"America is not in decline, it has declined."

Timothy Burke had the terrible experience of getting Lyme Disease, and, in the process of telling us about it, presents some reflections that enlighten more than just his particular disease, or even the particular problem he applies it to:

...as a matter of policy, the hospital was coping with a large number of local patients using its ER for ordinary medical care by passive-aggressive neglect. Unless you walked in with an immediately and obviously life-threatening condition, time would be your triage, not a medical professional. If you could endure waiting eight to nine hours, that was proof that your condition was sufficiently serious that you might need urgent care....

The basic problem faced by this hospital and many others is structurally serious and requires a strong nationally consistent solution. Given that one political party struggled to formulate a fussy, detail-strangled series of half-measures to address the problem and the other party apparently thinks there isn’t any issue in the first place, I’m resigned to this situation happening again to me, my loved ones, my friends, my fellow citizens, for the rest of my life.

This is where we are at now. Decline is not something we need to fear or forestall, it has already happened. America is not in decline, it has declined. A nine-hour wait at a well-built, well-staffed, well-resourced medical center for treatment of a serious condition is decline. As a traveller seeking urgent care, I’ve been seen more quickly in similar facilities in both Africa and Europe.

I've given a bit of the context so you can understand what he's saying a bit better, but let me highlight this part again:

I’m resigned to this situation happening again to me, my loved ones, my friends, my fellow citizens, for the rest of my life. This is where we are at now. Decline is not something we need to fear or forestall, it has already happened. America is not in decline, it has declined.

Yes: resigned. Because what can we really do? Politics seems hopeless -- and yes, I know, rage rage, the political Pascalian dilemma, and all that, but even if the rational thing to do -- even if the rationally irrational thing to do -- is to keep struggling, it just feels hopeless, a hopelessness that washes up and batters you like the sea.

Sometimes it's hard to feel like they've already knifed the country (if not the world) in the heart, and all that's left is the flopping around, the ugliness of blood, and a doctor's calling the time to make it official.