Saturday, March 20, 2010

In Praise of Doubt

I just finished a book called "In Praise of Doubt: How to Have Convictions Without Becoming a Fanatic" by Peter Berger and Anton Zijderveld. I had first heard of this book when I heard Berger on the Public Radio program "Speaking of Faith" in the fall, and then I hear him speak at the National Cathedral's Sunday forum a few weeks ago.

I knew from the very first minute that this book might very much "speak my mind" and know that I've finished it, I know this is so. I can also say that I suspect there is much in these pages that could benefit the Religious Society of Friends.

Increasingly, I am seeing myself as a 'bridge-builder'. Going back to my "coming out" days, when the conservative/military side of my family stunned me by being the only part of the family to unconditionally accept me, and continuing through my days of working with evangelical Christians on HIV and subsequently gay issues, and now in DC building bridges across the economic and geographic parts of this city, I see that this is something that, while not always easy or successful, comes natural. What I am clear about, however, is that I am not wishy-washy on issues. I am convinced that we need to have a cleaner environment, a less-consumer/greed driven society, and more equal footing from which all people start this journey of life. I also know that most people have the same basic values I have, but they may have different ideas of how to get there, where authority lies, who should call the shots, etc.

I am also convinced of this: no matter what a person believes, his/her intentions are good, he/she is intelligent, and love is some part of the equation. To be sure, there are fanatics, as Berger and Zijderveld write. "Fanatics" are those extremists who exist at the ends of any spectrum, and are convinced that their world view and their way is the only right way and, often, those who don't see it their way are clueless, amoral, unChristian, unAmerican, or some other demonized being. I try to not let that be me. I have run into my fair share of fanatics - both left and right - and what I find is that there is little room for dialogue, so really there is not much to be said, even though they, too, are often motivated by love (usually with a mix of fear and power). It is between the margins that I am convinced that the real possibility for transformation exists, for creating a more peaceful and just world.

In our modern society, it seems that we could use more civility as we deal with the problems that face us. No matter what the issue, leaders of the causes of these issues tend to push a "with us/against us" paradigm. For Quakers, this creates a dilemma: are we going to choose sides on issues, or are we going to try and bring greater civility (peace) to the discussion by committing to see the "others" perspective? To what extent do we achieve our aims by making the other "wrong", vs. being open to possibly being wrong ourselves? In a pluralist society, these are inherent challenges, and I truly believe that it is the Peace congregations and pacifists who could really take up this mantel of finding common ground. It is going to take a disciplined life, but it is something we can do. "In Praise of Doubt", similar to another book called "Blind Spots: Why Smart People Do Dumb Things", are great resources for grounding us in this without sacrificing what we believe.

As a tangent: "In Praise of Doubt" also raised a question of how we reactively respond to and adopt understanding of things without thinking more deeply. An example of this was in the discussion of liberalism, conservatism and socialism as the 3 points of the "democratic" triangle. Taken to extremes, liberalism goes to absolutist understanding of the market (libertarian), socialism goes toward a totalitarian control of institutions, and conservatism is a reactionary project of going back to some traditional sense of society. As moderating forces (basically bringing the best of each together), conservatism glorifies civil society (in modern day this means a democratic state and market economy), whereas liberalism and socialism understand the limits of both state (socialism) and market (liberalism). This understanding of liberalism is not one I had heard, but does raise the question: what do we really mean when we use the terms "liberal" and "conservative" to either define ourselves or the other?

Friday, March 5, 2010

The De-Institutionalization of HIV/AIDS

Part 1

1996 was a critical year. I had dealt with my own personal crisis of finding out in 1992 I had fairly advanced HIV (my t-cells were around 200 at initial diagnosis). I had come to grips that the "fact" that I would most likely not see my 40th birthday in 2001. I had finally gotten a full-time job working in HIV/AIDS services after spending a few years volunteering in various capacities while biding my time in more arduous social service jobs. I was going to be doing counseling at a holistic health clinic for people with HIV/AIDS. I had also been a client at this clinic. The pay was not great, but I didn’t care. I was doing something fulfilling – providing support for people who were on a fast-track to death, as I was. As a group (as people living with HIV, and as organizations committed to supporting people with HIV), we were resigned to a fate where HIV=death. Just two years before, the news about HIV-treatment was not good. Treatments were minimally effective and highly toxic. Weekly gay newspapers were full of obituaries of young men. Increasingly at this clinic, the demographic of clients also included people of color, especially black women. It was a real community of love for those of us who had only that to hold onto.

Then, the world changed. Protease Inhibitors were introduced, and I remember one of my first thoughts was “Uh, Oh”. If these new medications were as good as promised, the landscape had just dramatically shifted. I remember running support groups, and seeing people almost magically becoming healthy – in one case literally rising from his wheelchair. Andrew Sullivan, senior editor for The New Republic at that time, wrote a cover story for the New York Times Magazine called “When Plagues End”. He observed how skeptics were challenged to hold on to their skepticism in the face of such news, and how the big shift was that AIDS was no longer a death sentence, but a chronic condition (the entire article can be seen on-line at Sullivan took a beating over time from the skeptics. He was proved wrong, as AIDS remained a permanent fixture in the world. But was he really wrong? I think he was right, but he underestimated the power of the skeptics – many of whom had a career investment in him being wrong.

"Every great cause begins as a movement, becomes a business, and eventually degenerates into a racket” - Pat Buchanan, May 2008

So here we are, 2010. HIV is still vibrantly with us. We stand on the verge of another turning point. This time, the turning point is funds are drying up for treatment, and waiting lists are starting to emerge and grow. Despite advancements in treatment and testing technology, and significant advancements in communications (cell-phones, internet, texting, social networking), we continue to lose. But, despite the pleas that are heard for more money, none of this is a crisis. It is the course we have been on and as a society – a global society – we have no one to blame for this but ourselves. To be sure, “AIDS, Inc” has done little to encourage us to truly be different, or to seriously think about what should be done. From the beginning of the pandemic to the present day, we have not been encouraged to be reflective, only reactive and to obey the orders of the Institutions of AIDS. These include:
• “Spend it or lose it” policies that have resulted in keeping case loads full (this is not simply a problem is AIDS services, but of our whole sick-care approach). Since 2000, the real message should have been “Spend it and lose it, so spend wisely”.
• AIDS = poverty, women and children in Africa. This is a favorite among the evangelical world, as many can deny that HIV is primarily a sexually-transmitted disease. Thanks, Bono, for that one.
• Advocacy groups hold workshops (often made up of a mix of energized college students, people living with HIV), and immerse them in information about what to say and what to do. I even heard at one such training that people receiving HIV-services were actually told not to mention any complaints he/she might have about services. The message is never about systemic change, just money.
• Countless people talk about HIV/AIDS in countless arenas without covering and in many cases even knowing the basic (such as the four body fluids that can spread HIV).
• The Gay/HIV organizations do not speak at all to the fact that anal sex is the easiest means of sexually transmitting HIV. This is not a judgment, just a fact.
• More money, but maintain the cultural status quo.
• When it comes to HIV-testing, you have nothing to fear but you really NEED Counseling. The kicker is that the training to be a counselor is only three days, certainly not enough time if giving one an HIV+ diagnosis is so devastating.

On the surface, these all may make sense. But upon reflection, they are not going to get the job done or, more accurately, based on where we are now, they certainly haven’t gotten the job done. Given that state and national governments throughout the world are simply running out of funds (in Illinois, for example, the entire annual state budget is going to be spent by the end of the 6th month), we are once again at a turning point.

Crisis – a crucial or decisive point or situation; a turning point; a stage in a sequence of events at which the trend of all future events, esp. for better or for worse, is determined.

This time, the turning point is not the result of a new condition such as when HIV first emerged. The word “crisis” will be thrown about as if this was unforeseen, but this turning point has been long-coming, ever since “AIDS, Inc.” (this encompasses not just organizations, but the collective groupthink that pervades much of our global community) did not make the adjustments necessary after the second HIV/AIDS crisis – the introduction of protease inhibitors as effective treatment. That was a major turning point that, partnered with technology that allows for all people to self-administer an HIV-test (but remains unavailable to the general public) should have greatly altered our course. Unfortunately, despite so many accolades to people like Bush, Bono, Gates, Clinton, and the countless local, regional and global people and organizations who have played along, we have remained on the same course of chasing the virus – always remaining a few years behind.

What we need to do now is to take time to reflect while also taking action. In a very uncomfortable way, the current financial crisis may make this work easier. In his most recent book In Praise of Doubt, sociologist Peter Berger and philosopher Anton Zijderveld write that “a society’s taken-for-granted programs of action are called ‘institutions’…Individuals follow the institutional programs automatically, without having to stop and reflect” (pg. 15). Many of these institutions – public and private – are drastically reducing and eliminating programs, with more to come. But rather than fall into chaos, I would like to propose that through reflection – not lengthy reflection, but a few minutes of reflection – we can see that we have many choices at our finger tips and that, through these choices, we may actually be able to do some things more effectively. Our collective pluralist voices, rather than the singular voice of institutions, might be our saving grace.

Over the next few weeks, I will be writing some reflective pieces on what the institutional approaches have done and trained us to believe, and how we can help de-institutionalize some of the tasks and explore and create new ways of moving forward. There are no quick fixes, or easy answers. But we can do much to avoid the chaos as we come together.