Medicine

Dr Leo Spaceman on the "critically acclaimed"* comedy "30 Rock" once replied to a patient's inquiry with the observation "Medicine is not science."While meant to show that he is not the sharpest graduate of the Ho Chi Minh School of Medicine, it turns out to be more true than intended. Google "is medicine a science" and you'll get varied opinions on that subject. It's evidently a very real epistemological question for those who think about such things.

Brought into the Presidency just as the Crisis was becoming manifest, Obama's first policy focus was on reforming health care in the United States. There was plenty of reason to think that was needed, from people dying because they didn't have insurance, to massive Medicare fraud, to the crazy state of hospitals here.

That last being what sent me in this direction, after seeing the former site of the North Hollywood Medical Center. Google still shows the buildings, but it's currently a vacant lot in the process of becoming apartments. Before that, it was used for filming most of the seasons of "Scrubs." Which is to say that the next best valued uses for a decent sized medical facility were a) as a set for filming a medical comedy and b) as housing in an inflated but still lethargic market. Not as a hospital.

Which brings us to the Supreme Court spending three days on whether the healthcare reform passed - barely - two years ago is constitutional. The first day was concerned with whether they even could examine the question, under laws that require a tax to be paid before a suit can be brought. Tuesday, though, was the start of the big question: Can the federal government require people to purchase insurance? And if so, what is the constitutional justification?

Regulating interstate commerce, of course, is the go-to argument for this. And the precedent that said growing marijuana for your own medical use in a state that had legalized said use and without any crossing of state lines would seem to indicate that this is a wide-reaching power. I would hope this would be applied consistently, since otherwise it seems too much like these folks make up their mind on the outcome, then make the law fit.

The real problem, though, is that the American mindset doesn't like any of the options. The white-hatted cowboy wouldn't let the sick widow die for lack of funds, but he also knows that the free and open range is a place where not everything is able to survive. Americans like the idea that anything is possible, that nobody is stuck where they are and there's always a second chance, - that the town will always join together to help the unfortunate, and never for a lynch mob.

And even if you're a glass-half-full person, you have to acknowledge that's not true. Shifting back to the specific issue at hand, three people with equivalent- even identical - insurance options can have three radically different outcomes. One could go to a nationally-ranked facility, one to a local clinic, the other might do nothing -"it's just a cough." One doctor is an expert in this specific issue and the other dismisses it. Surgery usually cures it unless an infection happens; antibiotics administered are as good except with allergies; a radical treatment works perfectly unless you are in the unlucky 2%.

Maybe Dr. Spaceman is right: Medicine isn't science, since we can't run repeatable experiments well enough to KNOW just how to fix anyone who walks in for treatment. Perhaps no matter how we mess with the economics of the system, or the standards of the professionals, or the availability of preventative options, horror stories will happen.

* All bloggers are required to use "critically acclaimed" for this show. It's in the Terms of Service.

Calm

The stock market is up - largely due to Apple - gold is down, oil is flat, and so (more or less) are Treasuries. The Greece deal seems to have soothed the overall financial markets, and iPad 3 demand at least suggests consumer confidence.

Then again, there don't seem to be any great options for Afghanistan or Iran. For the former, there's no desire to stay - just not to appear chased off by some unfortunate events. For the latter, even assuaging Israel and avoiding intervention just feels like kicking the can down the road. The exceptional protection for Iran's nuclear facilities bring to mind Peenemunde more than General Electric. They give every indication of having weapons production (rather than fuel) as their goal. And the difference in reaction to, say, Iraq versus North Korea indicates that it's in Iran's best interest to become a nuclear power sooner rather than later.

Sometimes, though, kicking the can down the road is just what's needed. If there isn't support based on what's currently known (and on attitudes towards intervention / pre-emption / all-out war), then it's not action that can (or should be) forced. Waiting for fullness, as Valentine Smith would say, will allow whatever is necessary to be complete. Or, if it shouldn't happen, it will make the wisdom of avoiding it that much clearer.

Which brings us to a period - a day,a month, perhaps longer - where the Crisis isn't that bad. A hint of stress in the air, maybe. There was a point right after the credit crunch where it seemed too late to prepare, and the only option was to hang on for the ride. It's like that in reverse, right now: At the end of the loop-de-loop, we know the cars are being pulled up to the top of the next hill. Any good ride Designer will keep you guessing about what the next surprise is. Unless he's showing it to you intentionally, of course. Either way, it's the right time to take a deep breath.

Homelanders

By my estimation, the Crisis began in 2005, with Hurricane Katrina as a marker if not the Catalyst. That would mean that the oldest a Homelander could be is 10 years old (2012-2005+3). If you think the start was 2008's financial meltdown, the oldest would be 7.

But it seems like young people these days are being seen less as Heroes than they use to be. A college student on trial for "bias intimidation," a 10-year-old girl killed in a fight with another girl - Occupy activists treated less as saviors and more as bums. Overall, it's feeling like the Adaptives are taking the stage, except (as noted above) it's too early for that.

There are periods in life where children have to rebel just to distinguish themselves from their parents. Even though it's natural it's not easy to watch or to be involved with them at those times. Perhaps Millenials are just entering a "difficult stage" between hope for the future and guardians of our way of life.

Feature

The crazy times of the Crisis - of trying to decide which way to zig when the world is zagging, of living in the proverbial "interesting times" - gave this recent insight:

Adaptives and Prophets will look at the world of the First Turning and say "It's boring and safe and every day is the same!"

Reactives and Heroes will reply "Yes! That's the point!"

Whitney

What can you say: it's not exactly a shock that Whitney Houston died at a relatively early age. Substance abuse does that to a body, and once it gets to a certain point it's just a matter of time. I wonder that people are calling it a "tragedy," even, since that carries the implication that it's unexpected.

Every generation has its burdens to bear. Civics take the brunt of the dying in the Crisis, and Adaptives are overshadowed by it their whole lives. Prophets have grand ideas and a goal of remaking the entire world that, mostly, doesn't quite happen. Reactives end up known for these notable artistes that,well, almost had it all.

Polonius

Polonius, the king's counsellor from Shakespeare's "Hamlet," appears to me to be a Reactive. Among the reasons (which I may come back to) fare:
-- A person of his age at the time the play was written would have been a Reactive, raised during the Reformation.
-- Polonius is often said to be based on William Cecil Burghley, a (Reactive) counsellor to (also Reactive) Queen Elizabeth.

One problem is the traditional portrayal of Polonius as a sycophantic buffoon. This isn't easily squared with the practical attributes associated with the Nomad archetype. There are ways to play him that make this quite reasonable, though, especially when the Act II scene with Reynaldo is included. His surveillance of his son Laertes shows that he is very careful with those close to him, and able to plan an eminently practical method of determining just what is happening in Paris.

Except, of course, that halfway though a sentence he loses his train of though and has to ask Reynaldo to remind him where he was. One could treat this as another bit of trickery on his part, making sure that Reynaldo is paying attention. I might have said so myself ... Until yesterday, when exactly that happened to me while trying to explain How Something Works. So now, I'd have to say that it should be played straight. It's just an example of what sometimes happens when you are Of a Certain Age. As we all are, eventually.

Moonbase

A bit late on this but: Sorry Newt, a lunar base is very unlikely in your lifetime.

During the waning days of the Third Turning, it was just barely possible IF a prize (like a MUCH larger X-Prize) had been available. Dr. Pournelle's 30 people / 3 years / $10 billion could have done it. Just imagine trying to suggest an amount like that now. We have larger problems to deal with which will prevent either party from being able to move it forward in that form.

The alternative is a First Turning project comparable to Apollo or the Transcontinental Railroad. Even assuming a 2005 start to the 4T, we're at least 15 years from being able to start that.

"Ah," I hear you say, "The Transcontinental Railroad was built during the American Civil War, so why couldn't it happen now?" Certainly that could happen (although it wasn't finished until several years after) if there's some reason that a lunar base helps in this 4T. The only hypothetical I can imagine for that involves an energy war where Solar Power Satellites become worthwhile. Not saying it couldn't happen, just seems really unlikely. Even that would have to wait until the peak of the Crisis, which might be too late for Mr. Gingrich.