Tag Archives: EFMP

Armenia, healthcare, law, mental health

The Peace Corps is being sued over mental health policies…

The featured photo is the public domain version of the Peace Corps logo that existed when I was a Volunteer. It has since been updated, unlike the Peace Corps’ mental healthcare policies. 😉

Friday, at last! I’ve been waiting for today all week, because it means that tomorrow, we’re out of here for about ten days. I’ve been eagerly awaiting our trip for some weeks now, even though the first three nights of it will be in Germany because it’s time to see the dentist. I don’t love going to the dentist, but I don’t hate it, either. At least my teeth get nice and clean.

Facebook is telling me that we went to the dentist at this time last year, too. But last year, we stayed at a luxury hotel in Baiersbronn, which is a very pretty town in the Black Forest. I remember being stressed, because Arran was newly diagnosed with lymphoma, and I was afraid he might decompensate while we were gone. But he pulled through fine, and afterwards, we started his chemo, which gave him another five months with us. That might not seem like a significant success, but five months is a long time to a dog. And it meant that when the end of Arran’s life finally came in March, we could both be there for him. He also made it very clear to us that he wanted to live.

I think our time in Czechia is going to be great fun. The hotels we’ve booked have all contacted us with final details. I hope we find lots of art, and I’m able to take plenty of photos. The Cannstatter Volksfest is also going on right now. I just tried on my Dirndl, and I can still get into it. But I don’t think I’m going to bring it with me, because it really needs to be dry cleaned. Also, I think Bill and I are probably too old and crotchety for Wasen, even though we usually go on Sunday afternoons, when it’s not so crowded. Maybe we’ll go to Ludwigsburg instead, and see some huge pumpkins. We always seem to miss the pumpkin festival.

Yesterday, I noticed an article in The New York Times (temporarily unlocked) about the Peace Corps being sued over their mental health policies. Regular readers might remember that I served as a Volunteer in the Republic of Armenia for the Peace Corps from 1995 until 1997. Things have clearly changed a lot since my days as a Volunteer. In my day, you didn’t get your invitation to serve until you’d successfully passed the legal and medical clearances. From reading up on this lawsuit, I gather that prospective Volunteers can now get invited before they finish medical screenings. This policy is causing problems for a lot of people, hence the lawsuit.

It’s not that simple, folks.

According to the article in The New York Times, a group of three people, whose placement offers were rescinded over mental health treatment, have decided to sue the agency. They accuse the Peace Corps of “discriminating against applicants with disabilities in violation of the Rehabilitation Act, which prohibits discrimination in programs receiving federal funds.” Further from the article:

The lawsuit, which is seeking class-action status from the U.S. District Court for the District of Columbia, includes accounts from nine people whose Peace Corps invitations were rescinded for mental health reasons. The suit alleges that those decisions were made without considering reasonable accommodations or making individualized assessments based on current medical knowledge.

I was interested in this story because when I was a Peace Corps Volunteer, I totally suffered from clinical depression and anxiety. I did not get treatment for it until about a year after I left Armenia. In my case, depression and anxiety were chronic parts of my life that were so normal to me that I didn’t realize I was suffering as much as I had been for most of my life. It got pretty bad in 1998, when I was feeling really hopeless and worthless. Some of it was because of my service, but most of it had to do with genetics and having to live with my parents while I picked up my life.

Mental health treatment was a lifesaver and a game changer for me. It was a huge shock to me when we finally found the right antidepressant and I started feeling “normal”, for the first time. I stopped crying and hyperventilating at the drop of a hat. I stopped feeling worthless and hopeless. Indeed, four days after I took my first dose of Wellbutrin, I decided to go to graduate school, and I started taking decisive steps to make it happen. Within a few months, I had offers of admission to two universities.

I quit taking antidepressants in 2004. For the most part, I don’t miss taking them, although I gained weight when I got off of the drugs. I have been pretty stable, mentally speaking, for a long time. I’ve managed to finish two master’s degrees, and am about to celebrate 21 years of marriage to a great guy who treats me like gold.

However, after reading the article in the New York Times, as well as some anecdotes from other former Volunteers and applicants, I feel pretty sure that I would fail the medical part if I decided to reapply to the Peace Corps today, even though mentally, I’m a lot more stable. I am also a hell of lot more mature and experienced today, than I was in 1995. I’m sure I would be a better Volunteer today, in spite of my mental health treatment history.

I would probably fail the medical clearance due to having a history of mental health treatment, but I might also fail it for physical reasons. They gave me a lot of grief in 1995 because of my weight, which was less then than it is today. After sending me a nastygram about my weight, they did ultimately let me serve. I didn’t have any serious medical problems to speak of during those two years, nor have I had any in the 26 years following my service. I’ve also seen photos of recent Volunteers and it looks to me like maybe they’ve backed off somewhat from weight standards. Some of the people serving today are clearly bigger than I was in 1995.

The comments on this story are pretty divided. Quite a lot of people, including former Volunteers, think the Peace Corps should be very selective about allowing people with mental health histories to serve. They point to the fact that Volunteers are sent all over the world, and a lot of the countries they go to have very primitive healthcare facilities that can take hours to get to by public transportation. I got that.

However, I also know, from my own personal experience, that not every Volunteer lives in a jungle or a mud hut, nor are they all isolated from each other. Accommodations of all kinds vary widely in the countries where the Peace Corps serves. While certainly not every place has cell phone or Internet access, quite a lot of countries do have those technologies today. That can make treatment more feasible for Volunteers who need counseling. And in other countries, there’s really nothing easily available… so those places should get the healthiest Volunteers. Common sense, you see…

Armenia, where I served, was considered a “hardship” post in the 1990s. In those days, it really was a “true” Peace Corps location, although it wasn’t like the experiences someone might have in Africa or South America. Every country has its challenges, though… and some locations are tougher or more austere than others are. Armenia still has a Peace Corps program, although Volunteers don’t serve in the capital anymore. I was based in the capital, where I could get help somewhat easily if I needed it. I mean, I couldn’t even call someone across the street with my rotary dial phone, but I could easily walk or take a bus to the Peace Corps office. Armenia is the size of Maryland. If I’d been in a much larger country, it would have been a different story.

Granted, the Peace Corps is a vastly underfunded agency. Even though I know firsthand how valuable the work is, and how it helps foster trust and relations between US citizens and host country nationals, most Americans have no idea. I noticed a lot of people who clearly knew nothing about the Peace Corps opining on the article. A couple of people were bold enough to state that the Peace Corps is a waste of money, since the US shouldn’t be trying to “save the world”. They don’t understand that the Peace Corps has three goals:

I talk about Armenia all the time. I even spoke to one of Bill’s colleagues about Armenia recently, to help her understand the country that our military is now being tasked to help. I’ve also talked to school kids as well as people in the community about my service. And God knows I’ve written a lot about about it. I truly can’t say my time in Armenia was wasted. In fact, it changed my life and my perspective.

I do think it’s prudent to screen potential Volunteers for health issues of all kinds. I also agree that serving in the Peace Corps is a privilege and an honor, and not a right to all US tax paying comers. BUT… I also know that any agency affiliated with the US government, including the military, has very antiquated policies regarding mental healthcare. And I think that ought to change. I think it will HAVE to change, because there’s been a lot of work done to destigmatize accessing mental healthcare in the United States. More people than ever are seeking services to treat minor mental health crises.

In 2007, when Bill was deployed to Iraq, I did a supposedly mandatory Exceptional Family Member Program screening (EFMP) because we were going to move to Germany. I was forced to join EFMP– a program that is supposed to allow commands to consider the “special” needs of family members before sending them to certain assignments. I remember being really upset about that situation, since the doctor who screened me said I could suffer mental health issues in Germany, as Bill could go “downrange” (and he was already downrange when I spoke to her). Then she said there was a shortage of mental health professionals in some areas. Duh… I have a master’s degree in social work. I could have gotten licensed and they could have hired me! I would have just needed to pass an exam and pay a fee. I wasn’t some 19 year old bride, with no experience or ability to take care of myself. But that is how I was treated.

In my case, the military’s EFMP screening was utter bullshit, and in the end, it wasn’t even a problem for us. The National Guard didn’t care about my history of depression, and they’d already cut Bill’s orders for Germany before I even got the screening (that wasn’t supposed to happen). It was a waste of time. I totally could have skipped the whole fucking thing, which really pissed me off. I felt like I was being punished for doing the responsible thing and getting help for my depression and anxiety, and then being honest about it for the EFMP screening. I can see by comments left on the article that people affected by Peace Corps’ mental health policy feel similarly.

It’s not a small ordeal to apply for Peace Corps service. In my case, the whole process took less than three months, but that was only because I applied in the 90s. There were a lot more slots to fill at that time, as eastern Europe and many former Soviet countries offered chances to serve. In my day, people were getting invited to countries like Poland, Estonia, Latvia, Lithuania, Czechia, Slovakia, Hungary, Romania, Bulgaria, Ukraine, both eastern and western Russia, and the like. A lot of those programs have since closed, which means there aren’t as many programs that need Volunteers. That means it can take a lot longer for a person to be accepted and sent off somewhere.

But consider that there’s a lengthy application and interview, you have to have references– I think it’s three now, but it was six when I was a Volunteer– and you have to clear legal and medical. The medical exam is very thorough and arduous. I was fortunate enough to get mine at a military treatment facility /sarcasm, although at least it was provided free of charge! If you don’t have health insurance or the money to pay for the physical and dental screening, it can get pretty pricey. I also remember having to go to the county jail in my Virginia hometown of Gloucester and get fingerprinted. That was an experience!

Peace Corps staff members now apparently send invitations to applicants before they’ve passed all of the qualifications, which means that offers get rescinded after people have told their friends and families, sold or given away their possessions, quit their jobs, given up their housing, and made other life altering decisions. Consider also that many people who serve in the Peace Corps often tend to be high achievers, and having an offer rescinded can be personally devastating to them. The rejection, in and of itself, can cause mental health issues.

I read that this new policy of inviting people who aren’t completely cleared came about in 2012 or so, also because of the Rehabilitation Act. I’ve also read that the policy changed because Peace Corps is “competing” with graduate programs and jobs, so they have to make these offers before the applicants decide to go to graduate school or take a paid position. I suppose there could be some truth to that explanation, too.

Anyway… given what has happened in the world since 2020, I can’t imagine that the Peace Corps can continue this practice of screening out people who have sought mental health treatment. I have read that some people were successful in appealing decisions to rescind offers, although it doesn’t seem to be the norm. But– today’s youth have had to deal with a whole host of shit that my generation didn’t have to deal with– from 9/11, to school shootings, to two wars and terrorism, to COVID-19– they have really been through some tough stuff. They have also come of age at a time when people are being encouraged to seek mental health care if they need it. I think the Peace Corps will find that the pool of applicants with no documented mental health history whatsoever will eventually become very scarce.

Bwahahahaha… when I was a Volunteer, we were all issued a copy of this book. It was pretty useless in Armenia.

I do wish the plaintiffs luck with their lawsuit. It’s not because I think the Peace Corps should be sending anyone and everyone out into remote areas “where there is no doctor” (heh heh hehe… IYKYK). I just think the Peace Corps– like the US military– need to reevaluate their policies regarding mental health treatment. There’s a big difference between someone who gets counseling for situational depression and takes medication for awhile, and someone who is bipolar, has a serious eating disorder, is an alcoholic, or has schizophrenia (and some of those people do manage to slip into service, anyway). They shouldn’t punish people for being honest in their medical screenings, nor should people who do the mature thing and ask for help be penalized for taking care of themselves. And for Christ’s sakes, go back to offering invitations to service AFTER the applicant has jumped through all the hoops, so they don’t uproot their entire lives for NOTHING!

I’ve said it before, and I’ll say it again. Not a day passes that I don’t think of my time in Armenia and how much it changed my life, opened my eyes to the world, and altered my perspectives. I was not one who dreamt my whole life of serving in the Peace Corps, but I’m so grateful I did. I would have really hated to have missed that opportunity simply because I very responsibly sought mental healthcare for depression and anxiety before my service, instead of afterwards.

And I dare say the people I served in Armenia would have missed out on knowing me, too… a few of them even liked me. 😉 I look forward to seeing them soon.

Well, that about does it for today. Time to get on with my Friday. Have a good one, folks.

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mental health, psychology

No one should ever die over spilt coffee!

The last couple of years have really been quite the mess, haven’t they? I wouldn’t be a young person in America again for anything, especially in this post pandemic hellscape. Young people are under so much pressure to make it. I remember what it was like to be young and unsure, filled with anxiety and depression, feeling like a failure, and when I was clinically depressed, actually thinking about suicide on a daily basis.

I thought I would be broke and unloved, or working in a job that I hated, desperately trying to earn enough to pay my own way. I went through this anguish for years, only to somehow find myself on a career path to a career I probably wouldn’t have loved that much. Then I met Bill, and was soon swept off that path, and into a new future that I had never, in a million years, envisioned for myself. Even after twenty years, I can’t believe this happened. I never would have thought that the answer for me was finding the right man. That’s not how I was raised AT ALL.

I’ll be honest. There are times when I still feel anxious. There are times when I am depressed. Sometimes I worry about what’s going to happen. Then I am awed by what I have… amazed, even. And I’m glad I didn’t give in to the urge to commit suicide when I was still in my 20s. Then I think to myself… if I had done that, I wouldn’t have been any the wiser about what was to come. My life would have been unfinished, like Neuschwanstein… or an incomplete novel with no ending.

You might already be wondering what’s brought on today’s musings, which some people might find a little disturbing. Well, I don’t assume anyone worries about my mental health, and there’s no reason to do that now. I’m not feeling particularly depressed today. It’s just that this morning, I read a story about yet another high achieving young woman who decided to kill herself over something that really should have been a blip on the proverbial radar.

The Washington Post ran a story today about Katie Meyer, a young woman who, by most accounts, should have been on top of the world. On February 28, 2022, 22 year old Meyer was just a few months from finishing her degree at Stanford University, where she was a soccer star and captain of the university’s soccer team. She had a 3.84 GPA, and in 2019, had helped lead the prestigious university to a national championship in soccer. She had plans to attend law school. She’d hoped to attend Stanford for law school, too.

On February 28, Katie Meyer had done seemingly normal things. She went to classes, soccer practice, and an event for the Mayfield Fellows Program, for which she had recently been selected. She had FaceTimed with her mom and sister about her spring break plans. She had emailed her mother about plane tickets she had booked. She’d never make the flight, though. February 28, 2022 was her last day of life. Katie Meyer committed suicide that day.

So what happened on February 28 that led to Katie Meyer’s untimely death? It started with spilled coffee in August 2021.

On that fateful day in August 2021, Katie Meyer was riding her bike when she somehow spilled coffee on a football player who was accused of sexually assaulting (kissing without permission) one of Katie’s teammates, who was 17 years old. Katie maintained that the coffee spilling incident was an accident. The football player, who was not identified and never faced any disciplinary charges, didn’t even complain about the spilled coffee. However, the incident was reported to Stanford’s Office of Community Standards by the dean of residential education. An investigation ensued, and apparently, for the first time in her short life, Katie Meyer was in some trouble.

The complaint against Meyer indicated that spilling the coffee on the football player had caused physical injury. It was the university’s standard practice to review the incident and determine whether or not Katie should be disciplined. Meanwhile, the incident regarding the football player’s uninvited kiss of the soccer player was also reported to the Title IX office. However, that office determined that the criteria for investigating the kissing incident were not met.

In September, Meyer spoke with a university administrator about the coffee incident. She expressed how distressed she was by the investigation. Two months after that meeting, Meyer provided a formal statement about the incident, again explaining that the disciplinary process had caused her great worry and stress. She feared the incident would derail her career plans and ultimately even ruin her life. According to the Washington Post:

“My whole life I’ve been terrified to make any mistakes,” she wrote. “No alcohol, no speeding tickets, no A- marks on my report cards. Everything had to be perfect to get in and stay at Stanford. I suffer from anxiety and perfectionism, as so many female athletes do. We know all too well that in professional settings women have everything to lose and have to work twice as hard to prove that they are qualified and professional, and any mistake is magnified, any attitude of assertiveness is demonized.”

Man… I can remember feeling like that, too. And I am definitely NOT Stanford material. So often we think of high achievers like Katie Meyer– young, beautiful, brilliant, athletic– richly gifted in almost every way. We think of how lucky they are. We never stop to think about the incredible pressure they’re under and how much pressure they put on themselves. It’s easy for me, at age 50, to sit here and think this is ridiculous that a young woman like Katie Meyer– who seemingly had EVERYTHING going for her– would kill herself over spilled coffee.

I empathize with Katie. I remember very well being young and scared, and feeling like any little mistake I made would permanently ruin my life. I also felt like I needed to excel when I was very young. I felt like it was expected of me, not just from my parents and other elders in my life, but also and especially from myself. Unlike Katie, I didn’t excel at that much. But, like her, I felt like I really needed to achieve, and if I didn’t, my life would not be worth living.

I remember working as a temp in the admissions office at the College of William & Mary, where extremely talented, bright, high achieving young people attended school. I read their essays, letters of recommendation, and report cards, and filed them away, along with lots of other items they sent in to convince the admissions committee that they were worthy to matriculate at William & Mary in the fall of 1998. So many of them seemed desperate to achieve… and unaware that there are so many ways to succeed at life. In 1998, I was 26 years old, a graduate of a less prestigious college, and Returned Peace Corps Volunteer. I felt like a loser, even though I had already done a lot. Depression and anxiety will do that to a person, especially when they’re young.

I was fortunate, though, because I found a really kind and understanding therapist who helped me. I took medication that helped even out my thinking. I took voice lessons, which were relaxing and therapeutic for me… a form of expression that was easy for me and brought positive regard. Gradually, I started to see other pathways out of that hell. It took some time, but I finally moved past that dreaded anxiety ridden state of youth that causes young, ambitious, talented people to consider suicide.

In Katie’s situation, several months passed, and Katie apparently figured the trouble had blown over. She started to relax and look forward to her bright future. But then she got that email at about 7:00 pm on February 28th. She was alone, and when she read the email about disciplinary action toward her, she panicked. Hours later, she was found unresponsive in her dorm room. The email from the Office of Community Standards, informing her that there was a hold on her degree and she could be removed from the university due to the spilled coffee incident, was still open on her computer.

Apparently, Katie had not responded to a February 25th email indicating that more information had been added to her file regarding the spilled coffee incident. The Office of Community Standards had requested more exonerating evidence from Katie by February 28th. She was a very busy student, though, and had evidently missed the email. Since the supporting evidence had never arrived, the university sent the after hours email that left Meyer so distraught that she took that last devastating action.

Katie Meyer’s parents are now suing Stanford University for wrongful death. They maintain that the university had acted negligently and recklessly in the way they handled her disciplinary case. According to the Washington Post:

“Stanford’s after-hours disciplinary charge, and the reckless nature and manner of submission to Katie, caused Katie to suffer an acute stress reaction that impulsively led to her suicide,” said the complaint, filed last week in Santa Clara County Superior Court. “Katie’s suicide was completed without planning and solely in response to the shocking and deeply distressing information she received from Stanford while alone in her room without any support or resources.”

For its part, Stanford University is vehemently denying responsibility for Katie Meyer’s death. In an official statement to the Stanford community, university officials wrote:

The Stanford community continues to grieve Katie’s tragic death and we sympathize with her family for the unimaginable pain that Katie’s passing has caused them. However, we strongly disagree with any assertion that the university is responsible for her death. The complaint brought by the Meyer family unfortunately contains allegations that are false and misleading.

I don’t pretend to know what actually happened in this situation. The description of the coffee spilling incident is not very well explained in the article. Did she go up and hurl a cup of hot coffee at the football player while he was kissing Katie’s teammate? Or was she carrying a Starbucks while riding a bike and hit a bump in the road, causing it to fly from her hands? I can’t tell from the description in the newspaper article. However, whatever actually occurred with the football player, I do know that it should not have led a 22 year old woman with a very bright future to kill herself. I am so sorry for Katie’s parents and other friends and loved ones. But I’m not sure that the university is necessarily at fault, either. I would imagine that most people would not have reacted in such an extreme way to that email.

Extremely competitive universities like Stanford University do attract the best and brightest, and a lot of those students are extreme perfectionists, perhaps even to a pathological level. Maybe at a school like Stanford, it makes sense to be very careful about delivering that kind of bad news– the kind that might threaten a highly achieving young person’s future. However, Katie was 22 years old, which made her a grown woman. She was about to embark on a career in law. I would imagine that she would face some pretty threatening and stressful challenges in that arena, too. It sounds to me like Katie really needed mental health treatment. Perhaps the bigger question is, does Stanford University support and encourage students to seek out mental health services when they need them? Do they try not to penalize students for seeking help when they need it?

This is a topic near and dear to me, because my husband has spent most of his adult life in the military, in which a lot of lip service is paid about people seeking mental healthcare when they need it. However, those who do go to therapy and take medication often wind up being penalized when they lose security clearances or get reassigned to jobs that mess up their career aspirations. A lot of tragedies have occurred because of this policy, that punishes people for seeking help. Hell, in the military, a servicemember can wind up being “punished” even if a family member needs special services for their mental health or educational needs. See my rant about EFMP for more on that.

More recently, I read a Washington Post article about students at Yale University who were kicked out of school for having mental health issues. One student, Rachael Shaw-Rosenbaum, had a very hard time dealing with attending Yale during the pandemic. She needed help, but instead was driven to suicide. The article highlighted other stories of high achieving students being forced to withdraw from Yale after they needed psychiatric care. Some of those students did go on to kill themselves, because they felt like they’d failed and Yale simply wanted to “get rid of them”. Yale University also famously falsely accused a young woman of having an eating disorder and threatened to kick her out of school because she couldn’t gain two pounds. I wrote about Frances Chan, the “fake” anorexic, in my old blog, and since her story is relevant to this post, I will repost my 2014 article about her case today.

Anyway… I think it’s very sad that there’s a population of very bright, promising, young people who feel so overwhelmed, anxious, and depressed that they can no longer bear to go on. I thought it was hard enough in the 90s, when I was staring down the rest of my life, wondering what was going to become of me. At 22, I should have been on the brink of the best time in my life. But instead, I was scared, anxious, depressed, and occasionally suicidal. I feel fortunate that I managed to get through that time. I realize that not everyone can do what I managed to do. They lack the time, the money, the will, or they simply feel like they aren’t deserving. Some of them feel like they should be able to get over mental health issues by themselves. They’ve been taught that they have to be superhuman. But no one is superhuman.

It’s time that Americans stopped stigmatizing people who have mental health issues, especially when they are among the best and brightest. It’s time treatment for mental healthcare was prioritized, and made easy to afford and access. It’s time we stopped ruining people’s lives– or making them think their lives are ruined– simply because they made a mistake or got in some trouble or experience a temporary lapse in mental health due to stress, physical illness, or some other minor setback.

Life shouldn’t be so serious… or so hard, especially for young men and women on the brink of adulthood. No one should ever die over spilt coffee.

My condolences to Katie Meyer’s friends and family members. She sounds like she was an extraordinary person.

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healthcare, mental health, musings

Death of a head shrinker…

A few days ago, I read an article in The New York Times about new drugs that can help treat obesity and perhaps “end the stigma” of being overweight. I’m old enough to have seen a lot of so-called magic bullet obesity drugs on the market. I remember in the late 90s, there was Meridia, which used to be advertised on TV all the time. This ad showed pleasingly plump women in loud prints, breezily lumbering along with smiles on their faces… The ads promised that the drug would help fat people control their appetites and lose weight. Then it was voluntarily withdrawn from the U.S. market in 2010, because it was shown to increase risk of heart attacks and strokes.

I remember this ad so well…

In the 1990s, there was also the Fen-Phen combo of drugs, which was said to be very effective in helping people lose weight. Bill says his ex wife took that combination for awhile. Apparently, she was very upset when it was taken off the market. I remember that combination of Fenfluramine and Phentermine was removed because it supposedly caused heart valve problems as well as high blood pressure. Ex, indeed, reportedly had issues with her heart, other than the fact that it’s so small. She had to have surgery at some point.

And then there was the drug my former psychiatrist gave me. For some reason, my former shrink felt besides the antidepressants I definitely needed, I should also take Topamax to help me lose weight. Topamax is a drug that is used for stopping seizures, curing migraines, and treating bipolar disorder. My shrink didn’t give it to me for those purposes, though. He prescribed it because one of the side effects of Topamax is decreased appetite. He felt I was too fat, and Topamax would help me lose weight.

Granted, I wanted to lose weight… and I was tired of hearing him harp on my body when I went to see him for prescription refills. So I tried Topamax for awhile. I often got the third degree from pharmacists, since I was also taking Wellbutrin, which is said to cause seizures in some people (but not me). Pharmacists would become alarmed at the drug combination and question me, and I would have to tell them that I wasn’t taking Topamax because I have seizures. It was embarrassing.

The Topamax did kill my appetite, which Bill didn’t like, because I didn’t want to cook or eat dinner. It also made carbonated beverages taste terrible, which wasn’t a bad thing, since I was addicted to Diet Pepsi at the time. But even with health insurance, the drugs were expensive, especially since I was also taking name brand Wellbutrin (the generic version didn’t yet exist). I also didn’t lose a lot of weight, much to the psychiatrist’s dismay. He wondered if I had a slow thyroid.

I remember feeling really horrible about his comments. At the time I was seeing him, I had actually lost a lot of weight because I was waiting tables and didn’t have time to eat or sit down. The pounds came off pretty easily and most people thought I looked pretty good. However, I was constantly sick during that time, partly because I was fresh from the Peace Corps and kept getting skin infections and also because I was run down because I was always working. I developed a distinct disdain for that shrink because even though I suffered greatly from body image issues, eating disorder issues, anxiety and depression, this guy kept harassing me about my figure… even after I was happily married to Bill, who didn’t care that I wasn’t skinny.

I was reminded of this shrink the other day, as i read the article in The New York Times the “new” magic bullet drugs that could help people shed pounds and the scorn and harassment that comes from being overweight. I shared the article on Facebook and my former therapist, who is now a friend, commented that the article is interesting. I wrote that I thought his “friend”, the psychiatrist, should see it. My former therapist wrote, “Yes, but he’s dead.”

I hadn’t known the former head shrinker had died. I went looking for his obituary, and lo and behold, there it was. He actually died two years ago. I had no idea. Several people had left kind comments about his memory. If I’m honest, I could see how they came to their conclusions about him. On the surface, the former head shrinker was “nice” enough. I remember thinking he had kind of a gentle, steady air about him. But he also really pissed me off on a regular basis by calling me “kid” when I was a grown and married woman, making comments that were belittling, and giving me a hard time about not being thin when I already had terrible issues with self esteem. I got the impression that he had a personal bias. I also didn’t like it when he acted in a paternalistic way. He was very much an old school kind of doctor who treated me like a child. It wasn’t very helpful at a time when I was trying to launch.

Fortunately, I only went to see that doctor for medication. I saw my therapist, a younger, hipper, and more empathetic guy, for psychotherapy. I will give the head shrinker credit, too. He was a competent psychiatrist in that he found the right drug for me. Wellbutrin changed and maybe even saved my life. Within just a few days of taking it, I felt like a completely different person. After taking it for several years and then getting off the drug, I still haven’t gone back to the awful way I used to feel every day… the way that was normal for me, but made other people think I was legitimately crazy. People used to ask me if I was bipolar all the time. They don’t anymore, although I don’t spend much time around other people anymore.

In 2007, before we moved to Germany the first time, I requested my records from the shrinks. I needed them because the Army required all of my medical records so I could be evaluated for the EFMP (Exceptional Family Member Program). This was supposedly a must before they would send us to Germany, but as it turned out, the National Guard (Bill’s official employer– he was a full time “federalized” Guardsman) didn’t give a fuck about my EFMP status the way the regular Army would have. I was forced to join the EFMP, but it turned out that I could have skipped the whole process and the National Guard wouldn’t have been the wiser. It would have been nice if I had known that, since the whole EFMP screening process was traumatic for me on many levels. I won’t get into that now, though. I think I reposted about my experience with the whole EFMP business. Thank God Bill is retired.

Unwisely enough, I read the notes my shrinks wrote about me. My cool therapist wrote positive, affirming notes. The dead head shrinker wrote things that upset me… like, for instance, I had a “garish” appearance. I was a bit taken aback by that. People have described me in a lot of ways, but never “garish”. That implies that I looked tacky, gaudy, or like a clown. And I didn’t see what my choices in makeup and clothing had to do with my mental well-being. Isn’t it better if someone with depression isn’t wearing black? He also made comments about my weight in his notes… and on more than one occasion, seemed a bit frustrated that his chemical cures weren’t slimming me down. I know very well that I’m not a thin person… but he made it sound like I was just disgustingly obese. When I was seeing him regularly, I wore a size 14 or 16… which is pretty average among American women, even if it’s not ideal in terms of most women’s most attractive body size.

It was a little strange reading about this man’s death. I mean, I know it had to happen… he was old enough, although he was several years younger than my father was when he died. I noticed the obituary didn’t mention a wife. I remember he was married when I saw him. I’d heard she was his third wife, and she had been about my age, while the shrink was old enough to be my dad. He’d had a young daughter back in the late 90s, which would mean she’s a young adult now. He also had four other children. I remember thinking that I hoped his youngest daughter didn’t have weight issues when she was growing up. I had a feeling he would ride her about them. And I guess, just based on his obituary, that his wife was no longer married to him when he passed a couple of years ago. He was a tall, somewhat handsome man, and he didn’t have a weight problem. But that didn’t stop him from having problems of his own.

I don’t like seeing doctors. I haven’t seen one since 2010, when Bill made me go because we thought my gallbladder might need to come out. It turned out it wasn’t bad enough to be yanked. One of the reasons I don’t like seeing doctors is because of that shrink… as well as the horrible OB-GYN who did my very first (of only two) gynecological exams. She physically and mentally hurt me so bad and shamed me so much that I became a bit phobic of medical people, even though I have a background in healthcare. Now I don’t go to doctors unless I’m about to die.

But maybe I shouldn’t blame these doctors for turning me off of their services so much… They’re only human, right? I’m sure they had my best interests in mind when they fat shamed me. The OB-GYN wrongly predicted I would get very fat in Armenia. I actually lost a lot of weight there. I did gain it back, but then I came home and waited tables and lost even more weight. And then I gained it back when I quit waiting tables… which was a good move for my overall health– especially my mental health– even if I didn’t have as pretty a package for people to look at. I’m glad to hear about the new drugs that might help people lose weight. I think it’s a good thing to think of obesity as a medical problem rather than a character flaw. However, this is not the first time I’ve heard about drugs that can help with weight loss… and so many of them turn out to be harmful.

Well… one more week to go before Bill is home. I continue to try to keep the faith. Last night, I was thinking about places I might like to visit when we’re finally able to travel again. Funnily enough, I’m planning based on whichever place is the least likely to give me a hard time rather than where I’d really like to spend time. One of the many luxuries of living in Germany is that there are plenty of places to see, and a lot of them are not so hard to drive to. Last night, I was thinking about visiting Krakow, Poland. It’s about a 9 hour drive from where we live. Maybe we can go there this year… after my second vaccine next month.

Also… I guess I’ve now arrived. Yesterday, I was made aware of someone having made a cloned account from my Facebook profile. It had one of my photos from last year, a cover photo using a picture I took in Rothenburg in 2018, and claimed I was a Mexican living in Nashville. I reported the profile, but Facebook naturally says they can’t do anything about it because it “doesn’t violate standards”. Meanwhile, they can give me bullshit warnings because they claim one of my comments was racist hate speech when it was really a criticism of a racist game being pitched on Facebook. They really need to get some real people evaluating these reports again. Facebook sucks, and is becoming more of a joke by the day. Anyway, I left several more complaints, along with a profane comment on the cloned profile. I doubt it will amount to anything. I changed my passwords, just in case.

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healthcare, Military, rants

Repost: EFMP… There’s nothing “exceptional” about it.

I am rerunning this post that appeared on my original blog, back on March 10, 2013. I am no longer an “Army wife”, since Bill retired in 2014. However, we know the lifestyle and this post got tons of hits… plus, it came up last night as we were remembering how I was FORCED to join EFMP because I had taken antidepressants. And then, once we got to Germany after I had dutifully enrolled in EFMP, Bill got a shitty email from some uppity guy at Walter Reed Army Medical Center in Washington, DC, wanting to be “apprised” of my “condition”.

We were laughing about it, though, because unlike “Big Army”, the National Guard didn’t give a fuck about EFMP. They cut Bill’s orders for Germany before I ever visited the medical people in DC, so I probably could have skipped the whole thing and totally gotten away with it. Of course, that was in 2007, and things have probably changed.

Anyway… Bill was funny last night as we were remembering that time because he said, as we remembered the email, “No, you don’t. We’re already here. Fuck off.” He’s obviously benefiting from my “charms”, which have rubbed off on him. To clarify, no… that’s not what he actually said. Bill is very good at politely telling people to fuck off. He basically told the guy to leave us alone and they complied. But thirteen years later, he might say it. That makes me proud. So here’s the post from 2013. Maybe it will be interesting/helpful to someone while I wait for fresh inspiration.

Back in 2007, my husband was deployed to Iraq.  We were also planning to move to Germany.  Because Germany is not in the United States, I had to do some things to prepare for the move.  One of the things I had to do was get a physical.  I was really dreading having to do this for a lot of reasons.  First off, I’m not a big fan of going to the doctor’s office.  I especially hate going to military doctor’s offices.  It’s a pain in the ass to set up the appointment.  Military medical providers tend to talk to their patients as if they are either children or in the military, even if they are civilians.  I also had a very traumatic incident with a military provider in the 1990s that continues to haunt me today.

Anyway, I had to get this physical and then I had to be screened for the Exceptional Family Member Program, a supposed benefit for military families.  Basically, what EFMP does is allow a servicemember’s command to consider the medical and educational needs of a family member before moving their “sponsor”.  I have already ranted about the term “dependent” to describe spouses.  My husband is considered my sponsor.  How’s that for demeaning?

So I got a friend to help me set up my appointments.  I saw a physician’s assistant who turned out to be really kind and patient with me, especially after I told her about my first and last disastrous attempt to get a pap smear when I was 22 years old.  She thought I had high blood pressure, but it turned out my high readings were caused by white coat hypertension.  That was proven by 24 hour ambulatory blood pressure monitoring, which involved wearing a sphygmomanometer for 24 hours.  As soon as I stepped out of the military hospital, my blood pressure readings dropped to normal.

Finally, I arranged to be screened for the EFMP, which I had been told involved having a doctor look at my records and determining whether or not I had any conditions that warranted special consideration as to where my husband could be assigned.  From 1998 until 2004, I took antidepressants and went to therapy for depression and anxiety.  The worst of my issues were from 1998-99.  I chose to stay on antidepressants while I was in grad school mainly because I didn’t want to feel shitty while I was dealing with such a stressful time of my life.  At the time, I had no idea I would ever marry a military man.  I could have gotten off the antidepressants earlier than 2004.  I got off them because I dropped civilian health insurance and was hoping I might get pregnant.  I got off the drugs with no incident and didn’t even miss them, except they helped me keep my weight down.

What I didn’t know was that my time on antidepressants would come back to haunt me.  The EFMP required that I submit ALL of my medical records for the past five years.  Those records included my therapist’s notes about my depression, which were very personal.  I suppose in retrospect, I could have removed the records from before 2002.  I didn’t think to do that.  I showed up for the EFMP screening and was left sitting in the waiting room in the pediatrics department of the local military hospital while the doctor looked at my paperwork.  She finally came out and told me I needed to be in EFMP because I’d had depression and it might be risky to send me to Germany.  She listed the reasons she thought I was at risk.  I might have trouble adjusting to culture shock.  I might get depressed if my husband got deployed (even though he was already deployed when I met with this woman).  I might have problems with the fact that Germany isn’t as sunny as the USA is. 

Our conversation was laughable.  Here was this young doctor in a military uniform telling me that it was a good thing we were bound for Germany, since if we were going to Hawaii, I probably wouldn’t get to go.  She claimed there weren’t enough therapists in Hawaii.  I looked at her dumbfounded and said, “You know, I have an MSW.  The Army could hire me.”  Moreover, this move to Germany would be my third overseas.  I had already survived clinical depression while in Armenia.  I knew Germany would be a piece of cake for me.  But that didn’t matter… my thoughts about my own stability and personal desire to stay out of EFMP meant nothing.  It was fruitless to argue with the doctor, who was just covering her own ass.  She said I could try to disenroll in 2009 and maybe the EFMP would grant my request.

She then told me that if I didn’t comply, my husband could get kicked out of the Army.  And she said he wouldn’t get his orders if I didn’t do what she said.  Her face registered shock when I pulled out a set of orders, already listing me as having command sponsorship.  Apparently, the National Guard couldn’t care less whether or not I have depression.  She spluttered, “You’re not supposed to have those yet!”

It was truly ridiculous.  But because my husband was in Iraq and I didn’t want to cause issues, I complied with the demand that I join EFMP.  I filed the paperwork and we went to Germany.  Some months later, my husband got a nastygram from the very pushy EFMP coordinator in DC, demanding my status.  They needed to be “apprised of my condition”.  My husband sent him an email letting him know that I had no desire to be in the EFMP and didn’t need it.  We never heard another word about it and I got through my time in Germany without incident.

The military is pretty intolerant of head cases… even though if you read my articles about nutty Army folks, you know that the military is rife with them.  The official policy requires that servicemembers who are depressed seek help for their issues.  The unofficial policy is that if you or a family member see a therapist or take psychotropic drugs, your career will probably suffer.  You might lose your security clearance or be stuck in some shitty assignment indefinitely or get sent somewhere you’d rather not be.  I sought therapy for my depression and anxiety when I really needed to.  I’m glad I did it; it probably saved my life.  I had no way of knowing that making the very mature decision to seek help would end up in a ridiculous conversation with an intractable doctor who didn’t know me from Adam and was basing her medical opinions of me on three year old notes from other providers.

I understand why EFMP screening is mandatory for people going out of the country.  I just wish the process involved more subjectivity and people using common sense.  I wish that competent adults were treated more like stakeholders in their own healthcare and given more of a partnership in the process, rather than given the bullshit line about how the screening is for their own good.  The screening is about covering asses, saving money, and controlling people.  Moreover, you can get around the EFMP.  A lot depends on who you are and who you know.  I personally know someone who had her paperwork changed so the EFMP restrictions would be lifted and she could take her kids to Germany.  In her case, it worked out fine.  I know of other people who were not allowed to go abroad because of EFMP and they could not get their EFMP status changed. 

I don’t mean to say that EFMP is not a valuable program for those who need it.  There are families who have kids with special needs that need that special consideration.  It’s not good to go to a new duty station and find there are no suitable facilities to handle someone’s medical or educational issues.  That tends to lead to the family having to be sent elsewhere, which costs a lot of taxpayer money and causes lost productivity.  It’s also a pain in the ass for the family. 

However, the EFMP requirement is not good when it’s forced on a family, particularly when the “exceptional member” is a competent adult.  People know that EFMP can cause plum assignments to get cancelled.  Supposedly, this is not true… the military will tell people that EFMP won’t mess up a person’s career.  But in reality, being limited in where you can go can mess up your (or your sponsor’s) career.  Because of that, some people won’t get help for depression if they need it.  I mean, it’s hard enough to get help for depression because there’s so much stigma.  If it might also mean you can’t go to Germany with your husband, you might also hold off on calling for help.  And that can lead to tragic consequences.

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Neighbors, psychology

The neighbor from HELL!

Yesterday, I was on Toytown Germany, an English speaking forum for expats. I used to read it all the time when we lived in Germany the first time. Those were the days before Facebook, and I found it had a wealth of information for English speaking non-Germans. I still like reading it sometimes, because a lot of the people who use that forum are from Europe and aren’t affiliated with the U.S. military. They offer interesting perspectives and insights that my countrymen can’t deliver.

A little mood music for this post…

So anyway, I came across an interesting thread from 2011. A woman calling herself Gutgenug was living in Hesse, in a town called Heppenheim. Her husband was in the Army and she worked for the Army herself, at an installation that has since closed. Gutgenug’s story was an amazing one… and she had a few skeptics in her midst. I must say, having lived in Germany for awhile, I believe what she writes. I especially believe that she works for the Army because she has mastered the Army writing style.

Back in November 2011, Gutgenug wrote that her next door neighbor was suing her because she used incense in her house. This man, who, along with his wife, was a chain smoker, claimed that the incense was “offensive” to him. He also didn’t like that she was using candles in her house. He called the police on her several times a week. The police would come over and talk to her. When she later called the police on him, they would hang up on her. She got so freaked out that she had anxiety attacks and didn’t even want to leave her house.

Now… this would be bad enough, but over the weeks of her very long thread, she described increasingly bizarre harassment from this man. She claimed he set up an industrial sized fan, which he aimed at her house and ran for hours. She even shared a picture of the fan, the kind of equipment one uses to quickly dry paint or carpeting. She wrote that he climbed their fence and took down her windchimes. According to Gutgenug, he would purposely block them in their driveway and surveil them as they went about their daily business.

I started thinking about all of the neighbors we’ve had over the years. Some of them were annoying. I’m sure we’ve annoyed people, too. I have never encountered anyone quite as psycho as this lady’s neighbor was. I kind of hope some of what she wrote is made up… because just reading about some of his tactics was raising my blood pressure. It’s hard to believe that the local police would do nothing to help her, either. According to her, she actually had to call someone at the Army installation in a position of high authority. That person had connections with the German police and they had to go jerk a knot in the people running her local police department.

As the matter continued to escalate, the neighbor brought criminal charges against Gutgenug for filming him. She was actually filming the fan he kept aiming at her house, but he was apparently in the film and evidently, that’s against the law. He allegedly told her she and her husband should go back to America, since Germans didn’t want us here. And he supposedly is “better” at using the law to harass people, so she should just give up and leave.

Later, it came out that her landlord used to be friends with the neighbor. They are both handymen and now compete for business. Some people speculated that perhaps the neighbor was getting back at the landlord by driving out his tenants. By the end of the thread, it was revealed that the guy had driven several other families out using the same tactics and the local police reportedly didn’t care.

As interesting as the story was, I was even more intrigued by the solutions people came up with, a lot of which included their own stories about Nachbarkrieg (neighbor wars). One lady wrote about how one of her neighbors had committed Ausländer Unfreundlichkeit by calling her “Ausländer Schwein” (foreign pig). It’s against the law to insult people in Germany. The neighbor also called the police on her for having people over on a Sunday. When she opened the door to the police, she wrote that she almost fainted, because she was afraid something had happened to her kids. Actually, it was just the neighbor harassing her for having company that was too “loud” on Sunday. When the woman’s German husband went to mediation, the insult was brought up and the neighbor was quickly shamed for resorting to personal attacks. In the end, everything was settled amicably, and the troublesome neighbor moved away.

ZZ Top also does a version… it’s a bit different. Bill went to the same high school Billy Gibbons did, though not at the same time.

Another person suggested screaming at the guy in English. As tempting as that sounds, it also sounds like the kind of tactic that only works if the other person is in their right mind. It sounded to me like this woman’s neighbor, if he was the way she described, was not quite sane. He seemed to have a lot of time on his hands, as well as the imagination on how to creatively drive someone up a wall. And one guy suggested finding a large person to beat the living fuck out of the guy. Of course, he also mentioned that taking that approach might make the legal issues even worse.

Complicating matters for Gutgenug is that she was raised in an abusive environment. Having been brought up by an abuser, she has issues with anxiety and is passive. I got the sense, having read her post, that she may have served in the military herself. I would imagine that if she was, in fact, a veteran, she probably had some trouble with the job. I don’t know this from personal experience, but I think it would be difficult for a woman to climb the ranks if assertiveness is an issue. Also, I was a little surprised that if she had all of these anxiety issues, the Army let her come to Germany in the first place. Before people in the military are assigned overseas and allowed to bring their families, they usually have to go through EFMP screening. EFMP stands for the Exceptional Family Member Program, and it’s intended to identify people with special healthcare or educational needs so that they don’t get sent someplace where their needs can’t be met.

I had to undergo that screening myself the first time we moved to Germany and, because I had been treated for depression and asthma, was forced to join the program. Fortunately, my husband’s command didn’t have a problem with it and it was a non-issue for us, but I know other people have had assignments cancelled over EFMP issues. It sounds to me like Gutgenug’s problems, if known to the Army, would definitely warrant being put in the EFMP. I ranted about my own experience with EFMP. But anyway… I have also learned that in the military, when it comes to things like EFMP, a lot comes down to who you know, who you are, and who can “unfuck” things for you.

A few weeks ago, I wrote a post about German passive aggressiveness. That post is mostly about a couple of recent legal cases within Germany that involved two different men who were covertly trying to kill people. One man was a handyman who had issues with his neighbor and booby trapped her firewood. Another was a guy who just wanted to see what would happen if he poisoned his co-worker’s lunch. Although there are not nearly as many weapons here as there are in the United States (where the harassing neighbor guy might have been shot for his shenanigans), it’s easy to see that pissing someone off in Germany can lead to repercussions that may be just as sinister as being blown away.

In any case, it looks like Gutgenug eventually went back to the States. Her landlord was placed on the “no-referral” blacklist, and the housing office was no longer allowed to refer Americans to his home. It made me kind of sad to read Gutgenug’s story. I really enjoy living in Germany, for the most part. Yes, I’ve run into some true assholes here, but none any worse than people I’ve met in my homeland. And among the assholes are many wonderful people who are helpful and kind. It’s hard to be so far from home and, I’m sure, being in a foreign country where you can’t speak the language fluently and the natives are doing their best to mess with you, is extremely stressful. Life is short and no one has the time for that. If it had been me, I probably would have just moved out, but if Gutgenug’s story is for real, then it does at least sound like the situation was dealt with at last. Kudos to her for that. Not everyone has the courage or ability to fight back in these situations.

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