Ability to Pay is Out of One's Control: An Argument Against the Commercial Model of Health Care

1. The commercial model of health care states that quality health care (QHC) hinges upon one's ability to pay monetarily for the services of medical professionals.
2. Ability to pay for such health services is determined by one's ability to either acquire money oneself  – for example, through employment – and/or one's ability to solicit charity from others – such as from acquaintances or family members.
3. Among others, the conditions of stable personal employment requires that one be able bodied and able minded (i.e. not disabled or critically ill) and have received years of support from others in the form of constructive upbringing and formative education.
4. Both such conditions are out of one's control in that one cannot choose one's physical capacities and susceptibility and/or immunity to disease before birth (and in many cases after birth), and because one cannot control the actions of others (esp. as an infant, when one is most vulnerable).
5. Soliciting monetary charity from others, be it children from parents or stranger from stranger, is out of one's control for the same reason -- the actions of others are out of one's control.
6. Thus, in either case, the ability to pay monetarily for QHC is out of one's control.
7. Yet, irrespective of one's ability to pay, all humans are mortal, and being mortal, all humans are in need of QHC from time to time in order to continue to lead constructive lives.
8. Either no one deserves QHC, everyone deserves QHC, only those who can pay monetarily for QHC deserve it, or desert hinges upon a hitherto unarticulated matter.
9. If no one deserves QHC, then neither mortal need nor the ability to pay for QHC matters.
10. If everyone deserves QHC, then the commercial model is problematic, for it neglects those mortals who cannot pay for it.
11. If only those who can pay deserve QHC, then mortal need does not matter – what matters is only the chance (out-of-one's-control) circumstance that one is able to pay.
12. Given that QHC depends upon the actions of many individuals other than oneself, including those who developed medical science and care over the course of thousands of years, and given that it is both out of one's control whether one was born today and not (say) 10,000 years ago (or before the development of medical care), it is also out of one's control that one lives in a time wherein health care is a commercial transaction.
13. Thus, one does not deserve QHC simply because one can pay for it – for the historical development and present existence of medical care is out of one's control in the same way that a society of commercial transactions is out of one's control.
14. Thus, we are left with a choice between no one deserving QHC, everyone deserving QHC, or desert hinging upon some other factor than ability to pay.

Health Care and the Community: Thoughts Presented at a Social Justice Forum

What I'd like to bring to your attention on the topic of health care and the community, is the degree to which persons of low income can be trapped in qualitatively poor health care. Recently this problem entered directly into my life, as I have been diagnosed and treated for advanced skin cancer over the course of the last year. As I came to realize, there is a marked difference between health care and health coverage. At present – while there may be ever wider health coverage (health insurance, say) – we are still a community where quality of care, that is the ability to receive proper medical support and treatment in a timely manner, hinges upon income (or wealth). Your ability to pay more money than I for coverage, means that you are entitled to a greater quality of care than I. 

Yet, there is of course a problem here: Equating health care with a commercial transaction, neglects the fact that quality health care is a requirement of continued human existence, not to mention human flourishing. Quality care is like quality food or clean water: without these you soon perish. It doesn't matter whether you are wealthy.

But when it comes to the fair and equal distribution of quality health care as a resource, our community turns to money. How will we pay for it? is often the first question. Notice in this reflex, that money and self-protection so easily come to mind. How will we pay for it? The impulse here is the same impulse that has us walk past a homeless person with our eyes ahead, and the moral imagination only on oneself: I hope no one sees me ignoring them. When we are insulated by quality health care it is not so hard to fall into a similar kind of thinking: Yes I've heard about the quality crisis, but someone else (the government, say) will fix it; meanwhile I have good quality care.  

Well, in a small effort to stimulate our moral imagination, I'd like to share a bit from my own experiences being trapped in poor quality health care while in the grips of a life threatening illness.

So, three years ago – when I was twenty five, and still covered by my parents high quality health insurance – I noticed a weird mole on my left hand. To make a long story short: while it was ultimately thought benign, some of it's pathological properties were concerning. While skin cancer doesn't run in my family, as a precaution I was asked to see an oncologist and take ct scans for a two year observation period.

Moving forward two years: In May of last year – right after my final ct scan had been all clear – my wife –who was my girlfriend at the time, noticed a lump on my left arm. While I thought it was some kind of a cist which I had experienced before, given my history I went to have it checked out by my primary care doctor a few days later, and he authorized an ultrasound referral for me.

Now, at this moment in time I was a full time graduate student covered by Medi-caid – I qualified for California's Medi-cal program because while I worked part time, I didn't make enough money to be allowed to purchase publicly subsidized insurance (like Obamacare). Nor, of course, was it financially feasible for me to purchase private insurance.

I mention this because bureaucratic delays and high patient volume are well known in Medi-caid clinics, and would indeed be routine during my care. After waiting a few weeks I was informed that the first available appointment was the beginning of September - three months away!

So, September roles around, and the ultrasound looks concerning to the radiologist. A biopsy is performed. The biopsy results take a month to come back, but when they do I'm told that the growth is cancerous. Surgery is prescribed. But there are more delays, such that it was not until late October, almost five months after signaling the alarms with my primary care doctor, that the original tumor, all of my lymph nodes in my left armpit, and a newly developed tumor, are surgically removed.  

As you know, when it comes to cancer the sooner you catch it, the better. Simply given the delays I faced, it is likely that a treatable disease became a chronic or terminal illness. I recently read a study from the Case Western Reserve School of Medicine in Cleveland which indicated that "patients were two and a half times likelier to be diagnosed with late-stage melanoma if they were covered by Medicaid" as opposed to being diagnosed at an earlier stage with private insurance. No doubt delays play an important role in this data.

But unfortunately, diagnostic and scheduling delays are not the only issue. Doctor appointments often took all day: I'd arrive for a 9am appointment and not leave until 3pm or sometimes 6pm. Bear in mind that I'm a full time graduate student working part time during all of this, and when I'd arrive at the clinic, thirty or forty people would also be there waiting, due to overbooking.

More troubling, was that more times than not I would be treated by a medical Fellow I had never met before and knew next to nothing about my case, despite the fact I had been receiving treatment there for months.

The fact that no one was really acting as my doctor, it seems to me, led to a number of absurdities that I experienced with my subsequent treatment after surgery. First, when it came time to receive radiation treatment a few weeks after recuperating from my surgery the short window of time in which radiation is viable was mishandled and I never received it.

The next few absurdities are related. In January of this year – another ct scan showed that the cancer had spread to my liver and lungs. This was a great blow. Looking at the five year survival curves for stage four melanoma, and then realizing you are subject to the same prognosis is nearly unfathomable in your twenties.

As soon as they saw cancer in my liver and lungs, I was put on what's called targeted therapy – drugs designed to slow the growth of cancer. The issue, as I learned later, was that there is a high chance of toxicity when taking targeted therapy in combination with the immunotherapy drug I was also receiving since November. While I fortunately didn't have to learn this first hand, there was nevertheless a 30% chance I could have developed a ruptured colon from receiving both treatments – something I was not informed of at the time. In fact, the two drugs are never prescribed together.

The next absurdity was that my insurance denied me the targeted therapy I just mentioned. On the same day I was told I was stage 4, the head of the oncology department gave me a two week supply of the drugs – which were FDA approved – and wrote me a prescription. These samples ran out while myself, my girlfriend, and my mother battled with the insurance company. In the bureaucratic maze, no one could tell us why the drugs were denied until five weeks later: a different set of targeted therapy drugs that did the same thing were preferred, but they failed to make this clear to the doctors or to myself. 

The last absurdity I will relay, although I could go on, is perhaps the most symbolic of how income inequality determines quality of care:

I shall have to simplify this for time, but a week after I had ran out of the samples of the targeted therapy drugs had an appointment at the oncology clinic. A medical fellow I had never met before saw me, and I explained the battle I was having with the insurance company. I then asked the most obvious question: Might there be any more samples I could have? The fellow said that she was surprised that I was given samples at all: they were generally not given to county patients on Medi-caid, and instead reserved for patients at the fancy university cancer clinic down the street. 

The irony is that previously, when I was on my parents insurance, I had myself been a patient at the fancy university cancer clinic.

Needless to say, I didn't get any more samples. I found myself dying of a disease that was itself preventable if properly treated. I found myself being denied (what I thought was) life saving treatment because I didn't make enough money to be qualitatively insured. 

Anyway, after this absurd and intense period of delays, denials, and bureaucratic nihilism, myself, my girlfriend, and my family decided that we would pay out of pocket to see a melanoma specialist. This ended up being the right path. After extensive reasearch, we lucked into getting a consultation in February with one of the foremost experts of melanoma, and decided that I should be under his care.

But like everyone in my circumstance (except potentially Warren Buffet), I couldn't pay out of pocket for treatment when one months worth of prescriptions would total $10,000's and a standard PET scan cost nearly the same amount.

My way out was that I was in a loving relationship, and so had an additional option denied by most: get married, and assume health insurance together.

So, Leanne and I went and got married first thing on a Monday morning in February so that I would have reasonable insurance and be able to see our current doctor. By March we were covered by Obamacare, affording us the possibility of being treated with the quality of health care necessary to someone of my circumstance.

Now, at a Phase 1 trial clinic, all of my appointments are coordinated professionally, scans can be scheduled at a days notice, and support is granted whenever it is needed – I can essentially call my oncologist or a nurse who knows me and my case anytime.

I would like stress that through all that I have shared, I was the lucky one: I had a team of people researching and making phone calls, I had the privilege of a graduate education, and unlike many of the people I witnessed at the county clinics, speaking English wasn't a challenge to me.

Nevertheless the kind of neglect I experienced and witnessed in our health care system seems to me indicative of an invisible dark side of our community – a dark side that our current administration is a symptom of. It should be alarming to everyone that the dialogue about health care begins with money, esp. when no one would seriously challenge that quality care is a basic necessity (in the league of clean water). If there is a way out of the neglect and entrapment I've spoken of, I would wager that it starts with cultivating in ourselves and especially in our youth, a moral imagination suitable for citizens of a democracy. My experience in public schools growing up was that controversial topics – political, religious, ethical – were off limits for discussion. If we produce citizens incapable of critically discussing such things, we produce citizens who cannot fight the dark side of the community, the side that consumed by the impulse of self-protection, fails to recognize the interconnectedness of all life and our responsibilities to one another.

Excerpt from "A Man of the People" by Ursula K. Le Guin

"After a long silence, he nodded.

            She sat stricken, understanding that she had won. She had won badly.

            She reached across to him, trying to comfort him and herself. She was scared by the darkness in him, his grief, his mute acceptance of betrayal. But it wasn't betrayal - she rejected the word at once. She wouldn't betray him. They were in love. They loved each other. He would follow her in a year, two years at the most. They were adults, they must not cling together like children. Adult relationships are based on mutual freedom, mutual trust. She told herself all these things as she said them to him. He said yes, and held her, and comforted her. In the night, in the utter silence of the desert, the blood singing in his ears, he lay awake and though, 'It has died unborn. It was never conceived.'

            They stayed together in their little apartment at the School for the few more weeks before Tiu left. They made love cautiously, gently, talked about history and economics and ethnology, kept busy. Tiu had to prepare herself to work with the team she was going with, studying the Terran concepts of hiearchy; Zhiv had a paper to write on social-energy generation of Werel. They worked hard. Their friends gave Tiu a big farewell party. The next day Zhiv went with her to Ve Port. She kissed and held him, telling him to hurry, hurry and come to Terra. He saw her board the flyer that would take her up to the NAFAL ship waiting in orbit. He went back to the apartment on the South Campus of the School. There a friend found him three days later sitting at his desk in a curious condition, passive, speaking very slowly if at all, unable to eat or drink. Being pueblo-born, the friend recognized this state and called in the medicine man (the Hainish do not call them doctors). Having ascertained that he was from one of the Southern pueblos, the medicine man said, 'Havzhiva! The god cannot die in you here!'

            After a long silence the young man said softly in a voice which did not sound like his  voice, 'I need to go home.'

            'That is not possible now,' said the medicine man. 'But we can arrange a Staying chant while I find a person able to address the god.' He promptly put out a call for students who were ex-People of the South. Four responded. They sat all night with Havzhiva singing the Staying Chant in two languages and four dialects, until Havzhiva joined in a fifth dialect, whispering the words hoarsely, till he collapsed and slept for thirty hours.

            He woke in his own room. An old woman was having a conversation with nobody beside him. 'You aren't here,' she said. 'No, you are mistaken. You can't die here. It would not be right, it would be quite wrong. You now that. This is the wrong place. This is the wrong life. You know that! What are you doing here? Are you lost? Do you want to know the way home? Here it is. Listen.' She began singing in a thin, high voice, an almost tuneless, almost wordless song that was familiar to Havzhiva, as if he had heard it long ago. He fell asleep again while the old woman went on talking to nobody.

            When he woke again she was gone. He never knew who she was or where she came from; he never asked. She had spoke and sung in his own language, in the dialect of Stse."

--Ursula K. Le Guin, "A Man of the People," Four Ways to Forgiveness (Harper Perennial, 1995), pp. 153-155

A Challenge to Impersonalism of Philosophic Space: From Red Mars

"The only part of an argument that really matters is what we think of the people arguing. X claims a, Y claims b. They make arguments to support their claims, with any number of points. But when their listeners remember the discussion, what matters is simply that X believes a, and Y believes b. People then form their judgment on what they think of X and Y."

Kim Stanley Robinson, Red Mars (Bantam Spectra, 1993), p 77.

In The Shade

You come out here on some old hunt

limping

from formative wounds

dents to the fender

Friendless, new, shy

your eyes spin and squint

from culture shock and sun

Everyone who passes by

you think-ask: 

Won't you come kiss me
hold me
share this warmth

by the air-conditioner?

Stare into my eyes

under the ceiling fan?

In the shade
with your daemon

squirt gun in hand

a pack of sandwiches
upon your lap
you'll wait
heavy

heavy with knots
not drawn here 
tired from the bad chemicals
that follow

Movies I Like: L'Illusionniste

For some reason I want to say a few things about a handful of movies that I like. I don't know...

Ok (no order):

1. L'Illusionniste (The Illusionist - 2010). This is a hand drawn (romanticized-realist?) animation about a traveling magician and a protege he picks up along the way - a pretty young girl. There are no words; well, actually, there are Englishy mumbles, but that's as far as it goes. I had this movie saved to my parents DVR and would watch it before going to bed when I lived there. A kind of salve. I'm wondering if this has to do with the quality of whimsy present. A graying, middle aged whimsy. One doesn't leave this movie feeling bad.

There are parts of L'Illusionniste that I always want to watch (this is a preoccupation of mine, which will make other appearances in "Movies I like" to come) - like the magician taking boat rides out to Scotland, with all this wonderful green overcastness. God... And the music hits the spot - soulful soft classical piano, often in breathtaking waltz timing, occasionally accompanied by xylophones, jazz drums, and another thing or two. Clean and well-wishing, in an elderly way (as though you are spending the day with a sophisticated grandparent, and, incidentally, you two go to a doughnut shop and sip strangely good coffee and eat two frosting donuts, one with coconut and the other with chocolate chips). Reminds me of parts of Michael Giacchino's Up's score, but less heavyhanded with the melancholy/nostalgia. Here is an example.

As far as what the movie is about, to be honest I'm not really sure. I'll have to watch it again with that project in mind. I wasn't watching it for plot, though, and so it's hard to say what the meaning of the thing is. I've been taking it in episodically - to borrow Galen Strawson's term (see this paper for a run down on what episodism means, if you are interested). Nevertheless, I've seen the movie enough to know that the plot is like this: An understated, underdog-like magician performs in some big city, then travels to Scotland to perform, then travels back to the continent to perform, where he strikes the fancy of a girl (I'm thinking 15-18 years old) who follows him as a kind of stowaway. They eventually come to share an apartment, and the girl seems to want to learn magic - she thinks it's real, and the magician is having difficulties telling her to the contrary. Anyway, the magician is having a hard time getting any more gigs - as are all the other entertainment persons that surround them (clowns, gymnasts, etc.) - and he takes up other means of employment. The girl is presented with gifts (a coat, shoes, a dress) throughout the movie by the magician, and comes to affect some poise. This gains her the interest of a young man in town. When the magician sees them together, he decides to leave her some money and a note ("Magicians do no exist."), before taking a train out of town. We see the magician look at a handheld photograph longingly as he rides away (in fact, he eyeballs the photo a few time during the movie).

Maybe it has something to do with the destructive ramifications of consumerism. Maybe not. I tend to think everything I encounter now has this theme. I should probably look into that. The movie also seems to be about loss or something like that. I wouldn't have emphasized this connection, though, without reading the wikipedia page.

I will say, though, that fortunately, L'Illusionniste is not about a romance between the young woman (maybe girl?) and the middle aged magician. Every time I show L'Illusionniste to a friend, they always think it will go in that direction. But it doesn't. There is a purity about the movie. Maybe that's not quite right.

In any case the full movie is here.

I wonder what you think.

Initiation Song from the Finder's Lodge

Please bring strange things.
Please come bringing new things.
Let very old things come into your hands.
Let what you do not know come into your eyes.
Let desert sand harden your feet.
Let the arch of your feet be the mountains.
Let the paths of your fingertips be your maps
and the ways you go be the lines on your palms.
Let there be deep snow in your inbreathing
and your outbreath be the shining of ice.
May your mouth contain the shapes of strange words.
May you smell food cooking you have not eaten.
May the spring of a foreign river be your navel.
May your soul be at home where there are no houses.
Walk carefully, well loved one,
walk mindfully, well loved one,
walk fearlessly, well loved one.
Return with us, return to us,
be always coming home.

- Ursula K. Le Guin

From Always Coming Home (Harper & Row, 1985)

"Until a man is twenty-five, he still thinks, every so often, that under the right circumstances he could be the baddest motherfucker in the world. If I moved to a martial-arts monastery in China and studied real hard for ten years. If my family was wiped out by Colombian drug dealers and I swore myself revenge. If I got a fatal disease, had one year to live, devoted it to wiping out street crime. If I just dropped out and devoted my life to being bad."

Neal Stephenson, Snow Crash (Bantam, 1993), p. 271

What You Want For Yourself

Let's say you've packed up a vehicle

enough supplies, clothes

and the special personal things you need

and you're driving somewhere

Let's say you're driving and thinking

Where should I go?

Let's say you are driving

and that you resolve to get to the bottom of it

Finally

after all these years

the body like a wet towel twisted dry

your body

always digging yourself out

Let's say you pull over and pee and get some coffee

Then put on music you can think to

perhaps its Glass's 1000 Airplanes on the Roof
or Arvo Pärt's Fur Alina

Let's say you have found yourself into some money

It's origin is nothing extreme

not the lottery

not inheritance

not a sudden rise to success or fame

Let's say you are driving away

taking a break

if that's what you are doing

from the build up of the everyday

from whatever you need to take a break from

Let's say you're free

not the freedom of political theorists or metaphysicians

but the freedom of ease

a consciousness of no commitments

no identity

Let's say you pull off the road and park

That you jump the fence

the stringy low metal and wood kind

ubiquitous to country lanes

Let's say you walk

quiet roaming hillsides

you walk them until you can be with yourself

and then you sit Indian style

near the shade of a tree

a tree you couldn't name

Let's say you are no one anymore

you have no relationships

aside from the one's you will into effect

Let's say you needn't make any moves

you can sit here on this hillside

there are no rules

the world is an open game

the blank page of the painter

Let's say you ask

What do you want for yourself?

You Say:
What do I want for myself

on this quiet roaming hillside

the pleasure of having no one to please

having no one to be

like a ginger vitality

an inner beaming

at my back

"Most talk of 'artistic detachment' is disingenuous. No writer can depict the whole world - even if, like Balzac, he makes a credible attempt. All he can do is offer 'typical samples,' like a grocer allowing you to taste a piece of cheese. But as he holds out the cheese to you on the end of his knife, he is clearly implying that this sample tastes exactly the same as the rest of the cheese on the counter. The same goes for the novelist; as he hands you his 'slice of life', there is a tacit understanding that, as far as he knows, this tastes very much like any other slice he could offer you."

Colin Wilson, The Craft of the Novel (Ashgrove Press, 1990), pp. 57.

The Metaphysics of Vanessa

You say to yourself

Walk her to the parking lot after class

Talk about the New-Agey teacher

What we thought about

When he turned the lights off

And played a guided mediation tape

All quick questions

Defense Mechanisms

The barely-there norm

She’s this short, petite Latino girl

The speaker of a cautious, endearing language

Not the language of innocence

But of reserve and cheerfulness

Some knowing aspect

The cause of heritage

Of someone who hasn’t really strayed from life

Who doesn’t suspect there is a sour trick at play

Yet aware of this idea

Having felt its weight

Having persevered

Who may have been around the shady types

But does not advance it

A strange fact

In this strange thing

You say more liberalism would help

And a healthier economy

And we’d do well to spend time with family

Read a book every now and then

Stay in on Saturday night

And stare at yourself in the mirror

‘I know you’re after intensity’

You’ll say to the mirror

‘Cause I chased it too’

She says, We do it for ourselves

And then for others

Don’t confuse the order

For perhaps there is no way

But we shall not know coiled up

Sucking upon the second hand of centuries

The buildup of the easy

You say to her wonderful black hair

Remember:

We came out of the world

Without initiation

And the world came out of the world

Without initiation

I tell you this

But the hearers didn’t choose to hear

And the deaf did not choose otherwise

And you may withdrawal

Say you owe nothing

Say that you are your own thing

With your own projects

Your own pleasure

That no one can take that away

By her clothes

By her shyness

An honest young woman

You dwell on that

You

You are a liar

A politician

A teenage smirk

Glazed debris

You’ve sat against yourself

In the screaming body of a victim

Your body

So many years

Always digging yourself out

The body like a wet towel twisted dry

You first notice her on the bus

The back of her head

Her hair pulled back:

Over her ear the slimmest of strands

Out of order

In the wonderful sunlight

Blessing her

And you sit there

And you want to be surefooted and articulate

When you come into her view

You’ll exit and smile slightly

And you want to be the highest self

The highest there is

Self Love, Sea Lust

Been walking for sometime

don't know why I'm here

I no longer remember

Longings and hunger and thirst

have made their way with me

entangled, overgrown

this is what I know

I browse old photos

recordings

stars of the lid

I look at her eyes

how she was touching me

I look for clues

Oh, I'm a cog

a billiard ball

foaming

over and over

ripping, pleading

Will the next person

who comes down the path

save me

steer me away from here?

But down this path

is vacancy

is sea lust

a container

for the craving

of oceanic solace

of destination

In the mirror of ponds

I see tired eyes

blued eyes

foreign

in the cold of night

I hear chattering of teeth

startlingly near

But no one

there is no one

If you wonder why I walk

it's because I've already sat

hung my head

And sitting is much worse

you lose more than you know

spin yourself knots

dirt in every crevice

At least with walk

you dull the nerves

distract the eye

keep status quo

Again, again

I find myself here

in this forest

like yesterday

like the day before that

And on these days

shivers and shakes move through

I hear them come out of me

feel them as if emanating

from some wound

and the day follows night

even if night doesn't end

in your head

Yes, there's the typical resistance

to spilling myself

but I'm alone

would like at least one friend

even it is has to be me

Perhaps I will draw a map

if I cannot get myself out

to the sea

I will at least work

care for this path

removing obstacles from it's flow

cleaning it

with salt love

that burns

Am I a phoenix

from these ashes?

How many ponds does it take

to clean a man?

Will you tell me

friend?

Won't you tell me

Introduction to an ongoing project

Introduction: The Sting and Wisdom of Common Characterizations of Philosophy

            Over the course of the last few months I've been advised to visit with a number of specialists in the fields of dermatology and oncology to rule out a possible brush with a rare form of skin cancer.[1] Since I'm in my twenties the office visit small talk invariably revolves around whether I'm in school, what I'm studying, and so on. Having engaged in this type of ritual over and over within a short period of time, certain patterns begin taking shape when I've mentioned that I've just completed an undergraduate degree in philosophy. These patterns seem to me to be indicative of how the discipline-practice is commonly understood in a society, such as ours, which is crucially career oriented and pragmatic. Mixed with the prospect of death hanging in the air, something that never fails to sober things up, these patterns take on a bit more weight and bite.

            Apart from polite indifference and polite affirmation, one typical response is to imply that the study of philosophy is narrowly impractical for the workforce: "What do you plan on doing with that? Do you want to teach?" Another involves citing the reputation of academic philosophers for careful argumentation and reasoning to the point of irrelevant hair splitting, sophistry, or poor sportsmanship: "I sure don't want to get in an argument with you!" A final pattern  references the sheer intellectual complexity of the contemplative subject, perhaps signaling it's intoxication with and compulsive obsession in intellect: "Man, that's more difficult than med. school..." After running through some variation on these characterizations, the focus is then shifted to the explicit reason for the visit. When I walk away from such encounters, however, I feel the typical sting of being cut down to some extent, and this sting - when it becomes searching - acts to fuel my already present suspicions of a field which is so often, in John Dewey's phrase, a "self-indulgence for the few."[2]

            There is a kind of wisdom of the crowds that such characterizations flow from. In this case it's against, or at least suspicious of, the kind of technicalization and specialized projects which philosophers have taken on since perhaps they moved into the university and took their subject professionally serious. Candidacy for the sort of project I have in mind would be those which require a lot of back story to explain why anyone would undertake them and why they are worth the candle - and yet still seem hard to justify much effort. Perhaps an example would be the problem of Non-Being, sometimes called "Plato's Beard", in Ontology, which seeks to account for the type of being Non-Being has.[3]

            While this wisdom has much purchase there is a sense also that it is superficial - or at least not the whole story. Thus the sting. What I would like to consider here takes a stab at the whole story and lies at the source of the searching component of this sting. Another way to put this is that I would like to give weight to the best aspects of both sides of philosophy, the formal and the informal. I wish to honor both, as they both deserve our honor. Put in the form of a question my concern is, What is the value of philosophy and why should it be engaged in? My feeling is that taking an expansive step back and turning the philosophical gaze back upon itself will serve to give context to philosophy's disparate functions, some of which have gone largely unfulfilled in recent centuries, others of which have been misunderstood both by the layman and the professional. Perhaps too closing in on why philosophy is valuable will serve to keep our philosophical efforts properly motivated when they become stale, cloudy, and ostracized against - as they so often do.

            In any case, since responding to the question of value would be to utilize some vision of what philosophy is, and further, what it's functions are (for society, oneself, etc.), anyone taking on the value question must also take on these descriptive and functional aspects. It's in this way that the value question really breaks into a few parts. With this in mind, it will bear alluding to two stumbling blocks that tend to crop up naturally when talking about "philosophy" as such. These stumbling blocks may be referred to as the tunnel-vision tendency, which seems to arise out of philosophy's vastness and special seriousness, and the arrested-development objection, which seems to arise out of an anachronistic comparison between the "goods" of philosophy and the "goods" of science. After pointing these out I will be in a position to properly take up an analysis of what I think is a full response to the question of value - Bertrand Russell's response as in the last chapter of The Problems of Philosophy. My analysis will reveal that Russell posits three distinct values for philosophy: one springs from it's epistemic and speculative function, one from it's preservative function (of philosophical space), and the final springs from it's transformative potentiality. I will demonstrate that this threefold vision is meaningfully conversant with what I have referred to above as the formal and informal aspects of philosophy. Following insights from Richard Rorty, Richard Shusterman, and Alexander Nehamas, among others, I will show how these aspects refer to the "two basic forms" or poles of philosophy. Baldly, these poles, which can be seen as a spectrum, stretch from the critical-theoretical side of philosophy which tends to be formal and knowledge oriented, and the practical-transformative (or art-of-living) side of philosophy which tends to be less formal and oriented around producing flourishing or transformative insight for individuals and their communities. Final remarks will beef up Russell's account with some suggestions about philosophical lifestyle and the importance of non-intellectual educational mechanisms (which spring from the transformative function of philosophy), both of which Russell fails to say much about. Whereas Philip Kitcher has argued that a renewal of philosophy can be achieved by turning "philosophy inside out" - or by turning to it's fringe areas - I will argue that this renewal has much to do with re-balancing the two sides and bringing the art-of-living out from marginalization.

---

[1] Just for full disclosure: this brush with skin cancer has been reasonably ruled out as far as contemporary dermopathology is concerned.

[2] Kitcher, Philip, "Philosophy Inside Out"

[3] see Quine, W.V.O., "On What There is"

"They are a very strange people, the Hainish; older than any of us; infinitely generous. They are altruists. They are moved by a guilt we don't even understand, despite all our crimes. They are moved in all they do, I think, by the past, their endless past."

Ursula K. Le Guin, The Dispossessed (Perennial Classics, 2003), pp. 348. 

"I remember thinking, Oh great, it's four in the morning and I'm having some sort of weird mystical experience right in the kitchen of one of my best friends, merely by touching a woman I've never met before. This is not going to be easy to explain..."

Ken Wilbur, Grace and Grit (Shambhala, 2000), pp. 9.

"The private world of instinctive interests is a small one, set in the midst of a great and powerful world which must, sooner or later, lay our private world in ruins. Unless we can so enlarge our interests as to include the whole outer world, we remain like a garrison in a beleaguered fortress, knowing that the enemy prevents escape and that ultimate surrender is inevitable. In such a life there is no peace, but a constant strife between the insistence of desire and the powerlessness of the will. In one way or another, if our life is to be great and free, we must escape this prison and this strife."

Bertrand Russell, "The Value Of Philosophy", The Problems Of Philosophy (Oxford, 1997), pp. 158.

There Are No Angels (Dance In The Cracks - Part 2 of 3)

There's been this thought

tumbling around my head for a while

Perhaps a truism

It's that all good things

are the result of patience and care

That relationships

if they're to be worth a damn

ought to be no different

With this in mind

A worry entered

months ago

as I drove home

for the first time

from Cotati

I worried that the stages of infatuation
of surface

had not run their cycle

that patience and care

the bloom of sharing

and nearness

would not take

in this sand of long distance

so soon

this thing

so young

It was a worry tied to others

perhaps inevitable

perhaps circumstantial

The fact is that each of us hid ourselves

our motives

our hurts

I fragmented my anxieties

and loneliness

made them look mature

balanced

more then they really are

You suspended the rawness

of your past

and both of us

shaking

felt for the other

for warmth

for release

It happens that

We get what we sow

Yet even though I've never known

the raw de-centering

of heartache

until now

I'm still glad that things were put on pause

that it was felt necessary

to step back

halt the momentum

I'm glad because I was thinking similarly:

a step back was necessary

if our gentle thing

was to be worth a damn

if it was to get past the stages of infatuation

and enter into the depths of patience and care

if we were to even seriously talk

about what we wanted
if we were to look each other in the eye

To do this requires that we reveal those cracks

in the street

which we have fallen

to see the deep darks

It requires that we see one another

and ourselves

no longer as drugs

taken to forget our bodies

but as dying pining creatures

trying to create and maneuver

trying to face up

and sometimes flee

those hurts

that have crystallized into scar

that back us into corners

cut off the oxygen

prevent deep breaths

deep movement

that strand us in space

When we paused

and then when you stepped back

in your small orange notebook

allowing me to see you

from where you came

to what path you now peruse -

and how far I had gotten attached -

I was forced to sit with both revelations

and suspicions

things I saw off in the periphery

One suspicion:

I tended to use you

in a hazy way

as a distraction

yet deny

was a distraction

Often I saw you as sexual attraction

as playful spontaneity

I saw you as a respite for loneliness

a loneliness I've carried around

for years

I saw you as easing my anxiety

lack of confidence

philosophic crisis

post-college malaise

I saw you through the longing and hope for communion

Yet here you were

standing in front of me

naked

cold to numb

using me

for warmth

like I was using you

Oh, the distractions we'll sow

Yes

I know you are not without blind spots

and hang-ups and faults

There are no angels

in this world

Only longing

and trial and error

But I want you

I want you even though

the will to love

precedes the appearance

on the scene

of the beloved

I want you even though

the world gives no clues

as to what we should be up to

and we stand alone with what we take seriously

I want patience and care

to enter this picture

this story

I want to look directly into your eyes

for a couple sacred minutes

and longer

to not have you turn away

I want to be sacred with you

Did you know that? 

"While reading books I write notes in the page margins and I circle and memorize certain lines and passages. The people in each book might be different, but the plotline is basically the same: Somebody is unhappy and they do dangerous and foolish things trying to become happy."

Sherman Alexie, "Scenes From A Life". Blasphemy (Grove Press, 2012), pp. 233.

Letting In (Dance In The Cracks - Part 1 of 3)

Yesterday after work

I found a small orange notebook in the mail

Feel shaky as I read

and after

as the sun's setting

I take a walk

to feel my way

to think about you

It happens to be Halloween

and the sky is getting darker

more meaningful

and the kids in costume

fashioned or bought

are all about

Have you ever noticed

how our culture never seems so healthy

red cheeked

life affirming

as on Halloween?

With everyone in on the exciting ritual

with the homes of the streets open

When I long for a utopia

or some ideal at least

perhaps I ought to console myself

with the fact of suburban Halloween

Is this not a good sign?

A fine ideal?

My thoughts and feels as I walk

are much the same as they have been

a month

two months

more

But they're taut

teething

And so I attend to them

over and over

as they come upon me

It's like this:

I feel so much tenderness for you

don't want to see you go

Parts of me pitch fits

clench up

with all their force

turn into desperate White Dwarves

But I still have some energy

some light

And I want to make a play

to pursue you

Exhaust it, as a possibility

because I will always wonder

because I never fully have

Like a psychology student

or a mountain top fire spotter

I wish to sell myself some silence

Sell some to you too

If I can manage

I've said that I didn't have any regrets

out on the beach

some warm bellied resilience

but I'm thinking now that that conclusion was premature

Truth be told I wish I would have born my neck to you

more than I did at least

Let you in

Stopped showing off

And above all

Indicated where the gravity pulled

choked

Pointed out where the cracks lay

In your small orange notebook

you showed the gravity

spoke in your own voice

through the cracks

and I hear it

And even though

it was likely not intended

I listen like I'm sitting beside you

like you're Wittgenstein

holding my hand

letting me in

to your newest, vital meditations

to the R behind playful coolness

cultivating freedom

independence

solitude

searching for a way out

through

And I want to speak too

directly

More in my own voice

the warmth rushing out

something I rarely did

wished I did more of

and I want to say why

why I rarely did

wish I did more of

Maybe this takes time, care

Will you follow me

follow me just a bit?

Will you sit beside me here

take my hand?

mindfulness

all the run on sentences in my head

inevitably turn back to you

and those simple sacred insights

which i've labored so hard to steal

will not hold

taking care of the self

seems the most unambitious task

from a certain standpoint

we should rather be getting on

with colossal social tasks

orgiastic pleasures

but taking care?

that seems some trifling exercise

to be fit in

between a brisk jog

and piano scales
if the time is free

yet, the effort will be made

it will happen at sunrise

it will happen throughout the day 

and it will happen on into the night

it will happen

this is what i say

to the delicate eyes

of the bathroom mirror

at lunch break

for if i'm going to be of use

i need some clues

hints

more than what I've got at least

more than silence

and crippling