Thursday, December 10, 2009

Empire Declines: Today I Get Flu Shots, a Narrative and Meditation

9:28 A.M. Flu shots are available today. My doctor has told me to think of getting one after the bad case of bronchitis I had several weeks ago. I didn’t manage to get a shot earlier in the year because, well, without health insurance, I frankly put off necessary medical care until I think it’s absolutely unavoidable.

Steve’s workplace is the largest medical center in the state. He got a seasonal shot there, free for employees.

Local t.v. news channels have been touting the availability of the vaccine: Go to our website at and look. You’ll find all the locations that have vaccine now.

When these announcements hit our area, I went online to all the websites. No links at all providing details about when and where one could get a shot.

Happened to see a sign at the pharmacy in the local grocery store, a Kroger’s, saying flu vaccine—both seasonal and H1N1—was available again. I asked when I could get a shot. The reply: Well, we think a Kroger in Maumelle (some 20 miles north of Little Rock) has the vaccine. Try calling around.

Asked, too, at my local pharmacy, headed by a pharmacist who should really get a medal for his services to the community. In fact, I believe he has received awards. Several years ago, when Steve came down with pneumonia on a weekend in midwinter, I called him on a Sunday, telling him our doctor had asked that Steve start a round of antibiotics immediately. Though it was an icy day with freezing rain, Joe S. drove in, opened the pharmacy, and dispensed the medicines we needed.

If anyone would know where shots will be available, he would. I ask. He’s uncertain, keeps hearing that places that did have the vaccine have run out. I drive to a place he thinks may have it. No, they tell me, try the state health department.

AT 9:28 today, I google “Flu shots Little Rock.” Not much that is helpful comes up. I try reversing the search, “Little Rock flu shots,” and bingo, a hit comes up that links to what are supposed to be active local providers of flu shots.

I had heard the health department would be giving shots today in a mass inoculation initiative. I see that they’re doing so at the state fair grounds. The link at the google site to the state health department site is broken. I find a working link and double check: yes, fair grounds, Hall of Industry.

9:30: Steve and I drive to the fair grounds, passing the sign with a picture of Count Pulaski, for whom our county is named, that makes him look like a Frankenstein: a crackling glaze breaking his grim frowning black-and-white visage into tiny pieces. Who in God’s name put up such a sign? Did my tax dollars buy this monstrosity?

9:42: We arrive at the fairgrounds. There are no signs—none anywhere along the way or at the fairgrounds themselves—telling us we are at the right place, that flu shots are being given here today. Two lines of autos, long lines, are entering from opposite directions. Inexplicably, those directing traffic wave the line we’re not in to parking places. We sit and wait.

When our line is finally given a go-ahead, we’re told to park in a lot that seems miles away from what appears to be the Hall of Industry where shots are being given. We park and I start the uphill hike to what I believe is the shot location. Still no signs.

To be sure, I stop and ask one of the many people directing traffic and the crowd. He says he doesn’t know where the Hall of Industry is. Go there, he says, pointing in the direction in which most folks are trekking, though there’s a tent nearby in another direction with lots of folks under it.

I trust myself to the flow of folks, and arrive at the front door of the Hall of Industry. A big red arrow points me around to the side of the building.

9:50: I head there. Finally, lots of folks in orange sashes welcoming those who have come for shots, as if we’re doing them a favor. I’m directed to a table with a big sign, Triage, on it.

The sole orange-sashed staff member at that table seems dazed. The man ahead of me in line is also dazed. When we were directed to Triage, we were given forms to fill out, clipboards, pens, with no instructions about when and where to fill them out. He's dazed by the form, by the triage table, by the whole ball of wax. A line is forming behind him.

Another orange sash peers around a curtain, sees the bottleneck developing at Triage, waves us on, where there are those u-shaped stanchion things that cause a line to snake back and forth, as at an airport security checkpoint, before you reach your destination.

9:54: I reach the end of the stanchion maze, having filled out my form, as everyone else was doing, while we walked through the maze. A nice orange sash smiles and tells me to wait for a spot to open at one of the shot tables. I tell her to send me to one that doesn’t hurt. She laughs. I feel human.

9:55: I reach a shot table. I repeat the line about not hurting, telling the staff members I had been sent there because they give shots that don’t hurt. I roll up my arm. They notice I’ve signed for the seasonal flu shot. Don’t you want the H1N1?

Well, I had heard that it’s being reserved for high-need folks, the young and those with compromised immune systems. No, it’s for everyone, and we really encourage you to take it. The price is right, too.

Alright, then (I hadn’t known until then that the shots were free. None of the websites I had visited mentioned this). They were exceptionally grateful to me for having the H1N1 shot. Obviously, there’s some numbers game going on here, some need to show the effectiveness of the state health clinics. That must be why so few places have the flu vaccine now, why everyone is being shunted to this single mass-inoculation clinic.

I get the shots, both of them. I thank the two nurses, mention that I’m one of those Americans concerned about our health care system, because I have no insurance at all. The nurse giving me the H1N1 shot says, I’m surprised how many people I’ve met today without any insurance.

The crowd is predominantly white, though the neighborhood in which this immunization effort is taking place is predominantly black. Many of the folks getting shots are affluent, drove (as we did) to the clinic in foreign cars. There’s also a large proportion of people obviously near the bottom of the socio-economic ladder, working-class or out-of-work white folks for the most part, tattooed, chain-smoking, earringed men, women who look ill-used and bitter. People for whom life is a struggle.

I mention race in this narrative because race is in the air I breathe. It’s everywhere in my culture. To talk around it as if it is not there is to distort the truth of what I say, of how people think in my part of the declining empire, of the tensions that nag and distract from our struggle, black and white, for a better society.

One of my African-American friends, Wendell Griffen, a brilliant, courageous man, has been lambasted lately on local blogs, when he suggests that there’s something disturbing about the lack of any people of color on our state supreme court. I have logged in to support him when he’s attacked. The collusion of those intent on denying that race is a factor in all that we think and do in our corner of the declining empire, the vicious concerted attacks on a good man, disturb me intently.

I write about class for the same reason. I would falsify my narrative, make it useless as social commentary, if I flattened race or class, which are all around me, all the time, out of the narrative.

I tell the nurse, We have to do something to fix our health care system. People just aren’t being taken care of. She nods vigorously. I say, I’m unhappy with the record of our senators. We need to throw them out of office next election. More vigorous nods. A big smile.

10:10: More tables to go to. I have to turn in my paperwork. Where’s your long form?

What long form? These are the only ones I was given. You’re supposed to have a long form. To the orange sash next to her: Got any long forms? There’s one. No, it’s used. Here’s one.

I’m free to go? Yes. Thanks for coming.

10:12: I’ve succeeded in getting both flu shots, though the experience was a bit harrowing—the lack of any directions, the long uphill climb in very cold weather, which must have been hard for the elderly and infirm, the incomprehensible red tape of it all (triage, for God’s sake?).

Why is it so hard for Americans to get routine health care—preventive health care, which helps maintain the health of our entire society and cuts down on medical expenses that are a burden for the whole society? Why the profuse promises by local t.v. stations that the vaccine would be widely available this week, at many locations?

Why the lack of clear, easily accessed information to guide people to the clinic? And then, once they had arrived, the hurdles, one after the other.

Is it this way everywhere in the U.S. now? Or is some of this unique to our area, to the fringes of the declining empire?

10:15: Steve and I bat these questions around as we drive back home. We’re heading through a neighborhood of good, solid older houses dating from the end of the 19th century to the middle of the 20th century. It looks like a bombed-out area of a city at war. Many windows are boarded up.

The neighborhood was racially mixed up to the 1950s. White flight set in with a vengeance in the sixties, and it became largely black. It has now been abandoned by many middle-class black families who have followed the exodus to the suburbs.

Good houses, solid houses, usable houses, abandoned or rented to families living on the edge of the edge. Things look especially tawdry in the bleak winter weather. Signs of an empire in decline.

The decline of empires is always evident first in the hinterlands, the margins. People in Rome still had bread when there was famine in Judea, north Britain, north Africa. Roads still worked around Rome when they had become potted with holes, unusable, in all of those hinterland areas.

We’re a poor, marginal state, whose citizens routinely vote against our own economic self-interest because we’re promised bread and circuses. And God. God above all. And enemies to deflect our attention from our real, our real and really solvable, problems.

Daily, these days, I’m bombarded by phone calls from one special-interest group after another. All of the calls have to do with the Senate’s health care debates. The largest percentage encourage me to call my senators and tell them that I don’t want them using my tax money to pay for health care for others, when our country can’t afford this.

I’m particularly angry at the Chamber of Commerce, which has persistently called me through its Campaign for Responsible Health Care Reform. Each time I get a call from this group, I email and demand that they stop calling me. I email and inform the National Do Not Call Registry that this group persists in calling me though my name is on the National Registry. I’ve sent emails to the state attorney general’s office (which kindly wrote back and offered assistance), and to the national attorney general’s office.

I’m livid that a group which receives lavish tax support is fronting for the Republican party in this obtrusive way. I email the local Chamber of Commerce to tell them I oppose this political use of tax monies given to support the Chamber. I oppose their persistent invasion of my privacy. They email back, snippy emails telling me they are not allied with the national office—though the local website links directly to the national attack on health care reform, the Campaign for Responsible Health Care Reform.

My aunt tells me that she gets calls like this all day long. Yesterday, she got a call from a “survey.” The group calling—she didn’t know who they were—asked one question: Are you for abortion? She was mystified. She confused this call with some official survey about which she thought she had heard on the news, a government-sponsored one. She hung up on them.

10:28: Steve and I treat ourselves to an outing, a round of grocery shopping, since we’re out and about. We talk about his need to get the H1N1 shot if he can, now that vaccine seems to be available for folks not in the high-risk categories. He had gotten an announcement at work last week that shots were available and all employees were encouraged to get the shot.

But when he walked to the clinic at his workplace, the door was locked and a sign said that no vaccine was yet available. Steve has had a foot problem lately—a muscle-tendon problem now causing nerve problems in one foot—so extra steps are not easy for him.

Why is it so hard to obtain routine health care—preventive health care—in our nation? I’m grateful to have gotten these shots, grateful that they were offered at no cost. Though I complain of all the red tape, I feel sure there are places in which getting such inoculations is far more challenging. But I still ask: why do we make it so difficult for so many of our citizens to get routine preventive health care on an ongoing basis?

We shop—ingredients for the Christmas cookies I bake daily this time of year. I’ve made bourbon balls, jam-filled thumbprint cookies, pumpkin spice cookies, polvorones, Mexican wedding cookies. I have the ingredients out for Moravian spice cookies; my recollection is that that recipe is fiddly, requires letting the dough sit to ripen a day.

I’m working up to making the German cookies my cousin’s grandmother baked each year at Christmas, a recipe she brought from her home near Erfurt when she immigrated right before World War I. It takes a lot of work, a lot of weighing and mixing and judging how much more flour to use to roll the cookies once the dough has been mixed. But the cookies are worth it—crispy, not too sweet, full of butter and cinnamon.

I buy two roasting hens (old hens, Steve calls them disdainfully, with his farm memories of tough old birds that had to be boiled for hours to make them edible). A lady behind us at the check-out counter wants to know if they’re some kind of miniature turkeys.

No, ma’am, they’re roasting hens, I say. What do you do with them? Well, I like them for chicken and dressing, since they don’t fall apart the way fryers do. I’m not sure how much to try to explain—about how factory production of chickens makes them grow fast and grossly fat, so that the meat is too watery and insipid. Anyone who has ever cooked and eaten a farm-raised chicken knows the extraordinary difference in how they behave when cooked, in how they taste, when compared to mass-produced chicken-factory fryers.

How do you make the chicken and dressing? Well, I simmer the chickens a long time in water flavored with a stalk or two of celery, an onion and carrot or two, sprigs of parsley, a bay leaf, a few allspice berries, salt, pepper. When they’re tender, I put them into the dish of dressing and bake them along with the dressing.

How long? Maybe 45 minutes. Cover the dish for half an hour and then remove the cover the last 15 minutes. And you can debone the chicken before putting it into the dressing first, if you want.

This is how people cooked for Thanksgiving and Christmas before turkeys became all the rage, I tell her. She smiles and says she had never heard of chicken and dressing. The check-out lady, a very nice African-American woman who is a kind of buddy of mine, who had motioned us over to her 15-items or fewer line (the sign says, 15 items or less, jangling my nerves), beams as I explain chicken and dressing.

I don’t explain that I’m doing all of this ahead of time, before Christmas, because we’ll go to Houston for Christmas day, to spend the day (along with Christmas eve and the day after Christmas) with my elderly uncle there, and his son. I’ve offered to make dinner for my family in Little Rock on the Sunday after Christmas, and so I intend to make the chicken and dressing and other dishes ahead of time, freeze them, and then heat them the afternoon that we return home after Christmas.

He’s from the South, says my check-out friend to the lady asking about roasting hens—as if I’m dropping in from Georgia or Alabama or Mississippi. See, he bought collards and turnip greens. And I have turnips at home already, I say, smiling and waving.

Heading back to the streets of my little part of the empire in decline, bandaids on both arms from the flu shots, old hens in tow, dreams of chicken and dressing, collards and turnip greens, Moravian spice cookies, jumbling in my head.

Anno Domini 2009, the empire in decline. Veni, veni, Emanuel . . . . And ransom captive Israel/Little Rock/New York/Miami/Duluth/Tulsa/Mesa/Portland, any and every place people call home in this empire in decline, in all the declining and rising empires the world over.