When I was 15, my father was in a near-fatal car collision with a semi-trailer truck. At Strong Memorial Hospital in Rochester, NY, he lay in a coma for two months.

As the medical bills mounted and the insurance was running out, my mother had to make an agonizing decision. My father would have to be airlifted to the VA Medical Center in Kansas City, where his veteran’s benefits would defray the costs. She would go there with him; arrangements would have to be made for someone to take care of her home and kids while she was away. For how long, no one was certain.

Miraculously -- almost as if he realized what was going on -- Dad suddenly emerged from his coma and was released from Strong a short time later. He never fully recovered from the accident, but for that moment, at least, further domestic upheaval and financial chaos were averted.

Flash forward nearly 30 years and it was my mother who was now in the hospital, diminished physically and spiritually by dementia. Her children made the choice together but it was my sister, who had become her chief caregiver, who bore much of the brunt of the decision not to resuscitate.

In the months and years prior to my mother’s death, the kind of end-of-life counseling that health care reformers are talking about -- not the bizarre, phony “death panels” falsely conjured by Newt Gingrich, Sarah Palin, Betsy McCaughey and others, now including Iowa Republican Senator Chuck Grassley -- would have been welcome.

Everyone has personal stories like these, or certainly friends and colleagues who have had similar difficult experiences with our current health care system. We know it has to change, which makes it even more infuriating and frustrating that the national, you should excuse the expression, “dialogue” on the issue has deteriorated into so much gorilla dust, a hurling of invective, menace and disinformation meant to intimidate and force a retreat.

Those vein-popping, pistol toting, don’t confuse me with the facts town hall meetings are more like hockey brawls than an open exchange of ideas. But this uncivil disobedience and bullying are just the tip of the spear, the front line of an all out offensive on the streets, in the media and on Capitol Hill aimed at turning the debate over health care reform on its head and possibly keeping any kind of change from happening at all.

On Friday, Bloomberg News reported that 3,300 Washington lobbyists are working on health care: “That’s six lobbyists for each of the 535 members of the House and Senate, according to Senate records, and three times the number of people registered to lobby on defense. More than 1,500 organizations have health-care lobbyists, and about three more are signing up each day. Every one of the 10 biggest lobbying firms by revenue is involved in an effort that could affect 17 percent of the U.S. economy.”

According to the non-partisan Center for Responsive Politics, in the first half of the year, this adds up to $263.4 million worth of high-level kibitzing around the House and Senate office buildings and various other DC locales where ears and elbows are bent in advance of twisting arms. Bloomberg notes, “Drugmakers alone spent $134.5 million, 64 percent more than the next biggest spenders, oil and gas companies.”

The attacks on Bill and Hillary Clinton’s plan for health care reform back in the ’90s were a tiptoe through the tulips compared to the current assault. That’s because it’s about a lot more than attempting to ease the financial pain of illness -- or a socialist government takeover of medicine, depending on your point of view. Organizers (such as former Republican Majority Leader Dick Armey’s FreedomWorks), special interests and people who are just plain mad as hell have turned it into a shrill national referendum, reigniting age-old prejudices and fears that bubbled at the surface during last year’s presidential campaign.

What’s interesting is that there appears to be an emerging backlash from some of the more reasoned thinkers of the conservative movement. It seems to have begun late last week with a blog entry by former Bush speechwriter David Frum on his Web site, NewMajority.com. He asked, what if the right wins the health care fight? What happens then?

“The problem,” he wrote, “is that if we do that . . . we’ll still have the present healthcare system . . . We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and underperforming system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican Party exists to champion.”

Frum elaborated while in conversation with my colleague Bill Moyers on the current edition of public television’s BILL MOYERS JOURNAL. “They’re going to pass something,” he said of the health care reform fight. “So the question for Republicans is what do you want that to be? You have an interest here, too. You would like to see the rise in healthcare costs slow. And you would like to see more room in the federal budget for tax cuts in the future . . . But if the Republicans win, this is not going to be a great victory for individual liberty. It’s going to be a victory for the status quo.”

Frum’s sentiments have been echoed and amplified by conservative economist Bruce Bartlett. He’s worth citing at length. Writing on the Daily Beast website on August 12, Bartlett noted that, “Because reforming Medicare is an important part of getting health costs under control generally, Bush could have used the opportunity to develop a comprehensive health-reform plan. By not doing so, he left his party with nothing to offer as an alternative to the Obama plan. Instead, Republicans have opposed Obama’s initiative while proposing nothing themselves.

“In my opinion, conservative activists, who seem to believe that the louder they shout the more correct their beliefs must be, are less angry about Obama’s policies than they are about having lost the White House in 2008. They are primarily Republican Party hacks trying to overturn the election results, not representatives of a true grassroots revolt against liberal policies . . .

“Until conservatives once again hold Republicans to the same standard they hold Democrats, they will have no credibility and deserve no respect.”

One way to reestablish some shred of that credibility would be any kind of viable health care reform alternative from the GOP. Another would be to engage in a more reasoned debate. Neither has happened so far, and in the heat of the current ugly fray, neither seems likely.

Too much of the gorilla dust they’re throwing has blown back into their own eyes.