The Human Odyssey

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Large Investment Groups Buy Nursing Homes and Care Declines

The New York Times examined more than 1200 nursing homes purchased by private investment groups in the past eight years, and discovered that, compared to national averages, these homes declined in care given, and scored lower in 12 of 14 indicators used to track ailments of long-term residents.  Homes owned by such investment firms as Warburg Pincus and the Carlyle Group (owners of Dunkin' Donuts), had greater than average incidences in residents of bedsores, easily preventable infections, and unecessary restraints in freedom and mobility.  Investment firms move in and take over unprofitable nursing homes, fire nursing staff and cut back on other resources, begin making money, and then may sell the homes at a big profit.  While this particular strategy benefits investors, it leaves many aged nursing home residents more vulnerable to a range of age-related risks including depression, loss of mobility, and loss of the ability to dress and feed themselves.  A big problem with investor-owned nursing homes is that they often legallly structure their ownership in such a way that it becomes difficult to sue them when residents become ill or die due to neglect.  Because they are privately owned, they are also immune to many of the local, state, and national regulations that apply to publicly owned nursing homes.  They are, therefore, able to function below the radar screens, and above the law.  According to the New York Times, nursing homes received $75 billion in 2006 from Medicare and Medicaid, making them a veritable cash cow for those investment groups that prey on them, cutting expenses, making huge profits, and leaving residents with sub-par living conditions.  To read the entire New York Times article, click here. 

The Afterlife: A Brain-Mind Puzzle

Is there life after death?  Most rational individuals would say no.  The brain creates consciousness, and when the brain dies, consciousness is annihilated.  Problem solved.  However, this quick dismissal of the afterlife may actually be somewhat irrational based upon what we know from the history of western philosophy.  This view of the brain-mind problem is based upon what I'd like to call the "sticks with heads" model of reality.  In this view, there is an objective universe within which exists a planet, earth, upon which walk human beings (sticks) who have brains (heads) that are conscious of this objective universe.  Sounds good so far?  Let's back up a bit to see what's wrong with this picture. The fundamental assumption of this model of reality is that there is an objective universe.  And yet, in the history of western philosophy, it has never been proven that there exists an objective world independent of human consciousness.  One of my favorite philosophers is George Berkeley (1687-1753) whose book Three Dialogues Between Hylas and Philonous, made a huge impression upon me when I read it in high school.  In the book, Berkeley demolishes the idea that there can be an objective universe beyond our awareness (except in the mind of God).  According to Berkeley, we are only aware of our sensations of so-called objective phenomena.  If we eat an apple, we are aware of the taste, the smell, the textures, the shape and color.  But these are all subjective sensations.  If you take away these aspects of personal consciousness, what are you left with?  Nothing.  This, by the way, is something that the Buddha was acutely conscious of, which is why he said that at the heart of all things there is nothing, the void.  The Scottish philosopher David Hume (1711-1776)  was the next philosopher to demolish the idea of a stable rational world.  He argued, for example, that the notion of cause and effect was spurious.  We only infer that event x causes event y, because we have previously experienced cases where events like x were always followed by events like y.  And yet, according to Hume, there is no reason in the world why the next time event x happens, event z or q or s won't be the result.  It was this conundrum that Immanuel Kant (1724-1804) said "woke me up from my dogmatic slumber," and caused him to rush to the aid of the objective (or transcendental) world with his Critique of Pure Reason.  The amazing thing is that while Kant gave us some reason for hope (e.g. his transcendental categories of reason), he basically said that we CANNOT know the objective world (which he called noumena, or "things-in-themselves.").  This was about as far as western philosophy ever made it in terms of trying to prove the existence of the objective world.  After this there were the German idealists, who made quite a mess of Kant's philosophy, and the British positivists, who tried to show that only certain kinds of sentences had any objective meaning, and the American pragmatists, who didn't care whether there was an objective world or not just as long as there was some sort of cash value in whatever one believed, and a few other schools of thought.  But nobody ever proved the existence of the objective world -- that is, the world that exists apart from man's consciousness of it.  This means that the "sticks with heads" model of reality isn't really valid.  And if this is so, then the argument for dismissing life after death (e.g. annihilation of the brain destroys consciousness) is not valid either.  Notice that I'm using reason here, not wild New Age speculation. 

Appeals Court Rejects Patients Right To Take Potentially Life-Saving Drugs

Last week, a federal appeals court ruled that patients who have terminal illnesses do not have a constitutional right to take drugs that have not completed the labyrinthine approval process that is regulated by the Food and Drug Administration.  This holds even if the patient can no longer be helped by any FDA-approved drugs, and even if the patient's doctor believes that the experimental drug(s) may help the patient live.  This case pitted the needs of dying patients against the need for safe drugs.  In this case, the dying patients lost.  The Food and Drug Administration has taken hits from both sides of the aisle; those who criticize it for releasing unsafe drugs on the market, and now, those who chastise it for not making life-saving drugs available to those who have no other hope left.  It seems to me that there should be a special process through which people with catastrophic illnesses can apply for special use of an experimental drug when it is being recommended by their physicians.  Does the constitution give us a right to live?  I hope so!  Read about this issue in The New York Times. 

Death & Dying: Famous Last Words

"Open the second shutter so that more light may come in."  (Johann Wolfgang von Goethe - 1749-1832)

"Only one man understood me.  And he really didn't understand me."  (Georg Wilhelm Hegel - 1770-1831)

"Go on, get out!  Last words are for fools that haven't said enough." (Karl Marx - 1818-1883)

"Wait 'til I have finished my problem!" (Archimedes - 298-212 B.C.E.)

"Curtain!  Fast music! Lights!  Ready for the last finale! Great!  The show looks good. The show looks good."  Florenz Zigfield - 1869-1932)

"How were the circus receipts in Madison Square Garden?" (P.T. Barnum - 1810-1891)

"Bring down the curtain, the farce is played out."  Francois Rabelais (1494?-1553)

"I have offended God and mankind because my work did not reach the quality it should have." (Leonardo da Vinci - 1452-1519)

"Everybody has got to die, but I have always believed an exception would be made in my case.  Now what?"  (William Saroyan - 1908-1981)

"Either that wallpaper goes or I do."  (Oscar Wilde - 1854-1900)

Maps of the Human Life Cycle: Tibetan Buddhism

In the tradition of Tibetan Buddhism, the human life cycle is just that:  a cycle.  An individual soul is born, dies, and is reborn over and over again until it achieves liberation from all future rebirth.  At that point the cycle ends.  Until then, however, the cycle consists of six bardos or "transitional states."  The first three bardos occur "between" lifetimes (from the moment of death until the time of rebirth).  The Bardo Thodol (The Tibetan Book of the Dead) is essentially a guidebook to help the dying individual achieve liberation (or a favorable birth) as it moves through these "in between" states. The last three bardos occur after we have been reborn and are living as human beings on earth.

• The Chi-Kha Bardo - this state occurs at the moment of death, when the dying person has the potential to perceive The Clear Light of Ultimate Reality, and recognize it as his own ultimate being.  If the soul does this, it merges with the light and no longer has to be reborn.  This encounter, however, is quite an overwhelming experience, to put it mildly, and the individual may shrink back from this Light in fear.   If it does so, then the weight of its own karma will pull it into the next bardo.
• The Chhos-Nyid Bardo - this part of the journey is where the soul encounters "Peaceful Deities" and "Wrathful Deities," which are outer projections of its karma, or past experiences over innumerable rebirths.  The soul is counselled not to become attracted or repulsed by these deities, but to regard them as emanations of its own illusory self.  If the soul can do this, it achieves liberation.  However, if the soul ends up getting "caught" by one of these entities, it may end up hanging out in one of six possible "lokas" or "worlds," including those of the hungry ghosts, the warrior demons, the devas (or angels), the hell dwellers, the bestial world of animals, or back into the world of human beings (see next bardo).
• The Sid-Pa Bardo - this is the state where the soul, driven by the winds of its own karma, begins to seek rebirth.  It encounters the Lord of Death, who subjects the soul to a kind of "Judgment Day" that can be quite a painful ordeal.  Eventually it observes pairs of couples copulating (potential future parents), and goes through a kind of pre-birth Oedipal complex where it feels anger toward the same sex parent and lust toward the opposite sex parent.  Since there is no chance for liberation at this point, the soul is counselled to choose a "womb" that will optimize its chances of getting a favorable incarnation for future attempts at freedom from rebirth.
• The Skyes-Nas Bardo ("Life" ) - this is the bardo of ordinary waking consciousness experienced by a soul during its incarnation as a human being.
• The Rmi-Lam Bardo ("Dream") - this is the bardo of dream consciousness that occurs when we are experiencing rapid eye movement (REM) during sleep, or when we are in a semi-waking state of active imagination during our waking hours.
• The Bsam-Gtan Bardo ("Meditation") - this is the bardo of "trance consciousness" when we are in a deep state of meditation during our waking hours.

For more information, there are any number of translations of The Tibetan Book of the Dead, including those by:

Gyurme Dorje

Robert Thurman

Frencesca Fremantle and Chogyam Trungpa

W.Y. Evans-Wentz

See also, The Tibetan Book of Living and Dying by Sogyal Rinpoche

See an online exhibit at the University of Virginia based on The Tibetan Book of the Dead

The Music of Dying

When he was twenty-five years old, the German composer Richard Strauss composed a tone poem entitled "Death and Transfiguration."  The music reveals the thoughts of an artist as he lay dying.   In the course of the piece, the man reviews his life from childhood through adulthood.  The music ultimately culminates in a spiritual "transfiguration" at the moment of the artist's death.  Sixty years later, at the age of eighty-five, as Strauss lay on his own deathbed, he was heard to remark:  "Death is just as I composed it in 'Death and Transfiguration.'"  To hear a brief selection from this work, click here.