Life & COVID-19: Ain't No Fairy Tales

I have to feel sorry for Donald Trump. I mean it, he is so wrapped up in himself he'll never know the simple pleasure of people being nice to each other. 

He can't experience the pleasure I felt this afternoon when, idling in line at the recycling center, the person ahead noticed I'd arrived and pulled away. He was done, apparently, and since no one was behind him, was probably texting. I caught his attention as he passed, waved and smiled in thanks, he smiled and waved back. 

Opening the back window on my CRV I reflected on the simple kindness people seem inclined to show each other lately. We smile more easily, we're more considerate, we're more thoughtful. I wondered if it's because we don't know which of us is going to get COVID-19 next. Which one of us will go into the hospital and never go home again.

Not knowing who's next, we want to be kind to everyone, just in case. It's tragic it's taken a pandemic to get our attention, but at least it did. Not that we're all going around thinking about dying and asking, "What's it all about, Alfie?" 

I do think most of us are aware life has become more tenuous the past few months, though. A new microbe has ridden into town, gunning for all of us and the best we can do is try to stay out of its way. You can take my word for it, coronavirus is not one bit intimidated by liberal gun laws. Smith & Wesson can't protect anything from this outlaw.

But we don't need Smith & Wesson, anyway. If we can keep our heads long enough to smile and joke with strangers about being mistaken for robbers because we're wearing masks into Walmart, that's a good sign. If we can batten down the hatches on our pride, use some good sense and wear masks, wash our hands, and practice the pure human decency of social distancing, it's an even better sign we might help each other have half a chance.

It may not seem like a lot but at the moment it's what we've got, so let's use it with impunity. We're not talking about snake oil or something Trump has pulled out of his backside and tried to pass off as a miracle. 

The true fact is, we don't need a miracle. What we need is a healthy dose of reality. Take a spoonful every hour until this is all over and then keep taking it. Don't let some reality TV character sell you a story about a handful of magic beans and a goose and a golden egg. That only works in fairy tales and life and COVID-19 ain't no fairy tales, no matter who says they are.

(Creative Commons Image)

Virus Like Confetti

It is alarming, if not downright frightening, that in the midst of a crisis affecting the nation and the world, listening to the White House is not such a good idea.

I say that because the White House has developed the nasty habit lately of being less than reliable about passing along the best that medical science has to say about COVID-19. As a matter of fact, the daily White House briefs often as not reveal the President and his chief coronavirus expert at odds with one another. Of all the times to make sure you listened to your scientists and followed their advice, now would be the time, but it's not happening. 

I'm a psychiatrist, not an epidemiologist or politician, but I know enough about all three to know it's wise to recognize your limitations. If Dr. Fauci advised me to be cautious when it came to "opening up" the country, you can bet your life I'm going to be cautious. The last thing I'm going to do is play "guess who's smarter" games while your life is on the line.

The coronavirus health crisis is not make believe. It is not a conspiracy theory. It is not the flu. It is a virus-borne illness that has resulted in the deaths of over 40,458 Americans as of this moment. Over 762,690 cases have been confirmed, by the way, as of this moment. To those who dismiss it and insist on going to church or crowding around protesting, when you get sick, when you need an ICU bed, when you're  desperate for a ventilator, when you'd sell your soul for a doctor and nurse, just remember:  You were warned. 

A flattening of the bell curve as we've started seeing in New York doesn't mean we've got coronavirus on the run. It means what we've been doing to try and reduce its extent appears to be working. That's all it means. 

The good news is, we can still screw this up. All we have to do is lie. Close our minds and lie like our lives depended on it because they just might. Distort reality, deny the truth, and brag about being invincible. See? We still have time. We can still screw this up. 

When COVID-19 reruns hit the theaters this fall, tell you what, let's all go. It's all a hoax, right? Nobody at the White House wears a mask (at least in public) why should we? Forget social distancing. Let's cozy up and cough, sneeze in each other's faces, splattering virus like it was confetti at New Year's. Let's all get sick this time. Maybe even die.

Won't that be fun?


(Image by Mark Waugh and www.cartridgesave.co.uk)

Paranoia

"Paranoia strikes deep.
into your life it will creep..."
~ Stephen Stills

Of all we could say about paranoia, one thing is pretty clear: it's a symptom of something gone wrong. When we're coping well with life, we aren't generally suspicious or mistrusting without reasonable cause. Even under stress, when we are compensating, as we say in "shrink lingo," we're able to distinguish between real and imagined threats. True, we may not be able to cover every single solitary possibility imaginable -- no one's perfect -- but we do our best. And most days, in most situations, that's good enough.

In extraordinary situations, however, things can change rapidly. With good coping skills and a healthy ego, we're okay, maybe even better than okay. With poor skills or a weak ego, it's not so good. It may even get scary once in a while. Especially to those of us who are on the outside looking in. 

I'm referring specifically to the rash of paranoid ideations that have found their way into video and print in response to the terrorist attack in Paris. Don't let those Syrian refugees into America, they say, you can't tell the good guys from the bad guys. Well, maybe not, but haven't bad guys been able to enter the United States for a long time? What self-respecting, evil, scheming bad guy is so stupid that he'd masquerade as a refugee and expose himself to serious scrutiny, when he could simply walk through customs with a legal passport on any other day?

That's the problem with paranoia, especially the socially-acceptable kind. It checks its brains at the door and starts shouting about the sky falling when the issue is actually much closer to the ground. It becomes irrational even when couching its rhetoric in rational terms. It is true, America has endured terrorist attack before and it only makes sense to be prepared. Once burned, twice cautious. To become obsessed with the possibility to the point we abandon our leadership role on the world stage isn't caution. It's more like crazy.

These are times for brave, sensible people. People like the Parisian father who explained to his young son that memorial flowers and candles were there to protect them from bad people with guns. He's too young to grasp the concept that flowers and candles represent the collective will of good, solid, brave people who refuse to give in to terror. Someday he will, though. When he does I hope he also understands that paranoia is a warning, not a watchman to be heeded.


Creative Commons image by Katlew via Flickr.com.

Contraception and the New Fisherman

 
What's going on in Rome, lately? Is there a new voice crying in the wilderness? Pope Francis declaring the Church has become obsessed with birth control, abortion, and gay marriage? Shades of Anthony Quinn.

Who's Anthony Quinn? He was an actor probably best known for his roles in Zorba the Greek (1964) and The Guns of Navarone (1961). He was also cast as the first Russian pope in the film, The Shoes of the Fisherman (1968). What brings him to mind was his character's willingness to drain the Vatican of its wealth and holdings in order to feed a starving Chinese nation and stave off World War III. For him, charity took precedence over tradition. I wonder if that may be true for Pope Francis as well.

Whether it is or it isn't, he's certainly not afraid of going out on a limb. In an interview published in September, 2013, he stated: "A person once asked me, in a provocative manner, if I approved of homosexuality. I replied with another question: 'Tell me: when God looks at a gay person, does he endorse the existence of this person with love, or reject and condemn this person?' We must always consider the person."* This is fairly radical, it seems to me, bending Church doctrine around the needs of people rather than the other way around. 

Such a pope might prove to be a powerful ally at a time when faith-based groups are arguing for exemption from the stipulations of the Affordable Care Act regarding coverage for contraception. Bearing in mind their legitimate concerns about conscience, it helps to bear in mind another, equally legitimate concern, namely, of the four million births in the United States in 2011, 393,772 were to mothers ages 15-19. What is that, about 10%? The picture is complicated by the fact that teen pregnancies are associated with greater risks for low birth weight, preterm birth, and death in infancy.

How many of these births could have been avoided had their mothers had access to contraception? All of them, potentially. What if one was your daughter or mine? Which would we prefer, to discover she was having unprotected sex whether we approved of it or not, exposing herself to sexually-transmitted disease and unwanted pregnancy? Or to be assured that even if she was having sex, her future (and ours, by the way) was far less likely to be altered, negatively, by an unwanted pregnancy? 

I don't think there's a parent on the planet who welcomes the thought of their daughters or sons being sexually active teenagers, but it happens. It happens to the best of families in the best of communities. It happens to families of faith as well as families with no faith. It happens to Democrats and Republicans, Whites, African-Americans, Hispanics, and everyone else. It just happens.

Effective parenting is not ideal parenting because there are no ideal parents. There's only us and we try to do rightly by our children and sometimes that's not enough. An ounce of prevention is worth a pound of cure. Admitting the truth is hard, but the consequences of denial are much harder. Preparing our children for adulthood entails protecting them from the impact of their own impulses. I can't be with my children 24 hours a day and expect them to grow into independent, functional adults. I've got to give them a measure of freedom and that means taking a few risks. Of all the ones I must take, an unwanted pregnancy is not one of them. I hope it turns out, the New Fisherman agrees with me.

*Citation from The New York Times, 9/20/2013.

(Creative Commons image by twm1340 via Flickr)

The Death of a President

 
In psychiatry, a great deal depends on timing, including the correct diagnosis. For instance, while you may have experienced or witnessed a traumatic event or may have had prolonged exposure to highly stressful, traumatic, or abusive conditions, you can't be diagnosed with PTSD unless your symptoms have persisted longer than six months. Under six months, we call it acute stress disorder. PTSD symptoms can persist a long time.

Looking back, I definitely think 9/11 resulted in the semblance of a nation-wide case of PTSD from which we've done a fairly good job of recovering. We're more alert to danger but less likely to shut down the entire country over an isolated, local threat. We're no longer quite so eager to send in the troops at the sound of gunfire on the far side of the world. Life has begun to approximate "normal," though we're more aware of our vulnerability and the memory of tragedy is still there and always will be. Even the extreme political right seems more intent on defeating the president's health initiative than tackling terrorism. I don't think we've done as well with November 22, 1963.

I've often thought the free love, abundant drugs, and Tune-In, Turn-On, and Drop-Out mentality of the 60s was more an expression of anger -- acting out -- than typical adolescent rebellion. For the first time in our history, almost an entire generation gave the establishment the middle finger. Its hero was dead, LBJ had taken office, the Warren Commission was established, there was a national day of mourning, and now, it was time to move on. But this generation wasn't ready yet, and we would all have to wait for Kubler-Ross (On Death and Dying, 1969) to inform us the funeral was only the beginning.

Watching the 50th anniversary of the Kennedy assassination programming the past few days, I've been struck by how often someone uttered the phrase, "People don't want to think Kennedy could have been struck down by a single individual, acting alone. The magnitude of his personality as president seems to demand much more."  I'm not certain this is accurate. I don't believe his personal magnetism or his role as the nation's leader are nearly as important as the magnitude of his loss. Ongoing conspiracy theories and the tendency of 2/3 of Americans to doubt the findings of the Warren Report symbolize the depth of grief many still feel, as well as an abiding need for it to be recognized. Mistrust of government may have burst into full flower with Watergate, but it is rooted in the mismanagement of national grief over the death of a president.  

This is likely an unfair generalization, but there is still some truth in the statement that Lyndon Johnson's generation was more accustomed to putting tragedy behind them than paying close attention to what it means and mourning its significance. Anyone who's watched the HBO presentations of Band of Brothers (2001) or The Pacific (2010), or talked at length with veterans from the Great Generation knows how exceedingly reticent they are about digging up old wounds. The idea that the country as a whole needed time and leadership in the matter of grieving was unheard of in 1963. In a very real sense, we needed a president who understood and embraced his role as nation's chaplain as well as it's chief executive. Unfortunately, this was not one of JBJ's strengths, in contrast with our current president who has been known to take hours comforting the victims of gun violence.

I was also struck by the numbers of interviewees who commented on how America had changed, subsequent to the assassination. They lamented a loss of optimism, hopefulness, and the belief anything was possible. Whether those feelings are shared by all is debatable. There were and still are, sectors of the population that make no secret of their hatred of Kennedy and the causes he and his brothers championed. Nevertheless, his loss was felt by far more and the feelings associated with it have lasted far longer than anyone might have imagined. 
 
Grief isn't resolved, if it's ever truly resolved, by assigning blame, getting even, and nursing the satisfaction gained from a moment of passion. We learn to deal with our losses, to live with them, making them part of ourselves, by refusing to play down their impact and brush them away like crumbs from the table. Grief has to be honored and mourning respected if we're ever to regain the optimism, hope, and sense of the possible that seems forever out of reach when we feel bereft. If there are lessons worth learning from the past 50 years, this is one to take to heart. 


(Creative Commons image of eternal flame at grave of John F. Kennedy by Tim Evanson via Flickr)

Healthcare Without Politics: The Future is Now

Is it even possible anymore, healthcare without politics? 
I don't know, but I hope so. I'd hate to think the only place it could exist was Disney World. I hope we can reach the point midst all the  maneuvering and jockeying for power and influence where our concern for those who need healthcare exceeds its value as political capital. Sadly, we're not there yet.

Back in the day when, for the average person, Blue Cross/Blue Shield was pretty much the only health insurance game in town, coverage protected in case of catastrophe, i.e. hospitalization. I've described in other posts my own experience of kidney stones necessitating two major surgeries. My family paid out of pocket for outpatient doctor visits and prescriptions, grateful our Blue Cross policy meant the cost of my hospital stay wouldn't hit us with the force of a tsunami carrying the threat of bankruptcy in its wake.

At the time I was recovering from kidney stones and for a few years thereafter, doctors were reimbursed by insurance for services rendered. It was called a fee-for-service system. More services meant greater reimbursement. Eventually, managed care firms came into existence and in the effort to control the costs of operation, they established criteria that must be met, justifying tests and procedures, before  insurance claims would be paid and doctors reimbursed. Soon it became necessary for providers and/or policy holders to obtain authorizations for treatment before managed care considered itself obligated to pay. If you think about it from a business perspective, this makes sense. A company can only pay out so much before it is unable to pay at all.

The road to hell is lined with good intentions, as the saying goes, and while management of healthcare costs was doubtless a factor in the evolution of managed care, we have to remember, healthcare insurance is still a business and the first priority of any business is to make a profit. To accomplish this goal, a business has to increase revenues and/or reduce expenses. Determining which procedures or medications were clinically indicated, ostensibly based on empirical evidence, was one way of setting limits on expenses. Refusing to cover pre-existing conditions was another. Over time, decisions of medical necessity were taken over by managed care and stories of treatment denial, some of them truly horrible, started surfacing. You've heard them on the nightly news as have I.

Despite public outcry, doctors' frustration with a growing insurance beuracracy, and the efforts of congressional leaders like the late Senator Ted Kennedy, insurance reform lagged. Ours is a free-market economy, it was argued, competition lies at the heart of the American Way. Socialized medicine in Canada and Europe, opponents declared, provided poorer quality care and ours was the best in the world. The reality, however, failed to live up to the evidence even as the arguments proliferated.

Families on the verge of collapse because of alcoholism or drug abuse may resort to performing an intervention, confronting the substance abuser who is unwilling or unable to get treatment themselves. Not dissimilarly, someone had to intervene if healthcare insurance was going to obtain the "treatment" it had long needed. Relying on competition to even the field failed to yield more affordable coverage and the number of uninsured Americans continued to grow. Either free-market theory was wrong or the industry discovered how to prosper in spite of it. Although many believed there were good reasons for reforming the system, there was insufficient motivation for the system to reform itself.

Enter the Affordable Care and Patient Protection Act, the function of which is to enable one to obtain affordable healthcare insurance and provide protection against potential abuses by the insurance industry. Under its umbrella, patients can no longer be denied coverage because of preexisting conditions. The determination of medical necessity has been placed back into the hands of those who are committed to serve the needs of patients. Doctors now have the right to review private insurance company files that identified physicians with high utilization patient populations and directed new referrals to those whose patients were regarded as healthier and therefore cheaper to insure. 

It's not a perfect solution but imperfection doesn't automatically render it a bad one. If anything, we're discovering it's a work in progress and we'll need to adjust and adapt it as we go. I don't think it represents a step toward socialism anymore than the Selective Service represented a step toward a police state. Most of us are too smart to believe that line, even if politicians aren't smart enough to find a better one. 

The Affordable Care Act is an attempt to reform a system sorely in need of reform, not only for the sake of patients and policy holders, but for its own sake as well. As with any intervention, the insurance industry finds change painful and naturally responds with anger, disbelief, and a desire to bargain, hoping to retain something of the status quo. Over time, acceptance will ensue and the industry will find itself better off for the changes that have been made. In the meantime, we're past the point of no return; pretending the good old days were the best days is a fantasy and Fantasy Land is for cartoons. We live in Tomorrow Land and the future is now. 


(Creative Commons image of Walt Disney Politics by sbwoodside via Flickr)

Advising Mitt

 
I sort of feel sorry for Mitt Romney. He did what most of us have done, or I have anyway, and wished almost immediately we hadn't. Opened our mouths and watched as the unspeakable came out seemingly of its own accord. Maybe we were angry or afraid or eager to be viewed as acceptable and be embraced by others. At the time, it might have seemed innocent enough -- we thought we were in a protected environment -- and of course, we weren't, as demonstrated by the fallout we're unable to duck no matter how deep we dive into the shelter. Now, we're left, picking up the scattered remnants of our self-esteem, detritus from stepping on one of our own land mines.

Have you ever noticed how easily, on such occasions, a person  says, "But that wasn't me"? Well, if it wasn't, then who was it? It sure looked like me, it sounded like me, people say it was me. I haven't been cloned lately, so far as I know. It sure wasn't Robin Williams doing his best Beggar imitation. I "inhaled" in high school but my sensibilities have long since moved in other directions. I can't blame alcohol -- with my limited tolerance, slurred words are far more likely than misspoken ones. True, at least this way I'll never have to explain how "what made Milwaukee famous, made a loser out of me." (Thanks, Jerry Lee Lewis -- wish I'd written that line.)

So, basically, it was me, or you, or in this case, Mitt. Now, in retrospect, I'm sure he wishes he'd never said anything about the 47%, but it was caught on tape and splattered onto the news, so there's no denying it. The problem is, he's attempting to do what anyone would under similar circumstances, i.e. try to dissociate himself from the image he just created. That's normal -- we don't want people to think of us in terms of what we say or do when we wish we'd said or done something else -- and would if, please God, just this once, is it okay if we turn back the clock?

On the other hand, I sometimes wonder if a better strategy might be to simply own up and admit the truth. Instead of trying to convince us that he really is empathetic, state for the record, "Yes, I'm an elitist. I have a strong preference for associating with wealth, I don't relate well to the working class, I disapprove of welfare and those who depend on it, I'm opposed to government restrictions on business and given the opportunity, I'll lower taxes on people like me and if you want to see my tax returns, watch how fast hell freezes over."

You don't think that's going to get him elected. Well, you're probably right, I suppose it is asking a bit much. But trying to pretend he's someone he's not is even worse. The unconscious has a nasty way of making itself known and frequently does when least expected or welcomed. We all have an inner trickster who absolutely delights in making us appear foolish and the harder we try to keep her/him locked in the closet, the more determined s/he becomes to make us regret it. So, Mitt, if you still aspire to the presidency and you don't mind my unsolicited advice, admit you need to change. Trust me, it won't hurt. Okay, it will, but only your pride and most of us can use a little bit of that now and then.  


(Creative commons image, "Trickster Tales Sketch" by Amanda Schutz via Flickr)

Trickle-Down Economics

 
It used to be referred to as the horse and sparrow theory, i.e. if a horse was given enough oats, sooner or later some "ended up" in fields or along the road where sparrows could feed on them -- doesn't that sound lovely. But that's basically what trickle-down economics comes down to. Provide the wealthy with enough tax breaks or economic benefits and eventually the effect will trickle down to those on the lower rungs of the social ladder. As one who's worked his entire life for a living, as did my father (we were both business owners, by the way), you'll have to pardon me if I find that offensive.

For one thing, it's just too much like saying, if I devote myself to the care and feeding of a narcissistic parent, some day I'll be glad I did. Oh, please. For another, it's insulting to presume a "trickle" is all those who compose the majority of the American populace are deserving of. Who's making the rules here, anyway? Who decided a person born into a blue-collar family was less worthy of a seat at the socio-economic table than someone else born to wealth or privilege? It's not a good idea to forget history, you know.    

It was Paris, the summer of 1789, probably a warm and humid one like we had in Maine this year, when the so-called "benevolent aristocracy" came face to face with destiny.  Taxes were inequitable; merchants, tradesmen, and the poor bore the burden while the wealthy lived a life of the rich and famous. The court of Louis XVI had virtually spent the country into bankruptcy and reform was slow in coming. Food was scare and a revolution had taken place in America. The time was ripe for storming the Bastille.

Now, trust me, I'm not sounding the trumpet for revolution and I'm definitely not a member of the Tea Party. Nor, by the way, am I saying there's something wrong with having money. However, I do think it's time to take a look at the underpinnings of trickle-down aka supply-side economics, especially since one of the major presidential candidates seems to think it's the solution to what ails this country. As I see it, trickle-down economics is an outgrowth of an outmoded and substantially mistaken belief that wealth is a sign of moral, intellectual, and cultural superiority. Put another way, personal worth is what distinguishes saints from sinners. Not only is that theologically bogus, it's factually baseless. Crimes are committed by both rich and poor; Louis XVI lost his head making that clear. 

Of all the things we need in this country and God knows, we need a lot, a repeat performance of trickle-down economics isn't one of them. I don't know if anyone's noticed lately, but there are a great many of us out there who are first-generation college, graduate school, and medical school graduates. Like our parents, we've clawed our way through public education and worked like demons to establish ourselves as persons of social, if not yet economic, value. Not because we think that makes us "better" than anyone else or because we think it qualifies us to stand in judgement of those who've made different choices. We've done so because we believe our efforts create opportunities we and our children might not have had otherwise. Opportunities to be of service, opportunities to improve the lives of those around us, opportunities to establish justice and build a world where no one goes hungry or lives in fear of annihilation. It's not wealth that makes us do this, it's our humanity, and thank God for it.      

 (Creative Commons image by David Shankbone via Wikipedia)

Repeating History

Those who cannot remember the past are condemned to repeat it. ~ George Santayana

I don't know that remembering has much to do with it. Human nature being what it is, we seem bent on some things whether they've worked at all, worked only a little, or ended up in disaster. Knowing they've been tried before doesn't appear to prevent their being tried again with similar results. Mr. Hughes hid in Dylan's shoes and wearin' his disguise, as the late Rick Nelson put it.

I'm thinking about Germany in the early 20th century, in case you're wondering. High unemployment (30% in 1932), deficit spending, economic depression overlaid with inflation from the printing of large amounts of paper money, unable to meet foreign debt payments, national pride in the gutter. Whenever I watch something about the rise of Adolf Hitler, as did yesterday afternoon, I can't help thinking about the social conditions that made him possible. 

And then I start thinking about Santayana's quote.

I know, I know, Germany didn't have 1776 and the aftermath of two hundred years of democracy. Then again, she didn't have slavery and the subjugation of the western frontier. Let's play fair. I'm not one of those writers who makes a living telling you what's wrong with America, but neither do I want to ignore the obvious for the sake of good feelings. When something stinks, there's usually a reason.

What Hitler accomplished was masterful -- demonic, but masterful. Instead of taking reality on its own terms and leading Germany to do likewise, he fled into a delusional fantasy and created a massive marketing machine to sell it like Volkswagens. There are at least two ways to offer hope to those in need of it. One entails accepting responsibility for yourself, your successes and flat out, falling down failures, and by so doing, show others how to survive doing the same. Another is to imagine there's nothing wrong with you or wouldn't be if it wasn't for someone else. Say it often enough, sooner or later people will start believing. Say it long enough, maybe you'll win, and then you get to rewrite history so no one remembers the way it really was.

For instance, an editorial in an upcoming Southern Baptist theological journal, in complete ignorance of the wider social issues involved, described the fundamentalist takeover -- some have suggested "highjacking" is more apt -- of the Southern Baptist Convention a few years ago in terms of a restoration of biblical Christianity. The subsequent split with social-theological moderates, the virtual purging of non-strictly-doctrinaire seminary faculty, and the smear campaign against those who stood up to be counted, were conveniently overlooked. When the ends are used to justify the means, whether we're talking about theology, the search for weapons of mass destruction, or the virtues and vices of universal health care, a lot of things get overlooked.

Trouble is, this is precisely how we end up repeating history. And isn't that a hell of a thing.

(Creative Commons image of singer Rick Nelson via Wikipedia)

Stuck in the Trenches

If we could hop into Mr. Peabody's WABAK (pronounced Way Back) Machine -- remember Mr. Peabody and Sherman, the dog and his boy from The Adventures of Rocky and Bullwinkle? You can see original episodes on Hulu, revealing Bullwinkle to be not nearly as stupid as he was depicted in the movie, definitely an insult to tall people with big antlers everywhere. Anyway, if we could enter the WABAK and take it way, way, way, back -- hold on, it wasn't that long ago -- to my high school days, we'd find Dylan's The Times They Are a'Changing was one of my favorite songs.

As a fairly normal teenager with a fairly normal desire to separate from parental influence and declare my independence, I particularly liked the second verse:

Come mothers and fathers throughout the land,
and don't criticize what you can't understand;
Your sons and your daughters are beyond your command,
your old world is rapidly agin';
Please get out of the new one if you can't lend a hand,
for the times, they are a'changin. 

Naturally, this drove my father crazy, which was not my conscious intention -- unconscious is another matter. In some ways, though, I'm the same person now I was then. Not that I'd attempt to drive my dad crazy if he was still living; we'd gotten long past that conflict of interests by the time I was in college. What I mean is, I haven't lost my sense that change is a pretty good thing and it's even better to try and keep up with it.

I'm probably thinking about this because one of my housemates showed me his ipad over breakfast yesterday and it was the first time I'd seen one up close. Out loud, I wondered, tongue in cheek, if I shouldn't genuflect in its presence. Have you see one yet? They are something. Steve Job's crew outdid themselves big time. Surf the web, watch movies, make a phone call, you can even connect with your home computer and work on files at a distance. In the words of Will Smith at the helm of an alien spacecraft (Independence Day, 1997) "Man, I have got to get me one of these!"

The willingness to embrace and even promote change expresses the essence of the term, "liberal," or so I was taught in high school. Conservative, in contrast, was about preservation, and holding onto what's good about the past. A wise person, I reasoned, does both, since history forms the basis for whatever lies ahead. So, on the drive home yesterday -- turns out I had the day off, as well today, and it made no sense to spend the time up north when I could more comfortably spend it here with sleeping dogs around my chair -- I began thinking about something Jesus said. "The Sabbath was made for humanity, not humanity for the Sabbath."

The context for his statement was a conversation involving the religious leaders of his day, some of whom accused him of violating the laws concerning Sabbath observance. He countered by saying, the needs of people outweighed tradition. It was a pretty radical assertion, especially to make before a group of people who depended on maintaining tradition for a sense of meaning and purpose. Suggesting something else might take precedence, naturally drove them crazy.

Just then I switched the radio station and came upon a message from James Dobson's Focus on the Family, one of many contemporary organizations that seems intent upon codifying behaviors as either acceptable or unacceptable, and doing so on a religious basis. I thought about comfort and discomfort with change and it struck me that it's easier to become entrenched in what one believes than to expand one's beliefs to accommodate new ideas. Once we're entrenched, we have limited options for maneuvering.

Recognizing that none of us possesses the absolute, final word about anything and any description of ultimate truth is partial at best, might help. Not that there isn't a final word or an absolute truth, but how we speak of it reveals more about us than the truths we espouse. Even if we deny the existence of absolutes, that says something about us. I guess it's just hard to see that sometimes. Especially if we're stuck in the trenches.


(Image of unknown licensure via Wikipedia)

Jack the Ripper in Polartec

The things that unite us are greater than those that divide us, as President Barack Obama is fond of saying. The trouble is, I sometimes have a problem believing it. People seem prone to allow everything from the petty to the profane to come between them in the name of ideological purity. But that's one of the qualities I most admire about him, he believes the best even when I'm in doubt.

For instance, take the guy in a pickup truck a couple of days ago -- there were two guys in two trucks, actually, one and then the other. Both got my attention by surprise. You see, all day I'd been encouraging patients to control their cholesterol levels by losing weight, altering their food choices, and getting regular exercise. Sure, there are medications we can prescribe for high cholesterol, but those are mostly for levels that can't be readily controlled by other means. The idea is to get busy doing the things that eliminate the need for medications later on.

On my way home, thinking about a nap, I realized I ought to be practicing what I'd been preaching, so I drove down a nice, quiet country lane, pulled off to the side, set the emergency flashers, and headed off on foot. It was chilly but I had my gloves and jacket and figured I'd work up a sweat soon enough. I'd barely gotten a couple of blocks when I was startled by a horn honking and turned around to see Pickup Truck Driver #1 slowing down and lowering his passenger side window.

"Do you need a ride? Is that your truck back there?" he asked, gesturing with a thumb hooked in the direction of my CRV.

"No, I'm just walking for exercise, but thanks for stopping to ask," I replied. He gave me a curious look, as though he wasn't sure he'd heard me correctly, or if he had, was it time to call the police and have me delivered to the local looney bin. I smiled and did my best to look like a sane, harmless tree hugger who didn't know any better than to walk when I could have easily driven. It apparently worked, because he shook his head and drove off, waving pleasantly. It really was considerate of him to stop, you know? I couldn't help feeling appreciative for small town Mainers.

About two minutes later, another truck stopped and its driver, a white-haired fellow in his 60s with a great smile, asked if the vehicle he'd seen on the side of the road back yonder was mine (sound familiar?). I said yes, and he also offered me a ride. There I was, a complete stranger, and in less time than it takes for the average commercial break on television, I'm offered assistance by two guys, neither of whom apparently gave it a second thought that I might be Jack the Ripper in Polartec. Stephen King, on the other hand, would have a field day.

What is remarkable about all of this is the fact that I've got an Obama campaign sticker displayed on my rear bumper and the second guy stopped anyway. What's remarkable about that? Well, as he drove away, I saw a sticker on his rear window that read, "Don't blame me, I voted for the American." I guess Barack was right, after all. On this country road, at least, ideology be damned. What matters isn't the flavor of your politics, but being willing to help if someone needs it.


(Photo of a dairy farm near Skowhegan, ME copyright 2011 by the author)

Who You Gonna Trust?

Did you know the whole Viet Nam war was fought over a bet? A bet that Howard Hughes lost to Aristotle Onasis? ~ Jerry Fletcher

In the 1997 film, Conspiracy Theory, Jerry Fletcher (Mel Gibson) is a cab driver by day and author-publisher of a newsletter entitled, conveniently, "Conspiracy Theory," by night. If he seems a little paranoid at times, it's because he was recruited by a secret organization that uses mind-control techniques to train assassins. With the help of one of his potential targets, he escaped the clutches of the bad guys, and now they're looking for him. Pair this storyline with a rocking jazz sound track and Julia Roberts, and you've got a great, entertaining two hours ahead of you.

Despite his apparent craziness, Jerry has a proclivity for being right about the connections between what an average observer would consider random events. His personal experience has taught him that conspiracies can be found under our very noses, one of them involving Howard Hughes, Aristotle Onasis, and Viet Nam. Now, obviously, this is Hollywood, but Jerry's thinking betrays a reality-based concern, namely, that armed conflict could be engaged capriciously, leaving our loved ones to pay the price.

Such concerns are a predictable response to the kind of uncertainty that is increasingly associated with decisions contemplating military force in recent years. Despite the upsurge in patriotic fervor following 9/11, for example, mixed feelings were expressed about pursuit of war in Iraq. I mention this, not to call that strategy into question, but to point out how, even in the aftermath of a direct attack on this country, "we the people" weren't in complete agreement on the appropriate course of action.

I don't think this indicates we've somehow grown "soft" or ambivalent about how to act when threatened or abused. Rather, I believe it's the natural outgrowth of an awareness that simplistic solutions are rarely the correct ones for complex situations. Furthermore, there are very few superpowers anymore, and the fact is, some behaviors aren't really that acceptable if you are one and impulsiveness is close to the top of the list. It is rightly expected that a nation which has risen to the status of being a superpower should be capable of exhibiting self-control and acting wisely -- even like a gentleman -- within the international community.

This is not to say one should be a pushover or easily intimidated, but the character of a nation is as important as that of an individual. Who we are as a country, the variety of values we embrace, and our willingness to show restraint in anticipation of those times when action is necessary demonstrates not only trustworthiness and reliability, but genuine strength. It's a question of who you gonna trust. We anticipate seeing these qualities in our friends and the world has a right to anticipate seeing them in us.


(Creative Commons image by alvy via Flickr)

Unnecessary Uncertainty and Presidential Politics

Image via WikipediaAs a follow-up to yesterday's post, I've been thinking how the most recent presidential election in this country could be viewed as a shift with respect to social ambiguity. Anytime society undergoes change, ways of thinking and living will be challenged and our responses can range from open opposition to mild resistance, from moderate acceptance to enthusiastic embrace. That's pretty much a given.

In this country, the election of a president tends to be a marker predominantly indicating how registered voters (those who actually do vote, that is) feel about the direction society is taking. If things seem too uncertain or there seems to be too much departure from established norms, the trend will be toward conservative candidates. When change is in the air and people are feeling optimistic about new ideas, we favor liberal candidates.

If voting behavior can be taken to suggest comfort or discomfort with ambiguity, and if by my quick calculations, approximately 2/3 of the past 60 years have been under relative conservative presidential leadership, in general voters have preferred to lean towards certitude rather than incertitude. In other words, faced with changing social norms as a result of greater prosperity, multiplying avenues of self-expression, and the growth of a better educated and more sophisticated population, voters preferred someone who promised to slow or, perhaps in some cases, try to halt the rate of change.

2008 was a pivotal year because it resulted in the election of a candidate who represents a unique response to ambiguity, even more so than one might expect from "liberal" leadership. For one thing, he embodies it: Barack Obama is an individual of mixed racial heritage. As such, psychologically speaking, he is a transitional figure and not solely in a racial sense. He represents a willingness to look at ambiguity realistically and deal with it as an essential element in the make-up of the world community. Not in a radical sense of complete departure from our history and heritage, but a tempered response -- more than a baby step, less than a leap.

The fact that the children of Baby Boomers took such an active role in his election should tell us something. Issues that troubled their parents have little reference to their experience. They know nothing of the Cold War or duck and cover, November 1963 isn't a part of their collective consciousness, and their first car may easily be a BMW. The atmosphere in which they were raised was already fraught with change and they've adapted without a second thought. For them, the election of a Barack Obama would seem as normal as daily life.

Now, obviously, not everyone nor every young person, became his supporter and our national response to social and cultural ambiguity remains divided. And that, too, is to be expected. But what I think matters and will find its way into history is his potential to help us find effective ways of coping with uncertainty in a world that we sometimes fear has outgrown and moved on without us. Political considerations aside, I think his election represents a desire to proactively step into the currents of our time and make a difference in where they take us. They're going to flow anyway, we may as well learn how to swim; the alternative is to be swept along and for me, that spells unnecessary uncertainty.


(Collective Commons image via Wikipedia)

Expression Without Fear

-->Does anyone use a percolator anymore? To make coffee, I mean. The last time I used one was on a Boy Scout camp out. Perhaps the large, spigot-types can still be found at AA meetings, having become almost symbolic of 12-Step communities. Generally, though, they've been so thoroughly replaced by drip makers, some of my classmates may have never seen one.

Percolators work like this: a basket filled with ground coffee and a hollow stem is inserted into a pot filled with water. Usually, an electric current heats the water until it begins to bubble up through the stem and wash over the grounds. My grandmother placed hers on a wood stove and I heated the one I mentioned over an open fire, but the effect is the same. The downside is, if you're not careful using one of these gadgets, you can make the coffee strong enough to practically strip rust from beneath your car.

The upside is they've given us a great figure of speech: bubbling up. And, as you're probably thinking, something has bubbled up for me. If you've followed this blog or looked back over some of the more serious posts, you know I have one or two convictions that I let surface occasionally. One of them I learned as a child, namely, it's a good idea to follow the Golden Rule whenever possible.

I'm troubled, however, and deeply so, when convictions become the basis for hurtful behavior and specifically, I'm referring to hate messages received by members of Congress who voted in favor of the health care reform bill. What concerns me is not the bill itself, but the implication that voting one's conscience is dangerous to health and family. Convictions are powerful things and in a free society, one ought to be able to express them without fear.

And it's the mode of their expression that is at issue. I have friends who fall on opposite sides of the fence when it comes to a woman's right to choose, but our relationships are based on other factors besides politics. We've learned to respect one another because there's more to us than merely this one thing.

And maybe that's the problem. People resort to threats when they don't see how they have any other way to get their point across. Either that, or they've lost sight of what my friends and I have learned, that in the real world, we are more important than the discrepancies between us. Don't get me wrong, I believe strongly in the value of ideas. I just believe we serve them best when we refrain from turning them into baseball bats and threaten to use them to beat other people over the head. Figuratively or literally.

Health Care: Getting Our Priorities Straight

I don't know what economists would think of me. I don't believe in government owning the marketplace, which is what I'd call communism. Nor do I necessarily believe in government competing in the marketplace to the detriment of private companies, which I'd consider as a type of socialism. The first limits freedom by definition, the second by implication.

The government as a purveyor of goods and services is like a therapist dating a patient. Maybe he's seen her only for a consult or initial interview and then referred her to someone else, but a contact has occurred and that renders dating an unequal relationship implying unfair advantage. With governmental participation in the marketplace, a similar unequal relationship exists, which may also result in unfair advantage.

But here's the thing, I don't believe in a completely restraint-free marketplace, either. I think child labor laws are a pretty good idea. Workers ought to be able to organize in order to negotiate the terms of their employment. Unregulated use of the environment does not lead to the self-management of resources. Instead, it leads to species extinction and pollution. I'm sorry, but people are people and if We the People don't take steps to monitor our behavior, excesses ensue. This is why our children need to study history.

I've said all this as a preamble to bringing up health care and the legislation passed in Congress last night. My experience has taught me there is something foul afoot in the insurance industry. It is true that the cost of health care has gone up while the ability to pay has not. It is also true that there is an increasing demand as well as increasing need for high-quality health care services. I just don't believe the solution to this dilemma lies solely within the purview of economics.

I think it comes down to ethics. The things we value most are the things we generally find ways to afford. We may have to sacrifice in other areas, but somehow we manage to get the job done. If I have to forgo a new car to buy shoes for my children, I drive the Chevy another hundred thousand miles. Placing a value on the health of our citizenry means we aren't willing to settle for someone going without. And, by extension, it means we are going to take steps to ensure they have equal and affordable access.

In the course of the current debate, both sides have railed back and forth about cost-containment and where will the money come from. I've been waiting for a practical application of "we pledge to one another our lives, our fortunes, and our sacred honor." If those words were good enough in 1776, why aren't they now?

It seems to me the greatest thing we could do as a nation is demonstrate to the entire world our firm intention to take care of each other. Not because we have to, not because we need to, but simply because we believe it's the right thing to do. Once we've settled the question of ethics, the problems of cost and payment become challenges to overcome, rather than obstacles in the way. The place to begin is by getting our priorities straight.
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Canada: The Gold and Beyond

We really are different countries, the United States and Canada. Before you say, "Well, duh!" let me tell you what I mean. While watching the opening ceremonies of the 21st Olympiad last night, I couldn't help but marvel at the emphasis placed on the role of Canadian First Nation aboriginal peoples. The entire show was incredible and the creative dance depicting a young man soaring over the plains of Saskatchewan had me in tears.

I love the Olympics, particularly the winter games, and am an unabashed fool for heroism. Give me a story about someone overcoming the odds knowing full well they'll likely accomplish only a personal best, and I'm on my feet, cheering. Show me a medal winner overcome by emotion and I have to reach for my handkerchief, no matter which country they're from. John Denver said it, "There's a fire in the heart and it feels like a hunger, the spirit is burning consumed by the flame, to be one of the best of the best in the world is its name."

But as I watched the First Nations dance and celebrate their wide-ranging heritage, I couldn't help but think how difficult, if not impossible, it would be to have a similar presentation in this country. To begin with, America is very much a melting pot, to borrow a well-worn phrase. Most of us, at some time or other, have come from somewhere else. And, at the same time, our history, with respect to Native Americans, is complicated.

The settling of the American West was accompanied by encroachment onto tribal lands and the subsequent outbreak of war. Although I hesitate to use the word, "conquest" does seem applicable. Manifest Destiny -- the belief that America was destined, even divinely ordained, to expand to the Pacific -- provided sufficient justification for eliminating interference by native cultures. As a consequence, I think it's safe to say our national identity is not substantially rooted in the contributions of those who were here first. And certainly not in the ways Canadians demonstrated in Vancouver.

My intuition tells me that a similar broadcast in the United States would require some alteration of our national consciousness, lest it appear as little more than entertainment. While films like Dances With Wolves go a long way toward enlightenment on a popular level, we need to pay closer attention to what our children learn. If education can be the magic bullet, then the history of Native Americans should comprise more than a few pages in social studies. By the time a student graduates from high school, s/he ought to be familiar, not only with who lived where, when, how, and why, but who they are today and how they define themselves, for themselves.

That nearly all of us can trace our ancestry to another place and time, doesn't change the fact that we are here, now. Who we are as a People is marked by two hundred plus years of slavery, a Civil War, and our country by several thousand years of habitation by individuals who, at one time, also came from someplace else. This land was their land, to borrow from Woody Guthrie, and in many ways, it still is -- theirs and ours together. It does us all well to honor that relationship

(Creative Commons image of the statue of Ilanaaq the Inunnguaq, mascot of the 2010 Winter Olympics via

(The Gold and Beyond, words and music by John Denver; This Land is Your Land, words and music by Woody Guthrie)

Show Me The Way

Well, once again I've been AWOL from writing. The past three weeks have been awash with exams and whenever I've tried to write, the pressure of impending doom has disrupted my thinking and driven me back to the books.

Today I'm basking in the warmth of the first Sunday since fall that the temperature has risen above 50. That may not seem like much to those in warmer climates but in Maine, it's a heat wave. The sounds of water dripping from the roof and snow sliding off the barn are pleasant portents of spring that are truly welcome. My dog and I may actually walk today without bundling up.

For the most part, though, it still looks like winter. Snow covers the hayfield, I'm wearing flannel shirts (yes, from L.L. Bean -- who else?), and only a cock-eyed optimist would even think of taking the snow tires off the car before the end of April. So, it looks like we're in one of those transition periods where change is coming slowly.

I think American religious life is in a period of transition. For the past, oh I'd say thirty years, the trend toward fundamentalism has been a pretty dominant feature. I graduated from seminary in 1977 and the hottest topic of the day was what will the "End-Times" be like. The following year, students were arguing about the inerrancy of the Bible and by the mid-1990s the Southern Baptist Convention, the largest American Protestant denomination, had shifted to the right. The most recent Presidential election, however, showed signs of another shift, this time away from the extremes and back toward the middle.

Usually, during periods of social unrest and economic uncertainty, more conservative denominations flourish. But it seems people are hungry for more than the appearance of certainty, and in spite of the state of the economy report feeling more hopeful. What a paradox. Maybe we really are set on the brink of something new and vibrant in American life. Maybe for the first time in years, we're ready to stop looking for someone or something to blame and instead, looking to each other for solutions. I don't think we elected a President in the anticipation that he would be the agent of change. I think Americans are starting to feel the need to change themselves and they elected someone who can show them the way.

Darwin Rides Again

At the risk of sounding like something I don't intend, I have some serious questions about relying on the free market to manage itself. My guess is, I'm not alone if you look at the actions being taken in the Executive Branch. But the concerns I have stem from thinking about Darwinian theory.

If I understand it correctly, survival of the fittest means those species most adapted to their environment are most likely to be the ones that reproduce and thrive in adverse conditions. Now, this concept seems to be getting a lot of airplay lately as pundits argue about the appropriateness of a government bailout. Some insist the market itself is best capable of determining which businesses should survive and which should not.

There was a time -- not long ago, actually -- when a different kind of market determined the fate of human beings. I'm referring to that period in history before the advent of modern medicine. Just a little over a hundred years ago, battlefield amputation was common practice because there was little doctors could do to manage infection. More recently, I remember the polio scare of the 1950s. I doubt anyone would suggest we had no business intervening in the course of natural selection by developing antibiotics, vaccines, and learning how to treat diseases effectively.

Ultimately, we've grown in our knowledge and practice of medicine because it is humane to do so. We want calling a doctor to be a good thing. Can you imagine taking a sick child to the hospital only to be told that because she was ill and could not heal herself, she was not among those naturally selected for survival? True, some would argue managed care does precisely this but that's a topic for another day.

My point is, just like that child, the American economy is sick and most of us are suffering because of it. Intervention may not be entirely popular but clearly the market hasn't been able to heal itself. "Watch and wait" can be a very reasonable medical strategy in some situations, but if we do that with the economy the outcome may be far worse than the treatment.

Speaking metaphorically, there are some who seem to long for the good old days of Civil War medicine. You got shot, you lost your leg. Somewhere along the line people decided they wanted a better future than one spent on crutches. I think it's time we thought the same way about the economy. It's not something that can be regarded as independent of that living and breathing entity we call the American People. The economy is all of us working, living and sharing a fate that, together, we create. Its survival depends on far more than a toss of the Darwinian dice. It depends on us, and so kudos to Republicans Olympia Snow and Susan Collins of Maine for crossing the aisle and placing their constituents above party loyalty. They may pay a price for it, but in the long run, it's worth it.

An Open Door

Have you ever wondered why Congressional and Senatorial Democrats and Republicans seem to be much more effective at opposing, rather than working, with one another? Who hasn't? Well, on this morning of the inauguration, I'd like to offer a thought or two about this. And for the sake of simplicity, from now on I'll refer to them as Democrats and Republicans.

A minister friend of mine once said, "Belief determines behavior." If that's the case, then part of the reason Democrats and Republicans have difficulty working together is a no-brainer: they believe differently about the nature and role of government. On the surface, at least, this is true. When an economic stimulus package, for example, fails to pass the House, representatives on each side accuse one another either of failure to care about the American people or of having socialist inclinations. From the perspective of this observer, it's a sad state of affairs.

Now, before going any further, it's true that a great deal has been done in Washington with bi-partisan support. But generally speaking, there's enough backstage political engineering going on that "we the people" have every reason to wonder why they can't get along.

I think the basic problem lies in the fact that they just don't know how to leave partisanship behind and focus on the larger issues. Either there's too much at stake in terms of re-election or they can't imagine what it would look like to really work as one body. Furthermore, they've had no leadership. There has to be someone who is willing to say, what we've been doing isn't working and continuing to try the same thing over and over constitutes insanity.

Enter Barack Obama. Truthfully, I don't think his task will be straightforward. Well, I take that back. It is straightforward: he has to lead Congress in conceptualizing and enacting a new way of doing government. It's just not going to be easy. Working cooperatively has to become not only the ideal but the commitment of all. Now, human nature being what it is, I doubt we'll see the members of Congress lining up to accept this like new converts at an evangelistic crusade. But given time and appropriate modeling by the new President, there's a chance, and probably a pretty good one, that we're going to see a different Washington over the next four years.

The President Elect has already begun showing us how he intends to govern, not only by creating a bi-partisan cabinet, but by refusing to adopt a radical agenda. He has continued to actively seek input from the people. I've never heard a President in my lifetime ask the people to "keep those cards and letters coming in." The concept of a cooperative governance that includes the people, while a core principle of this Republic, is one that has not been so energetically promoted as it has by the President Elect. Here again, the internet has, and will continue, to play a key role. But my point is, Obama has shown an intention to govern from a position within the citizenry rather than from one that stands above the people. It's a leadership style that says, "go with me," instead of "go where I tell you."

The political pundits have been talking about how everyone who supports Obama has a story. For me, this inauguration represents an open door. Andrew Jackson used to invite the public inside the White House. I'm not sure we'll see quite that degree of freedom; we do live in far different times than Jackson. But it's not far-fetched to imagine a presidency that embraces the people, all of them, and particularly those who are in disagreement with its policies. For me, today is about a President who will stand at the door of government and say to everyone: "Welcome."

Transparency

When I checked my email this morning, I found a letter from the Obama Transition Team. It seems they have decided to post the activities of the team online and open them up to comment. This is definitely a different way of "doing government," and it reminds me of a wonderful story about Andrew Jackson. You've probably heard it before. It seems he was given a rather large -- several hundred pounds -- block of cheese and he left it in the foyer of the White House so that visitors could help themselves. Apparently, Jackson was fond of allowing the people to "drop by" from time to time.

The size of government can seem daunting and access limited. You write a letter to the President knowing an aid will read it -- maybe you get a reply, maybe not. But actually posting documents and inviting comments, removing the barriers of authority and sharing responsibility: this is new. Well, maybe not new, but certainly overdue.

I like the idea of transparency in government and I like the idea of inviting the people to participate in the process of governing. There are some who feel they've elected others who are "more qualified" to make decisions for them and that's fine. But if I've got an opinion that I think is worth sharing with my friends, what makes me think it's not worth sharing with those who have the power to act? I love the line spoken by Kevin Costner's character in the film, 13 Days, discussing the Cuban Missile Crisis: "There's no 'wise old man' here -- hell, there's just us." I'm not convinced its not always that way.

Fairy tales are metaphors for human experience, not just bed-time stories for children. And one theme that repeats itself over and over is the "young fool" who saves the kingdom. In the story of David and Goliath, for example, all the king's horses and all the king's men are inadequate for the task of facing the Philistine army with their secret weapon, Goliath, and it falls to a young shepherd to slay him with a stone.

Maybe we are all like David when faced with the magnitude of governing, but that doesn't mean we are unqualified. It simply means we are human. Take a moment and visit change.org -- read a bit, make a comment. Who knows what will happen?