Archive for June, 2011

If you’re ready for a tour of the “great beery, NASCAR loving, church-going, gun-owning America that has never set foot in a Starbucks,” and learn why they tend to vote for rich Republicans, then I urge you to read Deer Hunting with Jesus: Dispatches from America’s Class War by Joe Bageant.

Even if you’re not ready for such a tour I recommend you read the book anyway because it will challenge you, regardless of what your political beliefs are (he disses Democrats as often as he does Republicans), plus he’s a compelling storyteller. You’ll find yourself getting caught up in the stories of the people he knows in Winchester, like Dottie. (Here’s an excerpt I typed up from the book that will introduce you to Dottie. It’s long but I hope you’ll read it.)

The author grew up in a redneck family in Winchester, VA and returns to this community in his late 50s after a 30 year absence. He observed the  ways his working class family and friends had been “degraded and devalued” by the same forces they vote for in the voting booths (i.e. the working class tends to vote Republican). He wrote this book in 2007 to describe how his neighborhood in the richest nation on each is having a hard go of it.

Here’s just some of what you’ll learn from the book:

  • Why the working poor kid themselves they are middle class. (p. 5)
  • The real definition of “working class” (it has nothing to do with income or the color of your collar). (p. 11)
  • The role revenge against upper class snobbery plays in the voting preferences of the working class. (p. 14)
  • The only two American presidents who campaigned for universal health care (shockingly, both of them were Republicans). (p. 25)
  • How small businesses aren’t the bedrock of democracy you might think they are and why they are really “small feudal systems ruled by local networks of moneyed families, bankers, developers, lawyers and merchants.” (p. 44)
  • The difference between rednecks and white trash. (p. 70)
  • How getting a lousy education and spending a lifetime pitted against your co-workers in the “gladiatorial theater of the free market economy” allows working people to accept America’s wars without a blink. (p. 71)
  • Where the dreams of the working class go to die. (p. 73)
  • The #1 mistake the left made in dealing with the dissatisfaction of the working class and how the right swooped in and and tapped into working class dissatisfaction with great effectiveness. (p. 81)
  • How rich Republicans are able to connect with the working class on the working class’s own turf. (p. 84)
  • The true source of working class anger (hint: it has very little to do with abortion, gay rights or other political issues). (p. 89)
  • What happens when we stand by and “watch the humanity get hammered out of our fellow citizens, letting them be worked cheap and farmed like a human crop for profit.” (p. 91)
  • Why nobody but the soldier’s family and church gives a hoot when a working class soldier dies in a war. (p. 94)
  • The new terms of discrimination and how they are all about homes, vacations and private education. (p. 103)
  • What “white trashonomics” is and why it never works out. (p. 104)
  • Why the biggest organized racket in the US is the dream of owning one’s own home. (p. 106)
  • Why gun ownership touches the lives of most heartland voters even more than gay marriage, abortion, affirmative action and animal rights. (p. 132)
  • Think we need more gun control? You’ll rethink that when reading how poor women benefit the most from concealed-carry laws. (p. 135)
  • The real problem behind crime and how to whack the crime rate without hysterical “crime is caused by guns.” (p. 135)
  • Why the “theology of despair” is so seductive and how it is shaping the spirituality of millions of Christians today. (p. 166)
  • Why the most obvious class indicator in America is religious belief and how religious zeal is concentrated in lower class and working class whites. (p. 182).
  • The significance of one of the least understood political events in America: the conversion of millions of people from apolitical Christians into Christian political activists. (p. 188)
  • The main difference between Republicans and Democrats. (p. 260)
  • The two things our culture is based on. (p. 262).

Well, I could go on, but I hope that’s enough to interest you in the book. The most upsetting chapter for me was the one on health care. It was troubling to read about how nonprofit hospitals are the largest generator of bankruptcies. They tend to channel their profits into more buildings instead of reducing medical costs and care for the poor and drive small town hospitals out of business. Dottie makes an appearance in this section as well.

Anyway, this book is the best book I’ve ever read about class in America. Bobos In Paradise: The New Upper Class and How They Got There is a close second.

I’ll close with this poignant question Bageant asks:  “If the left is not about class equity, what is it about?”


There’s a party in your heart

I discovered Death Cab For Cutie’s new song You Are A Tourist this morning and have been listening to it repeatedly while working on a writing project.

When I first heard the line, “there’s a burning in your heart,” I thought it was, “there’s a party in your heart.” Our parakeet Shirley sings wildly while this song plays so I couldn’t hear the line properly, but I like my misinterpretation better than the original anyway. There’s obviously a party in her heart while singing along to this. Birds are as particular as we humans are in their musical preferences. She doesn’t sing along with any of the other songs on the new Death Cab For Cutie album. Neither do I, as it turns out.

Here’s a video of the song:


The pit crew of wounded healers

What do physicians have in common with NASCAR racers? What are the 3 essential skills today’s doctors need that don’t have anything to do with medicine? Read this from the New Yorker and find out.

Why is the Republican party no longer a comfortable fit for many doctors? Why do many doctors now support health insurance mandates and no longer care so much about limiting their own liability? Read this from the New York Times and find out.

As an aside, I’m always drawn to articles like these, partially because my paternal grandfather was a physician from the 1930s-1970s, but mostly because my mother was a RN in the 1960s-70s and told me countless nursing stories while I was growing up, which were far more enthralling to me than any story book she could have read to me. I suppose it’s not surprising that while I was in high school I picked up brochures from the guidance counselor’s office about anesthesiologists, oncologists, nursing, EMTs and physician’s assistants and fantasized about those sorts of medical careers. My father worked in insurance and those stories weren’t nearly as interesting, so that wasn’t on my list of things to do when I grew up.

Somewhat ironically, the closest I ever came to working in the medical field was when I worked part-time for an insurance company, of all places, during most of the 1990s. I was a unit leader and helped make sure the claims processors did their job correctly. I was certified as proficient in medical terminology and knew the most common procedure codes and ICD-9 diagnosis codes by heart. If only I had a dime for every 401.9 (hypertension), 250.00 (diabetes mellitus), 311 (depression) or 473.9 (sinusitis) claim I processed. I haven’t worked in that field for more than a decade but still remember many of the numbers and have visions of rattling off such numbers when I’m old and can’t remember the things I did five minutes ago. “Do the doctors think I have 290.20?” I’ll probably repeatedly ask my daughters. ;-)

Anyway, as dry as all that sounds, there were times I was able to glimpse the patient behind the insurance claim. When a claims processor in my unit would come upon a difficult claim that was as thick as a doctoral dissertation, he or she would usually slip into despair because processing that claim would take so much time it would make their speed percentage plummet (claims processors had to maintain high accuracy and speed percentages or, eventually, get demoted to the mail room). As a unit leader I was exempt from maintaining such percentages so I would usually take the claim off his or her hands and process it myself.

There were a few times I discreetly cried while processing those claims because the story the procedure codes and diagnosis codes told was a medical nightmare. I would feel terrible for the patient and his or her family. I carefully read those procedure codes and DX codes as if I was reading a novel. Page after page after page the story unfolded through the numbers. I made sure to process such claims with extreme care so that the claim would be paid correctly and the patient wouldn’t receive an erroneous bill, which would only have added yet more stress to their lives. It’s the closest I’ve ever come to taking care of a patient.

So I can see why the doctor in the New Yorker article I cited above says it’s pit crews today’s patients need. It can’t all fall onto the physician’s shoulders. And as Dr. Rachel Naomi Remen said in Kitchen Table Wisdom, “We are all providers of each other’s health… we are all wounded healers of each other. We have earned the wisdom to heal and the ability to care.”