A Eulogy To Words

wrial2Sometimes the greatest tragedies come quietly.

Today marks a week since the passing of The Writer’s Almanac, one of the few modern examples of true literary culture edging – just slightly – into the American mainstream.

The Almanac has been around for 24 years. Hosted by its creator, Garrison Keillor, each daily program included vignettes about authors and other noteworthy people whose birthdays or significant events coincided with the date of the particular program. There were also interesting excerpts of important events in history.

The program continued with one or more poems usually chosen and read by Keillor. The show ended with his traditional sign-off, “Be well, do good work, and keep in touch.” The theme music was a version of the Swedish song “Ge mig en dag”, performed by Richard Dworsky on piano.

Keillor has recently been accused of ‘inappropriate conduct’ by a co-worker at Minnesota Public Radio, which has the distribution rights to the show. He has been summarily removed from all his connections to the station, and, among other actions, the Almanac is no more. The details are murky. It isn’t clear what was committed; from crimes against humanity to repugnant boorishness to internecine office politics. But the Almanac is gone. That we know.

This loss is a terrible thing. The Almanac goes quietly, ‘with a whimper,’ but the magnitude of the demise cannot be understated. Thousands of writers, poets especially, saw a small sliver of light fall across their obscure desks because of the Almanac.

Ever heard of Athena Kildegaard? I hadn’t. ‘Till A Mother’s Poem showed up in my email the other day. Same for the poetry of Anne Sexton, Paul Hostovsky, David Romtvedt, Ogden Nash, Janice Moore Fuller, Dorianne Laux and hundreds of others. Each post in the Almanac included links to buy the works of these poets, which I’m sure was a huge benefit to them. Ever tried to sell a poem? Ever tried to keep the heat on in winter with income from your wordcraft? Give it a shot. Have fun.

Another casualty: The Poetry Foundation. Long fighting a valiant Thermopylae-esque battle for the attention of the American public, this beleaguered institution will crumble further into obscurity. Many of those who attempt to live by the spoken or written word will feel the effects of this ignominious end.

wrial4I think of all the people who made their living from the show too: The Almanac was written by Betsy Allister, Joy Biles, Priscilla Kinter, Heather McPherson, and Holly Vanderhaar, the program was engineered and edited by Thomas Scheuzger, Noah Smith, and Sam Hudson. Production assistance was by Kathy Roach and Katrina Cicala. I don’t know any of these people, but I presume they’re now using those fabulous writing skills on their resumes.

This is a blow to the English language itself. The Writer’s Almanac invited Americans to spend time with those who are excellent and exacting in their use of English. This, in turn, pushed those of us with lesser skills to be better with the craft. To avoid sentence fragments, for example. And fight the urge to grow wary when in fact we were weary. Great English avoids misconfusing conjunctions. And doesn’t use nouns to modify verbs (e.g. ‘travel safe’ is, ostensibly, a thing, ‘travel safely’ is a well wish). Great English makes whimsical and witty use of alliterations (you be the judge with that one).

wrial6But to my way of thinking, the greatest effect of the loss of the Almanac is to the American mind. I’ve long been suspicious of just how well the average American thinks, myself included. I’m dubious that we as a people place a high enough standard how and at what point we decide something is True. America today seems to be a land of sports spectacle and activism, neither of which lend themselves to nuanced and charitable thinking. Intellectual certainty abounds. Justice may rarely roll down like water these days, but arrogance about one’s opinions certainly does.

Poetry tends to avoid absolutes. It remains one of the few places where the dress could be blue, or gold, or both…and still be considered valid. And valuable. A poet once told me that a good poem has two completely different meanings, depending on how it is read –  a great poem has three. Poetry demands of us the ability to find both satisfaction and fascination in such unkempt intellectual complexity.

I met my future wife over Faulkner, but things really heated up when Cummings and Frost got involved. To say I owe my marriage, and all the glories that have resulted thereafter, to poetry is both overstatement and understatement. I mean, words…what can they really do for us? No doubt it was actually those relentless brown eyes. Then again, perhaps it was the waves, which did something to the shore that water never did to land before.

It may be that shutting down the Almanac was necessary; the justice of sins come home. Perhaps it is the victim of McCarthyist purges. Either way, the loss is incalculable. The exit of a Today Show anchor or a Hollywood movie producer barely rends the cultural fabric of America. But the loss of The Writer’s Almanac shreds it. All are bereft of so much more than can ever be said. Except, perhaps, by the poets, who are now even more quiet than they were before.

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RATIONal!

Yes, throwing a few words out there again.  Can’t help m’self.  Been a bit.

Living in Europe insulates the average human from goofy, over-the-top language meant to get people to do and think in ways that OTHER people want them to.  So, I haven’t been very caught up in, or all that impressed by, all the politics and steamy language coming out of my home country these past months.

Demilitarized Zone, North Korea
We have fast government. No arguing. You like. Like pizza.

Now the election is finally over, we find that Republicans have “swept” themselves into a level of “power” that assures exactly zero will happen unless they work with all the Democrats and Independents that never lost their jobs.  Some people think all the upcoming wrangling is a bad thing; I think it’s great.  A super-active government rarely doesn’t do anything well.  There IS a type of government that “gets things done” almost immediately, with little debate.  It’s called a dictatorship.  If you’re smitten with that idea, move to North Korea and try THAT speedy idea on and see how you like it.

Anyway, I received a link to a very persuasive and scary speech given by an orthopedic surgeon named Dr. David Janda, wherein he outlined the horrors and sneaky tricks piled into the Obama health care bill.  His speech was in support of Rob Steele, a cardiologist-turned-politician likely because he was mad as hell at the terrible direction of the country (*yawn*, aren’t we all?).  Presumably, said cardiologist is now back in the clinic, since he thoroughly

Republican Party Handbill, ca. 1880
Image by Cornell University Library via Flickr

lost the election of the 15th Congressional District of Michigan to John Dingell something like 83k votes to 118k votes.  Apparently, the Dingells have run that district for generations.  If you’re looking for nutty, inflammatory, manipulative language, look no further than at a political battle between a challenger losing in the polls as s/he tries to unseat a longstanding incumbent.

The gist of Dr. Janda’s speech is how Obama intends to RATION health care.  This actually sparked my interest.  I don’t really care about health care system politics; I’d rather just see patients, frankly.  But I have to just say to my fledgling SW101 crowd, I SUPPORT RATIONING.  Of every public resource.  Food. Gas. Sex (um, although I’d readily opt out of the “public” option).

New Orleans, Louisiana, 1943. Line at Rationin...
The whole idea of capitalism is so you don't have to share. Sharing sucks.

So many people take the idea of rationing to be unequivocally bad…as if it’s totally wrong and even beyond debate.  That’s the tack of Dr. Janda.  It’s something we all KNOW is wrong.  Like sticking needles in the eyes of baby squirrels or stomping on halloween pumpkins.

Incidentally, Janda is a specialist, supporting another specialist.  Primary care docs like me aren’t especially pleased with how specialists have garnered power and money for themselves in the AMS (Am. Med. System).  In particular, I’m speaking of orthopedic surgeons and cardiologists.  Specialists make fabulous money by ordering tests and procedures, none of which have ever been regulated or rationed in any way.  Echo’s and caths pay for the boat, private school and vacations to S. Pacific islands nobody can name.  Don’t tell me the only force driving clinical decisions is scientific evidence and standards of clinical care…money is money.  But even so, I’m for rationing.

President Barack Obama speaks to a joint sessi...
Hey friends! Here's a really mediocre idea!!

Let me say that I’m not happy about Obamacare. It was said well @ a recent conference, “who’s going to do a better job coming up with a fair, affordable national health care plan, 189 laywers in a room for half a year, or 10 family doctors in a room for a week? Obama went with the lawyers, he should have gone with the docs.”

That said, I FULLY AND COMPLETELY agree with rationing because it’s a necessity. In training, I followed a patient in the ICU who was costing close to 1 million dollars a day of PUBLIC MONEY for the last 4 months of her life. Somebody, somewhere needed to compassionately deny further intensive care to this woman, instead providing dignified hospice end-of-life management. Her case justified ONLY taxpayer-funded hospice care but nobody had the cajones to tell her that.

Every precious resource, if pooled for the common good, needs to be rationed. It’s where we get the term ‘rational’ and there’s a reason for it. Closer to home, my sister apparently has a University doctor telling her that she needs a thousand dollar procedure (colonoscopy). The procedure is not done by this doc’s specialty, and my sister hasn’t even had a rudimentary work-up to justify the cost of the scope.  She has not had a professional analyze of the risks vs. the benefits of doing it, either.  Yet she’s already being told that she needs this procedure.

Remember…EVERY test and procedure has significant risk associated with it. Wouldn’t it be nice to know that the doc my sis sees for a scope is a specialist? And, since that specialist pays for the Benz and sailboat from scope income, wouldn’t it be nice to know that he moved in a stepwise fashion through the GI workup process, a process that is peer-reviewed and widely accepted as essential before a scope is ordered?  This is the ‘rationing’ process that Obamacare advocates.  It puts serious limits on specialists in the provision of their care when it comes to big-ticket stuff like scopes, imaging and surgery.

But remember, we’re talking about rules in effect ONLY if you intend to get your neighbor to pay for your health care. YOU are welcome to pay for your own scope any time you wish. YOU can fund your own health insurance – one that doesn’t make docs do ANYTHING before they dig into your body – if you want.  I watched it work this way in Israel, and it was a pretty good deal.

However, the fact is most Americans believe they are SO important that they have the right to be treated like kings…paid for by peasants. But ethically, Americans have no right to whatever care they want whenever they want it, if they also expect someone else to pay for it.

Hugh Owen Thomas (1834-1891), British orthoped...
Trust me, I'm a DOCTOR! We ALL are.

The AMS does too many procedures and tests. The result of both is astronomical costs and HARM TO PATIENTS (through false-positive test results and procedure errors). So, not only is care rationing ethical and less costly, it is absolutely safer for patients. Healthcare is NOT safe. There is a risk-benefit ratio that must be considered any time a patient comes in contact with the health care system. Waiting for non-urgent care (knee replacements) and rationing of tests and procedures is ethical, cheaper and flat-out safer.

Incidentally, I argued this point in a debate in med school…waay before Obamacare. I have seen nothing since that time to sway my opinion. In fact, training and practice have only solidified that opinion with real-world facts.

Obama didn’t make our health care system right, but he did make it better. The Tea Party idea of repealing the new law is lunacy. If they REALLY want a free-market system, they need to dispense with EMTALA laws which dictate that ER docs (and now other specialties too) are required to see any and every patient.  THIS IS UNIVERSAL HEALTH CARE!!  It’s just the most inefficient, ineffective and expensive system in the world. We do have a social healthcare system. We just need to make it rational…starting with sensible rationing of limited resources.

#73

A few months back, I entered this blog in the Healthcare 100, a ranking system for health care blogs. I figured one day this lovely little work-of-life might end up on their list. Some of the very top blogs on the net are in their ranking system.
Turns out I didn’t have to wait as long as I expected. SW101 has just been ranked at #73! There are currently 783 listed blogs in their ranking database. To all who read the blog and offer comments, my sincere thanks for your support.