Danbury, Connecticut ,5 AM

            I woke  at 5 AM at  the  Danbury, Connecticut  Hilton,  son Dan sleeping in the other bed.  Another typical day.  Dan  is home from school for the weekend but his ride only went as far as Danbury, arriving  there at  2 AM.  We work today so we couldn’t pick him up 60 miles from home in the middle of the night .The logical  solution : See a movie (  Pride, not bad)  dine with friends,  then drive to Danbury,  check in at 11, PM, wake in the morning  with Dan and drive home in time for work. Easy.  Easy but exhausting.

            Shit. My first patient has a rash.  Rashes terrify me these days. Patient tells me about a new, painful rash blooming beneath the shirt. “Let me see,” I say with dread.

            Zoster.  Herpes Zoster,. Shingles. Shit

            “Is it contagious?”    

            I sigh “ You are  slightly contagious,” I start my well rehearsed  soliloquy. "You can infect others who lack an intact immune system.  You need to avoid babies and people who have never had chicken pox.   "And, “ I add, trying to drain the terror from my voice,  “you can infect anyone who has had a bone marrow transplant  within the last 5 years. You could  kill them  from disseminated Zoster. Now please  lower your shirt.”

            I bite my tongue, avoiding the following forbidden phrase … “ You know, I had a bone marrow transplant and this could  kill me.”

Disseminated Zoster

            I told a patient that a year ago, and I suspect he is still traumatized  by my confession. It’s not the patient’s fault I am damaged.  A normal person wouldn’t agree to see zoster patients, but I suspect a normal person would not   drive from Danbury to  Hartford at 6 AM to accommodate a college -aged child.               Anyway, why should I worry?  I gulp 1200 mg of  Acyclovir a day  and undergo  monthly infusions  of intravenous  immunoglobulin  to arm myself against  disseminated Zoster, a  disease as horrific as it is fatal.

             Later that day, I bump into the receptionist.

            “We were worried. We though it might be shingles, we didn’t want you to see the patient.”

            “It’s fine,” I say, trying to gather enthusiasm.  “Send me all your rashes.”

            I live in two worlds these days.   I want to  live an intact, healthy life, I want to  do crazy things at odd hours, I  don’t want others to pity me or make allowances for my medical condition.   And yet, I am not completely well. At a bar last night, waiting for the food to arrive, I suddenly felt weak, overtired. 

            “ Is there a chair for my husband? ” Cyn asked  a waiter.  “ My husband is sick.”

             I don’t want to be that guy.

I carefully plan each day, taking care not to exacerbate  the situation. I  wake early. I eat a high protein breakfast.   I  don’t eat at work,  carbs provoke  an insulin and cortisol storm  that  makes it difficult to concentrate.  I work 26 hours a week, 8 hours a day because becoming over tired leads to  GVHD storms.

            I don’t want to be that guy,  the  guy with excuses.  I  want to work extra shifts, because we are short staffed and I want to help out, after the other providers  were  kind to me when I was  hospitalized.   I want to set an example. What would I tell a patient who asked for life- long jury duty deferment because of  a cancer diagnosis? I would tell them to  buck up, cancer is not a death sentence, I’d tell him or her  that   I’d  give a year  deferment but after  that,  we’d have to reassess. And then I received my jury duty notice. I had the opportunity to avoid jury duty for life.  What to do?

This is what I did.

            I am  at a crucial point in my life. I have two choices:  Surrender to the discomfort and fatigue and request life-long disability.  Or, I can fight the fatigue, the weakness, the mouth sores. What do they say? Fake it till you make it?  Kurt Vonnegut wrote that turning fifty was like crossing the peak of a roof-top,  after that, one descends the other side.  I could descend slowly, carefully, or I could surrender and  slide off the roof.   Some days, I feel like letting go.

 Alli calls.  She is  looking for volunteers to work an understaffed office this week. But it’s at night, when I am tired, and that would mean working 6 out of seven days. I tell her no. Let someone else do it, someone who isnt having an immunologic war waged in his or her mouth.

            I  woke this morning in our temper pedic bed, contemplating  Steve Hawking radiation.  If an anti particle is destroyed while its particle twin  is released, doesn’t this imply a loss of data?  Doesn’t that  contradict the  quantum law of  information retention? Doesn’t this imply none of us exists? We are a hologram cast  against the heavens?   I try to roll out of bed.   Panic. The steroids and the GVHD have weakened my muscles and it's hard to move. I spend the rest of the day in a fog. I drop my chop sticks at dinner, the steroids and my recent bike riding have provoked a neuropathy.  I eat my rice like a westerner.  With a fork.

            I don’t want to be sick.  I am not looking for secondary gain. I want to work longer hours,  pick up extra shifts.

            This year, I am mentoring a first year medical  student. We see patients together one day a week.  I have been given the privilege of training future doctors.  I don’t want to teach her about cranial nerves and  the best technique to hear a   mitral murmur.  She ‘ll learn these skills elsewhere. 

            I  do want to show her why  my 90 year old patients   need  colonoscopies ( dying from colon  cancer isn’t a matter of just falling asleep, it  involves pain,  emergency  surgery,  intravenous medications and multiple hospitalizations)  I need to explain why people with terminal  cancer insist on  taking their anti cholesterol medications (even the terminally ill can hope for a prolonged survival)

            I want her to read Dylan Thomas, I want her know about   patients who rage against the dying of the light  and why.

            I wasn’t able to mentor in the past, afraid  I would be dead  or disabled before their 3 year long  education with me ended.  I wanted to mentor to demonstrate that cancer is not a death sentence, we can  receive  a  fatal diagnosis and still show up for work.

            I want to tell her  I’m working  because the alternative is to give up, to lie in  bed and  die.  I want to demonstrate that one s petty problems  can be   gracefully and gratefully ignored.

I haunt two worlds.  I have no idea how long this will last.  And  by “this” I refer to symptoms, but also to life itself.

            I think of  Emilio Zapada, the Mexican revolutionary.

            "It’s better to die on your feet than live on your knees.”

            But really, what choice to I have? 

The Big E

We returned to the Big E this week.

The Big E. The Eastern States Exposition . The state fair, held yearly in Springfield, Massachusetts , is where one can watch baby chicks  hatch,  horses cantor and  both huskers and  ears of corn, husk. 

Really?  Aromatherapy can cure Lupus? Dont tell Big Pharma!

A Selfie: me with two sleeping cows

and the inevitable conclusion. 

  I love the big E , long after friends and  family have  dismissed the gluttony and  the kitsch. They view the fair as hopelessly tawdry  and vulgar , appealing to  base,  blue collar appetites . 

            I love the Big E because I view the fair as a response to all that is wrong with our  modern lives . In a world of homogenous apathy, the Big E  may be the only place on the planet where one can view the lovingly  grown,  largest gourd  in Connecticut and  vicariously  experience the honest, exuberant  joy of a 16 year –old who  won a ribbon for raising the  best groomed cow in New England.

I have no idea what she's doing but she's proud and excited!

            I have always lived in proximity to state fairs.  We visited the  Danbury State fair  yearly until someone decided Connecticut  needed a Forever 21-chocked mall     more than a tractor pull  competition, and maybe they do.  The New York State Fair  lies 5 miles from upstate medical school in Syracuse.  I couldn’t begin a year  without inspecting the  life sized butter sculpture.

It’s September 21, 2011. I stand at the portal of the Brigham and woman’s hospital, checking-in for my stem cell transplant, We are silent and grim.  There is no future, only  disease.  “You have 10 years to live,” Firsh told me four years previous, and now, with my disease  surging ahead,  six more years  on this mortal coil seems an impossibility. The admitting nurse eyes us warily.

            “ Why are you here?”

             I ignore the existential entreaty.

  “We were told to show up at 9 AM.”

            “That’s crazy. They’ll just make you sit here all day, they wont admit  you until tomorrow. Go do something fun.”

             The  Dana Farber is  110 miles from the big E.  We had to go. The unspoken message was, of, course  “You may never  see a polled Hereford (1)  again, you might as well go.”

            We had, I recall, a wonderful time. I  was the proud possessor of a  central line, an IV that runs through the chest wall directly into the heart. I spent the day trying to fool everyone I was drinking beer through the plastic straw -like attachment protruding from my shirt.  I had been given a quick lecture about immunity and my complete lack thereof.  As far as I could tell,  everything one could see, touch or eat at the Big E was on some banned list. I remember Cyn running behind me, laying down a path of Purell as If I were a  giant  snail secreting a glistening alcohol trail.

            I remember taking real inspiration form the Big E that day. I was about to have buckets of poison and, apparently a little local beer, poured directly into my heart for the next few weeks but,  in  Springfield,  life went on, oblivious to my insanely  perplexing predicament. 

            At the Big E, each New England state is given a pavilion in which to display its local  wares, foods and customs.  The Maine pavilion serves  potatoes at 6 dollars a serving, demonstrating  Maine’s two famous  exports:  starchy tubers and chutzpah.  New Hampshire’s pavilion was transformed into a big state lottery ticket store. Massachusetts was all about the chowder.   Vermont ‘s  exhibit  extolled the virtues of flannel outer ware and  maple syrup.  In our Mall -saturated world,  where one can buy the same Victoria secret  bra  from coast to coast, shopping at Vermont’s  Flannel  shop  for  comfortable  plaid work shirts was strangely liberating.

            The day passed. We drove back to Boston.  I lived.

            We returned to the Big E last week.  The cancer is gone, but the malady lingers. I have aged  far  more than 3 years over the past 36 months.  I worry my enthusiasm and life -wonder is ebbing under a constant onslaught of medication and discomfort. This year, I was less willing to  dismiss the morbidly obese, lining up to buy hamburgers  served between two doughnuts.

            I had my shopping list for this year:  A new Timex watch from the Connecticut  pavilion,  some lavender soaps  and flannel  nightshirts from the Vermont  display,

            The fair has changed.  The Timex exhibit where I stock up yearly on  cheap watches  ( three for $50) is now home to  Pez, another  Connecticut product. There may be no more useful object on the planet than a cheap, rugged wristwatch.  There may be nothing more redundant and useless than a Daffy Duck Pez dispenser, available at any  Wal-Mart  across this  monotonous. indifferent   land of ours. I feel a real sense of loss as metal watch mechanisms  are replaced by  sugar and plastic.  The soaps are gone, replaced by yet another ice cream shoppe.  I do love Ben and Jerry but I can buy a  pallet of Cherry Garcia in  Stockton, California, and yet the one  factory in Vermont that produces  little bars of lovely    lavender soap is out of business.

            I left the Big E this year  with mixed emotions. I’ll be alive next year. I just  accepted a three year commitment with U.  Conn to mentor their med students, and I intend on  shaking their hand in four years. I’m just not sure If I’ll return  to the  Big E.

The joy of life is in the unexpected, the breathtaking, the unique. My survival is no longer  breathtaking  or unexpected  but neither is the Big E.

(1)  The Polled Hereford is a hornless variant of the Hereford with the polled gene, a natural genetic mutation that was selected into a separate breed beginning in 1889The Polled Hereford breed is bred for its deep forequarters, depth and muscling, docile temperament, fast-growing calves, and good quality of beef

To. Forgive. divine

DB Sweeny is terrified.  He is going to die.  They’re all going to die. His hand twitches  as he plots his B 25’s   course over the  North Sea with a red crayon.  He glances out the window.

“That’s the third Reich we’re flying over,” He says ruefully.

Memphis Belle.   World war two melodrama about young flyboys bombing Hitler’s empire.

The cartoon representing  our Airbus 330  has just  entered European  airspace. Somewhere below, the good people of Leiden are buying herring along  the canals,  sipping  coffee, bracing for another day’s onslaught  of euro socialism and legal hashish.

Lufthansa a has done a fine job spiriting us across the  Atlantic.  Some unseen hand drew all the Business Class shades in the middle of the might, letting us sleep an extra hour or so.   Dankeshein  They are an efficient people.  They could have won WWII if they had set less exulted goals than conquering the world and exterminating its Jews. They should have settled on annexing the Sudetenland and  sending  Golda Meir hate mail.

As a child, I remember my dad forbidding us from flying to Germany on Lufthansa. “You know,” He’d say in a tone that forbade contradiction or discussion,   “ the Lufthansa  pilots   flew for the Luftwaffe, during World War Two.”

         That may have been true in 1968, when the  average ex Luftwaffe pilot was probably  married and  raising teenagers.  The average   WW II  Luftwaffe  Pilot  would be  90  this year, so I feel a little less guilt.

Point made. I am appalling old.

         As the continent scrolls by beneath,  I start performing  the ominous math.  I was born 14 years after D Day.  Fourteen years ago I was… well, I was sitting in the same office I now occupy.

         It gets worse, much worse.  I was born in a country with 49 States. When I was born, the last Civil war veteran was still alive. He was 113, true, but alive.

How did I get so  old?
         The answer is easy: I didn’t die.

         On some level, this trip to Munich, with connections to Croatia , is taking me back to my roots.  More specifically, it’s taking me to the source of my stem cells.

         Dankeshein, Deuchland.

          I imagine trying to explain to a German civilian from the 1940s  exactly what I needed from him.

         “I know we are at war, and I know your leader has some misgivings about , you know, Jews, but  it turns out we have identical bone marrow. Would you be a dear and donate a pint of your stem cells to me? Otherwise, I die. “

Which part of this request would he find the most absurd?  That he shared  a bone marrow with an American  Jewish  stranger? Or would he want to know about a procedure that kills leukemia though a technique called “ Graft Versus Host Syndrome?”  In the end, I’m sure I’d tell him it was magic.

         We land in  Dubrovnik, Croatia, to start our bike trip.   Croatia is a lovely country,  evocative of  the Northern California coast with citrus trees, high mountains, and a long, attractive coastline.  An occasional soviet era  building  appears, hinting at an ominous  communist past.

         Dubrovnik is a medieval, walled city.   It’s evocative of Venice, not surprising when one realizes they were founded and built at the same time by the same people. Then you notice things

         You notice most of the  buildings in this  600 year old city have new roofs. The Yugoslavs tried to destroy the city in 1991.  You notice a pockmarked hotel, built by the communists and abandoned after the war because,  let’s face it, you  don’t rebuild  1985 era poured cement hotels.        

         Point made: War is eternal. One can wander past the Egyptian Obelisk along  the Thames in London and see  where the German bombs left pockmarks during World War I.

         The  1991 war was a prelude to the horrors of the  Bosnian conflict ten years later.  In that conflict, the Serbs decided to exterminate the Muslim Bosnians.  Slodidan Milosevic , the Serbian  ex- communist leader, was tried for war crimes and  eventually imprisoned. I asked our Croat  Bus driver about all this. “ Too bad he died so soon,” was his reply.

         The question lingers. How many years until the Serbians and Bosnians start swapping stem cells? Perhaps that time span, between extermination camp and  stem cell donation,  should become a unit of  time. It would represent a wonderful thing, the time it takes to forgive one’s tormentors.  

         I am old, I am old, I wear my modern, biking trousers rolled.  God my legs are thin.  Off for a week  biking across Croatia.

Summer stars

The flags fly in distress on Warrenton Avenue.

Every morning I drive Hartford’s West end on the way to work.  Hartford is a sad, strange, crumbling town. It was the center of the American intellectual universe in the 1870s when Mark Twain and HB Stowe lived down the road and American publishing  and insurance empires thrived on the banks of the Connecticut  river.

The large Victorian mansions have gone to seed; their decaying hulks still lurk amid the  empty lots and homeless shelters in our northern end.

  The West End is a little different.  The large houses are still in good repair, Mark Twain’s house still boasts a lovely multi colored slate tile roof.  The   mansions’ occupants work in the city and have  money enough  to maintain  their houses in good repair.  The neighborhood  is  populated  by restless, radical people who send their children to private school. They hang signs on their houses, “ End This Endless War “ and   “US out of Iraq.”   Rainbow flags adorn a fair number of homes.

I am startled by the number of American flags hanging  from the ramparts.  They are universally upside down, the sign of warning, distress. One must  never  sail by a boat with a reversed  flag, someone  is in trouble.

         The flags hang upside down. Someone is in trouble.

I haven’t  been sleeping these nights. I am uncertain why. The high dose steroids I  restarted to fight the Graft Versus host disease play havoc with my internal clock.  My leg cramps strike about 3 AM, catapulting me from bed.

         Doesn’t matter. It’s 3 AM and I am up for the day, ready to prowl the internet,  seek solace in the hot tub.

         I  once dismissed this 400  gallon tub of fermenting water as the ultimate bourgeois purchase.  When I see a hot tub, my mind  flashes to the ancient joke:

How many Californians does it  take to screw in a  light blub?

Californians don’t screw in  light bulbs they screw in hot tubs.

We lack sufficient  property to  frolic nude in  our hot tub, but the 101 degree water kills my leg cramps as efficiently  as an injection of  succinylcholine. 

So for this, I am grateful.

         I lie in the hot tub and examine the stars. At some point I suggested  placing  the tub in a  gazebo- like enclosure. Cyn declined, and she was right. Contemplating the stars is crucial when undergoing hydrotherapy in the hot tub. 

         I think of New Zealand, where we  biked a few  years ago.  The stars there are different. I finally saw my beloved Alpha Centuri, the star closest to earth, the subject of Science fiction intrigue. The stars there are upside down. The constellations were created  in the North and didn’t translate well to the southern hemisphere.  All the constellations stand on their heads

Orion skids across the sky on his skull  in New Zealand.

The stars are upside down. They are in trouble.

I was a nerd. I was a geek.

I love astronomy.

I glance up for comfort and the stars are all wrong.

All wrong in West Hartford  at 4 AM on a late August night.

All wrong.
Shakespeare wrote of the terror when day switches places with night, it’s how I feel when the wrong stars appear in my troubled skies.

And yesterday the owl  did sit

Even at noon-day upon the marketplace,

Hooting and shrieking.

Vega should float serenity at the apex of the sky, along with Deneb and Altair, and yet my summer friends are absent. 

from this brave overhanging firmament, this majestical roof fretted with golden fire. It appears no other thing to me than a vile and pestilent conflagration of vapor.

Orion the hunter says hi.

Orion should not be saying hi. Orion is my winter friend; He informs me snow should be on the ground.   I wait every late fall for the Big E   Exposition  and for  the  Hunter and Sirius, his trusty dog , to patrol the frosty night sky.

 These are difficult times

The very stars are askew.

"The time is out of joint: O cursed spite,
 That ever I was born to set it right!"

My universe is  altered, changed these days. I function, but function in pain.   Orion walks the night sky.

 One can see winter star in summer.  All it takes is a little Graft Versus Host disease, a little mouth pain, a little muscle cramp, a little existential terror that one’s condition will never change. At 4 AM, the stars in the August sky match those seen in winter at dusk.

They never mentioned this in the transplant brochure, that  an allogenic  transplant will make  winter stars appear on hot desultory summer nights.

One day  I’ll feel better

One day the stars will return to normal.

Until then, Orion and Sirius will patrol my summer  skies.

The woman screamed

You need a doctor! She was only trying to help, I know . I popped into the  CVS to pick up  gauze,  tape,  non stick  dressings,  antibiotics. You know, the stuff one usually ends up buying after the first day of a 100 -mile  bike  trip.

I looked like an extra from a zombie movie. Blood, every color of the crimson spectrum, flowed down my left leg, pooling on my high tech  sock. The effect was, and is, highly Hollywood, the zombies have taken an unhealthy bite from my kneecap,  and rivulets of unclogging clot  are starting to saturate my clothing.


Fun day, right?  The path to gore town is too tediuous to relate here, but includes new blood clots, anti coagulants and most importantly, a fall from my bike exactly 47.5 miles ago when I was the proud owner of 5 quarts of blood.
But that isn't the point of the story
Honestly, how do you women do it? How do you casually manage  5 quarts of sticky embarrassing red ooze while trying to have a life filled with dinner parties, white outfits and , more to the point,  vigorous exercise that  tends to unleash the red sticky flood gates?
I am falling.  I am falling behind.
The family, yours truly non withstanding, are going through miraculous rebirth. I burst with pride over Cyn who is thriving in a potential new managerial job. My heart sings for jeff, starting his second year at med school, cool and confident, reassured he chose the proper path in life.  Abber Dab is growing too, starting her new job, driving the roads in her 2011 silver honda civic. And dan.... Well,  as they say, he is well along his chosen career path, world domination.
And then there's me. My feet are doughy little muffins , the result of a lack of anti coagulation. The river of death actually courses down my left leg.  Cyn is negotiating a new contract , and she has used the phrase " my chronically sick husband" in her negotiations and here's the sad part: it's true.  I'm not fooling anyone " you're getting better" she says, but she says it in the same tone they use to describe the dead guy in the Monty Python " bring out your dead" sketch.  I am falling / I am falling/ and she is calling..
Kafka is such cliche but here I am ,Gregor Samsa, clinging to a wall as my family waits . We know how the story ends.  They are moving on and I'm scaring a  poor woman at the Northampton cvs

At what point do I run dry?

My dear brother just called in a panic, apparently  the blog implies I am  hospitalized.  I am at home,  Cyn cleaned up the mess at the Hotel.  Thanks, hon.

Falling, I am falling, but she keeps calling me home again.
Cant leave the stage  when I have such a devoted audience. 

It rains

ouch

It rains .  I wander.  The cabin lies in the woods,  20 miles south of the Canadian border. As is always the case it is 3:59 AM.
Always on the cusp of a new day.
Joe and Jenna are in love
Joe and Jenna are getting married.  I've been asked to officiate.  They are already married in the state of Vermont so my officiating  is moot at best.   They are married in the eyes of  the  IRS.  If Joe takes up with a waitress tonight, he'll have some splaining to do. They need some bald old guy to make up stories, seal the deal.

As it turns out, I can't discuss my most ancient  yet touching Joe-related anecdote.
 Joe's a good guy.  He did nothing wrong really.  He made the mistake of being  3 and being attacked by a jellyfish lurking in the Long Island  sound.  It’s an  embarrassing story due to the site of the bite and his horrified  expression.  It’s a sad day for any three year old to suddenly realize that nature doesn’t play fair, that we have a thousand  vulnerabilities.  The story I am able to relate at the wedding  isn't as juicy, it involves his  frolicking nude in his baby sisters’ blow- up pool   Harmless story, I guess,  until some lawyer  colleague tries to discredit Joe by  implying he's the sort of lawyer who spends  his days naked  and potentially drunk in a kiddie pool on a hot summer day

I've done worse.

I mention this because I love Joe.  I mention this story because I am honored that he and Jenna have asked me to officiate at their wedding.  I mention this story because it connects us with one another.

Most important, I mention this because now its 4:30 AM and I am watching the Social Network the Mark Zuckenberg Facebook story. Im sitting in our cabin, watching  Mark’s life unfold on my I pad and think “  Well,  Mr Big shot  Billionaire,  no one asked you to talk about  all the close connections you’ve made in your life.  Your Billions mean nothing  at the end of the day and you fly  across the world in your private Jet.”
I allow myself 20 minutes of sanctimonious  posturing   and then the Buddists spoil it. As they sometimes do.
I mention this because it's a Koen, an epigram that let's us glance at our  4 15 am selves

I am over whelmed by  glibness, false pride. I allow  myself 30 blessed moments of  self satisfaction, 30 minutes of Sally Field crowing "you like me, you like me."
The moment slips away, thanks to Zen Buddhism.  Zen teaches all possession is theft, whether the bijou in question is a gulf airstream  5 or a dear friend.
Possession is misery. All possession  is misery.
 In the end we are alone.
How do we address this paradox, how do we live in this world of pain?   Tell me quickly, I have to inspire the  newlyweds and I can hear the Sysco truck in the driveway, delivering the ice cream and Champagne.  I have to convince them with a wave of my arms and a false lurking baritone that  life can be wonderful. Otherwise, they definitely over paid for the  make your own sundae bar.

The answer  lies  in the detail, amid  the  angels in the architecture  . we live in  flashes of joy, of hope of memory. We live at weddings, in between chapters of wonderful books. We live in  between courses of delicious food, we live in those five  extra seconds when we realize the last comment  our oldest  and dearest friend made truly was was hysterical.

It goes beyond that.  The message is simple: Sometimes there are wonderful things that wait for us just beyond the corner.  Jelly fish lurk, but so does a perfect italian meal served in a small cafe .  The IRS is just finishing its touches on our subpoena
 but so  too lurks the most wonderful art exhibit at the Met.
We live in the single  precious moments before we realize life is short,  pointless and painful. We live in the 10 minutes  the pain suddenly and inexplicably disappears
We live between jelly fish bites,  in-between the rain drops, we live in the arms of those we love.

The secret? Just know the pain will stop, and in life , despite evidence to the contrary, the jellyfish will give you an occasional break. And maybe, just maybe, you’ll  say a few simple words while officiating at a wedding that  the happy couple will carry for the rest of their lives, long after you’re gone.


I love you, joe and Jenna.

obama care

“You must really hate Obama.”

I hear this weekly and it still disorients.  The message is that the affordable care act is the worst public health policy since female genital mutilation and Barack’s misguided polices are destroying our country.

            The thing is; they’re not.  Obama care is mostly wonderful.  People who never received preventive healthcare are now being treated.   Fewer people will die of colon cancer, stroke, and diabetes.  Ultimately , my insurance rates will drop as  patients undergo more preventive  healthcare.  A colonoscopy costs  $250. Treating metastatic colon cancer  costs  over  $50,000.   The real question is: why do benign,  helpful and kind spirited  policies  elicit such blind hatred?

Two stories.

A Genie appears before a Russian peasant. “You have two wishes. You may wish for anything.  Gold, power, immortality. Just name it.”  The Russian thinks a bit.

“I have no milk. I would like a cow.”

Done! a cow  appears. What’s next?

The old man thinks.   “OK, he says, I want you to kill my neighbor’s cow.”

 Point is, there is no success unless one’s neighbor suffers. 

In an updated version of this story,   the  peasant  works at  Whole Foods and receives   subsidized healthcare through his job .  Suddenly, his  foolish, slothful  neighbor, who works at  McDonalds and doesn’t receive health care,  is granted  health benefits.   Our Whole Foods worker persevered and obtained a job that came with healthcare. Now his benefits will come with an increased deductable to subsidize his  neighbor’s  newly acquired  Obama care. He is not his brother’s keeper. He resents chipping  in for  the new benefits.

     Story two

A few years ago, I suggested universal, compulsory vaccination   was a public duty, a civic responsibility.    After all, I reasoned, If your getting the measles vaccine protects me against s disease I am unable to be vaccinated against, you have a duty to be vaccinated

            I was amazed by the hate mail.   “Your  disease is not my problem”  I was told reputedly in  ( mostly) anonymous e mails. People felt they shouldn’t be forced to risk their lives to help others.

Healthcare is similar :   Your Obama care  colonoscopy  raises everyone’s insurance premiums.  By forcing  everyone to enroll in health care,   everyone  subsidizes  everyone else’s treatments.    This is painfully true for me: The costs for my stem cell transplant  was borne by everyone at Hartford Healthcare systems. I try to compensate by bringing in brownies, but  I suspect my  high carb  gifts are just provoking more diabetes among my  colleagues.   Sorry

My bleeding heart  is glad to  pay for others’  colonoscopies and blood screenings, if it will    spare  others the misery of  receiving treatment for  colon cancer.

But this begs the question: How and why did we become so mean?   When  did churches  stop  preaching the golden rule? When did  we  stop being our brothers’’  keepers?   This is the real disturbing part of   the story.   When did altruism become a weakness?  The Obama hated implies a nation of bitter malcontents, evokes a society where generosity and societal concern have mutated into undesirable traits.

The uninsured poor are   victims of their own sloth, stupidity, and greed.   I am aware that if I didn’t have a working spouse, I would not have health care. I wouldn’t have undergone my stem cell transplant, What if I lived in Mississippi? The answer is easy. I would be dead.  What amazes me that I am not unique.  Doesn’t the governor of Mississippi know anyone who contracted cancer?  Doesn’t he know  someone  so injured at work that he or she couldn’t work again?  I find it hard to believe the reason southern states don’t push for universal healthcare is that everyone there is so darn healthy.   Doesn’t anyone one watch Paula Dean?

Obama care has been a lifesaver for many. People are undergoing their colonoscopies,  receiving their  medications.  

I dislike Obama care because, suddenly, 60,000 people now have insurance in Connecticut and they need to be seen.

light blue states: No expansion of medicare. Dark blue:  increased coverage. Is there a trend  here?

Every week, the providers are asked to work more hours, see more patients as a direct result of expanding coverage.   As a lazy, tired, chronically ill patient I have issues with Obama care, sure. I have to work harder. But that’s no reason to hate the guy.