Retort

Sooner or later, in any discussion of health care reform (to the extent that screaming and fear-mongering can be gotten past and actual thoughts exchanged), the issue of tort reform is raised. On that subject I'm of two or more minds. Neither a student of the various proposals nor particularly well-versed on the veracity of claims and counter claims about tortophobia adding to costs of medical care, I can only speak based on personal experience. Which is why I'm multi-minded. I've seen good and bad. I don't think I altered my practice style to avoid malpractice suits, but I can see why people would.

The central issue is this: there's a difference between malpractice and adverse outcomes. Most certainly, the one leads to the other; but the other does not imply the one. Were that distinction properly made and encoded in the law, the rest of the issue would become moot. If malpractice suits were about bad care -- actual errors, poorly thought-out diagnoses or treatments, willful neglect of patient needs; that sort of stuff -- I'd have no problem with them.

I was raised among lawyers. I've lived in their dens, eaten their food, learned their language. I agree with their claim that malpractice suits have, over the years, led to improvement in care, institution of protective procedures. And I absolutely agree there are bad doctors out there; lazy, lacking in judgment, in it for the money. Drinkers, drug users. Representing an overwhelmingly small minority, they nevertheless give us all a bad name; they are the cause of and the justification for the worst views the public has of us.

But, unlike the guy struggling to fix my freezer as I sit and type this (peering occasionally at what he's doing: my home improvement skills have largely osmosed from such viewings), I dealt with soft stuff. Every freezer of this type is exactly the same; the wires, the machinery, the outcome if you plug x into y. Not so of us humanoids. (I'm not saying what he does is less important; we're having to get along without freezing tonic cubes for our G and T's [a trick I highly recommend to anyone so inclined]. Or, judging by his grunts and mutterings, any easier. Just more predictable.) If he makes the correct diagnosis and replaces the parts properly, the outcome is the same for the same problem, over and again, on every like freezer. I've had some sub-optimal outcomes, despite (take my word for it, okay?) doing everything right. Not often. Not, thankfully, catastrophic. But the possibility is always there.

I've been sued, and I've written about it. It's humiliating, frustrating, depressing, and anger-inducing. I'd say that's entirely because of my certainty that in no case was malpractice, as I understand the term, committed. On the other hand, had I ever done something (or failed to do something) in a way that fell into that category, the last thing I'd want to do would try to defend it on a witness stand, nor try to prevent the patient from being compensated. Patients need a mechanism by which they can be protected from errors, and their injuries redressed. What form that takes is a complicated subject. The current system, because it fails to separate bad outcome from errors in management, isn't the proper mechanism. It wasn't my intent, in writing this, to suggest solutions.

My point, at last, is that I don't think tort reform, per se, will have much impact on the total cost of health care. Reducing errors will. Addressing inefficiencies and variations in treatments among doctors will. To the extent that docs order tests to cover their legal asses, such behavior would be reduced, asses covered, if there were guidelines that indicated when such tests were medically necessary and when not. It's true that there were times, when deciding a course of action based on clinical judgment alone (diagnosing appendicitis without a CT scan or ultrasound is a perfect example; taking a patient with a rigid abdomen to the operating room without the delay of additional testing is another), that I felt a slight breeze on my backside. Many docs are unwilling to do it; partly out of fear, but partly, also, out of being trained in the era of judgment coming in pixels. I guess you can't legislate judgment, but guidelines would help.

And yet it seems there's no discussing it without raising the specter of rationing and death panels. When President Obama suggests that investigating what works would save lots of money and improve care, he's exactly right. That's where the big bucks are spent, and wasted. Addressing it would solve much, including the need for tort reform.

The political party who has argued for reducing Medicare since it began, whose most recent candidate ran on cutting it, has now, for pale political reasons, resorted to demagoging attempts to do just that, as fascist terror. Without diminishing service at all, huge amounts of money could be saved by doing exactly what Obama proposes. Surely there are a couple of Republican senators and representatives who know this. But, clearly, the resistance is not about effective reform. It's about politics, and defeating the party in power.

The public be damned.

Alternate Universe

Careful readers of this blog, those attuned to subtlety, may have sensed an occasional tendency to dip a toe, if ever so carefully, into political waters. My opinions, shrouded as they have been in gentle deference, may not have even been recognizable as such. Generally shy, and of the belief that I have no right to impose my thoughts on others, it will surely be agreed that I've never said anything unkind or provocative about politicians with whom I disagree.

I may have to speak up.

I begin with a question, a simple request for factual input: WHAT PLANET IS JOHN MCCAIN LIVING ON? HOW MUCH EFFLUVIUM OF BULLSHIT CAN ONE MAN SPEW BEFORE CHOKING ON IT? DOES HE REALLY THINK EVERYONE IS STUPID, OR IS IT JUST HIM???

Long have I admired politicians across the political spectrum for their ability to say one thing and do another, evidently free of embarrassment. It matters only which party is in power: complain about the other party's tactics until the power is reversed, then do exactly what it is you've been decrying. Without shame, without a second thought, without the need even to mumble something like, well, I realize I used to say "A" and now I'm saying "Z," but...

A pox on both parties. I'm partisan, but not above realizing that at the national level they're all a bunch of bullshitters. Still. It seems there must be some sort of line beyond which people couldn't cross without a grain of self-awareness pulling them back. Y'know: a point where it's so obvious they'd be unable to keep going, throat constricting involuntarily, words so ridiculous they'd be unutterable. Not so, evidently, with John McPOW.

So we have the spectacle, this week, of the economic meltdown. (Let's ignore the previously most obvious fact that everything he's been saying about Sarah Bush-in-Lipstick Palin has been proven false while he and she continue to say them). In response to the crisis, Barack Obama got together with several real heavyweight people -- past chairman of the Fed, previous Treasury Secretary, most successful investor on the planet, several others -- and calmly (okay not entirely without a political jab or two) presented a summary of reasons behind the crisis, and an approach to dealing with it. Called for bipartisan cooperation. John McNuts, on the other hand, got up and.... blamed the whole thing on Obama!!! He -- mister point man of the Keating Five -- claimed it was Obama who somehow represented everything that was wrong in Congress. His entire response was political attack, and at that, one entirely ungrounded in fact. Repeating, umpteenth, that Harold Raines is Obama's main economic advisor, among other demonstrably false notions. Disproven. No matter. John McCain, who's been in Congress since before the Constitution was written, whose actual economic advisor personally dismantled the regulations that were there to prevent such things as have happened, whose most visible (until a couple of days ago) surrogate on the economy was the CEO of HP who was fired after killing its market value but who nevertheless got a thirty million dollar severance package -- this guy actually stood up and said everything that has happened is entirely the fault of Barack Obama.

I mean, come ON!!!!

He didn't, of course, stop there. While choosing, rather than proposing anything serious, to spend the entire time blaming Obama, his campaign denounced Obama for "politicizing" the crisis. Complained about fundraising emails while sending out fundraising emails.

I know some conservatives. Even like some of them. Many are educated and thoughtful people: honest, generous (up to a point). So I'm quite sure that when the lights are off, bathed only in the holy light from their shrine to Ronald Reagan, some of them are cringing. He's lost it, they must think (in fact, before he was nominated, most of them thought he never had it.) Politicians distort, obfuscate, ignore facts. But really. McBush and Palin have crossed that line by so much that they're entirely untethered to Earth. Don't they even care? Evidently not. Nor, it seems, do their supporters, waving lipsticks in the air like lighters at a Dead concert.

I read a couple of articles recently that have helped me to understand. Here's one. It's touching. The other, if it's repeatable and accurate, really gets to the nub of the matter. Read it, and decide for yourself.

Delete "Elite," Tout de Suite

[Another weekend rant. But be of good cheer: it'll be my last. Also, I wrote it a while ago, so it's a little out of date. I'm emptying my drawers. As it were.]


Here is an opinion column that pretty much says what I've been thinking ever since Hillary Clinton's and John McCain's dismissal of the universal condemnation by economists of their gas tax holiday proposal. "Elitists," they called them. Them there 'lekshuals. Well, I've been thinking about it since she (unexpectedly), the wife of a president and daughter of the Seven Sisters, and McCain (expectedly), the son of admirals and duacentamillionaire by marriage, began trying to paint Barack Obama as an elitist. Naturally, the talking heads have taken up the cry. Just as it's assumed without scrutiny that John McCain is a wizard at foreign policy, pols promote the Obama/elitist meme as neogospel. The writer of the opinion piece said it well enough, but here's how I'd have put it:

FER GAWDS SAKE, PEOPLE!!! THE WORLD IS COMING APART AT THE SEAMS. WE'RE RUNNING OUT OF OIL, WE'RE MELTING, AND BEFORE WE'RE SWAMPED IN SEAWATER WE'LL MOST LIKELY DROWN IN DEBT. WAKE THE FUCK UP!! WE'VE TRIED IT WITH DUMB PEOPLE. ISN'T IT ABOUT TIME WE GAVE ANOTHER SHOT AT HAVING A SMART PERSON AS PRESIDENT??? NOW, WHEN OUR LIVES DEPEND ON IT??? SHOULDN'T IT BE A GOOD THING TO HAVE LEADERS WHO ARE WELL-EDUCATED AND CAPABLE OF A COMPLEX THOUGHT??? DON'T THE TIMES DEMAND AN A-STUDENT, FERCHRISSAKES? ISN'T THINKING BEYOND BUMPER-STICKER PHRASES EXACTLY WHAT WE NEED? WOULDN'T YOU LIKE OUR PRESIDENT TO BE THE SMARTEST PERSON IN THE ROOM, THE ELITE OF THE ELITE? ONE WHO LISTENS TO OTHER REALLY SMART PEOPLE, WHO ARE EXPERTS!!!??? WHAT THE HELL IS YOUR PROBLEM??? ARE YOU REALLY GONNA BUY THE CRAP THOSE IDIOTS ARE TRYING TO SELL YOU??? #%$$#@@%&?&RS!!!

Or something.

We seem to have come to a pass wherein people not only don't care about intelligence in our politicians but have elevated stupidity to some sort of golden ideal. C-student? Heck, we can do better than that! How about bottom of the class at a military academy? Voters, in numbers large enough to flip an election -- so it appears -- care more about "relating" to a candidate (whatever the heck that means!) than about what he or she says about the really difficult problems we face. Thus, the two-carbon-fragment test: who'd you rather have a beer shot with. I think it's a sort of a mind-melt, mentally checking out of the debate: it's just too damn hard to think about the important stuff, and too scary. Let's talk wives, flags, fist-bumps. Enter the stupid. Cling to it, one might say.

There's a paradox: we saw it in the reaction to Barack Obama's "bittergate." The very people whom Republicans want to characterize as insulted by Obama's remarks are those that they (Republican strategists) assume want the simplest answers in all spheres: the Bible is the inerrant and literal word of God. George Bush never made a mistake. Gay marriage is more important than energy policy. In decrying Obama's poorly phrased but easily contextualized words, they count on the very thing they pretend to dismiss. You gotta be pretty elitist to think like that! N'est-ce pas?

There's No Hope. Seriously. None.

[Yeah, it's another weekend rant. Don't know why I bother anymore.]


Maybe it's just me. Maybe things aren't as bad as I think they are. Perhaps a nine-trillion dollar debt isn't a threat to our country; maybe the rising cost and self-limited supply of oil doesn't bode ill. It could be that environmental degradation and global warming are just a bunch of hype; and, I suppose, our country is not facing the possibility of governmental gridlock and economic meltdown. Nor, it could be, is the war in Iraq leading us to self-destruction. I hope so. Because from where I sit, it's now or never.

I really thought people would get it. To me, it seemed tautological: eighty-plus percent of the people think the US is on the wrong track. Therefore, whatever direction they think it ought to take, the one thing everyone might agree on is that the politics of the last several decades isn't working. QED. If there's one kind of change behind which everyone could get, it's the way we elect people. Attack. Destroy. Make shit up. Focus on irrelevancies; distract from the important issues. Fear the impossible, ignore the actual. But no, it's clear I was wrong. Whomever we elect as our next president -- and likely the same is true for most of our congressional folk -- the decision will not turn on energy policy, the war, the unsustainability of our deficit spending. It will be about convincing the electorate (easily, it turns out) that one candidate is a closet terrorist; and/or that realigning our military priorities will amount to "waving the white flag" to al Queda, that someone wants to raise taxes (as opposed to what? Moneh from heaven?)

Barack Obama began his campaign by saying, among other important things, that he'd tell people what they need to hear, not what they want to hear. And, to a certain extent at least, he did. For a while. But he's finding out, big time, that that's not a winning strategy. People want to hear what they believe. Which, of course, fits perfectly with the fact that more than any other developed country, we are a nation of believers.

In comments on my rantings, people tell me to cool it. Why, they ask, do I get so upset about religion? Well, it seems pretty clear: the instinct for religious belief has slopped over into politics to the extent that it's made it impossible for us to face facts without magical thinking. Honestly, if people could keep their religious beliefs and their attendant make-believe separate from their ability to confront earthly truths, I'd have no problem with it. But to me, it's of a piece: magical thinking in the face of overwhelmingly difficult problems is the easy way out. It's the equivalent of the brain going into "tilt" mode. Fear of death, meaning of life? Sure. Do what it takes. Energy policy, economics, Iraq? Sorry. We need to look at them clear-eyed. If the magnitude of these problems isn't enough for people to stand up to the muck-meisters and say, NO, not now, not ever again, then it's over. Really. It's over. It's become apparent that the only way people might wise up and say it's time to elect people willing actually to confront problems is when those problems are so unignorable there's no longer any hope of fixing them.

The reason I've been so enamored of Barack Obama is that he seemed to be getting people to understand: what needs changing is not any particular policy (although they all need changing). What needs changing is the way we do politics. Young and old, left and right, people of all colors: if they could agree on anything, they ought to agree on that. Solutions, he seemed to be saying, will come from a gathering together of people of good intent from all points of view. The answers that we find will not be the verbatim policies of any candidate; those will only be a starting point, a set of priorities. It matters less what a candidate outlines in policy papers, than it does how he or she proposes to get there. But after the last few primaries, it's clear that voters haven't bought it. It's too complicated an idea; it doesn't fit on a bumper sticker. Even when the problems are so scary, old politics still works. The middle majority of voters really don't want to hear reality. They want politicians who give permission to look away. Scare and distract. Bait and switch. And if there's one thing we know about successful politicians -- McCain, Clinton, Gingrich, and their enablers, Limbaugh, O'Reilly, et al -- they're master baiters.

I'm convinced it ain't gonna happen. For this election, and so many more that it'll become impossible to reverse course, enough people will be influenced by the usual crap that they'll take us all down with them. Of that, I'm now sure. You see it in the polls, in what people say is important, the filthy ads and the reaction to them. The only thing I can't figure out is this: those purveyors of political porn; do they believe the shit they say and do, or are they the ultimate cynics? Tell people what they want to hear, because it still works. Take what they can get; rake it in while the getting's good; protect the status quo to make their pile and screw 'em all. And if that's who they are, could it be because they're convinced they'll still get raptured up, or is their religiosity just another gimmick, too: the megachurch of manipulation.

Everything's Fine

[Another weekend political rant. Go no further if you came here for surgery.]


Like John McCain, I'm not especially knowledgeable about the economy. Unlike him, evidently, I can think in a straight line. Nothing could be more obvious: George Bush has ruined the economy in ways so disastrous that the necessary fixes are, very possibly, politically undoable. But John McCain has already pledged to keep the faith (which is exactly what it is.) He's promised "no tax hikes." Since he'll be the next president, as the Democrats self-immolate and the electorate inevitably votes once again on fear of terrorism -- despite the fact that Bush's war, which McCain loves more than his traveling team of lobbyists, has made us less safe -- we're screwed.

In the comments on a previous post, we had a bit of a back and forth about the concept that lowering taxes increases government revenues; let's think about it some more. Following the logic to its extreme, eliminating all taxes should make revenue infinite. Can we agree that's not possible? Likewise, I'll concede that taxing at 100% would end all commerce and life as we know it. So it must be that for a given set of circumstances there's a "sweet spot." And it's also obvious that Bush hasn't found it any more than he found WMD in Iraq. (Help me out here: wasn't there a guy in recent memory who raised taxes, balanced the budget, and saw the economy roar forward?)

The current budget deficit is more than 400 billion. The forward costs of the war are estimated to be two to three TRILLION (by Joe Stiglitz -- whom I knew in college -- who won a Nobel Prize in economics, and whose methods and predictions have yet to be refuted, or even, far as I can tell, criticized.) We have sold our future to the Chinese and the Saudis, who own most of our debt, with payment due from our kids and our kids' kids. The value of the dollar is at an all-time low, oil at an all-time high. (George Bush, when running in 2000, decried the fact that under Clinton the price of oil had climbed to thirty bucks a barrel; said it was a shocking failure. It's approaching quadruple that now.) From another website: "The federal debt has increased 54 percent since President Bush took office, from approximately $5.6 trillion at the end of 2000 to an estimated $8.6 trillion at the end of 2006. By 2011, the President’s budget would increase the public debt to $11.8 trillion. (U.S. Department of the Treasury, Bureau of Public Debt)" Calling Bush's economic policy a failure is like comparing the tsunami of 2004 to a flooded basement. Housing. Banks. Jobs. Oil. "No tax hikes." McCain thinks he can scratch behind his earmarks and find the money to solve the problem. Straight talk, indeed.*

That the myth of tax cuts persists can only be explained by the efforts of those who are beyond danger -- i.e. rich enough -- to convince those who are fodder to buy into it. Or to look away. To inveigle people into focusing on abortion and gay marriage, and fear of terrorists, rather than on that which is actually destroying us. It's political prestidigitation: look at my left hand while I reach into your kids' pockets with my right. (And when I have all I need, screw you.) It works like a 600 hp, dual overhead cam, supercharged V-10. With cup holders.

Because religiously insane people flew into buildings and might do so again, we are willingly looking the other way at policies that most inarguably have made us less safe. Because of George Bush's idiotic response to the threat, we are more in debt, more dependent on the providers of oil who are the very basis for that threat, more unable to respond militarily if the need arose, are witnessing rising terrorism worldwide and the reconstitution of al Queda in the very place from which they directed the attack. But when scare comes to shitless, we vote for more of the same. Raise taxes to pay for the war and the troops coming home, and to reduce deficits and solidify the dollar? Heh. People would scream and run to emergency rooms (where, it seems, they'll be greeted with sympathy.) (If you go to that link, you must also go to this one -- the one that's mine.)

Democrats will be no less happy about indexing Social Security and Medicare than Republicans will be about raising taxes. But both will have to happen, and not very much in the future. Liberals won't like looking into safer nuclear power, and conservatives will deny there are problems with depending on and burning carbon. But they're both wrong. Democrats at least talk about the danger to our economy and our planet; Republicans see danger only when they look into caves (or into non-white faces.) Invading countries that have little or nothing to do with terrorism won't stop terrorism. Republicans don't want to hear that. To protect ourselves from attacks, we need both high-tech and low-tech intelligence gathering. Some Democrats would rather not hear that. (Although for most, myself included, it's only about doing it legally, with a little oversight, which ought not be all that big a hurdle, once George and his Dick are gone.)

So what's my point? This: we really are in existential trouble, but it has much less to do with guys in caves (other than the fact that they suckered us into slitting our own wrists) than it does with problems of our own making: economic, strategic, energetic, Constitutional. Because people don't want to hear it, and because politicians (with, I'd like to hope, some exceptions) are too cynical and weak to say it (they know that after thirty-five years of being fed bumper-sticker phrases, most people have stopped thinking), the chances of fixing it are slipping away. It's only if the electorate were to grow up, smarten up, and demand it that there's any hope at all. But the old guard of both parties, who have too much invested (quite literally) in the old ways are seeing to it that that hope is smothered in its crib, while the masses acquiesce: enablers, deniers, diggers of holes for their heads.

On the left, too many heads are in the clouds; on the right, in the sand. I'd rather be the former, because at least they are seeing the problems from up there. The modus operandi of the right is to believe that which is no longer -- nor ever was -- believable. Faith-based problem avoidance. If there's hope, I'm not seeing it any more.

*One of the more amazing things about our current state of mind is the ho-hum that people evince over deficits. Fifty years or so ago, Senator Everett Dirksen is famously said to have said "A billion here, a billion there.... pretty soon you're talking about real money." Today, nobody blinks at the idea of twelve billion a month spent on the war, deficits of hundreds of billions, or debt in the trillions. I guess we're overloaded; no doubt it's intentional. So it's useful once in a while to consider what a trillion dollars really is. Not that even such analogies really make it grokable, but here's a few: here, here, and here. Bush has been right about everything else, so when he says the economy is fine, I believe him. And so, evidently, does John McCain.

The Mendacity of Dumb

[Weekend rant to follow: my thoughts on the Tuesday primaries. Misery multiplies.]

Well, for a while there I actually allowed myself to think there was a chance things could change. I guess I was the stupid one. All along I've acknowledged that I could be kidding myself; but it felt good, really good, if only for a minute. Like a gentle touch under cool sheets. Until someone busted in and turned on the lights.

Living in the pacific-most and northwest-most corner of the Pacific Northwest, where the air is liberal and the coffee frothy, some might excuse me for thinking the idea of issue-based politics could take hold. Hanging with people who, like me, are information junkies and politically obsessed, I could even be forgiven for concluding that people were ready to reject the oldest and most Rovian ways of winning elections. Overlooking for a moment the reality that we are a nation of people who can't identify whole continents on maps, who can't list the three branches of government, who can't name the first president, I actually let myself imagine civil discourse and energetic attention to the important issues of our time -- now, finally, when it matters most. What an imbecile I am. You'd think the last person I'd delude would be me. (Yeah, like that's never happened before...)

I guess you can't blame Hillary for doing whatever it takes. Her campaign was floundering, and salvation was hanging there like rotten fruit on the lowest branch. Stating the obvious, she told herself it has always worked and is still there for the taking -- one man's call for the contrary to the contrary. So, like any smart politician -- and if nothing else, she's surely that -- she reached into the toilet of time and threw handsfull. He's not a Muslim.... far as I know. The phone at three a.m. Stuff that, while clearly false and fear-based (in what way, exactly, has she been "tested" to handle that call?) appeals to those who need short answers to long questions. You win elections by assuming the worst of us, not the best.

Now she claims both she and McCain have "crossed the Commander-in-Chief threshold." How, exactly? In the single most important military decision ever made, they were both wrong. Sleeping in the White House (on the other side of the bed from "the phone") is no more qualification, ipso facto, than is bleeding in the Hanoi Hilton. In fact McCain, who says his experiences have taught him what war is, not only agreed to the disaster but didn't speak up when he was told by the Army Chief of Staff that far more troops would be needed. Not until it was well past too late. Saying you're qualified doesn't make it so. Showing judgment when the chips are down might. I can see no objective measure by which Senator Clinton has a claim on the mantle more than Senator Obama. There just isn't one. But there is a reason the Constitution makes the Commander-in-Chief a civilian: he or she is supposed to be able think independently and separately from the military mind. One did. Two didn't.

Oil prices have more than tripled since Bush took office. The dollar is at an all-time low, and falling. Deficits -- and foreign ownership thereof -- are rising unsustainably. Yet people are convinced the over-riding issue is what happens at three a.m. in some imaginary scenario. The real danger, the very possible destruction of our economy from within -- which not only has more capacity to damage us than any terrorist, but is already under way, not imaginary at all -- gets no mention. We are treated like idiots. And like idiots we respond.

Yes, after these years of despair at what the old politics hath wrought, it turns out it still works, and, no doubt, always will, until we're entirely past the tipping point. And by then, waking up won't matter. Bullshit carries the day. So why the hell not? Other than the fact, of course, that Hillary Clinton has poisoned the pool and then drowned in it any hope of changing the political climate (not to mention any chance of a Democrat in the White House). So, great. She can fight like a Republican. Whoop-de-fricking-do. See ya around, America, it was nice knowing you. Show yourself out, if you don't mind. I need to sit here for awhile.

Pinning My Hopes...

[Here comes another weekend non-medical rant. This one is purely political.]

Might it really happen that Barack Obama wins the nomination and then loses the election for the lack of a lapel pin? Or a hand not over his heart? If the right wing bloggers and their oily machine (and even the "mainstream") have anything to say about it, he will. Throughout some parts of the political world, people are screaming about his pinless lapel. The horror!

Patriotism is no more about a lapel pin than love is about a charm bracelet. Or than support of our troops is about slapping a magnet on your car. In fact, when I think about the destruction to America's future and its ideals and laws that has been wreaked by the lapel-pin-wearing occupants of the West Wing of late, I'd propose the opposite relationship may well be true. There seems a smugness, a sense that as long as one wears the pin, any behavior is exempt from criticism: look at me, I'm a patriot. So sit the hell down and shut the hell up.

In choosing not to wear a lapel flag, I think Senator Obama is saying, "I'm not about short cuts and symbolism, which are so easy and so deceptive. I'm about saying what I mean and doing what I say, and letting that speak for me." Anyone can wear a pin and hope to hide behind it. Lapel pins are inexpensive, and not just in dollars. In the current climate, I find them a lot tainted and a little suspicious. And, mind you, I've gone to veterans' political rallies wearing my Purple Heart pin. Proudly.

Sometimes I've wished that he'd just poked one through that little hole and moved on. Why give the screamers a screed? But then I think how principled and brave it is to eschew a symbol that has been perverted and diluted and which, in its ubiquity among the slimiest of politicians, has become meaningless at best, and a perversion of patriotism at worst. Who'd want to accessorize like Tom Delay and Dick Cheney and Karl Rove? Or this guy. I think how utterly cynical, given the challenges that face the US, is the outrage of those who spread the smear, and how credulous in those who buy it. But on it rages. For a lot of voters -- maybe most -- it's easier to latch onto a spurious and simple-minded meme than to sink one's teeth into the meat of our problems. Rove knew that, and played it like a harp from hell.

What, in fact, is patriotism? Surely it's not as simple as what you wear. Is it love of country? I suppose it is; but what does that mean? What does it require, and how do you show it? Much as I admired JFK, when he said "Ask not what your country can do for you, ask what you can do for your country," I had questions. For whom is the government established, itself or us? Is it enough to work hard, follow the rules, educate yourself before you vote (and vote!), pay taxes, give to charities if you can afford it? Does the average person owe more? Obedience, acquiescence? Conversely, can you be considered a patriot if you render prisoners to other countries to be tortured? Is it patriotic to put the country trillions of dollars in debt and walk away, leaving it for others to fix? Wearing a lapel pin, it seems, absolves one of many sins. "Patriotism" has become just a concept with which to bludgeon one's rivals. Lightly it is that we use the word; empty it is of meaning. Like Yoda am I writing.

Barack Obama has been criticized for having too hopeful a vision of what's possible. But when he argues for a new kind of politics that brings people together over old divisions, when he says that the changes we need to restore viability require support from the bottom up (as opposed to the current top down, we're-in-charge-and-you're-not approach), it simply cannot be seen as the words of someone who doesn't love and want something good for his country, head in the clouds or not. Lapel pin or not.

To me, this is what's most attractive about Barack Obama: when he talks about "change" he's referring to exactly this kind of bullshit. He's asking (and, I'd aver, not just for his own sake) that people resoundingly reject politics that is all about fear and smear. The kind that, rather than discussing and trying to resolve the challenges we face, resorts to lies and innuendo to destroy a candidate. There is, I'd like to hope (and sometimes actually allow myself to believe-- oops, well, there it went again -- that was fast!) a huge portion of the country that's sick and tired of it. But the only (slim, very slim) chance that it could disappear is if the electorate stands up and demands it. By electing someone who specifically decries and overtly eschews it, and by unelecting those who don't. On both sides of the aisle. A pox on 'em all.

What if patriotism is redefined? What if we had a president who implored people to stay involved by letting their elected representatives know what they think, clearly and often? What if he said to the nation, "Now we need to address healthcare (or the deficit, or energy policy, or....) This is where I think we start, but we need legislators to come together. Whether you agree with my ideas or not, let your congressperson and senators know, demand they get to work. Email them; keep the pressure on them. They will respond to numbers, or risk losing their jobs." It's pretty simple, tapping out an email. But in that context, what could be more patriotic? What if people actually did it? Isn't that what Barack Obama is asking of us?

And as to the hand-over-heart thing: next time you're at a baseball game, look around during the Anthem. You'll see guys with hats on, beer in hand (bet they have "United We Stand" bumper stickers.) You'll also see people standing attentively, singing along with hats in hand and arms at their sides (that'd be me, doing the bass harmony). Bet those folks are all glad to be there and not in another country. Bet their devotion to country is a lot less than one running for President, risking it all.

How I Spent My Day

I went to an Obamarama today: he spoke in Seattle, at Key Arena, which is where concerts are held and where the Sonics play. Yesterday Hillary spoke to about five thousand people. Today when we arrived the line stretched for countless blocks; holding seventeen thousand, the place was filled and doors were closed while thousands of us remained in line. The media said it was three thousand who stayed to hear the speeches piped out to us; it looked like more, and it was after thousands left as soon as the news came that the place was full (it was cold and windy and a little rainy.)

Obama arrived after quite a wait, but when he did, he stopped before going in and addressed us lockedoutenfolk, which was thoughtful. In his speech he said all the things a candidate for whom I'd vote would have needed to say, and many others. It was worth the wait, even if I received some negative feedback from my bladder.

But here's the kicker: I'd been contacted recently by the woman who runs Washington Veterans for Obama. Turns out her father was in the Air Force in Vietnam at the same time I was, and was shot down, survived in the jungle and maintained radio contact for eleven days before he went silent, never to be heard from again. I remember hearing about it while I was there: we were waiting for word and possible rescue, but it never happened. She said they wanted some veterans on stage today, behind the Senator, and to call her when I was there; she might make it happen. So when we arrived I called her cellphone, but was only able to leave a message. I checked my phone a while later, and there was a voice mail: she had a VIP ticket waiting for me; I should leave the line and go right to the entrance.

By the time I got the message, it was too late.

Damn.