illness

I pretty much painted myself in a corner in my last post, but then these posts are notes to the supreme fiction nevertheless.  I have spent a lot of time awake over the last couple of nights worried about my wife, and worried about the finances, and worried about the finances most because I am worried about my wife.  She has spinal stenosis and has been experiencing symptoms of late.  She lost function of her leg the other day, and at her last doctor visit, she couldn't perform a simple task with her left hand.  It surprised and frightened her.  She couldn't move her finger from her nose to the doctor's upheld finger, which is not something one would expect to find impossible to perform.  They scheduled her for MRIs, and we spent most of the afternoon yesterday awaiting results.  They didn't come.

In the meantime, we were informed that the cost of the MRI, out of pocket, would be $1,800 dollars.  One of the mysteries of timing, right now, we have the money.  Five weeks ago, we would not have had it, and she said, "I wouldn't have had the test."  The $1800 is just the beginning.  The radiologist who reads the film will have charges, and whatever the treatment happens to be, there will be charges there that will exceed what our insurance will pay, and as the billing clerk points out, "will be our responsibility to pay."  There will come a point where our very modest savings will be wiped out yet one more time, and we will need to make some decisions.  Not doing what is necessary is inconceivable to me, and so the worry about the money is not cupidity, but the fear of being finally stymied in defeat.  No matter which path my mind goes down, it ends there -- stymied in defeat.

My work, and my philosophy, to a certain extent, are a distraction.  When I find myself tossing in bed, I try to think through a problem, a solvable problem, start to finish.  The other night, I tried to outline, top to bottom, my supreme fiction.  I went over it and over it in my mind, and I really didn't get far.  I know the end is a moral society, so therein lies the title, and it begins with my obsessive thinking about freedom and intentionality.  So the initial section would be titled "some basic concepts and distinctions," and it would address the underlying question, "are we free?"

The first concept is "intentionality," and it answers the question, "are we free?" in the negative, or perhaps more precisely with "not exactly."  Intentionality, I want to say, is "given."  Some are given physiologically (e.g. the need for food, drink, and sex).  Some are given psychologically (e.g. the need for recognition).  Some are given institutionally or as forms of life (e.g. the need to achieve checkmate in chess or cure patients of their ills in medicine).  I say, "not exactly," because there may be some freedom in the choice of one intentionality over another, but once chosen, the intentionality governs our behavior.

The second concept is "instrumentality," and it answers the question, "are we free?" likewise with "not exactly."  Our behavior is, I want to say, instrumental to the satisfaction of a given intentionality.  Here, of course, we choose the means instrumental to the given end.   The first limitation on our instrumental freedom is "utility."  Some actions are (while others are not) instrumental to the given intentionality.  The second limitation on our instrumental freedom is "capacity."  I do not have the personal capacity to address my wife's ills, and so must engage those who do, the health-care system, and my means of engaging is the health-care system is pecuniary.  My capacity to address my wife's ills is limited by the largess of my insurance and the depth of my pockets.  The third limitation on our instrumental freedom is "contingency."  I exist here and now and must make my choices from within the peculiar set of circumstances that surround me.  My worries about my wife would likely not be tainted by pecuniary worries were I situated in Mitt Romney's set of circumstances, or Paul Ryan's set of circumstances, but I am not.  My lot, so to speak, was cast into a very different world, with very different choices.

The third concept might be called "intermediacy."  We are not simple creatures.  A given intentionality is at once an end unto itself, but is often also intermediate to another end.  I engage in my "work" as an academic administrator, for example, not only as an end unto itself, but because it provides health insurance and remuneration which are instrumental to another intentionality.