01-09-12 Odarkhundred hours. Muir Beach. Fuji pops right out from under the comforter when I call, looking interested and a big groggy. She performs her usual perfect downward dog asana, then leaps from the bed and trots out through the door I’ve opened, accelerates, and bounds stiff legged into the dark, up the steep driveway towards the Ecchium, her favorite hunting ground... There’s a full moon blinging the Western sky, but in her jungle its dark, evoking several sharp barks and a growl or two. As usual I worry about the slavering coyote just waiting for a breakfast morsel of ginger colored barking 12.5 pound Chihuahua Mixdog.
But, as always, Fuji’s back in a few moments, huffing a little over the insulting behavior of whatever escaped her this morning. Last summer she did catch one insanely adventurous young squirrel, and out zigged several zagging chipmunks. This natural behavior evokes a variety of emotions in her human friends, as did the entire nest of baby rabbits that she brought home, very dead, one by one. Fuji has a strong ‘shake ‘em, break ‘em’ behavioral response to anything she can hold firmly in her jaws, but the follow-up eating behavior probably requires more hunger to initiate, so she hesitates, which gives the human intervention, removal, and interment response time to intervene.
I thought about that later, marching with a contingent of Active Elders down Capitol Mall in Sacramento. We had boarded our leased busses to support the annual Medical Student Lobby Day for Single Payer Health Care. I’ve been coming to Lobby Day, when circumstances permit, since it was started 5 years ago. This was the first time I’ve come by bus, and my first social action ever as a senior.
What I thought about on the bus ride and beyond, was natural behaviors and compassion. I have to admit that a part of the thought derived from a different source. A practice of compassion had been the apparent subject of Tenshin Reb Anderson’s Dharma Talk at Green Gulch Zen Monastery on Sunday. On the bus trip up, sitting by myself in the midst of a group of like-aged and older activists and background listening to their talk, I worked on a couple of necklace projects and did not read further in my copy of The Archeology of Knowledge. I have to admit that carrying a copy of Foucault tends to promote my accomplishing almost anything else.
Does Fuji experience Empathy? Or Compassion? Or is that simply not something that her brain concerns itself with? And how does one go about promoting these brain directed behaviors (are they behaviors?) in medical students? Or is it more a matter of not extinguishing the tendencies towards compassion that they already have in their pockets when they arrive at our Professional Reformatories?
These large busses where you sit up high (remember those low slung crouching Greyhounds with the squeaky air brakes and the panting diesels?) are damn fast, and we zoom across the Carquinez Bridge, leaving the old C&H sugar factory squatting beside on the left bank of the Sacramento River. The fleet of decaying Liberty Ships is on the right bank, but out of sight up river beyond Benicia, rusting yet ready for the next call to battle. We pull off at Solano to pick up three elder males and one female.
Now that we are all assembled, our leader (a youthful 40 something and organizer for this senior group whose name I can’t remember) distributes little oranges, granola bars and various flavored potato chips. This is a lot better than SDS on the March on Washington! She also has a printed sheet of our schedule in Sacramento, and takes one necklace worth of time to explain options, depending on mobility. You can get off and march 6 blocks with the students, or be let off at the rally on the Capitol Steps, and even choose to march on once the students are launched on their lobbying missions to ‘A Large Insurance Giant’ for some ‘Occupy Style Protest’, then a free lunch in the park provided by the California Nurses. I begin to think the instructions are excessive, but no; my fellow seniors have questions, and then want to begin a political discussion of the likelihood of SB 810 passing out of committee. SB 810 is this year’s version of Single Payer Health Care for California. In previous years, secure that The Gubernator would veto, it was easy to get democrats to vote the bill out of committee and even pass it on the floor of the Assembly. Now, the suspicion is that Governor Jerry Brown (who could be on the bus, he’s 70 something) doesn’t want it to get to his desk, because he has previously pledged to sign a Single Payer bill.
The bus roars and sways along through Yolo County, where your tomato sauce comes from. I came up here once or twice a week when I was doing ER work, going for an early morning pre-work run along the farm roads that are part of UC Davis Ag campus.
Well, Fuji certainly has a rich emotional life. You can almost feel the quivering passion evoked by a certain roadside smell, or the fierce joy of pursuit as she leaps into a flat out ears back low to the ground run to rout a crowd of ravens from the compost pile. And I think that’s what makes her bounce and bark to be picked up and included in any hugging. I am sure she would be there, licking my face, as she does with Joaquin when he’s hurt or sad. So, perhaps it’s empathy. But is that enough in a medical student? What’s compassion and how to we get it? Or looking at the other side of the reality dog door; what behaviors do we NOT want, and how do they take root?
Sacramento’s sole purpose these days is government, and so it’s a hop skip and jump from freeway to the Capitol Mall, and the bus pulls over next to a gaggle of students, many wearing the short white coats that allow easy identification in the hospitals where they train. And where they learn habits, behaviors, both good and bad. Compassionate or …well, uncaring..arrogant…callous; all those things we would rather our doctor were not.
About half of us seniors stay on the bus; we learn that the fierce independence that got us to this age must be replaced by an inter dependence. Six blocks is six blocks; better save energy for the trek to the ‘Insurance Giant’ and the ill-defined but tempting promise of ‘An Occupy like activity’. And here I take out my long white coat, emblem of my status as a Clinical Professor Emeritus (I actually bought this one at Goodwill for the sole purpose of taking to these demonstrations), and after slapping on my green sticky Senior for Single Payer label, I get off the bus (forgetting my sun glasses of course) and mill around with the laughing, talking, chanting group of the 1%. No, not THAT 1%...this is the 1% that has made it this far up the educational ladder. It takes a family to make a medical student. Sometimes the student has to invent and cathect a family of support when their own cannot function, sometimes the student herself is the reticent beneficiary of a mothers iron will. But one way or another, these young people are a very, very select crew. Lots of smiles, lots of black and brown faces; Asian, African, Native, Northern, Southern heritages evident in the physiognomic details. At least half are women. ARE women more likely to develop a compassionate medical practice? Irreverently, my mind fires back a typical response, a question to the question; ‘Does a dog have Buddha natures?’
“Single Payer, that’s our Right. We are here and we will fight”
“Insurance Greed makes People Bleed”
Each year a new set of well-dressed young women with megaphones leading chants. This year, three painted black Styrofoam full sized coffins, with the grim facts of death due to system failure printed on the sides. Wandering around, I acquire a sign (Single Payer Yes, Insurance Profits NO) and then see two third year students that I taught last year in the Berkeley medical program. Their short coats are gleaming white in the sun; I’m overdressed for the beautiful blue sky balmy day this is turning into (Last year was dark and cold). We chat about Board study (ours are all are in March) and their lives (not so much right now). And now we are marching, shouting, taking action, and the time for consideration of compassion is past for the moment.
The rally is noisy and energetic. The students in their short white coats (most all medical schools have a ‘white coat ceremony’ memorializing the students beginning of their clinical education), the elders with their green sticky badges, and a few of us longer white coats. The three Styrofoam coffins block my view of the speakers, but the PA system, for once, is excellent. And the speakers, including two legislators and various advocates, all give short effective sound bite speeches that I can’t help to think are a credit to our movement. Better than I could do. Writing that, I sense another salutary nudge of my own path towards interdependence. They can do it better. We did some good, they will do better.
Some genius arranged for the funeral procession theme to be led by a New Orleans style jazz band, and as the students head inside through the metal detectors that are part of our lives now (remember when…?) the band forms up and tootles off through Capitol Park. It turns out we are going to the California Organization of Health Plans, a medical insurance provider lobby group. We arrive, no stealth approach, and the lobby doors are immediately locked. The PA system and loudhailers stayed with the students, but a young woman gets up on a wall and with a rolled sign as a megaphone, shouts out “Mic Check”. There is an immediate response from about half the crowd, which is now mainly seniors. Have all of us attended an occupy, or is it learned from video? In either case, we all begin the short phrase group chorus communication methodology used by Occupy movements for their general assemblies. Some younger Occupiers have come along, and one overweight young man with a buzz cut skirmishes with the employees who are trying to let people with routine business in while keeping Occupiers out. Some seniors encourage him; most of us hope no one gets hurt.
The lunch is a big sandwich, and I share the lawn/wrap/spilled water process with an elder EMT from Modesto. His daughter doesn’t have any health insurance. He does; he discovered on his own that as a Vietnam vet he qualified for insurance. He’s been able to get his blood pressure and high cholesterol medication at a cost he can afford. Still, he thinks our current health situation lacks compassion. But before I can get started, a more urgent discussion surfaces. His daughter thinks single payer might drive doctors out of business because they would be paid less. We talk through that scenario, and after a few minutes he says that he’ll talk to her again and explain more about how it might work. She is currently paying off an ER visit where she was billed for $5200. She had a stomach pain. It turned out to be nothing.
A loudhailer announces there are extra lunch bags for those who want them. My lunch mate does. As I get up to leave a few moments later, I notice a set of car keys in the grass. I find him stowing two lunch bags in his backpack. “Dinner” he explains. I hold up the keys to explain I am not checking on him. “Oh, thanks”, he says. “Guess this is gonna happen more “
Yes, he and I will be forgetting more, leaving keys in the grass for younger eyes to find. And I hope that low level mass actions like this for Single Payer are going to be more frequent, as well. Thinking about recognizing and nurturing compassion in medical students, in the face of the system I will be leaving them with, sometimes seems almost futile. 'Maybe', the anarchomaniacal side of me mutters,' it just has to really collapse to get any change'. And then I am back on the elder bus, and we are roaring back down the highway, 10 miles to the gallon, back to Berkeley.
aloha
Alan
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