Fairness Which Strikes the Eye

Sometimes it seems we cannot help ourselves –the pull of the tide is just too strong to resist. And sometimes an argument, when considered too quickly, too uncritically, captures us with its ostensibly intuitive wisdom. We have no need to question it. No need to probe the basis of its logic.

The rhetoricians of old were well versed in this form of argument –the art of persuasion and how to best achieve it. Aristotle, for example, suggested three essential features of a convincing argument: ethos –the credibility of the contention; pathos –understanding the needs and emotions of the audience; and logos –the patterns of reasoning and the words chosen. His wisdom, although modified and woven into the contemporary tapestry, has not been lost in modern times.

What could provoke a greater sense of outrage in a population than the 1% contention? That is to say, in at least one of the iterations fostered by the Occupy Movement, that in the United States, 1% of the population controls 40% of the wealth. And to many, that unequal distribution of wealth, is symptomatic of what is wrong with Capitalism. It certainly resonates with those of us in the 99% who hear it. It begs for remonstrance; it demands rectification.

And yet there are usually many sides to a story –or at least this one, at any rate. There are times  when we need to move back a step or two in order to appreciate the different perspectives. Even so, I have to admit that an article in the BBC Future series came as an intriguing surprise: http://www.bbc.com/future/story/20170706-theres-a-problem-with-the-way-we-define-inequality It allowed me to entertain an alternative that I had not even considered.

As they tease at the beginning, ‘Some researchers argue that income disparity itself may not be the main problem. The issue, they say, is not the existence of a gap between rich and poor, but the existence of unfairness. Some people are treated preferentially and others unjustly – and acknowledging that both poverty and unfairness are related may be the challenge that matters more […] While many people may already view inequality as unfairness, making the distinction much clearer is important.’

They go on to say that ‘In a paper published in April in the journal Nature Human Behaviour called ‘Why people prefer unequal societies’, a team of researchers from Yale University argue that humans – even as young children and babies – actually prefer living in a world in which inequality exists. […] Because if people find themselves in a situation where everyone is equal, studies suggest that many become angry or bitter if people who work hard aren’t rewarded, or if slackers are over-rewarded.

‘“We argue that the public perception of wealth inequality itself being aversive to most people is incorrect, and that instead, what people are truly concerned about is unfairness,” says Christina Starmans, a psychology post-doc at Yale who worked on the paper.

“In the present-day US, and much of the world, these two issues are confounded, because there is so much inequality that the assumption is that it must be unfair. But this has led to an incorrect focus on wealth inequality itself as the problem that needs addressing, rather than the more central issue of fairness.” And as Mark Sheskin, one of the co-authors remarks, ‘“People typically prefer fair inequality to unfair equality”’.

In a way, a lot of the argument hinges on definitions. There are, after all, several ways to look at inequality: equality of opportunity, equality of distribution of benefits, and of course, equality of outcome. Must all of them be addressed, or is there a priority? Is the existence of a super-rich 1% the problem, or would it be more helpful ‘ to concentrate more on helping those less fortunate, who via a lack of fairness, are unable to improve their situation’?

‘Harry G Frankfurt is a professor emeritus of philosophy at Princeton University. In his book On Inequality, he argues that the moral obligation should be on eliminating poverty, not achieving equality, and striving to make sure everyone has the means to lead a good life.’ Poverty, in other words, is the problem; it is unfair…

I suppose, when considered practically, it would be unrealistic and unduly Utopian, to think that we could ever dispense with at least some degree of income disparity. People ‘don’t typically work, create or strive without the motivation to do so’. It seems to me that the unfairness does not lie in the money fairly accumulated for work done, so much as in the fact that ‘not everyone is afforded the same opportunities to succeed, even if they put in that hard work.’

But, on the other hand, it’s not all simply a matter of the equality of opportunity, nor even of equality, per se. Fairness is something different. The issue of fairness is in a different Magisterium altogether. I’m Canadian, and I believe that no one should have to live in poverty. Not everyone has the skills, or indeed, the capacity to hold a job, even if an opportunity presents itself. Some are disadvantaged by appearance, or gender; some are discriminated against by virtue of their origins, or life-style; some, even, have succumbed to past failures and have given up trying… It is unfair to give up on them –any of them- simply because of the lotteries of birth or circumstance.

Fairness, it seems to me, is universally available and accessible health care. It is a living wage that allows even the poorest to feed their family. It is safe and obtainable shelter. It is the respect afforded even to those we do not understand. It is toleration of difference, even when the rest of us may not understand, or agree with it.

It seems to me that inequality, by itself, is not what drives revolutions. Inequality is not what causes societies to weaken and their moral fabric to unweave. Inequality is just the chipped and discoloured veneer most easily visible on the surface. What festers directly underneath, sometimes only detectable when the surface weakens or is pulled asunder, is inequity. Injustice. Unfairness… Poverty, unlike wealth, offers little protection. And that is the iniquitous thing.

For some reason, I’m reminded of Shakespeare’s King Lear: Through tattered clothes great vices do appear; Robes and furred gowns hide all. Plate sin with gold and the strong lance of justice hurtless breaks. Arm it in rags, a pigmy’s straw does pierce it.

Prove me wrong…

 

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Hurtful Scents

I realize that to comment on odour is to confront a two edged sword –none of us journeys without a scented trail- but apart from those occasional inadvertent and indelicate smells, the time has probably arrived when we should be wary of artifice. Well, at least in those areas where there is no escape; where the air is as imprisoned as the nose; where the vulnerable may be subject to harm: the hospital.

Now, to be clear, I am not advocating the abandonment of deodorants, nor am I exculpating the voluntarily unwashed. I am merely suggesting that artificial scents may have unintended consequences, as an editorial in the Canadian Medical Association Journal points out: http://www.cmaj.ca/content/187/16/1187.full  And it would seem that, ‘According to large surveys of the general public, about 30% of people report having some sensitivity to scents worn by others. Twenty-seven percent of people with asthma say their disease is made worse by such exposures. There is emerging evidence that asthma in some cases is primarily aggravated by artificial scents. This is particularly concerning in hospitals, where vulnerable patients with asthma or other upper airway or skin sensitivities are concentrated. These patients may be involuntarily exposed to artificial scents from staff, other patients and visitors, resulting in worsening of their clinical condition.’ One has only to take the long journey to a distant floor on an elevator to know how uncomfortable odour can be.

And this danger is particularly applicable to health care facilities because: ‘Federal and provincial human rights acts require accommodation for employees who are sensitive to scents in the workplace, but not for patients in hospitals or clinics.’  As the editorialist points out: ‘Many public places promote a scent-free environment. Some hospitals also do so. But it is not policy in all Canadian hospitals, and it is not required in hospital accreditation standards. [italics mine]’ In this respect at least, the truly vulnerable are not being adequately protected.

But we all need protection; odour is one of those modalities that we have been taught to sublimate –or at least not bring to the owner’s attention lest it be misconstrued. In fact, the perpetrator may have long since been habituated and therefore be blissfully unaware of the effects of the smell on others. Or worse perhaps, wants to inflict it on the rest of us in the naive belief that it enhances their identity –or enforces it. There is a fine line between self and not-self, I think; the boundaries are subtle. How far do we extend? At what range is another person an intruder? Given that personal zones –comfort zones- are often culturally established it would seem to be a labyrinthine problem only soluble by sensitivity and, probably, trial and error.

It certainly works like that in my office.

I don’t like to characterize people –especially patients- as difficult, but sometimes I can’t help it; it is forced on me. One vicious peck from their eyes on my attire, or a facial attack on my beard and I can feel my cervical hair standing at attention… On guard, really. I’m not sure what it is about non-verbal criticism that is so difficult to take, but perhaps it is its unexpectedness, its lack of specificity that doesn’t allow for rebuttal. Whatever it is, it makes subsequent rapport more difficult to achieve.

Sometimes the office is a brutal affair with patients and complaints lined up like laundry hanging from a clothesline on a cloudy day. Even patches of sun are welcome diversions, and I had just seen a young woman who had biked across the city for her appointment. Sweating profusely but obviously proud of her achievement, her humour was a needed distraction from the long line still hanging in damp anticipation in the waiting room and I smiled fondly when she left. A flash of colour for my day.

But Elspeth, one of the last patients of the morning, was a mature lady who seemed to eschew colours, however. A large black bag sat beside her chair and she had a dark grey coat resting on her lap like a sleeping child. Her long black skirt topped with a pure white blouse complete with frilly cuffs would not have stood out in the waiting room ordinarily, but the way she wore her hair would. It was pulled so tightly off her forehead into a little raggedy tail at the back of her neck that it looked painful -her skin screaming in silent agony. Her expression mouthed the same feelings; she was not a happy person.

She stood to follow me into my office –reluctantly, I sensed- and I could feel her eyes burrowing into my back as we walked. Even in the office, her guard was up and her eyes tense and menacing.

I smiled to reassure her that I meant her no harm, but she ignored me and began to inspect the room suspiciously. She started with the walls, progressed to the various statues and plants in the corners, and finished with my desk and its contents. I wasn’t sure whether she was appraising their worth or my taste, but when she finally examined me like she was itemizing my clothing, I realized it was neither.

“There is a disturbing smell in here, doctor,” she said through her teeth.

How does one respond to that? “I… Uhmm…”

“And it’s not just in here,” she continued, “I first noticed it when I entered the waiting room.” Her eyes were angry. Mistrustful. “I thought perhaps it was somebody’s failed deodorant or a cover-up perfume so I tried sitting in several places, but it was the same everywhere.”

“I’m sorry Elspeth…”

Mrs. Trudle please, doctor. I don’t call you by your first name.”

“Sorry.” It was all I could think of replying.

“You of all people should know about the safety hazard of injurious odours and their effects on susceptible clients.”

Patients, Mrs. Trudle; I do not have clients! I am not a lawyer, nor a beautician.” I shouldn’t have said that –I don’t like the power implications inherent in the word ‘patient’- but I couldn’t resist. I felt attacked.

The effect, however, was almost immediate. The skin on her forehead rose briefly –perhaps to relieve the pressure- and then the ghost of a smile trickled across her face. “Touché, doctor,” she said and then chuckled. “I’m sorry if I was rude, but I’m terribly sensitive to smells nowadays. I find they give me headaches.”

I’m a gynaecologist, not an otolaryngologist, but her insistence that there was a disturbing odour in the office was worrisome –not least because nobody had commented on it before.

“Is it as bad in here as in the waiting room?” I asked, hoping it wasn’t my deodorant.

She thought about it for a moment before answering. “No… No I don’t think it is, although I can still detect it.”

“Any idea what it might be?” I wondered if it might be somebody’s perfume, or perhaps a chemical residue from the cleaning staff. We no longer had any carpets, so it couldn’t be unvacuumed dust or mold in the fabric.

“Well, many things seem to set me off… But here it was feet,” she said simply. I must have looked surprised, because the smile on her face grew larger and she sheathed her eyes.

“But…”

She nodded her head to interrupt me. “But there were only three other women in the waiting room -I know that. They must have thought I was demented to keep moving to different seats, but my headache was getting so bad I was afraid I was going to gag.” She slumped in her chair and closed her eyes for a moment. She looked uncomfortable. “Maybe it’s not the smell of feet so much as shoes…”

I just stared at her. I couldn’t make people take their shoes off at the door.

She shrugged and shifted uneasily in her chair. “I haven’t had a period for over two years, so I’m wondering if all of this is related to the menopause.” Her eyes scanned my face for some reassurance. “I’ve got an appointment to see a neurologist this afternoon, but I was hoping it was something simpler… more easily fixed.”

I smiled but I’m not sure my silence comforted her.

She sighed, and looked at me as if she felt she was wasting my time. Then she gathered up her coat and purse. “Hope is sometimes naïve, isn’t it?” She stood, started to walk towards the door and then stopped, but didn’t turn around. “Even ‘Lilies that fester smell far worse than weeds’, I guess…”

I recognized it as the ending of one of the more enigmatic of Shakespeare’s sonnets and I had the uncomfortable suspicion that she’d rehearsed it for just such an occasion.

Just as she left, she turned her head and smiled a sad smile. “I’m sorry,” she managed to whisper, and then disappeared through the door.

I was sorry as well… And all I could think of to respond was what Shakespeare’s King Lear says to Gloucester: Thou know’st the first time that we smell the air we wawl and cry… But I said nothing. Air was a continual surprise for Elspeth; and she was certainly not mad…

 

Sleeping in the Call Room

Sometimes in the sounding night, with footsteps rushing past and light-bound shadows flashing orally under the firmly closed door, I awaken, startled, and wonder if I am next. It takes me a moment to clear the fog of that constantly unsettled semi-sleep, and understand that I am not at home. And won’t be for uncountable time. The pillow is not right, and the bed is far too narrow. And empty. There is a dusty patina on the sheets that I can feel despite the dark. It makes me cough if I pull them close. But they are old, like the room. Echoes of the others who have slept here, echoes of the phone calls that suddenly scream their warnings in the night, echoes of opening and closing doors just outside  -all those echoes are trapped in here. All clamoring for an audience.

There are more things imprisoned within this room than a person should feel. To embrace even a small fraction of the anxiety plastered on the door, let alone the shadows rushing noisily past, would be to succumb to that which we are not allowed: fear. To suspect, even, that there may be a situation so dire, so entrenched and insoluble that we could only witness it in horror, is to abrogate the right to the room itself. The right to close the door, to close the eyes in pseudo sleep.

The desk that welcomes and entices in the light, holds no promise in the dark. Holds no answers to the urgent questions from the phone. Or to the voice whispering loudly near the door. Whispering things I should not hear, and can’t because they are too quickly said. Meant for others standing just outside or passing on their ways to other things. To other doors. Here be dragons…

There is no time that passes here. It is not allowed –nor should it be. This is a place of black and void, an empty space yet full of ghosts who do not talk, or pace about. There is no room in here: it is barren ground. A fissure carved deep within the building. An abyss, a surface with no boundaries –except perhaps, the door, and those who seem to wait outside. For whom? And why?

Do they, too, wait for a phone to ring before they pound restlessly on a door? Is there anything that starts their ceaseless pacing in the corridor? Or is it random? Brownian motion? Perhaps they’re too aware to sleep, anticipating pages not yet issued, problems not discovered. Maybe they walk the hall with with text books open in one hand, pencils ready to underline another fact, but smartphones in the other, an app, finger-close… Just to check, you understand. Prepared for what, they do not know…

It is not them I fear, nor the hallway that sanctifies their life. They have other duties in the night. Responsibilities they must guard, lest someone find them wanting. They are not mine; my door is just a mistake for them, an anomaly to tempt them from their task. Nothing more. They do not belong to me; they are not my specialty. Not my responsibility. I cannot answer for them and will not let myself be distracted.

There is a sentence I read somewhere –King Lear, I think- and it surfaces now and then in the dust motes circling around the light under the door. It, too, whispers to me when I am startled by a noise outside, and nudges me if I pretend too hard to sleep: O, that way madness lies; let me shun that; no more of that. And when it sounds, it loops and twists in my head like a roundabout, the words circling like vultures, going round and round and round again looking for an exit…

But my job, for now, is to pretend to sleep. To pretend I will be ready when my duty calls, my own phone rings to silence those calls for madness from without.