Sunday, September 28, 2008

"Toxic Debt" and other lies...

The image is of Winter in Glen Etive, Glen Coe by courtesy of D W Roberston Gallery and is an illustration for Tales of Travel (see below)

As I write news is coming over the radio about the resue plan put together in the US to save international markets from melt down, or whatever other thermodynamic metaphor is appropriate for this jolt out of the consensus trance we've all been in for the last thirty or so years, or longer.

I have the powerful feeling that the explanations we're being given for what has happened to the 'markets', and what we need to patch things up, is another deliberately administered dose of anaesthetic. The problem, we're being told, is that banks are no longer willing to lend each other money, and this 'freeze' is the cause of the problem.

At the heart of the crisis, allegedly, is "toxic debt", debts built up by poor people who were bamboozled into mortgages they couldn't afford, and can't repay. This level of "toxic debt" has "infected" the global financial system. I find it outrageous, but perfectly in keeping with the evil tenets of capitalism, that this language of poison and contagion should be used to define the heart of the problem; to denigrate and scapegoat the hapless undeserving poor, those who wanted to house their families, low-paid workers, single mothers, people from ethnic minorities.

The implication of what we're being told seems to be that banks actually have lots of money, but they don't trust anyone enough to lend it, including each other, because toxically infective "sub-prime" borrowers have contaminated the system, defaulted on loans, and infected the system like a type of rabies, paralysing it like 'lock-jaw'. So the banks are are sitting helplessly on the money they have left. The result is that no-one can borrow any more, so they have none to spend or 'invest'. There is, or soon will be, no money in circulation. Money has somehow congealed, clotted up.

The proposed solution seems to be that Governments will give a very large amount of money - "taxpayer's money" - to the banks. This is called "injecting liquidity" into the system to "lubricate it" or "free it up" or some other inane slogan borrowed from hydraulic engineering. This money will somehow, miraculously unblock the clogged-up system, and money will once again flow.

Presumably this borrowed money will be used to lend to other people, so that banks will "regain the confidence they need" to begin "lending money to each other", re-establish "confidence in the system" and everything will be AOK again. Except that you and I will be expected to pay for it through taxation, the privatisation of services, and the life-long indebtedness of our children.

Does anyone believe this anaesthetic nonsense? That the banks have money but are too mistrustful to lend it? That they need to be given money to steady their palsied nerves?

Well, I believe that in truth there is no money. The money that the banks and building societies have been lending to people doesn't exist, and never has. The money on your mortgage statement, or in your deposit account, the "equity" in your house, or the figure on your ISA certficate is just a mirage. Since the "Big Bang", money has just been an illusory row of noughts on the computer screen, from which people in the City and on Wall Street have been regularly helping themselves to huge tranches in currency bills, to buy or build mansions, Rolex watches, Maseratis and diamond encrusted crystal skulls as gee-gaws.

It seems to me that what is proposed is the launch of another illusory capitalist spree, a re-instatement of the status quo ante, business as usual in Wall Street and the square mile, a short term boom in the High Street as consumers "regain the confidence" they need to put a spring in their step in the long run-up to Christmas (expect the tinsel, toys and mince pies to greet you in Tescos, Wal-Mart and Sainsbury's soon enough). And the directors (and highly paid non-Execs like Tony Blair) will laugh all the way to their non-dom banks and off-shore Cayman Island havens.

What has this got to do with Buddhism? Well, as I said in an earlier post on the Social Care Green Paper, perhaps it's about seeing the world, or not seeing the world, from any perspective, but recognising that this is what we always do and recognising this, opening ourselves to the possible emergence of another way of being. As Ray Wills used to say "There must be another way". He didn't define what that other way might be because the Way doesn't have a destination in mind: it's a point of departure, an open road. What we can do (but it's hard and calls for energy and resolve) is to allow ourselves to open to another way of being, not adopting it or 'trying to' follow it, but rather becoming it.

A howl of outrage? An intemperate polemic? Well, yes, perhaps. But I'm human, and it's part of my way of opening up to another way being, and perhaps helping you, who knows. So I'll let it stand, and finish on a quieter note with the words The Vagabond, part of a song-cycle of verse (Songs of Travel) by R L Stevenson, set to music by a favourite composer, Ralph Vaughan Williams, and with the cool illustration of Glen Coe (above) as backdrop:

Give to me the life I love,
Let the lave go by me,
Give the jolly heaven above
And the byway nigh me.
Bed in the bush with stars to see,
Bread I dip in the river -
There's the life for a man like me,
There's the life for ever.

Let the blow fall soon or late,
Let what will be o'er me;
Give the face of earth around
And the road before me.
Wealth I seek not, hope nor love,
Nor a friend to know me;
All I seek, the heaven above
And the road below me.

Or let autumn fall on me
Where afield I linger,
Silencing the bird on tree,
Biting the blue finger.
White as meal the frosty field -
Warm the fireside haven -
Not to autumn will I yield,
Not to winter even!

Let the blow fall soon or late,
Let what will be o'er me;
Give the face of earth around,
And the road before me.
Wealth I ask not, hope nor love,
Nor a friend to know me;
All I ask, the heaven above
And the road below me.

Wednesday, September 24, 2008

Tacit knowledge

It has been a pretty exhausting week at my place of work, with a spate of sickness affecting several of the carers, so that everyone unaffected has had to pitch in to cover for absent colleagues, work extra shifts, and generally 'burn the candle at both ends'. In the last weeks I have worked several back-to-back shifts of fourteen consecutive hours duty, mostly engaged in 'hands-on' care, interspersed with such activities as helping to cook and serve meals, wash up pots, pans and dishes, do laundry, and variety of administrative chores besides.

At such times nerves can get frayed, patience is strained, and mistakes and accidents are more likely to happen. This morning, arriving at work at about 0645, I looked in on the laundry room to find that one of our washing machines had been loaded with two sets of nightclothes, both of which sets had been subject to a hot wash while still containing incontinence pads, which ought to have been removed. These 'pads' are disposable adult garments like large 'nappies' made of cellulose padding inside a thin plastic envelope, designed - of course - to capture and contain human wastes.

Presumably the overworked and overtired careworker who did the washing had been too distracted to remember to separate out the pads from the garments so as to put them in the clinical waste bin. Of course, they had disintegrated in the machines, dispersing the contents throughout the wash, and liberally coating the inside of the drum with unpleasant emulsified pap. Not a bright start to the day, but not unusual either.

After work this evening I turned to an article in my daily paper, hoping to take my mind off things clinical, but my eye was caught by an article, a critique, about the training of young doctors. Not a lot has changed in the fifty or years I have been in a position to observe this happening except, perhaps, that doctors have grown unaccountably younger, like policemen. Training is still very much hospital-based, and possibly even more fragmented and modularised than ever, with more tick-box-type assessments, and less time at the bedside.

Patients are in hospital for much shorter periods than twenty years ago, so that doctors have less time to get to know their charges, less time to see changes in their patients over time, for getting a feel for how people respond over time to disease, and watching what happens as they get better. The wisdom that emerges from being able to witness such evolutionary change is called "tacit knowledge".

One of its characteristics is a growth in the necessary humility that a practitioner develops about her own part in the processes of recovery and 'cure', and a deeper respect for the adaptive potential of the human organism, in both the physical and the psychological domains. Medicine, after all, is just a set of interventions that help to put the patient into a condition that allows nature to take its healing course. The same is true of nursing and all 'healing arts'.

In this respect, I believe, nurses are at an advantage over doctors, and many doctors (certainly most senior or older doctors) acknowledge the wider and deeper clinical acumen of nurses in making a difficult diagnosis, and a more reliable prognosis, than less seasoned doctors. Nurses, unlike doctors, see their patients day-in-day out, are privy to their informal conversations and reflections, and see them in a far wider repertoire of activities than doctors, sleeping, eating, eliminating, attending to their own needs, in relation to their families etc. Unfortunately, changes in the way nurse training has been structured and delivered have made for a much less coherent and "wholistic" relationship between nurse and patient, less physical intimacy, less thorough-going trust and rapport, and less of a long view on events in the curriculum of health and illness.

There are times when I am attending to one of my own patients, that I am thrown back in my experience to an earlier time when I first began to learn to nurse, fifty years ago. It's not memory in the sense of a picture in the mind, it's a felt physical thing, a reassurance of close contact, warmth, the complex scent of a close-held body, the touch of skin, awareness of a tremor, of a small weakness, of effort, of courage that always springs up in the other to meet the challenge of the moment, and something eternal too about trust and vulnerability.

Today I was helping an old fellow off his commode, helping him hitch his underpants and trousers up, his head against my chest, his arms round me in a politically incorrect and improperly conducted lift by Health and Safety rules, telling him, when he said "You know how to help me", "Yes, we know how to work well together", and meaning it, and knowing it's meaning is not to be found in me, but in the way things are, in that tacit knowledge, that unspoken wisdom that pervades everything, and always. Help is not something I do to another, it's a resource two people in a relationship share, born of the relationship and its circumstances, and always in perfect reciprocity, whatever happens.

"Though the Path is vast and fathomless I vow to understand it.

Though enlightenment is beyond attainment I vow to embody it fully."

Saturday, September 20, 2008

Social Care Green Paper

The diagram to the left is a representation of an aspect of the social care market, courtesy of Healthcare Economist Journal of the United States

Eminent Buddhist commentator and analyst Yann Lovelock has written to us inviting us to contribute to a discussion promoted by Government on the future of social care for old and very old people in our society. The link leads to a short introductory vox pop video in which a number of people offer views on the issue, framing the discussion, and linked to a site that presents the issues from the perspective of the working party preparing a Green Paper. The Green Paper is part of a process by which enabling legislation will be worked up, and services designed, to meet our social care needs in the years ahead.

As Yann reminds us, some of us will soon be facing questions of what care we need, what is available, what it is going to cost, and who will foot the bill. Some of us, of course, are facing these issues already.

These questions have been framed for us by the consultation document, and seem to me to have a very New Labour quality to them, in that they arise from a set of political assumptions about the meaning of care i.e. care as a commodity that individuals will want to buy, exercising choice over their purchases, purchases designed to support their independent living, a 'marketplace' for the setting out of care-wares, care-tariffs and so on (some of these terms are my own, I must confess).

Buddhists may want to challenge these assumptions, although they may not, of course. We are all used to viewing the world, its affairs, and our atomised part in those affairs, through a narrow slit of social and political conditioning. We constantly absorb through the media of TV, press, advertising and the Internet an insistent paradigm of existence that stresses individualism, consumer choice, competition, and the all-defining lifestyle.

I live my life mainly as a consumer; I can't help it. Although I make efforts to break out of consumerist samsara, it is deeply engrained, and I have no illusions about my intentionality or volition, which is weak and intermittent. My puny efforts are debilitating and discouraging, I often feel flaked out and hopeless.

But fettered as I am by the chains of my mind, I find that I must protest, even though I can't find the words to do so, except in the anguished cry,"There must be another way"!

I feel, I intuit, that there is another way to characterise care, a framework that expresses our interdependence, our shared vulnerability, our willingness to let go of the pride and intellectual arrogance that puts independence and individualism on a lofty pedestal, that "knows the price of everything and the value of nothing". I can not accept that care is, or should be, a commercial transaction, bound by contractual criteria, published as a menu of bite-sized interventions, packaged, audited, regulated, costed, 'branded', advertised, "starred", charter-marked and "visioned".

There must be another way.

N.B. I shall welcome your views, opinions and sugestions and, if you agree to my doing so, I will add them to views I am collating on behalf of the Network of Buddhist Organisations as a response to the Green Paper consultation. Or you can send them directly via the link given above.

Thursday, September 18, 2008

De mortuis nil nisi bonum

Speak only well of the dead. This came to mind today as I read a quite lengthy broadsheet obituary which ended as follows: "At one time he owned a parrot with a penchant for fried eggs and Guinness. His wife Doris died in 1992, and he is survived by his son, Andrew."

That I should ever deserve such such an eloquent summation! "At one time he owned a small knife with a bone handle, a gift from his school-friend Roger, who had bought it on a holiday visit to Switzerland with his father, an industrial glass salesman."

I was at the second meeting recently of the reconstituted "Inner Work School" meeting, held on the second Saturday of each month in Friends House, Euston Road. It was good to meet old friends again under familiar circumstances, albeit a new venue, paid for by the Buddhist Hospice Trust. It was also good to meet up with newcomers, thanks to the efforts of Ben (Bodhiprem) Shapiro and Mick Lewin in publicising the event, and convening the meeting.

By all accounts, the 'mood' of the first meeting was for open discussion to an emergent agenda, and the meeting I attended was carried on in this way too. It's hard to see how, with a fluctuating membership and no chairperson, an agenda could be developed that carried across meetings. But we shall see what emerges over time. For myself, I have enjoyed these gatherings, and got benefit from them, in ways hard to describe.

I know they have contributed to that softening of opinion in me that Buddhist practice produces, so that I can listen to the opinions of other people with something akin to empathy: it's like seeing the world from another point of view, through different eyes, and not in competition with one's own perspective. This is by no means my default position, I am almost if not fully as combative and confrontational and contraversial as I've always been; but there has been a change. Of course I am still always right, but other people have gradually much nearer to my position than they used to be, thus their expressions of dissent are more bearable.

"At one time around 1956 he owned a secondhand collarless Gieves shirt in a narrow blue stripe, which he wore with a white starched collar secured with a stud, loooking very much (as he thought) the fashionable young man-about -town, especially as he carried a rolled umbrella."

Am I alone in sensing a change in the temper of society since the "credit crunch" began? There seems to me to be a sense of sober expectancy amongst my fellows as I move about the town to do a bit of shopping or to pay bills. Do I also sense a "rabbit in the headlamps" paralysis in the unconvincing (and unconvinced) utterances of our national leaders? As if they understand the enormity of the show-down we face in the crisis of capitalism, the imminence of irreversible climate change, the here-and-now inescapability of 'peak oil', but lack the courage to do anything about it. The best thing would be to come clean, to spell out the situation, and to ask us to begin to develop ways of coping with a new reality. Offering structures that would mobilise our efforts for survival or, if we are not to survive, for a dignified extinction, worthy of a noble if flawed species. What might be our epitaph then?

"At one time he owned a portable Olivetti typewriter in a faux pig-skin carrying case, bought on Hire-Purchase terms from a door-to-door salesman who visited his rented flat in Moseley, Birmingham, in the autumnn of 1962."

Monday, September 15, 2008

The Buddhist Hospice Trust Blog: Mrs Waveney Miller

The Buddhist Hospice Trust Blog: Mrs Waveney Miller

Stephen Hodge, who was Waveney's first and much-loved teacher, has sent some kind and corrective comments on my earlier blog, and these can be read in full using this link. Thank you Stephen.