Author: Ed Weathers

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Opinion Viewpoint

Look Up, Not Down: A Message to Young Trump Supporters

CREDIT: Palinchak | Dreamstime

Editor’s note: Longtime journalist (and former Memphis magazine editor) Ed Weathers posted the essay below on his Facebook page. We thought it well worth sharing with Flyer readers.

The following is a screed that’s way way way too long for my Facebook page. For nearly all my friends, it will amount to preaching to the choir. On the other hand, the people who need to read it aren’t my friends on Facebook, so they won’t read it, either. In other words, what I write here will serve no useful purpose other than to let me vent. So here I go, spitting in the wind. …

Palinchak | Dreamstime

Donald Trump

Recently some younger Trump supporters I know — folks in their 20s and 30s — have expressed disdain toward fast-food workers who are asking for higher wages. They claim that such low-skilled jobs don’t deserve higher wages and that a higher minimum wage for them would just devalue the work of more skilled folks like themselves — first responders, welders, mechanics, construction workers, and the like.

These young Trump folks also resent anyone on welfare and, of course, most immigrants. They see all these folks as somehow damaging their own economic prospects or undermining their own small economic successes.

Their attitude infuriates me and discourages me. Here’s what I have to say to them:

If you’re a Trump supporter struggling to keep up with your rent, pay for your medicine, feed your kids, and maybe buy a small pick-up truck on long-term credit, then there’s a good chance you’re directing your anger, resentment, and disdain at exactly the wrong people.

You have bought into myths designed to protect the rich and feed their greed. You have been duped.

It’s not poor immigrants or the folks on welfare or the fast-food workers asking to raise the minimum wage who are keeping you down. No, your enemy is the Wall Street broker and the oil tycoon and the $40 million-a-year CEO who are sponging up the wealth before it ever trickles down to you. Your enemies are folks like the Koch brothers, Sheldon Adelson, the DuPonts, and the politicians they have in their pockets.

The super-rich want you to direct your resentments down the economic ladder at others, like yourselves, who are simply trying to get through the month without going hungry. They want to distract you from looking up the economic ladder at those who are exploiting the labor of folks just like you in order to pad their penthouses with more gold-plated trappings.

Many of the super-rich and their enablers (Republicans mostly but not exclusively, and Fox News) want you to think that if they make millions or billions of dollars, it’s because they are smarter or work harder or are more God-blessed than the rest of us.

I’ve spent time with the super-rich: They don’t work as hard as you do, and the only smarts they have is the sophistication to work a rigged system. Most of them have simply been lucky — no better than the guy who made a gazillion dollars from Beanie Babies. As for how God feels about the very rich, I refer you to the New Testament.

Many of the super-rich also want you to think of them as some kind of heroic “job creators.” That’s not what they are. It’s not what they’ve ever been.

No, the job creators are folks like you, who spend your whole income to buy the things you need and thereby keep every useful business in the country running. In fact, the super-rich are what they have always been: not job creators, but money manipulators and labor exploiters.

Yes, my young Trump-loving friends, you are being duped. When you look down at the fast-food server or the welfare mother or the immigrant farm worker, you’re looking where the super-rich want you to look — in exactly the wrong direction.

When you start looking up, so will our democracy.

A former editor of Memphis magazine, Ed Weathers is now retired and lives in Blacksburg, Virginia.

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Opinion Viewpoint

Battling Big Pharma: 10 Ways to Lower American Drug Costs

CREDIT: Greg Cravens

Fifty-five percent of Americans take at least one prescription medication.

Americans spend more than $325 billion per year on prescription drugs. We pay, by far, the highest prices for necessary prescription drugs in the world. We spend 50 percent more per capita on drugs than, say, Canada and Germany, and two to six times as much for specialty pharmaceuticals such as cancer and diabetes drugs.

The pharmaceutical industry wants to keep it that way. That’s why today it has 1,100 lobbyists in Washington, D.C. In the 2016 elections, it spent $58 million to support the campaigns of congressional and presidential candidates. This year, it will spend about $300 million on congressional lobbying. No wonder Congress is, shall we say, a bit shy about passing legislation that might lower the profits of U.S. drug companies.

Greg Cravens

But if Congress did want to lower drug prices, here are 10 things it could do. Some of these proposals are conservative (fewer drug regulations), some liberal (more government involvement in pricing). Nearly all are supported by a majority of voters in both parties:

1) Let Medicare negotiate drug prices. Nearly a third of all prescription-drug spending in the U.S. is done by Medicare, meaning it could have tremendous leverage to lower drug prices. Yet Medicare is, by law, forbidden from negotiating with pharmaceutical companies over the prices of the drugs it pays for. If Medicare negotiates, drug prices will drop.

2) Give generics a fighting chance. In theory, when the patent on a brand-name drug lapses, similarly effective, similarly designed generic drugs can enter the market to provide price competition. But FDA rules place huge obstacles in the way of creating generics; approval of a generic can take many years and cost millions of dollars. And Big Pharma often games the system: For example, a Big Pharma company can make a small, medically meaningless tweak in a patent-expired drug and then claim it is a “new” drug that is not duplicated by generics. Big brand-name companies are also known to pay smaller generic companies to keep their generics off the market, thereby avoiding generic competition.

3) Make drug companies justify their pricing. Require drug makers to be transparent about their manufacturing, research, development, advertising, and lobbying costs, and about how much profit is built into the price of each drug. Profiteering companies would be publicly shamed into moderating costs.

4) Allow drugs to be imported from Canada. Canadian drugs are just as safe as drugs made and sold in the U.S., and they are cheaper. But current Food and Drug Administration (FDA) rules, sometimes written by Big Pharma lobbyists, put big obstacles in the way of importing Canadian drugs.

5) Let more drugs be sold over the counter. In other countries, safe, well-researched drugs like statins and birth-control pills are sold over the counter, thereby eliminating the prescriber and pharmacy middlemen for many drugs.

6) Give automatic approval to drugs approved by the European Medicines Agency (EMA). Like Canadian drugs, these are as safe as FDA-approved drugs. The EMA’s approval process is at least at tough as that of the FDA, and the drugs are far cheaper, in most cases, than their American equivalents.

7) End direct-to-consumer advertising of prescription drugs. These are those TV ads you see during the nightly news. They often encourage the public to buy more expensive drugs than they need.

8) Set prices based on the effectiveness of drugs. Compel drug companies to reveal, more transparently than they do now, just how well their drugs work compared to their cheaper competitors.

9) Control the “orphan drug” designation more tightly. An orphan drug is a drug used by very few patients. To get a pharmaceutical company to make and sell the drug, the government gives it a monopoly on the drug, and then allows it to charge whatever it wants — sometimes thousands of times what the drug costs to make. Many Big Pharma companies have found ways — too complex to go into here — to earn the “orphan” designation by skirting regulations.

10) Stop issuing patent monopolies on essential drugs, and have the government determine those drug prices. This has worked in other developed countries, but it won’t soon happen here — too many Big Pharma lobbyists. No sense tilting at windmills, so better to focus on items 1 through 9.

Ed Weathers is a former editor of Memphis magazine, now retired from the faculty of Virginia Tech. He lives in Blacksburg, Virginia. Read about Ed’s personal battle with Big Pharma in the September 2017 issue of Memphis or at www.memphismagazine.com.

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Opinion Viewpoint

Anatomy of a Success

CREDIT: www.recovery.org

If you call something a “failure” often enough and loud enough, the public and the media will believe you — even if it’s not true.

This, unfortunately, has been the case with respect to the federal government’s response to the 2007-09 fiscal crisis now known as the Great Recession.

To review: In October 2008, in its initial response to the crisis, Congress, encouraged by the Bush administration, passed the Troubled Asset Relief Program (TARP) — sometimes called the “bailout.” Then, in early 2009, Congress, encouraged by the Obama administration, passed the American Recovery and Reinvestment Act (ARRA) — often referred to as the “stimulus.”

Since then, many politicians and pundits have vilified both TARP and ARRA, often conflating the two into the single term “stimulus” — a word they tend to say with a sneer. “Stimulus failure, stimulus failure, stimulus failure!” they shout. Indeed, they have so demonized the word “stimulus” that even Democratic candidates are afraid to use it while running for office this year.

And yet — here’s the surprise — by every important economic measure, TARP and ARRA together have been successful. Hugely successful. Simply put, these two “stimulus” acts saved our nation’s economy — created jobs by the millions, added trillions to the gross domestic product, and prevented the deficit from being twice as large as it would be without them.

These are the facts:

According to the nonpartisan Bureau of Labor Statistics, the U.S. economy was losing more than 750,000 jobs per month in the depth of the crisis. Today, it is adding 60,000 jobs per month. That’s not enough new jobs to lower the unemployment rate (because of new workers entering the work force), but it’s enough to hold the rate steady — a remarkable achievement, given where we were. Meanwhile, the nonpartisan Congressional Budget Office estimates that between 1.2 million and 2.8 million people now have jobs thanks solely to ARRA and that the unemployment rate would be two percentage points higher (closer to 11 percent than 9 percent) without the stimulus package.

Add in TARP, and estimates of the success of the federal government’s response are even more impressive. (Remember, TARP was a Bush policy; we are not engaged in Republican bashing here.)

The most thorough, objective, and fact-based analysis of the effects of TARP and ARRA on the economy was published in July 2010 by Alan S. Blinder, a Princeton economist and Wall Street Journal columnist, and Mark Zandi, chief economist at Moody’s Analytics. Blinder and Zandi are hardly flaming liberals. Their analysis, titled “How the Great Recession Was Brought to an End,” received little media attention when it was released. It is available online. Anyone interested in the facts should check it out.

Binder and Zandi’s analysis concludes that without TARP and ARRA, the gross domestic product (GDP, a key measure of the economy’s health) would have fallen 7.4 percent in 2009 and 3.7 percent in 2010, and the unemployment rate would have ultimately reached 16.5 percent. Instead, thanks to TARP and the stimulus package, GDP fell only 2.4 percent in 2009, is expanding about 2.9 percent in 2010, and is projected to expand 3.6 percent in 2011. According to Binder and Zandi, Bush’s TARP and Obama’s stimulus package, together, saved or created more than 10 million jobs and added $1.8 trillion to the economy.

As for the federal deficit? Binder and Zandi estimate that without TARP and ARRA, a still-crippled economy and anemic tax revenues would have resulted in a deficit that is nearly double what it is today and what it is expected to be in the next several years.

Bottom line: TARP and the stimulus package by themselves created millions of jobs, revived the economy, and kept the deficit from being much worse than it is.

Statistics aside, consider, too, that TARP arguably saved the U.S. auto industry (and perhaps the banking industry, as well), and ARRA kept food on the table for millions of the struggling and unemployed.

If you still don’t think TARP and the stimulus were successful, well, Wall Street does. Before the stimulus package took effect, the Dow Jones Industrial Average was around 6,600. Today it is around 10,800. If you own stocks, are enrolled in a pension plan, or maintain a 401(k), your investment future is about 64 percent brighter today than before — thanks in large part to TARP and the stimulus package. With inflation (the most regressive of “taxes”) still low, millions of Americans today are better off — much better off — thanks to the federal government’s two-pronged “stimulus” — one part generated by a Republican president, one part by a Democratic president.

Failure? Hardly. Indeed, the federal “stimulus” can, and should, be called a huge bipartisan success.

Ed Weathers is a former editor of Memphis magazine. He writes and teaches in Blacksburg, Virginia

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News News Feature

THE WEATHERS REPORT

THE WORLD ACCORDING TO MRS. WEATHERS

I just spent a week with my 89-year-old mother, Elsie Weathers. After a week with Mom, I think John Kerry has a chance against George W. Bush, but I worry for the future of the United States. What will happen to our politics when those who remember life before 1932 are dead?

My mother is not a swing voter. She is not undecided. She is not an independent. Elsie Weathers is a Democrat. Let me amend that: Elsie Weathers is a DEMOCRAT! The first president my mother ever voted for was FDR. So was the second. And the third. And the fourth. She would like to vote for FDR this year. She’ll settle for John Kerry.

Politics for my mother is simple: The Republicans are the party of the greedy, the Democrats are the party of the needy, and the most important role of government is to protect the needy poor from the greedy rich. My mother has never voted for a Republican.

My mother grew up on a hardscrabble farm in upstate New York. She was the daughter of Finnish immigrants who never learned to speak English. Her family was poor. She tells many stories of how poor. My favorite is this: My mother has always loved animals. When she was a little girl, she desperately wanted a lamb for Christmas. She begged and begged her parents for a lamb. On Christmas Day she ran downstairs expecting to find her lamb under the Christmas tree. What she got instead was woolen underwear.

For my mother, all politics is personal. It is all about stories like the lamb and the underwear.

Socialized medicine? My mother is all for it. After all, she spent four years in a state-subsidized tuberculosis sanitorium in the 1940s. Despite the fact that she nearly died of the disease, my mother remembers that period almost fondly. The doctors and nurses were, in her mind, angels. The government paid for it all. That, my mother believes, is what a government should do.

Worker protection laws? OSHA? My mother is all for them. She tells of her brother-in-law, Eino, who contracted silicosis in the coal mines of Pennsylvania. He died of it–slowly, agonizingly. The coal mine company never considered protecting him when he worked or helping him after he got sick. They threw him aside and hired someone else they could exploit and sicken.

Unions? My late sainted father was a union man. My mother still believes it was the reason the phone company never promoted him. She still remembers what the world was like before unions were strong. She repeats the story my father used to tell, of when he was a teenager working for a coal company in Kentucky. His job was to serve food to the workers, who were largely “paid” in food and company-owned housing. (Feeding and housing them was, Mom points out, a way for the coal company to keep the workers under its control. Actual wages the workers could have saved, so they could have improved themselves and maybe moved on to other jobs. The company didn’t like that possibility.) My father told of how the hungry workers would ask him, as he dished out their food, “Just one mo’ poke chop, young mister? Just one?” But he would have been fired if he gave them one.

Laissez-faire capitalism? My mother tells the story of the January day my father (still a boy working for the coal company) saw one of the workers pick up a piece of coal by the railroad tracks leading out of the coal plant and put it in his pocket, to take home to warm his family. Another worker also witnessed the incident and reported the worker who pocketed the coal. My father was forced to testify against the coal-taker, who was fired. My father felt horrible about it to the day he died. In my mother’s mind, a capitalist is a person who, if not restrained by law, will kill his workers slowly and refuse a lump of coal to a sick and freezing man in order to make an extra buck.

Abortion? A relation of my mother’s got his girlfriend pregnant in the 1930s. The girl decided to have an abortion, illegal at the time. The abortion was botched. The man watched his girlfriend slowly bleed to death on the backroom bed of an abortion house. My mother also tells of all the girls she knew who kept their babies and were forced by (presumably Republican) social pressure into marriages they hated for a lifetime. My mother believes in clean, safe, legal abortions.

“Preventive” wars? My mother and my father would have drugged me, put me in the trunk of the car, and driven me across the border into Canada themselves to keep me out of the Vietnam War. The war was about me. She bleeds for every soldier and every child killed in Iraq, one at a time. She lingers over every newspaper story about the boy who enlists against his mother’s wishes and then dies in action. War, like politics, is personal for my mother.

Liberals? My mother plays bridge with a group of women who rarely discuss politics, but occasionally one of them, usually a generation younger, will begin to rail against liberals. My mother is a shy little stooped-over woman. She never initiates talk about politics. But she will not countenance criticism of liberals, especially in her liberated old age. “I’m a liberal,” she’ll declare, her voice trembling with anger. “And I’m proud of it. In fact, if you want to call me a bleeding-heart liberal, you go right ahead. Because that’s what I am.” Then, if you put her to the test, she will tell you how it was the “liberals” who came up with social security, worker-protection laws, consumer-protection laws, environmental-protection laws, and Medicare, and how it was the Republicans who, consistently and repeatedly, opposed them.

Protect the needy from the greedy.

My mother does not trust the rich. In his capacity as president of the New York State School Boards Association (a voluntary job), my father had some school-aid dealings with Nelson Rockefeller when Rockefeller, a Republican, was governor of New York. My father respected Rockefeller, who, by current standards, was something of a liberal himself. (The current Rockefeller in the Senate is a Democrat.) But my mother never trusted Rockefeller, because he was rich. She felt vindicated when he reportedly died in a fancy Park Avenue penthouse while in the arms of a woman who was not his wife.

Last week, my mother said she didn’t really like John Kerry’s wife Teresa. “He needs to keep her quiet until after the election,” my mother says, unliberatedly. It is Teresa Kerry’s hint of arrogance and condescension, not her candor, that most bothers my mother. “She always has that little smile,” my mother says. It is the smirk of the rich, I think, that my mother objects to. Kerry would do well to listen to my mother.

When my mother thinks of politicians, she rarely thinks in terms of their policies. (Why consider policies? Democratic policies are good. Republican policies are bad. Q.E.D.) Mrs. Weathers thinks instead in terms of personality. She began despising Richard Nixon in the 1940s, when he first used Red Scare tactics to win a seat in the Senate. His demise in the 1970s was almost an anti-climax for her, she had hated him for so long. She felt disdain, but not disgust, for Ronald Reagan, whom she dismissed as little more than a script-reader. She is even capable (though rarely) of disliking a Democrat; she abhorred Lyndon Johnson. My mother has a fine eye, almost a sixth sense, for spotting the morally corrupt.

I can almost exactly calibrate how a Presidential election will go by observing how much my mother hates the Republican candidate and loves the Democratic candidate, then factoring in current events. If she doesn’t dislike the Republican candidate too much (Eisenhower, Reagan, Bush the Elder), then he has a good chance of winning, especially if she is tepid about the Democratic candidate (McGovern, Dukakis, Gore). If she hates the Republican candidate (Nixon) and adores the Democratic candidate (Hubert Humphrey, John Kennedy), the race will be, at worst, close. Other than FDR, her favorite all-time presidential candidate was Adlai Stevenson, because he had integrity and gave great speeches. She would have enjoyed voting for Mario Cuomo and is disappointed that she never got the chance.

Mrs. Weathers loathes George W. Bush. He embodies for her everything she hates about Republicans: knee-jerk militarism, flag-waving jingoism, narrow-minded moralism, smug wealth, and especially economic elitism. He is for the fat cats (an expression that is vivid and real for my mother), and he oppresses the underdog (an equally vivid expression for this woman who still sees the world from the perspective of animals–dogs, cats, lambs). Bush, my mother is convinced, just wants the rich to get richer. John Edwards’ speech about “two Americas–one for the rich, another for the poor and middle class” resonates deeply with her. According to Mrs. Weathers, George W. Bush is a liar and a fraud. He is killing American soldiers to make his friends richer. He is corrupt. As I said, my mother has a sixth sense about corruption.

This is good news for the Democrats, but of course it is not news at all to political analysts. People like my mother are the heart of the Democratic Party, and we all know that the Democrats have been spurred to almost unprecedented heights of political action by their dislike of George W. Bush.

The question, then, is, How does my mother feel about John Kerry?

Well, she likes him pretty well, but she doesn’t adore him the way she adored Stevenson and JFK and Humphrey. I asked her how she liked Kerry’s speech at the Democratic Convention. “I think he did very well,” she replied. This is rather tepid praise from my mother when speaking of a Democrat. Asked how she liked the keynote speech of Barack Obama, she replied, “Oh, he was wonderful!” There are a lot of votes between Kerry’s period and Obama’s exclamation mark.

In her old age, my mother doesn’t follow politics too closely anymore. She knew almost nothing about Howard Dean’s campaign last year, and very little about Kerry until the convention. Let’s hope Kerry earns an exclamation mark from her before November. It could mean the election.

But as important as the election is, what is even more important is what America will be like after my mother’s generation dies off–the generation that knew first-hand the world as it was before government put the reins on capitalist greed. After my mother dies, who will replace her? Let’s hope that the world replaces her with others who study a bit of history so they can understand her point of view. But I worry that that won’t happen. I worry about that a lot.

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Politics Politics Beat Blog

FOUR WINNERS


Assessor Rita Clark, here flanked by Shelby County Mayor A C Wharton (l) and husband Robin Clark, gathers a crowd for a post-election photo to celebrate her re-election to a third term.


Sheriff Mark Luttrell (l) congratulates Chris Turner, reelected to a third term as General Sessions clerk.


Chancellor Arnold Goldin (l), winner of a special election to retain office, is congratulated by his brother, Barry Goldin.


Newly nominated as the Republican candidate for state representative in District 83, Brian Kelsey takes a call from one of his defeated opponents.

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News News Feature

BOARD TAKES BACK BENEFITS BOOST FOR TOM JONES

There was a flurry of activity in Shelby County government last week involving Tom Jones, a top aide to three former county mayors who pleaded guilty last year to federal embezzlment charges.

Jones is scheduled to report to a federal correctional institution in Forrest City, Arkansas, this month to begin serving his one-year term. But the latest controversy, which featured the personal intervention of Shelby County Mayor A C Wharton, was over Jones’ retirement benefits and his reinstatement to a county job for three days earlier this year.

The details are complicated, but the bottom line is that Jones was put back on county employment roles for three days in May and, because of that, was in a position to double his retirement benefit from approximately $1,595 a month to $3,090 per month. Wharton apparently became aware of this in the last two weeks and decided that the matter needed to be presented to the Shelby County Retirement Board at its monthly meeting on August 3rd.

Following presentations by Wharton, Chief Administrative Officer John Fowlkes, and board chairman and attorney Susan Callison at the meeting, the board voted 7-1 to rescind Jones’ higher benefits package.

Jones was notified this week that the Retirement Board “has determined that an improper determination was made in the processing of your pension benefit.” He can request an appeal hearing. There is no indication of any deception on his part, and all the rights he invoked are available to county employees. The error appears to be on the part of the Retirement Board.

Fowlkes said Wharton didn’t know what was going on until about a week ago. And it was not until Monday evening that Wharton decided to bring up the issue at the Retirement Board meeting the next morning. Jones’ paperwork was processed by Human Resources Administrator Janet Shipman, and Manager of Retirement Waverly Seward.

“In the mayor’s view, it was not an administrative act,” said Fowlkes. “It was significant enough to require the board to review the facts.”

Jones worked for the county from 1976 until 2002 and was a participant in the county retirement system for nearly 24 years. For most of that time, he was head of public affairs and dealt with reporters and wrote speeches for mayors Roy Nixon, Bill Morris, and Jim Rout. He took on more responsibilities under Morris and Rout and served on numerous boards. He was heavily involved in the planning of the FedEx Forum, among other projects.

In August of 2002, one week before the end of his second term, Rout announced that Jones had been suspended for questions involving his use of county credit cards. Wharton did not reappoint Jones. In 2003, Jones pleaded guilty to federal and state charges of embezzling an amount between $50,000 and $100,000.

In the county pension system, 55 is an important age threshold for a higher pension. Jones was not yet 55 when he was suspended in 2002, but he was over 55 when he was “rehired” this year. Early in his career with county government, Jones held a Civil Service job. Under Civil Service provisions, he applied this year for reinstatement to his Civil Service job, exercising what is known as fallback rights.

Documents show Shipman wrote to Jones that she would “being the process of identifying a position for your return to employment within Shelby County government.”

She also wrote that due to his federal and state convictions, the county would move to suspend him immediately upon his return to employment.

Jones was placed back on the employment roles on May 28, although Fowlkes said he did not report to work or draw any pay. On June 17th, Seward notified him by letter that the Retirement Board “has approved your application for service retirement benefits” of $3,090 per month, less deductions for insurance.

On Monday, Wharton received a four-page letter from attorney Susan Callison regarding Jones’ status in the retirement system and whether a change in his status should have been submitted to the board for a vote. It isn’t clear when Wharton asked for the legal opinion.

“It is my opinion that Mr. Jones’ pension should have been calculated based upon the type of pension that the Board approved for him– the deferred vested pension, and that, therefore, an error was made and should be corrected,” Callison wrote.

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News News Feature

THE WEATHERS REPORT

WHY I DEFIED MY DOCTOR

At age 58, I am in the vanguard of the Baby Boomer generation. This morning I did something that most Boomers–heck, most people of any age–will think is stupid and childish: I cancelled an elective colonoscopy I was scheduled to undergo next Monday.

Last night, during several hours of productive sleeplessness (a Boomer specialty), I thought hard about whether to undergo the procedure, and by this morning I had decided not to. My reasons, I think, will resonate among the over-50 crowd, though even after I explain them, I suspect most will still think my decision foolish. That doesn’t matter to me. I’m comfortable with it.

Most Baby Boomers know what a colonoscopy is. In case you don’t: It is a procedure whereby a flexible tube about 1/2 inch in diameter and up to six feet long is inserted into the patient’s rectum and funneled up into his large intestine (the colon). The tube contains fiberoptics which send pictures to a videoscreen, allowing a doctor to look for tumors and bumps, or polyps, which could be precancerous. If the polyps are discovered early enough, they can be removed and, theoretically, the cancer can be cut out or prevented. About 57,000 people die from colon or rectal cancer every year in the United States. Among cancers, only lung cancer kills more people.

When he was president, Ronald Reagan had several colonoscopies, which did find polyps; in 1985 he had two feet of his colon removed because cancer was found. President George W. Bush has had the procedure at least three times (in 1998, 1999 and 2002) and twice had polyps removed. TV personality Katie Couric lost her husband, Jay Monahan, to colon cancer when he was just 42; since then, she has been the most high-profile public advocate for colonoscopies. The American College of Gastroenterology says that colonoscopies are quick, safe, and painless. According to the American Cancer Society, early detection by colonoscopy is the best way to prevent colorectal cancer death, and everyone–male and female–over the age of 50 should have a colonoscopy every five to ten years.

I was scheduled to undergo my first colonoscopy next Monday. Given all the facts above, why on earth did I cancel it? The reasons reach deep into my character and into my feelings about medicine. They also reflect my beliefs about life and death.

My first reason for canceling my colonoscopy is the obvious one: I find it to be an ugly, intrusive, embarrassing procedure that violates everything I value about myself. I’m the kind of person who doesn’t have a lot of dignity to spare, so I’m loath to give up even a smidgeon of what little I have. My primary motive in life is to avoid embarrassment. (It’s one of the reasons I won’t dance in public or sing karaoke or get drunk.) Avoiding embarrassment is not a particularly admirable motivation, but I’ve learned to accept it. I’m also the kind of person who doesn’t like someone else to mess with his body–I’ve never liked the playful jab or the tickle or the unprovoked hug. I am, to be honest, just a little uptight. In fact, the term “tightass” would not be inappropriate for me. Now take that term and weigh it against the description of a colonoscopy in the third paragraph, above. There is not, so to speak, a good fit here.

My second reason for canceling my colonoscopy has to do with how it came to be scheduled in the first place. I have no symptoms that suggest colon cancer or any other intestinal disease. I have no family history of colorectal cancer. Yet at my most recent physical, last month, my new family physician told me I needed a colonoscopy. Why? Simply because I was over 50. Sheeplike, I agreed to undergo the procedure, purely electively. After all, this was a doctor speaking.

My family doctor’s office then made arrangements with a gastroenterologist (GE) to perform the colonoscopy this month. I had never met the GE. I was told to go to his office a week before the procedure to pick up a “prep kit” telling me how to get ready for it. When I went to the GE’s office a couple of days ago, a nurse or an assistant–I never found out which–handed me 1) a prescription for a superlaxative and 2) a sheet telling me what to eat in the week before the colonoscopy: no aspirin, nothing fried, nothing red, nothing with seeds, no apples, no oranges, no nuts, no raisins, no olives, no pepper, no popcorn, no pickles, and so on. The day before the procedure, the sheet said, I was to eat nothing at all except transparent stuff like Jell-0 and to drink only clear liquids. The evening before, I was to take the superlaxative. On Monday, the day of the procedure, I was not to eat or drink anything at all, although I wasn’t told exactly when on Monday I needed to be at the hospital. I was told that to find out when the procedure was to be done, I had to call the hospital on the Friday before.

The nurse sent me home with all this information. I never spoke with the gastroenterologist who was going to do the procedure. He didn’t even know what I looked like, much less anything about my personality or my family history or my general health. I didn’t know what he looked like, whether he seemed bright or dim, whether his hands shook or not. No one said anything about, or handed me any information about, the discomfort and risks involved in a colonoscopy. No one told me that the superlaxative would give me fairly violent diarrhea. No one said there was about a 1% chance that I would be allergic to the anesthesia (no one even told me what level of anesthesia would be required) or that I could develop problems at the site the anesthetic was administered or that during the procedure the colonoscope could perforate the wall of my colon, requiring real surgery, or that I might start hemmorhaging. No one told me that air would be pumped into my colon to help the procedure or that the resultant “bloating” could cause “discomfort” or that I might experience some other kinds of “discomfort” for days after. Looking back, I realize that no one–not my own doctor, not the GE’s assistant, and certainly not the invisible GE himself–ever even told me what exactly a colonoscopy was designed to look for, what colorectal cancer was, or how serious a problem it could be. No, all that information I had to seek out for myself. Nearly everything you’ve read about colonoscopy in this article I found on the Internet. I’m sure when I arrived at the hospital on Monday, I would have been given a sheet to read telling me some of this. I know I would have been given a disclaimer to sign.

This is the nature of modern medicine, and it says much about the relationship between doctor and patient in the 21st Century: If a doctor tells you to do something, you are expected to do it, no questions asked. Well, I have some questions, a lot of questions. For example:

¥ On average, how much longer does a person who has a colonoscopy live than one who doesn’t?

¥ What percentage of people with no symptoms and with no family history of colorectal problems are discovered by colonoscopy to have colon cancer?

¥ What large, longterm studies suggest that colonoscopies are actually effective in prolonging life?

¥ If I have the colonoscopy and they discover cancer, what will my quality of life be after they cut it out?

The nurse in the gastroenterologist’s office told me I could call if I had any questions, but I didn’t call. I’m pretty sure she couldn’t have answered any of these questions, and I didn’t want to embarrass her. I couldn’t even find the answers to these questions on the Internet. My second reason for canceling my colonoscopy, then, was that I resented the way I was led to it by the medical establishment–in darkness and ignorance and under a fog of condescension–and I had been given no compelling reason to submit to such an invasive, uncomfortable and potentially dangerous procedure.

Finally, there is the matter of life and death, and the few choices one gets to make in such matters. To explain my feelings about that, let me tell about two friends:

My friend Lee was a tennis teaching pro who worked out regularly. He had a family history of cancer, so he took special care to be on the lookout for cancer signs, and he smeared himself liberally with sunblock to prevent skin cancer. He died of a massive heart attack at age 53.

My friend Tom died just two weeks ago. He had a family history of heart disease, so he kept himself in wonderful aerobic condition and ate a vegetarian diet. His cholesterol was well in the safety zone. He died of stomach cancer at age 57.

As valuable as organizations like the American Heart Association and the American Cancer Society are, they have a rather narrow view of the world. The AHA would consider Tom a success story: he didn’t die of a heart attack. The ACS would consider Lee a success story: he didn’t die of cancer.

But both Lee and Tom are dead, and I miss them. They did what they were supposed to do (for all I know, they even had colonoscopies), and they’re still dead.

When I tell people I cancelled my colonoscopy, I know what they will say–because it is what Katie Couric says and what the American Cancer Society says. They will say, “But it could save your life!” Well, they’re wrong. It couldn’t save my life. In the end, my life is not savable, because I’m human, and someday I’m going to die–of something. If it’s not cancer, it will be a heart attack. If it’s not a heart attack, it will be a stroke. If it’s not a stroke, it will be a drunk driver. I remember reading a few years back that if you spend the rest of your life eating all the right foods to keep your cholesterol down, you will definitely lower your risk of a heart attack–but you will add only three months to your life span. Because you’ll still die. Of something.

Consider Ronald Reagan. In 1985, he had a colonoscopy which found cancerous polyps. The consequent surgery added perhaps 10 years to his life. Now look at the last ten years of Ronald Reagan’s life, during which he plummeted into the bleak chaos of Alzheimer’s disease. If it had been me, I would have taken my chances with colon cancer. Likewise, if it comes to a choice between colon cancer and a stroke, for example, I’ll choose the cancer. And if the cancer is awful enough . . . well, I have no philosophical objection to suicide.

The fact is, of course, that we can’t choose our diseases. I may get colon cancer. If I do, I’m sure that I will for a time beat myself up for not having had the colonoscopy. But I’ll also recall Tom and Lee and Reagan. They did what the American Heart Association said, and what the American Cancer Society said, and what the American College of Gastroenterology said. And still they died.

No, we can’t choose our diseases–but we can choose our cures. Short of suicide, we can’t choose how we’ll die–but we must choose how we’ll live. And as in any choice, the decision about how we care for ourselves should reflect who we are and what we believe. Next Monday, then, I will choose to play golf.

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KICKING BACK

Spent Thursday night with a group of Jewish folks,mainly couples, mainly in their 60s and 70s, at the Jewish Community Center. Talk about salt of the earth! It was one of those audiences that you get more comfortable with the longer you stay with them. Hugely well informed and diverse about politics. When my prepared remarks (such as they were!) flattened out, they juiced up the evening with a flurry of good provocative questions. Took several ad hoc polls, and, for what it’s worth, Bush won the presidential straw poll over Kerry. The reason? Belief that he’s serious about supporting Israel, although some of those expressing a preference did so for reasons of economic conservatism as well. But the mix of viewpoints and perspectives (about equally split on Iraq, for example) was impressive.

Don’t want to mention too many names for fear of inadvertently stiffing some people, but have to mention Bernard and Miriam Danzig, with whom I shared a table (and some prior personal history); the Weiners, who are friends and boosters of Democratic lawyer (and erstwhile city council candidate) Jim Strickland; Steve Shankman, who made my day once with a phone-call version of a fan letter; the Felt Brothers, who undertook to educate me about the demographics of Palestine, and Max Notowitz, whom I remembered from twenty years ago as one of Memphis’ premiere runners. (Physical problems have sidelined him since, but he still looks stout.) I had forgotten that Max had spent time in a concentration camp as a boy and was somewhat jolted to be reminded — both because I had relegated that era of human history of a longer-ago time than it actually was and because it is always a jolt to be reminded what human beings are capable of (there are, of course, some present-tense reminders as well).

Max told me stories of hiding out in a Polish forest after escaping from the concentration camp and having to do some hard things to survive. He never lost his morality in the process, however, and he emigrated to the U.S., determined to raise a family, protect it, educate it, and see it thrive in an environment of freedom. All by himself, he’s the real deal, a reminder of what our political process is all about. So was the evening. Thanks, all.

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THE WEATHERS REPORT

DEMON WISHES, DARK HOPES

If you root against an incumbent president, you must brace yourself against impure thoughts.

I want George W. Bush voted out of office this November. I believe that in the long run his ouster will be the only way to preserve domestic civil liberties, rectify economic injustice, repair our country’s reputation, prevent further warfare, and save lives. According to the polls, about half of all Americans believe as I do. We believe that there is urgency in defeating George W. Bush–that it is deeply, deeply important that he lose in Novermber. Our fondest wish is that Bush be replaced in the White House.

But is it really our fondest wish?

You see, there are other wishes of which I am also quite fond–wishes that somehow contradict the wish that Bush be defeated. For example:

¥ I wish that gasoline prices would drop. But if they do, it is all the more likely that Bush will win.

¥ I wish that a million new high-paying jobs would be created in the United States in the next three months. But if they are, it is all the more likely that Bush will win.

¥ I wish that inflation would be held in check. But if it is, it is all the more likely that Bush will win.

¥ I wish that Colin Powell would help design a ceasefire between Israel and the Palestinians by September. But if he does, it is all the more likely that Bush will win.

¥ I wish that Osama Bin Laden would be captured and Al Qaeda put out of business. But if that happens, it is all the more likely that Bush will win.

¥ I wish that the political conventions and the Olympics would take place without terrorism or any other form of violence. But if they do, it is all the more likely that Bush will win.

¥ I wish that the new Iraqi government would prove its independence from the U.S., end violence from north to south, begin rebuilding its economy, and show that democracy will work there. But if it does, it is all the more likely that Bush will win.

¥ I wish that there would be an end to killing in Iraq and Afghanistan. But if there is, it is all the more likely that Bush will win.

¥ I wish that American soldiers would be safe everywhere in the world, starting now. But if that happens, it is all the more likely that Bush will win.

In other words, my wishes for a better world are shadowed by that other wish–that Bush be defeated. This is why those of us who root against an incumbent president must feel the pull of impure thoughts.

Let me admit something shameful: Sometimes I find myself hoping that the world does not improve–until after the election is over. Sometimes I find myself hoping that gasoline prices stay high and that the economy stays sluggish for just four more months–so that Bush will lose. This is an impure thought.

Now let me admit something much worse: Sometimes I find myself entertaining the fleeting hope that Osama is not captured and that things don’t get better in Iraq, Afghanistan or Israel–until after the election is over and Bush is defeated. This is a low, dark hope, and I am ashamed of it. I dismiss it as fast as I can and tell it to leave the room, treating it like a seductress with a communicable disease. No, I promise myself, I am too decent for this evil hope. I don’t want any more American soldiers to die. I don’t want any more Iraqi children to have their limbs blown off. I want war to end, killing to end, democracy to prosper in Baghdad as soon as possible–even if it means George W. Bush is more likely to be reelected.

But, oh, the temptation of such demon wishes, such dark hopes! Even logic encourages one to give in to that temptation. What if, says logic, ten more soldiers dying in Iraq means that Bush loses the election? Would their deaths be worth it if they helped prevent a war-happy administration from getting back into office and destroying far more lives in future wars? No, no, again no, you tell yourself. That is the same hollow logic employed by those who justify actual torture in the name of preventing hypothetical deaths. It is a twisted pseudo-logic leading to evil conclusions.

And so those of us who would defeat George W. Bush must confront those unwished-for wishes and those unhoped-for hopes that occasionally spring forth in our unguarded brains. And we must exorcise them.

It helps to remember, of course, that wishes and hopes are not actions. To wish for troubles in the world is not to make trouble; to hope for turmoil is not to create turmoil. We would not do anything to hurt anyone or to make anyone’s life more miserable, just to defeat Bush. We wouldn’t raise the price of gasoline. We wouldn’t leave that single mother unemployed. We wouldn’t kill a child or a marine.

Nevertheless, even the brief thought without the deed is dangerous. We must weed out such wishes and hopes as fast as we can. We mustn’t indulge them, even for a moment, lest they start to seem somehow legitimate. Somewhere in the United States today is a Kerry supporter who briefly considers the possibility that a bomb on a train in Chicago might do for this election what a bomb in Spain did there, sending the incumbent administration packing. Let that thought be brief. Let that Kerry supporter berate himself for even thinking such a thought and then go back to stuffing envelopes and making phone calls for his candidate–the kind of good deeds that bury bad notions.

So, at the end of the day, I will wish and work for a better world right now, and I will continue to believe that in a better world we can surely defeat a president who violates our best wishes and our happiest hopes.

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More Efficient Care

Arkansas Governor Mike Huckabee (left) is bemused and Mississippi Governor Haley Barbous seems amused as Tennessee Governor Phil Bredesen consults his muse before members of the Tri-State Press Associations’ annual summer conference at The Peabody Friday.

Photo by Jackson Baker

Governor Phil Bredesen visited Memphis on Friday, stopping by the University of Memphis to announce a new Southwest Tennessee health initiative to improve care in the area.

The project, or ÒVolunteer eHealth InitiativeÓ will electronically link hospitals, doctors, clinics, and other health-care stakeholders in the three-county area of Shelby, Fayette, and Tipton. To assist with the program Bredesen has allocated up to $10 million of state dollars to fund the initial phase of the program during the next five years. If successful in this region, the program could be expanded statewide. The state, in a partnership with Vanderbilt University Medical Center, will manage Volunteer eHealth.

Ò[The initiative] is receiving top priority at the state level,Ó said Bredesen. ÒTechnology is improving virtually every aspect of our daily lives. ItÕs time we start making better use of it to improve patient care and to make our health-care system more efficient.Ó

The project began as part of long-term efforts to reform TennCare, but after exploration of the possible benefits of the program, the initiative was expanded to include all residents in this area. Bredesen was joined at the FedEx Institute of Technology by Shelby County Mayor A C Wharton, Health Department Director Yvonne Madlock, state senator Roscoe Dixon, and hospital representatives supporting the plan. More than a dozen health-care entities, like The Med, Baptist Hospitals, and the Shelby County Health Department, have pledged their support as charter members of the project. These organizations will participate in a six-month planning process to develop the program. Part of the planning will focus on creating a medical record for each patient to be accessed wherever they seek care, and share the latest best care practices between physicians.

Through data sharing, the project is expected to reduces the costs of duplicating time-consuming tests ordered by physicians for the same patient. To adhere to HIPAA health-care privacy laws, physicians would have to receive a patientÕs permission before admitting their information into the technology system. Bredesen said it is unknown how this process will be administered.

ÒThere are other states that have some technology like this, but nothing locally,Ó said Med president and CEO Bruce Steinhauer. Ò[Local] hospitals share information about patients with each other now through faxes and e-mails and things, but the process is cumbersome. So many of our patients are uninsured so they go from place to place to receive care, and this will really help us to keep track of their care.Ó

Memphis was chosen as the site for the initial phase due to its large concentration of TennCare patents. Of the 260,000 enrollees, about 18 percent live in Memphis and Shelby County, more than any other area statewide.