Sunday, January 31, 2010

While Washington Dithers, Tony Judt Confronts Nightfall

As of now, Barack Obama and the Congressional Democrats have precisely nothing to show for their year-long healthcare effort. They had a vision of bureaucratic control that failed with the American people, and it will most likely crater completely in Congress this year. This failure was a loss for the Democrats, as recent elections make clear. But it was also a loss for the American people--because all of us would like live healthier and longer.

Such thoughts on mortality are stirred yet again by a new elegiac diary of illness, published by Tony Judt, a professor at NYU and a leading scholar of modern European history, who is now wasting away from ALS--Amyotrophic Lateral Sclerosis, also known as Lou Gehrig's Disease. Lou Gehrig, known as "The Iron Horse" for his steady playing and playmaking over a decade-and-a-half in major league baseball, died at the age of 37. That was back in 1941.

Seventy years after the disease became famous, it doesn't seem that much has changed for ALS sufferers; we have to wonder what we have done with these seven decades. Judt describes his health situation in The New York Review of Books, in a piece called, simply, "Night." He is now, he tell us, a quadriplegic:

In effect, ALS constitutes progressive imprisonment without parole. First you lose the use of a digit or two; then a limb; then and almost inevitably, all four. The muscles of the torso decline into near torpor, a practical problem from the digestive point of view but also life-threatening, in that breathing becomes at first difficult and eventually impossible without external assistance in the form of a tube-and-pump apparatus. In the more extreme variants of the disease, associated with dysfunction of the upper motor neurons (the rest of the body is driven by the so-called lower motor neurons), swallowing, speaking, and even controlling the jaw and head become impossible. I do not (yet) suffer from this aspect of the disease, or else I could not dictate this text.

Such a fate is a tragedy for anyone, but Judt is a great scholar, and we shall miss his intellectual voice. From his professorship at New York University, he earned a reputation as a humane observer of politics and culture. He was always on the left, but possessed an Isaiah Berlin-like awareness of the danger of absolutism and dogmatism of any kind, and so he was interesting and useful to all sides in a debate. Just four years ago, he completed a major work, Postwar: A History of Europe Since 1945, which I reviewed, favorably, here, for The American Conservative.

And Judt, born in 1948, is only in his early sixties. A Baby Boomer. How much will we all lose if his voice is finally stilled, way before his time?

If the US government really wanted to make America a better and healthier place, it would focus on curing diseases such as ALS. It would be working with the Chinese, and the Europeans, and the Arabs, and anyone else, on a grand project. A grand project for world health--because we all, everywhere, have a stake in cures.

But instead, as we all know, when the US government thinks about "health," it immediately slips a category--it immediately shifts to "health insurance reform," which is not the same thing. Thus a scientific project becomes a political project--even when the American people don't want it done to them. It's hard to think of a bigger lost opportunity. A new young president who campaigned on "hope," who seemed so eager to try new things, found himself sinking into the mire of unpopular bureaucratic programs. But of course, nobody made him do it--he did it to himself. That's the lost opportunity, to do something positive with all that energy. A lost opportunity to truly "bend the curve" on healthcare, by helping people live healthier and longer lives.

Truly a lose-lose. This failure was a loss for the Democrats, as recent elections show, but it was also a loss for the American people, because none of us have that long to wait. So there's a power struggle going on, between the American government and the American people. Neither side is winning, and so, as a result, we are all dying.

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