Dependency 360 is sadly NOT another CNN show

Dependency 360 is sadly NOT another CNN showMy good friend and long-time patient Joe E from Buffalo, NY emailed me this anecdote a couple of days ago that I find quite enlightening:

A Ford Dealer from Latham Reports this true story: ”One of my salesmen here had a woman in his office yesterday wanting to lease a brand new Focus.   As  he was reviewing her credit application with her he noticed she was on social security disability. He said to her you don’t look like you’re disabled and unable to work. She said well I’m really not. I could work if I wanted to, but I make more now than I did when I was working and got hurt (non-disabling injury). She said the gov’t sends her $1500.00 a month in 1 check. And she gets $700.00 a month on an EBT card (food stamps), and $800.00 a month for rent. Oh yeah, and 250 minutes free on her phone. That is just south of $3500.00 a month.When she was working, she was taking home about $330.00 per week. Do the math and then ask yourself why the hell should she go back to work.”   

This attitude and should I say “way of life” is quite pervasive in 2012 America. You all heard on the news about the lottery ticket winner who staid on food stamps. As a doctor in NY and NJ I have known for years that patients made more tax-free money on disability and/or workers compensation than actually working. Where is the incentive to see the glass half full?

Even fresh immigrants or refugees figure out this version of the American dream right off the boat. It is almost as if it is inscribed in the visa papers they have to complete at the consulate prior to coming! I remember in the late 1980s I was a resident in a hospital in Brooklyn and there was an influx of jewish russian refugees so we were interviewing some of them to try to employ them in some capacity. One guy who spoke good english said he was a psychologist and I grinned because we could always use one of those in rehabilitation. He was only one week in the US yet he made it very clear to me that it will have to be off the books or else he would loose his Medicaid status. My grin disappeared. I have encountered similar behaviors among the bosnian refugees in Utica. Being on the dole was kind of a way of life there. in socialist Yougoslavia,  so they were longing to reproduce it here. 

From NJ Governor Brandon Byrne’s perspective and famous say: "I never met a piece of glass I did not like", a glass half-empty is a call to arms, a rallying cry, screaming to be filled.Hence the other 180 degrees of the Dependency circle, this half is not societal or financial, it is chemical in nature, alcohol for the Gov, drugs for others. When these two halves meet it is definitely not the Lion King’s Circle of Love, it is more the Hyenas’ Circle of Hate.

Indeed the vicious circle of dependency feeds upon itself and gains momentum as it does so like a powerful centrifuge. A physical dependency leads into financial dependency and vice-versa every day of the week. The drug or dole addictions are two heads of the same Medusa: you kill only one the other one laughs at you while the severed one regrows. You have to kill both in unison to decisively kill that Medusa.

This cyclotron of dependency is so self-powered that very soon both drug dependency and financial dependency melt into an all-encompassing dependency addiction.  The subjects of this 360 dependency become addicted to dependency itself. It becomes their raison d’être, their modus operandi. Pretty soon they stop knowing any better and they identify with this way of life. Try reaching out to them then. Try disrupting this vicious circle. You might as well amputate one of their limbs.

The 90 become 180 becomes 270 becomes 360 at an astonishing speed. Witnessing it is like witnessing a patient ravaged by leshmaniasis (flesh-eating bacterial disease).

The rate of this D360 transformation is reaching epidemic proportions and our response to it has been tantamount to throwing some blankets at a brush fire. The answer is in the core of that circle: the more hollow it is the more debris amasses at the periphery and the thicker the crust to cut through. As this goes on and spreads engulfing the nation, I remember a Yogi Berra say:

"the future is not what it used to be"

…and that’s putting it mildly!