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braindamageforbeginners · 6 years

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On the nature of evil

Cycle 5, Day 9 I’m in the grips of an infusion hangover; it’s not the worst I’ve ever had, and I predict be back up to full-speed in a few hours, with the help of a lot of coffee and aspirin. However, recent events - combined with my fatigue (fhe coffee has’t kicked in yet) inspired me to go dig this out of the “Drafts” bin and finish rather than start from scratch. This will be long - my apologies - and have more than few typos and problems in it (for starters, I stitched it out of three or four other ideas/observations/proto-essays, and I’m all chemo hung-over now).

I’ve thought an awful lot lately about the nature of good and evil - as you do, when you face an existential threat that originates in your own body (and, because it’s me, I’m not going to get there in a straight-line path). I’m a reductionist (that’s shocking, I know), and, as a child, I wanted to know what made us us (DNA, I know, but I was hoping for more details). I once asked my high school biology teacher whether it would be more accurate to describe us as multicellular critters, or as walking colonies of specialized cells. She said the latter. Later in life, I put the same question to my biochemistry professor; his learned opinion was that we’re just walking, talking biochemical reactions that existed to provide the carbon molecules within us the best, most-stable shot in a hostile universe (that might seem dehumanizing until you realize that all life, in all its myriad forms, and all human progress and endeavors - from laying cement to composing an adagio - stem from a few basic rules of chemistry and physics, which is almost miraculous if you think about it). Which means that my tumor is the result of one or two brain cells getting very specific mutations (six or seven I think: I have the exact list of mutations written in my personal notebook, but I’m not sure it’s that interesting), and then growing, spreading, and recruiting other rogue cells. That’s not particularly evil; it’s just the horrible result of a few cells being in the wrong place at the wrong time. It’s just some rogue, reprogrammed bits of me; but, unlike the harmless bacteria in my gut or the fungus on my feet, it will grow and spread without constraint... until it kills me (hopefully that won’t happen, but it’s important to keep that in mind throughout the essay)..

One accusation I’ve occasionally heard leveled at atheists, agnostics, humanists, and other non-religious folk like myself is that by not having some grand villain to creation, we refuse to acknowledge the existence of evil. As a pragmatist, has always been, “Well, you have to. The bar has to be set somewhere.” Even though human morality may not exist in the vacuum of space beyond Pluto, humans have to have it - or at least pretend to (we’ll get to that very shortly). The best, most-useful definition comes from an obscure short story written by M. Shayne Bell, “Evil exists; it is intelligence in the service of entropy.”

To further pad this essay, and make it all about me; I have not mentioned my psychiatrist much (this isn’t Shrink; they’re two different people). This is both to protect her privacy, and because, despite what you might think from these writings, I do have aspects of my life I don’t spill out to the general public. But, she is - like everyone else on my health team - not above using any and all tools available to her. Which means that she’ll prescribe any medication she feels is indicated (I am indebted to her for her reviewing my meds and recommending the exotic antidepressant I’m on)(and the rather more-common anti-anxiety meds I’m on). However, despite being up-to-date on all psych meds (as far as I know, she specializes in cancer patients, so that one’s important)(she’s the doctor who noted my previous antidepressant lowers seizure threshold, so it might not be ideal for me), she’s still what I would call old-fashioned. Which she’ll listen for a few minutes, then say something deeply wounding. Or, worse, means she’ll say something innocuous that you’ll wake up at three am to think about. She was the person who told me to look at my current situation (namely, I have stay within easy driving distance of my oncology teams in SoCal and NoCal for a year) as a form of probation, rather than a sentence. I know my father hated that metaphor when I discussed it with him, but it was what I needed to hear (and, more importantly, she knows me well enough to know I despise and mistrust people who sugar-coat things) to start changing my thinking. A few months ago, when she asked how I spent most of my day, I told I wrote, went to the gym... and spent most of my time dealing with the unfortunate, bureaucratic paperwork and bills (well, as many as I can deal with) that tend to stack up when you get sick. Her response was, “That’s depressing” and it felt good initially, to hear a real grown-up say that, because it reassured me that I wasn’t just going insane. However, as I thought about it, I got angry, because she’s right - it is depressing - it should not be a full-time job to be a sick person, but that is exactly what it takes. I have access to some of the best doctors and medicine, and there is a still dangerous amount of luck involved in this project. There’s been a lot of skill on my part at gaming the insurance companies, when I can (which is rare), and I’ve had a tremendous amount of financial support from my family, but there are sick people who die by the boatload from very, very treatable diseases (yes, hospitals do throw you out; it actually happened to me). And even though there are resources available, there are not enough, and anyone who claims that we don’t have the money is clearly not familiar with the bloated military industrial complex, which even most hard-core conservatives I know admit is bloated.

If the theme of Day 47 was “How much have we, as a species, lost because we all went out of our way to stomp someone,” the theme of today is, “how many people have we unwittingly killed - how much blood is on our hands - because we never said “No” to the few dozen psychopaths who maintain a system that is addicted to death and misery. And, let’s be honest, there is a massive difference between considering how much potential we destroyed when we chased the neighbor kids off our lawn, and nobody giving Jeffrey Dahmer a damned good thrashing when he set the cat on fire (for starters, we can actually quantify Jeff’s evil based on how many people we found in the freezer; the mountains those kids never climbed are completely imaginary).

Returning to mathematics and statistics (it comforts me); just as I am a medical rarity (I’ve done the math, the word “freak” might be cruel, but it’s not inaccurate), but the vast majority of you, readers, are healthy and able-bodied - in other words, if the law of averages works, if you spread it across a population - then, just as I’m becoming aware that almost all of us are filled with madness and wonder and magic; then a few of us contain black holes from which light can not escape. Bipedal nightmares, if you will.

The point of this piece is not to frighten you, although some of you might be frightened. It’s merely to recognize that psychopaths and people with psychopathic tendencies (we’ll get there shortly) exist, and, in order to triumph, you don’t have to do much. Just don’t let them walk over you. That’s it.

Now, this is one area where I definitely am largely uneducated (I like writing, because, as long as I flash that warning up front, I feel I’ve done my duty), and I’m not going to discuss psychopaths (well, not yet, we’ll get there very shortly) inasmuch as I am going to discuss anti-social personality problems. Despite the name, it doesn’t describe people like myself who’d much rather sit at home with my dog, a beer, and the latest sci-fi series from Netflix rather than go out or meet new people (which I would, thanks). It describes people whose actions describe a lack of empathy or caring about other people; which includes psychopaths.

Here’s the thing; according to Ron Jonson’s “The Psychopath Test,” people with anti-social traits make up 1-3% of the general population, however, 30-40% of politicians, CEOs, financiers, etc. - the people at the helm of society, if you will - have anti-social personality traits. I’m sure that number is entirely inaccurate, and the wealthiest, most-powerful class of Western society is quite normal and compassionate, and we serfs are entirely responsible for the harmful, dangerous policies that govern us. I’m sure there’s some sort of long-term wisdom in the medico-legal policies governing my access to medicine I’m not aware of, and me dying or going bankrupt in the process is a minor price to pay for everyone else to benefit (and it might be, using that Law of Averages idea).

Of course, that might be a little extreme; however, law and morality are miles apart, and you confuse the two at your peril (as any racial minority who’s received an unnecessary traffic citation can attest). In my own case, at age 17, after an MRI confirmed that I had a brain tumor; my insurance company literally pulled the plug as I was being wheeled into the OR - entirely legally, I might add, using a loophole in the law in my coverage (I think it’s the hall-mark of morality to let a teen die of a preventable disease)(yes, hospitals do throw people out into the street). Thankfully, my parents were calmer and faster on their feet than I, and they were able to get things back on track - two days later.

The point is, we live in a society seemingly created by, and for, people who are unhindered by any sense of morality. Of course, I’ll admit that I’m an exceedingly small minority, and a self-solving problem, as far as society at large is concerned (literally, all it takes is stopping funding to a few programs at the FDA and NIH and I’ll be finding out if Pascalor or Marcus Aurelius was right. It’s quite possible the rules have changed (I’m sure they have, because I’ve successfully taken advantage of those changes)(and paid a lot of money for that privilege), and the faceless companies that were so eager to see me dead at various points are now fully-invested in my survival (good news, if I’m reading the FDA testing info right, I’m one of 80 people in this drug trial, and my gruesome end would represent a failure rate of 1.25%. I doubt that’s enough for them to step in and dramatically intervene on my behalf, but I’ll settle for CVS being a little more competent and generous about the Temodar).

As someone who is occasionally (okay, so more than occasionally) thoughtless or insensitive, but also horrified at the depths of human cruelty, I also feel like pointing out that we have an unhealthy fascination with anti-social personalities and anti-social personality problems. We marry them. We vote for them. We work for them. When, quite frankly, all it would take would be us - or someone else along the line - refusing to let these idiots get away with it. If we made them pay their taxes and stand at the back of the line. Now, that wouldn’t rid of us John Wayne Gacy or Ted Kaczynski, but they aren’t the problem. Adolf Eichmann is. Those of you familiar with recent history will probably have recoiled from the screen - probably rightfully; to the rest of you; Eichmann was a Colonel in the SS, and one of Hitler’s lieutenants; if there is one single person responsible for the planning and execution of the “Final Solution,” it is this man. Yes, I just broke Godwin’s Law, because the problem with Nazi Germany wasn’t actually the Nazis. Don’t get me wrong; they had to go; my point is, the relatively few Nazi zealots in power would have been completely incapacitated if their clerks and underlings had simply refused orders. Or if someone had dragged them off and told them that wasn’t cool.

Of course, this is being played in real-time with US detention of immigrant children. Again, I’ll bring up Nazis, but in this terrifying context: they didn’t have first, or even the biggest genocide; they were just the first to keep records that allowed the prosecution to build a case. So when you hear a hospital administrator say, “We’ll get back to you about that,” or a border bureaucrat say “We don’t know where the girls and toddlers are,” it should raise the hackles on the back of your neck. Once you get lost in the paperwork - in medical administration or the actual administration - that’s the first, quiet sign that someone doesn’t want to be held accountable if something bad happens (to counteract that, I’ve had good luck demanding to speak to supervisors or get employee ID numbers)(we will ignore the irony - in a few cases - that I was way too tired or in pain to really back up any threats).

At each step in this thing from July 5, 2002 until now, I’ve been lucky enough to find great doctors, surgeons, nurses, etc. who cared about their patients. Sadly, we live in a society that views Gregory House as a realistic character (there’s a fun med student drinking game where you sip whenever he inadvertently kills a patient). And the common thread throughout is that no one thinks it’s just a job or a paycheck or a way to get rich (if you want that, get MBA and become a hospital administrator - they’re usually paid way more than doctors). I think Mad Scientist and Senior Warlock would show up at the hospital tomorrow if they won the Powerball today (I could see them quitting work after finding some definitive cause of brain tumors and/or winning a Nobel Prize). In other words, the trick to finding great medical groups - is the same trick as finding someone who loves their job and would keep working even if all their financial obligations were met. In other words, you find someone who loves their job or their patients, and they’ll focus on being a better doctor. Which means fewer mistakes and/or dead patients.

To tie this all together - or attempt to, this is a Frankenstein’s Monster of writing combined with a morning head - I met, a med student a number of years ago (two neurosurgeries), who said, about my near-disastrous first-surgery (that’s the one where I was thrown out of the hospital while being wheeled into the OR, thanks to an insurance screw-up) that the medical system - such as it is, was more or less fine, dismissing me with “I’m sorry things didn’t work out for you.“ Telling someone they deserve to die due to profit margins and bureaucracy is right up with “Have you gained weight” as far as ways to promptly alienate and piss off other people. He also boasted about how many women hit on him, even though he wore a wedding ring (to be fair, I’d give it a 50-50 chance his wife was actually his mother’s corpse in a wedding dress), and how you have to be careful when providing free service because “poor people will tell their friends” - that man was not very smart (although I have no doubt he’d pass an IQ test)(BTW, there are a lot of studies showing that IQ tests are only slightly better than the MBTI or mood rings when judging intelligence; and it’s telling that whenever one of my crazy, brilliant physicians wants to assess my intelligence, they don’t use an IQ test), but, as far as I know, there are no set systems in place to ensure he didn’t graduate and go into practice (I mean, it’s possible he passed through med school and never got into a residency; I really hope some interview board looked at each afterward and said, “This is the creepiest motherfucker I’ve ever met; do we need another cadaver?”) . And, if he is practicing, I promise you - I’d bet my new lease on life on that statement (you need to understand, though, you’re betting your life on that statement if you’re one of his patients) - that he has, probably unintentionally, killed people because of his complete lack of interest in anything apart from money, sex, and self-aggrandizement - he has absolutely no interest or incentive to improve himself, or save more people, or take anything, other than his bank account to the next level. It’s possible the fear and/or wrongful death suits got to him (again, that’s assuming a lot). It’s a single case, but it’s demonstrative that our society has no real check against human evil or one person getting a dangerous amount of power. You can read into that whatever political statements you like, I’m just noting as a chronic patient a few observations about the importance of compassion (or curiosity) as a quick indicator of physician quality.

The other important lesson here regarding medical sociopathy - and I might’ve written about this previously, forgive me - is that talent attracts talent. I write a lot about the nurses and physicians, but in the chemo ward, I have never seen the orderlies not take out the trash and/or replace linens (and they recently went on strike - and I really hope they got all their demands met, because they’re making it possible to be in a hospital and not feel under a microbial threat). My point is, even the orderlies - a group no one ever thinks of, are top-level. And when that’s just the cleaning staff, everyone else is of a similar competence. I don’t know why they (the orderlies) work there - it might just be a paycheck - but they’re good, and the nurses and doctors aren’t going to outshone by the facilities. Meanwhile, think of that one great doctor in an otherwise lousy practice or hospital. Go ahead and do some research if necessary; I’ll wait. I’m guessing there aren’t a whole lot.out there.

To bring all of this back to the current medico-political situation, the White House has something of a staffing problem, to say the least. At this point, I believe we have a series of rubber stamps in office at this point (everyone familiar with my “Fall Risk” story will know how I feel about that issue), and not particularly competent ones. That’s disturbing in and of itself, but the greater problem is that it’s an endorsement of psychopathy as policy, and, as noted, psychopaths aren’t even particularly intelligent or efficient. But, more importantly, the way you’re betting - if you’re a majority member - is that you will be, personally as wealthy, healthy, and powerful as you are now, and that you will never need the help of someone else. If you don’t feel comfortable with that, then maybe just slap the bullies when you see them. I’m more-serious than you might think; they’re not all going to stand down and behave, but it’s a safer bet than that Immortan Joe will overlook you and behave charitably.

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