The Panopticon Effect


This post is part of the series: The Debriefing. Click to read all posts in this series.


So at my most recent conference there were a lot of research presentations. One of the fascinating things that comes up in clinical studies of diseases that are self-managed, and which was highlighted on several slides, is something I’ve come to call the panopticon effect. It might have a proper name, but if so, I haven’t heard it. The idea is fairly simple, and fairly obvious. For every study that has a control group, almost always, the control group shows better outcomes than the statistical averages.

In cases where control groups receive a placebo treatment, this discrepancy can be attributed to the placebo effect. But the effect persists even when there is no intervention whatsoever. It seems that merely being enrolled in a study is enough to create an increase in whatever outcome is being measured over what would normally be expected.
This could be a subtler extension of the placebo effect. We are constantly finding that placebo, mindfulness, and the like, while never substitutes for actual treatment, do have a measurable positive impact. But there is probably a simpler solution: these people know they are being watched. Even when data is anonomized, and there are no consequences for bad outcomes, there is still the pressure of being under surveillance.   And I suspect it has to do with an obligation that study participants feel to be worthy of the research being conducted.
I have heard variations on this theme slipped subtly in to enough different discussions that I have started to cue in on it lately. It is an idea similar to the ones raised over the obligations that patients often feel to fundraise and advocate on behalf of the organizations that bankroll research for their diseases; not mere camaraderie between people with shared experiences, but a sense of guilt for receiving tangential benefits from others’ work.
To briefly repeat what I have said in previous Debriefing articles: this mindset is embedded deep in the collective psyche of the communities with which I have experience, and in some instances is actively exploited by charity and advocacy organizations. The stereotype of sick and disabled being egregiously kindhearted and single-mindedly dedicated to fundraising and/or advocacy is both a cause and effect of this cycle. The same is naturally true of attention from healthcare professionals and researchers.
Frequent patients, especially in the United States, are constantly reminded of the scarcity of help. In every day-long phone call with insurance, in every long wait in the triage room, and every doctor visit cut short because appointments are scheduled back to back months in advance, we are reminded that what we need is in high demand and short supply. We are lucky to be able to get what we need, and there are plenty of others that are not so fortunate. Perhaps, on paper, we are entitled to life liberty, and the pursuit of happiness; to a standard of healthcare and quality of life; but in reality, we are privileged to get even as little as we do.
There is therefore great pressure to be deserving of the privileges we have received. To be worthy of great collective effort that has gone into keeping us alive. This is even more true where research is concerned; where the attention of the world’s brightest minds and taxpayer dollars are being put forth in a gamble to advance the frontiers of humanity. Being part of these efforts is something that is taken extremely seriously by many patients. For many of them, who are disqualified from military service and unable to perform many jobs unaided, contributing to scientific research is the highest calling they can answer.
This pressure manifests itself in many different ways. In many, it inspires an almost religious zeal; in others, it is a subtler, possibly even unconscious, response. In some cases, this pressure to live up to the help given by others stokes rebellion, displayed either as antisocial antipathy or even self harming tendencies. No one I have ever spoken to on the matter has yet failed to describe this pressure or agree that it exists in their life.
Moreover, the effect seems to be self reinforcing; the more attention a person receives, the more they feel an obligation to repay it, often through volunteering in research. This in turn increases the amount of attention received, and so on. As noted, participation in these studies seems to produce a statistically significant positive impact in whatever is being measured, completely divorced from any intervention or placebo effect.
We know that people behave differently when they feel they are being watched, and even more so when they feel that the people watching have expectations. We also know that prolonged stress, such as the stress of having to keep up external appearances over an extended period, take a toll, both psychologically and physiologically, on the patient. We must therefore ask at what cost this additional scrutiny, and the marginal positive impact on health results, comes.
We will probably never have a definitive answer to these sorts of questions. The  intersection of chronic physical conditions and mental health is convoluted, to say the least. Chronic health issues can certainly add additional stress and increase risk of mental illness, yet at the same time, make it harder to isolate and treat. After all, can you really say a person is unreasonably anxious when they worry about a disease that is currently killing them? In any case, if we are not likely to ever know for sure the precise effects of these added stresses, then we should at least commit to making them a known unknown.

The N-Word


This post is part of the series: The Debriefing. Click to read all posts in this series.


The worst insult that can be leveled against a person with chronic illness is, without a doubt, the n-word. Oh sure, there are those who defend its use, citing that it has, or possibly had, a proper context. That it evolved from scientific, then clinical, jargon, before finding its way into use as a common slur. They cite dozens of other slurs that are casually slung against the sick and disabled, and ask how such an innocuous phrase with a relatively short history can compare with a more traditionally vulgar term with more malicious intent. But these people are wrong. There is, in the present English lexicon, no word known to me which is worse than the n-word.

Noncompliant.

There is so much wrong with this word that’s it hard to know where to start. Much as it pains me to dwell on this phrase, I think it would be helpful for me to break it down a bit, and explain why it is such a toxic word; a radiological bomb of a slur, causing and spreading otherwise invisible pain and suffering for long after it is used.

It first assumes a moral high ground, implying that the person using it is in a position to dictate morality unto the patient. Then it assumes total control of the patient’s affairs, with the implication that the patient’s only role in their only health is to comply. As though healthcare were run by hydra.

“Your vital signs for this quarter aren’t where we want them. I want you to take a deep breath, and clear your mind. You know what’s best. What’s best is you comply.”

At best, it assumes that a failure to follow instructions is solely the fault of the patient, as though there is no force in the cosmos, let alone everyday life, that could interfere with the timely execution of a medical regimen. Never mind the fact that the kind of regimens we’re talking about- mixing chemicals into usable medicine, drawing up precise doses in syringes, and delivering them several times a day – are routines that, as a healthcare worker, require months of training at minimum, yet patients are lucky if they get half an hour of professional training before being tossed back into the wild.

No, clearly, if you can’t keep to a schedule drawn up by a pencil pusher in a lab, because when the allotted hour rolls around you’re not in a good place to be dealing with sterile medical equipment, never mind your own mental state, it’s your own fault. You clearly don’t care about your own health as much as this doctor that you see once every three months does. So childish are you that you can’t re-organize your entire life to be at the back and call of this disease.

That is the implication of noncompliance. Either a willing petulance, a childish cluelessness, or, at worst, a mental derangement. For indeed, noncompliance is often colloquially synonymous with self-harm. Well obviously we can’t let you have input on your own care if you’re suicidal. Clearly the solution here is to double down and set tighter targets. The n-word is immensely destabilizing in this way, as it insinuates that the patient is incompetent in a way that is extremely difficult to argue against, at least from the patient’s perspective.

All of this assumes that the problem is with the execution of the treatment rather than the treatment itself. For, all to often, patient noncompliance is tossed off as a face-saving excuse by doctors who aren’t getting results from the treatment they prescribed. After all, few patients will actually admit to disregarding medical advice, and so the n-word is often a deduction by doctors based off of clinical results rather than a patient’s activities. The problem is, clinical results can have multiple causes and interpretations.

These issues are not mutually exclusive. A patient may easily stop following their regimen once they find it stops working for them, or once they find they can no longer endure the problems of trying to slot their regimen into their life. And mental health issues which are preventing the execution of a patient’s medical regimen are as much a problem for the doctor as for the patient.

A doctor that leaves a patient with a treatment that does not work for them, for whatever reason, has not done their job. But the nature of the n-word is that is a patient’s problem. Or possibly, it is a problem with the patient, always outside the purview of the doctor’s job.

But too often all this is ignored. The clinician sees bad test results, and sees that they prescribed the treatment which seemed reasonable to them at the time, and so concludes that the patient is noncompliant, jots down a note to that effect, and gives the patient a stern lecture before sending them on their way and encouraging them to do better next time.

There is so much wrong with this situation, and with the dynamic it feeds, which is at best unproductive, and at worst borderline abusive. But by far the worst part is the impact on future healthcare. Because a patient that is labeled as noncompliant is marked. In the United States, this can cause serious issues with insurance and pharmacies in getting medication. The mechanisms by which these problems occur are designed to mitigate abuse of particularly dangerous prescription medications, such as opioid painkillers and antibiotics, which I suppose is fair enough, but because of how medicine in the US works, are applied to anything requiring a prescription.

For people who need their medication to survive, this can be life threatening. As noted previously, being labeled noncompliant can happen even if a patient is doing their absolute best. For those without the resources to switch doctors or fight insurance diktats, the n-word can have deadly consequences, and what’s more, can make patients think they deserve it.

To call a patient noncompliant is to, in a single word, strike at everything they have done to make their life, and to imply that they are not worthy of it. It is an awful slur borne of misguided assumptions and a perspective on healthcare that gives preference to doctors over patients. It is a case study in so many of the problems in the capitalist healthcare system. Unfortunately, this word will not simply go away simply because we all acknowledge that it is awful.

For indeed, the things that make the n-word terrible are in many cases only microcosms of the items which cause suffering to those with chronic health issues. The path to eradicating this slur, therefore, is a combination of renewed curative effort, reforms to the healthcare system, and a greater focus on the patient perspective.

A Witch’s Parable

Addendum: Oh good grief. This was supposed to go up at the beginning of the week, but something went awry. Alas! Well, it’s up now.


Suppose we live in colonial times, in a town on an archipelago. The islands are individually small and isolated, but their position relative to the prevailing winds and ocean currents mean that different small islands can grow a wide variety of crops that are normally only obtainable by intercontinental trade. The presence of these crops, and good, predictable winds and currents, has made those islands that don’t grow food into world renowned trade hubs, and attracted overseas investment.

With access to capital and a wide variety goods, the archipelago has boomed. Artisans, taking advantage of access to exotic painting supplies, have taken to the islands, and scientists of all stripes have flocked to the archipelago, both to study the exotic flora and fauna, and to set up workshops and universities in this rising world capital. As a result of this local renaissance, denizens of the islands enjoy a quality of life hitherto undreamt of, and matched only in the palaces of Europe.

The archipelago is officially designated as a free port, open to ships from across the globe, but most of daily life on the islands is managed by the Honorable South India Trading Company, who collect taxes and manage infrastructure. Nobody likes the HSITC, whose governor is the jealous brother of the king, and is constantly appropriating funds meant for infrastructure investment to spend on court intrigue.

Still, the HSITC is entrenched in the islands, and few are willing to risk jeopardizing what they’ve accomplished by attempting insurrection. The cramped, aging vessels employed by the HSITC as ferries between the islands pale in comparison to the new, foreign ships that dock at the harbors, and their taxes seem to grow larger each year, but as long as the ferry system continues to function, there is little more than idle complaint.

In this town, a local woman, who let’s say is your neighbor, is accused of witchcraft. After the debacle at Salem, the local magistrates are unwilling to prosecute her without absolute proof, which obviously fails to materialize. Nevertheless, vicious rumors about men being transmogrified into newts, and satanic rituals conducted at night, spread. Local schoolchildren and off duty laborers congregate around your house, hoping to get a glimpse of the hideous wretch that legend tells dwells next door.
For your part, you carry on with your daily business as best you can, until one day, while waiting at the docks to board a ferry to the apothecary, a spat erupts between the woman in question and the dock guard, who insists that he shan’t allow her to board, lest her witchery cause them to become shipwrecked. The woman is denied boarding, and since the HSITC run all the ferries, this now means that she’s effectively cut off from rest of the world, not by any conviction, but because there were not adequate safeguards against the whims of an unaccountable monopoly.
As you’ve probably guessed, this is a parable about the dangers posed by the removal of net neutrality regulations. The internet these days is more than content. We have banks, schools, even healthcare infrastructure that exist solely online. In my own case, my life support systems rely on internet connectivity, and leverage software and platforms that are distributed through open source code sharing. These projects are not possible without a free and open internet.
Others with more resources than I have already thoroughly debunked the claims made by ISPs against net neutrality. The overwhelming economic consensus is that the regulations on the table will only increase economic growth, and will have no impact on ISP investment. The senate has already passed a bill to restore the preexisting regulations that were rescinded under dubious circumstances, and a house vote is expected soon.
I would ask that you contact your elected representatives, but this issue requires more than that. Who has access to the internet, and under what terms, may well be the defining question of this generation, and regardless of how the vote in the house goes, this issue and variants of it will continue to crop up. I therefore ask instead that you become an active participant in the discussion, wherever it takes us. Get informed, stay informed, and use your information to persuade others.
I truly believe that the internet, and its related technologies, have the potential to bring about a new renaissance. But this can only happen if all of us are aware and active in striving for the future we seek. This call to arms marks the beginning of a story that in all likelihood will continue for the duration of most of our lifetimes. We must consult with each other, and our elected representatives, and march, and rally, and vote, by all means, vote. Vote for an open internet, for equal access, for progress, and for the future.

Wanted: Backpack

Job opening: Backpack, medium to large, willing to work long hours in rugged and varied environments to replace aging current backpack. Benefits few, but travel is included, and mandatory. Candidates must include:

Minimum two separate pockets

At least one water bottle pouch capable of holding at least one standard sized 24oz bottle without breaking or losing bottle

At least two comfortable straps, capable of being adjusted to fit other wearers, in line with orthopedic recommendations

Ability to be easily crammed into small spaces without damage to backpack or its contents. Examples of spaces to be crammed into include, but are not limited to: lockers, x-ray bins, underneath airplane seats, underneath tables while fully loaded.

Easily able to be opened and searched by hand, or scanned by x-ray.

Resistance to dirt, dust, pollen, sand, sunlight, and water.

Must conform to FAA, TSA, and airline personal item standards.

Candidates will be tested on a variety of metrics. Preference will be given to brands that carry a long warranty period. Although no specific color is required, the requirement to work in all weather conditions means that backpacks which have a high albedo (i.e. light colors) will be preferred.

Shiny

Alright, listen up Pandora, Diamonds International, Tiffany & Co., and other brands of fancy upscale jewelry that I can’t be bothered to recall at this time because I’m a guy. I’m about to talk about an idea that could help you dodge a bullet and get ahead of the next big thing.

Let’s face it, jewelry is seen as feminine. This is true to a place where guys feel out of place in a jewelry store; not just lost, but in many cases subtly unwelcome. This is a problem for you, because, as businesses, you want to be able to appeal to as wide an audience as possible. And perhaps more to the point, you don’t want to be marked as being too much part of traditional gender roles in the minds of the younger generation.
To your credit, you’re clearly trying, with your displays of cuff links, tie clips, and other implements of haberdashery. There’s just one problem- I have only the vaguest idea what a cuff link or a tie clip is supposed to do for me. As far as I know for sure, cuff links are the little pieces that hold the two wrist parts in handcuffs together, and tie clips are part of a wardrobe organizational system that prevent ties from becoming creased in a way that’s noticeable. And I’ll wager a lot that I’m far from the only guy for whom this holds true.
So you need something more obvious in its application. Something that I can walk up to the display and immediately surmise and articulate precisely why it is I need to own that thing, instead of needing a sales representative to explain to me how back in the olden days, fancy shirts didn’t used to come with buttons on their cuffs, and why I should care to replace mine with something more expensive and less practical.
Like, say, a wristwatch. It’s obvious why I would want to have a watch to tell me the time, and if I’m going to be wearing one anyways, a convincing argument can be made that I ought to treat myself to the finest and shiniest, which, I will be told, has been perfectly painstakingly custom engineered by the best in alpine watchmaking tradition. I may not have any use for such a watch today, but at least it’s a defensible reason for me to indulge myself to peruse shiny and expensive objects.
Except wristwatches are dying. Not just fancy and expensive models that use gratuitous amounts of valuable metals and stones, which have been slowly getting replaced by smaller, lighter, digital models that can also tell me the date, weather, set alarms, and act as a stopwatch since the calculator watches of the 1970s, but even these are being edged out. In some cases by smart watches, which can do everything listed previously, and then also take over several functions of a phone. But in most cases, watches are simply disappearing and being replaced by… nothing.
That’s because the need for a watch has been steadily eroded as young people have decided that they can just use their phone to tell the time. The smartphone didn’t kill the wristwatch, but the cultural shift towards having the action of glancing at one’s phone as casually acceptable as looking at one’s watch will. The more accepted having phones out becomes in polite company, the faster watches will disappear.
So, how do watches compete? It is still marginally easier to glance at a watch than to take a phone out from a pocket and look at it. But when a phone can also do so much more, to the point that pulling out a phone is a routine action anyways (to check texts, news alerts, and the like), the watch is still going to lose. The watch has to be able to take over some tasks from the phone in the same way that the phone can from the watch.
Modern smart watches already meet this threshold. On my own pebble smartwatch, I can receive text messages and other notifications, and decided whether I need to respond without ever having to touch my phone. I can screen incoming calls, and route them through my headphones. I can play and adjust my music, all without ever having to unlock my phone. It does exactly what I need it to, which is why it is an essential part of my essential kit.
There’s just one problem. My smartwatch is made of clunky looking, albeit durable and relatively cheap, plastic components. It stands out like a sore thumb in a formal outfit. Moreover, smart watches aren’t accepted in the same way that smartphones are.
So, jewelry companies: you need a trend you can cash in on with young men? Try smart watches. Cast them in silver and gold, with sparkling diamonds on the menu buttons, and custom engravings. Or heck, cut out watches entirely and go straight to phone cases. The important part is embracing this paradigm shift rather than stubbornly insisting that I still need a miniature grandfather clock on my wrist because my wearable computer isn’t fancy enough.

Life Changing?

What does it take to change a life? To have such an impact on another person that it changes their default behaviors and life trajectory, even if subtly? Certainly it can be argued that it takes very little, since our behaviors are always being influenced by our surroundings. But what about a long-term difference? What does it take to really change someone?

The year 2007 was perhaps the most important and most impactful of my life. I say that 2007 was the year that my childhood ended. This may be a slight over exaggeration, but not by much. It was a year of drama and trauma, of new highs and extreme lows. In my personal history, the year 2007 stands out like 1914 in European history. It is a date I measure things from, even more so than my birthday.
That year contained both the best and worst days of my life to date. The worst day, July 20th, 2007, and the bad days that followed it, I have already written about. But what about the best day? What happened on that day?
January 5th, 2007 had all the hallmarks of a good day. I was on school holiday- summer holiday, in fact, since the Australian school calendar follows Australian seasons so that our main break comes around Christmas -and I was traveling. Being ever-curious and ever-precocious, I loved traveling, especially by plane.
All the mechanisms of air travel fascinated me: the terminals, with their lights and signs and displays, acting as literal gateways to every far flung exotic locale on the planet. Customs and security, with its fancy DHS eagles, and its sense of officiality, and finality, advertising that it once you cross this line, you have crossed some important threshold from which you could not simply return, as if somewhere, someone reading your story would be holding their breath while turning the page. And of course, the planes themselves, which not only seemed to defy physics in their flight, not only liked the world together, but did so in such comfort and luxury.
That day, we started early from the family farm in Indiana to the Indianapolis Airport, via a road that had enough dips and bumps that we called it affectionately “the rollercoaster road”. We arrived at Indianapolis Airport for our short flight to transfer at my all time favorite airport, Chicago O’hare, which I adore for its dinosaur skeleton, its Vienna beef hot dogs, and its inter-concourse tunnel, where I would stare up in wonder from the moving walkway at the ceiling light display. I was told that the abstract neon colors were meant to represent the aurora, but for my part, having seen both, I have always thought the lights at O’hare to be more impressive than the aurora.
We arrived in Orlando at about 8:00pm, which, to my then childish mind, was a kind of magical hour. Things only happened after 8:00 on special occasions- watching New Year’s fireworks or space shuttle launches on television, calls from relatives in different time zones. After 8:00pm was the time of big and exceptional things, and the fact that we were only now boarding the bus from the airport to Disney World only seemed to vindicate the feeling I had woken up with that morning that it was going to be a great day.
Much of the resort was already closed by the time we arrived. But even then, there was much excitement to be had. We found our rooms, and as we wound our way around the Port Orleans Resort, I remember drinking in every detail of the scenery and design, and thinking to myself about how much attention and intent must have gone onto adding all the little details and embellishments. At this time I used to enjoy drawing, but whenever I did, I would become obsessed with details and embellishments. I would draw an airplane, and become fixated on the precise curvature of the engines, the alignment of the ailerons, the number of windows depending on whether it was a Boeing 747 like the one we took to San Francisco or an Embraer like the one we took…
You get the idea. Details were important to me. For me to see that someone had paid enough attention to the details to add all these little decorative Easter eggs, like hidden Mickeys, or a plastic frog on a Lilly pad in a small pond beside the concrete path. To see these little acknowledgments of my attentiveness told me that other people had been paying at least as much attention as I had, which put me at ease, and made me feel welcome and safe, at a time when I had spent most of my life as a foreigner, and a great deal of my time at school being bullied.
Thus assured that I was in a place that was safe and well designed by people who thought like I did, I let loose, skipping happily along as I never did in school for fear of being mocked, and sang songs I had memorized from the inflight children’s “radio station” (which was actually just a recording loop) about fishing worms, the state of Michigan, and carps in tubs.
The next day, I was reunited with my Best Friend in the Whole Entire World, whom I knew from Australia, but who had recently moved to Denver. It was the first time we had seen each other since he had moved away. I had missed his going away party because, in what now seems like a foreshadowing of what was to come, I had been in the hospital with Acute Pan Sinusitis, and after having my immune system wiped out by the drugs, was stuck in protective quarantine.
Together, we tore up the parks, going on rides and eating Mickey out of house and home. This last point proved to be dire foreshadowing, as looking back I can say it was the first time that the earliest symptoms of the medical calamity that would consume my life just six months later were indisputably noticeable. In fact, the symptoms of hunger and thirst were so bad that they caused problems trying to eat off the Disney meal plan. It was the only bittersweet thing about the trip- that it was the last great experience of my life unmarried by the specter of disability and looming death. But that’s a story for another time.
So, back to the question at hand: what does it take to change a life? Was my trip life-changing? Did it change who I am as a person, or alter my future behavior or trajectory in a meaningful way? Hard to say. Despite picking a solidly philosophical topic I’m not willing to sit down for the requisite hours of navel gazing to try and formulate the probable alternate histories if that trip hadn’t gone just so.
It’s tempting, then, to brush it off and say that even though I definitely see that event as one of the high points of my existence, that it never changed who I am at my core. It certainly didn’t change the course of events that were about to happen, which were in retrospect so obviously already in motion. It would be easy to extrapolate that the whole event had no effect on me, but for the fact that I know of a counterexample.
The day itself, more than a decade in the past, has gotten old enough in my mind that parts of it have started to fade around the edges. I don’t, for example, remember which side of the two connecting rooms my brother and I slept in, and which side my parents slept in. The parts I do remember are as much vaguely connected vignettes as they are a consistent narrative, and correlate more to the things that struck me as important at the time than what might be important to the story now. Hence why I can’t tell you what rides we went on, but I can describe the exact configuration of the twisty straw that I had with my milkshake.
One of the things that I remember clearest about that day, one of the things that to this day will occasionally interrupt my stream of consciousness, was the in flight radio. In particular, I recall there being several songs about environmental themes. And I recall sitting there, consciously rethinking my point of view. My train of thought went something like this: The reason I’m hearing this song, which, though decent, isn’t artistically great, is because it’s about a cause, which is clearly important to whomever is picking songs to play.
The kind of causes that get songs written about them, and, despite artistic shortcomings, played constantly at children, are ones that are important to society at large: learning one’s ABCs, being prepared for emergencies, and national crises like a world war (Over There) or pandemic (there was a song about washing one’s hands that was circulated during the Mad Cow scare). That I am hearing this song indicates that it is viewed not just as something of idle interest, but as a crisis of immediate concern.
It was at that moment that I remember mentally upgrading the issue of environmentalism from something that I was merely passively sympathetic towards, to something which I actively supported where possible. Hearing that song on that trip changed my life. Or if it is melodramatic to say that hearing a song single handed lyrics changed my life trajectory, then at least it is accurate to say that hearing those songs at that time provoked me into a change in attitude and behavior.
Would I still have had such a moment of revelation on a different day? Probably, but I doubt I would have remembered it. But as to the question of what it takes to change a life, we are forced to consider how much effort it took for me to hear those songs. There is no good answer here. On the one hand, it took a massive amount of societal machinery to record, license, and select the song, and then see that it was played on the flight that I happened to be on. To do this purposely would require a massive conspiracy.
On the other hand, it requires no small number of miracles from a huge number of contributors to get me the iPad I’m writing on, and the web server I’m posting to, and massive amounts of effort to maintain the global system of communications that allow you to view my words, and yet I’d hardly argue that my writing here is the pinnacle of all of society thus far. Perhaps so, in a strictly epistemological, navel-gazing sense that is largely meaningless for the purpose of guiding future individual actions. But realistically, my authorial exercise here is only slightly more effort than recording my unpolished stream of consciousness.
The truth is, even when I can identify what it has taken in the past to change my own life, I can’t extrapolate that knowledge into a meaningful rule. It’s clearly not that hard, given that it’s happened so many times before, and on such flimsy pretenses. But it also clearly can’t be that easy, or else everyone would already be their best self.
People have in the past attempted to compliment me by insinuating that my writing, or my speeches at events, or my support, have changed their lives. Despite their intentions at flattery, I have generally been disinclined to believe them, on the grounds that, though I may take pride that my writing is decent, it is certainly not of a caliber great enough to be called life-changing. But upon reflection, perhaps it doesn’t need to be. Perhaps the bar isn’t nearly that high. Perhaps, I venture to hope, one does not need to be perfect to change another’s life for the better.

Personal Surveillance – Part 2

This is the second installment in a continued multi-part series entitled Personal Surveillance. To read the other parts once they become available, click here.


Our modern surveillance system is not the totalitarian paradigm foreseen by Orwell, but a decentralized, and in the strictest sense, voluntary, though practically compulsory network. The goal and means are different, but the ends, a society with total insight into the very thoughts of its inhabitants, are the same.

Which brings me to last week. Last week, I was approached by a parent concerned about the conduct of her daughter. Specifically, her daughter has one of the same diagnoses I do, and had been struggling awfully to keep to her regimen, and suffering as a result. When I was contacted the daughter had just been admitted to the hospital to treat the acute symptoms and bring her back from the brink. This state of affairs is naturally unsustainable, in both medical and epistemological terms. I was asked if there was any advice I could provide, from my experience of dealing with my own medical situation as a teenager, and in working closely with other teenagers and young adults.

Of course, the proper response depends inextricably upon the root cause of the problem. After all, treating what may be a form of self harm, whether intentional or not, which has been noted to be endemic to adolescents who have to execute their own medical regimen, or some other mental illness, with the kind of disciplinary tactics that might be suited to the more ordinary teenage rebellion and antipathy, would be not only ineffective and counterproductive, but dangerous. There are a myriad of different potential causes, many of which are mutually exclusive, all of which require different tactics, and none of which can be ruled out without more information.

I gave several recommendations, including the one I have been turning over in my head since. I recommended that this mother look into her daughter’s digital activities; into her social media, her messages, and her browser history. I gave the mother a list of things to look out for: evidence of bullying online or at school, signs that the daughter had been browsing sites linked to mental illness, in particular eating disorders and depression, messages to her friends complaining about her illness or medical regimen, or even a confession that she was willfully going against it. The idea was to try and get more information to contextualize her actions, and that this would help her parents help her.

After reflecting for some time, I don’t feel bad about telling the mother to look through private messages. The parents are presumably paying for the phone, and it’s generally accepted that parents have some leeway to meddle in children’s private lives, especially when it involves medical issues. What bothers me isn’t any one line being crossed. What bothers me is this notion of looking into someone’s entire life like this.

That is, after all, the point here. The mother is trying to pry into her daughter’s whole life at once, into her mind, to figure out what makes her tick, why she does what she does, and what she is likely to do in the future. Based on the information I was provided, it seemed justified; even generous. As described, the daughter’s behavior towards her health is at best negligent, and at worst suggests she is unstable and a danger to herself. The tactics described, sinister though they are, are still preferable to bringing down the boot-heel of discipline or committing her to psychiatric care if neither may be warranted.

This admittedly presupposes that intervention is necessary in any case, in effect presuming guilt. In this instance, it was necessary, because the alternative of allowing the daughter to continue her conduct, which was, intentional or not, causing medical harm and caused her to be hospitalized, was untenable. At least, based on the information I had. But even such information was certainly enough to be gravely concerned, if not enough to make a decision on a course of action.

The goal, in this case, was as benevolent as possible: to help the daughter overcome whatever it was that landed her in this crisis in the first place. Sometimes such matters truly are a matter of doing something “for their own good”. But such matters have to be executed with the utmost kindness and open-mindedness. Violating someone’s privacy may or may not be acceptable under certain circumstances, but certainly never for petty vendettas.

It would not, for example, be acceptable for the mother to punish the daughter for a unkind comment made to a friend regarding the mother. Even though this might suggest that some discipline is in order to solve the original problem, as, without other evidence to the contrary, it suggests a pattern of rebellion that could reasonably be extrapolated to include willful disobedience of one’s medical regimen, such discipline needs to be meted out for the original violation, not for one that was only discovered because of this surveillance.

Mind you, I’m not just talking out of my hat here. This is not just a philosophical notion, but a legal one as well. The fifth amendment, and more broadly the protections against self-incrimination, are centered around protecting the core personhood- a person’s thoughts and soul -from what is known as inquisitorial prosecution. Better scholars than I have explained why this cornerstone is essential to our understanding of justice and morality, but, to quickly summarize: coercing a person by using their private thoughts against them deprives them of the ability to make their own moral choices, and destroys the entire notion of rights, responsibilities, and justice.

Lawyers will be quick to point out that the fifth amendment as written doesn’t apply here per se (and as a matter of law, they’d be right). But we know that our own intentions are to look into the daughter’s life as a whole, her thoughts and intentions, which is a certain kind of self incrimination, even if you would be hard pressed to write a law around it. We are doing this not to find evidence of new wrongs to right, but to gain context which is necessary for the effective remedy of problems that are already apparent, that were already proven. By metaphor: we are not looking to prosecute the drug user for additional crimes, but to complete rehabilitation treatment following a previous conviction.

In government, the state can circumvent the problems posed to fact-finding by the fifth amendment by granting immunity to the testifying witness so that anything they say can not be used against them, as though they had never said it, neutralizing self-incrimination. In our circumstances, it is imperative that the information gathered only be used as context for the behaviors we already know about. I tried to convey this point in my recommendations to the mother in a way that also avoided implying that I expected she would launch an inquisition at the first opportunity.

Of course, this line of thinking is extremely idealistic. Can a person really just ignore a social taboo, or minor breach, and carry on unbiased and impartial in digging through someone’s entire digital life? Can that person who has been exposed to everything the subject has ever done, but not lived any of it, even make an objective judgment? The law sweeps this question under the rug, because it makes law even more of an epistemological nightmare than it already is, and in practical terms probably doesn’t matter unless we are prepared to overhaul our entire constitutional system. But it is a pertinent question for understanding these tactics.

The question of whether such all-inclusive surveillance of our digital lives can be thought to constitute self-incrimination cannot be answered in a blog post, and is unlikely to be settled in the foreseeable future. The generation which is now growing up, which will eventually have grown up with nothing else but the internet, will, I am sure, be an interesting test case. It is certainly not difficult to imagine that with all the focus on privacy and manipulation of online data that we will see a shift in opinions, so that parts of one’s online presence will be thought to be included as part of one’s mind. Or perhaps, once law enforcement catches up to the 21st century, we will see a subtle uptick in the efficacy of catching minor crimes and breaches of taboo, possibly before they even happen.

Personal Surveillance – Part 1

This is the first installment in a multi-part series entitled Personal Surveillance. To read the other parts once they become available, click here.


George Orwell predicted, among many other things, a massive state surveillance apparatus. He wasn’t wrong; we certainly have that. But I’d submit that it’s also not the average person’s greatest threat to privacy. There’s the old saying that the only thing protecting citizens from government overreach is government inefficiency, and in this case there’s something to that. Surveillance programs are terrifyingly massive in their reach, but simply aren’t staffed well enough to parse everything. This may change as algorithms become more advanced in sifting through data, but at the moment, we aren’t efficient enough to have a thought police.

The real danger to privacy isn’t what a bureaucrat is able to pry from an unwilling suspect, but what an onlooker is able to discern from an average person without any special investigative tools or legal duress. The average person is generally more at risk from stalkers than surveillance. Social media is especially dangerous in this regard, and the latest scandals surrounding Cambridge Analytica, et. al. are a good example of how social media can be used for nefarious purposes.

Yet despite lofty and varied criticism, I am willing to bet the overall conclusion of this latest furor: the eventual consensus will be that, while social media may be at fault, its developers are not guilty of intentional malice, but rather of pursuing misaligned incentives, combined with an inability to keep up, whether through laziness or not grasping the complete picture soon enough, with the accelerating pace with which our lives have become digitized.

Because that is the root problem. Facebook and its ilk started as essentially decentralized contact lists and curated galleries, and twitter and its facsimiles started as essentially open-ended messaging services, but they have evolved into so much more. Life happens on the Internet nowadays.

In harkening back to the halcyon days before the scandal du jour, older people have called attention to the brief period between the widespread adoption of television and the diversification; the days when there were maybe a baker’s dozen channels. In such times, we are told, people were held together by what was on TV. The political issues of the day were chosen by journalists, and public discourse shaped almost solely by the way they were presented on those few channels. Popular culture, we are told, was shaped in much the same way, so that there was always a baseline of commonality.

Whether or not this happened in practice, I cannot say. But I think the claim about those being the halcyon days before all this divide and subdivide are backwards. On the contrary, I would submit that those halcyon days were the beginning of the current pattern, as people began to adapt to the notion that life is a collective enterprise understood through an expansive network. Perhaps that time was still a honeymoon phase of sorts. Or perhaps the nature of this emerging pattern of interconnectedness is one of constant acceleration, like a planet falling into a black hole, slowly, imperceptibly at first, but always getting faster.

But getting back to the original point, in addition to accelerating fragmentation, we are also seeing accelerated sharing of information, which is always, constantly being integrated, woven into a more complete mosaic narrative. Given this, it would be foolish to think that we could be a part of it without our own information being woven into the whole. Indeed, it would be foolish to think that we could live in a world so defined by interconnectedness and not be ourselves part of the collective.

Life, whether we like it or not, is now digital. Social media, in the broadest sense, is the lenses through which current events are now projected onto the world, regardless of whether or not social media was built for or to withstand this purpose. Participation is compulsory (that is, under compulsion, if not strictly mandatory) to be a part of modern public life. And to this point, jealous scrutiny of one’s internet presence is far more powerful than merely collecting biographical or contact information, such as looking one up in an old fashioned directory.

Yet society has not adapted to this power. We have not adapted to treat social media interactions with the same dignity with which we respect, for example, conversations between friends in public. We recognize that a person following us and listening in while we were in public would be a gross violation of our privacy, even if it might skirt by the letter of the law*. But trawling back through potentially decades of interactions online, is, well… we haven’t really formulated a moral benchmark.

This process is complicated by the legitimate uses of social media as a sort of collective memory. As more and more mental labor is unloaded onto the Internet, the importance of being able to call up some detail from several years ago becomes increasingly important. Take birthdays, for example. Hardly anyone nowadays bothers to commit birthdays to memory, and of the people I know, increasingly few keep private records, opting instead to rely on Facebook notifications to send greetings. And what about remembering other events, like who was at that great party last year, or the exact itinerary of last summer’s road trip?

Human memory fades, even more quickly now that we have machines to consult, and no longer have to exercise our own powers of recognizance. Trawling through a close friend’s feed in order to find the picture of the both of you from Turks and Caicos, so that you can get it framed as a present, is a perfectly legitimate, even beneficial, use of their otherwise private, even intimate, data, which would hardly be possible if that data were not available and accessible. The modern social system- our friendships, our jobs, our leisure -rely on this accelerating flow of information. To invoke one’s privacy even on a personal level seems now to border on the antisocial.

Entitlements

I am decidedly upset because of what happened a few weeks ago as I was hassled in public at my local theater because of my disability. At a bag check, immediately after several people, including my able-bodied family were passed over with no more than a cursory inspection, I was stopped and briefly detained. I was told that I would not be allowed in with the contents of my bag. I explained that the items which she had indicated were medically necessary. The woman persisted, insisting that it was house policy, to which I replied that denying me access over a matter of medical necessity where it pertained to a legally recognized physical disability would be a blatant case of discrimination and a clear violation of the law. Or I tried to; I was flustered by her unusually pugnacious attitude, and the crowd that was gathering behind me.

After a few more moments of back and forth she switched to saying that while I might be allowed to bring in my backpack, I would certainly have to dump out the contents of my water bottle, which I also need for medical purposes. I was initially prepared to accept this on the assumption that it was a matter of security (this is, after all, what I do at TSA; I empty my water bottle before screening and refill it after at a public fountain) until she added the suggestion that I could purchase water at the concession stand; that this was a matter of commercial policy. That’s a horse of a different color. After all, I need my water. If I’m not able to refill it for free, then I’m being forced to pay because of my medical condition. And of course, when one is compelled to pay extra because one is disabled, that’s discrimination.

I tried explaining this. The lady seemed to relent on the water, but then demanded that I prove that I’m disabled and need these things. This is a trap, for two reasons. First, it’s essentially impossible for a person to positively prove that they need something to survive and be healthy to someone who is determined to be skeptical. To use an intentionally ludicrous example: Sure, you say you need oxygen, but have you tried going without it? Maybe you should try not breathing for a while and then get back to me. So asking someone to prove they’re disabled isn’t so much an honest question as a remarkably effective logical fallacy used to browbeat people.

The other reason this is a trap relates to HIPPA. Legally*, medical information is confidential and privileged, unless and until the patient reveals it voluntarily. Once the information is disclosed, however, it’s fair game. Kinda, sorta. It gets complicated real fast, and comes down to the comparatively squishy world of case law, reasonableness and intent. But it does mean that they can try and argue, based on whatever bits of medical trivia they happen to know, that they know your disease better than you, and they can (try to) say you don’t need whatever specific thing you’re asking for.

Usually, this is a moot point, because HIPPA is very clear that a person can’t be coerced to reveal their confidential medical information. The interpretation of coercion is broad enough that it could reasonably include requiring disclosure of medical issues to receive disability accommodations. The logic here is that if you are, in fact, disabled, that either option results in your rights being violated; either your right to equal opportunity or your right to privacy.

As a result, most institutions have a policy of not asking at all and only acting on what you give them. So, at most places, if you tell them you need a water bottle, and you haven’t given them any reason to disbelieve you (i.e. you haven’t mentioned a specific diagnosis that they think they’re familiar with), they won’t bother you. But apparently this lady didn’t get the memo.

I showed her the Medic Alert bracelet that I wear just to get her to let me go. Of course, I didn’t tell her that the bracelet, which is a third party nonprofit, wasn’t particularly more legitimate as proof than my backpack, which is a design given by another nonprofit to families with children diagnosed with one of my issues. The truth is that there is no universal, or even officially sanctioned, form of proof, since that too would either violate privacy by being tailored to specific diagnoses, or would have to be so broad as to give every person carrying an EpiPen personal aides, full access to handicap parking, free motorized wheelchairs, and every other accommodation in history.

I did politely tell her, because at this point I was growing rapidly annoyed with her attitude, that asking me to reveal my diagnosis and to try and prove it was a violation of my HIPPA rights. And since I’m the only person being required to disclose, is still discrimination. She shook her head indignantly, and tried to justify to me, claiming that she had encountered many other people who had claimed to need various things for medical reasons, but didn’t really need them.

I kept my mouth more or less shut, because I couldn’t at the time think of a polite way to respond; to suggest that it was quite possible that some of those people, though perhaps not all, did in fact need as they said, and that rather than catch the guilty, she had merely browbeaten the innocent into bending their medical protocol and risking their health in the process, as has happened to many I have met. I did not retort that her finding a way to reconcile her employer’s policy and federal law is distinctly not my problem, nor is it my problem to speak on behalf of everyone who might need disability accommodations to bring her up to speed.

If ever I seem to act entitled, it is because, as a matter of fact, the world does owe me. The world owes me not because I have suffered pain in the past, or because I have been discriminated against in a society that is supposed to avoid such things, and punish violators. Although it might be nice to receive some recognition for the struggles I have gone through, I am not so naive and petty as to think that the world is fair, and that I am entitled to compensation, even if I might deserve it. I am, however, entitled to my rights, and to my dignity. I believe that I am entitled to going out in public without being accosted and interrogated. I do not think this is too much to ask.

*Obligatory reminder: I am not a lawyer. And while I do my best to always be right, if you’re having actual legal issues, you should consult an actual lawyer. Which I am not.

My Experiences With Guns

Note: This post talks about guns, and some of my experiences with them and opinions about them, some of which are, let’s say, charged. This post may not be appropriate for everyone. Reader discretion is advised.

I have a few different stories about guns. The first come from Australia. Most Americans are vaguely aware that Australia has adopted fairly tight regulations around guns as a consequence of a mass shooting several years ago. It does indeed have tight restrictions, but it is indeed still quite possible to own guns in Australia. I know this because my mother shot competitively while we lived there. She applied and was granted a license to own and shoot pistols for sport. She was actually quite good at it.

The process involved plenty of paperwork and questions. It also involved having a new safe installed in our house under close supervision to make sure it was properly bolted to the wall, and couldn’t be accessed improperly. But even as a foreign immigrant and a mere amateur, her permit was granted. Of course, after she got her license, she had to use it often enough to prove that she was in fact shooting for sport. As a child I spent time at pistol clubs and shooting arenas watching my mother compete.

Occasionally we would be subject to police inspections to see that my mother’s pistols were being stored according to regulation. The officers were perfectly courteous about the whole affair, and often gave me and my brother tokens, like coloring pages and trading cards featuring glossy color photographs of police helicopters, and the off-road vehicles they used in the outback.

Not everyone was satisfied with the way things worked. Many of the people we met a the various pistol clubs grumbled about the restrictions, and more broadly, the vilification of their hobby. Several others, mostly schoolmates and friends of schoolmates, thought that the restrictions weren’t enough; that there was no reason for anyone outside of the military to have a gun (our local police, when they carried weapons, mostly used tasers when on ordinary patrol, and even this was widely seen as too intimidating for police), and certainly no reason to keep one at home.

The balance struck by the law was a compromise. Very few were completely happy, but almost everyone agreed that it was preferable to one extreme or the other. Those who would shoot for sport could still do so, albeit with some safety precautions, and checks to prevent the notion of sport from becoming a loophole. Those who lived in the outback, and were in danger from wildlife, or too far away from settlements to rely on police, were still permitted arms to defend themselves. However, one could not simply decide to purchase a gun on a mere whim.

My second story, which is quite a bit longer, was several years later, on an unassuming Friday in December, almost four years after moving back to the United States. Like most days, I was sick, more reeling than recovering from a recurrent sinus infection that had knocked me off my feet for most of the first semester. I had slept through most of the morning, but after a hearty brunch felt well enough to try my hand going into school for the afternoon. My first sign that something might be amiss was a news alert; a national headline flagged for my attention because it was local. Police were responding to an incident at an elementary school in neighboring Newtown. There were no details to be had at that exact moment, so I shuffled out the door towards school.

My second sign that something was wrong were the police cars parked around the school building. I was stopped getting out of the car, by the police officer I knew from middle school DARE sessions. He shouted from where he stood behind the squad car, which was positioned between the curb and the school doors, as if to barricade the entrance, and told me that the school was on lockdown.

I hesitated, car door still open, and asked if it was about whatever was going on in Newtown. His face stiffened, and he asked what I knew. I explained the vague news alert. After a moment’s hesitation, he said that there had been an attack, and it was possible that there was a second gunman. Hence the lockdown. So far there had been no reports from our town, but we were close enough that even if the suspect had fled on foot, as was suspected, we were still potentially a target. Classes were still going on inside, but the school buildings were all sealed, and police had been dispatched to secure key sites around town.

I looked back to the car, then at my schoolbag, then at the school. I asked if I should go home, if he school was on lockdown. The officer hesitated for a long moment, looking me over, and then looking at the building. In a low, almost conspiratorial voice, he told me to go ahead in. He knew me, after all. He cracked a halfhearted joke, saying that I wasn’t the suspect they were looking for, and that I should move along. I chuckled politely.

Class was never so quiet and so disorderly at the same time. Any pretense of productive work had disappeared. Despite classes still nominally occurring, the bell schedule had been suspended; either because they wanted to minimize the number of students in the halls in the event that a full lockdown had to be initiated, or because students were already so distracted and distraught that it didn’t particularly matter if they wasted time in their classrooms for period six or period seven.

My teacher kept a slide up on the smart board with all of the key points from the lesson we had been supposed to cover, just in case anyone wanted to distract themselves with schoolwork. In the back of the room, students paced anxiously, awaiting phone calls or messages from friends and loved ones with news. In the corner, a girl I was tangentially friends with wept, trying every few moments to regain her composure, only to lose it anew in a fresh wave of sobbing. Someone she knew had lost a sibling. A few other girls, who were better friends with her than I, sat with her.

In the center of the room, a handful of students had pulled chairs together in a loose circle, and were trying to scrape together all the information they could between themselves, exchanging screenshots and headlines on cell phones and laptops. The idea, I think, was that if we knew what was going on, that it would make the news easier to take. That, and the idea that doing something, applying this familiar method or coordination and research, gave us back some small modicum of power over this thing being wrought upon us.

The teacher sent us home without any homework, and waived the assignments that would have been due soon. In a moment that reflected why he was one of my favorite teachers, he took a moment to urge all of us to look after ourselves first, to take time off or see the guidance office if we felt we needed to. The next day back, the guidance office brought in extra counselors and therapy dogs. Several dark jokes circulated that this level of tragedy was the only thing that could cause the teachers of AP classes to let up on homework.

The mood in the hallways over the next several days was so heavy it was palpable. It seemed that students moved slowly, as though physically wading through grief, staring either at the floor, or at some invisible point a thousand yards off. You would see students at lunch tables weeping silently alone or in groups. I remember in one instance, a girl who was walking down the hallway suddenly halted, and broke down right there. Her books fell out of her hands and her head and shoulders slumped forward as she started crying. One of the extra counselors wove his way through the stopped crowd and silently put a protective arm around her, and walked her to the counseling office.

Several days later, the unthinkable happened as, without any kind of instruction or official sanction, our school dressed up in the colors of our rival, Newtown High School. Even the cheerleaders and football players, those dual bastions of school tribalism, donned the uniforms of their enemies, not as a prank, but in solidarity. It was a bold statement covered in all the papers, and captured on local TV news.

Despite having memories of the period, it’s a bit of a stretch to say that I actually remember the attacks of September 11th. Certainly I took note of the marines stationed at the consulate, and the way they regarded even my infant brother with the kind of paranoid suspicion that is learned from loss. I recall how in the days after, people would recognize our American accents on the street, and stop us to offer condolences, solidarity, and hugs. But I don’t have enough memories from before that to form a meaningful context, at least not from my own experiences. Some bad people had done a bad thing, and people were sad and angry and scared, but I didn’t know enough to feel those things myself except as a reflection of the adults around me.

I imagine that people felt on September 11th the way we felt on the day of Sandy Hook. For that matter, I imagine that is roughly how those who lived through it felt after Pearl Harbor. We had been attacked. Our community had been attacked, savagely and deliberately, without warning, and without any apparent reason other than the unknowable agenda of a probable lunatic. A bad person did a bad thing, and now children and teachers were dead, and our whole community was grieving and looking for answers.

There was a caveat to our shared grief. Not a silver lining; it was an unadulterated tragedy, without qualification. But a footnote. We saw the media attention that this local tragedy was getting. We saw the world grieving with us. For my part, I had old friends half a world away, who didn’t didn’t know anything about US geography, but who knew I lived in the same general area as the places suddenly mentioned on the news calling me. We saw the massive reverberations, and we were comforted in the fact that we were not alone.

There was no silver lining. But the caveat was that the same tragedy that had touched us personally had set things in motion on a larger scale. Our world had been shaken up, but things were righting themselves, and in doing so it seemed like there would have to be consequences. The adults seemed to agree that this was a tragedy, and that it could not be allowed to happen again. The outcry seemed to demand change, which we took to mean that those who had lost would not have lost in vain, and that there would be new laws so that we could put this incident behind us, and feel safe again.

We waited for the change that seemed so inevitable that most hardly even bothered advocating for it. It seemed so blatantly obvious that we needed to update our laws to keep guns out of the hands of madmen. Perhaps because we were children, we took it as given that all those adults who had sent their hopes and prayers would realize what was painfully, tearfully obvious to us: that the current balance on gun control had failed miserably, and needed to be renegotiated. As the police and then the media dug in to the details of which loopholes and lapses had been exploited to create this tragedy, we assumed, perhaps naively, that our leaders would take note, and close them.

We waited in vain. The promised reforms never came. As the immediate sting faded for those who hadn’t been close enough to see any kind of firsthand, or even, as in my case, secondhand, consequences, people stopped asking questions. And those who did, instead of focusing on questions like why a madman could access unsecured weapons of war, or why such weapons exist in abundance among civilians in the first places, focused on other questions, like why a school isn’t build to withstand a literal siege, and whether the people who are stricken by grief because of this are even real people at all.

Instead of a safer society with fewer possibilities for mass murder, our government helped to fortify our school, replacing the windows and glass doors we passed through each day on the way to our classrooms with bulletproof glass and reinforced steel, under supervision of increased police and armed security. More dark jokes circulated through the student body, comparing our building to a prison, or a Maginot fortress. A handful of brave students and other adults did speak out, gathering signatures and organizing demonstrations, but they faced fierce backlash, and in some instances, came under attack from conspiracy theorists who accused them of orchestrating the whole tragedy.

For many people I knew, who were motivated by grief and a need for closure, this broke them. To have the worst day of their life scrutinized, torn apart, twisted, perverted, and then thrown back in their face with hostility and accusation was simply too much. The toxicity of conspiracy theorists and professional pundits, coupled with the deafening silence of our leaders, broke their resolve. And so the tragedy at Newtown became just another event in a long list of tragedies mentioned occasionally in passing on anniversaries or during political debates. The camera crews left, and life went on, indifferent to those of us still grieving or looking for answers.

Many of the people I knew who were most passionate about seeing change in the immediate aftermath eventually let up, not because their opinions changed, but because they lost hope. New mass shootings, even school shootings, happened, pushing our local tragedy further and further into distant memory. Nothing happened, or at least, nothing large enough on a large enough scale to shift the balance from the current decidedly pro-gun stance, happened. Those of us who waited after Newtown, or whatever other tragedy touched them personally, as there have been so many, still wait, while those of us who have seen other systems work, possibly even work better, silently lament.

It is perhaps worth reiterating explicitly what has been mentioned previously: any conclusion on gun regulation will be a compromise. This is not merely a realistic view of politics, but a matter of reality. No country, even those cited as having overly draconian laws, has completely outlawed firearms, for essentially the same reasons that no country has completely outlawed painkillers. Every country wants to ensure that sportsmen (and women) can hone their craft, that serious hunters can enjoy their hobby, and citizens can defend themselves, even if they disagree to what extent these activities themselves ought be regulated.

Every solution is a compromise; a tradeoff. And naturally, the balance which is best suited to one country may not be as effective in another. I do not suppose that the Australian system, which despite its ample criticisms, did mostly work for Australia, could be copied wholesale for the United States, at least not without serious teething issues. Yet I also think it is obvious to all that the current balance is untenable. With so many unsecured weapons in so many untrained hands, there are simply too many points of failure.

Perhaps the solution is to focus not on restricting firearms purchases, but on training and storage. Maybe this is an issue of better an more consistent enforcement of existing laws. There is also certainly a pressing need for improvements in mental health, though the kind of comprehensive system that might conceivably be able to counterbalance the inordinate ease of access to weapons; the kind of system that can identify, intervene, and treat a sick person, possibly before they have any symptoms, probably against their will, would require not only enormous year to year funding, but the kind of governmental machinery that is fundamentally inimical to the American zeitgeist (see: American attitudes towards socialized medicine).

Every solution is a tradeoff. Some are better than others, but none are perfect. But one thing is clear: the current solution is unacceptable. Scores of children murdered is not an acceptable tradeoff for being legally permitted to buy firearms at Walmart. If ensuring that students of the future do not have to cower in ad-hoc shelters means eliminating some weapons from a hobbyist’s arsenal, then so be it. If preventing the next soft target terrorist attack requires us to foot the bill for extra police to get out into the communities and enforce the laws before the next crisis, then so be it. And if preventing these tragedies which are unique to our country requires the erection of a unique and unprecedented mental health machinery, which will cost an inordinate amount as it tries to address a gun problem without touching guns, then so be it. But a new solution is needed, and urgently.