More American Worries

Went back to work again this week and the more I sit and listen the more I have to worry about.  My patients are the least of my worries.  They come for help.  Most of them have a good idea of what is wrong and they are trying to get their lives together, many from very chaotic situations, crazy families, and a tough economy.

But it is what my patients tell me about what is happening with their families, extended families and communities that worries me more.  There is such a growing number of people who are slipping away.  There are more and more people who can't function well in this world as it becomes faster and more complex.

Much of it is the result of all the new technology, the globalization, the recession, and the deterioration of families and the educational structure.

There are three kinds of populations that are really not doing well and they have very little hope of improvement.  They will become increasingly expensive to society and no one seems to have a real workable approach to solving these problems.

The first group has always been there but now there are more of them; the poor, minorities, unskilled, learning disabled, and left out.  These people are now unemployed all over the world.  More and more places are looking like India with some very rich people, and many more very poor.

Now there is a second group that had been a rung above the forever under-class.  Now there are more mainstream people who had been working but are no longer needed.  The older ones, who worked for twenty to forty years in jobs that have been made obsolete by technology, or out sourced, are just lost and depressed.  But there are many younger people who never really found a place, never really learned how to work hard, and have kind of faded to the side.  They are home playing video games, they are taking too many drugs, they are often angry and causing trouble, they are having children they don't know how to take care of.  These are from places and families that were doing OK before, but now many of them can't keep up, can't find a way to really be independent.

There is also a third group that is under the radar, and very difficult to talk about without sounding mean.  These people didn't exist fifty years ago, but they do now, and they are very expensive.  They are people who would not be alive except for the fantastic progress in medical care.  Some of them were pre-mature births, some were from in-vitro multiple births, some were kept alive by amazing interventions, and others have illness that were previously fatal but now medicine can keep people alive, but not really very healthy.

I don't mean to imply that these people shouldn't be alive, or that they don't appreciate all that has been done for them, but there are many more like them who are in pain, have severe learning disabilities, ADHD, and other major handicaps.  Many of these people can't work, and they begin to get disability payments and complex, expensive medical treatment at an early age, and while it is good to have them around, and their families mostly love and care for them, it is very expensive and very time consuming.

As of right now, I don't have an answer for all of this.  It will probably take more than just me working on it to solve these problems.  But they are here, and they are getting worse, and no one is really paying attention to the magnitude of the problem.