Had breakfast with Alan yesterday at the Lakeshore Cafe. Told him about the interesting failure of the bank we tried to create for the poorest of the poor. This was after a 1989 trip to Bogota where we spent a week with staff of the Fundacion Grupo Social.
This group, now a huge corporation, began with Jesuit inspired credit circles for citizens of barrio Jerusalem. In order to give small loans when these folks had no assets the Jesuits conceived of co-signing. If I wanted money to start a small business or build a home (a shack, really), you could co-sign as my guarantor. The default rate on these loans was minimal. Social cohesion is as good as a down payment. This was the start of the micro-credit idea.
We worked hard for a year to put together a Minnesota version, but a recession forced the bank that was working with us to withdraw their generous offer of two million dollars for capitalization.
Alan asked last week over breakfast what I’d done. When I told him a few things: West Bank Community Development Corporation work, Jobs Now, MICAH (Metropolitan Interfaith Affordable Housing Coalition), Minnesota Council of Non-Profits, I surprised myself by being eager to talk about it. Realized that with the exception of Kate and Jon a little bit, no one here in Colorado knew my Minnesota story, my second phase of family and work.
Life is so different here. No contacts. No friends of decades. Only a few places with memories, most tied to the grandkids.
The West has always been a place to start over for Americans from the humid east, guess I’m no exception. No expectations based on prior achievements or prior failures. A new person rising where the sun sets.
Debra came by yesterday with chicken, couscous, cucumber, and a swiss chard topping. We ate the meal with her. I’ve not seen Debra in some time, wanted to catch up. The mitzvah committee at CBE has gotten traction with the meals. Gratitude.
In other news. Trump still occupies the Whitehouse. I think occupies is a good word here, since it feels like an unfriendly invasion. With Boris Johnson becoming Britain’s Prime Minister, Trump will have competition for xenophobic, racist, generally clueless utterances. Must be that special relationship?
On the downward slope with the radiation. Twenty-four fractions given, eleven more to go. Since the bed bug incident moved my finish date to August seventh, I will now complete my treatment between the anniversaries of the atomic bombs: Hiroshima on August sixth and Nagasaki on August 9th.
Consider atomic bombs, nuclear tipped missiles, the “club” of nations with nuclear weapons, nuclear power plants generating electricity, axumin and other radio isotope scans, radiation treatments for cancer. Nuclear engineering has had a big impact on the world though its negatives often (usually?) overshadow its positives.
Malignant uses multiplied after WWII. Most nations tacitly agreed nuclear weapons should never be used again after the horrors of Japan, yet nuclear weapons themselves became the apex of military power. There are uneasy, even dangerous situations right now that involve nuclear weapons: North Korea, Iran, India/Pakistan. Those old enough to remember the Cold War know, too, that whenever relations with Russia sour, the world’s two largest nuclear arsenals have humanity ending power.
The peaceful uses of nuclear power seemed to hold a lot of promise. Nuclear power plants generate electricity without the burden of adding carbon emissions to the sky. Yet Chernobyl, Three Mile Island, and Fukushima proved that potential problems with nuclear power can become awful reality.
In my own opinion nuclear power should still be a part of the transition to renewable sources of energy. Nuclear power plants built with adequate safeguards can help move us beyond fossil fuels. Yes, there’s the question of nuclear waste, but it’s a solvable problem, at least in the short term. Nuclear power and renewables can be a bridge to a world where nuclear fusion is our dominant energy source.
The medical and industrial uses of nuclear engineering have proven themselves over the decades since WWII. I’m glowing proof of that.
Let’s see. Heat waves. Bad ones. The moon landing at 50. 50? And, of course, Send them back! Send them back! I really tried to stop it in the biggest way. Nobody could have tried to stop it harder. Nobody.
Consequential. Each of them. I still remember the first time I was in Phoenix. 107. Might have been August or September. Walking from the motel a few blocks to experience the heat I could feel the sidewalk through the soles of my shoes. The air was still.
Downtown Phoenix had several places that had misters, spraying a sheen of water out and over sidewalks, open air cafes. Fans aided the cooling effect. It was delicious. A revelation. But. It was still hot.
On a CME venture with Kate early in our marriage we went to Mexico City where Kate saw Rigoberta Menchu. Afterward we went to Oaxaca and Merida. We stayed at Casa de Balam, the House of the Leopard, in Merida. Our bodies have conditionings of which we are unaware until they are challenged.
It was hot. And, humid, unlike Phoenix. In the afternoon rain clouds gathered over Merida. Rain fell. And the heat and humidity got worse. It was like an open air steam bath. Rain washes away heat. After the rain comes a cool breeze, a sigh of relief. Nope. Not in Merida. Not that day. It shocked my body before I even realized what was odd.
Both of those times stick in my mind (plus that trek across Singapore’s Botanical Garden in 2016) as outliers, extreme situations occurring in places I visited infrequently. Now, Merida is coming to a city near you.
The moon landing. July 20, 1969. College was done. Judy and I had a small apartment in Muncie. It was hot. No AC. No misting water. Just sweat. I put aluminum foil on the rabbit ears of our tiny television, waved them through the air to find our best reception. The most complicated electric appliance in our apartment was my Selectric typewriter, the one with the ball.
We wore as little as possible. The moon was new that night, so the sky was starry. I remember the scratchy voice of Walter Cronkite saying something. The scene, like a set from a 1950’s sci fi movie, had a strange desolation, Buzz Aldrin would the call the moonscape, “Magnificent desolation.”
Cold beer. A joint. As night fell, we began to wonder if the astronauts would ever come out. The Eagle had landed at 3:17 pm and now it was nearing ten. Then, the hatch opened, a bulky white suit emerged and went slowly down the metal ladder. A human about to touch a surface other than earth’s. “One small step for a man, one giant step for mankind.” (btw: correct quote according to NASA and Armstrong.)
Our chests flew open, all of us, that night. We saw the unimaginable. We were alive when the first human walked on the moon. I was 22, drunk and stoned. But high, too. Up there. With Buzz and Neil.
No visa required. No passport control. No detention centers in the Sea of Tranquility.
Our current sadness. The smallness of the fearful white person. Fed by the orange would be Julius. On July 20, 1969, the federal government gave us a moment of wonder, of awe, a moment shared with the world. On the 50th anniversary of this remarkable human accomplishment this once great country now separates families at detention centers. Its President tells four U.S. citizens to go home. He encourages the cries of his base base, Send them back. Send them back.
And that heat. Study shows opening up Federal lands to oil and gas exploitation will increase climate change. Huh? Really? The administration has silenced scientific analysis, by government scientists, on the risks posed by climate change. Including the military, which sees climate change as a national security issue.
Oh to slide back into the wonder of the moon landing. To imagine a world where feats of human innovation still wow us. Where government fights racism instead of propogating it. That’s a backward look though. Let’s look forward instead. To a new, cooler time with awesome moments still ahead.
Another Yankee Doodle birthday. SeoAh turned 41. The U.S.A. 243. SeoAh’s birth culture is thousands of years old, as is Joe’s.
We’re such a baby from a historical perspective. Our relative youth is on display in every interaction we have with China, an ancient civilization like Korea and India that has lasted into the time of nation-states. One commentator I read a while back refers to China as a civilization state, rather than a nation state for that reason.
China engages the world as a regional hegemon, a role its held for most of its long history. It abuts so many different cultures, unlike the U.S. Vietnam, India, Myanmar, Bangladesh, the Himalayan kingdoms, the Stans, Russia, North Korea, even Japan if you see the South China Sea from China’s perspective. It does not share the great geopolitical advantage of the U.S., world ocean moats on both eastern and western borders.
The dynastic period of China, begun during the mostly lost in the mists Xia dynasty, only ended in the 20th century with the Qing ending in 1912. Thus, there are patterns and assumptions built into even the Chinese Communist party that reach far, far back in the Middle Kingdom’s political experience.
Among them is strategic patience, a trait sorely missing from U.S. foreign policy in the 21st century. The Chinese waited until its 99 year lease on Hong Kong was up, then reabsorbed this city-state. Not without difficulty, yes, but even the one country-two systems policy has Hong Kong, like Tibet, as an administrative district of the larger nation. They are also waiting to absorb Taiwan, sometimes patiently, sometimes not.
The world is big enough for China and the U.S. as regional hegemons, not big enough for either of us to dominate. China knows that. I’m not sure we do.
If I could have a birthday wish for the U.S.A., it would be a leavening of our foreign policy with the wisdom of history. Hard to pull off when our supreme leader doesn’t read, I know. We, as a citizenry, may have to exercise strategic patience with him and his followers. Trump and his base are not the vanguard of a revolution, rather they are equivalent of the village peasant in traditional societies.
They are defensive in posture, that’s what America First means. You only wish for America First if you believe we’re already somehow less than others. I don’t.
DJT and his cult hold onto economic givens long out of date. Manufacturing and its supply chain, though still crucial to our economy, we’re #2 in the world after, guess who, China, has been in steady decline as an employer since the 1990’s, continuing a long slide begun in the 1940’s. see this Wikipedia article. Tariff man reflects a belief that the U.S. is somehow getting screwed on a regular basis.
They hold onto social givens like fear of the other, affecting immigration, race, and gender identity. The unearned privilege of the white American male is still regarded among them, and their leader, as a privilege given by hard work and innovation, rather than a teetering social contract based on patriarchy and ruthless oppression of minorities.
This is a passing phase, often at its strongest when its proponents sense their weakness, perhaps for the first time. Strategic patience involves doing everything possible to align their national political influence with their actual minority status. It means working against the Proud Boy in the White House and for politicians existing in today’s world, not yesterday’s. It also means not succumbing to despair or nihilism.
That’s tough, I know, especially with the climate crisis literally breathing hot air on our necks. But one way to not succumb is to do what is possible politically while focusing on those local and state level initiatives that will position us later for strong climate action.
Standing with you all in this, our 243rd year of a grand national experiment: Can a nation be built on political values rather than culture?
The Radiation Moon will take me all the way to August 1st, within 5 days of the finish. The Algonquin’s called it the Thunder Moon. In the traditional Chinese calendar the July moon is the Ghost Moon. The Hungry Ghost festival follows in August, now the month of the Ghost Moon. Thundering ghosts radiating from the heavens. Or, hells.
Last radiation day this week. July 4th long weekend ahead. Breakfast with Alan at Dandelion.
Not sure what we’re going to do for the 4th although we have never gone to fireworks. Crowds and up too late. In Andover we could see the fireworks the city put on from our house. Later, we could hear the fireworks loving neighbors displaying what they’d found. Meanwhile the dogs would cower in their crates or up against our legs.
In the fire prone foothills fireworks displays are often called off. This would be the year for them, since the fire danger is much less than usual. The monsoon season is here already with afternoon storms. You’d think the added water would get the fire danger back down to low, but it’s been stuck at moderate for the last week.
Trump’s very big, biggest ever, best ever fourth of July celebration. With tanks! You can see his mind turning over television news clips of military parades in Hitler’s Germany, North Korea, Russia, even some European countries. Oh, boy. Look at us. Big missiles! Big tanks! Lots of soldiers! Flags. We’re patriotic. We love America. Enough to put on a big fancy beautiful wonderful moment. When will it ever end?
Yellow stains even on my keyboard. The stuff is everywhere, though the rain yesterday knocked yet more of it down, out of the air. I imagine that’s why my Lodgepole pollen allergy has been calmer this year.
A lot of intellectual heavy breathing going on right now. Examples: “The 2020 issue that matters is democracy itself” E.J.Dionne, Washington Post, July 1, 2019. “Do the Republicans Even Believe in Democracy Anymore?” Michael Tomasky, NYT, July 1, 2019. “Climate Change Is a Public Health Emergency, Medical Groups Warn“, Dana Najjar, Medscape, July 1, 2019. And so on.
There has been, over the last year, a rise in climate nihilists, ones that look at the data, especially the still rapidly rising carbon load in the atmosphere, and conclude that we have neither the tools, nor, most importantly, the will, to modulate carbon emissions.
Articles question the future of democracy. They point to Trump, Putin, Erdogan, Kim, and Viktor Orban of Hungary. They also point to the rise of the alt-right, Brexit and Boorish Johnson, the success of China’s centralized rule. The Washington Post had an article titled, “We’re in an anti-liberal moment. Liberals need better answers.” WP, June 21, 2019.*
Instead of Fukuyama’s The End of History, we have the end of democracy and the possible end of human civilization. A heady turn around from his credulous opinion that liberalism and capitalism had finished off the conflicts of the past.
While I have sympathy with the naysayers, even agree with some of their main conclusions, I’m reminded of those folks who’ve predicted the end of the world over the centuries. Always wrong. Why? Because the apocalypse is not monocausal. If this is the relative death of democracy, we can look back at history and know that even that reality will change. If the climate nihilists are right, adaptive technologies and now unknown human responses to an overheated environment ensure some will survive and thrive.
The black outlook surfacing in so many news sources, from so many intelligent people, reflects instead a general feeling that, as Wordsworth said,
The world is too much with us; late and soon, Getting and spending, we lay waste our powers;— Little we see in Nature that is ours; We have given our hearts away…
“The World is Too Much With Us” William Wordsworth
I’ve quoted some from the Washington Post article below because I believe it offers a solid anti-dote to despair. It underlines liberalism’s promise of a life lived with creative freedom, a sort of life that should be available to all. It also admits that liberalism has gotten too cozy with capitalism, evidenced by the so-true political cliche that both Republicans and Democratics are parties of and for corporate America.
As we near the fourth of July, I’m going with Emma Lazarus, with Scott Nearing, with Ram Dass, with Mary Oliver. Thomas Berry. Emma Goldman and Joe Hill. With Ruth and Gabe as they project our family into the maw of both strongman politics and radical climate change. None of this changes how much I love my family, how much I believe in human inventiveness, how much I care about politics and the Great Work.
*” …liberals in recent decades have spent most of their time focusing on the coexistence of different outlooks — promoting interdenominational peace, a public square in which religious and secular voices can both speak, and above all an emphasis on groups asserting their special identities — and forgetting to foster a sense of life well lived. Liberals have promoted group tolerance at the expense of self-cultivation. In the face of increasing criticism, however, liberals need to answer that they already champion a highest good: creative freedom…”
” Liberalism’s main problem is that its vision of a life well lived has been corrupted — not by too much license and self-expression, but by an overemphasis on economic freedom that has undercut its own promise.” We’re in an anti-liberal moment. Liberals need better answers.Washington Post, June 21, 2019
Leave in an hour for the mythical imaging services of Littleton Adventist. I’ll begin to believe in them when they put me on the slide and move me into the magnets. An unhappy yesterday. It had me reaching for distractions, not from the cancer, but from the American health care system.
I know it’s a cliche and I know the comparison is overblown, but I’m going to say it anyway. One of the three young women from Centura Health benefits said, when I asked to pay what my insurance company would have paid: “I don’t make the policy, I just abide by it.” Cindy and Vanessa, too. All of those I talked to except Amanda. I’m just following orders.
A fascinating book on the Holocaust dispelled the myth that the Germans who served as its agents were psychopaths or ideologues. No, they were just ordinary people who chose, over and over again, to do what they’d been told. These agents of denial are all following the arcane and often invisible dictats of bureaucracies built to serve themselves. In the case of United Health Care it’s about the bottom line. In the case of Medicare it’s about the rules. In both instances the clerks, the phone callers and phone answerers, the case managers, (I find myself wanting to put quotation marks around a lot of these words.), the administrators all sleep because they don’t make the policy, they just abide by it.
In neither case is the patient’s health the prime objective. The prime objective is what sustains the organization. You may say, what’s the alternative? I would say single payer health care. Why? Because in that situation it is the patient’s health that drives the system, it is the rule. Would it be perfect, without self-serving bureaucracy? No. Certainly not. But it would have as its raison d’etre the health of the country’s populace. That would make these frustrations much, much different. At least to me.
In the meantime we have a system that, not all the time, but frequently enough, puts people like me, desperate for some answers, in between dollars and health care. It also serves to dehumanize its agents who must again and again say, no, that’s not been approved. No, sorry, I don’t make policy, I just abide by it.
Health “benefits” from Centura called this morning. Hey, guess what? You know those scans? Not approved. What! Twice in two weeks? What’s going on?
In spite of being the patient, hereinafter to be known as the victim, of our health care system, I was having a hell of time accessing any of it.
I don’t like phones. I like to see the people I’m talking to, even if I know them. It’s a thing and I’ve had it for decades.
This morning, however, was a phone morning. I called United Health Care. Nothing had been submitted for approval. Say what? It’s the day before these scans which were ordered last Friday. Who submits these things for approval? The doctor.
Anova Healthcare. Amanda, the heroine of the morning, or good Amanda as I think of her now, answered. The Littleton office handles authorizations. OH, I thought. She’s going to make me call them. Nope. She called. Vanessa, who has responsibility for my case, would call me back. Amanda had talked to the manager of the authorization department. I assume the same one that failed to get my axumin scan through.
Anyhow, Vanessa never called. I got a call again from Centura where I learned of another authorization hurdle. It’s internal to New West Physicians and focuses on Medicare claims. Oh. AARP Secure Horizons, which Kate and I have, is a Medicare advantage plan administered by United Health Care. Apparently this is the first point of contact with potential payors.
Cindy answered. I’m sad and a little scared. Can you help me with this? The doctor ordering the test marked it as routine and Vanessa (bad Vanessa) only sent it to them yesterday at 3 pm. Oh, come on. The doctor had to change routine to urgent. Could you call the doctor? No, we usually don’t do that.
OK. Back on the phone. This time Amanda again. Answering machine. I told her what Cindy said. Amanda called me back in a short time. She’d already talked to Cindy. (Good Amanda) The bone scan is authorized. The CT is awaiting a decision. We’re half way there.
Here’s the thing though. All these phone calls, which took me all morning, were made by me, the victim. Ratcheting up my stress level each time. And, the result, which I sought all morning, was to get back to where I thought we were to begin with.
This left me with my head in my hands, talking to Kate at the dinner table, saying often, I don’t know. I really don’t know. A sort of ringing and head pressure came and went, my body trying to adjust itself to the feelings coursing through it.
I’m glad I’m not anxious, not much anyhow. But, I am stressed.
No scan. AARP Secure Horizons denied payment. When I asked how much it would be as a self pay. Pet scan, $2,600, axium dose somewhere between $1,000 and $3,000. Nope. And, I made the decision for the same reason AARP probably did. The scan’s accuracy is around 60% and that goes down the lower the PSA. My PSA is well above the reemergence marker of .2 at 1.3, but it’s still pretty low for imaging studies.
What makes me angry about this is that I scheduled this scan on April 25th. That’s twenty days ago. If they’d come up with these problems even last week, I’d have had a chance to call the insurance company and Dr. Eigner, Dr. Gilroy, see if something could be done; or, if it was clear no payment option existed, what new imaging studies I could have. Now I still have to do all that, but 20 days after I put this study on my calendar. Meanwhile those little cancer cells don’t care. They just go right on chasing immortality at the expense of my health.
I had an image yesterday of our health care, that is, doctors, nurses, labs, hospitals. The entire province of folks and structures who provide medical services. They’re all there, most of them competent, capable people who got into medicine to help people, to cure illness. Now. Imagine all of those people and their support behind a huge wall, a really huge wall, the best wall possible.
On this side of the wall, where you and I are, is the money used to pay everybody in medicine. If you are a one percenter, there’s a special gate you can walk through anytime you need it. You can access all of the excellent care that is available. If you’re the rest of us, no money passes through the wall unless several corporate, bureaucratic entities and individual people within them, say yes. Those entities include private, for-profit health insurance companies, medicare, medicaid, non-profit health insurance, banks, credit card companies.
According to this CNBC article, $3.4 trillion dollars pass from the money side of the wall to the health care delivery side of the wall each year. That’s $3.4 trillion. In this interesting nyt article, author Matt Bruenig makes a case for treating health insurance premiums that employees pay for company insurance plans as taxes. He makes this claim: “Moving from our system to a European-style system would make our overall system of taxes and health insurance payments much more progressive for the majority of Americans, because the elimination of private health premiums would more than offset the rise in formal taxes for all but the wealthy.”
Such a shift would eliminate all of the corporate gate-keepers who have an interest in profit for their company. Perhaps they could all go work for the TSA and use their previous employment experience to annoy the hell out of travelers.
Would such a change mean I get my scan? Not necessarily. There would still be assessments made about the appropriateness of particular care; but, those decisions would be made by people who have my health and the health of our medical system at heart, not the wallets of investors. In that case I’d trust a decision to withhold the scan as a considered one based on those criteria, not on what’s best for United Health Care’s bottom line.
Here is a cautionary tale about health care. On April 24th or 25th I scheduled my axumin scan for today. That’s twenty days ago. It’s purpose is to tell where my cancer reemergence is located and to help stage it. This after the rise in PSA caused consternation for both me and my urologist, Dr. Eigner. I was glad we could get it on the calendar so quickly.
Yesterday, after we got home from Dr. Gupta’s there were two messages on the phone. One was an “urgent” message from the hospital health benefits department. The double speak in the system unveiled itself when the “benefits” person told me they did not have approval for my scan. This is at 11:30 am the day before the scan. Eigner didn’t get the information to the insurance company in a timely fashion, they said. The insurance company, which claimed to have 72 hours to make a decision couldn’t make one in time.
I could come in today, they said, and sign a waiver for self-pay and await the decision or I could reschedule. If you recall, the axumin isotope is in limited production. The hospital only gets a dose once a week. There was no certainty about when I could reschedule either. They put me in a box by waiting until midday of the day before the scan. It’s possible the insurance company could deny it. It’s new, though not experimental.
Should I go in today, sign the waiver, and keep my appointment with the radiation oncologist on Friday? When I told Eigner my PSA rise, he said, “Get another PSA done and get into see me ASAP.” A post-prostatectomy rise in the PSA to .2 is a biochemical recurrence. That’s the clinical definition. Mine was at 1.3. Everyone I spoke with had a sense of urgency about this. That made me have one, too.
I’m going in, gonna sign the waiver. My concern level, for myself, is high. I’m distracted. An occasional feeling of dread passes through me, floats my stomach. It’s fear of the unknown. Though I’m not afraid to die, I’m not eager, either. In this case it seems that time matters. At least to me.
I did not need to worry about money, too. This problem cranked up my anxiety level by putting another weight on the scale. Not. Needed.