Good morning/afternoon all.
I woke up with a bit of a headache, various pains in my joints (spine seems to be the worse today, but only slightly worse than my left hip) and a stuffy nose. Like every other day, my abdomenal region was distended and I experience a vague sense of discomfort. The palms of hands have broken out with odd little bumps which itch interminably, and only give me relief while I sleep. I will not eat any solid food until this evening because once I do I’ll feel nauseated, my abdomen will swell even larger, and I’ll be forced to retire to bed. I take a gaggle of medications, all of which are palliative in that they treat only my underlying symptoms, and not my underlying condition, for which no medical doctors have been able to provide me with a conclusive diagnosis.
I’ve been to specialists in gastroenterology, immunology, functional disorders, rheumatology and even rare genetic diseases. I’ve been seen by doctors at the Mayo Clinic and participated in protocols at the NIH (National Institutes of Health). I’ve had my gall bladder removed and so many colonoscopies and endoscopies, Cat scans, MRI’s and other even stranger procedures involving irradiated substances, dyes, DNA tests, etc. that I’ve lost count. No one understands my condition or its cause. All who have seen me agree, however, that my condition made it impossible for me to continue to work as an attorney.
Yet, back in 2000, a doctor employed by my disability insurance carrier, after looking over the already numerous medical reports from the various doctors I had seen (this was pre-Mayo Clinic and NIH, but I’d already seen over a dozen different specialists), concluded, without once having examined me, that whatever my condition was, he did not consider it disabling, and so the insurance carrier, from which my law firm purchased its group disability policy, was able to deny my claim for disability benefits.
You see, that doctor, was paid on a contract basis by the disability carrier. He must have known that his compensation and continued employment depended upon him finding that X number of claimants were not disabled. So, in my case, he latched on to a comment in one report from one specialist I had seen, which he felt supported his position that I was not disabled. My law firm and I took the insurance company to court, where the judge agreed with us that under normal standards of proof I had a case, but since this was a special employee benefit plan created under ERISA in which the insurance carrier acted as the trustee for my disability plan. As trustee, all they had to do to show that they had wrongly denied my claim was prove that they had not acted arbitrarily and capriciously, a standard of proof so low, that short of a smoking gun memo to the insurance company’s doctor directing him to deny my claim no matter what my condition, I was bound to lose. As I did.
The judge in my case ruled that his hands were tied. Since the insurance carrier had my case reviewed by a medical professional, and he had concluded that I was not disabled, the company had not acted arbitrarily and capriciously. My lawsuit was dismissed.
The insurance company doctor didn’t have to understand my condition, nor did he even make the attempt to do so. Nor did the insurance company even try to understand my situation. That wasn’t their objective. Their objective was to maximize profits, and to do that they had to minimize payouts to disability claimants, like myself. It was a rigged game, one in which Congress had colluded with the Insurance industry when it established the ERISA framework for employee benefit plans. Too bad for me. My result was, in one sense pre-determined. Absent a condition that no one in their right mind could deny created a disability (say, becoming a paraplegic, for example, or a severe stroke, etc.) I was screwed.
So why am I discussing what is old history for me now? Why am I dredging up this unpleasant memory from my past? Well, it’s not to complain about insurance companies and the way they have emasculated patient’s rights (though I’m sure that would make an interesting and valuable blog post in and of itself). No, my purpose today is to use my story as a metaphor.
Follow me below the fold and I’ll do my best to explain what I mean.
You see, the key to my story is literally the word I chose for the title of this little essay: understanding.
Understanding something, whether it’s someone’s medical condition, or a national security issue such as the threat posed to our country by terrorism, is hard work. It requires approaching the situation with an open mind, with no predetermined biases or prejudices about what you might discover once you dive in. It means that you have to look at all the information provided to you, and then analyze that information carefully, checking and re-checking each source for that bit of data for credibility and reliability. It requires listening to opposing viewpoints about the value of the information available to you. It means taking the time to assess the situation, and not jumping to early or easy conclusions. It especially requires you to listen most attentively to those who know more about the problems or issues involved than you do.
Bush went to war in Iraq because of a fundamental failure to understand what we would be getting ourselves into after we deposed Saddam Hussein. Indeed, the neoconservatives at the Pentagon and in Vice president Cheney’s office, who controlled the policy’s formulation and implementation, were woefully lacking in their efforts to understand the region, the people, the true threat posed by Iraq and even the goals they hoped to accomplish. It’s not like they didn’t have lots of information available to them.
They were told by the CIA, other foreign intelligence agencies, and even Colin Powell, that Saddam was contained and not a threat to the United states or its neighbors.
They were advised by intelligence reports that any connection between Osama bin Laden’s Al Qaeda network and the Iraqi government were tenuous at best, and that Saddam’s government had not been involved in the 9/11 attacks.
They were warned by General Shinseki, then head of the Joints Chiefs of Staff, that any invasion and occupation of Iraq would require many hundreds of thousands of troops more that they were planning to deploy in order to adequately secure the country post-invasion.
The State Department’s own working groups on Iraq prepared an extensive plan for the occupation phase of the Operation Iraqi Freedom called the “Future of Iraq Project”, which, in over 1200 pages, spelled out in great detail many of the problems which could be (and in fact were) encountered after deposing Saddam’s regime and occupying the country.
Yet despite this great mass of information that was available to the Bush administration we recently discovered that our President, the man who made the decision to invade Iraq, didn’t even know there were two sects of Islam, Sunni and Shi’a, antagonistic to one another, and that large populations of both co-existed uneasily in Iraq. He didn’t know this, rather fundamental and essential fact, because understanding, in general, was not a prerequisite to making the decision that led to war.
Understanding the situation on the ground in Iraq regarding the various animosities between Arab and Kurd, Sunni and Shi’ite, tribe vs., tribe, was not considered important. Understanding the history of Britain’s past occupation of the region following World War I, which resulted in a bloody and prolonged insurgency was not considered relevant.
Understanding the consequences on the region of destroying Saddam’s regime, and how this might empower and embolden a more militant Iran, was never on the neocons radar screen.
You see, Bush and the Neocons upon which he relies have never seen understanding as a key goal. Indeed, they have deliberately ignored the warnings and predictions of experts and critics. Understanding was seen by them as something for wimps. Real men know what they want and they go out and get it. The process of understanding the problem or issue which confronts them only gets in their way.
So, you see, this was why the intelligence was fixed around the policy. Much like my insurance company, they knew what their goal was, and they didn’t want or need to understand the situation before making their decision. What they needed were justifications for going ahead and doing what they wanted to all along. And that’s exactly what they got.
Now in the case of my disability insurance carrier, the only persons who were affected by the company’s refusal to understand my situation and honestly evaluate my disability claim were the members of my family and I.
But the people who were affected by President Bush’s failure, and the failure of his advisors and policy makers, to understand the situation in Iraq before going in with guns, bombs and missiles blazing are thousands of dead and wounded, Iraqis and Americans alike, the millions made homeless or suffering from the prolonged stress of a bloody and ever more violent conflict, and the future safety and security of the entire Western world, Europe and America, both, from the increased rage and hatred directed toward all of us by ordinary Muslims, whether in the Middle East or in our own societies.
And it seems likely that Bush is about to repeat the very same mistakes he made regarding Iraq with respect to Iran. Once again he is preparing to go to war with another Middle Eastern, oil rich country without understanding their culture, their politics, or the likely consequences that will flow from any such attack.
That is what happens when you refuse to understand the world in which you live. You keep repeating the same mistakes you’ve made before. And, in Bush’s case, his continued refusal to understand the world in which he “decides” what America should do next is increasingly dangerous to us all.
Also posted at Daily Kos
and crossposted at My Left Wing.
Great piece, Steven D. I love the way you interweave the personal and the political, blurring the lines, showing the themes present across the board.
It also resonated for me personally, as I became suddenly and chronically ill 7 years ago (almost to the day, actually) and am still disabled, under-diagnosed, and under-treated. My only income is SSDI, as I was putting myself through college at the time. Every day of my life is fucking terrifying (to varying degrees), and under BushCo and my increasing certainty that the Democrats (as a group) are not really any more interested in helping me than my family of origin (who pitched me out in the streets at age 16 for being queer), that terror is magnified greatly.
We have, bar none, the worst medical assistnce system in the free world. If you have money or good insurance you receive top care. Everyone after that gets shorted to some degree.
I agree. I think it’s a clear result of the over-commodification of medical care; seeing it as a consumer good rather than as a human right is hurting not just the poor and disabled, such as myself, but it’s taking a major toll on the middle class as well. Not to mention developing nations whose citizens could benefit from the innovation of a wealthier nation such as ours if we took a more philanthropic approach — which would ultimately have economic benefits for everyone, but that does require the understanding that you emphasize as well as a more long term view, rather than the “gimme gimme right now and fuck everyone else” view of so many of our fellow ‘Murkans.
a year ago at Democracyfest, Rep. Jesse Jackson talked about health care as a human right and stated that it was one of the rights about which Dems should introduce amendments to the Constitution. Imagine. Health care for all Americans as a Constitutional right!
Sadly, it doesn’t appear that Jackson or the rest of the Dems have made any progress on this issue.
That is exactly what happened to me and why I got screwed over by worker’s comp after my tbi, and I had a lawyer. (Nothing will convince me that some $$ didn’t change hands.)
First, Steven, I had no idea of your suffering. I wish I could give you a big hug and a magic wand to wave away such troubles, but of course, the first wouldn’t do much good and the second doesn’t exist. Still, my heart goes out to you.
Second, what a fantastic, clear analogy of all that’s wrong in the Bush administration. The failure not only to understand, but to SEEK to understand. People don’t typically seek out bad news. They don’t want to be proven wrong. But it’s so important for all of us to continually challenge our beliefs. Someone said (this has been attributed to Artemus Ward, Ralph Waldo Emerson, and Mark Twain – which pretty well proves the point of this quote):
Understanding is not cost effective.
It does not lead to maximum profits with minimum overhead.
It does not provide enough drama to create “Breaking News”
It gets very little publicity or votes for politicians.
It holds no pay off for powermongers at all.
In fact, “understanding” is completely detrimental to a free market system now under corporate control, that has also taken over our government.
“Umderstanding”, IMO, is about the last human atttribute any American can expect to see in operation at any level anymore.
In Project Runway language, “It’s OUT.”
Period.
It has left the runway.
One thought: has any medical expert ever ruled out the possibilty of Primary Biliary Cirrhosis? (PBC)
That’s a new one to me. I’ll have to check it out.
I was just thinking it might be PBC. I have had PBC for about 17 years, and many of the symptoms sound familiar.
Interesting melding of different situations to try and identify their common origins, Steven. Ironically, a process of the kind a good doctor would do to work toward a difficult diagnosis.
I think what you’ve described in the case of Bush et al is the same thing I’ve meant in describing their kind as psychopathic. A good leader, a good person, has to have a desire for understanding as a very basic, very powerful, component of their personality. Bushies lack this quality because their intellects do not extend beyond their own personal aggression and class/race/family loyalties. They are essentially perpetual infants. They are also the kind of being hugely admired in American culture — shoot first and let god sort them out. Win at all costs. Look out for number one.
Understanding, in its true sense, does not advance the goals of such personalities. In fact it impedes them. Hence the unremitting propaganda against “navel gazers”, “intellectuals”, science, liberal arts, and so forth. The ideal is action, the more mindless the better. Your insurance crooks operate with only one goal: to take in as much money as they can, by hook or by crook, and to pay back as little as possible, by hook or by crook. Understanding the complexities of their customers’ conditions would only distract from the program, just as understanding cultures and history and the workings of nations would only distract from the Bush neocon psychotic imperatives. It is no accident that Bush brags about never reading anything.
In the minds of way too many Americans, both your insurance company’s “doctor”-whore and the shock-and-awe crowd represent the ideal. I think America’s future as a civilized entity depends on radically changing that perception. It will be a herculean and probably hopeless effort.
The unmitigated quest not only for profits, but a guaranteed and constantly rising level of profits, has undermined far too many industries… it doesn’t seem to matter whether the industry is selling products, services, or entertainment. The greed for profit — not a steady level of profit but the ever-increasing need for more and higher profit — has tainted them all.
Too much of the healthcare industry has forgotten that its original mission was to help people who are sick or injured.
And far too much of the insurance industry has forgotten that its original mission was to pay claims made by policy holders from the pooled resources of combined premiums, not to collect premiums merely so they can use them as investment capital to make their stockholders rich.
And the current Administration has forgotten — if indeed, they ever accepted — that the original mission of government was to serve the people, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity.…. not make profits by using the powers, authority and vast resources the government has at its command to enrich themselves and a small percentage of the population who are their “friends.”
Understanding and empathy for others are very closely related. It IS hard work, and it’s an ongoing thing — one never totally understands another person, point of view, experience or culture. You have to be open to new information, re-evaluation, even admitting your previous understanding was in fact incorrect. It also requires a willingness to understand yourself — and face your own ignorance, fallibility, previous errors of judgment, painful experiences, prejudices and insecurities, which no one in the current Administration, from the guy in the Oval Office on down, seems capable of or willing to do.
Understanding – or at least making as good an homest attempt at understanding as one can make — IS key.
(and best well-wishes to you, StevenD)
Dear Steven: Your symptoms mirror most of my own and then some we won’t discuss, through no help of the scores of pokers & proders otherwise calling themselves doctors, I stumbled across the source of my malady and perhaps yours as well. Commonly known as celiac disease it is, to be overly simplistic here, an allergy like reaction to wheat and wheat products. A simple test you can try is just cutting out all wheat products from your diet for 2 weeks. Some people feel better in a matter of days, for me it took a week. One of the added bonuses to above was I wasn’t so stiff and sore in the am. Maybe you’ve already gone down this road, if not, it’s a pretty harmless test and recent studies show 1:300 people share this but symptoms haven’t given way to diagnosis.
Sorry. They tested me for celiac disease. Came up negative.
Steven, you are awesome and I’m sorry you are going through this horrible health situation.
Your analogy is so very clear and straightforward, yet I can think of a few people I know who would read it and still deny reality.
Recently I have read in a number of sources that the Neo-cons are true and brilliant intellectuals. How this can be, when they make “not” understanding a badge of honor, is beyond me.
Your situation is very similar to mine including the denial of health care benefits. Would you want to talk or are you just sick of it all at this point? I don’t know if I could help because it sounds like you’ve tried everything. I would suggest that you consider all this a reaction to a sub chronic chemical exposure since all the test came up negative for common problems.
Take a real good look at anything you use on a regular basis for cleaning etc. The drugs you are on also cause toxic problems which can compound and disguse a chemical exposure.
Being disabled without a medical clue really sucks.