Once upon a time in a city called Troy, on a peaceful day after a decade of war with Greece, an immense and beautiful wooden horse has been brought in from beyond the walls as an offering to the gods and symbol of the city’s victory. Later that night:
Through the city the Trojans
fall silent: sleep enfolds their weary limbs.
And now the Greek phalanx of battle-ready ships sailed
from Tenedos, in the benign stillness of the silent moon,
seeking the known shore, when the royal galley raised
a torch, and Sinon, protected by the gods’ unjust doom,
sets free the Greeks imprisoned by planks of pine,
in the horses’ belly. Opened, it releases them to the air,
and sliding down a lowered rope…
They invade the city that’s drowned in sleep and wine,
kill the watchmen, welcome their comrades
at the open gates, and link their clandestine ranks.
It was the hour when first sleep begins for weary mortals,
and steals over them as the sweetest gift of the gods.
- Virgil, The Aeneid
Even if you only ever read the Cliffs Notes version of the epic western poems, you probably remember the gist of this story. 10 years of war and stalemate between the Greeks and the people of the city-state, Troy, ends in the total destruction of that city based on a clever ruse by the enemy. The Trojans believe the Greeks have finally tired and sailed home, leaving an offering to the gods for their safe passage in the form of this gigantic wooden horse. The horse is a symbol of Troy, and it’s so beautifully crafted, why shouldn’t they bring it inside? Of course the horse is full of enemy soldiers, who spring out under the cover of darkness, and let in the rest of the Greek army who proceed to destroy the city and kill its inhabitants. These stories have staying power in our culture if only in part because they remind us of basic human truths that still govern our behavior. Deceptive external appearances often cloud our judgment, little threats that seem trivial get dismissed, we tire and let our guard down, and the results can quickly turn ruinous. More Trojans should have had a bad feeling about welcoming that horse into their city.
As a health care activist, I must admit a kind of battle weariness since the passage of the Affordable Care Act. And watching the Republican presidential primary debates isn’t helping matters. There’s of course been plenty of stock small government and deregulation rhetoric, and threats to dismantle health care reform and the patients’ bill of rights, and I glumly expect that same kind of language will still be there in time for the general election next year. And to a certain degree, that’s fine. Civilized people can disagree about tax rates and the best means to reduce the deficit while creating jobs, and we as a country can handle the debate about the individual insurance mandate. But what really bewilders and overwhelms me lately is the crowd at these gatherings. I don’t think I’ve seen a public forum in this country during my lifetime where there’s been so much sustained hatefulness, lack of empathy, and proud ignorance couched as American values.
As a physician, I find that certain applause lines make my skin crawl more than others. There was the uproarious clapping for Gov. Rick Perry when it was mentioned that he holds the record for number of executions authorized in the history of the Republic – 234 people. Meanwhile Texas also stands out for the number people it puts to death with questionable guilt. And in some cases, new evidence has arisen post-mortem that would have led to exonerations or at least stays of execution.
Then on the flip side, Gov Perry got booed during the next debate for his support of opt-out HPV vaccines for adolescent girls to protect them from cervical cancer. (Dr. Chris Lillis, here on September 16th, gave a superb treatment of how thoroughly important vaccines like this are for public and individual health, and how opposition to them traces its roots to corrupt doctors and hysterical celebrities - not science; not evidence.)
But then the really chilling moment came when Congressman Ron Paul was asked about whether or not our society should let young people die if they need life-sustaining medical care they personally couldn’t pay for. “Yeah!!” cut in a small number of audience members! Oh, the irony. The camp that shrilly warned of imaginary death panels for your grandma, now doesn’t mind death by neglect for your sister. Dr. Paul, for his part dodged the comment and instead offered that churches should pick up the bill for the uninsured, though he surely didn’t mean all 50 million of them.
So we have a troubling pattern developing here among these likely primary voters, who have gotten so brazen and confident in their numbers that they don’t mind acting like animals for the TV cameras. And don’t tell me that these outbursts reflect only the views of a few foot soldiers. Someone in that crowd of patriotic Americans should have stood up and challenged them. No one did. Not a word. These people routinely demonstrate they can boo at ideas they disagree with, but when it comes to leaving the uninsured to die, little girls exposed to cervical cancer, or carrying out record levels of state sponsored violence that not infrequently kill innocent people, the whole room was complicit every time. And even regardless of what one thinks about these issues taken in isolation, it’s hard to ignore the trend. The base of the right wing going into the next election is taking on an increasingly violent, destructive tone, and their vision for America is one that I personally find totally alien and more than a little frightening.
In this world view, the ills of society that spring from poverty and marginalization are not to be addressed in any systematic way by the government, not even one for and by the people. Rather they insist that our democracy exists strictly for the purpose of providing security, and it should otherwise butt out. Indeed one begins to wonder whether or not these people care at all about the problems our country faces, or perhaps they think their personal situation is so secure that they can afford to forget about their neighbors. They don’t mind that the poor just get poorer, because in their view the answer to the resulting societal instability and crime is simple, just kill the criminals. Meanwhile health care is a luxury commodity, and prudish theology trumps science and public health. Mainstream Republicans, for their part, have historically been better than this, and they better start to speak up. The candidates had better speak up. We all had better speak up. If we do not, if we allow this ugly selfishness to pass for civilized discourse, we will see this kind of barbarity skillfully repackaged in preparation for the general election.
As for me, I know that physicians, chief amongst us, have a responsibility to our broader society. In particular we are natural advocates for the poor, because they turn out to be the sickest in our society. Mine are not strictly left or right wing views. I have plenty of conservative friends that recognize that a completely laissez-faire country, where the upper class has everything, the lower class has nothing, and the middle class has died is not a place you would want to live. But that’s what the ideas being hooped and hollered in the debates support. When your basic quality and quantity of life is first and foremost a function of your income, what you get is a third world country, not the United States of America. So, I will not sit quietly by while wicked, selfish ideas masquerade in the American flag and sneak their way further into our body politic under the cover of night. I will not stand aside as they cut our social safety nets to ribbons, attack our health care infrastructure, and erode our basic sense of responsibility to one another. I will say to anyone who will listen what should have been said in reply to those mobs. This self-centeredness is beneath of our civilization; it is a greater threat to our way of life than any external enemy.
So pay attention to these primary debates this fall before the campaign advisors start rebranding the demands of the base, because barbarity is at the gate now and it’s showing its true intentions. But come next year, we may peer over the walls and see nothing but an exquisitely crafted wooden horse.