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    PROFESSIONAL DISTANCE: A Discussion of Health Care Reform

    Jalianwala Bagh Massacre


    On April 13, 1919 there was a massacre at a place known as the Jallianwala Bagh (Garden) in the northern Indian city of Amritsar. 

    Thousands of people gathered in the Jallianwala Bagh (garden) near the Golden Temple in Amritsar, on Baisakhi, both a harvest festival and the Sikh religious new year. There were speakers present to discuss a number of issues.

    British Indian Army soldiers under the command of Brigadier-General Reginald Dyer opened fire on an unarmed gathering of men, women and children. The firing lasted for 10 to 15 minutes, until they ran out of ammunition.[1] Official British Raj sources placed the fatalities at 379, and with 1100 wounded.[2] Civil Surgeon Dr. Smith indicated that there were 1,526 casualties.[3]  For more see:  http://en.wikipedia.org/wiki/Jallianwala_Bagh_massacre

    I was introduced to this modern day example of human sacrifice when I first saw the movie Gandhi.


    In the movie, following the depiction of the carnage, there was a Military Commission of Inquiry. I tracked down the script and found this:


    A Government Advocate (English) turns 
    to face Dyer.
    ADVOCATE: General Dyer, is it correct 
    that you ordered your troops to fire
    at the thickest part of the crowd?

    Dyer glances woodenly at the panel--a
    man in some shock at the consequences
    of what he assumed was an act worthy
    of praise.

    DYER (righteously): That is so.
    The Advocate looks at him with a degree 
    of disbelief -more at his attitude than
     his statement.
    ADVOCATE: One thousand five hundred and
    sixteen casualties with one thousand six
    hundred and fifty bullets.
    A slight reaction from the public section.
    Dyer's jaw tightens.
    DYER: My intention was to inflict a lesson
    that would have an impact throughout all
    India.
    He stares at the panel like a reasonable man
    making a reasonable point. The evasiveness,
    the only half-buried embarrassment of their
    response only deepens his own withdrawal
    into himself.
    INDIAN BARRISTER: General, had you been able
    to take in the armored car, would you have
    opened fire with the machine gun?
    Dyer thinks about it. Then unashamedly -
     
    DYER: I think, probably - yes.
    A muted reaction from the public section.
    The Indian barrister stares at him a moment,
    then simply lowers his eyes to his notes.

    HUNTER: General, did you realize there were 
    children - and women - in the crowd?
    DYER (a beat): I did.
    For the first time there is the hint of
    uncertainty in his manner.
    ADVOCATE: But that was irrelevant to the
    point you were making?
    DYER: That is correct.
    There is just a tremor of distaste quickly
    suppressed among the panel. Not so quickly
    in the public section.
    ADVOCATE: Could I ask you what provision
    you made for the wounded?
    Dyer looks at him quickly. The question is
    unexpected, even a little"clever." The
    officers listening clearly resent it.
    DYER (a moment, then firmly): I was ready to
    help any who applied.
    And that answer stops the Advocate. He
    smiles dryly.
     
    ADVOCATE: General . . . how does a child 
    shot with a 3-0-3 Enfield "apply" for
    help?
     
    Dyer faces him stonily, a seed of panic
    taking root deep in his gut.
     
    h

     

    I watched this within the last month I should think, and every time I see this epic, I am drawn to this particular scene.  There is something about Dyer.  Edward Fox, who also starred in Day of the Jackal http://www.imdb.com/title/tt0069947/ does a remarkable job of depicting the evil British General.

    There is a concept in psychotherapy known as 'professional distance'.

    In the following link, the psychotherapist wraps it up for a woman who over a course of only a few years struggled with cancer, first losing her arm, then her life.  During this ordeal she met with a psychotherapist through a referral from her oncologist:

    Although we had each struggled to maintain professional distance, it is hard to watch someone you work with lose their life to cancer at such an early age. The feelings that are rarely expressed come easily to the fore at a funeral. Knowing that you may have helped someone to adapt to a difficult life situation eases, but never eliminates, the pain. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660155/

    And just for the hell of it, check out this link

    http://aic.gov.au/en/criminal_justice_system/policing/~/media/conferences/policewomen3/crehan.ashx


    The first link deals with the problem of  'professionals' getting to close to their patients; become overly sympathetic to their plight so that it interferes with the professional's ability to help the patient.

    The second link has to do with boinking your secretary or back stabbing your co worker.  Basically it is telling you to stay out of a fellow employee's shite.

     

    WASHINGTON (Reuters) - Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.

    "We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

    Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

    The findings come amid a fierce debate over Democrats' efforts to reform the nation's $2.5 trillion U.S. healthcare industry by expanding coverage and reducing healthcare costs.

    President Barack Obama's has made the overhaul a top domestic policy priority, but his plan has been besieged by critics and slowed by intense political battles in Congress, with the insurance and healthcare industries fighting some parts of the plan.

    The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance.

    An similar study in 1993 found those without insurance had a 25 percent greater risk of death, according to the Harvard group. The Institute of Medicine later used that data in its 2002 estimate showing about 18,000 people a year died because they lacked coverage.

    Part of the increased risk now is due to the growing ranks of the uninsured, Himmelstein said. Roughly 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reported last week, up from 45.7 million in 2007.   http://www.reuters.com/article/healthNews/idUSTRE58G6W520090917

    Many at Café have related their individual confrontation with pain and suffering along with the prospects of death.  Scores of posts have related individual struggles with the powers that be for the right to be treated for their diseases or injuries. It is not fruitful to merely read articles like the one from reuters without also reviewing the individual cases. The instances where our health care system just shuts the door on someone's pain and suffering and even death.

    Death panels. JESUS CHRIST THE DEATH PANELS HAVE BEEN SET UP AND WORKING DAILY FOR DECADES. Who is kidding whom?  But I digress.

    Alan Grayson is not afraid of crossing that line, the line of professional distance:

    On Wednesday afternoon, Rep. Alan Grayson (D-Fla.) shed tears on the House floor during a speech on the need for health insurance reform. Reading letters from people who have lost their loved ones because they did not have health coverage, the emotional Congressman paid tribute to victims who he said "aren't often heard from."

    "There are 44,789, who die every year from lack of health insurance," Grayson said. "In the course of my speech tonight, there will be five more."

    The moving stories narrated by Grayson came from his website namesofthedead.com. Unveiled on the House floor last week, the congressman's initiative aims to shine light on the innocent victims of the U.S. health care system. "I hope that honoring them will help us end this senseless loss of American lives," Grayson wrote. Read more at: http://www.huffingtonpost.com/2009/10/29/alan-grayson-cries-on-the_n_338324.html

    Peggy Noonan

    I think the health plan is being slowed and may well be stopped not by ideology, or even by philosophy in a strict sense, but by simple American common sense. I suspect voters, the past few weeks, have been giving themselves an internal Q-and-A that goes something like this:

    Will whatever health care bill is produced by Congress increase the deficit? "Of course." Will it mean tax increases? "Of course." Will it mean new fees or fines? "Probably." Can I afford it right now? "No, I'm already getting clobbered." Will it make the marketplace freer and better? "Probably not." Is our health care system in crisis? "Yeah, it has been for years." Is it the most pressing crisis right now? "No, the economy is." Will a health-care bill improve the economy? "I doubt it." http://online.wsj.com/article/SB10001424052970203517304574306533556532364.html

    Peggy always likes to tweak her nose like on bewitched and commiserate with Joe Scarborough about how this is just not the right time to revise our health care system.

    Mitch McConnell

    "Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition," the letter stated. "Ultimately, we would be left with a single government-run program controlling all of the market. This would take health care decisions out of doctors and patients and place them in the hands of another Washington bureaucracy." http://www.politico.com/news/stories/0309/19633.html

    Joe Lieberman

    This afternoon, Sen. Joe Lieberman (I-CT) appeared on Fox News to defend his intention to filibuster any health care reform bill that includes a national public option. Lieberman argued that a public plan would "stifle" the economic recovery and increase "the debt." "It's just unnecessary," Lieberman said. The public option is "a new entitlement program and the taxpayers and the premium-payers are going to end up paying for it, or else the debt will go higher."

    Responding to proponents of the public plan who argue that it would actually lower costs, Lieberman insisted that if the public option paid lower reimbursement rates than private insurers, medical providers would shift costs to Americans with private coverage:

    LIEBERMAN: If the public option, the government run health insurance company negotiates hard to lower the reimbursement -- the money it's paying to hospitals, doctors -- they're [providers] going to have to get that money somewhere. And where they're going to get it is from the 200 million Americans who today have private health insurance. Premiums will go up. It's exactly what's happened with Medicare and Medicaid. [...]

    When people hear public option, I think they think it's for free. It's not for free. Somebody is going to have to pay for it and you can bet it's going to be the taxpayers and the people who pay health insurance premiums now.  http://thinkprogress.org/2009/10/28/lieberman-public-option/

    I may wish to delve further into this at a later date.  Suffice it to say that Noonan, Scarborough, McConnell and Lieberman all kind of stick to the same arguments in their battle against real health care reform.  Basically:

    IT'S A BAD TIME RIGHT NOW

    IT IS ONE OF THE SEVEN DEADLY SINS TO GO AHEAD AND RAISE TAXES.


    TOO MANY OTHER ISSUES ON THE TABLE RIGHT NOW

    THE SICKLY WILL ALWAYS BE WITH US

    THOSE WITH INSURANCE WILL BE HURT

    CAPITALISM WORKS FOR RESPONSIBLE PEOPLE

    Whatever.....What they really mean is:

    READY, AIM, FIRE

    Oh there are those who outright lie about the blood in the streets like Anthony Perkins, http://tpmcafe.talkingpointsmemo.com/talk/blogs/dikkday48yahoocom/2009/10/anthony-perkins-the-newest-psy.php#more

    I mean Perkins talks about the five million in this country without health insurance who are taken good care of anyway.

    It does not matter. Every time I see these people defending the status quo I hear General Dyer saying:

    I was ready to
    help any who applied.

    NOW THAT IS PROFESSIONAL DISTANCE

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