Strange Bedfellows of the Mind: Justice Kennedy

Justice Kennedy

Supreme Court Justice Kennedy has been on the wrong side of some of the most important decisions of the past decade.  In the case of Florence, which allowed strip searches of those arrested (not convicted mind you) whenever they are hauled off, against their will to jail. The man involved had an outstanding warrant in the police computer, which, it turned out was an error.  He was dragged to three different jails and stripped at each and all of this was okay with Justice Kennedy because, don't you know, people arrested on what sound like the most harmless offenses are sometimes  just the worst sort of person. And from that, every teen aged girl who rolls through a stop sign is now at risk from the probing fingers and security cameras of every local police station and jail.

He voted that money is speech in Citizens United.

He voted to condemn  a high school student who was offended because his principal required that he participate in a celebration of that crass commercial enterprise called the "Olympic movement" and protested by leaving school property and holding up a sign "Bong Hits for Jesus." 

Mr. Kennedy was born to privilege, the son of a wealthy and powerful California lawyer, a devout Irish Catholic, went to Stanford and Harvard Law and clerked for all the right people and was appointed to the Court by none other than Ronald Reagan.  He has shown little sympathy for the disadvantaged and great respect for the authorities.

And yet...In the Obergefell gay marriage decision he fastened on the crucial argument for change now:  When justice is delayed, that can mean justice denied.  Facing the withering disdain of Justices Roberts and Scalia who insisted any change in attitudes toward homosexuality should come through the slow process integral to state legislatures and referendum, Kennedy said no. That would mean a whole generation might grow up living with the stigma of illegitimacy as children of gay couples, and it would mean the gay couples would live their whole lives with the demeaning effects of being denied official status and with the practical disadvantages in terms of inheritance and access to loved ones during medical emergencies. Time, Kennedy argued is a perishable commodity.

This is really the same argument Andrew Marvell made to his coy mistress. If we had eternity, then delay would not be a problem, but the sands of time run fast and ineluctably, and they put pressure on life. 

That may be why the twenty somethings who worked the cancer wards at Sloan Kettering were so hypersexual, and the same for the interns and nurses in every part of the hospital where high mortality abounded. You see people dying every shift and you realize, life is not forever.  Two hundred years to adore each breast if we had centuries, but time's winged chariot do rush near. 

Looking at the guy, it's difficult to believe he would respond to the "Let us sport us while we may...like amorous birds of prey. Roll all our strength and  all our sweetness up into one ball/And tear our pleasures with rough strife/Through the iron gates of life."

This is a man who would blush to consider those lines. And yet, he seemed, for one, brief shining moment to hear the intimations of mortality and to act.

A Week To Remember

Hayfield along Exeter Road in Hampton Before the Storm

If we'd thought about it, we might have known this would be a week of change and consequence, but we were living out our daily routines and not paying attention to the notices that the Supreme Court would hand down their rulings on Obamacare and gay marriage, and there were notices that a storm was coming at week's end and the world might seem to be changing under our feet. It is blowing hard out there in Hampton today, and cold, fifty something at the last week in June. The world seems to have changed; winds of change.

Plaice Cove Surging 

Mr. Boat and I went for our customary morning gambol at Plaice Cove and had the beach to ourselves initially; then a solitary dog, followed by his human companion, pushing forward against the force of the winds which carried with them rising seas and great crashing breakers such as we have never seen at that beach. I was afraid for a moment those waves surging in and rushing out might carry Mr. Boat out to sea.  When the dog walker got close enough to me to be heard, he lifted his eyes and said, "I think it might snow." Anything seemed possible, this week.

We laughed but I thought he had captured the moment: nothing about this week seemed ordinary. The breakers crashing in on a strong wind constituted what they call "pathetic fallacy" in English lit classes--as when a storm crashes behind King Lear to reflect the passions surging within the king.

And passions were surging this week: Those who believe they have the right to tell others who to love were outraged by those five "lawyers" who said, no, actually, you can choose who you love, but you cannot tell others they cannot love who they love. And if those others make choices you find outrageous, you will have to live with that.

"Choices" is likely a loaded word--it's been used by people who vilify homosexuals to suggest gay people could simply have chosen to be different but they have perversely "chosen" to be nasty and homosexual, just to spite their parents and proper society. Of course, it's not like that. Gays do not look for that life; they simply discover what attracts them and likely are powerless to resist or change that chemistry.

Even heterosexuals may experience something like that when they run across someone they feel drawn to.  As Justice Kennedy noted, children raised by gay parents show no ill effects except those emanating from those who disapprove of their families. L'enver est less autres. Hell is other people. It's not the love which spawns the misery, it's the naysayers.

Gail Collins noted this is the court which disemboweled campaign finance reform with Citizen's United and handed the keys to the kingdom, once again, to the rich and powerful and they have rendered a series of decisions injurious to the commonweal, but at least this week, they got it right.

Sea Grass in the Wind

News from Washington washed across our small town in New Hampshire; winds from the West swept our sea; it has felt like we have been driven by forces greater than our own, carried along by tides not under our control, and yet, there is a happiness here and we find ourselves smiling.

Corporate Medicine

Yesterday I had the classic experience in corporate medicine.  
A woman arrived without a letter from the referring physician. This is not unusual nowadays because the referring physicians are seeing so many patients so quickly they have by and large dispensed with the practice of calling or writing the doctor to whom they refer patients, so it's up to the consultant to divine what the issue might be. 

This particular lady said "the office" had referred her, which mean a nurse or secretary called her on the phone and told her to see me. 

The patient was taking prednisone for temporal arteritis and she felt "punk," by which she meant, it turned out after much questioning, she was unable to walk up a hill or do any of her customary exercise without feeling exhausted and her heart raced now and then. She had read on line the prednisone might make her adrenal glands atrophy, which could cause her to be fatigued. Apparently, she had phoned her doctor's office and someone had spoke to someone and eventually a blood test was ordered and was found to be abnormal and someone in the office (maybe a nurse, perhaps the secretary, possibly the custodian answering a phone) decided to send her to an endocrinologist.

The blood test was an ACTH level, which was almost unmeasurable. This is a predictable and expected result of taking prednisone.  So, I had solved the "problem" that is, I did what any self respecting 3rd year medical student could have done: I explained the abnormal finding. Next patient. 

The thing is, the patient was still feeling crummy and had palpitations. So, I did what I had been trained to do in internal medicine residency: I listened to her heart. Her first heart sound was of variable intensity. That could mean atrial fibrillation. 

I asked my administrator if we had an EKG machine and she said, "You are an endocrinologist. Why would you need an EKG machine?"  

Turned out, we did have one, which the cardiologist uses when he is in the office twice a week. 

She was in atrial fib. She had never been  known to have this heart dysrhythmia before. The thing about A fib is-- it doesn't do the heart much harm, if the ventricular rate is not to fast.  But it can be complicated by stroke. That's the problem with A fib.

I called her primary care doctor, who happened to be a cardiologist, and he said he was embarrassed she got referred for that ACTH, which apparently was not his idea and he asked me to send the patient to the ER so they could get the A fib treated and the patient feeling better.

My younger colleagues were appalled at how I handled this case.

"You listened to her heart?  You did an EKG? You're an endocrinologist! You solved the problem; you should have moved on to the next patient. Your numbers will be way low if you keep doing stuff like this."

"We're supposed to be internists first, and specialists second," I said.

"Yeah, like in the dark ages. Now, you got to worry about your numbers. Enter the patient into the electronic medical record, check the boxes, move on. And what if you had misread the EKG? Think of the liability. Oh, corporate would have been delighted with that. How long did it take you to do all that?"

"Well, by the time we dug up the EKG machine and the call to the PCP and explaining it to the patient, about an hour."

"Were you late for your next patient?"
"Yes, and the one after that left because I had got behind in my schedule."

"So, your numbers for today were down. You got all into being the hero doc and you you cost corporate money."


The doctor who instructed me thusly is not quite half my age.
"What ever happened to 'Put the patient first?'"
"I don't know what you are talking about," the young doctor replied. "Welcome to 21st century America."

From the mouths of babes.

American Exceptionalism

Every drop of blood drawn by the lash, paid by another drawn by the sword

Yet, if God wills that it continue until all the wealth piled by the bondsman's two hundred and fifty years of unrequited toil shall be sunk, and until every drop of blood drawn with the lash shall be paid by another drawn with the sword, as was said three thousand years ago, so still it must be said "the judgments of the Lord are true and righteous altogether."

Abraham Lincoln, Second Inaugural Address

Holderness, NH Civil War Dead

Whenever I hear some right winger trot out the phrase, "American Exceptionalism" I cringe.  I have never quite understood what Rush Limbaugh and his fellow travelers mean by this, except something on the order of "We are special among all others" or "We are God's chosen people" or something like that. 

I have to think this belief emanates from some wish to believe yourself special, better and from a deep ignorance of the rest of the world.  Or, it's just part of what drives so many racists--a deep sense of inferiority and the desire to feel superior to someone. Whatever it is, wherever it comes from, I can't help but think it's pathological.

On the other hand, I do think there is something exceptional about The United States of America, and I was surprised to see it flick across the screen during an episode of "The West Wing."

It happened quickly and was gone--during an exchange between Josh and a Black civil rights lawyer who was arguing for reparations for American Blacks for having been held in slavery, a trillion dollars, give or take.  And Josh replied with a thought I've had myself, but knowing my own ignorance of the world and world history, I've been loathe to voice: "Well, I might point out roughly 600,000 white guys died to pay back that debt, which, as far as I know, is the only time that's happened in all history."

Personally, I'm well aware of my own ignorance of world history. My last course was high school and most of what I read since  is about American history, so admittedly, I'm a provincial. But, I have to ask, when, in the history of mankind, has a nation fought a civil war to free an underclass, to right so monstrous wrong as America did?

Oh, I know, millions went off to war, and each had his own reasons for going, and many, if not most, of the union troops were indifferent, if not hostile, to the cause of emancipation. But only the most entrenched revisionist can believe that war was fought, at it's base, for any other reason than to crush slavery. Without that, there would have been no conflict between North and South, no need to cry "States Rights!"  Lincoln finally admitted it publicly, during his second inaugural address, one of his finest, and he said it often enough in less public settings.  There is a possibly apocryphal story about his meeting Harriet Beecher Stowe, who wrote the famous screed against slavery, Uncle Tom's Cabin, and he bent over the diminutive author to shake her hand and he said, "So, this is the little lady who wrote the book that started the great big war."

Oh, yes, there are those who will say it was all about "States Rights," but that's just the dodge to make the Southern "Cause" more palatable. It was then (and would still be now) hard to say, "We are fighting for slavery. We are fighting to keep people enslaved, to keep people in chains, while we profit from their labors." So they try to shift the discussion. Well, it is all about economics. It's about our right to be left alone, to manage our own affairs. It's about your arrogance in wanting to tell me how to live my life. The South has cotton and cotton requires plantations and plantations require we do what is economically viable to keep the cotton flowing to Northern and European mills.  And so on. 

It was about slavery. 

The drumbeat to end that peculiar institution started in Northern churches and enough people up there were unwilling to simply live with the idea that something really evil was festering down South, they were willing to march off to war, and to send their sons and their neighbors' sons off to die. 

You can see the results now in every small town in New Hampshire. From Holderness to Gilmanton, you walk among the headstones and see the dates etched in stone: B. 1845 D. 1863.  Not every 18-28 year old in those graveyards died in the war, but you know most of them did. The war was fought by every little hamlet from Maine to Florida, from Minnesota to Mississippi. 

And the response of the South was--what have we ever done to you? Let us do what we do--as long as you are not injured, why come down and make war on us?

Now, this is a blog with readers from across the globe. I know that because Google has these nifty little graphics where you can look up where your readers are located. (Knowing Google, they can probably tell you what those readers eat for breakfast cereal, but that's another story.)  For reasons I will likely never know, we are big in Ukraine. Australia, France, Germany and parts of the Far East seem to find some interest in what comes out of New Hampshire, again for no readily discernible reason.  

So, if anyone out there has a story from his/her own country's history which matches or approaches the American Civil War--a war fought across the entire nation in which the offended marched to emancipate an enslaved population,  I'd very much like to hear it.

Life: The Big Voyage

Odysseus Hears the Sirens' Call 

One Christmas, when I was about 10, I opened a present, a book, which I think was the last present I opened because it was so clearly a book and I was 10 and more interested in boxes which might have toy guns or baseball mitts. The book was "The Iliad and the Odyssey" and I asked my parents what it was and why I'd been given it and they simply smiled knowingly and said, "Read it."  I still have that book, one of my all time favorites.  My own sons were captivated by the Iliad, and my older son read it again in college in a course called, "Anger" and I asked him why they read that book in that course and he smiled and said, "Well, there isn't much in the Iliad that isn't anger." Of course, there was more, but he had got at a core theme. 

Later, in college, when I read Dr. Faustus and that famous line, "Is this the face that launched a thousand ships?"  the face being that of Helen (of Troy, formerly of Greece) I needed no explanation for what that meant.  And when Faustus added, "Her lips suck forth my soul,"  that, too was clear enough to me. I had been on that voyage as a youngster and its lessons stuck with me.

The Iliad, which followed the Greeks piling into their ships to sail off to Troy to retrieve the stolen princess, was thrilling and dark and wonderful, but what really set me dreaming was the Odyssey, the trip back home, the trip through so many surreal and fantastical places in time and space. 

Odysseus just wanted to go home, back to his roots,  but he had no phone, and he had to get there through all sorts of obstacles. It was not the last story about a man who travels through a long path seeking to return home--Cold Mountain springs to mind, and there are no doubt hundreds if not thousands of others--but the Odyssey was one of the first. And the expression "the journey is the reason" derives from that. 

Some years ago I decided to leave home, the town where I'd grown up and to which I returned after 16 years away. I was Odysseus returned home, back to my roots.   I lived the next two decades there. I raised my kids where I had grown up, and they attended some of the same schools I had,  but then they left to seek out their own adventures and I faced the choice of simply living out the rest of my life where I had "roots" or seeking out a new adventure. 

John Steinbeck addresses this notion of "roots" in Travels with Charley, and he cites the remarks of a man he met along the road who lived in a mobile home, an electrician who told him the whole notion of a person being "rooted" was bogus. He could find a job anywhere and if business dried up, nobody, not his family, not his friends, not his current customers would be able to help him, so he would have to move. But he embraced that idea of rootlessness because people, he said, are not trees. People can move and should. We really are not organisms with roots. We evolved to move. 

Here in New England, I meet people every day who were born in a town like Haverhill, Massachusetts or Methuen or Laconia, New Hampshire and have never moved. Their families live within a few miles and they are "rooted."  And there is something wonderful about that continuity, but it may be, in some senses, illusory.

Vacationing on  Kezar Lake, in Maine, I was invited to play baseball by the plumber who came to fix a toilet in our cabin and I quickly realized the guys in this game had all grown up in the town and had known each other since childhood and had played in this game for decades. They never had to finish a joke--they all knew all the punch lines. That was remarkable to me because I had grown up with kids who knew we would all be leaving home after high school and few of us expected to return to our home town. There was something warm and rich about that sense of continuity among these baseball players.

But, as I listened, I realized these men who had remained physically planted and rooted were not the same kids they had been decades earlier. Some had made more money than others. Some had led happy lives, others not. Apparently, one had married the former wife of another. Nothing remains the same, no matter how "rooted" you are. 

One of my favorite nephews is facing an uprooting and it has been traumatic for him and his family. He was raised in the South, in  North Carolina, and he went to college in Nashville, where he now lives. His wife is from Michigan, but she has lived in the South since she married him. His kids were born in Nashville. Now he has to move to New York City for three years as part of a corporate training program. 

At first, they thought they would try to reproduce their suburban life by living in New Jersey, but once they looked around New York City, they began to see the virtues of adventure. The wife took her daughter to a local private school in Manhattan for an interview. They were told there were really no places available for either child, but the school agreed to at least meet with the family. The children were gone for an extended period, and when the school officials finally emerged, they were smiling. Things had changed dramatically. "We'll make room," they said. "We would be very much like to have Ellie and her brother become part of our family."  

Apparently, the daughter had answered whatever questions they had asked impressively. The son had kept responding, "Yes, sir" and "No Ma'm."  These children would not have to be taught manners and whatever the daughter said apparently got the attention of the adults who run the school 

So the disruption may prove less injurious and more positive than they had imagined.
The daughter was quite taken with the subways and the son was thrilled by the Lego store on 5th Avenue. Leaving Nashville behind will not be a problem for these kids. The parents will simply learn from their children.

In our New Hampshire town, most graduates of Winacunnet High School, I gather, stay in New Hampshire of nearby New England. But some go further afield. A neighbor's son finished college and traveled to China, where he is now studying for a degree at a Chinese university. He speaks Chinese. He is going boldly forth where few of his classmates will ever go.  What combination of parenting and experience and talent allowed him to become an explorer? 

Not all change is good. Not every journey through life is harmless. But there is a chance the new will be as good or better than the old. We go forth boldly where we have never ventured before. 

My grandparents took an even more perilous journey--they left Europe on a boat for New York City, with little in their pockets and unknown risks ahead of them. That was the greatest gift they ever gave me. They took a chance and although they did not reap the benefits much, I did. 

There is a wonderful musician on the internet who calls himself simply, "Big Voyage."  He's got that essence of what life is all about.

The Anvil of Friendship

Why do people remember high school friends with special affection? One reason may be high school is a time of substantial stress--people are undergoing a visible metamorphosis, leaving childhood, discovering sex and failure and getting launched into the future or crashing and burning, with results which seem momentous at the time.

Duress, conflict, intensity of feeling all forge friendship. You don't really know someone until you've lived through some sort of conflict with him or her. You can work alongside someone in an office for years and hear about their family and their vacations, but if there is no real conflict or pressure at work, you are unlikely to develop much feeling for that person.

Soldiers say their war time friends are more than friends: They are brothers. Some of that is romanticized, but some is very real. Conflict can shred bonds, but it can forge them.

People will say you can't really become friends with someone until you've locked horns and sparred and while I'm not sure a fight is necessary, I can hardly imagine considering someone a friend until I've really challenged that person, pressed them until they have felt uncomfortable and had to fight to defend a position or a belief. Until you draw blood, a friendship is anemic. 

Among some cultures, conflict is avoided and considered unfortunate, covered over. But for my money, a friend you've never tested is not yet earned.