Category Archives: healthcare

The Trumpcare Train Wreck: Incompetence + Hubris = Disaster

Friends of Padre Steve’s World,

Mark Twain once wrote, “Reader, suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself.” That being said is amazing to watch a political party with a majority in the House and Senate, combined with their party’s President, drive the train of government over a cliff in pursuit of legislation that was at best ill-conceived and misbegotten, and at worst an abortion wrapped in a train wreck driven by haughty hubris, and guided by the unparalleled incompetence of the Trump administration and the House leadership. Despite warnings that he did not have the votes to get the bill through the House, the President pushed on, insisting on a vote that brought an end to the bill. It reminded me of Barbara Tuchman’s immortal words:

“Wooden-headedness, the source of self-deception, is a factor that plays a remarkably large role in government. It consists in assessing a situation in terms of preconceived fixed notions while ignoring or rejecting any contrary signs. It is acting according to wish while not allowing oneself to be deflected by the facts.”

I watched in morbid fascination this week as the House GOP led by Paul Ryan attempted to ram through this hopelessly flawed bill to repeal and replace Obamacare, only to pull it minutes before the vote. Ryan had to run to the White House to tell the President that they didn’t have the votes as Trump’s display of intra-party brinksmanship crashed and burned in the face of House realists who recognized that the bill would doom them with their constituents and Freedom Caucus extremists who could have cared less about theirs.

The bill would have caused as many as 26 million people to lose their insurance, not reduced the deficit by much, and raised the cost of insurance for those who still were able to have it. The effort exposed both the incompetence of the GOP as well as the lie that they actually care about the people that put them in power, with the worst effects of the bill being felt in the counties and states that most heavily voted for President Trump and the GOP majority. It exposed the basic immorality of this party which regards the acquisition of wealth for wealth’s sake as more important as people, or the best interest of the country, in the best tradition of Thomas Hobbes, and Paul Ryan’s inspiration, Ayn Rand.

I have never seen anything like it in my life, and never want to see anything like it again. It is a a disaster for the President equal to the failure of James Buchannan to pass the Lecompton Constitution which would of admitted Kansas as a Slave State, over the desire of much of the Democratic Party of 1857 and 1858. To see this happening even as more and more facts come out about the possibility of members of the Trump administration, and campaign team being paid and influenced by Vladimir Putin’s Russia made the week even more surreal.

Watching the reactions of the House leadership and the President afterward was even more fascinating, and disturbing. It looked to me that the President is willing to destroy Paul Ryan and the House leadership, while blaming the the Democrats for not helping. Likewise there were times that it looked like Ryan was trying to undercut Trump even as the Freedom Caucus tried to undermine both Trump and Ryan. Sadly, the GOP did nothing to bring any Democrats over to their side as to vote for Trumpcare would have been a poison pill.

What will happen next is still to be determined, but the first major attempt by Trump and the GOP Congressional majority to pass what was supposed to be their signature and defining legislation demonstrated that they are incapable of governing. Say what you want about the polices of Ronald Reagan or George W. Bush, one cannot accuse either of incompetence when it came to passing difficult legislation and even winning Democrats to their cause.

As a person who was a Republican from 1976 until 2008 are a disgrace to the party of Abraham Lincoln, Teddy Roosevelt, and Dwight Eisenhower. They are incompetent ideologues and demagogues who will destroy each other if they don’t succeed in destroying the country first, and I hope that we all can keep them from doing the latter.

Have a great weekend.

Peace

Padre Steve+

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Filed under healthcare, History, laws and legislation, News and current events, political commentary

A Reflection on HIV/AIDS for World AIDS Day

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Friends of Padre Steve’s World,

Thursday was World AIDS Day, and so today I am going to reminisce about the events in my life that helped bring me to not just care about the treatment of people infected with HIV or suffering from AIDS but for becoming an advocate for the Gay Community. This is kind of an emotional post as I have friends from high school, college, and the military who have died of AIDS, I have known far too many others who have been cut off from their families, and faith communities once they were discovered to be infected with HIV or came out and admitted that they were homosexual.

The role of right wing political Christians in condemning these men and women has been one of the most disgraceful aspects of my experience, and I am a straight, married, white Christian minister. Sadly, many of the people that I will mention in this article continue to condemn LGBTQ people, those infected with HIV, and those suffering with AIDS. Likewise, they have been involved with demonizing men and women infected with Ebola a couple of years ago. They are without compassion, and without empathy. Gustave Gilbert, a psychologist who worked with the Nazi War Criminals at Nuremberg. Gilbert noted: “In my work with the defendants (at the Nuremberg Trails 1945-1949) I was searching for the nature of evil and I now think I have come close to defining it. A lack of empathy. It’s the one characteristic that connects all the
defendants, a genuine incapacity to feel with their fellow men.
Evil, I think, is the absence of empathy.”
It is the same lack of empathy demonstrated by supposedly Christian leaders that bothers me today, including Vice President Elect Pence, and several of Donald Trump’s cabinet nominees, and many of his advisors. 

In 1986 the late Dr. C. Everett Koop, then the Surgeon General courageously went against the feelings of many people, especially his fellow Evangelical Christians by saying:

“At the beginning of the AIDS epidemic many Americans had little sympathy for people with AIDS…The feeling was that somehow people from certain groups ‘deserved’ their illness. Let us put those feelings behind us. We are fighting a disease, not a people.”

Dr. Koop reminded us all of the basic humanity of those suffering with AIDS and would go on to be a committed advocate for caring for the men and women infected, often going against the bulwarks of the Religious Right including James Dobson and Phyllis Schafly. As a young man he became an inspiration to me.

I met someone with AIDS for the first time, at least knowingly for the first time in the summer of 1987 while serving as a Medical Service Corps personnel officer at the Academy of Health Sciences, Fort Sam Houston Texas. I was the Adjutant for the Academy Brigade, which is the unit that all medical training courses fell under for administrative and command and control issues. My job normally was consisted of basic personnel administration, working with commanders and legal officers when court-martial proceedings were needed, appointing investigating officers for different purposes, reviewing line of duty investigations and running duty rosters. It was nothing to write home about.

But that summer, after years of ignoring the issue the Reagan administration, which had made light of the disease and refused to do anything about it following the initial clinical diagnosis of it in 1981, belatedly, directed the Defense Department to start testing servicemen and women for the disease and to develop personnel policies for infected personnel.

Since it was considered by most in the mainstream to be a “gay” disease the Reagan administration treated it with distain, during some of the White House press conferences, Press Secretary Larry Speakes mocked and laughed about it to reporters who asked questions about it.

On October 15th 1982 this exchange took place: in the White House Briefing Room.

Q: Larry, does the President have any reaction to the announcement—the Centers for Disease Control in Atlanta, that AIDS is now an epidemic and have over 600 cases?

  1. SPEAKES: What’s AIDS?

Q: Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that get this have died. And I wondered if the President is aware of it?

  1. SPEAKES: I don’t have it. Do you? (Laughter.)

Q: No, I don’t. MR. SPEAKES: You didn’t answer my question.

Q: Well, I just wondered, does the President—

  1. SPEAKES: How do you know? (Laughter.)

Q: In other words, the White House looks on this as a great joke? MR. SPEAKES: No, I don’t know anything about it, Lester.

Q: Does the President, does anybody in the White House know about this epidemic, Larry?

  1. SPEAKES: I don’t think so. I don’t think there’s been any—

Q: Nobody knows? MR. SPEAKES: There has been no personal experience here, Lester. Q: No, I mean, I thought you were keeping—

  1. SPEAKES: I checked thoroughly with Dr. Ruge this morning and he’s had no—(laughter)—no patients suffering from AIDS or whatever it is.

Q: The President doesn’t have gay plague, is that what you’re saying or what?

  1. SPEAKES: No, I didn’t say that.

Q: Didn’t say that?

  1. SPEAKES: I thought I heard you on the State Department over there. Why didn’t you stay there? (Laughter.)

Q: Because I love you, Larry, that’s why. (Laughter.)

  1. SPEAKES: Oh, I see. Just don’t put it in those terms, Lester. (Laughter.)

Q: Oh, I retract that.

  1. SPEAKES: I hope so.

Q: It’s too late.

Read more: http://www.alan.com/2014/10/18/that-time-the-reagan-white-house-press-briefing-erupted-with-laughter-over-aids-13-times/#ixzz3GcMPItu7

The late Congressman from San Francisco, Phil Burton told those seeking government help in diagnosing and treating the new disease that:

“I’ll introduce a bill. But if all the angels came dancing down to earth like the Rockettes, even they couldn’t get a dime out of this administration for anything with the name “gay” on it.”

I seriously doubt had Reagan’s friend, Rock Hudson, a closeted homosexual who was a cinematic idol in his day had not died of AIDS in October of 1985 if the administration would have even acted then. Their intentional disregard and negligence was criminal. But they finally did act, and the military acted to begin testing for the disease and to develop personnel policies for infected service members.

Back then no one wanted to deal with AIDS or the people infected by it. This was especially true in much of the military. Since I was the junior Medical Service personnel officer at the Academy of Health Sciences I was told that I would coordinate all services to those infected and work with those appointed by the Army Surgeon General’s office to develop appropriate personnel policies. People in the office joked that I was “CINC AIDS.” That was not a compliment.

When a soldier was diagnosed then they were given a form by their physician stating that they would let any partners know that they were HIV positive and that if they had sex they would only have protected sex. These were a host of other restrictions given in that medical “counseling” and all of these were reinforced as each soldier was then given an order by their commander to the same effect. The difference was that what the doctor gave was “counseling” and what the commander gave was an order, which if disobeyed could result in punishment under the Uniform Code of Military Justice.

Following this they were sent to me to discuss assignment limitations and career options. When people saw a soldier sitting outside my door, they pretty much knew what the person was there to see me for, as my job became more and more about dealing with those infected with HIV. As I took the job I read everything that I could and discussed the matter with physicians dealing with the disease.

Despite that in the beginning it was a scary experience. I attended a local mega-church and much of what I heard, read and listened to on Christian radio was full of paranoia, conspiracy theories and an attitude that could only be explained as an almost joyful gloating that the “homosexuals” were being judged by God. Not only that since HIV was determined to come from Africa, there was a tremendous amount of “old South” racism interspersed with their theological pronouncements.

Dr. James Dobson and Dr. D. James Kennedy, early leaders of the political religious right were particularly vindictive. These unscrupulous leaders helped spread much disinformation about HIV from the a book published by a charlatan named Gene Antonio who wrote what was then a popular book called “The AIDS Cover Up,” They claimed that AIDS could be spread by kissing, mosquito bites or even by touching surfaces that had been touched by those infected. These men were bolstered by their allies in the Reagan White House, Secretary of education Bill Bennett and his assistant Gary Bauer who were the official administration spokesmen regarding AIDS.

These political preachers and activists marginalized Surgeon General Koop who noted in the early days of the epidemic how he was “completely cut off from AIDS” by Bennett and others in the Reagan Administration. They were so wrong that Koop, who was by no means a liberal took them to task on their hateful, dishonest and un-Christian proclamations. Koop told a journalist:

“the Christian activity in reference to AIDS of both D. James Kennedy and Jim Dobson is reprehensible. The first time that Kennedy ever made a statement about AIDS, I saw it on television. It was so terrible, so homophobic, so pure Antonio that I wrote him a letter.”

Koop said of Dobson, who he had worked with earlier on HIV/AIDS: “I don’t know what happened to him. He changed his mind, and last August in his paper he attacked me for two pages as leading people down the garden path. But again his arguments were full of holes. I just cannot believe the poor scholarship of so many Christians.”

But that was the world that part of me lived in. The other world was one of logic and reason, informed by human compassion, so unlike what I was being fed by church leaders and the “Christian” media that I immersed myself.

The sad truth of the matter is then, as today, that far too many Christians, especially influential leaders intentionally and malevolently spread lies to bolster their position. For them it is far easier to profit from demonizing people than it is to work with people they hate, to find solutions that help everyone. In my view many of these supposedly “Christian” leaders, apart from their fashionable clothes, are no different than the Nazis who blamed the Jews, Socialists and homosexuals for every ill in society; or the Japanese leaders who organized the Kamikaze Corps to send true believers to their deaths in a hopeless cause simply to maintain their power.

There is no love, there is no care and there is no empathy in any of them. As Army psychologist Captain Gustave Gilbert noted at Nuremberg “evil is the absence of empathy.”

When you do not know or have never have met someone being demonized by religious people it is easy to surround yourself in comfortable theology. However, when a family member, friend or colleague becomes one of those being demonized it tends to blow up your comfortable theology unless you are a sociopath.

I never will forget the day in the late summer of 1987 when an officer came to my office. He was the first person who I had ever met who was HIV positive. He was a medical professional, an Army Captain who had been selected for promotion to Major. He was married, had children and was a “born-again Christian.” He had contracted HIV when dealing with a combative drunk patient, who was HIV positive. The patient smashed glass, cutting himself severely and started bleeding. The shattered glass cut this officer as he tried to intervene and subdue the man. The officer was infected by the man’s infected blood, which entered him through his own wounds. Though he attempted to disinfect himself by normal protocols he became infected. I was looking at a man, just a few years older than me. A man who loved God, loved his family, who had did all the right things but had become HIV positive.

Even now I can see and hear this man, his face is etched deep into my memory, struggling to fit what happened to him into the message of God’s judgment that his fellow Christians and church members said was the cause of his disease. As I talked to him I realized that what I was being told by men who I was listening to every day on the way to work, as well as what I was reading by “Christian” authors and what I was hearing in church was a lie.

My worldview was forever changed that day. I realized that this man had done nothing wrong, in fact he was trying to do his job as a medical professional to keep a patient from further harm. I was able to help him get into a Master’s degree program in Healthcare Administration since he was no longer allowed to serve in a clinical environment. I have no idea what happened to him after I left the active duty Army to attend seminary in late 1988, but I presume since the mortality rate for HIV/AIDS was so high back then that he probably died years ago. I would hope that by some miracle that this man was fortunate and like NBA great Ervin “Magic” Johnson has not only survived but continues to do well. But I know that the odds were not in his favor.

When he left my office we shook hands, something that my fellow Christians said that I needed to avoid. Not only did I shake his hand, but I gave him a hug and I did not wash my hands or disinfect myself. I figured that God wanted me to get HIV from caring for and accepting someone infected with it than it didn’t matter.

Since that time I have worked with, cared for and ministered to more victims of HIV/AIDS, their families and their friends than I can count. Many of them have made significant impressions on me, my life, and my faith. Without them my life would not be as rich as it has been. I continued to deal with case after case and it is interesting to read the citation from my end of tour award for my time as the Adjutant of the Academy Brigade. It is almost all about AIDS.

So we fast forward to 2016. I’m still in the military, only now I am not a Medical Service Corps Officer in the Army but a Navy Chaplain and I am now teaching Ethics. During my career I spent about eight years in the critical care environment of major medical center ERs, trauma departments and ICUs. I have a rather unique perspective having experience with AIDS and other highly infectious diseases, as well as the ethics of treatment.

Since I was previously qualified as a Nuclear, Chemical and Biological Defense officer when I served in the Army in the 1980s, I understand the importance of, as well as the limitations of personal protective equipment and decontamination procedures. Of course because I know a good number of physicians who specialize in critical care, infectious diseases and pandemics and try to remain current in regard to such diseases, their causes, and the vectors by which they spread.

Thus I realize when I see and hear the Trinity of Evil; the politicians, pundits and preachers who make their living promoting fear, panic and hatred to keep their jobs and obscene profits coming in are at work in demonizing President Obama, the CDC and NIH and poor Africans in Liberia, Ghana and other countries. Like the HIV/AIDS crisis of the 1980s, the same cast of disingenuous, unscrupulous and dishonest preachers, pundits and politicians are at work today as we wrestle with the Ebola crisis, which is neither an epidemic nor a judgment from God.

Sadly, these people are not limited to their own religious networks to spread their lies, propaganda and hate. They have the full buy in from a major cable news network and countless political “news” services, “think tanks” and Political Action Committees; who are their fellow travelers in their quest to demonize those that they hate and dominate society.

The Ebola crisis of 2013-2014 provided these same people, this Trinity of Evil, and their followers; with the avenue to create havoc without taking any personal or corporate responsibility to demonize people, to hinder rational and reasonable solutions to meet the crisis and to ensure the political destruction of the Black man in the White House who they hate with a hatred beyond comprehension, and beginning in January these same people will have massive influence in the White House and Congress to do their worst in harming people by denying medical care, funding, and research into not just HIV/AIDS and Ebola, but any other disease that they choose to label as God’s punishment on people that they despise.

Their words and actions, often clothed in the language of faith may seem to some as a demonstration of righteousness; only now they are even more closely linked to political and economic entities that simply want more power and profit and use them to achieve their malevolent purposes.

The sad thing is that while the leaders of the “Religious Right” benefit from this deal, their followers do not. In fact should Ebola ever reach epidemic or pandemic status in the United States because of their actions which have helped to hinder the government’s response to it; they don’t have to worry, they have good healthcare coverage which is paid for by their followers; and little threat of exposure. On the other hand their followers will have to fend for themselves, paying exceptionally high insurance rates if they can even afford it all the while the people that they support fight to ensure that they do not have affordable, or reliable access to health care.

The sad thing is that Ebola, as bad is it is; is a hard disease to catch, unless you happen to get blasted by a load of the massively infected vomit or bodily fluids of someone in the final stages of it. In fact Ebola is a lot harder to catch many forms of the Bird or Swine Flu, which are airborne viruses and highly contagious. History has shown that both are far more deadly in terms of numbers killed than either Ebola or AIDS have ever been.

Sadly, the same people who fought against treating HIV/AIDS and Ebola are the same people who mock public health experts and agencies when they warn of potential Influenza epidemics or pandemics, and fight against reasonable vaccination and prevention programs and education.

The actions of these religious and political leaders and their media supporters are unethical, irresponsible and at odds with measure of human compassion. It is like they have a death wish for the planet. But truthfully I have to say that it does not look to me that they seem to care so long as they reap a political and economic benefit from it.

Dr. Koop was condemned by fanatical extremists like the late Phyllis Schlafly who said that Koop’s recommendations in his report about preventing AIDS looked “like it was edited by the Gay Task Force” and Schlafly, ever the loving, honest and ethical Christian that she is accused Koop of advocating that third-graders learn the rules of “safe sodomy.”

Koop replied in a very courageous manner to Schafly, who in my view was one of the most loathsome people to ever unite religion and politics: “I’m not surgeon general to make Phyllis Schafly happy. I’m surgeon general to save lives.”

In 1988 Dr. Koop said something that most people in positions of any public responsibility, be they public health officials, medical professionals, politicians or even loathsome preacher should abide:

“I separate ideology, religion and other things from my sworn duty as a health officer in this country.”

But then as it did in the 1980s, the band continues to play on… and those that unite religion and their hatred of others continue to do everything that they can to ensure that people die as they lie. As for me, I am glad that finally saw the truth about these people and I thank people like that HIV positive Army officer who walked into my office in 1987 who humanized that terrible virus, and for helping me see the light.

But our fight is not over, we have to continue to bear witness and speak the truth.

Peace

Padre Steve+

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Try to Understand: The Kindest, Noblest, & Best Thing You Will Ever Do

grant and sherman

Grant and Sherman

Friends of Padre Steve’s World,

The great American Civil War general William Tecumseh Sherman once said of his relationship with Ulysses S. Grant, “Grant stood by me when I was crazy, and I stood by him when he was drunk. Now we stand together.” Having been both crazy, and at times drunk, I can relate to both men, both of whom also often suffered from severe and often disabling depression at different points in their lives.

Yesterday I wrote an article about depression and I decided to follow it up with another on the same subject. Yesterday I mentioned the late Iris Chang and her comments about how depression is not rational, and C.S. Lewis who talked about how mental pain is harder to deal with than physical pain. During my worst phases of depression in the years after I came back from Iraq, I fought every day to find something to hold onto, something to keep me from ending my life. If you have never experienced real depression, the kind that slowly eats away the very fabric of your being, you might not understand. In fact it was something that I really didn’t understand until I went through years of it.

Depression is far different than being sad. It is like the difference between having a cold, which you know should pass, and having an insidious cancer which even if it goes into remission lurks for another chance to strike again.

I think that Elizabeth Wurtzel, the author of the book Prozac Nation, hit what I am describing on the head, “That’s the thing about depression: A human being can survive almost anything, as long as he sees the end in sight. But depression is so insidious, and in compounds daily, that it’s impossible to ever see the end.”

In a similar manner, J.K. Rowling, the author of the Harry Potter books noted, “Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.”

I have to agree with both of these writers, depression is the worst. I can live with insomnia, and night terrors, even with anxiety, but depression is the worst, it never seems like it will end. I was fortunate that I got through my most difficult times, including a period just over a year ago where I was nearly suicidal after very bad treatment in the Mental Health Department at the local naval medical center. It took the intervention of my former commanding officer, a doctor named David Lane, who had just been selected for promotion to admiral to get me the help that I needed, but not everyone has that kind of ace in the hole. I wouldn’t have thought of asking him, but his Command Master Chief, and my friend Ed Moreno, intervened, told him of how bad I was doing and that made all the difference. Ed didn’t try to fix me, he just stood beside me and when I needed help, he came through as a friend, and he is still a friend. That is what friends do.

I still struggle, sometimes with depression, but more often the nightmares and night terrors associated with my PTSD. Last night my wife woke me up when in one of my high definition nightmares I was thrashing around trying to defend myself from an enemy insurgent in Iraq. Now mind you, I was never in a close combat situation, but I took part in a number of missions where we didn’t know who the good guys or bad guys were and I was unarmed. But I can live with that, depression without end is far different.

In my worst times I had a lot of people tell me what I needed to do to get out of being depressed. Most were well meaning but didn’t have a clue as to what I really needed. I didn’t need someone to fix me. I didn’t need a checklist of things to make me well. I didn’t need to pray more, or read my Bible more. I didn’t need to work ungodly numbers of hours in ICUs where lives of people were hanging in the balance… all I needed was people who would say I love you, I care for you, and I value you for who you are, not what I want you to be, and will be there for you no matter what, or maybe, let me buy you a beer. Thankfully, there were a few people who did all of those things, and they have been there for me since I emerged from that darkness.

As for the others, who seemed more like “Job’s helpers” it is sometime embarrassing to come across them. Of course I am polite and I do not avoid them. That being said, once you have gone through this, you can see just how uncomfortable that they are to be around you. So those encounters tend to be brief and uncomfortable, as Job’s helpers quickly move along to avoid the awkwardness of the situation. The interesting thing is now I am perfectly fine with their discomfort.

I think that some of the best advice for those who live with, work with, or are friends with a person struggling with depression was written by English comedian Stephen Fry, who said, “Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.” That is empathy in action.

I have a number of friends; classmates, and other people I have served with in the military who this very day just hope to stay alive, to find something to live for. The depression that they feel is often overwhelming. They are wonderful, talented and gifted people, people who have a strong amount of empathy for others, but they are enveloped by a darkness and fog which makes it hard for them to see any sign that the depression will ever lift. I have been there, and now I try to be there for them. For me it comes back to what Sherman said about Grant, If I don’t stand with those who suffer from depression after what I have been through, what good would I be?

Peace

Padre Steve+

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Separate Ideology & Religion from Sworn Duty: The Legacy of Dr. C. Everett Koop

c-everett-koop-1db591308d7eb474

“At the beginning of the AIDS epidemic many Americans had little sympathy for people with AIDS…. The feeling was that somehow people from certain groups ‘deserved’ their illness. Let us put those feelings behind us. We are fighting a disease, not a people.” C. Everett Koop, Surgeon General 1986

Friends of Padre Steve’s World,

I have mentioned that I have been reflecting on many things over the past few weeks and months. Of course if you follow my writings you know what I think about public officials who refuse to do their duty to follow the law and protect the rights of other citizens, even of those that they happen to disapprove. This came to a head recently with the case of the anti-marriage equity county clerk, Kim Davis. I am not going to revisit her case as I have been worn out by it and have no need to waste any more time on her.

That being said I can point out the case of a public official, a conservative, pro-life, Evangelical Christian who served as Surgeon General under President Reagan, Dr. C. Everett Koop. In an era of extreme intolerance and hatred for those infected with HIV, Dr. Koop became one of the leading proponents of compassionate and responsible care for victims of HIV/AIDS, most of whom were homosexual men. He met opposition within the administration, where despite his impressive credentials he was marginalized and was vilified by conservative Christians.

Dr. James Dobson and Dr. D. James Kennedy, early leaders of the political religious right were particularly vindictive. These unscrupulous leaders helped spread much disinformation about HIV from the a book published by a charlatan named Gene Antonio who wrote what was then a popular book called “The AIDS Cover Up,” They claimed that AIDS could be spread by kissing, mosquito bites or even by touching surfaces that had been touched by those infected. These men were bolstered by their allies in the Reagan White House, Secretary of education Bill Bennett and his assistant Gary Bauer who were the official administration spokesmen regarding AIDS.

They marginalized the Surgeon General; Dr. C. Everett Koop who noted in the early days of the epidemic was “completely cut off from AIDS” by Bennett and others in the Reagan Administration. They were so wrong that Koop, who was by no means a liberal took them to task on their hateful, dishonest and un-Christian proclamations. Koop told a journalist:

“the Christian activity in reference to AIDS of both D. James Kennedy and Jim Dobson is reprehensible. The first time that Kennedy ever made a statement about AIDS, I saw it on television. It was so terrible, so homophobic, so pure Antonio that I wrote him a letter.”

Koop said of Dobson, who he had worked with earlier on HIV/AIDS: “I don’t know what happened to him. He changed his mind, and last August in his paper he attacked me for two pages as leading people down the garden path. But again his arguments were full of holes. I just cannot believe the poor scholarship of so many Christians.”

Despite the opposition and attacks on his character by leaders of the Christian Right, Dr. Koop was undeterred and had no problem taking on these men and women. Some of these supposedly Christian leaders still are with us and spout the same hatred for homosexuals that they did in the 1980s. Dr. Koop realized that many of his fellow Christians really didn’t care about people, and believed that HIV was God’s judgment against people that they already despised and had in their theology condemned to Hell. He also realized that many of these leaders would resort to poor scholarship and even inflammatory statements to influence public opinion.

For doing so Dr. Koop was condemned by fanatical extremists like Phyllis Schlafly who said that Koop’s recommendations in his report about preventing AIDS looked “like it was edited by the Gay Task Force” and Schlafly, ever the loving, honest and ethical Christian that she is accused Koop of advocating that third-graders learn the rules of “safe sodomy.”

Koop replied in a very courageous manner to Schlafly, who in my view is one of the most loathsome people to ever unite religion and politics: “I’m not surgeon general to make Phyllis Schlafly happy. I’m surgeon general to save lives.”

Dr. Koop understood the oath that he took as a physician and the oath that he took when he became Surgeon General; sadly Mrs. Davis and many in the Christian Right will never understand that. In 1988 Dr. Koop said something that most people in positions of any public responsibility, be they public health officials, medical professionals, politicians or even the most partisan political preachers should abide: “I separate ideology, religion and other things from my sworn duty as a health officer in this country.”

Dr. Koop’s words should be heeded by any Christian in public office, but sadly, those who do will be treated with the same scorn and hatred as Dobson, Kennedy, Bauer, and Schlafly heaped on him.

I can understand Dr. Koop’s plight. I have been set upon by some of the disciples of Bauer, Dobson, Schlafly, Kennedy and others for simply defending people’s rights under the Constitution and obeying the oath of office that I took in 1981 and have continued to affirm since. Sadly, the truth is that many so-called Christians will attempt to destroy the lives, reputation and careers of other Christians who do not tow their ideological line, and sadly this has become much worse than it was in the 1980s.

I will write more about this but for now I will wish you a good day.

Peace

Padre Steve+

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It’s Not You It’s Me: Firing Your Military Therapist

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Friends of Padre Steve’s World

Another week, another therapist… At least that is what it seems like to me. Those who have been following my writings for any length of time know of my struggles with PTSD and its associated maladies, as well as my struggles dealing with the military mental health system. This week is no different.

Last week I got a new “bungee-therapist” who I would have had less than three months before his rotation at the clinic is done. He is a nice young man, only 32 years old, I have been in the military longer than he he has been alive. He still in his residency; well trained, but not very experienced and it shows. Truthfully, though I don’t have as much specific education in psychology as the provider, I do have more clinical experience working with trauma and PTSD than the young man.

So on the second appointment I fired him. I think the biggest issue was what I saw as a lack of continuity in care and the mismatch in age and experience.

I was really anxious about the visit. This was based on an experience with another young provider last year. That experience caused me to crash and have some troubling thoughts about offing myself. Since I love life and am not a fan of taking the eternal celestial dirt nap; which some readers assure me will have me taking the eternal vacation on the Lake of Fire, but I digress….

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Like I said I was anxious due to the previous experience. But, the two of us handled it very well and it was an amicable parting, a clean breakup if you will. I even used the George Costanza tested “it’s not you it’s me” breakup line. But hey, Ces’t l’apres-guerre… (such is life after war)

My plan now is to get with a senior shrink that I know and have worked with to help get me someone more compatible for what I need at this point in life. I just hope that by “breaking-up” with my therapist that I won’t get shafted by the institution.

But I have learned to live with this; I realize that the military mental health system is not in the business of trying to get you better, it is in the business of trying to return young men and women to be able to go back to war. If you actually get better in the process that is kind of a twofer. Honestly I could have gone back to war with  a year of coming home. Going to war is easy, coming home intact is not.

Do not get me wrong, it is not that there are not providers willing to help; there are plenty of them. But the system , crowded with people who need more help than it can provide and without with ever shrinking budgets; almost makes it impossible to get help. If you can be patched up and sent back out, they have done their job, if you crash after you leave the service not their problem. Sadly, I have lost too many friends, some to suicide after they left the military, including men whose credentials as real American heroes were unmatched. This is not a new issue, ask any vet who has dealt with getting post-service care at the VA or anywhere.

Likewise, if you remain in service and have a chronic-long-term condition, of any kind, physical or mental the attitude seems to be “fuck you.” If you get the label as a “broke” Marine, Sailor, Soldier, or Airman your career is pretty much over, unless you are one of the lucky few like me who had some superiors who looked beyond that and protected you. I know that because it is not just my experience but the experience of hundreds of combat vets that I have dealt with.

I can live with this as long as I am on my meds, and have friends and beer, but then I am an old guy looking at retirement at the end of this tour. If I were a young guy, with my whole career ahead of me I would be fucked. So when I retire I will be a pain in the ass to the system to ensure that the young guys who will be fighting our wars in the future as well as those who are out of the military gets the care that they need.

But as far as my condition goes, I am oddly comforted by the words of Raymond “Red Reddington (James Spader) in The Blacklist:

“There is nothing that can take the pain away. But eventually, you will find a way to live with it. There will be nightmares. And everyday when you wake up, it will be the first thing you think about. Until one day, it’s the second.”

Many things haunt me; but unlike many people who have little self-awareness I might have just a bit too much. I have talked about the nightmares, night terrors and insomnia that I have many times following my return from Iraq. I used to believe, at least back in the first year or so after I returned that I thought that eventually I would get over it. I don’t believe that anymore, now I just believe that I will find a way to live with them.

I guess that is the secret to life. Instead of wishing that something would miraculously take way the pain, I guess that it is better to find a way to live with it because one day something else will replace it.

Is that an ideal way to deal with life? Probably not, but I know that I am an idealist anymore. I used to be, but that was a while back. It took time, but war and the lies of men that I voted for, men who I trusted because they professed my faith, my love of country, and some who even shared my vocation as a priest and chaplain took that from me.

Some experts call this “moral injury.” For me it is connected with my tour in Iraq, PTSD and what I experience when I came home from colleagues, and people in my former church. Betrayal and abandonment is a terrible thing, but I am learning to live with it. It is not pretty but I am learning with every passing night and morning. Alexander Dumas wrote in The Count of Monte Cristo:

“Moral wounds have this peculiarity – they may be hidden, but they never close; always painful, always ready to bleed when touched, they remain fresh and open in the heart.”

My life is full again, there is meaning and purpose, but it is tempered by realism and the expectation that every day I will wake up and still think about those painful memories until finally something else takes their place.

I guess that the secret to living with darkness and pain is simply to live with it because the saying that “time heals all wounds” is a lie, it is the fabrication of people that don’t want to deal with the real world. God might heal, but then God may not. I have learned to be okay with that. I know that there are some Christians who might disagree and even say that I do not have enough “faith,” whatever that means, but I can live with this.

So I will live with it and in doing so I will continue on and in the process hopefully be there for others that also struggle with pain that does not want to go away and nightmares that never seem to end. As the late Henri Nouwen wrote: “Ministry means the ongoing attempt to put one’s own search for God, with all the moments of pain and joy, despair and hope, at the disposal of those who want to join this search but do not know how.” Not exactly perfection, but it will work.

This now is my goal and my prayer: God grant me the courage to change the things I cannot accept; Serenity to accept the things I have changed; And the wisdom to know I’m different. Amen.

Peace

Padre Steve+

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Leave them on the Ice Floe to Die: Post Hospitalization Health Care in the United States

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Friends of Padre Steve’s World

Thank you all for your expressions of support, kind thoughts, positive waves, and prayers over the past few weeks. My wife Judy is doing well, her wound is no longer draining, the sutures are healing and it looks like her staples will come out Monday. She is pretty much able to take care of herself and it looks like she will have a good number of visitors while I am in Gettysburg.

Now this has been an interesting experience. You see when someone leaves the hospital after major surgery insurance companies, even good ones are loath to pay for any in-home care, so everything falls on the family of the person, in our case since we don’t have 19 kids to saddle with the work, that person is me. In fact for most people the work falls on their spouse or their significant other, or possibly a teenage kid.

Now I am lucky, I am a fairly senior military officer and I work in an academic setting where I do not have to deploy and have a command that is very supportive of whatever time I need to care for Judy. I don’t have to worry about my paycheck getting docked ort losing my job. Sadly, a majority of Americans have to worry about that if their family member is sick, or needs post surgery care. I think that is a terrible situation if you ask me; condemn Europeans as socialists who pay too much in taxes, but at least they get something for what they pay, most European countries have effective health care and social service systems that do not let people fall through the crack.

For a nation that considers itself the pinnacle of humanitarianism and which is supposedly “pro-life” the situation is shameful, and frankly I think we should be ashamed. We are not pro-life at all, even the people that call themselves that tend to be pro-birth and the hell with you after that, unless you are rich.

Interestingly enough the Commonwealth Fund, hardly a liberal institution, ranked the United States 11th of 11 developed western countries in terms of health care, including accessibility and outcomes, of course all of those countries are willing to have universal health care, and sorry even Obamacare is not socialized medicine, it is simply a modified version of the Heritage Foundation’s plan that they touted over a decade ago and similar to Romneycare. It still keeps the insurance companies in control of most healthcare decisions. If you want to see where the United States ranks here is the listing:

  1. United Kingdom
  2. Switzerland
  3. Sweden
  4. Australia
  5. Germany & Netherlands (tied)
  6. New Zealand & Norway (tied)
  7. France
  8. Canada
  9. United States

The link to the Forbes Magazine article where you can find the report is here: http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/

But anyway, I digress. When a person leaves the hospital the family, with very few exceptions is lead to fend for themselves. Post hospital prescriptions may be covered by insurance, ours are, but nothing else is. If you need surgical pads, gauze, bandages, antiseptic wipes or a host of other potential needs, they come out of your pocket, thankfully mine are deep enough to handle these expenses, but think of the person who lives paycheck to paycheck and because they have to take unpaid leave are not getting a paycheck during their loved one’s illness.

When your loved one is recovering you become all the things that the hospital provides while they are an inpatient. You are nursing services, you get to check, clean and dress their wounds, make sure they get their medicines and monitor them for anything that might be going wrong. Now for me this is not a problem, I have a significant amount of medical background as a Medical Service Corps officer in the Army as well as a hospital chaplain working trauma, critical-care and ICUs. Blood, guts, bodily fluids, I can handle them; spot infection, got it; change dressings, and do other things that gross people out, can do. Again, I am lucky; I have training and experience but sadly when most people leave the hospital their untrained and inexperienced relatives get to do this. The family also is the nursing aid, the dietary service, rehab service, housekeeping and laundry service. It is a full time job, which most families are not, trained to deal with and many do not have the resources to do. Let’s say that because they have to pay rent the caregiver has to leave the recovering patient alone, they are hosed unless perhaps a friend or neighbor volunteers to do this, once again at no cost to the insurance company of the health care system.

For those that do not think that nurses earn their money they are sadly mistaken, nursing is hard, it is physical and emotional. I know why nurses only work 3-4 days before they get a break, it is demanding. Judy often tells me from previous experiences with me as her nurse that I graduated from the Leave Them on the Ice Floe to Die School of Nursing. Now with global warming and the ice flows all melting I had no place to put her so I really had to work hard. Actually, I didn’t mind it, I wanted to make sure that there were no complications and that nothing happened to her I really worked hard to care for her, and I wanted to do it. However, that being said that is what our health care system does to people when it puts them out of hospital, it leaves them and their families out on the ice flow and sadly the ice floes are disappearing. We need to really change how we do health care in this country before they are gone.

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So anyway, I am now on the way to Gettysburg to lead 20 students as well as some faculty and family members on my third staff ride of the year. Tomorrow and Sunday I will be out and about the battlefield teaching. I’ll post something short tomorrow night.

Again thank you and blessings

Peace

Padre Steve+

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Not to Be Alone: Why Gay Marriage Matters

Friends of Padre Steve’s World

I have been thinking about the profound legal and moral implications of the Supreme Court ruling on marriage equity, the Obergfell v. Hodges case. One of those impacts in in a very simple and human concern, the ability of people to be with their loved ones during medical crisis or when they are dying. I saw the profound implications of not having this right when I was a young chaplain doing my hospital residency at Parkland Hospital in Dallas, Texas 1993 and 1994. This is the story of those two encounters and how they changed me.

Peace

Padre Steve+

marriage equality

For me it is still hard to comprehend, a young chaplain; two relatively young men dying of AIDS, two partners, two families and two radically different experiences of humanity, faith, religion and authentic loving relationships.

I was still a relatively inexperienced minister and chaplain back when I was doing my Pastoral Care residency at Parkland Memorial Hospital in Dallas Texas back in 1993 and 1994. Yes I had graduated from seminary. Yes I had a bit of chaplain experience as an Army National Guard chaplain and as a counselor at a major evangelical Christian ministry, and yes I had experience in dealing with AIDS as a Medical Service Corps officer in the Army.

Despite that, I was so ill prepared to deal with the massively different treatment of people dying from AIDS from their families. Families that in some cases shared the same Christian faith as me. I think that is one of the things that young ministers struggle with when they enter the nether world between life and death, mortality and immortality, faith and unbelief in the real world. When I was in seminary the senior pastor of the mega-church that I attended told a story about being approached by a family member of someone who was very sick and in hospital. The person wanted him to visit them while they were a patient. He had been their pastor for years. When they ask him if he would come, he refused. He recounted that the “parishioner asked just how sick he would have to be to get a hospital visit?” The pastor told us his response. He laughed and said “you don’t want to be that sick.” The congregation laughed and I was devastated.

The pastor was a leader in the New Apostolic Reformation, a friend of John Wimber, Rick Joyner and others who helped to pave the way to the heartless, unfeeling, political “Christianity” and “Dominion theology” that is in vogue with the Tea Party and Religious Right today. When I questioned him about his comments later he told me that thought that pastoral care of those in his congregation, especially in regard to hospital visits was “below his office as an apostle, that others had that responsibility.” The thing that disturbed me the most was that he had ordained me as an Evangelical minister in that church to be a chaplain barely two years before this. I had respected him and now I felt a tremendous sense of emptiness when I left his office.

So when I began my pastoral care residency at Parkland I found that I had a lot to learn about the real world of religious faith, religious hypocrisy and religious hatred and intolerance.

Early in my residency I dealt with a number of AIDS cases. I wrote about one of those cases last night, although that was not really early in my residency, it was closer to the end of it. There were two cases besides that one that made such deep impressions on me that I can never forget them. Both involved young, white, homosexual men dying of the complications from full blown AIDS. Both came from very “Evangelical Christian” families (both were Southern Baptist) and both were being grieved by what we called then, their “significant others” as well as their biological families. But that was where the similarities ended.

The first case was in the second month of my residency, when I was the chaplain for the Medical ICU, before the Pastoral Care Director wisely moved me to the Trauma and Surgery department. A patient came to us, a man, about my age, a successful architect with many friends who was experiencing pneumonia brought about by his immunodeficiency brought about by HIV.

When he arrived he was still able to communicate and he had many of his friends as well as his significant other visiting him. They loved him and he loved them. There was a sense of community and if I dare say real family as they visited. In those first few days I got to know him and these people, most of who were homosexual but not all. There were a number of women there, who I am sure had the patient, who was a remarkably handsome man, been a heterosexual, would have loved to have been his wife.

My encounter with him, before his condition worsened to the point that he had to go on a ventilator and was sedated was transforming. He grew up in the church, knew that he was homosexual, attempted to live with it and finally came out as gay, and was disowned by his family. Despite this he became a highly successful architect, had many friends, was active in charitable works, and still maintained his faith in Jesus. I came to appreciate him, the man who for was for all purposes his spouse and his friends.

However, when his condition deteriorated his estranged family, the people who had disowned him, rushed to his “rescue.” In good Christian form they brought their pastor who though their son was unconscious proceeded to preach at him regarding his need to “repent” and “to come back to Jesus.” The family also took advantage of the law. They were his biological family and next of kin. They banned the man’s partner and friends from his room as he lay dying.

The family’s pastor preached at the dying man and glared at the people closest to him while he was present.  I was appalled by his, and their behavior. While they isolated their son from those closest to him and allowed their pastor to condemn him as he died, I remained with his partner and friends. I prayed with them, I cried with them, I embraced them. When the family left I went with them to be with this young man’s mortal body. We prayed and after the nurses prepared his body and the doctors completed their final notes, I walked with them as we took his body on that long trip from the ninth floor to basement, where the morgue awaited. I still cry when I think of this encounter, of how supposedly Christian people would not only keep their son, who they had rejected and condemned from those who loved him the most as he lay dying.

A couple of months later I was in my element as the Trauma and Surgery Department Chaplain, but I still had on call duty where I was responsible for crisis situations anywhere in the house. One of those wild nights I got a call from the nursing staff of Nine South, the Medical Step Down unit where the lady that I wrote about last night had passed away, but that was still in the future.

This time there was another young white man, another partner, another family. This young man was not in the ICU fighting for his life, he was passing away in the quiet solitude of his room with his mother and father, his partner and his friends at his side. Like the other young man he was a man of faith. He loved Jesus, he loved his family and he loved his partner.

He was from the area west of Dallas, the area between Fort Worth and Abilene. His mom and dad were ranchers, dad was wearing his cowboy hat, a plaid shirt, classic western Levi’s jeans and cowboy boots. His mom was wearing a simple dress. Both were thing, tanned and their faces lined by the sun and weather and from being out on the range with their cattle. The young man who was with them, the dying man’s partner was casually dressed but though he was from the same area was not a rancher.

I spent time with all of them. The contrast between the “Christian” parents and pastor of the first young man could have not been more profound. Like the architect’s parents, they were Christians. In fact they were Southern Baptists who attended a small country church in the town that they lived. By any sense of the word they could be described as “Fundamentalist” Christians, but unlike so many fundamentalists they focused on loving God and loving people, even people that so many Christians reject out of hand.

I arrived as the patient was breathing his last. I remained with him, his parents, partner and friends as he passed away, and when his parents asked I offered a prayer commending his soul to God. As I did this his partner was in a state of near collapse, exclaiming “I have no one now, I am alone!” His grief was overwhelming, he had no legal status, in the eyes of the law he meant nothing, though the man that he loved had just died. My heart was rent, and I held on to him.

As I did, the patient’s father came alongside of us. The father said to the young man “You are not alone, you are our son now, we love you.” When this dear man said this we all were in tears, as I am right now. I stayed with all of these dear people as the nursing staff prepared the young man’s body to go to the morgue. At some point the parents escorted their son’s now widowed partner out of the hospital. Mom and dad walked on either side of him as they left the ward. If there was anyone couple on this either who were true Christians, it was this dear couple. As we parted I could not hold back the tears, and the father of the deceased gave me a hug and thanked me for being with them and honoring his son.

I remained with the nursing staff and the internal medicine resident as they complete their duties and took the young man’s body to the morgue. After that I went back to the emergency room where some of the nursing staff, including a RN who at one time had been an Assemblies of God pastor, but was now an avowed atheist who loved to torment chaplains, except me, comforted me in my grief. It is funny that an atheist would be comforting the chaplain after such an event, but then if I do believe in God, why can’t I believe that anyone cannot share in the grief of others and of comfort and care.

It was a story that I could only share with my pastoral care residency supervisor, in our residency group and with my wife Judy, as I knew if I shared my experience at church that at best I would only be humored, and most probably be ostracized. In fact I had to keep that story pretty much under wraps until 2010 when was told to leave the church which had ordained me a priest, for among other things speaking out for the rights of Gays, Lesbians and the LGBTQ community. By then I had met and served with far too many Gays who were far better Christians than most of the Christians who condemned them not to do so.

But, in a way it was a step to freedom because I realized that what I had been taught for so long was so horribly at odds with the message of Jesus.

Two deaths, two men, two partners, two families, two experiences of God’s grace, two experiences of a common humanity and the experience of one very flawed, but no longer confused chaplain…

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