Forgiving Major Hasan

One photograph of Major Nidal Malik Hasan, the Fort Hood shooter, has been most frequently posted online. When I look at that picture, I don’t see the soulless eyes that are often visible in a picture of a mass murderer. On the contrary, looking at his picture, it is easy to believe the contentions of his relatives that he was once a kind, caring, and decent man. Obviously, something went terribly wrong. Yet, portraying Hasan as either an Islamic terrorist blinded by hatred or a man who snapped because he was reluctant to be deployed to Afghanistan does not ring true to me.

Major Hasan has a medical degree as well as a master’s degree in public health. Perhaps because I am an educator, the recollections of Lt. Col. Val Finnell, Hasan’s classmate in the public health program, caught my interest. Finnell “recalled one time when his classmates were giving presentations in an environmental health class on topics like soil and water contamination and the effects of mold. When it was Hasan’s turn, he said, he got up in front of the class and began to speak about his chosen topic, ‘Is the War on Terror a war on Islam?’”

Despite objections from the class, the professor allowed the presentation to continue. Being non-responsive to assignments became a pattern with Hasan. As a senior-year psychiatric resident at Walter Reed Army Medical Center, Hasan was “supposed to make a presentation on a medical topic of his choosing as a culminating exercise of the residency program.” Instead according to the Washington Post “he stood before his supervisors and about 25 other mental health staff members and lectured on Islam, suicide bombers and threats the military could encounter from Muslims conflicted about fighting in the Muslim countries.” I have read Hasan’s presentation which is available here. There’s nothing in the presentation that a reasonable person could conclude was a medical topic. In other words, he was again completely nonresponsive to the assignment he was given.

Every few semesters, I encounter a graduate student who submits work that is completely nonresponsive to an assignment. I contact the student and tell him that he has received an F on the assignment, but I invite a resubmission. As a consequence of my intervention, the outcome of this process is often (but not always) a significant learning experience for the student. Sometimes students are nonresponsive to assignments because their schedules are out of balance. Other times, they are simply not serious students. In the end, some students are relieved to have been confronted because it gives them an opening to make new choices.

Dr. Hasan’s professors and medical supervisors clearly dropped the ball. They refused to fulfill their professional obligations; instead, they passed Hasan through. Did they drop the ball because of political correctness or were they simply cowardly, inept, and/or lazy?  Of course, we don’t know; but because they didn’t carry out their professional obligations and hold Dr. Hasan to the same standards they were presumably holding others too, Dr. Hassan was taught very bad lessons. He was taught he was different, that he was a mere object, and that he was less than his classmates.  We can never know how the outcome would have differed; but clearly, opportunities for intervention were missed in Major Hasan’s career.

In his book Beyond Conflict, psychiatrist Dr. Peter Breggin outlines the attributes of the perpetrator as someone who abuses, coerces, or uses violence against others. Perpetrators, among other things, “deny or minimize the damage they are doing to others;” “blame the victim;” “rationalize the harm they are doing;” and “dehumanize their victims.” I can only imagine the rationalizations Hasan’s professors went through as they passed his shoddy work. Of course, I’m not blaming Hasan’s professors for his murderous rampage. I am merely pointing out that it is unlikely Hasan would have been in the position he was in if he had been held accountable in earlier stages of his career.

Through his numerous other books, Dr. Breggin has also exposed the dangers of widely prescribed mood altering psychiatric drugs. In Medication Madness, Breggin tells numerous true stories of the sometimes horrific side effects of psychotropic drugs. One such story is about Harry.

Harry, normally gentle and considerate, began to take Paxil for depression. He became nervously agitated and, eventually, suicidal. He tried to end his life by stealing a gun from a policeman; and in the process, Harry ran over the policeman with a car. Harry related to Breggin that during his assault, he was not thinking about the harm he was inflicting on anyone. As the effects of Paxil wore off, Harry was genuinely horrified over what he had done.

Dr. Breggin calls the effects of these drugs medication spellbinding. One characteristic of spellbinding medications that Breggin identifies is that the patient has no idea he has a deteriorating mental condition. Ultimately, compulsions and destructive behavior take over the patient’s life. The problem, again, is that the harmful effects of the drug are masked. The medicated patient has become insane and doesn’t know it. How frightening!

Given Hasan’s difficulties in his professional studies and his conflict over his religious and military duties, it would be instructive to ask whether Maj. Hasan was on psychotropic drugs? We do know that Dr. Hasan, as a psychiatrist, was trained to believe that human emotions, such as depression and anxiety, reflect biochemical imbalances in the brain that can be treated with psychotropic drugs.  A 2007 study in the journal Psychotherapy and Psychosomatics revealed that almost 16% of psychiatrists self-medicated for depression. I would expect that any commission that investigates Hasan’s rampage will ignore the issue of drugs. The pharmaceutical lobby is simply too powerful.

Neither drugs, nor any past incidents in Hasan’s life, absolve him of any responsibility. But pointing out these things begins to humanize Hasan as more than a soulless monster; and in so doing, we can learn. We can learn that choices motivated by political correctness can be destructive. We can courageously investigate whether Hasan’s mind was altered by drugs. And we can forgive Dr. Hasan.

The word forgiveness is a loaded one. For some, the word brings up fears that forgiveness means we won’t take appropriate action, that we’ll excuse Hasan’s actions, or that we won’t punish him. Forgiveness means none of the above. We forgive Dr. Hasan for our own sake and for the sake of the world we live in.

Author Joe Bailey wrote in Slowing Down to the Speed of Love, “Forgiveness is not merely saying the words I forgive you, it is a change in our level of understanding and feeling. It is a release of all anger and guilt. Forgiveness sees past the illusion that we are totally separate beings, or that one of us is better than another, to the truth that we are all one.”

Can we really be one with a murderer, someone that is labeled by society as a monster? Although we will never be certain of why Hasan choose to be a murderer, we know one thing for sure: In the hours before and during his rampage, Hasan was overcome by murderous thoughts. If we can’t forgive him, how can we forgive our own toxic thoughts? True, few of us ruminate over murderous thoughts; but most of us hold grievances. We get angry and vindictive; sometimes we entertain these angry thoughts for longer periods of time than we would like to admit.

If we can’t forgive, then we must condemn ourselves for our own thoughts. As we condemn our thoughts, we bury our thoughts. We may not take psychotropic drugs, but we may self-medicate with alcohol, excessive shopping, excessive television, and the like. All of these things are forms of resistance, and what we resist truly does persist.

As we try to control our thinking, our resistance lets our thinking take control of us. The harder we resist, the more our fearful and frightening thoughts take front and center stage in our minds. But, there is an alternative to this never-ending struggle, beginning with the liberal application of the healing balm of forgiveness and compassion.

Forgiveness is ours as we become aware of our own negative thinking but do not judge, resist, or justify our unwanted thoughts—we find that troubled thoughts pass by as easily as clouds drifting by on an otherwise sunny afternoon. Then we are free to allow thoughts of kindness, of compassion, and of peace come to us. I’m under no illusion that the cycle of violence in the world will be end anytime soon; but as we forgive ourselves for our own toxic thinking and we forgive Maj. Hasan, we will be just a little bit more compassionate, a little bit kinder, and a little bit more effective in our organizations. We will make our own little corner of the world just a bit more peaceful.

Do Children Need Cocoa Krispies?

My children were home from high school Monday and Tuesday with a cold and fever. They slept a lot; and we hastened their recovery with immunological system boosting substances such as astragalus, ginger, elderberry, and miso soup with shiitake mushrooms.

How foolish my wife and I were; if we were to follow the advice of one food manufacturer and the government watchdog agency—the Food and Drug Administration (FDA)—we should have skipped the astragalus and miso soup and served big bowls of Kellogg’s Cocoa Krispies instead.

Before I go any further, for those of you who are unfamiliar with astragalus, I should explain what it is. Astragalus is a root chiefly grown in China where, because of its antiviral activity as well as its ability to strengthen individual’s qi (vital energy), it is a traditional medicine for cold and flu. Astragalus is readily available in natural food stores as herbal tinctures or pills, as well as in the dried root form for adding to soups. Like ginger, I consider astragalus a food grade root; which to me means that there are no side effects in any reasonable dosage.

Dr. Andrew Weil is a well known American physician and author who—having twice been on the cover of Time magazine—probably has done more than anybody to popularize the field of alternative medicine. He markets under his name a product line of vitamins and herbs. One of his products is Dr. Weil Immune Support Formula which contains astragalus and dried mushrooms such as reishi. I don’t personally consume this product, but his formula seems to be a good one.

Kellogg’s Cocoa Krispies is a sugar laden cereal with partially hydrogenated oil added for further health benefits (yes, I’m being sarcastic). Sugar is a well-known suppressor of the immunological system.

Now here is a pop quiz: Which product, Cocoa Krispies or Dr. Weil Immune Support Formula, should be allowed to claim that it boosts the immunological system. As you can guess—I wouldn’t be writing about this issue otherwise—the answer, according to the Food and Drug Administration, is Cocoa Krispies.

Kellogg's Cocoa Krispies

The FDA has no problem with the ridiculous claim that Cocoa Krispies: “helps support your child’s immunity.” As for Dr. Weil, he is not so lucky.  He received, in October, a cease and desist letter from the FDA for claims such as “The Immune Support Formula contains astragalus. . . . Astragalus … is used traditionally to ward off colds and flu and has been well studied for its antiviral and immunity-enhancing properties.” Although this is an absolutely true statement, Weil was warned, “If your firm fails to take corrective action immediately, FDA may take enforcement action, such as seizure or injunction for violations of the FFDC Act without further notice. Firms that fail to take corrective action may also be referred to FDA’s Office of Criminal Investigations for possible criminal prosecution for violations of the FFDC Act and other federal laws.”

Your tax dollars at work—allow the absurd false claim that a heavily processed and sugar laden cereal boosts immunity while persecuting sellers of natural remedies. The FDA has been captured by industrial food manufacturers and the pharmaceutical industry.

Almost 2 years ago I wrote about the satirical film Idiocracy. I asked the question: Do Crops Need Brawndo? In the movie, which is set 500 years in the future, a Gatorade-type product—Brawndo—has completely replaced water. Indeed, the product called Brawndo has replaced all other foods on the government’s food pyramid chart. Talk about life imitating the movies—if we are to believe Kellogg’s and the FDA, this flu season, a loving parent should ask: Do my children need Cocoa Krispies?

Miles to Go, Promises to Break

We are assured that whatever version of healthcare reform is passed, it will save us money and provide more access to healthcare. Promises can be made, but the laws of economics trump words.

There are indeed ways to reduce health care costs. Increasing competition and/or increasing innovation can reduce costs by increasing supply. Demand can be reduced; demand for health care falls when consumers take more responsibility through self-care, diet, and exercise. Demand can also be reduced by lowering the quality of the product or by rationing care. With a process controlled by politicians who are ignorant of economics and by lobbyists from the medical and pharmaceutical industry, which door do you think will be chosen? If you answered “ration care or reduce quality” you are correct. Fundamental reforms that increase competition will not be accepted by doctors; increasing consumer responsibility is against the interests of the pharmaceutical industry who depends upon millions of Americans taking drugs for conditions that could be treated in safer and less invasive ways.

I am sure of one thing—any healthcare reforms passed by government will take us more towards top-down, centralized healthcare and move us further away from a free-market. This will in turn create the need for even more “reform” that moves us further from a free-market. There are indeed many problems with our current healthcare system, but unlike our cousins in Canada and the United Kingdom, a dire shortage of healthcare is not one of them.

Allow me to share a tale. Last week, I began to experience light flashes in the corner of my eye; a few days later I began to experience what appeared to be black filaments floating in front of my field of vision. From that starting point, I will contrast my experience with the experience of a United Kingdom (UK) citizen who had similar symptoms.

My experience: My wife calls a Blue Cross hotline and speaks to a registered nurse. The nurse advises my wife to get me to an emergency room immediately as I was at risk of suffering from a detached retina.

UK citizen: “I went to see my GP (I’m from the UK). He didn’t seem to know much about it so he had to resort to looking in his pocket book of family health (which really gave me a lot of confidence). Despite his clear lack of knowledge, he suddenly decided he was an expert and told me that I was just worrying about nothing, everyone gets them etc. But I told him that this had just suddenly come on over a week, but he just said I was a worrier and that there was really nothing wrong.”

My experience: We consider our options. There is a local rural hospital close by or there is Dartmouth-Hitchcock Medical Center which is about an hour and half drive away. We decide that should I need surgery, Dartmouth-Hitchcock is the place to be. I pack an overnight bag and off we go.

UK citizen : “I wasn’t satisfied with that so I went to the opticians who were surprisingly well equipped with digital retina cameras etc. The optician was very nice and took great interest in finding out was wrong. He could clearly see that something was wrong (and unofficially made the correct diagnosis) and referred me to a specialist.” [Brownstein’s note—the only place that our UK cousin got good care was from the optician who is not part of the NHS (National Health Service.)]

My experience: I arrive at Dartmouth-Hitchcock where, in the emergency room, I am triaged into a high priority category. An ophthalmological surgeon is immediately called in who does a very thorough and caring exam. Fortunately, mine is a benign condition called vitreous separation, there is absolutely no retinal damage. I am referred to a local ophthalmologist for follow-up checkups. My wife and I go out to lunch, feeling greatly relieved.

UK citizen: “When I eventually got to see the specialist (this is the NHS I’m talking about, so it took a while), he said I had a detached vitreous in both eyes. He then shooed me away like I was wasting his time.”

Now a fair criticism of my account would be something like this: “You have insurance that allowed you to seek the best possible care. What about someone who has no insurance? A fair enough question indeed; I would not want to go through my experience having either no money to pay for care or to be told that it would be weeks or months until I could see a specialist.

Now, I realize that the current proposals do not call for socialized healthcare as in the Canada or the United Kingdom. But this is a slippery slope—more regulations cause more problems, which breed more regulations, which create lower quality care and less access. The answers lie in true market-based reforms that remove barriers to competition and give more access at lower costs to more Americans. Access to a waiting list, like the UK citizen experienced, is not access at all.

Producers and Thieves

Today it was announced that Kenneth Feinberg, the Treasury Department’s special master for compensation, “will slash compensation for the 25 highest-paid employees at seven firms receiving large sums of government aid.” In a free-society, there is no room for a “compensation czar;” the problem will be gone instantly when the aid is eliminated.

In his classic book The State, the German sociologist Franz Oppenheimer taught there are two means to wealth: economics and political. In his inimitable blunt style Murray Rothbard sums up the difference between the two:

There are only two ways for men to acquire wealth. The first method is by producing a good or a service and voluntarily exchanging that good for the product of somebody else. This is the method of exchange, the method of the free market; it’s creative and expands production; it is not a zero-sum game because production expands and both parties to the exchange benefit. Oppenheimer called this method the “economic means” for the acquisition of wealth.

The second method is seizing another person’s property without his consent, i.e., by robbery, exploitation, looting. When you seize someone’s prop­erty without his consent, then you are benefiting at his expense, at the expense of the producer; here is truly a zero-sum “game”–not much of a “game,” by the way, from the point of view of the victim. Instead of expanding production, this method of robbery clearly hobbles and restricts production. So in addition to being immoral while peaceful exchange is moral, the method of robbery hobbles production because it is parasitic upon the effort of the producers.

With brilliant astuteness, Oppenheimer called this method of obtaining wealth “the political means.” And then he went on to define the state, or government, as “the organization of the political means,” i.e., the regularization, legiti­mation, and permanent establishment of the political means for the acquisition of wealth.

In other words, the state is organized theft, organized robbery, organized exploitation. And this essential nature of the state is high­lighted by the fact that the state ever rests upon the crucial instrument of taxation.

What good is a theory if it is not applied? I don’t know if Max Keiser has ever read Oppenheimer or Rothbard, but listen to Keiser as he colorfully explains the differences between firms like Google who earn their wealth through production and the banking industry who he explains has obtained its wealth through theft.

Is this mere hyperbole on Keiser’s part? While I can’t say, as Keiser does, that accounting fraud is currently being committed by the banks, I can say that the bonuses being paid would not be paid on a free market. These bonuses are being financed, in part, by direct transfer of taxpayer’s money and by record low interest rates that indirectly transfer resources from productive savers into the hands of banks and debtors. The latter is a direct consequence of Federal Reserve policy.

For many, Keiser’s words create cognitive dissonance; and cognitive dissonance may cause an instant rejection of his message. Cognitive dissonance “is an uncomfortable feeling caused by holding two contradictory ideas simultaneously.” Dissonance, according to psychologist Carol Tavris, “produces mental discomfort, ranging from minor pains to deep anguish; people don’t rest easy until they find a way to reduce it.” After all, aren’t our government officials looking out for our well-being? Surely they are more concerned about the well-being of all Americans than they are concerned about the bankers? If you believe the answer is “yes” to both questions, then Keiser’s message will produce dissonance in you. Yet, the facts suggest Keiser is more right than wrong:

• “An analysis of Mr. Geithner’s calendars…shows that Mr. Geithner had contact with top executives at Citigroup, Goldman Sachs and JPMorgan Chase more than 80 times during his first seven months at Treasury.” Source here.
• “Goldman Sachs posted near record trading profits in the third quarter of 2009.  The projected 2009 Goldman Sachs bonus pool will be around $20 billion, a near record amount. Therefore the average pay out per employee could be more than the $661,490.” Source here.
• “As a whole financial firms “accounting for more $350 billion in federal bailout funds, increased these perks and benefits 4 percent on average last year, according to an analysis of corporate disclosures filed in recent months.” Source here.

Without government bailouts, these result would not have been possible—failing firms do not pay bonuses.

None of this is to say that officials like Treasury Secretary Geithner are evil individuals who are consciously trying to undermine the American economy. Instead, perhaps Geithner has his own form of cognitive dissonance as he tries to internally justify his behavior. He may begin with a truth that a healthy banking system is essential to the American economy; and then, he may resolve his dissonance by adding the false premise that JPMorgan, Chase, Citibank, etc. are essential to a healthy banking system.

Nothing could be further from the truth. The financial institutions that are being subsidized took reckless risks. The economy cannot have a sustained recovery until those firms which made bad loans and who can not survive without government assistance are liquidated. Nothing in the conduct of these financial institutions suggests that they have reformed. They will continue to seek the political means to wealth; and like a drug addict who would destroy his family before giving up his habit, they and their government enablers will do the same to America. And when they are through, they will relieve their cognitive dissonance by chanting the big lie—there was nothing else we could have done.

A Government by the Irresponsible and for the Irresponsible

We know the accepted narrative by now: Swine flu is potentially deadly. Pharmaceutical companies in partnership with the government have made a heroic effort to get a vaccine ready for mass immunization. Anyone who does not take the vaccine is endangering the public health.

In their must read essay, “Does the Vaccine Matter?” in the November issue of The Atlantic, Shannon Brownlee and Jeanne Lenzer ask: “But what if everything we think we know about fighting influenza is wrong? What if flu vaccines do not protect people from dying—particularly the elderly, who account for 90 percent of deaths from seasonal flu?”

Brownlee and Lenzer don’t ask these questions rhetorically. They cite specific medical studies that call into question the entire flu shot mythology. Alarmingly, they give a glimpse into the power of the flu lobby. Lisa Jackson, is a physician and senior investigator with the Group Health Research Center in Seattle. When she began to question studies which claimed astonishing benefits from the flu vaccine, she related her experience to  Brownlee and Lenzer: “People told me, ‘No good can come of [asking] this.’” She was warned, “‘Potentially a lot of bad could happen’ for me professionally by raising any criticism that might dissuade people from getting vaccinated, because of course, ‘We know that vaccine works.’ This was the prevailing wisdom.”

When you read the essay by Brownlee and Lenzer you ask yourself, “What is motivating those who push the flu vaccines?” Many clearly are sincere professionals who believe in what they do. But others deserve the title that Lila Rajiva gave them: “Swine Floozies.” Rajiva defines a swine floozy: “A cheap tart who’ll sell you anything to make a buck…They sell you government cures. In almost all cases, these cures are worse than the disease.”

“Government cures”? “Aren’t the vaccines developed by free-market pharmaceutical companies?” you might wonder. It is no free-market when your primary customer is the government, and when in July, Secretary of Health and Human Services Kathleen Sebelius “granted both the vaccine makers and government immunity from lawsuits that could result from the swine flu vaccine.”

The best judges of risk are the actuaries who work for insurance companies. Why is it difficult to buy insurance for beachfront property in a hurricane zone? The simple answer is that there is a large risk of loss. In a free-market, there would be no government insurance in hurricane zones. You would agree to take the risk or buy insurance at a prohibitively high price. Would there be less development? Of course! And that’s how it should be.

Would there be less swine flu vaccine without government involvement? The answer, as with housing development in a hurricane zone, is “yes.” Individuals who wanted to take the vaccine anyway would be free to sign a waiver that released the pharmaceutical company from potential damages. Or, alternatively, pharmaceutical companies could produce vaccines that insurance companies recognize as safe. I won’t debate the safety of the swine flu vaccine, but for me the judgments of the insurance companies are compelling.

Brownlee and Lenzer ask a second critical question: “And what if the expensive antiviral drugs that the government has stockpiled over the past few years also have little, if any, power to reduce the number of people who die or are hospitalized?” Their answer:

As with vaccines, the scientific evidence for Tamiflu and Relenza is thin at best. In its general-information section, the CDC’s Web site tells readers that antiviral drugs can “make you feel better faster.” True, but not by much. On average, Tamiflu (which accounts for 85 to 90 percent of the flu antiviral-drug market) cuts the duration of flu symptoms by twenty-four hours in otherwise healthy people. In exchange for a slightly shorter bout of illness, as many as one in five people taking Tamiflu will experience nausea and vomiting. About one in five children will have neuropsychiatric side effects, possibly including anxiety and suicidal behavior. Between 2001 and 2007 in Japan, where Tamiflu is liberally prescribed, the drug may have been responsible for 50 deaths from cardiopulmonary arrest, according to Rokuro Hama, the chair of the Japan Institute of Pharmacovigilance.

Indeed, Japan has banned the use of Tamiflu for teenagers after several kids jumped out of windows while on the drug. Yet, in spite of its dubious effectiveness, billions of taxpayer dollars have been spent stockpiling these drugs– another boondoggle for the pharmaceutical companies. Rajiva gives us “Tami-Floozy”—“Tami-Floozies make a direct killing from investing in the drugs sold to cure the diseases hyped by the other floozies. Donald Rumsfeld is the best-known of the type.”

Brownlee and Lenzer explain how vaccination may be counterproductive:

In the U.S., by contrast, our reliance on vaccination may have the opposite effect: breeding feelings of invulnerability, and leading some people to ignore simple measures like better-than-normal hygiene, staying away from those who are sick, and staying home when they feel ill. Likewise, our encouragement of early treatment with antiviral drugs will likely lead many people to show up at the hospital at first sniffle.

Brownlee and Lenzer are too kind. This feeling of invulnerability leads people to continue their irresponsible ways and to become potential breeding grounds for disease. Nothing we can do will guarantee health, but there are steps we can take that tilt the odds in our favor. Sugar laden diets suppress the immunological system, while exercise boosts it. This year, the average American will eat over 200 pounds of disease-promoting sugar and corn syrup and will consuming only about 8 pounds of disease-fighting broccoli. They will drink their sugar laden sodas and eat their desserts while watching propaganda programs instructing them to be properly terrified of the flu. The stress induced from these fear-laced programs further compromises the body’s immunological system.

I would never presume to know what is right for anybody else, but it is simply a fact that millions of people who take little responsibility for maintaining their health will be lining up for their vaccines. If Brownlee and Lenzer are correct, at best, we have done no better than to waste billions and to encourage irresponsible behavior. We have the irresponsible government that our irresponsible behavior deserves.

The Missing Ingredient

The film The Ramen Girl tells the story of Abby, a twenty-something American women who is stranded in Tokyo after being dumped by her boyfriend. She decides to stay. To earn a living, she begs a tyrannical Japanese ramen chef, who doesn’t speak a word of English, to teach her the art of making ramen. In Japan, ramen making is a high art.

Abby and her teacher clash, but the ramen master begins to soften towards Abby. Yet, despite all of her hard work, Abby cannot make a decent ramen bowl. In desperation, the master takes Abby to see his own mother. The scene unfolds as Abby prepares a bowl of ramen and serves it to the master’s mother:

Ramen master’s mother: Her broth is bland.

Ramen master: I wonder why? She’s mastered the techniques perfectly.

Mother talking to her son: Sometimes too much technical training can get in the way.

Mother talking to Abby: You cook with your head. Understand? Your head is full of noise. You must learn to cook from the quieter place deep inside of you.

Abby: How?

Mother:  Each bowl of ramen that you prepare is a gift to your customer. The food that you serve your customers becomes part of them. It contains your spirit. That’s why your ramen must be an expression of pure love; a gift from your heart.

Is this new age blather? Or, are we hearing business wisdom? After all, you can sell many things without having much regard for your customer. But, what about in today’s emerging economy where frugality will be the norm?

My wife enjoys an occasional cup of coffee. She recently told me the story of a coffee shop in town that she visited once and then did not return to for over a year. Why? It is a small shop, she related, and the server was not very welcoming. Drinking a cup of coffee, like eating ramen, is an experience. This is nothing new; companies like Starbucks were built on the experience they offer.

But does Abby really need to be so responsive to her customers that her work becomes an expression of love? The workday of a ramen chef is very long and repetitive. Many of her customers she may never see again. Kahil Gibran asked the question, “And what is it to work with love?” He answered his own question with advice that echoes that of the ramen master’s mother:

It is to weave the cloth with threads drawn from your heart, even as if your beloved were to wear that cloth.
It is to build a house with affection, even as if your beloved were to dwell in that house.
It is to sow seeds with tenderness and reap the harvest with joy, even as if your beloved were to eat the fruit.
It is to charge all things you fashion with a breath of your own spirit…

Inspiring words, indeed. But what about the noise in Abby’s head that is getting in her way? Gibran asks us, “When you work you are a flute through whose heart the whispering of the hours turns to music. Which of you would be a reed, dumb and silent, when all else sings together in unison?”

Gibran is offering a pointer. We must allow ourselves to be found by life—to be found by the music that wants to sing through us in harmony with every living thing. A ramen cook becomes a ramen master when his cooking nourishes more than the body. A cook’s ingredients may be high quality, but there is more to cooking than ingredients. Are we part of the web of life that unites us all? Or, have we cut ourselves off? To ask the question is to be ready to receive the answer.

Abby is clearly trying to find her place in the world; but understandably given her circumstances, she is preoccupied with herself. The way out for Abby is to give even more of herself. This giving is enlivening rather than exhausting. Abby is called upon to have an intimate relationship with her customers—she is called upon to share fully of the gifts of her spirit. Doing so, she is united with her customers in their human journey; they are not mere objects playing their parts in Abby’s journey.

Eric Butterworth wrote, “Love is not an emotion that begins in us and ends in the positive response of another.” That kind of love is merely a deal destined to fall apart. Love doesn’t begin in us. We allow Love to flow through us when we can laugh at the noise in our head which is focused on the gratification of the endless demands of our own ego.

As she gives more, Abby gets more. But what she gets she could not have planned for or even conceived of. Some people go through life expecting to get before they give. Others go through life giving but then keeping score to see if what they receive back is in balance with what they give. Neither of these ways of being in the world will allow life to sing through us. We are the ones placing boundaries on the notes that can be played. If we continue to see the world through the eyes of our egos, life becomes very small and tedious.

In many of our organizations, work is tedious. Employees don’t share their gifts fully, interpersonal conflict is the norm, and dubious decision-making is routine. For the successful corporations in the future, a culture which supports the idea that their products and services are an expression of pure love will become a business necessity. Consumers will be buying more of what adds real value to their lives, and by economic necessity, they will be buying less of what merely fills the void in an unfulfilled life.

The Great Splintering Ahead

One year ago yesterday, the Dow Jones Index fell 777.68 points. Today, we are fed contradictory propositions: The bailouts have saved us from another depression. And, the Republicans are poised to capitalize on growing public dissatisfaction with the economic policies of the Democrats. Both propositions are false.

Long time Wall Street observer, Richard Russell recently wrote: “Fed Chairman Benjamin S. Bernanke is like a madman during a hurricane. He’s shaking his fist at the sky and vowing to stop the wind.” Of course, Bernanke is doing more than that; he is claiming he has stopped the wind. More than a few agree he has.

When the calm eye of this economic hurricane passes and economic storms rage again, it is a dubious proposition that the public will turn back to the Republicans. Of course, some diehard partisans will. But for many more, the Republicans have been discredited as a pro-war, big deficit, corporate welfare loving, hypocritical bunch. If you said that description fits the Democrats as well, you’d get no argument from me.

We are at two major inflection points in history. We have come to the end of the road for our deficit-based economy. More wasteful stimulus will not bring to life this dead horse. We have also come to the end of the road for this fake wrestling match between Democrats and Republicans, where the party out of power promises to reform the evils committed by the party in power; then, once in power, commits to a variation of the same positions they campaigned against. As in professional wrestling, promoters have to keep changing the good guys and the bad guys in order to keep the public interested. As my brother-in-law once quipped bitingly at a family outing: “It’s time to get new characters for this show.”

No, the Democrats and Republicans, however discredited, will not disappear overnight. But, they will face new competition. First, the good news: There will be at least one major pro-freedom party—led by a Ron Paul type individual. This party will be for both economic and civil liberties. They will stand for lower taxes and lower spending; they’ll stand against needless military adventures. We can thank the Libertarian Party for tilling this soil for so many years. Yet, for various reasons, I don’t see the Libertarian Party emerging to occupy this ground. The pro-freedom party that emerges will also have to touch people’s hearts.

Most Americans alive today have grown up experiencing a world untouched by war and economic hardship. It is understandable that we believe life will always get better. When economic losses and deprivations beyond our imagination visit us, we will be bewildered; leaders of a pro-freedom party will have to respond to Americans with heartfelt compassion. At the same time, these leaders will have to point the way to a hopeful future based upon timeless principles. Such pro-freedom leaders will have to counter a new populist-based movement that will insist Americans are never to suffer loses; this, the populists will claim, is our entitlement. The new populist-based movement will promise cheap fixes and more income redistribution. To shift attention away from problems at home, populists may follow an aggressive foreign policy.

In my experience, many Americans lack a basic understanding of the history of poverty and war that has routinely plagued mankind. The suffering of others has been swept from view, because we don’t want to deal with the possibilities of suffering for ourselves. In his book The Three Marriages, David Whyte writes:

Once we have renounced the need to live without suffering, to be special, to be exempt from the losses and doubts that have afflicted all people since the beginning of time, we can see the difficulties of others without being afraid ourselves. Our fearful, disappointed surface face starts to fall away. We could welcome other people into our lives because no matter their fears, they do not make us afraid.

This journey—the journey of accepting our losses without lashing out, while working towards a genuine and lasting prosperity—will take spiritual maturity. Such a spiritual maturity would involve a deep understanding of our connection to all living beings. We must understand that our choice to live by higher values and timeless principles is the pathway to achieve true happiness and sustainable prosperity.

It would be a mistake to believe that, at this point in our history, most Americans are prepared to make such a journey. Many are. Still, many are not. And for those who are not, the coming great splintering of our political parties will produce populist leaders who will tell them what they want to hear: That there is a quick fix, and that others are to blame. Some of these leaders will be comparably benign; others will be frighteningly demagogic and warlike.

Beyond envisioning serious competition for Democrats and Republicans, I have no idea what our political future holds. If an election were held today between Obama, McCain, a comparably benign populist such as Palin, and a pro-freedom leader such as Ron Paul, my guess is that Obama would win again. In 2012, there will be choices on the political spectrum that we never expected to see; the results will depend upon how spiritually mature our nation has become.

Martha’s Mile

Sunday was a glorious early fall day in the White Mountains. We opted to hike a pair of peaks that we had never hiked before: Mount Martha, named after the President’s wife, and Owl’s Head with its unique and sweeping view of the entire Presidential Range.

The view from the summit of Mount Martha is almost dead center on Mt. Washington ten miles away.

The mellow trail up Mount Martha and then across Martha’s Mile takes you through a col and on to Owl’s Head, a trail much less rocky than the typical trail in the Whites. Martha’s Mile, made gentle by time and footsteps, is in keeping with Martha Washington’s character. In the 1770s, Martha described herself as “steady as a clock, busy as a bee, and cheerful as a cricket.” Most agreed with her self-assessment. Abigail Adams praised her as “one of those unassuming characters which create Love and Esteem.”

When you’re hiking a mountain, if you’ve planned your hike well, there are few choices to make. Either you happily put one foot in front of another and enjoy the physical exertion, or you mentally struggle against what is. Either way, you’re going to the same place; but your mental activity will greatly influence your experience of the journey.

Off the trail, life seems to offer a lot of choices, but most of those choices are ultimately meaningless: LCD vs. Plasma, which television show to watch tonight, which new pair of shoes to buy tomorrow. We focus on these choices; and in the process, we lose track of our values and of our way of being of the world. Walt Disney’s brother Roy had it right when he said, “It’s not hard to make decisions when you know what your values are.”

In Martha’s time, the choices to be made were fewer; and for many, values ran deeper. Most lived and died in the same town where they were born. They had a couple of changes of clothes a year, they ate what was seasonal and locally grown, and they entertained themselves.

No, I do not romanticize those times. Even for those of means like Martha, life was much harder than it is today. Two of her four children died in childhood, and the other two died as young adults.

She played the part of First Lady well—always putting guests at ease—but playing her part was not her favorite thing to do. She wrote, “(I would) much rather be at home” and “I think I am more like a state prisoner than anything else, there is certain bounds set for me which I must not depart from….”

After the Revolutionary War, Martha wrote: “The difficulties, and distresses to which we have been exposed during the war must now be forgotten. We must endeavor to let our ways be the ways of pleasantness, and all our paths Peace.”

All our paths Peace! What a beautiful thought. I’m not sure why Martha capitalized Peace. Did she recognize that Peace was something she allowed to live through her? Did she know that Peace is not something any of us creates?  How many of us forget these simple truths. We spend our day rehearsing grievances—real and imaginary—about life. We are like the hiker who mentally curses the bugs, the heat, and the exertion and then wonders why the hike was unpleasant. In truth, those hikers are few; they simply give up the activity. But, we all have our miles to go and our life’s journey to complete.  And just like Martha and her Mile, there will be some stones and rough spots; but our values can see us through.

A Dose of Reality

This week, Ben Bernanke told us that the recession “is very likely over.” Jim Cramer told us, “We’re in much better shape than anyone could have hoped for a year ago, despite the pessimistic chatter.” I have often reviewed the dismal records of Bernanke and Cramer; you would be wise to manage your finances without considering their prognostications. A news story yesterday echoed Bernanke and Cramer: “Americans’ wealth rose this spring for the first time in nearly two years, with stocks and home values gaining as the recession faded.” No doubt, with these kinds of stories appearing almost daily and the Dow approaching 10,000, many small investors will be caught up in the growing bullishness.

If you are worried that you will be left behind by a new bull market, read a recent interview with Nassim Taleb, author The Black Swan: The Impact of the Highly Improbable. Talem—who does not believe that experts such as economists, bankers, and government officials can control the economy—is an outsider to the orthodoxy.

Notably, in the interview, Talem disputes those who say the economic crisis was an unpredictable  “black swan event,” to use the language of his book. His failure to predict should disqualify Bernanke from making policy about anything. Below are excerpts from the interview in Toronto’s Globe and Mail.

Nassim Taleb (NT): Today we still have the same amount of debt, but it belongs to governments. Normally debt would get destroyed and turn to air. Debt is a mistake between lender and borrower, and both should suffer. But the government is socializing all these losses by transforming them into liabilities for your children and grandchildren and great-grandchildren. What is the effect? The doctor has shown up and relieved the patient’s symptoms – and transformed the tumour into a metastatic tumour. We still have the same disease. We still have too much debt, too many big banks, too much state sponsorship of risk-taking. And now we have six million more Americans who are unemployed – a lot more than that if you count hidden unemployment.

Margaret Wente (MW): Are you saying the U.S. shouldn’t have done all those bailouts? What was the alternative?

NT: Blood, sweat and tears. A lot of the growth of the past few years was fake growth from debt. So swallow the losses, be dignified and move on. Suck it up.

MW: I gather you’re not too impressed with the folks in Washington who are handling this crisis.

NT: Ben Bernanke saved nothing! He shouldn’t be allowed in Washington. He’s like a doctor who misses the metastatic tumour and says the patient is doing very well. The first thing I would tell Chinese officials is, how can you buy U.S. bonds as long as Larry Summers is there? He’s a textbook case of overconfidence. Look what happened to Harvard’s finances. They took a lot of risk they didn’t understand, and it was a disaster. That’s the Larry Summers mentality.

To use a baseball analogy, if you believe Bernanke, we are in the 9^th inning of a game. The home team, with their star reliever on the mound, is about to win. If you look at our problems through another lens—a lens which rejects the idea that economies can be cured by throwing good money after bad—we are in the 3^rd or 4^th inning of a global economic crisis with the most frightening part of the game still to be played.

The Medicalization of America

I am bewildered by the angry speakers at the health care town-hall meetings. They defend both the current system of medical care and their freedom to choose. Freedom to choose? You can send an overnight letter by FedEx, but that hardly means we have a free market in mail service. Similarly, the medical industry is far, far removed from a free-market. A complex web of subsidies and licensing has resulted in a distorted health care market. People cling to it because it is what they know. A free market in health care would no more resemble our current system than the modern supermarket industry in the United State resembles food distribution in the former Soviet Union.

Lost in the heated debate is an examination of assumptions. Those who promote a position, by speaking in sound bites, are often unaware of the assumptions that underlie their position.

Naïve patients, patients who eschew responsibility, and arrogant and/or inexperienced doctors agree on a big lie: Medicine is an objective science. Present the same patient to ten doctors and all but the incompetent will agree on the diagnostic tests to run and the treatment protocol to follow.  None of this is remotely true.

I observe another, related hidden assumption held by many: At any time, there is an objective, fixed amount of disease and poor health. Thus if more diagnosis and treatment is applied, disease and poor health will decline. This assumption is false. It is no more true than believing additional food is the solution to poor nutritional habits.

You have probably never heard of Jack Wennberg. In her brilliant book Overtreated, Shannon Brownlee writes that Jack Wennberg “is one of the heroes of modern medicine.”  After reading Wennberg’s story it would be hard to disagree with Brownlee’s assessment.

Dr. Wennberg has been a professor at Dartmouth Medical School for over thirty years. As a young physician, Wennberg bought into the assumption that the most serious problem in health care was that there was not enough of it. Joining the University of Vermont in 1967, Wennberg began to compile statistics that would cause him to question his basic assumption. In some towns in Vermont, only 7% of children under sixteen had had their tonsils removed; in other towns, 70% had had their tonsils removed. Wennberg found similar variations for many treatments, including hysterectomies and appendectomies. As he shared his findings, physicians dismissed them. His critics explained that where surgery rates were higher, patients needed the surgery; where surgery rates were lower patients, patients were not getting needed treatment. In other words, Wennberg’s statistics were explained away with a “there is not enough medical care in some areas of Vermont” narrative.

Wennberg, along with statistician Alan Gittelsohn, dug deeper. According to Brownlee, they found the population of Vermont was “remarkably homogeneous in their health, their socioeconomic status, their level of education, and how well-insured they were. Practically everybody was white; nearly everybody had a personal physician, whom they visited on average about as often from one region to the next.” There was one explanation for significantly higher rates of surgery in some towns: The anomaly was not “driven by patients but rather by doctors.”

Wennberg’s conclusion was not welcome among doctors, especially those who maintained the delusion that a medical diagnosis was an objective, scientific fact. Eventually, Wennberg was run out of his position at the University of Vermont. In 1979 he joined the faculty at Dartmouth. The same pattern he found in Vermont, and later in Maine, he found all over the country. He found it for virtually every medical procedure: CT scans, cardiac catheterizations, back surgeries, knee replacements, etc. In 1993, Dr. Wennberg became the founding editor of The Dartmouth Atlas Project (DAP) to study “health care markets in the United States, measuring variations in health care resources and their utilization.”

In a June 2009 essay in The New Yorker, Dr. Atul Gawande summarized some of Dartmouth’s eye opening findings:

Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse… Two economists working at Dartmouth, Katherine Baicker and Amitabh Chandra, found that the more money Medicare spent per person in a given state the lower that state’s quality ranking tended to be. In fact, the four states with the highest levels of spending—Louisiana, Texas, California, and Florida—were near the bottom of the national rankings on the quality of patient care.

In a 2003 study, another Dartmouth team, led by the internist Elliott Fisher, examined the treatment received by a million elderly Americans diagnosed with colon or rectal cancer, a hip fracture, or a heart attack. They found that patients in higher-spending regions received sixty per cent more care than elsewhere. They got more frequent tests and procedures, more visits with specialists, and more frequent admission to hospitals. Yet they did no better than other patients, whether this was measured in terms of survival, their ability to function, or satisfaction with the care they received. If anything, they seemed to do worse.

That’s because nothing in medicine is without risks. Complications can arise from hospital stays, medications, procedures, and tests, and when these things are of marginal value the harm can be greater than the benefits. In recent years, we doctors have markedly increased the number of operations we do. For instance, in 2006, doctors performed at least sixty million surgical procedures, one for every five Americans. No other country does anything like as many operations on its citizens. Are we better off for it? No one knows for sure, but it seems highly unlikely. After all, some hundred thousand people die each year from complications of surgery—far more than die in car crashes.

To make matters worse, Fisher found that patients in high-cost areas were actually less likely to receive low-cost preventive services, such as flu and pneumonia vaccines, faced longer waits at doctor and emergency-room visits, and were less likely to have a primary-care physician. They got more of the stuff that cost more, but not more of what they needed.

Unfortunately, some, including President Obama, draw incorrect conclusions. If some areas of the country spend too much, they reason, experts can prevent the waste; and the saving can be applied elsewhere in the health care system. They believe that government, acting as a smart third party, can provide coordination so that high cost and/or excessive treatment options are rejected. This is an impossible dream! In the next part in a series on health care, we will explore why. More government involvement in health care means more medicalization of America, not less.