Generational Challenges

We know how to combat Ebola effectively as the Firestone Plantation demonstrates. But, in its drive to multiply Ebola has an ally in our decaying culture and its abandonment of personal responsibility and imposition of penalties for violating cultural norms. Not all such actions result in the spread of the disease but the spread depends on a sufficient number of such actions. The question we should be asking is where we will find the will to properly combat this disease.

Let’s start with Patient Zero. He knew he had been exposed to Ebola and I strongly suspect he came to America to obtain the best care he could. Can’t blame him for that at all. I’d spend $3,400 to survive. However, he does not appear to be one of the Liberian 1 percenters, so the question arises, where did he get the sum, which must be an enormous expenditure to one of the 99 percent in a country whose average annual income is $450? Somebody else probably paid to bring him into the country illegally to gain access to our medical system. Who was it? Is anybody investigating to find out? Would any action be taken if we knew whom it was? We all know how unlikely that is. So the person or persons who have paid to import Ebola into the US will not be held accountable.

And Patient Zero was not held accountable by society for his action in deceitfully spreading the disease. He was wanted in Liberia for lying on his exit papers. We could have put him in a Hazmat suit and flown him back to Liberia to face charges. Instead we gave him an entire floor of a major metropolitan hospital. And I doubt he had insurance.

Then there’s Dr. (and I use the title advisedly) Nancy Snyderman. She goes to Liberia with her news crew and returns when one of them is infected with the disease. She agrees to a voluntary quarantine that she soon violates to go get takeout from her local restaurant. If I were in her shoes, the last place I would be is in a confined car with friends in public. I’d find a place to stay, away from my family, alone for three weeks, and eat take out delivered to my door step. But Nancy doesn’t need to do that. She can take the chance that she is exposing the nation to this virus to satisfy her culinary cravings. And what sanctions does she face? A State order of mandatory quarantine and a public apology. No doubt she’ll be back on the air at the end of the 21 days pontificating on the disease she might have spread.

Nurse 2 finds she has a fever. She calls the CDC to get permission to do what she suspects she shouldn’t. And she gets it! Just so she can go home on an airplane potentially exposing hundreds to the disease. Do you want someone who exercises this kind of judgment making literal life and death decisions for you? And who gave her permission to fly? Why is that person still employed at the CDC? Do they not take this outbreak seriously?

Finally there is Dr. Frieden. Clearly his agency failed to prepare the nation’s health care system to deal with this crisis. And now his risible statements about the situation are making him the Baghdad Bob of Ebola. He has become ineffective as a public leader and his continued presence serves to increase panic, not inspire confidence. But he continues in office.

These are all individuals making decisions that they think are in their best interest. And because they anticipate no penalty for violating societal norms.

This prevalence of irresponsibility did not happen overnight. For 80 years we have been creating a culture where the few do not have to bear the burden for their actions or chance events. Instead the burden is spread lightly on the many so that the few can have security. This can work as long as the few are few and the security is provided mainly for chance events. But as more of the few are protected from their actions and more become members of the few, the system creates moral hazard and a resulting decline of personal responsibility. As we have become rich and secure we have become more compassionate, a luxury we can afford as we can do so with other people’s money.

Strauss & Howe posit that each Civic generation must overcome a challenge that threatens the very existence of the nation. Having overcome the challenge, the generation is revered for its courage. However, the Civics are led to success by a Prophetic generation that makes the decisions upon which success depends. Though the Greatest Generation did the fighting and dying in World War II, it was the Missionary Generation that made the decisions to defeat Germany first, demand unconditional surrender, and totally mobilize the economy in support of the war effort. These were not easy decisions and different decisions could have been made with much different costs and consequences.

I have often wondered what challenge my Millennial children, a Civic generation, would face. War in the Middle East is nasty, but ultimately a nuisance, not an existential threat. War with China seems unlikely and would be accidental and tragic like World War I, not existential like World War II. Ebola may be their challenge. And I fear for the leadership they will receive from their Boomer elders. Having lived as a compassionate culture that increasingly prefers not to hold individuals accountable for the actions Boomers may not have the strength to make the unpleasant decisions necessary to defeat Ebola. That seems to be the case so far. Both at the bottom, where individuals make decisions without consideration for their wider effects and at the top where the leaders a majority of us elect behave similarly. Ebola will not be defeated by compassion and selfishness. Perhaps Ebola will be the existential threat the Millenials must overcome. Will the Boomers provide the leadership?

14 thoughts on “Generational Challenges”

  1. This is an era of magical thinking. We see simple applications like “New Age” medicine and psychology. We see less benign manifestations like the vaccine avoidance that is typical of the well off, not the poor. Santa Monica, a wealthy coastal enclave of Los Angeles has a large proportion of school children that have not been vaccinated against childhood diseases that my generation endured.

    They found that vaccination rates in elite neighborhoods like Santa Monica and Beverly Hills have tanked, and the incidence of whooping cough there has skyrocketed.

    Here’s a map of the schools with dangerously low vaccination rates (an interactive version is on their site). Note how the schools cluster together as little red dots all over the wealthy, crazy Westside—not unlike crimson spots on a measles patient:

    This is typical of the same group that has adopted “Global Warming” and accuses skeptics of being “against science.”

    Now, we see such thinking (to be generous) in play in governing. Flights from Africa cannot be stopped because Obama’s support in Africa is lower than that of George Bush. No matter the risk and the readership of the New York Times agrees. Those are residents of a city plagued with bed bugs that used to be treated with DDT, a chemical that cannot be used. Millions die in Africa of malaria because rich Americans worry about mythological risks to pelican eggs.

    Can reality intrude in this warm feelings generation ? I wonder.

  2. “I have often wondered what challenge my Millennial children, a Civic generation, would face”

    It looks like it’s going to be World War Z

  3. It depends how truly they take to heart the dictum “Better dead than rude”. I think we may be shocked to learn how many will choose death over choices that offend the sensibilities they have believed in for their entire lives, fantasy though they may be. Or choose death over acknowledging that someone who maybe once said something favorable about Sarah Palin could ever possibly be correct about anything on planet earth.

    Because deep in their hearts, they know “dead” will always be referring to the other guy. Such things as these could never penetrate their own precious little world.

    Until they do. Then the vacant-eyed Obama-shirt wearing Millenials will finally give up the fantasy and literally get real.

    And it will be too late.

  4. Where is the US Public Health Service? I may be misinformed but I’m not sure CDC has the authority for the field implementation of border control. A few years ago I was on a flight from Zurich to Newark with a group of Somalis being generously relocated to Minnesota (another story). It was winter back in the SARS era and a young Somali boy got sniffles on the flight. When we landed we could not get off the plane while a team of EMT’s and a Public Health Service physician (she was in full PHS naval uniform) came on board. 30 minutes later they concluded the boy just had a cold. While I was slightly inconvenienced, it was at least reassuring that this was taken seriously.

    Every port of entry has a USPHS presence for contagion control so why isn’t the Surgeon General on TV (oops I just checked and see we only have an Acting Surgeon General and assistant surgeon general since 2013!).

    A few uniformed physicians controlling entry to potential disease carrying visitors would help public morale.

  5. Barry is no doubt going to nominate Frieden as Surgeon General after the midterms based on his masterful handling of the CDC as witnessed by the Ebola strategy. Using health policy for redistribution of disease is just a part of social justice.


  6. In Strauss and Howe terms, the magical thinking about health and vaccinations comes from the next generation up – Gen X nomads. I know because I see them all the time. They don’t trust institutions or collective solutions like herd immunity.

    I think the Millennials will need to watch out for too much trust in the institutions that are clearly dysfunctional and are currently hellbent on sacrificing them for political correctness.
    They’re more likely to go in the opposite direction and rush in where angels fear to tread in some latter day Somme Offensive against something that we’ve had no collective experience against for generations.
    I was doubting the efficacy of the Saeculum Theory recently because of the apparent lower intensity of potential crises, but now I see how these things are working out. It never comes from where you expect it, otherwise it wouldn’t be a crisis.

  7. Welcome Mrs. Davis. I am glad you sort of tossed the boomers under the bus, and I believe that many of them will be shown the door for not only poor talent, but terrible policy (note, this is not to say that all boomers are bad). I also think that Gen X will have to put forward some people to help move the country forward and that they will do so. The Millenials will deal with that group of leaders much better than the boomers. And they will have to for the short term.

  8. “a compassionate culture”: too kind, Mrs D, altogether too kind. It’s a culture that affects compassion, which is not at all the same thing. I commend to you the treatment meted out to Admiral Byng: “He was court-martialled and found guilty of failing to “do his utmost” … sentenced to death, and shot by firing squad on 14 March 1757.”

    Treating a few bureaucrats thus would constitute a true show of compassion for the poor sods who are otherwise going to perish in this outbreak.

  9. I was reading about a large desalinization plant that has finally been approved to be built near San Diego that will supply drinking water to people in southern California. It took eight years to get through the permits and fight and win 14 lawsuits from environmental groups that intended to stop construction.

    I also watched a small video someone made driving across an area in Utah called the San Rafeal Swell, an uplifted then eroded landscape feature of amazing beauty (if you like that sort of thing). I couldn’t help but think that if anyone proposed putting a interstate though that area today the enviros would have an apoplectic meltdown. Instead, millions of people get to experience, at least in passing, something they would not otherwise ever get to see.

    I’ve also been thinking about Hoover and Glen Canyon and Grand Coulee dams, the amount of water they capture, the clean power they provide, the recreational benefits they provide, even the tourist dollars they bring into those areas. Those dams opened large swaths of otherwise uninhabitable country. We called that progress once upon a time. That is no longer the correct view, so we are told by many.

    We are drowning in red tape and regulations designed, not for the common good, but to appease a special interest group in return for their votes, or to reward a lobby in return for their cash payments. Everything is open to be stalled or stopped by a lawsuit, often with the active collusion of tax-funded government agencies like the EPA. Laws and regulations are churned out by the basket-full by unelected bureaucrats running agencies funded by autopilot and answerable to essentially no one. We can’t get anything done anymore. We can only get the smallest things done by great effort.

    If the Millennials have a challenge, it is untangling the ball of twine we’ve so wrapped ourselves in that we are unable to move.

  10. “It took eight years to get through the permits and fight and win 14 lawsuits from environmental groups that intended to stop construction.”

    The California bullet train to nowhere is, however, on track, so to speak, in spite of the fact that the ballot measure required things that have not been done.

    Kings County and two landowners filed an appeal last month challenging an appellate court decision in July that concluded that the authority basically met the requirements of a successful 2008 ballot proposition approving $9 billion in bonds for the project.

    The measure required rail officials to identify all funding and obtain all environmental clearances for the first segment before the bonds could be sold. Earlier, Sacramento County Superior Court Judge Michael Kenny concluded that neither provision had been met.

    It’s OK because you can trust Jerry Brown to do the best for the voters.

  11. A war with China will be an hegemonic war, one of the big, damaging types, like WWI/II. Obama seems to be setting us up to fail, intentionally or not.

    They have the ambition and the sense of entitlement.

  12. “Nurse 2 finds she has a fever. She calls the CDC to get permission to do what she suspects she shouldn’t. And she gets it! Just so she can go home on an airplane potentially exposing hundreds to the disease. Do you want someone who exercises this kind of judgment making literal life and death decisions for you?”

    Actually I can only fault that nurse for being insufficiently cynical about the competence of the CDC, and that’s not a *good* thing but it’s not a major disqualification for making basic medical decisions for me.

    There are *enormous* variations in contagiousness in diseases, with plenty of things that are dangerous in some ways but not others. And there are lots of weird niche diseases (especially in the tropics, even more especially in Africa) and just being a generalist biological or health professional doesn’t mean you should personally know about them beforehand. I knew a doctor who trained and practiced in the Philippines before coming to the US, and he could talk at length about diseases of the tropics and sometimes-understandable mistakes that US doctors make when they’re not prepped to recognize them: common sense and generalist knowledge only gets you so far when dealing with the microorganism menagerie and its interactions with the human immune system.

    I have a biology degree, and did some lab work in a building where there were lab monkeys, so I got the basic safety warning about Herpes B, which is a risk from monkey bites and can be horribly bad for a human that gets it. I fully appreciate that that Herpes B is very bad, but still I wouldn’t much worry much about being in the same plane flight as a person who might have contracted it. And there are plenty of diseases much further down the contagion scale, like some of the ones whose lifecycle runs through another organism (one family of mosquito, e.g.) that might not even be present on the same continent. Moreover, just the fact that a disease is so rare in the US that the nurse never dealt with it is strong circumstantial evidence that a disease is one of the diseases that is low on the contagion scale under US conditions, so the nonspecialist professional is naturally predisposed to not worry about it too much unless it’s one of the diseases that specialists specifically freak out about. In this case the “strong circumstantial evidence” rule does fail (though only somewhat: not-very-sick-yet Ebola patients seem to be slightly but really not very contagious, so disease hotspots are places like hospitals and funerals, not places like cafes and buses) but the fallback “so check with a specialist” rule is important, but the main problem is that she got blindsided by the CDC, not that she didn’t do a creditable job of following the rule.

    So: I think it’s entirely normal and professional to check with a competent specialist and then follow what the specialist says, and the nurse’s error was the previously widespread and fairly excusable error of believing that “checking with the CDC” and “checking with a competent specialist” had much to do with each other.

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