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September 11th Perspectives on Fear and Healthcare Reform

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My fingers are disintegrating as I type, as if the words leaving me are taking me with them. Oh. It's just dry skin. My hands are raw, dry, almost bloody. With the threat of H1N1 all around (there are signs everywhere at the airport ticket counter about covering one's mouth when coughing), I've been washing my hands or using hand gel every fifteen minutes for my entire Washington week. This town is all about handshakes, business cards, and cramped quarters in elevators. It is contagion central, and I have the urge to disinfect everything around me.


I'm sitting in the Reagan International Airport with a lot of time on my scratchy hands. I got here really early to check in because it is Sept 11th and here I am in a Washington, D.C. airport of all places. I was afraid there might be extra security to deal with. CNN is scrolling and looping its inexorable bad news on the TV monitor up above me. The headline just came by "Another Terrorist Attack: Vigilance or Lucky?"...and they played an old sound-byte of President Bush saying that terrorism was a "ticking time bomb set to go off."


Then they had an interview with an expert about the imminent H1N1 epidemic.


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Rewind to about 40 minutes earlier. I was checking out of the Residence Inn, hunting for a cab which is impossible to find on a D.C. morning like this one when it is pouring rain. The hotel staff tells me there's a "special hotel cab" (translation: you'll pay some exorbitant fee since it is not one of the regular city cabs) with another guest who is already going to Reagan, so I can ride with him. We pile me and my luggage into a Secret Service looking SUV, and I offer a friendly but I-don't-really-want-to-engage-in-conversation-at-this-time-of-morning "hello."


The man's blue jeans and Dallas Cowboys sweatshirt are streaked with rainwater, but he is cheerful: "Good morning. Where are you from?" he asks.


"Portland," comes my groggy response.


"Maine or the other one?" he inquires.


"The other one--Oregon," I offer, hoping to close off the pleasantries.


"Never been there. I'm from Texas. A little border town. Been working on healthcare stuff this week. Got nothing else to do since I lost my job back in June." He is now drying his clothes and bag off with some Burger King napkins.


He has hit my weak-spot topic, and I am impressed that someone who has lost their job would spend money in a time like that to come all the way to Washington to work on an issue they believe in. So I go for it: "Oh...very sorry to hear about your job. It's a scary economy. But it's great for you to volunteer your time here. I've been working on healthcare reform, too. Trying to get them to focus on moving healthcare to the home with the help of technologies."


His face is reddening: "I've been here all week on illegal aliens. We've got to stop this thing. I see it. I live in a border town, so I know it. We're in another war--these Mexicans drug lords are getting crazy on the border with lots of big time weapons. I was stationed in Iraq--I've seen this and lived this before--and now we've got a bona fide insurgence happening right here at home from Mexico." His neck muscles are bulging out as he continues: "But we're just inviting them into America and giving them a job, a car, and now health insurance on top of it!"


Oh lord. Surely my face was now reddening, too. I bid to close down the conversation: "Well, Washington is a crazy place, but now it's time to go home, thank god." And I opened up my USA Today as a conversation shield.

My bid was denied. He attacked. "We can't let the President get away with giving them our healthcare. We've got to fight that nonsense. His speech was horse shit! That Congressman was right to yell out!"


I wish I had come up with a courageous, eloquent soliloquy that somehow set this man and the world on a different course with his thinking, but I did not. I was actually scared at this point...angry but also afraid that it was plausible for a fist fight to break out in this luxurious cab with my well-muscled border-line travel companion. And I'm not that kind of fighter. So, with a promise to myself that I would never again talk to people in the airport, on the way to the airport, or anywhere near the airport, I said what I could: "Sir, I really disagree with you, but I don't feel well enough to argue with you...could we just get to the airport and get home?"


Miracle of miracles, he said: "Oh. Okay. Yes. Sorry."


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So here I am, safely arrived to wait for my (now delayed) flight, trying to ignore the scrolling headlines. I wasn't even going to blog about any of this until I just heard that quote on TV: "ticking time bomb waiting to go off." Ah, the perpetual imminence of threat, magnified by the television ticker.


I don't think of myself as a fearful person, but as I think back on it, this short beginning of a day has already been filled with a convergence of little and large fears: terrorist attacks, H1N1, losing a job, war in Iraq, illegal aliens, drugs lords, guns, and fighting with a perfect stranger.


The terrible images of 9/11 were already in my head well before the news started shocking me with them again this morning on the anniversary. Even a month ago when my assistant printed out this trip reservation and I first realized that I would be flying out of D.C. on Sept 11th, I said to her: "Gosh, I'm not sure I really want to do that." If I am really honest with myself, my heart missed several beats this morning at the upstairs check-in when I saw a foreign man with a head covering of some kind. And there was even that little moment of hyper scrutiny when I scanned the foreign face of my cab driver, who was also sniffling and sounded congested. Terrorist? H1N1? I actually tried to steer my roll aboard so that he would never handle my luggage in case he was sick, and out came the hand gel as soon as I got into the airport!


All week I've been asking myself over and over how "people" could be so fearful as to believe that death squads for seniors are coming...that healthcare reform is somehow the Red Scare all over again...that the President actually wants to let illegal immigrants take over our country...or that he has hidden, sinister motives to take away our healthcare benefits? How can people believe these crazy things--how can they be so afraid? But...oh my god...this backdrop of fear is actually inside me, too. I'm not consciously worrying all the time or dwelling on these feelings, but I'm acting upon them in quick glances, small worries, and micro panics. I'm letting them insidiously color my view of the world.


Is there a poisonous paranoia that many, if not most, of us in America have internalized to varying degrees? Has "threat level orange" become the new normal? Are we somehow transferring our fears for things that seem out of our control--wars, recessions, epidemics, and terrorists--onto things like healthcare reform legislation that we feel that we can control? These questions put me at risk of practicing armchair psychology on a grandiose scale, but it feels important to understand how and why this healthcare debate feels at time as embattled, as escalated, as emotionally intense as an all-out war.


While the President's healthcare speech this week was not what I had asked for in my blog the night before, I am beginning to think it is what was needed. Like President Bush standing on the rubble in New York City after Sept 11th, President Obama needed to calm and assure the nation. But, while urgent and even potentially life-saving to many people, this healthcare reform doesn't warrant outright panic or fear of that magnitude. Hard debate about emotional topics such as public options, malpractice lawsuits, abortion, and covering illegal immigrants need to be had (along with hundreds of far less emotional topics), but let's ratchet down the noise and emotional intensity.


The amount of fear, rage, and rhetoric around healthcare reform seems a bit misplaced and mis-calibrated.  As we reflect on 9/11--on what it means to each of us as individuals and as a nation--maybe we can admit that we have a broader, more pervasive fear problem in the national psyche that is coloring our view of healthcare reform. And that perhaps watching the news is not good for our collective health.


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I'm on the plane now, looking down at large cities and small towns from above. I like the fuzzy view from up here because the scars, ugliness, and decay in our society blurs or even disappears for a while from this lofty perspective. Even as I know that these words here will be cast by some cynics as naïve and dreamy (I read the hurtful emails, too), I hope and pray we can work on hard problems like healthcare, without needing to recreate the terrifying trauma of Sept 11th in order to make ourselves come together. I'm not asking us to ignore ideological differences or rubber stamp significant legislative changes in healthcare for the sake of a sense of community, but let's not prey on--and escalate--our fears from 9/11 and other cultural traumas in order to achieve political wins at any cost.


I, for one, don't want to live as if there is a "ticking time bomb set to go off." I'd like to detox from this poisonous paranoia. I like the other quote I have seen tickering by on the television this wait-full wistful morning: "We did not come to fear the future. We came here to shape it." Ah, so not all of the news is bad after all.


Comments are welcome.  please post to: http://blogs.intel.com/healthcare/ 


NOTE:  ERIC DISHMAN'S 'HOME BLOG' PAGE HAS MOVED TO:  blogs.intel.com/healthcare.