Hip-pocrates And Me

October 24, 2013

tagWhen you have hip trouble due to the normal arthritis of advancing years (as opposed to a collision or other violent trauma), no doctor is going to tell you, “My advice is to have a Total Hip Replacement.” They won’t let you defer the decision to somebody else, not even an authority figure wearing a lab coat. What you get instead is, “When your hip adversely affects your quality of life, that’s when you should consider a THR.”

I’ve suffered from intense discomfort – it didn’t actually rise to pain unless I stepped on a cobblestone wrong with my right leg – since spending a month in Phoenix with my father-in-law after his wife passed away four years ago. Each day I squeezed into and out of her little car for two short trips. By the time I got back home, my right hip had started aching – and it never really stopped.

After I postponed a trip to the chiropractor for about a year (hey: I’m a guy), x-rays revealed that both my hips were arthritic, and, in fact, the left one was technically even worse. But because I hadn’t been using it to corkscrew into a car seat, I never felt any discomfort on the left side, and I still don’t. What, doc, I need a new hip? “When your hip adversely affects your quality of life…”

My malady was intermittent. Some days going up a flight of stairs was agony. (Anybody who’s ever ridden New York express-line subways will immediately apprehend my problem.) Some days I’d limp noticeably, other times I looked just fine. My quality of life sure as hell deteriorated, but it was gradual, like that frog in the slowly heating pan. I could still walk a long way, but not as fast as everybody else. I couldn’t sprint or stop on a dime; no more tennis. I had to use a “recumbent” bike at the gym to keep the load off my hip. I haven’t attempted a golf swing since this thing really got serious, but just the thought of it brings on some imaginary owies. I can’t take a stress test on a treadmill because I can’t walk fast enough to rev my ticker. (The solution is a “nuclear” IV that races your heart while you’re just lying there, which is far creepier than being winded fair and square.)

Finally I gathered up the courage to ask my friend Josh Chasin, who’d just had a successful THR, for the name of his surgeon. I checked with my own M.D., Jeff Buckner, and a few other health care people I knew, and all thumbs were raised. Not only was Dr. Amar Ranawat one of the leading sawbones around (his pop and brother are also in the family business), but the Hospital for Special Surgery was about the top place in the country to host the procedure. So I found myself in his office with a few staff on September 9, after undergoing a battery of preliminary x-rays and tests. I kept waiting for somebody to say you can’t do it because of your blahblahosis, but everybody kept staring at me. Dr. Ranawat said, “You might think you just wasted four years suffering. You didn’t. That’s what gave you the guts to come in today. But first, you had to decide that you’d finally had enough.” He sent me to his scheduler, who would not let me leave the office until we set a date. I’ve heard this is SOP for crybabies like me. I bluffed: “I have to check with my wife.” She called: “What’s her number? Let’s do it right now.” When I walked out (without checking), I was on the docket for Tuesday, October 15.

Thus began a full month of utter scared-shitlessness.

First, I’m squeamish to a significant but not quite neurotic degree. I have never, ever, ever wanted to be a doctor: can’t take the ick. Several physicians are among the finest people I’ve ever known: caustic, playful, tolerant, skeptical – you guys (and gals) take that vital profession and enjoy; enjoy. But now we’re talking about cutting on me? This would be my very first time under the knife: I’ve never so much as broken a bone. It would be lots easier if, oh, I’d smashed my hip in Woodstock riding bitch behind Bob Dylan; then it wouldn’t be up to me. But no, I’m bringing this on myself, by choice. As they say, there’s no such thing as “minor surgery” when it’s on you. I guess it requires a smidge of fortitude, but bravery? That’s the infantryman in Walter Reed who charged into a free-fire zone because his captain told him to and is still fighting for his life nine months later. All I could summon up for “bravery” was to resist the operating-table urge to blubber like Daffy Duck. (“Is this it, Doc?…I think I see <kaff, kaff> that old wagon comin <kaff> round the bend…”)

As with all things, the anticipation is far worse than the actuality. Dread wins every time. Creators of horror stories and movies have been dining out on this phenomenon for years: the less you show, the more the audience will fill in for itself, and who knows what gruesome little beasties live inside those innocent psyches. Let them invent their own terrors. To you this was just some routine hip surgery; to me it was time for the Five Stages Of Grief, beginning with Denial: as long as it was still September, I had nuthin to worry about! Then Father Time dragged his raggedy ass into October, and a week out from renewed hipness I went over to HSS and spent most of the day there. I took a class on what to expect and how to rehab, got blood work and an EKG, and met Dr. Joseph Markenson, the on-site M.D. who would be looking out for me. When I left the Doc’s office, it had become real real. Three days later I had to take one last stress test, and when that failed to wave it away, there was nothing else between me and the slab.

You have to show up three hours before surgery, so you can (a) fill out a shitload of admission forms and (b) lie around in a hospital gown on a gurney, waiting for this or that person to deliver their own personal forms and ask you the same questions over and over. Even at the world’s greatest medical centers, the various departments don’t coordinate with each other, and there’s no Permanent Record like your grade-school teachers threatened you with (well, mine did). I presume the thinking is to get it right by redundancy and eliminate the possibility of a data-entry error that sticks around (though see Pastoral Care below). Before my orientation class, the teacher had asked me to list all the prescription drugs I was taking, the dosage, frequency, etc. I had brought the info as instructed and transferred it to a sheet of paper. She left and came back with 10 photocopies. “You’re going to need these. Make sure you take them everywhere.” It was the single best piece of advice I got. Sure enough, every sumbitch I saw, beginning with Dr. Markenson that day and ending with a gas-passer while I was lying on the gurney a week later, asked me for a list of my scrips. From my point of view, why not just enter them into The System? Accuracy through redundancy. (We’ll pass over the possibility that I myself might have made a data-entry error on that handwritten sheet so as not to frighten ourselves any further.)

Have you heard stories about mistaken operations on the wrong hip? At HSS, that’s impossible – at least, I can’t come up with a scenario in which it happens by accident. First, you get an ID band which goes on the opposite wrist from the operating area and never comes off till you’re back home. You have to state the name and birthdate on that band from memory before anybody will do anything for you. (That’s mine in the photo up top, instants after I grabbed a pair of scissors from my beloved desk drawer and liberated the frackin mammajamma from my wrist.) Second, the parade of people with clipboards each asks you exactly what you’re here for (after glomming hisser own personal copy of your page of scrips), along with an identical list of health history questions – the anesthesiologist needs his, the pharmacist needs his, the surgeon needs his, etc. Finally the great man comes in to wish you well, and signs the correct surgical location with a Sharpie. To foil this system, Al Qaeda would have to sneak in, cut the ID band and clip a phony copy onto the other wrist, stain off the Sharpie and replace it with a perfect forgery, re-prep the wrong side, and never be seen by the dietician who’s been standing there this whole time waiting to get another goddam health history and page of scrips. And all the terrorists would have for this prodigious effort is a USA patriot who limps on the left side.

Those pre-op hours were the most nerve-wracking of all. By now I just wanted to get it over with. I’d invented a Zen thought to help me through recovery: when I wake up after surgery, I’ve already started healing. Om, right? Fortunately I had my trusty Kindle and a really lightweight, easily interruptible book, the Johnny Carson revenge tell-all by his former lawyer Henry Bushkin. I finished it in-hospital and moved on to my first post-film reading of David Mitchell’s CLOUD ATLAS. Avid readers make their own sort of anesthetic; within moments we can render ourselves oblivious. A medicine for monotony.

Finally came high noon. Actually, about four o‘clock; I’d been on-site since high noon and on-slab (comfy, with my Kindle) since maybe two. No more clipboards, just a gang of big burly masked men who rolled me through the halls. This trip is almost a relief, but they know you’re still scared. I said, “Too late to back out now?” One puckish guy said, “You have about thirty seconds, but I wouldn’t make the surgeon mad right now.” The point-of-view seemed like Rock Hudson’s in SECONDS; that’s how shallow I am. (I wanted some fuzzy focus and goofy zooms, as if Al Qaeda had drugged me after sabotaging my surgery.) Now into the operating room itself, and enough lights to perform “Swanee.”

A veteran colonoscopy patient, I knew this would be my last memory of the actual procedure. As is my custom, I asked the anesthesiologist for “the full monty,” s’il vous plaît. He said, “think of a really nice place.” Annnd…cut.

# # # # #

Weirdest thing? When you wake up, it doesn’t hurt. Second weirdest thing? It doesn’t hurt because you’re doped out of your mind. Linda had planned to come visit me at about 8:30 (they call your loved one directly afterwards to tell them the surgery went fine), which would have been perfect, but a bureaucratic blood-test snafu held up the start time. So I was still in Oz when she got there. I remember waking up, lying on my non-operated side, looking at a chair, and mumbling to the docs. I must have fallen asleep again, because Linda appeared in the chair, POP!, like a Méliès effect. I spoke to the ghostly figure. I remember cogent sentences being formed in my mind, but even I couldn’t understand the gibberish coming out of my mouth. “I’ve already started healing” might turn into “I red sharty hee.” G’night, honey!

bedEverything up to now, everything that really counted, had been buttoned-down and by the book. Everybody had been superb. But now that we’d crossed a certain summit of physical danger and were headed downhill again, the place reverted, in some aspects, to the clutter and bustle of a normal hospital, complete with tardiness, dietetic errors and lots of mole-whacking by the overworked staff. I only found out upon leaving that the upcoming weekend would be one of HSS’s infrequent “Surgical Saturdays,” devised to let patients complete their work weeks. The in- and outflow at the dropoff point was amazing, like Grand Central. The orderly who helped me out said, “your bed was filled again in about thirty seconds.” The place was packed, and would remain so through the weekend. That explained a lot of confused service, and a constant shuffling of personnel: “my night nurse” might not still be mine by the end of her shift.

My teacher at the orientation said she’d been in this line of work for thirty years, and back then, THR patients stayed in the hospital for a whole month. I spent three nights there, and the third was my choice; I wanted just a little more physical therapy practice before I went home. As I was enjoying my final lunch, a nice woman from Pastoral Care came in and said she was sorry for the mistake because I had requested some spiritual care and they’d just gotten to it now. I said, (1) I didn’t request any spiritual care, and (2) anyhow, another nice lady with a clipboard bearing the same erroneous info had come to visit the previous day. Somebody must have made a data entry error, and two different departments got the same wild goose to chase. I’m going to call that progress.

I came home last Friday, almost a week ago, and began the process of rehab. And that is the point on the road to recovery where I’m sitting right now.


Inside The Pubble

September 30, 2013

CruzLast week, in the well of the United States Senate, a man began talking, he announced, on the subject of freedom, specifically the Patient Protection and Affordable Care Act, popularly known as “Obamacare.” He said he intended to keep talking for as long as he could stand, which was the first lie of his speech: Senate Majority Leader Harry Reid had already scheduled a vote for debate on the bill in question the next afternoon, whether the orator was finished or not. The speechmaker likened Obamacare to life in Nazi Germany and the Bataan Death March; attacked members of his own party as Chamberlain-like appeasers, a “surrender caucus”; quoted author Ayn Rand, actor Ashton Kutcher, country singer Toby Keith, and the father of conservative broadcaster Rush Limbaugh; shared how much he enjoyed White Castle hamburgers; imitated Darth Vader; and read an entire children’s book, Dr. Seuss’s GREEN EGGS & HAM, to his young daughters, since he couldn’t read it to them in person because he was otherwise engaged in delivering this puzzling address. More than 21 hours later, he finally relinquished the podium, declining Leader Reid’s offer of an additional hour in which to dig his bizarre hole just a bit deeper. The garish display wasn’t even a true filibuster, since the babbler was only forestalling debate on a piece of legislation he didn’t like, but when the time came at last, he switched the position he had been putatively arguing and the action was carried on a unanimous voice vote, officially recorded as 100-0. This whole maniacal publicity stunt had been an utter and abject waste of time, a fleabag circus sullying what was once considered the world’s greatest deliberative body, where ten or so supportive members in attendance were reduced to a group of groundlings forced to binge-watch The Ted Cruz Show.

The Texas senator, who had been in office for only nine months, frequently complained about how Obamacare was harming the economy, costing jobs, destroying freedom. An amazing swath of destruction, that, considering that the core provisions of the law hadn’t even gone into effect; the part that did simply allowed young people to remain covered by their parents’ health care plans until age 26. Americans will be able to sign up for health care “exchanges” beginning tomorrow, and they can receive services under Obamacare starting on Jan. 1, 2014. Furthermore, this learned solon rose to demand that other Senators stand with him to either defund Obamacare – a law duly passed by Congress and affirmed by the Supreme Court – or refuse to pass a budget at all, thus shutting down the entire federal government, an action that would not only destroy jobs (800,000 immediate furloughs), but also delay or eliminate payments to millions more, including soldiers and retirees. His marathon rant was nominally before a Senate controlled by Democrats: even if they decided to pass such a measure – fully as improbable as replicating cold fusion – it would then be up to President Obama to decide whether or not to gut his most significant legislative achievement, one that will finally bring health care to millions of uninsured Americans. A veto would be all but certain, a simple layup for the Hoopster-In-Chief. Even Sen. Cruz’s silly choice of literature, GREEN EGGS & HAM, was baffling: the whole point of the story is that you shouldn’t criticize something new before you’ve even tried it! But irony escapes this Harvard Law graduate and Princeton debating champion. To call Ted Cruz’s excruciating performance “Quixotic” is to insult Cervantes.

As expected, the Senate amended the budget bill after first restoring funding for Obamacare (specifically, a 2.3% surcharge on medical equipment intended to help finance the program) and sent it back to the House, with these words from Leader Reid: “Here’s a president who less than a year ago won the election by five million votes, five million votes. Obamacare has been the law for four years. Why don’t they get a life and talk about something else? People deserve better.” House Republicans originally demanded the following “concessions” (the list is incomplete because more demands were constantly being added) in exchange for permitting the government to continue functioning past midnight tonight: increase oil drilling on federal lands, roll back regulations on greenhouse gases, construct the Keystone XL oil pipeline immediately, defund the Consumer Financial Protection Bureau, make it more difficult to sue for medical malpractice, and one last item: postpone the Obamacare rollout by one year. It’s a colicky tantrum from an infant, or maybe a ransom note from hapless C-movie gangsters: nice country you got here…be a real shame if something happened to it. Barring an eleventh-hour miracle, some federal kneecaps are going to get broken on the same day Obamacare exchanges (the ones controlled by individual states, that is) begin accepting members. This from the party that lost the 2012 elections, except for its intractable gerrymandered majority in the House – which, as we will see, actually represents fewer voters than does the “minority.”

Are these people crazy? It’s as if they actually want the country to fall back into recession!

Where did this topsy-turvy world come from, a land where the defeated minority in a democracy can grip the nation by the throat and seriously threaten to reverse its limping recovery from the worst recession in half a century? Why would anyone who truly cares for our country even consider doing damage like that? In fairness, Sen. John McCain (R-AZ), no friend to health care reform, did seize the Senate floor to denounce the Cruz debacle – it only took him ten minutes – but by then the Texan’s tired tonsils were already, incredibly, being lionized by his party’s extreme right wing, the daffy tri-cornered-hat crowd, starting with a fawning interview on Limbaugh’s own radio show.

What in the name of the Founding Fathers is going on?

Despite all propaganda to the contrary, America is not a right-wing nation. An interesting piece by Elizabeth Drew in the New York Review of Books doesn’t really cover any new ground regarding what she calls the Republican “stranglehold on our politics,” but it sure does connect lots of dots. In her view, Pubs have paid better attention to elections in off-years (the next midterm election’s only a year from now; usually about half as many voters turn out than in Presidential years, but nearly all the fanatics do, giving them outsized influence through apathy) and at the state and local level (there will be 36 governorships at stake next year, several of them in key swing states whose guvs, as Pubs have long understood, control everything else). But when more people are more engaged, it suddenly doesn’t look so hot. Republicans have lost the popular vote in five of the last six Presidential elections; the sole exception was 2004, when Dick Cheney played the fear card so clumsily that he nearly gave up the game. “If we make the wrong choice,” he warned, “then the danger is that we’ll get hit again – that we’ll be hit in a way that will be devastating from the standpoint of the United States.” In other words, vote for me or die. That’s desperation, friends. The Republicans are the party of rich white men and those it can persuade to help them become richer. Its base is already outnumbered, and it’s getting weaker every year as the Reaper continues to chip away at the diehards. (Hard they may be, but they die nonetheless.) The GOP’s natural hegemony is over.

Now, if you can no longer win elections on the issues, you have two simple alternatives: rig the game so you can’t lose, or if that’s too tough (as in statewide races), then prevent your opponents from voting. The right wing has found ways to do both, and their methods are based in what was formerly progressive territory: the grass roots.

Ms. Drew points out that though President Obama won the 2012 election with 51.1% of the vote, due to redistricting in key states after the 2010 census (you may recall that Tom DeLay in Texas couldn’t even wait that long to redraw his state and add five shoo-in Republican seats to the delegation; he did this just before the 2004 election), House Republicans represent only 47.5% of the 2012 electorate. The Democratic “minority” represents 48.8%. Put another way, well over a million more Americans elected Democratic House members in 2012 than voted for victorious Republicans. But the current Congress is 234-201 Republican.

Four examples of gerrymandered Congressional districts. Computer analysis has this sort of election-fixing down to a science.

Four examples of gerrymandered Congressional districts. Computer analysis has this sort of election-fixing down to a science.

How in the world does that work? Let’s look with Ms. Drew at Ohio, a state the President won with 51% of the vote. Because of redistricting – heck, let’s call it by its proper name, gerrymandering, or deliberately (1) lumping likeminded voters together, no matter where they live, or (2) splitting the enemy among several districts, a bit of power dilution known as “cracking,” which, for example, has emasculated “liberal” Columbus – today’s Ohio House delegation is three-quarters Republican. It doesn’t represent the general Ohio electorate at all, only the guys who did the redistricting. Now, in fairness, both parties press their advantage through gerrymandering. There are some funky-looking districts in Maryland, for example, that were drawn up by Democrats. But if this “false equivalency” – an argument that claims it’s OK because the other guys act exactly the same, featured nightly on Faux News – were genuine, we’d have a more closely divided Congress. The fact is, Pubs have simply been better at this for at least twenty years. It’s not equivalent. They’ve gamed the system. But, as we will see, they should have been careful what they wished for, because they got it. (In code for evangelical Christians: I’m saying thou hath reaped the whirlwind.)

The other significant tactic which keeps a minority in power is voter suppression. Whenever you see the term “voter ID law,” you’re looking at a baby step toward the heinous poll-tax laws which threatened true freedom for most of the 20th century. Pubs will tell you that they’re trying to defeat the scourge of rampant “voter fraud,” a malady they’ve never been able to demonstrate. That’s their moral cover for what’s turned out to be a 21st-century version of Jim Crow – only this time, it includes those seditious traitors, college students. In our ole pal Texas, for example, a gun license is acceptable ID for voting, but not a student ID, presumably because gun owners tip Pub, and college kids think too much. The law went into effect instants after the Supreme Court recently invalidated the critical portion of the 1965 Voting Rights Act, the one that made partisan horseshit like this subject to prior federal approval in the several states with long histories of voter suppression.

Why not show ID at the polls? You have to do it for almost anything else: to get a bank loan, to get a driver’s license, etc. But what about people who don’t have bank loans, credit cards, driver’s licenses, or any kind of photo ID? What about voters who are temporarily away from home because they’re in college, or who don’t have the means to drive across town, or who live out in the country? What about people who can’t afford photo IDs? Wait: they get to vote too? We can’t have that: poor people tend to vote for the only folks who know they’re alive! Yet simply having lawfully voted in every election since LBJ isn’t enough these days. Pennsylvania House Majority Leader Mike Turzai (R-Allegheny) ticked off part of a laundry list before a group of Pubs in summer 2012: “Voter ID, which is gonna allow Governor Romney to win the state of Pennsylvania, done.” (Fun fact: The President won Pennsylvania, 52% to 47%, but he had to fight uphill over voter ID, not to mention rich-guy super-PACs.)

What would a Pub America really look like? To observe a conservative wonderland first-hand, a place where the right-wing id is suddenly leading a joyous ideological slamdance, to see what unfettered Teabag rule would actually produce, simply turn to poor North Carolina. Once it was the jewel of the Deep South, its Research Triangle a glittering star that attracted bright people from around the world. As Ms. Drew recounts, President Obama won the state in 2008. But the Pubs took over the legislature in the decennial year of 2010 (immediately redistricting the state in their favor) and the governorship in 2012, attaining unassailable “supermajorities” that could pass anything they liked without even consulting the other side. Now they wasted no time in cutting unemployment insurance and tax credits for low-income workers, banning Sharia law (whew, just in time!), restricting abortion and voting rights (their war on student voting borders on the laughable, but it’s the frickin state law), and transforming a once beautiful state into North Pubistan in only three years. Nancy McFarlane, the horrified mayor of Raleigh, could barely get a sentence out: “It’s hard to get people to understand the impact of what they’re doing is going to be.” Thinking people are going to think twice about moving to the Tarheel State, and there goes your Research Triangle. Sorry, Ms. Mayor.

Why would well-intentioned people subscribe to such madness? It’s because they talk to each other, and only to each other. They live in a different world, a right-wing echo chamber, the Republican bubble: the Pubble. Ms. Drew cites the tumultuous 1994 midterms, which restored Pub House control after forty years and handed Prof. Newt Gingrich the tiller, but I would suggest an earlier flash point: 1987, when the Reagan-era FCC repealed the Fairness Doctrine, which held that opposing views should be granted equal time on the public airwaves. In that instant, baldly partisan broadcasting, immune to any “equivalency” whatsoever, was born. Anybody in radio will tell you that Rush Limbaugh saved the AM dial when he went on the air in 1988, and back then there probably was a progressive bias in mass media. (Although news organizations did strive for objectivity.) But Limbaugh’s immediate sensational success spawned dozens of radio imitators, and, in 1996, the Fox News Channel on television. Nowadays “the liberal media” is a fictional construct that preserves conservatives’ ability to paint themselves as victims, or to “work the refs” so that actual news organizations fall all over themselves to present the right-wing point of view even when they know the earth is more than six thousand years old and that man did not coexist with dinosaurs. El Rushbo is still the hottest thing on radio, and Fox News tops the cable ratings. When I lived in Georgia in the early Seventies, I loved Atlanta’s WRNG, “Ring Radio,” which was 24-hour call-ins; the station would entertain me during long drives. Their best “jock” was a guy named Neal Boortz, a Colbert-like improvver, you loved his quick mind. Post-Rushbo, Boortz re-invented himself as a conservative raver, and now he’s a syndicated big-shot; his verbal effluvia sometimes make their way to THE DAILY SHOW. Based on long stints spent inside Boortz’s radio-expressed mind, I know this particular guy is now only acting, but he heard the trumpets sound. If anything, the loudest megaphone these days belongs to the conservative media.

I used to think that Roger Ailes, Bill O’Reilly, Glenn Beck, Sean Hannity, Megyn Kelly and the others were, like Boortz, just entertainers, performers; they couldn’t possibly believe half the stuff they were spouting. But now I honestly wonder. The Pubble is opaque and soundproof. Barack Obama is the worst president in history, a Kenya-born socialist who hates America. If government would just get out of the way, the invisible hand of the market would regulate itself – except for the military, which merits ever-rising budgets. America is the greatest country in the world in all respects, and those who don’t think so should leave. Other nations hate us because we’re so free. Poverty is caused by laziness, and people lounge on their welfare payments rather than looking for work — but raising the minimum wage to subsistence level will destroy small businesses. Immigrants are stealing our jobs. Evolution and climate change are only theories, therefore we should disregard them. Health care is a privilege for those who can afford it. Any limitation on a private citizen’s firearms will turn us into a police state. CEOs deserve to make hundreds of times what their employees do because of competition for top talent. Tax cuts stimulate growth; spending dampens it. We should keep our hands off the big banks: they know what they’re doing. This is and always has been a Christian nation, with instructions for righteous living found in the Bible. The Israelis are freedom fighters; the Palestinians are terrorists. The government should lay off our personal liberties, unless it involves abortion or our sex lives. There is, of course, an opposing view on each of these issues, but inside the Pubble it’s all received wisdom.

Nothing illustrated the Pubble’s sturdiness more starkly than Election Night 2012. I have a friend in Mississippi who had laid in a nice bottle of champagne to celebrate Mitt Romney’s victory, and he wasn’t alone. Though statistician Nate Silver had been warning for weeks that the President was likely to earn re-election, the Pubble dismissed it as rubbish from the “liberal media.” The greatest moment of the night was watching an exasperated Karl Rove, once the Sultan of Stats, dispute the numbers coming in from his own network, Fox News Channel. To her credit Megyn Kelly, the anchor, defended her statisticians, at one point even acknowledging the Pubble’s existence. “Is this just math that you do as a Republican to make yourself feel better,” she asked Rove, “or is this real?” The Pubble was flabbergasted, like Pauline Kael in 1972: she only knew one person who’d voted for Nixon! Rove’s confused bluster provided welcome schadenfreude for those who remembered the catastrophic Bush years. (A few days later he had the gall to blame voter suppression, but by then nobody was listening, because his American Crossroads Super PAC had infamously blown through $100 million that we know of on the 2012 election cycle, only to lose 10 of its 13 targeted races. Oh yeah, and the White House too.)

If you don’t think there’s room inside the Pubble for racism – “we’re not racists, we just think Obama is un-American!” – consider the amount of disrespect and sheer hate this President has been forced to endure, more than any other in my lifetime, more than Bill Clinton, more than Dubya. After all, nobody screamed “YOU LIE!” at 42 or 43 during a speech to a joint session, like the oafish Rep. Joe Wilson (R-SC). Nobody held up huge signs saying WHAT PLAN? like the pathologically dim Rep. Louie Gohmert (R-TX). You don’t see others angrily pointing fingers in POTUS’s face like Gov. Jan Brewer (R-AZ). And just consider what happened when someone observed that Sen. Cruz was not born in this country, but in Calgary, Alberta, Canada, to a Cuban father and American mother. The Constitution states that a Presidential candidate must be “native-born,” but it doesn’t define the term. Cruz’s response? My mother was American, therefore I am too, and by the way, I’m renouncing my Canadian citizenship. The accompanying sound? Crickets. Now compare that to the President, who actually is native-born, also to an American mother, but was still being visited by annoying unhinged “birthers” well into his second term. What could possibly account for the difference? When Senate Minority Leader Mitch McConnell said, just after the 2008 election, “The single most important thing we want to achieve is for President Obama to be a one-term president,” he was acknowledging that there was something wrong that needed to be set aright, and inside the Pubble the dog-whistle message was quite clear. Of course the legislative minority is expected to loyally oppose the majority – but to call deposing Obama “the single most important thing”? Jobs? Infrastructure? Health? Here, now, was the Pubble’s ultimate Other, that literal dark force that threatened the American way of life. We will now, McConnell said, foreshorten his presidency by denying him any achievement whatsoever, and Pubs have done their worst ever since to do just that: the current 113th Congress is on track to be the least productive in recent history. That’s why such events as the passage of Obamacare and the killing of Osama bin Laden — any achievements at all — are so disturbing inside the Pubble.

The “Tea Party” was nowhere to be seen when George W. Bush spent eight years busting the budget. It emerged almost instantly to bedevil the Obama administration. (I’m only half joking when I tag the origin of the Tea Party at about, oh, noonish on Jan. 20, 2009.) But a funny thing happened on the way to “liberty.” Egged on by Fox News and the rest of now-mighty conservative media, plus PACs and “think tanks” financed by the likes of the Koch brothers, the tri-cornered set crashed “town meetings” of legislators, following carefully scripted orders to assemble way down front so it would look like they represented the whole room, and thus, the whole country. Old pros like Dick Armey and Jim DeMint helped fan the flames and work the grassroots to produce actual candidates – the only surefire way to seize power. But they ran into an unintended consequence. They’d intended Tea Partiers to be rabble-rousers and not much else. But the radical right hunkered down deeper inside the Pubble, and before you knew it, the liberty baby was being thrown out with the freedom bathwater.

The Tea Party concluded that we had mistakenly elected a socialist Kenyan president not because Pub candidates were too conservative, but because they were not conservative enough. So you had the spectacle of thinking senators like Bob Bennett of Utah, as right-wing as they come but still earthbound, tossed over the side for Tea Party candidates, while others simply quit in disgust. That chilled Pub incumbents in both Houses: if you didn’t hew to the tri-corner gang’s extremism, if you didn’t keep the customer satisfied, even if you were in a district that was super-safe in any general election, you could still be “primaried” from the right! This wave of zealot candidates, and intensified zealotry among fearful incumbents, has had two deleterious effects.

First, it turned away reliable Pub Senatorial candidates, some of them incumbents, for the likes of Sharron Angle in Nevada (“People are really looking toward those Second Amendment remedies and saying my goodness, what can we do to turn this country around? I’ll tell you the first thing we need to do is take Harry Reid out!”), Christine O’Donnell in Delaware (“I am not a witch”), Richard Mourdock in Indiana (“Even when life begins in that horrible situation of rape, that…is something that God intended to happen”), and Todd Akin in Missouri (“From what I understand from doctors…if it’s a legitimate rape, the female body has ways to try to shut that whole thing down”). Each of these candidates proved too icky for the electorate, but each of the Senate seats they sought had been eminently winnable by more sensible Pub candidates. The wacko-birds simply threw those opportunities away, and thus potential control of the Senate for at least two election cycles.

Second, yo-yos like this actually started to win House races in districts so tightly gerrymandered that you could wear a tinfoil hat to your own fundraiser and feel right at home. John Boehner, the most ineffective Speaker of the House of modern times, has lost control over his caucus because so many of them are newly elected Tea-Party bombthrowers who see nothing wrong with bringing government to its knees, or failing to make good on obligations the country has already made (that’s what “raising the debt ceiling” means). They literally don’t know any better. Dr. Frankenstein’s monster has broken loose, and not even Dick Armey knows what to do now.

Why all the hue and cry, the garment-rending, the Cruz clowning, over Obamacare just this minute? Simple. It’s because inside the Pubble, folks never expected to be sitting here right now. Romney would stomp the Kenyan, Pubs would retake the Senate, and Anycare would be D.O.A. It’s not that Pubs actually fear the country will be wrecked by the ACA (a term many of them have now gone back to employing; ever since the President shrewdly embraced the term “Obamacare,” the “person-you-don’t-like-care” usage, which dates back to Hillary Clinton’s efforts twenty years ago, has lost most of its fizz). If that were so, then why not just let it happen and preside over the post-apocalypse? No, to the contrary: they’re afraid the country will like having affordable health care. This is why they continue kicking and screaming, now urging young people in TV spots to “burn your [nonexistent] health care cards” (isn’t that rich, Pubs invoking draft-card burning? Younger folk have noticed too) and doing everything possible to scuttle health care reform by any means necessary. They’re afraid it will work, that Big Medicine will be reined in just a tad, and universal health care will become yet another “entitlement” for the “takers.” They should be afraid.

Deep down in Karl Rove’s mind has to be a thought that would torture him to madness if he actually cared, and boy, I wish he really did. It’s this. If the fear-fueled Tea Party had never emerged, Republicans would have long since controlled the Senate, and today there would be no such thing as Obamacare – and, just possibly, as a little sweetener, no such thing as Senator Ted Cruz.

Ah, Senator Cruz. Back to our star of the moment. It doesn’t take an Ivy League degree to understand why he staged his narcissistic spectacle: he was only trying to attract cameras. (The biggest whopper of his entire blabathon came in Hour 18: “I would be perfectly happy if not a single story coming out of this mentioned my name.”) On March 6, Sen. Rand Paul (R-KY) unwound a 12-hour corker on unmanned drone strikes that actually stalled an Obama nomination – and people started taking him seriously as a Presidential candidate. Then, in June, Democratic Texas state senator Wendy Davis successfully ran out the clock on the legislative session with a 13-hour speech against an omnibus abortion bill – and unlike the two gentlemen, she was required by Texas law to remain on topic the whole time, and she could not be “spelled” for a break, as Cruz himself did for Paul. She became not only a statewide but a national sensation, and in a few days she’s expected to announce her candidacy for governor; if elected she would be the first woman, and first Democrat, to hold that position in twenty years. Well, Sen. Cruz thinks he is also fit for higher office. And that alone is why he embarked on his pathetic fauxlibuster. But, as with his tin-eared choice of Seussian morality lessons, he had no actual substance to offer, only windbaggery on which he even turned his back himself. He claims he’s “listening to the American people,” but all he can really hear are the people on his own Twitter feed. He’s affected nothing, proved nothing, and achieved nothing more than the winner of a beard-growing contest. It makes perverse sense that they love such a man inside the Pubble.

11/2/14: THE DAILY SHOW spent last week in Austin, Texas, a proudly progressive oasis in a very red state. One of their field pieces showed how Tom DeLay & company’s savage redistricting has disenfranchised, even nullified Austin. Here’s what happens when you live under Pub rule: Austin’s population of 885,000 is represented by no less than five Congressmen, four of which are not simply Pubs, but preening members of the party’s loony wing. Some of their districts, which each edge into different portions of Austin in order to dilute its Democratic vote, stretch for two hundred miles. Austin has been “cracked” down to the neighborhood level, so that it can be “represented” by wingnuts who don’t really represent it at all.


The June Surprise

June 28, 2012

I was all set to write the piece about the yapping dog having finally caught the car, because if the Supreme Court had struck down the Affordable Care Act, it would then fall to the Republican opposition to produce a solution to our looming healthcare crisis which would satisfy the Congress, the Prez, SCOTUS, and – jeez, I almost forgot – the public. “Obamacare” didn’t get that same chance because (1) most of its beneficial effects haven’t kicked in yet, and (2) the Dems did such a lousy job of explaining it to the American people. I think most Dems didn’t believe the President could actually pull it off. They know better now – I hope.

Reams of paper will be wasted on the reason Chief Justice Roberts decided to join the “liberal” [ha!] minority to produce another 5-4 decision, only very surprising this time. Could knowing what was about to happen be the reason Justice Scalia blew his top from the bench re Arizona?

Roe v. Wade galvanized the anti-abortion movement back in 1973. For massive conspiracy theorists, consider: Roberts deliberately joined the minority to give the Pubs a rallying cry for the fall elections! Nope, I’m not sayin’, but I’ll use the Faux News way out: “Some people believe…”

Of course, that’s fantasy. The efficacy of the ACA, as well as its repairable problems, will be revealed in the fullness of time. But right now, this is one achievement of President Obama’s that the Disloyal Opposition was unable to prevent.


Them’s Frightin’ Words!

May 15, 2011

You have to hand this to the right wing: they know how to reduce complex issues down to a sound bite or two. It takes gifted people like Frank Luntz, the pollster and best propagandist they have these days, to turn, say, “anti-abortion” into “pro-life,” “estate tax” into “death tax,” “oil drilling” into “energy exploration.” I’m starting to catch another meme, and I hope you’ll pay attention to see if it spreads. The word is “Mediscare,” and if it didn’t come from Luntz (whose 2007 book was subtitled, “It’s Not What You Say, It’s What People Hear”), I’ll bet he wishes it had.

This word is emerging because during the recent congressional recess, several firebrands went back home to meet a “town-hall” crowd of pitchfork-wielding Frankenstein-movie villagers. Turns out that lots of seniors don‘t like Rep. Paul Ryan’s Ayn-Randish plan to eviscerate Medicare for their descendants. In other words, they fear objectivism; what’s gonna happen when my kid needs care and can’t afford it? You got yours; screw your kid! is diminishing as a vote-winning response. In New York’s 26th congressional district, around red-meat Buffalo, Jane Corwin was supposed to win a May 24 special election (called because of the resignation of her fellow Republican, Chris Lee, the family-values paragon who fired out that shirtless photo on Craigslist) in a walk, but now it’s a dead heat between her and Democrat Kathy Hochul. Some feel the gap was zapped by Ms. Corwin’s steadfast support for Rep. Ryan’s scheme, and Ms. Hochul’s fiery opposition. It would be such an embarrassment to lose this seat – and such an ominous sign for 2012 – that Pubs have sent out big-shot worthies including Majority Leader Eric Cantor and Speaker John Boehner, who said in the district on May 9 that Democrats were trying to “steal this election.” (That’s Republican for “win a seat that we thought was in our back pocket.”) So they came up with this word, “Mediscare.”

The implication is that Democrats are using scare tactics to make seniors uneasy about Pub intentions for Medicare. (Seniors are actually treated most kindly, at least at the beginning, by Rep. Ryan; it’s the rest of the country, except maybe for insurance companies, that should be uneasy.) Hmmm…isn’t that exactly what Pubs did two years ago to inflame teabaggers and other gullibles against the Affordable Health Care Act? Remember “death panels” – another great sound bite? For a generation, they’ve tainted any attempt to rein in the insurance/pharmaceutical machine by tagging it as “[person you don’t like]care.” First it was Hillarycare. In Massachusetts, Romneycare. Baggers, I’ll make you the same deal that Bill Maher offers: I’ll stop calling you “teabaggers” when you stop calling it “Obamacare.”

I’ve seen the word “Mediscare” at least twice recently on the opinion pages of The Wall Street Journal, the staging area for most Pub-speak trial balloons. (That’s where Sarah Palin found the cool-sounding-to-her phrase “blood libel.” Maybe she regrets using the term by now, but I really doubt it.) In order to make it work, they’ll have to repeat it hundreds of times on Drudge and Fox News; I don’t see those media regularly, so for all I know they’re doing it already. The “lamestream media” (zing!) don’t matter in the slightest. Otherwise the Pubs won’t own it; it hasn’t been that long ago that they themselves were wailing about those death panels and pulling the plug on granny. Nope, it has to be turned around and directed at Democrats. Then, next summer, Pubs can head out to “town halls” and say, “Those stats and facts the other guy’s throwing out? Heck, that’s just Mediscare!”

The Republicans have read their Orwell. (Luntz offers this, um, Orwellian interpretation of the author’s essay “Politics and the English Language”: “To be ‘Orwellian’ is to speak with absolute clarity, to be succinct, to explain what the event is, to talk about what triggers something happening… and to do so without any pejorative whatsoever.”) “No Child Left Behind.” “The Clear Skies Act,” which weakened the “Clean Air Act.” The USA PATRIOT Act, a laboriously tortured acronym (“Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001” is its Sunday-go-to-meetin’ name). And their masterpiece, H.R. 2 in the current Congress, “Repealing the Job-Killing Health Care Law Act.” A bit much, Mr. Speaker? Naw, we aren’t renaming the bill because of some little dustup in Tucson! Let’s face it: Machete don’t text, and Pubs don’t do nuance.

5/25/11: The Democrat, Kathy Hochul, won the seat in New York’s 26th, 47 percent to 43 percent, with a Tea Party candidate taking 9 percent. The turnout was large for a special election, and exit polling showed the race turned almost entirely on Medicare. Total spending was more than $6 million, with Republicans spending the most. The 26th is one of only four districts in New York which voted for John McCain in 2008; the seat has been in Republican hands for four decades (Jack Kemp once held it). You can’t derive a national trend out of a special election in a single congressional district, but this result is going to have Frank Luntz, and his Democratic counterparts, thinking hard about next year.


It’s Time To Reconcile

February 27, 2010

The “health care summit” was every bit the useless exercise we all expected. Depending on your position, you saw what you wanted to see. But clearly, there’s no future in seeking compromise with the Pubs, who are too busy salivating over their chances in November to do anything positive. It’s time to pass health care reform the only way possible: through the reconciliation process.

Pubs and their fellow crawlers are already howling, because they know it’s possible – even easy. After all, that’s how they passed Dick Cheney’s two big tax cuts. Oops, I mean George W. Bush’s. Or maybe I don’t. They damn near got the Arctic National Wildlife Refuge okayed for oil drilling the same way: reconciliation, which smooths the way through the Senate and does away with the 60-vote requirement to cut off debate. But now they’re talking about how this process subverts the will of the people. Hey, dickweeds, you’re in the minority because of the will of the people! But, of course, there’s another principle involved here, an overriding tenet that supersedes everything: it’s OK if you’re a Republican.

Crushing deficits? “Reagan proved it: deficits don’t matter.” — Dick Cheney, and nobody could convince him otherwise, not with two wars being fought off the books with credit cards. But now they do matter, all of a sudden! IOKIYAR, dudes.

Signing statements? “A poke in the eye of the democratic process.” Yet the Cheney/Bush administration objected to more than 1,200 sections of legally passed statutes, more than twice as many as any previous administration. I don’t like this part of the bill, so I’m gonna ignore it, and you can just come and catch me, if you dare. Eyeoky-yar!

Recess appointments “in the dark of night”? Cheney/Bush made 167 recess appointments, including the U.S. ambassador to the United Nations, before Harry Reid finally stopped them in 2007 by keeping the Senate in continuous session. Before Reid stepped in, they were on their way to smashing Ronald Reagan’s dark-of-night tally of a record 243 recess appointments. Yet eyeoky-yar!

Former Sen. Bill Frist, a proud M.D., lectures us on the use of reconciliation for social issues like health care; he says it’s supposed to be for the budget only. (What does he think this whole thing’s about? – and by the way, hi there and eyeoky-yar, ANWR!) But he lost a load of credibility on the health care issue when he cruelly misdiagnosed Terri Schiavo after looking at a video tape, and sat on his hands while Tom DeLay continued twisting House arms in the literal “dark of night” for a bogus prescription-drug “benefit” that benefits nobody but Big Pharma. Sorry, Senator: I can’t hear you any more on the subject of health care. At least now you have no chance of becoming President, just as Ken Starr will never sit on the Supreme Court. Sometimes we have to be thankful for smaller things.

The Disloyal Opposition keeps saying they have a plan of their own, but they keep failing to produce it. All we heard on Thursday was that we need to “start over.” Well, I’ve listened to their excuses for “debate,” starring this absurd “death panel” falsehood that some sad, gullible people actually believe. By the way, “real Americans,” it’s impossible to be a “socialist” and a “fascist” at the same time, and we can’t take our government hands off your Medicare, because it’s the government-run single-payer program you say you despise!

Well, screw the Pubs. There’s no room to move. They don’t care. They’ve decided that it’s more politically expedient to just say no than actually go to work on a compromise. Let’s keep in mind that the Senate has already passed a health care bill. If the House were simply to approve it, health care reform would be enacted. But if the House sends something amended, then let’s get this passed through the reconciliation process. It’s too important. The plan’s not perfect, but half a loaf is better than none, and the longer we sit here sucking our thumbs, the worse our national problem’s going to get.

Sure, the Democrats are going to take a drubbing in the fall. But we already know what happens when Pubs are in charge: they have the equivalent of wild toga parties and put the Democrats on the defensive — because by the time voters get disgusted enough to throw them out, there’s no chance left to do anything but try and clean up the mess. That’s why Katrina-style incompetence actually helps conservatives: they can point to it and say, “See, we told you, government doesn’t work!”

It’s time to set the mess-cleaning mop aside for a moment and do something constructive: enact the most critically needed legislation since the civil rights era. If you think refraining from doing so is going to change fall Swift Boat-style campaign ads one whit, then you didn’t pay attention to the still-right-leaning Supreme Court’s recent ruling: “Corporations, start your engines!” There’ll never be a more propitious time, particularly if the tea-bagging backlash doesn’t pay any more thoughtful attention to this issue next year than it’s doing now. The moment will have passed — not only to our fiscal detriment, which ought to be enough, but also to our eternal shame as compassionate human beings.


How To Fix American Health Care, Only It Won’t Happen In A Million Years

September 4, 2009

In David Brooks’s Times column this morning, he recommends that President Obama read this clearly-stated essay in this month’s Atlantic. Now, I implore, you read it. I did earlier this week on a long plane flight, and it almost made me sob half a dozen times. When a patient is covered by Medicare, the layman author writes after a year’s worth of research into the system’s underbelly, he’s not the patient any more: Medicare is. This brilliant piece doesn’t just point fingers, it offers solutions. But they will require an upending of our entire system, and there are only a handful of members of Congress with the guts to do so: everybody else is in the pocket of Big Pharma and the hopelessly fouled insurance industry. What it will take is enough people who understand what needs to be done to rise up. Are there enough such people in America? We’ll see, but they face fierce, mean foes.


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