Category Archives: Health & Illness

Kinds of Help

Posted on November 3, 2012 by Lisa Roney

Last month, two graduate students that I work with invited me to speak at a round-table event about blogging later in November. I agreed, enthusiastically, put it on the calendar, and then promptly stopped posting on my blog. The two things, I promise, don’t have anything to do with each other, but their juxtaposition nonetheless has made me more aware of both of them. If I’m going to go and talk about the benefits of blogging, what does it mean that I’ve gone inactive? And does there come a time when it’s better not to blog?

There is nothing worse than those blogs that never quite get off the ground, where the blogger posts promises about blogging and not much else. “I’ll be back soon.” Or, even worse, “I’m back! I’m committed,” and then nothing more. As one stumbles through the blogosphere, one sees many such entries. That’s one reason why I have not even signed on to explain my hiatus.

Yet, I do find that being on break from the blog has been yet another learning experience about blogging.

First, that I do sincerely miss it. I miss the sense of discipline, the accomplishment of writing something every week that’s self-contained and “done,” and the connectedness that comes with all the public and private responses I get. This has given me insight into the junkie nature of attention to one’s writing—I’ve never had much, but I can see easily how that gets to driving some writers, for better and for worse.

I have also learned that as much as I love the blog and feel devoted to it, there are other things that take priority. The main reason I haven’t been blogging is because I have been spending every spare minute I have working on the book with Oxford for which I have a contract. There are other secondary reasons—I’ve had to have a minor surgery, I’ve been out of town, I’ve been formulating a project and soliciting an illustrator for it, I’ve been back in the classroom again and attending to all the prosaic demands of the university bureaucracy—course descriptions, book orders for next term, making benefits decisions during open enrollment, etc. etc.

Frankly, I’ve also been trying not-so-successfully to deal with the stress and anxiety of it all. A couple of weeks ago, my neurologist’s nurse told me that my latest MRI looks “completely normal.” She asked if I’d been having any symptoms, and I reported to her that I seem basically fine but don’t feel like myself. I wondered if my forgetfulness, irritability, inability to get a training response to exercise, and lack of concentration are sequelae to my brain events or just middle age. After asking me a few questions, she came to a different conclusion.

You know how it is when someone tells you something that you already really know, but it just clicks? There’s an aha moment even though the idea is nothing new.

“I think,” the neurology nurse said, “that there’s nothing wrong with your brain. You have the classic symptoms of insomnia and anxiety. You need to get eight hours of sleep at least two or three nights a week.” (I was getting between three and six. Once a month, maybe seven.)

So, last week I discussed this with my endocrinologist. He’s one of the good ones—a doctor who cares, who knows his stuff, and who makes time to really listen. When I was in the hospital after my brain hemorrhage, either he or his nurse came by to see me every day, even though I was not under their care at the time.

Anyway, I came home with a new prescription to help me deal with the insomnia and anxiety, a very minor dosage of a mostly harmless medication. I feel better already. That’s not really the interesting part, though. The interesting part is that Dr. M. spoke to me very personally. I have never, ever had a physician do so before, and it was a red-letter day for me.

When I was telling him about how sometimes I would be in the car driving somewhere and forget how to get there, have to call my friend and ask which exit is the best for her house, he laughed and said, “That sounds just like me. I usually get off at the right exit, but sometimes I don’t remember how I got there.”

When I told him how I feel that the powers that be just make it harder and harder for me to do my job well, and how it seems that my colleagues who take short-cuts or behave selfishly are the ones that are rewarded, he nodded. I told him that I used to love my job and that I thought I always would, but that now I always have to force myself to find the good things in it and that if I won the lottery I would quit tomorrow. He said, “I feel the same way. The adminstrators are always telling us we are only allowed to spend five minutes with a patient, and I am always telling them that’s not enough for a Type 1 with a pump, but they don’t care.”

I told him that the medical appointments—all designed to maximize the amount the doctor can charge the insurance company—have run me ragged. I told him that I had to have a total of eight appointments to have the D&C I had a couple of weeks ago—the initial appointment where all we did was set up other appointments and then appointments for the first lab work, the ultrasound, the tests the doctor performed, the pre-op, the pre-op labwork at the hospital, the procedure itself, and then the post-op. “That’s eight appointments,” I said. “Not including all the procedures themselves and the waiting in offices, that’s eight hours of me just driving around town, a whole day of work just driving around so that the docs can charge more. The number of appointments could certainly have been cut in half. Easily.

He looked chagrined, and we agreed that the tail is wagging the dog. We agreed that these circumstances are designed to promote those who don’t care about the quality of their work, and that it’s a mystery why we all seem to agree to live this way.

“I’m not mentally ill,” I said to him, and he agreed. “I need medication because we have come to find ourselves living in a world that’s intolerable.”

In fact, the percentage of my friends and relatives and their kids and their spouses and their parents that take some kind of psychotropic medication is enormous. At least one in five Americans is now taking at least one such medication, according to the American Psychological Association. And the percentage of people who aren’t taking prescription help often participate widely in the phenomenon known as self-medicating via alcohol, caffeine, nicotine, and illegal recreational drugs. (Studies noted by Mental Health America and Health Services Research indicate the severity of this issue.)

The APA notes that the recent rapid increase in the use of these medications indicates “inappropriate prescribing,” and I agree. I have known people whose diagnoses I thought were overblown and who seem to me worse off than before they were medicated. The insurance companies and the medical world have tended to turn away from the hard work of intensive psychotherapy for those with real issues and have turned toward the easy pop-a-pill (or four) mentality.

But there is also a societal change going on that contributes to this in a different way, I believe. I believe that recent years’ move away from concepts of the public good toward more personal greed and supposed “self-reliance” have turned us more and more toward dog-eat-dog. Community is not emphasized, helping out is not emphasized—it’s every man, woman, child, and dog for itself. This leads inevitably to stress.

My father retired when he was 56 years old. He has lived the past twenty years in a secure retirement. He did some consulting work, he helps his wife with her small collectibles business, he got into crime writing workshops and wrote a novel, he plays tennis, he’s taken care of aging and infirm colleagues and relatives. And now he and his wife babysit her grandchildren. He has remained an active and contributing member of society, and he is a classic case of why the middle-class is a great thing.

We are unfortunately losing the middle class. My brother and I—highly educated, hard-working people who had our first jobs by age 16 or 17—have no secure retirement to look forward to. We only hope it will be there, and there’s no way that either of us will be able to retire before we’re nearly 70 years old. The future is even less sanguine for my brother’s daughter and for my students.

These are choices our society has been making and continues to make. There is plenty of money in our society, though it is consolidated in fewer and fewer hands. And there are plenty of us who want to help each other and be parts of a community, not just self-protective egotists. Even those that I encounter in my work life who seem the most selfish, self-promoting, and communally harmful seem to me to really wish for something else. They only feel that they are doing what they have to do to survive. Who can condemn them for that? I myself have turned away from demands I can’t handle, that I have felt might sink me.

Sometimes I marvel over the fact that there’s so much stress involved in being an English professor. I always think, “Hell, it’s not like I’m an ER doctor or an airplane pilot who could take out hundreds of lives with one error.” Not to mention that I don’t live in a war-torn place or one where I’m likely to starve. As the Rolling Stones song points out, though, even cooking dinner can be a trial, and there’s something stressful about the compromises that we make to have our comfortable lives. Vivian Gornick captured the same idle desperation of English departments in her wonderful essay “At the University: Little Murders of the Soul.” There is nothing more deadening than corporate expectations (or perhaps housewifely ones). And corporate expectations have taken over everywhere. My students can’t even have a minimum-wage job nowadays without being constantly harangued about their enthusiasm.

I have a hard time reconciling this high level of psychological distress across society with the idea that we are all living the way we choose to live. If we have all this choice in our lives that the gurus speak of, if we create the world we dream of, if we only have to envision success faithfully in order to get it, could we please envision something more benign, something more cooperative and less manipulative?

I know this is probably not stuff I should discuss in public on a blog with my name on it. That’s probably one more reason why I’ve been hanging back from blogging lately–just too many unspeakables on my mind. But I just have to say that if this is scandalous, then I have to laugh. More likely, of course, it could give an enemy a vulnerability to attack. But one thing I have always liked about myself—among the admittedly many things I’ve longed to change—is that I go ahead and do what I think is right. I go ahead and say what I’m thinking. I try to do this in ways that aren’t designed to hurt others, but I am not afraid to be hurt myself. I’d rather be real than afraid. I’m not invulnerable, but I am brave. I don’t mean to make more of that than it is. There are many things I am not that I would prefer to be. This is no Facebook brag or depiction of my life as peachy and perfect, of me as a hero of all that I survey, a wild success, a best human in the world. Nope, nope, nope. But I do marshal on. Today, a little more calmly.

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Lia Lee: The Spirit Catches You

Posted on September 18, 2012 by Lisa Roney

Lia Lee at age 4, from the cover of Anne Fadiman’s The Spirit Catches You and You Fall Down.

The news reached me over the weekend that Lia Lee has passed away. I responded, as I’m sure many others did, with mixed feelings. Lia Lee had been in a vegetative state since 1986, and the bulk of the tragedy associated with her was in some ways already long over. Yet, as this Sacramento Bee obituary notes, her mother nonetheless wept and expressed sorrow over her absence since her death on August 31.

Lia Lee and her family are best known for forcing a radical re-thinking of the value of severely disabled people’s lives and the need for Western medical personnel to deal better with other cultural beliefs during treatment. Hmong immigrants from Laos, the Lees brought with them to the U.S. different ways of thinking both about the epilepsy that led to Lia’s brain-death and about family responsibilities and love. They considered Lia a full-fledged human being even after Western medicine had pronounced her gone.

If you don’t know about Lia Lee, then right now you should take the steps to get ahold of Anne Fadiman’s wonderful book about her, The Spirit Catches You and You Fall Down. I remember reading it shortly after it was published in 1997, and the amazement with which I turned the pages. Fadiman tells the tale of the Lee family’s desperate flight from Laos, their sense of abandonment by the U.S. government after the Hmong had helped out against the Viet-Cong in the “Secret War” during the 1970s, and their bewilderment at the treatment Lia received for her epilepsy at hospitals in their adopted California.

In fact, one small facet of this book has long affected how I teach creative writing. Early on in the book, Fadiman describes how one of Lia’s older sisters had written in elementary school a chronicle of her family’s escape from Laos—swimming across the Mekong River under attack by the Viet-Cong, even losing the life of one family member, enduring squalid refugee camps before finally managing to reach the U.S.—and the teacher’s comments along the lines of “What an interesting life you have led! Watch for proper comma use.” I decided right then and there that I would never trivialize what my students wrote about—that I would always emphasize that the details of writing are not about correctness in itself but about being able to better express the truth of the story you want to tell. I would always treat them as human beings first and writers second. Even this small lesson has served me well.

But The Spirit Catches You and You Fall Down taught so many other important lessons. The impact of Fadiman’s book really cannot be well summarized, even though this New York Times article tries to do so. It’s a book characterized by an unusual depth of research, but also of feeling. There are too few books written with this kind of attention to detail and this kind of sensitivity. Fadiman cared enough to get it right, though even she stands corrected on a few matters. I read a lot of books these days that are superficial or sloppy—and, in spite of some imperfections, Fadiman’s book , even after all these years, puts them all to shame. It is a story that endures even though what it teaches to medical personnel about cultural sensitivity has become close to standard (albeit still too seldom acted on) by now.

May the spirit of Lia Lee live on, and may we remember her as well as her family took care of her.

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The Bureaucracy of Fantasy

Posted on September 13, 2012 by Lisa Roney

Dobrynya Nikitich, a great Russian dragonslayer. Close-up of the painting Bogatyrs (1898) by Viktor Vasnetsov.

When I started drafting this post, I included a long list of my recent encounters with the medical and health insurance bureaucracies. I’ve deleted all those specifics—you don’t need them because you have a list of your own. Everyone does because virtually everyone lives embedded in bureaucracy. There are very few walks of life where a person doesn’t have to deal with red tape and forms on a more or less constant basis.

Just stop and think how many forms you have filled out in the past year, and how much of your life that has taken up. Then add on the time you’ve spent on hold or dealing with some low-level “customer service” rep on the phone or instant messaging, and the sad truth of these many wasted hours comes clear.

As a person with a chronic illness that is likely to shorten my expected lifespan, I have always chafed at this set of circumstances. While I understand the need for much of it—the driver’s licenses, the voter registration cards, the building permits, the medical histories—I have always grown very impatient with needless bureaucratic obstacles.

But today while I was thinking about this issue, I happened upon some good news for me: Life expectancy for those with Type 1 diabetes has improved greatly in the past couple of decades and for those of us born between 1965 and 1980 is only about 4 years shorter than those in the general population. When I was diagnosed in 1972, it was a whopping 15 or 20 years lower than average. Maybe I am no longer justified in my impatience.

It would be fascinating if someone would do a study about what diabetics do with those extra years we now get to live. I suspect that a goodly portion of it will be spent waiting in doctor’s offices, hassling with health insurance providers and third-party billing profiteers, shuttling medical records from one doc to another, and filling out paperwork related to treatments and benefits.

What I also fear—for all of us caught up in this increasingly bureaucratized world—is that we will turn more and more to fantasy as the antidote.

Because even the word “bureaucracy” is really boring, right? Who wants to even discuss the issue when every one of us has some version of it in his or her own life. Who needs more?

I have a theory that the rise of genre fiction (and movies and gaming and so on and on) has to do with the concomitant rise of bureaucracy all around us, even through and in us. We are living in ways that it’s truly unacceptable to live—inhuman ways that denigrate us. Not that we are living in squalor—perhaps the trappings of comfort and leisure (the TVs, the cars, the iPads, the flights to Paris) allow those of us in the middle class to ignore these cold wastes of time. After all, desperate living and working conditions, hunger and illiteracy, dysentery and violent repression all continue the world over, and are worse than mere bureaucracy.

Perhaps it is fitting, then, that we don’t answer the bureaucratic inhumanity with the rally or the march or the strike. These methods seem to have lost their effectiveness to a great extent anyway—people march and rally and strike, and the powers that be wait them out. Our “first-world” problems don’t seem to deserve that kind of outcry. When it’s attempted—as in Occupy Wall Street, which I greatly respected as an attempt to bring attention to these and related economic issues—the result is moderate and the fun-poking is huge. The reaction of much of the bureaucratized population to the Occupy movement was “Get a job.” No matter how unjust the implications, that tone has been common.

For the middle class, then, the main protest activity seems to be a retreat into fantasy. Fantasy seems to be something that almost everyone can get behind, no matter one’s political party, no matter one’s income level, no matter one’s level of education. Whether it’s interstellar space exploration or misty dragon-filled castles, whether it’s pretend wars where everyone can be a paintball hero or perfumed spas staffed by buff young men who will oil and rub one’s muscles, whether it’s in book or movie or video game or cosplay form—almost everyone seems more interested in an alternate world than the one we actually live in.

Never in my life have I seen a more prescient film than Brazil. It’s a film I will admit that I didn’t enjoy watching—it’s an ugly film and hard to follow. But the world that it presents—where the only escape from the bureaucracy is in a fantasy where the main character takes on armor and the wings of an angel—seems to me more and more like the world I live in now.

And I think that Brazil anticipates the way in which more and more extreme reliance on bureaucratic thinking about fitting in, strange self-fulfilling forms of meaningless success, pursuit of superficial beauty at any price—these things all lead us not to rethink our own world and its possibilities, but to fall back on hope in the magical.

The real horses are starving due to drought. It’s okay, though, because we can pretend that Dobrynya Nikitich and other dragonslayers will ride in on their beautiful steeds and save the day.

This strategy is fine with the powers that be, with those that impose further and further bureaucratic strictures. It is a great opiate. It lets everyone off the hook. It’s the religion without the requisite belief or morality. Win-win, I guess.

I’m sure that if I can only convince myself I have some angel wings somewhere, those waits in doctors’ offices and on hold won’t bug me so much. Until, of course, the end of the fantasy.

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Does It Matter Whether a Smile Is Real?

Posted on July 18, 2012 by Lisa Roney

The relationship of our happiness to our willingness to fake it has been the topic of debate for a long time, and many a bromide supports the idea that it’s a good thing to fake it if need be. Consider these:

Fake it til you make it.

Go through the motions, and the motives will follow.

Keep smiling—it will make people wonder what you’ve been up to.

Keep your chin up!

If you can’t be with the one you love, love the one you’re with.

If life deals you lemons, make lemonade.

Put on a happy face! (my video selection above, from the film Bye, Bye, Birdie, 1963)

Of course, there are many sources that repeat this general idea endlessly. But there are also sources that report on the nuances and limitations of such ideas, that qualify the findings of all this research that supposedly demands smiling even if you have to fake it.

Follow with me a kind of trajectory:

First, there’s this kind of thing that notes we have plenty of reasons to smile even when we don’t feel like it. Even when you go to a more professional psychology source that cites particular studies, there’s a kind of silly gloss on it all that bugs me. Take the final study noted on the PSYBLOG—the report here ignores the fact that causation has not been established, only the barest correlation. Photos of baseball players over the years show that the ones that smiled more lived longer. What this most likely proves is not that if you smile more, you will live longer, but that if you are healthy, you will smile more.

I get purely annoyed by this kind of thing. Partly because few of these sources even acknowledge that there is also plenty of research that shows the opposite—the fact that faking happiness can in itself have a negative impact. Here, a study notes that fake smiles can deepen depression, and here that faking happiness at work over time has negative health consequences.

As an aside, I think that the questionable research about smiling at work and the increased productiveness of employees in a good mood is particularly dangerous. While the Wall Street Journal here gives a well-balanced sense that it’s not a matter of axing the less cheerful, but of businesses actually taking some responsibility to provide resources for good cheer, all too often we see imperatives that become dictatorial and inhumane, as in the situation described here of the enforced-smile McDonald’s counter clerk. Not to mention those hideous hiring tests that seek to classify personalities and refuse jobs to those who aren’t as perky as others, no matter their competence.

All of the articles that I read about negative consequences of faking or that call into question the assertions about the benefits of positivity, of course, have to mention those positivity assertions. There’s an odd unevenness in this regard. The sane side has to acknowledge the overly simplified positivity side, but the positivity side feels no compunction whatsoever to mention the nuances and limitations of this body of research.

In a recent example, Jane Brody wrote a column for the New York Times, “A Richer Life by Seeing the Glass Half Full.” If you read the comments, you will note that there are many who leap to agree and many who bare their teeth and attack the Brody bromides. Yet, when Brody followed up about the responses she received, she acknowledged only the “hundreds of comments from readers who testified to the value of living life as a glass half full.” She doesn’t deign to even acknowledge the other kinds of responses she received.

Don’t we have to know that something is terribly, terribly wrong when professional science journalists won’t even acknowledge that the science is mixed at best on these matters and that there are people who hold different perspectives? It taxes my credulity, especially when even an undergraduate college student can summarize the research so clearly in such a short paper as this one. The student clearly acknowledges there’s only a minor correlation, but even she has wrongly concluded that “smiling can never hurt, so go ahead and try it out!”

And let me observe that people have been trying to prove a stronger correlation and causation since Darwin’s time. They have been unable to demonstrate the facial feedback theory in all these years in spite of overwhelming resources spent toward that end.

However, you can go on to find scientists who are laboring to truly understand emotions in a complex and useful way—and one that won’t be used to hammer people over the head uselessly and cruelly or dismissively. One of these I’ll discuss in my next blog post, but, for now, I invite you to head over to the BBC Spot the Fake Smile test.

If we’re going to be constantly interacting with people who believe that faking their smiles will actually make them happier and that it will earn them our trust, forgiveness, sexual interest, and a whole host of other benefits, then perhaps we want to be more savvy about these fake smiles. I scored 19/20 right, which is evidently quite unusual. Maybe I should publish a paper about the benefits of skepticism: it helps you spot one of those fake cheery people from a mile away. And run like hell away from them and their agendas.

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Hallelujah

Posted on May 31, 2012 by Lisa Roney

A beautiful song for the third anniversary of my marriage to Bruce. This “Hallelujah” was written by Leonard Cohen, whom I posted about just the other day, and is sung here by kd lang, who Bruce and I saw in concert here in Orlando last Sunday.

So many thoughts—

One reason why this song is perfect for today is that Bruce, like lang and Cohen, is a Canadian. “Canadian content” is one of our short-hand phrases for pointing that out—the distance from which we came together.

Another reason is that the love of people our age is complicated. Just this morning, I woke up with a low blood sugar and burst into tears over anxiety about our upcoming trip to Berlin—all my fears of not being able to keep up because of the arthritis in my foot and needing to rummage around in his friends’ kitchen for low-blood-sugar juice in the middle of the night and of my stomach getting upset over unfamiliar foods… Bruce and I had to talk it all out, and I told him after I realized what day it is that maybe I should wish him an unhappy anniversary. But, no, he loves me—and I love him—in spite of all the flaws of our human condition. “All the perfect and broken Hallelujahs have an equal value,” Cohen is quoted as saying about the song, and that seems appropriate today, even though I would not call my love a cold or broken hallelujah. Quite the contrary.

But even the kd lang concert the other night gave me much food for thought. Beyond the beauty of lang’s voice and the sheer pleasure of the concert, I have to note that it was not particularly well attended. Bruce and I—and no telling how many others—had gotten free tickets in a last-minute promotion, which was no doubt inspired by poor ticket sales. The Hard Rock Café concert space was even so only about 2/3 full, and I felt bad about this. Lang gave a terrific performance, and I know that non-sellout shows must be a standard feature of the musician’s life, but it was hard for me to believe that someone as distinguished as kd lang hadn’t filled the place up.

Bruce noted that there’s really no great way to keep up with events going on in Orlando, and several friends commented later that they, alas, had not realized she would be here. We ourselves had missed a John Prine concert just a few days earlier in spite of the fact that I’m his fan on Facebook and would have loved to be there. (I first saw him in concert in about 1977, and perhaps we should label him with “Appalachian content” to also indicate the different roots Bruce and I have.) It’s just hard to keep up, and we are distracted from our “entertainment” options, even the profound ones, by our work.

Such is the unpredictable and accidental nature of fame, art, love, and human life. Today, I am grateful to be experiencing all that together with him.

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An Encounter with Buddhist Meditation

Posted on May 7, 2012 by Lisa Roney

In my ongoing quest for understanding about the life of the feelings, yesterday I attended a half-day event on “Dealing with Destructive Emotions.” Now, this was not some egregiously awful, dumbed-down positive psychology event, but a “meditation workshop” led by Dr. Barry Kerzin, personal physician of the Dalai Lama and a Buddhist monk.

I had had the pleasure of joining a group that took Dr. Kerzin to dinner on a previous visit to UCF last April, and I found him charming, compassionate, and intelligent. He had been particularly kind to me in that vulnerable time after my brain hemorrhage—that time when some people were so very kind and others showed their cruelty and indifference so clearly. I also know and admire the two organizers of the event, both of whom are leaving UCF for better positions elsewhere, and I wanted to support their final efforts here.

In addition, though I’m not a Buddhist and I can’t even claim to be all that knowledgeable, I was motivated to attend because I find much appealing in the Buddhist approach to happiness. I’ve posted before about the Buddhist concept of self-compassion, and there are other ways in which I think the Buddhists have it right. For one, they readily acknowledge that suffering is also a part of life, and they refrain from the blame that so many purveyors of popularized positive psychology allow themselves to indulge in.

For instance, in the talk I link to above, Dr. Kerzin cites a study about women with breast cancer and happiness. What’s different about this from so many of the kinds of “if you’re happier you will be healthier and live longer” assertions is that Kerzin notes not that the happier patients who lived longer were somehow innately more happy as persons (and therefore superior), but that they received tender loving care and that it was this compassion that contributed to their happiness and better health outcomes.

I think this is a radically important difference. In Buddhist thinking, we are responsible for helping ourselves be happier, but we are just as called upon to help other people. That mutuality and interdependence is key to keeping the search for happiness from becoming a weapon against those less fortunate than oneself. This kind of nuance distinguishes many Buddhist teachings from a lot of junk positive psychology, and so I feel myself more open to its strivings for a better world.

But I also attended with some apprehension based on my own make-up as a human being. As I put it to my husband yesterday, my pathology is such that group hugs just make me feel more alone and alienated than almost anything else. I am squeamish about crowds of all sorts, and the most common of types—the roaring audience of the sporting event or the rock concert—I find downright revolting, terrifying, really. Even a lecture given and a meditation practice led by someone I find intelligent and compelling can make me feel queasy in a large-group setting. When everyone else is sharing life-affirming togetherness, I usually feel more and more as though I don’t belong anywhere. So, I went with my mind as far open to that sort of thing as I could pry it, though I knew I would find myself uncomfortable. I assured myself that I nonetheless would be able to use it as a point of useful contemplation. Everything, as they say, is grist.

The day was divided into three segments, one before lunch and two after lunch. Each hour, Dr. Kerzin would talk for a while, take questions, and then lead a brief meditation.

In the opening session, Dr. Kerzin talked for quite a bit about where he had recently traveled, where he was traveling next, and the few days he had spent on a silent retreat near Deland, writing, reading, and kayaking. He talked a bit about his encounter on the St. John’s River with an alligator, which he would touch upon throughout the talk.

What I noticed right away was my own destructive impatience. I wanted Dr. Kerzin to start getting to the point, to give me something that I could take away from this talk. He wasn’t, after all, talking in any way about how to deal with destructive emotions, but about the pleasures and challenges of his lifestyle.

After a while, he transitioned into talking about the way that Buddhism defines “destructive emotions” or kleshas in Sanskrit. (He gave us Tibetan terms as well, but I could not venture to spell those.) He spoke of the three roots of these kleshas—anger, desire, and distorted ignorance—from which negative feelings arise. This all seemed obvious to me—of course, while I understand the need to define things clearly, I felt I knew what destructive emotions are, including the ones I was having in that moment. I wanted not to define them, but to work on “dealing with” them.

By the end of the day, I would realize, of course, that in itself this was a productive lesson for me. As the day went on, it dawned on me how utterly exhausted I would be by giving a program that lasted so many hours, especially one where my presence and wisdom might be sources of expected sustenance for so many. And yet, Dr. Kerzin did not show signs of exhaustion or stress. The slow pace of his talk, rather, allowed a relaxed approach that might help prevent burn-out. I will think much more about this as I return to teaching next year with a desire not to kill myself with frenzied overwork.

Kerzin’s entire first segment, it seems to me now, was about sticking with things and how you can do that in spite of impatience. He noted several times the Dalai Lama’s fondness for saying, “Never give up,” and he went through a long and rather elaborate description of various phases of awareness and practice—at first, you may have an intellectual understanding, and only later will that become felt or experienced. You start with an awareness that there’s another possible way of responding other than getting angry, and from the brief “sigh of relief” that can give, you keep trying and move on to being able to laugh at appearances, then to a point when “love boils up” and the conflictual appearances subside.

As I sat in the ballroom, I contemplated a task that faces me today—calling the health insurance company and the hospital about bills that I’ve been receiving and don’t understand. If there is one thing that sends me into a rage, it is dealing with the medical world in our bureaucratized and profit-motivated system. The last time I talked with someone in the billing department at the hospital and he kept repeating, “That’s our policy,” I ended up calling him a drone. He got all insulted and told me he was a human being. I told him he didn’t act like one. It was a terrible impasse all around. We’ll see if I can do better today, because one thing is certain, and it’s that my fury about this system does me no good on a daily basis. I need to transform that fury into larger action rather than letting it eat me up or letting it make me mean.

At one point, as in the video above, Kerzin asked the audience if there was anyone who had let go of all of his or her anger. There were actually a couple of people who raised their hands. Perhaps it was then I began to feel alienated. How can anyone claim that? I felt suddenly as though I were in a room of poseurs, fake Buddhas. I can’t even imagine what it would be like to have no anger left in me, only what it is like to keep trying to let go of it. Probably, if I’m honest, I’m not even fully convinced that I should let go of all of it.

Kerzin ended the first session by taking some questions and then leading us in a five-minute meditation, starting and ending with a toll of a chime, in which we were to empty our minds and concentrate only on our breathing. Once, years ago, when I regularly practiced yoga, I could sometimes do this. Lately, I can only observe as the thoughts fly in and out of my brain like so many pieces of confetti. If meditation could produce a panic attack, I’m a likely candidate these days.

Once dismissed for lunch, I discovered my blood sugar was a low 63, and I stumbled out onto the empty campus and found a vending machine. No doubt the low affected my responses, and I hoped I’d feel better later on. I had told myself that I would go to the library over the hour-and-a-half-long lunch period, but it was closed for semester break, and so I sat on a bench and enjoyed the sunshine until the ants started biting my ankles.

As I watched two middle-school-aged boys playing in the fountain, I contemplated Kerzin’s talk. I was grateful at his nuance. It seemed to me that some of the audience questions had been agenda-driven and tended toward the oversimplifications that so offend me. Kerzin always made important distinctions. “Anger,” he noted, “needs to be distinguished from strength and courage and passion. The problem with anger is that its motivation is harm or revenge, even directed at oneself.”

“Fear,” he noted, on the other hand, “can in itself be sensible.” When you face an alligator, he noted, some fear is a correct response and can keep you alive. “Fear becomes a problem when it becomes habitual anxiety that doesn’t serve to remove you from the danger.”

Dr. Kerzin started the afternoon sessions with reminders once again to be patient and to be gentle with ourselves and others. Once again, he made a distinction important to me: If you ever think you’ve “got it,” he said, you are falling into a trap, the trap of arrogance. He emphasized the lack of right answers and formulas.

He posed the question of how it is that distorted ignorance appears and noted that it’s built in to the assumptions we live with and are born into. Then he used an acronym—PPI—for permanent, partless, and independent. Leisurely, he discussed how people assume these qualities for themselves and other things in the world.

Another destructive emotion invaded me at this point… I felt a little bored. Certainly, on an intellectual basis, I have understood a world that is ever-changing, multi-faceted, and interdependent for a long time. True that I often don’t experience it that way, and in that ballroom I felt atomistic as can be. But this wasn’t introducing me to new concepts.

I felt relieved when we moved on to the practice of a new meditation—that he called “tonglen”—where you breathe in the sorrow or pain (of one person or animal or a group or opened to the general sorrow of the world), and then transform it on the out breath to healing love to alleviate that suffering. It was striking to me throughout the day that Dr. Kerzin included animals as sentient beings, especially because I was once again very worried about my elderly cat, who had done so well over the past couple of weeks but who has now taken another down turn. I was grateful to be able to focus my meditation at least in part on my little cat.

After this second meditation, while we took a short break, I also thought about how it is that I am a practice person rather than an intellectual one. This, of course, is always a factor in academia and one of the reasons why I seldom feel truly at home there. Academia is a traditionally scholarly place, and scholars are oriented toward concepts and ideas, whereas artists of various stripes are oriented toward practice.

This led me to thinking about myself in the context of a large lecture hall full of people. I feel so fortunate to teach the generally small and often truly intimate creative writing courses that I teach. For some in the ballroom yesterday, there was a sense of closeness and sharing encouraged by Dr. Kerzin, but because I am so used to the much more intimate workshop setting, it continued to feel rather abstract and distant to me. This made me grateful for the usual practice of which I’m a part, and reinforced once again my sense of the value and specialness of that method. There are workshops that do unfortunately become the site of intimate brutalization, but for the most part I think the creative writing workshop is a primary location of exploration and sharing of human qualities. When Kerzin mentioned how in his study with his Buddhist teachers, there was often a lot of laughter, I thought of my workshops.

The last hour of the day, Dr. Kerzin mostly took questions from the audience. Several people seemed to me again to have come with agendas—to show off their knowledge, to question him about Taoist principles (not his area), to demonstrate to this wise man how good they were. One even seemed to have that good old positive psychology agenda. I had heard him during the break talking about studies that supposedly showed that people could affect reality with the strength of their thoughts. He asked about the Buddhist precept that “nothing exists.”

Dr. Kerzin gently corrected him. The Buddha, he noted, taught that nothing exists in itself, but he also taught that there is a reality behind the common reality based on experience. The way that we commonly perceive things may be an illusion, but a belief that nothing exists at all would be considered nihilism, and is not a tenet of most kinds of Buddhism. (See also, the third paragraph in the Second Dharmachakra here.) This is another one of those oversimplifications that tend to infest people’s thinking, and I was grateful he pointed that out.

We ended the day with a walking meditation, in which we all stood, found a spot in the room and began walking as slowly as possible, paying attention to the way our feet moved and touched the carpet. This was delightfully new for me. Sitting meditation was always hard for my fluttering mind, but recently has also become physically hard for me with my back aches. Many of the yoga practices I used to do to work on my sense of balance (such as the tree pose), I simply can’t hold now. Even walking itself has sometimes become painful with my arthritic foot.

I found it amazingly challenging to walk so slowly, and it proved a great balance exercise. It also was easy on my foot, as the slowness prevented any pounding of my bones on the floor. Perhaps it was also true for me that the activity helped calm and focus my mind, so that I felt more meditative than I usually ever accomplish sitting.

Besides, as the featured video below will show, it’s wacky to do in close proximity to others, and I am always glad to greet the wacky. Finally, I enjoyed all the other people in the room, their various and varied bodies moving around the space, encountering each other and yet not colliding, all of us doing the best we could do at this deceptively simple task.

It was a good way to end the day, and I came home with plenty to think about and the empty spaces in my head in which to do so.

I enjoyed the walking meditation so much, I’ll include links to a few more videos about it in addition to the one below.

Minimalist instructions (1 minute, 40 seconds)
Calming verbal instructions with pretty pictures (3:12)
Monk Thich Nhat Hanh demonstrating and discussing walking meditation (5:44)
Longer step-by-step instructions (10:00)
Perky, Westernized instructions (2:49 plus ad)

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Beware the Enthymeme!

Posted on April 30, 2012 by Lisa Roney

It's bad enough to debate complex issues in slogans, but even worse when the slogans so cheerfully lie.

In Florida, as in many states, there are a variety of license plate designs for car owners to choose from. I always think that these, like bumper stickers, are a strange way to express oneself, though I’ve been known to slap a bumper sticker on my car now and then. Last presidential election cycle, I had two Obama stickers stolen off my car, and I have a long-term one that says, “Please don’t breed or buy while shelter pets die. Opt to adopt.” Other than one time when a friend at first thought it protested the breeding of humans and was an insult to his parenthood, that one has been uncontroversial. At least as far as I know. And I guess that’s the joy of broadcasting one’s opinions this way. Unless you meet up with a crazy person who will bash into your vehicle, you are safe from argument.

One of the popular license plates around here is a yellow one with red crayon-like boy and girl figures that imply they were drawn by a child and that says “Choose Life.”

It might be an okay message if it really meant what it says. Of course, most of those who sport this license plate don’t actually mean that. What they mean is that they would rather force every pregnant woman to bring any pregnancy to term. What they mean is not “choose life,” but “choose to support laws and organizations that offer no choice to women.” And, as this Slate article reports, “the legislation in most states [that have these plates] expressly provides that any program offering referrals or even discussing the option of abortion is barred from funding.” In other words, these plates support lack of choice, not a choice.

There is an odd way in which the language gets twisted like this. Of course, progressives and liberals do it too, but what I notice lately is the way that Republicans and right-wingers do this all the freaking time. No doubt, we are gearing up for a maelstrom of misused language in this coming election season.

What I also notice is that progressives have a hard time correcting these misuses of language. I guess they don’t want to be accused of nit-picking about semantics or something like that. But the use of language is one of the most important things we can pay attention to. This is one of the things that rhetorical analysis is good for, and it pains me that so many can get through high school and freshman comp and even four or more years of college and still not be able to understand the manipulations of language to which they are subject on a daily basis.

I will never forget one of my early teaching experiences, when I was laboring as a freshman-composition TA at Penn State during the fall of 1991. At the same time, playing out in the media, were the Senate confirmation hearings for Supreme Court nominee Clarence Thomas. Anita Hill, who had worked as his assistant some years earlier, arrived on the scene with her testimony about Thomas sexually harassing her.

Hill’s testimony lasted only a few hours, but the discussion of it went on for weeks and months, even years. The issue even resurfaced in 2010, when Clarence Thomas’s wife called Anita Hill and suggested she should apologize.

In spite of the fact that Hill subjected herself to a polygraph test that indicated her testimony was honest, whereas Thomas refused a polygraph, and in spite of another woman’s affidavit that she had received similar treatment, Hill’s testimony was vehemently called into question. And one of the prime reasons people gave for their disbelief was that Hill had continued to work for Thomas rather than quitting her job, had in fact even worked for him at a second position after the time during which she said he harassed her. This line of discussion had been begun during her Senate testimony when Republican senators Arlen Specter and Orrin Hatch strove quite clearly to discredit her. (The entire hearings are available via C-Span. About half-way through Day 1, Part 3, Specter grills her about why she continued to work for Thomas).

This discussion nagged at me and nagged at me. Finally one day when I was set to teach the enthymeme, I realized why. Dully, I had been writing a traditional enthymeme lesson (that had been provided to us new TAs) on the chalkboard:

Johnathan lives in Japan.
Johnathan speaks Japanese.

And then out to the side the missing link: People who live in Japan speak Japanese.

In a fit of inspiration, I erased it and wrote instead:

Anita Hill claims she was sexually harassed by Clarence Thomas.
She’s probably lying.

“How many of you agree with this?” I asked. More than half the class raised their hands, most of the men and a few of the women.

For the next half hour, we explored the possible unstated assumptions behind the conclusion. The students eventually had to admit that the basic assumption they were making was that women should always put their “purity” above their careers. Certainly, that was the assumption that the all-male panel of senators who had grilled Hill clearly made. If this were not true, there might be a host of other priorities that Hill would put before quitting her job to escape Thomas’s advances and inappropriate comments.

Once we teased these assumptions out into the open, there were very few students (maybe only one) in the class who agreed with the statement that women should always put their “purity” over their career advancement. Most of them found themselves confronted with an assumption they didn’t agree with but that they had allowed to underpin their opinions on a matter of national importance.

A few of the young women in class began to make the connection to their own experience. “Oh, yeah,” one said, “I have a manager who is so offensive—he always stares at us waitresses too much and puts his hands on us whenever he can—but I haven’t quit my job! We all just ignore him. And it’s a nothing job.” Every female in the class could cite at least one instance of sexual harassment that she had let slide. We agreed that none of us would quit a job over it unless there was actual threat of rape or a high level of severity and directness in the harassment, but that this did not erase the fact of the harassment. It was a daily part of our collective lives.

By the end of class, because they could understand why Anita Hill might have stayed in her job in spite of harassment, they no longer deemed her a liar. I will never forget their mouths hanging open in disbelief at what they had been duped into repeating from the media to friends and family members. They rushed off after class to correct themselves. Thomas, of course, had already been approved as a Supreme Court justice.

I wonder about this kind of thing in the media. It seems to me that both the “neutral” media and the progressive factions do too little to correct this kind of blatantly stupid and unsupported claim. They do too little to monitor the use of language in blatantly deceptive ways. Some, including, of course, FOX News, are notorious for participating in this kind of ridiculous bias themselves (several examples here and one here that’s particularly about twisting of language). Lately, even our senators and representatives have felt free to make utterly false and ridiculous claims, and later to say they didn’t mean them as factual or to insist on defending their mischaracterizations. Only in these most blatant of examples are they called out on it.

For instance, in response to an email I sent to Florida Governor Rick Scott’s ridiculous decision to sign off on establishment of a new (unneeded) state university in Florida, I received a reply containing this statement: “Governor Scott’s top priority this legislative session was adding $1.06 billion in new funding for K-12 education.” First, nothing in Scott’s email responded to the subject I had addressed. And second, this is bull. Scott has been ballyhooing his great increase in state funding for K-12 education this year, after he cut $1.3 billion last year. A few reporters note toward the end of their articles that Scott’s budget doesn’t even replace what he has previously cut, but the headlines mostly remain that he is raising the budget. (Notice that this blogger put a more accurate headline on the same article published with an innocuous-sounding headline in the Palm Coast Observer. But, hey, at least the reporter mentions the facts.)

I believe that these twisted uses of language are one of the reasons why our society has become so divided and discussions so disharmonious. I think that we need to do all we can every time we hear these false uses of language to stop them in their tracks, even if it means making conversation halting. The fact is that it’s one thing to disagree about the substance of things and another for someone to lie in order to exaggerate our disagreements.

There are many examples, but I have gone on long enough. Today’s exhortation, again in support of so many friends who are ending long semesters of teaching freshman comp (and other courses that attempt to teach critical thinking), is: REMEMBER THE ENTHYMEME! Talk about the enthymeme. Pick apart the enthymeme.

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How Can a Poor Man Stand Such Times and Live?

Posted on April 19, 2012 by Lisa Roney

I’m in a mood today where I am feeling angry about the rich getting richer. I’m not poor, so I can stand it and live on. But it makes me wonder why it is that some wealthy people (like Bruce Springsteen) and some middle-class people (like me) feel for the poor and wish for more evening out of income and opportunities, whereas others just get greedy.

I encounter this profiteering greed mostly through the arena of healthcare. I don’t have high-brow tastes—I don’t spend a lot of money on cars, or clothes, or jewelry, or furs (god forbid), or expensive vacations, or fancy wine, or recreational drugs, or makeovers, or the many other vanities that I’m not even aware of. I spend money on my health. I’ve been doing a lot of that especially over the past five years, as I’ve encountered several issues with my health.

To me, most of the time, it doesn’t seem as though it’s the physicians who are greedy. They may make a better living than I do, but they mostly seem still fundamentally upper middle-class in spite of (or because of) their BMWs in the parking lot.

But the corporate entities with which I deal make me crazy. Recent examples:

* Today I was told by Florida Hospital that I have to pre-pay more than $400 for a colonoscopy scheduled for next week. (It’s my first ever, and is enough to dread by itself.) My insurer told me that, no, a routine preventive procedure is covered at 100%. We (together) called the hospital back and were told that they charge for a diagnostic rather than routine procedure, even though the latter is what the doctor ordered. “Just in case,” the drone said, “they find something wrong.” So they are charging in advance for a service that I may or may not need and that the doctor didn’t order. How can that be?

Ultimately, of course, they will refund my money. But it will be in their coffers for six to eight weeks or more.

* I mentioned on Monday that my insulin pump company holds me hostage. Every time a pump goes bad, they send me an emergency loaner. But if I don’t buy my next permanent pump from them, they will charge me $3600 for 90 days’ use of the loaner. The pump itself is barely worth that much, as they send old, reconditioned ones.

They also constantly try to force me to sign up for automatic supplies deliveries and billing. But diabetes is not a condition where you take one pill every day for a stable dosage. No, use of insulin varies, and so use of supplies varies. I don’t want to get a new order until I need one. The customer service has become so problematic, however, that it now often takes more than a month between when I order supplies and when they arrive. Several times I have run completely out of supplies and had to call for an emergency overnight order. How can it be that I can get a book or a pair of shoes or some obscure piece of computer gear in two days, but it takes a month or more for vital, life-sustaining medical supplies?

* A few years ago, I was told by a dentist at Greenberg Dental that I needed a crown and perhaps a root canal. Both of these are procedures that my dental insurance was supposed to cover completely. But suddenly Greenberg told me that only their general dentists were in the insurance plan, whereas that those who do the root canals were not. So, I was forced to either pay for the root canal myself or find another dentist who would do it and then send me back to Greenberg for the crown, leaving several days in between when I’d have to walk around with a hole in my tooth. I did the latter, and it was then that Greenberg started adding on charges to the crown. First, they said it was a lab charge, but when I called my insurance, I was told no such charge was allowed. It took several days for Greenberg to back down. “We bill them this way all the time,” I was told. “People always pay it.” Not me. Eventually they took the false charge off the bill, but then they added another. This went back and forth while I had a hole in my tooth. Finally, I settled on a $30 overcharge for an item that had never been listed on any of the earlier estimates. It became clear to me that there was collusion between the health insurance company and Greenberg.

These stories are boring. Sorry. They accumulate and accumulate in my life. Even though they are boring, they make me angrier and angrier every time I encounter such practices.

Our health care system is just fucked up, plain and simple.

Even if you believe that profit is the best incentive for good medical care (I don’t but even if you do), the problem is that you can never talk to anyone who makes decisions. You get customer service representatives who spout platitudes, who tell you “that’s our policy” or “that’s just the way it is.” There is never anything they can do to change it. And there is never any use appealing to a sense of right and wrong or a sense of decency.

These people are paid to insulate the people at the top who are reaping all the financial benefit of these predatory and unethical practices. Every time I think of them, I think of Michael Moore. Michael Moore has his flaws, but, by god, he was right to go for the executives in Roger and Me and in Sicko. But notice that he could get at far fewer of them by the time of Sicko. (Roger and Me was released in 1989 and Sicko in 2007.) The wealthy protect themselves from the rest of us so effectively nowadays that there’s seemingly little we can ever do to affect their unconscionable greed.

And healthcare is just not like other, non-vital services and goods. Shopping is impossible or at least very inconvenient, if not dangerous.

I will encourage my gastroenterologist to establish a relationship with a testing center that has more responsible and fair billing practices, and to move his tests away from Florida Hospital. I will raise hell on the phone with the corporate shills at the front line of “customer service” just on the off-chance that, like politicians’ offices, they keep track of “customer reactions.”

It doesn’t seem like enough. I languish today in my inability to change the practices of an industry that affects my life all too much.

You can watch Sicko in its entirety here if you haven’t seen it already: http://topdocumentaryfilms.com/sicko/.

But at least watch the trailer to remind yourself that things have not improved since Moore made Sicko. In fact, the profiteering continues to rise, and the healthcare industry continues to use unethical practices that make it look less profitable than it is.

How do people get so corrupt? Why do our laws no longer protect us, the people, but only the powers that be? We live in dangerous, dangerous times.

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The End of Illness: A Review

Posted on March 21, 2012 by Lisa Roney

We would all like to live to a vibrant old age, but this book's promises are overblown and ignore the inaccessibility of health care for too many.

I read this book with some eagerness, as I’m always glad to hear a whole-systems approach to medicine. However, I ended up being disappointed. I am sure that Dr. David B. Agus is a highly intelligent man who has made strides in his field of oncology, but I am unimpressed with the job that his ghostwriter did. The End of Illness relies very heavily on standard health advice—get plenty of sleep and exercise, eat whole foods, try to be less sedentary, etc. And even what’s offered as “new”—take baby aspirin and a statin drug after age 40, throw out your vitamin supplements, and wear comfortable shoes—are really not all that new. If you hadn’t heard about these debates and suggestions already, then you weren’t paying much attention.

That doesn’t mean that there aren’t good things about this book. I celebrate any physician who is trying to focus on preventive medicine and who believes in empowering people with information about their health. He is absolutely right that we need to do things differently in health care, and even in taking care of ourselves. He has some good ideas about what some of those things are. I do think his intentions are a step in the right direction. However, his orientation toward the wealthy and the celebrity aspects of his work lead him astray a bit. (Both Lance Armstrong and Al Gore endorse his book on the back cover, and Agus mentions several other well known people visiting him.)

This book is flawed in a few important ways and raises for me some questions that are relevant to our health care system in a way that Agus probably doesn’t intend. It reminded me of my constant (though usually low-level) mistrust because our medical system is oriented toward profit.

First of all, the entire first part of the book felt a lot like an infomercial for genetic testing. Dr. Agus admits that he is part owner of a genetic testing corporation, which he names, but that still didn’t ease my sense of having paid for a book that was a big promotion for his profit-making corporation. It was almost as if they sat around the corporate board room and asked, “How can we get more customers? Oh, let’s put out a book that is really an ad. We’ll have profits from the book AND more genetic testing customers.” It may also be that Navigenics is using the book to try to change the public attitude toward genetic testing, since it has recently been caught up in regulatory wrangles.

While Agus’s company is not a “bottom-feeder” or “scammer” corporation, as the regulatory article notes, it also doesn’t get the greatest reviews online. Even Wired, which generally supports the industry and introduced Navigenics as more user-friendly than others, noted that it is overpriced compared with similar companies. And most of us do not have health insurance that will help pay for it, nor do we have doctors that can interpret the information obtained. Dr. Agus’s fantasy of health care that is tailored to the individual based on genetic screening is both futuristic and out of the reach of most people financially (though obviously not of the likes of Armstrong or Gore).

Then, in his chapter on tossing out vitamin supplements, Agus notes two things: a) correlation is not the same as causation and b) animal and petri-dish studies don’t always apply to the whole human person. I couldn’t be happier for someone to say this. I have always had the sense that vitamin and supplement obsessions are inappropriate in this well-fed nation, just the same way the insistence on drinking bottled water is ridiculous and wasteful, when in the U.S. we have some of the safest public water in history.

Yet, as the book progresses and Agus turns to his causes, he uses the same kind of questionable study results as though correlation IS causation and as though animal and lab studies CAN be generalized to people. There are many examples, but, for instance, on p. 255, he uses a study of rats to claim that people need downtime. Now, I believe in downtime, but this study doesn’t prove its need for humans. He also does this with the issue of “positive” people living longer or surviving cancer longer—a chicken and egg question if ever there was one. And he notes in cavalier fashion that “study after study” shows that happier people live longer. Even if the research results were that clear, which they are not, that does not mean that the happiness causes people to live longer. This is a classic confusion of correlation and causation, which he criticized before. Maybe I’m missing something, and I certainly don’t have the same level of expertise at analyzing medical studies that Agus has. But, something is inconsistent here.

Lastly, Agus claims that we need to become personally responsible for our health, and I am certainly a person who has years of experience doing so. But taking good care of oneself and advocating for the right tests, medications, and other treatments can only go so far, and Agus hedges about the need for universal health care. While he does cite the brutal statistics involving our health care system (p. 296-297), he also states that “we need health-care reform at a much more basic and fundamental level before we can get to the financial end of it” (p. 279).

I think he has it backwards. In fact, Agus calls on all of us to gather our own health data and share it fearlessly and openly so that large-scale analysis of such data can be conducted. That is a great idea, but it is not likely to happen as long as the health insurance industry is able to disenfranchise any of us at a moment’s notice and as long as people are discriminated against because of their health standing, and, in fact, can’t get independent health insurance with certain pre-existing conditions. Agus notes that many corporate fitness programs do collect data anonymously and preserve individuals’ privacy. Would that I trusted that would always continue. But I know full well that those policies can change with the political climate. As long as profit is the motive for the health insurance industry, then some individuals will always have the potential to have their health information held against them. To assert otherwise is unrealistic.

In fact, Agus’s claim that if you do what he suggests, you can “live robustly to a ripe old age of one hundred or more” and “die peacefully in your sleep after your last dance that evening” (p. 2) seems way overblown. And this brings me to my Joyous Crybaby theme of authenticity. Why do people feel such a need to exaggerate their claims so, especially in the realm of health? Because I have a hard time believing that Agus really believes the exaggerated nature of his claims, my lack of trust is heightened. What, I wonder, does he really have in mind here? Do his goals really have to do with helping me live longer and better? Or is he more interested in promoting his genetic testing business and pushing for the establishment of open medical records for research purposes?

I know that there are some people who don’t feel those last two purposes would in any way conflict with a passionate interest in my own personal health. The right-wing argument about the “superiority” of the U.S. health care system is based on there being no conflict between the financial gain of physicians and the health insurance, medical device, and pharmaceutical industries, on the one hand, and consumer-patients on the other.

But this is demonstrably false, as the following relatively brief list of links demonstrates:

This rich list of studies and reports includes several that show physician denial about their own lack of objectivity in the face of profit motives.

Here is a terrific article about the corruption of medical research by the profit motive.

The government has had to step in repeatedly because of the failure of professional self-regulation.

Even within the field of medicine, the potential for corruption is acknowledged.

Even since regulations have been tightened regarding conflicts of interest, physicians are not accurate in their self-reporting.

And, even though individual research studies are now required to reveal any potential conflicts, the meta-analyses that most physicians rely on to stay current in their fields are not required to do so and often do not reveal such conflicts.

Questionable and patient-threatening research is reported in numerous sub-fields:

Diabetes drugs
AIDS drugs
Cancer
Cardiovascular health
Renal disease
and in the obtaining and use of body parts for research.

And in terms of the daily practice of medicine, even as far back as 1997, Harvard researchers reported conflicts between the profit motives of health insurers and patient care. These conflicts have only increased in the past 15 years, and they are likely much worse in HMOs.

If you want to talk about research that is definitive, the research about the lack of objectivity of privately funded researchers and physicians is what is crystal clear, far more so than the research about cheerfulness supposedly making you healthier. The evidence has been so undeniable and the results of these conflicts of interest so deadly that even anti-government right-wingers have not stood in the way of increased regulation and prosecutions by the Justice Department. Yet, in spite of decades of social science research that demonstrates profit is not the main motivator for creative and complex problem-solving (as summarized by Daniel Pink and mentioned on this blog before), our medical industry is still largely dominated by the assumption that wealth should be its main goal and that innovation will cease without scientists and physicians having the prospect of great riches as their primary reward.

I think that assumption is hogwash. I myself believe that most scientists and physicians go into their fields with a genuine desire to help humanity. And I believe that the industry emphasis on profits turns them into hollow and unhappy practitioners of half-science in the laboratory and half-medicine in the hospital. Certainly, if they can’t survive financially while practicing medicine compassionately, the financial reward grows more and more important. It is all, perhaps, that they are left with, and a sour reward it must be.

This is why I greet something like Dr. Agus’s book with such mixed feelings. He wants to help people—I truly believe that—but he ducks out on the hard issue of trust in a profit-oriented system. And, even though I will take a suggestion or two of his such as walking around while I’m talking on the phone, I can’t trust him and I don’t think this book will change people’s, and certainly not the nation’s, health outcomes.

A shorter version of this review was originally published on Goodreads.

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What Comes After Valentine’s Day

Posted on February 16, 2012 by Lisa Roney

Diego Velázquez’s portrait of Juan de Pareja, c. 1650, in the collection of the Metropolitan Museum of Art, New York.

“Are you ready to make plans for New York now?” Bruce laughs a little hopelessly as he asks.

I feel the panic rise in my throat like a hairball, even though we are lying in bed. He thinks that a trip is in order for me to meet with my new editor at Oxford and with my agent, who has been unwilling to give me the time of day. He thinks my new relationship with Oxford will make her take notice. And last year we missed making our usual annual pilgrimage to see our dear friends there because I’d had a brain hemorrhage.

Bruce loves the city, loves clearing away all travel challenges with his efficient handling, loves touring galleries, sitting in cafes, and walking the bustling streets, hour upon hour. He loves the atmosphere of culture and excitement that we just don’t have in the city where we live, which is a suburb through and through. He loves to fall into step with our friend Craig, their long legs matching in pace and rhythm as they talk about Kant or Hegel while John and I try to keep up behind them. He loves revisiting his favorite painting in the Met, Velázquez’s portrait of Juan de Pareja, and holding my hand while we stand in front of the soulful eyes of a man long since dead whose pain and dignity we can still feel. He and I both love that a slave could hold himself so proudly, undaunted by the injustices of his world.

Last time we flew to New York, however, my feet swelled so badly I had to get a new pair of shoes. Now I have been diagnosed with arthritis in my right foot. Now I have mysterious and as yet undiagnosed damage in the left basal ganglia of my brain. Six months of doctor’s appointments and tests later, and I still feel uncertain in the world. I want to stay close to home.

So I cry and tell Bruce that I can’t do it. Not yet, while I don’t know what the future holds. I tell him angrily because I am afraid. I tell him that I know he wants to travel—he wants to take me to Berlin this summer and to Kenya someday soon—and that he may have gotten a bad deal when he married me just two and a half years ago. It has not been a very romantic time since we got married, especially the past year and a half since the brain hemorrhage—and now all this.

“It’s okay,” he says. “I may just have to travel by myself.”

I know this is his attempt at letting me off the hook, but it makes me cry harder. It makes me angrier.

“Oh, great,” I say. “It’s not like I don’t want to go. Don’t you understand? I can’t physically do it. I can’t pound the concrete with you and Craig. I can’t stand for hours on the hard museum floor. I will be in agony if I try to do that. But being left behind doesn’t sound like that nice of an alternative.”

We lie silent for a few minutes as disability wafts over us in the air from the slowly turning ceiling fan.

It is a couple of days before Valentine’s Day, but the day after I have a lumbar puncture scheduled for an analysis of my cerebrospinal fluid. We have no plans to celebrate the love holiday. We both know that it is a marketing ploy, and we agree with efforts to knock back the Romantic-Industrial Complex. We have also each spent enough Valentines Days alone over the years to have experienced the whole thing as yet another competitive way for some people to feel superior to others—“I’m loved and you’re not. So I’m a better person. Hah.” We are aware of all of that, but we also are just tired and distracted by my health and other depredations of things we hold dear (like our lives’ work in higher education). These things put a damper on the mood.

Bruce is no Newt, but I am also well aware that the divorce rate is higher among couples where one member becomes chronically ill or disabled, and I am well aware that men leave disabled women more often than the other way around. I have also been rejected many times in my life, and I wonder whether Bruce wouldn’t be happier with a spryer partner.

“You may not like this idea,” he says, and I steel myself. “But what about seeing the museum in a wheelchair?”

It is not what I feared, but exactly what I’d been thinking about myself—ways to make things at least somewhat possible. Accommodations, I’d told myself, that’s the key.

“I like it just fine,” I say, and I hear Bruce sigh a little with relief. “I mean, it’s not thrilling, but I have no problem with having a chair to sit in while I look at paintings.”

“We can just take cabs everywhere,” he adds.

“I like it,” I say. “You know, that seems a lot better to me than your leaving me, either on all your travels or completely.”

“That never occurred to me,” he says. Even though this is only one of the reasons I love him, it is a big deal. Maybe one day it will never occur to me either.

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Posted in Culture & Arts, Health & Illness, Psychology, Relationships, Visual Arts and tagged , , , , . Bookmark the permalink.
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