And Where Do We Go From Here?

Here’s the song reference:

David Essex – Rock On

The election is over, thank goodness.  I can now turn on my television and watch commercials for vehicles I can’t afford to buy, Cialis, and Monistat.  Strange that this would be somehow more appealing to me than to have to sit through more political nonsense. But perhaps not so strange.  I guess I have now sunk to a new low…. 😉  What worries me is people’s inability to agree to disagree and move past that to find common ground to start to address the challenges we face.

A good example of this was last night.  I responded to a pro-life  newsfeed on my fb  – very politely outlined my position and the reasons for it, clearly stated that I respectfully disagreed with their opinion.  Was promptly told that their opinion was fact, and that I was ignorant, and did I think I was right with God? Which I believe was a fairly polite way of telling me that I am going to hell for having a brain?  Me – with a BA college education, 30 years in human services, and a 147 IQ….. I told them that 1. my relationship with God was none of their business, and that 2.  I do in fact sleep well at night.  And that no, opinion is opinion.  Again reiterated that I respected their stance but that their values were just that – theirs – not necessarily mine.  I also mentioned that pro-choice does not necessarily mean pro-abortion.  What a firestorm.  Later in the evening Bill Nye the Science Guy shows up on G4 on a repeat of “Attack of the Show” and blew me away .  50% of people still believe the moon generates its own light –  this does not bode well. My opinion – We need scientists and creative thinkers, not  zombies who spout the party line and can’t or won’t think for themselves. I’m tired of being attacked because I disagree with someone’s opinion. Science is based on fact, and we discover new things every day, facts are constantly evolving.  Our viewpoints need to do so as well.

Romney lost the election because he failed to distance himself from the extremists who would have us living in a religious dictatorship where women have few rights and recourses – similar to Middle Eastern countries.   He should have immediately publicly scolded and removed his support from the idiots who spouted off about rape and conception.  Moderation and willingness to cooperate to find solutions is what wins elections.  Obama, much as I dislike him, did this much more effectively than Romney. I also think that people relate better to Obama – he portrays himself as a common person and while Mitt is, I’m sure, a down to earth, caring, and nice man – his money gets in the way.  I never did hear back from his campaign after I sent my letter/blog post Who We Are, What We Need. Obama’s campaign sent me a response within a week. People just can’t see how someone who is so far removed from financial worries can understand them. Mitt never clearly communicated relate-ability to the votes/voters that mattered, and really never seemed to have clear reasons why his plan was better than Obama’s.  I noted in the debates that they coincided and agreed on many of the issues. The need for vocational training, greater emphasis on education, job creation at home.  But, in the long run I think a lot of people just figured  “Better the devil you know, than the devil you don’t”

We continue to be right between a rock and a hard place. With many many excruciating decisions ahead of us.  Lots of unhappy people.   We really do have to start thinking of the government as a business and finding ways  to cut waste and decrease spending. Rant commencing in 5, 4, 3…

In my feeblemindedness, I believe some of this spending decrease can come within the health care system.  I honestly believe there is no medical necessity for erectile dysfunction medication, or rogaine.  Its a vanity thing.  Insurance should not have to cover the cost of such prescriptions. If someone wants to take it, they should pay full price. Don’t people realize that after a certain age you’ll use up your insurances drug benefits buying these vanity drugs and wont be able to afford your heart, cholesterol or blood pressure medication. So yeah, you’ll have a full head of hair and a functioning penis, but you’ll drop dead of a bp induced stroke  while mowing your lawn, or while schtupping the bimbo you never should have left your post-menopausal wife for….. Some trade off.  Karma’s a bitch ain’t it?  😉

Now on to a more volatile example:  Abortion is an elective procedure in most cases, and I feel stongly the cost in these cases should be out of pocket for the individual. (Except in cases of genuine medical or psychological necessity – ie the pregnancy being life threatening or the pregnancy resulted from rape or incest and the mother cannot handle the pregnancy psychologically and chooses to terminate). Its called consequences.  Dance, pay the band. And if you can’t pay, have the baby – insurance should and does cover that – and there’s plenty of loving couples who would be thrilled beyond words for a chance to adopt your “OOPS!”    So too, plastic surgery.  Insurance companies should not have to pay for boob or nose jobs. You want it, pay for it yourself.

Of course, the government should also stop awarding grants to researchers whose research is frivolous (damn those stupid shrimp on those dumb treadmills!) If you cannot demonstrate that your research benefits humanity and the ecosystem AND those benefits are  tangible and fairly immediate –  buh-bye dinero.  Lets work on overhauling the EBT system and make it more difficult to abuse that system.  Lets start holding people accountable instead of making excuses for them. After all, excuses are like anuses – we’ve all got them, and they all stink. NO YOU CANT BUY PUSH POPS WITH YOUR EBT CARD, SIR.   I don’t care if your kid doesn’t get to have a snack – where is it written that I have to pay  for that snack and then also your kids dental bill? Because instead of providing them with healthy food you chose to feed them crap on my dime.   The bill of rights does not extend to assuring that all children get candy.

OK – I’m being deliberately, provocatively, and supremely snarky, but really – I’VE HAD IT.  Rant concluded. Whew!

OK I’m back now.  Hopefully we can get to a place where people in this country become mentors and assisters rather than enablers, we rediscover a work ethic and a sense of pride in actual work. We realign our values to reflect a sense of personal responsibility rather than self-entitlement. And we take care of our own FIRST.   I’m crossing my fingers, but stockpiling supplies – just in case. (well not really yet, but I am seriously considering it)   Perhaps a mountain cabin tucked away in the Sierra Nevadas or the Rockies would be more defensible that a small bungalow in  Western MA suburbia?   I’m rusty, but I think I can manage to hit whatever I aim at with a .22.  😉  Rock On! \m/

 

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27 thoughts on “And Where Do We Go From Here?

  1. And to Ms. Neutron, yes, I also saw Mantle as much more than a druggie and alcoholic. But that was an earlier time. His abuses destroyed his liver, not me. Then to pay for a new one, when every protocal in the medical world said he was not a good candidate, while another, more worthy candidate was passed over, is what I take issue with. Where is his personal responsibility? Where are the consequences of his own actions? Where is the procedures we have in place for transplants in these cases? That’s where my problem lies. Mickey had every right to drink himself into a stupor every night of the week. What he didn’t have is the right to then thumb his nose at basic human decency and jump to the front of the transplant line, so to speak.

    This is especially poignant considering he died only a short while later.

    • He had money, and was famous. Nobody was going to turn that away and be known for killing Mickey Mantle. Money always talks. But I do agree with your arguments. The basic question or issue for me is how to make the process more equitable. And how do we decide which life is more valuable or worthy? Though a detestable way to do so, money does make the process or decision making easier in many ways. Payment for service is guaranteed, after all. Ethics 202 on My Magnificent Mess! Here endeth the lesson!? ;).

      • I can’t buy into the which life is more valuable argument. The protocols for transplants are pretty strict, taking into account age, history, current health, past abuses, likelihood of recovery, expected outcomes, and expected additional years/quality of life.

        In Mantle’s case, all of this was bypassed in favor of $$$$ and fame.

        One question was what gave me the right to comment? Easy. As card carrying, dues paying members of society, when faced with a crisis, we all expect to be faced with a level playing field. Anything else is an affront to human dignity, and yes I know it goes on every day—doesn’t make it right.

        BTW: I was wrong about Garcia. He wanted the transplant, but never got it. My screw up! Doesn’t change my thinking however.

        Best

        Barney

        • It becomes that argument when the procedure is bought outside of the usual protocols. By circumventing them, the message of who’s more valuable is sent loud and clear. It should be illegal to line jump.

        • You make a curious argument Barney. You write: ..”I can’t buy into the which life is more valuable argument.”… And then proceed to list a protocol that does just that. Nothing is on the level Barney, especially the “playing field”. How can that not be obvious to anyone with eyes to see and ears to hear?

          Human dignity? What a laugh. You may just as well talk of chipmunk dignity, or stick insect dignity. Don’t you read the papers Old Boy?

          You go on to say that the Schaivo case had nothing to do with miracles, and… “There was not a legitimate doctor in the country who believed for even 1 minute that Terry was anything other than living in a vegetive state, fed and watered by machines.”…

          If that is so, why aren’t ALL the plugs pulled? Are you contending that some army of “illegitimate” doctors are standing in the way? Or, could it be that our entire Judeo-Christian culture is predicated upon a universe that runs on nothing BUT miracles and we don’t quite know how to get along without believing in them?

          But, this I really don’t get. You write: ..”Just imagine the grief they unnecessarily went through, the not letting go that must have weighed so heavily on them, their family, their friends.”…

          Do you want a protocol for that too. Someone to decide when your grief is necessary and when it’s not?

          I’m going to go with Momma E’s words on this one.

          …” What suffering and pain they all went through. As a Mother, I shudder; and pray I will never have to make such a horrifying decision.”…

  2. The Schaivo case had everything to do with guilt and not letting go, and nothing to do with miracles. There was not a legitimate doctor in the country who believed for even 1 minute that Terry was anything other than living in a vegative state, fed and watered by machines. Of course there was Frist, who did a diagnosis by watching a TV newscast, but for the parents, it was a matter of too much money and guilt and unwillingness to let their daughter go. Fro 7 years! Just imagine the grief they unnecessarily went through, the not letting go that must have weighed so heavily on them, their family, their friends.

    And the pain and anomosity caused to her husband. He was never anything more than a loving spouse put through hell by parents with too much time and money, greedy
    lawyers and politicians looking for a moment in the sun, at any cost.

    And I do believe Garcia, like Mantle, got a liver.

    Best

    • While basically in agreement with you, I view the husband with more of a jaundiced eye. I found it very unsettling that he had moved on with his life yet still was the primary decision maker for her care. He had a family with another woman yet remained married to Terry. For her to keep insurance coverage? It was really creepy to me. I do feel the parents were in denial big time, as there was no hope of any recovery. What suffering and pain they all went through. As a Mother, I shudder; and pray I will never have to make such a horrifying decision. I’m still an emotional wreck about euthanizing my pets. I also find it strange that Terry supposedly said nothing to her parents about her wishes. My entire family and friends know what I want, should the worst happen. Did they blank that conversation out? Or did their son in law lie in order to finally free himself completely? We will probably never know. However, most people I know do not want extraordinary measures taken to preserve life if there would be no quality to it. So I believe she did say so. And yes, i think millions of dollars were wasted. Yet part of me asks: what if that were my daughter, and she hadn’t made her wishes clear to me? Could I let her go? That’s my baby, my cherished and adored child. Not sure I’m strong enough to do that if I don’t know what she would have wanted. I applaud the husband for making the hard choice, I just think he should have done it before he went and had a family with someone else. But I feel great empathy for her parents.

  3. Donna, the comments sure took this post in a new direction. I am more encouraged by the election not only by Obama’s victory, but also by the losses by people who espoused some very interesting and disturbing views. I am encouarged by Bloomberg stating the obvious about global warming and hope this is the tipping point. I am encouraged by Christie complimenting Obama and then chastising some of the pundits on Fox who wanted him to give Romney a tour. I am encouraged that Boehner is giving the right signals, now it is up to him to deliver collaboration to match that of the President’s. On the end of life stuff, please make sure your older relatives and yourself define clearly what you want to have done in the event you are unable to make decisions near the end. It makes a huge difference to loved ones arguing over what Mom would have wanted. Well done, Momma E. BTG

  4. Now lets really raise some hackles, and ask: Should a 75 year old have a heart/lung transplant? How about new knees? How do we address the fact that almost half of medicare money spent is in the last 6 months of life. What price heroic gestures simply to prolong life a few more weeks? But then, this gets us into forcing us to face end of life issues, the fact that death is part of life, which Palin twisted into “Death Panels.” The question is where, and more importantly, who draws the line on whats covered, and whats not. That is really the core of the dilemma and the resulting high costs.

    • …”How do we address the fact that almost half of medicare money spent is in the last 6 months of life.”…

      We examine just who is making the decisions. Are doctors and hospital corporations milking the system? Or, is it the patients who, on the one hand insist they have an eternal home with Jesus, but, on the other will spend any amount NOT to go?

      The Liverpool Protocol seems to make sense, but, you won’t sell it in a country where Jesus is regularly seen in driveway oil slicks and the arrangement of mozzarella cheese on pizzas.
      http://en.wikipedia.org/wiki/Liverpool_Care_Pathway_for_the_Dying_Patient

      • I’m not aware of liverpool protocol, but will certainly look into it. There is another program referred to as the Dartmouth Study that really takes our medical care systems apart, and proves the medical equivilency of outcomes, even where one study site throws money and tests at problems like confetti, another gives bare bones, but standard protocol services.

        Personally? I think a great deal of money is wasted on end of life decisions not by doctors or providers, but by guilty families who insist that all measures possible must be taken to keep grandma alive. It’s certainly not care and concern driven.

        But really, why can’t we get past the point that just because something is possible, does not mean it should become automatic for everyone in the country. To my first question about the 75 year old lung transplant. The person has lived 3/4 of a century, hopefully with some good times and bad. Even ideally they may only have a few years left, then why is the public expected to pay the hundreds of thousands of dollars in what will only be short term care? Perhaps its time to realize in these cases, if you want the transplant, then pay for it. If you can’t then welcome to the real, practical world where people actually grow old and die. Death is part of the life experience, and we need to do a better job of accepting that.

        If grandma is terminally ill, then why not do everything possible to make her confortable and pain free, in a caring hospice or home with family. For the life of me, I pray that no one thinks my life is worth living when I am hooked up to machines breathing for me and pumping my blood. That, is the ultimate personal insult.

        • It’s a failure of both culture and religion Barney. We meet death unprepared and as a result will pay any price to hold it at bay. All cultures and all religions do not share this shortcoming. Some are quite good at preparing people for death. Christianity, quite frankly, stinks at it.

          To Momma E.
          We don’t have this problem with our pets because we see them as meat machines. There is nothing “eternal” or “magical” about their lives. They suffer and we can relieve that suffering. Human beings, as our culture teaches us, are more than that. Our innate paranormal belief systems preclude us from ending something that is sacred and magical. If we can do it to “them” then someone else can do it to us. Of course if they are not a member of our “group”, tribe, or, if vengeance is involved…. We may kill freely and with total impunity.

          • Lots to digest here as well. I would have to agree with much of what you say here. However, I will say that all of my pets have been beloved members of my family who I believe are waiting to greet me when it’s my turn to move on. But thats my own belief/hope. Deciding to end their suffering was excruciatingly difficult. Barney hit the nail on the head earlier for sure, as did you. This culture does indeed stink when it comes to preparing for Death. It’s been my experience that this is slowly changing, with DNR’s and health care proxys, funeral plans, and people more and more willing to discuss their wishes with family and friends prior to their demise. Of course this does not guarantee that those wishes will be followed unless there is legal paperwork to back them up. But it’s a start. I’m going to go read about Liverpool care now. Thanks for writing! D.

          • Momma E.

            Did you see the movie Annie Hall? Woody keeps trying to get Annie to read a book. The book is “The Denial of Death” by Ernest Becker. It won the Pulitzer Prize. If you want to understand death (and a whole lot more) read it at your next opportunity. You won’t be sorry. It’s a life changer.

            Respectfully
            Mrs. N.

      • It would seem we treat our beloved pets at their end of life in a more dignified manner than we do our elderly at the end of theirs. Thanks for writing. Great food for thought. 🙂

      • If I’m understanding this article correctly, it doesn’t indicate how much the family and the patient are involved in the decision to put the patient on the pathway. In my mind this is critical to involve them mot the greatest extent possible. The article talked a bit about patients being put on the pathway without talking to the patient/family, which i found disturbing.
        Comfort care plays a big part and it doesn’t seem to be much different from the hospice model here in the US. I lost my father suddenly in 2007. Fortunately we were well aware of what measures he would have wanted if they became necessary. We did not have to make those decisions though. I have friends who can’t say enough wonderful things about hospice programs that assisted them and their dying loved one through the process.
        Part of the issue as I see it is that nobody wants to lose a loved one, nor die themselves. It leaves a hole in our hearts. And nobody knows for sure what happens next. That’s wicked scary. So we cling, even when hope dims and flickers out. Then quality of life issues like the Terry Schaivo case come up, and everyone gets in an uproar. Would that it were easier. Thanks for bringing this to my attention, and for your thoughts. Always a pleasure to hear from you.

        • The Terry Schiavo case is the one that sets off my rockets! The poor woman, although not personally aware, suffered every indignity possible at the hands of a family unwilling to accept her wishes and what she had arranged with her husband. Then to beat all, the politicians got involved, and really made fools of themselves and this country. GW Bush promising to fly straight home from Texas when the congress passed her “life saving” bill. Jeb Bush, brother and governor of Florida, sticking his nose in with a special law. Senate Leader Bill Frist, who hadn’t been a practicing doctor for years, shows up on the floor of the senate with a stethescope hanging around his neck. The poor woman and husband were forced to suffer the indignity of politicians run amok, trying to garner a few extra votes. How Sick!

          And I hold her parents in equal disdain. They were the Guilty ones, just like trying to keep her alive, although all medical experts pointed to the impossibility of her being anything other than a vegetable. They fought in the courts and on television, tirading about the evil husband, destroying his life and those close around them. For what? They wasted millions of health care dollars, dollars that might have helped others. And in the end, the final autopsy proved her brain was mush.

          This is shameful episode in our political and medical care history.

          Enough of that rant.

          Mickey Mantle was a druggie and an abusive alchoholic. yet with his millions, he was able to buy a liver, one that could well have prolonged the life of a more deserving person, one who had a chance at a long life. The same for Gerry Garcia of the Grateful Dead. Money bought them a position at the head of the line, and as a result, two much more deserving victims were sentenced to death.

          I also believe, that many of our citizens truly do not know the alternatives they are faced with, nor the total implications of those alternatives. One that I frequently see is “Well, the insurance pays for it.” You and I and 300 million other citizens pay for it. Health care continues to outpace our cost of living because of the cavalier attitude that insurance pays for it.

          Whew, guess you got me going today. What a great conversation starter. Congrats!

          • You are not going to stop people from believing in miracles Barney. Attempting to do so is always met with stiff opposition. Miracles are an integral part of our culture. Believing openly in miracles gets lots of votes.
            Mickey Mantle was a hell of a ball player. Who are you to decide who is “deserving”? Who am I? Jerry Garcia never got a liver, but, so what if he did?

            As long as health care is “fee for service” it will remain immoral, almost by definition.

            …”Mickey Mantle was a druggie and an abusive alcoholic.”…

            Anything else? Do you think there is a chance that, maybe once or twice, someone might have seen him to be more than that?

          • Which brings up the issue of being deserving of these gifts. You’re right in that a fee for service is immoral in these situations anyway. Mantle should have waited in line on UNOS (?spelling) like every other potential recipient. But he had plenty of money so he got a liver, then promptly died shortly thereafter. So here’s my dilemma. There’s a 30 year old addict whose liver is failing, and a 70 yr old retired businessman who is suffering the same. One liver. Who gets it? How do we assure limited resources go where they will do the most good for the greatest amount of time…

          • Perhaps Momma E. the problem isn’t with “who is deserving”, or, “who gets the liver”.

            The entire concept of … “How do we assure limited resources go where they will do the most good for the greatest amount of time…” may be nothing more than an exercise in asking the wrong question. 50,000 people will die in the next 24 hours because they don’t have enough to eat or clean water to drink.

            Dick Cheney was instrumental in starting a war that killed untold amounts of people. Did he deserve a new heart? Does anybody deserve anything, or, are we just semi-clever monkeys attempting to make sense out of an uncaring universe… making up silly rules to make ourselves feel ever so less terrified by it all.

            I guess, up there in Massachusetts, you would have to conclude it’s all just wicked complicated.

            All the Best
            Mrs. N.

          • O Cynicism thy name is Mrs Neutron. 😉 But seriously, it may just be the exercise in futility you describe. I’m hoping not, but “Ayuh, it’s wicked complicated fah sure.” We don’t seem to be able to “get thay-ah from he-yah.” How do we evolve and grow while remaining kind and compassionate? Can we? Thinking globally, as you and many on here do, and acting locally as many of us also do, is a start. Certainly better than doing nothing. Hugs! D.

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