Respect: Another Way of Looking at Class Structure

About a year ago I got a tattoo of the staff of Asclepius from a shop in Hudson to commemorate the end of my career in medical publishing.  It's cute and I still like it.  While weeding my garden yesterday and contemplating the end of my professional life, I tried to think a bit more deeply about the meaning of this image and the value, if any, of spending three decades providing primary care doctors -- the major physician caregivers -- with information. 

I had just completed a contract with Medscape, which involved writing captions and an article on survey results for physician compensation, and, no surprise, the survey shows that primary care physicians (family docs, general interns, and pediatricians) are the lowest paid among all specialties. The highest earners are the surgeons and interventionalists.  (Of interest, dermatologists fall slightly above the middle in compensation but in our Medscape surveys are the happiest physicians.)  

In considering the different specialties and the disparities in how physicians are rewarded by our society, I began to conceive of a slightly different American class system, which determines a person's cultural status not by income but by respect based on the visibility of a person's successes or failures within specific groups.  A key element in this structure is the low regard given the caregivers in our society. As with all my theories, this one is half-baked and will not stand up to any rigorous investigation, but I thought it was worth a blog entry.

The following are the five categories in my new class system, with examples of participants, ranked highest to lowest by respect according to our society's values --- or lack of them:

1. Exploiters: Most corporate leaders, wealthy indolent heirs, people in financial services, major criminals, and long-term politicians. Some major religious figures, media personalities, performance and conceptual artists, and all cats. Although exploiters can be feared and hated by their victims, they have attained the greatest respect in our culture because of the high visibility of their success (ostentatious display of money, power, tooth and claw) and their considerable resources (money, power, tooth and claw) to conceal any failures. On the rare occasions where non-feline exploiter failures are exposed (e.g. Madoff, Nixon), their fall in cultural respect can have extreme consequences -- massive public humiliation, jail, and in some cases death, although this doesn't always happen (e.g. Limbaugh).
2. Heroes: Cops, firemen, soldiers, surgeons and medical interventionalists.  Heroes (except for surgeons) are not always rewarded well financially but they are ranked second in cultural respect because their successes are dramatic, immediate, and highly visible. Failure can be fatal for non-surgeon heroes and is not associated with a reduction in public respect. Surgeon failure might be fatal to their patients, in which case they do risk being sued, but not necessarily lose their place in the respect ranking.
3. Observers:  Most of the working and middle class, including nearly everyone who spends more than four hours a day looking at a screen and all editors, figurative artists, academics, and dermatologists. This very large group falls solidly in the neutral center, because it bestows cultural respect and disrespect, rather than having either. Neither its minor failures nor successes are very visible, and are vaguely noted only by small circles of family and friends.
4. Caregivers: Most primary care physicians, nurses, teachers, social workers, baby sitters, religious professionals who practice what they preach, parents or anyone who cares for family members, plus a few short-term politicians. This group doesn't make much money, and any cultural respect paid is usually lip service. Their success relies on improving the lives of victims (see below) and it is slow and rarely visible.  If they fail their victims, however, they are typically scapegoated and severely punished.
5. Victims: Infants, toddlers, dogs, patients with chronic or fatal illnesses, small farmers who rely on the weather, people who get cheated sexually or financially, addicts, students in impoverished areas, and any adults without jobs and money for whatever reason. Victims have no success at all and only their failure is visible, which, except for very small children, dogs, and local farmers, is often considered to be self-imposed or caused by their caregivers.  Rarely are exploiters considered causal in a victim's failure, although they usually are. Some victims are momentarily saved by heroes.  Observers frequently contribute money to prop them up, but like heroic action, the success that this produces is typically brief and not visible.  In general, victims are served long-term only by caregivers. (In the past one or two victims have lifted themselves visibly into the exploiter class by their bootstraps, although unfortunately no one knows what a bootstrap is anymore.) 

The amount of respect and status bestowed on individuals in these groups has nothing to do with whether they are good or not. Although most exploiters are bad, many lose power and money and transform into other categories, usually victims.  Heroes and victims can be either good or bad, sometimes in the extreme. Observers shuffle back and forth between mild versions of the two states, typically living out their lives in variations of guilt, resentment, and smug contentment. Caregivers are generally good, just by virtue of their choices, but a caregiver who turns bad is bad indeed, typically transforming into an exploiter.

My Place in the Class System

I've been lucky enough so far not to be a victim (but Old Lady Gaga lurks in the shadows).  I never had the interest or nature to be an exploiter, but I was too much a physical coward to be a hero and too emotionally helpless to become a caregiver. My career as an editor, writer, and publisher puts me solidly in the observer category.

The best I can say about my place in the respect system is that I have been a caregiver cheerleader, counting some good friends and children in this best of all groups and spending most of my working life providing high-level information that will save time for the family doctors, general internists, and pediatricians -- the physician caregivers.

Caregivers: The Best Class With Nearly the Least Respect

Caregivers, who do not turn into exploiters, have made active life decisions to engage and not to be observers and to provide services for both the real and imagined victims.  

Caregiver incomes, no matter what profession, are nearly always low, because they typically rely on society for salaries and they don't kill anything and they don't steal.  And, the more victims there are, the more caregivers are needed, and the less money there is available to pay them.  So the more work caregivers have, the less money they make. 

Their success depends on the consequent improvements for the victims they serve. If they succeed, however, they are rarely credited with success because their actions are non-heroic, slowly progressive, and rarely visible. (The student goes to college five years after his teacher took a chance and gave him an A on a badly written history paper because his intelligence was obvious in its ideas; the patient with high blood pressure controls it with weight loss and exercise after months of badgering by her family doc; the mental patient goes back on his meds after he's considered what his social worker said in the emergency room a week before.) 

More often then not, however, in spite of caregivers' best efforts, they fail the victims, sometimes because victims are lazy or criminal but most often because of intransigent barriers to success: genetics, poor environment, severe emotional or physical illnesses, financial downturns, catastrophes, just lousy luck, and, of course, exploitation.  Unfortunately, when something seriously bad happens to a victim under someone's care, that failure is often visible (student drops out, psychotic kills himself, patient has a heart attack, child is abused), and because the real causes are unresolvable, the caregivers are often blamed and subsequently humiliated, yelled at, fired, attacked, or sued. 

So maybe there should be a sixth group--a highly loud and visible Monster Nagging Uber Caregiver, reminding the exploiters, the heroes, the observers, and the victims that the best chance our culture has is not only to pay caregivers a decent income and give them the deep regard they deserve, but to transform everyone into well-paid, publically respected caregivers.  Each of us a brother's keeper.  Now, where's my next victim?

The Lure of Big Jim

A lecturer on vegetables during Garden Day at the community college told the class that it was too late to plant chili seeds. "Get them in before March 15^th or it's too late."

 "What?' I asked, alarmed. "What if I get them planted this week?" (It was April 2.)

 "It's over for them."

I don't think she understood the cruelty of her remark. She is a no-nonsense upstate second-generation farmer, who wanted nothing to do with fancy seeds, like heirlooms or, horrors, those from New Mexico. On the other hand, why am I so worried?

Green chilies, specifically Numex 6 and Big Jim, may be the primary reason why I'm leaving New York. Michael introduced me to them 25 years ago on my first trip out to Albuquerque, where he grew up. Duran's, a drugstore, across from Old Town, served a cheeseburger graced with green chili -- spicy, slightly sweet, with a subtle sweaty undertone. It grows on you. Eventually everyone becomes addicted. Sometimes people overdose. (My daughter who moved out West with her husband and kids years ago was a major addict but recently and unexpectedly has switched over to red. She sent me a recipe yesterday that was obviously intended to undermine my faith!) 

I started my first vegetable garden up here nearly 10 years ago with the intention of growing the basics for my favorite dish -- eggplant Parmesan. I had previously identified the perfect eggplant -- Rosa Bianca -- at the Union Square greenmarket, which is about four blocks from our New York apartment. You slice this oval, beautifully tinted lavender fruit into pretty thick rounds, coat it with flour and parm and sauté it first before you bake it layered between homemade tomato sauce, cremini mushrooms, and fresh mozzarella. When it's cooked through (and that's important!) the eggplant comes out tasting like thick custard, and everything else is dense, gooey and fabulous.

So I planted this eggplant and its pals San Marzano tomatoes and basil, and tossed in a cast of boring extras -- beans, cucumbers, squash and other WASP vegetables that my farmer lecturer would approve of. That first summer the beans turned to rust, and after one salad I let the cucumbers bulge and rot, because I didn't know what else to do with them. But the tomatoes and eggplant and basil thrived. My landlord Dave and I bought a freezer together, and I loaded one side with tomato sauce and grilled eggplant, ready for winter.

Encouraged by the egg-parm success, I introduced green chilies a couple years later. I bought the seed from Chimayo, New Mexico, a small town north of Albuquerque, which has its own eponymous chili and is known for a church that has a pit inside filled with miracle-established sacred soil that is sold by the teaspoonful. I bought a tiny box of it along with a couple of green chili packets, added them to my garden plan for the season, and, although not expecting much, by August, the miracle had worked. There they were, long, shiny, and green, dangling like jewelry and nearly invisible underneath the green shiny leaves that they closely matched. The first thrill every August is this discovery.

The second is grilling them on the Weber in the yard behind the barn, watching them char, then shoving them into brown paper bags, where they cool a little and their skins loosen up. Sitting like an old dog in the late summer grass, I flay the chilies and pile them up in steel bowls, ready for freezing.

The third and ongoing thrill is using them: The fattest ones are doomed for a pseudo chili relleno, stuffed with cheese, lathered with a batter, and baked for an hour. The thinner chilies are typically chopped and cooked with onions, garlic, and chicken stock. I might just freeze this mix, or put it in the processor with roasted tomatillos and cilantro (both growing in the garden) and mush it all together for salsa verde. This serves as a base for almost everything I cook over the winter. It goes into pasta sauces, mayonnaise for sandwiches, marinades for any kind of meat, and it cheers up soups and stews I am also planting cucumbers again for making sweet spicy pickles with raw chilies. Last year I threw soaked apple wood into the weber and smoked the chilies, which processed into a subtle chipotle. If I could put green chili into deserts I would.

I can't always count on the heat of the green chili, so I also plant two serranos, which emerge as tiny hot green thumbs early in the season. They have a neutral flavor and reliable spiciness, so I can throw them in with the New Mexico chili sauce to boost heat if I need to. And at the end of the summer, when the serranos turn red, I roast and process them by themselves with turmeric, cilantro, ancho chili powder, cumin, garlic, and a thick tomato base to make a phony harissa. Note to daughter: this does not predict any movement in my belief system to the red state. Serranos are no substitutes for the Numex 6 and the Big Jim. Nothing is.

I still buy my seeds from an online site located in Chimayo. Unfortunately, no one else grows New Mexico chilies around here, so if my plants don't make it, I won't even be able to buy the final produce in local farmers markets or even in the Ur-Market in Union Square. I don't know why I’m worrying. I'm a victim of upstate expertise, even against my own experience. The farmer down the road who nurses my new plants every spring in his green house never gets the seed in until April. One year, a chipmunk broke in and ate every one of the green chili plantlings, and he had to replant them again in early May. Even then the chilies still grew, although a lesser crop. But if the lecturer is right and "It's over for the peppers", then I guess we'll be forced to move to New Mexico.  Although I planted some Italian broccoli and cauliflower last year that were pretty great...And then there's a new kind of eggplant and Mosque de Provence pumpkin, which lends itself to all kinds of variations on its theme..We'll probably stay here even if Big Jim betrays me this season.