The Truth Is Funny Sometimes

A real-estate developer is about to build a monstrous set of apartments in the field at the end of my street. The impression you get on first seeing the drawings for it is that it looks like a prison. All my neighbors are aghast and hate the thing. The plans have been debated back and forth for two years, and about twenty changes have come before the Zoning Board and the Zoning Board of Appeals. The thing was obviously not properly thought out at the beginning. 

Anyway, there was another hearing at the Zoning Board of Appeals last week and I got up and gave a five-minute talk on why I thought the plans had not been properly thought out and why the neighbors hate the thing so much. There were newspaper people there and TV cameras, money-people with neckties and such, developers, and the architects. 

So, I'm giving my short talk and I notice people laughing, as if this were a comedy of some kind. I couldn't figure out why they were laughing, but I went right ahead and said what seemed to be the obvious truth, that the thing hadn't been adequately thought out and was hated by the people who live in the neighborhood. 

No one spoke to me after the speech or after the meeting adjourned, so I walked home from City Hall quite lost and confused. I didn't have a clue as to why they were laughing, or how well I had gotten my two points across. I was a bit upset and decided to go out to a restaurant to have something to eat to think it over. No clue.

But the next morning I get a note from a lady who attended the hearing saying that I had “stolen the show,” that I was right on target, educated, articulate, witty, effective, etc. Later, a couple neighbors said similar words. But I still feel that I don't quite get it. My best guess is that I apparently got at the heart of the problem and articulated it so simply and clearly that it seemed sarcastic, funny, ironic or something like that. I think I was so right, and what I was combating was so clearly wrong, that it seemed comic. Also, what I stated had a lot of life behind it, a lot of thought and experience with the absurdities of society. It also has gone through my mind that somehow my mother's arch irony played into it. 

Anyway, I had the audience's startling and complete attention, and I could see that some of the audience was “with me,” and that there was laughter. But I was just concentrating on what was the obvious, clear truth, and feeling that I will just say the truth regardless of what all the respectables or anyone else might think. I'm still a bit amazed by the reaction, as you can tell, and I still don't quite get why they were laughing. 

What goes through my mind right now is that perhaps people already know the truth about many things, but they are surprized when somebody unexpectedly comes right out and thoroughly says it.

Medical Errors

I keep discovering new depths of the incompetence in the medical industry beyond what I had imagined before I had my recent hospitalizations. There is a large and growing literature on the subject and the most recent piece appeared on TV, in major newspapers like The Washington Post and on the Internet at the same time.

This piece, which has received such remarkable attention, is an article in the BMJ, formerly known as “The British Medical Journal,” by Martin Makary and Michael Daniel , entitled “Medical error—the third leading cause of death in the US.”

Makary had already published a book on the subject in 2012 which I've just finished reading, “Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care.”

Makary is worth reading because he has clearly put a lot of experience and thought into the subject of medical errors and because he definitely cares about it. You sense that he has seen it, that he means what he is saying, that he truly cares about it.

 His remedy is transparency, sunlight - “Sunlight is the best disinfectant,” he writes. So he writes these books and articles, hoping to increase awareness within and without the profession of the nature and extent of medical errors.

My best guess is that he is probably right about enlightenment being the best cure, knowledge being the best hope for reducing the problem.

But there is a part of me that feels that knowledge alone – sunshine and transparency - is only part of the remedy, and probably even a very real part of the problem.

For one thing, there is already a massive amount of knowledge, sunshine, about the existence and prevalence of medical error. Just Makary's stuff alone proves it. The doctors themslves know this better than anyone else. I think it is well established that when you go to a medical doctor, you are more likely to be harmed than to be helped.

And there is also this matter of the almost universal spiritual corruption involved, especially when it comes to “making money” or “keeping one's job” or “supporting one's family.” If you speak the truth, spread the sunshine, it is almost certain that you will not be able to support your family, or even yourself.

Now that makes the solution tougher than what we normally think of as knowledge, enlightenment, transparency, sunshine, or such. In fact, the belief that knowledge itself is the cure may itself be the biggest part of the problem. If it is thanks to human love that we live, then just knowledge itself, is not enough. It seems to me that Makary consciously avoids coming anywhere near mentioning this.

e.e. cummings Is Good Medicine

Now begins the month of May, so full of the joy of re-emerging life and love, the time when I think of e. e. cummings' poems.

i thank You God for most this amazing
day:for the leaping greenly spirits of trees
and a blue true dream of sky; and for everything
which is natural which is infinite which is yes

(i who have died am alive again today,
and this is the sun’s birthday; this is the birth
day of life and of love and wings: and of the gay
great happening illimitably earth)

how should tasting touching hearing seeing
breathing any–lifted from the no
of all nothing–human merely being
doubt unimaginable You?

(now the ears of my ears awake and
now the eyes of my eyes are opened)

This contrasts greatly with everything I was taught at university. I can remember my first course in English literature, at McGill University, the Royal Institute for the Advancement of Learning, then very much British, in Montreal as I young man. I was just starting out on the great adventure and exploration of “higher education,” and was given the following T. S. Eliot line by my serious, highly-qualified, trusted, highly-honored and paid professor:

       “April is the cruelest month.”

Such great insight, such penetration right into the essence of Spring! It was considered important, great literature. And wisdom. April is the cruelest month. Then we had to read Eliot's “The Wasteland” and “Murder in the Cathedral,” and to ferret out all the obscure allusions.

That poetry, that higher education, that tradition, was pure poison - or a disease. It nearly killed me. I now hold, however, that being given that poison or disease when I was young required of me, through reflection and later life experience, to understand how deeply corrupt the establishment is. It was necessary either to overcome it through understanding or to die, and, surprisingly I didn't die. I did die, in the sense that cummings refers to it above - but “i who have died am alive again today and this is the sun's birthday...”

e.e. cummings was Good Medicine, my best medicine.

"The Discovery of the Unconscious" by Ellenberger

The Henri Ellenberger book, “The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry,” has been very useful to me in my attempt as an adult to understand the oldest, deepest, largest, strongest part of our minds. I can not remember where I heard about the book but I know it wasn't until my seventy-fifth year on this planet.

Ellenberger's history of hypnosis is deeper and more comprehensive than anything else I've read, relating it's central place and context in the search for understanding the subconscious. I mention hypnosis particularly because my own study and practice of it created the path through dreams and fairy tales that enabled me to slay dragons and discover their hoarded gold in their caves and bring the inhabitants of the castle and town back to life, and the leaves to come back out on the trees.

Here (p. 207) he quotes Carl Gustave Carus (1789-1869):

The key to the knowledge of the nature of the soul's conscious life lies in the realm of the unconscious. This explains the difficulty, if not the impossibility, of getting a real comprehension of the soul's secret. If it were an absolute impossibility to find the unconscious in the conscious, then Man should despair of ever getting knowledge of his soul, that is a knowledge of himself. But if this impossibility is only apparent, then the first task of a science of the soul is to state how the spirit of Man is able to descend into those depths.

One of our most important struggles in life is surely to “know thyself,” to achieve a realistic, universalistic selfhood that enables us to coordinate our actions with others and to construct courses of action that work for everyone. And yet, I invariably reflect upon reading something like Ellenberger's history of how rare it is that we even hear once about such a book. All those years of school, university, graduate school, continuing education, self-education but finding the really good stuff like this is pretty much a matter of sheer luck. I suppose, yes, that a whole lot of intense labor, searching, criticism, preparation, failure and experience is absolutely necessary to get anything out of Ellenberger as well as his protagonists like Charcot, Janet, Freud, Jung and the others. It's probably a miracle that as many of us do get the minuscule bit we do get, given that most of us have all we can do just to survive, never mind to raise children, to work, and to get some sleep.

It feels like an infinite luxury to have the circumstances to be able to work on a book like this. But it also feels like a complete sacrifice of one's life! It's like that corn of wheat that must fall into the ground and die.

Predatory Professionals

The social theme that touches my spirit most deeply these spring days in Dayton, Ohio, 2016, is the corruption of the professions and the professionals.

Thomas Frank writes about it in his “Listen, Liberal, or Whatever

Happened to the Party of the People?” which is the best thing I've read on the subject. So I thought I would share a couple quotes from it with you:

p. 27: But generally speaking, the system of professionalism was long ago subverted and transformed into something different and more rapacious. Today we live in a world of predatory bankers, predatory educators, even predatory health care providers, all out for themselves. The corruption of the professions...

And there is this from his chapter "The Blue State Model," which is about Massachusetts, particularly Boston, as being representative of what is wrong:

p. 183: ... Boston is the headquarters for two industries that are steadily bankrupting middle America: big learning and big medicine, both of them imposing costs that everyone else is basically required to pay and yet which increase at a pace far more rapid than wages or inflation. A thousand dollars a pill, thirty grand a semester: the debts that are gradually choking the life out of people where you live are what has made this city so very rich.

 My final quote is from a central chapter, The Defects of a Superior Mind, which struck particularly deeply with me because I have long held, but now more than ever, that clever, well-graduated, bright, intelligent people come a dime a dozen and are much more likely to harmful than not:

pp. 172-173: “One of the challenges in our society is that the truth is kind of a disequalizer,” Larry Summers told journalist Ron Suskind during the early days of the Obama administration. “One of the reasons that inequality has probably gone up in our society is that people are being treated closer the way they're supposed to be treated.”

“Remember, as you let that last sentence slide slowly down your throat, that this was a Democrat saying this – a prominent Democrat, a high-ranking cabinet official in the Clinton years and the man standing at the right hand of power in the first Obama administration.”

I don't think this one is going away - too many people are suffering and more will be suffering for it to "go away." Nothing is "set in stone" or "inevitable" when it comes to human beings and what they think, but there are realities that have to be dealt with successfully, like the melting of the ice caps and subsequent rising level of the oceans. This problem of an oligarchy by the highly-paid people whom Frank calls “the well-graduated” seems to me to be one of those problems that has barely begun to be recognized.

Patient Mistakes and Patient Advocates

There is an absolutely massive literature now on the danger to your health posed by the U.S. medical industry and I am always glad to see any sign of help or even acknowledgement of the need of help in the situation. So I enjoyed finding Trisha Torrey's recent book entitled “You Bet Your Life! The 10 Mistakes Every Patient Makes.”

Trisha Torrey is a professional Patient Advocate – I didn't even know such a profession existed: people who will go to the hospital with you to fight for you. An old friend who was a professional nurse asked me when she heard that I had had a major injury in the hospital, “Didn't you have anyone to go with you to fight for you?”

Here are seven of the mistakes on Torrey's list of ten:

#1 Thinking your healthcare is focused on you, the patient.

#2. Thinking the doctors put their patients' needs first.

#3. Not confirming your diagnosis with a second or third opinion.

#4. Thinking you've been told all about your treatment options.

#5. Thinking you are safe in the hands of the healthcare system.

#6. Not understanding the reach or risk of medical records.

#7. Spending time in the hospital unless it's absolutely necessary.

My own conclusion from reading the such literature is that our chances are greater of being harmed rather than helped by the U.S. medical industry, but that we take that chance because of hope. Becoming aware of the ways it can harm us is shocking, overthrowing so much of what we have assumed or believed in the past, but I find it useful and infinitely restoring after my own recent experience in a hospital.