For years now, I've been telling friends that I fully expect to land in prison one day; not because I knock over liquor stores, steal cars, cheat on my taxes or make inappropriate advances towards young ladies.  No, I'll end up there because I have the wrong opinions.  Take this post, cut it out and put it in the time-capsule.  Because we'll have political prisons in this country; probably in my lifetime. 

Why is that?  Because the freedom to express ideas is no longer valued by those on the political left.  Ironically, free speech was a traditionally liberal idea, in the old, noble meaning of liberal as something which advanced human liberty.  Now, free speech is an annoyance.  There are constant attempts to circumvent the 'wrong' opinions, whether through things like the fairness doctrine,  through 'speech police' on university campuses or as in other countries such as Canada and the UK, by calling unpleasant speech a 'human rights' violation and offering fines and imprisonment to those who speak out in unwelcome ways.  Read a bit about columnist Mark Steyn and his struggles in the Great White North,  read about the European and Canadian tendency to prosecute pastors who speak out against homosexuality from the pulpit; if you do you'll know that trouble is a-brewin'. 

'But isn't that extreme?  Political prisons in the land of the free?'  Not a bit.  The reason I know is that I have tried to have conversations or correspondence with ardent liberals, and the interactions often end in shouting, profanity and the ubiquitous, inflammatory word 'whatever,' on the part of the so called progressive. 

Well, if these folks come to power, do you think they'll tolerate engaging and enlightened dialogue?  No, they'll fine first, then censure, then call for re-education and ultimately, for those of us who are 'hard cases,' they'll imprison.  The reason being, 'tolerance' doesn't exist.  And since a good society can't 'tolerate' the wrong opinions, the only way to manage those opinionated folks will be to lock them away and deny them access to other more enlightened humans, or to media outlets. 

If you think I'm wrong, that's fine.  Maybe I'm just too paranoid.  But go to a group of liberals and tell them you don't believe in anthropogenic global warming, tell them you think abortion is murder and tell them you think that homosexuals should not be allowed to marry or form civil unions because it violates scriptural guidelines. Tell them that any sex outside of marriage between a man and woman is sinful.  Tell them that profit is good and socialism is bad; and that you have the historical evidence to prove it. 

Then sit back and watch the lather form.  They won't pull out texts or articles.  For all their scientific atheism and love of rational thought, they won't refute you calmly, or engage in 'dialogue,' over a glass of Merlot while referring to scholarly articles.  They'll fairly explode. 

When intolerance of another opinion becomes that vicious, the only way people (without a spiritual bed-rock of concern for human equality) can manage it is to shut it up and put it away. 

So, reserve my room in the prison.  I think and say all of the wrong things.  And eventually, as is already happening in modern democracies elsewhere, people like me will end up in deep trouble. 

At least I won't have to worry about whether I put away enough money for retirement!

Edwin 

I realized, not long ago, that the modern  hospital emergency department is much more than meets the eye.  Sure, it's the place where the severely ill and injured receive modern, timely care by well-trained professionals.  Obviously, it's the place where many Americans receive their primary care, due to their inability to pay, or their lack of insurance (voluntary or involuntary). 

And yes, it's the place where physicians and nurses wrestle the drunks, the drug abusers, the overdoses, the arrested felons with 'seizures,' and manage many of society's other problems when no one else wants to deal with them.  This includes looking after the homeless when shelters aren't available or willing, caring for the schizophrenic and suicidal when all the psych beds are full and they have no insurance (most of them, incidentally), helping with nursing-home placement for frustrated family members of demented elderly men and women; the list goes on and on.

And of course, let's not forget that the emergency department is the source of a huge amount of the illegal prescription drugs that circulate in America, thanks to modern medicine's acceptance of the already-tired dogma that we should always treat everyone's pain, and never doubt their story.

But more than all of these things, the modern emergency department is a kind of social sciences laboratory.  In fact, about 30 years into the existence of the specialty of emergency medicine, I feel comfortable saying that we have shown.with remarkable precision that the more radical social revolutions of the 20th century were abject, stunning failures.  And the reason I can say it is not based on carefully designed studies, or because I've observed it from the comfort of the ivory tower of academia, but because I, and many others like me, treat the casualties of those social revolutions day, after day, after day.  Some examples, you ask?

'Drug use is normal, good, relaxing and enlightening.  Only Puritans and other fundamentalists have any problems with drugs.' 

I see the scars from years of injecting heroin and methamphetamine.  I see the lifeless, pointless existence of heavy marijuana users, who don't have the inertia to do much of anything.  I see the agitated misery, heart attacks and strokes of cocaine users.  I see the endless somnolence of narcotic abusers who are 'hurting so bad,' even as they fall asleep begging for another prescription for Oxycontin, Percocet, Vicodin, Methadone, Morphine or whatever their narcotic of choice may be.  I see the shattered parents, the displaced children, the wounded spouses, the frustrated police officers.  I see the way they drain society of patience and money; and the horrible way their lives were ruined, when they could have been happy and productive.  Drugs are liberating?  I don't think so.

'Sex is natural and anyone who tries to limit sex is an old-fashioned prude; probably a Puritan or fundamentalist...see above re: drugs.'

Well, there's nothing more exciting and liberating than a fresh, painful case of herpes in a teen-age girl.  I just saw one.  She was in pain, and she was crying, and she knew that it would never be cured.  'Well, sure, but if she used a condom...'  If she used a condom, she'd still be faced with the reality that condoms are only 50% effective at preventing STD transmission.  She was 17 and had already given birth to one child.  Sex certainly liberated her.  See, in the emergency department we see the painful pelvic infections women endure, the infertility they develop, the mistrust between partners when one has an STD and another does not.  We see embarrassed young men with burning infections.  We see the depressed and anxious who are suffering from infidelity.  We see the unplanned, undesired pregnancies and the children left behind by infidelity.  We see those teenage girls with the exploding rates of STD's.  (Half of all African-American teen girls have a sexually transmitted infection.)

The mantra of 'free love' that began in the 60's wasn't about liberation; it was about enslavement to the desires of those who started it and who wanted no restraint on their behavior.  The echoes of that movement still sound today in the weeping of patients with non-lethal infections and the grief of those with HIV.  Nice work guys!  We're finally free from sexual restraint.  And more miserable than ever.  Not to mention the marriages broken by infidelity and pornography.  The 'liberated' women all but enslaved in the pornography industry, or trapped in lives of prostitution where they develop diseases, or are victims of violence, and eventually end up in the emergency room themselves, liberated from health and self-respect.

'The way to fix poverty is to give services, food and money to them, so that they will feel compelled to improve themselves.'

Well, sure.  Plenty of families need help.  I love helping them.  I don't care a bit when I don't get paid by a family in need.  But plenty of families are lazy; and have been lazy for generations, thanks to the welfare state.  We see them come to the ER en masse, an entire family with cold symptoms or insect bites, all checking in because 'we might as well, since we're here.'  They call ambulances for prescription refills but never do the things that might help them, like giving up cigarettes.   They over-eat, over-drink and under-move, all the while collecting welfare to support their obesity; disability for 'nerves' or 'anxiety' or some unverifiable pain, all the while working on cars, partying, hunting and having the physical capacity to make multiple children, all supported by the state, all supported by the tax dollars of the gainfully employed.  Their children?  Rarely are they ever taught that there is value to education, value to knowledge for knowledge sake, seldom are they aware that a home can be a place of hope and encouragement, progress and comfort.  Great idea; give people just enough to keep them from starving, but don't expect enough from them to let them lift themselves up from their low estate. 

'Families can be defined in any way, and frankly, men are entirely unnecessary except as 'sperm donors;' and how hard is that?'

Do you know why I see children who are anxious and afraid?  Do you know why children seek each other out for sex, and hafve children of their own at such a young age?  Because they are terrified. Why is that?  They lack the peace of safe and stable families.  They lack the boundaries and discipline, born of love, that proper families give.  They want the protection, wisdom, affection of a man and woman, together for the long haul.  Without those things, we see what we do; teen mothers, teen fathers, irresponsible parents shifting sexual alliances from week to week, month to month, moving in with lovers and moving away from them.  The children are circling in a whirlpool of pending disaster, and they know it.  They are depressed, fearful and lonely.  They have sex inappropriately for their ages; they use alcohol and drugs; they mark their bodies with tattoos and piercings, seeking to make themselves interesting, or beautiful, or acceptable to someone, since they don't have that acceptance at home, where the definition of family changes from week to week, fad to fad.  The ER is full of young people, and adults, who are so devastated by the lack of family that they can barely function.  Is family necessary?  Absolutely.  Are we just as well off without it?  Not a chance. 

'Religion is an impedance to modern thought, and we need to be liberated from it.'

Great!  Now, when someone's child is crushed in a car wreck, when someone's spouse is murdered, when cancer is discovered on a routine exam, when death comes suddenly and unexpectedly, you scientific folks go and comfort them with the knowledge that their loved ones will merely fertilize the earth for future generations.  What?  Too busy to hang out comforting the sick and dying?  Right, I understand. 
Well, how about the people who were from those broken homes, who were and are addicted, who lived as hookers and thieves, or the ones whose families were intact but unkind.  What about all of those who hear the voices that say, 'you're not good, you're worthless!'  What say you to them?  'Well, if you try hard enough, you may be worthwhile and do something useful.  Here are some financial handouts to help you along.  Take these pills and see a psychiatrist if you can afford one.'  How about this, for all those broken hearts I see day in and day out?  'The God of the universe says you're his beloved, and wants you to know that your sins are forgiven if only you'll accept the gift!  Your past will be wiped away, and you will be new.  It won't be easy, but the church will do its best to love you, and you can know in your heart that your heavenly Father adores you.'  That's better.  At least it offers hope without any request of performance, and without the fickle approval of human beings.

See, the ER is the laboratory where we have seen the truth.  And the truth is, America lost its way.   Read research from sociologists if you want.  Study academic journals over a cappucino.  Wax poetic about the masses and their struggles, about the judgmental 'religionists.'  Seek higher taxes as if money were the balm for all suffering.  Tell jokes about drugs and sex; watch some porn, smoke some pot.  Relax over a glass of wine and plan ways to make America even more free, more fair, more progressive.  But take it from a guy down in the mud, it's a hurting world; and hurt all the more by social revolutions that led, ultimately, to disaster; disasters seen with crystal clarity in America's emergency departments. 

Edwin