I speak of obsessive-compulsive disorder (OCD), and springing, as I do, from a long line of hand-washers, list-makers, and stove checkers, I consider myself eminently qualified to make the diagnosis—despite my lack of Board Certification in Psychiatry, Participation in Recognized Psychiatric Quality Improvement Activities, Demonstrations of Continued Competence in Psychiatry, Letters of Recommendation from Peers in the psychiatric field, a satisfactory score on a Certifying Examination in Psychiatric Diagnosis, completion of Physician Self-evaluations or Practice Assessments, or
documentation of Psychiatric Patient Satisfaction Surveys.
After all, I do make up for it in Home Study.
Indeed, I began the study of this fascinating but insidiously deadly disorder as a child, when I observed male members of the immediate and extended family not only compiling lists of people’s birthdays—harmless enough, even useful—but also dates on which light bulbs had been changed, and other small mechanical tasks completed. On two occasions, female members of the family perceived a deficit in their stove-checking, and insisted, once by phone from 12 miles out at sea, on having the fire department check.
A friend of mine who is a former administrative law judge informs me that the obsessive-compulsive characteristic of saving newspapers is the most common problem cited by people who put their relatives into institutions.
Currently, our national obsessive-compulsive neurosis takes the form of an urgent quest for total cleanliness, absolute safety, and complete uniformity and conformity, usually to government directives that seek to force people to “comply” with rules and regulations covering ever more minute areas of life.
Recently, upon encountering efforts to make us “safer” in the United States, I have pondered such things as this warning on a child’s Halloween “Batman” costume: “Warning: Cape does not enable user to fly.” On a college campus, “Warning: Unpaved pathways may contain ruts, obstacles or ice.” Multiple warnings on ladders. All these, I suppose, are from the sage, widely respected luminaries in Congress to the idiots who populate the remainder of the nation. True, it is also an obsessive retreat from militaristic lawyers; but I note that it is a retreat, rather than a defense.
On the other side of the coin, I read in the that some place in Germany performed an experiment to cut down on road sign clutter; they eliminated all road signs, and found that the number of accidents went down. I theorize that this occurred because it made drivers rely more on being watchful themselves, Wall Street Journal than rather counting on road signs to substitute for their own senses and judgment, and that the sheer number of commands on the signs distracted drivers. I would cite the article, but with all the newspapers around here, I cannot find it.
On contemplating the journey of Lewis and Clark from St.Louis to the Pacific Northwest in 1800, it has been a puzzle to me how they did it without the Occupational Safety and Health Administration (OSHA) to tell them that their boat was designed for several fewer people than crossed various rivers in it, and that without personal flotation devices, they were subject to fines and impoundment; that Seaman, Lewis’s Newfoundland dog, was not up to date on his rabies shots; that the guns should have trigger locks on them; and Sacajawea’s newborn baby would have to be given its hepatitis B shot forthwith, or the expedition would not be allowed to proceed.
A.J. Liebling, the correspondent for who covered World War II, reported the American soldiers’ ingenuity and initiative when they encountered the famed hedges of Normandy, planted on berms, which exposed their tanks’ undersides as they attempted to punch through in pursuit of the Germans. The soldiers went down to the beaches, cut up the hideous Belgian gates the Germans had fruitlessly used to fortify the beaches, and attached them to the tanks, so that they could slice right through the hedges, berm and all. Likewise, he described what he termed the “lordly Negroes” who, understanding that the jeeps full of soldiers racing alongside their quartermaster corps trucks on the way to Paris would need food, simply took the initiative: They made the decision on their own to distribute the provisions in the most efficient way, by tossing boxes of food expertly into the jeeps as they passed by.
Contrast those stories with the accounts of those who raced to the assistance of fellow Americans after hurricane . Trucks full of supplies were turned away because government functionaries wanted to control every aspect of the situation. Refugees from the hurricane in University City, Missouri, were harassed because they did not have an “occupancy permit” for the house in which they were sheltered, which the government considered to be not big enough for the number of people in it. Policemen in New Orleans went from house to house, illegally confiscating guns, leaving citizens defenseless, even as other New Orleans policemen went AWOL.
True leaders inspire by example. George Washington developed great self-control, worked industriously, and stayed with his troops. He did not, from a distance, simply tell others what to do.We now have a woman running for President who says she has a vision for America. Well, I have a vision for myself, and it does not include having her obsessions foisted on me. The other 299,999,999 or so of us also have our own visions of our own America.
The candidate says that says she has a lot of plans for America, but the country cannot afford them all. She is quite right about that. We cannot afford to have any of them foisted on us. She says she has a national “Health Care” plan, and that we will all be forced to subscribe to it, whether we want to or not. There will be an “enforcement mechanism,” she concedes. However, medical care is not a proper function of government. Citizens should not be wards of the state, whether voluntarily or not. She does not own us. We are not stock on her ranch, and our nation is not her ranch. On a narrower but still nationwide matter, the Federation of State Medical Boards (FSMB) frets and fusses about ways to make certain, by expanding their revenue stream and usurping power, that physicians “retain skills throughout their careers.” I have a good idea: Harass the physicians enough, and they will give up their careers in medicine before their skills atrophy, or before they even fully develop. Maybe even before they enter medical school, they will think better of a decision to subject themselves to the nagging of the FSMB and all the state apparatchiks, and a life of frustration and annoyance.
FSMB members seem to imagine that physicians, who have demonstrated drive, initiative, industry, and responsibility through a very rigorous educational process, will become deadheads without their nagging. They want “self-evaluation,” and “practice assessment,” letters of recommendation, patient satisfaction surveys, home study courses, some demonstration of “continued competence” in patient care and medical knowledge, more exams. This seems reminiscent of the attempts to ensure loyalty in the old Soviet Union: a vast bureaucracy dedicated to busywork, to enchaining the creativity and energy of professionals, and distracting them from their work.
The FSMB claims to be responding to “a greater public demand for physician accountability” and a call for “greater attention to patient safety.” This is a manifestation, once again, of obsessive compulsive neurosis. Americans have the best medical care in the world. They live in a safety unheard of until very recent times. They themselves also must take responsibility for their own safety.
Of course, we can expect the criticism that “You’re against safety!?” “You don’t think safety is a good thing!?” That is a logical fallacy. It is just that the pursuit of safety above all else will not be worth any marginal benefit, because it is destroying freedom. The freedom to learn, invent, attempt, and investigate, free of the nagging restraints of tyrannical regimes, has made our nation the leader in world medicine just 232 years after our founding Europe sneered at us as rubes, but we have left them far behind, and we did it without the FSMB, or the nagging interference of government, which is a more recent phenomenon.
Our earlier freedom still yields dividends, but it may be the dividend that the waning western light of day still yields those working in the late afternoon. There is no guarantee that the Gulliver of our nation’s energetic and inventive people will survive being fettered by government Lilliputians’ niggling, wearying, degrading rules and regulations, hedges, and leashes not fit for fourth graders. We have “followed after knowledge and excellence.”1 We are not slaves, or commodities, even though we and our care and services are taken for granted, as a given to which all are entitled.