Maybe Death Isn’t All That Bad: Trump’s Budget Proposal Slashes Spending by $3.6 Trillion Over 10 years – Guess Who Pays ?

The “oil spot” theory of counter-insurgency asserts, in brief, that if we take an area and make it safe for the population, the effect of this improved safety would spread beyond the confines of the area made safe(er), kind of like an oil spot spreads. Not being a counter-insurgency expert, I can’t be sure I have this exactly right, nor that it actually works – Viet Nam, Afghanistan and Iraq come quickly to mind – but you get the point.

This oil spot analogy may work in life as well; at least in my life as I am living it now. I am thinking, specifically, about death.

I know Charon well. He and I have been dancing for many years now. Although we are often on opposite side of a battle – not quite, but almost, enemies – we sometimes end up as allies of convenience.

Writing this, I stop and extend my hands, examining them, thinking: Over several decades, people – mothers, fathers, sons, daughters – whom I have cared for have died in these hands. Almost always, the medical team of which I have been a part, has tried to save life and, thus, Charon and I have been at odds, doing battle; I know – I always know – that in the end he wins no matter what I do. Occasionally, however, the battle is not to save life, but to allow life to breathe its’ last, to surrender, with some dignity. In those situations, Charon and I are allies of convenience.

Stopping my typing on this computer, stopping my conversation – if a bit one-sided – with you, dear reader, I look again at my hands; they order me: Do the math ! Do the math !

The math. It is easiest this way: I spent 28 years at the University of Florida, about 25 of those was as faculty in the Intensive Care Unit, on call every other week. So, 26 weeks per year times 25 years is 650 weeks; we admitted about 1,500 patients to our unit per year, and our mortality rate was consistently 6% to 10% per year. So, over 25 years we admitted about 37,500 patients of whom 6% – lets say – died; that is 2,250 deaths. I was there every other week, so 1,125 humans, people I cared for, died in my hands. That is the math. Those were the battles I lost with Charon.

Is this too morbid ? I think not even slightly. I am thinking – as I mentioned to you at the start of this piece – about death. There are many reasons this comes to mind now, most of which will interest you not at all. But there is something that SHOULD interest you.

The creatures inhabiting the highest levels of the US Government – Mr. Trump and his fellow troglodytes – have put together a “health care” bill (The American Health Care Act, AHCA) which is about death, not life. It will – in its present form – take away health care from something between 24 and 30 million Americans; anyone who states otherwise is either a fool or a liar or both.

It will, in its present form, result in the deaths of thousands of Americans. Actually, more Americans will die due to this piece of regressive and spite-filled legislation than have been killed in our country by terrorists. Anyone who says, as Representative Raul Labrador (R-Idaho) did that “nobody dies because they dont have access to health care”, is either a fool or a liar or – more likely – both.

Our American health system, already at the bottom of the industrialized world in terms of measurable quality and outcomes (Amenable Mortality), will sink even deeper as a result of the AHCA.

The slashing cuts in taxes that will be used to defund Medicaid, throw people off of the insurance rolls, these cuts in taxes, this loss to our Treasury, helps exactly whom ? The rich. The top 0.1%. Think it doesn’t matter to you ? Look for yourself what will be cut, and hope you don’t need clean water or health care.

This is why I am thinking of death.

This is what Trump is doing to us, to you. Are you afraid of terrorists ? Be afraid of the terrorist Trump and his Cabinet. They will kill many more of us than ISIS could ever dream of.

This is why I am thinking of death.

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the approximately 10 years until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director and Co-Chairman of Critical Care Medicine in PA; this ended in 2017. He served as a Physician in the Surgical Group with Médecins sans Frontières (MSF, Doctors without Borders) through 2018 and is presently an intensivist in Florida, struggling through the SARS-CoV-2 crisis. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". Follow on Twitter @ajlayon
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