Death At Death's Door

           [Take your pic pick. Couldn't decide.]

A doctor friend working in a Texas hospital foretells rationing ventilators, as Covid-19 patients overrun their ICUs. Who, he asks, should be denied? Vaccination refusers? Other than being partially-innocent victims of well-organized lying, their primacy on the rejection list is compelling. The brainwashed don’t know they’re brainwashed, but, as ubiquitous evidence makes persisting ignorance indefensible, sympathy wanes.

They sent a Covid patient to North Dakota for care. Needing a ventilator for non-Covid illness, another Texan had to be airlifted 150 miles; prior to which he required approval by a team husbanding the scarce resources. It’s Sarah Palin’s death panels, incarnate; necessitated by people made unable to process information. Unlike the stuff of her disordered mind, this is real. Texas’ Trumpicly irresponsible governor now begs smarter states to send help.

Why it’s happening is obvious. Trump’s pandemic ignorance and lies and inattention showed Republican leaders a winning strategy: To keep people distracted from their pre-failed economic agenda, and sending money, make it about “freedom,” or “communism.” Or, a perfect exemplar of effective disinformation, believing “Critical Race Theory” is taught in K-12 schools. Hint: It isn’t.

“Unmasked, Unmuzzled, Unvaccinated, Unafraid,” say their T-shirts. Translation: “Uninformed, Uneducated, Unreachable, Uncaring.” “I do my own research” – a claim that refutes itself. 

So successful is it that, dismissing massive contrary documentation, Trumpublicans still believe vaccines and masks are ineffective and/or dangerous; liberal “wokeness” signifiers. Had Trump, Trumpophile governors, and their media heroes urged their victims to pitch in, as Americans amidst crises always have, this Delta-variant siege wouldn’t have happened. Viruses spread -- and mutate -- among the unvaccinated. Deeming it acceptable collateral damage, Trump’s party has become a killer party. Why? Consider who benefits.

As their media stars pound rare breakthrough cases among the vaccinated, widespread deaths and deathbed regrets of anti-vaxers are ignored. Consumers only of Trump-approved news sources may have missed these data from the CDC, current as of July 31:

Of the 164m fully vaccinated in the U.S., 99.9% have NOT tested positive for Covid-19. Breakthrough cases represent .077%. Hospitalized: .004%. Died: .001%.

In contrast, 99% of those hospitalized and/or dying of Covid-19 are unvaccinated. A Florida church just lost six parishioners in ten days; four under thirty-five. Previously healthy. Unvaccinated.

Given those numbers, who of right mind refuses vaccination and masks? Trumpists. Among whom, because of disturbingly easy and successful mass deception, it appears no right minds remain. Killing thousands, manipulated and abandoned, for the most cynical of reasons: payola for bankrollers.

For decades, having nothing else to offer, Republicans created a human variant disinterested in truth; not changing course even as their voters are endangered. Only in a killer party could that be considered leadership.

On fawning media, Trump blames President Biden for the resurgence. Unlike Trump, he made vaccination widely available, fast, and urged it. Biden’s fault, says Trump, while his blinded flock refuse vaccination and masks, enabling Delta’s rise.

What hope is there for a county in which millions of such zombified people exist? (Bad analogy. They’re not eating brains, they’re offering their own to their leaders for lunch.) Evidence, mounting hourly, is ignored. And, no: evolving recommendations don’t validate their disbelief. It’s science: seeking and remaining open to new information. Why has that become “conservative” anathema?

Proving the point is a quote for our times, forced from lungs filling with Covid-19, spoken by a 31-year-old man in Branson, MO: “I was strongly against getting the vaccine,” Barker said through labored breathing. “Just because we’re a strong conservative family.” That’s Trumpofoxification in the mortifying flesh. What Trumpian acolytes have done is criminal. Murder most literal.

That poor guy is a victim of Trumpism. This one isn’t: a smug, bullying, attention-seeking, taxi-driving avatar for all of Trumpworld, who refuses masked or vaccinated passengers. Patriotic. Heroic.

For needed karmic relief, Texas Republicans provide: Covid-19 has derailed (temporarily, no doubt) their determination to suppress Democratic votes; the only way they can keep winning.

There are much worse and deadlier issues, though: Whereas the pandemic might end up killing only a million or two Americans, the latest IPCC report shows climate change on a trajectory to kill far more.

Unlike his pandemic dereliction, Trump’s climate denial isn’t wholly responsible. But he and his party did less than nothing about it: deregulating, dissembling, deceiving. Departing accords. All for fossil-fuel money. And to “stick it to the libs.” If that’s both murderous and suicidal, their reactionary inaction on climate change is pan-humanity genocidal.

Unconvinced by heatwaves, drought, acidifying oceans, dying reefs, wildfires, starvation, dried-up rivers and reservoirs, melting glaciers and methane-spewing tundra, Trumpists continue to laugh it off.

Against such radical resistance to reality, what can thoughtful citizens, actual patriots, do? Minimize energy use. Make it green as possible. And, since Trumpists are irretrievably uneducable, stop electing them. Until Texas, et. red, make that impossible, too.

Doing The Right Thing

When I read this, I knew there'd be hell to pay for President Obama. It also impressed the hell out of me. It's political... courage.

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

No question the president knew what would be coming. Shit like this. And yet, because it's the right thing, he presses on, politics be damned. That's leadership. That's guts, or some other slightly more southerly anatomical metaphor.

Even readers of The New York Times, evidently, are caught up in the fecal efflux coming from the right (as in "wrong") side of our politics. Here's a recent letter to the editor, among several:

I read your article about “end-of-life planning” and I am completely appalled. I have been a longtime supporter of President Obama, but it appears as if death panels are becoming a reality.

My mom, 93, recently received a diagnosis of colon cancer, and her doctors recommended an operation to remove the tumor. It was successful and she can now expect to live several more years.

Who are we, or any doctor, or any president to judge when the end of life is and when to deny aggressive care?

What a shame. How sad to be so misinformed.

For the length of my career as a physician, and in the recent declines and deaths of my parents, I've come to appreciate the need for health care directives, and, unlike the mouth-breathers of the right wing and the fears of the letter-writer, I came easily (for it's simple, obvious, and completely logical, absent the screamings of the screamers) to understand what they are. And, more importantly, what they are NOT. Once again, the so-called controversy begs the question: are the dissemblers really that stupid, or are they, per usual, grasping at anything they think they can sell to a gullible public in an effort to discredit our president? (My opinion: there's a lot of stupidity seeping sadly from the screamers, but they can't be so dumb as to believe their own words in this matter. It's cynical politics at its very worst.)

That the lady of the letter is so misinformed is not entirely her fault. For one thing, there's confusion -- because our fourth estate is so damned incompetent -- between end of life directives and the concept of effectiveness research. Though very different (and useful) ideas, such intellects as Sarah Palin and Glenn Beck have used the concepts interchangeably in their race to the bottom of the pickle barrel of demagogues. Because they're cynical assholes (to use diagnostic terminology), I doubt it's accidental.

Simply put, end of life directives are a way for people to ensure that their wishes are carried out. Shall I repeat? Ensure that their wishes are carried out. Carried out!!! It's the absolute opposite of a "death panel." It's a directive. By the patient. And it applies only when that patient is unable to express his/her wishes. It's not an unbreakable contract that overrides one's current wishes. Like my dad. In his directive, he'd said he didn't want to be hooked up to a ventilator. When the time came, he chose to be intubated. No one did -- or could have -- told him, sorry, we have your directive here, and it says no.

As long as you're capable of expressing your desire, the directive does not apply, no matter what it says. DOES NOT APPLY. There is no panel, nohow, nowhere, that can decide otherwise. Period.

No. Fricking. Panel.

[What panels there are, by the way, are those instituted by Republican governors, in Republican states.]

The other concept -- effectiveness research -- is more complicated and, because of the very nature of medical research, rightly a subject of controversy and disagreement. But, for one thing, that's not what the president and the NYT article were talking about. For another, who, given a moment's thought, would want to be treated using methods shown to be ineffective? If -- and it's not a tiny "if" -- research could point to the best treatment and away from those that are a waste of time and hope and effort and suffering and money, would that not be something we'd want? Demand??!! Even if the idea came from a black guy?

But the Sarah Palins and Foxobeckians of the world, the teabaggers, are neither capable of such subtle thinking nor interested in what's reasonable or factual. Not to mention what's in the best interest of our country. Never missing an opportunity to lie and to frighten, they spew their dishonesty and people like that poor letterer are deceived. Like my ninety-three year old aunt who just underwent colon resection and chemotherapy for cancer, the writer's mother got the treatment she needed. There's nothing about end-of-life directives that would have changed that -- or even addressed it! -- unless she were in a coma and had previously directed that, under those circumstances, she'd not want aggressive care.

Likewise, effectiveness research might have prevented her from having her back manipulated and taking homeopathic remedies or aromatherapy for her cancer, or, possibly, from receiving Avastin for it; but, until the day arrives that there are data showing surgery doesn't cure colon cancer, she'd receive that, too.

Unless, of course, we ever get around to looking at the books and deciding how much we want to and/or can afford to spend on medical care; and if, when we realize that there's a limit, we're willing to confront whether, given limits on resources, paying for colon surgery for a ninety-three year old carries the same weight as doing so for a forty year old.

But that's another matter entirely. Nor will it ever fit into the minds of teabaggers, who want simultaneously to reduce taxes and bitch about cuts in medical care; who call it "rationing" to refuse to pay for treatments that don't work.