Tag Archives: healthcare

celebrities, controversies, ethics, mental health, music, politics, social media, Virginia, YouTube

A few more thoughts about “Rich Men North of Richmond”…

When I wrote yesterday’s post about Oliver Anthony’s popular anthem, I didn’t know much at all about him. I was simply reacting to the lyrics of “Rich Men North of Richmond.” Consequently, my post, based solely on my first reactions to his popular song, may not have been as accurate as it could have been. I have since learned more about Oliver Anthony, whose real name is Christopher Anthony Lunsford.

According to Wikipedia— admittedly not always the best source for information– Oliver Anthony is between 29 and 31 years old. He comes from Farmville, Virginia, which is a town I know well. I went to college in Farmville, home of Longwood University (Longwood College when I went there). Anthony might have been born when I was still a college student in his hometown, a place where there is poverty and lots and lots of funeral homes. In all seriousness… I remember there were quite a few nursing homes and funeral homes in Farmville, when I lived there. Maybe that’s changed, though. Longwood has certainly changed a lot since my college days.

I read that Mr. Anthony dropped out of high school and later got a General Equivalency Diploma. He worked a lot of industrial jobs in Virginia and North Carolina. Farmville isn’t too far from the North Carolina border. Evidently, while working at a paper mill in North Carolina, Anthony suffered an accident that fractured his skull and left him unable to work for six months. He’s suffered from mental health issues and alcoholism. Much to my surprise, he claims to be “non-partisan”, saying “I sit pretty dead center down the aisle on politics and always have.”[8][50]

If it’s true that Oliver Anthony is non-partisan, how is it that he’s become such a darling of the conservative, “anti-woke” crowd? I noticed a few of his other videos on YouTube. He’s written and sung a lot of songs that are about the plight of the working man. Indeed, he recorded most of his songs on a cellphone, singing near his off the grid camper. In the wake of his supposedly stunning debut, he’s made history, having become the first songwriter to debut at number one on the Billboard Hot 100 with no prior chart history.

Record companies are reportedly clamoring to sign Oliver Anthony. He’s “brushed off” $8 million contracts, claiming he doesn’t want to be in the spotlight, nor does he want the trappings that usually come from success in the music business. If that’s true, I commend him. Just like light bulbs, people who burn really brightly tend to burn out quickly. I think it’s good if Anthony is grounded enough to realize that losing what’s led to his relatability would be a mistake.

I also think that jumping into sudden wealth can quickly lead to disaster. Many people get caught up in the idea of living in mansions and driving fancy cars, but they forget about the associated negative things like taxes, fairweather friends, unscrupulous business associates, gold diggers, and criminals who suddenly take notice, and unhealthy interest.

I don’t have any personal experience with this phenomenon myself, but I have read and heard a lot of stories about overnight sensations who become the hottest thing in town without proper support from honest people. Next thing you know, they’re hooked on drugs and/or alcohol, suffering from severe mental health problems, and have fallen among the down and out. Mr. Anthony has already admitted that he has issues with alcohol and his mental health. Like a lot of people with mental health issues, he’s shown extraordinary talent that speaks to a lot of people. I would hope there are people near him who are looking out for his well being.

Now… about that song. Personally, I am still not a big fan of it. I mostly explained why yesterday. It reduces a lot of very complex and serious issues into a three minute song that, I think, blames some of the wrong people. I especially don’t like that Mr. Anthony, while trying to represent the working people of America, throws poor people under the bus, especially as he alludes to personal responsibility. I think those particular lyrics, reposted below, are hypocritical and ignorant.

I wish politicians would look out for miners
And not just minors on an island somewhere
Lord, we got folks in the street, ain’t got nothin’ to eat
And the obese milkin’ welfare

Well, God, if you’re 5-foot-3 and you’re 300 pounds
Taxes ought not to pay for your bags of fudge rounds
Young men are puttin’ themselves six feet in the ground
‘Cause all this damn country does is keep on kickin’ them down

I get being a “salt of the earth” person, and I might even agree, on the surface, that taxes shouldn’t pay for junk food. However, as I mentioned in yesterday’s rant, what seems simple to so many people, isn’t actually simple at all. A poor, obese person using a SNAP card and eating fudge rounds is likely facing a lot of problems. Many of the problems they face are not so different than the ones Mr. Anthony has faced, and tried to drown with alcohol. Moreover, someone who weighs 300 pounds at 5’3″ probably has a legitimate eating disorder.

A lot of people scoff at the whole idea of eating disorders… especially folks who come from a lower middle class background (or poorer). Many people have also only heard of the most famous eating disorders, anorexia nervosa and bulimia. Those are the ones that get the books, TV specials, and movies, especially when someone famous suffers or dies after having been afflicted with them.

But there are many other eating disorders out there, and they are comorbid with a host of physical, emotional, and mental health problems. They aren’t fun to have, and they can have devastating effects on people’s lives and livelihoods. The deleterious effects of eating disorders don’t just negatively affect the person suffering from them, either. Their family members, loved ones, and friends also suffer, as does society as a whole.

It seems like common sense for someone who is very obese to just quit eating so much and start exercising more. I also know that plenty of people, lucky enough not to be bothered by eating disorders, will add that fat people shouldn’t be eating junk food. And, you know, people with obesity really shouldn’t eat junk food… nor should anyone else, really, be eating junk food. But it’s so easy to think or say what people should or shouldn’t be doing, especially when you know nothing about them, their lives, or the issues they’re facing.

People develop eating disorders for different reasons. Sometimes it’s genetic. Sometimes, it happens because of trauma. Sometimes a person uses overeating, purging, or starvation as a means of coping with stress or even pain. Sugar rushes temporarily make people feel good. So do endorphin and adrenaline rushes. Fat consumption can be very comforting to some people, not to mention flavorful. Food that tastes good makes people feel better… for a short while, anyway.

When I was a lot younger, I used to skip meals a lot in an attempt to lose weight and, if I’m honest, get attention from others. Doing that usually made me really bitchy (more so than usual, that is), but sometimes I’d get an endorphin rush not unlike the ones I’d get after cutting myself or maybe hitting my head (or another body part). That rush can feel really good, especially to someone who is in some kind of pain or distress. I hasten to add here, I didn’t deliberately cut myself to get endorphin rushes. I’m merely mentioning that rush I’ve experienced after accidentally hurting myself somehow.

Deliberate cutting is an associated behavior for some people with mental health issues seeking stress or pain relief in unconventional ways. Sometimes people cut themselves on purpose as a means of distracting themselves from another kind of pain, such as replacing physical pain and bleeding with psychological pain. And the bonus is that rush of endorphins that sometimes happens when a person is hurting physically.

As a side note… I just started entering search terms on Google and it somehow knew I was going to ask about eating disorders. I typed “Why do people develop”, and it immediately suggested “eating disorders” as the top result. Obviously, I’m not the only person who wonders about it.

The truth is, there’s no one definitive reason why a person might develop problematic eating patterns. But, impoverished people often have had a lot of trauma in their lives, and food is a cheap and readily available way to soothe bad feelings. What makes a food addiction especially problematic is that people have to eat to survive, and food (especially junk food) tends to be ubiquitous. And as I mentioned yesterday, it isn’t always easy for everyone to simply eat good, nutritious food.

I imagine that Mr. Anthony, who reportedly has himself been living off the grid, would know that firsthand, just as he apparently knows about being an alcoholic. I’ll bet Oliver Anthony doesn’t like it when people point at him and claim he’s the source of a complicated societal problem. And I’ll bet the poor people who eat fudge rounds don’t like that, either. It’s not a crime to be poor, and lobbing abuse and hate toward people unfortunate enough to need welfare assistance is neither productive, nor fair. Moreover, if a person is going to sermonize about personal responsibility, they really ought to start by taking a good hard look at themselves and their personal responsibility for their own situations before pointing fingers at other people.

No matter what, though… individual welfare recipients are not directly responsible for keeping the working poor in poverty. It’s probably more likely that Anthony’s song title has the true culprit within it. That is– wealthy people who make many times what the workers make, and are more interested in keeping investors and shareholders happy are probably the ones keeping down the working folks who are just scraping by in life. Add in the fact that basic necessities like health insurance cost so much– again, because healthcare is a business, rather than a human right.

A few days ago, I mentioned my college friend who was doing well enough to recently take a vacation in Hawaii. Just after she came home from that trip, she was in a catastrophic car accident. She may never fully recover from that accident, and there’s now a crowdfunding effort to help her family accommodate her needs when she’s discharged from the rehab hospital where she’s spent the summer.

While I don’t mind helping my friends, and I did help my friend’s cause, she’s in this situation because she was in an accident. Why should she depend on the kindness of family and friends to get the care she obviously needs? Especially when there are American people who have made so much money that they’ll never be able to spend it all in their lifetime, yet they’re constantly trying to find ways to avoid paying taxes. And you know as well as I do that the vast majority of those super rich people didn’t get rich without a lot of help from the much less wealthy.

Anyway… I’d like to see Oliver Anthony dig a little deeper into the issue. And if he really is non-partisan, I’d like to see his lyrics focus less on shitting on people who are already down, regardless of their body size. We all have problems. Everybody has a story. While a lot of people can relate to “Rich Men North of Richmond” and think it’s perfectly fine that Anthony specifically calls out fat people on welfare, personally, I’m not very impressed by it. It seems like a really cheap shot to me. Maybe some more reflection and empathy are in order.

Just my opinion, folks… perhaps I should write a song about it, too.

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controversies, elections, narcissists, politicians, politics, Trump

Rachel Maddow scared the hell out of me yesterday…

Every once in awhile, I watch segments from Rachel Maddow’s show on YouTube. During the afternoon yesterday, I saw a couple of segments from her show that gave me chills. It’s strange for me– an American living in Germany– to watch the United States from afar these days. It seems like there’s a group of radicalized culty Republicans who are trying to turn the United States into a dystopian nightmare. It’s so disturbing for me, even as I realize that part of Rachel Maddow’s job is to stir up the masses and score ratings for her network.

The first video I watched was about how attorneys general in 19 red states signed a letter to Joe Biden about how they want to be able to track female residents who leave the state for abortion care. This idea, to me, is extremely creepy and wrong. What’s especially upsetting is that not all of the people who signed it were men! Have a look at Rachel’s commentary on this. It’s not just abortion care that is at risk, either– it’s also gender affirming care for people who are transgender… even potentially fertility care or birth control!

Maybe it’s time to donate more money to NARAL and Planned Parenthood. This is an absolute OUTRAGE!

What the hell has happened to our country? Have people lost their minds? Are some people so fixated on money, power, and control over women that they are willing to harass them over their PRIVATE medical records and healthcare choices? This is fucked up. What’s sad is that so many people just don’t care, and are willing to hand over their freedom and privacy to people who would champion this kind of public policy.

Later, I caught another segment on Rachel’s show… This one was even scarier to me, because unlike the one about reproductive rights, this one affects everyone if Trump gets re-elected. I doubt his fans are listening, but if they vote for him, they are voting for the end of the United States as we know it. Trump would like to be a literal dictator, and there are some dimwitted minions who are still trying to help his cause.

Please do not vote for this asshole. He belongs in PRISON.

I hear so many Republicans talking about how important the Constitution is. But, according to Rachel Maddow, Trump and his buddies would like to toss out the Constitution, which was supposedly “made up by liberals”, and give the president all of the power. What Rachel described in her segment was pretty much the Russian model of government– you know, the government controls everything, and we no longer have the right to speak up or criticize on pain of going to prison? Seriously… watch that segment. It’s scary stuff, and so many people are sleepwalking, simply responding to Trump’s nauseating brand of charisma. He says what they want to hear, but what he actually wants to do is control everyone and everything. He is a very dangerous man.

Weren’t Republicans supposed to be the party of less government control? According to Rachel Maddow, Republicans want to take away states’ rights– “identify the pockets of independents and seize them”. It’s being pushed by a group called the Heritage Foundation.

Since I have a subscription to the New York Times, I can gift the article that explains this plan in depth. Click here if you want to read about it. Here’s a brief excerpt for those who don’t want to read the gift article.

“The president’s plan should be to fundamentally reorient the federal government in a way that hasn’t been done since F.D.R.’s New Deal,” said John McEntee, a former White House personnel chief who began Mr. Trump’s systematic attempt to sweep out officials deemed to be disloyal in 2020 and who is now involved in mapping out the new approach.

“Our current executive branch,” Mr. McEntee added, “was conceived of by liberals for the purpose of promulgating liberal policies. There is no way to make the existing structure function in a conservative manner. It’s not enough to get the personnel right. What’s necessary is a complete system overhaul.”

Mr. Trump and his advisers are making no secret of their intentions — proclaiming them in rallies and on his campaign website, describing them in white papers and openly discussing them.

Why in the HELL should Donald Trump, someone with a long record of screwing over people, have any right or ability to overhaul the US government? This is a man who only cares about money and power. Voting for him is like voting for Saddam Hussein or Kim Jong Un. And his followers, mainly, are just plain blind to the fact that by empowering them, they are causing their own demise!

I really hope that Trump’s campaign goes right down the sewer, where it belongs. He’s a criminal madman, who needs to be put away somewhere before he completely destroys our country. Below is a little bit more from the article…

“What we’re trying to do is identify the pockets of independence and seize them,” said Russell T. Vought, who ran the Office of Management and Budget in the Trump White House and now runs a policy organization, the Center for Renewing America.

The strategy in talking openly about such “paradigm-shifting ideas” before the election, Mr. Vought said, is to “plant a flag” — both to shift the debate and to later be able to claim a mandate. He said he was delighted to see few of Mr. Trump’s Republican primary rivals defend the norm of Justice Department independence after the former president openly attacked it.

People wonder why I passively hope to be beamed up… it’s because of people like Donald Trump. Rich, powerful, corrupt, and evil people… and I don’t feel like there’s anything I can do except vote and write blog posts… and donate whatever money I can to causes that fight against fascism and taking our country back 100 years. He’s still got his cheerleaders, though.

Steven Cheung, a spokesman for Mr. Trump’s campaign, said in a statement that the former president has “laid out a bold and transparent agenda for his second term, something no other candidate has done.” He added, “Voters will know exactly how President Trump will supercharge the economy, bring down inflation, secure the border, protect communities and eradicate the deep state that works against Americans once and for all.”

Yeah, cuz he did so much during his first term… golfing, feeding football players fast food, making racist and sexist statements, and otherwise fucking up on the daily! And none of the “promises” he made during his first term ever came to fruition, either. Instead, it was one scandal and circus act after another! Now we’re stuck with Trump’s terrible Supreme Court picks, who are fucking extremists! More from the Times…

The two driving forces of this effort to reshape the executive branch are Mr. Trump’s own campaign policy shop and a well-funded network of conservative groups, many of which are populated by former senior Trump administration officials who would most likely play key roles in any second term.

I am quite worried about this. And I would love it if a well placed lightning strike hit Trump during his next golf game. Of course it won’t happen, but I can dream, can’t I? People say Biden is demented… I say Trump and his cronies are much worse. The New York Times and Rachel Maddow are warning us.

Personal power has always been a driving force for Mr. Trump. He often gestures toward it in a more simplistic manner, such as in 2019, when he declared to a cheering crowd, “I have an Article 2, where I have the right to do whatever I want as president.”

Mr. Trump made the remark in reference to his claimed ability to directly fire Robert S. Mueller III, the special counsel in the Russia inquiry, which primed his hostility toward law enforcement and intelligence agencies. He also tried to get a subordinate to have Mr. Mueller ousted, but was defied.

Early in Mr. Trump’s presidency, his chief strategist, Stephen K. Bannon, promised a “deconstruction of the administrative state.” But Mr. Trump installed people in other key roles who ended up telling him that more radical ideas were unworkable or illegal. In the final year of his presidency, he told aides he was fed up with being constrained by subordinates.

FUCK YOU, TRUMP!!!!! AND FUCK TRUMP SUPPORTERS, WHO WANT TO FOIST HIM AND HIS SICK BRAND OF “LEADERSHIP” ON THE REST OF US! At least I still have the right to say these things… for now.

As much as Trump’s first term was a disappointing farce, a second term for him would be disastrous. He would have no constraints, and no reason to rein in his impulses to try to control the country and its citizens. He must be stopped.

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book reviews, healthcare

A review of Amy Silverstein’s My Glory Was I Had Such Friends: A Memoir…

On April 18 of this year, the New York Times ran a beautifully written op-ed by the author, Amy Silverstein. I knew who Amy Silverstein was, because about 15 years ago, I read her amazing book, Sick Girl, which she published in 2007. Reading Sick Girl was life changing for me. At the time, we were living in Germany the first time, and I had ordered the hard copy of the book, because I didn’t own a Kindle. I’m not even sure if Kindles existed at that time. I think I decided to buy Silverstein’s book about her experiences as a heart transplant recipient after reading a review of Sick Girl in People. I love books about real life health crises… or, at least I used to love them when I was younger and the crises seemed less like something I might experience personally.

I read Sick Girl in 2008 and reviewed it for Epinions.com. I reposted my review here, combining it with another review I wrote about a book called Change of Heart, which was written by Claire Sylvia, another transplant recipient. The two books were very striking to me, as they had such different moods to them. Claire Sylvia’s book about being a double transplant recipient (heart and lung) was overwhelmingly positive and grateful. After she wrote her book, Claire Sylvia went on to also receive a kidney transplant. She died August 19, 2009, 21 years after her heart and lung transplant.

Amy Silverstein’s book, Sick Girl, by contrast, was a lot more negative and honest. Silverstein wrote a no holds barred account of what it actually means to be a transplant recipient. She received her first heart in 1988, when as a 25 year old law student, she had health problems that revealed a congenital heart defect. In Sick Girl, Silverstein explained that many people believe that organ transplants are miraculous cures for people whose organs fail. But really, organ transplants just trade one health problem for another, as recipients have to take medications that keep their immune systems from destroying the foreign organs. Amy Silverstein had a life expectancy of about ten years in 1988, after she accepted a heart belonging to a 13 year old girl who happened to die in an accident at just the right time to save Amy’s life.

In 2007, when Sick Girl was published, Amy had already defied her doctors’ expectations for her survival by an additional ten years. But even though she’d had 19 years, when she was expected to only have ten, and even though she’d become a wife and adopted her son, Casey, Amy had seriously contemplated suicide. She was tired of being a “sick girl”. In 2005, when Amy was thinking about taking her own life, she was fixated on how difficult the regime was, and how she didn’t want to live that way anymore.

When I read Amy’s book, written a couple of years after she had those suicidal feelings, I empathized. I could totally understand why she was so tired of being sick and tired all the time. She had to submit to a grueling regime that included procedures like heart biopsies, and taking medications that made her throw up and put her at risk for every virus in the atmosphere. A simple cold could leave her bedridden for weeks. And people didn’t understand what it was like for her and made clueless comments that were infuriating in their innocence… and ignorance. So she wrote her book to educate the masses.

Not everyone liked Sick Girl. A lot of people thought Amy Silverstein was ungrateful and unpleasant. Some people found her whiny and self-absorbed. Quite a few folks seem to believe that anyone who gets an organ transplant should shut up and be eternally grateful, even if they are constantly sick and having to see doctors for painful, invasive, and expensive treatments and screenings. I, for one, heartily disagree, because if no one ever complained about the experience of having transplanted organs, scientists and doctors would never know what to improve about the experience for future patients. Moreover, I don’t think that just because someone gets a new lease on life, they should be expected to just shut up and act happy. I also don’t believe Amy Silverstein was ungrateful.

Amy’s first heart lasted an astonishing 24 years, before it started to fail due to the ravages of her immune system, antibodies that her body developed to attack the heart, and the many powerful anti-rejection drugs she had to take to stay alive. She needed another heart transplant, but having undergone one already and knowing what receiving a second heart would mean for her, Amy Silverstein hesitated. But then she got by with a little help from her friends.

***

In 2017, Amy Silverstein wrote another book, titled My Glory Was I Had Such Friends: A Memoir. I downloaded the book in September 2020, but never got around to reading it until this month. I read it after reading Amy Silverstein’s obituary in The New York Times, which appeared just a few weeks after her lovely essay, titled “My Transplanted Heart and I Will Die Soon”, appeared in mid April. In the essay, Silverstein wrote that she had taken excellent care of her second heart, which she received in 2012. However, because of the drugs she had taken since 1988, Amy developed several types of cancer. From the op-ed:

Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors. And I understand the irony of an incredibly successful and fortunate two-time heart transplant recipient making this case, but my longevity also provides me with a unique vantage point. Standing on the edge of death now, I feel compelled to use my experience in the transplant trenches to illuminate and challenge the status quo.

Over the last almost four decades a toxic triad of immunosuppressive medicines — calcineurin inhibitors, antimetabolites, steroids — has remained essentially the same with limited exceptions. These transplant drugs (which must be taken once or twice daily for life, since rejection is an ongoing risk and the immune system will always regard a donor organ as a foreign invader) cause secondary diseases and dangerous conditions, including diabetes, uncontrollable high blood pressure, kidney damage and failure, serious infections and cancers. The negative impact on recipients is not offset by effectiveness: the current transplant medicine regimen does not work well over time to protect donor organs from immune attack and destruction.

After I read the New York Times op-ed in April, I remembered that I had downloaded Amy Silverstein’s second book about her second heart transplant, and how her friends had helped her (and her husband, Scott) through the experience. I made a mental note to read that book, but didn’t get to it until I read Amy’s obituary, which ran in the New York Times on May 16, 2023. Amy died on May 5, 2023. Two weeks after reading about her death, I’ve finished reading My Glory Was I Had Such Friends. Once again, I’m left very moved and better educated about organ transplants than I was before I read the book.

Although Amy’s op-ed indicates that transplant science hasn’t changed a lot since the late 80s, when she received her first heart, her second book indicates that things have actually changed somewhat. Because of her unusual circumstances, and the fact that she’d had her first heart for so long, Amy Silverstein was advised to go to Cedars-Sinai Medical Center in Los Angeles, California, which has the most advanced transplant program in the United States. Amy’s first heart transplant was done in New York, and she’d spent the ensuing decades seeing doctors in New York. But even though they knew her better than anyone else, her doctors told her she should be treated by Dr. Jon Kobashigawa, a renowned transplant surgeon there. So that’s what Amy did. She packed and went cross country for treatment in Los Angeles. But she needed help, and that’s where her posse of friends came into the picture. They all had their own unique strengths that helped Amy survive in her hour of need.

Amy Silverstein was blessed with several female friends who loved her dearly. And those friends picked up their lives to be with Amy and her husband, Scott, as they waited for a new heart to become available to her. It was a very difficult time, and in the brutally honest and somewhat negative style of her first book, Silverstein explains how difficult it was… and how much a lot of it really sucked. Again, I could hardly blame her. Some of what she endured sounded absolutely horrifying. Also, as Amy got older, she became much less interested in indulging the egos of some of the people who treated her. I found her stories of what she endured both fascinating and dreadful… and again, I could hardly blame her for complaining. Meanwhile, she had these devoted friends who were there for her, in spite of Amy’s apparently difficult and demanding personality. There must have been good reasons for them to love her as much as they obviously did.

When I read the reviews on Amazon.com, I wasn’t surprised to see that, once again, some readers found Amy Silverstein abrasive and ungrateful. And, once again, I think they missed the point and probably didn’t think very long and hard about what Amy was enduring. As the negative reviewers complained about Amy Silverstein’s apparent lack of gratitude, they failed to have any empathy for her situation. It’s easy to think that if you or I were in such a grave situation, we wouldn’t be perfect patients, endlessly patient, sweet, compliant, and never once failing to constantly thank everyone profusely. But the reality is, if you are, yourself, in that situation, cooped up in a hospital room, unable to breathe or sleep, using a pacemaker that constantly sends painful shocks into your body because your heart is so diseased, and not even able to enjoy sunlight or fresh air, your attitude might suck, too. You might become demanding and unpleasant. Moreover, I don’t think Amy Silverstein was, at all, ungrateful.

If Amy Silverstein had really been an ungrateful patient, she never would have lived for as long as she did. Amy Silverstein respected both of her donors by taking excellent care of both hearts. An ungrateful person would not have done that. They would have simply given up, stopped taking their medications with the unpleasant side effects, quit seeing their doctors, and just up and died. Amy’s second donor was also a thirteen year old girl, who had been an athlete. After she received her second heart, Amy recovered within weeks. She went running, because she felt well… In fact, she felt better than she had since before her first transplant. Of course she was grateful! And she got another ten years to enjoy that heart before she died… not because the heart failed, but because of the drugs she had to take to keep it beating. I would imagine that the COVID-19 pandemic was especially hard for Amy, who was regularly wearing face masks years ago, because she was a transplant patient.

When I read My Glory Was I Had Such Friends, I could relate to Amy Silverstein’s story, and I knew she wasn’t blowing any smoke up my ass about what it’s like to be a transplant recipient. Yes, it’s important to be grateful, but as I mentioned up post, if no one ever complains, then improvements can’t be made. No one would ever see the need for improvements. That makes it harder for the patients of the future. Moreover, sometimes people should be told the brutally honest truth, so they can have a more realistic perspective. Yes, organ transplants are kind of miraculous, but they aren’t a cure. Amy Silverstein helped me realize how fine the line is between life and death for transplant patients. She would have turned 60 on June 3rd of this year, and she managed to accomplish so much in her lifetime. No one expected her to live beyond age 35, yet here we are. Maybe the reason she did live for so long is because she was so very “difficult” and “demanding”. Not complaining might have meant giving in… and giving up.

Anyway, I really enjoyed both of Amy Silverstein’s books, and I am grateful that she shared her experiences so candidly. I agree that sometimes she was negative, and I’m sure some staff at the hospitals she attended thought of her as a pain in the ass. But, I found Amy’s accounts of her experiences authentic, realistic, and important, and she was a very expressive writer.

I’m glad Amy didn’t simply shut up and stop whining. Those who found Amy insufferable can now take comfort that she won’t ever bother anyone again with her “negativity”, but she no doubt taught countless healthcare professionals through her remarkable case and astonishing longevity. Anyone who regularly reads my blog probably knows that I’m big on being real and occasionally “inappropriate”, warts and all. For me, Amy Silverstein’s books check all the boxes. I highly recommend them both.

As an Amazon Associate, I get a small commission from Amazon on sales made through my site.

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Duggars, healthcare, law

Repost: It’s HIPAA, not HIPPA, for God’s sake!

I’m reposting this article that appeared in my original Blogspot version of The Overeducated Housewife on December 22, 2018. I’m mainly reposting it because I have an older post that linked to the original on Blogspot, and that blog is now private. I’m mostly leaving this as/is, so please keep that in mind. What was written in that post was current as of 2018, not 2023.

This morning, I read an interesting little tidbit on the Duggar Family News: Life is not all pickles and hairspray Facebook page (not to be confused with the Facebook group by the same name and run by the same person).  It seems that “Pickles”, who has sources in the Duggar family and regularly breaks Duggar gossip before it hits the press, got the news that John David Duggar, newly married to his wife, Abbie, was recently hospitalized.

Pickles states that the information she got was unconfirmed, but “seems reliable”.  A poster on the page chastised Pickles for sharing what she feels is personal information, particularly when the news is unverified.  It wasn’t long before a debate about the Health Insurance Portability and Accountability Act of 1996 (HIPAA) started.  Poster after poster quoted their credentials as to why they know that law intimately.  Over half of them referred to the law as “HIPPA”.

I can understand why people do this so often.  HIPAA, when said out loud, sounds like “hippo”.  It’s counterintuitive to spell it HIPAA, with two a’s at the end.  However, HIPAA is an acronym.  It’s not a typical word.  Then, there’s also the auto-correct we’re all saddled with on almost every electronic device these days.  The computer thinks it knows better than the user does, and will “fix” things that don’t need fixing.  But then, “hippa” is also not a real word in English, so auto-correct should not be an issue in this case.

I was amazed by the number of “experts” who kept misspelling the acronym that represents the law they claim to know so well.  You’d think if the law was so well burned into their heads, they’d know how to spell the acronym properly.

I myself learned a little bit about HIPAA when I was earning my master’s degree in public health.  My focus of study was on what was then called “health administration (HADM)”.  The program from which I graduated later changed the name to Health Services Policy and Management (HSPM).  I’ve noticed other changes, both in the Arnold School of Public Health and the College of Social Work at the University of South Carolina in Columbia.  For example, when I was a student, both programs were strictly for graduate students.  Now, both programs offer bachelor’s degrees.  You can bet the people in those programs know which acronym is theirs.

Anyway, I know it sounds petty to be complaining about this.  God knows, despite having a degree in English, I don’t always do things exactly right when I write.  I guess it’s because the older I get, the more crotchety I become, particularly about petty issues.  I also think that when people claim to know something really well, to the point at which they qualify their statements with their credentials, they should be able to get a five letter acronym exactly right.  If you really know about HIPAA, and want me to believe that you know about it, then you should know that it’s not spelled “HIPPA”.

By the way, I doubt there are that many actual experts on the HIPAA law.  Indeed, have a look at the Wikipedia article about HIPAA.  It’s my understanding that HIPAA is a very complex piece of legislation that encompasses a lot of different areas regarding healthcare.  It’s not simply about your right to healthcare privacy; it’s also about taxes, application and enforcement of group health insurance requirements, fraud prevention, and a host of other things that I don’t feel like looking up right now.  So while many people do have to work within the HIPAA law, my guess is that they only know the part that specifically pertains to the work they do.

If I wanted to, I could provide screenshots of the “expert commentary” on the HIPAA law where self-described expert after expert refers to it as “HIPPA”.  I don’t feel like doing that, though, because it would mean my having to take the time to block out their names to protect their privacy.  I can’t be arsed to do that this morning, especially when anyone who really cares about this issue can simply check out the page.  The Duggar Family News page is open to all.  If this post were in the group, where one must be added by the admin, I might be more inclined to provide some cable.

As to John David Duggar and his possible hospital stay…  Well, honestly, I don’t care about it too much.  While I agree in principle that everyone is entitled to privacy, particularly when it comes to their healthcare, I also think the Duggars are public figures.  The adult Duggars who continue to stay in the “family business” kind of sign up for random people caring about why they’re in the hospital.

On the other hand, I personally believe that the Duggars’ fifteen minutes of fame probably should have been over a while ago.  I mean, they’re mostly famous for being fundie Christians and Michelle Duggar’s hyperactive womb.  A lot of what made them interesting, when they first came on the scene in the early 00s, are now relics of the past.  They’ve moved into the Tinkertoy Mansion, so we don’t see them all sleeping on top of each other like they did years ago.  The children no longer wear the frumpy, freakish, fundie uniforms they used to wear.  I mean, the girls still wear long skirts and flip flops, but they don’t wear the ugly homemade jumpers and lacy collared blouses.  The boys don’t wear the khaki pants and polo shirts.  A lot of the youngsters have graduated from the School of the Dining Room Table.  And some of the married women are now wearing pants and have piercings.

I don’t wish ill on any of the Duggars, per se.  I don’t even wish ill on “sex pest” Josh Duggar.  I just think that wondering why John David might have been hospitalized is a waste of time.  I’d rather wonder about other things, like whether or not there’s lint in my butt crack and bellybutton.  But that’s just me.

I just hope that if I’ve done one productive thing today, it’s to impart upon my readers that if you really want to seem knowledgeable about something, the first thing you should do is learn how to properly spell the name of your topic.  I don’t know about other people, but I have a hard time respecting a person’s so-called expert credentials about something when they keep misspelling its name… especially when the name consists of just five little letters.  But then, I’m also the type of person who gets annoyed when people write “breath” when they mean “breathe”, or “phase” when they mean “faze”, or “per say” when they mean “per se”.  To me, spelling is fundamental.  That’s why I’m still an overeducated housewife.

And below are the original comments from 2018. Here’s a link to the follow up post.

  1. AlexisARDecember 23, 2018 at 1:16 AM. I’m not tremendously concerned about John David’s hospital stay (real or imaginary) either, and neither am I an expert on medical privacy regulations beyond the common sense factors I need to know to avoid violating anyone’s privacy (in med school we had to pass shelf exams on the elements of HIPAA pertinent to us, but it’s mostly common sense), but unless the information concerning John David happened to have been disclosed without authorization by medical, insurance, or review board personnel with access to his information, would it be in any way relevant to HIPAA regulations?

    I’m still here for one more day before I return to the Great White North. Santa Barbara was gorgeous.
  2. RebeckahDecember 23, 2018 at 2:38 AM You’re right, Alexis — I’m a Homecare Aide and we have to know about the HIPAA privacy aspect (and pass annual tests about it too). If I were providing care in some way to John then I would violate his privacy (and violate HIPAA) if I told people about it. However, if is sister Mary Lou Who decided to share the news because she can’t stand the fact that he ate the last sugar cookie when she was 12 — well that’s just family for you. lol
  3. knottyDecember 23, 2018 at 5:50 AM. I couldn’t stand it, so I posted the correct spelling. Pickles’ response was “whatever”, which I find disappointing. Someone else flat out called me out and said I was wrong, which prompted me to provide a link to the law’s official Web page, proving I’m right. I know it makes me sound anal retentive, but I think people who want to act like they’re in the know about HIPAA should know the way to spell it. And I also got quite a few likes, so there’s the ego boost for that, too. Ha haha… I could use an ego boost.
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controversies, healthcare, law, Police

Repost: Hey, all you druggie pregnant folks! We’re warning you!

Since I don’t really feel like typing any significant fresh content today, I’m going to repost this blog entry from the original Blogspot OH. This post appeared April 19, 2015. It’s been retitled and edited somewhat, because there was dated and irrelevant content in the original post.

Last night, I shared this photo, which randomly popped up on my Facebook feed.  A woman I knew in school had posted it with the comment “You’ve been warned.  No excuses.” I knew the photo would generate discussion, and it did. Most of my friends were horrified by the photo, although “Papa Smurf” was a notable and predictable outlier. [Papa Smurf is a former friend now… he was a mansplaining pain in my ass one too many times, and I finally advised him to fuck off. I call him Papa Smurf because he was very sanctimonious and enjoyed trying to act like everybody’s daddy.]

I understand the idea behind this sign and I comprehend why a lot of people are behind its sentiment.  However, while I get why people agree with it, I think it’s counterproductive to threaten patients before they’ve even been seen.  All a sign like this does is tell the pregnant mom who might be using drugs that the doctor would prefer them to go somewhere else for their prenatal care.  Indeed, that could be why the sign was posted.  OB-GYNs typically pay a lot in malpractice insurance, and a pregnant person with drug issues could potentially have a riskier pregnancy.  Of course, a drug abusing mom who is really bad off probably wouldn’t bother with prenatal care anyway. 

Those who use drugs recreationally might see a doctor, but if the doctor flat out tells them they will call the law on them, they will very likely avoid medical care.  That may be fine and dandy for the doctor who doesn’t have to deal with them, but what about the unborn child?  The sign seems to be advocating for the welfare of the unborn baby, but if the doctor scares off the mother, what good does that do?  And doesn’t that sort of conflict with what doctors are supposed to be doing, which is providing healthcare to people who need it?

I happen to be pro-choice, but I couldn’t help but notice.  As long as abortion is legal in the United States [remember, this was written in 2015], it seems kind of ridiculous to take this sort of attitude, anyway.  I mean, the mother to be can terminate her pregnancy if she chooses.  Using illegal drugs is against the law, anyway.  Why turn it into a crime against the unborn?  Why does the fact that the mom to be is pregnant even come into it?  She’s breaking the law, so deal with her. 

At this point, we don’t force people to see their doctors.  People have a hard enough time accessing appropriate medical care for reasons other than being threatened and alienated.  This attitude of needing to police private citizens is creepy to me [I really had no idea what was coming, eight years ago, did I?], and in the long run, I don’t think it makes things better for anybody.  Of course a pregnant woman shouldn’t be using drugs, and something should be done if she comes up positive on a drug screen.  I think the attitude toward her should be more supportive and helpful, not threatening.    

Besides…  a woman whose newborn baby comes up positive on a drug screen at the hospital is going to be referred to CPS anyway.  All that sign does is encourage the mother to avoid seeing doctors and give birth outside of a medical setting.

Here’s another thought.  For most medical procedures, physicians must get informed consent before they go ahead with it.  I suppose a sign like this informs patients that the doctor(s) at this practice will do random drug screens, and gives them the option of going elsewhere for their prenatal care.  But what about health care professionals that do screenings without the patient’s knowledge or consent?  Isn’t that a violation of their rights?

I know there have been cases in which mothers have been arrested for having positive drug screens and have gone to court.  In South Carolina, there was a big case involving pregnant women, Ferguson v. City of Charleston, who were tested for drugs without their knowledge or consent.  It went all the way to the Supreme Court, which ruled that the search in question was unreasonable, especially since the searches had the potential to land someone in jail.

In any case, while I certainly wouldn’t condone a pregnant woman using drugs, and I agree something should be done to help or dissuade drug abuse in pregnant women, I don’t think taking an adversarial, threatening attitude is in the best interest of patients.  The goal shouldn’t be to sell mom down the river; it should be to get her appropriate help so she can successfully raise her child.  I think it would be hard to do that by threatening patients with getting the police and child protective services involved before they’ve even been seen.  

Edited to add in 2023: I don’t know if the photo is real or fake. I just thought the discussion it generated was interesting. You can see the original post here.

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