Tag Archives: health insurance

healthcare, mental health, psychology

“Please, Doc, don’t weigh me unless it’s really necessary!”

Yesterday marked the first day of National Eating Disorders Week 2022. Fittingly, a few days ago, I read an interesting article in the Washington Post about a new trend in U.S. healthcare. It involves special cards that one can hand to a physician. See below:

I like this idea.
From the More-Love.org Web site.

I haven’t seen a doctor since 2010. One of the main reasons I don’t visit doctors is because I once had a very traumatic and unnecessarily physically painful and humiliating experience with one. I did see doctors a few times after the traumatic experience, but as I’ve gotten older, it’s gotten even harder to make the phone call for an appointment. I know very well that this isn’t the greatest policy for promoting my personal longevity. I could definitely use a check up. However, for many reasons, visiting medical people causes me a great deal of stress. One of the main reasons it’s stressful is because of that goddamned scale, and my long history with eating disorders. No, I don’t mean the obvious ones that might put a person in the hospital. There are actually a lot of eating disorders out there, and most don’t get diagnosed. But they do exist, and I’ve struggled with them for years. I have less of a problem with them now, mainly because I have a very loving and understanding husband who doesn’t body shame me. I would be lying, though, if I said those problems have gone away entirely. There isn’t a day that goes by that I don’t think about it.

I know I usually have less of a problem going to see a doctor if I know I won’t have to be weighed. For instance, in 1999, I had facial cellulitis that almost put me in the hospital. I had to see an ear, nose, and throat doctor for treatment. He was a great doctor, but one thing that I especially liked about him was that he didn’t force me to get on a scale. He simply looked at the mess on my face and prescribed antibiotics. The family practice doctor who sent me to the ENT guy was kind of an all knower, but he actually reassured me that my weight wasn’t that bad. At that time, it wasn’t that bad, since I was waiting tables and lost a lot of pounds because of that. However, I was never so sick, so often, as I was in those days.

Although I know weight is an important measure for some health issues, I think it’s pretty cool that someone has realized how absolutely mortifying getting on the scale is for some people. The above cards were offered at Element Primary Care in Omaha, Nebraska. A 30 year old woman named Dani Donovan, who is an attention deficit/hyperactivity advocate and suffers from binge eating disorder, happened to see the cards at the office. Donovan reportedly avoids going to see physicians because of the stress of being weighed. She happened to find a practice where, apparently, the staff recognizes this issue, and how it prevents people from seeking care. According to the WaPo article:

“I didn’t even know that saying ‘no’ to being weighed was a thing you could do,” said Donovan, 30, an attention-deficit/hyperactivity disorder advocate who has a binge-eating disorder and often avoided doctor’s appointments because being weighed was so stressful. The card led to a good conversation with her doctor, Donovan said, that helped build trust and make her feel empowered.

Donovan took a photo of one of the cards and posted it on Twitter. It’s caused quite a stir.

These cards were developed in 2019 by a Los Angeles area eating disorder coach named Ginny Jones. Jones is a survivor of several eating disorders, including anorexia and bulimia. Jones came up with the cards after many experiences she had when visiting physicians. A lot of them would praise her for losing weight, even when it was noted in her records that she has had eating disorders. She now offers the cards for sale on her Web site. When Jones was contacted for a statement about her cards, she said:

“I wish I could say I was surprised by the ‘controversy’ around the cards. I created them to address weight stigma, and it’s basically fatphobia to jump to conclusions and say blanketly that asking not to be weighed is unhealthy.”

Personally, I think these cards are great, although I can’t imagine presenting one to any of the military doctors I’ve seen in my lifetime. But then, again, I haven’t been to see a doctor in about 12 years. My blood pressure shoots up whenever I’m in a military healthcare facility, and they usually take one look at me and assume I have any number of health issues just by my appearance. I have found that a lot of doctors aren’t good listeners, either. That is especially true with military providers, in my experience.

In 2007, before we moved to Germany the first time, I actually wore an ambulatory blood pressure monitor for 24 hours to prove that I didn’t have hypertension, because my blood pressure readings were so high in the office. As soon as I stepped out of the military hospital, my blood pressure was completely normal and stayed that way. I came back to the office the next day with a bruised arm and documentation in my file that I have white coat hypertension. That may no longer be true today, given my family history, but the way the providers acted during that last visit put me off of going back, even though the person I saw was actually very kind to me when I told her what had happened to me at the hands of an Air Force gynecologist back in the 1990s.

The Air Force gyno I saw back then gave me my very first (of two in my entire lifetime) gynecological exams. It was so painful and distressing that I left her office traumatized and horrified, and actually felt violated on the level of sexual assault. Besides really hurting me with her instruments and not apologizing for the pain she caused me, this doctor also fat shamed me and predicted that when I went to Armenia, I would gain tons of weight. In the 90s, I was dealing with eating disorders more acutely than I do today. Today, I seem to have replaced eating issues with drinking issues. Again… not healthy, and I probably should see a doctor, but I just can’t bring myself to do it. Even having these cards probably wouldn’t get me into the office, although I do think they would help, if I found a kind and understanding physician who was sensitive to these issues.

According to the Washington Post article, as well as my own anecdotal experience, there are a lot of physicians who have a bias against obesity. They seem to take obese patients less seriously, especially if they’re women. The article reports, “one piece published in the British Medical Journal found that weight stigma actually led to increased mortality and other chronic diseases and ‘most ironically, (weight stigma) actually begets heightened risk of obesity.'” There have been a number of articles about how the medical community tends to focus on weight, even when a medical issue is clearly not related to the patient’s weight. Like, for instance, someone comes in with a broken arm and gets told that weight loss would benefit them. There’s no doubt, weight loss would be beneficial, but that’s not why the person came in to see the doctor. In that sense, I can see how these cards could be useful. If you’re going to see the doctor for a specific issue that has nothing to do with obesity, perhaps it wouldn’t be a bad thing to skip the scale, at least for that visit.

Of course, some physicians will never be onboard with avoiding weigh-ins. In the WaPo article, a physician named “Umbereen S. Nehal, a former chief medical officer for Community Healthcare Network in New York and a board-certified pediatrician,” reported that she strongly believes patients must “be weighed every time, regardless of when they were last weighed or why they are in the doctor’s office.” The doctor claims to be have sympathy for patients like Donovan, but she’s not convinced that avoiding the scale will improve healthcare outcomes. She says, “Is the hypothesis that somebody who is obese, let’s say, if we don’t weigh them, fatphobia will go away? Those visual cues will not go away. So my beef with this is that it disrupts processes in the system for efficient data collection and that data are used for a variety of things.”

My answer to Dr. Nehal is that a lot of people avoid the doctor entirely because of this issue. She may be getting more data when she weighs patients at every visit, but a lot of people won’t even come see her because of the mortifying prospect of being weighed, the psychological stresses that come from that experience, as well as the potential humiliation that comes from a fat shaming doctor. Seriously… if you’re feeling fine, and you don’t want to deal with the discomfort of being weighed, how likely are you to schedule screenings? Is that the outcome Dr. Nehal wants? For people not to come in to see her at all? Then she won’t get ANY data, and the person will show up in the emergency room instead. And that will not only lead to poorer healthcare outcomes, but it will also lead to much higher medical bills.

Another doctor who was quoted in the article, Fatima Cody Stanford, an internist who specializes in obesity medicine, also insists that weight is an important measure. She notes that U.S. medical schools do a terrible job teaching students about weight, and that many people don’t visit their doctors very often. Stanford says she would tweak the card to something that says:

“I’m happy to get weighed but please do not provide any negative or derogatory comments associated with my weight.”

That way, the doctor gets their data, and the patient doesn’t have to deal with fat shaming. I would add, though, that in my case, it would not be true that I am “happy to get weighed”. I hate being weighed every time. It causes me a lot of distress, and that’s why I avoid doctors unless I’m about to croak. So I think Dr. Stanford might want to rethink that wording, although I appreciate that she recognizes how upsetting being weighed is for some patients.

I looked at Element Primary Care’s Web site, and it appears that their approach to care is different on many levels. For instance, I notice they offer telemedicine appointments, focus on keeping their practice small, and it appears that instead of using a traditional insurance model, they provide care for a monthly fee. This eliminates co-pays and insurance deductibles, and allows patients to access care when they need it. The direct primary care membership plan can be combined with a high deductible/less expensive insurance plan which would cover hospital care or other unforeseen care needs that still use the traditional insurance model. I have heard of a growing number physicians’ practices eschewing traditional insurance coverage, which allows them to be able to make medical decisions that don’t have to go through third parties at insurance companies. I think it’s a great idea, although it will probably take some time for it to catch on nationwide. Change can be slow, but I do think overhauling our health insurance model could be a game changer for a lot of people.

At Element Primary Care, about half of the patients decline to be weighed, but some will weigh themselves at home and report their weight that way. Or, if they have a condition that requires their weight to be monitored, the patient can turn backwards on the scale, which is how many eating disorder patients get treated. That way, they don’t have to know that number, and it won’t affect their psyche. The cards allow the patients to advocate for themselves and be more of team member in their healthcare. It may also make them feel “safer” from judgment and humiliation. Personally, I don’t weigh myself at all anymore, and when I have gone to see the doctor, I don’t let them tell me how much I weigh. I know from personal experience that knowing the number can lead to distress.

I think the pandemic has caused a lot of issues with weight and mental health. I recently read that a number of young people have developed eating disorders during the pandemic. Even President Biden is addressing it, which is very fitting, since National Eating Disorders Awareness Week begins today. Kudos to Mr. Biden for bringing this up, since I know Trump doesn’t care about helping people with eating disorders. I recently read that doctors are seeing a lot of adolescents in emergency rooms, dealing with eating disorders. There’s also a lot of depression and anxiety being reported, due to the pandemic. I think any measure that makes seeking help easier is commendable.

While it may not always be medically appropriate to skip stepping on the scale, I like the fact that some healthcare professionals are noticing and addressing this issue. And I think it’s amazing that some people are empowering themselves by presenting these cards, although I would not be surprised if some people get lectured by their doctors for not being weighed. I would like to see less lectures from doctors as a general rule. People need to take ownership for their own health, and physicians need to stop seeing patients as people who need to be given orders or lectures about taking care of themselves. Especially if they are competent adults.

Anyway… I probably won’t be going to see a doctor anytime soon, and in fact, I hope I don’t live to be super old. I think it’s overrated. But I definitely think the cards are kind of cool, even if I’m sure they don’t always go over too well with more traditional physicians. I know that if I had given one to my ex psychiatrist, for instance, he probably would have laughed me out of his office. And he never weighed me once– but he did fat shame me quite a few times before I told him to stop. He also gave me a prescription for Topamax off label, hoping it would slim me down. Is it any wonder why I hate seeing doctors?

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healthcare, law, LDS

Utah’s new “pregnancy and pre-natal child support” law…

Last night, as I watched Liam Neeson kicking ass in his Taken series, I was scanning the news for interesting headlines. Sure enough, The New York Times delivered with a story about a new law set to go into effect in Utah next month. The headline read, “Utah Will Require Fathers to Help With Pregnancy Bills”. It was inspired by a law signed by Utah Governor Spencer J. Cox on March 16th, which amends Utah’s Child Support Act by “requiring any father whose paternity has been established to pay half of the mother’s insurance premiums while she is pregnant, and any related medical costs, including the birth.” The new law is set to take effect on May 5th of this year.

Utah’s new law comes from HB113, which was sponsored State Representative Brady Brammer and State Senator Daniel McCay, both of whom are Republicans. The men said they came up with this law as a way of addressing the very contentious abortion debates that have come up in recent years, as “pro-life” people try to convince the Supreme Court to overturn Roe v. Wade. Mr. Brammer confirmed that he hoped this bill would be sort of a “pro-life” measure, although he didn’t intend it to be about abortion, per se. It’s more that he recognizes that pregnant people are in a “really tough spot, making a really tough decision.” In other words, he acknowledges that many women decide to terminate their pregnancies because of the high cost of being pregnant and giving birth. Personally, I don’t think it’s a bad thing that Mr. Brammer acknowledges that simple fact. It’s true– fathers’ names aren’t the ones on the medical bills when it comes to pregnancy, and since they are responsible for making women pregnant, theoretically, they should be paying.

On the surface, this new law, which may be the nation’s first stand-alone law to mandate prenatal child support, sounds like a good thing. In fact, given the culture of Utah, I can see why prenatal child support has now been made a state law. Utah is a state full of Latter-day Saints (Mormons), and Mormons are famously pro-marriage and family– as long as the marriage and family involves a man and a woman… or women, as they case may be. Utah is historically not so tough on polygamist families. However, once I started thinking about the law, I realized that it could cause some problems. And then I looked at the comment section, and sure enough, I saw how this new law could end up complicating matters for a lot of women. The first point made in the story, in fact, illustrates that the new law doesn’t directly assist pregnant women and could tie them to abusive partners.

In Utah, a person who is considering having an abortion must wait 72 hours and receive “counseling”. The counseling includes information that is designed to discourage abortion, rather than allowing pregnant people to simply hear the facts about the procedure and determine the right course of action for themselves. Supposedly, if the woman also has some help paying the bills, that might also convince her to have the baby instead of terminating the pregnancy. That is probably true in some cases, although it doesn’t address the fact that some women just plain don’t want to be pregnant or go through childbirth, particularly if the baby is the product of a tryst with someone she doesn’t know or care about. While adoption is still an option for people who don’t wish to parent their offspring, a lot of pregnant people decide not to choose adoption. They have some good reasons for not choosing that path, too. Frankly, if I were pregnant and didn’t want a baby, I would probably not choose adoption over abortion. But I have always wanted to have kids and didn’t get the chance.

Looking at the comment section, I saw many men opining that thanks to this law, men might FINALLY have a say in forcing women to birth babies when they don’t wish to be pregnant. After all, if he’s paying his fair share, shouldn’t he be able to dictate that the woman stay pregnant? Personally, I don’t think so. It’s still her body that is being used as a vessel. It’s still her health on the line. It’s her kidneys and bladder being danced upon in the middle of the night, and her nether regions that will be ripped apart as the baby passes through the birth canal… and it’s her blood pressure that might rise to unhealthy levels that could lead to a stroke and permanent disability or even death. Financial support from fathers is a very good and necessary thing for pregnant people, but it’s still not an equalizer of the situation at hand when it comes to making babies.

The bill would also require the paternity to be confirmed. There are situations in which the paternity can’t be confirmed, or perhaps the pregnant person does not wish to identify the father. In those situations, the mother would presumably still be paying her own bills. Although I know that there are initiatives that exist that encourage mothers to identify the fathers of their babies– mainly so that the government can go after deadbeat fathers. I was once interviewed for a job that would have had me encouraging new mothers to name the fathers of their babies if they hadn’t already. It wasn’t about involving dads, though. It was mainly about money, and preventing mothers from using welfare or other social safety nets.

If you’ve followed my story, you know that I’m very much in favor of father’s rights, once the babies are born. Even if the mother thinks the father is a total shithead, I think the father should have rights. After all, in most situations, the women chose the fathers of their children when they consented to having sex with them. And before anyone jumps my shit, let me reiterate that I also know that there are exceptions. In fact, the exceptions are one reason why I strongly believe in a person’s right to have an abortion. However, if the baby is born, and there is a father, and he wants to be in the baby’s life, I think it should be allowed and encouraged. If fathers had stronger rights when Bill’s kids were young and Bill could have feasibly gotten custody of his daughters, maybe they wouldn’t have gone through all they did. And I write that knowing that Bill also chose a poor mother for his daughters.

However, I don’t think the time leading up to parenthood is the same for males and females. Men do their part at the time of conception. So many of them do choose to walk away from their responsibilities, and it seems that a lot of them either never think twice about it or don’t ever know the difference because they’re never told about the pregnancy. Either way, once they’ve fertilized the egg, their path to parenthood involves waiting and, if they’re a decent sort or the relationship is amicable, supporting the woman through the pregnancy. Women, on the other hand, have to deal with the physical, emotional, mental, and hormonal effects of being pregnant. Some of it, I’ve heard, is pretty amazing and interesting. A lot of it is unpleasant or even dangerous. All of it is potentially very expensive.

Anyway… it wouldn’t be one of my blog posts without a few reactions from the peanut gallery. Here are some of the unedited comments that made me laugh, scratch my head, or feel genuine concern for the people of Utah who will be testing this new law. As you can see, reactions ran the gamut. Some people, whose comments I didn’t include, were aghast because they live in countries where this isn’t an issue because healthcare is a fundamental right, rather than an overpriced privilege.

Agreed, however this is more about Mormons and polygamy than it is about a cultural problem with men taking paternal responsibility for creating children. It’s Utah. (probably)

When I was pregnant in the 80’s I was told that the most dangerous time in a women’s life was when she was pregnant. This just makes it more dangerous to be a woman. (this could be true, too… there will be some men that won’t pay and will think murder is a better solution)

That’s a start. The impregnator should also pay all the funeral expenses, if the pregnant woman dies from complications caused by the pregnancy. The impregnator should also be assessed a portion of the funds necessary to care for any underage children the pregnant woman might have as a result of other impregnators, since she’s no longer alive to contribute her share of support for those children.

Story cut out on me but that’s what I’m talking about. And don’t stop with pregnancy bills. Get some hard and fast bills on the floor to make sure these fathers are paying child support. Real child support; not 5.25/wk you (I, anyway) see these moms receiving. Of course, women are more susceptible to being murdered by an alleged love one during pregnancy than any other time. Maybe we need to rethink that whole mandatory vasectomy thing. Do it at age 15 – when they’re mature enough, and wish to start a family, reverse it. After all, a male can impregnate multiple women a day if he were so inclined whereas a woman if going to produce 1 child in 40 weeks. (side note– not all vasectomies are reversible. I know this from Bill’s experience. I would NEVER support mandatory vasectomies, for the same reason I support a woman’s right to have an abortion. No one should have a say over another person’s bodily autonomy.)

Utah is creative in its efforts to allow men to control women’s reproduction.

I have a strong feeling were going to be seeing a lot of fathers move out of Utah and make it a strictly women only state.

They should make this retroactive. It would bankrupt the LDS Church.

Great, as long as the putative father has the right to demand an abortion. (make up your minds, guys…)

But they don’t get any say about abortion.

So are they having a voice on abortion or not ? (Why is this so important?)

Good….now it paves the way for father’s to have a say in abortion too.

Nice. Can fathers block abortions now? Accountability is a two way street. (not in cases of rape or incest, you cave dwelling twit.)

Great, but also should have concent before his baby is murdered as well.

They should be able to veto abortion decisions then. Their money their choice. (This comment got a shitload of replies. Why do so many people seem to think that an investment of money trumps everything? This guy seems to think that paying money for pregnancy and pre-natal support is akin to paying a prostitute.)

So the father has to pay half the medical bills (I agree because he helped make that baby) but the father has no say if the mother wants to commit murder and have an abortion? (ABORTION ISN’T MURDER!)

If guys have no say in preventing an abortion, then they shouldn’t be forced to pay pre baby costs. (They DO have a say. Don’t have sex with a woman with whom you don’t wish to make babies.)

And just like that – the words “it doesn’t feel as good with a condom” were never said in Utah ever again… (bwahahaahaa!)

This is what happens when you let men set the “birthing” agenda. Next thing you know, we’ll be requiring DNA testing of every fetus to determine the father. How long is that gonna take, who’s gonna pay for it and what if a woman refuses to name the father, or the man she names refuses to provide a sample? Too ridiculous. (I think she’s right.)

First, how do you establish paternity before birth? Second, does this give the presumed father the right to monitor the woman’s pregnancy and behavior? Will he have a say in the birth plan? Is he allowed to attend medical appointments? Will he be there for the birth? Or does he just get to foot the bill with the mother? What if the mother doesn’t desire or need his assistance? This could go south really quickly. (Yep… this was my thought, too.)

As long as the mother and fetus can be on my family insurance during the pregnancy then I don’t have a problem with it. The problem is that if I’m not married to the woman, how can she be on my insurance? (this guy is clearly NOT a mental giant… dude, maybe you shouldn’t be having sex with people to whom you aren’t married, if her not being on your “family insurance” is a concern? In fairness to him, he did come back and clarify, showing that he’s not really as dumb as that comment seems… Besides, the law indicates that the man must pay half of the woman’s health insurance premium, not put her on his insurance. And with a pregnancy rider, that’s probably gonna be pricey.)

And one guy, whose comment I can no longer find, said he was fine with the new law as long as a woman didn’t “trap” him into being a father. Now– I know for a fact that men CAN be raped, but the odds of a male rape leading to pregnancy are pretty small. I think the bigger issue is convincing men to use condoms and/or not have sex so freely with women they don’t wish to make babies with. I doubt being trapped in fatherhood is a real thing for the vast majority of men, if the man is being responsible.

There were many more comments, but I don’t have all day to share them. Bill was up very late last night, working in the office. We got a late start this morning and I want to practice guitar and do some reading. Anyway, after March’s visit from Aunt Flow, which was a bit irregular, I realize that this is an issue that really won’t affect me at all for much longer… and probably doesn’t affect me now, if I’m honest. It’ll be interesting to see what Utah does with this new legislation and how it changes things in the Beehive State. I’ll be watching for the headlines.

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healthcare

Instant karma’s gonna get you…

Remember that old song by John Lennon? I read that he coined the term, “instant karma”. It’s supposed to reference actions taken by a person that cause harm to another that later come back to bite them in the ass. Lennon wrote a great song about it.

Wise words…

Well… what I’m about to describe may not really be “instant karma” per se. I don’t know exactly what I’d call it. You can tell me what you think it is. Here goes…

Last night, for some reason, I randomly decided to check out the Facebook page of one of my first cousins once removed. Her dad is my first cousin, since his mother and my father were siblings. As I was reading my young relative’s social media page, I noticed a post about another cousin… my relative’s aunt, and also my first cousin. I’ll call her Nell, although that’s not her name.

Nell is the eldest of 22 grandchildren on my dad’s side of the family. She’s nineteen years older than I am. For a number of reasons, I don’t feel very close to her. I never have. It’s partly because she’s a lot older than I am and because of that, I never got to know her as well as my older sisters did; but it’s also because we’re very different in terms of how we view the world. Nell is a conservative Republican and very religious. I… am not.

Although I am Facebook friends with Nell’s siblings, none of them follow me, probably because I’m not religious or conservative and I swear a lot. I used to be friends with Nell, but I’m not anymore, for a few reasons. The main one is that I never got the sense that she liked me very much. Nell sings, writes songs, and plays guitar, and I always got the feeling that maybe she resented me for also being a singer. I cuss a lot, drink a lot, and don’t go to church, and it seemed like she disapproved of that. Nell and I don’t agree on a lot of things, particularly regarding politics and religion. It seemed like she’d be “nice” to me in person, but there was always an undercurrent of disapproval. After awhile, that behavior became hurtful to me, so I disassociated with her on Facebook, and I haven’t been “home” to Virginia since 2014, so it’s been awhile since I last spoke to her.

Nell’s niece, who is still one of my Facebook friends, posted that Nell had been undergoing chemotherapy. She recently got her last treatment. I don’t know exactly what kind of cancer she had, but I suspect that it might have been leukemia or something along those lines. There were comments about her platelet counts, and in the pictures, I noticed she had what looked like a port-a-cath in her chest. In some of the pictures, Nell looked a bit wan… pale, tired, and weak.

Suddenly, I remembered a Facebook incident involving her a few years ago. At that time, Nell was in her early 60s, and apparently healthy. On January 30, 2016, I posted this graphic that came from Bernie Sanders’ Facebook page. This was just as the 2016 election year was cranking up.

I commented on Facebook how unfair I think it is that Americans are forced to pay so much for prescription drugs and that our system needs to change…

We were having a good discussion on my Facebook page about drug prices and health insurance, when Nell came along and left the following comment…

So success is defined by having cheap drugs? Those 35 million Americans that take these drugs don’t realize they are dying quicker by taking them than by doing without. We’re enslaved by Big Pharma whether the price is small or great. BTW, I’m a Republican. I am 62 and don’t take any medicine.

I was a bit taken aback by the comment for a couple of reasons. First off, Nell very rarely commented on my Facebook page. I doubt she even followed it much because my views and use of colorful language probably really offended her. She once got upset with me for writing “damn”. And secondly, I honestly didn’t feel like this was a controversial topic. I mean, sure, Americans use a lot of drugs, sometimes for preventable conditions. But plenty of people use drugs for conditions that are beyond their control or because they’ve been in accidents.

I had no idea why my cousin posted her comments about being “enslaved” by Big Pharma.  I don’t really see what that has to do with the fact that necessary drugs are way overpriced.  A lot of people have to take medications, not because they’re looking for a magic pill instead of eating right and exercising, but because they have medical problems beyond their control.  And those drugs are very expensive and, for some people, unaffordable.  This is a huge problem and it needs to be addressed.

Many people can’t afford medications even if they are fortunate enough to be insured. And in 2020, our feckless president is still trying to get rid of the Affordable Care Act, even in the midst of a global pandemic! Nell was, and probably still is, an enthusiastic supporter of Donald Trump and anyone else who runs on the Republican ticket. I know her brother is, since just the other day, he shared a 2016 era piece that is complimentary of Trump as a person.

The conversation continued, with many of my friends posting “WTF” comments. The people who were commenting weren’t all liberals, either. At least one vociferous poster is very conservative politically, but needed expensive medications when she was pregnant. Fortunately, she qualified for Tricare, so they were fully covered. Another friend suffers from multiple sclerosis and needs to take expensive, life preserving drugs for the rest of her life. She worries what will happen when her husband leaves the Army this year, even though her husband is a very high ranking officer and a lawyer.

Awhile later, Nell came back and posted this…

Don’t mind me, I’m just Jenny’s off the grid organic farmer cousin. I don’t mean to be insensitive to those who really need medicine but there are drug companies and doctors who push all sorts of medicine unnecessarily. For the most part if folks would just take responsibility for their diet 3/4ths of the medicine now prescribed would not be necessary. But Medicine is big business. I live on the edge with no health care and use a lot of essential oils. I would rather pay a penalty than pump $6K a year or more into the healthcare insurance business. Call me crazy.

My response to her was this…

“As a matter of fact, I do think it’s crazy not to have health insurance.  Essential oils don’t do dick for people who have been in catastrophic accidents or are born with congenital diseases.  And if you do end up having to go to the hospital and you rack up a huge bill that you can’t pay, then everyone else has to pay for what you can’t.  That’s one of the main reasons why healthcare costs so much.  Yes, it’s true that Big Pharma is big business, but the fact is, many people need to take drugs through no fault or responsibility of their own.”

As I have mentioned many times, this topic is kind of in my wheelhouse, since if I had not become an Overeducated Housewife, I probably would be dealing with people caught up by this issue on a daily basis. After all, I trained to be a public health social worker. I remember how, back in 2016, I rarely posted about politics and didn’t really care about conservatives vs. liberals. My, how things have changed.

Well… as I was looking at pictures of Nell with her port-a-cath, I couldn’t help but wonder if she ever got health insurance. I wondered how she was paying for the medicine she clearly needed. And I wondered if her essential oils were much help to her when she was diagnosed. Don’t get me wrong. I don’t wish cancer on anyone at all… certainly not my cousin, whom I do love, even if I don’t always like her. But I do hope she wised up before she vitally needed medical treatment. Too bad the oils and the proper diet didn’t ward off cancer.

After I reminisced about my cousin’s political screed on my page, which upset a lot of my friends, I remembered her comments about the late Brittany Maynard. Remember her? Back in the fall of 2014, she was in the news because she was 29 years old, newly married, and had a brain tumor that was killing her. Rather than let the tumor take her faculties and force her to be a burden to her family, Brittany decided to commit suicide. My cousin had something to say about that, too. First, she posted a link from a popular Christian blogger named Ann Voskamp, who had posted a rebuttal to Brittany’s decision to end her life that was written by Kara Tippetts. Tippetts also had cancer and has since passed away from her illness.

Tippetts, who had stage four breast cancer, was a dedicated Christian and she asserted that by committing suicide, Maynard was robbing her friends and family the opportunity to work through Christ. She wrote:

“Suffering is not the absence of goodness, it is not the absence of beauty, but perhaps it can be the place where true beauty can be known. In your choosing your own death, you are robbing those that love you with the such tenderness, the opportunity of meeting you in your last moments and extending you love in your last breaths.”

I remember that Nell wrote that she felt “blessed” that she had been able to help take care of her mother during her mother’s last days. Like Brittany Maynard, Nell’s mom, who was my aunt, had an inoperable brain tumor. She received the diagnosis just after Thanksgiving 1993. I remember it because that was the last time I spoke to my aunt. She was an alum of Longwood University (although it was called the State Teacher’s College when she graduated and Longwood College when I graduated). I remember we sat and talked about the school and how much it meant to us. A few weeks later, I heard about her diagnosis. About a year after that, she was gone. I mailed my application to the Peace Corps on my way to Georgia to attend her funeral.

I didn’t know much about how that last year went for my aunt. At the time, I was 22 years old and freshly graduated from college, trying to launch into adulthood. In 2014, when Nell wrote about Brittany Maynard’s brain tumor and how wrong it was for Brittany to make the call as to when she’d be exiting her life, she insinuated that the last year was pretty bad. But Nell wrote that she had felt fortunate that she could “serve” her mother, and therefore, serve Christ. It didn’t seem to matter that perhaps her mother’s dignity was diminished or that maybe she was in great pain. Not that my aunt had expressed a desire to have a physician assisted suicide… I really don’t know. My aunt had family and friends who were willing and able to help her. I suspect Brittany did, too. But not everyone is that fortunate, and not everyone believes in God. Moreover, when a person gets to the point at which they can no longer take care of themselves physically or make their own decisions, they can and do become very burdensome to others. Not everyone has people in their lives who are willing to responsibly and compassionately take on those burdens.

I don’t remember posting my thoughts on Nell’s Facebook page. I knew it wouldn’t be received well. I had seen Nell engage in arguments with more liberal family members in person, in particular my late aunt who was once a nurse for Planned Parenthood. My aunt, like most everyone else in my family, was very conservative. However, she was pro-choice because she’d worked for Planned Parenthood and seen girls and women who needed access to abortions. She had developed empathy for their situations. She was a very opinionated and outspoken lady, too, so the discussion she had with Nell about abortion was a very lively one. I didn’t want the same to happen between Nell and me on social media.

Anyway… I don’t talk to Nell much nowadays. In fact, there are quite a few family members I quit talking to, mainly over politics and religion. I can’t bear the cognitive dissonance. I am truly sorry about Nell’s bout with cancer, although it does appear that she’s recovered for the time being. She’s lucky that she had the means to get good and effective treatment and has so many friends and family members willing to care for her and pray for her well-being. I don’t know that we’ll ever be close… I still remember the way she treated me the last time I saw our grandmother alive. She basically guarded her, as if I was a threat. In retrospect, maybe I should have reminded Nell that Granny was my relative too, and I had a right to visit with her.

Nell also has a habit of taking pictures and sending them out, even if they aren’t very flattering. She’s one of the main reasons I don’t feel very welcome around my family anymore and why I may not go back to the family homestead. But I do wish her well, and I hope she develops some perspective and empathy for people who don’t think and feel the same way she does.

 

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mental health

I know you mean well, but…

It bothers me when people blast boiler plate social media statuses reaching out to the depressed and suicidal among us. It probably shouldn’t bother me, since I know their hearts are in the “right” place, but it does. I read such a status this morning. I personally know the woman who posted it, and I’m absolutely certain she meant well when she wrote that she knew “life can suck” sometimes, but it’s also “amazing and beautiful”. I’m positive that she also meant it when she posted, “you are loved.” And yet, somehow I still felt kind of diminished when I read that status, even though I’m no longer depressed.

I have a hard time believing it when most people post those kinds of statuses, particularly when they didn’t write them themselves. It’s hard to feel like something came from the heart when it’s been rehashed by hundreds of people. It’s not just trite suicide and depression “support” statuses that bug me, either. It’s those kinds of posts about any illness or social ill. People share them, but don’t really mean them… and they mainly do it because they want to feel better about themselves, not because they want to help other people in pain.

I have been suicidal before. It was a long time ago, and I haven’t felt that despondent in many years. There was a time in my life when I felt like shit every day and it didn’t seem like it would ever get better. In fact, it did take months before I stopped feeling so downtrodden and exhausted by living. It makes me sad to remember that time, since I was still very young and I had so many opportunities ahead of me. There were things I could have done that would have taken me to exciting places– places different than where I am now. Where I am now isn’t awful by any stretch, but I can’t help but be wistful remembering that I spent my mid twenties feeling like packing it in. I remember thinking that my twenties were supposed to be the best years of my life, and yet I felt so crummy. How would I deal with my thirties, forties, and fifties if I felt so shitty at what was supposed to be the prime time of my life?

I probably wasted a good two or three years feeling horrible, even though I was getting treatment at the time. There were many days when I fantasized about suicide, since as far as I could tell, the rest of my life would be just as bleak and hopeless as that time seemed. I remember thinking no one cared, even though there was some evidence to the contrary. I also remember people not wanting to talk about depression. I remember being told that I shouldn’t talk about it, either, and that all I really needed was God, more exercise, better nutrition, or St. John’s Wort.

Fortunately, at that time, Facebook didn’t exist. I didn’t have to read trite blasts on social media about how life is beautiful and someone out there “cared”. I think on a basic level, I knew that life was beautiful– but to me, it seemed like it was beautiful only for other people, not for me. And I knew that people “cared”, but when I was in that state of mind, it seemed more like they cared because I was a burden to them. They wanted me to feel better, because my depression was “catching”, or somehow made them feel anxious or guilty. It wasn’t about my feelings; it was about theirs. Then, when I felt better, they could go back to not caring anymore. I now realize those feelings aren’t really accurate. But that’s how they seemed when I was depressed.

I guess that’s what really bugs me about those kinds of posts. They make sense when you’re mentally well or not in a desperate situation where it seems like things are really bleak. They don’t make sense when you’re not thinking clearly. I liken depression to a thick, heavy, dark burka… stifling, uncomfortable, exhausting, and opaque. It’s hard to see beyond the thick, suffocating folds of the burka, how life can be “beautiful” and “amazing” some time in the future. When you’re buried in the thick layers of depression, you can’t imagine anything beyond that heavy cloak of despair. At least in my case, no amount of someone telling me how amazing life is was going to make me understand or believe it.

Trite statements against suicidal ideation make it seem so easy to just “get over it”. It’s like the person who wrote it says, “I know you feel like shit on a daily basis and things seem hopeless and aren’t getting any better, but I ‘care’ and I want you to keep living, even though you’re in pain. Life is beautiful!” And then, feeling good about themselves, they go away while the depressed person is just sitting there thinking “WTF”. Is that person really going to be there to help walk another person out of despair? I know some people will do it, especially if it’s their job, but in my experience, most people won’t. When it comes down to it, a person has to have the will and the energy to take care of themselves, and some people don’t have either of those qualities.

What if life is truly not beautiful? You say you “care”, but you’re just someone on social media. Could I really call you in the middle of the night when I’m feeling especially desperate or despondent? Would you really want to hear from me when I’ve got the non-stop tapes running in my head, telling me how futile living is and how rotten I am? In the case of my friend who posted that status, maybe I could… if I had her phone number, which I don’t. We live in different time zones, anyway. For a lot of other people, I doubt I would take them seriously and I know that if I did call them, they’d be annoyed.

Life got better for me when I started taking the right antidepressant. Four days after my first dose, my mood improved markedly. I started feeling like the burka was loosening until it finally fell off. I was able to make plans and get out of the situation I was in that had me feeling so down and helpless. I continued treatment for the time I was in graduate school, then within a couple of years of graduation, stopped taking antidepressants. I literally don’t feel the way I used to. I still get depressed and anxious, but it’s not that heavy, dull, stifling burka. It’s more like an ill fitting windbreaker. It’s like my body chemistry is permanently changed. But that’s how it is for me. I was very, very lucky. I don’t know if that’s how it would be for someone else, and I can’t judge them for the way they feel, since I am not living their lives and I’m not in their circumstances.

Yes… although sometimes life really may not be worth living. I respect that possibility, too.

I also don’t like it when people ask suicidal people to live for someone else. I think suicidal people have enough guilty feelings without being told that it’s their duty to keep living for another person. I might waver a bit on this if the suicidal person is a parent. After all, parents bring new people into the world, and they have a responsibility to see to their children’s care. But… even in those cases, I see suicide as more of a terminal event than a selfish act of self-pity. People die of cancer, diabetes, heart disease, or any other manner of physical ailments. Depression is no different. I don’t see it as the “common cold” of mental illness. It’s more like a chronic disease, like diabetes or lupus. Unfortunately, sometimes people die of depression, just like they would any other disease.

There are many hurdles to getting over depression. First, there’s the idea of picking up the phone and calling a therapist. For me, that was the toughest part. I had to find one who could help me, and that seemed like a really daunting task. Fortunately, someone I knew at the time had a lot of experience with seeing mental health professionals. He recommended the psychologist who helped me feel better. I haven’t spoken to that guy in many years, but I owe him a huge debt of gratitude. He may have even saved my life. He was one person who said he would help, meant it, and followed through with real assistance. But even with that recommendation for an excellent therapist, it took me weeks to make the phone call to arrange for my first appointment. I was terrified and mortified. I happened to call when the therapist was on his annual fly fishing vacation, so I had to wait two weeks.

Then there’s the idea of paying for therapy, which if you don’t have a lot of money, but you do have a lot of anxiety, can seem petrifying. I was lucky enough to be working at a job where I made good money, and I lived with my parents, who didn’t charge me rent. But if I weren’t in that fortuitous situation, it would have been much harder for me, especially since even with insurance (an individual policy I paid for with money from the job that had contributed to my depression), the medications I needed were very expensive. Also, I had never used civilian health insurance before, so I wasn’t sure what the process was. That’s a skill they really should teach in high school– how to use health insurance and why it’s so important.

You have to work up the energy and commitment to try to get over depression… and when you’re feeling apathetic and worthless, it hardly seems worth the bother. So… I guess, when I read a trite statement by a well meaning person reminding me that “life is beautiful” and “someone cares”, it just seems kind of dismissive and maybe even a little bit rude, especially when we live in a country where lawmakers don’t want to help people who need to be helped. People talk about wanting to prevent suicide… or abortion… but when it comes down to it, they don’t want to take action that would make choosing life more feasible. Instead, a lot of people would rather just toss the mentally ill into prison or condemn them for being lazy or self-centered.

I’m going to segue briefly, because I recently came across something not akin to depression or suicide, but still kind of illustrating my point. A couple of days ago, I read about a woman named Jamie Jeffries, who claims to be pro-life. She posted on Facebook about how she’d talked a mom out of having an abortion. Six months after the baby boy was born, CPS took him into their care due to neglect and abuse. The family put Jeffries down as the next preferred placement for the baby. Do you know what Ms. Jeffries’ reaction was to that? Have a look…

Mmmmkay… so you feel just fine about talking a woman out of having an abortion, even though she was ill equipped to care for her baby. But when the shit went down, you were not willing to help her. Shame on you, Jamie.

I know a lot of people would ask why the mother didn’t put the baby up for adoption. Many people don’t consider how difficult that is. Just because the mother wasn’t ready to take care of a baby, that doesn’t mean she was prepared to give away her child. Maybe that would have been the more moral thing to do in some people’s eyes, but it might have still been impossible for her. It’s a lot to ask. Others would condemn the mother for having unprotected sex when she wasn’t ready to have a baby. So she made a mistake. Are you perfect? I don’t know what the circumstances were that put her in the situation she was in, but she’d already made up her mind and had come to the right conclusion that she wasn’t ready to be a mother. Then Jamie Jeffries tried to “help”.

Anyway… this piece isn’t about abortion, per se, nor is it really about suicide. It’s more about people making promises they can’t keep. It’s like Captain Lee on Below Deck saying “Your mouth just wrote a check that your ass can’t cash.” (he’s full of these kinds of profane sayings– I find them very funny) People often say they care and will help. But when it comes down to it, most of their “mouths write checks their asses can’t cash”. Where does that leave the person for whom they mean well?

I am always grateful to those who want to help and mean it. If you really mean it when you say a depressed person can call you day or night, then good on you. If you mean it that you’ll drive someone to a doctor’s appointment, listen to them cry, help them pay for their healthcare, and, if they’re pregnant and considering abortion, do what you can to help them care for their baby, then I have nothing but respect and admiration for you. But in my experience, most people who make these claims aren’t serious. So, when I see something like that posted on social media, I think it’s often more about them feeling better about themselves and looking noble than actually wanting to help someone in need. And that’s probably why I feel diminished and put off when I see those kinds of well meaning “feel good” statuses posted on social media.

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