Re: My advice

1

I just read that article about 90 seconds before you put up this post. Fortunately, I had Flickr pics of Apo's adorable kids as the next entries in my RSS reader or I'd be jumping out the window.


Posted by: Becks | Link to this comment | 06-24-07 2:53 PM
horizontal rule
2

"All our savings, all our money, was just emptied ... the 401(k)s, everything," said Joseph Briseno, who took a new job a year and a half ago to make ends meet.

Why the holy fuck should that happen?


Posted by: nattarGcM ttaM | Link to this comment | 06-24-07 2:54 PM
horizontal rule
3

It's disgusting that it should, but it happens because he needs 24 hour nursing care and for some reason that's the sort of thing American health coverage is incredibly resistant about paying for -- if you don't have family to take care of you, you're screwed.

This is the guy from Johnny Got His Gun, pretty much. The wounded from WW I didn't end war, and this won't either. I wish I hadn't read that story.


Posted by: LizardBreath | Link to this comment | 06-24-07 3:01 PM
horizontal rule
4

It's disgusting that it should, but it happens because he needs 24 hour nursing care and for some reason that's the sort of thing American health coverage is incredibly resistant about paying for -- if you don't have family to take care of you, you're screwed.

Yeah, I know you have a barbarous health care system.

But this guy got that way through military service -- the state owes him. It makes a mockery of the whole hypocritical 'support the troops' thing.


Posted by: nattarGcM ttaM | Link to this comment | 06-24-07 3:03 PM
horizontal rule
5

2: As horrible as the guy's condition is, that's the line that made me want to scream. My God, that poor family.


Posted by: Jesus McQueen | Link to this comment | 06-24-07 3:05 PM
horizontal rule
6

2: Because if the government paid for all that, then he wouldn't get to choose his own doctor, he'd face long waits and rationing of care, and, of course, there'd be prison camps full of political political dissidents, just like in all the other countries with national health care. Duh.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 3:05 PM
horizontal rule
7

I'm floored. I'm trying to think of something to type but all I can think is why no one has accidentally pulled the plug yet. Sweet Jesus.


Posted by: Cala | Link to this comment | 06-24-07 3:09 PM
horizontal rule
8

6: Oops, left out a hyphen after the first "political".


Posted by: M/tch M/lls | Link to this comment | 06-24-07 3:11 PM
horizontal rule
9

I said you shouldn't read it...


Posted by: FL | Link to this comment | 06-24-07 3:14 PM
horizontal rule
10

In fact, if you don't have family to help on stuff like this, they stick you in some kind of cheap nursing home where you can easily get infections or choke on your saliva or just die in the night because no one is watching. And (although I can't remember where I read this) I remember reading an absolutely horrible story from a paralyzed woman who had to struggle to get Medicaid to cover enough of the sterile breathing/keeping-you-from-choking supplies she needed, placing her in real danger of choking to death on her own spit. The amount that was covered was about half of what was needed for correct use.


Posted by: Frowner | Link to this comment | 06-24-07 3:15 PM
horizontal rule
11

This is the thread version of SiCKO.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 3:16 PM
horizontal rule
12

This post seems to relate rather neatly to the conversation about libertarianism taking place elsewhere. I guess if you're a broke libertarian without a dedicated, healthy family you'd better not be paralyzed, huh? Or even develop any kind of chronic condition, for that matter.


Posted by: Frowner | Link to this comment | 06-24-07 3:17 PM
horizontal rule
13

Although I hasten to add that the movie isn't only or even mostly about enraging/sickening stories of our f*cked up health care system.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 3:17 PM
horizontal rule
14

I know I'm serially-commenting here, but people who are terribly crippled can actually live lives that are difficult but not unbearably horrible, not empty, not just a round of boredom and suffering--but that requires money and social support.


Posted by: Frowner | Link to this comment | 06-24-07 3:19 PM
horizontal rule
15

Health care, libertarianism, and JMPP in one thread: remember that post recently where she said that most expensive health problems resulted from peoples' choices?


Posted by: FL | Link to this comment | 06-24-07 3:21 PM
horizontal rule
16

Well, we do have a volunteer army.


Posted by: Cala | Link to this comment | 06-24-07 3:23 PM
horizontal rule
17

Point taken, Cala.


Posted by: FL | Link to this comment | 06-24-07 3:25 PM
horizontal rule
18

I'm not going to click through, so maybe someone can tell me whether "better off dead" is a thought to consider here. There's no way to decide in advance who should live and who should die, but there are clearly people being saved who would be better off dead.


Posted by: ogged | Link to this comment | 06-24-07 3:26 PM
horizontal rule
19

14 & 18, yeah, point taken about what life is like from the inside, but in this case it's not clear that his life is meaningful, or that he has the means to make that decision.


Posted by: FL | Link to this comment | 06-24-07 3:27 PM
horizontal rule
20

Now, after telling people not to read the thing, I'm going to reread carefully in order to figure out if the article is clear about his level of mental functioning....ogged, you prick, this is all your fault.


Posted by: FL | Link to this comment | 06-24-07 3:28 PM
horizontal rule
21

I'm sure the fact the guy can still say occasionally groan out "mom" (even if he can't put together sentences) has something to do with the fact the plug hasn't been pulled.


Posted by: Becks | Link to this comment | 06-24-07 3:28 PM
horizontal rule
22

There's no way to decide in advance who should live and who should die

But there are living wills. Even when they're not legally enforceable, they can offer tremendous guidance and clarity to the family.

(I can't bring myself to read the article.)


Posted by: Witt | Link to this comment | 06-24-07 3:29 PM
horizontal rule
23

Well, better off for whom? Isn't it generally accepted that people who initially believe themselves to have been injured so severely they'd rather be dead change their minds, at some point? As long as you have some plausible goals (which he does; independent breathing among them) then I think it's hard to say when you wouldn't have a purpose in life.

Better for his parents, sure, probably. But I can't imagine they'd ever admit that.

I saw a talk recently by this guy; he'd studied the self-reported happiness of various allegedly put-upon groups, among them paraplegics, and he found that self-reported happiness among paraplegics was way higher than what healthy people imagined their happiness level to be were they to become disabled.


Posted by: Sifu Tweety | Link to this comment | 06-24-07 3:30 PM
horizontal rule
24

Pretty well pwned by 14, now that I look at it.


Posted by: Sifu Tweety | Link to this comment | 06-24-07 3:31 PM
horizontal rule
25

I guess I feel like "is this person better off dead?" is an understandable reaction to a very scary and tragic situation, but as policy-planning/serious political commentary it's kind of putting the accent on the wrong syllable. We can't know whether this guy is better off; his family might be able to guess, maybe. Or what if someone is capable of a physically comfortable existance with, say, the mental capacity of a two-year-old? Are they "better off dead" because they've lost their previous abilities? It's just an almost unknowable thing, even if it's natural to speculate.


Posted by: Frowner | Link to this comment | 06-24-07 3:33 PM
horizontal rule
26

It seems to me that the article is ambiguous on cognitive functioning. He can use a few words inconsistently, he's said to know what happened to him, though this isn't explained, and he has severe head trauma. It's not clear that breathing on his own is *his* goal. Remember this NYer article? similar levels of horror.


Posted by: FL | Link to this comment | 06-24-07 3:33 PM
horizontal rule
27

I've heard that, too, which makes living wills a bit tricky since people do find that their quality of life is better than they thought.

But christ. The guy's in constant pain, can't breathe, can't move, can't sleep if left in the same position too long, and can't see, plus the full paralysis. From the article, it sounded like the absolute best case scenario is that maybe one day he'll take some breaths without the respirator.


Posted by: Cala | Link to this comment | 06-24-07 3:34 PM
horizontal rule
28

Cala, if you were taking my medical ethics class, you'd be engrossed by the seemingly endless discussion of autonomy, informed consent, and adaptation effects.


Posted by: FL | Link to this comment | 06-24-07 3:36 PM
horizontal rule
29

About trolleys, of course.


Posted by: Cala | Link to this comment | 06-24-07 3:38 PM
horizontal rule
30

27: right, but does that mean he wants to die? Does that mean that he doesn't want to breathe without the respirator?

They said they trained him to be able to eat pureed food... that seems like it'd be a pretty big thing, if he can still taste.

Anyhow I think it's impossible for us to judge what somebody else's disability means for them and their quality of life. It's unfortunate that nobody can ask him, but I would argue the default position should be that he probably does want to live, given that he has at least a little higher cognitive function.


Posted by: Sifu Tweety | Link to this comment | 06-24-07 3:39 PM
horizontal rule
31

Wait, why am I having this discussion with people who teach medical ethics classes? Labs, just tell us the answer.


Posted by: Sifu Tweety | Link to this comment | 06-24-07 3:40 PM
horizontal rule
32

Yah, "better off dead" is a legit thing to decide for yourself, but not so cool to decide for others. I think many of us would surprise ourselves by just what conditions began to seem tolerable, once we ourselves were in 'em.


Posted by: Anderson | Link to this comment | 06-24-07 3:43 PM
horizontal rule
33

Labs, just tell us the answer.

If he makes it that easy, then how could his university charge tuition for the classes? He could just tell everybody the first day, "really, who the hell knows?" and then spend the rest of the semester blogging ... hey, waitaminute ...


Posted by: Anderson | Link to this comment | 06-24-07 3:44 PM
horizontal rule
34

Hey, anyone want to see JMPP wielding archaic weaponry? Might lighten the mood.


Posted by: FL | Link to this comment | 06-24-07 3:44 PM
horizontal rule
35

ST, I'm not really qualified to do that. Can I interest you in some far-fetched hypothetical cases?


Posted by: FL | Link to this comment | 06-24-07 3:45 PM
horizontal rule
36

35: I've always been fascinated by public transportation, sure.

Incidentally, one of the other allegedly put-upon groups Kahneman interviewed was women over 40. Their self-reported happiness was, well, perfectly within normal parameters. Ask a 18-34 year old male how happy women over 40 must be, and they basically answer, according to Kahneman, "might as well be dead."


Posted by: Sifu Tweety | Link to this comment | 06-24-07 3:49 PM
horizontal rule
37

I am not of course advocating that we should go around kicking out the ventilator plugs of horribly disabled veterans because I'm too cheap to pay for it. And I'm sure that the guy has enough lucidity that it's unthinkable for his parents to decide to give up. Just noting my horrified reaction was that if there is such a thing as a fate worse than death, think this is a pretty good candidate.


Posted by: Cala | Link to this comment | 06-24-07 3:49 PM
horizontal rule
38

Cala is the very face of the veteran-euthanizing left today.


Posted by: FL | Link to this comment | 06-24-07 3:53 PM
horizontal rule
39

because I'm too cheap to pay for it.

In this situation (and in the cancer, mental illness, dialysis-dependent, and other cheerful threads we've had around here) it's worth noting that quality of life is somewhat contextual.

When your nearest and dearest are exhausted and bankrupt from trying to get you proper (even minimal!) care, your choices may feel/look substantially more bleak than if our society was able to provide basic care without such hassle.


Posted by: Witt | Link to this comment | 06-24-07 3:55 PM
horizontal rule
40

I would argue the default position should be that he probably does want to live

I might argue against this.

But look, I'm not going to bother.

Having been near-dead once, I can say that if I were to be maintained in that state, I'd not want it.


Posted by: parsimon | Link to this comment | 06-24-07 3:56 PM
horizontal rule
41

Sifu Tweety thinks women over 40 have nothing better to look forward to than pureed food!


Posted by: Cala | Link to this comment | 06-24-07 3:56 PM
horizontal rule
42

On the outrage front, I was talking just last night to a friend who is basically an advocate for veteran care, and he's been meeting with people in the military and people on the Hill--he said that everyone knows there's a problem, and there are various task forces trying to figure out solutions, but right now, the senior people "have bigger fish to fry," which I took to mean that things are so incredibly fucked up in Iraq that this issue isn't getting high priority.


Posted by: ogged | Link to this comment | 06-24-07 3:56 PM
horizontal rule
43

42: I don't think immersion in hot oil is going to help wounded veterans one bit.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 3:59 PM
horizontal rule
44

Actually, there *is* a moderately interesting point of Emersonian drift I can make at this point, in line with 39: a lot of traditional medical ethics discussions treat the decision to end life more or less in a vacuum, removed from, say, the social and financial circumstances that make ending life an attractive choice, which I think is a serious failing.


Posted by: FL | Link to this comment | 06-24-07 4:00 PM
horizontal rule
45

but right now, the senior people "have bigger fish to fry,"

Is that the weirdest, or what? You would think the competing parties would be climbing over each other to be The Party That Loves the Vets Better Than That Other Party.


Posted by: Anderson | Link to this comment | 06-24-07 4:00 PM
horizontal rule
46

44: Velleman's piece on it didn't.


Posted by: Cala | Link to this comment | 06-24-07 4:01 PM
horizontal rule
47

That's because Velleman was tied to the tracks when he wrote it.


Posted by: FL | Link to this comment | 06-24-07 4:02 PM
horizontal rule
48

Is that the weirdest, or what?

You'd think so, but my guess is that this is something people can get emotional about without really caring all that much when it comes time to vote, because it affects relatively few people.


Posted by: ogged | Link to this comment | 06-24-07 4:03 PM
horizontal rule
49

There's a Conrad novel in which someone gets hit by a trolley and needs to be cared for.


Posted by: eb | Link to this comment | 06-24-07 4:05 PM
horizontal rule
50

49: Was it a fat guy? Did a utilitarian push him in front of the trolley to save six others?


Posted by: zadfrack | Link to this comment | 06-24-07 4:07 PM
horizontal rule
51

48: I wonder if it's because the Republicans more or less have a lock on the military vote in the way that Dems have a lock on the African-American vote.


Posted by: SomeCallMeTim | Link to this comment | 06-24-07 4:08 PM
horizontal rule
52

51: Do they? I know they have a lock on the votes of the officers, but what about the enlisted men and women, and their families?


Posted by: zadfrack | Link to this comment | 06-24-07 4:12 PM
horizontal rule
53

52: Poor, rural, & Middle America & Christian. Probably going Republican anyway.


Posted by: Cala | Link to this comment | 06-24-07 4:13 PM
horizontal rule
54

52: What's "poor" doing in that list?


Posted by: zadfrack | Link to this comment | 06-24-07 4:16 PM
horizontal rule
55

"52" s/b "53".


Posted by: zadfrack | Link to this comment | 06-24-07 4:16 PM
horizontal rule
56

the Republicans more or less have a lock on the military vote

Are we sure this is true any more? Call me naive or hopeful, but actually I hear that there's significant dissatisfaction in the military with the current administration. Much more than you'd think.


Posted by: parsimon | Link to this comment | 06-24-07 4:16 PM
horizontal rule
57

pwned by 52. And with that I'm outta here.


Posted by: parsimon | Link to this comment | 06-24-07 4:18 PM
horizontal rule
58

56: Actually, there's probably much less than you'd think, given what this administration has done to our military.

But yes, I do think that dissatisfaction and dissent are growing.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 4:19 PM
horizontal rule
59

pwned by 52. And with that I'm outta here.

Some people don't take pwnage well.


Posted by: ogged | Link to this comment | 06-24-07 4:20 PM
horizontal rule
60

53: Even so, I'm surprised that the issue gets pretty much no traction. Dems don't raise it frequently or forcefully enough, probably, but the moral case seems clear. Then again, I am out of touch with the American people.


Posted by: Jesus McQueen | Link to this comment | 06-24-07 4:21 PM
horizontal rule
61

I suspect that there's a difference between dissatisfaction with the Administration and dissatisfaction with the Republican Party.

Some set of Big Dems should go on fairly public missions to various Big Name Universities and Colleges to get whatever restrictions on ROTC and military recruitment remain in place removed or mitigated. I'm not sure it would pay off in the short term, but it might help build greater long-term credibility. (Do they still exist, and why are they there in the first place?)


Posted by: SomeCallMeTim | Link to this comment | 06-24-07 4:23 PM
horizontal rule
62

pwnage is a dish best-served cold.


Posted by: zadfrack | Link to this comment | 06-24-07 4:23 PM
horizontal rule
63

62 is clever, but deeply wrong. The best pwnage is only seconds old.


Posted by: M/tch M/lls | Link to this comment | 06-24-07 4:26 PM
horizontal rule
64

61: The anti-military-recruiting restrictions are just a result of universities consistently applying anti-discrimination restrictions on recruiting in general.

The universities say that no company that discriminates on the basis of sexual orientation can recruit. The military discriminates on the basis of sexual orientation.

This is not to say that universities might shouldn't make any exception for the military. (I love the multiple modals available to me as a Southerner!) But there is a lot to be said for consistently applying one's principles, and that's what the universities are doing.


Posted by: zadfrack | Link to this comment | 06-24-07 4:28 PM
horizontal rule
65

61: They still exist, and it's either because the military isn't an equal-opportunity employer, or because they all left around Vietnam.


Posted by: Cala | Link to this comment | 06-24-07 4:29 PM
horizontal rule
66

60:If you understand the games Bush is playing with the budget, you can understand the Democratic Congress a little better. Bush has his veto pen out, and any increase in Veteran's benefits will have to be matched by cuts in Social Services elsewhere. This is fact. Somebody will have to suffer.

Of course, we can also blame the Republicans in Congress. I wasn't sure that it was a good idea to win Congress in 2006 for this reason.


Posted by: bob mcmanus | Link to this comment | 06-24-07 4:38 PM
horizontal rule
67

I really don't think this is a good context to analyze 'better off dead' in. Get the guy the very best of possible care without impoverishing his family, and then maybe think about figuring out if he's better off dead. And I don't understand at all why we're not paying for better care for these guys.


Posted by: LizardBreath | Link to this comment | 06-24-07 4:42 PM
horizontal rule
68

67 is right.


Posted by: nattarGcM ttaM | Link to this comment | 06-24-07 4:48 PM
horizontal rule
69

And I don't understand at all why we're not paying for better care for these guys.

I can understand that resources might occasionally get stretched, or that sometimes in any bureaucracy that people might occasionally slip through the cracks, but everything I read says this is not what is happening here. It's systematic neglect as a matter of policy. or at least a consistent de-prioritisation of stuff that should be a huge priority.


Posted by: nattarGcM ttaM | Link to this comment | 06-24-07 4:51 PM
horizontal rule
70

66: I'd rather they forced him to get his veto pen out, and made Republicans in Congress pay as well. Dems ought to make it an issue now, because even if it doesn't matter to voters, it matters to increasing numbers of vets and their famillies, and they should be in a position to do something about it soon if they end up controlling both the White House and Congress in 2009.


Posted by: Jesus McQueen | Link to this comment | 06-24-07 4:52 PM
horizontal rule
71

The only thing I can figure is that military health care system has just been slow to adapt to the idea that these soldiers are going to need permanent care (instead of dying.) and that they're resistant to treating mental health as an actual medical need.

But that's not really an excuse four years into a stupid war. Can't we just take some of the money otherwise earmarked for contractors?


Posted by: Cala | Link to this comment | 06-24-07 4:58 PM
horizontal rule
72

The only thing I can figure is that military health care system has just been slow to adapt to the idea that these soldiers are going to need permanent care

Some of that slowness to adapt is probably by design, to keep the overall price tag of the war down.


Posted by: mrh | Link to this comment | 06-24-07 6:19 PM
horizontal rule
73

I'm not going to click through, so maybe someone can tell me whether "better off dead" is a thought to consider here.

Absolutely. I did click through, and they'd be doing that kid a favor by killing him.


Posted by: gswift | Link to this comment | 06-24-07 6:49 PM
horizontal rule
74

Everyone should click through. I know people don't like to see and hear this stuff, but too bad. War is our guys coming back as blind mute quadriplegics. Our country sent him over there, and the least we can do is acknowledge what happened to him, and keep it mind next time we wonder about things like whether we should pull out or not.


Posted by: gswift | Link to this comment | 06-24-07 7:10 PM
horizontal rule
75

the least we can do is acknowledge what happened to him

Or write your Congressperson.

Or contribute your time, your money, or your presence to veterans' groups. Heck, the easiest thing I've ever done was buy magazine subscriptions from a co-worker's fundraiser and have them sent to my local VA hospital.


Posted by: Witt | Link to this comment | 06-24-07 7:32 PM
horizontal rule
76

61: In addition to the fact that there actually are good (or at the very least, logically consistent) reasons for what anti-recruitment policies exist like 64 and 65 said, I also don't think getting running against them would help Democrats very much anyways. Anyone who votes against Democrats because some colleges (ideologically aligned, maybe, but institutionally unaffiliated) have entirely legal policies against military recruiters recruiting on campus, probably wouldn't vote for them anyways. Or, even more nebulously, if they still believe somehow that Democrats are less ""serious""* on national security than Republicans, I doubt this would change their minds.

Where did the phrase "I used to consider myself a Democrat but thanks to 9/11 I'm outraged by Chappaquiddick," come from - LGM, alicublog, or somewhere else entirely?

* Because a single set of quotation marks just didn't seem sufficiently mocking.


Posted by: Cyrus | Link to this comment | 06-25-07 10:22 AM
horizontal rule
77

Berube maybe? I think it was him.


Posted by: LizardBreath | Link to this comment | 06-25-07 10:23 AM
horizontal rule
78

Yeah, that's Berube's fantastic line.


Posted by: ogged | Link to this comment | 06-25-07 10:28 AM
horizontal rule
79

Origin.


Posted by: apostropher | Link to this comment | 06-25-07 10:29 AM
horizontal rule
80

I can understand why people might argue that it shouldn't be a consideration, but I'm sure that if I were in this guy's position, (assuming his brain injuries allow this kind of thought), the prospect of draining all the comfort out of my elderly parents' remaining days would be a serious contributor to my wish not to carry on.

My father has made me promise many times that if he were to become sufficiently infirm that I will "roll his wheelchair off the end of the dock," which of course I couldn't literally do, but I do worry about how it will go if/when I have to make this kind of decision for real, either for myself or my parents.

And this is the kind of thing that most infuriates me about the idea that being pro-war is somehow the serious position in foreign policy. Even the most justified wars produce horrors like this. The threshold for justification should be accordingly high, and yet you're a dirty hippie for saying so.


Posted by: cerebrocrat | Link to this comment | 06-25-07 10:51 AM
horizontal rule
81

isn't there a metallica video about this guy?


Posted by: verbal | Link to this comment | 06-25-07 3:15 PM
horizontal rule