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2005 – Page 4 – Life as an Extreme Sport
Life as an Extreme Sport

The Daily: Health Care ‘Miracle’

As I have mentioned, briefly, I am writing an opinion column for The Daily this quarter. It’s good experience for me; it gives me a chance to hit weekly deadlines and see immediate results for making those deadlines. It also forces me to stretch my thinking and writing, and work within word limit boundaries.

It’s also an important career move. Bioethicists commonly write for local papers, either doing op-ed’s, or running series. In fact, many of the people I’ll be working with next year have long-running series with various major newspapers around the country. One of my favourite souls, Greg Pence, who’s down at the University of Alabama, collected his newspaper opinion columns into a book recently. I believe Jon Moreno (University of Virginia) might have done similar. And of course, Art Caplan (UPenn) is one of the most prolific writers in the industry. So, this is good for me; I’m building a portfolio, and hopefully will be able to convince the campus paper folks at SUNY-A to allow me to continue the fun.

But enough digression and set-up. This is the link to my first story, which I’m also including here. In the future, I’ll publish my stories in this blog a week after they print.

Health care ‘Miracle’
Publish Date: 2006-03-28

A quarter of Americans have either no health coverage, or very lousy coverage.

For years now, doctors have complained that people without access to preventative care have been flooding emergency rooms for basic health care, clogging the system when emergent cases actually do arrive.

And what’s the solution to this growing medical crisis or low or no coverage? Why, reality television, of course.

The television station that likes to promote itself as producing reality TV with heart, ABC, has brought us a new show, Miracle Workers, which airs Monday nights at 10 p.m.

According to the show’s Web site, every week Miracle Workers features two people “who do not have the network, access to the necessary medical community or in some cases the resources” to the needed medical procedures.

So far, the show has featured surgery to restore a blind man’s sight, several spinal surgeries, electrical stimulation therapy to treat Tourette’s Syndrome, and laser-guided hip replacement surgery.

But what might be worse than what the show features is what the show implies — that the only sexy and exciting medicine is the medicine that occurs on the frontiers: that which is not available to everyone, but only those blessed with fairy godparents masquerading as ABC executives.

According to professor Rick Carlson of the UW School of Public Health, we have spent $15 trillion on health care in the last 10 years. That’s $1.5 trillion a year, still resulting in a full quarter of our population without adequate health coverage. Yet, we still have people turning to the benevolent producers at ABC in order to receive necessary medical treatment.

Of course, medicine is a business, as is television.

Obviously it was assumed these were two great ideas that would work even better together. But when medicine begins competing with television to provide medical services to people in need, the only clear conclusion we can draw is that reform is necessary.

The next time you need to see the doctor, or have some surgery or other medical procedure done, ask yourself whether or not you’re pretty, sexy, compelling or charismatic enough to be picked out of a flood of applicants to receive that necessary care. And if not, what’s your back-up plan? Are you willing to play the one-in-four odds of not getting coverage?

Carlson notes that “real reforms must ask very different questions about our values, and our goals and aspirations.”

So we need to ask ourselves: do we want medical care to continue becoming a theatre of entertainment, something you should be lucky to receive? Or do we want to step up to the plate, take that $1.5 trillion a year, and guarantee at least a basic level of care for everyone?

It’s our call – how do you feel about those odds?

To Affect and Be Affected

Have you ever poked a sea anemone? It’s open and fluttering its little tendrils in the brackish water, and then suddenly and without any warning, this stick comes out of nowhere, jabbing into its soft, fleshy bits. The anemone reacts, without thinking – it curls in on itself, pulling tight and protective. After a while, it might send out a few questioning tentacles at a time, searching and seeing if it’s safe again. And when it’s determined that it is safe, it will unfurl again, until the next stick descends.

This is affect at its simplest, an emotive, embodied response to stimulus. It is “the modifications of the body by which the power of acting of the body itself is increased, diminished, helped or hindered, together with the ideas of these modifications.”1 That is to say, according to Baruch Spinoza, affect is the sum of our drives, our motivations, feelings, and emotions. But it is not just a mental construct; there is a physicality to affect. Our emotions exist within our body; as we have them we react instinctively–to pain and pleasure and their derivatives. There is a dynamic engagement of the body; these reactions race across our bodies prior to our experiencing the feeling related to the emotion. This can be most clearly seen in the lower-ordered vertebrates and invertebrates, which have emotional responses to pain, such as the anemone removing itself from a painful stimulus. Does this then mean that the anemone has a feeling?2 No, most likely not. It does, however, suggest the evolutionary advantage to the development of feelings; feelings became motivations to encourage the doing of things good for the emotions (and what was good for the emotions was good for the genes, and so on).

Brian Massumi says that affect is relationality, not a self having feelings but a distinctive being in and of the world. This notion of affect gives us a phenomenological perspective3 on the connections that exist between us that is grounded in the body itself. To paraphrase Maurice Merleau-Ponty, it allows us to embrace the space between us not as that which separates us from the world, but to be the medium that binds us together.4 Affect becomes a reverberative process of perception and engagement, where the sea anemone acts on the environment as much as the environment acts on the sea anemone.

Affect. To affect and be affected. To touch and be touched. To produce a change in something, while a change can concurrently happen in yourself. There is often an attempt to isolate affect as a manifestation of the self, something that is internally regulated. Antonio Damasio says that

You can look at Picasso’s Guernica as intensely as you wish, for as long as you wish, and as emotionally as you wish, but nothing will happen to the painting itself. Your thoughts about it change, of course, but the object remains intact…In the case of feeling, the object itself can be changed radically.

He is saying that because the origin of feeling is internal to the mind, rather than external, the body can act directly upon that perception of feeling. And while this is undoubtedly true, the scenario he describes leaves out one situation, which is that of a person looking intently at another person. That object, the person, is not the static object of a painting, but another moving, breathing, perceiving being, and your own body of perception can act upon them, and they upon you. Affect, then, becomes a part of that interplay, that give and take that exists between us, and binds us to one another.

Affect, then, represents the whole modification of a person, both mentally and physically. It is “not a personal feeling, nor is it a characteristic; it is the effectuation of a power…that throws the self into upheaval and makes it real.”5 Affect is the unsplit mind and body, which are a functional whole too often split in an effort to scrutinize separately, to believe one disjointed from the other. But they are not separate parts resting together to create a functional being, but, paraphrasing Spinoza, are parallel aspects of the same substance. And as mind/body are not separate, but instead a being made whole by affect, that being is not isolated, and that which imparts a change in an individual being will impart change in another, through the medium that connects beings, through the beings themselves–the order and the connection of being and beings.

Sea anemones can live alone, but most often they live grouped together in clusters. When you poke one anemone, it acts and reacts, folding in on itself for protection. And if you watch carefully, you’ll notice that the anemones around it, while perhaps not folding in as dramatically as the poked anemone, will retract their tendrils in reaction, as well.

Dualing

My star students have written dualing and completely opposing papers this week. I really want to set them in a room together and say “argue it out”, just to see what would come of it; however, I suspect one would be irritated with me for doing that, and the other…oh wait, already is irritated with me. Nevermind.

Still, it’s interesting to see two bright minds taking one story in completely different directions. Can we experience and interpret events of the past in the context of the past, or are we always stuck with our judgments of the present when looking past?

A Failure to Thrive

I ran into two former Hum 102 students today, one at lunch at the other on my way home from work. They both wanted to know if I’d be teaching with Phillip in the spring; I told them that, as far as I knew, I would be assisting with Phillip and Giorgia’s class. Both students lit up with huge smiles and told me that was just what they wanted to hear, and they were going to figure out how to get in my section for the class, because they really wanted to spend another quarter working with me.

I’ve been thinking about teaching again, these last two or three days. Tomorrow is my last small group of the quarter. I have one more focus group, one more presentation, one more movie, and then that’s it. It’ll just be papers and a grade and goodbye. It’s a weird time of the quarter to be in, when you’re busy thinking about next quarter and syllabi and aren’t here as much as you should be. I think part of that is just distancing yourself; you get invested in the class, and then it has to end, and it’s never fun to have something you’ve invested so much of yourself in just…dissipate.

I think, in retrospect, it’s why it tickles me so much to hear someone use an idea I taught months, a year, later. Because it tells me that my effort did something; the structure of the class might have dissipated, but there was a lasting impact, somewhere. Even if it’s just a small one.

I haven’t felt very successful as any sort of instructor this quarter. Really, when it comes down to it, I haven’t felt very successful much at all this quarter. To hear, from two separate people at two separate times, that they valued their time spent with me so much they wanted to do it again, was a quiet affirmation that although things might not have gone as well as I would have hoped this quarter, I am not a failure, and my efforts are both valued, and appreciated.