Mourning David Carr, another stranger who made my life brighter

I was thinking about how much I am mourning New York Times reporter David Carr. I never met him even once, though many of my friends and colleagues remember him as a treasured friend and mentor. I particularly liked this remembrance, and this, and this.

Carr’s death stops me in my tracks for many reasons. He was struck down at the top of his game. He had such tremendous human vitality. I would so look forward to catching his latest column on my morning commute. He was just someone who made my life a little brighter, provided a flash of wit and insight, delivered with apparently effortless style.

As I thought about him, I started thinking about a few wonderful friends living with advanced cancer, about the morning last week when I happened to break bread with two good friends who are pretty amazing in their different ways, who I hadn’t seen in awhile.

We all know so many amazing people who light up our lives in routine everyday ways. We take them for granted. How could we not? You can’t start every morning sending effusive emails to every friend, acquaintance, let alone every stranger who makes life a little more special today. It’s more than too time-consuming. It would be staggering even to draw up the list.

We often don’t notice these special people until something unexpected happens that snatches them away. But they are there. Our lives are part of something so much bigger than ourselves.

Why paranoids make the best suckers

My Twitter feed was filled this weekend with anger directed at parents who fail to vaccinate their children. The anger is justified, since these parents have fueled a resurgence of measles and other preventable diseases.

One of many striking aspects is the way that many educated parents buy into junk science, exemplified by false claims that vaccines cause autism. It’s sociologically interesting that so many otherwise well-informed people embrace crazy theories so readily-debunked after a few minutes of web-searching.

I tweeted about it, and got a surprisingly widespread response.

No one factor explains what’s happening. Many intentional non-vaccinators are simply free-riding on the herd immunity they hope is created by other people’s children. Such collective action problems provide the basic case for mandatory vaccination…. Continue Reading…

The President was right (though politically clumsy) to go after those luscious 529 college accounts

At the State of the Union, President Obama proposed limiting the tax advantages of 529 college savings accounts. If you’re an affluent college parent, you probably already know this. If you’re not a parent and/or you are not affluent, you probably said “Huh? What is a 529 account?” Which rather exemplifies the problem.

I have 529s for both of my daughters. I recommend these to all my friends with children. These accounts allow you to accumulate tax-free investment gains to help finance your kids’ college. These also provide a good mechanism for relatives to chip in on birthdays and holidays. Given time to accumulate interest, a few hundred dollars a year from Grandma can easily accumulate to cover a whole semester at a state college. 529s provide a convenient nudge to help you save more, too, though the net impact of such tax-advantaged savings vehicles appears to be quite limited.

The president’s proposal produced an entirely-predictable uproar among affluent families and within the industry of financial and college-savings advisors.  Leading Democrats such as Nancy Pelosi and Charles Schumer immediately ran from the proposal.  Political heat was so intense that President Obama was forced to beat a hasty retreat and to abandon the proposal….

Continue Reading…

This weird-looking Medicaid expansion map would sadden Dr. King on his holiday

(This column is cross-posted at the Huffington Post.)

I wonder what Dr. King would think about the current health reform debate. OK I don’t really wonder. Here, for example, are his comments, apparently made here in Chicago:

Of all the forms of inequality, injustice in health care is the most shocking and inhumane.

Martin Luther King supported health care as a human right. He also knew how far we had to go as a nation in making that right a reality.

King was the energizing force behind the Southern Christian Leadership Conference (SCLC). I suspect he would be ashamed but unsurprised to see his home region so resistant to the basic expansion of health insurance coverage to Americans with incomes below the poverty line. To some extent, the extent of southern resistance is obscured by maps such as the one below, that display which states have rejected the Medicaid expansio­­­n around the country:

Screen Shot 2015-01-19 at 3.13.50 PMMany of the shaded states such as Wyoming and Montana are huge but sparsely populated. Others such as Wisconsin have small populations left uncovered for other reasons.

Harvard post-doctoral researcher Laura Yasaitis is an expert at drawing different kinds of maps. At my request, she made me a map in which the size of every state was proportional to the number of people who landed in the “Medicaid gap.” (She couldn’t quite do that, since states such as California and New York would simply vanish. We drew each of these states as if they had shut out 2,000 state residents instead of zero. She also taught me how to make Cartograms. SO you may see more such items in this space.)

When we did all that, here’s what the US map would like if it were scaled by the number of affected people in each state (see below): Continue Reading…

It’s a pain in the neck to live with an intellectual disability

My bro-in-law Vincent was in a bad mood the other day. He was irritated, and I wasn’t as sympathetic as I might have been. He was frustrated because he was defeated by one of life’s unimportant but aggravating logic puzzles that plague him like a stumbling-block before the blind.

It’s difficult to grasp–let alone convey–the human experience of living with an intellectual disability. In any event, there’s no single common experience to convey. People living with intellectual disabilities have such varied challenges, personalities, and life circumstances.

There is one common thread. Intellectual disability is a pain in the neck. Imagine, if you will, that you are visiting Starbucks. Your barista has just prepared your favorite skinny mocha latte. She has it right there. She’ll be happy to hand it to you–right after you solve this Rubik’s cube and then reset your iCloud password and settings.

Yeah, it would be pretty annoying, constantly having to solve lots of hard and annoying little logic puzzles just to make it through the day.

Richard Ford makes me cry

No policy memo or psychometric scale can capture the tactile experience of private sadness, trauma, and loss. For that, we need the literary or the biographical imagination.

Richard Ford’s Sportswriter trilogy is ostensibly about many things. Yet as Stephen Metcalf observed in Slate, these books are really about the shattering (and then the gradual, only-partial reconstruction) of protagonist Frank Bascombe’s life brought about by the death of his young son from Reye’s syndrome.

In Lay of the Land, the third book of the trilogy, Frank’s life takes various twists and turns on the way to Thanksgiving. Sitting in a bar, waiting for a car to be repaired, Frank’s attention is drawn to a random stranger who has also lost a child. And so, Bascombe reports, “my son Ralph Bascombe, age twenty-nine (or for accuracy’s sake, age nine), comes seeking audience in my brain.”

…when you have a child die—as I did nineteen years ago—you carry him forever and ever after. Of course you should. And not that I “talk” to him (though some might) or obsess endlessly (as his brother, Paul, did for years until it made him loony), or that I expect Ralph to turn up at my door … (I’ve fantasized that could happen, though it was just a way to stay interested as years went by). For me, left back, there has been no dead-zone sensation of life suspended, hollowed, wind-raddled, no sense of not leading my real life but only some consolation-prize life nobody would want—I’m sure that can happen, too.

Though what has developed is that my life’s become alloyed with loss. Ralph, and then Ralph being dead, long ago became embedded in all my doings and behaviors. And not like a disease you carry that never gets better, but more the way being left-handed is ever your companion, or that you don’t like parsnips and never eat them, or that once there was a girl you loved for the very first time, and you couldn’t help thinking of her—nonspecifically—every single day. And while this may seem profane or untrue to say, the life it’s made has been and goes on being a much more than merely livable life. It’s made a good life, this loss, one I don’t at all regret….

Of course Ralph’s death was why Ann and I couldn’t stay married another day seventeen years back. We were always thinking the same things, occupying and dividing up the same tiny piece of salted turf, couldn’t surprise and please each other the way marrieds need to. Death became all we had in common, a common jail. And who wanted that till our own deaths did us part? There would be a forever, we knew, and we had to live on into it, divided and joined by death. And not that it was harder on us than it was on Ralph, who died after all, and not willingly. But it was hard enough.

Everyone–myself no more or less, particularly, than anyone else–experiences sadness and loss. Thank God these losses rarely stem from a child’s death in the year 2014. Still, we mourn now-gone parents, siblings, friends, and spouses. We undergo painful divorces and romantic disappointment. We lose jobs or experience economic hardship. We watch people succumb to cancer or AIDS. Someone we love suffers because of one, randomly awful, repeated genetic sequence.

These aching experiences sometimes strengthen us. They sometimes diminish us or leave us vulnerable in unexpected ways. Whatever they do to us, they become part of us, embedded in our lives. Although we might give anything to have avoided these misfortunes, at some point we can’t fathom what our lives would be like without whatever they’ve left behind.

CS Lewis informs us that this is the way God does his work. The blows of God’s chisel, which hurt us so much, ultimately sculpt something better in us. Maybe so, though I’m not much for apologetics. Like Frank Bascombe, I wish there were some other way.

Living well with breast cancer by choosing wisely

Over at Wonkblog, I checked back in with one of my favorite people, Amy Berman.AmyBerman_1x1 5 (1)

Amy is a program officer at the Hartford Foundation. She is on my real-life Madden team. She has been living with stage IV breast cancer for several years now. By the judicious use of palliative care, she is living well despite the challenges of a spreading cancer. It is a strange experience yucking it up over Skype sipping diet soda and discussing metastatic cancer. Life is funny like that.

We spend so much time debating what a good death might look like in end-of-life care. She has had a good life for the past several years despite an incurable cancer, because she has sought and received excellent care.

More here.