Archive for July, 2009

Do Americans Watch Too Many Hospital Shows?

July 31, 2009

Watching Marcus Welby may have led Americans of a Certain Age to expect house calls and long conversations with their doctors.  Watching ER may have led younger Americans to expect a lot of noisy rapid action.  Watching Grey’s Anatomy or General Hospital may have led many of us to sneak a peek into supposedly empty hospital rooms in hope of catching younger medical personnel in flagrante delicto.  Popular culture undoubtedly shapes our expectations of the health care system, for better and for worse.

Age, class, and gender play their part, too.  Younger males, especially blue-collar men, want as little contact with the health care system as possible.  Real men don’t go to doctors and don’t take meds.  Real blue-collar men watch ESPN, which rarely deals with medical issues other than the ingestion of illegal substances by professional athletes. Naturally, this tends to make doctors, when seen at all, the bad guys.

Women generally get stuck functioning as the designated interface with the health care system on behalf of everybody else in the family until they are old enough to need somebody else to handle those duties on their own behalf.

Middle-class, educated, white-collar Americans have higher expectations, because in addition to watching Private Practice and Hawthorne, they read Scientific American and the Health section of the daily paper.  Which leads them into the same trap we collectively fall into:  losing track of the distinction between what we can imagine being able to do, what science has worked out the how-tos for but not implemented yet, what elite medical care can provide if paid enough for it, what is actually being done in the majority of American facilities, and what poor people can get if they’re really lucky.  The popular culture culprit here may not be a hospital show at all, but CSI and other purveyors of gee-whiz technology.  In an earlier generation, we didn’t have so much trouble realizing that Dr. McCoy’s scanner was a couple of centuries away. Today, we rarely think about the fact that the various non-invasive technologies for imaging and surgery  that we really do have available now are EXPENSIVE.  ER was pretty good about discussing the financial facts of medical life where they were relevant to the plotline, but of course, in an emergency room, the law requires every bona fide emergency patient to be treated regardless of ability to pay, so the issue didn’t necessarily come up until much later, usually long after the show was over.

Quite possibly what popular culture and the health care system should be working on together is a medical version of Car Talk.  You know, that Public Radio show on which, every Saturday morning, two Italian-American mechanics (both MIT-educated, and one of whom has a PhD, so much for blue-collar credentials) take questions from listeners nationwide about the foibles and failings of cars and mechanics.  They have a pretty healthy and realistic attitude toward both.  Cars are mortal.  All cars eventually disintegrate and die.  Mechanics are fallible and sometimes greedy.  Car dealers and their repair and maintenance facilities are not necessarily much better.  But most of us can keep our cars running for well over 100,000 miles by paying attention to telltale noises (Car Talk makes me wonder if good hearing and possibly even perfect pitch are Bona Fide Occupational Qualifications for a car mechanic), tending to routine maintenance regularly, and not doing Really Dumb Things.  Some car problems are Really Dangerous, and some are just trivial or unpleasant.  Check with your mechanic to see which is which, and don’t hesitate to get a second opinion when the first one doesn’t sound right. Since most of their calls involve cars over five years old (that’s forty-five in people years), they have no gee-whiz technology to call upon, just basic grease-monkey stuff.  [Cars with GPS and rear view cameras are still brand new and under dealer warranty, so the Car Talk Boys never hear about them.]

This is precisely the level of technology most of us need to hear about when our bodies act up, except that we don’t usually give off telltale noises (other than the stuff stethoscopes listen for, which was probably a much larger part of the practice of medicine seventy years ago.)  Unfortunately, doctors are mostly too nervous about getting sued to offer medical advice to strangers on the public airwaves (note that the Car Talk Boys never issue any disclaimers about their advice. Is this because so far, most of us don’t sue our mechanics?)  There should be ways to work around this.  Because, at least until we start heading into the Geezer Years, most of us think of our bodies pretty much the way we think of our cars: we just want to keep them running reasonably well at reasonable cost for as long as possible.  We want our doctors to function like good car mechanics.  Mostly, we want them to specialize in doing things we mostly think we could do for ourselves if we wanted to take the time and trouble, but it’s easier to let somebody else do it.  We want hints on how to do some of the easy stuff for ourselves, and then we just want to leave the complicated stuff to them.  If we could drop our bodies off at the hospital and come back for them later, most of us probably would, especially if we could get a suitable loaner in the meantime (Here’s a slightly used Mel Gibson, shouldn’t give you any trouble, but it’s only got a quarter tank of gas, be sure and have dinner on the way home tonight…)

And in the Geezer Years, we probably don’t expect what the medical establishment seems to think we do.  We don’t want to live forever. We just want to keep functioning more or less normally for as long as possible. We don’t want to fight as long as possible.  Whose idea was it to depict medical intervention in terms of combat in the first place anyway?  These days, a lot of patients regardless of gender seem to buy into the model, but I suspect that’s mostly because they are made to think they ought to.  I know the denizens of That Other Blog will say I’m pushing euthanasia or assisted suicide or something, but I think if the medical establishment were willing to tell patients it’s okay to give up or give in beyond a certain point, a lot of people would, thereby sparing themselves a lot of unnecessary pain and perhaps also cutting down on the enormous proportion of lifetime health care expenditures that is now spent in the last six months of life.    Nurses are often better at talking about these realities than doctors, and maybe they should be encouraged to do it more often.  It is their primary job, after all, to care about how the patient feels. Maybe hospital chaplains should be recruited for these discussions too; they are mostly connected with faith traditions that tell us the soul is more important than the body, after all.  Doctors, on the other hand, tend to see themselves as the patient’s designated champion in the combat against death.

Well, enough of awkwardly chosen metaphors (a man’s reach should exceed his grasp, or what’s a metaphor?)  Now that Obama has started talking about what used to be health care reform as health insurance reform, we will need to start looking elsewhere to change the health care system.  Stay tuned for The Body Talk Boys, Mark and David Welby, and don’t eat like my brother.


The Wise-*ss Latina Woman, and Other “Racists”

July 30, 2009

Full disclosure: I guess I’m a Latina woman, sort of.  My parents were both born in Cuba. They told their secrets in Spanish, which is a great way to raise a bilingual kid without working at it.  Wise?  Dunno, let the reader decide.

Anyway, I’m fascinated by the latest tactic of the Radical Right:  calling any person of color or member of a minority group “racist” when s/he suggests that colorless people may in a particular instance be behaving in a prejudiced manner, or that race may still be a significant factor in current social conditions.

Sonia Sotomayor mentioned (in 4 or 5 different versions of the “wise Latina” speech) that the experience of being a double minority might enrich her judicial perspective, and the Republicans glommed onto the remark as if it were their last hope of salvation. In fact, it was more like their last chance at having anything at all to say in her confirmation hearings, in light of her 14 years of impeccably straight arrow judicial decisions.  Maybe if her paper trail had looked more like Robert Bork’s, they wouldn’t have bothered with the “wise Latina” stuff.  But her Republican opponents and several other critics have called her a racist for using the phrase.

And then the President called the behavior of the Cambridge cops “stupid” when they arrested Harvard professor Henry Louis Gates Jr. for having broken into his own house. He started out by admitting he didn’t have all the facts yet.  In fact, he never will, and neither will the rest of us. The facts will undoubtedly never be completely clarified, since so far we have 4 different (and discordant) accounts, and there are a number of participants who have not yet been heard from.  Does that mean nobody is allowed to express an opinion, or just that POTUS should have kept his highly influential and controversial mouth shut?  Anyway, despite his diligent efforts at trying to cool things down with the aid of a Bud Lite, the “stupid” remark got him called a racist by several conservative types.

Apparently the reasoning of the Hard Right is that we are, or at least should be aspiring to become, a color-blind society.  Anyone who reminds us that race is still a significant social reality is obstructing this effort.  Anyone who obstructs our progress toward color-blindness by definition is a racist.

Some of my best friends espouse the ideal of a color-blind society.  They refuse to check the white/black/other boxes on the various forms everybody has to fill out these days. I can see why that’s attractive.  It would be nice to just cast off the shackles of our old errors and move on into a bright future for all of us, without regard to race, creed, color, or gender or………………….

Hey, wait a minute!  Would that mean we shouldn’t notice any difference between men and women?  Ummm, words fail me.  The species could be seriously disadvantaged in its chances for survival if the two sexes couldn’t even recognize each other.

And, assuming that there is some serious metaphysical difference between distinguishing characteristics people are born with and those they choose, does that mean that we should stop noticing race, but it’s okay to discriminate against Unitarians or anybody else who chooses a minority religion?  The gay rights movement has in some quarters gotten bogged down in a dispute over whether sexual orientation is inborn or chosen.  Are we sure we want that to matter?

Okay, I don’t want race to matter, when it comes to distributing social goodies, like the right to vote or move into a neighborhood or go to school or get a decent job.  I also don’t want religion, gender, or sexual orientation to matter for those purposes.  Does that mean I don’t want to KNOW about those things? Or that I don’t want the people distributing the social goodies to know about them?

Sometimes we do set up blinding mechanisms to screen out possible discriminatory effects.  It’s how we do reputable laboratory research—divide our subjects into two groups, without letting anybody know which group any individual subject is in, and experiment on one group while leaving the other along except for placebo tinkering.  It’s how the Berlin Philharmonic Orchestra does its auditions—the musician plays from behind a screen, so the judges cannot ascertain his/her race, gender, age, or physical appearance.  They start with the premise that none of those things matter for their purposes.  All they need to know, and therefore all they want to know, is how good the candidate sounds.  Some academic journals do peer review by removing the author’s name and other identifying details from the article before distributing it to reviewers, to keep them from being blinded by gender, past reputation, or academic affiliations.  They don’t need to know any of those things to know whether the article is any good.  It should stand on its own anonymous merits. Same goes for juried art exhibits.

And it’s how the civil service system and the union seniority system are supposed to operate. Individuals get “points” for seniority and test scores, and if your points put you at the top of the list, you get the next job.  But as a practical matter, you don’t get into the seniority system until you get into the union, and until fairly recently, that often required a recommendation from a friend or relative.  As a practical matter, the civil service points awarded to military veterans are essentially an affirmative action program for men, since the military sets limits on both the number and the proportion of women admitted into the service.  Civil service doesn’t screen out as many high-scoring women as it used to, since there are a lot more women veterans than there used to be.  But the system still favors males.

Mr. Wired had a brilliant suggestion some years ago:  why don’t employers get serious about deciding what the real qualifications are for doing a particular job, advertise the job opening and qualifications to the general public, and then just hire the first qualified person who walks through the door?  These days, most employment discrimination doesn’t involve hiring unqualified people in preference to qualified people, but in choosing one qualified person over another for reasons having nothing to do with qualifications.  So let’s eliminate that step from the process.

I don’t know anybody other than Mr. Wired and us who likes that idea.  Most employers think they want to hire the most qualified person available for a particular job.  Of course, a lot of things get in the way of doing that, like figuring out what the qualifications really are for a particular job, and deciding how much they’re willing to pay for stellar qualifications, and dealing with candidates whose wage demands may be as high as their qualifications.

And of course, there are the intangible qualifications. “Character.”  “Fit.”  “Comfort level.”  How the candidate comes across in an interview (which, of course, is never conducted from behind a screen.)  All the things that serve as proxies for whether the candidate reminds the interviewer of his/her best friend.  All the areas into which considerations of race, religion, class, age, gender, and sexual orientation can creep unrecognized, especially if one isn’t even allowed to notice how they affect the total employee mix that results from these decisions.

I would love to live in a society in which none of this stuff mattered to a person’s chance at the Good Life.  Gandhi says “we must live the change we wish to see,” and a lot of the time I think he’s right.  But living as if we had already overcome racism and other forms of discrimination will not actually overcome them.  It will merely blind us, not to color, but to its effect on the world we live in.  No doubt some of the people obsessed with race and discrimination are racists, or maybe just politically savvy race card players.  But most of them, I suspect, are just trying to avoid being blinded to the racist realities that still surround us.

Watch This Space for a further examination of such questions as:

Do we presume that the unspoken basic job qualification for most decent jobs is white middle class culture?  Are we willing to treat people of color, women, GLBT types, and people with disabilities like white middle-classniks only to the extent that they can disguise themselves as white middle-classniks?

If we do admit these outgroups to the white middle class, do they become fully qualified members of the Tribe, or only a cheap knockoff (I was going to say “pale imitation,” but that obviously won’t work) of the real thing?

Are we willing to accept people we recognize as different from ourselves as nonetheless entitled to be treated like ourselves?  That is, is equality possible without sameness?


Child-Rearing in Public

July 29, 2009

One of the commenters on That Other Blog has problems with other people’s over-indulged kids acting up in public, and their parents standing ineffectually by.  I guess I’ve seen that once or twice in my life.  It may reflect the kinds of neighborhood I frequent that I see abusive parents and their kids in public places a lot more often.  It annoys me just as much, and in addition sometimes puts me in a moral quandary.

I was brought up in Florida, which was still pretty Southern at the time. That may account for the fact that it wasn’t until I moved up North for college that I first heard a parent tell her child, “I’m going to kill you.”  I heard it fairly often after that.  These were white, more or less blue-collar parents in New England.  When I moved out to Chicago, I saw a somewhat different pattern: African-American parents telling their kids, “Sit down and shut up, stop crying, sit still!!”  And sometimes reinforcing words with slaps.  The kids, in all the instances I saw, were doing nothing worse than crying. Most of them weren’t even doing that. They were just squirming or waving their arms or trying to get up and walk around. The thing that bothered me most was that most of these parents (in fairness, some of them were undoubtedly grandparents) seemed to take absolutely no joy from their children. No, this is not a function of poverty, as nearly as I can tell.  Hispanic and Asian parents in what appears to be the same income bracket generally look really happy with their kids, even when the kids are acting up.

The more middle-class parents I see usually don’t pick on their kids by yelling at them and slapping them. They are more subtle and more annoying about it.  The ones who tell their kids, “If you don’t stop [whatever], I’m going to call the policeman and he’ll put you in jail” (how on earth are the kids supposed to know that the policeman is who you go to for help?) The ones who tell the kid to stop [whatever] because “you’re bothering that lady”, meaning me.  (I am not the least bit bothered, except by being used as a club to beat up on a helpless child.)

Obviously I’m not the only person who sees this kind of thing. People write to advice columnists all the time about it.  The columnists, who are probably nicer people than I am, generally say that the way to respond to these situations is to offer sympathy or even help to the abusive parent, who is probably just really overwhelmed.  Maybe so, but on the rare occasions when I have tried to talk to a mother in this situation, I generally get told to mind my own business.

Which I can sort of understand, from the other side.  From the first instant a woman starts to look pregnant, until the last day she appears in public with anybody too young to vote, her parenting skills and the conduct of the said young person are fair game for the entire world of total strangers to comment on and advise.  It may or may not take a village to raise a child, but the village certainly feels entitled to kibitz on the process whenever they get the chance.  Unless I see abuse rising to a level that would interest the official child welfare establishment (which so far I haven’t, and having worked in the Juvenile Court system for many years I’m quite familiar with the standards), I figure everybody is better off if I keep my mouth shut.  I do give occasional “know-your-law” talks in the community, which gives me the chance to talk about the official standards for child abuse and neglect to people who are actually interested in listening or they wouldn’t be there.

But these issues seem to make a lot of parents feel that their children simply don’t belong in the public realm at all until they’re old enough to go to the mall by themselves.  Of course, keeping kids at home in front of the television until they are teenagers who can be dropped off at the mall means that they will probably behave really obnoxiously at the mall, since they have so far had no chance to practice proper public behavior.  This is not a solution.

The solution, I think, lies in all of us—parents, non-parents, ex-parents, future parents—accepting our obligation toward the next generation, who will after all be paying the Social Security and maintaining the economy of childless people in this generation.  They need us, and ultimately we will need them.  So in the meantime, parents need to be willing to bring their children out in public without feeling either embarrassed or belligerent about how the kids behave, and willing to accept kibitzing from strangers, and non-parents need to be willing to tolerate and even encourage small people who are not yet very good at sitting still and shutting up.  Any society that is not willing to share in accommodating the next generation doesn’t deserve to have one.


Miscellaneous Meanderings

July 28, 2009

There is, somewhere in one of “Official Rules” books, a Law which states, “Any organization founded to unite a proliferation of splinter groups invariably becomes one more splinter group.”  By the same token, any attempt to sum up everybody’s wide-ranging opinions on a particularly controversial subject invariably becomes yet another wide-ranging opinion.  But whattheheck, I’m going to try anyway.

There seem to be two repeating themes in the Gates-gate discussion:

 the police are entitled to be treated with respect or even deference, and are also entitled to use their power to enforce that right; anybody who mouths off to a cop deserves what s/he gets.
 there is a persistent disparity in the way different racial groups are treated by the law enforcement system, which cannot be completely explained by the behavior of those groups and their members.

These two propositions are not mutually inconsistent. They could both be true.  My sister Red appears to think that the former proposition is just plain dead wrong and is responsible (perhaps as part of a larger pattern of the male sense of entitlement and willingness to enforce it by the most direct means available) for a lot of serious violence between police and people of color.  I haven’t talked to Jane about this yet, but, being something of a statistical wonk, she probably accepts the latter proposition without boggling, and would be willing to go along with the former just for the sake of everybody getting along.

Everybody getting along is, in fact, a laudable goal.  When the major cause of death among the 16 – to – 35-year-old males of a particular group is homicide, mostly committed within that group (let’s leave the cops out of this for a moment), maybe the male sense of entitlement is a particular problem within that group.  As Jane would say, this needs more thought.

But, on the perennial other hand, unlike such cultural subgroups, the police are not “them.” They are “us.” They are acting in our name, on our behalf, and on our money. We cannot dismiss their behavior as “men will be boys.”  We cannot merely advise them to talk amongst themselves to come up with a better method for achieving their goals. Their goals, after all, are our goals.  They are doing the job we have assigned them to. If that job gets innocent people killed, that blood is on our hands.  We need to decide, as a society, whether we want the police to be able to protect the authority they wield in our name by arresting people, or worse, merely for transgressing social boundaries.  Maybe we do.  If so, the Constitution and the legal system we live by require that we put it in writing, and set written limits to the power we confer.

And, by the way, our mother always told us that “you can catch more flies with honey than with vinegar.”  We have recently discovered that flies—at least the ones that frequent the Wired residence—like vinegar.  Haven’t tried them with honey yet, but this casts doubt on all the old verities.  As Jane would say, this needs more thought.


Black and White and Blue All Over

July 26, 2009

Gates-gate is, of course, only the most recent installment of the American Dilemma, and not nearly as bad as it could have been—nobody got killed, or even physically injured.  Dunno whether this means we are learning how to do this stuff less dangerously, or just that a Harvard professor in a classy college neighborhood is less likely to get shot for mouthing off to a cop than a Haitian cabdriver in the ghetto.  I would like to believe the former, but experience tells me it’s probably the latter.  Having lived fairly near Gates’ neighborhood myself for a while, I find that reasonable.

But I’m hearing all sorts of people saying that Gates himself obviously had a chip on his shoulder or the incident wouldn’t have happened in the first place; or that Obama only made things worse by commenting on the incident (which he did only in response to a reporter’s question, which he couldn’t have avoided without also making things worse, after all.)  Or that any African-American who presumes that the cop in the case was racist is only a reverse racist himself.  Or that anybody, white, black, or purple, who mouths off to a cop, regardless of circumstances, deserves what he gets.

Some of my best friends and favorite students have been cops.  As an attorney and an English teacher, I have crossed paths with cops in my professional capacities and occasionally in theirs.  (In case you were wondering, they get trained to write police report English, in which nobody ever gets out of a car, they always exit the vehicle.) I have been arrested once, in an incident which ultimately got me a couple of grand in a settlement.  My husband was shaken down by the police on a couple of occasions.  My surrogate nephew was arrested for driving without a license on suspicion of being Chinese. (Long story. Charges ultimately dismissed, when judge took judicial notice of the fact that he was clearly not Chinese.)  I have also handled a number of divorce cases involving police officers as parties.  It’s a sufficiently varied spectrum of experience that I don’t think I’m biased one way or the other.  But I am still really bothered by the idea that police officers are trained to establish and maintain their authority before doing anything else.

I have occasionally given talks to local kids and their parents about staying out of legal trouble. That usually includes a subchapter on dealing with cops.  Talk softly and slowly.  Keep your hands empty and in plain view.  Move slowly.  Don’t run, in either direction. Don’t swear.  After the second or third time around, I realized that these instructions are very similar to what I would tell somebody heading into a wildlife preserve, about how to behave so as not to get eaten by a grizzly bear.  It is sound advice (for both purposes.) But are we supposed to be training, arming, and paying our police officers to behave like grizzly bears?  Aren’t they supposed to be ones who can keep their heads when all about them are losing theirs?  Aren’t they supposed to be keeping the peace, not protecting their own prerogatives?

I do have a certain personal concern, because one of my clients is a young, very tall, African-American man, with a mental problem.  His mother has her own personal private nightmare, which, however, finds its way into the public press a couple of times a year:  young Black man starts behaving erratically; somebody calls the police; the police arrive, start yelling and giving orders to establish their authority; young Black man, confused, threatened, and utterly bewildered, fails to respond appropriately, makes a move the police interpret as threatening, and ends up getting shot and killed.  So far this hasn’t happened to my client, but I can’t blame his mother for fearing that it could. So do I.  Why aren’t the police being trained in grizzly-bear-mollification techniques, which would obviously be appropriate when dealing with people who have mental problems?  (Okay, apology here—apparently some such training is being given, at least in Chicago. It just doesn’t seem to have penetrated the Department all the way down yet.  Like the training in handling domestic violence complaints, which took about 20 years to make its way through the whole Department. Jody Weis’ current proposal to encourage early retirement among the older generation of Chicago cops may have some hidden benefits.)

Getting back to Gates-gate, we still don’t know all the facts.  Did Gates misplace his keys, or just have trouble opening the door after unlocking it?  At what point in the incident did he show his ID to the police?  What did the police do after that?  Where was Gates when he started mouthing off to the police?  Was this before or after the police had succeeded in establishing that Gates was on his own property?  The answers matter.  Once it was clear that Gates legitimately lived in the house, there was no reason for the police to stick around, no matter how Gates was expressing himself.

Regardless of the facts in this particular all’s-well-that-ends-well case, it would be a good idea to establish once and for all the principle that the police have no business using their arrest powers merely to maintain their own authority against mouthy civilians.  We can clear up the racial rights and wrongs later, but can’t we at least stop adding fuel to the fire in the meantime?

Red Emma

Dear Sir or Madman

July 16, 2009

Yesterday’s Yahoo news carried a piece on avoiding typos in one’s resume and cover letter to prospective employers, pointing out that the recipient would probably dump the offending documents in the nearest recycle bin upon catching the first such typo.  As a former English teacher, I can certainly sympathize with that response.  On the other hand, I suspect that most prospective employers are themselves ignorant of alot of such typo’s, and mere HR staffers would be even moreso.  Indeed, between you and I, many such solecisms were originally the fault of misguided English teachers to begin with (such as my son-in-law’s 4th grade teacher, whom he swears taught him never to use “and me”) and are therefore much more likely to be committed by people who really care about proper usage.

Of course, the corrolary to this rule is that many job applications may land in the circular file, not because of they’re poor grasp of English usage, but because of the recipients.

Jane Grey

Revisionist News

July 14, 2009

or, The Sanford Hypotheses

In deference to a friend of mine who used to work for the Appalachian Mountain Club (, I am hoping to revise the commonly accepted view of what Mark Sanford was doing over Independence Day weekend, to forestall the snickers one currently hears whenever the phrase “hiking in the Appalachians” comes up.  The Appalachians are a beautiful place and do not deserve to have their reputation thus sullied.

In fact, it is entirely possible that the Guv really was hiking in the Appalachians at the beginning of that weekend.  And then, he was abducted by

UFO aliens       )

Communists      )    pick one

Terrorists          )

who flew him to Argentina and dumped him in an inappropriate bed for purposes of public embarrassment.  Obviously, Sanford and his staff were dealing with the only thing that would have been more embarrassing than a tryst in Buenos Aires—a kidnapping by critters most of us don’t believe in.  Give it a thought.

Red Emma

The Bennigan’s Index, July ’09 edition

The latest victim of The Economy here in Chicago is the Symphony Store, where Chicago Symphony memorabilia are sold on the first floor of the Symphony Center.  It now has a “closing” sign out front, alas.  On the other hand, it is located right across the street from our local Bennigan’s, which has reopened!!

On yet another hand, the Spertus Institute of Jewish Studies recently moved into a super-fancy bespoke building (is that the proper term?), and has now closed down most of it, allegedly until the economy improves.  Times are hard even in the nonprofit sector.

Jane Grey

More Haste, Less Speed

Mr. Wired and I have long accepted that “rush hour” is in fact the slowest time to get anywhere on most roads.  Now we are also adjusting to the fact that, if you have a medical emergency that needs immediate attention, the “emergency room” is the last place you want to go for that attention.  The last time we did, in April, we were there for 10 hours before even being triaged. If you are visibly bleeding from an artery or a bullet wound, the staff may take more immediate notice, but anything else, no matter how acute and alarming the symptoms, will run you into double-digit waiting times, at least on the South Side of Chicago.  Not sure whether this is a deliberate policy to discourage use of the ER for anything that does not require transportation by ambulance.  Any ideas from the docs among us?


More About Innocence

July 12, 2009

In 1995, Rolando Cruz, who was twice tried and convicted for the murder of Jeanine Nicarico, was granted a new trial by the Illinois Supreme Court, which finally decided that someone else’s confession to the crime just might be a significant piece of data.  The prosecutor claimed to be infuriated and appalled.  So were the victim’s parents.  They had a right to have this case finished, they said.  “Cruz has already had a lot more chances than my daughter had,” Jeanine’s father said.  The case has lived a year longer than Jeanine herself did.

What this tells us is pretty much the same thing the Gary Dotson case told us, the same thing we learned from the 1994 Texas death penalty case in which the U.S. Supreme Court in its wisdom decided that innocence, at least if not asserted in the proper time, place, and manner, is a mere technicality, the same thing we just learned in the Supremes’ Osborne decision from Alaska.  We learn from all of these cases that the “criminal justice system” is not actually about justice.  Indeed, it is not even about vengeance and retribution, as we ordinarily understand them–doing unto the others who have done unto us.  It’s about human sacrifice.  If the Bad Guys have caused X amount of destruction, pain, and death to the Good Guys (us), the Good Guys are thereby entitled to cause roughly the same amount of destruction, pain, and death to any member of the Bad Guy class–i.e., young, poor, non-white, male, high school dropouts with prior criminal records.  The Bad Guys, like all sacrificial animals, are interchangeable.  We may be horrified when we find santeros sacrificing livestock in the public park, but, after all, we generally find chickens more likeable than Bad Guys.

Once upon a time, criminology students were taught that the purposes of the punishment meted out by the law enforcement system were four: rehabilitation, deterrence, incapacitation, and retribution.  Well, we gave up on rehabilitation 30 years ago, on deterrence 20 years ago, and on incapacitation 10 years ago.  Now we are giving up on specific individual retribution.  That is:
1) we no longer believe the criminal justice system can reform the Bad Guys–once a Bad Guy, always a Bad Guy
2) we have decided that we do such an uncertain and sloppy job of catching the Bad Guys that almost no one from the Bad Guy class is deterred from committing crimes by the prospect of arrest, prosecution, conviction, and punishment
3) we can’t even be sure of keeping Bad Guys off the street for any length of time any more; and now
4) we can’t afford to take the time and effort to make sure we’re punishing the right Bad Guy for a particular crime he actually committed.  This, of course, should have been obvious to us 30 years ago, when, for the first time, more criminal charges were resolved by “plea bargains” than by trial.  The whole point of the plea bargaining system is that, if the prosecution can’t prove and doesn’t know what the defendant has done to deserve punishment, the defendant does know. Currently, 95% of all criminal cases are resolved with plea bargains, in which the prosecution doesn’t have to care if the defendant did what he was accused of doing, so long as he meets the other requirements of membership in the Bad Guy class and can be persuaded that he will get a better deal by pleading guilty to whatever the prosecutor wants to charge him with than by going to trial.

At the same time, in parallel with these developments, the victims’ rights movement has been evolving.  It arose as a reaction to the increasing mechanization of prosecutorial offices.  Prosecutors currently consider “unwinnable” any case that depends on the testimony of an innocent civilian witness, as opposed to someone they can rely on to testify as and when required–a police officer, a paid police informant, or an accomplice of the defendant.  So prosecutors rarely go out of their way either to file or to follow up charges brought by innocent civilian witnesses.  They see their job as “disposing of cases,” rather than convicting people for acts they have actually and provably committed.

Victims and their families, not unreasonably, got tired after a while of having to take time off from work again and again to go to court without ever having an opportunity to testify.  They got furious with not being informed of all court dates, and then seeing cases dismissed because “the complaining witness did not appear.”  (As a practical matter, the defendant can probably turn up missing several times before anything serious happens to him; if the complaining witness fails to show up once, the case is almost automatically dismissed.) They got utterly fed up when the prosecution bargained their cases down to time served and turned the criminal out onto the street, without even warning the victim, much less consulting her.  And they found it even more infuriating that they–and all other taxpayers–had to pay exorbitant sums in tax money to maintain this system.  The defendants get free room and board (with no obligation to do anything to repair the damage done to the victim); the lawyers get a job; and the prosecutor gets elected to whatever he’s running for this year. And the victims get–a lot of lost time from work, a lot of intimidation in court from the defendant and his buddies, the pain of having to remember and recount the victimization over and over for years, and the same gigantic tax bill the rest of us get.  Who can blame them for being angry?

And some of the responses of the criminal justice system to the victims’ rights movement were in fact fairly appropriate:
1) the use of civil suits against defendants, to prevent them from ever being able to profit from book and movie rights resulting from the crime, or ever being able to get rich at all, from any source;
2) Victim-witness assistance programs, to counsel victims and witnesses, and keep them informed of court dates
3) in many jurisdictions, requirements that the prosecutor must consult with the victim or the victim’s surviving family before plea bargaining the case
4) in some jurisdictions, the right of the victim or his/her surviving family to address the court before sentencing, whether the conviction results from a trial or a plea bargain.

The problems arise when the victim or his/her family demand a role in the process of adjudication (the “did he do it or didn’t he?” phase of the trial) beyond that of occurrence witness, and use that role to testify to the victim’s good character and beloved place in the community, or the devastating consequences of the crime.  These issues have no relevance at all in the adjudication phase.  At that point, it is the job of the prosecution to prove beyond a reasonable doubt that they have prosecuted the actual perpetrator, and of the trier of fact to find that they have done so, before any questions connected to the victim’s character and value to others can even be considered.  Before we can talk about the kind of person the victim was, we need to establish that s/he was in fact this defendant’s victim. The victim and his/her family have no right to see a particular defendant convicted, unless he happens to be provably guilty.

Indeed, even at sentencing, the fact that the victim was a good person, loved and valued by community and family, and that the loss of the victim, especially in such a horrendous crime, has devastated the family and the community, is only dubiously relevant.  Is it really more heinous to kill a church-going mother of 2 small children than a homeless man with no known family? If we take this position, we are only a short distance away from giving a medal to a person convicted of murdering a street person or some other general nuisance, instead of punishing him. The victim’s character and value to family and community are certainly valid questions in a civil suit, for purposes of calculating damages.  But in a criminal case, the controlling issue in sentencing should be the effect of the crime on the public welfare (what the medievals called “the king’s peace.”)

Well, okay, that was then.  Now, we’ve already decided that justice has been done, the victims made whole, and the “king’s peace” restored, if anybody is convicted of the crime.  The fact that the wrong person may be languishing in jail is of no consequence, so long as he is the right kind of person–young, male, preferably non-white, poor, high school dropout with a prior criminal record.  Whether or not he committed this particular crime, we figure we are all better off if people like him are in jail rather than on the street.

Most recently, we are even willing to extend this reasoning to the death penalty.  It’s okay to fry the wrong person so long as we fry somebody from the Bad Guy class.

We are not even made particularly uncomfortable by the fact that convicting or punishing the wrong person may well mean that the right person is still on the streets, threatening and victimizing other Good Guys.  After all, given enough time and the proper working of karma, and a wide enough dragnet for “the usual suspects,” the person who escapes prosecution for a crime he has actually committed will probably end up behind bars or even on Death Row for somebody else’s crime, or another one of his own (as Brian Dugan–the confessed killer of Jeanine Nicarico–did, after all.)

The criminal justice system has turned into an actuarial operation, which is defined as functioning properly when the people most likely to be guilty of some violent street crime are also most likely to be convicted of and punished for some violent street crime, whether or not the two crimes are identical, and whether or not any individual “most likely” suspect is actually guilty of any violent crime at all.

Of course, at this point, we may simply not have the money to use the criminal justice system for its original purpose.  The FBI estimates that only a tenth of all violent crimes committed are reported; less than half of all reported crimes result in arrest; less than half of all arrests result in the bringing of criminal charges; and, as stated earlier, 85% of all criminal charges are resolved by “plea bargaining” rather than trial.  Serious pursuit and trial of all violent criminals would increase the cost of the criminal justice system by a factor of 240.  No politician on the face of the earth would seriously consider proposing this to the taxpaying voters.

But, if we are not to have a real system of justice, why should we pay as much as we are paying, just for the current actuarial arrangement?  Why not take the actuarial concept to its logical conclusion and just hold a lottery on a regular basis, to choose the members of the Bad Guy class who get to go to jail, and for how long?   Once or twice a year, we could hold a big lottery to pick a candidate (or two, or however many our marketing mavens think would pay off maximally) for Death Row?  The system would not only be cheaper than our current one, it could actually be made to pay for itself or even run a surplus, if we turned it into a state-sponsored, televised “Reality Show” sweepstakes.

We wouldn’t even have to televise the actual executions, if the do-gooders insist on keeping them off the screen.  Just Vanna White drawing numbers out of a rotating basket, with the pictures of  the suspects sweating it out until the word comes down, and then reacting appropriately to winning or losing.  Then we interview all parties on Oprah (hey, it pays a whole lot better than a presentence investigation–can you say “privatization”?) and hold a contest for school kids to write in with the most original ideas for execution.  First prize, obviously, is a ringside seat for the winner and his or her family; second prize is a working model of the winner’s choice of an electric chair or guillotine; third prize is a statue of the Lady with the scales.  Only she’s dressed in a spandex bustier and hot pants, fishnet stockings, and spike heels, with twenty-dollar bills peeking out of her cleavage.


A Vocabulary Exercise in Virtue

July 7, 2009

David Brooks and Charles Murray are depressed because we don’t use words like “dignity” and “duty” any more. They have a point.  A lot of good words have fallen into disuse over the last century or so.  “Piety,” for instance. “Sublime.”  “Sin,” “Vice,” and “Virtue,” except in the context of diet and exercise.  It would be hard to imagine Bernie Madoff using any of these words, even in the course of lamenting his failings.  Well, heck, it would be hard to imagine Bernie Madoff lamenting his failings.

Back in 1999, Jed Purdy tried to start an anti-irony movement that might have rehabilitated some of the good old Victorian words.  It seems to have pretty much fallen flat.  The last time anybody advised me to be careful for my dignity was when I was in high school, and the teacher who gave us that advice was a source of giggles for weeks afterward.

So here’s an exercise in expanding our moral vocabulary:

The Four Cardinal Virtues—Prudence, Courage, Justice, and Temperance: Courage and Justice do get a fair amount of use, though not necessarily the way Aristotle would have liked.  We are a lot more concerned about other people treating us with Justice than about being just in our dealings with other people.  And we talk about Courage, often, when we are really describing gall, nerve, or chutzpah.  Charles Murray says we don’t talk about Prudence or Temperance at all, rather than risk derision.  Perhaps we make up for our reluctance to talk about Temperance by having created an entire spiritual path to support it, the Twelve-Step Movement.  Prudence gets no such backup, at least not since Bush Senior espoused it and got laughed out of office in 1992.  Let’s try to use each of these words once a week, in its original meaning.

The Seven Deadly Sins—Pride, Anger, Envy, Greed, Gluttony, Lust, and Sloth, get a surprising amount of attention on the History Channel, of which I am a late-night aficionado. lists 10,638 “results” for a search of “Seven Deadly Sins.”  What none of these respectable sources do, as nearly as I can tell, is approach the subject without irony.  Who am I to blame them, when my college roommates and I spent most of our sophomore year devising ways to commit all seven of the deadly sins within 24 hours? (Needless to say, Sloth was the deal-breaker.) Face it, we like sin.  We admire it.  Let’s try to use each of these words, without irony, at least once a week.

Let’s try to use the words “sin,” “vice,” and “virtue” in some context other than diet and exercise, at least once a week.  And then tell us all how other people respond and how you feel about doing it.


The More Things Change…

July 5, 2009

Mr. Wired and I are spending a lazy summer Sunday afternoon listening to NPR, while Krista Tippett interviews an expert on children’s play, who tells us, wonder of wonders, that play is good for children.  Mr. Wired finds it annoying that Stuart Brown, the expert in question, is claiming credit for this discovery, when it was a commonplace while we were growing up.

Actually, it was a commonplace long before that. Froebel, the first official child psychologist, coined the phrase “Play is the child’s work” in the early 1800s.  Two hundred years earlier, John Commenius said some of the same things.  And Huizinga’s Homo Ludens, which quotes both of them, was published when Mr. Wired and I were in grade school.

That bothers Mr. Wired more than it bothers me.  Yes, it’s true that academic scholarship is supposed to be dedicated to giving credit where credit is due, rather than claiming three-hundred-year-old ideas as one’s own.  The rabbinic tradition says, BTW, that teaching something in the name of the person from whom one learned it hastens the redemption of the world.  I take this seriously, to the point where I publish all my blogging under Talmudic copyright—use my stuff as much as you like, just mention my name (or at least one of my pseudonyms) when you do.

But these days, we don’t want to know where good ideas came from originally.  The people who promulgate good ideas now want to be able to claim credit for them, at least if the only other contenders are safely dead or in the public domain and therefore not likely to sue.  If a scholar can’t take credit for passing on somebody else’s good idea, s/he won’t bother publishing it in the first place.  [In the case of the value of children’s play, that means a lot of young first-time parents won’t have access to that useful information and their children will be stuck in preschool 8 hours a day, without recess, learning their letters and colors and shapes beginning at age 3 and then popped in front of a TV set for the rest of the day.]  Scholarly ego, in short, serves the same sort of evolutionary purpose as the peacock’s display plumage, or the self-interest of Adam Smith’s pin manufacturer.  By allowing the scholar to promote himself, we allow him to promote ideas we all need to hear about.  Okay, we have a copy of Homo Ludens somewhere on our shelves, left over from my grad school years.  Our neighbors upstairs, raising a four-year-old and a toddler, don’t.  They need to hear these ideas somewhere. Their kids need them to hear those ideas even more.  Feeding a pseudo-scholar’s fraudulent ego is a small price to pay for that.

Jane Grey