Reform

Generally I avoid political topics while posting on our family blog, just like I avoid sports. By and large they're not germane to our daily family life (even though Kate shows signs of becoming a bigger Celtics fan than I am--however sadly that she'll never be able to appreciate fully just how much Kevin Garnett changed this team in 2007. But I digress). But Kate has seen me become, at times, a compulsive reader of political news over the past four months, and be at times short of temper or even lose sleep over the dominant political issue of 2009-2010: reform of American health care. Now, on the night of the House of Representatives' vote to approve the Senate reform bill, I think it's an opportune moment to give my opinion.

I've had my first bouts of ongoing health issues over the past three years, first with a series of cellulitis infections in my leg, which have come and go but never been eradicated. My latest, though mild, outbreak was about three weeks ago. Somewhat more seriously, over the past 18 months I've had some digestive problems which rise from the level of inconvenience to sometimes embarrassment. Mom and Dad both having died from cancer, that class of disease is never far from my mind, but I'm less worried now about that--in 18 months I'd expect more serious symptoms to emerge if I had cancer--than just having some chronic annoyance that will be a constant drain on our family economy.

My problems have been quite mild compared to many folks' around the country. And of course, last year, while Kate was pregnant with Eva, the fact that she was initially single permitted her to receive free care from Rhode Island, even after we married. I believe we pay taxes for civic benefits like that, and I'll always be grateful--foolish though the concept may be concerning a state agency--for the coverage my wife and child-to-be received. As Eva squirms and spits and whines at this instant six feet away from me, with Kate doing everything her ingenuity can devise to quiet the little girl down, ever more reasons for that gratitude are welling up freshly in me.

Though I live a mostly quiet life, and tend to be conservative in my behavior, I'm liberal enough to think of health care in our country as a right. We're one of the most industrialized nations on earth, and the leading economy. We have enough surplus wealth to divert some to taking care of our own. Over the long-term life of a society, I think health care, education and conservation of the environment are the three most important tasks toward preserving and improving society. I won't make the foolish claim that armed forces aren't necessary--they are--but the more resources we divert to them, the less we have for the basic elements of life itself. The military's product--"readiness", in the form of being prepared to fight on a moment's notice--is only occasionally of real use. The rest of the time, "readiness", the effective threat of violence, does nothing but maintain the status quo. In a world full of aggressors (including the US), status quo isn't necessarily bad. But while political status quo is merely maintained, billions of people are still busy leading their lives.

I think a rich nation like the United States has the responsibility to invest in its own population, in order to foster the nation's growth as a whole. Our very Constitution has become a model for almost every government which has followed. The American system of public education--however flawed and now in parts decaying--was a previously unheard-of innovation in the 1800's. Public education laid the foundation for this country's worldwide, amazing display of talent and ingenuity throughout the 19th, 20th and into the 21st century. Public education is nothing more than the public option in educational form. Private schools, at all levels, did and continue to thrive, for those who choose to pay more. The Constitution says nothing about the federal government's right or duty to educate its citizens, but it has become an accepted part of our society that access to basic learning is a fundamental civic good.

I feel that basic public health is no different. In order to promote the welfare of its citizens and of the country as a whole, the federal government has an obligation to guarantee basic health services for every American citizen. There are a whole range of ways to make this actuality. Some (admittedly far smaller) countries, like the Netherlands and Switzerland, have private insurance companies strictly regulated by the central government--much like how our FAA closely monitors private airlines. Others, like France, Canada and England (and, oddly enough, Costa Rica, where Rush Limbaugh said he'd go for care from now on) have nationally-run health plans. We do too--Medicare. I think the passionate reaction over the last nine months of people currently on Medicare, to the prospect of that program being changed or closed down, is fine testimony to its effectiveness and popularity.

I favor a public option in health care. In markets, such as Louisiana where I worked for part of a year and where there is only one dominant health care provider, a federal option would provide some meaningful competition to the private plan. Lack of competition happens to be the exact rallying cry of those opposed to reform. In most markets now, there is no competition. Health care is mostly a set of local or regional monopolies.

Politically (and from my distant, ill-informed vantage point, I lay much of the onus on Obama), a strong public option wasn't viable. The bill we have doesn't do enough to control costs, and is still unduly restrictive on abortion.

A quick tangent on abortion. I believe in a woman's right to choose. For my own part, I could never choose to abort my own child, or ask a woman to do so. When Kate first told me last year that she was pregnant, the thought of aborting the little life that would become Eva never seriously occurred to me. Of course I knew it was a possibility, but not one I would consider. Kate was of identical mind. The fact that we both emphatically chose life for our child, doesn't change my feeling that a woman, at least early in her pregnancy, should have the right to choose whether to carry to term or not. If a woman feels she's not mature enough, or willing, or lacks resources, to raise a child, I do think the more humane course of action is to give her the legal option to abort. The efforts of some lawmakers to kill the entire reform bill unless the right to choose were further limited, disgusted me.

My list of complaints with the bill as it is, is long. There is still no meaningful competition to most private providers. I'm not even sure if the anti-trust exemption for insurance companies--freeing them from much federal oversight--is done away with or not. Much of the subsidy for lower-income plans is borne by the middle class, already disproportionately burdened after the 2003 tax cuts.

But the bill will do three things for the independent (i.e., non-Medicare, non-employer-based) insurance market, which represent a tremendous improvement over the system we know now: first, it will prohibit insurers from denying care to anyone with pre-existing conditions (as Kate's pregnancy was considered--and even my Louisiana Blue Cross would have denied her), and it will prohibit lifetime caps on benefits (helpful to those who actually get very sick, like my mother did); second, it requires everyone to buy insurance (the only way to broaden the risk pool); and third, subsidizes the cost for those who don't have much money.

Those three elements alone constitute tremendous reform. If we can add in effective cost control at some future point in time, and then spread the cost of the subsidies more equitably through society, then I think we'll have a mature, modern health care system.

As it is, I salute the vote being taken right now to reform American health care. I do believe in the better-off among us contributing to help take care of those at a disadvantage. (And though Kate and I have received some help ourselves, on the whole, I consider us to be among the better-off.) I think our country took a large step forward tonight with this vote.

To those who say that Barack Obama's receiving the Nobel Peace Prize was merely affirmative action, I repeat the thought: Barack Obama's being elected President of the United States alone was worthy of a Nobel Peace prize. Consider the legacy of hatred and racism this country has transmitted through the generations since slavery. Consider the horrendous inequality in opportunity, rights and overall treatment between races through the past and still now. Consider the viciousness of the attacks, past and present, upon Obama. Still, by the force of his words and personality, Obama persauded a majority of Americans to vote for him.

Certainly Obama has shown himself to be more centrist than many of his campaign promises. He has also shown the inexperience his critics accused him of. But just as surely, he has engineered a historic change in the American state. Will we eliminate world hunger by 2015, as he promised last year? I doubt it. Will he face continuing opposition to the remainder of his to-do list, including a number of issues dear to progressives like me: climate change legislation; Wall Street reform; immigration reform; and correcting the Supreme Court's handover of the electoral process to corporate interests? Of course. Will I always be happy with Obama's own actions and words, to say nothing of the actual results? Of course not.

But the fact that a half-black man became President, and that same man helped extend basic health care to millions who lacked it, is cause in my heart for tremendous pride in my country. Not to mention, I'll be sleeping a bit easier at nights, with the health of a wife and daughter to care about.

Hope has become somewhat of a dirty word among many in the past year, too charged politically and racially to have a glad meaning. But I will use the words glad, and proud. The United States constitutionally enshrines conservative and progressive elements. The system is conservative enough to make the preservation of the state, and the society surrounding it, possible. The system also provides means for progressive change, that the state may change to more accurately fit its society, as society itself changes, through time. Occasionally, a major progressive change overcomes conservative resistance, and the state is changed irrevocably. Emancipation was one such change. Enfranchisement of women, another. The New Deal, yet another. Enactment of civil rights, still another. And today, March 22--the vote is final as I type this--nearly universal health care is the law of the United States.

So yes, I'm proud of my country, and I'm glad that I live here.

Ditz

Cold nor'easter today, wind whipping leafless branches and rain slapping everything. The bassess and tenors of the RI Civic Chorale, which I'm a tenor in, had a sectional rehearsal this morning because, well, we suck.

Not totally, of course. But a number of guys have serious problems pronouncing foreign languages, and we're doing one piece each in two of the more difficult languages to sing, German and French. German's difficult because the consonants are so percussive, and you need to keep the percussion right on your teeth and lips in order to be intelligible at all. With words like "knabe" and "gnade" and "noch jetzt", tongue-twisters start to seem easy. And even some of the softer sounds, the blends, can be tricky. "-ig" sounds like "ich", but isn't as far back in the mouth as "-och". Even if you know the correct pronunciation it's hard to keep them all straight sometimes, especially when you're more concerned with rhythm, phrasing or (we're amateurs, after all) notes.

And French...it's in some ways the opposite of German. The consonants are in some cases ignored, or lightly flipped over, in an unstoppable flowing stream of constantly changing vowels. When the delicate timing involved in a dipthong becomes tiresome, it can sometimes start to run together and seems like there's only one vowel in the language: "-eugh". As for the double-vowels, take the word for sleep, "sommeil", pronounced "sohm-MAY". The "may" syllable requires some attention. It's not a single vowel sound--there are at least two, and more if you really want to color it. But at a minimum, you've got "ehhh-ee", with the "ee" barely appearing at the end before you move on. English has many diphthongs like that, but French is bursting with them. Then, there are three different accents for the letter "e", and even without accents, a few different ways to pronounce it. Many wrestle that letter and lose every time they sing it.

So we had some pronunciation issues to work on today. I deeply love the German and French pieces--Nun danket alle Gott by Johann Pachelbel, and Cantique de Jean Racine by Gabriel Faure'--and they happen to be fairly easy, with no extremely fast runs, and pretty much squarely in the middle of my range. So far as I'm able, I can float through them and enjoy the ride. So this morning was a big confidence-booster for me, two hours spent on the pieces I'm most confident with, and I felt pretty studly because I could nail the pronunciation.

Now, our concert is next Saturday night, and I've still got to, ahem, get a little more familiar with Mozart's Sparrow Mass in the next six days, but I will. I'm not the best musician among the tenors, or the most highly-trained voice, but I am the loudest, so I feel a certain responsibility.

On the way home I picked up fixings for sushi tonight (we finished the first bottle of soy! Hurrah) as well as two rental DVD's: The Good, the Bad and the Ugly (got to introduce Kate to young Eastwood and spaghetti Westerns--she thought I'd made the term up) and Amadeus.

I can't speak of Mozart of Beethoven as my favorite musicians when I'm hardly familiar enough with their work to discuss it at all. I've performed Mozart's requiem perhaps ten times, and several of his masses and other pieces (I sing Ave Verum to Eva many evenings), but the man wrote over 600 pieces of music, and I've sampled only a small fraction of that--30 or 40, maybe. Just a taste. The requiem does set my imagination afire like almost no other (only Beethoven's) music can.

The opening chords are so modest, grand and dreadful, and they grow with such grace and ghostly foreboding that I feel surrounded in a shroud of music already, within the first ten seconds. The thrills, dread, despair, hope and at times violent emotion within a soul anticipating death are like the facets of the jewel that is his requiem mass. Flash ahead in the post a bit--we watched Amadeus tonight--and the latter half of the film is occupied with Mozart's composition of this requiem, his last piece. He got barely halfway through it, according to tradition, dictating the Lacrimosa from his deatbhed, at 35. Purportedly his student, Franz Sussmayr, finished it (the last movement being largely a quote of the first, and the intervening five (from Lacrimosa up to Lux Aeterna, the finale) being Sussmayr's. Say history and myth what they may, the Lacrimosa is the beating, crying, screaming heart of the mass. The music feels so infinitely heavy that I can't even imagine a person creating it. It's of the sort of grandeur that simply exists, without beginning.

This requiem will be peformed not far from where we live, next Sunday, the day after the Chorale's concert. Kate's willing to go (and we'll bring Eva, of course). We could be in for a community theater-quality performance, with accurate chords and cutoffs few and far between, but I think it's worth checking out. And if it's Kate's first time listening to the piece in its entirety, or at least listening to it live, then some occasional errors will be forgivable.

(The only Beethoven piece I'm comparably familiar with is the Ninth, but that's worth an essay--er, post--of its own, so I won't degrade it with a tangent here.)

So, Beethoven and Mozart, two lordly figures whom I would have studied madly and obsessively had I chosen a life in music.

I wasn't sure I wanted to see something as heavy as Amadeus--of course, much of Mozart's life was colorful and brilliant, but it comes to a tragic end, and he was surrounded by treachery of those who wanted to squelch or control his talent--so part of me leaned toward Good, Bad and Ugly. I threw the decision over to Kate and she chose Amadeus. Sigh--this would be a much harder film to watch, but then, I'll have tonight and tomorrow to consider it, and recover.

We made our dinner (and another family movie. Osbournes, we're gaining on you!...), placed it in front of the TV, and got ready for the show. Kate pulled out the disc and looked at both sides. "Side B," she mentioned, "wide-screen edition. Side A, wide-screen...crap! Well, I guess it doesn't matter what version we have now."

I looked at the video box, and it seemed to me that one side was the movie, the other side extra features. So dropped the disc in the tray, loaded it, and we started watching. The first scene showed a long, shadowy tunnel, with a man walking past. Then, the same man walking down a street. Soon, we saw a haggard Mozart working in his salon, when a sharp rap came at the door. There stood a tall figure in a black robe, with a black two-faced mask. Mozart recoiled in terror, and the figure demanded he write a requiem, "For one who didn't receive it but deserves it," without naming the patron.

The story carried on from there, with Mozart composing the requiem and some other operas by turn, as his fortunes and health both failed. He died in the night as rival composer Antonio Salieri pushed him to keep composing the death mass, meanwhile taking it down in dictation. (In the movie, his plan was to claim authorship. He's not a nice guy, at all, in this film.)

It ended rather abruptly, we thought, since we'd had some trouble identifying whether Salieri was in fact the man in the mask (he was), and being very surprised when it was revealed that Salieri was, in later years, in an insane asylum. Besides, we'd both remembered distinctly a scene where a young Wolfgang played a harpsichord, while being held upside down. We didn't both miss the scene...was it in the Beethoven movie? Kate wondered. But I hadn't seen the Beethoven movie...

Enter Wikipedia. Salieri's life showed him to not necessarily have been so insanely jealous of Mozart, and that his scheme to murder Mozart was very likely a complete fiction. The film also vastly understates his actual inflence on the musical world, but it's true that where Mozart is a household name, Salieri is now known only to those who study music, or are familiar with Mozart.

We both grew suspicious that the film should be longer, especially when Kate saw "Running time: 180 mins." on the box, and we'd been watching for not even an hour and a half. So she flipped the disc over, hit play...and the movie began.

Teehee.

I can't honestly call it her mistake, because if I'd known any better, I'd've said something ninety minutes earlier when we started watching the movie from the middle. Still, knowing the resolution made the treachery of the film's major characters somewhat easier to digest as it happened, though it was painful to compare the later state of Mozart's house with its magnificence earlier in the movie.

Salieri is an effective narrator, a musician sensitive to Mozart's music but jealous of his own comparative incompetence. The film goes so far as to make him reject God, for God's having rejected Salieri's prayer to be an immortal of music. "To give me the desire to celebrate God in music, and then to strike me mute...why?" A bit melodramatic, but a good narrative tool. It keeps the story in human terms, from being too fawning at moments and vicious at others. When the fawning over Mozart's musical triumphs would be greatest, Salieri's envy crescendoes as a counterpoint. When Mozart descends into loutishness, the pulsing rhythm is Salieri's confusion and awe that the source of sublimity can be so impish.

But like his music, Salieri himself in the film can be forgotten. There's only Mozart's music, always charming, sometimes chilling.

Sick Baby

Now before you readers go all ape-crap on me and start worrying about the baby, or why I'd blog about her sickness, I'll say up front that Eva doesn't seem to be very sick at all. The baseline indicators of health--like I was told once about my cat, oddly enough--are, (1) is she eating and pooping, and (2) is she sleeping well? The answers to both are yes, and always have been. (That girl's plumbing is about as robust as it could be.) But Eva's come down with a cough and wheezing recently, which has sent Kate and me through some minor emotional contortions.

A silent anxiety sinks its talons into the shoulders of parents of a baby with breathing trouble. Is this cough and wheezing a simple cold? Is there a major infection, which is starting slowly and even good doctors would likely miss at first glance? Is this a chronic condition? Will our baby survive her first year? How can someone so small, gentle and delicate, mount any kind of fight against a virulent disease?

Breathing affects everything. I've had more experience of that in the last year than I ever wanted, with bronchitis becoming asthma, which still limits my ability to exercise and sing (I'm up to 12 minutes on the treadmill at 6 mph, and I can make it through a chorus rehearsal with only 2 or 3 shortness-of-breath fits, whoohoo! Tomorrow I try basketball again. Will I last more than 15 minutes? Unlikely, but we'll find out). If you have any doubts or curiosity as to the importance of a thing, look to other cultures to see how prevalently it's mentioned. This is a good rule in art, and you'll discover the universality of human concern with our origin as a species, with death, with birth and sex--especially, male fascination with and fear of female sexuality and reproductive powers (and the resulting obsession with tightly controlling both). But that's off-topic to my post.

My point now is, the Indian yoga which Kate practices, emphasizes first and last, the breath. Breath is acknowledged as life itself, and control of the breath leads to control of the mind, body, and all things.

So when the baby's breath is messed up, we get worried. Every breath Eva draws is precious to us, and when those breaths are difficult for her, they're difficult for us too. On those mornings, or even other times of day, when she seems particularly hard asleep, I'll lean closer and inspect her chest for motion. In the morning, since she's due to get up soon anyway, I might stroke her head to see if she stirs. So far she always has, but it's a thought I don't like dwelling on--a life as small and gentle as hers, could so easily and gently slip away. Eva's grasp on life at times seems no more firm than her hold on any toy we might place in her hands--a toy which she lightly drops as she looks elsewhere.

I treat life in myself, and in the other adults I know, as an assumption. Whether people I've known for many years, or folks like Kate's family I've gotten to know only in the last fifteen months or so, everyone's existence is more or less synonymous with my own. And I've seen death. My own parents', of course. Dad's was shocking in its quickness--brain cancer, and it was like an ambush--and Mom's was slower, more inexorable. I mourned Mom more as she died than I did Dad, but I was also more exhausted by the end. And in taking care of her for her last year, I got to know many of her and Dad's friends, most of an age to be of increasingly failing health themselves.

And two were struck that same year as Mom died, 2005. As fine a lady as ever lived, Nancy Starrett, who provided invaluable help to me all winter by watching Mom as I went out to do errands (and go to the gym, of course!)--she was dying of breast cancer at the time, and knew it, but said nothing of it. I'd known that she'd had it once before, but it had seemingly gone away. And the most hideous irony of all is that, I believed of Nancy, the very thing people believed of both my parents: she's happy, strong, and spirited--she'll beat it. If anyone can, she will.

She didn't. When I found out about her death, five months after my own mother's, it hurt worse than when Mom died. The surprise, the broken faith, and the building anger and despair made me start to feel a little savage. Then two months later, her lifelong husband John (and one of my father's very closest friends) died of a broken heart. I began feeling like I was going a little crazy, like I had no emotional bearings any more. I watched my mother slowly die, and devoted all my effort to preparing myself for it. But these two family friends, gone without warning, started breaking my control over my emotions. That's as far as I'll take that story for now, except to say that, at least as far as my career is concerned, I'm still feeling the repercussions.

But Eva...a baby whose mind is still developing, who can barely communicate at all, who's innocent of everything except the simplest needs and feelings...the world wouldn't notice the passing of so small a life. I, and Kate, would feel it for the rest of ours, of course. She's a very smiley baby, and I take it as a compliment when people observe how happy she is. Above all else I want her to learn happiness from me. Love too, of course, but that permeates the happiness.

So when this little baby girl, this beautiful little bundle of hope and possibility, seems to have some trouble surviving, her mother and I can think of almost nothing else.

Parenting is, like everything else in life, a learning process. Sicknesses come and go, some more serious than others. We'll be dealing with the emotional ups-and-downs of this one, and hopefully others, in years to come. Not to mention all the other practical issues, like the occasional car accident or broken bone or mishap of some other nature. And through it all, parents (not to mention children) develop a sense of balance, a sense of recognition as to what clues are telltales of more important things, and what are trivial.

But my bride and I are new at this. Our balance isn't so good yet. Kate in particular is a hard-core worrier, prone to terrifying herself with YouTube videos of sick kids when she suspects some illness in her baby. (Now I like to go for some comic effect by writing that Kate terrifies herself. Obviously, she's intelligent about it, and is listening for points of similarity to Eva's issues, and she can readily recognize the differences. But she's gone hunting on the web several times to study up on baby coughs. And one of her hunts succeeded in scaring me into a sleepless night. Thanks, babe.)

So a few weeks ago, Eva turned up with what at first seemed a very dainty, "excuse-me-but-I-require-your-attention" cough. Kind of an "eheh" noise, a baby clearing her throat. But soon it seemed to me that her lungs couldn't cough with too much more force--they're the size of my thumb, after all, so they can't push much air--and I took more notice. Kate did likewise, and soon it seemed that she was coughing constantly.

That led to the first frantic online search for whooping cough sounds, and my sleepless night (thanks again, darling). And what we heard was partly reassuring, partly not: Eva's cough wasn't so bad, but we'd heard the whooping-style wheeze more than once. (Besides, we'd already heard about the eating-pooping-sleeping thing, and she still had no trouble with any of those.) But we were now worried.

Despite being on half budget, we sprang for a basic vaporizer to put in Eva's room, to help moisturize the air she breathes at night. (Kate puzzled over the seemingly paradoxical advice we got, to both moisten the air and dry out Eva's mucous passages with a pediatric antihistamine. So we held off from the drug.)

At first, there was improvement, but a week later the cough returned, and in the last few days, the wheeze has become prominent when she's reclining or lying down. This was enough to scare both of us, and send me into the kind of thoughts I described above. We wangled an appointment with Eva's doctor today, and brought her in for an emergency checkup.

Of course these folks are used to dealing with terrified parents, and the whole staff--all women--are superbly gentle and reassuring in their demeanor. So right away I felt more comfortable once we were in the examination room, and with the physican's assistant (we couldn't see the doctor on such short notice). After the standard preliminary observations, the PA spent several minutes listening to Eva's front and back with a stethoscope, and gave me the most reassuring assessment of the day: "Her lungs sound perfectly clear. There's no wheezing or rasping." The wheezing, she judged, was more in the throat, likely the result of post-nasal drip, itself likely due to an allergy. And she recommended the vaporizer and antihistamine.

So Kate was back to her paradox: moisten 'er up and dry 'er out. But hearing the advice again, and from a pro, after a full checkup (including booster shots! Awright), was the best outcome I could've hoped for. And Kate was immensely reassured. She went from stiff and fearful in her demeanor, to relaxed and willing to smile again.

I don't like it when my little bengal is scared.

Eva's upstairs now enjoying her evening nap, and placidity reigns in the Sutherland home.

Now it's time for me to git cracking again on that Hebrew...

Shalom am tov!