The newborn baby enters this world naked, helpless, and essentially without any freedom or independence; its ability to choose comes from instinct instead of intellectual processing, and it is entirely dependent on others for its survival. As the child grows, and the ability to make choices increases, the battle for independence begins; for good and for bad, older caretakers restrict many choices that could otherwise be made. During the teenage years, the battle for independence becomes a full-fledged war; the teenager is still mostly dependent on others for meeting basics needs, but now his or her wants have become insatiable, especially the want for complete, unrestricted, freedom of choice, and quite immaturely, freedom from consequence. Adulthood begins when the consequences of choices are understood and accepted, some level of independence is realized by choosing to provide for one’s self, and the ability to consider the interests of others is greater than the focus on self. Unfortunately, many teenagers reach adult age, but never reach adulthood.
Considering the realities of these different stages in life, freedom is a summation of the ability to choose, the opportunity to choose, the level of independence earned, and the restricting consequences resulting from choices made by self and others, and is represented mathmatically:
aoi - r = f
a = ability to choose = the natural and the personally acquired intellectual, physical, emotional, and spiritual capability to make decisions
o = opportunity to choose = the degree to which others are not limiting the choices that could otherwise be made
i = independence earned = the degree to which dependency has been reduced through the use of choice to provide for one’s self
r = restricting consequences = the limitations naturally and unnaturally placed upon an individual according to certain choices that have been made by self and others
f = freedom = the summation of choice, action, and consequence
Often the word freedom is ignorantly used to describe a false freedom: the idea that one should be able to do whatever they want whenever they want without any consequence, or in other words, eliminating "r" from the equation. True freedom is the result of maximizing "a" "o" and "i," and minimizing "r" through making good choices.
The ironic truth about true freedom is that higher levels are only approached when the ability to choose the interest of others is greater than the interest in self.
Thursday, June 24, 2010
Wednesday, June 9, 2010
Life or Death - "Get on that gurney!!"
Last Saturday I arrived with my 13 year-old son at a large, well-run Boy Scout camp. During my physical that evening, the camp doctor (Doc Sharp) got a funny expression on his face while listening to my heart on his stethoscope. For a few minutes he used his fingers to feel my pulse from my wrist before finally declaring, “You’re skipping a heartbeat every 20 to 30 seconds.” He had the nurse verify the same, and then called an ER doctor down in civilization who rendered the opinion that it was nothing urgent, but that it should get checked after camp is over.
“So what does this mean?” I asked with consternation, and then received a long narrative that mostly went over my head. What I did understand is that besides his disclaimer that he was an orthopedic surgeon and not a heart doctor, he remembered a lot about the heart from his general medical training 20 years ago, and that even though 10 years ago he had felt the same skipping in his pulse in a hotel room in New York City shortly after 9/11, he’s never had a problem since and the skipping went away. I left the exam room quite concerned, and naturally began to wrestle with many difficult questions consuming my mind.
I ran into Doc Sharp at breakfast Monday morning and he asked how I was doing. “Fine,” I replied before inquiring, “on Saturday when you asked if I had had any palpitations, what exactly does that feel like?” His explanation made sense and I carried on with the morning. Late morning while working on the computer, I began to feel the palpitations exactly as he had described them. I tried to brush it off as merely psychologically induced, but when it persisted I headed to the health lodge to have the nurse listen to it (the doctor wasn’t in). After intently listening on the stethoscope, she matter-of-factly said, “The skipping is gone, but now I’m hearing rapid extra beats.” She seemed pretty casual about the whole thing and suggested it wouldn’t hurt to have the doctor listen again when he was on duty later in the evening. After lying down for 15 minutes the palpitations left; at least I thought they did.
When dinner was over, I debated whether or not to have Doc Sharp listen again; other than his “skip” report and the nurses “extra beat” report, I felt fine and had no other symptoms. I finally concluded that it wouldn’t hurt to have him listen. After a long silent five minutes of stethoscope on my heart and an index finger on my wrist, he said with a puzzled look, “I don’t hear anything. It’s all normal.” Good, I thought, until he picked up the phone to call the ER doc for a second opinion. When he hung up he emphatically told me arrangements were being made for me to “go down the hill” to get checked out at the ER. It didn’t seem prudent to challenge him and so I said nothing.
On the ride down I fretted about the fact that I currently don’t have health insurance. I followed instructions as the triage nurse entered my information into the system. When she told me to take a seat, I explained that I didn’t have insurance and wanted to know what the costs of the tests would be. She rolled her eyes, gave me a disgusted look, and then dismissing me again to go take a seat, ordered me to make sure I checked out with her when I was done. On the door was a sign posted that publicly disclosed the law requiring the hospital to give treatment to anyone, whether or not they could pay for the services.
A few minutes later a nurse opened the door and called out, “Irregular heartbeat?” The other patient in the waiting room looked to be in extreme pain, but it was obvious I was being summoned first. As we walked I responded to her questions before asking my own, “Can you tell me how much an EKG is going to cost?” She stopped walking and stuttered, “I don’t know. You need to get checked.” I explained my situation and how I needed to know the costs before I agreed to the services. She continued to stutter as a result of my out-of-the-ordinary questions, and now the conversation was attracting the complete attention of everyone working in the nearby nurses’ station.
Suddenly a different nurse appeared, and interrupting me mid sentence sternly commanded, “Take your shirt off, and get on that gurney. We’re doing an EKG.” I followed her to the gurney she was walking towards, and when we arrived, I gingerly asked, “Do I have a choice?” “NO,” she immediately declared with great irritation. With the bizarre concern that she was going to grab my shirt and body slam me onto the gurney, I repeated my dialogue I had had with the first nurse. Her demeanor hardly softened as she impatiently told me that there’s no way for them to tell me what the costs are, that it’s never less than $500 for someone to be seen in their ER, and if I can’t pay for it, they’ll put me on a payment plan. The conversation was going nowhere when a third nurse suddenly appeared and introduced herself as the “nurse in charge.” She was the “good cop” in what appeared to be evolving into a “good cop/bad cop” routine, and she listened better than the previous two nurses. After I once again explained that I didn’t want the hospital to perform services that I couldn’t afford, and that I didn’t want to take advantage of the law posted on the waiting room door, she confirmed that there was no way for them to give me dollar figures, and then indicated that the bill could be as much as $12,000. So I asked the bottom line question, “What are my options?”
She hesitated for a moment, and then answered, “Well, you’re walking fine and talking coherently, and so we can’t force you to lie down and be tested; if you weren’t, we’d have no choice, and neither would you. I would strongly suggest you get tested, but if you decide not to, we’ll delete you out of the system right now and you won’t be billed for coming through these doors.” I received her words with great relief: I had a choice, even if the decision wasn’t an easy one. If I didn’t get tested, for liability reasons, I wasn’t sure if Doc Sharp would let me back into camp and I really wanted to finish the week with my son. If I did get tested, I would probably be looking at a bill that would be a devastating financial setback. It wasn’t that I didn’t want to be tested; I didn’t think it was necessary to do it immediately in an expensive ER setting, and I needed a little bit of time to do some research and explore other options that might better fit my personal situation.
I decided to walk out. Doc Sharp was not happy when he got my call, but fortunately after consultation with the camp director, he stated that liability concerns aside, I was welcome back to camp. Doc Sharp's last words were that he was going to be really mad if he had to perform CPR on me. I hung up the phone and contemplated on the concern we both shared.
During the drive back to camp, my mind began to explore how this experience related to freedom, and our innate right to choose. When I was born, I inherently possessed the right to life, liberty, and the pursuit of happiness. These rights were not to have life, liberty, and happiness, but the right to choose through my own initiative the maintenance of life, the preservation of liberty, and the realization of happiness. Because of my poor eating habits and limited exercising, at 45 years of age I should be honest and admit that I have not made good choices regarding the maintenance of life. The consequences of my choices should be mine, and not someone else’s to bear. My moral dilemma in the ER was whether or not I should use the law to force someone else to pay for the choices I’ve made, to take away some of their freedom of choice, and hinder the realization of the happiness they may be rightfully pursuing. It was tempting to dismiss the conflict by rationalizing that no one person was really being forced to assist me; it’s “they,” that nameless, faceless, multitude of benefactors who owe me something for nothing in return. I guess according to current societal norms, I was perfectly justified in playing the system by closing my eyes and doing what I was told, and then when the bill came use the law to stop the collection process.
My conscience wouldn’t let me go there, legally justified or not. The irregular heartbeats are disconcerting, and I do want to be tested, but as difficult as it is for me to accept, I should only access these medical services within the realm of what I can afford, and not demand or expect someone else to pay for it. Does this mean I might die any minute of any day? Of course, which is exactly the same reality I share with six billion others. No one is exempt from death; it comes as the consequence of our own choices, someone else’s choice, or merely as the result of naturally occurring circumstances. If death comes due to my own choices, then owing to the importance of protecting the right to life, liberty and the pursuit of happiness, no one should be forced to come to my aid, even if no one volunteers. If death comes due to someone else’s choice to intentionally terminate my life, I would hope that government would do their best to protect my God-given right to life (see Patriot or Slave, A Modern Declaration of Independence, pages 14 - 19). If death comes due to naturally occurring circumstances that are either impossible to mitigate or I cannot afford to pay to have them mitigated, then I must accept the reality that the clock recording the time of my life will have expired.
I hope that I can appropriately accept any of these potential realities, and be confident that in the course of my life, I did not undermine the universal quest of freedom to choose for myself, and that I did not deprive anyone else of the same.
“So what does this mean?” I asked with consternation, and then received a long narrative that mostly went over my head. What I did understand is that besides his disclaimer that he was an orthopedic surgeon and not a heart doctor, he remembered a lot about the heart from his general medical training 20 years ago, and that even though 10 years ago he had felt the same skipping in his pulse in a hotel room in New York City shortly after 9/11, he’s never had a problem since and the skipping went away. I left the exam room quite concerned, and naturally began to wrestle with many difficult questions consuming my mind.
I ran into Doc Sharp at breakfast Monday morning and he asked how I was doing. “Fine,” I replied before inquiring, “on Saturday when you asked if I had had any palpitations, what exactly does that feel like?” His explanation made sense and I carried on with the morning. Late morning while working on the computer, I began to feel the palpitations exactly as he had described them. I tried to brush it off as merely psychologically induced, but when it persisted I headed to the health lodge to have the nurse listen to it (the doctor wasn’t in). After intently listening on the stethoscope, she matter-of-factly said, “The skipping is gone, but now I’m hearing rapid extra beats.” She seemed pretty casual about the whole thing and suggested it wouldn’t hurt to have the doctor listen again when he was on duty later in the evening. After lying down for 15 minutes the palpitations left; at least I thought they did.
When dinner was over, I debated whether or not to have Doc Sharp listen again; other than his “skip” report and the nurses “extra beat” report, I felt fine and had no other symptoms. I finally concluded that it wouldn’t hurt to have him listen. After a long silent five minutes of stethoscope on my heart and an index finger on my wrist, he said with a puzzled look, “I don’t hear anything. It’s all normal.” Good, I thought, until he picked up the phone to call the ER doc for a second opinion. When he hung up he emphatically told me arrangements were being made for me to “go down the hill” to get checked out at the ER. It didn’t seem prudent to challenge him and so I said nothing.
On the ride down I fretted about the fact that I currently don’t have health insurance. I followed instructions as the triage nurse entered my information into the system. When she told me to take a seat, I explained that I didn’t have insurance and wanted to know what the costs of the tests would be. She rolled her eyes, gave me a disgusted look, and then dismissing me again to go take a seat, ordered me to make sure I checked out with her when I was done. On the door was a sign posted that publicly disclosed the law requiring the hospital to give treatment to anyone, whether or not they could pay for the services.
A few minutes later a nurse opened the door and called out, “Irregular heartbeat?” The other patient in the waiting room looked to be in extreme pain, but it was obvious I was being summoned first. As we walked I responded to her questions before asking my own, “Can you tell me how much an EKG is going to cost?” She stopped walking and stuttered, “I don’t know. You need to get checked.” I explained my situation and how I needed to know the costs before I agreed to the services. She continued to stutter as a result of my out-of-the-ordinary questions, and now the conversation was attracting the complete attention of everyone working in the nearby nurses’ station.
Suddenly a different nurse appeared, and interrupting me mid sentence sternly commanded, “Take your shirt off, and get on that gurney. We’re doing an EKG.” I followed her to the gurney she was walking towards, and when we arrived, I gingerly asked, “Do I have a choice?” “NO,” she immediately declared with great irritation. With the bizarre concern that she was going to grab my shirt and body slam me onto the gurney, I repeated my dialogue I had had with the first nurse. Her demeanor hardly softened as she impatiently told me that there’s no way for them to tell me what the costs are, that it’s never less than $500 for someone to be seen in their ER, and if I can’t pay for it, they’ll put me on a payment plan. The conversation was going nowhere when a third nurse suddenly appeared and introduced herself as the “nurse in charge.” She was the “good cop” in what appeared to be evolving into a “good cop/bad cop” routine, and she listened better than the previous two nurses. After I once again explained that I didn’t want the hospital to perform services that I couldn’t afford, and that I didn’t want to take advantage of the law posted on the waiting room door, she confirmed that there was no way for them to give me dollar figures, and then indicated that the bill could be as much as $12,000. So I asked the bottom line question, “What are my options?”
She hesitated for a moment, and then answered, “Well, you’re walking fine and talking coherently, and so we can’t force you to lie down and be tested; if you weren’t, we’d have no choice, and neither would you. I would strongly suggest you get tested, but if you decide not to, we’ll delete you out of the system right now and you won’t be billed for coming through these doors.” I received her words with great relief: I had a choice, even if the decision wasn’t an easy one. If I didn’t get tested, for liability reasons, I wasn’t sure if Doc Sharp would let me back into camp and I really wanted to finish the week with my son. If I did get tested, I would probably be looking at a bill that would be a devastating financial setback. It wasn’t that I didn’t want to be tested; I didn’t think it was necessary to do it immediately in an expensive ER setting, and I needed a little bit of time to do some research and explore other options that might better fit my personal situation.
I decided to walk out. Doc Sharp was not happy when he got my call, but fortunately after consultation with the camp director, he stated that liability concerns aside, I was welcome back to camp. Doc Sharp's last words were that he was going to be really mad if he had to perform CPR on me. I hung up the phone and contemplated on the concern we both shared.
During the drive back to camp, my mind began to explore how this experience related to freedom, and our innate right to choose. When I was born, I inherently possessed the right to life, liberty, and the pursuit of happiness. These rights were not to have life, liberty, and happiness, but the right to choose through my own initiative the maintenance of life, the preservation of liberty, and the realization of happiness. Because of my poor eating habits and limited exercising, at 45 years of age I should be honest and admit that I have not made good choices regarding the maintenance of life. The consequences of my choices should be mine, and not someone else’s to bear. My moral dilemma in the ER was whether or not I should use the law to force someone else to pay for the choices I’ve made, to take away some of their freedom of choice, and hinder the realization of the happiness they may be rightfully pursuing. It was tempting to dismiss the conflict by rationalizing that no one person was really being forced to assist me; it’s “they,” that nameless, faceless, multitude of benefactors who owe me something for nothing in return. I guess according to current societal norms, I was perfectly justified in playing the system by closing my eyes and doing what I was told, and then when the bill came use the law to stop the collection process.
My conscience wouldn’t let me go there, legally justified or not. The irregular heartbeats are disconcerting, and I do want to be tested, but as difficult as it is for me to accept, I should only access these medical services within the realm of what I can afford, and not demand or expect someone else to pay for it. Does this mean I might die any minute of any day? Of course, which is exactly the same reality I share with six billion others. No one is exempt from death; it comes as the consequence of our own choices, someone else’s choice, or merely as the result of naturally occurring circumstances. If death comes due to my own choices, then owing to the importance of protecting the right to life, liberty and the pursuit of happiness, no one should be forced to come to my aid, even if no one volunteers. If death comes due to someone else’s choice to intentionally terminate my life, I would hope that government would do their best to protect my God-given right to life (see Patriot or Slave, A Modern Declaration of Independence, pages 14 - 19). If death comes due to naturally occurring circumstances that are either impossible to mitigate or I cannot afford to pay to have them mitigated, then I must accept the reality that the clock recording the time of my life will have expired.
I hope that I can appropriately accept any of these potential realities, and be confident that in the course of my life, I did not undermine the universal quest of freedom to choose for myself, and that I did not deprive anyone else of the same.
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