Need And Suffering And Just Dessert

I have been thinking much lately of people screwing themselves and expecting someone else to fix it.  It’s a lot of my job, of course, and my caseload is especially heavy with that at the moment.

But they are ill.  It is an open question how much they can fix it themselves now.

In most cases, they were able to do better than they did do.  They didn’t report income so social security is withholding the overpayment; they didn’t keep appointments; they expect the VA to pay for care at another agency; they don’t like how the meds make them feel so they stop them and lose customers, break leases, etc.  In all four cases, their families – uh, excuse me, their moms – expect someone to pick up the pieces on this and fix it.  Probably because if no one does, they will feel they are on the hook.

There is a powerful underlying attitude of “well I/he can’t, so someone somewhere has to.”  Conservatives are fond of claiming that this attitude is part of our national deterioration and is exactly what needs to be changed.  I don’t know this to be true.  No, really, I don’t know one way or the other, I can see arguments either way, and am pretty damn sure no one has any hard numbers on the matter, just impressions. We each have a narrative, and confirmation bias is powerful.  We know people who are not obviously ill we believe should be made to stand up and take responsibility; we know people we believe have been burdened more than they can bear and deserve greater help.

First, it is true that people sometimes do not rally until their backs are against the wall and there’s no one else, at which point they rise up and do heroic things. We know this to be true, not only because of what we have seen in other people, but in ourselves.  We know of places where we endured or accomplished what we thought we could not, because we had to.  And it has been part of making us who we are, and we should not take that away from people.

On the other hand, some people seem unable to rally even when necessity requires it, and this was true in the Good Old Days as well.  People slipped to less and less care by family, by church, by town – often at least partly by their own choosing as they wandered in search of…something.  A job, a home, a meal.  And they died, same as now. 

Also, those around us might disagree that conquering these obstacles “made” us.  They might point to those same events as having destroyed us, we just don’t see it that way.  I am hard pressed to decide whether life’s hard events have been a net good or not. 

Some folks try really hard, yet for some reason things just don’t work, and it’s not only a bad economy that makes that happen.  Tragedies and disabilities and plain bad luck are real things – they may not be society’s fault or the taxpayer’s fault, but they may not be the person’s fault either. And how much weight the structure will bear is not easy to discern.

So. Withholding assistance – giving the person the dignity of real adulthood and real risk - sometimes fixes things, but sometimes it doesn’t, and they die, or dig themselves in deeper, or go to jail. I don’t know what we do about this. 

Actually, I do.  We make the best guess we can, as we have always done, and pray a lot.  We try not to deceive ourselves according to our current political and social beliefs – that our predecessors were uncaring and unjust oppressors or that they were noble achievers whose shoes were are not fit to tie.  They were us.  They seem to have been more likely to inflict physical pain and endure physical pain.  I’m not sure there’s much else we can assert with confidence.

Bruce Kessler over at Maggie's has something on this.