n.jackson_headshotJust before your debut novel was published, someone told you that Bhanu Khapil refers to creative projects are “a complete gesture.” Is yours?

Ah, the kindness of strangers and friends. I’ve been lucky enough to receive both recently. Hearing about Khapil’s notion of “a complete gesture” was helpful when I was struggling to let the book go and let readers and the world do with it as they will. I wouldn’t call myself a perfectionist, but I do have high standards for myself and my writing. Which means that I’m still making corrections to the book as I’m reading it aloud from it these days, even though it’s already printed and between hard covers. Some friends, the Shutes, sent me a copy of Ann Patchett’s essay about being on book tour in The Story of a Happy Marriage, and that’s been a balm too. So has sleep and spending time with friends and family who keep me grounded.

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January is a month for beginnings. This isn’t a new concept, nor is it one that I’ve ever particularly subscribed to: calendar dates are mostly arbitrary, rarely aligning with actual historical events and watershed moments. The president was inaugurated, again; the trees remained bare and scrawny; winter quarter at the university commenced. For me, though, two very new sensations appeared: my arms and legs began to shake uncontrollably, vibrating as if by some odd, latent tic; and I became convinced that I didn’t exist.

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Like so many people, I spent the days after the Boston Marathon bombing glued to social media, the TV blaring in the background. I read everything I could about the Tsarnaev brothers, their parents, their friends, the detectives chasing them.  I learned who the victims were, where their families were standing when the blasts occurred, how close each runner was to the finish line.  Once the press had (finally) correctly identified the suspects, I started following a reporter on Twitter named Wesley Lowery, who, it seemed, was always about two feet away from the action, live-tweeting every gunshot. And on the night that police found Dzhokhar hiding in a boat in Watertown, I was up long after my husband and kids had gone to bed, unable to look away. 

 

I have measured out my life in sentences: composing, reading, revising and discarding them; talking to students about how to write, interpret, and edit them. I have dreaded the sentence that doesn’t come easily. I have learned at times to play with words that feel like nonsense in order to discover and organize thoughts, teasing words to make clarity appear.

There are sentences with gaps and missing pieces. Redundant sentences. Muscular sentences. Transitional sentences. Sentences that sing. Then: stylistic fragments. Intentional run-ons. Does the reader trust your sentences? If you break the rules, will the reader follow? Sentences that capture complicated feelings or thoughts by uniting verbs with precise subjects and prepositional direction. I’m lost in this sentence. Is this the best place for this sentence? Could these sentences be combined?

You’ve begun to feel like some neurasthenic Joan Didion character.  Only without the shiny coating of beauty and glamour.

Increasingly, you have nothing to say.  You are, distressingly, empty.  Empty and blank and tired and done.  Just…done.  

All you’ve ever wanted is to make everyone happy.  Now, you make no one happy.  You are nothing.

You listen to Azure Ray and cry, hating yourself and slicing up your arms with razor blades.

In The Bell Jar, you think, Esther got that plum internship.  Where’s your fucking prize?

You exist.  Just barely.

Henry

By Kate Axelrod

Essay

Laura and I were sitting up front, and Henry was directly behind me. This was a couple of months ago and we were driving out to Westchester on a Monday afternoon. I was periodically checking on Henry through the rearview mirror. He was usually extremely talkative, bordering on manic, but his eyes kept closing shut and he was slipping in and out of sleep. He was middle aged but boyish in so many ways; today he looked like an overgrown teenager in a boy’s tee shirt and a baseball cap. I’d only known him for a couple months, but from the beginning I felt a tug of affection toward him—for the ways that he was forthcoming and insightful about his addiction and his depression, and how he confided that sometimes he honestly felt more comfortable when he was in prison than when he was out.

My life is a series of nervous breakdowns. They happen more slowly as I get used to the movement, the up and down, the dizzying breadth followed by the very very narrow, and then a sheer drop to nothing that you climb up by inches. As a little girl I was perplexed by my frequent nervous breakdowns. Sometimes simple tantrums. Sometimes I could have killed, if I’d had the power of laser vision, or death rays shooting from my wrists, or curses or other violence. So I tried to fight my enemies weaponless, not even sure where the enemies were; I’d find out later, and even then I’d be wrong. I fought blind, screaming, caring and caring and caring. My socks, for example, were a great source of many a fine nervous breakdown. I really hated having the seam anywhere but exactly at the edges of my toes at all times; surely this was reasonable.

Since psychiatry has proven itself to be anything but a science, the entire concept of mental anguish must be reexamined. Might the elements of “mental illness” more properly be called personality traits as well as reflections of the societies in which those traits occur? Might those elements even be called talents of a sort?

Psychiatry’s masterwork of pseudo-science, the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), once included homosexuality amongst its “scientific” diagnoses. Psychiatry thus reflects the “values” of the United States far more than concerning itself with patients, much less looking past and through society’s existing prejudices.

Even those behind psychiatry’s Shroud of Turin question its validity. Of late, there has been talk of attributing DSM diagnoses by degrees rather than mere labels. Thus, a person would “have” a “mental illness” on a scale, not just “have” it. In such a case, the flatliners who dominate the population would once again establish the “typical American’s” plot-pointed life as “sanity.”

Yet no one who suffers emotional distress would applaud the benefits of that distress. To do so would be to refute its existence and betray oneself as an imposter. Far more likely is it that many flatliners never mention their irregular heartbeats. Could it be a Second Renaissance lies beneath the ever-recycling digital ruins and its constant skies of acid rain?

Consider anxiety. Those with anxious traits are often highly-attuned. To call them “sensitive” is, in this society, an insult. “Sensitive” implies weakness, an inability to “man up.” Instead, the anxious should be viewed as a tuning fork against which society reveals itself — rather than the “patient” — as out of tune. That no one else recognizes society’s discordant sounds only proves the anxious to be society’s musicians. Countless permutations of that metaphor support themselves.

The same may be said about every other “diagnosis.” Schizophrenia might be viewed as a William S. Burroughs’ cutup of “reality” as presented, emphasis on “presented” because, of course, most of our environment has nothing natural about it and is, in fact, a presentation in every sense.

Some conditions do respond to medication. Usually, the reasons remain unknown. In turn, the medication may solve one “problem” while creating many more. Those who take most antidepressants may no longer feel depressed about nothing, but they feel depressed about their diminished sexuality, especially males whenever they try to… express their end of sexuality’s conclusion.

Returning to anxiety, medication does relieve its incapacitating aspect, but the medications that accomplish the effect also accomplish something else, that being the worst addiction known to humankind. This class of drugs, benzodiazepines, includes Xanax, Valium, Ativan, etc., the whole lot of tranquilizers, excepting the rarely-prescribed barbiturates. In some cases, antidepressants may relieve anxiety. However, they do so for reasons as unknown as the reasons antidepressants diminish depression. Likewise, they alleviate anxiety but create symptoms that mirror anxiety, such as trembling hands, odd emotional states, etc.

Rather than diagnoses, all of these traits show themselves to be products of society, products of the product society uses to diagnose those personality traits, and the products society sells to treat the products of the product society uses to diagnose those personality traits. That’s to say, they’re products of an environment completely divorced from nature.

All of this enshrouds some rather simplistic facts about a complicated subject. To martyr those suffering in the way biographers now “diagnose” every author, musician and artist “of the ages” as “bipolar” reduces suffering by labeling it, making suffering a product of their products, that being books and, eventually, films based on those books. Those who write memoirs about their “mental illnesses” bend over backwards for sainthood and reveal themselves willing to do endure any humiliation in exchange for profit.

On the other hand, failing to notice the strange talents hidden within the emotionally inflamed creates an even greater injustice. These strange talents do not prove the existence of artistic talent, as many would like to believe, but they do reveal an artistic temperament. No one can suffer emotionally but for recognition of something and, more likely, many things, and their recognitions go unnoticed by the general public. Why does no one listen to them? Who do “doctors” listen only to themselves when they recognize nothing beyond the power of their prescription pads? Is it because they realize their absolute lack of talent, strange or otherwise?

Most of those suffering in the ways described cycle through life in various stages of function and dysfunction, and most have periods of absolute dysfunction. To calls these periods “nervous breakdowns” would be far more accurate than to split the hairs of the suffering with psychiatry’s blunt axe. They must be tended to as they once were, in humane sanitariums surrounded by the true environment. Such sanitariums could — with no joke intended — be established on useless golf courses around the nation.

With that, some proposals:

1) Psychiatry should be abolished. It simply lacks the will, or even desire to have the will, to fulfill its dream of being medicine. Psychiatrists should be stripped of their meaningless licenses and sent on their way to more suitable careers, like accounting.

2) The “mentally ill” should be educated to understand their conditions as also encompassing strange talents, until they begin to believe the fact that their recognitions are true even when masked by the wildest hallucinations.

3) Medications should be dispensed by doctors who have achieved certification in dispensing those medications. They should know, and prove that knowledge by required yearly testing, that they understand prescribing medications and the facts of addictions that may occur to any such medication they dispense.As it stands, psychiatrists receive eight hours of addiction “education.”

4) Medications known to cause addiction should be removed from any policing or government surveillance whatsoever. Those subject to mental anguish should not be criminalized for trying to relieve that anguish, including and even especially when relieving the added anguish of addiction to a prescribed medication.

5) All those suffering from the acute perceptions so well described in Rumblefish should ultimately determine their own treatment, including beginning or continuing use of addictive prescribed substances, even when addiction has established itself, for the suffering caused by eliminating that addiction will likely lead to more dangerous and illegal addiction.

Flatliners already receive society’s benefits. Those who benefit society without society knowing it — those with strange talents — deserve just as many benefits.

Major Depressive Disorder (Source: NIMH)

  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.
  • Major Depressive Disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.
  • While Major Depressive Disorder can develop at any age, the median age at onset is 32.
  • Major Depressive Disorder is more prevalent in women than in men.

*

I had to look those numbers up, because too often I feel alone in my diagnosis.

You see, contrary to most people’s impression of me, I am depressive. Clinically. Sometimes, debilitatingly. But only my two closest friends and my psychiatrist (no, not even my family) know how grim I can get.

*

Here’s how it usually goes when I mention it to the uninformed:

“I’m sad.”

“But your life is so awesome. You are so awesome. Cheer up!”

*

I don’t know how to write about it. It’s embarrassing. And I don’t understand it.

But I do know what pisses me off about it.

Articles like this one, recently published in The New York Times:

Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy

The article examines the switch from psychiatric talk therapy to becoming mere pill factories and how disgruntled older psychiatrists are (or aren’t) about it and how patients are suffering nonetheless.

*

I was going through a crippling wave of depression about seven years ago. I was finally convinced to see my friend’s psychiatrist. I was terrified. This would be my first trip to a real, live, “New York Shrink”.

I had been to one social worker/therapist in Chicago six years before that, but with awful results. After two visits and a recommendation for a bottle of St. John’s Wort and a couple bars of dark chocolate, I was sent home with a treacle-dripping “Feel better!” and a wave.

And that was during the truly borderline years.

So while I told myself that a ‘professional’ would be better than that particular weirdo therapist, I knew I didn’t want drugs to solve my problems. I knew I was a smart person and that I could figure things out if someone would just listen to me and understand me and give me some tools to help me fix the sadness.

*

I got a prescription for Zoloft at the end of my first visit.

“After you’re chemically balanced, we’ll be able to figure out what’s really going on.”

After I was chemically balanced, I had nothing to talk about.

*

Sure, I was no longer on the emotional roller coaster, but neither did I have the capacity to talk about what was making me so miserable, because suddenly nothing was making me miserable.

I spent two years rehashing broken relationships, parental annoyances, professional disappointments, but they seemed so inconsequential. I was putting on a performance for her, because that was what I felt I was supposed to be doing, and I didn’t want to waste a penny of my $200 45-minute hour.

Also, I got fat.

Zoloft stopped what little metabolism my diabetically-inclined body has, and because I was an emotionless blob, I started eating and staring at the television all the time.

More than usual, anyway.

Add ‘overweight slob’ to my weekly schpiel.

*

Eventually, thankfully, my rational senses took over and I weaned myself off of the drugs and the shrink’s staid head-nodding, non-responsive “um-hmm” attempts at fixing me.

And for a while, I was better. I was. My brain came back. I met a guy. The thrill of meeting him was exhilarating, the orgasms were mind-blowing and the break-up was devastating.

As it should be.

*

Life resumed its normalcy.

*

Slowly, ever so slowly, the depression came back. I don’t know where it came from. It’s genetic, I had learned that, so certainly it was in my DNA. A chemical imbalance? Maybe. A learned coping mechanism? Sure. I could see that.

But whatever it was, things were getting bad again.

Really bad.

And I didn’t know how to deal, other than I knew I needed to talk and I didn’t want to keep bothering my two friends. I know friends say that’s what they’re there for, but nobody is there for long when things get like my things get.

So I looked for another psychiatrist.

But no drugs this time. I was adamant.

Plus, it took me two long years to lose those additional 40 lbs.

And I was lookin’ good.

*

I found one. One who was in the business for all the right reasons. He didn’t think I needed drugs. He even gave me a massive discount because I was broker than broke.

I talked.

He talked back.

And it helped.

A lot.

*

I’ve been away from him and our bi-monthly sessions for nine months and I can feel the all-too-familiar twinge creeping back.

But I recognize it now. And I know what to do before it gets too ugly.

I have to go talk to someone.

*

No drugs.

*

Talk.

*

My appointment’s next Tuesday.

Originally published by Press Media Group & The Lynchburg Ledger. Reprinted with permission.

A sad turn of events took place Friday when 27-year-old, Tim Davis, a local Charlottesville disc jockey with the radio station, WNRN, was taken off life support after being gunned down on the Blue Ridge parkway by another paranoid maniac with a gun, allegedly Ralph Leon Jackson, 56, of Augusta County, who was taken into custody Wednesday, April 7, 2010.

Picture a beautiful sunset, the sun falling below the horizon. The sky is turning a haze of orange and a fiery globe is sinking behind the sculpted stone structures of God’s hands. A friend is by your side and you watch, and she watches, one of the most beautiful scenes of life unveiling before your eyes. In an instant, both of you are struggling to even take one last breath, to live even one more second.

None of us knows the thoughts that went through Tim Davis as he laid there, a sitting duck by a gunman he could not see, whose gunshot he never heard because by the time the echo shouted across the Blue Ridge horizon it was already too late. We only know another headline in the papers, at the top of the hour on the news, that, in a sense, we have almost become numb to – another senseless act of violence, another shooting in the Commonwealth. Another death that, as soon as it takes place, someone makes a point to be the spokesman for gun owners this country over stating on a news website message board, on Facebook, on the television screen, “It wasn’t the gun. It was the person behind the gun.”

What if I told you that it was perfectly legal for you to purchase a gun out of the back of someone’s trunk at a gun show in the state of Virginia without a background check?

Would you think I am lying? Because I am not.

According to a 60 Minutes segment from July 26, 2009, Gun Sales: Will the ‘Loophole’ Close?, despite a 30% increase in FBI background checks in 2009 compared to 2008, “The number of FBI background checks does not reflect all the gun sales, because of something called ‘the loophole.’ In Virginia and more than 30 other states, people who aren’t gun dealers can sell firearms at gun shows without conducting background checks . . . Actually, these private sellers can peddle their guns anywhere: at shows, in their private homes, or out of their cars” to convicted felons, to the mentally ill, to any old Joe that appears off the street with a wallet in his or her back pocket or pocketbook.

We do not do extensive mental health checks in this country for a number of reasons. The number one reason is because of political pandering and the wealth and influence bought by gun advocates and organizations who do not take into account the 2nd Amendment right they so love to quote was created at a time when cannonballs still existed, when knives were still molded onto the ends of guns.

Another reason is economic. It does not pay to do extensive mental health checks – not enough resources, not enough manpower to carry out the task.

Tell me, how much is a life worth? Is it not worth it to undertake this humane initiative to curtail at least one act of senseless violence? Sure, there is no way to stop every act of senseless violence in the U.S. It would be ignorant and idealistic to think so; but if you can stop one—just one—then we have saved the grief and lives of many.

When the Appomattox shootings took place on January 19, 2010, which took the lives of eight people including three teenagers and a four-year-old, I didn’t write that a friend of mine, the boyfriend to my wife’s youngest sister, who I have known for years, lost his mom, sister, and stepdad that day because they were at the wrong place at the wrong time, dropping a friend off at her home, a home that would become the scene of a very devastating disaster to the communities and families of Appomattox, forever a fixture in so many memories.

I first heard of the Appomattox shootings from my wife via a panicked phone call while I was at work. Her sister was in the emergency room with her boyfriend. His stepdad, Jon Quarles, 43, was the man found in the road that had been shot in the head and was still alive when the paramedics arrived.

My friend frantically tried calling his mom and sister over and over again but could not get in touch with them. Almost a day passed before it was confirmed that they too had perished just as his stepdad did while they were in the emergency room at Lynchburg.

I do not know what it is like to have a family member die in such a way, to not know their fate and to have to sit and think the worst possible thoughts for so many hours that seem like an eternity. I only know what it is like to lose a close friend to brain cancer and to lose a dad to leukemia – to see their suffering, to pray with all I have that I can take away their pain and suffering. Then to know I cannot; and it pains me to see others in such a helpless situation and it is the emotions of anger, frustration, and love for these people I know and for these strangers which I do not, that fuels this article.

Honestly, what will it take for this state and this country to wake up to common sense gun laws? When will the day come that in order to purchase any gun, big or small, we will invest in extensive mental health checks? It’s more of a pain in the behind in this country to get a new photograph for my driver’s license at the local DMV than it is to buy a gun, an object with the potential to take another human being’s life.

Somehow, a certain segment of our population believes that certain politicians have an agenda to strip away the constitutional rights of gun owners. This is ludicrous. I hear relatives and friends claim that Barack Obama, the Democrats, the liberals, anyone and everyone that is not a card-carrying member of the NRA, would love to strip them of their 2nd amendment rights, that these people salivate in simply thinking they could one day bust into their homes and take away all their guns and ammunition.

Nonsense.

Paranoid, ludicrous nonsense.

For starters, gun rights have sadly been expanded since Barack Obama took office. Not only can you take a gun with you to a national forest now (when you could not two years ago), now you can stroll onto Amtrak packing heat so long as you have a gun license.

I did not learn this until after the fact when I went to Washington, D.C. for a performance at The Kennedy Center to see Young Frankenstein. Considering the tragedy of September 11 and the strict enforcement at airports, I thought to myself while boarding the train, “Are they really not checking luggage?” Then when I got home, I looked up the laws surrounding baggage checks on railways.

They do not exist.

I thought about how I sat on the train, cramped with hundreds of other passengers, the stench of sweat and the food cart being wheeled down the aisle, literally sitting ducks if someone decided to go bat shit crazy with a gun of any kind. It would have been a massacre and a massacre no one could have stopped because shooting victim headlines come and go with the news.

We may not forget about the potentials of stopping these heinous crimes as soon as another story takes its place but we sit idly by and do nothing to voice our protest after the fact. We do nothing in our legislature to prevent this from happening again, and Virginia, unfortunately is leading the pack in this regard.

We grieve. We feel saddened for the families and victims. Then we live to see another day. They don’t.

And another Tim Davis down the road will be another senseless victim because we don’t even know what to be outraged in this country about anymore.

Another Virginia Tech will take place sometime, somewhere because another Seung-Hui Cho can buy guns off the internet any old time he pleases. Another Christopher Bryan Speight will take his government conspiracy theories to the next level believing that someone is going to steal his land and his guns. Another Ralph Leon Jackson will sit camouflaged on the mountainside choosing innocent young adults as his day’s target practice to pick off.

And what do we do?

Nothing.

Nada.

Our political discourse in this country oftentimes amounts to a hill of beans. Is Barack Obama a socialist? Is the U.S.A turning into the U.S.S.A? How could Tiger Woods do such a thing? I can’t believe Heidi Montag had plastic surgery again — anything and everything that distracts us from reality, from really sitting down and making new laws that protect us and our families from the cold reality of the world we live in and seem to ignore when we wake up in the morning and go to bed at night. Alive.

We make the same pathetic arguments that you could kill someone with a knife, a pencil, or a piece of broken glass; but riddle me this: how many people can be killed at a distance with a knife, a pencil, or a piece of broken glass?

Two weeks ago, coming from a training class on the Adobe Creative Suite from McClung based in Waynesboro, Virginia, I stopped by the same stretch of road that Tim Davis met his fate on. I looked across the Blue Ridge mountains and felt the cold chills run up my arm. I felt the presence of a being more powerful than myself.

“I know you’re seeing this,” I said to my dad who died last May. The music was turned down and I gazed across the mountains taking in their beauty. It’s hard to believe less than a week later, someone could stand there just as I and meet their death in a time of great beauty as the sun fell behind the peaks.

I wrote this back in August, 2009. At the time, Palin was making her big splash about death panels, and the health care debate was lost in the fracas. By December, Palin and her death panels won the Lie of the Year Award from PolitiFact, but the damage had been done: the sound and fury was too loud, even though it signified nothing.

We remain mired in health care debate. Though the smoke from the death panels has cleared, new ridiculous problems have arisen to take its place. The seed of the piece remains as true as it did when I wrote it, though the death panels have fallen to the level of satire.

Plus, my father really wanted me to post this. I have to make Dad happy once in a while.


This health care debate–I admit I haven’t been following it all that closely. I suppose that my reasoning is somewhat lazy, as is my response to it, but not my feeling about health care. That isn’t lazy at all.

I haven’t been following because as soon as there’s the kind of vitriol and spew in the media that has been involved in this so-called “debate” the issues are lost to us. There are no more examples of what would help, how it might work, who it would effect; instead it becomes about who is the most inflammatory, who can come up with the most hysterical argument, and how we can continue to be mired in the crap unchanged and unchallenged to think in new ways.

But this is about me and my life, and I would like someone to recognize that.

For example, since we are self-employed around these parts, we also have to pick up the tab on our health insurance. Do you know what it costs? Close to 600 bones a month. Do you know what our co-pay is? Thirty bucks every time we set foot in an office, no matter if it’s to take a temperature or get a splinter out. And forget our deductible: we actually had to make the choice between 2,500 dollars per year or 10,000. I think we could call this level of insurance “catastrophic.”

What about eye care? Non-existent. For us, that means that every year, though our 5-year-old son needs glasses for something considered “medical,” his glasses are not covered by our insurance. Do you know how many glasses a kid goes through? Hundreds of dollars a year spent on specs. And my husband and I who merely have age-deficient eyeballs cough up hundreds of dollars to keep the words from blurring on the page and the traffic signs in focus.

Dental: Non-existent. This despite all the studies that have shown that good dental care is one sure-fire way to keep health costs down because of all the attendant ailments that accompany crappy teeth and gums. But that aside, let’s just talk about dollars: two hundred+ bucks apiece to get our teeth cleaned and tuned up every six months. Why do we go that often? So we can avoid the much more painful thousands of dollars that result from crummy gummies. I had to pay close to two thousand dollars a few years ago for a root canal and all its attendant horrors; I would like to avoid that again if possible, so I go to the dentist.

Of course, we have other mouth woes that we both keep ignoring; my husband’s teeth have become so crunched together they’re wearing down and I’ve been missing a tooth in back since my twenties. As a result, my teeth are wearing unevenly and flopping over. But maybe we would have those things fixed if we weren’t hemorrhaging so much money down the other medical rat holes.

Back problems? Forget it; out of pocket. I have chiro coverage, but never once has my chiropractor been paid through my insurance plan because he’s not a member of their tribe or something. Mental health issues? Better to be healthy but crazy, I suppose.

And we’ve got good health. What happens if one of us gets really sick? God help us. Individual health plans are notoriously skint on their lifetime limit–we’ve got two million bucks of coverage and then–buh-bye. Talk about a “death panel.”  Seriously, what happens if they have to fix a liver or kidney, or my heart? Do we run up to the two million and then the insurance adjuster says, “I’m sorry–we were just about to plug in that heart of yours but you’ve reached your limit.”

We’re the lucky ones. Whether by fiat or hard work we’ve been fortunate to have enough money to buy our own health insurance. Many don’t. Many of our friends, who are completely and solidly middle class, cannot afford to spend the extra money each month on their own medical insurance.

The result? Treatment for the most severe form of cervical cancer in a free clinic in Los Angeles. Pre-diabetic health monitoring that is so spotty as to be pointless. Out of pocket expenses of many-multiple thousands for a CPAP machine to keep our friend breathing through the night. Amount paid for emergency oral surgery: ten thousand dollars in cash. Two hip replacements for our friend, a young woman in her twenties, which she couldn’t pay for, and then had to claim bankruptcy. Type 1 diabetes with no insurance–a horror my step-sister has navigated partly by ducking back into school to get insured again. Otherwise, her now “pre-existing condition” rules her out of almost all other plans. What happens when she graduates?

These are ailments affecting people in their twenties through their forties. This is not a discussion about how to care for the elderly. This is about people in the prime of their life who would, with proper preventive health care and better access to good medical teams, live a long time. These same people may have their lives dramatically shortened because they cannot afford insurance.

So these discussions are an obfuscation which offend me personally. I take umbrage with these cavalierly hurled arguments because they are playing with the lives of people I love, active members of American society, taxpayers and voters, who may die prematurely because the health care system won’t care for them.

And what about my Dad?* Where is he in the discussion? The death panels apparently have him and his Stage 4 cancer singled out, but I don’t think he feels tremendously threatened by these medical bureaucrats waving their mighty pens of death over his head.

In fact, he’s relieved that his whole medical team understands in black and white terms that he does not want his life prolonged unnecessarily. That he has the choice to say no to being hooked up to machines and medical devices which may hand him a few more days or weeks, but in a manner which would hardly be called “vital.” That he may choose between that and living out his days comfortably, without strident measures, without hysteria or intubation, without medicine that is as potentially toxic as it is prolonging.

Is that last inkling of life so truly desirable, if sculpted by equipment, money, interventions, and resources that give no comfort or solace? Is the mere fact of living enough, no matter what the condition of the life? Is it life for life’s sake, or life for living?

If you ask me, and nobody did, I think this “health debate” is about a country’s unwillingness to step up to care for its citizens in a responsible way. I think it is about companies and industries so mired in bureaucracies of their own making that they cannot envision another way. I think it is about people’s lives being less important than the evolution of the pay-to-play system, and nickel-and-diming by the insurance industry. I think it is about trying to unravel the Gordian knot woven during the horrid evolution of the PPO, where codes of symptoms and ailments became more important than a holistic view of any given patient.**

We are the ones who pay the price of their inflexibility with diseases and easily treated injuries winding up in the least efficient places on earth: the Emergency Room. Or unable to save money for our retirement because we’re too busy spending it on glasses and CPAP machines, claiming bankruptcy for medically imperative operations, and insurance that is so expensive we have little left at the end of the month. So this disingenuous legerdemain being perpetrated to take the issues out of the hands of patients makes me pretty damned angry.

You can call it a death panel if you want, but I’ll take it for what it is: life and living under our own terms.

*Painting by my father Charles Moone, called “Self Portrait,” painted in 1972. His headstone reads: “Where Will You Spend Eternity?”

**Sometimes there are even articles to back up my opinions! A nice article called the “Five Myths About Health Care Around the World” from the Washington Post, which I found on Metafilter after I wrote this. Call it synchronicity.