Says Who??

Verstehen, through shared perspectives


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WAR ON PHYSICIANS AND PATIENTS, CHAPTER 2

I wanted to believe that the State of Indiana, my new home, was a place where wise, knowledgeable heads prevailed; a place where lawmakers did not succumb to the pressures of being politically correct while morally wrong when lives were at stake. I have even twice used this blog space to compliment them on setting up a law regarding the prescribing of opioids that clearly recognized the difference between regulations and felonies, while protecting both patients and physicians.

I was wrong. The failed war on drugs has affected the State of Indiana as it has so many others, and opioid hysteria is prevailing over perspective in government circles. The law scheduled to become effective on December 31, 2014 will include limits on every form of opioid pain relief for chronic pain patients that are so restrictive as to completely ignore the uniqueness of every patient. Pain patients differ in their perspective of pain, in their experience of pain, their tolerance for pain, and their response to ANY treatment for pain—including opioids.

The treatment of chronic pain is not amenable to cookie-cutter protocols. Nor does it fit nicely into the “15 minute per patient” rule imposed as a necessity to satisfy insurance company/corporate bureaucracy requirements. It takes time, patience and extensive knowledge to successfully treat a patient with chronic pain and disability, to try to bring that patient back to some form of productive life. When this is not possible because of the extent of the disability, then the goal must be adjusted to simply making life bearable for the patient.

Indiana lawmakers once understood these facts. Now they seem to have abandoned reality and chosen to break their own law even before it takes effect. The law demands that physicians spend an almost impossible amount of time and effort being face to face with each patient before prescribing for them – yet lawmakers who never set eyes on these patients and who collectively have no medical license or even relevant training are prescribing what an allowable course of treatment can be for any pain patient. ANY pain patient, regardless of the cause of their pain, the disability it may cause, and the length of time the patient has suffered. Regardless of their tolerance for the treatment. Regardless of their response to treatment.

A physician notes:

“Regulatory overreach has a chilling effect by making prescribers fearful of jeopardizing their licenses.  This fear can result in physicians abandoning pain sufferers, even forcing some patients to seek black market medications or illicit drugs.  Such has been the unfortunate case in states that hastily passed burdensome pain regulations.  Heroin use in these states has increased dramatically as the supply of prescription pain medications has dwindled.” http://jamespmurphymd.com/2013/10/07/an-open-letter-to-the-medical-licensing-board-of-indiana/comment-page-1/#comment-1158

Just last week WHAS News (Louisville KY) reported that since the Kentucky Pain Law of 2012, Heroin overdoses rose from 3% to 40%. Heroin overdose EMS calls have risen a stunning 700%. All this, despite the fact that heroin trafficking arrests have risen 1300%. These statistics were attributed to the “unintended consequences” of the unrealistic, overly burdensome pain regulations.

Unintended consequences. Beautiful, bright college students found dead of heroin overdose. Physicians wrongly charged with felony prescribing, found dead by their own hands. Countless patients, deprived of their medications (many without even the option of being slowly weaned off of them) turning to suicide in their pain, or alternatively, to the criminal activity of street drugs.

And all we can say is “Oops! We did not intend for this to happen.” ???? Wake up, Indiana! Don’t willfully head down this same slippery slope!

The War on Drugs has failed. The War on Physicians and Patients is close to taking more lives than the Iraq war, and ruining just as many others. Simply passing harsher and more impossible laws is NOT going to help anyone. There is a better way.

Education is the better way. We have First Aid Certification, CPR, Lifeguard training and certification – so many lifesaving training programs for the general public as well as medical personnel. We need to add Basic training programs for the public on how to deal with drugs. We need Continuing Education programs for physicians and medical personnel on how to deal with opioids. Early education and continuing education can prevent deaths and disability from drug abuse, and help physicians to prescribe knowledgably. Alliances between physicians and pharmacists in drug management programs would make a huge difference in keeping legitimate patients and their caregivers safe.

Stay on the high road. Political power should be about making Americans safe, and so far the Wars on Drugs, Physicians and Patients have failed miserably in that regard. Please do not wait until that college student dead of heroin overdose is your child, or grandchild. Fight this battle WITH the physicians, not against them.


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I VOTED ALREADY

I live in a state where early voting is allowed, and easily accessible. People at the Polling station were friendly and relatively relaxed. No one was listening to, or reporting, early return results. There were no long lines, no waiting period at all. I was in and out in less than ten minutes, despite taking my time and mentally reviewing everything I could remember about the candidates. There were some names I did not recognize; fortunately they were either unopposed, or were running against people I did know about and intended to vote for.

Being an independent, I did not vote along party lines. I voted for the candidate that I truly believed would do the best job and in at least two cases, despite being very disappointed in them for letting me down by not doing what they had said they would do. Fortunately, it is not necessary for me to like a candidate in order to believe that they are at least a better choice, if not ideally suited in terms of my preferences.

When possible, I voted for candidates who did not indulge in mudslinging and blatant lies. I voted for candidates whose concerns have at least seemed to put the needs of their constituents and those of the country ahead of personal gain; at least, I did so when I could see some evidence that this might be true.

But we are a democracy, and we are also a polarized country. No matter who wins, almost half of the voters will feel defeated. If the past twenty or so years are any predictor for the future, this will result in more bitterness, more lies, and more attempts to discredit the winning candidate and his or her party regardless of what (or who) is destroyed in the process.

Two years down the road, when we have our next big election, will we have overcome this tendency? Or will self-service and greed have resulted in two more years of stalemate and wasted taxpayer funds on yet another do-nothing Congress?

Election day was once a day of renewed hope—a day when we could anticipate new ideas, new commitment to the nation, and the retirement of ideas that no longer work, along with their supporters.

Maybe I have just grown old and disillusioned. This time, I left the polling place being glad on the one hand that there was only one week to have to listen to the incessant whine of political ads telling me why I shouldn’t vote for an opponent, instead of why I should vote for the speaker. My phone calls may once again be from real people instead of computerized voices telling me who I should vote for.  On the other hand, I am not hoping for much from the new configuration of elected officials, so there was no reason to anticipate any long-term climate change in politics after the election.  Talk about mixed feelings!

But I voted. I voted responsibly and fairly. At least I can still do that.

As to the future, for once in my life I would be absolutely ecstatic to be proven wrong. Because if I am wrong, then there are good days ahead for the USA. I want so very much to be wrong.


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BLESSED ARE THE RICH????? NOT REALLY.

1587_landing_of_the_pilgrims_at_plymouth_-_color_versionThe mythology got mixed up with theology and became canonized byScene_at_the_Signing_of_the_Constitution_of_the_United_States our founding fathers somewhere between the 16th and 18th centuries. That didn’t make it Biblical, or even an unsacred truth, but somehow because of the nature of our patriotism and need to believe that those who “started” us were wonderful, upstanding people who got it all right, there are people today who still believe the lie. Mostly they are wealthy people. The same ones who believe that the beatitude “Blessed are the poor” ends right there. Look it up—there’s more. Because the “more” is also somewhat opaque for our understanding, I will leave that to those trained in exegesis. However, there is little doubt as to the nature of scriptural direction about wealth—in particular, excessive wealth.

For example, in the New Testament we read about the Rich Fool, who refused to help the beggar at his feet but instead tore down his barns to build bigger barns so that he could hoard more wealth. Wealth was not just money, then or now. It included material possessions like land, cattle, crops, and even family. His reward for such activity was to burn in Hell, pleading for a drop of water from the hands of the beggar he never helped, who was in heaven. (He was denied, by the way.) Sure, this is a just a parable; it is a story with a moral point– “Moral” being the key word.

Another story, this one repeated by eye witnesses, is about the rich young ruler who came to Jesus, claiming to have kept all the religious laws from his youth. He inquired “What must I do to be saved?” and Jesus replied “Give all that you have to the poor, and follow me.” The young man could have lived in America today, because he turned away sadly and left the followers of Jesus.

Maybe that is why scripture also tells us that it is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God. Old and New Testaments alike repeatedly tell us to take care of the poor, the widows, and the orphans, the sick and disabled. The commands are unequivocal: Don’t hoard wealth. Don’t succumb to greed.   Take care of those who are in need. Love your neighbor as you love yourself. What’s more, most religions have similar values and ethical concerns about matters of wealth, poverty, and human relationships.

For example, in many cultures one who would be holy must give up all material things as well as family and other relationships, wandering alone and without visible support in order to meet the requirements of holiness. In the Christian traditions, the closer one is to God, the more likely it is that one would join a holy order and renounce wealth and personal possessions. We have a long history of people defined as saints because they dedicated their lives to caring for others, rather than for themselves. Nowhere in anything I have ever read or experienced has anyone achieved sainthood by loving and caring only for themselves.

st francis

 So how did the Puritans—and our founding fathers—get it so wrong? What made them believe that being rich and powerful was a sign that they were truly better than others? Well first of all, they came from a country steeped in the mystique of the aristocracy. Even though they came here to found a new nation that would denounce the way of life they left behind (yes, our forefathers were rebels and immigrants!) there were some ideas deeply rooted in their zeitgeist, to which they still clung.

Reinforcing the belief that wealth and power signified a better race of human beings was the Calvinistic belief in predestination. Actually, the concept of predestination was not the problem. The problem entered AFTER these people were taught to believe that there was a heaven and a hell, and that God knew and had always known who was destined for each place–and the outcome could not be changed. The problem came to life because these folks needed to believe that they were among the chosen. After all that they had sacrificed, and all the difficulties they encountered in the new world, they needed to believe that there would be some post-death reward to make it worthwhile.

So, the Puritans were smart and lived well. They worked hard, saved for the future, and circulated their money in the community.   They prospered accordingly (see Max Weber’s Puritan Ethic and the Spirit of Capitalism for a classic sociological analysis of this phenomenon). And when they prospered they chose to believe, lacking evidence to the contrary, that they were among the Chosen. They prospered, therefore they believed that they were special, and that God was showing them that they were predestined for eternal life in His heaven.

This need to connect prosperity with God’s blessing returns again and again in our history. A few years ago the “prosperity gospel” gained in popularity with the promise that God would prosper those who followed Him according to the tenets of that particular line of interpretation. Followers of this belief system may still exist, but they are much quieter now. Louder are the voices of those who were disappointed by the lack of evidence that the purpose of Christian living is to gain wealth.

I believe that right now we are experiencing a far more malignant resurgence of the myth that the wealthy are superior beings, blessed by God (in those cases where they claim a belief in any God but money). Their belief not only justifies to them the dehumanization of the vast majority of the world who are not wealthy, but also the hoarding of wealth. Many of the latter—exemplified by the pre-Christmas Scrooge of Dickens fame—care for nothing more than wealth and power. scroogeLike Scrooge, they are quite literally insane with this addiction, justified by an ancient myth that has been repeatedly denounced by philosophers, poets, theologians and followers of holy writ from every religion. In their insanity, these believe they are doing the “right thing” to destroy all that has been good about our nation.

As it happens, I have met very few people of wealth and power who also were people of integrity. Some who began public service with honorable intentions to change the system from the inside soon succumbed to the seductive nature of wealth and power. But not all of them. There are a few truly fine people who hold positions of power, and who manage despite everything to remember the nature of wholesomeness, trust, and accountability.

Accountability is vitally important. I must be accountable to others if I am to be an ethical person. Moreover, alone I cannot effect  positive societal change. I can speak out, and I can join others who recognize our need to be free of the idea that our nation should be returned to a time when people believed that a few wealthy persons were of a superior race. But, unlike those of the present, the Puritans of our past usually knew that if you would prosper, you had to build up the people around you as well. The necessary recirculation of wealth and resources made communities stronger. They were accountable. There was no such lie as “trickle-down” economics.

The past is done. Today the idea of strength in numbers can still be applied: Together, we can reclaim the excellence in education, health, and industry that once made us strong. It is a new day, a new time, and the ways and means of doing this have changed. But the values that built our nation have not. Those values are timeless.people-holding-hands-th

How many times are we going to have to renounce the mythology that the rich are superior beings, blessed by God and destined for a heaven populated only by their “own kind?” Probably again, and again, and in ever more determined and righteous ways. Of course, those who actually believe that ethical rules or the holy writings of many religions are just nonsense will laugh at all this, and return to the pleasures that help to salve the perceived injury they suffer from constantly being challenged by the resilient presence of those they would choose to ignore, to dehumanize and disenfranchise. But we who do not buy into any belief in “superiority” simply by virtue of wealth are not going away. The scriptures attest to that, as well.   And we are many.

 

People are hungry for God.

People are hungry for love. Are you aware of that?

Do you know that? Do you see that?

Do you have eyes to see?

Quite often we look but we don’t see.

We are all passing through this world.

We need to open our eyes and see.

 

Mother Teresa


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CONFESSIONS OF A BIGOT, UPDATED

July 21, 2016

Two years ago I posted the article below. At the time, I was just beginning treatment for the chronic pain and other illnesses that had required my retirement the year before. But I was also sick from, and sick of, my ongoing anger at how inhumanely we so-called humans treat one another, and just beginning to fully realize that I was in peril of joining the ranks of the haters. I hated intolerance, poverty, unjust legal systems—you name it. I hated those who were intolerant.

I would be reminded by those wanting to help me, of all the people who gave money and time to charities, and how we as a nation spent so much money on welfare, Medicaid, and help for people in other countries. Knowing that I was both activist and teacher, people would say they were agreeing with me by quoting the old saying: Give a man a fish and you feed him for a day; teach him to fish and you feed him for a lifetime. To which black South Africans replied in the years prior to 1994: Yes, but what if the pond is closed to him?

When I returned home from South Africa at the end of 1995, I was devastated to find that the country of my birth was not the one to which I had returned. It seemed that I had somehow found myself back in apartheid South Africa. I have listed the reasons in another post at about the same time as this one:  https://maryleejames.com/2014/08/01/the-election-is-hanging-in-the-balance/ .  Now I must stress that we are steadily closing the pond for more and more members of our nation’s citizens. Worse, large numbers of our countrymen simply do not care. Life is cheap in America today, just as it was in South Africa in the days of apartheid.

In a post pondering the first year of my new life written one year ago, I have also elaborated on my struggles with anger and the increasing movement of this country toward the actual conditions of apartheid, but now in new clothing. https://maryleejames.com/2015/06/20/ponderings-on-the-first-year-of-my-second-chance-at-life/.

Now it has been two years, and I am not sure just how successful I have been at conquering my anger—or my inability to cope with other’s intolerance. But I do still believe all that I have said in the post below, and the others mentioned. I know I am not the only person in America struggling with this anger. About half of us, however, are on the opposite side of the ones we believe are creating our anger.

But the truth is that we are all the same. We have different ideas and different beliefs in our heads, but since we hate the mere sight of those who differ in any way, we can’t talk about and either resolve or respect those differences. As a result, our nation is in chaos. Our legislators wonder why this is the case, when they have stubbornly failed to do their jobs, and to show leadership with integrity by putting the needs of our country before their own. I could cite specifics, but it is not necessary. We all know what they are, we just can’t agree on which acts were right and which were detrimental to the nation.

Civic Responsibility. Civil Rights. Civil discourse. All based on the same root word, all meaning being accountable to, and for, other members of our country. They are requirements for a democratic process to succeed. And they all rule out acting on our hatreds and require putting ourselves in the other person’s shoes, even if only for the time it takes to work out a common problem.

Otherwise, we become responsible for wiping out hundreds of years of human progress, and become the savages that Hobbes once claimed we were.

 God, bless America,

by returning to us the love we once had for You,

and for your Image in all human beings.

 

June 20, 2015

bare tree

I am of an age where I sometimes remember things that happened years ago better than I remember what I had for breakfast, or even what I intended to do when I walked into this room.   Today, I am recalling a conversation with a fellow college student, when I exclaimed impatiently that I “just cannot stand intolerant people!” I was, in a word, furious.

As I recall the day in question, the other students and I were discussing a “typically racist” response to a situation in our city. In memory, I clearly see the bemused expression on the face of the co-ed, and the hesitation in her voice, when following my outburst she inquired: “is that not just another form of bigotry?” She was pretty brave to venture such a profound observation, considering both the twenty-plus years of difference in our ages, and the potentially negative reaction that bigots may exhibit when being called out. For the record, she remained unharmed and we remained friends. Nevertheless, it was an enlightening and humbling moment for me.

I do have to admit that did not mean that I was cured of my ability to intensely dislike and resent certain people or groups of people whose behavior results in harm to others. I was just no longer able to demonstrate my dislike free of the knowledge that my own behavior could place me on the playing field alongside my adversaries. I am getting better at saying “I hate your behavior, but I do not hate you,” and really meaning it. But usually that can only happen if I am able to swallow the anger that rises up whenever I see people being hurt or deprived of their rights; of their humanity. Sometimes, still, it does not happen until the sentiment is no longer relevant to the target of my ire, but at least I can resolve the bitterness that otherwise would cripple me.

I have never been able to understand hating others because of skin color, ethnicity, socioeconomic status, or religion. That is probably why my first academic choice was anthropology, until circumstances placed me in a trajectory towards a degree in sociology. Today, it occurs to me that as a sociologist by profession and a social activist by nature, I am forever dealing with the ambiguity that exists at the point of intersection where I need to speak out in an attempt to rectify the harmful actions that take place in our society, while at the same time—as one who deeply wishes to acknowledge that we are all made in the image of the God we profess to be our own creator—at the same time honoring that Image in the very ones with whom I am at odds. All too often, the realization that I am less than human in the eyes of those same people makes it even more difficult to deal with my own prejudices.

Worse, I begin to stereotype entire groups of people based on their membership in the same category as the people who are creating my problem….it may be

politicians.

lobbyists.

 media.

insurance companies and by implication, insurance agents, or

CEOs of all corporations, for example.

The list goes on, and long after the situation is ended the prejudice tends to remain. So I must deal with myself before, during and after each campaign to right a wrong if I am to honestly claim the title of Christian as well as living as a social activist. In fact, by now I would venture to say that I must do this if I am to have any integrity as a human being. But in practice, this tends only to add to the ambiguities of the situation.

For example, if I work to expose the wrongdoing of a person or group, what credibility will I have if I fail to express my anger at the results of the wrongdoing? At what point do I cross the line between hating the behavior, and hating the person? In a situation within a group where the contenders know each other and acknowledge some important values in common, it is much easier to respect the humanity of the opposing faction. In the broader context, however, it becomes nearly impossible to see that threatening party—almost always a stranger–as a member of one’s own species, let alone as another who is also made in God’s image.

In such cases, the battle can only escalate until one side or the other is thoroughly defeated. They may be relatively harmlessly defeated by being ousted from power, but failing that, they may be only defeated by death. In the case of our country, if we carried this scenario to its extreme, democracy would have been defeated as well.  Anarchy will have won, for it is not possible to live in harmony without trust in a system and in the people who empower that process, when we have failed to protect the vital essence of the humanity of each and every person who inhabits the system.

The good news is that despite the ongoing need for corrections within our society, we are a people who daily live with their neighbors and friends in a peaceful and productive manner. We are people who love our families, our vocations, our churches and our cities. We are proud Americans, and we still enjoy some of the freedoms of a democracy. Our nation is NOT broken! But even the most tolerant of us is still capable of bigotry, and most of us don’t recognize our own role in it. I know, from long experience, that I am most susceptible to this kind of bigotry when I am suffering from the most justifiable (in my eyes, at least), most righteous, anger.

I will never be free of the need to take a deep breath, and with deliberation and truthfulness remind myself that He who made me also created my enemy. He created my enemy, who in some instances may also be praying to that same God for victory in this particular situation.

I sometimes imagine that God could be wondering when His creatures will stop hating each other in His name, and honor that Name by working out our problems with each other instead of asking Him to take sides.

Admittedly, that is a utopian wish. Such ongoing peace is rarely achieved in families, much less in nations.  I am enough of an historian to know that ours is not a story of prolonged periods of living in peace with one another as a nation, yet we share the common value of our unity and in the past have achieved significant results by putting aside our differences in order to protect our common values.

We know how to do this. Our differences are not insurmountable as long as we stop reinforcing the walls that separate us to the point that we can no longer see what we have in common. Perhaps also, as I have constantly to do, we will have to tame the bigot within ourselves before we can work together again as fellow humans.

“One nation……” Like all relationships, it takes work and commitment.  Right now, I have that commitment still.

But I am very angry.

butterfly - Maya Angelou


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FIRST DO NO HARM

First do no harm. Immediately our minds turn to physicians when we read or hear this phrase, yet the reality of “Pill Mills” in our cities and neighborhoods is one factor fueling the present crisis of faith in our health care system for many people. We are a nation that labels and stereotypes with great abandon, and with the numbers of criminals using an MD degree to illegally provide narcotic prescriptions for the price of an office visit, the negative label on the entire pain management profession was no doubt inevitable.

I was guilty of supporting that label, myself. For sixteen years I lived in a region where in the beginning, alcohol and marijuana were the primary recreational drugs. Over the years, however, I saw many beautiful, bright and charming young people become addicted to narcotics, and the drugs became easier and easier to obtain even in that isolated part of the country. A few years back, I learned about growing numbers of pain clinics in the region, and that students were “safely” obtaining legal prescriptions for their recreational drugs. The words “pain clinic” became anathema to me.

After I retired and moved close to a city several hours from where I had worked, my back pain was so severe and disabling that my primary care physician told me he was going to refer me to a pain management physician. I was stunned, then just plain mad. “No, thanks!” I told him, and he may have understood the unspoken question “Have you lost your mind,” though I tried to hide it. It took some time for him to convince me, first that the physician in question was highly skilled in interventions like epidural nerve blocks for the pain, and second that he was completely legal. Even so, I did not hesitate to inform said pain management specialist that I did not need his services except for the epidurals.

I like to think that I am a fairly open-minded person, and six months later (and in much better health largely as a result of the care received from my pain management physician) I am now a patient in the pain management clinic, where my physical intolerance of narcotics and other medications is taken in stride. That is to say, I finally remembered my sociological training (to say nothing of my own teaching on the subject) and realized that no matter what my experience was in my former place of work, it did not come close to describing an entire branch of medical expertise and practice.

First, do no harm. But physicians are not the only group that should make decisions with this caveat in mind. I, for one, had to accept that the caveat applied to me, as well. How much harm did I commit in my righteous indignation over the felonious pill mills? I hope not as much as our legislators and law enforcers have done by tarring innocent physicians and patients with the stereotypical labels of pill pushers and drug seekers.

Legislators can bring about costly changes in the way that laws are made and enforced, resulting in potential harm to many people. The current “war” on opioids is a prime example.

Lawmakers are subject to pressures from the press, from their financial supporters, and their colleagues. Faced with the need to satisfy so many groups with vested interests, to first do no harm often seems to be the farthest thing from these officials’ minds. However, a few states have passed legislation designed to protect both patients with chronic pain and the physicians who prescribe for them. Indiana is one such state.

In 2012, an Indiana Senate committee introduced a bill that would become IN SB246. The final version of this bill http://www.in.gov/legislative/bills/2013/SB/SB0246.2.html was passed in 2013, based on advice from a panel that included physicians and the Medical Licensing Board.   The Medical Licensing Board then enacted an Emergency Rule effective on December 15, 2013 http://www.IN.gov/mlb . The Emergency Rule established standards and protocols for physicians who prescribe controlled substances for the treatment of pain.

You will note in reading the rules that there is a clear separation between medical license regulations, and activities termed felonious that must be prosecuted. The law covers the latter category only, and leaves control of errors in staying within the bounds of regulations to the proper authority: the Medical Licensing Board. This is precisely where many other state, local and federal government bodies have gone overboard, causing unnecessary pain and grief – even loss of life—to innocent persons by including professional regulations with actual laws. As a result, people have been needlessly targeted – “profiled,” to be exact—as living outside the law. People such as respectable physicians, living within the law, as well as persons who have been non-addicted, chronic pain sufferers, trying to manage their suffering “just enough to cope,” to remain productive. All have suffered needless, devastating, harm.

To some, the Indiana Emergency Rule seems very strict. However, given the reality of drug abuse, illegal drug trafficking, accidental and purposeful suicides using opioids, and the growing number of people misusing a medical degree to set up “pill mills,” I choose to defer to the wisdom of the Indiana Senate and the advisory committee that worked with them. I believe they tried to first do no harm. In actuality, the Emergency Rule does not prevent physicians from prescribing opioids for chronic pain patients. Both physicians and chronic pain patients are protected when both groups stay within the parameters of this legislation. Anxiety over the new rules should be lessened as prescribers become familiar with the details.

If we are to be successful in striking the balance between battling drug abuse and providing effective pain care, we must begin with education, followed with continuous reassessment of the results of our words, our laws, and our practice of medicine. Succumbing to the hysteria currently surrounding the prescription of opioids for pain care will take away the hope that chronic pain sufferers might find pain relief “enough to cope.” This will propagate a great deal of harm to millions of our fellow citizens. Laws that lead to the arrest of compassionate physicians, who are genuinely attempting to help their patients, create a situation in which great harm could befall upon innocents.

Thanks are due to those state legislative groups who have not bowed to the hysteria that would ban these pain relievers. Thank you, Indiana Senate, for thoughtfully drawing up a law that does not harm the citizens of our state. We can only pray that other states will follow your example; perhaps even improve upon it. As long as they also…

First, do no harm.


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INDELIBLE LABELS

clothing label 4Remember when the labels in our shirts used to scratch and irritate the skin on the back of our necks? It’s not so bad, any more, since they began stamping the labels into the material. Labels are now not only part of the garments that we wear, but they are also indelible and unlikely to wear off for the life of the garment.

Which got me thinking…..labels that are put on people, by other people, also may become an indelible part of who that person is allowed to be in our society. We are labeled with diseases (both physical and mental), with eccentricities of character, with our socioeconomic status, with our vocations, with family membership, and even by the region where we live. Labels fit easily into stereotypes, and stereotypes can lead to social disasters like racial profiling, as well as to the impossible expectations of success (Justin Bieber and Miley Cyrus, for example).

Labels, with their baggage of expectations, have burdened me my entire life, even as a child:

“You have a heart disease, so you can’t……”

“You are the preacher’s daughter, so you can’t…..”

“You are the preacher’s daughter, so you must…..

“You are a woman, so you can’t….

Enough. You get the picture. Everyone wants to put me in a box with a label that they understand, so that they know what to expect from me, and what to keep from me. Some people can become quite ferocious when I don’t stay in that box. Nevertheless, I developed an aversion to being told either that I could not do something, or that I had to do it. My knee-jerk reaction has inevitably been “Yes, I can” to the first, and “No, I don’t” to the second, even if it might not work in my own best interest to respond in this way. For example, that is how I wound up in South Africa in the middle of a revolution. Several misguided but well-meaning souls told me I couldn’t go there. (On the other hand, I am so glad that I did!).

Until recently, I thought I may have mellowed a bit – become more reasonable, perhaps even occasionally diplomatic. Then we entered an election year. I am pressured on all sides by the most vilifying arguments to commit to voting Democratic, to defeat the Republicans, or to vote Republican, to defeat the Democrats. A few years ago I realized that I had never voted a straight party ticket—either way—in my entire history of voting. I was not interested in the party the candidate belonged to; I wanted to know if they could do the job, and if putting them in office was in the best interests of the country, or the state, or the county/township. So I changed my voter registration to “Independent.” (Kind of fits me, if I have to wear a political label of some sort–at least, it is a label of my own choice).

So, getting back to labels, I am watching a country that is beginning to wear its political labels indelibly. The label is now an internalized part of the person’s identity, never to be mistaken for something that can, or should be, changed. This is not democracy, it is tribalism. In a democracy, you think and work for the best of the country. In a tribe, you can become a victim of the kind of groupthink that may feel so threatened that all other tribes must be demonized. Not only does our indelible group label define the very essence of our being at that point, it labels other groups as inferior, undesirable, and unnecessary; probably, eventually, as subhuman. Our lizard brain kicks in, seeing extermination of the enemy as a necessity. Think Ferguson.   Think Rwanda. Think Bosnia.

These events and the tribalism that drove them are definitely incompatible with our ideal of democracy—”One nation, under God” does not translate as “destroy everyone who fails to conform.” Dialogue and mutual respect are the tools of democracy. As a teacher, I learned that my effectiveness did not depend on my respect for all of the actions and ideas of my students. It did, however, depend on my respect for them as human beings, worthy of having the opportunity to speak their thoughts and be heard—to enter the conversation of life.

Loyalty to ideals, to the group we belong to, and to the planet we live on, can still be conducive to democratic process when we also hold to the ideals of inclusiveness and tolerance, and when we carefully monitor our own actions for signs of demonizing other human beings. No matter how much I may dislike someone’s actions or ideas, I am not compelled to dehumanize them in order to fight for the goals of my own group. I just need to make my own fight that much more worthy, and good, and appropriate for my country.

Vote, whatever you do. But vote for the best candidate to get the job done, not for the “group, whether right or wrong.”  Hint:  Look carefully for candidates who can win you over through who they are, rather than through their claims of who everyone else isn’t.   Labels are for clothes and grocery items, not for humans.


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THE ELECTION IS HANGING IN THE BALANCE

I am what one could call “an elder.” My station in life affords me the ability, or perhaps burden, to look back and assess the arc of history’s swinging pendulum. I’ve seen this play before. I didn’t like it then and I don’t like it now.

It’s only August, and only midterm elections, but already the advertisements have been repeated so often for so long that I can lip sync with them. At least the primaries held some interest, with more candidates to listen to and select from. Now we are down to a predictable routine: “He doesn’t do” this or that job, to which the answer is always “HE LIES!” It was a lot more interesting when I was teaching, and we had debates based on research of actual records, and mock elections. Grades were given based on points won while sticking to the facts, and class discussions were even more heated than the TV versions. No wonder I’m bored with it now.

Every two years since my return from South Africa, I am reminded of a conversation with one of my dear friends as we sat up through the night awaiting the results of the presidential election of 1992. I am always impressed with how very politically informed about the world people in other countries are, compared to Americans, and this day was no exception. “You know,” she began wistfully, “I wish so very much that when our national elections are held democratically we could be as civilized about the results as Americans are.”

“How so?” I was intrigued. Aileen, more intelligent than most people I knew, was bound to have a profound insight on this subject. “Because, even though this election is a fierce battle between your political parties, once the election is over you all will settle down, accept the winner, and once again pull together for the good of the country. Because you love your democracy so much, and you really believe in it. And that is why it works.”

And I believed her. Because her words corroborated my experience, up to that time. Sure, I had lived through the whole Watergate saga, as well as Contra-Gate. But we survived all that, didn’t we? I was never more proud to be an American than I was that night, seeing my country, and democracy, through the eyes of this remarkable Afrikaans woman.

Then, early 1996, I was home again. Or at least I thought that was where I had come. Eyes wide with astonishment, mouth agape, day after day I watched my elected representatives behaving like maladjusted toddlers not just in public, but on national TV.   I had never seen such infantile behavior by political leadership, including the entire seven years I spent in Africa. In Africa, political disagreements were life threatening more often than not; in America they sounded life threatening even though they were far from such extreme issues. In 1996, I witnessed for the first time the failure of my fellow Americans to graciously accept the working of the democratic process. Rather than accept, they hated it so much, in fact, that the losing party seemed to wish the leadership of the winning party dead. From the noise, it sounded like nothing else would satisfy them.

By 2000, I was already comparing the good ol’ USA to apartheid South Africa. It was getting more like the old RSA every day, to my understanding. People no longer identified themselves by ethnicity, vocation or religion. They “became” a Republican, or a Democrat, so that in much the same way as we used to say “I’m a plumber,” or “I’m Baptist,” what had begun as a personal option had become an entire identity.

What I found so alarming about this was that in South Africa I lived in the middle of a revolution, where people died, sometimes as innocent bystanders, but always because of a political identity. The anger I felt and witnessed here was just as deep, just as mindless, as what I saw in South Africa – despite the absence of war and terrorism. Then, in September of 2001, we had terrorism. For all too brief a time, we were Americans, together, again. Then we had the Patriot Act, and the War, and Homeland Security. It was the latter, despite all the protected rights that we lost permanently with the Patriot Act, that spelled out “South Africa” for me in huge letters.

Of all the names they could have given that agency, they picked Homeland Security. The name of the most abusive agency in South Africa, the agency that could do whatever it wished to any person, and justify it under the name of Homeland Security. Forget your rights, if Homeland Security considered you any kind of threat to South Africa. Now I live, again, in a country where I say the same thing about an agency with the same name and mission.

In apartheid South Africa, the poor were disenfranchised and abused by the wealthy. And so, it seems, they will be in America. Politics in South Africa were corrupt. People hated other people for being different, and it was enough to kill them for. The wealthy, to protect themselves, lived in walled compounds with security guards – actually prisoners in their own homes.   I often longed for the freedom of a small town neighborhood in America, where I could take a walk by myself late in the evening, or sleep with my windows open. Now, locking my door here in America is such a habit that I keep locking myself out when I go to get the mail.

Finally, in South Africa the architects of apartheid (pronounced, appropriately, “apart – hate”) based their political stand on their religious belief that the Bible clearly stated that the races should not intermarry. Like many such interpretations, even if true, it is hardly enough to merit committing murder. Especially if you are able to ignore virtually dozens of other “thou shalt nots” without turning a hair. They also subscribed to the belief that they were the chosen people of God, who had given them South Africa for their own, and their political wealth and power to prove His point. Take the race issues out of the question and look at the scene in socioeconomic colors, and the parallels with America today become really depressing.

In the end, South Africa also learned that you can’t legislate morality.   America has forgotten that truth.

I am certain that in every generation there are the elders, looking back with saddened eyes and faces, mourning the country that they once knew. Today, I am one of those. The pendulum of history has swung too far since the craziness of the 60s, and a swing back to the opposite point again is inevitable. I just hope to live to see it hesitate, for a little while, in the balance of moderation.