Tag Archives: lonliness

Analog and Chronic

Digital:Analog::Acute:Chronic (Digital is to analog as acute is to Chronic). If you get that analogy, you probably can already guess where I am going. If you don’t, I’m not sure what will follow will help. But, I like the sound of my own voice, and I’m trying to understand it myself, so here goes. Digital is 1’s and 0’s; there is nothing in between. The only thing that digital can do to fill in the spaces in between is increase the frequency. Analog is a continuous stream capturing all the fuzzy stuff in between. The easy things like 1/2 and the transcendental like .14159…(PI-3). Acute is a medical term meaning short lasting and either curable or quickly leading to death (or zero). Chronic is the other medical term meaning long-term ongoing. You don’t cure Chronic; you manage it. We live in a world that wishes to treat everything as digital or acute. Reality is analog and chronic.

Ezra Klein in a wonderful reported piece looks at a medicare experiment that worked. It both reduced cost and added quality of life. It is also being killed because it takes the world as it is.

…Health Quality Partners is all about going there. The program enrolls Medicare patients with at least one chronic illness and one hospitalization in the past year. It then sends a trained nurse to see them every week, or every month, whether they’re healthy or sick. It sounds simple and, in a way, it is. But simple things can be revolutionary.

Most care-management systems rely on nurses sitting in call centers, checking up on patients over the phone. That model has mostly been a failure. And while many health systems send a nurse regularly in the weeks or months after a serious hospitalization, few send one regularly to even seemingly healthy patients. This a radical redefinition of the health-care system’s role in the lives of the elderly. It redefines being old and chronically ill as a condition requiring professional medical management…

Graefe has been a nurse for 28 years. She has worked in cardiac wards and with patients in rehab. She has been in hospitals, in call centers, and now on home visits. “This is the best nursing I’ve ever done in my life,” she says. “And that’s because it’s really all about nursing.”…I asked a half-dozen seniors what difference Health Quality Partners made in their lives. Every one of them began the same way: They could ask their nurse questions, they said with evident relief. They could get help understanding and navigating their doctor’s orders. They didn’t feel like they were being a burden if they needed to ask one more thing, or have their medications explained to them again…

Coburn’s basic insight is a discomfiting one. He doesn’t really believe in “better,” at least not for elderly, chronically ill patients. He wants someone going over frequently to see if they’re depressed, if their color is good, if they understand their medications, if there’s anything they need. This isn’t medicine so much as it’s supervision.

At another time, these functions would have been filled by the family, who would be right in the other room, and who would know if their mother looked different than she had a few weeks ago. But few of today’s elderly live with their children. Many don’t even live in the same state, or they don’t have any contact with their children, or they don’t have children…

I quoted larger sections there because Mr. Klein has some great points, but ultimately his point is polishing the government system of healthcare. He is staring at the analog chronic and trying to produce acute answers (i.e. single payer is the only workable system that can push these things, which reduces the world to 1 = gov’t med care, 0 = leave). Please notice that what this experiment highlighted has done is reproduce some of the elements of a church: a “cleric” that visits, gentle encouragement of better action, explanation of basic doctrine in a safe place, and a place of contact that recognizes subtle analog changes like mood and color. The analog chronic problem is best captured in those last two paragraphs. “He doesn’t really believe in better”, and “these would have been filled by family”. Things that have or want to have a digital acute relationship with you (like the healthcare system) can improve, but still miss the point. What is missing is recognition that we are analog and chronic. We are built for long standing relationships, and we are tragically flawed creatures. Our society tells us lies on both accounts.

First polite society tells us that relationships, people, place are fungible and secondary. Got a better job offer a world away? Take it, you can always join something there. (Without telling you that “Oh, you won’t or won’t have time to do so” and “those long time bands just can’t be recreated”.) And second it tells you that you aren’t so bad and are always getting better. The reality is that we rarely change and then only when we die to ourselves and rise to something new. Those long-term relationships know all about your sharp points and love you anyway. Leaving the analog and chronic behind and joining the digital and acute world leaves us searching for those spaces in between. We long for that simple intimacy of an extended family and that transcendental place of love with wife or husband. But all the digital world can do is increase the frequency. One more bad relationship or hook-up. One more church hoping. One more job. One more gadget. High frequency, but still 1’s and 0’s, still chronic longing.

I keep being attracted to a specific group of writers because I think they capture this modern problem better than anyone else. And in a way it makes sense. At the epicenter of our modern replacements for the analog and chronic – sex and money/work – is the homosexual community. According to this next author my previous paragraph might stumble into a problem of “blaming society”, but that is not really what I’m after. Yes, society tells us certain things take priority. I disagree with those messages and think they are deeply wrong. But, the point is not to find a scapegoat and retreat. The point is to call Christians to make better choices. To understand when we choose: home, job, mate, church we are deciding things that will govern us, not the other way around. Christians should make better choices. But, back to the core point. This is Melinda Selmys on longing and chastity.

This frustration is caused by a lack of companionship and solidarity. All forms of chastity demand communion and community because chastity is the virtue that is ordered towards the communio personarum. The most common cause of sexual sin is isolation and loneliness. The sexual appetite is an urge to overcome isolation, to give and receive another person. A person who is fulfilled in their daily life through other forms of “knowing and being known” will find that chastity frees them to be generous and loving and to receive love and generosity without the clinging neediness of sex. The problem is that most people in the contemporary world are literally starving for human communion, and sex fills that need at least temporarily.

This is Wesley Hill on the order of primacy in those deep choices.

If I am a Christian, then I belong (like it or not) to the Body of Christ. By virtue of baptism, I am no longer “my own person”; in belonging to Christ, I also belong to the other members of his body, the church. And so, these days, I find myself less and less interested in asking where each gay Christian, myself included, “stands” on the question of the morality of gay sex. Instead, I want—even, or precisely, as an Anglican—to explore the question Eve Tushnet, a Roman Catholic, raised recently: is there a way to see my own convictions as somehow less important than the matter of my membership in the church of which I’m a part?

And this is Eve Tushnet reflecting on what I’ll call the paradoxical reality that we only grow beyond ourselves, we only truly connect, when we limit ourselves.

I have this hilariously conflicted relationship with authority, in which I simultaneously long for like real, awesome authority and yet rebel against and get cranky about the smaller everyday authorities which come into my life, like my teachers and the Man, man. Society! I’m right though. Chesterton said so! “Break the conventions, keep the Commandments.” The merely-human authorities are often pretty awful, abuse of power comes as no surprise etc etc, and yet without submission to authority our lives are only as big as our own minds can make them.

We all have a chronic problem, sin. We will have it as long as we are in this body. There is no acute care for sin. The only care for sin is analog. It’s this thing called the body of Christ that has a multitude of parts, or is drawn from every people, tribe, language and nation. That is the call of the church, to be the analog and chronic care for sinners.