A Holiday Break: Arrowsmith by Sinclair Lewis

Books are always the best holiday gift for me. The only thing I like better than the anticipation of reading a long sought after title is the fondness that comes with remembering the discovery of an unexpected treasure.

As I look back on all the books I've profiled here in 2021, the one I'd most like to revisit is Arrowsmith by Sinclair Lewis, which I blogged about back in November. On the surface, it is the story of Martin Arrowsmith, a young doctor who vacillates between the two opposite poles of all physicians -- the life of the clinician and the life of the researcher. But in Lewis’s capable hands, the tension between these two objectives takes on a more universal and philosophical importance.

As Martin vacillates, the reader is presented with competing ideals and competing understandings of the world. What is the thing that matters? Practical success? Or esoteric greatness? And why is it not possible to have both? For that, as we read and enjoy all of Lewis’s prose describing Martin’s vacillations, is the underlying truth of it all. Whichever one chooses, the other has to be sacrificed in order to attain it.

For me, it is reminiscent of the same choice that Charles Strickland makes at the beginning of The Moon and Sixpence. To achieve something, something else must be sacrificed. In the most general of terms, if you want comfort, you must sacrifice art; and if you want art, you must sacrifice comfort. There’s no other way to approach it, and that may be what I like best about Lewis’s novel.

As you enjoy your holiday break, I hope you find some time to curl up with a good book. I know I will.

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This post was written by Eric Lanke, an association executive, blogger and author. For more information, visit www.ericlanke.blogspot.com, follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

Taming the Big Data Tidal Wave by Bill Franks

I didn’t dogear a single page or scribble a single marginal note while reading this 304-page business book.

I don’t blame it. From my distant perspective, it seems like a good overview of its subject, even though some of its content undoubtedly aging as the years keep passing by (it was published in 2012). But to be fair, I don’t think I was the intended audience.

The primary focus [of this book] is educating the reader on what big data is all about and how it can be utilized through analytics, and providing guidance on how to approach the creation and evolution of a world-class advanced analytics ecosystem in today’s big data environment. A wide range of readers will find this book to be of value and interest. Whether you are an analytics professional, a businessperson who uses the results that analytics produce, or just someone with an interest in big data and advanced analytics, this book has something for you.

I picked it up because I thought I might have been at least one of those things. If the book subsequently taught me anything, it is that I am clearly none of those things -- at least not at the scale or level that the author expected.

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This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

Dragons - Chapter 77 (DRAFT)

Going to the clinic where Jenny saw her doctor was like going to another world -- an alien world where everything had its place and everything was in its place, even the broken and suffering human creatures that had journeyed there, often at great risk and peril to themselves. The building had four wings that spread out from a central core like the splayed limbs of a condemned man -- one, seemingly, for each of that man’s ages: birth, youth, adult, and old age, better known to the medically-literate as obstetrics, pediatrics, internal medicine, and geriatrics. The wayward and shuffling souls that each made their way through the whooshing automatic doors went first up to an enormous reception desk to make their offerings of insurance cards and co-pays, where, once recognized and registered, they would be sent down to one of the spacious waiting areas at the center of each wing, each customized for those whose ailments and concerns brought them to that temporary destination.

Lots of mothers with small children, obviously, found their way to the obstetrics waiting area, and, as such, it was appropriately decked-out with comfortable recliners, small, private lactation chambers, and, for the elder siblings of the soon-to-be-birthed, an elaborate and modular jungle gym of sorts -- a series of ramps, platforms, and slides that even toddlers could push around in order to create unique configurations of their play space.

Needless to say, Jacob loved this jungle gym. It was the thing that we could use to consistently coax him to both behave and to go peacefully to the doctor. They had a larger and more elaborate version in the pediatrics waiting area, but even the one meant for toddlers in the obstetrics area was usually enough for him. We had used it again that morning, simply reminding him of its existence and how much fun he could have with it. Suddenly, he had no longer wanted to stay home and play with his trains. He wanted to go to Mommy’s doctor and play with the jungle gym.

Not that getting there and getting settled in was any easier after that. Even with Jacob fully on board we couldn’t get to the clinic any sooner than ten minutes past Jenny’s appointment time. We hustled as quick as we could down the throat of the beast and arrived breathless at its thumping, thriving heart. There, we received a disapproving look from the school marm that sat there, her day evidently ruined by the need to wait for the tardy Larson family to arrive.

Jacob was already tugging on my arm and Jenny told us to go -- knowing both where we would be going and that he would just be a distraction as she went through the ritual of getting checked in and placed in the queue. Once we got within eyesight of the Holy Land I let Jacob go and he half-jumped, half-ran the remaining distance, too excited to do either one consistently. As I settled into one of the ordinary waiting room chairs (not the recliners, oh no; even if vacant, a man sitting in one of those was akin to parking on top of a handicapped person in one of their coveted spots), I watched Jacob immediately set about to start re-arranging the modular pieces in the way that scratched his particular itch.

There were two other kids already playing there, their parents among the half dozen or so adults scattered about. I carefully avoided eye contact with all of them, and used my kindest parent voice to caution Jacob to play nice with the others.

Soon Jenny came waddling down the concourse, a clipboard in one hand and her heavy purse slung over the opposite shoulder. She came and sat down next to me, exhaling deeply as she settled into the ordinary chair.

“How is he?” she asked.

“Fine,” I said, looking up to see Jacob in some kind of friendly discussion with another one of the children, each navigating how to compel the other to create the playzone each preferred, but apparently doing it amicably. “No screaming or tears, yet.”

“Good,” Jenny said, turning her attention down to the form attached to her clipboard and beginning to scribble the information it requested with the provided pen. It was a simple ballpoint, but it was taped to a large and long tongue depressor, which in turn was taped to a three foot length of heavy twine, the other end of which was in turn taped to the shiny metal clip at the business end of the clipboard. It appeared like an entire roll of tape had been used to create the contraption.

“Do they think you’re going to steal their pen?” I asked.

Jenny mumbled a response.

“And why do they make you fill out that same form every single time?” I asked, my annoyance springing from some unknown place. “They must have all that information already. We’ve been coming here for years.”

“It’s just their process,” Jenny said, the pen continuing to scratch its way across the form. 

“Well, their process is stupid.”

Jenny shushed me. “Alan, keep your voice down.”

“Keep my voice down?” I asked, unconsciously lowering my voice. “Why? Are you afraid of being kicked out by the stupid process police?”

She gave me a sarcastic smile. “Here,” she said, pushing the clipboard into my hands. “I’m done. Go put this in the bin for me. My feet hurt.”

“I’m sure they do,” I said, pretending to be more upset than I actually was. I got up in a feigned huff and went over to the door that led back to the various examination rooms. This was also part of the stupid process. I wrapped the tethered pen around the top of the clipboard and placed it along with Jenny’s completed form into a large document bin that had been attached to the wall next to the door. Next to the bin was a small panel with a series of lighted buttons on it, each one labelled with the name of one of the doctors that were busy working today. I pushed the button that matched Jenny’s doctor and made sure the light came on. Somewhere within, I knew, there was a matching panel, and the same little light had just gone on there, alerting whoever’s job it was to monitor such things that Doctor Mauser had a patient patiently waiting. 

My assigned task in the ritual completed, I went back to sit down next to my wife. As I passed, I happened to catch the gaze of another of the expecting mothers, waiting for the light that corresponded with her doctor to also be noticed so that she could be called back into the inner sanctum. She gave me only a passing glance, but it felt overly hostile.

Jenny was already deep into one of her magazines when I sat back down. “I just got the stink eye,” I whispered to her.

“From who?” she whispered back, not looking up from the glossy photographs.

“That woman over there,” I said, just as the door opened and a nurse in scrubs called for the very woman I was referring to. She got slowly to her feet, gathered her paraphernalia, and started making her slow way out of the waiting room.

Jenny watched her go. “You’re imagining things,” she told me, and then turned back to her magazine. “Now, sit there quietly and stop making trouble.”

I decided not to dwell on that one for very long. It seemed to me that I could either be imagining things OR I could be making trouble, not both. But Jenny, typically, saw things from a different angle than I did. In her view, two opposite things could be true at the same time.

Instead, I turned my attention back to Jacob and his playmates and settled in for what I called “the long wait.” No matter what time one arrived at the clinic, twenty minutes early or twenty minutes late, you were always left to stew in your own juices in the waiting area for at least forty-five minutes. They were either chronically behind schedule, or they had determined that patients had to marinate for an designated period of time before they were ready to be poked and prodded.

Deciding to test my theory, I brought up the stopwatch function on my watch and set it going.

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“Dragons” is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author's imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. For more information, go here.

This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

Image Source

http://lres.com/heres-why-amcs-need-to-pay-close-attention-to-looming-regulatory-changes/businessman-in-the-middle-of-a-labyrinth/

Madness and Civilization by Michel Foucault

This is the second work of Foucault’s that I’ve read. Both of these works contain what I often call a “big idea” -- a way of looking at the world and our place in it (i.e., a philosophy) that provides new and intriguing explanatory powers. In The History of Sexuality, Volume 1, the big idea was that sexuality is not a science, subject to an empirical understanding of its tenets and mechanisms, but an ideology, constructed out of a particular sociological context with no other binding effects. Here, in Madness and Civilization, the big idea is similarly that madness is also essentially an ideology -- something that existed in another form prior to the Age of Enlightenment, but which was re-contextualized into its current abhorrent configuration during the initial rise of that civilization. As is well summarized on the back cover of my paperback edition:

What does it mean to be mad? In Madness and Civilization, perhaps his masterpiece, Michel Foucault examines the archaeology of madness in the West from 1500 to 1800 -- from the late Middle Ages, when insanity was still considered part of everyday life and fools and lunatics walked the streets freely, to the time when such people began to be considered a threat, asylums were first built, and walls were erected between the “insane” and the rest of humanity.

The quotation marks around “insane” in that last sentence are really doing a lot of work, because it’s not that Foucault is claiming that the insane did not exist prior to the Renaissance, just that they weren’t treated as something antipodal to the new civilization, people to be excised from that enterprise, almost like the lepers of the previous age. Indeed, as Foucault sets up the premise for his case, he will describe in the historical disappearance of the leper colony both the context and the structure for the new “insane.” As the leper was removed from the body of the Church in order to save both his soul and the souls of the unaffected…

If the leper was removed from the world, and from the community of the Church visible, his existence was yet a constant manifestation of God, since it was a sign both of His anger and of His grace: “My friend,” says the ritual of the Church of Vienne, “it pleaseth Our Lord that thou shouldst be infected with this malady, and thou hast great grace at the hands of Our Lord that he desireth to punish thee for thy iniquities in this world.” And at the very moment when the priest and his assistants drag him out of the church with backward step, the leper is assured that he still bears witness for God: “And howsoever thou mayest be apart from the Church and the company of the Sound, yet art thou not apart from the grace of God.” Brueghel’s lepers attend at a distance, but forever, that climb to Calvary on which the entire people accompanies Christ. Hieratic witnesses of evil, they accomplish their salvation in and by their very exclusion: in a strange reversibility that is the opposite of good works and prayer, they are saved by the hand that is not stretched out.

...the lunatic will come to be removed from Civilization using the same mechanisms and for the same reasons.

Leprosy disappeared, the leper vanished, or almost, from memory; these structures remained. Often, in these same places, the formulas of exclusion would be repeated, strangely similar two or three centuries later. Poor vagabonds, criminals, and “deranged minds” would take the part played by the leper, and we shall see what salvation was expected from this exclusion, for them and for those who excluded them as well. With an altogether new meaning and in a very different culture, the forms would remain -- essentially that major form of a rigorous division which is social exclusion but spiritual reintegration.

But there is more to the argument than “the insane are the new lepers.” Much more. Because, with a glance back at those quotation marks, we can come to understand that the “lunatics” of the Renaissance are not the same “lunatics” that freely moved about the landscape of the Middle Ages. No, because the very definition of insane will also change to better encompass those who are increasingly at odds with the tenants of the new civilization.

To inhabit the reaches long since abandoned by the lepers, they chose a group that to our eyes is strangely mixed and confused. But what is for us merely an undifferentiated sensibility must have been, for those living in the classical age, a clearly articulated perception. It is this mode of perception which we must investigate in order to discover the form of sensibility to madness in an epoch we are accustomed to define by the privileges of Reason. The act which, by tracing the locus of confinement, conferred upon it its power of segregation and provided a new homeland for madness, though it may be coherent and concerted, is not simple. It organizes into a complex unity a new sensibility to poverty and to the duties of assistance, new forms of reaction to the economic problems of unemployment and idleness, a new ethic of work, and also the dream of a city where moral obligation was joined to civil law, within the authoritarian forms of constraint. Obscurely, these themes are present during the construction of the cities of confinement and their organization. They give a meaning to this ritual, and explain in part the mode in which madness was perceived, and experienced, by the classical age.

That, like a lot of Michel’s writing, is a dense paragraph, but it well summarizes the ideological forces at work as the “new insane” were defined and then confined in practical “cities” of incarceration. No longer just the motley fools and village idiots of their pastoral precedents, these new lunatics would include the poor, the unemployed, the shiftless -- any and all who would be perceived as failing to properly embrace the spirit of the new age and, because of the moral force given to civilization and its gatekeepers, they, like the lepers before them, could be seen as being very properly punished for their sins of accident, ineptitude, and opposition.

If there is, in classical madness, something which refers elsewhere, and to other things, it is no longer because the madman comes from the world of the irrational and bears its stigmata; rather, it is because he crosses the frontiers of bourgeois order of his own accord, and alienates himself outside the sacred limits of its ethic.

In fact, the relation between the practice of confinement and the insistence on work is not defined by economic conditions; far from it. A moral perception sustains and animates it. When the Board of Trade published its report on the poor in which it proposed the means “to render them useful to the public,” it was made quite clear that the origin of poverty was neither scarcity of commodities nor unemployment, but “the weakening of discipline and the relaxation of morals.”

In this, it seems, we see the beginnings of one of the great moral canards of not just this civilization but ours as well: that the poor are not just morally deficient, but that they are poor because of their moral deficiency, and that we, their moral superiors, are morally justified in making them pay for their “sins.”

The edict of 1657, too, was full of moral denunciations and strange threats. “The libertinage of beggars has risen to excess because of an unfortunate tolerance of crimes of all sorts, which attract the curse of God upon the State when they remain unpunished.” This “libertinage” is not the kind that can be defined in relation to the great law of work, but a moral libertinage: “Experience having taught those persons who are employed in charitable occupations that many among them of either sex live together without marriage, that many of their children are unbaptized, and that almost all of them live in ignorance of religion, disdaining the sacraments, and continually practicing all sorts of vice.”

In 1657 in France the power to regulate these moral infractions was given to the “Hôpital Général” -- a new kind of institution that saw to the infirmities of both the body and the soul.

Hence the Hôpital does not have the appearance of a mere refuge for those whom age, infirmity, or sickness keep from working; it will have not only the aspect of a forced labor camp, but also that of a moral institution responsible for punishing, for correcting a certain moral “abeyance” which does not merit the tribunal of men, but cannot be corrected by the severity of penance alone. The Hôpital Général has an ethical status. It is this moral charge which invests its directors, and they are granted every judicial apparatus and means of repression: “They have power of authority, of direction, of administration and punishment”; and to accomplish this task “stakes, irons, prisons, and dungeons” are put at their disposal.

This is all leading somewhere. In Foucault’s estimation, this power to both define the cage and to place people within it is about more than just an expansion of our collective understanding of who is and is not insane. His chapter on this subject is called “The Great Confinement,” referring to the thousands who suddenly found themselves behind bars, but it could just as easily have been called “The Great Conflation,” since in this time two separate forces appeared to have been conflated together in a way not previously seen.

Thus we see inscribed in the institutions of absolute monarchy -- in the very ones that long remained the symbol of its arbitrary power -- the great bourgeois, and soon republican, idea that virtue, too, is an affair of state, that decrees can be published to make it flourish, that an authority can be established to make sure it is respected. The walls of confinement actually enclose the negative of that moral city of which the bourgeois conscience began to dream in the seventeenth century; a moral city for those who sought, from the start, to avoid it, a city where right reigns only by virtue of a force without appeal -- a sort of sovereignty of good, in which intimidation alone prevails and the only recompense of virtue (to this degree its own reward) is to escape punishment. In the shadows of the bourgeois city is born this strange republic of the good which is imposed by force on all those suspected of belonging to evil. This is the underside of the bourgeoisie’s great dream and great preoccupation in the classical age: the laws of the State and the laws of the heart at last identical.

This, indeed, may be Foucault’s second big idea in this short work. What we call madness and who we identify as madmen is ideology, yes, but the effect of that ideology in our age is to conflate the State with the “moral city,” and those who transgress one are, by definition, transgressing the other.

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This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.