Health Care Access: Two Stories

health care handsHealth insurance exchanges launch next week.  To honor the occasion, a couple stories feel like they need to be told.  One was a story I heard on NPR about a Yale University professor.  She cut her hand in a freak accident when cleaning a glass bowl.  She told the Yale hospital emergency room physician treating her that she was a knitter, and that fine motor control was important to her.  He assured her he knew what he was doing and she would be fine.  Unexpectedly, one of her students interning in the emergency room happened by and exclaimed, “Professor, what are you doing here?”  Her attending physician stood rigid.  “You’re a Yale professor?” he asked.  When she affirmed she was, he stopped and called in a surgical hand specialist.

Moral of the story:  We don’t have equal access to health care.  Even the affluent.

The other story I heard last night in jail.  An inmate was a passenger in a car wreck six months ago.  She was rushed to the nearest emergency room where surgeons operated on her right hand.  She needed more surgery, but she didn’t have insurance.  The day after the accident, doctors amputated mid-forearm.  The following day, she was discharged with 30 pain pills.

Nothing hurls someone recovering from addiction into relapse like fresh trauma.  That’s the arc of this story.  Traumatized by the accident and in excruciating pain, she turned to drugs.  She was arrested on a drug charge two months later.  It was in jail that her cast, bandages and stitches were removed, revealing her stump to her for the first time.  She shed a grateful tear when describing the officers’ care for her in jail.

Moral of the story:  We don’t have equal access to health care.  Especially the uninsured.

Lest we be tempted to disregard this as an isolated case affecting only the poorest, let’s look at the numbers.  It’s a sad fact that Texas inmates receive better health care than the 26% of Texans who lack insurance.  Uninsured Texans outnumber the entire population of Yale’s home state, Connecticut, by a factor of almost 2.  One in 4 Texans could reasonably expect this level of care.  Only because the woman became incarcerated did a caseworker recognize her need for additional medical care, trauma counseling and rehabilitation to help her learn things like writing with her left hand, buttoning her pants, and slicing a bell pepper.

That’s a bright spot, I guess, but I have to add, time and time again I see people in jail who wouldn’t be there if they had access to health or mental health care.  The lack of access puts a terrible strain on jails, to speak nothing of the strain on people falling through the cracks and landing in jail.  And for the cold hearted out there unmoved by the human toll (you know who you are), our de facto jail-as-a-last-resort system costs taxpayers more than access to appropriate care in the first place.  Would a surgical hand specialist have saved this woman’s hand?  I don’t know.  What I do know is recovery in jail costs more than recovery at home, and now she qualifies for disability for the rest of her life.

Access to health care will never be equal.  Some will always have more.  I don’t begrudge them that.  Here’s the salient point: starting next week, no one else has to live this inmate’s story.  That’s a relief.

Join the conversation.  Where do you draw the line between a person’s responsibility for his own health and our responsibility for each other?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

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Banality of Evil: Take Two

let them eat cakeThe “Let them eat cake” celebration by House Republicans marking today’s passage of yet another bill to defund healthcare for the uninsured and continuing the sequester is unseemly.  The New York Times called their glee “grotesque.”  Having just separated millions of people from public housing subsidies, Head Start, and unemployment  benefits, and coming as it did on the heels of ending food stamps for almost 4 million people, one might expect a somber tone.  Celebrating the sequester… who wudda thunk?

Rather comically, the Majority Whip took pains to emphasize, repeatedly, the vote was bipartisan.  Perhaps being math challenged is part of the House’s problem.  Two of 190 Democrats voted for it.  I would call that 99% along party lines, but, hey, that’s just me.   Majority Leader Eric Cantor, who pushed yesterday’s food stamps vote, shared the podium.  The provisions of that bill would impact those with an average yearly income of $2,500 or less, truly the poorest of the poor. One commenter poignantly wondered what Cantor prayed for on Yom Kippur.  Could it have been to take even more away from those at the bottom?

The juxtaposition of such harsh treatment of the poor happening the week following the highest Holy Day of the Jewish year, the Day of Atonement, is difficult to reconcile, even for non-Jews like me.  The Jewish path to Atonement with God requires t’fillah, teshuvah, and tzedakah.  These translate roughly to prayer, repentance for wrongs, and the charity that justice demands.  Charity is a particularly bad translation for tzedakah.  In many ways, they’re opposites.  Charity is optional, at the discretion of the giver, and something to which the recipient is not entitled.  Tzedakah is commanded of each and every individual, regardless of wealth, and in the Jewish tradition, recipients are entitled to tzedakah.

The Jewish tradition doesn’t try to equalize income or wealth.  While it t recognizes vast gulfs between the haves and have-nots, it also recognizes a sense of fairness.  Food, clean drinking water, a safe place to sleep and other essentials for survival are things every human is entitled to, for the sake of social justice.  Even those who receive tzedakah are required to give it.  They may render aid rather than material provision.  The Jewish way of engaging with those in need is full of dignity, on all sides.  Dignity is what seems to be sorely lacking in the US House of Representatives this week, but today especially.

The specter of powerful politicians usurping the powerless is not the worst of it.  What gives me greater pause are the millions of Americans drinking the Kool-Aid and voting against their own economic interest.  It calls to mind Hannah Arendt’s landmark book chronicling the trial of a Nazi war criminal.  In it she coins the term “banality of evil” and argues the Holocaust (and indeed, all the great evils in history) resulted not so much from the actions of evil people as from ordinary people blindly accepting and participating in evil behaviors promoted as “normal” by the state.  About the criminal she concludes, “…everybody could see that this man was not a ‘monster,’ but it was difficult indeed not to suspect that he was a clown.”

While it may be tempting to describe our elected representatives as clowns this week, the consequences of their clownery is costing real people real lives.  Who represents them?

Join the conversation.  Why do so many Americans participate in the anti-healthcare, anti-poor rhetoric?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Looking for Cover

Jerry McClure/Dallas Morning News Special Contributor

Jerry McClure/Dallas Morning News Special Contributor

My local paper had this photo of scantily clad revelers on its main page most of last week. Unusual? Hardly.  The Dallas Morning News served a steady diet of bikini pics throughout the summer.  I ask, when did wearing skimpy bathing suits to public events become a good idea? Never mind. It was never a good idea. Perhaps the more salient question is:  When did it become a cultural norm?

I’m seeing more skin in mainstream media. I think it started with “news” coverage of celebrities lacking coverage. Recently, it extended to pornography personalities. Six months ago, I couldn’t name a single porn star. Now I can, thanks to Huffington Post main page headlines. I’m not sure when porn stars became mainstream. I’m more concerned about when wearing bikinis to public events became mainstream.  Are they related?

I can shake my head at the 20-somethings in the photos, but my three teenage daughters can’t. They have to process media messaging somehow.  As a teen unhappy with her body, the models in Elle, Seventeen and clothing catalogs tormented me. But those models were clothed. My daughters are pelted with images of unclothed women, and like it or not, that media messaging establishes cultural norms and expectations. Teenage boys have always wanted to see skin (so I’m told), but now they expect to see it. Teenage girls feel expected to show it, and they do—both the girls with bodies that conform to cultural ideals and those whose bodies do not. Feeling pressured by (and moreover, complying with) cultural expectations damages self-esteem when the message is showing skin counts more than showing intellect or showing heart.

My daughters span a wide range of changing shapes and sizes. In May, one decided to avoid swimsuits all summer. She was relatively successful, even with a beach vacation. Where highs reached the low 70’s, lounging under a beach umbrella in shorts and a t-shirt was not only comfortable but also common among the fair skinned. More difficult was avoiding our sailing club.  Kids wear life jackets by law when sailing, so that wasn’t as problematic as the club pool (where adult behavior isn’t always at its best). When the others wanted to go, she dug in her heals or went to a friend’s instead.  Consequently, our family sailed less this summer.

Her plan broke down at her evangelical Christian camp, of all places. Although the camp went to lengths to protect girls’ modesty—no spaghetti straps, shorts less than fingertip length or 2-piece swimsuits—water sports could not be avoided. She survived, maybe by wearing t-shirts over her swimsuit, or maybe because it’s a place where showing heart counts more than showing skin.

Her quandary made me ponder covered women in the Islamic tradition. Several of my Duke Summer Institute classmates spent years in community with covered women. What my classmates relayed, and what Muslim women at the local mosque expressed, was a deep sense of freedom. Ironically, the burka westerners view as oppressive Muslim women view as liberating. They feel free to be themselves and to express themselves without being judged by appearances. They are utterly aghast at the pressures American women must resist to maintain their dignity, and they can’t fathom women presenting themselves as sex objects by choice. Conversely, covered women feel respected by men who don’t expect them to show skin for male attention, and they feel protected by a culture that doesn’t prize appearance above all else.

Join the conversation. Who’s more exploited—the ones choosing bikinis or burkas?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com

Misunderstood

Reza Aslan interviewA TV interview dubbed “the most embarrassing ever” is garnering bad press for the interviewer and book sales for the author interviewed.  Although admittedly painful to watch, the interview lacks any real substance.  The ensuing brouhaha is classic news-making-the-news media sensationalism.  I suspect the only reason it is getting coverage is the interview comes off as a Christian-Muslim ambush fail.  The aftermath leaves me wondering who ambushed whom.

I happen to think the interviewer asked a good question, and the author, Reza Aslan, missed an opportunity.  The interviewer asked why a Muslim would write a book about Jesus.  Aslan responded, perhaps a bit patronizingly, that as an academic New Testament historian, it is his job.  By responding to the question as a personal attack on his authority or motivation, he missed an opportunity to elucidate Muslims’ regard for Jesus as a great prophet.  The bigger opportunity he missed, in my opinion, was making a case for why anyone from any spiritual tradition ever considers different ways of looking at things—it fosters deepening spirituality.

No spiritual tradition has cornered the market on truth.  The spiritual experience is full of mystery.  Some questions are bigger than the human capacity to comprehend.  Yet some people are more perceptive than others.  How do the perceptive ones do it?  We expand our power to perceive when we steady ourselves with truths anchored in traditional wisdom and reach into the unknown.  Some truths transcend many spiritual traditions.

When making the case for reaching across traditions, I like to point out that Moses changed his perspective to get a better look at the burning bush.  (Ex3:3)  We too must change our perspective to see truth in a new light.  We work harder to understand even our own comfortable beliefs when we are drawn into tension by differing views.

On a personal note, Amy-Jill Levine’s The Misunderstood Jew fundamentally changed my understanding of Jesus’ parables.  Oh, and by the way, Levine is a New Testament scholar at predominantly Protestant Vanderbilt who also happens to belong to a Conservative Jewish congregation.  As songwriter and occasional Texas gubernatorial candidate Kinky Friedman sings, “They Ain‘t Making Jews Like Jesus Anymore,” and Levine quite compellingly explains how Jesus’ Jewishness is essential to understanding his ministry.  It’s a good read.

Christian-Jewish dialog, however, is nowhere near as charged as Christian-Muslim dialog these days.  Christian and Jewish authors can only dream of receiving the publicity Reza Aslan is getting.  Aslan made the question all about him when he could have made the question about all Muslims or about all spiritual seekers.  Maybe he has a publicist who told him being a jerk and making a spectacle of the interview would sell more books.  While true, it obfuscates the substance of his book and leaves unanswered important questions about what we all can learn from each other.

Join the conversation.  Have you had a spiritual experience that transcended a particular religion?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

What Fear Gets You

MLK Trayvon juxtopositionThe Zimmerman verdict had me moping around for a couple days. I read a little about Zimmerman when he was first charged, and he really sounded like a manipulative bully. Just the kind of guy who would want, but shouldn’t have, a gun. And then there was his “apology” that expressed regret for the consequences of his actions, but notably, not for the actions he chose. He even had the gall to assert Trayvon’s death was God’s will. The Guardian had a piece I thought sounded all the right notes.  Namely, since Zimmerman targeted Trayvon, where was Trayvon’s ground to stand?

After sleeping on it, I wonder if in some ways this tragedy is playing out in miniature a dynamic happening in America at large. Both men acted out of fear for their lives. One had lethal power and one had no power at all, but each felt genuinely threatened (whether justified or not). Likewise, almost half the people in this country own almost all the wealth, while the other half has almost none, and yet both feel threatened. To be more specific, the top 40% of Americans enjoy 95% of American wealth while the bottom 40% cling to 0.3%. The top 1% holds 42%–almost half–of American financial wealth, and yet many of those at the top are genuinely afraid that somehow healthcare for all or better public education or some other common good will take something away from their own wellbeing. They genuinely feel financially threatened and, frighteningly, have the clout to drive domestic policy.

Imaginary threats drive foreign policy as well. We dove into a decade of war that cost thousands of lives and trillions in taxpayer debt predicated on imaginary weapons that never turned up. The fear is not rational.  Dare I say, Americans would be more secure today had trillions been spent on diplomacy and education instead of war. And the richest Americans would benefit financially from a healthy, educated workforce. Despite this, much of policy discourse is driven by (and in fact depends on) people feeling genuine fear.

What happened to courage? High school kids all over Dallas have been assigned Devil in the White City for summer reading. It’s stacked on bookstore display tables and has long request lists at area libraries. Two kids in my house are reading it. From what I can remember from having read it a decade ago, it offered a fascinating account of how architecture and police work were done in the 1890’s. More fascinating still was the civic pride of ordinary citizens and their courage to undertake such an ambitious project. Where today, in our vapid celebrity culture, do we find ordinary people undertaking extraordinary things for the sake of human achievement?  Please comment with examples.  They would surely lighten my mood.

For both Zimmerman and Trayvon, fear drove the fatal missteps. If Zimmerman had had the courage to question Trayvon without a gun, if Trayvon had had the courage to respond without fists, if either had had the courage simply to ignore the other, what would have been possible? What would be possible if the 1% advocated common good or governments advanced diplomacy over jingoism?

Join the conversation. What fears can you identify within yourself, and what could a little courage make possible for you?

Copyright 2013 Stephanie Walker All rights reserved. Visit http://www.AcrossTraditions.com.

Caught Unaware

I’ve been pondering the plight of the spouses caught unaware in the Petraeus affair.  It seems all the players in the drama sought some personal gain from their relationships with the others.  They were all climbers, but we know little about the spouses.

What we know about Holly Petraeus is she has worked admirably on behalf of military families and she hails from a well-connected military family. We know little else, except that she is facing a very public betrayal.  Even if she had prior suspicions of infidelity, the publicity is humiliating.  She certainly seems to be a victim in the drama.

The Twelve Step tradition teaches addiction recovery seekers to examine their own role in their victimization.  This is a pretty tough teaching.  I know recovery seekers who were victims of child sexual abuse, and they strenuously resist the idea that an innocent child could in any way be culpable for adult actions against him.  I must affirm child victims bear no blame for crimes against them whatsoever.  The most insidious and lasting consequences of abuse are the blame and shame abuse survivors carry into adulthood.

The Twelve Step teaching is pointing to a different occasion of victimization.  Often people wounded in childhood develop behavior patterns that continually rip the scabs off old sores that can never heal.  It is not the initial wounding that is being called out for examination but the response to wounding.  The Twelve Steps teach recovery seekers to examine how impaired responses lead to behavior patterns that expose them to more wounding, and more importantly, what alternative responses are possible.

Holly Petraeus would seem to be in no way accountable for the actions of betrayal by her husband.  His actions are clearly on his side of the street, and he has taken responsibility publicly for that.  Nothing suggests Holly Petraeus experienced childhood wounding or has Twelve Step experience, but nonetheless I do ponder how her own actions may have exposed her to injury.

Let me first reject out of pocket notions that her appearance invited betrayal.  Trying to live up to another person’s or a cultural ideal of beauty is a recipe for unhappiness.  The Twelve Step tradition has a name for it—people pleasing.  People pleasing is seeking affirmation not from what is authentic within our own souls but from others’ opinions of us.  It’s proven to be a losing proposition.   I don’t know if Holly Petraeus has people pleasing tendencies, but she appears not to be a slave to fashion, and I applaud her for that.

What were Holly Petraeus’ alternatives?  She grew up in a powerful military family.  When she married, she chose to stay in the ecosystem that prized her connections.  She could have married outside the military, to someone who might have valued her only for her authentic self.  Attractions are a complex mix of personality, intelligence, soulfulness, and, undeniably, looks and power.  I couldn’t possibly deconstruct her husband’s attraction 38 years ago, much less the attraction of hypothetical non-military suitors.

The question does, however, invite us to contemplate what draws us into relationship.  Am I seeking some personal gain, a lifestyle or cachet?  Do I seek validation based on my connections, looks or power?  Or is it genuine appreciation of another human soul that leads me into relationship?

Join the conversation.  What relationships have most nurtured you and what was your initial attraction?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

A Voice in the Storm

Marathon runners at Staten Island ferry preparing to volunteer to help Hurricane Sandy victims.(Photo: Christina Wallace (@cmwalla) / Instagram

Mayor Bloomberg’s reluctance to cancel the NY Marathon is understandable.  The show-must-go-on come-hell-or-high-water attitude is a distinctly NYC thing.  He made the right call in the end, of course, and I loved reading news stories about NY Marathon runners and race volunteers distributing marathon ponchos and offering disaster relief.  With another winter storm on the way, it sounds like the need for blankets in areas hard hit by Sandy is real and growing.  I caught myself wondering why people who had plenty of time to evacuate might be needing blankets, and that reminded me of a story.

Over a decade ago, two kids interned with my church for a year immediately after graduating from college.  The purpose was to discern their calling in ministry.  During the course of that year each gave a sermon.  Andie Wigodsky graduated from my alma mater, Duke, and her sermon described a spring break mission trip.  Torrential rain and flooding had destroyed tobacco crops in North Carolina that year, and a group of Dukies gathered blankets and warm clothing before heading south to offer disaster relief.  They expected to find housing swept away by flood water and migrant workers left with nothing but the clothes on their backs.

That’s not what they found.  What they found was housing untouched by flood water and migrant workers who had nothing but the clothes on their backs in the first place.  The blankets and clothes were much appreciated, but the disaster was more complex—and actually worse—than what they had expected.  The workers were visiting the US on work visas that restricted their ability to leave the farms on which they were licensed to work.  Their pay was based on farm productivity, so the fact that the crops were destroyed meant they would be paid nothing for all labor they had already given.  Worse, they were bound to remain on the farms for the duration of the season, even though there would be no pay.  Migrant workers make considerable family sacrifices for work to send money home, and the futility of their sacrifice was heartbreaking.  That speaks nothing of the injustice of their prison-like conditions.

The story stayed with me because I think it encapsulates in microcosm what we so often encounter when we try to offer help to people in need.  We tend to have an oversimplified notion of what the needs actually are.  Often the situation, and the injustice underlying the situation, is more complex than we realize.

Now that New Yorkers hardest hit by the storm are coming to grips with how long it will take to get back to normal, we’re hearing stories about needs and frustrations.  Some of the 34,000 people FEMA is putting up in hotels have short term housing needs (they will return to habitable homes with heat and power within days), and some are not so lucky.  The worst case estimate is 40,000 people in need of shelter, half of whom depend on public housing.  I wonder about their needs that pre-date Sandy.

The greatest injustice the migrant workers faced wasn’t deplorable conditions but having no voice in a regulatory system stacked against them.  Voting is how we make our voice heard.  At a time when the only obvious vote fraud is poll access restrictions under the pretense of preventing vote fraud, I sincerely hope all those displaced by Sandy, and everyone else, will have a chance to vote and make their voices heard today.

Join the conversation.  What injustice do you seek to right with your vote today?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.