(viperam nutricare sub ala)

^"Hello. I'm Shannon O'Brien. This is Doctor Marcus Macaluso," She offered a polite handshake while nodding toward the doctor.

"Mrs. O'Brien. Doctor."

Macaluso superimposed his hello on hers then hesitated his, " Nice to meet you, sir," reservedly, not knowing just who he was greeting. His hand was out in reflex, but then checked as Shannon's grip was not yet released.

"You are.." Shannon enquired slowly in an unsure voice, "..Mr. Dryfus? Somehow, you look - familiar," her hand still - strangely - trapped in his.

"Dimmed memory. We weren't all that sober, so it's quite understandable. Sean Price. Sean Price, madam, at your service." The big red faced man with white bushy eyebrows and flowing hair, bearing a senatorial look folded in a prideful brow made a graceful deep bow and kissed her hand. It was the kind of gesture one would associate with an Elizabethan courtier, lacking only the large plumed hat.

Shannon did a responsive curtsey, then gave the big guy a hug. "Ooooh, I had no idea that YOU would be here. I don't remember half of that night. My mind was sa-wimming after the third toast. " Macaluso winced imperceptibly at the swimming reference, his own mind trying to navigate this exchange.

"Well, after the church we hit Fegan's Bar. Pretty darned hard, I might add. The whole wedding party - including Father Kelly."

"Oh-mih-god, Father Kelly! What was the deal?" Shannon was laughing with her hand on her forehead.

Price rolled his eyes and nodded his head, "It WAS Saint Paddy's day too, after all. His reverence, was celebrating both occasions with holy spirits. You know, I almost pee'd my pants when the good father, hah - at the reception, .." turning to doctor Macaluso briefly to not keep him excluded, ".. gave his dinner blessing and then began reciting the whole bloody wedding ceremony again! Damn, he was blitzed." He guffawed to a grand gesture landing his hands on his hips. With that, Shannon got her hand back. He looked as if he were choreographed in a three musketeers scene. Doctor Macaluso had mentally painted in a sword hanging in its scabbard from the man's middle, while wondering when he would swing on a conveniently appearing chandelier.

Shannon, on the other hand, was thoroughly engaged in this. "Oh God. Yes," She chuckled with rolling eyes, "Most couples don't have second vows until their twenty-fifth or fiftieth anniversary, if at all. What was their's? Three hours later? Although, ..." pausing in reflection, "I liked their vows better the second time. I mean, how many times do you have marriage vows with a drunken groom grabbing the bride's ass and staring down her cleavage?"

"No! I didn't see that!" Price was leaning backward, still with his hands poised like a Hollywood swashbuckler.

"Well, I did. John's got a picture of your son-in-law with a fist full of your daughter's buttock. Speaking of which, did my bad boy twist your arm for you to come and preside over this meeting?" with a my-John-is-a-naughty-boy face.

"No. No. Not at all. Nobody twists these arms. I'm here just for the kick off. A little show of serious intent is all you need from me," again making a grand smile with a puffed out chest and a very self certain expression drawn across the eyebrows. Macaluso's inner beast suddenly roused. Serious intent? Translated? Power? Why was power needed, here? Was this a reluctant gathering? A simple word would lay on him like a bludgeon. Price added weight to that impact as the law professors entered. His resonant voice amplified so as to be overheard, the magisterial Mister Price pretended to address Shannon, "If these two eggheads don't help you, let me know. I'll buy two new ones. Ha ha ha."

Having made polite mirrored laughs, the two entrants introduced themselves graciously. Price excused himself, in mocked obeisance to the ever Irish Mrs. O'Brien, by reciting Mavourneen, a short and particularly sentimental poem by the so-called terrorist McGuiness. Shannon caught that. It wasn't meant to be subtle, return of favor, a thank you, of sorts, two law professors for one poet. The professors, having no idea of what that drippy rendering really was all about and probably not caring, just let it go by. Gaelic eccentricity. Marcus took it much further.

So, what had just happened here? To Shannon, Sean Price made an effort to be gracious and went a bit out of his way to see to it that a project bearing his imprimatur got off to a proper start. But Macaluso's inner beast linked with a speaker, attuned to breathing rate and depth, eye flutter and pupil size, voice tonal qualities and altering resonances, word choices, juxtapositions of manner and phrasing, weight shifts, lip moisture, jaw thrust, head angles, hand postures and simple thumb twitches, tiny wavers, or tremors. Body movement has meaning and masters of speech use it in their art for subterfuge. But to the connected listener, one who's perception exceeds the actor's artifice fastening on the speaker viscerally, tiny details, trifles, peculiarities, minutia were of more significance than the larger theatrical movements. From these, the beast could and did read a steady stream of unconsciously conveyed semaphore. There was sub-text layered under, over, and, behind the spoken conversation. That message was quite different from the words Shannon heard and the content words disguised.

What Macaluso's beast heard was, "Your husband, John, did me an unavoidable and modest nonessential favor related to a wedding reception which I, for color, allowed some ethnic riff-raff to attend. Although elevating John by allowing him to be the purveyor of that color, by arranging this meeting, any debt which you may mistakenly perceive to be mine, to you, is now repaid IN FULL. Don't expect anything more from me. As a very important and powerful man, small favors from me have much more intrinsic value than grand and painful efforts from you. I, by right, am owed consideration. You, in contrast, have to earn it." The man was a beacon of arrogance projecting obligation to no one, just entanglements. That's what the beast heard and concluded. Nevertheless, the beast held its tongue, Macaluso's.

Shannon was upbeat. This was, to her, an embryonic first of many potentially escalating meetings which would first explore common ground, then grow in exploration toward solution. Eventually a process of implementation would emerge. To doctor Macaluso, this meeting must either explode with shared outrage over substance and with implementation derived from compatible skills of equally driven participants who in joining together create powerful mechanisms of remedy - or - it was over. Dead. Right now, odds strongly favored dead. Doomed or otherwise, Shannon would never forgive him if he began trashing things. So, he told himself, just shut up and smile amicably, contemplate the universe, and offer an occasional polite Hmmmm. Got a point, there. He could do that. Yeah. Just shut up and keep out it.

Introductions were followed by brief autobiographical familiarizations of the participants. Dorothy Bela had extensive experience in advocacy for the poor and, in fact, was the primary legal advisor on the AIP, Advocacy Issues Panel, at Teson Hall Law School as well as being chair person of several major institutions dealing with advocacy issues. Suddenly her expertise seemed more important than her stature as a department head.

Adam Dryfus had practiced law longer than Bela, but in his case it was in the so-called front lines as a pit bull attorney for a firm that catered to corporate structures and enterprise. A thought crossed Macaluso's mind, or maybe it was his beast, that Dryfus could very well have been a target of Bela at one time. In any event, pit bull Dryfus choked on the hand that was feeding him as the other hand was goosing him simultaneously. Embezzlement of the firm's funds by a founding partner was discovered. That was lethal to the firm and to his career, as clients vaporized in the melee which followed. Teson Hall was, at first, a cushion, but became, apparently an unexpected full time new direction for the personally hurt Mister Dryfus, or so he claimed. The doctor wondered about those who get driven from Eden trying to create their own Edens? But Macaluso's only immediate question was, "How much time do we have?" wondering how long he had to feign interest. Of course, it sounded just the reverse.

"All you can stand. We can send out for supper and for breakfast in the morning, if you like," Bela smiled.

Shannon was ecstatic. Some poetry, she thought to herself, better appreciating her husband's agile networking skills. John had joked that you never could tell when you might need a terrorist poet. Shannon was doing not so subtle whispered told-you-so's in savoring that often repeated line in Mac's ear as the two professors were unloading papers and folders from their bulging leather bags. She also needled him about the Price-Johnson wedding reception being a major coup with emphasis on Price's son-in-law being a Protestant whereas his daughter was a Catholic like her mother. Macaluso just grit his teeth, she thought in obvious affirmation of that problem. But the grimace was from irritation that anybody could even give a shit.

Mac quickly nodded. He had heard so many fragments of this event that its mere recall was numbing. He began to detach, "Hmmmm. Got a point, there," he tested. It worked, he thought, slipping out, just keeping a half ear out. Shannon and each of the two lawyers thought that his comment was directed to one of the two others and each one felt a little embarrassed about having not caught the thing about which the doctor had thought a point had been made. So they began to attend to each other's comments promptly and got into the subject matter in earnest.

The discussion of legal issues became wallpaper. Only intermittently seeded by surrounding conversation and Shannon's gloating, Macaluso's mind was floating on the flood of recent inconsistencies. There were so many. Seeking connection, incongruous thoughts were tumbling in ill fitting juxtapositions. Deeper and deeper into his disconnect, fragments, events, discussions, readings, nostalgia, and projection - all swirled transparently in a color show of overlapping hues of interpretation.

"Don't trust him. Price. Some name! Got a price. Bet everything has, to him. Maybe an axe to grind..." An oddly appealing mental image of a twisted bitter poet gripping a blood dripping axe interposed itself. A demon poet, "..sucking up to that overbearing ass hole, mmm, nah, that didn't gel. Gotta be more there. Though the newspapers did report... a fugative?.. at a recent wedding reception? Facts fit but not the spirituality. And what's the terrorism deal when the whole thing was planned? Whose bull shit was that? Axes to grind... so many... McGuiness.. a man of every imaginable description, clean shaven to wooly bearded. People aren't that stupid. Nah. Well, some are. Hmm. A lot are. No shortage of dumb asses out there, actually.. But no, disinformation... that was his protection... made him invisible. No one knows.. Terrorist? That's it? Gavin McGuiness? Poet?" Matter and antimatter embraced in a dance of havoc, he thought. It was that very sort of potential for incendiary ruin and self destruction that had Macaluso distracted, reflecting on the many stories that he had heard from Shannon and John over various dinners.

But then, was Price also invisible? In character? Who really knew him? That deep bow, that was tutelage, not homage. "Something about him... mmm.. no humility.. eyes of Mammon.."

Shannon was still nudging Marcus with a few more gloating reminiscences of the wedding event as the professors were comparing notes on some legal point, but they were all by now well tuned out. "Hmmmm. Got a point, there." Bela and Dryfus read material which they thought might be relevant from the piles of case law material weighting heavily on the large board room table. "Hmmmm. Got a point, there." Marcus withered even deeper into his own spiraling thoughts, not connecting well with his misgivings. Grab the ring on the next go round, he thought, and thought, "walnuts.. shelled.. John Irish issues O'Brien... a wanna be historian.. mmm no.. no shovel .. can't dig shit without a shovel ... John and the Irish Culture Forum, the good ole lCF.. wouldn't it be cool if he was really a gun runner.. digs with a bayonet... ICF, Irish Catholics Screwed.. bipartisan?... buy partisans.. was that one quart of milk or two?.. walnuts, milk and and surface to air missiles.. forwardly bipartisan... but... retrograde judgmental ... two.. Dryfus.. Doofus hah Doofus.. Justice.. blind? .. fair isn't blind... blind.. to what.. need butter.. they screw you with a bag over your head... John isn't blind.. quarter pound?.. is he... though... privately.. judgmental.. William of Orange.. Dutch touch... bend over.. that's one stick, right?..  Hmmmm. Got a point, there. William.. Billy.. Billy Butcher... annihilator... kill'em bill'em.. gotta pay.. and pay, forever.. yo Billy... children killer, nits become lice.. cultur killer.. exterminate.. forever .. long time, forever.. repress.. orange.. nuts.. shelled.. people shelled.. orange something is people - people.. what?.. sibilant orange?.. something .. jubilant orange is people?.. wasn't that Moses.. something orange was people.. orange Julius... come'on down.. kill the natives .. replant. .. the planting... orange planting... the orange planting is people - people.. silent orange? succulent orange?... agent orange... AGENT ORANGE, just as well.. oranges... come on down - and devour the natives.. bring a stick of butter.. batter... batterer.. make them poor... keep them poor... nuts.. crush them.. in every germ of enterprise... degrade them into a servile race... lose the race.. without hope... William Soil Lent Orange.. ordination.. eater of hope... hope heartburn... flames.. the devil.. Devlin... John there... Devlin.. key to whose heart.. Hewey Newton? ... Same battle.... give up?.. nuts.. shelled.. same damn battle... girl had balls... same nuts.. symbolism?.. Hmmmm. Got a point, there. ... Irish Americans.. Irish.. American blacks.. same songs... who shall overcome... weeds shall overcome.. by how.. By Any Means Necessary.. serious reading... same book.. X .. Malcolm.. X... X... X is who?... invisible man... penal laws... penile laws.. no property allowed?... letters of the no ownership laws.. Y.. leather of the law.. whips.. possessions stripped to letters... take it off, take it all off... strip searched to letters of the law... nothing returned... butter.. bend over.. tumescent letters of up the ass fucking law? penal laws.. whose pene up whose ass? no jobs ? ever? ... X.. nation of laws... not of X'd men.. standing men.. men of that nation... nor education in law... bizarre fucking rules... plenty of letters... one certified man five votes and a building full of X's holding their nuts... shells of men.. shell game laws of letters.. ligatures.. rat writs.. ordinances.. laws of somebody else... unlanded laws of expropriation... to strokes of pens... new laws... new letters... new art.. folks stroked away of pens .. Xs.. X'd out.. repression?.. mmmm.. apartheid... apartheid! cattle! We the people? Cattle to expropriated law? ...not suppression... dehumanization.. ant farming... plates of glass... Leaves of Grass.. laws... laws of diminishment and control... the blinded lady doesn't want to see... just put some gold on the scale, thank you... I'll represent the money.. Hmmmm. Got a point, there. England... needed troops.. to whack us.. a transatlantic fuck job.. only then... a pledge of representation... hey! but first, the enlistments! Year after year after year... promises... promise always ... loopholes.. shell games.. keep your eye on the promise.. promises unkept... undone in the fine print... lawyers circling the sun.. waste of fuel... why are we here?.. new letters to old laws... people X'd out... America.. to ordnance.. Washington ... our new country of.. of X's?.. of WE THE PEOPLE.. the United States of America... We the X+X+X+X's.. Saint Patrick's day.. a new nation of men, men rejecting laws... more Irish born than American born... rejecting laws... rejecting X-hood.. X'ing out British fuck you up the ass laws.. Hmmmm. Got a point, there. ...celebrating who?.. drove out snakes... and what? driving out their own... snakes... subversion.. repression?.. unequal treatment... arrogant snakes... snakes of inequality... bearings of dissimilitude... arrogance... How do we know that Price isn't a snake, himself?  ..John.. need a stick of butter... never said... shelled.. he actually liked the man... shelled... or trusted him... snakes.. hmmm... elegant bow... the man lords... he may slither.. Sin crouches at the door.. law... courts... two of milk.. one of Teson... lady with a blindfold... and a see-through blouse.. and long quick zippers.. for sale.. scales.. scales...blind? ... no... blindfolded... doesn't want to see the results... X'd out consequences... she puts out... you got the cash you get the lady... tongue costs extra.. words of consequence.. her words.. Lillith in their bed.. her letters.. with scales of fish... scale the walls... take the gold... who bids abides... Jesus!... Jesus in the temple... what am I doing here?... trusts?... trust no one... law.. enforcement of letters... force of letters....  crimes against their own people.. absence of law?... vigilantes... no... absence of justice... no justice.. vacuum... the Omega... England... short term memory... land is ours... always was... kill ... jail corrections of fact... letters... whose?... labels.. good to package oppression... Like spies... outside the order. Outside the the letters.... stripped by Lords of letters of land ... of rights... of economic access ... of education.. of history.. need shovels.. big fucking shovels so much lettered shit piled on . The law. They don't respect law.. Lords, or law for sale, what's the difference? Packaging? Wrapped in silk... silken law... ERISA... all, depths of the pool... Hmmmm. Got a point, there. ..Irreverent of law.. of order, of a justice of eternal spite.. spit spite spat .. the green.. discussion is treason... thinking equals crime... speech, a crime.. hope...a crime... treason... words a capital offense... death for words or for bullets.. why bother with words? Law and order. What law? Whose order? Nation of laws. Whose? Nation of laws? Not, nation of justice? Independence.. can't judge by religion... issue is domination... to be.. to do... Price?... I married one, you know....Hmmmm. Got a point, there... law... business... business connections... a businessman in a law school - I married one, you know. ...one what? Caution... He crafts the law... in his own image.. oh my God! Goats to Azazel.. Same as over there... orange... owns the fucking law... maybe we should go. .. we don't belong here, we the people.. We don't belong here? ... Hmmmm. Got a point, there."

This last, "Hmmmm. Got a point, there," drew a fast and full length kick in the ankle from Shannon who, to deliver it, braced both hands on the table. Macaluso pled ignorance, but Dorothy Bela couldn't help but laugh out loud. Dry, huh? "Suture!" holding out her hand palm down in a surgeon's gesture as if to place him more in his own environment.

Macaluso was uncomfortable in this environment. A law school. Nation of laws. The idea finally galled him. That phrase! It finally clicked. Repeated so often it seemed to be a reality, a prime of our structure, rather than a trick of mirrors. A diversion. A theft! Judges have so many in their quiver and can select to their whim. Blame the arrow whose poison was so carefully chosen for its effect - not the judge - nation of laws, not men. Ten judges ten different outcomes, so where's the fucking law? He was angering to his own assimilations. Where in our constitution does it actually say that? He only recalled, WE THE PEOPLE. He thought, our land... our well being... of the people, by the people, for the people... FOR THE PEOPLE, that's it, that's the measure, the ruler, the line not to be crossed... law is just words and words to a highest bidder... where the hell is justice? Equity! Justice drives populations together and injustice drives them to war. Nations of law, rigidity, resoluteness against inevitable change are nations on the brink. Justice is a pain in the ass to law, making it harder to sell. The amenities that were being exchanged were miles away, muffled background to the jumble of his concerns, Law... crooks... law... letters of law.. contracts... lawyers... hired guns.. school for hire and hired guns... whose?... highest bidders... money.. We have no money. We are their food.

Shannon did not care whether Price initiated this meeting out of Irish friendship or for business points. That was irrelevant, as she later argued to Marcus during their drive home. Right now, savoring that swiftly delivered kick to his shin, she sat down. Her immediate concern was getting these new acquaintances oriented to a repressed reality. With that as her goal she started hammering out her cause - without even relating to the long academic legal readings that had just now finally relented. She began by reading clinical cases. Real human stories. Unlike all the hazy areas as described in the law that was just recalled, these stories were simple enough. Only an ass hole stuck on letters wouldn't get it.

"The Kasovitch family has a child with cerebral palsy, a girl aged seven. The giant firm for which the father works, let's see - fifteen years there, B&TT, opted for replacement of their medical insurance plan by an HMO. Blah blah blah, let's see .. MediTrust Health takes over but excludes four families from the B&TT plan for strange technical reasons. All four families have children with birth defects. The Kasovitch child is ineligible for public assistance because of his employment, yet will be destitute if medical costs are uncovered. She is now cut off from therapy and from planned reconstructive surgeries for lack of a follow up mechanism to see it through."

"Let's see... next, here, OK. Billy Holterman, a bright eight year old, with partial paraplegia was unable to walk. His HMO, FreedomCall Health Trust, approved a five day hospitalization for reconstructive surgery and approved the site for the surgery. They agreed that therapy would be needed afterward. Eight hours of surgery moved multiple muscles in both of his legs and - uh - also in the pelvis, let's see, uh rerouting various functions so that this youngster could walk. A total body cast - from chest to toes - was worn for four week as things healed.

As typical, with such massive surgery, including abdominal work, Billy was on intravenous fluids and intravenous morphine, unable to eat, at all, for four days. It went well. Discharged on the fifth day , home, to be admitted for therapy at the PT facility when the body cast was removed - four weeks post op."

"FreedomCall, at that point, claimed that although the number of days for surgery were approved, payment for the surgery was not, nor for hospital days post op. As the surgery payment was not approved, the physical therapy that was required afterward, the special rented wheelchair for mobility in his body cast, and the surgery itself would not be covered. As the therapy was not covered, the additional days in the hospital, past the actual day of surgery, were - in essence - recuperative and rehabilitative and therefore not covered. Because the post op days - days during which he was on IV's and getting extensive medications - because those days were not actually surgical in content, a nursing home was all that was medically indicated."

Dorothy jumped in for a clarification, "You mean a nursing home, like for those old ladies? Or a pediatric rehab hospital?"

"No. Unskilled nursing on site, means put the kid with the old folks with Altzheimer's - essentially," then went on despite her questioner's raised eye brows. "The child was then referred to a charity facility in another state, by the HMO, with the claim that they were certified providers. That facility refused the case based on their assessment of the medical situation, but that refusal was deemed another issue not related to payment issues."

Dryfus interjected, "To hell with supper, let's get some Bourbon in here. Shit. You taking this in Dot?"

"I don't know. Trying."

Shannon went on, "Let's see... case three.. Katie Mitchell is a ten year old who was healthy until at - um - age five - she developed a fever of 105 which nearly killed her. It occurred just as her family, due to a job change, came under the care of a health maintenance organization. Let's see, ProtectiSheild Blue another subsidiary of AM Inc. After a long recovery, at home, hospitalization was deemed unnecessary, she became preoccupied with eating. Later, she had to be intermittently restrained due to food rages. She beat in the refrigerator door - they had to replace it - she beat it with a bat when she was hungry screaming, 'Why does everybody smell so bad?' Simply opening the refrigerator door to get the food didn't occur to her. They kept her fed as hunger and rage were the same. Thirst was similar. She actually broke the water spigot from the kitchen sink trying to get water. Turning the knob for water was easy for her when she wasn't thirsty. There was a lack of simple problem solving during these rages.

After these thirst and feeding rages she would collapse on the floor exhausted, and wet her pants and sleep - sometimes for an hour. Her mother pleaded and demanded evaluation of her daughter's problem. The ProtectiSheild gait keeper told her that eating disorders were common in young girls. She would outgrow it. Besides, with behavior like that, she needed a good spanking.

Rather than yield and get an EEG, on incessant prodding from the mother with written complaints, a specialist visit - it was called - was allowed. That specialist, Dr. Patel, officed in the next room, had no diplomas to indicate any specialty training in neurology but asserted that she had a special interest in problems like this. The story was retold and the final advice was to sit on Katie when she gets out of hand, and if need be, slap her until she stops." Bela's head was hanging like that of a low tone baby. "The mother presented this child to us for a general exam without any history. 'Just tell me what you think,' she asked of us. Katie was obviously ataxic, had grossly abnormal reflexes, and an inability to mimic hand gestures. Later in the conversation, her mother produced a neurology text which she had purchased and enquired about temporal lobe seizures, uncal fits, hypothalamic damage from high fever, and the need for base line evaluation EEG, MRI etc. We agreed. She then told us the whole story. This organized and concerted neglect went on for five years. The child had been left back in school three years, and was grossly deformed by the horrendous obesity secondary to her eating disorder. One month on proper treatment ended the entire issue. The diagnostic tests, the neurologist, medication, and the nutritionist's handling of the weight loss program were all disclaimed as they were out of network and unauthorized."

"Make that doubles," Dryfus groaned.

Dorothy Bela jumped in, "But wait... uh.... these aren't Medicaid cases. Right?"

Macaluso and Shannon both startled and simultaneously looked at each other. That was an unexpected comment to both of them. Shannon hesitantly responded, "Medicaid isn't a problem." Then she clarified, "Medicaid doesn't pay squat to practitioners. Mac does them all for charity. But, Medicaid never refutes proper diagnosis and treatment. They have paper rituals that are pure torture, but you get used to THAT. They do pay hospitals reasonably, just not doctors."

And as the two lawyers were having their turn looking puzzled, Shannon clarified further, "They never say use this provider or that vendor over the ones we suggest. They do question costs and refuse payment for prescriptive devices which are priced over established norms which are, actually, pretty reasonable. If you appeal, you get a real appeal doctor who understands and just needs to be sure the client isn't getting raked or somebody isn't ripping off the system."

"That happens? I mean that they pick up relative cost problems?" Dryfus asked.

"Oh yea," Mac clarified. Finally making an offering, "One mother found a very nice stair capable wheel chair for her child because the school had steps and was hard to retrofit. Medicaid refused the thirty grand price tag and solved the problem better with an on site engineer at the school. An easier fix, good for all similar kids to follow. That's fine. If they run out of cash, everybody loses."

"Whoa," Dryfus was bolt upright in his chair, "You're saying that Medicaid is BETTER than HMO care?"

Shannon and Mac together, "Yes. Absolutely."

Shannon, "They're cheap, for sure, but at least, they're FAIR."

Mac piped in, "They've got no axe to grind. There's just not a lot of money there. Our job is to stretch Medicaid's resources. That's a big job. It isn't a bottomless well. They pay about 7% of an 80% calculation of the going rate figured in 1984 - or something weird like that. It isn't much. Most docs won't touch it. Without additional benefactors, it couldn't possibly work. They are like a constant contributor to a charitable mechanism. They need to supervise their expenditures. It's their bureaucratic structure that screws them up, not their nature." Leaning over and getting darker, Mac went on. "Many of the HMOs are simply evil. They are the epitome of power structures. They exist to feed the top. Like a Hitler or Stalin or whatever monster that has power, the bottom feeds the top. You must read the papers. The CEO of AmeriMed Inc. took a fifty million dollar mid year bonus. That's on top of twelve million in stock options. The year isn't over. The CEOs of most of the big HMOs are bathing themselves in obnoxious wealth. We are back to the silk mills and dye factories of the twenties and thirties."

Thumping his pointing index finger on the table he exposed his inner dark side, "It's the ism thing. Nazi-ism, Stalin-ism, Capital-ism, Social-ism, whatever... you lose yourself in ism dialectics and you stay there - lost. Forget the words. Watch the footwork. We are talking about power. People with power do what their power will let them do. Our nation was not founded on isms but on a premise to protect us, we the people, from power, power that wraps itself in isms, even religious isms.

Balance of power is where freedom lives, where good lives, where sanity prevails. Good isn't a philosophic concept. It isn't a politic. It isn't truth or charity. It's a place. It's a place that lives precariously between equally pitted and often maniacal forces. Like the eye of the hurricane it moves with the wind. This isn't about medicine, it's about America and what we are becoming. We are here discussing imbalance. Imbalance of power. Power purchased and placed beyond the control of WE THE PEOPLE. In the name of isms powerful people buy the law and our refrain FOR THE PEOPLE is drowned out by a roaring spew of NATION-OF-LAWS bull shit."

Shannon was holding her hands over her face, but the professors liked to see human inner workings so exposed. "Chopping at windmills are we?" Dorothy Bela asked.

"Damn, I hope not," Macaluso recomposed himself. "Look, we have been seeking legal help for several years now. I know it's stupid, but, let me just expose my ignorance. I know evil when I see it, but I don't know the proper language, or, or, or process. I've been reading law books."

A general groan, as Shannon apologized that, "He's possessed." They had already caught that.

"Let me just put it out there, then correct me," Mac continued a bit less pressured, but only a bit. "For years professional corporations were simply not permitted."

"Still aren't in a lot of places," Dryfus inserted.

Mac nodded, then went on. "The idea was that professionals are responsible for what they do, as individuals."

"Nuremberg." Dryfus instructed, "You ARE responsible for your acts. Eichman went to his death on the just following orders defense."

"Yes. Yes," Mac agreed in delight. "You are responsible as a professional. You see, in order to allow professionals to not be penalized in pension and hiring stuff, and all the go-withs, a new kind of corporation was synthesized - the professional corporation. The only difference between a professional corporation and a regular corporation is that liability goes straight to the doer of the deeds and the maker's of decisions that bear on the deeds. You can't shield liability in a professional corporation, period. Ten sub corporations deep - doesn't matter - you did it, you're responsible. Your policy - you pay." He paused, "Am I right about this?"

Dryfus shook his head. "There are details, but yes, that's it."

"Well, now, into the medical arena, come corporations using general - not professional - corporate structure and contract law and there goes professionalism. It's gone. Poof. Nuremberg? Where the fuck is Nuremberg today? Nuremberg my ass, try Wall Street. HMO contracts read like nothing you have ever seen in medicine. Look!" Tossing a copy of FreedomCare Health Systems standard contract across the table to Dryfus, "Eichman gets off! Read the drek in there. Nobody in that corporation is responsible for anything. nada.. nyent... zippo... nothing. Just read that garbage. The policies that dictate slapping children with seizures would claim no recourse for improper knowledge, actions, or intentions. Who wrote this shit? Why is it tolerated?"

Dorothy Bela had her head down, forehead in her hand, shaking with laughter. "He wrote it," pointing blindly at Bill.

"I wrote it," Dryfus confessed. "It's standard corporate boiler plate liability protection."

Mac stood up. "Medicine ain't selling fucking futons!"

"Easy, guy." Dryfus was laughing with both hands forward in feigned submission. "I was working for them. I was just doing my job. Oooo..., that sounds familiar. Oh, well, that was then. This is now. Point me. No, finish up, your homework, your books, keep going, so far so good... Get the demons out."

Wiping his mouth with his open palm, Mac went on. "Well, any way, I tried to understand just what goes into a contract. What is its history? Well, in the dark ages, our ancestors toiled under German tribal custom. Individuality did not exist. There was common property and common liability. Your family was held for acts committed by any member. If you traveled, you might find yourself captured for debts of another of your region - whether you knew him or not."

The doctor went on. "There were no cities then. No countries, either, practically speaking - tribal regions ill defined, maybe a cluster of villages near a natural resource, but no unifying political threads. Kings had no local seat. They ruled only the area that they could travel. No real structure, that is, except in the church. Only the church had structure. That, too, only evolved late in the dark ages as the Benedictine monks and others evolved a hierarchial structure free from local princes - tribal chiefs, and later free from secular appointments.

The Abby of Cluny in, what is now southern France, developed this the furthest and set itself to a peace movement against regional power factions. The Cluniac reforms were asserted and given justification by the meticulous and voluminous writings of the monks drawing from all available sources. Those sources included, scriptures, to be sure, but eventually pulled in Plato and the big bang came with the rediscovery of the texts of Justinian law that survived the pagan sacking of Rome. That law was poured over and transcribed ad infinitum in the monasteries - especially in Bologna, which grew up around the first university - a place dedicated to reading aloud and discussing these Justinian texts.

Roman law was a major find - as it was detailed and it was FAIR. It stood in huge contrast to the German tribal shit that, basically, depressed even the German chieftains. It was an easy sell. These texts of Justinian, however, lacked by careful design, generalities. There were endless lists of case specifics, drawn- to be sure- from previous cases, with judgements, but never stated in a general way. Always specific. Never abstracted.

The Romans, whose special forte was their fair legal structure, felt that justice was at risk if entrusted to specific words and letters. Words could be exploited to undermine reason. Letters of the law - so to speak - in Justinian law were illegal. Courts derived sense from prior case specifics, requiring consistency, like our common law, but always in the light of current context. Decisions had to be fair in the context of the case at hand. Decisions had to make sense and had to be fair.

However, translations of the texts yielded to summaries. Summaries yielded to reorganizations and then on to generalizations, the very thing Roman law avoided. To the populace, at large, the church, local monks, abbots, and clergy in general, were the law, although not enforcers. Any deal between simple farmers required seeking out clergy for two main reasons. First, the clergy were just about the only ones who could write, and later on, read what they wrote. Second they were impartial. Any detail not earlier considered would be determined by them. A contract essentially set up the means of handling differences that might arise, foreseen or unforeseen. Thus was born contract law. A vehicle of action between three parties. Three. Not two. There are two, who propose to act in a certain manner and the third party to referee. This was much better than the Germanic blood baths or trials by fire and water - the two most popular Germanic tribal deities.

That third party, the clergy, however, declined to be involved unless fair play was inherent in the deal. Any contract had to have equal burdens and equal benefits. Any dispute of value was to be derived from going assessment of applicable values by the referee, not by the contractees. Furthermore, deals between educated and uneducated were frowned upon - yet necessary. All too often, the wily would use their enlightenment to cheat, swindle, or renege. Contracts between professional persons or organizations were specially considered to be in existence to protect the nonprofessional, the uneducated, the unwary, the uninitiated. These were one way contracts. The professional knew the ropes and the risks and the ways to cheat. Protection was to the little guy.

Thus the 'AS IS' contract - or contracts of adhesion, a contract supplied by an established working entity of powerful means who provides no mechanism of alterations of terms and agreed to by an individual of little expertise. It is not a result of discussion, but drafted in advance by one party, in the absence of the referee. These are special. Cannon Law, which became our western law, holds these contracts retroactively accountable - after the fact.

Yet, the epitome of AS IS contracts - we see here. Only letters of law - in this case law means contract wording - only letters of law seem to have any weight. Who is appealed to? Who determines appeal outcomes? The stronger party IS NOW THE REFEREE! The stronger party is also the judge! What the fuck is that all about?

How about warranty? Even in general contracts and business transactions warranty is both asserted and implied. In Community Television versus Dresser Industries, a pamphlet, by Dresser, but not included in any of the negotiations proclaimed the superiority of Dresser's transmission towers and ability to withstand high winds in all sorts of weather.."

"Let's see.. Community versus Dresser. 1978. U.S. Court of Appeals, Eighth circuit. Right?" Dryfus indicating his expertise.

"Something like that... Anyway, where was I?"

Dryfus, "The weather."

"Oh yea. Even though ice thickened the cross bars so that wind forces exceeded those established in the written specs in very strict engineering terms, the pamphlet described towers that would withstand even hurricane - whatever - forces regardless of ice or snow. Dresser had to replace the tower that was blown down by forces that exceeded their specs quoted in the contract. Why? Because the plain language, the language of the purchaser, strongly implied that their towers would withstand exactly the storm that toppled it. The buyer knew his weather and knew what the pamphlet said. That was the warranty. That's the law. That is how law is supposed to work.

Do you see and hear the ads of these HMO's? Where in hell is the warranty protection of the consumer? They're not selling taste. It isn't jelly beans or hot pants. This is a technical product with precise prevailing conditions and expected outcomes. Why isn't warranty law applied? They scream comprehensiveness, easy access, highest quality over the radio... every day. Try to get a kid with Lyme disease diagnosed! They deny the test then deny the treatment if you test anyway. Where is warranty law? Huh?

In our tradition of law, there are two main aspects to be considered, law and order is one. Order meaning the day to day details of commonly agreed behaviors and frequently arbitrary acquiescences for living sanity. Drive on the right. Go at green, stop at red. Arbitrary, but needed for safety, for progress, whatever. Order. Details. Such law of order is US, WE THE PEOPLE, giving ourselves confines for our own sanity, safety, and ease of living. Law is from US. WE are the law.

The other aspect of law is JUSTICE. Order without justice is slavery. Contractual order without justice, without equal benefits, without parity, is oppression. Contracts not in the interest of WE THE PEOPLE are void. Void! The words are only conduits of power - our power. We do not grant our power to thieves. Period.

What is the difference if a fascist brown shirt clubs you and steals your possessions while reciting fascist slogans or a large corporation takes your house in the name of skewed contractual details - contracts without parity. Could the contract signer take the corporate headquarters if they don't provide the service that they promise, that they imply in advertising, sing in jingles, state in trade deals, or otherwise represent?

Justice implies that action can go both ways. Just who deals with these HMOs when they fuck everybody over? Again and again and again. Who gets the appeal? THEY DO. You appeal to them! They review secretly - no transcripts- no impartial review - and THEY decide whether they are right or not. We have lost our heritage of equal protection under the law, law rich in history and rights, to predatory contract law which only takes and gives nothing back. Self evident truths have no place.

What fucking law is that? You wrote this shit, Dryfus? You're going to hell. God will smite you, you wretched weasel. This is immoral! We have had revolutions over lesser shit than this."

Dryfus and Bela were both mouths agape, but Macaluso was on his stride. "Get this, SafeMed of Connecticut, denied a child with spina bifida - that's an open spinal column with paralysis - simple leg braces after corrective leg and foot surgery. We fought with them for two months and meanwhile lost foot position and had to reoperate. In court, they LOST, and were told to pay. They paid for ONE brace. ONE! Two legs, one brace. Back to court, they lost again and were told to pay for both. One year later they refused to revise the braces - for growth. Back in court again, - by the way her father is a sitting federal judge - these ass holes don't care. They lost again and again only paid one brace adjustment. Even when you win, they don't lose.

Meanwhile two other children with the same disorder, also in that HMO, were getting the same refusals. Their families shared many things. Given transcripts of the court decisions in exactly similar cases, the HMO simply did not respond, even to registered letters. Group actions are not allowed. And penalties for repeated offences don't exist! There is no mechanism for relief of harassment by way of bureaucratic evasive behaviors. And liability for ill effects of policy is not provided for. Where in hell is Nuremberg? On the moon? What country is this?"

"Wipe you mouth," Shannon whispered, making a subtle gesture with her hand.

Mac fell into his chair, using his sleeve to tidy up. Shannon took over and summarized more cases. The last three were the most vile. A four year old double amputee, from a train mishap, was allowed only one prosthetic limb - forever. No argument satisfied. Two missing legs to share one prosthesis. No growth allowed.

An Amerimed reviewer told a mother that if she persisted in pushing for coverage for her two year old daughter, who had post chicken pox encephalitis paralysis, that they had ways of dropping the entire family from coverage. They even implied that the father's job could be lost.

An HMO denied treatment of osteomyelitis, bacterial infection of bone, in the hospital in a one year old child with a fever of 104 showing clear cut septic embolism. Coverage was denied because it could have been treated with pills at home, they asserted. Amerimed refused hearing aids, denied as unnecessary treatment for an array of children with congenital hearing impairments, as was sign language instruction and speech therapy - called 'unproven treatments'. The use of physical therapy in treating children with cases of paralysis was called unproven treatment and thus uncovered. No level of documentation changed that view. No third party resided over the judgement.

More cases followed, after which Dorothy Bela began recapping her observations. "Well, we thought we came here to learn about Medicaid problems. It would seem, we have another framework to consider. First we need to study the applicable law. Often, in law there are gross contradictions. Such contradictions are not allowed. They must be resolved. Special circumstances that result in such contradictions are usually resolved by only using APPLICABLE LAW. Law of marriage contracts does not apply to mercantile contracts. Torts and criminal law are apart. What is the applicable law?

It seems that you have a good issue - need to dig deeper, because there are cases in appeals level courts that would assert that the corporate dealings you are at odds with - are in fact OK. Marcus was rambling about refusals to cover insulin for children with diabetes, "only for coma - not maintenance - fuckers," as Bela ignored and went on. "However, the actual context of applicability was never challenged. They are very detail specific, not general enough to produce a new judicial concept. We can get one of the seniors, Bill, how about that seminar group - are they overloaded?"

"Actually," Dryfus staring at the ceiling, as if reading from it," this would be better than what we had planned as our project." He hung back, mulling mental choices. "They'd learn a lot digging into the pedigree of the applicable law. Question is , what's the scope and the time we have. Let me do a cursory, first."

Bela nodded, "I have to tell you, legislation is the real issue here. A traffic law without a summons is useless. Clearly, the corporations have - how shall we say - eased little heeded legislation by championing them - uh - encouraging legislators to attach them to various bills of great popularity."

"Like pork?" Shannon squinted with unease.

"Same idea. A bill to stop sewage pollution of the North Island shore line gets a snippet that limits contractual action to the cost. As there are no contractual issues in illegal pollution, the writers don't give a hoot. The inducements from this clause - champion the pollution bill and pay for advertising, public relations, you know."

"Try bribe. Inducements!" Mac was getting more and more cynical. The scope of this avenue of action was looking Herculean.

Bela went on, "Reality is, legislation is expensive."

"The pool! It's the fucking pool!" Macaluso blurted in sudden recognition.

"Excuse me?" Bela startled.

Shannon inserted herself, "No, nothing. That's another issue, altogether."

Marcus quieted, but whispered to Shannon, "No it's not," as Bela resumed.

"A Well selected case, chosen for general applicability and pointed not at resolution but at high appeal level capability might be the cheapest avenue. Even this is expensive, but here we have organizational funds for such legal challenges and the discretion on usage."

Dryfus punctuated," And it's a better forum for our students. Legislation is more mud wrestling than legal advocacy." Then with a flourish, he proclaimed, "According to Aristotle, 'What creates the problem is that the equitable is just, but not legally just, but a correction of legal justice. The reason is that all law is universal, but about some things it is not possible to make a universal statement which shall be correct.' "

Darkly and slowly, Doctor Macaluso invocated, "The man who would have you define justice is the man you kill."

Bela startled, "Who said THAT?"

"Nino."

"Who the hell is Nino?" Dryfus gawked.

"He is the last man you don't hear coming."

Mac settled back and became distant as the others mapped out potential dates for preliminary meetings, possible resources that needed exploration, old acquaintances held in common... "He's the one you don't hear coming," he thought, his only thought. "He's the one." The beast was in control.

Shannon pulled her sweater over her shoulders. She hadn't noticed the chill before.