Fetterman’s debate struggle is a lesson about stroke recovery — and debate formats > Dogecointool

Fetterman’s debate struggle is a lesson about stroke recovery — and debate formats

The Morning Meeting with Al Tompkins is a daily Poynter briefing of story ideas worth considering and other timely context for journalists, written by senior faculty Al Tompkins.

I happen to be teaching at Penn State this week, so I was intensely interested in watching the only debate that Democrat Lt. Gov. John Fetterman agreed to with Republican Dr. Mehmet Oz.  Fetterman experienced a stroke five months ago and he has been dodgy about releasing detailed information about his recovery. Before the debate, I thought we were making too much of an issue about Fetterman’s cognition but now voters have a reason to want to know more.  

Tuesday night Fetterman opened with “Good night” rather than “Good evening.” From that moment on I began thinking that this would be one time when a debate might tell us more than the polished talking points they usually deliver.

I have two main thoughts about the event that affects more than the voters of Pennsylvania. The first is that debates that allow 60 seconds or even more 30 seconds or 15 seconds for an answer are not useful when we are supposedly trying to understand how candidates stand on complex issues like abortion, our nation’s energy future and the economy. That format guarantees that we will not learn anything that comes close to nuanced answers. It is a test of who can recite soundbite-sized responses. The format made Fetterman’s stumbling more pronounced. 

While watching this televised train wreck, I kept thinking that this will require Fetterman to get more transparent about releasing his medical records. But it is also a time when journalists could help us learn more about stroke recovery since 7 million Americans are stroke survivors. USA Today found that stroke survivors and their families have identified with Fetterman’s very public recovery journey. They also identified with preconceptions that stroke victims “will never be the same” or are diminished mentally compared to their former selves. 

Let’s start with some stroke facts from the CDC so you can understand why so many people may see the Fetterman debate and see the faces of their loved ones on that screen:

In 2020, 1 in 6 deaths from cardiovascular disease was due to stroke. Every 40 seconds, someone in the United States has a stroke. Every 3.5 minutes, someone dies of stroke.

Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes.

About 185,000 strokes—nearly 1 in 4—are in people who have had a previous stroke.

About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked.

Stroke-related costs in the United States came to nearly $53 billion between 2017 and 2018. This total includes the cost of health care services, medicines to treat stroke, and missed days of work.

Stroke is a leading cause of serious long-term disability. Stroke reduces mobility in more than half of stroke survivors age 65 and older.

The states with the highest stroke rate are, in order, Mississippi, Alabama, Delaware, Louisiana, Ohio, Michigan, North Carolina, Tennessee, South Carolina and Arkansas.  It’s as if those states are being punished for having good food. But I digress.

The rapid-fire debate magnifies what stroke experts say is common during the stroke recovery period, which can last more than a year. Commonly, stroke patients suffer auditory processing problems that can jumble both what the person is hearing and speaking. And people who have suffered strokes can sometimes more easily have one-on-one conversations while struggling in chaotic conversations. Pennsylvania voters will want assurance that there is a difference between Fetterman’s cognitive ability and his auditory processing. 

The Philadelphia Inquirer reported:

Rehabilitation specialists say that these lingering effects of Fetterman’s May 13 stroke are no surprise, and that by doing therapeutic exercises, patients in his situation can continue to make progress for many months.

And for debate viewers who might wonder if these types of speech issues are any reflection of diminished intellect, stroke experts say the answer is no.

Fetterman’s physicians have said his stroke caused deficits in something called auditory processing. That term may be confusing for laypeople because it sounds as if it refers to hearing ability, not speech, said Brooke Hatfield, a speech-language pathologist who works for the American Speech-Language-Hearing Association (ASHA).

In fact, auditory processing refers to a host of brain functions that make both hearing and speaking possible — among them, recognizing sounds as speech, mapping them against known words, and formulating a response. These language networks in the brain are distinct from the pathways involved in critical thinking and cognition, Hatfield said.

The Inquirer’s reporting included an explanation of how people with auditory problems can struggle, especially in a rapid-fire exchange. 

Oz, a physician at one point snapped, “Obviously I wasn’t clear enough for you to understand this.” Was the compassionate physician saying the struggling stroke victim was too out of it to keep up with the conversation? It felt like a peek-behind-the-curtain moment that revealed the Wizard of Oz himself, like we were getting an unrehearsed insight into the real person. On the other hand, Fetterman is not his patient. He is a political opponent who aggressively interrupted and taunted Oz a few times, and this is a high stakes election in which the very balance of the U.S. Senate is at stake.  

Pennsylvania, for example, does not allow vote-by-mail ballots to be processed prior to Election Day, so nobody is going to be surprised when, again this year, it is days after the voting ends before we will have a final vote count. The delay, of course, adds to suspicions and rumors that somebody is corrupting the count.

The National Conference of State Legislators says:

Thirty-eight states and the Virgin Islands permit election officials to begin processing absentee/mail ballots prior to the election. (Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Utah, Vermont, Virgin Islands, Virginia, Washington and Wyoming.)

Nine states and Washington, D.C., permit election officials to begin processing absentee/mail ballots on Election Day, but prior to the closing of the polls. (Alabama, District of Columbia, Michigan, Mississippi, New Hampshire, Pennsylvania, South Carolina, South Dakota, West Virginia and Wisconsin.)

Maryland does not permit the processing of absentee/mail ballots until 10 a.m. on Thursday after an election, based on state regulation.

And in two states and Puerto Rico, the day on which processing may begin is not specified:

Connecticut allows processing to begin at the discretion of the local registrar of voters.

Ohio allows processing to begin before counting at a time determined by the board of elections.

Puerto Rico does not specify.

Jessica Huseman at VoteBeat says vote counting will take several days in some places and the official certification will take even longer.  

When the balance of power in the Senate and House hangs in the balance, any delay in declaring winners in the most hotly contested states will get magnified attention this year. 

President Joe Biden has found a topical issue that could resonate with voters right before the election. He is taking on what he calls “junk fees” like bank overdraft charges that he says are creeping across the country. Think about all of the fees you pay to book an airline seat, resort fees at hotels, “convenience fees” to buy a concert or sports event ticket, and late fees on credit cards. The President told the White House Competition Council, “What we’re talking about today is something that’s weighing down family budgets: Unnecessary hidden fees, known in the parlance as ‘junk fees’, are hitting families at a time when they can’t afford it. They shouldn’t be paying it anyway, in my view – but at a time when they can’t afford it.” 

The Consumer Finance Protection Bureau headed by Rohit Chopra is already going after these fees. The Guardian reported:

Agencies like the CFPB have authority over banks, credit unions, loan servicers and debt collection agencies, where junk fees also predominate. Another federal entity, the Department of Transportation, headed by Pete Buttigieg, is also cracking down on airline fees associated with seat selection, baggage and rebooking.

“We’ve already issued some policies on a host of them. One is pay-to-pay fees, where debt collectors charge you a fee for paying them. Then there’s other ones that we’ve identified, [like] overdraft, but another fee is a so-called ‘NSF fee’, or non-sufficient funds fee, and that’s where you get charged when you supposedly don’t have enough money in your bank account,” he said.

A report published by the CFPB estimates that $12bn in credit card late fees are being charged. Chopra said the goal here is transparency in pricing and healthy competition in the sector.

“What I want to see in the market is competitively priced services. We want to make sure that people are competing up front, rather than imposing gotcha fees on the back end. That creates a marketplace where people can choose more wisely. And too often across the economy, we see products and services advertised as ‘free’, but there are really costs baked in the back end of it.”

The Federal Trade Commission says it is exploring new regulations on junk fees including:

Unnecessary charges for worthless, free, or fake products or services: Consumers may be slammed with charges for products or services that cost companies nothing to provide, are available for free, or should be included as part of the purchase price. Companies might also upsell consumers on fake products or services that either have no value or never materialize.

Unavoidable charges imposed on captive consumers: Consumers may be forced to pay junk fees because they have no way to avoid or opt out of them. They might be dealing with a company with a monopoly or exclusive rights that can extract fees because there is no competing option. Or consumers might get hit with fees after they have already sunk costs into a product or service, and they can’t easily walk away.

Surprise charges that secretly push up the purchase price: Consumers can experience junk fee shock when companies unexpectedly tack on mystery charges they did not know about, consent to, or factor into the purchase. Companies might hide these fees in the fine print, cram them on at the end of a purchase process, or use digital dark patterns or other deception to collect on them. Some companies might claim that they do not charge any fees and then add on fees after the purchase or sign-up.

FTC Commissioner Rebecca Slaughter said, 

There is probably no greater and universal frustration in modern American life than seeing an advertised price for a product or service and then getting to the cashier or online payment page and seeing that price balloon. 

“Unfair or deceptive pricing practices aren’t just annoying, they can prey on people’s sunk costs in a transaction to squeeze even more money out of them at the last minute — effectively raising prices without appearing to do so. Empirical research on hidden fees and drip pricing has suggested that these fees “cause, or even trick, people into buying things they would not otherwise.” In a time when many folks need to make hard choices about what to spend money on, this kind of deception is even more concerning.”

The New York Times tells us about a new-ish luxury bus business with companies like Red CoachVonlane, the Jet and Napaway that make runs between D.C. and New York City or D.C. to Nashville, for example. The coaches include workspace and, in some cases, flat beds. And all of this for a fraction of the cost of airfares to and from the same cities.

Napaway promises WiFi, pillows, blankets and privacy in a “personal suite.” (See video)

The Jet has a bar on board, is a bus that would normally carry 50 people but now is fitted for 14 seats. And the seats are “motion-canceling,” which promoters say gives you the sensation of hovering or floating. See video

The New York Times’ Maria Cramer jumped on board the Napaway to get a first-hand look. I think these could be great holiday-travel stories that would be a big departure from the crammed airports.

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