search results matching tag: widower

» channel: learn

go advanced with your query
Search took 0.000 seconds

    Videos (94)     Sift Talk (4)     Blogs (4)     Comments (177)   

Everything Wrong With The Avengers In 3 Minutes Or Less

poolcleaner says...

Isn't that the Negative Zone? I'm fairly certain it works like however Marvel wants it to work. Sort of like the Power Cosmic. Stupid review judging it as a movie outside the bounds of comic book conventions.

Comics are silly, convoluted, and prefer form over function:

1. Thor and Iron Man are required to have pissing contests.
2. Sunglasses and eye patches make people without super powers look badass.
3. Banner on a motorcycle is a good juxtaposition against his Hulky-jump-through-the-air travel form.
4. Loki is a conceited god so the Iron Man delay works -- didn't this reviewer. already assess that Loki was there to convert and not kill?
5. Of course CAPTAIN AMERICA just jumped from a plane. Idiot.
6. Did he just judge the movie according the Captain America's silly costume? Idiot.
7. No lap dance? He wants to watch the Russian dude give Black Widow a lap dance? I'm confused.
8. Bad guys running laps happens in... most action films with bad guys that need to fill in some time and guide direction visually. Reeeaaaally dumb criticism.
9. Plasma screens? You'd prefer to see a cell phone and then a split screen with 4 other people on cell phones? WTF
10. Loki's scepter is also a space phone??? My phone is also a camera, GPS, medical adviser, blogging tool, gaming device, and if I could download an app that performed mind control, I would. Loki is a god so he can.
11. The hellicarrier was created by Jack Kirby. Fuck you, this is an Avengers movie.
12. Sweeping cameras may sound silly, but comic book logic dictates that this is fine. Why not?
13. His criticism of little girls being able to find Bruce Banner is a criticism of our emotional attachment to the Gavroche, not the Avengers. Is the mystique of a street smart urchin gone from our collective unconscious?
14. Hawkeye's virus arrow is perfectly executed and makes sense according to his abilities.
15. Thor being easily tricked by Loki using low brow tactics is true even in Norse mythology. What exactly are we critiquing here?
16. Loki's objective in being captured is partly him being an overly confidant asshole god. He's just sort of going around half cocked because he can and likes to do so. The gods aren't smarter than us, just more powerful and with magical abilities that trump technology. In fact, this means they don't need to try as hard and would definitely be candidates in the personality disorder department. Hell, for all we know they could suffer from intellectual disorders that would never have become an issue (aside from making them stupidly violent) considering their power.
17. Hawkeye versus Black Widow is not cool? Damn.
18. Fury also gave an intimidating death stare in Jurassic Park when Nedry's "Ah ah ah, you didn't say the magic word" security screen pops up. HOLD ONTO YOUR BUTTS. I liked the half reference.
19. If you have trouble understanding the powers of Mjölnir, why do you also complain about the plodding exposition?! These things require exposition and it's so arbitrary that it becomes plodding. Comics are FILLED with plodding exposition because of this and there's a point where you just have to know the characters. Do they explain superman's laser eyes in the movies? Actually... do they?
20. Black Widow is a weapons expert, including theoretical weaponry.
21. In the comics Hulk learns to control his powers and can even be intellectual in said form.
22. The alien invasion would do more damage than a nuclear bomb. These villains enslave entire worlds.
23. The ending requires homework??? THE ENTIRE SERIES OF MOVIES REQUIRES HOMEWORK.


That being said, I agree with a good number of the points:

1. The tesseract was a rebranding of the Cosmic Cube which has a long history in the Marvel universe. (So I guess this movie was made for comic book fans?)
2. Well lit facility. There should have been some sort of cloaking shield around it, which is perfectly acceptable in a comic book world, if not the real.
3. Cap's bet. I don't believe Cap would have done that because it isn't just.
4. Speaking in English to Germans. It would have been cool to hear him speak in German. Damn!
5. Hawkeye's arrow fucking up the hellicarrier. However, I could see this happening in a comic book, I just don't like it.
6. Captain America's ear piece and bad aim.
7. Tesseract mind control wearing off after blunt trauma.
8. Cap's super powers are kinda lame in these movies, but I'm sure if they weren't, then this review would contain criticism about how his human fists can smash through metal.
9. The aliens are a pretty shitty replacement for the Skrulls. This is what makes me the saddest.
10. Imiatating transformers... this bugged the crap out of me when I first saw the trailer. UGH!
11. Thor's lightning must have a long cooldown.
12. Yeah, it was pretty lame when the aliens died after they were cut off from the mother ship. Inferior to the Skrulls fo sho.

Oklahoma Doctors vs. Obamacare

MrFisk says...

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

Romney Asked 14 Times if he'd De-fund FEMA

renatojj says...

@enoch why, is society so incapable of voluntary charity that, without government, people would simply have no concern for each other? Stating that it's a basic, fundamental role, doesn't make it so. Maybe you should question that.

@Yogi but you're not exactly giving money to an old widow or helping kids at school, you're just being forced into funding a corporation called "government", trusting that they won't steal that money for bailouts, corruption or sheer incompetence. Not wanting government involved doesn't imply lack of concern for the poor and needy or non-willingness to do charity by other means.

America is one of the most charitable countries in the world, more than $200 billion last year alone, most of the contributions coming from middle class individuals. Why are you so distrustful of the kindness of the human spirit, so sure that if government didn't make people do charity at the point of a gun, people would always let their neighbors starve and die?

Romney Asked 14 Times if he'd De-fund FEMA

Yogi says...

>> ^renatojj:

We don't need government for emergency relief, because society doesn't need to be forced into taking care and being charitable towards each other.
Those who think otherwise don't understand the nature of charity at all, they act as if only they have the noblest of goals, while doubting anyone else is capable of being charitable out of their own free will and means.


I think when my paying taxes goes to helping the old widow down the way get food, or help the kids at their school I feel very good about that. I would agree as would most Americans would to giving more of my money to schools and the poor.

The problem is that you don't know anything.

The Truth about Atheism

shinyblurry says...

as an agnostic I think one of the key things that atheists AND religious people alike need to get past is the possibility that maybe there is a god, but religion as we know it is just flat out wrong.

Most religion as we know it is wrong. This is the religion approved by God:

James 1:27

Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction, and to keep oneself unstained from the world

Maybe there is a god, but there is no religion. Maybe god doesn't care if you pray or don't pray. Maybe a god created us, but has since moved on and isn't watching us and otherwise doesn't give a damn about us anymore

What if god isn't really god, maybe we were created, but by some hyper-advanced aliens
.

Maybe God became a man, Jesus Christ, and died for the sins of the world?

What if god doesn't dictate morality...maybe we create morality. God used to be ok with slavery...then we decided differently. Why aren't we getting flooded again if God was down with slavery?

http://www.comereason.org/soc_culture/soc060.asp

What if god is a tyrant? You know what the US does with tyrannical governments right?

I'm not really sure how to reply to this comment.

Whenever I used to think about that stuff as a kid . I put myself in god's shoes. Ok, I just created humanity. What's that? you're worshiping me and giving me thanks? ok that's sweet and all, but I want you to go out and do stuff. What's that? a whole day devoted to me? no...just no. I get it that you're thankful..but it's time to move on. What's that? you're killing other humans in my name? Just...no..just stop it!


Why would you think, as a flawed, subjective, morally imperfect being (that's all of us), that you could understand the mind of God? Perhaps God ordained worship for a reason that you don't understand?

Seriously, I think that's what every religious person needs to ask themselves. If you created a species. Would you want it constantly fighting and bickering and killing each other in your name? Nah, you'd want people to get along no matter how different they were?

If people followed what Jesus taught, none of that would be happening.

Religious people who are parents, would you really like it if your kids CONSTANTLY prayed to you and gave you thanks? We currently only spend Father's Day and Mother's Day devoted to our parents. Do you really think kids should be that devoted to their parents? Or do you want them to grow up and go out into the world and do big things?

Our parents don't uphold the atoms in our bodies. God is who makes all things possible.

James 1:17

Every good gift and every perfect gift is from above, coming down from the Father of lights with whom there is no variation or shadow due to change.

I'm sure there are many times in your life that you've wanted to give thanks for the good things God has done for you, but you have no one to thank. I think that's is a sad moment for an unbeliever.

Bottom line is that what we know is completely and utterly dominated by what we don't know. Column A is just a TAD bit bigger than Column B if you know what I mean. So it's utter absurdity to make claims that you know that there is no god..just the same as it is to claim that there is a god and you know exactly what it wants. Even people in the same religion can't seem to agree what god wants and get into extremely petty and hurtful fights over this shit.

so this supposed "battle" between theists and atheists is just ego getting completely out of hand IMO

We're all on the same fucking team...start acting like it.


The only way you could know the truth is if you are omnipotent, or an omnipotent being told you. Christians are claiming the latter. I have a route to truth, and you don't, so how are you telling me I don't know what it is? How would you know that?

>> ^VoodooV

Chick-fil-A Admits to Anti-Gay Funding

Trancecoach says...

Yes, if you don't support gay marriage, you are, by definition, anti-gay. (I have never heard of any gay person who doesn't like straight people getting married. Have you???)

You're correct that homosexuals aren't defined by their ability to marry one another. They, like all humans, are defined in part by their rights, of which marriage is one.

You're correct, Chik Fil-A didn't donate to anti-gay campaigns. They donated to the anti-gay organizations that run them. Same difference, as far as I'm concerned, but if you want to split hairs...

As our country is more closely aligned with fascism inasmuch as government is "gay married" to the corporations, then where/how corporations spend their money is of increasing importance to the consumers who are, in essence, voting to support issues with their dollars.

Your analogy of the birthday present is not the same thing, because I, unlike a corporation, do not have political power like they do. If the present was $50 Million, and it was donated to Al Qaeda, then yes, you would have supported terrorism with your "gift."

Anyone who says the following is clearly running an anti-gay agenda:
"I think we are inviting God's judgment on our nation when we shake our fist at Him and say 'we know better than you as to what constitutes a marriage' and I pray God's mercy on our generation that has such a prideful, arrogant attitude to think that we have the audacity to try to redefine what marriage is all about."

Dan Cathy, Chick-Fil-A Pres. and COO, The Ken Coleman Show, June 16th.


... even though he clearly has little understanding of how marriage was originally defined in the Bible (which commands that brothers-in-law marry widows, or that rapists marry the women they rape) as if that even mattered!.


>> ^Edgeman2112:

>> ^Trancecoach:
You're right. The fact that they do things for married couples doesn't mean that they're anti-gay. The fact that they donate large bundles of money to anti-gay campaigns, on the other hand, does mean that they support anti-gay policies.
Did you not watch the video??>> ^Edgeman2112:
This is reaaaaaaaaaaaallly stretching it. Just because they do things for married couples doesn't mean they hate gays. I side with the chicken people on this one because they're a victim of gross generalization.


Yes I watched the video, but you are the one who fell for the sensationalism.
Let's be rational and fair here. If you don't support gay marriage, does that automatically label you as anti-gay? F-ck no it doesn't. If gay people don't like straight people getting married, does that make they're anti-straight? F-ck no it doesn't. It's a ludicrous generalization.
Each group of people isn't defined by their ability to marry one another. This is the mistake complainers are often guilty of making.
And no, they didn't make donations to anti-gay campaigns. They made donations to the organizations. What they then do with that money is not Chic Fil A's business. If I give you 50$ for a birthday present, then you donate that to Al-Queda, the media will portray me as supporting terrorism.
I don't like to jump to conclusions based on things I hear on the internet, and I do love that spicy chicken sandwich with a half and half sweet tea and waffle fries.

This is what snake venom does to blood!

shagen454 says...

Oh man, and I just saw two rattle snakes a couple of days ago. Thank goodness I was in a car! I don't know if I can live here anymore. Bears, mountain lions, bobcats, tarantulas, all sorts of fucking snakes, black widows, sharks, scorpions, coyotes... man it's a fucking jungle out there and I think I am going to be sick.

WWII Widow Finally Learns What Happened to Her Husband

MilkmanDan says...

Ok, in all likelihood the Congressman never actually checked. BUT, considering that she got multiple conflicting reports back closer to the time it actually happened, I'd say that it is certainly possible that he (or a staffer) looked into it and got a different answer from some different resource.

My mother is very big into Genealogy. Sometimes in her research she finds conflicting information -- just something one has to deal with. I am glad this widow has the satisfaction of closure and someplace specific to send her flowers, and I think she has the right attitude about not being upset or holding a grudge against the Congressman. If anyone failed her, it was the Army back when her husband actually died.

How The Avengers Should Have Ended

siftbot says...

Tags for this video have been changed from 'iron man, thor, captain america, hulk, black widow, hawkeye, shawarma' to 'iron man, thor, captain america, hulk, black widow, hawkeye, shawarma, spoiler' - edited by MrFisk

Cinco De Cuatro!

Police Video: No Blood, Bruises On George Zimmerman

Porksandwich says...

>> ^Lawdeedaw:

A stereo thief hit a guy with a bag of like 6 pounds. He got stabbed to death. The stabber got off. The stabber had been the one to chase him down... SYoG...


Dunno how anyone can see stuff like that transpire and think it's a good idea to let someone go under that law who actively pursues and kills.

The Wiki on SYG has this blurb:

Stand your ground laws are frequently criticized and called "shoot first" laws by critics, including the Brady Campaign to Prevent Gun Violence.[36] In Florida, the law has resulted in self-defense claims tripling, with all but one of those killed unarmed.[37][36] The law's critics argue that Florida's law makes it very difficult to prosecute cases against people who shoot others and then claim self-defense. The shooter can argue they felt threatened, and in most cases, the only witness who could have argued otherwise is the victim who was shot and killed. The Florida law has been used to excuse neighborhood brawls, bar fights, road rage, and even street gang violence.[36] Before passage of the law, Miami police chief John F. Timoney called the law unnecessary and dangerous in that "[w]hether it's trick-or-treaters or kids playing in the yard of someone who doesn't want them there or some drunk guy stumbling into the wrong house, you're encouraging people to possibly use deadly physical force where it shouldn't be used." This is in reference to Sarah McKinley, a teen widow with her infant child, who shot an intruder who broke through the front door. The intruder was apparently drunk, screaming and at the wrong house


Self Defense claims tripling should be indicative that you got some problems on your hands. And I doubt they count these cases as "crimes", making their crime rate lower. Reinforcing the idea that the law is sound.


And I'll just note, I've never heard of your stabbing case prior to you mentioning it. Whether it's got no racial elements to exploit or no gun involved to exploit for news, I don't know. But people care a lot less if it's anything but a gun involved.

Cenk Loses his Shit on former Republican Senator Bob McEwen

Winstonfield_Pennypacker says...

When you say "we got by just fine without" Social Security, who's the "we"

We is the general citizenry of the United States. Back in 'the day' when the nuclear family was stronger, working families would take care of thier elderly. Often they would live under the same roof until they died. Also before Social Security, people would save for thier own retirement and generally (not always, but generally) would have enough saved up for a good living when they stopped working. There were a few cases of widows, or other hard luck cases who were in genuine need, but this vision you are creating where every elderly person was living in a box and eating dog food is bunk.

You see - SS was originally designed to be ONLY for those rare 1 in 100,000 elderly persons who was in GENUINE need. It was supposed to be a very very very small program, only to be tapped in the most exigent of circumstances. It was not ever supposed to be a program that took more from a person's paycheck than INCOME TAX (it is today). It was not supposed to be the de-facto 'retirement program' for every man, woman, and child in the nation (it is today). It was not supposed to be the biggest item in the national budget (it is today). But that's what happens you you take a simple problem (take care of the 0.01% of the needy) and hand it to the Federal Government.

The number of people who qualify for SS should be infinitesimally small. The amount taken from taxpayers for the program should also be virtually nothing. All of the needy eldery can be cared for with state programs which can receive RARE and OCCASIONAL assistance from the tiny Federal program. The order of operations is "Family" first, then "Extended family", then "Community", then "State", and the very very very very very LAST place you ever go is Federal.

the idea that fiscal conservatives are the ones looking out for the long-term fiscal health of the nation is laughable

They are - but you (like many) are confusing "Republican" with "fiscal conservative". The GOP is not filled with fiscal conservatives. In fact, the GOP routinely and regularly opposes fiscal conservatives. The Tea Party is filled with Republicans, Democrats, and Independants that are all united under a banner of "fiscal conservatism". The GOP doesn't like them. Not one bit. Fiscal Conservatives are not in a position to "look after the long-term fiscal health of the nation" because they are not in a position to do so. The GOP and the Democrats are both dominated by big-spend, Big Tax, Big Government leftists. The GOP panders to both social and fiscal conservatives with a bunch of lip service, but (as you noted) they don't walk the walk.

Can Wisdom Save Us? – Documentary on preventing collapse.

shinyblurry says...

If religion is the disease, then why did we have over 100 million deaths from atheistic regimes in the 20th century? They made it their express goal to exterminate religion and in the process committed some of the worst atrocities in history. No, the problem is clearly human nature. When man tries to get rid of God he just replaces God with himself. I agree with you, that religion itself has contributed to the suffering and degeneration of the planet. Jesus hated religion. That's why He drove the moneychangers out of the temple. That is why He railed against the pharisees. He said, these people worship God with their lips but their hearts are far from Him. Scripture says this about religion:

James 1:27

Pure religion and undefiled before God and the Father is this, To visit the fatherless and widows in their affliction, and to keep himself unspotted from the world.

The problem has always been that people follow the traditions of men rather than demonstrate the love of God. Even just a few decades after the cross, Paul wrote about men who preached a different gospel, one that glorified men rather than God. The contamination is universally human nature. Nothing is pure in the hands of an impure heart.

Examine history and see the parallels. Humanity is just repeating the same story, over and over again. There is nothing going on today that hasn't already happened before. The set and props have changed, but our nature hasn't changed. Man corrupts everything he touches because his scheming is against the will of God. There is a way that seems right to a man, but its end are the ways of death. The problem is outlined in this video. Yes we have more knowledge, but knowledge doesn't help us. What we need is wisdom. However, wisdom doesn't come from man, it comes from God. Wisdom isn't something you can engineer..explore some philosophy and you will see that ultimately it has no real answers.

The divine wisdom, however, ordained that Jesus Christ would come in the flesh to give us our answer. It says that message of the cross is foolishness to those who are perishing. The world in its wisdom knows nothing of the ways of God, so God chose what the world would consider foolish to shame the wise. God chose to save us in a way people would consider foolish, because the foolishness of God is wiser than mans wisdom, and the weakness of God is stronger than mans strength. You think it's ridiculous, but God is simply showing up the wisdom of the world for what it is: foolishness.


>> ^Fletch:
Religion is the disease, Blurry. You're feverish rants, nonsense ramblings, and tone-deafness are primary symptoms. Reason is the only thing that can save you or this planet, but I fear it is too late for you and your fellow carriers. The infection has mutated into hundreds of different, self-preserving variations, and reason, although a powerful medicine (and requisite for wisdom), cannot cure those who refuse treatment in the first place, or have simply become immune to it's healing due to past, repeated undertreatment. Religion has evolved into a superbug.
Can the next version of VS please hide ignored comments that have been quoted in a subsequent comment?

Revenge Sex

Ron Paul Booed For Endorsing The Golden Rule

GeeSussFreeK says...

>> ^Grimm:

RP wants to end all the needless wars. If any war is worth fighting then he would only require that Congress "declares war" as it is outlined in the Constitution.


Exactly, I think that would answer some of @bcglorf 's hold up on isolationism. Like isn't so black and white, especially on matter of war. Which is why he is an advocate of declaring war, not the president just going in willy nilly. We can never really answer the question of if a particular war is good or not morally for every person at once, but we don't want to leave that moral choice in the hands of one man for no good reason other than self defense. My like the recent stop to the SOPA legislation due to pressure from the outside, the same kind of pressure could of been used to help in Libya..but only if the supporters of that action could sway enough people to support that decision...just like a democracy should. And I don't think hiding behind things like NATO or the US should undermine our Presidents responsibility to us, he works for us first after all. Like in most questions of this nature, there isn't really a right or wrong when the action is taken or not taken in the most strict sense...only what was the most supported.

I think it is a little, in that light, to say that we couldn't declare war on the Libyan government. We are just so used to the President going to war for us, that we have basically abdicated our responsibility in this area. That is one of the major dangers I see in Statism is when you outsource responsibility, you usually don't relegate much thought to it. The plumber fixes my pipes, I don't concern myself with how they work. Likewise, when you place all sorts of powers in agents hands, you tend to concern yourself with the goings ons...till they break. I think a Statism and Libertarianism have the same net effect if the people don't take an active concern in all forms of domestic affairs. I think that Statism might have a higher entropy, though, because it invokes an active outsourcing of all matters of life to agents. While that could work if you are always haggling your agent to make sure he is doing his best, and not up to shenanigans, why not just cut out the middleman and keep up with the basic concern yourself?

I think the idea of the Democracy is starting to fail, not because of some flaw in it that wasn't already widely known, but the culture we find ourselves in. For a Democracy to exist in a healthy way, each citizen has to see his role as a citizen to provide enrichment for the body politic. In this way, the Wests focus on individual rights and Libertarian ethics sorts of causes entropy on this notion. We would much rather be watching a movie, or some other form of playboy recreation, then running down to our local City Council and partake of our duty (not only to others, but ourselves).

I don't mean to ramble, but I wanted to make that point, that it doesn't matter if you are a federalist, or a anti-federalist. If your voting body is poor in intellect, will, and a toxic cultural environment, then no matter of political philosophy will save you. I think Jefferson foresaw that this entropy, and the saying, "The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." comes from; that things have to get really bad enough for us to actually care about democracy for it to work again for us, and more importantly, us for it.

But more to @bcglorf 's point on genocide, and cowardice. I don't think it is fair to say cowardice when your only course of action is making more widows and orphans. And more importantly, it is an entirely different thing for some president to commit you to that course of action without any "due process", in this case, a declaration of war. I don't think it is cowardice, persay, to not want to kill someone that doesn't want to kill you, and might have a legitimate claim to kill the person they want to kill. But that is neither here nor there, a moral question that most likely will never see commonly, the point is, that each of us should have a voice in the action we collectively have to take, action or inaction. The benefit of defaulting to inaction is that it doesn't stop someone morally convicted like yourself to fund operations of support for whatever side. That is why I usually side with Libertarian answers for complicated issues, sometimes, you don't need one answer for everyone. Sometimes, dare I say most times, it is actually better to let those whom are convicted on the goodness of something to take the risk themselves and not try and hedge everyone in with them.



Send this Article to a Friend



Separate multiple emails with a comma (,); limit 5 recipients






Your email has been sent successfully!

Manage this Video in Your Playlists

Beggar's Canyon