Wednesday, May 27, 2009

God’s Grace

Jeanie was in my first grade class. Jeanie was just like any of us in the first grade except she was shorter. She was the smallest first grader at our school and smaller than a lot of kindergarteners. That’s it. She was just short. She wore pretty dresses, her hair in curls, and had a nice smile. She wasn’t retarded and she didn’t misbehave. She was in a couple of my groups for working on projects. I liked Jeanie. She was OK.

She was short because one leg was shorter than the other, or because her back was almost completely hunched over, or because one arm didn’t move very well, or because she really couldn’t hold her head up very well. None of that stuff seemed to matter to any of us. Jeanie was just Jeanie.

Sometimes she had a little trouble getting in and out of her desk, but that didn’t slow her down. I don’t remember Mrs. Lideck singling her out in any way. There were no speeches about how Jeanie might be different, or require special assistance from any of us. To us, she was just Jeanie.

Maybe we were too young to be inconvenienced by the thought of someone who might be different. It didn’t seem to matter. We didn’t leave her out of any games. She knew how to laugh. She got Valentine’s cards, she got invited to birthday parties, and she got to do show and tell in front of the class just like everybody else. Maybe that’s because, in the first grade, she was just like anybody else.

Prejudice isn’t natural. It is not innate. We don’t seem to be born with it. We don’t start filtering people who aren’t like us out of our lives until we are taught how to do it by our teachers, or by our parents, or by our friends who think they know better. (That doesn’t happen until later, but it doesn’t take long for us to get good at it.) I don’t know how it is now, but back then kids generally didn’t start getting cruel to each other until sometime after the first grade.

Having accidents is rather common place both in kindergarten and in the first grade. Kids are always throwing up in class and the janitors have to be called in to sprinkle the deodorizing barf dust around and sweep it up. Some kids wet their pants. Stuff happens. Teachers handle this sort of thing as a matter of course. When they can, they are quick to get the rest of us out the room before the sympathetic queasiness starts to set in among the most sensitive and the vomiting becomes epidemic.

One day Jeanie had an accident. She was obviously in distress, but quietly and while still at her desk voided her bladder and bowels. This was not good for her. She sat there crying. Marilyn who sat next to Jeanie and was a little Miss Prissy raised her hand and announced that Jeanie had a problem. Accidents happen. No big deal, except maybe for James who had already been taught something the rest of us had been spared and found the situation funny. Mrs. Lideck looked more concerned with James than usual. James was promptly sent to the principal’s office. Mrs. Lideck got the janitors in quickly and took care of things. Jeanie’s mom came and took her home.

That was the last time any of us saw Jeanie. We later heard rumors from some of our classmates that she was in the hospital -- something about kidneys. Jeanie was the topic of conversation for several days. We got to work individually at our desks to make get well soon cards for her. Then there was nothing.

Finally, someone remembered to ask, “Will Jeanie ever be coming back?”

Mrs. Lideck said, “No, Jeanie’s gone.” It was not a satisfying answer, but it was the only one she had.

Jeanie’s name comes from Hebrew. The root source isYochana, from which was derived the later Latin variants of Joanna and Johanna. Those were taken by the old French and loosely pronounced “Jehanne.” The name means "God's grace," or alternately, “the Lord is Gracious." Shakespeare felt that names were not particularly significant and had Juliet expound on names with “What's in a name? That which we call a rose by any other name would smell as sweet."

But by any other name, she wouldn’t have been Jeanie.

© 2009 Mark Indermill - All Rights Reserved

Tuesday, May 26, 2009

The Art Collector

Mrs. Hartman taught third grade. She was perhaps the first teacher that I really liked -- liked in the sense of those crushes little boys have on their teachers. My mother facilitated our romance by giving me camellias off our bushes to take to her a couple of times a week. Mrs. Hartman seemed to appreciate them. I don’t think she thought much about it though because I only managed to bring her flowers when my mother was helping out in class. Things never really heated up between us. Besides, she was already married.

Third grade is when we got to practice our printing, do addition and subtraction tables, and learn about local government. Our highlighted project of the year was a giant map of our county that we drew on a roll of butcher paper. Onto this map we drew all the important things about which we knew. The map had fine drawings of the airport with a requisite plane, the museum and some representations of a few of the old buildings in Pioneer Village. (Pioneer Village, part of the Museum, was a unique historical park with many preserved buildings from our fine county’s early years.) There were pictures of oil derricks and movie theaters and the river and, of course, our school. Some of my classmates drew their own houses complete with their family cars parked out front. We had room for all of this detail because it was literally on a roll of butcher paper. While modern cartographers might applaud the effort, I doubt that they would be moved to praise its accuracy.

There were a couple things I learned while working on this mapping project, when I wasn’t trying to figure out why Bruce was taller than I was or why Jeanie was as crippled as she was. I had lost interest in Denise, and Terry Richardson had moved to the other third grade classroom. There were two really good drawers in our class. Both Mark and Cliff made drawings that looked like real things. Their pictures had detail, scale, and realism that are traditionally lacking in a third grade effort. For the rest of us, our attempts at drawing paled in comparison. Of course, most of us spent five minutes on our little scene and then we were done. We quickly found other things to do at our desks or outside at recess, but Mark and Cliff stayed at it and worked. Evidently, they had found their passion while the rest of us were still looking for somebody to play marbles with.

That they had found their true calling in the third grade is something that I have since been able to confirm. I know that they had found their true mission in life because they are both graphic artists today. They live three thousand miles apart and I doubt if they have even spoken to each other since. It is only through the magic of the internet that I know who and where they are. Whatever their recollection of me might be, they have survived all of their adult lives without any desire to refresh it. I don’t think that they would have much interest in how this little fragment of their lives contributed to my greater understanding of the world.

They both approached their drawing in two quite distinctly different ways. Mark drew in short redundant pencil strokes, back and forth, back and forth with a little more forth each time until he got to the end of his line. He often would pick up his pencil and start in a new place and bring all his lines together into the picture. They were both left handed. Maybe that was it. Cliff, on the other hand, rarely lifted his pencil. His lines were contour lines that outlined the objects and then filled in. Cliff would have been good on an Etch-a-Sketch. I was amazed at their differing techniques and thought that just technique might be the secret to good drawing. I tried my hand at both for awhile in my room at home, but “technique” didn’t seem to be the secret. I soon lost interest. I guess this lesson in left handed passion didn’t quite resonate yet. It would still be a couple of years before I took up the saxophone and got really confused about this passion thing.

Third grade passed without incident. After summer we reconvened in Mrs. Eckhardt’s fourth grade classroom. After a few weeks, I had occasion to go back to visit Mrs. Hartman to see if the flame still flickered, but when I got there, I realized that whatever magic she had held for me in the third grade simply had no appeal to an older, more mature fourth grader. I found myself suddenly without purpose, so I asked her about the County map we had all drawn. Surprisingly, she still had it and got it out for me to see. Once unrolled, the clarity of the Mark and Cliff contributions was startling compared to anything else on the paper. My own picture looked something a third grader would have drawn.

Mrs. Hartman offered to let me have the map, but I really had no more use for it than she did. It did remind me of how good Cliff and Mark could draw and I really wanted one of them to draw me a picture.

In the fourth grade we moved on to the study of cursive writing and early American history. The math got harder with multiplication and division added to the mix. Cliff was willing to sacrifice a little recess time. I asked him to copy for me a painting of the signing of the Declaration of Independence that was printed in our history book. I liked the painting, we were studying American history and Cliff was willing. I was going to begin the first of my personal collection of great American artists with an original hand drawing by Cliff, a soon to be future great American artist.

There we sat, Cliff and I, during recess one day. I watched the drawing take shape. Cliff was so good and so fast that I was amazed at how he must look at a picture and break it down into outlines, shapes, contours, shadows and light.

At the end of recess, the drawing was almost done. Mrs. Eckhardt magically appeared over my shoulder and gasped and gushed over Cliff’s efforts. She heaped praise on his talents, and said that she simply must have that drawing to put up on the bulletin board for our history lessons. Before I knew it, my commission of Cliff’s drawing had been swept up from his desk and posted on the bulletin board for all to see. I was helpless to do anything about it. Cliff said nothing. For all intents and purposes, it was gone. Cliff wasn’t going to do another one for me and Mrs. Eckhardt wasn’t ever going to give it up. That drawing teased me from its special position on the board for several months before it just disappeared and a new poster on the finer arts of forming a capital cursive “G” appeared in its place.

I regret that I wasn't somehow able to keep that picture. I doubt that even if I had managed to keep Cliff’s drawing for myself, it would have survived in my possession to this day, having long been thrown away with everything else from elementary school. But, one never knows.

That one drawing could have been the foundation of a great collection of great works. It could have been the starting point to igniting my passion for appreciating the finer arts. If only Mrs. Eckhardt had not intervened, I might have had an earlier start on discovering my true self. Damn you, Mrs. Eckhardt.

© 2009 Mark Indermill - All Rights Reserved

Wednesday, May 13, 2009

Modern Health Care

I broke my foot the other day in a silly accident.  Nothing exotic.  Nothing that I really will have great stories about.  It was a common household accident that could and probably does happen to a couple of thousand people everyday.  I stepped on my foot the wrong way and just went down.  After a couple of minutes on the floor to assess the damage, I got up and walked carefully a few feet to sit down.  After twenty minutes, it was clear that this was more than a simple sprain.  It was time to go see somebody who knew what they were doing.


I went to an urgent care clinic that was staffed by some office help and a physician’s assistant.  In a stroke of good fortune, I was their only patient.  I was still there for an hour and 45 minutes while they diagnosed my broken bones, provided me with crutches and a nice fancy boot for a broken foot, and an appointment with a real doctor to confirm my brokenness.  Three days later I spent maybe 5 minutes with the Orthopedist who said I was doing everything I was supposed to and to keep it up for another 5 weeks.   A gentle pat on the head and I was sent away.  It was almost demeaning in a way.  I guess that is the price I have been made to pay by the depersonalization of our health care. 


Not that I minded much.  The doctor didn’t have to spend very much time with me.  I would have felt better if he had, but there was really no reason to do so.  There was no question that he knew what he was doing, and clear to him that I was doing what I should be doing and should continue to do.  We were done, but I still would have liked some professional sympathy.  Apparently, my private health care dollars don’t pay for sympathy.


Of course, these days health care spending is very expensive and out of control – out of reach for a lot of Americans.  This is just the kind of thing that falls under the governmental care that our forefathers so thoughtfully wrote into our constitution’s preamble in the phrase “promote the general welfare.”  This little phrase does not require socialized health care, but it does demand some reasonable solution to control the escalation of costs.  Health care spending is out of control for a whole bunch of reasons.  It is the kind of thing that we expect our government to fix, but that seems unlikely. There are many things to blame, and not very many palatable ways to fix it in a capitalistic economic system without seeming cruel and arbitrary, not to mention the ever popular sobriquets of racism, bigotry, other name calling, and miscellaneous slights from their constituency that keep our politicians from dealing with real economic problems. 


In a simpler time, we trusted our doctors.  We trusted them to have done all their research and know which illnesses were fatal and which we would survive, which drugs could help us and which could hurt us, which pains led to appendicitis and which led to the flu.  We did not question their judgment.  There were important maladies that neither the tincture of time nor bed rest itself could cure, and our doctors did their best to diagnose and provide us with the best care they could.  We paid our doctors as we needed them, and though they made more money than most, they were still affordable.  Doctors made house calls.  Life was simpler.  Then we learned to watch TV.


In a simpler time, there were no HMOs, or PPOs, and clinics were small self organized offices.  Hospitals were small providers of specialized care, not big businesses.  Health insurance was affordable, but hardly needed.  If you were really risk averse, you might have purchased a policy for “Major Medical.”  It would have been no more expensive than most people’s Starbuck’s budget for the month in this modern day. 


In a simpler time, there were no advertisements on TV for prescription drugs.  Television was black and white.  It was reserved for local news shows, cartoons on Saturday mornings and movies with good guys and bad guys, or with cowboys, horses and the occasional Indian.  Now we are assaulted with all sorts of colorful, informative advertisements that send us to our doctors demanding certain medications that we know we must have because the television has told us so.  We demand allergy medicines, flu shots, pills for our blood pressure and our cholesterol levels and our ulcers and our regularity and our post nasal drip and our dry eyes.  We demand pills to help us sleep at night, or to feel better about ourselves in these most uncertain times, or to calm our hyperactive children, or to lose weight, or to have better sex, or to alleviate our natural aches and pains.  We do this because we crave the simplicity of the uncomplicated and healthy lives we see on TV without the pain of earning an uncomplicated or healthy life by eating well and exercising.


We demand these things from our doctors and because, well, time is money and we don’t have the time to be sick and they don’t have the time to waste on the education of their patients. It is so much simpler to just give us what we want.  Our doctors have sought shelter in great assemblages of doctors and they generally give us what we ask for…because it is easier and less time consuming than arguing with us about appropriate patient care and drug protocols.  These doctors work normal 9 to 5 shifts in large hospitals and institutional clinics where the terms like HMO and PPO abound.  The term “house call” has been dropped from the vernacular.


In a simpler time, we had doctors and nurses.  Now we are seen by physician assistants who are well meaning, but neither as educated as a doctor nor as fulfilled in their vocation as a nurse.  They consult with real doctors when their patients present with more than a simple cold.  They are kind of “tweener”…an economical response to patients that want to dictate their own course of care.  They don’t get paid as much as doctors, but serve as a useful front line of defense to keep doctors from squandering their real doctoring on patients that just have the flu, or just have a cold, or just started running a fever.  The fact that most people try to put themselves in front of a doctor at the first sign of any physical discomfort is the most compelling reason for doctors to hide behind their assistants, and the most obvious indicator that people who prescribe a course of medical care for themselves don’t have a clue about anything but what they see on TV and should be dealt with at arms length.


It turns out that my physician’s assistant knew exactly what he was talking about. This was simply confirmed by the more time constrained, more expensive orthopedist who obviously had bigger bones to pick than my poor metatarsal.  I wasn't paying him to be empathetic.




So I’m talking with a little old church lady, Miss Sally Mae, about my broken foot and the inconvenience of crutches.  There are a couple things you need to know about Miss Sally Mae. 1) She was a red hat lady before there were red hat ladies.  She wears anything bright and spangled.  She has sequined ball caps and gold glitter tennis shoes, and wears earrings the size of hub caps.  2) She broke her pelvis about 5 years ago and carries a cane with her now wherever she goes.  (I think that has more to do with a litigious legal history than her ability to walk without it.)  She does not use the cane; she carries it like she’s leading a dog on a leash.  There is no wear on the rubber tip.  She decorates it seasonally as is her fashion.  She and her cane are quite the pair. 


Her conversation with me reminded me of the 1970’s movie, The Graduate, with Dustin Hoffman.  In the opening scene, Dustin has just graduated from college and is at a pool party thrown by his parents.  All the guests are family friends, but mostly business associates of his father’s.  A few of the men speak with the new graduate and give him a wink and a sly elbow nudge while whispering the word “plastics” into his ear. “Plastics” being the wave of the future.  Anyway, Miss Sally Mae and I are talking about my foot and I told her that I never thought I would say that I was going to be happy to get to walk with a cane in a couple of weeks.  She leans into me and with a conspiratorial wink and a quick glance at her cane, she says, “reflective tape.”  I can hardly wait.


This brief brush with our medical care delivery system brought to my attention an article in the paper the other day.  The state of Texas spent over $3 million caring for only three, otherwise healthy human beings who, over the course of three years had visited the emergency room of their local hospital on an average of once a week.  Each week these people felt they had a need to receive medical care of the highest order.  Each week they showed up in the emergency room with ill-defined complaints, and each week they received a battery of tests and visits from assorted medical personnel.   Each week their bills were 5 to 6 thousand dollars.  Now I realize that this is an extreme example of run away health care expenditures, but I’m wondering if they sort of felt like I felt in the Orthopedist’s office and just wanted some professional sympathy.  I missed not having received it, but I don’t actually regret that I didn’t get any.  Now if we could just get that sympathy product advertised on TV….

© 2009 Mark Indermill - All Rights Reserved