The Best Health Care In The World

Senator Ted Kennedy is said to already be walking the halls of his hospital. The operation they said was a success and he’s ready to go from North Carolina to Boston for radiation and chemo. His courage and fighting spirit have been mentioned, and so they should be. In fact it seems to me they are a trademark of everyone I’ve ever known to fight cancer–as if in a way they were pre-requisites, and perhaps they are for studies do show how important attitude is in relation to the success of cancer treatments.
But so far no one has mentioned another important factor, his ability to obtain the best health care available for this condition, perhaps in the world. Given his position and connections Senator Kennedy was and is in a position to find out and have access to the very best of anything. Going to North Carolina may have stopped some, but he had the means. The surgeon’s schedule may have been a problem for some, but if you are Senator Kennedy surely it is easy to have concessions made in your name even if they were not asked for. Congress has some of the best health coverage in the country, on top of which the Senator is in a position to have out of pocket expenses many could not handle. There are those who would not know how to research the best surgeons, the best hospitals, whose doctors may or may not be willing or able to guide them through the maze it can be. Again Senator Kennedy’s position must have made a difference.
The result is that the Senator was able to have a delicate surgery performed under optimum circumstances for someone of his age and his type of malignancy. The problem is not that Ted Kennedy is getting the best treatment possible, why shouldn’t he, and certainly not that his life is undoubtedly being prolonged, albeit who knows for how much longer. The problem is that I who is among the few to have decent health coverage would probably not have this kind of care available were I to have this kind of cancer, and neither would anyone I know.
I am quite sure the Senator himself is aware of this discrepancy, and it may be behind the reasons he has championed health care causes for decades. It all adds to the irony that he is now an example of the difference between the health care haves and health care haves-not. Still the lesson for us is the vivid reminder of how often the inequality in health care access is a life and death matter.

McCleland v. The Press Corps

I am sure that former presidential press secretary Scott McCleland expected an uproar with the publication of his book. I wonder if he expected to have no ally. That’s what I find far more interesting than the revelations of the book. Most interesting of all is the reaction of the Washington press corps. They apparently looked up to him while he was at the White House podium. Now, they question his motives. From what I’ve heard and read the content of the book hasn’t been the topic of discussion, rather the question on the mind of several different kinds of reporters from several different kinds of TV channels has been, if he toed the line for seven years, why is he coming out now? All seem incredulous, all seem to not quite believe McCleland, all indicate their skepticism in a number of ways, some disparage him openly. Transpose the situation: If someone had been in a difficult marriage for seven years, and put on a good front until one day he or she filed for divorce and then the beans would be spilled with great gusto, people may wonder why this or why that but basically they would understand a shift that only seems sudden to outsiders. While an issue may be elevated when it involves the White House, people are people, and high or low, certain human traits apply. If one is to give Mr. McCleland the benefit of the doubt, and why shouldn’t we, then whether through this or some other scenario, there can be more than one explanation for his unburdening himself.
The men and women of the Washington press corps are savvy, clever, hard working, intelligent, driven, energetic, knowledgeable among other laudable qualities, but their job does come with occupational hazards. In this case, as it seems to have been at the beginning of the Iraq war, it is not being able to draw a hard enough line between sincerity and spin, falsehood and fact, even understanding and naivete. There is much talk about ethics and the role of loyalty, so much in fact it makes a listener recall Mr. Shakespeare’s “…the lady doth protest too much.” Regardless of whether this applies or not, it does seem that being hard nosed doesn’t always serve the public interest.

Beyond Ray Bradbury

The Phoenix spacecraft landed on Mars and sent pictures. Its nine months journey( perhaps symbolic) to the red and icy planet a great hope for scientists to discover whether there once was or ever could be life beneath the craggy looking surface. We’ve been fascinated with Mars for decades now, perhaps since Ray Bradbury’s Martian Chronicles titillated our imagination about Martians and what they would be like and would or would not do. We tended to assume them as funny looking bipeds, and when the idea of life on Mars seemed remote, we transferred our fantasies to aliens from whatever planet or galaxy. Carl Sagan’s beliefs in extra terrestrials infused us with the idea that it is not only possible, the probability is higher than many had up to then dared to think. And Steven Spielberg’s endearing ET made us pine for contact with an extra-terrestrial. The more we know about science the more we realize that for humans to be the only form life in this vast universe may be an anomaly. So naturally we look for life elsewhere, and when science is too slow our wishful thinking makes up the difference. I am so amazed by the form these thoughts often take. Perhaps it is due to the memorable The Day The Earth Stood Still. Do I remember them correctly,weren’t the magic words klatu, berata nicto? In the movie the ET is wise, all knowing, coming from a civilization more advanced than earth issuing a warning for us to stop our warring ways. It seems as if that idea has colored so much of our imagination, which also surfaced in another Spielberg movie, Close Encounters of the Third Kind. That ET too seemed wiser than we are. But would that be so?
The Vatican has now joined the fray, indicating that aliens are possible and would be like us children of god, since god’s realm extends to the universe. It is a good point and one that may be more useful to the debate than many have given it credit for. Still whether or not other life forms in the universe would be children of god does not automatically endow them with wisdom, love or the desire for peace. There’s at least a fifty fifty chance that they could be behind us in development or mirroring certain periods in our history when we were more brutal and savage than we are now.
When contemplating whether there’s life out there, the idea may not be whether it exists, but whether we are ready to handle the possibility with all its unknowns and possible dangers?

The Guidelines Mean Me

Earlier this month a consortium of influential physicians issued a first, a set of guidelines to be used in a pandemic or similar disaster. To put it bluntly the following groups would not be treated: the very elderly, seriously hurt trauma victims, severely burned patients and those with dementia. The idea is not to just let some people die, but to insure that scarce resources, meaning equipment like ventilators, medicines, as well as doctors and nurses, are not only used to best advantage but in a uniform, objective way.
The physicians involved in drawing up these guidelines came from top universities as well as from government agencies such as the Centers for Disease Control, the Department of Homeland Security, the Department of Health and Human Services. Their suggestions get down to the nitty gritty. For example, those who won’t get life saving care include people with a severe chronic disease such as advanced heart failure, lung disease or poorly controlled diabetes. I am in one of those group. I have several lung problems. They are under control, but in a traumatic situation without medications I suppose it could soon become acute. Add to this the reality of the circumstance, in emergency conditions, with a shortage of personnel since many people would be needing attention, the triage nurse or doctor could or could not make a mistake about my condition and judge it worse than it is, and with the few seconds he or she would have to make a decision regarding my fate, just be the catalyst for me to have X numbers of days left. It’s one thing to watch reruns of M*A*S*H and see Major Hoolahan faultlessly triage and decide what happens to each incoming wounded, it’s another to transpose that kind of activity to real life. So, while nothing is for certain, and I may be borderline, the fact is that there is great likelihood those guidelines mean me and I may well be among those who would not receive care. Regardless, I do think these guidelines are an achievement. Certainly mistakes will be made, they are inevitable in a way and occur with or without guidelines. Still the fact that they exist and that (whether or not they would directly affect me) they are sound ought to be hailed by many. Sure, it is a grim subject, one none wants to really draw attention to or discuss, but it is a necessary one. The rationing of medical care when it is based on income is one thing–and of course indirectly happens anyway by leaving out those who cannot afford certain medical insurance or procedures–but the allotment of resources where they can do the most good is this side of wisdom. If that means me, then I must accept it, not only in the name of those who might be saved, but also because given whatever shape I may be in, it may be a treatment I myself would not want, a set of consequences I would deem undesirable. I can only hope that if this is how I am to go, as a result of the guidelines for a pandemic or disaster, that by then what I am trying to do before I go, is finished. And should there be a mistake, with me or with anyone, may it be one that allows the decision makers to refine the guidelines and make them a better gauge of who is not to receive treatment.