Pit Bulls and Fire Hoses

“It comes as a great shock around the age of 5, 6, or 7 to discover that the flag to which you have pledged allegiance, along with everybody else, has not pledged allegiance to you. It comes as a great shock to see Gary Cooper killing off the Indians and, although you are rooting for Gary Cooper, that the Indians are you.”
-- James Baldwin 1924-87: Cambridge Union, England, 17 February 1965 (On the American Dream and the American Negro)

THE MCCPALINATOR EXPRESS

Take a good look at Ricky Thompson here. He’s the kind of banjo playin’ Deliverance He-Bloken, Limbaugh worshippin’, redneck hayseed that fantasizes about a Palin blowjob while contemplating what we should do about the possibility of putting a nigger-terrorist in the White House. Here’s what he had to say about Barack Obama’s racial heritage: “He’s neither-nor. It’s in the Bible. Come as one. Don’t create other breeds.” Here’s some more chestnuts from our southern brethren: “I would think of him as I would of another mixed race. God taught the children of Israel not to intermarry.” Thank you Mr. Glenn Reynolds of Martinsdale Virginia. A guffawing James Halsey had this to say: “He’s going to tear up the rose bushes and plant a watermelon patch.” Hardyharhar! Jim Pagans of Roanoke Virginia wisely noted that although Obama was “half-Caucasion,” he had the characteristics of the blacks.” WOW!

Recall this passage from Sarah Palin’s speech at the Republican convention: “And a writer observed, ‘We grow good people in our small towns, with honesty and sincerity and dignity,’ and I know just the kind of people that writer had in mind when he praised Harry Truman.” This “writer” Palin is referring to is none other than the notorious right wing bigot, Westbrook Pegler. Who, you may ask, was Westbrook Pegler? Tiphanie Dickson, a defense attorney who specializes in international criminal law offers a description of Pegler and some of his quotes: “’This Truman,’ Pegler wrote, when Harry was nominated for vice president, ‘is thin-lipped, a hater, and not above offering you his hand to yank you off balance, and work you over with a chair leg, a pool cue, or something out of his pocket.’ Pegler's earlier description of Truman lacks in homespun integrity what it more than makes up for in grit: Truman is portrayed as a pit bull, another of the strongest notes in Palin's speech. Westbrook Pegler was not just a Hearst populist, he was a raving McCarthyite whose hatred of communists ultimately turned his prose into anti-semitic bile.”

But let’s talk McCain. Thomas Dowd, the former Bush strategist had this to say on Tuesday, McCain “ knows that…when this race is over….he put somebody unqualified on that ballot, and he put the country at risk.” On McCain’s stooping to sic the Palinese Mastiff on what turns out to be a not-so-gullible public, Christopher Hitchens writes, “Given the nasty and lowly task of stirring up the whack-job fringe of the party’s right wing and of recycling patent falsehoods about Obama’s position on Afghanistan, she has drawn upon the only talent that she apparently possesses.” David Brooks called her a “fatal cancer on the Republican Party.” Oh yes, Palin does have one high profile admirer.

In today’s New York Times, Julie Bosman writes: “Perhaps no one else in the media has gushed over Gov. Sarah Palin more than Rush Limbaugh, the conservative radio host. On Tuesday, Ms. Palin, the Republican nominee for vice president, returned the favor, calling into his show from the campaign trail in Scranton, Pa., before heading into a morning rally. ‘I tell you, I’m in a quandary here this morning,’ Mr. Limbaugh began. ‘I admire you so much. I really don’t even know what to ask.’” It really wouldn’t matter, since Palin has already shown herself incapable of answering a direct question. Of Palin and Limbaugh I would say this: simple minds think alike.

But I said McCain, so let me get back to that. Nat Hentoff, a truly maverick and bi-partisan intellectual when it comes to standing up for all citizens’ civil liberties, wrote this about Barack Obama’s crediting McCain for his stance against torture:

“His [McCain’s] actual votes in Congress tell a different, shameful story. He voted for the Detainees Treatment Act of 2005 that stripped Guantanamo Bay prisoners of their habeas corpus rights (until the Supreme Court tried to intervene). That law added an "appeal" procedure that prevented prisoners from appealing their conditions of confinement -- where the "coercive interrogations" and brutal force-feeding happened with no objection from McCain. In 2006, McCain voted for the Military Commissions Act after the Supreme Court (Hamdan v. Rumsfeld) temporarily restored habeas rights at Guantanamo. That new law essentially overruled the Supreme Court for a time and gave George W. Bush the right, by himself, to interpret the Geneva Conventions, which expressly forbid "cruel, inhuman and degrading treatment" of prisoners. When the president then, by executive order, continued the "special powers" he had given the CIA in their secret prisons ("black sites") wholly beyond U.S. and international laws, McCain did not object. It was in one of those prisons, we now know, that the CIA practiced waterboarding, a criminal act, according to our (and international) laws.”

THE ECONOMY

No amount of bailing is going to keep the Titanic that is the American economy from sinking. Yesterday’s bailout, when the CEOs of the largest banks in the USA were handed a $250 billion dollar credit stimulus, reminded me of the scene from Titanic when Billy Zane asks if there is room for a “gentleman” in the lifeboats loading up the upper crust women and children. He, of course, survives, while the lower class masses in Steerage are delegated to a watery grave. Stuart Hoffman, chief economist at the PNC Bank, had this to say about the giveaway to the rich: “Everything the government has done is not going to prevent further deterioration in the economy. At the end of all this, what matters is what the economy does.” So what if these fat cats have been handed billions to lend. Who can buy anything when no one has a job and unemployment rate is skyrocketing. None of this band aid quick fix crap does a thing for the auto companies, and oh, by the way, any Ford, GM, Chrysler, type of merger would only lead to more layoffs and higher unemployment. Fasten your seat belts folks, the gangster vultures are getting hungry and the public feast is about to begin. Greed is the order of the day. Any fool who’s watched these money-thugs knew that the 900+ gain on Monday would be gone by today (Wednesday). And oh, by the way, as I write this the Dow is down 600+ points. These guys are so addicted to the fast buck they’ll fuck each other, or for that matter their own mothers, on the whimsical possibility of a quick profit. Let’s privatize the profits and socialize the debt. What if they had privatized medicare, or social security? I just checked again, make that down 700+ points. How’s your retirement fund doing friends?

And now a word from Sudsy

Remember when pathetic losers used to yell "Get a job!" or "Go back to Russia!" when we'd protest the Vietnam war? If you have the stomach for it, watch these pathetic losers (McCain supporters) on "The Sidewalk to Nowhere" in Bethlehem, Penn. 

How To Quit Smoking

“A custom loathsome to the eye,
hateful to the nose, harmful to the
brain, dangerous to the lungs, and in
the black, stinking fume thereof,
nearest resembling the horrible
Stygian smoke of the pit that is
Bottomless.”
-- James I 1566-1625: “A Counterblast to Tobacco” (1604)

“The wretcheder one is, the more one
smokes; and the more one smokes
the wretcheder one gets—a vicious
circle!”
-- George du Maurier 1834-96” “Peter Ibbetson” (1892)

WASHINGTON, DC — September 10, 2004 — Smokers risk damage to almost all major organs in their bodies, according to the latest report by the surgeon general (Health Consequences of Smoking, Surgeon General’s Report). The list of diseases caused by tobacco now includes cancers of the kidneys, stomach, cervix, and pancreas as well as leukemia, cataracts, pneumonia, and gum disease. These illnesses are in addition to diseases previously known to be caused by smoking— bladder, esophageal, laryngeal, lung, oral, and throat cancers, chronic lung diseases, coronary heart and cardiovascular diseases, and sudden infant death syndrome.
Smoking also reduces overall health, contributing to conditions such as hip fractures, complications from diabetes, increased wound infections

following surgery, and various reproductive problems.

Smoking cigarettes with lower machine–measured yields of tar and nicotine does not help. “There is no safe cigarette, whether it is called ‘light,’ ‘ultra–light,’ or any other name,” U.S. Surgeon General Dr. Richard Carmona commented. “The science is clear: the only way to avoid the health hazards of smoking is to quit completely or to never start smoking” (Health and Human Services, Press Release).
By current estimates, tobacco use causes 440,000 deaths per year and costs about $157 billion in health–related losses. An estimated 46,000 adults smoked in 2001. On average, men who smoke cut their lives short by 13.2 years, and female smokers lose 14.5 years. “Since the 1964 surgeon general’s report, more than 12 million people have died from smoking–related illness,” Dr. Carmona said. “These include 4.1 million deaths from cancer, 5.5 million deaths from cardiovascular diseases, 2.1 million deaths from respiratory diseases, and 94,000 perinatal deaths…We’ve known for decades that smoking is bad for your health, but this [latest] report shows that it’s even worse than we knew. The toxins from cigarette smoke go everywhere the blood flows.”

Quitting smoking has immediate as well as long–term benefits, according to the surgeon general’s report. The heart rate drops towards normal and circulation improves. The risk of having a heart attack or stroke or of developing lung cancer diminishes. Even seniors who quit after many years can experience positive effects. A smoker who gives up the habit at the age of 65 reduces his or her risk of dying from a tobacco–related disease by half.

Dedicated to the memory of Bill Behnke, Dale Bergland, Doris Campbell, Mary, Francis, and Roy Tuttle, and all those whose lives have been cut short by smoking.

Peace- Randy

"WE DON'T NEED ANOTHER HERO" Tina Turner

“The infliction of cruelty with a good conscience is a delight to moralists. That is why they invented Hell.” Bertrand Russell 1872-1070: “Skeptical Essays (1928)

POLITICS

Anonymous has left a new comment on your post "Stepford Politics.”

”Does a Sarah Palin really matter? Won't there be countless reinventions of mediocrity to strut and rant upon the media stage? The public remains hypnotized by the sham of so called representation while the true goals of the House and Senate are to increase the wealth of the actual ruling class thereby realizing the logical outcome of capitalism--full scale economic global de-stabilization, a seamless power grab at cyber speed.Welcome to the brave new world of new age acceptance; ain't it empowering to know all your carrots were merely sticks to keep you performing your useless tricks? Political correctness, gender equality, double income, Mcmansion mortgage, whole fool diets, minimum slave wages, union busted, baloney education, oh, and sex, sex, sex! Social "gains" that merely ensure the steady erosion of the individual. Wonderful social engineering! Then unleash a climate of fear and confusion to achieve the final answer -- obedience. Welcome to the New Slave World.”

“WASHINGTON – An investigation by the military has concluded that American airstrikes on Aug. 22 in a village in western Afghanistan killed far more civilians than American commanders there have acknowledged, according to American military officials.” (Eric Schmitt, The New York Times 10/08/08)

“The Bush administration this month is quietly cutting off birth control supplies to some of the world’s poorest women in Africa. Thus the paradox of a ‘pro-life’ administration adopting a policy whose result will be tens of thousands of additional abortions each year—along with more women dying in childbirth.” (Nicholas D. Kristof, The New York Times 10/09/08)

I hate it when my students quote the dictionary, but a recent essay in The New Republic (“Death Defying: Heroism’s grip on the political subconscious,” John B. Judis 10/22/08) has compelled me to do exactly that. My dictionary has 14 different meanings of “character.” The two I want to single out are, 4, moral or ethical strength, and, 9.a., a notable or well-known person. Regarding this second definition, the point of Judis’s article is that “heroism,” as it applies to the American public’s opinion of what makes a good leader, is a far more important aspect of presidential elections than “moral or ethical strength.”

According to Judis, unlike parliamentary governments, where the prime minister dictates policy and oversees legislation, the American president functions as both head of state and political leader. Judis cites George Mason, delegate from Virginia to the first U.S. constitutional convention, in defining the presidency as an “elective monarchy,” which only makes sense if we think of how King George W. Bush has managed the office. This would explain why an actor, like Ronald Reagan, was so attractive to the electorate. We care less about policy issues than matters of character. We would much prefer Shane to Jimmy Carter, or Arnold Shwarzenegger (if he were American born) to Dennis Kucinich.

In essentially applying a Freudian psychoanalytical reading to the uniquely American psychological attraction to heroic candidates, Judis argues that stories like McCain’s “resonate with Americans’ deepest fears and hopes about their own mortality.” In other words, our fear of death, what Freud described as our repression of the death instinct, “thanatos,” is assuaged by those who live with risk, overcome danger, and altruistically resurrect themselves after surviving a rite of passage that results in a state of rebirth rather than death. If Dorothy from “The Wizard of Oz” were to run, she would win in a landslide (would that Sarah Palin demonstrate Dorothy’s wisdom). Judis, of course, cites Joseph Campbell’s “Hero With a Thousand Faces,” but he might just as well have quoted Mircea Elliade, or Clifford Geertz on the Christian (supernatural and monothestic) co-option of pagan (anthropomorphic and polytheistic) hero-stories.

Judis’s point is that because our innate fear of death must be constantly repressed, lest we walk around in a paranoid psychosis over our ultimately impending doom, we look for embodied analogues (other humans) that represent what it means to ignore our own fear of death.

What we should take from this is that, in the words of Tina Turner, “we don’t need another hero.” And so as Bush rides off into the sunset, we need to radically reinvent ourselves, which is, after all, a quintessentially American trait; and reject the long held American-Frontier-Western-Myth of redemption through violence which can only undermine the repositioning of America’s place in the post-twilight of empire; and courageously shout at the top of our collective lungs, “Shane, DON’T come back.”

Larry Campbell

Stop All the Clocks ...

by W. H. Auden

Stop all the clocks, cut off the telephone,
Prevent the dog from barking with a juicy bone,
Silence the pianos and with muffled drum
Bring out the coffin, let the mourners come.

Let aeroplanes circle moaning overhead
Scribbling on the sky the message He Is Dead,
Put crepe bows round the white necks of the public doves,
Let the traffic policemen wear black cotton gloves.

He was my North, my South, my East and West,
My working week and my Sunday rest,
My noon, my midnight, my talk, my song;
I thought that love would last for ever: I was wrong.

The stars are not wanted now: put out every one;
Pack up the moon and dismantle the sun;
Pour away the ocean and sweep up the wood.
For nothing now can ever come to any good.

“Life is a great surprise. I do not see why death should not be an even greater one.”
-- Vladimir Nabokov 1899-1977: “Pale Fire” (1962)

I first met Larry Campbell when he was 10. I was about to marry his sister, Marcia, and, since I like most kids, except sometimes my own, we hit it off fabulously. Like his beautiful mother, Doris, he loved nature in every way. He knew where to find Whooping Cranes, Chanterelles, Partridge, Sulphur Shelf, wild Watercress, Chicken-in-the-Woods, Loon, Morels, Deer, Trout, Ducks, and all that makes this world sacred. No doubt he got this from his sainted mother. Doris didn’t talk to the animals, but I have to think she came closer to this miracle than even St. Francis of Assisi. Here was a hockey mom that could’ve run the world, but Doris was above such hubristic nonsense. She was a photographer, conversationalist, master chef, and naturalist, intuitively gifted in all of these things. After Jim and Larry would fish Big Bay, she’d prepare a fish boil whereby she would bring a spicy delicious cauldron of water to a bubble and gently cook the fish to perfection. She also made Brandy Manhattans that I have yet seen topped, even in Manahattan itself.

Larry was a fantastic hockey player. Having played in the state finals at U-M’s Yost Arena in Ann Arbor in, I think, 1977 (I have photos of those games), he held a number of records at Marquette High that stood for years. After that he graduated from Michigan State University and subsequently worked with the Michigan DNR and Department of Fish and Wildlife. One time I saw Larry working the Lamprey weir on the Iron River. Recognizing my kids’ curiosity, he fished out one of the slithering eels and showed us its suckerlike mouth, causing the children to be taken aback by that wondrous disgust that so delights the young. Another time, I took George Bedard out to Presque Isle, where we stopped at Black Rock cove. So, we’re standing there, admiring the sublime majesty of Gitchee Gumme, when lo and behold, an entity reminiscent of the creature from the black lagoon emerges from the water looking like something out of Jules Verne’s 20,000 Leagues Under the Sea! It was Larry. Yes, he was also an accomplished scuba diver.

As a personal testament to Larry’s knowledge of field and stream, I offer two examples. He once took my kids, Russ and Sarah, fishing on Lake Independence, where they promptly limited out on Walleye. He then skillfully fileted them and presented them as a Chinese dish much akin to Red Fish with Hoisin sauce. Yummy! On another occasion, we needed a garnish for a particular venison mushroom delicacy he prepared. No problem. We hopped in the Scout, drove down 550 to 510, and parked above Clear Creek, where Larry quickly scooped up the wild watercress needed for our repast. Mmmm…good! Having worked as a chef at the exclusive Huron Mountain Club, Larry was, like his mom, an excellent cook.

Given my avowed atheism, it may surprise some that I believe in angels and demons. How, you may ask, can this be? It’s simple, I see these entities as terrestrial phenomena, that is to say, of this world. For me, angels are physical, outward manifestations, in that they take the form of people. Doris was one such angel. Demons, on the other hand, are internalized, psychological behaviors and characteristics, something that all but the most blessed of us must deal with and struggle against. I wish I could count myself as a part of that blessed group, but I can’t.

When I die, I have told those close to me that I want my ashes spead across the waters off Squaw Beach. And then, I too might join Larry in that bliss of an hereafter with no void or vacuum. A state of nothingness where no demons lurk and peace prevails, free from the grips of this mortal coil. We love you, Larry.

Peace - Randy

Stepford Politics

“Take care of the sense, and the sounds will take care of themselves.”
-- Lewis Carroll 1832-98: “Alice’s Adventures in Wonderland,” (1865)

Yep, it’s Me again. It’s a Sunday morning, praise God, and I’m going to experiment with presenting a rhetorical editorial salad that combines quotes from the columnists, Charles M. Blow, Bob Herbert, Gail Collins, and Steven Pinker. All passages are from the op-ed page of the Saturday, October 4, New York Times. You will also find the sage analysis of Me Interspersed among the quotes. So here goes.

Let’s take the lipstick off the pig. Impenetrable, that’s the only word I could think of in listening to Sarah Palin’s performance in the veep debate. Remarking on Palin’s perceived success with her conservative base, Charles M. Blow had this to say: “In truth, after her horrendous performance with Katie Couric, anything short of her head spinning around and spewing vomit would have been considered an improvement.”

She presents a run-on word jumble that out sudokus the hoodoo man. Some kind of weird Rubik's-cube-speak. Say what? No wonder she said, “I may not answer the questions the way that either the moderator or you want to hear.” Bob Herbert had it wrong when he raised the frightening possibility that “the country could be left with an exclamation point as president.” I think “ex-claymation” is a better description of Palin’s public image. “Say it ain’t so, Joe.” Why did this non-sequitor admonition leave Biden looking like Kevin Kline during that orgasm in “A Fish Called Wanda.” Here’s Herbert: “Of course [Biden] didn’t know where to start because Ms. Palin’s words don’t mean anything. She’s all punctuation.” The only constituency that might possibly have understood her were the Joe six-pack voters sleeping on couches with a football game blaring in the background. She even had Shadow cocking her quizzical little head.

Gail Collins writes: “In an airplane hangar in Ohio recently, she told the people of Youngstown she was happy to be there because Alaska has, per capita, the nation’s most ‘small planes and small pilots.’” This was obviously a Freudian slip, much like her “drill baby, drill,” mantra, which I’m sure she intones when she’s atop her Eskimo-pie daddy. The Russians can probably hear them from Kamchatka. K2 comes to Denali. Of course the Palinator, dyslexic has she is, still thinks the locals call it Denial. Anyway, no doubt her reference to “small pilots” is a swipe at Ohioan men's small dicks. Which is why them rutting, buckeye, he-cops in their Smokey hats have to vote for Obama. I mean she’s implying that Terelle Pryor has a mini-wang. “Say it ain’t so, Sarah.”

Steven Pinker contends that Palin fared much better than in her face-to-face interview with Katie Couric “because in a one-on-one conversation, you can’t launch into a prepared speech on a topic unrelated to the question….When the questioner is 30 feet away on the floor and you’re on a stage talking to a camera, which can’t interrupt or make faces, you can reel off a script without making faces.” This made it easier for her insane Stepford grin to Svengaliize a public Ostrich that momentarily reared it’s sandy head. As Blow put it, “Palin launched into her charm offensive—winking, smiling, dodging questions and speaking in her signature Sarah-phonics, a mash up of sentence fragments and colloquialisms glued together with misplaced also’s and there’s—gibberish really.” If Palin meant to emphasize the desperation fueled Republican theme that, as Pinker puts it, “expertise is overrated, homespun sincerity is better than sophistication, [and] conviction is more important than analysis,” she was golden. So what does intellect and critical thinking amount to in the McCain scheme of things? Here’s Pinker: “Being able to see Russia from Alaska, then, means you have an understanding of foreign policy; living in an Arctic state means that you have an understanding of climate change. In Mr. McCain’s case, it means, as he wrote last month, understanding technology policy because he flew airplanes in Vietnam and being concerned about the ocean’s health because he served in the Navy.” It’s worth remembering, as “Rolling Stone’s” Tim Dickinson reminds us, Bush was a better pilot than McCain.

On the issue of global warming, she was only interested in discussing how to limit its impact, and not the issue of causality. And this makes perfect sense if your overarching political agenda involves finding ways to maximize profits while continuing to pollute the earth. Responding to Dick Cheney’s bizarre, Strangelovian notion that the vice president is a part of both the executive and legislative branches of government, Palin offered up this pre-simian response: “Well, our founding fathers were very wise there in allowing through the constitution much flexibility there in the office of the vice president. And we will do what is best for the American people in tapping into that position and ushering in an agenda that is supportive and cooperative with the president’s agenda in that position.” Say what? A lot of “there’s” and “agenda’s” there. Given that folks like Palin, Antonin Scalia comes to mind here, see the constitution as an “enduring,” that is to say, static document, one can only ask who watched these “founding fathers’” slaves while they were in Philly, and how Palin feels about the fact that women were not given the constitutional right to vote until the 20th century. Should we not have abolished slavery and given women equal rights? Collins has a point in seeing Palin’s ascendancy as a consequence of the women’s liberation run amok, as its dark side: “This entire election season has been a long-running saga about the rise of women in American politics. On Thursday, it all went sour.”

Palin had this to say about the possibility of using atomic weapons: “Nuclear weaponry, of course, would be the be-all, and end-all of just too many people in too many parts of our planet, so those dangerous regimes, again, cannot be allowed to acquire nuclear weapons, period.” Can you imagine Palin’s finger on the button. Praise God! Nevermind that North Korea just started up their nuke production again after Bush lifted all sanctions against a country that has a starving population and absolutely no regard for human rights. And, speaking of “dangerous regimes” posing global annihilation, none is more threatening than our anti-terrorist ally, and a country about to be overrun by maniacal fanatics, Pakistan. Lastly, that most dangerous of regimes, and the one with far and away the greatest nuclear arsenal is, of course, the United States. We have met the enemy, and they are us!

Next time I’ll tell you how I really feel.

Love - Me

PAIN versus SUFFERING?

“About suffering they were never
wrong,
The old masters: how well they
understood
Its human position; how it takes place
While someone else is eating or
opening a window or just walking
dully along.”
-- W. H. Auden 1907-73: “Musee des Beaux Arts” (1940)

A good physician has four central tasks: ascertain what the ailment is (diagnosis), get to the bottom of why it occurred (cause), prescribe a course of action (treatment), and, related to treatment, forecast the consequences (prognosis). But there is a danger in isolating this chronology from a fifth, and often overlooked, component—the suffering person. The traditional, and fundamentally flawed, assumption is that, while people may be different, diseases are static entities. In other words, lymphoma is lymphoma, no matter who has it. But as any doctor worth her salt knows, the sufferer and illness aren’t discrete entities, and to treat them as such is tantamount to throwing out the baby with the bathwater. As an example of this, I would cite an incident from my own cancer experience.

During the course of my chemotherapy, my physician, Dr. Asra Ahmed, would regularly consult with her boss, the world renowned lymphoma expert, Dr. Mark Kaminski. At one point, because of some extremely high AZT/liver levels in my blood work, and because of the complication of my having hepititis C, she asked Kaminski about lowering my chemo dose. His response was that (and he may have been right) based on my history and past blood enzyme levels, I could take the toxic hammering. Now, I don’t know if my current state of health and continuing remission can be attributed to Dr. Ahmed’s decision, but I would say what she elected to do was based on her medical intution, as well as the experiential component of the doctor-patient relationship. She lowered the chemo dosage as a kindness to my gizzard, err, liver, based on a purely subjective equation that weighed the potential future damage to my liver against the success of the chemo in eradicating the cancer. To my mind, this amounted to a holistic decision. In a sense, she took the calculated risk of, at once, keeping me off the transplant list and eliminating the cancer. Good job, Asra. My point is that the dynamic between disease, sufferer, and I would argue, doctor, is always unique and unprecedented.

Regarding palliation, the treatment of disease and alleviation of suffering can’t be separated. As I recently told a friend, a physician can be a good doctor, but a poor pain manager. The treatment of illness requires more than knowing the nature of the disease and the science that accounts for it; it also demands a compassionate understanding of the person who is ill. Again, consider another example from my own experience. One of the paradoxes of modern medicine is that suffering is commonly the result of the treatment rather than the disease. In brief, I found there are two components to cancer suffering, pain related to symptoms, that which drives you to the doctor, and pain related to the treatment, that which results from the side-effects of chemo (which I’ve discussed in some detail at other times in this blog). Regarding treatment suffering, cancer patients are typically given palliative medications should they experience specific discomfort, like bone, nerve, or tumor pain. But aside from the specific physical pains, there is an existential pain, a general feeling of feeling crappy about feeling crappy, if that makes any sense.

Key here, is my struggle to name exactly what kind of discomfort I experienced. This is where Eric J. Cassell’s definition of suffering as “the state of severe distress associated with events that threaten the intactness of person” seems apt. He found that while there are many references to pain in medical and social science literature, there is a dearth of information on suffering. Because suffering is associated with mind in the traditional Descartian paradigm, Cassell writes, “as long as the mind-body dichotomy is accepted, suffering is either subjective and thus not truly “real”—not within medicine’s domain—or identified exclusively with bodily pain.” It’s no accident that nurses and physician’s assistants would invariably ask, ‘where, specifically, is your pain? To say ‘I’m suffering,’ rather than I’m in pain would, no doubt, draw a blank, and affect a return to the issue of specific pain. Which is why I always had a readily available laundry list of specific pains, should I encounter a skeptical nurse (of which there are many) trying to disabuse me of what she considered to be my somatic misconceptions.

In my case, I made the decision to use pain--don't call them suffering--meds, which I self-monitored in a controlled way, as a way of allowing myself a distraction from the general malaise which so often accompanies prolonged illness. My doctor could have questioned this decision. She might have staked out a moral high ground to which I could only aspire. She didn’t, and I’m glad. There is no greater mistake a doctor can make than to assume a knowledge of someone else’s pain based on cruel and barbaric assumptions related to intellectual and moral paternalism.

Cassell’s influential book, “The Nature of Suffering And The Goals Of Medicine” (1991) makes the case that the task of medicine in the 21st century is to learn more about the relationship between healing and personhood. Focusing on the historically intractable assumption that the subject is unknowable, Cassell contends that the similarity of our ideas, language, customs, and cultural beliefs allows us to know much more about who we are as individual persons than is commonly thought. He argues that just as the focus of the 19th and 20th centuries was on the “power of the body,” our future aim should be on the person who is sick as much as the sick person. Cassell believes that the modern prejudice that all knowledge apart from scientifically arrived at facts is not real, has delegated any subjective inquiry into what individual suffering entails as invalid.

Cassell writes: “Our perceptions of other persons are not based on elemental facts alone but also on values and aesthetic criteria….[v]alues are not mere prejudices but a kind of information that can be consistently and reliably employed in our knowledge of persons. Were it not so there would be no stability in our personal or social lives. Aesthetic criteria, which at first might seem foreign to medicine, are also essential for knowing whole persons within space and across time. Values and aesthetics raise the specter of subjectivity so worrisome to medicine and medical science.”

What Cassell emphasizes is that experiential knowledge, as much as scientific expertise, must act in concert if the physician is to be successful in relieving pain and suffering. If passion and emotion must enter into the equation, so be it. It bears remembering that people treat people, and that machines, medicines, and chemical remedies can never provide that central ingredient in the alleviation of suffering—empathetic understanding.