Do You Really Want to Know?
Theodore Dalyrymple has a wonderful article on whether doctors should give terminally sick patients the brutal prognosis or whether they should soften the sentence by giving them more hope than they can reasonably expect. Most of the commenenters on the article’s site clearly said they wanted to know the truth — however unpleasant — when their time came.
… the patient who wants to know, deserves the truth. the doctor who lies to his patient should lose his license … If it’s my time, I want to know. I have things to do and affairs to close. …
My mother was diagnosed with a very aggressive cancer and died 3 months later. I would have highly preferred the doctors to be honest (I had to push them to get the honest answer). I thought they didn’t tell me because I was 6 months pregnant at the time, but it sounds like they do this with every patient. Knowing the truth helps you prepare for it, not only mentally, but financially as well …
It is false mercy to tell a dying man that he isn’t dying. He needs to prepare himself spiritually to meet his Judge. Call in a priest to give him the Last Rites as he draws near to death, and pray for God to heal what doctors cannot, but do not lie to him by denying that he is beyond the help of man’s medicine.
But are those commenters the exception rather than the rule?
Dalyrymple’s major point is that many listeners are themselves deaf to the news of death. The doctors may bear the bad tidings and still they may choose to misunderstand. Dalyrymple quotes literature to explain why we avert our gaze. “Human kind cannot bear very much reality, wrote T. S. Eliot … as La Rochefoucauld said back in the seventeenth century, one can stare neither at the sun nor at death for very long.”
The market for denial is huge and evergreen. Nothing sells so well and the cosmetics industry and politics are testaments to that fact. “On the whole oncologists do tell their mortally ill patients that they are dying,” says Dalyrymple, but from a commercial point of view the truth is poor salesmanship. How many used car salesmen would sell the inventory if they told the customer what the cars on the lot were really like?
Recently the American electorate was faced with a choice between a candidate who told them they economy was sick and another candidate who told them that Happy Days were just around the corner; between a politician who told them that only hard work might save them from bankruptcy and another who promised the certainty of free healthcare, foodstamps, education for all and universal respect for lady parts. Guess who the voters chose?
Hope is a commodity which by definition you can sell even when you can’t deliver . Ran Spiegler wrote an economic paper called The Market For Quacks. In it he defined quacks as suppliers who “possess no skills relative to the default”. By that he meant a patient’s chances of survival are neither improved nor degraded by quackery. What a quack does has no effect on anything but his pocket-book.
If patients understood this model, they would realize that the entire industry provides a worthless service, and the “market for quacks” would be inactive. Indeed, standard market models presuppose that all market agents, firms and consumers alike, have “common knowledge of the model”.
But the market for quacks is not inactive. On the contrary it is quite lucrative because it is arguably easier to sell false hope than it is to sell the unvarnished and unpleasant truth. Why is this so? Spiegler argues this springs from the individual belief that they will be the exception to the rule. The mortality tables may say that a given disease is 99.9% fatal in 3 months. But there is something about the individual that allows him to think he will be in the 0.01%.
Instead of reasoning probabilistically with respect to a correct market model, patients reason anecdotally: they rely on random, casual stories regarding the quality of treatments, and react to these stories as if they are fully informative of the actual quality of treatments. As a result, patients are exposed to exploitation by healers, because they attribute their occasional success to skill rather than luck. The question is whether market competition could mitigate this exploitative e¤ect. I examine the extreme case of a “market for quacks” – that is, a market for a completely worthless good or service – in order to bring this question into sharper focus.
What Spiegler does not address very well is what I would call the breakdown of rationality in life and death conditions. The normal scale of values is altered at the point of death. A billionaire in health might not consider it worthwhile to spend a 100 million dollars on a .00001% chance of survival. But since he can’t take the money with him, wagering on a quack at the point of dying may seem more attractive if he is given a dire prognosis by a doctor.
Jay Kim and John Haleblian in another economics paper argue that desperation can make a firm overpay for assets it might otherwise not acquire, something that all of us probably intuitively understand. Historians have long known that men entering battle have steadied themselves by thinking that however dire the situation, they might be the ones to just make it out.
Hope is most valuable when it is least plausible. Hence the market for quacks.
This raises the interesting possibility that Barack Obama’s re-election was in part aided by the abject failure of his first term. The patient, having been brought by the quack to the point of death, then had a choice between a doctor who, as Dr. Dalyrmple’s commenters preferred, told them the truth. The alternative was even more quackery. Realizing that Dr. Romney’s treatments might be painful and uncertain, is it any wonder that so many voters chose the medico who promised free, easy and miraculous recovery?
Those who think that a second, even more disastrous Obama second term will ensure the rejection of his policies should consider whether they might not make things so bad that the only possibility of survival is more of the same.
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Romney = Mean ole Parent.
Obama = Hip Metrosexual Boyfriend
TWANLOC = Silly Girls
“Spiegler argues this springs from the individual belief that they will be the exception to the rule.”
Sounds like every teenager in history of humankind, myself included. I’d like to think I’ve matured a little since then.
Somewhat o/t, here’s a place where market for quackery was a hard sell: http://www.bbc.co.uk/news/business-20299388
Steve Jobs was a billionaire who first of all denied his cancer to himself and others and spent millions on quack remedies.
Christopher Hitchens was a anti-theist ” rationalist” who smoked 50+ fags a day for for 45 years and drank at least a bottle of whiskey and multiple bottles of wine a day for 40 years -
- all the while denouncing Christians as foolish sheep who were in denial of reality.
People are not ” rational ” they rationalize
Jobs and Hitchens both “rationalized” until the grim reaper took them.
The grim reaper for America is the national debt-fortunately if we harvest our energy in oil gas and coal we could be the worlds largest energy exporter-combine that with ending aid to foreign countries and offering visas to technologists/scientists/entrepreneurs and we will be fine in 7 years.
The main ingredient in quack remedies is ” hope ” the rest water.
Spot on. I don’t know if this Ace post influenced this one, but it’s certainly on a parallel brain wave. The snake oil salesmen have always been with us, and always will be. Today they just go on TV to peddle miracle holy water, impotence cures, and free government money in a suit emblazoned with question marks. I’m sure they’re doing land office business in times like these.
Hell, we’ve got plenty of the peddlers of false hope among the essayists on PJM, but of a different kind. I don’t doubt the sincerity of any of them; they are not doing it to make money, but because they truly believe in the cause. We’ll win it back next election! (Yeah, your team might win the next election, but they aren’t going to do what it takes to change things).
But I’m tired of the lame rah-rah halftime pep talks. It’s the 4th quarter, with 5:00 remaining, and we’re down 21-3. Yeah, there’s a tiny mathematical probability of us making a comeback (and everyone remembers with great pride the one time in history that it actually happened), but there’s really a snowball’s chance in hell that we could actually win. As any sports fan knows, hope always springs eternal, so you believe that your team can pull it off, even though they almost never do in that situation. If one points out that maybe it’s best to screw hope and start planning for the next game, the True Fan shouts him down as a heretic. Seems like the same dynamic here. The True Fan isn’t a bad guy, but he’s got his head hopelessly in the clouds.
“if we harvest our energy in oil gas and coal we could be the worlds largest energy exporter”
That train has already left the station. What part of NoBama don’t you understand?
“We’ll win it back next election!” Yes we will… and I am mulling over monkeys or pigs and flying and stuff. The only way forward is to crash the system. Kiddies will always vote for free stuff if they think they are going to get it. Let them suck the teat dry and suffer.
*shrug* I know a woman with breast cancer metastatic to the lungs and bones, yet she lives and works two jobs and takes care of the small granddaughter that she has custody of, for her daughter is on drugs. She didn’t understand when the doctor told her that treatment would only be palliative, not curative. She was relieved that she wouldn’t have to undergo surgery or chemo or radiation treatment because she has custody of the grandchild and has to work two jobs. She doesn’t have time to be sick.
She has lived under this sentence of incurable cancer for a couple years now and her tumors have been shrinking.
There are always people that have beaten the odds for whatever reason, but would they have beaten the odds if told they were dying and there was no hope whatsoever?
People die the same way they live. There is no dramatic seeing of the light that inspires a difference, no changing one’s temperament or behavior. if they lived with their hands over their ears yelling “nanananan i can’t hear you”, they die that way.
10 years ago my (then betrothed) husband’s father was diagnosed with lung cancer. 6 years earlier, on one of our first dates, my husband took me out to dinner with his father, who had a nasty cough that sounded like a death rattle of emphysema or worse. I even asked about it, and he said, “just allergies”. i knew then he was wrong. 5 years after that night, he was exercising 2 hours a day, taking yoga, no alcohol, low fat calorie restriction diet. he knew, but he didn’t want to know.
We were there when the pulmonologist delivered the bad news of cancer, and there later that day when the oncologist told us he had 6 months to live. he made it 4.
we, husband and myself, were the only two in the family who heard what the doctor said that day, though my husband’s step mother, her other sons, my husband’s sister, my husband’s aunt, and many others were physically there when the doctor said these things. they all refused to comprehend that the chemo and RT were purely palliative. nothing would persuade them, any of them. their anger at us when we said anything was visceral, nearly violent, unforgiving. and because of their denial, they wasted the opportunity to spend those months saying the things they wanted to say to each other.
he was the worst though. at the end, he blamed the docs for bad care, angry when we told him that his wife could not manage to care for him at home. he was mas that they hadn’t cured him, and refused to admit he needed to be in a hospice. didn’t matter, the next day the nurses pulled rank and he ended up in a hospice, overmedicated, and unable to communicate.
he died a couple weeks later, the family shocked that the treatment hadn’t helped. angry at the docs and us, we were not forgiven for “having given up hope.”
you cannot tell people the truth if they don’t want to hear. and when they crash into reality, they still don’t admit it.
it will never be O’s fault, or theirs for electing him. it will be the Rich’s fault for stealing the pension funds, for bankrupting America. everyonebut themselves.
and when
My dad has been living the past 15 years with a six months until death diagnosis. Three heart attacks, two rounds of surgery for cancer- some of it remains in his body- organs cut out, organs cut in parts…he has a shaving kit full of all the drugs he takes every day to function. He has standing appointments with various doctors.
It’s doctors vs sumbitchness, sometimes.
OTOH, the genuinely decent, good guy father of one of my kids friends died in 8 months flat, from first symptom to funeral. My age.
My dear old dad, a Brit ex-pat mechanical engineer who left Merry Ole in 1949 when it was clear which way the wind was blowing, used to say with pride (right around Watergate) “The American public can tolerate anything as long as it’s the truth.”
I’m glad he didn’t live to see this mess. God am I glad he didn’t live to see this mess…
My best friends father was a decent and simple man who loved to debate or just talk things over with you. He had a firm belief in this idea;
We are each alotted three score and ten.
If you live three score and twelve, then you have borrowed, or taken, those extra two years from someone who now had to die at sixty eight. He believed firmly in the saying; “You’re living on borrowed time.”
Of course he was right statisticly but thats not how he saw it.
I’ve remember the lines from Shakespeares ‘Julius Caesar’ we had to memorize in Hi School;
“Cowards die a thousand times before their death, the valiant taste of death but once. Of all the wonders I have yet seen, it seems to me most strange, that men should fear, seeing that death, a natural end, will come when it will come”
We know that WWII and 50 million deaths could probably have been averted if only the British and French had stood up to Hitler in 1937 when he ordered his troops to occupy the Rhineland. Yet, they kept trying to get a deal long past the point where any sane man could expect one. Churchill spent many years as an object of hate crying in the wilderness and warning the people of the gathering storm. Yet, they turned him out not long after saving them from destruction. Suicidal self-destruction is our lot in this life. However unfair as it may be, it remains our responsibility to tell the truth to the people, even when they don’t appreciate it, and be ready to pick up the pieces when they invariably make a hash of things.
My dad has been in the hospital going on 2 months now. Went in for something routine now is being medicated to death for all I can tell. Sharp as a whip… used to tell me that he intended to outlive me and I believed him. His body is now frail and I don’t expect him to make it to the end of the year. My mom, strong as an ox was diagnosed with Alzheimer’s earlier in the year. She is barking mad now though I am amazed that she surfaces for moments of clarity. My older brother is freaking out and trying to force the issue on both counts. I admonish him that there will be time. Let events play out. Do not over react. Right now my major life plans is to cook a turkey with all of the trimmings this Thanksgiving. Thanksgiving, that is what it will be for what is in all probability the last with living parents. It is, after all, a blessing. Never forget that we, the living, have been blessed with full lives. Should we be greedy for more than our share? Don’t know but we should be grateful for that which we so undeservedly received.
“Yet, they turned him out not long after saving them from destruction.”
Yes and it took some 70 years before the first communist president of the United States sent it back as an act of shame. It was a good run.
Elmo is a pedophile.
All of this thirsting after truth leads to a harsh question for this parched pilgrim. Wretchard, how do you correct for bad inputs, corrupted data and cognitive bias? A few days ago, in the comments section, you wrote:
“If you have confidence in the correctness of your judgment then you really have nothing to fear. I have learned, just now, that what I thought was true was not in fact completely true. So I can no longer hew to that. For whatever reason that’s how things are.
That requires adaptation. A plan B which must be validated by reality. One cannot go through life insisting on is right when one is losing. I have to start winning otherwise I’m just kidding myself.”
Fascinating. It appears like many of us, you too swallowed a “poison pawn,” some false hope in the guise of real polling data. Before we can strategize for the present we must have a clear picture of the terrain around us, the field of battle, and the forces in alliance and opposition. Any suggestions?
I too, want to start winning.
nothing would persuade them, any of them. their anger at us when we said anything was visceral, nearly violent, unforgiving.
Among all the other things that Obama is “transforming” about America is, it seems, the disappearing of our national character trait of compassion. I don’t think it’s just election-season pique that I’m witnessing … I think it is a genuine, long-term change that is taking place.
Americans have traditionally been an incredibly charitable and generous people, leading the world in giving:
No developed country approaches American giving. For example, in 1995 (the most recent year for which data are available), Americans gave, per capita, three and a half times as much to causes and charities as the French, seven times as much as the Germans, and 14 times as much as the Italians. Similarly, in 1998, Americans were 15 percent more likely to volunteer their time than the Dutch, 21 percent more likely than the Swiss, and 32 percent more likely than the Germans. These differences are not attributable to demographic characteristics such as education, income, age, sex, or marital status. On the contrary, if we look at two people who are identical in all these ways except that one is European and the other American, the probability is still far lower that the European will volunteer than the American.
But guess what. Stoking envy & class division, bold political looting & the encouragement of voting for one’s income rather than working for it … this kind of stuff has an effect even worse (IMO) than economic hardship. Because what it does is destroy any impulse that hard-working & productive people might have had to help those with less, when devastation hits.
The Dems spent the entire presidential campaign decrying Republicans for (the false accusation) that conservative values of self-reliance & independence amount to “every man for himself.” The irony is that the Democrats are producing exactly that kind of environment. The more they villify, the more they accuse, hector, punish and loot … the more the wails of their dependent constituents will fall on deaf ears as things continue to go downhill.
Read the comments sections of just about any news story on the aftermath of Sandy in deep-blue NYC. There is a tremendous amount of, shall we say, lack of sympathy out there. “You get what you vote for; elections have consequences” is probably the #1 most common comment by far.
As much as such remarks make me cringe on the one hand, I have to admit that I am pretty much at the end of my sympathy leash as well. Re-electing Obama was a truly psychotic (as in, detached from reality) and childish tantrum by 60 million people who did not want even to hear about, let alone deal with, the fiscal catastrophe overtaking this country.
And it wasn’t just the screeching-with-fingers-in-ears-eyes-closed-foot-stomping dramatics that got unleashed. It was the invective towards those who were trying to be responsible adults talking about the debt, the economy, and how to address the problems with each. According to the screaming brat, us conservatives are mean ole poopyheads, and the brat hates us. Yes, HATES us.
Now it’s one thing (forgivable) when it’s your own child who says this to your face. Quite another when it’s a grown-up who votes, a $130K/yr Georgetown law student who won’t spring $500/yr for her own birth control pills, or a govt employee who lives off your tax dollars and gets better bennies than you do & will retire at 52 while you will likely die in harness at 78 or 80 (if the stress doesn’t kill you at 63). Somehow, from these people, the banshee shrieks of poopyhead hate are not so charming.
The worm is turning.
I wonder if this episode of national psychosis will be studied in psych texts someday & not just the history books.
The real question is not if you would tell the patient but if you would tell his friends and family.
It really does not matter in terms of the future of the patient. But his friends and family will have to make plans to deal with his imminent loss, with caring for him until he dies, with handling the aftermath, probably even with finding a new source of income, and being able to indicate their feeling for him in an unreserved manner until they could no longer. You would have to tell them.
And I think Obama did that much, intentional or not. While he strutted about as always, he surely must know that a good percentage of the country had him pegged last time and essentially half had his IFF code this time. Studies by Frank Lunz and CNN both showed that 6 to 7% of his voters 2008 decided to vote for Romney this time.
He got 99% of the black vote last time. He got 93% this time. Incredibly, the difference matches that 6% overall number of voters who switched. Black people Ided him as a disaster at the same rate as whites!
He won only because Republican voters were more disgusted with Romney than his “base” were disgusted with him. It is said that victory goes to the guy who makes the least mistakes, not the one who is the most brilliant and innovative.
So does he know that he did fool half the people and did not fool the other half? I think that likely. And that means, effectively, he told the family but not the patient. Maybe he is counting all those John Gaults out there pitching in. Maybe he thinks he can shame them into it or frighten them into it or even legislate them into it. Or maybe he figures that when it all ultimately comes unzipped he’ll be safe somewhere in any case; if so, I think he’s wrong on all counts.
11. ACS – Yep. And who, once the war was over, led the charge for booting out Churchill? Oh, yeah, the media. Quelle surprise.
12. Annoy Mouse – Hang in there. Been there, done that many times (grandparents, parents, aunts/uncles/cousins). First rule: Stay grounded, and don’t forget to take care of yourself as well as others. Second rule: See if you can find a doctor who favors minimal drug intervention. Time and again, I’ve seen elders do better/best under the “less is more” approach. Take care, our thoughts and prayers are with you.
“It appears like many of us, you too swallowed a “poison pawn,” some false hope in the guise of real polling data.”
Let’s start with my official election day prediction at PJMedia:
You will notice what relative strengths I assigned Obama. In my view he had a stronger underlying base. The GOP, I estimated was more “energized”, but that would be chipped away by ground game that would be implemented to win “by any means necessary”.
I will put it to you that I was objectively pretty much on the money. But why did Romney lose?
What I am trying to decide in my mind is whether my estimate was an accurate or “true” estimate of the polling data; if in a completely honest election, the prediction I made was a correct one. Or did I get the underlying right, but underestimate the “ground game” and overestimate the “energizing” factor.
It’s important to know what you were wrong about. It’s also important to know what you were right about. Was I wrong about the fundamentals
The talking points being shopped around is that the mistake conservatives made is in believing they could beat the democrats; to believe they could escape demographic fate.
Do I believe that? No. I think that base to base it was pretty as I called it. Or do I believe that the problem was underestimating the weight the ground game? Recall also that I never put much store by Romney. (Read Storming the Castle) I wrote shortly before the election that at best he could buy some time.
I have to say that I believed for a time I was wrong that it would be so close. The buzz before the election was that Romney would blow it out, making my official prediction unnecessarily gloomy. But then again that goes to show how easy it is to be herded into a meme.
If you go back to Nagumo, his big mistake was to let events hijack his plan. He sent his planes up and down to the hangers with anti-land, oops anti-ship, oops anti-land, oops anti-ship. That was when McClusky caught him. Had he looked for the carriers from the start and stuck to it we might be speaking Japanese today.
By and large I think that my analysis has held up remarkably well; that the mistake if any, is to depart from the reasoned prediction and embark on a wave of enthusiasm. That goes for gloom too. It is now all the fashion to self-flagellate. My belief the whip should be plied on the enemy before one flogs oneself.
More than ever I believe that the weapon of decision is the local election run to recapture the conservative cause. To some extent I should congratulate myself: my own estimates compare quite favorably with Michael Barone’s or George Will’s. And they believed in battleships like the GOP. I think the day of the battleship is done.
As for Axelrod, he’s just another kind of battleship. The lesson of 2012 is not that battleships rule the waves, but that some battleships are more obsolete than others.
Quackery is not neutral in effect. There is always the Opportunity Cost.
Hospitals should be required to provide the prospective patients with detailed lists on probabilities of results for procedures as well as publish standard fee tables. As it now is when you walk into a hospital you have no idea what odds of a range of possible outcomes are and what the bill will be until they pull a rabbit out of a hat.
Once I walked in with a small cut to a finger and got sent a thousand dollar bill. Getting to that is way way up on my priority list. Now where did I put that list?
#12 Annoy: God bless you. You’ve got a tough row to hoe there and I don’t envy you at all. Be strong and love them while you have them. Remember the good times. Leads me to this:
#17 GDI is absolutely right–my mom had chronic back pain and ended up addicted to various narcotics. By the time she weaned herself off that addiction she decided the pain wasn’t as bad as the side effects of the drugs.
Annoy, find the best damned GP you can to look at your Dad, before they all quit in anticipation of full implementation of Obamacare.
am @ 12: Went in for something routine now is being medicated to death for all I can tell.
AM, hang in there. Every story is different but few are easy. I see that you seem to know, and it’s just a day at a time for all of us who live, that’s what comes through when the story gets to this part. Then we the living look to remember the good that was, and if necessary the bad.
My parents’ medical travails over their last few years does not give one huge confidence in the system. I suppose they were helped in ways not available a hundred or a thousand years ago but the end of the curve comes out about the same even so, and perhaps always will. But it also makes Dalyrymple’s concerns seem pretty self-absorbed. The difficulties and the dramas involved are in some ways irreducible, try anything, doctors, in regard to the bedside manner, just don’t try to make it the center of the story.
The layman, the family, the patient, are not optimal consumers in any case. The doctors’ main problem is their expertise, they can hardly empathize with the principals, words just won’t do it. You can see this on some of the episodes of House, where they put on display the apparent callousness of the professionals involved, but they go through this ten times a day and they have to survive too. I got to discuss my parents’ situations with medical professionals in my own family, who really cared, and yet the quick answers from their experience – don’t change the underlying facts. So, I’ll take Mister Spock for a physician, thank you, along with Doctor McCoy, and perhaps this is where they can agree. Get the science right, and try to be objective about the situation, treat every case on its merits, and support those humans in their emotional excursions, which are after all not really yours.
–
What, and then morph this to Dr. Romney’s little liver pills? That’s what the RINOs say, the pills weren’t tasty enough, lacked sufficient snake oil. Maybe the real problem is that Dr. Romney came across as a quack, indistinguishable from either Dr. Barry or checking out of the hospital and into the cat house, where you might as well go for one last fling. Mondale didn’t get very far telling voters he would raise their taxes for their own good either. Too moral a man to go for just raising the taxes on the rich, like Obambus, even when clearly raising taxes on just the rich won’t put a dent in the deficit, but probably will put a large dent in the economy. DO NO HARM, Dr. O, or didn’t they cover that in your constitutional law class?
There are some really good movies that blow the lid off of truth coverups. Watch Steven Spielberg or Oliver Stone.
Some folks would rather be out-of-touch with reality than know all about things.
Whenever I hear about the hard truth and shuffling people off to die with dignity I think of my mom. The doctor wanted me to sign some do not resuscitate form and shuffle her off because she was ‘failing’.
By ‘failing’ it meant she wasn’t hungry and did not want to do her physical therapy. It developed that she did not want to do her physical therapy because she had a broken leg. And it hurt.
So therefore for me and mine, I want all the machinery and resuscitation possible. If God wanted us to die young he wouldn’t have created doctors.
Wretchard @ #18: Your analysis is good. However, you along with many others—–including me—– totally misread the nature of the Obama “ground game”.
The person or persons masterminding Obama never stopped campaigning after 2008. They kept up a full-time and costly effort. They indentified the so-called swing states. Those that could go Republican in 2012. They next figured out how many votes outside their assured base they needed to hold and profiled what motivated different portions of those groups.
This allowed them to isolate and target what amounts to a lunatic fringe. Those who are going to believe the most preposterous no matter what. Thus all the failures of the administration were touted as accomplishments protecting “the peepul” (the 99%???) against the predatory practices of the productive. Solyndra was a bulwark against Bain Capital. Fast and Furious kept the NRA at bay. A National Debt that could not be paid was protection against poverty. Sandra Fluke was a Madonna struggling against the Wicked Witch of (Ann) Romney who conducted a war on women. Had to stop fracking at 15,000 feet some the water table at 100 feet would not poison the drinking water pumped from a lake. And there was but a single source of salvation against the forces of evil (white that is): Teh Won, Teh Won and Teh Won! After all, Won plus Won plus Won only equals a Trinity of One.
So while the Obama vote totals shrank drastically, there were and are enough lunatics to hold onto the swing states.
That is enough to give me some concerns about the future of our electorate. And that ain’t all. Normal political operatives and donors only want to go home after a campaign. Finding and paying enough people to stay on the job for four years is rather commensurate with a centrally directed PSYOP/AGITPROP/DISINFORMATION Campaign. One whose goals start with an Obama but do not end there. I think so investigation is in order. Debunk me if you can BCers. This is something I had rather be wrong about than right.
At any rate though, all this does show where enemy vulnerabilities lie. In their financial logistics. (rather like those of Ferdinand Marcos) Insane borrowing even when the checking accounts are full followed by obligating all income to PayDay Loans in order to make minimum payments of the Credit Card.
Throw a monkey wrench into that machinery and you will see a conspiracy unravel in front of your eyes!
Now for another topic: Tell the patient?
C. S. Lewis had a few choice comments on this. Speaking as Screwtape to Wormwood,he noted that in war men were prepared to die and consequently kept their souls in good working order. A fact which negated some instances of cruelty and excessive indulgences in minor vices such as whiskey and women.
Therefore how much better it would be for “Our Father Below” if all were to die comfortably in bed surrounded by Doctors that lied, nurses that lied, friends that lied and family that lied. That way they would expire thinking they were going to recover and could then go and sin lots more thereby provided tasty repasts for the demonic larder.
I think Lewis had it right.
I understand that the point of this thread is to highlight the extent to which people will evade awareness of trouble, preferring to linger in the magic of wishful thinking and denial. The medical examples are of unjustified hope trumping clear minded truth.
But when Obamacare is fully operational, we will see unjustified negativity (AKA “Death Panels”) to deny care to those who fail to meet the cost-saving algorithms. Thus granny will be denied her hip replacement because she had breast cancer 20 years ago and borderline type two diabetes. And an unknown number of patients will be counseled to accept death who might otherwise have been saved.
False positives and false negatives. We can never reduce them to zero, but they certainly do seem to be on the increase.
Listen friends, and mark my words in this moment and this hour–
God is jealous for his name for his name is jealous.
Nor is this a charming flower to set before a man
nor one of his commands.
Yet, without Jesus, this is more than we can love as we desire peace,
and less than we can know as we desire joy.
For the sacred fire
that makes us liars–
I mean, that separates speech from dreams,
and separates our flesh from the future–
is God’s power manifested.
So, in the year and the hour– for his sake, invest your desire in Jesus.
Follow his holy fire for right now. Right now he intercedes for us in heaven!
Some will say we are people of the way.
We are people of the way.
We praise his holy name
Yahweh.
I am who I am.
I cause things to be.
I am the first cause of creation.
We praise his holy name
Elohym.
And say “Thank you Jesus for your precious blood–
better, so much better than the blood of Abel.
How then should we pray?
I pray bless me a lot oh God.
Show me your kingdom and righteousness
in such a way that my thoughts words and deeds
reflect your wisdom and power–
and that– for the sake of your honor and glory.
So that I will live in your presence
in this life and the next.
For your name sake
Let me hear my children praise your name
And their children too.
Let them woo 10 generations
coiled up in their dimensions
to the praise of your name.
Let my enemies,neighbors,family, friends,
strangers praise Jesus–
the risen Lord
I pray all this in Jesus name.
So, what will be the effect of reality’s vote in a year’s time? Is there any set of circumstances that could conceivably lead the left to critical introspection, doubt, a course correction? I submit the answer to this is an emphatic ‘no.’ There is nothing left now but for the thread to play out. Bring it on, reality. Show us what you got.
So, what will be the effect of reality’s vote in a year’s time? Is there any set of circumstances that could conceivably lead the left to critical introspection, doubt, a course correction? I submit the answer to this is an emphatic no. There is nothing left now but for the thread to play out. Bring it on, reality. Show us what you got.
We are still hearing from supposedly knowledgeable people that McCain garnered 3 million more votes than Romney. wrong! The vote difference is now down to about 1 million and closing.
The major hits that Romney took compared to McCain were 700,000 in California, 500,000 in New York and 150,000 in New Jersey. About half a million of those were in the New York/New Jersey coastal area alone. Thank you Chris Christie!
Romney did better in all the battleground states. He did worse in about a dozen states, some of which had significant votes for the the Libertarian candidate.
Annoy Mouse @ 12:
Your major life plan is the tops. May God bless it. I’m sorry and moved about your troubles.
30 @Aristide
The major hits that Romney took compared to McCain were 700,000 in California
If I had to guess, that’s probably the demoralizing effect of being in what is effectively a now one-party state. It is hard at times to drag yourself to the polls when you know your vote isn’t going to mean jack crap. I live in a state that is not quite as leftist as CA, but is now leftist enough that a Republican will never win a statewide seat, that pretty much every progressive ballot measure gets passed and ones that roll back the state almost never win. I don’t think I’ve ever voted for a winning candidate in a major position and very rarely have been on the winning side of a ballot measure, except for the relatively trivial ones. It’s tough to get shellacked every election and have any enthusiasm to return for yet another beating.
On a somewhat related tangent, the rock-ribbed conservatives I follow on Twitter are all gung-ho, ready to rally the troops for 2014 (and the Libertarians are congratulating themselves for getting 1% and doing a smug “I told you so” to conservatives). But I don’t have it in my heart to dive into electoral politics again right now. I just want to live my freaking life. I seem to remember a time when there wasn’t a perpetual campaign, am I mistaken about that? I guess this makes me a lousy person, but I just want to live my life and be left alone by politics and politicians for a while. Maybe I don’t really want to know any more.
Wretchard @ 18: “It’s important to know what you were wrong about. It’s also important to know what you were right about. Was I wrong about the fundamentals[?]“
I have bored people on this blog often enough with the topic of the Contingent Voter. But even if the analysis is unfashionable, it remains the best explanation of presidential elections since Watergate. Romney lost the election because he failed to motivate Contingent Voters to come out & vote.
Yes, anti-Soetero conservatives were highly motivated. But they were motivated by their disgust for Soetero, not by their desire for a Romney presidency. Yes, Soetero ran an expensive campaign, but its efficacy was rather questionable: even with the precincts where 140% of the electorate voted and those where 99% voted for the crook, Soetero still fell millions of votes behind his last election. Where was that “magnificent” ground game?
The Republican candidate has been the key factor in every presidential election since Watergate. The Democrat candidate gets the genetically-determined Democrat tribal vote (plus the vote shenanigans uplift), and that is all. The Republican candidate is stuck with the (smaller) genetically-determined Republican vote, unless he can reach out to the Contingent Voters and offer them something positive to vote for — generally anti-Washington, smaller government.
What those of us who detest Soetero may have missed was the number of Republicans who were enthusiastic about getting rid of Soetero but much less enthusiastic about candidate Romney. That was the important signal we missed. Romney failed to sell a credible message that he would fight for smaller less-intrusive government. Without that positive message, the Contingent Voters stayed home, and Romney lost.
Looking forward, the key to winning the next presidential election is for Republicans to choose a candidate who gives the Contingent Voters something positive to vote for. Very simple. But in war & politics, doing simple things can be very difficult. How do Republicans take back their nominating process from the media?
Kin@33 I think you have the made the case for the contingent voter.
Whether or not Romney got as many votes as McCain is besides the point. Both failed to deliver the base and connect to those who feel the whole system is corrupt and ineffectual.
It is now pretty much a proven fact that Romney’ s Project ORCA was a complete waste of money and effort. With the exception of his selection of Ryan and his first debate performance, Romney’s campaign in hindsight was a near total bust. He assumed that the disgust of Obama was enough to beat Obama, so he didn’t need to provide much in the way of credible policy alternatives. He played prevent defense from the beginning and was shocked when it didn’t work.
Within the limits of his lack of accomplishments, Obama ran a highly disciplined negative campaign that knew where and who his potential voters were, and played those meager cards masterfully. His people also knew where Romney’s potential vulnerabilities were and took advantage.
Romney, on the other hand, ran away or simply refused to engage millions of his potential voters from the beginning. Culturally, Romney’s people detested the contingent voter/conservative base and chose not to go after it with any vigor. They chose instead to go after and base their whole campaign on attracting the slim pickings of the undecided moderates who more often than not break Democrat. That is why Romney lost. His fatally flawed campaign concept was heavily biased towards the people he culturally felt closer to – the moderate Progressives.
And now we are stuck- almost on the outside looking in – of a country we thought once knew, betrayed repeatedly by those we elected of our party and almost powerless to change the course of our nation careening so it seems towards totalitarianism, collapse and chaos.
Dalyrymple quotes literature to explain why we avert our gaze. “Human kind cannot bear very much reality, wrote T. S. Eliot
Atheists seem to think that it is believers who need a pleasant fiction to get them through. But, on the contrary, it has always seemed to me that if unbelievers ever really and truly squarely faced all the ramifications of their position, then they would be forced to either (a)believe, or (b)avert their gaze.
This is why I could never really trust an unbeliever. There is such a lot they have to gloss over in order to go on about their business with some modicum of sanity.
#15: Among all the other things that Obama is “transforming” about America is, it seems, the disappearing of our national character trait of compassion.
Bogie makes a good point here. I do worry about all the worthy charities out there and how they will fare in the days and years ahead. I wouldn’t even be surprised to see at some point a move to take away their tax-exempt status. At least some of them, the less politically favored ones perhaps.
I’ve read a lot of explanations about where the Romney campaign went wrong but the fact is the truth was plain for anyone with eyes to see, in spite of our less-than-ideal candidate. Only an already demoralized electorate with an already compromised character could decide that cradle-to-grave care is a proper role for government. The Collective can’t care; only an individual can care. We have a lot of people out there celebrating and congratulating themselves because their guy won, the good guy, the guy who “cares most about people like me.” Food, shelter, healthcare… oh yeah, just turn all these things over to the people who wield the sword, now that’s compassion! And those who will pay for it will be forced to pay for it. How wonderfully compassionate can you get? Is this a great society or what? So sorry to have to say this but for half the people in the country to be that untethered to reality means we’ve gone past the point of no return.
“Instead of reasoning probabilistically with respect to a correct market model, patients reason anecdotally: they rely on random, casual stories regarding the quality of treatments, and react to these stories as if they are fully informative of the actual quality of treatments.”
This is the element of human behavior that has always existed but which religion and community and cultural institutions have (correctly) tamped down over the millenia. When, in the 20th century, it was unleashed and lionized, we called it postmodernism. The cherry picking of the facts to justify some preferred agenda over reality was seen as evidence of unhingedness until very recently. Now it is the attitude of choice for so-called progressive political behavior.
So, in essence, the left is behaving like a patient with a terminal disease who casts about looking for crystals or laetrile instead of dealing with reality.
Karen Yvonne #35:
“Atheists seem to think that it is believers who need a pleasant fiction to get them through. But, on the contrary, it has always seemed to me that if unbelievers ever really and truly squarely faced all the ramifications of their position, then they would be forced to either (a)believe, or (b)avert their gaze.
This is why I could never really trust an unbeliever. There is such a lot they have to gloss over in order to go on about their business with some modicum of sanity.”
“Only an already demoralized electorate with an already compromised character could decide that cradle-to-grave care is a proper role for government. The Collective can’t care; only an individual can care.”
“So sorry to have to say this but for half the people in the country to be that untethered to reality means we’ve gone past the point of no return.”
Karen, this is what happens when the cultural elite in the country decide en masse that they wil buy into the aforementioned postmodern avoidance of reality and abandon the wisdom of the ages. Societal trends move much more rapidly and more devastatingly when they affect the elite more than the public at large. The U.S. could probably retain its character and function with as much as forty percent atheists in the general public, if the elite were still reality based and had the intellectual governor of belief and its restraints on certain behaviors relating particularly towards envy.
The critical mass is much lower in the elite. Once it got to ten or fifteen percent of the education and government bureaucracy industries there was a cascade effect. In essence, a small number of badly behaving and deluded TWANLOC elites “gave permission” to millions of other people to behave badly also, and this permission is easily distributed nowadays with the media machine and the bully pulpit of publicly subsidized “education” at all levels.
Add to this the fact that on an absolute historical human scale life is still comfortable enough that Kinuachdrach’s “contingent voter” still believes he can sit out the plebiscite because he has told himself “things aren’t really all that bad right this minute”, and here we are.
When a nation is governed by greedy envy driven thugs combined with NPR-listening pseudointellectuals, and people who could end it sit at home based upon comfort and minutiae, you get Obama’s America.
“they wasted the opportunity to spend those months saying the things they wanted to say to each other.”
Lucky them.
Not everyone’s life is Hollywood movie. My mother spent the last waking days of her life berating her children for failing her.
Karen #35:
“Only an already demoralized electorate with an already compromised character could decide that cradle-to-grave care is a proper role for government.”
Yes, we have to recognize that some Americans are already lost, to us, to the country, to themselves. They are the “terminal cases,” while we are like the family members who need to hear the grim news and prepare accordingly.
The ones who said “Now that Obama is elected I’ll never have to worry about paying for gas for my car or my mortgage.” are lost, permanently, terminal. They have no future. Mitt had it right; it’s not our job to worry about them.
Others may be lost as well, like those who have graduated from college, are presently hoping to find a job flipping bugers but are convinced that The Government should provide them with a job as directing movies, like a memorable OWS protestor. It remains to be seen for them.
Thanks guys.
I think that one must be at peace with one’s maker and ready to face that which will come inevitably to reconcile the same inevitability in others. It is my parents lot that they shall pass before I do. It is as it should be and I have stared headlong into the abyss one too many times than necessary to realize that but for the grace of god I will be making that journey soon enough. I have in some way dreaded this outcome for the past 30 years and so have managed to treat time with my parents, flawed and human as they are, with respect and the kind of love that children have towards their elders. I more or less missed this opportunity with my grandparents and was determined not to repeat it.
Talley Ho.
db @ 32: If I had to guess, that’s probably the demoralizing effect of being in what is effectively a now one-party state. It is hard at times to drag yourself to the polls when you know your vote isn’t going to mean jack crap.
You can also go to the polls but leave the office unvoted. I often do that, for judges and school board races I have not read up on. Wouldn’t surprise me if a fair number of Republicans just go and vote on a few selected propositions. Or, sure, skip the whole exercise as time wasted and an offense against all that is good and right.
‘It is false mercy to tell a dying man that he isn’t dying.’
Of course; 1 + 1 = 2 as well. Why would anyone even bother discuss this.
A doctor can give you an expectation, and some factors influencing the variation, but not your own precise endpoint. Stephen Jay Gould figured he would beat the median. Here’s how…
… in writing:
http://cancerguide.org/median_not_msg.html
or read aloud:
http://www.youtube.com/watch?v=cH6XuiOBbkc