Barbara Ehrenreich: Nickel and Dimed

In this book the author descends from the upper class to play class tourist for a few months. She waits tables, cleans hotel room and arranges clothing at a Wal-Mart. Kind of like The Simple Life for the Sex and the City gals.  Couldn’t help but hum the peppy Pulp song Common People while reading this, as it’s about a woman wants to live like a commoner because it seems “cool”….and of course to have sex with Jarvis Cocker.

Unsurprisingly the working poor in the United States have it terribly. They don’t earn enough to cover the basic necessities of life, even if they work like animals. They are treated with disdain in the culture (“trailer trash”) and face daily humiliations in the form of drug testing and supervisors bent on degrading them.

The author herself was depressing as she does care about the poor, but is so obliviously classist that she demeans and classifies the poor as the “other” constantly. She points out a million times that she has a PHD, as though this implies some kind of superpower. When she shares a laugh with a co-worker, she is quick to point out that she laughs from a “feminist” perspective while the co-worker laughs from a “Christian” perspective. She mentions that an African American friend is an “educated feminist,” as though she wouldn’t befriend your average African American, only special ones.

The sad part is that even on the supposed left these are all euphemisms meant to denote a higher standing of class, when the emphasis should be that we are all humans. When working at Wal-Mart she mocks the distinction between brands on offer (Jordache – eww) and wonders why her co-workers show respect to their equally dim-witted bosses. She’s totally oblivious to the fact that, for the actual poor, their jobs matter and they have to submit to their superiors, the same as Ehrenreich would probably submit to her editor at the NY Times. I’m sure Jordache and Wrangler are every bit as different and make as much sense as Prada and Gucci.

It gets worse and Ehrenreich begins to imagine during her time at Wal-Mart that she is far too intelligent to simply do her job, so she starts directing her energy towards whipping up pro-union sentiments. She acts as though any average Wal-Mart employee is too stupid to think of this as opposed to the reality, which is that they are too exhausted and probably worry rightfully about being fired or punished. It perpetuates the myth that the poor are stupid and lazy, which the book is supposedly trying to eliminate.

I suppose if you are entirely oblivious to the poor or can only understand their plight if Samatha Bradshaw goes to live with them then this book accomplishes something.

I’ll let Jarvis provide the last word:

” ‘Cause everybody hates a tourist,
Especially one who thinks it’s all such a laugh,
Yeah and the chip stain’s grease,
Will come out in the bath.

You will never understand
How it feels to live your life
With no meaning or control
And with nowhere left to go.
You are amazed that they exist
And they burn so bright,
Whilst you can only wonder why.”

Rick Hanson : Buddha’s Brain

In a great podcast by Philosophize This the host Stephen West describes Buddhism as less a religion than the greatest self-help book ever written. Siddhartha Gautama left a pampered rich life for poverty as he realized that, even when you have everything most people aspire to, you are still unhappy.  If money or adoration don’t bring happiness, what does? The OG Buddha left wealth to try to find an answer. He sat alone under a tree where he could observe how his own mind works while also using that same mind to reshape his thinking to generate inner happiness. This was in about 500 BC.

Fast forward to 2017 and in the richest nation in the history of the planet, 1 in 10 people are on anti-depressants. A few days ago the lead singer of Linkin Park, a celebrity who is supposed to be the apex of our culture, took his own life, as did his friend Chris Cornell a few months earlier. South Korea, one of the world’s top 50 nations in wealth, has the 10th highest suicide rate, while Somalia, the absolute worst, is not even in the top 100.

So what gives? If wealth, success or adoration don’t make you happy, what does? The Buddha arguably deduced this in 500 BC and came up with a cure.  Remarkably, as Buddha’s Brain outlines, modern neuroscience is allowing us to see how the brain works and it matches the Buddha.  To use a car analogy it’s like driving a car, thinking very hard about it, and then drawing up a perfect diagram of what’s under the hood. Crazy.

The main point made in the book is that our brain was not developed to create happiness – it was developed for survival. We are naturally fearful and anxious. The brain remembers negative events, but not positive ones. If we gave 100 great presentations and a single poor one, the bad one is remembered.  Our brain also plays out mini simulations almost constantly, some conscious, some not, even when we are asleep. These simulations are usually negative, imagining what others think about us or bad things that could occur but are unlikely. The phrase “bad dream” is common, but there’s no “good dream” equivalent. We do have nice dreams, but not as often and when we do, we tend to forget them quickly.

From an evolutionary standpoint all of the above makes sense. It stopped us from being eaten by lions or drinking from a toxic watering hole. It paid to be neurotic, anxious and afraid. Unlike animals though, who also possess a fearful “monkey mind,” we are also able to reflect on pain that we’ve suffered and have secondary reactions to it.

For example, if someone cuts off of in traffic the actual impact is insignificant. It delays you a few seconds. If they gave you the finger you’d probably be more angry, but that has no actual tangible impact whatsoever. It’s only our secondary reactions that cause us to stew and to suffer: anger, self-doubt, fear, worthlessness etc. The author refers to these as secondary darts and most of us are a tangled mess of pain from the accumulation of all these darts. Animals don’t have these. A dog doesn’t stew over the fact that the other dog cut him off. No wonder they always seem so happy.

The Buddha and this book offer a way out from evolutionary impulses that cause so much suffering. If we use that same brain and other evolutionary traits (empathy, for example, as our brains are wired to be empathetic since our children take very long to reach adulthood) we can rewire ourselves to relax, focus attention on what’s important and reduce the simulations and secondary ruminations that cause us pain.

When people think of Buddhism they think of meditation. Meditation is, in part, the method to achieving this. Meditation involves intense focus on (basically) nothing, which eliminates the simulations and the secondary darts from our minds. Without these we become mindful, which is just to say that our attention is free from anxiety and can be concentrated on what we find to be truly important.

The book explains all of this in scientific terms (i.e. brain scans, chemicals etc.) and through modern psychology. The great news is that this works! I’ve attended the local Buddhist center and meditated regularly for a period of time. It produced a calm feeling and a sense of purpose and concentration I’d never had. I was doing things that would actually make me happy in the long-term, like eating a carrot instead of a cookie, or going to bed on time instead of watching a TV show that could wait, and this didn’t require restraining myself from impulse. It was legitimately what I wanted to do. The bad news is that rolling back thousands of years of evolution is extremely hard work, requiring regular meditation (which is HARD) and constant attention to your own thoughts and actions.

I don’t have any big insights except to say that I hope I can become more mindful and get back to meditating regularly. It would benefit both myself and others around me. This type of Buddhist philosophy or practice is becoming more accepted in the West, particularly in medicine. It’s my hope that it gains more and more traction and others can benefit. Over time hopefully society sees a value in meditation, which is at odds with our consumerist culture as it produces no tangible result and doesn’t make for an interesting Instagram update.

When I think of the ideal end-state it’s Roger Federer. He always seems relaxed, entirely focused, doesn’t react angrily and is quick to praise others and be empathetic.  Watch this video of his acceptance speech at Wimbledon. If that’s not zen he’s doing a great imitation!

I’d highly recommend this book even if you have no intention of meditating or practicing mindfulness as it will at least allow you to understand how your brain works and what might make you happier over the long-term.

Gwynne Dyer: ISIS, Terror and Today’s Middle East – Don’t Panic

Gwynne Dyer is a Middle-East expert and long standing owner of the most ghoulish head shot in print media. Seriously, they can’t find a better picture? Guess not. Makes Rex Murphy look handsome.

Like practically everyone I’m a bit Jihaded out. It’s like reading a comic and no longer caring that Nick Fury is about to go back in time to kill Hitler. The invisible woman and the guy with super long arms, you had me, but this is too much! Osama Bin Ladin wanting the United States out of Saudi Arabia, fair enough, but the messiah riding in on a white horse to drive back the anti-christ, after defeating the Roman Empire? Really?

Or, as a dude (it has to be a dude) that maintains wrote about serial killer BTK wearing his victims underwear: “Normally, I try not to pass judgment on the people I write about, even killers. However, this is just too disgusting…I don’t understand it, and I hope I never do.”  Whatever the reason for shooting teens at an Ariana Grande concert, I take the approach that sometimes something is so odious that you know it’s sick and the particulars of why are irrelevant.

If I have to keep up on something so odious, I’d rather read a detached and contextualized account, as Dyer presents here. It isn’t sensational like your average CNN ISIS update on some poor hostage getting his head cut off or threat #1592 to slaughter the infidel.

Gwynne Dyer senses that there is a need for some perspective rather than daily insanity and Don’t Panic, a short history that traces the origins of ISIS from the Iraq War (II) up until 2015, provides this.  The central thesis is that the Islamists require a foreign intervention or hatred of Westerners to inspire Muslims to take up their cause. Whether it’s Russia in Afghanistan, the U.S. in Iraq or Jews in Israel, he argues convincingly that the Jihadists want and need infidels to meddle so they can rally the population to their side.

I think there’s obvious truth in this argument and it is important not to take the Jihadist bait at every cast. Still, even if the West basically ignored them and stayed out of the Middle-East, the Jihadists will always manufacture some sort of grievance, legitimate or not, and attempt to kill and antagonize. After the first Iraqi war the Americans did not occupy Iraq for Dyer’s stated reasons and they defended Muslims in the Balkans. In return they got 9/11. So the question is how to slow down the Islamists without also inspiring more people to join their cause? The best argument I’ve seen is to allow secular thugs like Sadaam or Assad to suppress them. Not an admirable position, but as Obama learned in Syria, there’s no third option available. Maybe provide an air strike if things get real bad, but that’s about it.

Personally I think the battleground is one of ideas and I think the West has done a horrible job articulating the merits of liberalism. Liberalism is not about iphones and strippers, it is about freedom.  George Bush II attempted to make this argument and I think he was sincere, but the freedom he preached was hard to square with a massive invasion. Likewise Steve Bannon sees a war between Christianity and Islam, but there is nothing underpinning his side of the war, since the majority of the West is no longer even Christian. Trump himself isn’t Christian and he is a manifestation of everything rotten that liberalism allows: materialism, ego-centrism and vacancy of mind and purpose.  Suicidal post-modernism is also not useful as shooting teens at a pop concert or removing girls genitals isn’t alright and believing it is amounts to suicide.

This is where I think Dyer goes astray. His argument is that the Middle-East is a tiny portion of the Earth and insignificant to the West. We should just ignore it like you’d ignore a bee and it won’t bother you. Even if you get stung, best just to move on. Terror attacks aren’t car crashes or bee stings though, they are political acts.

If it is a war of ideas you need to offer up a strong counter-point and some of the ideas, for example, held by British Muslims, population 2.7 million, are horrific.  Terror attacks stemming from such ideas aren’t meaningless like a car crash, they are the outward manifestation of political beliefs. If these ideas gain sway there will be sectarian violence, as we see in the Middle-East and now frequently in France and Britain.  To call out these ideas, as citizens do, is derided as racist, but I’ve yet to see a Western politician articulate their side of the argument with conviction. Dyer doesn’t seem to see this as necessary either.  It shouldn’t then be shocking that, when this responsibility is abdicated, the worst manifestation of liberalism, who happens to be speaking truthfully on this issue, is elected.

Julius Caesar: The Gallic War

In his early thirties Julius Caesar is said to have looked upon a statue of Alexander the Great and felt miserable. At the same age Alexander had already conquered much of the known world. What had Caesar accomplished? He’d served as a priest, raised a fleet to crucify pirates, had a gay love affair with a foreign king (allegedly), and was responsible for governing part of Spain. If your benchmark is Alexander though, this is small potatoes. What kind of person is so ambitious that their standard is the greatest conqueror ever known?

Caesar left that statue and went back to Rome, where he was elected consul, serving with two others as rulers of Rome.  As happens in politics things got tense and Caesar deemed it wise to leave Rome to earn glory and money (he was a bit broke) as Governor and military commander of Gaul . I’d equate this to the modern politician who leaves office to do speaking tours, write a book and be on the board of directors for a few companies. Raise your profile and make lots of money, but stay out of the fray.

Thus in 58 BC Caesar exits politics to cement Rome’s authority over Gaul, which is basically all of modern France, Belgium, Northern Italy and parts of Spain. Rome had been in Gaul for over 70 years, but did not exactly have a firm command of the territory. Only 50 years previous a barbarian tribe, the Cimbri, had marched from northern Europe through Gaul and terrorized the Romans.

This book is Caesar’s account of his attempt to conquer and subdue Gaul from 58 to 52 BC and to gain the sort of glory that would put him in the echelon of Alexander. Caesar recounts numerous wars with individual Gallic tribes. When I hear the word tribe I think of a few thousand people, but the Gallic tribes were massive, often able to deploy nearly 100,000 men for a single battle. This is real life Game of Thrones as everyone involved, within their own clan or externally, vies for dominance over the others through all manner of subterfuge and gamesmanship.

Caesar is able to crush individual tribes in huge battles, but must use all of his political savvy to attempt to control them and prevent future wars. It is impressive how adaptable he is and how well he understands the human psyche. When he catches a tribe leader plotting against him, Caesar has the sense to simply forgive him, as the alternative leader is worse. In another instance he cuts off the hands of an entire rebel army rather than kill them, so as to leave a permanent reminder to their neighbours not to mess with Rome. In a siege he has the sense to divert an entire river, cutting the enemy town off from water. Whatever the situation calls for he adapts and uses all of his abilities to solve the problem.

With his own troops, often fighting far from home and against long odds, he is a true leader. When he senses that they are fearful, he knows what to say. If words seem insufficient, he picks up a a sword and shield and leads them to battle.  He knows when to push and when to ease off. He often references the advantage of battles where those fighting can be seen by their own side since the peer pressure prevents cowardliness and inspires bravery.

In the end the Gallic tribes fighting individually fail to defeat Caesar.  Vercingetorix, a tribal leader appeals to the Gauls to join forces behind him. As he states, it was accepted that one tribe would attack another; the Cimbri had sacked most of Gaul not long ago. The difference though, is that while they raped and pillaged, they also left. The Romans didn’t intend to leave though, they intended to rule.  Gaul, always warring with one another, stood together to fight the Romans, their own White Walkers. The final battle is as massive as it is conclusive.

What is striking is how terrifying living in this era would have been. As Caesar states “what is out of sight disturbs men’s minds more seriously than what they see.” Damn near everything in this era is out of sight.

One tribe, the Helvetti, feel like they are geographically constrained, so burn all of their own villages and crops (so they can’t change their minds) and decide to migrate. All 300,000 people give up everything they have and simply march in another direction, hoping for good fortune. Imagine all of Switzerland burned to the ground, its citizens simply picking up and walking East. Except most of the ancient Gauls probably hadn’t traveled more than 50 kilometres and were entirely ignorant of what existed in the world outside these limits.

Caesar at one point decides that tribes in Britain are helping his enemies, so builds boats to take an army across the English Channel. The unknowns involved are incredible. This mission involves traversing an unknown ocean with rudimentary ships, finding a safe harbour to land over 50 ships and then fighting whatever people live there, with almost no food. At one point all of the Roman ships are shattered due to weather.  So the Romans are stuck on a British beach with minimal food and the enemy literally swarming above them. The only option is to fight these unknown people of unknown numbers. Oh and these people are blue (they dye their skin) and fight on horses equipped with a kind of chariot sidecar nobody has ever seen. When the Romans first fight Germans it is noted that they are physically massive compared to the shorter Romans and are half-naked, the rest covered only in animal skins.

Imagine being an average person in Uxellodunum and the Romans are besieging your city. You know that a previously besieged city ran out of food, but your leaders have planned ahead and you have enough food to last years, if need be. One side of the town is mountain and the other a river, behind which are massive fortifications. The Romans shouldn’t be able to breach the walls. You should be safe. But a short while into the siege there is less and less water. Eventually the spring running under the city runs bone dry. The options are to die of thirst or open the gates to the Romans.

Overall the book doesn’t provide much in the way of historical context so it helps if you know a bit about Roman history already. Dan Carlin’s podcast series on Rome is a perfect prelude to this if that’s your thing.  In the book itself you don’t feel as though you are reading something written by Caesar as it isn’t written in first person and doesn’t provide insight into his own internal thinking, only what he did and the rationale for these actions. It was easy to get lost in repetitive minutiae at times.

The ambition of Caesar is incredible. Whenever an option presents itself he opts for immediate action, often taking insane risks in pursuit of greater glory.  Alexander did more at a younger age, but Caesar left a much larger imprint. He likely wouldn’t be dissatisfied that someone 34  is blogging about him in 2017 and feeling a bit inadequate.

Jeffrey Simpson: Chronic Condition

This entry is a bit late coming. Why? I hated this book!  You tend to not pick up a book when you aren’t enjoying it. I didn’t quit, I gutted out all 376 torturous pages.

Chronic Condition is a look at Canada’s health care system, written by Jeffrey Simpson. Full disclosure, I’ve never liked Simpson. I’ve always thought he is a Liberal party stooge that toes the media line and never says anything interesting. The main problem with this book is that Simpson is a political writer, not a policy wonk.  I never got the impression he understood the Canadian healthcare system or even how the bureaucracy works. A political affairs writer is essentially TMZ for something more important than Snooki. It covers people involved in public policy, but it doesn’t get into the ins and outs of government programs and policies.  As a result the book was scattershot, highly repetitive and dedicated 100 pages to a political history of Canadian health care, when it could have been 10.

I never gave too much thought to the ins and outs of our health system in my twenties, but over the past two years I’ve been chronically ill. My partner is also an MD and we talk a lot about her work. The system works well in some ways (making sure people at immediate risk of dying don’t die mainly), but the more I learn the more I realize that it is an inefficient and incoherent mess. And nobody seems to mind this. Like all  massive bureaucracies “that’s just the way it is” and good luck changing it. I don’t think that’s good enough when it accounts for 40% of our provincial taxes!

I was hoping this book would give me some real insights, but I knew there’d be little insight when, speaking on the matter of finding efficiencies in the system, Simpson just says “that never works.” True it is inordinately hard to change the way a large, complex and entrenched system functions, but the book should be about giving it a crack. The other glaring omission is that Simpson barely speaks at all about what technology can do to make health care cheaper, or to better serve patients.

The book confirms that if you have cancer or are in a horrible car accident, you’ll be treated first and receive excellent care. It is everything else where we fail: wait times for specialists; treating chronic conditions; access to primary care; mental health services; and overall navigability.

In 2017 our medical system still runs on paper, phones and fax machines. Doctors communicate and refer among each other based, in large part, on who they happen to know. This is beyond inefficient, it is wasteful.

The system also serves mainly the practitioner and not the patient. Horribly ill and have to move 500 kms away? No, the Doctor will not talk to you over the phone for even 5 seconds. You must travel 1000 kms.

For the patient there are no options, no evident triaging based on need, no knowledge of what records are sent where. My family Doctor is part of a family health team that operated an after hours walk-in for its patients. Great, it’ll keep people out of the emergency room. At some point the after hours clinic stopped operating, but nobody ever told me. They don’t email patients. They don’t have a website. They have no incentive to inform me of how the system works, so why would they bother?

In my own case I waited so long to see specialists, that I ended up in the hospital for a couple of weeks.  This is probably, without exaggeration, 1000 times more expensive to the state than the ten 15 minute appointments that never happened.

At my wife’s clinic, probably 10% of appointments are not kept. Perhaps an automated auto-dialer or e-mail reminder might help lower this number? Nope. No time to call people.  That’s 10% of the time for someone being paid, on average, $250,000. Might as well burn $25,000 for each Doctor at the clinic (there are about 6 so that’s $150,000, almost enough to hire a new Doctor or a couple of nurses).

There should be some obvious priorities to fix:

  • Mandatory electronic health records that are connected to all physicians and pharmacies and which the patient can access. We do this for our taxes, why not health care?
  • Referrals to specialists that are structured, not based on who a Doctor happens to know. If a patient is willing to travel 1000 kms if it saves three months wait, let them have the option. It frees up space and gets people healthy.
  • Electronic referral, based on your geographic location and your health problem, to the correct practitioner (hospital, family Dr, nurse practitioner, walk in clinic etc.).
    • Let’s say I have a cut that needs stitches. Where should I go? I know that the hospital will deal with this, albeit after about an 8 hour wait. This is by far the most expensive place to go for the system. Is there another option? How do I even go about figuring this out? I don’t know. I doubt others do either, so they go to the hospital.
      • It is assumed patients understand how the system works. They don’t. How would they?
    • Do we need a yearly check up? My wife gets people coming in for these appointments, but they are apparently unnecessary.  How would the patient know this?

I agree with Simpson on this: some private medicine is a good idea; pharmaceutical prices should be negotiated by the federal government (we pay the 2nd highest prices for drugs in the world); there should be nominal fees for access ($15); and funding should follow patients and performance.

All and all a dull read that only touches the surface of what’s wrong and likely what’s possible. It could have been fascinating and there is still an amazing book out there for the right author!