Front List / Back List: Readings To Affirm The Health Care Bill

Unless you live under a rock or own an XBox 360 the news that a health care bill has passed both houses has reached you. We, in the US, have a form of public health care available to us, as in all of us. All that remains is a final vote by the Senate to affirm the changes made to the original legislation as it scraped its way through the House. Even if these changes are defeated the bill in some shape or another will land on the desk of Barack Obama and await what will be possibly his most lasting signature.

At least to date... No telling what will be next.

Despite the fact that many progressives find the bill too weak and many conservatives find it, well, too hard on their lobbyists, the bill is still a landmark for the people of the United States. The freedom to chose between public and private is something that cannot be underestimated. It will now be possible to change jobs, start businesses or continue education without fear of losing health insurance.

The middle class, lower middle class and impoverished American will obviously benefit most. Those that have loved ones with dire illness an no insurance will no longer have to equate the hospital or doctor's office with bankruptcy court and those that have pre-existing conditions will no longer be unable to find an insurer. Uncle Sam will have their backs, so to speak.

So it is with this in mind that I wanted to do a special "all Back List" post and call forth a trio of short stories dealing with medical woes, the first of which should just about sum up why the bill passed last night is of utmost importance.

And demonstrate how long a time it's been coming.

All three stories should affirm in some small way the great progress made over the last year, which culminated late Sunday night. March 21st, 2010. Wonder how long the Texas State Board of Education can avoid including that day in history books.

Shall we begin? Welty, Xun and Kafka. In that order.

For the record, you can read all three of these short stories in less than two hours. The three add up to less than thirty pages.


A Worn Path by Eudora Welty. Published in the Atlantic Monthly in 1940. Best Available Format: The Collected Stories of Eudora Welty. Mariner Books. Trade Paperback. ISBN: 9780156189217.

"Throat never heals, does it?" said the nurse, speaking in a loud, sure voice to old Phoenix. By now she had a card with something written on it, a little list. "Yes. Swallowed lyse. When was it? - January - two, three years ago-"

Phoenix spoke unasked now. "No, missy, he not dead, he just the same. Every little while his throat begin to close up again, and he not able to swallow. He not get his breath. He not able to help himself. So the time come around, and I go on another trip for the soothing medicine."

"All right. The doctor said as long as you came to get it, you could have it," said the nurse. "But it's an obstinate case."

Obstinate case = Pre-existing condition?

The paragraph that follows the one above is among the most tender in literature. Phoenix Jackson, an ancient black woman who has lived through slavery and its uncertain aftermath, has a charge. Her grandson drank lye three years ago and now his throat will never heal properly and on occasion it begins to close up with fatal implication. The medicine required to save her grandson is found in a distant town, which requires old Pheonix to walk miles through swamps, woods and in the case of A Worn Path, all during a frigid December.

The story is a masterpiece. I love understated fiction, where exposition is achieved through implication, and perhaps there is no better story where this is achieved. A Worn Path story is taught in schools from grade school to college and is considered a "classic" of the form. It has been compared to the Odyssey because of its narrative device of repetitive journey then encounter, not to mention the wily, not altogether honest nature of Phoenix Jackson, which parallels nicely with that famously devious Greek.

The implications of the story, which play out in their most extreme during the moment when Phoenix arrives at the doctor's office, are what interest me most in the case of this post. The above quote comes after Phoenix fails to answer the nurse why she's there. Phoenix can't remember. She is extremely old and has just journeyed miles through a frigid wilderness, even falling in a ditch at one point. She sits there in the doctor's office, impossibly trying to remember her grandson and the medicine.

Phoenix cannot afford the medicine to begin with, and as hinted at in the selection, the arrangement between her and the doctor is a finite one. As long as she comes to get the medicine he will give it to her as charity, which Welty is careful to emphasize by including the nurse "writing off" the medicine in a ledger.

It does not explicitly end in tragedy, but you have to wonder about the small child, reliant on a remarkable but flagging grandmother to obtain life-saving medicine. There are no other family members and the trip will not get easier for old Phoenix. Let alone the fact that the doctor's arrangement ends when Phoenix dies.

Maybe Obama should have worked some Welty into his town hall meetings.


Medicine by Lu Xun. Written in 1919. Best Available Format: Selected Stories Of Lu Hsun. Trade paperback. ISBN: 9780393008487. NOTE: Quotes are taken from the Yang Xianyi and Gladys Wang translation made for the Foreign Language Press in Beijing.

Old Shuan looked in that direction too, but could only see people's backs. Craning their necks as far as they would go, they looked like so many ducks, held and lifted by some invisible hand. For a moment all was still; then a sound was heard, and a stir swept through the onlookers. There was a rumble as they pushed back, sweeping past Old Shuan and nearly knocking him down.

"Hey! Give me the cash, and I'll give you the goods!" A man clad entirely in black stood before him, his eyes like daggers, making Old Shuan shrink to half his normal size. This man was thrusting one huge extended hand towards him, while in the other he had a roll of steamed bread, from which crimson drops were dripping to the ground.

Medicine is sometimes compared to Eudora Welty's A Worn Path and there certainly are some major themes shared by the two stories.

In Xun's tale it is an old man who has saved all his money in order to make a trip to a folk medicine practitioner and purchase a cure for his son's terminal case of tuberculosis. The common theme is of course the selfless sacrifice made by a parent for their child.

The settings are obviously different, as Xun's tale takes place in pre-revolutionary China and Welty's upon the shaky ground of post the Civil War American south. Lu Xun was a physician as well as a writer, not to mention anti-monarchist and revolutionary. While race is a subtext in Welty's tale, it is class and economic status that hovers in the background of Xun's.

Medicine is a grim tale that manages to engage many issues that concerned the China of Xun's time and probably, unfortunately, today's China as well. Superstition, bourgeois elitism and the iron fist of suppression inhabit the ten pages of this masterful story, not to mention the tender relationship of parent and child.

There is a scene in Medicine towards the middle of the story that I couldn't help but correlate to the barroom aspect of the healthcare debate. It has to do with a false surety of the greatness of a situation. Think of someone deriding foreign medical bureaucracies with a certainty that belies their lack of ever experiencing said institutions.

Mr. Kang, a bloated blowhard from the upper middle class, takes over the small tea house that the Shuan's earn a living from with his bombastic talk of a executed revolutionary and the sureness of the cure Old Shuan has bought for his son. Kang is completely certain the cure will work.

"A guaranteed cure!" Kang says over and over again in between proclamations about the insanity of the young man who was executed that day. Xun carefully installs a sense of futility in the reader that somehow goes beyond mere skepticism and disdain. Of course the cure won't work.

Steamed bread soaked in the fresh blood of a human being is not a cure for tuberculosis.


A Country Doctor by Franz Kafka. Written in 1919. Best Available Format: The Complete Short Stories by Franz Kafka. Schocken Books. Translated by Howard V. Hong and Edna H. Hong. Introduction by John Updike. Trade paperback. ISBN: 9780805210552.

I wanted to push open a window; but first I had to look at my patient. Gaunt, without any fever, not cold, not warm, with vacant eyes, without a shirt, the youngster heaved himself up from under the feather bedding, threw his arms around my neck, and whispered in my ear: “Dotor, let me die.”

Among Kafka’s more enigmatic offerings, A Country Doctor is essentially a fable of perceived versus actual confidence. What better profession to choose for such a parable than the doctor, whose practice concerns itself with our very well being.

The story opens with the old country doctor at a loss to procure a horse. His has just died and he must treat a gravely ill patient who lives far away. His servant girl is trying very hard to borrow a horse from someone in town and is unable to do so.

Enter the somewhat demonic force of action that seems to be ubiquitous in Kafka’s world. A groom, presumably unknown to the doctor or servant girl, climbs from a pigsty on the doctor’s property. The doctor had just kicked the door of the stall in a supreme act of futility. The groom meanwhile leads two heavily muscled horses, steaming with unnatural heat from the sty and into the courtyard. Before tending to the horses the groom savagely bites the servant girl on her cheek, clearly proving the young stable boy’s somewhat untoward intentions. Still, the doctor is unable to do anything and in short order finds himself climbing into the seat and preparing to set. It is to these horses that the doctor’s light gig is hitched and by these two tireless beasts his life is altered, or so claims the doctor.

Reality is a hard thing to gauge in a Kafka story. Sometimes the writer is very straightforward in his narrative and at other times he seems to purposefully leave out an important ellipsis that would have proven useful to the reader. In the case of A Country Doctor I believe it is a straightforward tale of, as I said before, the vantages of capability and requirements of competence.

The young boy who hugs the doctor seeks a merciful god and the boy’s family sees a competent and steadfast practitioner of the healing arts. The young servant girl sees a protector and provider and the doctor himself, well, he sees the contradictions. The groom sees a weak man waiting to be exploited.

While unable to admit his fallibility, the doctor yet blames himself and others for his current predicament, which is that of wanting to suddenly be back home and protecting the young girl from the groom’s lewd intentions. Yet at this same time, that inability to realize his limitations creates a problem for the boy and his family. His chief limitation is his inability to cure the boy’s infection and therefore his insistence that the wound where it dwells is not significant. In the end, the doctor has a complete mess before him. He owns now the loss of respect as a doctor because of his inability to cure the boy. Not to mention the loss of innocence because of his inability to protect the young girl and finally, loss of his viability as a person in society as his medical practice dries up.

Indeed.

Correlations anyone? Thankfully they’re more or less a part of the past now.