I wish I could tune out...

Sometimes I envy the people who watch Fox as though it really were Fair and Accurate. I wish that I, too, could stick my head in a hole in the ground where all I could hear echoed back at me was what I just want to believe. Instead, I see as a responsibility of citizenship the need to be informed, whether or not I like the news that is being delivered. So, I even force myself to know what Fox is all about - like the "tea party" in DC yesterday, which I cannot help but see as a fitting end to what seems like a Summer of Hate, during which even the birthright to citizenship became challenged.

Because I did not have my head stuck in a hole, I heard this interview on Fresh Air - with journalist Jane Mayer, who published an article in the current issue of The New Yorker on the two billionaire brothers funding the alleged grassroots "tea party" movement.

The article itself had me in half a mind to boycott products like Dixie cups and clothing made with Lycra - two products in the holdings of the Koch brothers. I mean, why should "my" money become diverted to their causes, which ultimately serve their own interests?

Frank Rich, in his column today, commented:

The New Yorker article stirred up the right, too. Some of Mayer’s blogging detractors unwittingly upheld the premise of her article (titled “Covert Operations”) by conceding that they have been Koch grantees. None of them found any factual errors in her 10,000 words. Many of them tried to change the subject to George Soros, the billionaire backer of liberal causes. But Soros is a publicity hound who is transparent about where he shovels his money. And like many liberals — selflessly or foolishly, depending on your point of view — he supports causes that are unrelated to his business interests and that, if anything, raise his taxes.

Which caused StraightMan to declare that the so-called Giving Pledge among billionaires like Warren Buffett and Bill Gates really might not be such a great idea after all. (For more on this, I now have Ralph Nader's novel, Only the Super Rich Can Save Us! on my to-read list.) Do we want to - can we - trust them to give to the causes that matter most to most people? The "right" causes and not the "right-wing" causes?

(I admit my own partiality. OK?)

For the thoughtful billionaire who wants to do good, but is not certain how to do it, StraightMan proposes a solution: Pledge to give more in taxes, which will go to public works like universal pre-K and school nutrition programs and universal health coverage and infrastructure.

True, you will not receive all the adulation given to the Buffett-and-Gates gang, but you need not defer the good you will do until you pass on - which means you also might reap some rewards, like healthy and skilled employees, which contribute to your bottom line. Win-win!

Here is another take, from Slate, on how to "fix" the Giving Pledge.

Given how the summer went, I dread the coming season of mid-term elections.

What had me laughing aloud

Oh, David Sedaris... If only they could bottle you...

See his essay, "Standing By: Fear, Loathing, Flying," in the August 9th issue of The New Yorker. I was reading it aloud to StraightMan as he washed the dishes. It was hard to get through because I kept choking with snortles:

Everywhere I go, someone in an eight-dollar T-shirt is whipping out a cell phone and delivering the fine print of his or her delay. One can't help but listen in, but then my focus shifts and I find myself staring. I should be used to the way Americans dress when travelling, yet still it manages to amaze me. It's as if the person next to you had been washing shoe polish off a pig, then suddenly threw down his sponge, saying, "Fuck this. I'm going to Los Angeles!"

I am laughing aloud, again, as I type this.

I confess that this comment felt spot-on to me:

It was one of those situations I often find myself in while travelling. Something's said by a stranger I've been randomly thrown into contact with, and I want to say, "Listen. I'm with you on most of this, but before we continue I need to know whom you voted for in this last election.

If the grandmother's criticism was coming from the same place as mine, if she as just being petty and judgmental, we could go on all day, perhaps even form a friendship. If, on the other hand, it was tied to a conservative agenda, I was going to have to switch tracks, and side with the [teenage father wearing the T-shirt printed with] Freaky Mothafocka, who was, after all, just a kid."

Petty and judgmental, but no friend of Glenn Beck, thank you.

Ars moriendi

Atul Gawande has a thoughtful essay, titled "Letting Go: What Should Medicine Do When It Can't Save Your Life," in the August 2nd issue of The New Yorker.

In it, he considers end-of-life issues and reports on the benefits of hospice and palliative care. Here is a finding that seems important:

Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But studies suggest otherwise. In one, researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure. They found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer.

Gawande notes that hospice, both in principle and in practice, departs from the rest of medicine today - for example, enabling people to live their everyday lives, keeping them comfortable, talking and listening to them about their wants and needs. I find it telling that an oncologist interviewed in the article admits that it is "easier" for her simply to prescribe another round of chemotherapy, even a second or third-line drug that in all probability will make no difference, than to have a conversation about the fact that a patient will die.

Yet, he notes also that doctors and nurses can learn what to do and how to do it and to become practiced in it. Susan Block, a palliative care specialist, tells Gawande: "A family meeting is a procedure, and it requires no less skill than performing an operation." She notes that words matter, so that instead of saying, "I'm sorry," you say, "I wish things were different," and instead of asking, "What do you want when you are dying," you ask, "If time becomes short, what is most important to you?"

Gawande, a doctor's doctor, is thinking aloud in this piece about how our ability to do (e.g., develop new therapies that might not cure disease, but at least can prolong life) outstrips our ability to make sense and esp. meaning of it all: In other words, cultural and social challenges for the individuals deciding what their lives (and deaths) are all about, including for the doctors and nurses.

This is, in fact, a point that I feel is important to make in my class on Medical Anthropology. So, I might consider assigning this article. The issues and the reporting here already have been published widely - from the journalist's perspective, there is no really new news here - but the article is compelling to read, in part due to Gawande's assured and compassionate voice, and in part due to the heartbreaking story that frames it: Towards the end of her pregnancy, an otherwise healthy woman in her early 30's learns that she has an aggressive cancer. She delivers her child and immediately begins what reads like a painful and unending course of grasping at straws. Yet, who could blame her? I thought about Beanie and Bubbie, and I suddenly became conscious of my own breathing.

The point I present to my students is that perhaps medicine as we take it for granted in our society both succeeds and fails at what matters to us. Gawande points out that there is "a still unresolved argument about what the function of medicine really is" - which I suggest has to do with the aggressively ahistorical stance that medicine itself takes. The only history that seems to exist is a path of "progress." There seems little perspective that as medicine "progresses," our experiences and expectations also change - and that progress and change are not the same. It seems like resorting to "heroics" in medicine might have meant one thing when death was what Gawande describes as "typically a brief process" of hours or even days or weeks, but it seems to mean another thing when it involves months or even years. Is that not enough time to consider living, and if so, then what is? Is it then not worth remembering that living itself is the process of dying?

Here is what Gawande says to the doctors:

We are increasingly the generals who march the soldiers onward, saying all the while, "You let me know when you want to stop." All-out treatment, we tell the terminally ill, is a train you can get off at any time - just say when. But for most patients and their families this is asking too much. They remain riven by doubt and fear and desperation; some are deluded by a fantasy of what medical science can achieve. But our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come - and to escape a warehoused oblivion that few really want.

I would add that this is not the responsibility only of the doctors and nurses, though they clearly can have one to their patients, and they might be able, in fact, to serve as the agents of change.

I can't fix it

Today, I am going Garrison Keillor on you. No, not by cracking jokes about Lutherans - ha ha ha! Here is a poem that I think summarizes exactly what a house of one's own means for StraightMan and me, esp. in this summer of repair.

It is "Handymen" by Cornelius Eady, published in The New Yorker on October 8, 2007:

The furnace wheezes like a drenched lung.
You can’t fix it.
The toilet babbles like a speed freak.
You can’t fix it.
The fuse box is a nest of rattlers.
You can’t fix it.
The screens yawn the bees through.
Your fingers are dumb against the hammer.
Your eyes can’t tell plumb from plums.
The frost heaves against the doorjambs,
The ice turns the power lines to brittle candy.
No one told you about how things pop and fizzle,
No one schooled you in spare parts.
That’s what the guy says but doesn’t say
As he tosses his lingo at your apartment-dweller ears,
A bit bemused, a touch impatient,
After the spring melt has wrecked something, stopped something,
After the hard wind has lifted something away,
After the mystery has plugged the pipes,
That rattle coughs up something sinister.
An easy fix, but not for you.
It’s different when you own it,
When it’s yours, he says as the meter runs,
Then smiles like an adult.

BTW, we have this poem taped to the wall of our kitchen, right above the light switch for the basement, which as far as I am concerned is a place that contains things that certainly are vital, but also leak and rust and crust over...

Like my colon, I want to be able to take for granted the working condition of the nether parts of my house. It is bad news when they call attention to themselves.

Talking like a spook

It was a question nagging at me ever since I heard about the FBI's arrest of a network of alleged Russian spies earlier this month - but, like, how could you not know? Did they use speech coaches?

Apparently, this has been baffling also to linguists and phonologists, as an item in the July 12 & 19th issue of The New Yorker reports - b/c in fact, the alleged spies did not use speech coaches. Instead, they claimed to be from Belgium or from Quebec.

Which sociolinguist Joshua Fishman described as rather a smart move: "Being a spy, all you have to do is count on American ignorance," Fishman said. "They were trying to use something the Americans don't know how to pigeonhole."

Belgium plays well into this blindspot. Arguably, Flemish (a variation of Dutch) would sound like Greek to most Americans. Canadian French, too, in that it has the reputation among American speakers of French as being "different" and "harder" to understand than the kind of French, so-called Parisian, that is taught in U.S. schools as "correct."

Societal monolingualism and linguistic stereotypes: Threats to national security, ce n'est vrai?

I want to go to there

From "State of Play: How Tot Lots Became Places to Build Children's Brains" by Rebecca Mead, in the July 5th issue of The New Yorker:

Blocks are an essential element at the new Imagination Playground, which is [architect David] Rockwell's contribution to playground design. Five years in the making, it is schedule to open later this summer, at Burling Slip, at the South Street Seaport.... Rockwell's playground has no monkey bars, or swings, or jungle gyms. It has almost no fixed equipment at all, except for a dual-level, three-thousand-square-foot sandpit; a pool with running water; four masts, ranging from eleven to fourteen feet high, equipped with ropes and pulleys; and a sixteen-foot tower in the form of a crow's nest....

The imagination Playground will, however, have hundred of what play theorists call "loose parts": big lightweight blocks made from bright-blue molded foam.... In an influential essay entitled "How Not to Cheat Children: The Theory of Loose Parts," [architect Simon] Nicholson wrote, "In any environment, both the degree of inventiveness and creativity, and the possibility of discovery, are directly proportional to the number and kind of variables in it."

Hmm. Could it be that I need more loose parts in my life?!

Brunch for thought

Just read Thomas Friedman's Sunday column reflecting on the BP catastrophe and the question of "responsibility." In it, he quotes from a letter to the editor that appeared in The Beaufort Gazette in South Carolina. "It is the best reaction I’ve seen to the BP oil spill — and also the best advice to President Obama on exactly whom to kick you know where," Friedman writes.

The letter is sincere. It resonates. It expresses sentiments that I think a lot of thoughtful people share right now:

It’s my fault. I’m the one to blame and I’m sorry. It’s my fault because I haven’t digested the world’s in-your-face hints that maybe I ought to think about the future and change the unsustainable way I live my life. If the geopolitical, economic, and technological shifts of the 1990s didn’t do it; if the terrorist attacks of Sept. 11 didn’t do it; if the current economic crisis didn’t do it; perhaps this oil spill will be the catalyst for me, as a citizen, to wean myself off of my petroleum-based lifestyle. ‘Citizen’ is the key word.

I especially like the emphasis on citizenship.

However. (You knew it was coming.) I think about the terrifying speed at which an assertion like this, which I read as the attempt of a citizen (and the other citizens who share it) to take control of the public discourse and direct our efforts and energies in directions like an energy climate bill, financial regulation, and immigration reform (as Friedman suggests), instead will become appropriated or co-opted by, say, BP, Transocean, or whomever has an interest, frankly, in not seeing an energized citizenry.

Is there a way that We the People can take control over the terms of discourse and the agenda for action without (at least rhetorically) blaming ourselves? In part because I fear the hijacking of this narrative and the control it is meant to assert on behalf of citizens. More important because I think it is not in itself the irreducible truth of the matter: I mean, think about the ways in which, as individuals, the decisions we make in our day-to-day lives are structured.

The point is not to recuse ourselves from these proceedings or absolve the actions that we take. I think the impulse to take the blame comes from the desire and the ability that we have to understand what is happening, even when it is painful and unflattering to ourselves. So, let us continue to take that hard look: We tend to see ourselves as people with biographies, or our own life's stories, or to use another word, memories. We fail to recognize ourselves as people with and in history, which apparently happened somewhere "in the past" with little to do with individuals. (Unless you happen to be one of the Great Men or Great Women of History.)

So, I want to stop talking about "blame." I want to talk about history. We need to see ourselves as the people who have been making histories that we do not approve or even especially wish to claim, much less control, and the the people whose histories have made us what we are.

As an aside - this reference to the difference between memory and history has haunted me for the last two days since I read it in the June 7th issue of The New Yorker, in a review of Hirsi Ali's Nomad: From Islam to America - A Personal Journey Through the Clash of Civilizations. The review tells us that Ali is a fellow at the American Enterprise Institute, and a Somali woman who has rejected Islam. I appreciated this observation in the review, in response to Ali's comments on visiting a neighborhood of Muslim immigrants in London:

Whitechapel has much in its past - oppression, bigotry, poverty, radicalism - that would have helped Hirsi Ali understand not only the neighborhood's newest inhabitants but also her own family. But "Nomad" reveals that her life experiences have yet to ripen into a sense of history. The sad truth is that the problems she blames on Islam - fear of sexuality, oppression of women, militant millenarianism - are to be found wherever traditionalist peoples confront the transition to an individualistic urban culture of modernity.

The last bit I find to be rather a sweeping statement that could be explained further - like, how individualism and modernity are never quite a done deal, but constantly being claimed and asserted, and that the problem is not a retreat in "traditionalism" in the face of modernity, but that the so-called confrontation or more precisely the process of modernity can be seen as itself producing such effects. For example, social anthropologists over the decades have suggested that "witchcraft" and "sorcery" become reintroduced and reinvented in moments of historical instability. Tradition is not the problem per se. "Modernity" - and this concept, like tradition, needs to be unpacked - is.

The BP catastrophe, including the laying and claiming of blame, clearly represents the problems of modernity.

So exactly like it was

Did you attend any heady institution of higher education during the 1980s (which in my opinion ended in 1991) and major in English? If so, then this bit (lampooning specifically Brown) might seem familiar:

Semiotics 211 was limited to ten students. Of those ten, eight had taken Introduction to Semiotic Theory. This was visually apparent at the first class meeting. Lounging around the seminar table, when Madeleine came into the room from the wintry weather outside, were eight people in black T-shirts and ripped black jeans. A few had razored off the necks or sleeves of their T-shirts. There was something creepy about one guy's face - it was like a baby's face that had hideously aged - and it took Madeleine full minute to realize that he'd shaved off his eyebrows. Everyone in the room was so spectral-looking that Madeleine's natural healthiness seemed suspect, like a vote for Reagan.

From a short story in the June 7th issue of The New Yorker, "Extreme Solitude" by Jeffrey Eugenides. Whom I heart.

The common touch

Or, how aristocrats manage to keep on being aristocrats - with the assent of everyone else. From the June 7th issue of The New Yorker, a description of Nick Clegg, the leader of the Liberal Democrats party in Britain, which recently formed a coalition government with the Conservatives (Tories):

He has also mastered one of the most important British upper-middle-class skills, that of seeming less entitled than he is. He has the nuanced understanding of class dynamics which comes from having a great-great uncle who was murdered by his own peasants.

Not dead yet

Here is a case for majoring in the liberal arts, from The Talk of the Town in the June 7th issue of The New Yorker:

The skip-college advocates' contention - that, with the economic downturn, a college degree may not be the best investment - has its appeal. Given the high cost of attending college in the United States, the question of whether a student is getting his or her money's worth tends to loom large with whoever is paying the tuition fees and the meal-plan bills. Even so, one needn't necessarily be a liberal arts graduate to regard as distinctly and speciously utilitarian the idea that higher education is, above, a route to economic advancement. Unaddressed in that calculus is any question of what else an education might be for: to nurture critical thought; to expose individuals to the signal accomplishments of humankind; to develop in them an ability not just to listen actively but to respond intelligently.

I know, I know. This sounds so grandiose and so familiar. The sentiments that become trod and retrod around this time of year at commencement exercises across the country. I have to say, however, that I am tired of people not taking these ideas seriously.

I am thinking that a "defense" of the liberal arts - btw, I am tired also of the liberal arts requiring defense, as though degrees in programs like accounting, business, or communication were self-evidently useful - is a lot like a case for craft, whether in our individualized pursuits or (as I have suggested previously) in the reinvention of work itself. As Rebecca Mead, the author of this particular Talk of the Town item, writes: "All these are habits of mind that are useful for an engaged citizenry, and from which a letter carrier, no less than a college professor, might derive a sense of self-worth."

That seems to get at the heart of the matter, I think: From what, or in what, do we find our self-worth? Clearly, in the United States today, it is connected largely with money. So, craft is important and meaningful as an alternative to, counter-discourse on, and metaphor for Money as Self-Worth. Craft is also an idea and a practice that parents can teach to their children - which opens a real possibility for meaningful change that leads us straight back to the conditions in which we work.

Dismal science

Finally finished reading what I found to be a fascinating and somewhat maddening article in the May 17th issue of The New Yorker - a profile of Esther Duflo, a development economist who directs MIT's Poverty Action Lab. Finally b/c I read it in spurts of a few paragraphs in the mornings, here and there between making ham and cheese for Beanie's lunch and pouring more Cheerios for Bubbie and brushing my own teeth. Such is my life.

The article describes Duflo's work - the economics of poverty, which necessarily means looking not only at poor "people" but poor "nations" (and rich people and rich nations) - and her particular approach to it - running randomized clinical trials of economic interventions in order to be able to compare their effects.

It was interesting to me to read that "the dominant economic model of the poor was that they were 'poor but efficient' - that is, they acted with the same freedom and self-interest as the wealthy" - that simply recognizing this might not be true represented a paradigm shift in development economics. For me, this illustrates not that the pointy heads miss what seems like a big duh, but that science works in a controlled and exacting manner. Even radical transformations require talking in the terms of the discipline. For better and worse.

In the article, Duflo contends that too much development policy has been implemented (and too much development aid invested) without really knowing whether or not the interventions work. "We have no idea. We're not better than the medieval doctors and their leeches," she is quoted during a presentation that she gives.

Really? I mean, do we really not know what is good or bad for poor people and poor nations?

This is where I wish to return to the idea that talking in the terms of the discipline works for better and worse. When Duflo claims that "we" have no idea, it seems to me worth asking exactly who is this "we." At first, I found the idea of randomized trials intriguing, even promising, but the further along I read, the more I started to feel outside Duflo's "we."

Silly rabbit. Such tricks are for the stakeholders of development - not poor people or poor nations, but the rich people and rich nations that implement and invest development policy and aid. That is the "we" interested in efficacy and efficiency. Those are the kind of "we" (not me) that might be expected to read The New Yorker. I imagine that others like me might become absorbed into the "we" as they become convinced by reading the article?

I was not, or I am not. I admit that I side with bleeding heart Friend of Bono economist Jeffrey Sachs, who commented that "careful measurement and comparisons are, of course , vital" - that is what StraightMan and other development anthropologists also observe and study - but that, "if I go into a village without bed nets, it pains me." I think this gets to the point that poverty is like disease (with which it is shown to be correlated) in that withholding a therapy known to work (which I believe bed nets have been) runs counter to research ethics even or especially in randomized clinical trials. Not to mention human ethics. In this sense, I feel like Duflo, strangely enough, underestimates the significance of her work, as when she defends her methodology by pointing to its versatile applications: "I once sat through a presentation where randomized trials had been used to choose the best packaging for yogurt." Did I miss the point, or did she? I see development interventions as more like medical therapies than like the packaging of Yoplait.

Also, as a teacher and scholar from the so-called softer side of the sciences - anthropology - I maintain that not everything actually can be learned from randomized trials. It is only one method among others, some of which might be themselves more effective and efficient for learning and understanding what we seek to know. The New Yorker quotes Angus Deaton, who critiques Duflo's work on the ground that (1) "experiments are frequently subject to practical problems that undermine any claims to statistical or epistemic superiority" and (2) "even if your data are perfect, how can you generalize from the information? Does the policy that works in India work in Brazil?" Spoken like someone who might appreciate a bit of anthropology and ethnography.