Madness

"I will do such things,
What they are, yet I know not; but they shall be...
The terrors of the earth."
--William Shakespeare, King Lear

“O! Let me not be mad, not mad, sweet heaven; keep me in temper; I would not be mad!”
― William Shakespeare, King Lear

I'm flying to Thailand very early on Sunday.  I have packing and other preparations to complete.  And I seem to be acquiring a cold or some other ailment that makes me sleepy.  So you're not going to get a well-written, well-reasoned final posting to this blog before I fly off to another hemisphere.

But you, like me, have been watching our Great Leader.  Watching him claim with gusto that the disastrous election results were tantamount to a personal victory for himself.  Laughing at those pathetic Republicans who lost, lost only because in his imagination they weren't devoted enough to Trump.  Focusing on the gain of a seat or two in the Senate, and ignoring -- except for those barbs at the losers in his own party -- the losses in the House, the governorships, and the various legislatures.

Seemingly believing himself beloved by the nation, when the raw figures from the Congressional elections (Democrats 56.9 percent to Republicans 41.5 percent in the Senate races)  show an overwhelming majority of the country is hostile to him, and/or his party.

And then there was Europe.  Trump rushes off to France to honor the American war dead from the two world wars, and then doesn't.  He sits in his hotel room and broods and tweets.  There's more, much more, and you've read it in news and opinion reports. He shows up at meetings with other leaders; while they chat and laugh, he stands alone scowling and bitter.

My question is whether he is sane.  I'm not talking about personality disorders -- God knows he clearly has many -- but about whether he is teetering on the brink of sheer madness.  Probably not yet.  We like to apply strict scientific criteria today in diagnosing psychosis.  But in Shakespeare's time, the average citizen felt free to size up the situation, relying on common sense. 

King Donald's court would be buzzing with the question -- is he quite mad?

As far back as February 2017, conservative columnist and blogger Andrew Sullivan asked the question:

I keep asking myself this simple question: If you came across someone in your everyday life who repeatedly said fantastically and demonstrably untrue things, what would you think of him? If you showed up at a neighbor’s, say, and your host showed you his newly painted living room, which was a deep blue, and then insisted repeatedly — manically — that it was a lovely shade of scarlet, what would your reaction be? If he then dragged out a member of his family and insisted she repeat this obvious untruth in front of you, how would you respond? If the next time you dropped by, he was still raving about his gorgeous new red walls, what would you think? Here’s what I’d think: This man is off his rocker. He’s deranged; he’s bizarrely living in an alternative universe; he’s delusional. If he kept this up, at some point you’d excuse yourself and edge slowly out of the room and the house and never return.

In the 21 months since those words were written, has Mr. Trump come to appear more rational, more disciplined, more in touch with reality?  I leave the answer as an exercise for the reader.

In the last week, David Remnick wrote a column in the New Yorker, discussing the same issue in often picturesque language.

The President of the United States rages daily on the heath, finding enemies in the shapes of clouds.

Quite.

I shall sit calmly in Chiang Mai, Thailand, contemplating nature, clearing my mind of disturbing thoughts, seeking only the best in the people I meet.  I'll return to America with some trepidation.
 

Placebo effect

Personal injury attorneys know a lot of medicine.  They may not know it well.  They may not understand what they know.  But they grasp it well enough to persuade a jury that they understand medicine as well, if not better, than the physician who is testifying.

Those of us who have spent our careers as defense attorneys -- persuading juries that injured plaintiffs were not really injured, or at least not injured as badly as they say they are -- find our quasi-medical erudition flavored with a healthy dose of cynicism.

"Of course you are suffering from "whiplash"," we sneer, putting sarcastic air quotes around "whiplash.".  "Of course your lung cancer was caused by that rear end accident six years ago."

One aspect of medicine with which we are well familiar is the "placebo effect" -- the known fact that many patients who complain of pain do in fact feel much better if provided totally worthless treatment.  For example, if a physician tells the patient that he's giving him or her a pain reliever, but actually provides sugar pills, the patient will often actually feel much better.  This suggests to a newbie defense attorney that the injury was fake to begin with.  But doctors he trusts will assure him that even a real injury will respond to the patient's belief that he is being given drugs or other treatment that will relieve his pain.

An article by Gary Greenberg in the New York Times Magazine examines recent research into the placebo effect.  As the article notes:

Give people a sugar pill, they have shown, and those patients — especially if they have one of the chronic, stress-related conditions that register the strongest placebo effects and if the treatment is delivered by someone in whom they have confidence — will improve. Tell someone a normal milkshake is a diet beverage, and his gut will respond as if the drink were low fat. Take athletes to the top of the Alps, put them on exercise machines and hook them to an oxygen tank, and they will perform better than when they are breathing room air — even if room air is all that’s in the tank. Wake a patient from surgery and tell him you’ve done an arthroscopic repair, and his knee gets better even if all you did was knock him out and put a couple of incisions in his skin.

The article examines two possible bases for the placebo effect:  One, the more classically "medical," is that certain brain chemicals -- those associated with stress, reward, and good feeling -- are produced in some, but not all, patients in reaction to the interaction that the patient has with a doctor whom he trusts.

This makes sense to me.  If stress can give you a headache or an upset stomach, a caring relationship with a doctor or an acupuncturist or a naturopath could well make your backache feel better.

The second approach, insofar as I understand it, may be completely compatible with the first.  Maybe only the emphasis is different.  Its proponents feel that the placebo effect results almost entirely from the caring interaction between doctor and patient.  These researchers are more interested in the caring relationship than in any chemical or "molecular" basis for the placebo effect.  Their primary proponent, Ted Kaptchuk, has done

a comparative study of conventional medicine, acupuncture and Navajo “chantway rituals,” in which healers lead storytelling ceremonies for the sick. He argued that all three approaches unfold in a space set aside for the purpose and proceed as if according to a script, with prescribed roles for every participant. Each modality, in other words, is its own kind of ritual, and Kaptchuk suggested that the ritual itself is part of what makes the procedure effective, as if the combined experiences of the healer and the patient, reinforced by the special-but-familiar surroundings, evoke a healing response that operates independently of the treatment’s specifics.

"Whoa," I might have exclaimed if I'd taken this fellow's deposition.  "Voodoo medicine."

I'm less skeptical now, partly because the two approaches tend to examine the same phenomenon, merely from different directions.  The more intense the providing of medical care, or the Navajo chanting, or the administering of acupuncture by an empathetic practitioner, the more likely the production of the appropriate brain chemicals under the purely medical model.

Many people, both doctors and laymen, worry that medicine has become too cold and impersonal.  An annual medical exam too often feels like a quick check to see if any expensive drugs or procedures are justified.  If new developments in the understanding of placebo medicine lead to a greater realization that a warm and empathetic relationship between the physician and the patient is therapeutic in itself -- not just as a means to reach a proper diagnosis -- we may be approaching a more effective and satisfying form of medicine.

My skepticism remains to some degree, but is tending to fade away.  As Shakespeare had Hamlet declaim some five centuries ago:

There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy.

And that may go for medicine as well.

Sand through the hourglass

We pass through time like someone walking through a swarm of mayflies:  The moments come so thick that we hardly notice them dropping around us, and we can't imagine they will ever be gone.  …
We are contiguous with everything that is gone.  We are history.  This moment is already over.
--Sam Anderson (New York Times Magazine)

It is 11:20 a.m. in Seattle.  The temperature is 47 degrees.  The sun is shining; the air is crisp and cold; people walk by my house wearing warm jackets and gloves.  I see one such person being dragged along by a dog on a leash, a large dog wearing a large, warm sweater.  The temperature is forecast to reach a maximum of 52 degrees by 2 p.m.  By then, I will have gone for a walk under autumn leaves.

It is 2:20 a.m. Monday in Chiang Mai, Thailand.  The temperature is 75 degrees.  It is dark and cloudy, and most people are asleep.  The temperature is forecast to reach 85 degrees by 2 p.m..  Showers are forecast all day; it's the tail-end of the monsoon season.

One week from this moment, I will be almost an hour into a twelve-hour flight to Seoul, where I will change planes for a six hour flight to Chiang Mai.  Drinks will have been offered.  I probably will have declined, puritanically concerned about adjusting my circadian rhythms.  I'll accept wine with dinner.

Eighteen hours after that proffered drink, I will arrive in Chiang Mai.  It will be 10 p.m. Monday evening.  The temperature will be about 76 degrees.  I will be greeted by my sister and her son at the airport, and whisked off to her rental home.

By the time I'm in bed that night, I will be not only physically in Chiang Mai, but mentally as well.  It will be nearly midnight Monday night, and the temperature will be in the mid-70s.  I will no longer be in Seattle.  Supposedly, it will be 9 a.m. Monday morning in Seattle, and the temperature will be somewhere around 40 degrees.  But that will not be my world.  Not my reality.  That will be the world of a different place.  And a different time.

My world will be warm and dark.  I will go happily to sleep, eager to re-explore Chiang Mai in the morning, a morning when I'll be wearing shorts and a t-shirt, not jeans and a sweater.

As Sam Anderson suggests, the "today" in which I'm now writing will be history.  This moment, writing in this blog, is in fact over even as I write.  And Seattle itself will be over, finis, kaput, next week.  Just one portion of the mayflies through which I have swum throughout my life, albeit a large portion.  And a portion of that swarm to which I must return two weeks later. 

I will return to it two weeks later, and feel a slight surprise as my train carries me from Sea-Tac airport to Husky Stadium near my home, a ride during which I'll see how little has changed since I left.  A few minor changes, perhaps, as though the "Seattle" set had been hastily reconstructed for my arrival, so hastily reconstructed that a few inaccuracies had escaped the eyes of the workmen. 

But I'll be back.  As though I had never left.  Chiang Mai will move on, so they try to persuade me, undisturbed by both my coming and my going.  But to me it will have been dismantled and stored, awaiting my hoped-for return. 

And I'll be in Seattle once again.  With only photographs to persuade me that my memory matched reality, that I had in fact, for a short time, dwelt in another world.

Is it blue?

I was in Salem last month, as I noted a few posts ago, checking out the House of the Seven Gables and various witchcraft-related sites.  At the end of the day, sitting at the station waiting for the train back to Boston, the talk between a mother and her young daughter sitting next to me kept me entertained.

The little girl was two years old, three at the most.  Like most kids that age, she was more than keeping up her end of the conversation.  She was asking Mom about colors.  "Is this blue?  What about this, Mama?  But is this blue, too?"  

The mother patiently answered all the questions.  "Yes, that's blue. No, that looks kind  of blue but it's really purple.  That's right, the sky is blue today."

I admired the woman's patience.  Myself being the sort of guy who very soon would have told my little girl that Daddy's had a hard day and needs a little alone time, so why don't you go play on the track?  (Oh, not really, but you know what I mean.)

Then I began thinking about the girl's questions.  Color isn't all that easy a concept for a child's brain to grasp, even though her eyes come with the ability to distinguish between colors.  When Mom tells little Betty that something is "blue," what is she talking about?  Is she talking about shape or size or the object's use?  The child has to keep asking if various things are blue in order to figure out what they all have in common.  The sky is blue, her jeans are blue, Mama's necklace is blue.  Sooner or later, she realizes why these disparate items are all called "blue."

Suppose you're a teacher explaining color to a group of intelligent kids who, for some reason, have never learned the concept of color.  How do you even begin to tell them what they're supposed to be looking for?  You can do it only by showing them objects that have the same color, contrasting those items with other objects of a different color, and hoping the kids catch on.

Even then, how do you explain which color is "blue"?  Once learned, the difference between the various shades of blue and, say, orange seems intuitively obvious.  But it really isn't.  A scientist can give an objective definition of "blue" as light with a wavelength between about 4,500 and 4,900 angstroms.  That doesn't help a child.  Again, once they understand "color," you teach them by contrasting blue objects with non-blue objects.  Just as the mother in Salem was doing with her daughter.

Somehow, virtually all of us learn colors, regardless of how skillful, or not, our parenting may have been.  But I recall even in first grade working on numerous exercises where we colored objects blue where the word "blue" was written. We were learning to read the words, of course, but we were also learning (or reinforcing our ability) to differentiate one color from another.

I thought to myself -- in fact I noted on Facebook -- that the little girl was fortunate to have a mother so patient and so involved in her daughter's learning.  Yes, the child no doubt would learn "blue" eventually, even if her mother totally ignored her.  But how much better to learn it from a loving mother when she was two or three, rather than as a novel concept among scornful classmates when she reached kindergarten.

I remember a girl in high school literature class who -- it finally became obvious to everyone -- had no understanding of the concept of "rhyme."  The teacher had been increasingly irritated that she would pick one word to rhyme with another when their sounds had only the vaguest resemblance.  For example, she might have said that "trick" and "track" rhyme.  Or "paper" and "pavement."   I doubt that the girl -- not the sharpest blade in the drawer, admittedly -- had an organic inability to detect whether two words rhymed.  It was just something she had never thought about, and that no one had ever explained to her.

The concept of rhyming poetry itself was probably a complete novelty to her.  Our tenth grade teacher wasn't inclined to start from scratch with the poor girl.  The teacher just more or less threw up her hands and began talking to someone else.

School teachers are (or can be)  great, but parents are their kids' first and best teachers.  Few children in school will ever find a teacher who can offer them the time and attention that a parent will.  Kids whose curiosity has been ignored or throttled before starting school may find themselves at a disadvantage that they are never able to overcome.

Trump country

Until last night, like everyone else I had mentally divided the country into blue states and red states.  We on the two coasts were blue, as were portions of the industrial mid-West.  Most of the rest of the country was red.  Ghastly red.

What I saw last night, as the election returns were posted by CNN and other networks, was that reality was more complex.  Most states had red sections and blue sections.  When the analysis was fine-tuned, it was apparent that even single Congressional districts had red areas and blue areas.  For example, the district in south central Florida to which the announcer kept returning -- in the southern portion, it was urban and blue, but in the north it was rural and red.  Which section would produce the most votes, and thus determine the winner?

It appears that the most crucial predictor in guessing whether a voter is apt to be be pro-Trump or anti-Trump -- which in today's world means Republican or Democrat -- isn't whether  he is undereducated, or unemployed, or White, or over the age of 60, or fears loss of status.  All of those factors do affect the calculus, but the most critical factor is whether he lives in a city or suburb, as opposed to a rural area or small town.

Last night, sitting before our television sets, we looked for hours at the map of Texas.  A big red state, but with small blue islands representing a disproportionately large number of voters in Houston, Dallas, San Antonio, Austin, and El Paso.  Enough voters in those small blue islands to almost give Texas a Democratic senator.  In Kansas and Missouri, the districts including the two parts of Kansas City were two tiny specks in a mass of red.  In the center of Oklahoma -- the epitome of a red state -- was a spot of blue, representing Oklahoma City.  And even in Utah, the district including Salt Lake City is -- as of this writing -- trending blue.

My own Washington has long been a blue state, but on the map you see a large red state with a splash of blue surrounding the shores of Puget Sound.  Those are the most urban portions of the state, joined together with their great suburban areas -- suburbs once pure red that have, like suburbs across America, turned blue in recent years. 

The House went decidedly blue while, at the same time, the Senate has gone a bit redder.  It seems odd.  But it isn't.

Although the national map showing House victories is mostly red, away from the coasts, it is thus sprinkled with blue representing urban areas.  But on the Senate map, those areas are pure red.  Senators are chosen by statewide majorities.

The Great Compromise, at the time the Constitution was written, gave every state equal representation in the Senate.  It was "undemocratic" -- but it was a necessary concession to persuade small states like Delaware and Rhode Island to join in a union with large states like Virginia and Pennsylvania.  Those colonies had all been equal after independence, and the smaller colonies were understandably nervous about surrendering their total independence without some protection against rule by a nationwide majority in the newly created Republic.

But the unintended consequence is that protection of states with small populations is only of incidental importance in today's politics.  What is being protected -- and greatly magnified -- is the dominance of the interests of rural areas and small towns over the interests of the more populous urban and suburban populations.  Oklahoma and Kansas, for example, may each send a Democratic member to Congress, but their senators will always be Republican.  State after state through the farm states of the prairie Mid-West and the southern cotton-growing regions each sends its two Republican senators off to Washington.  North and South Dakota together send only two representatives to the 435-member House, but they together send four senators to the 100-member Senate.

Quite apart from the question of gerrymandering in House districts, the constitutional arrangement for the Senate's composition virtually assures that for the foreseeable future rural America will have an outsized institutional advantage over the rest of the country.  Only when people with urban interests and background begin living in great numbers in rural states -- as is perhaps beginning to happen in Montana -- will  this bias cease to be so obvious.  (Not many red states, of course, have Montana's scenic and recreational attractions.)

One solution would be for our national population to become increasingly uniform in interests and concerns, regardless of whether they live in cities or farms.  I might have predicted such a confluence of characteristics, because television and the internet interconnect us so radically.  But the opposite appears to be happening -- rural people are digging in their heals and increasing in their disdain of "city folk."  And something analogous is obvious among urban residents.

Solution?  I have none.  I just observe the problem with interest.  And note that Article 5 of the Constitution prohibits any amendment changing the way the Senate is constituted, insofar as that amendment would permit a state,"without its Consent, [to] be deprived of its equal Suffrage in the Senate."  

Deracination

I was once part of the flow, never thinking of myself as a presence.  Then I looked in the mirror and decided to be free.  All that my freedom has brought me is the knowledge that I have a face and have a body, that I must feed this body and clothe this body for a certain number of years.  Then it will be over.

As Americans, we are accustomed to being a magnet for the unhappy, the dissatisfied, and the persecuted from other countries.  Whether we welcome immigrants, or hate them, we take for granted that every migrant who passes our border, documented or not, has essentially hit the jackpot, won the lottery.  He has reached the land of eternal bliss.

We fail to appreciate the sacrifices the migrant has made to reach America.  Not merely the discomfort and dangers of travel, and the risk of arrest and deportation, but also the loss of homeland.  So what, we ask?  Some poor soul from a backward, third world country?  How can he complain of loss when he has reached the land of milk and honey?

Santosh was a domestic worker living in Bombay.  He worked as a cook for a middle class businessman.  He slept on the sidewalks, except during the monsoon when he slept in a small closet under his employer's stairs.  His job earned him a pittance, but his needs were few. 

He lived in squalor, we would say.  He wouldn't agree.

I was so happy in Bombay.  I had a certain position.  I worked for an important man.  The highest in the land came to our bachelor chambers and enjoyed my food and showered compliments on me. I also had my friends.  We met in the evenings on the pavement below the gallery of our chambers.  Some of us, like the tailor's bearer and myself, were domestics who lived in the street.  ... 
In the evenings it was cool.  …  The pavement was swept and sprinkled, bedding brought out from daytime hiding places, little oil-lamps lit.  … [W]e read newspapers, played cards, told stories and smoked. 
[In the morning,] I was free simply to stroll.  I liked walking beside the Arabian Sea, waiting for the sun to come up.  Then the city and the ocean gleamed like gold.  Alas for those morning walks, that sudden ocean dazzle, the moist salt breeze on my face, the flap of my shirt, that first cup of hot sweet tea from a stall, the taste of the first leaf-cigarette.

Alas, indeed.  Santosh's employer was sent by his company to Washington, D.C.  Santosh faced the choice -- go with his employer, or return to his hill village where his wife and children lived.  He had become too much an urbanite.  He chose to travel to America.

V. S. Naipaul's novella "One Out of Many" was published in 1971, as part of a collection entitled In a Free State.  Bombay (now Mumbai) was not the modern city it is today, and Washington was experiencing devastating race riots and arson; entire sections of Washington, including the area in which Santosh and his employer lived, were being blackened with flames.  But I suspect that in much of Mumbai life, beyond the tourist areas, life goes on much as Santosh describes it.  And I suspect that at least some of the racial tensions that prompted the riots in our nation's capital still simmer below the surface.

But Santosh's problems are far more fundamental than coping with tensions between the whites (which he did not consider himself) and the people he knew as hubshi, blacks who aroused at least as much prejudice in India as they did in America.  The physical city itself he found disorienting, and the behavior of the people of all classes and races was impenetrable.  He spoke virtually no English on arrival.   He had no friends.  He had no status.  He enjoyed cooking for his employer -- and for the restaurant for which he later worked -- but when work hours were over he was at a total loss, despite gradually picking up some English.

His only ventures outside his quarters eventually were limited to visits to the supermarket, excursions that made him uncomfortable.  He watched television, which gave him his only (distorted) insight into the life of white Americans.

Eventually, he married a hubshi woman who had shown some interest in him.  They knew nothing about each other when he asked and she accepted.  He tells us nothing about his marriage, but his account of how he spends his days does not include mention of his wife.

Like many immigrants -- some of whom, unlike Santosh, never learn any English at all -- he has no real life or enjoyments.  As he says in my quotation from the story's conclusion, he merely goes through the motions as he waits for his eventual death.

Santosh's story reminds me of André Aciman's frequent accounts of his childhood life in Alexandria.  Aciman and his family came from an infinitely more sophisticated and cosmopolitan background than did the humble cook from Bombay.  But André, too, continually laments that no matter where he lives or visits, he never feels he is "home."  Home is Alexandria, or more accurately a now-dead Alexandria, to which he can never return.

Permanently leaving the society you grow up in is a radical act. It is an act requiring much bravery, and is usually motivated by intolerable difficulty in living life in one's true "home."  Groups of men, women, and children do not lightly  leave their homes and walk 1,600 miles to a country they know little about.  We can't assure them happiness in our very different society, although -- as the Latinos of our Southwest show -- we can offer them hope for their children's future happiness.

Midterm elections

Four more days until the mid-term elections.  The campaign seems to have lasted forever.  Actually, it pretty much has lasted for two years.  But finally, we're about to get some decisions.

I have no idea who is going to win in any race, or which party will win overall.  Those who are paid to prognosticate seem, for the most part, to predict that the Democrats will regain the House by a small margin, and that the Republicans will slightly improve their position in the Senate.

But then we remember how accurate the polls were two years ago, right?  Let's face it, the decision could go either way, especially in the House.

This midterm election seems far more critical -- apocalyptic, actually -- because Trump has decided not to run on his own program or against the program of the Democrats, but on voter loyalty to himself as The Leader.  Surprise!  To those of us unpersuaded that Trump is the new Thomas Jefferson or Abraham Lincoln, the election thus becomes a referendum on the extent to which the American voters are willing to confirm in power a government that increasingly seems fascist in its pretensions and its approaches to governing.  

Mr. Trump's swooning over the election of a right wing autocrat in Brazil hasn't given us much cause for comfort.

Trump, and the Republican party itself since at least the Nixon administration, has made polarization of the American voting public a major objective.  This produces what has been called tribalization -- where voters no longer vote based on an analysis of the issues, or -- in voting for Congress -- the personality and character of the candidates, but for Blue or Red -- i.e., liberal or conservative, urban or rural, coastal or "flyover," globalist or nationalist.  All these opposing tendencies have now been aligned, so that all you need to say is "Blue" or "Red," and for most voters their position on all issues is totally predictable.

Trump has taken advantage of this polarization, and has enhanced it.  He prefers to think not in terms of Blue or Red, but of Trumpist or anti-Trumpist.  Being a Republican is not enough, nor is being a conservative.  If you don't toe the Trumpist line -- whatever that line may be as of 3 a.m. this morning as Trump broods over his Twitter feed -- then you are an Enemy.  Ask the Speaker of the House.  It took only a slight suggestion from Paul Ryan that Trump couldn't unilaterally amend the Constitution to bring the full brunt of Trumpist scorn down upon his head.

So, yeah, I'd say the election is important.  Even just gaining control of the House would permit the Democrats to stymie some of the more disastrous ideas that Trump may dream up over the next two years, although the Republicans' retaining control of the Senate would leave Trump free to make crazy appointments at will.

Because of the New Tribalism, there is no longer a large independent swing vote.  Polls show that everyone who loved Trump in 2016 loves him still today, and the same with those opposed.  The problem, therefore, hasn't been to persuade voters on the merits of the issues, but to get them to vote.  Hence the importance of those polls that try to determine which side's voters are the most fired up and eager to vote.

And we don't know, really.  It could go either way.

So -- if you would prefer to retain a traditional democracy in America, get out there and VOTE! And make sure your relatives and friends do so as well.

If you feel more comfortable having Trump run the country via tweet, then relax.  Your man's almost certain to win.  It's cold outside, and I suggest you crack open another six-pack of brewskies, sit back and relax, and watch NASCAR on TV, come Tuesday.