Under the Crescent Moon

This week I read the astounding, first-hand account of a New York Times reporter who was captured by the Taliban in Afghanistan, along with his translator and driver.


All were held hostage in Pakistan for over 7 months, before he and his translator escaped. The story is a chilling portrait of the mindset of the fighters and a discouraging look into the political realities of the Pakistan-Afghanistan border.

The story is fascinating for many reasons, but it is also timely given the tipping point that the U.S. seems to be at with its battle in Afghanistan and Pakistan. President Obama sent more troops to Afghanistan this year, and more already on the way, which will bring the total there to 68,000. And the general in command in Afghanistan has requested more troops, up to 40,000 more. Meanwhile Afghanistan is trying to hold a runoff presidential election, and Pakistan seems to actually be taking on the Taliban and/or Al Qaeda that has taken over parts of Pakistan.

It's tempting to read stories like this hostage one, remember that a US soldier is being held hostage there, see the mounting deaths of Americans and Afghanis, military and civilian, and just say, "Get us out of there."

How do you weigh the cost of staying against the cost of leaving? Yes, the reality is gut-wrenching with unyielding anger and senseless violence, and maddening with its futility of political partnerships and inconsistent Western involvement. But there are also those, like the translator held hostage, who are the larger part of the population and who would partner with legitimate and consistent efforts to bring peace to their families. I saw it put this way recently:

The hell of withdrawal is what kind of drama would fill the vacuum, who would re-emerge, who would be empowered, what Pakistan would look like with a newly redrawn reality in the neighborhood, what tremors would shake the ground there as the U.S. troops march out. It is the hell of a great nation that had made a commitment in retreat, abandoning not only its investment of blood and treasure but those on the ground, and elsewhere, who had one way or another cast their lot with us. It would involve the hell, too, of a U.N. commitment, an allied commitment, deflated to the point of collapse.

The hell of staying is equally clear, and vivid: more loss of American and allied troops, more damage to men and resources, an American national debate that would be a continuing wound and possibly a debilitating one, an overstretched military given no relief and in fact stretched thinner, a huge and continuing financial cost in a time when our economy is low. There is no particular guarantee of, or even a completely persuasive definition of, success. And Pakistan may blow anyway.

The debate is over which hell is less damaging in the long term, which hell is more livable.

So which hell is the better choice? Or is there an alternative? Are the only choices abandoning the vulnerable population or waging an ugly and violent war?

The Rich Stay Healthy, The Sick Stay Poor

Health care reform is moving again in Congress. I believe there are two viable bills in the Senate and one in the House. The belief is that the two Senate bills will be combined in some way, then the House and Senate bill will go to conference.

It's hard for me to call these bills "reform." I guess it might change things for the better, but I apparently need to grieve the lost opportunity for what I believe to be the needed change: universal coverage and a single payer system.

Here's where I start the health care discussion: EVERY human being is Yahweh’s child and protecting the health of every human being is a profoundly important personal and communal responsibility. The proposal that best meets those values, that I have seen so far, was put forward by George McGovern. To steward my energy, I copy his proposal:

It's Simple: Medicare for All
By George S. McGovern
Sunday, September 13, 2009
Washington Post

For many years, a handful of American political leaders -- including the late senator Ted Kennedy and now President Obama -- have been trying to gain passage of comprehensive health care for all Americans. As far back as President Harry S. Truman, they have urged Congress to act on this national need. In a presentation before a joint session of Congress last week, Obama offered his view of the best way forward.

But what seems missing in the current battle is a single proposal that everyone can understand and that does not lend itself to demagoguery. If we want comprehensive health care for all our citizens, we can achieve it with a single sentence: Congress hereby extends Medicare to all Americans.

Those of us over 65 have been enjoying this program for years. I go to the doctor or hospital of my choice, and my taxes pay all the bills. It's wonderful. But I would have appreciated it even more if my wife and children and I had had such health-care coverage when we were younger. I want every American, from birth to death, to get the kind of health care I now receive. Removing the payments now going to the insurance corporations would considerably offset the tax increase necessary to cover all Americans.

I don't feel as though the government is meddling in my life when it pays my doctor and hospital fees. There are some things the government does that I don't like -- most notably getting us into needless wars that cost many times what health care for all Americans would cost. Investing in the health of our citizens will enhance the well-being and security of the nation.

We know that Medicare has worked well for half a century for those of us over 65. Why does it become "socialized medicine" when we extend it to younger Americans?

Taking such a shortsighted view would leave nearly 50 million Americans without health insurance and without the means to buy it. It would leave other Americans struggling to pay the rising cost of insurance premiums. These private insurance plans are frequently terminated if the holder contracts a serious long-term ailment. And some people lose their insurance if they lose their jobs or if the plant where they work moves to another location -- perhaps overseas.

We recently bailed out the finance houses and banks to the tune of $700 billion. A country that can afford such an outlay while paying for wars in Iraq and Afghanistan can afford to do what every other advanced democracy has done: underwrite quality health care for all its citizens.

If Medicare needs a few modifications in order to serve all Americans, we can make such adjustments now or later. But let's make sure Congress has an up or down vote on Medicare for all before it adjourns this year. Let's not waste time trying to reinvent the wheel. We all know what Medicare is. Do we want health care for all, or only for those over 65? ...

Head First, Then Foot, Then Heart Sets Sail

Three weeks ago at this time in the afternoon, I was passed out cold on the floor. My descent into oblivion began about an hour earlier as I watched Casey and Henri struggle to make the miraculous, but harrowing, transition from womb to earth.

It was almost 4 weeks before Henri's due date, but he had been experiencing a decelerated heart rate with Casey's occasional contractions. Casey's doctor decided that the risks of continuing the pregnancy were more than the risks of early birth. Casey and I were nervous, but the extensive monitoring of Henri in the prior weeks gave us confidence that he was healthy. Casey stayed in the hospital overnight on Tuesday, September 22, and was scheduled to have labor induced in the morning.



Wednesday, September 23, started early for us, and everything seemed to be going as planned, labor was progressing and Henri was handling the strain. By early afternoon, however, labor had stalled and Henri was showing signs of stress. Casey and I knew the situation was becoming serious, and the nurse said she was bringing the doctor back. I whispered to Casey that we would know how serious this was by how quickly the doctor arrived. It seemed like she arrived immediately, and our concern grew even more when the doctor had the room cleared of the trays and stands that have the baby equipment. It seemed that Henri was probably not going to be born in this room.

Knowing my propensity for getting light-headed with trauma, I had eaten healthy and sufficiently all day. I even had a bottle of Mountain Dew close by to amp my blood sugar when needed. As my fear for Henri mounted, despite my planning, I began to get light-headed. When Henri's heartbeat could not be located for a second and then third time, my vision began to gray and I thought it best to sit in the chair next to Casey's bed and not stand. Unable to see anything, as the flurry of voices and activity grew, it took every ounce of concentration I had to stay conscious. I was concentrating on only the voice of the doctor, and listening to every word. When she said, "We're going!" and I knew Casey would be wheeled to the O.R., I stood up. The nurses told me my head bounced off the wall before I hit the floor. The noise caused more of a concern than needed, because the glance off the wall probably helped my head by slowing the fall.

I regained consciousness on the chair-bed, with a doctor and nurses huddled around me. I was pretty agitated and anxious to get to the O.R., but I knew I would be a liability if I moved so I stayed lying down, distraught and in disbelief that I would miss what was happening.

As they wheeled Casey down the hall, they said she needed to have her nose piercing out. No one was able to do it for her, so Casey pulled it out. No one was able to take it from her, so she threw it. They had also said she needed her wedding ring off, but when she got that off, they yelled, "Don't throw it! Just put it back on!" In the O.R., Casey's doctor knew Casey had received an epidural, but did not know there had not been enough time for it to work. As the C-Section started, Casey felt the slice. The anesthesiologist used a fast-acting, general anesthetic to put Casey out. At 2:42 p.m., Henri David VanDyke was born, and both of his parents missed it.

As I was regaining my senses, I was keeping tabs, through the medical staff, on what was happening with Casey and Henri. I knew moments before Henri would be wheeled by the door and managed to get up and make it out to see him. My first moments of seeing Henri...



The first reports on Henri were very positive. His weight was good (5 lbs 9 oz), he had cried after birth, things generally looked good. He was going to the Intensive Care Nursery, but the Neonatologist sounded very positive. I was told I couldn't see Casey for an hour, so I followed Henri into the ICN.

It didn't take long in the ICN to see that Henri was having trouble breathing and would need help. Henri's Respiratory Therapist gave calm, detailed information on exactly what was going on inside Henri and what they were doing about it. There was an intense helplessness in watching the skin suck under Henri's ribs as he breathed, so understanding what was happening brought a (desperately) needed sense of security.



Over the next hour, more help was added for Henri and more monitors. It was an interesting mix of feelings about the tubes and monitors. These efforts were saving Henri's life, so mixed with the helplessness, fear and sadness was a sense of gratefulness. And at times I could see right through the mechanics and see only the precious baby boy.



The next few days, we saw improvements that would exhilarate and declines that would devastate. I spent hours turning from Henri to the monitors, and back. I can tell you where every lead went, what the purpose was of every monitor, and what the numbers indicated. It's an exhausting way to exist, but the small sense of purpose or control probably stabilized me in some way.



After four days, on Sunday afternoon, Casey went home. That's more her story than mine or Henri's, so I feel inadequate to explain how difficult that was, other than to say it went against Casey's every biological and emotional instinct.

The good news was that from Sunday on, Henri steadily (though slowly) improved. He breathed with a tube instead of the ventilator, then room air. Then he ate on his own and the feeding tube was removed. Then the final hurdle of maintaining his own body temperature. On Thursday afternoon, October 1, after 8 days in the ICN, Henri came home.



This is the story as bare as I can tell it. Each of Henri's first 8 days could be a chapter. I could go on about the 2 boys at home and how amazingly well they handled it, and also the unique situations the stress brought for us and them. As usual, I can't imagine how I would have survived without my friends, especially Casey's mom and my sister. With Casey's mom taking care of the boys and the house, I was able to spend 4 nights at the hospital and most of those first 4 days. Late night proved many times to be a valuable time to be in the ICN; I first held Henri at Midnight Friday. My sister was there through that first day and I am extremely grateful. She was who Casey called for when I went down (a nurse came in asking "What's Laurie's last name?!" and in my poor condition I hollered "VanDyke!"). She was there right after I regained consciousness. She was there as I reeled from news and as I wept in my few moments away from the action. I felt comforted and grateful for her.

I am also keenly aware of the positive reality of Henri's situation. Living in the ICN for 8 days gave me accurate perspective on what other babies and their parents have endured, and some of them still are.

This is simply how Henri arrived. And my heart sails.