Savagery

This story is possible because of three errors. Yesterday I had the good fortune to smash my toe into another piece of furniture (yes, gentle reader, and the singular is not an accident, this is a common pass-time around Chez Shit-Storm). This is the first of our errors. Today, the bruising and swelling became even more impressive than the last installment -- it looked like my toe had been tie died in a long thin bright red and blue strip down its length. It didn't really hurt, but I thought I would call the "talk to a nurse" number on the back of my insurance card to let someone talk me out of going to an ER. Instead, she agreed that it might be broken and told me that I should seek help.

The second mistake of our story, and I am assuming it is a mistake, is that she referred me to the county hospital. Were I nefariously minded, I might imagine that she did so because she anticipated that no health care would actually be delivered there, or at least that billing would never be accomplished. She would have been right on both counts.

The final mistake in our story is that I took her up on it, rather than seek help at the closer private ER. I'm not new in town, but still new enough to forget the name of the indigent hospital -- and that's where I went.

However prepared you are intellectually for the depth of inequality in health care in the United States, it is always dramatically more forceful up close. I walked in, tapped in my chief complaint to the TRIAGE-O-MATIC 3000 computer screen and then sat down for the next three hours to chat with: 1) a plainly homeless woman who could not have weighed 75 pounds, sitting on and off with her head in her hands weeping -- she had been there 13 hours 2) an autoworker who had ripped the web of his hand off in a work accident, and could feel and see the tendons move against his bone -- he had been there 12 hours, 3) a very friendly, hyper woman of limited intellectual faculties sporting a rapidly ballooning poisoning bug bite on her arm the size of a fucking baseball, who had covered the bite all day at work for fear of being fired --she had only been there four hours and left in frustration without being triaged, 4) a spectacularly good natured christian AA guy, who taught the hyper bite victim Sudoku, and compared notes on his own rather impressive spider bite -- he had been there 11 hours, 5) a family that had been there 10 hours, and approached the desk to learn that they expected them to be there 12 hours more. A group of amputees crutched around and looked for seating, which they didn't find. Nurses emerged every 30 minnutes or so and wandered around calling names, most of whom had already left in frustration. I saw nobody at all around me called for treatment. After 3 hours, I was triaged by a nurse, who said my toe was probably broken, but also probably not a priority for her. I told her I had insurance, and she suggested I go "anywhere but here." I obliged, and headed to the private ER.

Parking for private ER seemed frustrating, but that was only because there was an expectation that you would valet. There was exactly one person in the waiting room, reading a book and smiling at me. The three staff at the desk promptly entreated me to approach and told me a nurse would be with me in just a minute. This was literally true, I timed it. The ER was perfectly clean, modern furniture, out of freakin, you know, Danish office furniture land. There were three aquariums.

The nurse immediately looked at my foot and ordered an X-Ray. He escorted me to a room immediately at the conclusion of this intake visit, before which he did not make me fill out any paperwork. To reiterate, the transition between the visit to the triage nurse and the trip to the doctor-room was upwards of 12 MOTHER FUCKING HOURS for the guy whose tendons were poking out of his skin at the indigi-care palace. At HospitalCorp. TM, I waited a scandalous 7 minutes before a young doctor entered with a team of two medical professionals in tow. He waited patiently as I explained my concern about going to India with a broken foot this Friday, and confirmed the order for the X-Ray. There was another scandalous wait of 3-5 minutes as the staff tried to figure out how to code toe X-Ray on the computer. An orderly came by and insisted on transporting me by wheel-chair, even though I said I could walk. The X-Rays were immediately performed, and evaluated within about five minutes.

One fact I forgot to mention: driving away from the first hospital toward the second, I passed the spider bite woman, walking down the roadside to nowhere, untreated.

Let's not and say we did...

or actually, if the Back to the Future trilogy counts as a way of "saying we did," let's not and say we didn't, or more precisely, not and not say we did.

From now on...

nobody gets to use the word "Al-Qaeda" unless they are actually talking about Al-Qaeda. Yes, it's loosely organized, but it is not any armed Islamic organization. It's Sunni, and it is centered in Southwest Asia. It is the organization that grew out of the Afghani resistance to Soviet occupation. Anyone that refers to Shi'ite insurgents or militias, or allies or Iran, as Al-Qaeda has decided that from now on "Al-Qaeda" simply means "evil Muslim" and is committed to a generalized war on a religion, on a region, and on a race. That, or they are willing to abet those who are so committed in order to posture.

Pet Peeve

I hear a lot of people criticize what they describe as Bush's theory of the "unitary executive." What they usually seem to mean is Bush's theory (I say "Bush's theory" but of course, I mean his handlers' theory, since he is clinically retarded*) that the executive has a constitutional right not merely to discharge his Article I duties without limitation, but that any act by any other branch that arguably complicates that effort is unconstitutional, even if it is plainly a core function of that branch (like, say, hearing habeas appeals from unlimited incarceration, or oversight). But that's not quite the theory of the unitary executive -- I'm not sure what that is, the theory of the imperial presidency, I guess. Strictly speaking, the unitary executive is the theory that any one who discharges an executive function is someone that is directly accountable to, and can be fired by, the President. I suspect it was raised from obscurity as a principled objection to the growth of independent agencies into political significance when Nixon tried to fire the special prosecutors. Bush embraces this theory, of course, and it is quite breathtaking, but its only the tiniest bit of his assault on separation of powers. And by "his" of couse, I mean his handlers.

* Shitstorm fully supports the complete integration of the clinically retarded into the fabric of American society, and encourages readers to support all measures and organizations that promote their autonomy and well-being. Please forgive the ghetto-ass* cut and paste link. http://www1.nmha.org/fund/support/donate_now.cfm

*Shitstorm fully supports the complete integration of the American inner-cities into the fabric of American life, and encourages all readers to support all measures and organizations that promote the improvement of economically depressed regions of our fucked up* country. http://partners.guidestar.org/controller/searchResults.gs?action_donateReport=1&partner=networkforgood&ein=52-0880375

* Shitstorm fully supports the complete integration of the fucked-up into American life, and in particular, their right to blog. www.flingerstorm.blogspot.com

UPDATES
Heh, turns out Presidential powers arise from Article II, not Article I. Heh... Yeah... Heh.

Reader Survey

Is it ok to thank people for things they are effectively forced to do? Why or why not?

WB Reeves, at against all flags, presents a plausible basis upon which the right might be tagged as anti-american

While this may have some utility for political messaging, I remain unconvinced that patriotism (which is, after all, merely nationalism when you are the nationalist) ought to be infused with any positive content at all. American history is littered with imperialism, genocide, and slavery, and a plausible series of connections can probably be drawn between the nation's values and culture and its foreign policy behavior. And embracing a form of patriotism that commits to a nation's people irrespective of its politics creates an arbitrary moral hierarchy based on one's presence on one or another side of an imaginary line.

Why not simply describe, in dispassionate terms, its successes and failures, movements within it worth joining, and those worth condemning, and call it a day? Why patriotism at all?

Why I am at this minute, afraid that US withdrawal could result in a larger series of massacres

Because, I am not convinced that whoever is responsible for sectarian violence in Baghdad is entirely motivated by a desire to control the national government, rather that there is a more sinister form of hatred playing out on the municipal level. My fear is that after a withdrawal, the national government might be motivated to aid and abet the Shi'ite militias in Baghdad, and could transform a more inchoate form of sectarian civil war into something more efficient. But that's not the same as thinking that if Shi'ite leaders with connections to the militias controlled the government, their interest in using force against Sunnis in Baghdad would be satisfied. No, that opinion is not based on the kind of information or mastery of the facts I would want policy makers to have -- it's based on the volume of sectarian attacks in Baghdad, and the shift away from US forces as targets since about 2005. I reason from this evidence that those repsonsible for the violence are as motivated by mutual antipathy as by the US presence, and that involvement in sectarian violence in Baghdad is widespread and popularly based, rather than limited to a tiny minority of trained fighters. In short, the kind of thing that suggests a goal on the ground other than acquisition of the state.

Nicholas Beaudrot argues at the link that the risk could be reduced with timely negotiation. He is right that if this the concern, it is theoretically possible to bribe whatever group begins to take on state-like features during the civil war. I would want to know more about the Shi'ite leadership outside the government to know whether this is possible. Speaking more generally, there are a number of international regimes that opted for brutality at home rather than aid and trade. If anyone has any thoughts about why the whoever is likely to take power after US departure is not likely to be one of them, I am all ears.

In short, the reason that I believe that US forces are a net security asset is that I don't believe that most of the violence is motivated by a desire to get rid of us. Militias in Baghdad might well use it as a recruiting tool and then deploy their recruits against sectarian rivals. But given the frequency and volume of sectarian violence, my suspicion is that the critical mass necessary for a more orchestrated campaign in the city is already adequate.