spontaneous remission from this disease of unknown cause.   She told me that most nephrologists, going by what she hears every day, are arrogant jerks.  She said the profession apparently attracts these types.  I told her my experience did not contradict this.  

Here is my problem with the insecure, defensive, arrogant jerk who was treating me, until two months ago.  She did not feel the need to answer questions, was dismissive, manipulative, untruthful, incapable of sincere apology.   Aside from those things, which tend to increase a patient’s stress level, I’m sure she is an excellent doctor.  My biggest problem, now that I have learned much more about this disease and proposed treatments, is her refusal to give me the information I needed to make an informed choice about a side effect-rich course of IV steroids and toxic agents designed to shut down my immune system.  This therapy is recommended only for high risk patients, all others are treated with supportive therapy and counseled about diet and exercise and watched for signs the disease has progressed or begun to wane.

I wrote this, earlier, to send to this gender-neutral asshole nephrologist, for my physician friend’s feedback:

You seem to have concluded that I am a high risk idiopathic membranous nephropathy patient and that therefore immediate immunosuppressive therapy is necessary.   I’d appreciate if you could set out the factors you considered to determine that I am in this high risk category, as these were not explained to me in any detail.

Thank you

Full transparency, which would have called for a “Fuck you” instead of “Thank you” at the end, must sometimes be sacrificed for the greater good.  In this case, I need to know what tests and other factors she considered, in the absence of the standard 24-hour urine test, to determine that I need to begin a chemotherapy regime immediately. 

We all tend to phrase things in terms of our own concerns.  I don’t mean to keep harping about my kidney disease, although it is on my mind.  It serves as a perfect metaphor for many killing situations that are just part of the status quo in our competitive, materialistic USA! USA!!!   If you are not afflicted by a serious disease, the many problems of Obamacare, the calls for its repeal, are abstractions, troubling though they may also be.  If you are unable to get treatment from any of the highly recommended nephrologists you’ve been referred to, doctors allegedly in your insurance network, you are, as they say: fucked.