Friday, October 28, 2016


Prince, apparently, overdosed. He’s hardly alone, just famous. After all, death rates are up and life expectancy is down for a lot of people and overdoses seem to be a big part of the problem. You can plausibly make numerical comparisons. Here’s AIDS deaths in the US from 1987 through 1997:

The number of overdoses in 2014? 47,055 of which at least 29,467 are attributable to opiates. The population is larger now, of course, but even the death rates are comparable. And rising. As with AIDS, families are being “hollowed out” with elders raising grandchildren, the intervening generation lost before their time. As with AIDS, neighborhoods are collapsing into the demands of dying, or of caring for the dying. This too is beginning to feel like a detonation.

There’s a second, related detonation to consider. Suicide is up as well. The two go together: some people commit suicide by overdose, and conversely addiction is a miserable experience that leads many addicts to end it rather than continue to be the people they recognize they’ve become to family and friends, but there’s a deeper connection as well. Both suicide and addiction speak to a larger question of despair. Despair, loneliness, and a search, either temporarily or permanently, for a way out. (...)

AIDS generated a response. Groups like GMHC and ACT-UP screamed against the dying of the light, almost before it was clear how much darkness was descending, but the gay men’s community in the 1970’s and 80’s was an actual community. They had bars, bathhouses, bookstores. They had landlords and carpools and support groups. They had urban meccas and rural oases. The word “community” is much abused now, used in journo-speak to mean “a group of people with one salient characteristic in common” like “banking community” or “jet-ski riding community” but the gay community at the time was the real deal: a dense network of reciprocal social and personal obligations and friendships, with second- and even third-degree connections given substantial heft. If you want a quick shorthand, your community is the set of people you could plausibly ask to watch your cat for a week, and the people they would in turn ask to come by and change the litterbox on the day they had to work late. There’s nothing like that for addicts, nor suicides, not now and not in the past, and in fact that’s part of the phenomenon I want to talk about here. This is a despair that sticks when there’s no-one around who cares about you.

The View From Here

Its no secret that I live right smack in the middle of all this, in the rusted-out part of the American midwest. My county is on both maps: rural, broke, disconsolated. Before it was heroin it was oxycontin, and before it was oxycontin it was meth. Death, and overdose death in particular, are how things go here.

I spent several months occasionally sitting in with the Medical Examiner and the working humour was, predictably, quite dark. A typical day would include three overdoses, one infant suffocated by an intoxicated parent sleeping on top of them, one suicide, and one other autopsy that could be anything from a tree-felling accident to a car wreck (this distribution reflects that not all bodies are autopsied, obviously.) You start to long for the car wrecks.

The workers would tell jokes. To get these jokes you have to know that toxicology results take weeks to come back, but autopsies are typically done within a few days of death, so generally the coroners don’t know what drugs are on board when they cut up a body. First joke: any body with more than two tattoos is an opiate overdose (tattoos are virtually universal in the rural midwest). Second joke: the student residents will never recognize a normal lung (opiates kill by stopping the brain’s signal to breathe; the result is that fluid backs up in the lungs creating a distinctive soggy mess, also seen when brain signalling is interrupted by other causes, like a broken neck). Another joke: any obituary under fifty years and under fifty words is drug overdose or suicide. Are you laughing yet?

And yet this isn’t seen as a crisis, except by statisticians and public health workers. Unlike the AIDS crisis, there’s no sense of oppressive doom over everyone. There is no overdose-death art. There are no musicals. There’s no community, rising up in anger, demanding someone bear witness to their grief. There’s no sympathy at all. The term of art in my part of the world is “dirtybutts.” Who cares? Let the dirtybutts die.

Facing the Unnecessariat

You probably missed this story about the death of a woman in Oklahoma from liver disease. Go read it. I’ll wait here until you come back. Here, in a quiet article about a quiet tragedy in a quiet place, is the future of America:
Goals receded into the distance while reality stretched on for day after day after exhausting day, until it was only natural to desire a little something beyond yourself. Maybe it was just some mindless TV or time on Facebook. Maybe a sleeping pill to ease you through the night. Maybe a prescription narcotic to numb the physical and psychological pain, or a trip to the Indian casino that you couldn’t really afford, or some marijuana, or meth, or the drug that had run strongest on both sides of her family for three generations and counting.
In 2011, economist Guy Standing coined the term “precariat” to refer to workers whose jobs were insecure, underpaid, and mobile, who had to engage in substantial “work for labor” to remain employed, whose survival could, at any time, be compromised by employers (who, for instance held their visas) and who therefore could do nothing to improve their lot. The term found favor in the Occupy movement, and was colloquially expanded to include not just farmworkers, contract workers, “gig” workers, but also unpaid interns, adjunct faculty, etc. Looking back from 2016, one pertinent characteristic seems obvious: no matter how tenuous, the precariat had jobs. The new dying Americans, the ones killing themselves on purpose or with drugs, don’t. Don’t, won’t, and know it.

Here’s the thing: from where I live, the world has drifted away. We aren’t precarious, we’re unnecessary. The money has gone to the top. The wages have gone to the top. The recovery has gone to the top. And what’s worst of all, everybody who matters seems basically pretty okay with that. The new bright sparks, cheerfully referred to as “Young Gods” believe themselves to be the honest winners in a new invent-or-die economy, and are busily planning to escape into space or acquire superpowers, and instead of worrying about this, the talking heads on TV tell you its all a good thing- don’t worry, the recession’s over and everything’s better now, and technology is TOTES AMAZEBALLS!

The Rent-Seeking Is Too Damn High

If there’s no economic plan for the Unnecessariat, there’s certainly an abundance for plans to extract value from them. No-one has the option to just make their own way and be left alone at it. It used to be that people were uninsured and if they got seriously sick they’d declare bankruptcy and lose the farm, but now they have a (mandatory) $1k/month plan with a $5k deductible: they’ll still declare bankruptcy and lose the farm if they get sick, but in the meantime they pay a shit-ton to the shareholders of United Healthcare, or Aetna, or whoever. This, like shifting the chronically jobless from “unemployed” to “disabled” is seen as a major improvement in status, at least on television.

Every four years some political ingenue decides that the solution to “poverty” is “retraining”: for the information economy, except that tech companies only hire Stanford grads, or for health care, except that an abundance of sick people doesn’t translate into good jobs for nurses’ aides, or nowadays for “the trades” as if the world suffered a shortage of plumbers. The retraining programs come and go, often mandated for recipients of EBT, but the accumulated tuition debt remains behind, payable to the banks that wouldn’t even look twice at a graduate’s resume. There is now a booming market in debtor’s prisons for unpaid bills, and as we saw in Ferguson the threat of jail is a great way to extract cash from the otherwise broke (thought it can backfire too). Eventually all those homes in Oklahoma, in Ohio, in Wyoming, will be lost in bankruptcy and made available for vacation homes, doomsteads, or hobby farms for the “real” Americans, the ones for whom the ads and special sections in the New York Times are relevant, and their current occupants know this. They are denizens, to use Standing’s term, in their own hometowns.

This is the world highlighted in those maps, brought to the fore by drug deaths and bullets to the brain- a world in which a significant part of the population has been rendered unnecessary, superfluous, a bit of a pain but not likely to last long. Utopians on the coasts occasionally feel obliged to dream up some scheme whereby the unnecessariat become useful again, but its crap and nobody ever holds them to it. If you even think about it for a minute, it becomes obvious: what if Sanders (or your political savior of choice) had won? Would that fix the Ohio river valley? Would it bring back Youngstown Sheet and Tube, or something comparable that could pay off a mortgage? Would it end the drug game in Appalachia, New England, and the Great Plains? Would it call back the economic viability of small farms in Illinois, of ranching in Oklahoma and Kansas? Would it make a hardware store viable again in Iowa, or a bookstore in Nevada? Who even bothers to pretend anymore?

Well, I suppose you might. You’re probably reading this thinking: “I wouldn’t live like that.” Maybe you’re thinking “I wouldn’t overdose” or “I wouldn’t try heroin,” or maybe “I wouldn’t let my vicodin get so out of control I couldn’t afford it anymore” or “I wouldn’t accept opioid pain killers for my crushed arm.” Maybe you’re thinking “I wouldn’t have tried to clear the baler myself” or “I wouldn’t be pulling a 40-year-old baler with a cracked bearing so the tie-arm wobbles and jams” or “I wouldn’t accept a job that had a risk profile like that” or “I wouldn’t have been unemployed for six months” or basically something else that means “I wouldn’t ever let things change and get so that I was no longer in total control of my life.” And maybe you haven’t. Yet.

This isn’t the first time someone’s felt this way about the dying. In fact, many of the unnecessariat agree with you and blame themselves- that’s why they’re shooting drugs and not dynamiting the Google Barge. The bottom line, repeated just below the surface of every speech, is this: those people are in the way, and its all their fault. The world of self-driving cars and global outsourcing doesn’t want or need them. Someday it won’t want you either. They can either self-rescue with unicorns and rainbows or they can sell us their land and wait for death in an apartment somewhere. You’ll get there too.

by Anne Amnesia, MCTE/MCTW |  Read more:
Image: National Center for Health Statistics