Q 74 Enfin Libres Finally Free

Enfin Libres The Message to the USA from a rational Country

“Finally  free” is the headline of the local newspaper, Sud Ouest, in Bordeaux. On the second page the headline is “Now Liberty will become the rule again.” Ask yourself when you will see that on the frontpage of the NYT. 

This a clear example of the results of having a thoughtful rational leader who gives a clear consistent message.  Our motto is E Pluribus Unum, from “many comes one.” The French national motto is “Liberte’, equalite’ and fraternite’.  Roughly translated, by a non French speaker, as liberty, equality and brotherhood.  This phrase governed the reaction of a socialist leaning country as they responded to the epidemic. France is a very regulated society that allows freedom in concert with equality and reverence for the common good..  There was no absence of griping and some lack of Masques in stores but generally they daily filled out an attestation which they carried with them, checking the boxes which stated their destination: doctor, work , visiting a sick relative , going to court or government office or exercising themselves or their dogs. These documents were available on line at midnight on the first day of Confinement.  I was stopped twice by gendarmes who inspected my document. In case you don’t have a computer and printer the back page of the paper had four copies everyday for you and your family to fill out.

Seen from this vantage point it is clear that equality and brotherhood are not in our souls.  The events of Minneapolis and the widespread protests against wearing a mask or staying out of large groups reflects a failure of our society to believe that the common good should be the driving force. The concept that liberty allows one to do whatever they want will not produce a functional or livable  society.  This epidemic ripped th,e mask off our facade that we care about one another.  It has exposed in all its ugliness, the truth that Me, ME, Me and me will not work.  Sometimes we have to accept restrictions for the purpose of making it better for everyone. 

Make no mistake!  Small shop owners and restaurants and barbershop and hairdressers and pedicurists and manicurists suffered in this time. Monday will be the 75^th  day since confinement began.  I know the woman who owns my favorite restaurant and we have talked about her financial situation.  She and her husband and son have been damaged economically but not destroyed.  They have health care and the school has opened up on a limited basis and no one is going to evict them from their home. In the midst of all of this, she ran for city council, and although her list lost, because of proportional voting, she has one of the two opposition seats on the council. It took  her a month to gear up to do take out but she is keeping the wolf from the door. This is La Pen (Trump) country but here everyone generally wore masks. Working in a vineyard is not like working in the Renault Auto plant. But they recognized the fears and concern of their neighbors.

What makes it sad for me is seeing that if Our beloved leader had simply worn a mask and made it  a masculine symbol of virility on March 10^th  we could all be recovering in a few days. But he has adopted a program that seems to say, “ let the old and weak and the young take care of themselves.  We 20-60 year olds won’t get sick so lets do whatever we want.  Let’s be free and don’t you dare tread on me.”

The resultant chaos has led to 1000’s of layoffs The resultant chaos in tourism, travel , higher education and health care will take a long painful time to repair.  It didn’t have to be this way if we had remembered that America was not built by rugged individualists on Harley-Davidsons.  It was built by ill prepared Pilgrims who were saved from starvation by Native people who had been here for thousands of years. Our Capitol was built with slave labor and the West was by railroads built by Chinese that weren’t allowed in the picture of driving the Golden Spike in Utah. Barns were built and grain harvested by communal labor, not by “sharpies” from Chicago in Suits and white shirts.

My hope is that this epidemic will rekindle the “common good flame” in the American people so we can add “equality and brotherhood” to our national motto.   

Q 53 Anum Cara=Soul Friend

I just walked 6800 steps through the vineyard and never met a car or a human being. One and half hours of solitude as I thought of friends I had not heard from and wondered how they were surviving this isolation.  All my life I’ve made a habit of calling someone whose name comes to mind.  I think it is a remnant of the Highland Gaelic belief in the Second Sight. I often feel I know things I have no reason or basis to know.

I am blessed with a coterie of friends who fit the definition of Anam Cara which is described in a book   written by John O’Donohue.  Anum cara is the word for a Soul Friend in Gaelic. When you pick up the phone or meet someone you have heard from for a week or a year or 3 years and you pick up the conversation as if there had been no interruption You are talking to a soul friend.  The depth of the conversation is the sign of the real depth of the Anam Cara ness. You can talk the weather or how is your job.  That doesn’t count.

The real connection comes when you begin to reveal your soul.  Life changing experiences of death, divorce, professional failure or loss of dreams for the future. It can’t be one way. Both you and your Anam Cara need to share the view of our souls. Then it is real.

A real Anum Cara is someone who can accept you with all your warts and faults and not turn away. There is no one who does not have characteristics that might make one want to walk away angry or disgusted.    For some, the desire to eat animals that were living breathing creatures and subjecting them to the process of meat production is repulsive. One of my AC is one such, but she can accept that I love bacon and lamb sandwiches and still communicate deeply with me.  I suspect she will never stop verbally raising the images of abattoirs, but I will always laugh gently and move away from breakfast or lunch conversations.

Racial references that are hurtful present the same problem even among good friends. I told a political story about the Southern US just as it was told to me, using the Governor’s actual words that were commonly used in the 1950’s. One of my AC was offended and told me so.  The point was that for him that word was never to be used.  We have worked together for years and our friendship is still deep although we don’t see each other very much.  I’m sure if I picked up the phone and called, he would pick up our conversation that has 2-year gap in it like we had spoken only yesterday.

If you think through your friendships call the names that come to mind. I have always loved the “Concept of 6 Degrees of Separation” expanded by the Hungarian author, Karinthy in 1929.  His idea was that 2 individuals are separated by only 5 people. He believed that if he wanted to, he could contact to any human being on earth through personal acquaintances.  I found my first girlfriend that I hadn’t seen in 40 years with 5 phone calls. Try it sometime in Quarantine when the world seems to be closing in.  I did this before Linked-In or Facebook which are only technologies based on this theory. I bet writing the patent on this idea was very interesting.

We all have Anam Caras if we allow ourselves to think about what is hardest to bear in the social isolation required by public measures in an epidemic. Loss of human touch can be mitigated by a phone call or two.  Reach out and touch them.  

Q 50 Touch

As I walk through the vineyards awakening from the winter, my mind turns to the clouds which makes me think of the ceiling of the Sistine Chapel. Although you may not have been in Rome, most everyone has seen the Michelangelo scene of God touching the finger of Adam, creating the humanity of human beings. This an iconic image that is everywhere in the Western world.  As I am walking alone through the vines, I long for the touch of another human being.

Quarantine or social isolation is most difficult for me and others because we can not touch or hold or caress those closest to us: lovers, sons and daughters, parents, grandchildren and on and on the list goes. Intellectually we understand why the isolation is necessary whether it is in a Covid-19 case or just an ICU after some medical procedure.   

Usually we think there is a time limit on the prohibition, but there is no end in sight for this epidemic because we don’t know what the virus will do next. We fear a second wave, but we don’t even know when, or if, it will come. It is like a thief in the night that disturbs our sleep. How can we cope with endless estrangement from human touch?

My little village has several meetings about how to reopen the primary school. How do you enforce social isolation in children who are interacting physically with one another? Everyone who is or has been a parent knows that each school year brings an unending string of sniffles and coughs as children bring to school or home, whatever they have come in contact with.

Imagine being a teacher and unable to put a hand on a child’s shoulder to encourage or comfort a child. Which then brings up the whole subject of learning on-line.  This is not a panacea because again, you have social distancing that makes it hard to ask questions or to judge whether the answer given was satisfactory. Anyone who has spent 5-6 hours a day staring at a computer screen on Zoom feels a little detached.

We have five senses by which we take in information: touch, smell, taste, hearing and sight.  I once had an intense discussion with a violinist about which sense I would miss most.  We only talked about seeing and hearing. The other senses are primitive and useful perhaps in other times. I took the position that eyesight would be the biggest loss, but she insisted that hearing loss was the worst. She pointed out to me that the process of hearing is done in milliseconds with no chance to rehear the sound. Sight, on the other hand, allows us to refer back to the subject to see if what we thought we saw was in fact true. Was the sound “in tune” is decided instantly but “is it green or blue” can be reviewed. Watching old people who are deaf shows the isolation they feel and retreat into unless they get hearing aids.

I thought about that conversation and I think we both missed touch. We say, “That touched me” about both things we hear and see. Maybe we say that because it reaches out deepest level of understanding. I’ve read stories of people who are in solitary confinement who develop relationships with mice or other creatures.  I now understand better people who live solitary lives and relate to birds and plants. As I have talked to people about this ache in my soul they send me all kinds of interesting information.  The German Psychiatric Association has a message on-line: “We are flooded with calls. During Quarantine it is completely normal if you talk with walls, flowers and some other items. Please only call us when they are talking with you.”  It is hard to tell if it is tongue-in-cheek but lots of people tell me how much they miss touch of a Human being.

In a totally unrelated conversation my brother and I got to talking about how we surviving the lock down and he surprised me by saying, “I miss touch.” He is an extraordinary dancer, especially in Contra and Irish set dancing where the dancers are touching one another all the time as they do intricate steps, taking the lead from one of the partners. As I thought about this, I thought of an old Joke in the world of religion.

The religious leader was asked if having intimate relations while standing” up was acceptable. The emphatic answer was “NO”.  The questioner asked for a rational for that response and was told, “Because it would lead to dancing.”

The next question is “When can we touch?” Will we resume shaking hands, or will the French and other Europeans resume kissing on the cheek? I look forward to the day when I can give a hug again to someone I care about.

As I was walking, I was reminded of our basic animal nature by a growling dog I met. A neighbor yelled at the dog in French, so I don’t know what he said.   The dog slunk away with its tail between its legs.

The next day I met the dog and he growled. I yelled at him and he slunk away.  The dog lives around the corner from me and as returned home from my walk the dog followed me at a distance. On instinct, I summoned the dog in a quiet friendly voice. He came to me and let me pet him and wanted to follow me into my house. It seemed like he needed me to touch him and I needed to touch him for my soul needed a touch.

Q 44 Only You can decide

Something has provoked me to write this essay several times since I left Congress.  In this instance, it was the response of medical experts on the Task Force on COVID19 to the president’s “musing” that the internal use of disinfectants might be helpful to those who had or were fearful of having COVID19. That comes on the heels of the ”game-changer,” Hydro chloroquine.

Professionals who serve in government are perpetually faced with choices between what their profession has taught them and what is politically expedient. No one in government is exempt from these painful choices. My own experience came to this choice point in 1968. Should I enter the US Navy as a psychiatrist during the War in Vietnam? I struggled with this Question and decide to explore other routes to fulfill my obligation to my country. I tried to transfer to the Peace Corps, but I was refused that route.

I wrote to the Norwegian government about the possibility to go to Norway and work in a Mental Hospital. They told me of the possibility in Tromso which is above the Arctic circle. There was a regional hospital opening there.

I wrestled with the idea for a long time and decided to go into the Navy with my passport in my pocket, hoping to serve my time and come out to work to change my country. That was always the underlying force in my service in government. That is all history now. I tell this to say that I have a deep feeling about the internal struggle any doctor feels about his decisions. With each patient I saw I had 3 options: !. fit for duty, 2. To the Naval Hospital for treatment or 3. Recommend an Administrative discharge due to unfitness for service. I saw 8-10 patients per day for two years. 

On some occasions I was so upset by what I saw that I wrote the Chief of Naval operations or the Medical Chief of operations. I irritated my superiors at the Naval Station so much that I was put on the list to go to Vietnam despite having one child and a second on the way. I was saved from that fate by my local Medical commander who wanted me to run his alcoholic Rehab clinic. The other day I felt like I was standing next to Captain Crosier on the deck of the Teddy Roosevelt when he was cashiered off his ship because dared to contact people outside the chain of command. 

I was enraged by mental health professionals who enabled Vice President Cheney to torture Iraqis with a patina of humanity in the process. The step to Dr. Mengele is too close and I felt they should resign from the CIA. I tried to enact President Obama’s Executive Order into law, but I failed.

President Trump presents a whole set of problems. First and foremost is whether he is fit to be president.  The American Psychiatric Association has an ethics rule that prohibits members from diagnosing a person whom the professional has not seen personally.  It is a good rule, but times have changed since that rule was written in the 1960’s.  Today telemedicine makes it possible for professionals, including mental health professionals, to work with patients at a remote site.   Drugs are prescribed and treatments are recommended based on television observation.

Over the last 3 ½ years we have had adequate opportunity to observe the president’s state of mind.  Paranoia, narcissism, obsessive lying and disregard of establish health precautions are in evidence on a daily basis. 

The refusal of the US Senate to impeach him was evidence that the political process has failed to hold him to the Constitutional Standards. So he now feels vindicated and free to do anything.

This puts medical professionals in the position of being the last protectors of the people from his irrational behavior.  All that matters to him is his TV ratings and reelection.

Those who stay with him are simply caught in the vice between doing what they know is right and trying not to offend a vindictive tyrant so that they can influence him in his decision-making process. The flaw here is that he has no decision-making process.  His decisions are coming from a childish and immature intuition. He really consults no one except the approval polls.

Elliot Richardson and Bill Ruckelshaus stood up to Nixon in October 1973.  Robert Bork caved to the president and fired Archibald Cox and 10 days later the Impeachment of Nixon began.

There are several Medical professionals who are enabling the president to spread dangerous and potentially lethal medical misinformation.  They all need to stand up with the Hippocratic oath in hand and resign.
 

Some say let’s wait and get him in the election in 190 days.  Consider for a second, all the damage, delay, obstruction and chaos he can create in 6 months and 10 days. Is a foolish attack on Iran or a confrontation with China in our best interest?  His warped sense of intuition may make those seem like good political moves to help his reelection.  You don’t have to work your imagination too hard to see the damage he can do. 

None of those professionals will have any impact. But their public stand will show the American public what they can expect from this rudderless leader. Trump is talking about a housecleaning at HHS and replacing Secretary Azar with one of the medical professionals. He will have co-opted all their professional integrity by one move.  

A Faustian bargain has never worked  and never will.