No Words for Thank You

Tibet - photo by JoAnn Sturman

by Scott Sturman

Looking back over a nearly forty year medical career, advancements in technology and interference from bureaucrats have redefined the practice of medicine, but patient attitudes, particularly those receiving government sponsored care, are no less significant.  Early in practice, most welfare patients seemed to appreciate the efforts of the medical staff who treated them.  There was a tacit understanding the care they received resulted from the sacrifice, generosity, and ethical commitment on the part of physicians, nurses, and hospital administrations.  This relationship has changed.

In the series Game of Thrones Viserys Targaryen arranges for his sister Daenerys to marry Drogo, the Dothraki king, in order for the Targaryens to reclaim the Iron Throne.  It’s a match of power politics, for at first glance it is difficult to imagine an odder couple.  Drogo is a brute of a man and epitomizes his culture’s savagery and thirst for violence, while Daenerys appears meek, sheltered, and physically graceful.  They are worlds apart and speak no common language.  When Daenerys, also known as Khaleesi, receives her wedding gift from Drogo, she asks her knight Jorah Mormont how to say “thank you” in the Dothraki language, so she can express her gratitude to Drogo personally.  Mormont replies, “Khaleesi, there are no words in Dothraki for ‘thank you’.”

Obstetric floors specializing in indigent care provide a glimpse into the mind set of the welfare class.  Most patients are either young or have had a generational affiliation with government funded health care.  The likelihood that any of them have ever paid for medical care is vanishing small.  It is a way of life, an expectation, and a right. 

Labor epidurals are the standard of care whether a patient pays for the service or not.  The technique provides great benefit but is not without medical or legal risk.  Within minutes after the nerve block is placed, the patient realizes near complete pain relief.  And who is more likely to offer the physician an unsolicited “thank you,” the paying patient or the welfare patient?  Ironically, it is almost always the former.

On occasion after the procedure and prior to leaving the patient’s room I’ll ask her, “What do you say when someone does something good for you?”  The answer depends, of course, whether Dothraki is one’s primary language.  More often than not, there will be a pause and a reply more in the form of a question, “Thank you?”  Yes, that is the right answer, but one that should not have to be coaxed or coerced and whose meaning is frequently lost on those who view medical services as an entitlement.  

      Passion Tree - photo by JoAnn Sturman

(No kidding, we found this tree along a path in Costa Rica)

Barrack Obama and the Game of Thrones

Graffiti on Mt. Kilimanjaro - photo by JoAnn Sturman

Scott Sturman
fliesinyoureyes.com

This past spring I found my son reading the four book series A Song of Fire and Ice and by coincidence saw the initial episode of its first book Game of Thrones on HBO in March. After viewing the first ten shows I was hooked and could not wait until next spring to see the adaptation of the second book, so I bought the books, only to discover a fifth will be released this summer. 5000 pages of intrigue, deception, sex, violence, politics, heroes, and villains for less than $40 is cheap entertainment by any standard.

Although controversial, the book’s most loathsome character is Joffrey Baratheon, pubescent King of the Seven Kingdoms. Handsome, privileged, cruel, narcissistic, and conniving, he sits on the Iron Throne illegally thanks to the Machiavellian maneuvers of his powerful and wealthy family, the Lannisters. For all of his flaws, his ascension to the throne establishes a legacy for his ambitious supporters whose strength waxes as they gain control of the treasury, political apparatus, and propaganda services of the Seven Kingdoms. Joffrey is unfit to lead; he is strictly a puppet with more capable, yet nefarious orchestrators pulling the strings.

Who pulls the President’s strings? As long as his image of the second Messiah remained untarnished, his personal abilities were not called into question. His role was to bask in the adoration of the masses and leave governance to key advisors who formulated policy and spoke through his rich baritone. Yet as the President’s masterly crafted facade began to crack, the public received a glimpse of the real man, the man whose talents were overwhelmed by the problems that faced him.

Joffrey Baratheon is a despicable character, and his entourage and political advisors are well aware of his foibles. Yet their mutual success is dependent on his continued reign and the ability to convince his subjects he is the rightful heir to the throne. When the legitimate king Stannis Baratheon discloses that Joffrey is the bastard son of his mother the Queen Cersei and her twin brother Jaime, Joffrey’s retinue vigorously denies the truth and smears Stannis’ credibility.

Game of Thrones is entertaining fiction, but demonstrates effective propaganda can transform real people of modest ability into fictional personalities, who are more god than human. Cersei, the queen regent, holds the kingdom's populace in gross contempt but gives them her perfect son to lead them. If hateful, tell them he is loving. If slow witted and self serving, tell them he is brilliant and caring. If unable to lead during times of hardship or develop coherent policies, tell them he possesses unrivaled leadership abilities and sees the future with clear vision. Sound familiar?