Sunday, September 30, 2018

What to do for women

It was very confusing, coming of age in the late 1960s and early ‘70s. There were many women who hadn’t figured out yet that they would prefer to be left alone, and men — even white men — could have the mistaken impression that their kind had actually achieved something of value over the centuries, and that someone could actually like them. Sure, we needed to be less pushy and more open minded. The true depths of male — particularly white male — depravity were concealed behind the facade built brick by brick by the patriarchy to secure dominance in perpetuity. It is hard to come to terms with the harsh truth that one’s entire world view was built on lies, but there it is.

As an average heteronormative schmuck, I found women desirable and acted like various kinds of idiot to try to get to spend some time with them. I am limited by my own lack of social skills in this, but you can find all kinds of support for the idea that you may be socially awkward, but deep down you're actually really cool and people will want to be with you.

That's a comforting lie. The key to its survival is that it is comforting. It seems empowering and encouraging of diversity. But hooking up is a competitive activity. There's a lot of weeding. If your motivation includes what we call the pleasures of the flesh, you need to qualify. Hell, if all you want is conversation and a break from the endless loneliness of shy dorks, and you happen to like the company and insights of women, you still need to avoid wearing out your welcome.

Obviously, based on the avalanche of stories of women who have been attacked and forced into sexual contact, a lot of men don't worry about qualifying. They just grab. In so doing, they give all of male horniness a bad name.

Maybe male horniness is only worthy of a bad name. It's as common as dirt, and less healthy to get on you. Actual dirt contains beneficial microbes.

I was once young enough that a woman might give me a second glance, and even an audition. I was no prize, but I was deceptively attractively packaged. It fooled both them and me. I apologize retroactively for believing my own shit. We were all being raised to believe that we had promising futures, and that life was to be enjoyed. My blunders haunt me to this day.

What I finally realized was that the best thing men can do for women is purposely, consciously, and in large numbers, get out of their way. 

What have you read on social media since Thursday? Women saying that they wished they could walk around without constant fear of some aggressive creep assaulting them with anything from words and gestures to actual physical force. Women in vast numbers calling for an end to paternalistic, misogynistic oppression. Women drawing comics about how great the world would be if all men vanished.

Paternalistic misogynists will continue to make what they consider to be their case. They can cite a lot of history, and call upon female allies who have, for generations, worked within that system in their own ways, and present it as the norm. Women are not unanimous in their support of Brett Kavanaugh's accusers. They're not uniformly supportive of survivors of sexual assault. This is jarring and incomprehensible, but it's part of the bewildering variety of human experience."Good girls" won't have any problems. Feisty ones will suggest that a woman simply needs to be armed and ready to fight off any male who tries to go too far. It's a pretty sad view of human nature, that the best we can ever do is learn all the ways in which to defeat the inevitable attack.

A woman named Nancy Theeman wrote that she taught at Holton Arms when Christine Blasey Ford was a student. One thing she mentioned was the value of single sex education to create empowered women. Because the students were all women, they held all leadership positions by default. They competed among themselves on their own merits to achieve these positions, unfiltered by any judgment stemming from mere anatomy. But at the same time, at an all boys' school, young men are in an undiluted environment of male assumptions. And the empowered women coming out of the all-female incubator emerge into a world that is not ordered that way at all. If no one is teaching all the men how to be anything but entitled chauvinists, the system never changes.

Men need to listen. Don't jump in the minute you think you get it. Shut up and listen. Then shut up and listen some more. We have centuries of shutting up and listening to catch up on. Don't expect to knock it out in a couple of days. You can't pull an all-nighter for this. And if all goes well, the world that you knew will never exist again.

A lot of men simply aren't going to listen. It's easy for me to say shut up and listen, because I was not indoctrinated in the notion that it was my right and duty to lead the world. And by observing my father's frustrations as a skilled and loyal officer of a government increasingly controlled by the military-industrial complex, I was not drawn at all to the established power structure, even if that was where the money was. Like him, I believed that the ideals of our nation were sound, but that the execution of them fell far short of the promise of the words.

Naively, I believed that everyone would eventually agree. And I figured that far better minds than mine were working on it. Far better minds than mine have been working on a lot of stuff. Some of them have been working on this. A lot more of them have been exploiting the existing trends toward wealth consolidation and reinforcing existing hierarchies of race and gender.

Tuesday, September 25, 2018

The Rat Maze of American Health Care

In January 2017, I passed a kidney stone. I self-diagnosed, and got through the long night of pain with only profanity, lots of water, and a little bit of beer -- taken medicinally for its diuretic qualities -- to get me ready for work the next day.

After several months, I thought it might be a good idea to inform what passes for my primary care physician that I had suffered this misfortune. I used to go to an actual doctor, but he took advantage of his superior financial decisions to leave the practice and go adventuring. He was a bright guy who laughed at my jokes, but he was also really good at keeping the clinical wall between us. The practice has not provided a consistent replacement practitioner since his departure. The nominal MD at the head of it has never seen me as a patient.  The people I have seen have been delightful, but the place seems to be the last stop before imminent retirement for all of them. Or, if it's a young PA or someone like that, it's just a stepping stone on the way to greater things. There's no continuity and little sense of any more than formulaic care for the person rather than the customer.

As an uninsured American -- or even as one with the typical overpriced, under-insuring policy -- I was reluctant to get into the investigation at all, because of the bureaucratic rat maze and unclear pricing of health care services. Because there is no uniform standard for charges and service quality, people travel a long distance to find either providers "in their network" or self-pay prices that they can afford for diagnostic services that their insurance company's accountants have deemed unnecessary to cover.

Does every community disparage its local hospital? Certainly the one around here has garnered its share of scathing reviews from former patients and the surviving family members of patients who didn't make it. Whatever the truth of the matter may be, local gossip describes it as a place to pay too much for too little when you have no other choice.

Because health care is a marketed commodity in this country, health care providers use advertising to communicate, rather than presenting information fully, completely, and readily accessibly. Hospitals are selling themselves. They want you to be happy with the result so that you will patronize them again and tell your friends that it was good, but if you're not happy they'd prefer that you shut up and stay out of sight, same as any other business would. A good business tries to learn from its dissatisfied customers, but dissatisfied customers do not feature as the lead element in any of their advertising.

By a stroke of pure chance, a customer at the bike shop where I work is a nephrologist in the Harvard Medical School system. He had offered many times to help any of us with medical issues. Indeed, as one of the leading researchers studying polycystic kidney disease, he had been very helpful and comforting to my wife and members of her family after they discovered that several of them had that genetic disease. So, when I had a kidney issue, I eventually turned to him. Because he had no commercial motive, and his credentials as a scientist are impeccable, I trusted his judgment.

Unfortunately, his ability to conduct examinations and treatment is limited by his contractual obligations to the hospital in Boston where he works. He can provide his time and knowledge, but no lab work or medical imaging. I have had to scrounge those up for myself, with as much guidance from him as he can provide.

The process of navigating the health care labyrinth is awkward enough without adding any confusion. I already felt unwelcome because of my inconvenient income level and the fact that I don't sport the brand logo of an insurance company. The health care industry in this country is geared toward extracting as much money as possible from reluctant third-party payers. They seem very accommodating to self-payers. But because the majority of participants in the system operate within the framework of the adversarial game between insurance companies and medical facilities, things are very compartmentalized. The seeker of services has to open every door and look in every room with few allies who don't have their own financial stake in the game.

When I go to the local hospital for a service requested by a Boston doctor, what will the local providers think...if anything? Will it occur to them that this is an outgrowth of the intimidating facade of commercialized medicine? Or will they just be resentful that I seem to consider myself "too good" for them? Conversely, will they automatically pigeonhole me as a charity case, uninsured because I am destitute, or a cheapass who simply refuses to fork over the coin for a real insurance policy?

When I was a kid, it was simple. If I got sick, my parents took me to the doctor. If I needed more than what the office could provide, it was arranged. Granted, my parents had the backing of the United States government through CHAMPUS. And I was a kid. Complexities were hidden from me. But health care on the whole seemed a lot more systematic, geared toward healing rather than cash flow.

As I read the history of CHAMPUS, and its transition to the current Tricare system, between the lines I infer that a growing population of people who don't die of their injuries and ailments puts increasing financial strain on any system of medical care. That would be true no matter who is paying, so it does not in the least justify our current American system based on profiting from fear and ill health. But it does explain how accounting departments looking to shift costs would entertain increasingly complex mechanisms to divert expenses onto someone -- anyone -- else. This burst forth in the 1980s and has mostly gotten worse as our country does anything it can to avoid settling down to create one coordinated system based entirely on patient outcomes rather than its own income.

Discouraged by the prospect that any pursuit of health services could metaphorically lead me down an alley where my pockets would be emptied, I have been very slow to follow up on my situation. Having an illness is bad enough. Feeling like an illness turns you into some corporation's cash crop makes it all the worse. I feel like a beggar, and a blind beggar at that. I dropped the ball last autumn after the first round of lab work ordered by my nephrologist friend because I still felt awkward taking him up on his offer, no matter how often he had repeated it. When he confirmed it this summer in person, I felt like I'd  let him down by taking so long to go further. But I still have to make the contract for services and pay whatever the bill turns out to be when the dice finish rolling and stare up at me.

In the end, looking for cost-contained, competent medical advice and treatment, I'm not sure if I merely made it much more complicated as I try to manage the interface between my doctor friend and the other service providers in the process. And my situation isn't the stereotypical nightmare of phone tag with higher and higher levels of corporate supervisors that a lot of really sick people have to go through. Imagine having a really serious illness and having to go through a process clearly designed to weed you out.

A genuine system of universal care is decades overdue in this country.

Tuesday, September 18, 2018

AR-15s and stuff like that

I just got a commission to work on some drawings for political advertising. The first assignment was easy: it supported environmental science. The second one is extremely hard, and it may make or break my chances to draw for hire for any other installments in the campaign. This is a bummer, because overall I support the "progressive" policies that this group espouses.

The second target of the ad campaign is gun control, notably the control of so-called assault weapons.

Let me be clear. I don't like the proliferation of guns. I find the point of view that we have to be ready to kill each other at a moment's notice extremely depressing. I deplore the use of semi-automatic, militarily-styled weapons as fetish objects, and particularly their use to slaughter crowds of what we call innocent people. That being said, I hear the arguments of the pro-gun contingent, that murderers use a much greater variety of weapons than the "assault" category, and that militarily styled weapons in responsible hands are just a different style of projectile thrower, better for some uses and worse for others.

AR-15s are kind of like the pit bull of guns. People get cranked up over a breed of dog which might or might not be more prone to take someone's face off or mutilate someone else's family pet, and out come all the pit bull devotees with their stories of loving canine companions who live in homes full of happy children. We have a mass shooting and the voices rise again to ban the weapon. Other voices shout back about mental health care. Supporters of the particular piece of killing hardware make their points again about the total acceptability of the tool itself, and the Constitutional amendment that guarantees every citizen's right to have as many as they can afford.

I also hear the arguments specifically aimed at restricting militarily-styled rifles. Militarily styled weapons feed into a fantasy that does not have animals as its targets. Armies don't fight deer. They don't even fight grizzlies and mountain lions. They don't fight coyotes, peccaries, groundhogs, or raccoons. Armies of humans aim high-capacity, automatic rifles at each other to kill each other. The purpose of a military weapon is to put a round or rounds through the flesh and bone of an adversary who would be just as happy to reciprocate.

How much does form follow function? Much of the sinister looks of a militarily-styled weapon grow from the design requirements to make it do what it does with the least amount of undesirable feedback to the shooter. These include recoil, heat, and muzzle rise. Even a silencer and flash suppressor have actual uses during certain hunting conditions.

All that being said, when I looked at a half-dozen "best deer rifle" lists, nothing with military styling headed any of them. The "best" deer rifles were bolt-action, with a capacity of about three shots. Militarily styled weapons did appear in every list, but as an option for the shooter already so inclined. If you want that style of rifle, reviewers have checked out a few choices. If the militarily-styled rife is your preference, you'll then want to accessorize it to make it work better for you.

This does not answer why the militarily-styled rifle is your choice. People are attracted to some weird stuff, that's for sure. However, lots of people like things that aren't used to kill. It's the killing part that moves the gun hobby from harmless diversion to political firestorm. It's what motivates people to take a position inspired by the perfectly valid desire to go about their daily lives without wondering when they might be caught in a hail of lead.

I'm left with an approaching deadline and a nuanced situation I'm asked to depict in a simple manner. So I'll do the drawing and take the check, but I guarantee that it will not have the desired effect except on readers who were already inclined to agree. As much as I support the Parkland survivors, I see this election turning on other issues. Some people I know who are Republicans who don't particularly care for religious people or hunters will still vote the party on the basis of other issues, or they won't vote at all. And the real participants in the debate will continue to throw statistics and Constitutional interpretations at each other in an endless war that no one wins.

Monday, September 17, 2018

The Woman Haters

When I was about seven years old, living in a little residential neighborhood called Rogers Heights, in Annapolis, my friends and I played in the woods that abutted all of our back yards, on the other side of a rainbow-hued trickle that flowed eventually down to Weems Creek underneath the Rowe Boulevard bridge. This was around 1963.

Our group included at least one girl. She was just another grubby kid looking for frogs, like the rest of us. We gave no thought to gender in our loose group of poison ivy finders. Not much, anyway.

We never saw anyone in the woods that we hadn't brought with us, but the other kids would refer to an ominous group of older boys who called themselves The Woman Haters. We never actually saw any of them that I recall, but we did see a tree fort that the kids in the know said was their headquarters. A flag made out of an old cloth diaper hung limply from it in the windless summer air. Whatever design had been painted on it remained obscured in its folds. Feeling that we might be under surveillance from that eyrie of junior misogynists, we withdrew quietly to the safety of our yards. We had no fences, so the collective yard formed a long strip of field between our houses and the near bank of the stream.

The day that safety was violated by a BB gun sniper who shot me in the arm, everyone agreed that it was the work of The Woman Haters. Apparently they weren't too fond of anyone.

I never encountered anything like that when we moved to Newport, Rhode Island, and then to Thomaston, Maine. And when I returned to Maryland at age 11 to face an unending assault of other preadolescent stresses, we lived in a different neighborhood where enmity was much more pointed and personal.

I wonder now whether The Woman Haters existed, who was in the club, and what became of them as they grew older. But I don't waste any time wondering enough to investigate. We're all too old to matter anymore. If they made careers of misogyny, they've done their damage. If they didn't, their club name was just another stupid boy thing. I don't imagine they inherited it as a secret society, as old as the Knights Templar, and passed their lodge rituals on to new generations. I think they just liked to sit in their tree house and take pot shots at smaller kids. It was the sort of thing that never surprised smaller kids. We were the punching bags and continual irritant of older siblings and their friends.

I was not aware of woman-hating sentiments among my fellow bottle breakers and stone skippers. I never went through a phase where I "hated gurlz." I always rather liked them. Later, in adolescence and beyond, I was cruel to some of them, but never out of malice, only out of selfishness and self consciousness. That makes it no less hurtful, and, therefore, unforgivable, but they weren't the acts of a twisted man with deep-seated hostility. Just another insecure dork trying to fake out both the bullies and the objects of his desire.

Self consciousness is very different from self awareness. Self awareness puts you on solid ground to figure out how to be the person you want to be. Self consciousness never finds solid ground. For some of us, the tension between the two forces never ends.