America Is Afflicted With Neurotic Displacement

America Suffers From Neurotic Displacement

 

Our political discourse is afflicted with a disease that generally effects people.  The disease has been called neurotic displacement, displaced pain and sometimes just plain displacement.   Before I can explain how this country has succumbed to this malady, I think it makes sense to first describe this ailment in individuals. .

The disease is present in both medicine and psychiatry.  In bodily disease, this condition manifests itself when Organ A will hurt even though Organ B is really the organ suffering from organic disease. In psychopathology, a patient may complain about his inability to score over 95 in Spanish when in fact he really is plagued by the trauma of a loved one’s recent death.   The rationale for this condition seems to be that since it would be too painful for the diseased organ to feel the full brunt of the pain, the pain is shifted or displaced to another organ.  Sometimes it is described as something that arises because a person simply could not bear to face the truth of what is bothering him and so establishes fictions to distract him from realities he cannot endure.

 

Certain cases of appendicitis offer a dramatic example of this process.     Although the appendix is in the lower right quadrant of the abdomen, sometimes a patient’s pain is displaced to regions of the abdomen far from the appendix.  Tens of thousands of Americans die each year from appendicitis that was mistakenly brushed–off as gastritis.  (The moral of the story:  When a patient suffers acute abdominal pain, the abdomen must be palpated.)  In psychiatry, the condition presents itself in truly remarkable ways.  In hysterical blindness (The patient genuinely cannot see but we can detect no defects in the eye or optic nerve), the patient expresses only scant concern for her failure to see and will profess to be very much upset about relatively picayune affairs.

 

This phenomenon is very much evident in the nation’s political discourse, particularly as it exists on television.  The titans of the television news media, CBS, NBC,  ABC, CNN, spend a truly inordinate amount of time talking about things that are, relative to what is really important, infantile drivel.  We hear about all sorts of stupid, silly stars getting into stupid silly scrapes over drugs, significant others and the police.  This nation decided it would have a national nervous breakdown when a young intern with a loud and brazen beret had oral sex with the President.  When a boy named Elian Gonzalez was brought to the country, and his Cuban Father wanted him returned to Cuba, large portions of the country seemed ready to go through the cold war all over again.  Very recently, a ferry collided against a pier in Lower Manhattan.  No one was killed.   I have been told that for the next five hours, New York One (which broadcasts television news in New York City) and CNN spent in excess of ninety percent of their coverage on the ferry accident.

 

Of course, such inane news programming might make sense if we lived in some Eden-like Mr. Roger’s Neighborhood where nasty things are a rare occurrence.  But that is not where we live.  Sometimes I think a Hades on earth is more like it.

 

Now there is no mathematical formula that one can devise to guide us in allotting news time to various subjects.  This is all terribly subjective, and a host of factors, other than the importance of the story, will dictate what the news will consist of.  But the bottom line is undeniable:  The most important stories are hardly given more than a passing glance.

 

I can think of so many sheer and utter scandals, large and small, that are hardly touched upon.  The American War in Afghanistan is now in its 12th year, and most of the American people are blithely and happily oblivious to the carnage —  it is no wonder when the media is busily attending to such earth-shattering matters as Paris Hilton’s petty, narcissitic heart (I must concede that I know nothing about that woman)  In the United States, banks have evicted millions of people from their homes through fraud and chicanery while the media concentrates on the lovely homes inhabited by the mental midgets on Real Housewives from Atlanta.

 

Medicine is one of my obssesions, and the media’s coverage of medicine is truly horrendous.  Consider this story which, to my knowledge, got no attention on the evening news:  In America, two of the most promising drugs for non hodgkin’s lymphoma, Zevalon and Bexxar, were not being used because of insufficient demand. (The New York Times, July 14, 2007.)  Of course there were plenty of dying people who needed these drugs, but the evils (I don’t think that’s too primitive or strong a word) of the marketplace condemned them to disuse. Why?  These drugs were radioactive and could only be administered in hospitals.  However, most doctors don’t have their offices in hospitals and so cannot dispense these drugs.  However, doctors love to administer drugs in their offices because they are reimbursed at a fantastic rate when their nurses stick a needle in a patient in the doctor’s office  (About five hundred dollar for a three-hour infusion.) According to the New York Times, most patients were getting inferior drugs which could be administered in a doctor’s private office to boost a doctor’s earnings – and while the doctors got richer, the patients often died. (Of course, according to the intellectual bimbos on Fox, the only bad thing about medicine is what the government might do to it, and the rapaciousness of some doctors, and the death ensuing from their greed, does not exist.)

 

So what does the news media talk about when it opts to discuss medicine.  First, they concentrate on the immaterial audio-visuals: The TV screen shows film footage of long lines at clinics and babies crying when they get a shot. (ooh, how cute, the stupid Edith Bunkers coo) And then the narrator relates his grave and gripping news story:  We are in flu season, and it is rough.

 

I live in New York City, which imagines that it is the utter apogee of journalistic excellence.  In New York, millions of people are spending upwards of half of their income on rent, and are living in rat-infested and dilapidated conditions, and the local television news is telling us about the aforesaid ferry accident which resulted in no deaths, a bake sale at a parochial school, and, if they are in a particularly moronic mood, a lead story will consist of a lot of moaning and groaning because a storm had the temerity to deposit a mere two inches of snow on the ground.

 

Obviously, this pathological coverage means that important stories are ignored.  However there is another way in which we suffer because of the dearth of coverage of important stories. When the television news concentrates on dog shows and other such nonsense, people assume that little is really wrong with society or that if there are problems they are not the result of malfeasance or negligence on the part of big business or government.  Surely, if bad things were happening, they would be reported upon, ordinary folk assume.  For example I remember an allegedly bright woman (she was an attorney) telling me, in 1988, that AIDS “was no longer a problem.”  I asked her what made her come to this conclusion, and she responded, in her inimitably stupid way, by saying, “Well, they talked about it a lot on TV, back in 1985, what with Rock Hudson and all, and I don’t hear that much about it anymore.”  Of course, things were much worse in 1988 than they were in 1985.  (The infection rate was going up like a parabola on a Cartesian plane.  There were 1000 cases in 1982, 10,000 cases in 1984 and by 1988 about 1,000,000 people in this country were infected – and in those days our medicinal arsenal was virtually empty)  That woman’s views had nothing to do with reality and were nothing other than the neutered version of reality she had imbibed from her tame and lame television – of course, television, we are told, is better than ever because it is “high definition” television; the caliber and intellectual content of the programming is of no moment.

 

This problem has always been with us but now it is only getting worse.  Yes, in 1964 the government fabricated a crisis in the Gulf of Tonkin to broaden our involvement in Vietnam, and the media was sold on the lie, but the media did not smile too much.  Walter Cronkite reported the news in his gravelly voice, did not behave as a mouthpiece for government propaganda, and showed us the villages we torched as part of our Orwellian “pacification” program.  But today the media behaves like fawning fools of the government, and when Bush declared — all dressed up in military drag — in 2004 that his mission In Iraq was accomplished, the television announcers ran their brushes through their blow-dried hair and smiled wide and told us that the President was a very virile man.  And so  we have our bread and  circuses, our Lay’s potato chips to give us type two diabetes and our network and cable news to lead us inexorably towards senile dementia.

 

Copyright, David Gottfried, 2013


WHY DOCTORS SHOULD BE SUED MORE FREQUENTLY FOR MEDICAL MALPRACTICE

WHY DOCTORS SHOULD BE SUED MORE FREQUENTLY FOR MEDICAL MALPRACTICE

A doctor’s compensation, for the most part, has nothing to do with medical excellence or healing patients.   A doctor’s earnings are, for the most  part, contingent on only one thing:  The quality of forms and paperwork sent to third party payers such as private insurance companies and Medicare.

Whether or not you are cured is really very much beside the point.  Indeed, you can drop dead five minutes after exiting a doctor’s haughty office on Park Avenue, and your doctor will still get paid if the forms are in order.  Very simply, doctors don’t have much of an incentive to do anything good or right.  Of course, many of them were filled to the brim with benevolence when they were young, but a) the crassness of the profession, b) the need to make oneself cold so as to avoid becoming emotionally involved in a case, c) the millions made by wall street executives in the course of screwing people over (What is the essence of the Capitalistic Act?  Taking a piece of junk worth twenty dollars and convincing some poor shnook it is worth fifty dollars), d) the torture endured by young doctors in hospitals, and e) the very understandable tendency to get sick and tired of stupid patients who call the doctor about every little thing (I knew a woman who called her doctor on every Tuesday.  Tuesday was the day the science section of the New York Times came out.   Invariably, there would be some cutesy little article which said that garlic or some other seasoning was salubrious, and invariably this woman, while stuffing her face with strawberry shortcake, would ask the doctor, “So, answer me this:  Is it really true than ginger ale can get rid of wrinkles”), make doctors SICK OF THEIR PATIENTS.

Accordingly, the average doctor older than thirty-five is a son of a bitch.   His altruism has withered away.  He just wants to make the bucks, and the bucks are made not by curing people – Blue Cross and Medicare couldn’t care less if you are alive or dead or enduring hundreds of bed sores, lonely and forgotten in a hospital ward – but by sending the insurance companies and their ilk good paperwork.

You think this is all imaginary?   Then why do 100,000 Americans die every year of nosocomial (Hospital acquired) infections.  Because the sons of bitches are too damn self-centered to wash their fucking hands.    You think I am paranoid?  If a surgery goes awry because of blatant medical error, do you think the patient knows about it.  He was unconscious during the  surgery.  (Indeed, most of the time people don’t even know they were hurt by doctors.  A Harvard study – admittedly somewhat old as I heard about it in Law school and I was graduated from law school in 1985 – said that for every medical malpractice action initiated in New York State, 20 valid actions were not started)  Do you think it’s easy to bring a suit for malpractice?  Do you have any idea how hard it is to find a doctor willing to testify against another  doctor and how much he’ll charge you if he will consent to testify?

The cases of malpractice, and of really egregious and astounding malpractice, are ubiquitous, but I don’t think most people have any idea of what is going on.  Just as Alexis de tocqueville said that Americans are so certain that they are free and fine that they rarely question whether they are free and fine, Americans are so certain that we have the greatest medical industrial complex in the world that they’ve never taken a look to see the dead bodies in the machine.   About once every two weeks or so, I see a story in the New York Times which documents the atrociousness of doctors, but that story is on page 16 or so, and what proportion of Americans read,  or hear of, or even know what page 16 of the Times looks like.  The Americans are listening to Fox or CNN.  CNN will cover the news all the time, but they simply repeat the same superficial things every ten minutes or so.  Metternich said the masses were inert, and they are, and let’s not forget that they are grotesquely stupid too.  If you have any doubt, just examine the pea-brain discussions that dominate the presidential elections.

In any event, we need to make it easier for Plaintiffs to bring medical malpractice actions because medical malpractice actions are the most potent incentive to encourage the responsible practice of medicine.

Copyright, David Gottfried, 2012