Saturday, October 25, 2014

Of Guns, The NRA and the 2nd Amendment, Fear and Loathing

They could buy guns in Walmart today

The Clutter Family: Slain at Home


Any discussion of guns quickly degenerates into the expression of gut feelings over dispassionate examination.

News from the latest, but certainly not the last, school shooting  (this one in the state of Washington,)raises the issue again.

The Phantom is caught betwixt and between on this one.

On the one hand, it does appear probable that if we ceased the production and sales of guns tomorrow, there would still be millions, likely a billion guns out there in the USA, and guns can be buried in the backyard, hidden in houses, cars. They simply are never going to go away, not in our life time, not likely for the next 100 years.  So trying to deny maniacs guns by restricting sales is likely to be an imperfect solution at best. 

Chris Rock may have the best approach: Raise the price of ammunition. If some thug knows each bullet cost $500, he's not going to spray a classroom.

Beyond that, the Phantom once moved to a farm with his girlfriend. They had lived together in New York City and never felt unsafe, but on that farm, with nothing but ponds and fields and lonely unlit roads, well, it gave the Phantom pause. He went out and bought a bow and arrow set and instructed his girlfriend in its use, but, as she pointed out, she had grown up shooting skeet and could handle a gun, and if he wanted her to be safe, a gun might make more sense, although she refused to have a gun in the house. She had grown up with guns, and they were locked up in her house, and would not have been available to prevent a home invasion. For that, you'd need to wear one on your hip at all times. 

Her father was a lifetime member of the NRA and a career military man. He owned dozens of guns, and kept detailed logs about the characteristics of each, which pulled to the right and by how much at what distances.  But he also noted when soldiers were sent out to the rifle range, the number of live rounds they were given was carefully counted and they had better return with 12 shell casings if they had been given 12 rounds. The Army was this careful. And why? Because they didn't want some disgruntled grunt shooting his drill instructor.

So that killing machine, that organization based on guns, was very careful about controlling access to live ammunition and very controlling of guns.

Gail Collins points to an ad about guns in the some deep South state election, which shows a mother at home with her children and a shadow passes over the window and then a voice says don't vote for whomever, the candidate who will take away your guns, your best protection. This strikes Gail Collins as the politics of fear, which it most certainly is. 

But, having lived in rural areas, miles and a good hour away from any police, the Phantom understands where that fear comes from. There was that famous case of the Clutter family home invasion in Holcomb, Kansas, which became the basis for In Cold Blood.  People out in the hinterlands may feel vulnerable.

And this is not new:  Going back to The Last of the Mohicans, there is the family which was massacred by Indians, and when the daughter of the commander of the local garrison looks at their bodies she asks in shock why anyone would live so far out, so exposed, having only their own guns to defend them, when their adversaries could simply mass more guns and overwhelm them. 

And, in the case of the Clutters, in Kansas, there was that more common thing--surprise. Are you going to go to the door holding a gun every time there is a knock?

Having said all this, there is one essential truth which the NRA denies. Here is the 2nd Amendment, in its entirety, all 27 words:  "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed."

Now, making allowances for this having been written by 18th century men in whigs, it is still abundantly clear, the right granted is to a group, not to individuals, and the purpose is to secure the State, not to guarantee security of individuals within their houses.  That justices Scalia/Alito/Thomas/Roberts/Kennedy choose to wear blinders, does not make a right to personal firearm so. Some day a new court will have the courage to speak the truth and say: No, the Constitution does not guarantee every citizen the right to own a gun. Local law may allow it. It may be granted by the federal government, but the Constitution, that thing on which we cannot vote, that highest law of the land, does not guarantee it.

The fact is, the psychology of guns comes down to fear and loathing. The fear is the vulnerability in isolated circumstances, rural America.  The loathing is the little man, the man who senses he is a loser, a weakling, but he can feel big and powerful and fearsome if he straps on a gun. 

Until we can get past that Joe Sixpack inferiority complex, we'll have guns, and bullets and dead school kids.


Wednesday, October 22, 2014

American Doctors: Here Today; Gone Tomorrow

Norman Rockwell 


One of the great untold stories of American life today is that of the itinerant physician.  For decades, one of the operating values of American medicine has been "continuity of care," which meant that a patient could see a doctor who actually "learned" the patient, got to know the patient, took care of the patient over a prolonged period of time, so the patient did not have to recapitulate his or her own history with every visit to the doctor's office. 

This concept even extended to the hospital, where a patient was "admitted" by an intern and resident who stuck with that patient for his entire stay in the hospital, and in the bad old days, stuck with the patient through the first 24-72 hours, getting the patient through his crisis. 

In the hospital setting, this feature of "continuity" had its disadvantages--to be able to stick with the patient, the intern was frequently exhausted, although rarely incoherent as its detractors charged.  So, with Libby Zion laws, the concept of "handing off" the patient to a "team" of shift workers emerged, with results which proved both  better and worse.

But now, if you are observant, this is happening at the level of office practice. 

Doctors have looked at the prospect of signing an office lease, which often committed them to a $500,000 debt over 5 years, and they looked at malpractice insurance policies which, in the case of an internist, might be $5.000 this year and $20,000 the next, and they looked at the costs of telephone and computer systems, and they saw  the costs of employees and their health and unemployment insurance and they looked at the diminishing reimbursements from insurance companies and they said, "ENOUGH! I'M OUTTA HERE." 

And so now arguably 90% of all primary care physicians and non surgical specialists are no longer in "private practice" but work as employees, either for groups of doctors or for large corporate entities.  

What these doctors find is the first contract they sign is the highest pay level they will ever see. Typically, they get 2 years at a set salary and then they go on commission and their salaries plummet. 

So, what do they do? They quit their jobs and move on to another 2 year gig and they keep doing this. 

This poses problems for their families, because taking a new job often means relocating, but if the physician is a woman, she may be a second income in the house and they may not have to move if she can find another gig in the area, and often she can find at least part time work. If the doctor is the primary bread winner, he or she may opt to stay at the corporation at a lower salary, but often they opt to move.

In a state like New Hampshire, which allows "non compete" clauses in contracts, doctors frequently have to move out of state or at least 20 miles away, so there is a built in uprooting. In Massachusetts, where non compete clauses are illegal, the doctor may move down the road or to a neighboring town and simply commutes longer. But he often winds up abandoning his patients and setting up a new practice.

And where does all this leave the patient?

It means you will not likely have a long term relationship with your doctor. It means you will find a new doctor "relearning" you every couple of years. It means your doctor looks at you as a customer to be served rather than as a patient or a friend and it will depersonalize the relationship.

Not that this is all bad, but it is a change.

But have you read about this sea change in medical care in the New York Times or the Washington Post or heard about it on The News Hour or the Business Report or in the Wall Street Journal?




Saturday, October 18, 2014

Empty Phrases: Times of Innocence and The American Dream

Oh, he's pursuing The American Dream




Here's a good way to know a person does not know what he/she is talking about: Just listen for the phrase, "The American Dream"  or "It was a time of innocence."

What do people mean, when they use that phrase: The American Dream?   What they are really talking about, almost always,  is simple avarice, the desire for stuff, for money, for a well paying job and the money it provides and the things it will buy. 

"The American Dream," then is nothing exalted, ordinarily. It's simply a wish for prosperity. 

Unless, you are Martin Luther King. When he used that phrase in his astonishing "I Have a Dream" speech, he went on to define a very different and more powerful dream for life in America than simply the mundane acquisition of wealth. He defined the American Dream not simply as a world in which people had all of the stuff they dreamed about having when they were suffering through the Depression, or sitting in foxholes. He was talking about the dream of world in which justice would reign and liberty would prevail for everyone, not just white men and women and their lucky progeny. His American Dream is a new plane of psychological liberation, in which his four children will be judged by the content of their character rather than by the color of their skin. Now that, is a real dream state, new state of mind. 


She's Got her American Dream
Not Innocence: Willful Ignorance 

But, when most people use that phrase, "The American Dream," they are really just talking about making more money, and that is nothing all that exalted. In fact, they'll tell you on Sunday, the pursuit of mammon is not a good thing. Ah, but if it is the pursuit of the American Dream, that is a good thing. So the "American Dream," the dream of riches, the dream of acquiring mammon, stuff, nice houses and fast cars, that is a socially acceptable, commendable dream. 

And then there is that dreary phrase, "Oh, it was an age of innocence."

Fact is, since Homo sapiens stood up on hid hind legs and became Homo erectus, there never has been an age of innocence. Every generation has known about murder and rape and greed and vice and nastiness. Some have tried to banish discussion. Some have tried to portray a society in which the mass of men and women did not have any of these traits--the asexual, aseptic, eternally smiling men and women of those ads from the minds of 1950's Madison Avenue mad men, who made the ads.

 Fact is, never was such a world nor such a time. The fifties were no more "innocent" than the 1920's or the 1930's. The fifties were simply more repressed. They were a reaction to the horrible 1940's, when rape, murder, destruction, societal breakdown happened on a massive scale worldwide. Armies swept through Europe and women were raped on a massive scale.  Children, women and men were lined up and gased and then cremated.  Whole cities were incinerated.  In reaction to that, people dreamed about a time and place where none of that would happen, where people didn't think about all that. 

There have always been times when discussion of sex, desire, lust and ambition have been suppressed, but that does not make those times "innocent." It makes them simply dishonest or, at best, times of denial.

So let us banish these phrases, "a time of innocence" and "The American Dream" from American discourse. 

Good riddance to bad rubbish.


Thursday, October 16, 2014

Weddings vs Funerals



Since my first funeral, I've hated funerals.

I can't recall the first wedding I attended, but for many years, I could almost enjoy weddings because I got to see a lot of my friends.

But now, in the 21st century, I have to admit, I can hardly abide weddings.

I can suffer through funerals, which is, after all, what most funerals are about: suffering, loss, the end of life, the end of dreams, the sadness of parting.

But weddings are just so essentially phony, to their core.

Funerals, at least, make sense. They are the opposite of phony. They are the real deal. No denying what a funeral means.  There is no doubt about the event they mark, and there is honesty about what happened and no dispute: Someone died. 

But as Mark Twain once asked: Why is it we rejoice at weddings and cry at funerals? Is it because we are not the one involved?

For some, of course, death is a release, a welcomed end to suffering. Hopefully, a re launch.

But weddings are such a sham.
Once upon a time, there was a real divide between the virginal, prenuptial life and the breaking of the virginal seal on the wedding night and the connecting of genetic material and blood lines. 

Now, not so much. 

Women, if they are lucky and well brought up, start having sex in their teens and will look forward to relationships with a succession of men over their lives, having children with different men if they can afford to, and often even if they cannot afford to.

A wedding now simply marks a public statement about a temporary relationship entered into during  your second or third decade with high hopes (often held by both parties, but often not) and well understood to be likely temporary. 

As Betty Freedan noted in the Feminine Mystique, all this began to be examined around 1964, when women who had been educated, allowed to enter the greater world beyond the home found themselves trapped in suburban houses, with kids, and told they would and should be happy if they got enough stuff in their kitchen, a nice car, a white picket fence and a PTA meeting to go to.

But women discovered this was a pretty boring and depressing life in a gilded cage, not at all rewarding and the term "desperate housewife" gained real currency.

The whole marriage trap unraveled during the sixties and it has never been the same since.

There are, of course, good marriages, but they are actually the exception.

If organized religion were not dominant in most weddings, the ceremony would likely say, "Here is a couple who like each other, will have children and each will pursue a life and hopefully, they'll be happy, at least long enough to raise the kids and get them out of the house. After that, well, if they are happy, bless them, if not, new adventures." 

But what do we hear from the pastors and priests?  God has a plan. God has chosen your mate for you. What God has placed together let no man set asunder. God wants these people to be together. 

Where is the free will of the man and the woman involved? It was all written for them. Fated. 

Ugh.

If the Phantom were elected benign dictator, among the first day's acts would be an executive order to de-institutionalize marriage. If you want your party, your day as the primadona in the spot light, throw yourself a party. Call it a wedding. But please don't expect the rest of us to do more than drink your champagne and dance to your band that night. 

After that, you are, as new couples have always actually been, on your own.