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Eileen W.'s avatar

Thank you for this post. It really hit home this morning after reading about a toddler’s death in the local newspaper. A mother murdered her toddler son. Bludgeoned him to death. Reading further on, two of the mother’s family members are in prison for murdering family members. The cycle went on. We as a country can do so much better. We submit to the will of the wealthy oligarchs of this country and fail to see but the crumbs we are offered.

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Kathy's avatar

This is a wonderful post, and it has given me a lot to think about. I have read it three times already today, and I get more meaning from the post each time I read it. This post also shows your kind and caring character.

Parents care. Parents cannot effectively care for their children when they are forced to compete for resources which causes stress, anxiety, and guilt. Parents will do anything for their children. In America, this often translates into a culture of overwork.

My father grew up poor, and paid for all of his clothes starting at age 12. He was able to transcend the poor, working, and middle classes, and was well established in the upper middle class by the time I was born, in 1987. At my grandmother's funeral (his mother's), people were stating that they wished they were as industrious as my father when they were kids! The sad part about it is that my father died before he was 60, and before his mother. It comes at a huge price.

Overwork kills. Ironically, Stanford University, which has a culture of overwork, produces interesting research on this subject. Jeffrey Pfeffer writes about this extensively in his book "Dying for a Paycheck". He estimates that the fifth leading cause of death is due to overwork in the United States, along with 5 to 8 percent of medical costs being attributed to overwork. Another Stanford professor, John Pencavel, states in the journal article, "The Productivity of Working Hours" [1], that workers essentially lose their productive capabilities when they work past 55 hours per week. For example, if an individual plans on working 60 hours per week, they will work about 9% slower, which causes their output to be the same as if they worked 55 hours per week. This is borne from data out of data from a British bomb factory from WWI. In [1], figures 1 and 2 (page 2060 and 2061) this demonstrates, across four cohorts, doing different types of tasks, that work output plateaus at approximately 48 hours/week. Work output from a 70 hour work week was actually slightly lower than a 48 hour work week. Remember that these individuals were extremely motivated due to war, and that they were doing skilled work (but not creative work) so this is likely an upper limit to human capacity. Also, there is a lot of interesting data published about working conditions from the British Health of Munition Workers Committee.

With respect to your book, "Our Malady": My father, who had a pre-existing heart condition, died from preventable medical errors. The third leading cause of death in the United States is believed to be preventable medical errors [2]. The study I cite has been validated repeatedly by several peer-reviewed research papers. The reason why this fact is never explicitly stated in the United States is because deaths are reported differently here compared to other developed countries. Information about deaths attributed to medical errors, whether they are amenable medical errors or not amenable medical errors, are omitted on death certificates. This forces researchers to have to make estimates about these deaths.

Also, you may want to check out the research published on HealthData.org, from the IMHE group, which ironically does the IMHE coronavirus estimates and projections. They are a world-renowned team from the University of Washington. The peer-reviewed journal articles are solid. You may be particularly interested in "Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories using data from the Global Burden of Disease Study 2016" [3], since you like to look into the future and the various possibilities that it brings. You will find other fascinating articles from the IMHE from their special edition journals regarding the Global Burden of Disease [4]. You also have to try out the Global Burden of Disease visualization tool, which allows you to compare causes of death, disability, and also life expectancy, in the past, present and future (all in the same figure), by country [5].

Also, there is an extremely relevant book now, with the pandemic, that is from a Russian author, Nikolai Gogol. The book is called Dead Souls. There is a must-read review article about the book, from The Paris Review [6], called "America's Dead Souls", from Molly McGhee, that is quite revealing. In America, we really do have profound sadism. This book also relates to your description of our bodies as objects to profit off of in "Our Malady".

From "America's Dead Souls":

> "There is money to be made off the dead. Nikolai Gogol knew this when he wrote his masterpiece, Dead Souls, the story of a middle-aged man named Chichikov who buys dead serfs with the intention of mortgaging their souls for a profit. I chose to read this novel at the start of quarantine, when everyone else was reading War and Peace. I had already read War and Peace. It ruined my life. I wasn’t keen to have my life ruined again. I wanted some other grand, sweeping Russian epic to fill my time."

....

> "Sound logic, I thought. Surely, surrealism is safe. Except shortly after I picked up Dead Souls, my mother died a gruesome, absurd death, and I quickly found that the surrealism of Gogol was not so surreal after all. Chichikov knew more of life’s truths than I did: no matter how poor, there is money to be made from the dead. The poor are worth more dead than alive."

> "At the end of her life my mother made less than $10,000 a year. Suffering from debilitating depression while caring for her aging parents, she found herself chronically unemployed, undermedicated, and overstressed. In our final phone call, as we navigated her looming eviction, she asked me, rhetorically: “Why are these people harassing me? What good does it do them?” I didn’t have an answer for her. Or I did, but it felt obvious and stupid to say out loud. They wanted money. Everybody wants money. The people in power don’t care if we live or die, as long as they get paid. My last correspondence with my mom was a $2,500 money order (two and a half months of my pay), which I hoped would buy me time to cobble together a more sustainable plan."

...

> "Well, not all of it. I didn’t inherit the assets. She didn’t leave a will, which meant the state of Tennessee inherited her house. What I inherited was her debt."

...

> "I suddenly found myself looking down a double-barreled future of doom and despair. The hospital where my mother died claimed I owed them more than a quarter of a million dollars. Wells Fargo held me responsible for a house I no longer had legal claim to. Creditors and housing developers knew about my mom’s death before my extended family did. I was a few months away from turning twenty-six. Two days after she died they began calling me."

I hope this was insightful.

[1] "The Productivity of Working Hours": https://onlinelibrary.wiley.com/doi/abs/10.1111/ecoj.12166

[2] "Medical error—the third leading cause of death in the US": https://www.bmj.com/content/353/bmj.i2139/rapid-responses

[3] "Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories using data from the Global Burden of Disease Study 2016": http://www.healthdata.org/research-article/forecasting-life-expectancy-years-life-lost-and-all-cause-and-cause-specific

[4] The Lancet: Global Burden of Disease: https://www.thelancet.com/gbd#2019GBDIssue

[5] Global Burden of Disease: Visualization and Country Comparison Tool: https://vizhub.healthdata.org/gbd-compare/

[6] "America’s Dead Souls", from The Paris Review: https://www.theparisreview.org/blog/2021/05/17/americas-dead-souls/

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