Tag Archives: public health

condescending twatbags, healthcare, law

Confusion, chaos, and crass behavior continues, as US ends mask mandates on transportation…

It’s a beautiful spring day here in lovely Wiesbaden, Germany. The sun is shining and the air is fresh, crisp, and cool. I can see my neighbors’ trees heavy with flowers. Later, when I walk my dogs, I expect to see plenty of beautiful blooms in well-tended gardens. I probably should enjoy being outside more, especially since the weather in this part of the world isn’t always as nice as it is right now. It’s always so nice to see spring arrive in Germany, since the earliest months of the year are usually pretty crappy, when it comes to the weather. Making things even nicer is that on April 2, 2022, Germany finally lifted face mask requirements and vaccine checks in many venues, although they remain on public transportation.

Because masks are still required in airports and on public transportation in Germany, Bill and I will be driving to Italy next week. Actually, we might have decided to do that anyway, since we will probably be buying wine, cheese, and other groceries and it’s easier to transport that stuff in a car than on a plane. I like road trips, as a general rule. In my opinion, one of the best things about living in Europe is having the option to drive to so many beautiful places.

My countrymen aren’t so fortunate when it comes to traveling abroad. A person in the United States can’t drive to Europe, Africa, Australia, or Asia. In fact, it’s not so easy to get from coast to coast in the United States by car. It takes awhile to drive from, say, Virginia to California, and a lot of Americans prefer to fly, because vacation days are precious in the US and flying takes less time. So yesterday’s ruling, made with a stroke from federal Judge Kathryn Kimball Mizelle’s pen, has caused a big ruckus among Americans. Public reaction to her decision has been decisively split. Judge Mizelle’s ruling makes it okay to forgo face masks on domestic flights, although it’s my understanding that they are still required on planes that are flying to places where the masks are still required.

Cue mass hysteria.
Something tells me that this decision is going to prompt policy changes.

Many people are hailing Judge Mizelle for setting them free from face masks on public transportation. Others are cursing her and calling her “incompetent” for allowing people to suddenly take off their masks mid flight yesterday. The facts that she’s from Florida, is somewhat young and attractive, and was appointed by Donald Trump, don’t help some people’s negative impressions of her worthiness as a judge. Some public health and medical experts are very concerned about this restoration of facial freedom the judge has bestowed upon the public. And some people are feeling more emboldened than ever to shoot the finger at people they regard as sanctimonious virtue signalers.

If you read this blog regularly, you know that I’m liberal about a lot of things. But you may also know that I’m not a fan of face masks, even though I am a master’s level graduate of an accredited school of public health. I was never really in favor of them, even at the beginning of the pandemic. I don’t think a lot of people wear the masks properly. Here in Germany, we’ve been forced to wear heavy FFP2 masks (like N95s), but the infections continue, probably because no one is forced to cover their eyes. And so, I conclude that a lot of the masking is basically theater, although I can certainly understand why they are important in certain medical settings.

Two years ago, before we had vaccines and most people had zero immunity to the virus, I could see why they were initially necessary, even though the masks most people wore at the beginning of the pandemic were pretty useless. As the variants have become milder, and fewer people seem to be getting quite so sick and dying, I can see why the masks are being phased out. For the most part, I think it’s time. It’s been two years, and while I’m sure there are some people who would love to see everyone masked forever, that’s not a very realistic goal.

Many people legitimately hate the masks because they can be uncomfortable and inconvenient. They do cause legitimate problems for some people, particularly those who suffer from anxiety, are hard of hearing, or have sensory processing disorders. They aren’t a good long time solution, in my opinion, because they are so polarizing, and because they hinder communication. Even if face masks were the best idea ever, it would take some time for people to accept them as normal. I am old enough to remember when a lot of Americans didn’t voluntarily wear seatbelts in their cars. It wasn’t until I was a young adult that they became normal for most people. At least that was how it was in the United States. In most countries in Europe, mandatory use of seatbelts for all passengers has been the rule for a lot longer, and fines are pretty stiff for non-compliance. But even a lot of Europeans are over the masks.

I still live in Germany, where public health ministers are still wanting to limit freedoms and impose COVID restrictions. A lot of Germans seem to be fed up with the rules, too, although they do seem to be a lot more willing to submit to them than Americans are. What I like about Germany, though, is that people seem to be somewhat less insulting, whichever side of the mask debate they’re on. And Germans, as a rule, are more community minded about most things. Many people here are still wearing masks, even though they are no longer legally required to wear them. Those who don’t wear masks mostly don’t get harassed for not wearing them. Maybe they get the side eye from one or two people, but no one is getting belligerent or aggressive about it, and there’s a lot less violence all around. I doubt if the mask rules were relaxed in the middle of a Lufthansa flight, that people would be whooping and hollering like they reportedly were on US flights yesterday. But yes, there would probably be people gratefully removing them.

As usual, I took a look at the comments on the news articles. It didn’t surprise me that a lot of people were whining about their fears regarding this decision, while others were being really offensively belligerent about their “freedoms”. I suspect that if the mask mandates are reinstated in the United States, there will be even more of an uproar and possibly, more violence. I have noticed, as many have, that since the mask mandates were in place, the behavior of people on planes was more violent and unruly than it’s ever been. After all, flights in economy class are uncomfortable enough as it is. The masks made them even less pleasant for a large number of people, even though some people don’t mind the masks and never found wearing them “onerous”.

Obviously, the masks make it harder for flight crews, as people have gotten violent over having to wear them on planes.

One thing that I’ve noticed and don’t really like from either side of this issue, is that people aren’t willing to compromise or concede. Why can’t the pro-maskers, for instance, understand why people hate wearing masks? Why do they feel it necessary to insult, belittle, and berate people for their valid opinions? Being nasty and sanctimonious to people does not inspire their cooperation. Moreover, I don’t find it very convincing when a person in a mask brags about “caring for other people” as they verbally abuse those who don’t share their opinions and dare to express themselves. I’ve seen more than one comment by a supposed “concerned mask wearing humanitarian” indicating that they think anyone who disagrees with them deserves to die. That’s not a very caring and kind attitude, in my opinion, and it doesn’t necessarily make me want to wear a mask for the sake of others. In fact, I think it’s the height of hypocrisy.

Conversely, I also think it’s awful that there are so many anti-maskers and anti-vaxxers out there who feel the need to laugh, gloat, and insult people who are genuinely afraid of getting very sick from the virus. I happen to agree that masking should be a choice, even though given a choice, many people won’t choose to wear a mask. Having the right to choose is part of living in a free society. But I also empathize with people who are afraid of COVID, or are concerned that they will spread it to vulnerable loved ones. Unfortunately, this was a problem even before COVID, and it will continue to be a problem. Forced mask wearing is not going to make the basic challenges faced by immunocompromised people go away, even if they appear to make things safer. I do agree, however, that we could all stand to be kinder and more considerate about this problem.

I read an op-ed on the Washington Post this morning about the relaxed rules. Robin Givhan, who wrote the opinion piece, demonstrated the attitude that, personally, I’ve found very off-putting throughout the pandemic. Her piece, titled “Whoops of selfish delight”, lamented that people were cheering about the suddenly dropped mask mandates. The mood of her opinion was that people were behaving badly for being visibly happy to be rid of the masks. This was Givhan’s sarcastic comment about the midflight announcement:

“They reveled in the knowledge that while they might be required to buckle their seat belt, turn off their cellphone, put their seat backs in the upright position and refrain from smoking on their grueling one-hour-and-20-minute flight, the one thing they would not have to do was wear a mask. The long, torturous nightmare of government overreach, which is how so many aggrieved passengers viewed the mandate effecting public transportation, has come to an end.”

I just want to ask her what the hell she was expecting. Of course people in their tight airplane seats with no leg room, strapped in and masked up, while their neighbors eye them suspiciously and with hostility, are going to be delighted with the prospect of being free to breathe unmasked. A lot of people– and I’m sure many in the travel industry, especially– are thrilled not to have to wear masks or enforce the wearing of masks, temporary as it may end up being.

Now, maybe it was rude to “whoop” about it, if only because yelling can spread viruses faster, and there are people who are legitimately terrified of being around maskless people. But I don’t think people are being selfish when they’re happy to be allowed to unmask. It’s perfectly natural, especially after two years of this weird, dystopian, plague we’ve been enduring. And if the mask mandates are reimposed, be prepared for backlash. I suspect it could be even worse after people have gotten a taste of freedom. No amount of shaming, virtue signaling, and berating is going to cow certain people into compliance. I just hope there won’t be more violence.

Anyway… count me among those who are for putting away the face masks, although I probably won’t be flying or taking transportation anytime soon. I never liked the masks, and I’m not going to submit to peer pressure to be a cheerleader for them. I’ll wear a mask if I’m asked to, but I certainly don’t want to do it. Not wearing a mask doesn’t make me a shitty person, especially since I don’t hang around people much, anyway. I also don’t care if other people wear masks. They can wear as many as they want to. It’s their choice, and I respect that. It would be nice if we could respect each other’s choices, since we all have to breathe. When it comes down to it, COVID is just another one of the many, many risks we face on a daily basis. Over the past two years, I’ve lost several people in my life, all of whom died years before perhaps they should have. Not a single one of them died of COVID… most of them had cancer or another chronic disease that might not have been adequately addressed, partly thanks to this virus. One died of suicide, and another was killed in a hit and run. I think that’s something to consider.

In other news…

I’m in trouble again.

I got another “restriction” from Facebook yesterday. They claimed I posted “hate speech” for referring to “dumb Americans”. My “punishment” is having my group posts filtered to the bottom for a month. I’m annoyed by this new ding, but I guess I should have expected it. Facebook must have a quota of sanctioning people for posting “offensive” content. What I find especially stupid is that people can and do post all sorts of offensive stuff toward strangers, but I refer to Americans as “dumb” because they won’t allow a children’s author to read his book about unicorns, and I get accused of posting “hate speech”.

I saw this on the Duggar Family News page. Wonder if it will get flagged for being offensive…

Just as I would like to ditch masks, I would also really like to ditch Facebook. I may end up doing that at some point, although it’s the best and easiest way to stay in touch with people. But I resent their stupid bots making false accusations about my posts that are taken out of context. The other day, someone referred to me as a “baby killer”, complete with vomiting emojis because I support the rights of people to get abortions. But that’s apparently okay– to call an individual stranger a “baby killer” as you react with puke emojis. Call Americans “dumb”, and your account gets restricted. It’s very aggravating. But, based on the comments from friends, at least I am in good company with these inane “punishments”. And at least this time, my offensive post was only a few days old, instead of four years old, as it was the last time I got slapped on the wrist. And this time, Facebook said I could appeal their decision. I don’t care enough about this particular issue to do that, though. I’ll just put up with another month of wearing a red badge of shame.

Standard
homosexuality, music, psychology, YouTube

Phil Donahue inadvertently introduces me to a virtuoso…

Monday, after I had finished my usual chores, I was trying to decide what to do with the afternoon. Suddenly, I remembered the old talk show, Donahue, which aired the whole time I was growing up in the 80s. Hosted by the follicle blessed Phil Donahue, husband of actress, Marlo Thomas, this was a show I heard a lot about in those days, but never watched. It was a precursor to Maury Povich and Geraldo Rivera, and even Oprah Winfrey and her protege, Dr. Phil. But, as I was a child in the early 80s, I wasn’t interested in watching talk shows. I do remember the theme music, though, because I think my mom was a fan, even though Donahue was pretty liberal for those days.

Anyway, I went searching on YouTube, and sure enough, someone had posted episodes of Donahue that dated to the early 80s. The first episode I watched was particularly engrossing, as it aired on November 17, 1982. I was ten years old, and AIDS was becoming the latest public health terror. Prior to that year, AIDS existed, but rank and file Americans didn’t hear about it, because people mainly got it in Africa. On that November 1982 episode of Donahue, there were several fascinating guests. There was, Dr. Dan William, a doctor who was one of the pioneers in treating AIDS. Phillip Lanzaratta, man who had Kaposi’s sarcoma was there to talk about the then rare cancerous lesion he had because of AIDS. And there was also, Larry Kramer, a leader of a gay men’s crisis organization. All three of these guests are now dead, although Larry Kramer died fairly recently– in 2020, I believe.

If you have time and are interested, this is a fascinating episode.

What really struck me about the AIDS episode of Donahue is just how new and terrifying the disease was, and just how little we knew about it. I grew up in the time when kids who were unlucky enough to get HIV, the virus that causes AIDS, were not allowed to go to school. Ryan White was one of my contemporaries; he was six months older than me. Years later, I also read the heartbreaking story of Ariel Glaser, daughter of actor Paul Michael Glaser (Starsky and Hutch) and his late white, Elizabeth Glaser, who started hemorrhaging when she was giving birth in 1981. She was given a blood transfusion that, sadly, was contaminated with the virus. She breastfed Ariel, who contracted the virus that way. Elizabeth didn’t know she had the virus until 1985, when she and Ariel both mysteriously got sick. Ariel died in 1988, and her mother helped found the Pediatric AIDS Foundation. Elizabeth, who died in 1994, also had a son with Paul Michael Glaser, Jake. Jake was born with HIV, but has survived into adulthood. Before she died, Elizabeth wrote a book called In the Absence of Angels, which is a great read. I read the paperback version years ago. Maybe I should try to read it again.

Joshua Bell’s dad!

Since I had nothing better to do, I watched the next episode of Donahue that came up on YouTube. That episode, which aired October 14, 1981, had to do with homosexuality. The episode’s title was “Are Gays Born This Way?” I don’t think Lady Gaga was yet born when this show aired. 😉 The guests were Alan Bell, Ph.D. (author of “Sexual Preference”) and Lawrence Hatterer, M.D. (Professor of Psychiatry at Cornell University), each of whom came to their respective conclusions in different ways. I was particularly interested in Dr. Bell’s comments. He was very emphatic about his conclusions. He also reminded me of an old soap opera actor I used to enjoy on Guiding Light, Ron Raines, who played Alan Spaulding in the later years of the show. Interestingly enough, he took over a role that was played by the late Christopher Bernau, who was gay and died in 1988 of a heart attack that was brought on by AIDS. Bernau was only 49 years old when he passed– same age I am now.

Are Gays Born This Way? Yes… but it would take many years before Lady Gaga gave us the news.

I got caught up in the commercials, too, which were very different back then. They were longer, involved actual acting, and often starred people who went on to big fame. For instance, during the Donahue show, the actor Ian Ziering (of the original 90210 fame and a former Guiding Light alum) is in an ad for Scott paper towels. I’m pretty sure I saw Shelley Long, before her film and Cheers days, hawking furniture in another ad.

I looked up Alan Bell, and learned that his son, Joshua, is an incredibly gifted violinist. Much to my shame, I had no idea. He’s a few years older than I am, and very cute. Joshua Bell’s mother, Shirley Bell, worked as a therapist, and his father, Alan Bell, was a highly regarded psychologist at Indiana University. Shirley Bell’s mother was from Minsk, in Belarus, and her father was from Palestine; hence, she was Jewish. Bell was of Scottish descent. No wonder Joshua Bell had such great musical chops. 😉 The story goes that when Joshua was very young, he used rubber bands to make strings across the nine knobs on his dresser. His mother caught him plucking out music he’d heard her playing on the piano. Being a savvy sort of mom, Shirley Bell found her son a violin teacher. Now, Joshua Bell plays a Stradivarius and makes absolutely beautiful music. Seriously, I’m listening to him play as I write this… he really is extraordinary, and he doesn’t just play the classics.

The song I was just listening to… SIGH!!!!
And Joshua Bell playing “live”.

I also learned that Joshua Bell had a touch of his dad in him. Some years ago, he conducted an experiment for the Washington Post, donning a New York Yankees baseball cap and playing 45 minutes for free in the Washington, DC metro station. He earned $32.17 from passersby, not counting the $20 someone who recognized him gave him. Three days prior to his “free” concert in the metro station, Bell earned a whole lot more money playing for paying customers at a concert. Washington Post columnist Gene Weingarten won the 2008 Pulitzer Prize for Feature Writing for his article about the experiment.

Fascinating! You just never know who’s busking.

As an aside, I always make a point of giving money to buskers. I know how much goes into learning how to play music, and I appreciate the ambiance they contribute, especially in Europe. There have been a few occasions when I’ve even cried listening to some of the more talented street players. Like, for instance, a certain Polish guitarist Bill and I met last time we visited Florence (in 2013). We will be going back to Florence at the end of this month. I hope I run into Piotr again… and I’m so glad we bought his beautiful CD.

My friend Donna used to work at a classical radio station when she was a teenager. She said she had a huge crush on Joshua Bell back then. I’m ashamed to say that I simply hadn’t heard of him until two days ago, but last night, I bought several of his albums not having heard them before. I am listening to them now, and I’m not sorry I bought them. And to think I have Phil Donahue to thank for this! Who says you can’t learn from TV? Or from YouTube, for that matter?

Speaking of YouTube… about a month ago, some people on RfM who had endured some of my videos told me that I should try singing on camera. I don’t typically do that, because I get very self-conscious about my appearance. Also, I don’t put on makeup or regular clothes unless I’m going out in public, which I don’t do very often these days. But one poster was pretty adamant that I should try it. He also looks forward to seeing me play guitar and sing at the same time on video. I decided to buy a mic stand after that discussion, but only got around to making an on camera video yesterday. No, I’m not quite ready to play and sing at the same time, but yesterday I decided to record my version of an Alison Krauss cover of “Dreaming My Dreams With You”. I got notified by my favorite karaoke track vendor that the recording was available, so I downloaded it… and since yesterday, it was chilly and cloudy and I wanted to stall walking the dogs, I decided to try it on camera. I kind of cringe watching it, but the music turned out nicely, I think.

No makeup, no bra, and in fact, that is one of my nightgowns I am wearing… But it was well-received, anyway. I shocked a few people who knew me in high school, when I didn’t sing.

I don’t know what today will hold. Wednesday isn’t a big household chore day for me, so I’ll probably watch more Donahue. He does seem to be pretty interested in homosexuality… or at least he was in the 80s. But what really blows me away are some of the comments from the audience members. Listening to some of these folks is a reminder of how different society was in the early 80s. It’s a poignant look at what people who weren’t (or aren’t) straight had to deal with in the days before many people started to accept that not everyone is cisgendered. I generally have a lot of compassion for people who are different, but I am especially compassionate towards people who grew up at a time when it was especially difficult to be who they really are without risking huge consequences. And listening to some of the callers and audience members talk about homosexuality really just drives home what a challenge that must have been for so many people. My heart goes out to them.

Well, so ends another blog post. I’m going to practice guitar and maybe walk the dogs… and then I might look for another rabbit hole to fall into. Later, y’all!

Standard
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?

Standard
complaints, disasters, healthcare, music, politics, poor judgment, rants

I’d like to propose a toast– to difficult and unpopular decisions…

This version of “Ladies Who Lunch” suits my mood today…
And so does this one…

In contrast to my bubbly mood yesterday, today I’m feeling kind of flat and bitter. I think the constant barrage of bad news is getting me down. So are mean spirited Trump supporters.

Last night, I got a comment from someone who didn’t enjoy a post I wrote in November 2020. The person wrote that I made stupid people seem smart. I checked StatCounter to see how long he or she spent on my blog. It was a grand total of about two minutes. Nevertheless, the person was moved enough to send me an insulting comment. I’ll admit, it irritated me. I did not publish the comment. I trashed it, after sending the person a very short and profane emailed response.

I actually wish I hadn’t done that. My temper got the better of me, as it sometimes does. The wine helped. I should have just ignored the comment and been grateful for the hit, especially since the person obviously doesn’t know me and was just lashing out. Next time, I’ll try to do better.

I did give some thought to turning off comments, though, just because I’m tired of dealing with the type of person who screams about personal freedom, but can’t respect my personal freedom and perfect right to express an opinion on my space. Oh well… I guess I touched a nerve. Obviously, that person isn’t very confident in their support of the orange turd if something I wrote moved them to take the time to call me “stupid”.

I’ve been reading a lot of comments about Afghanistan. A lot of people are blaming Joe Biden for what appears to have been a disastrous departure from a country the United States has occupied for twenty years. I, for one, don’t blame Mr. Biden. We were there for twenty years. At some point, we had to leave. Biden merely carried out actions initiated by Trump, whom I seem to recall wanted us out of Afghanistan last year. I suspect Biden will be a one term president, so he’s doing a lot of unpopular but necessary stuff. Like any good and caring leader, he’s making difficult and unpopular decisions. I prefer Biden’s method to Donald Trump’s “seat of the pants drunken uncle” approach to solving problems.

Leaving Afghanistan was necessary. I doubt most of the people who are armchair quarterbacking could do better, anyway. And… for the record, I KNOW Trump would not have done better. But I will concede that mistakes were definitely made, and some statements by both Trump and Biden have aged like milk. It’s very interesting to me, however, that so many Trump supporters are upset about the humanitarian crisis in Afghanistan and the heartbreaking images on video, but they still don’t give a flying fuck about the crisis at our southern border involving people who are fleeing violence and oppression in their homelands. Also, I don’t see many of those people cheering that some Afghans actually were spirited out of the country by our military. I guess a lot of those folks are fine with empathizing with people who have brown skin, as long as they come from distant countries.

The Afghanistan news was paired with news about COVID-19. My grad school alma mater, The University of South Carolina, currently has an interim president in Dr. Harris Pastides. Dr. Pastides was formerly president of the university, as well as a professor in the Arnold School of Public Health, of which I am a graduate. This morning, I read the news that he is going to require face masks in buildings. People are really pissed, even though Dr. Pastides, who is an epidemiologist by training, is eminently qualified to make this call. I read many comments from people who wished they hadn’t written a tuition check. All I can do is shake my head at the stupidity. I hate the masks, too, and would certainly hate them in South Carolina in August. BUT… since many people still refuse to get vaccinated, I can see why Dr. Pastides made this particular difficult, and unpopular, decision.

This news didn’t go over well with a lot of people. There was much non-sensical bitching going on. I think it’s very sad when you can tell a person’s political leanings by their responses to public health mandates. That being said, I do sympathize. I’m glad I am done with school, and anything else that would require me to wear a mask all day. They do legitimately suck, even if they help control the spread of sickness.

I absolutely don’t deny that masks are a pain in the ass. They’re inconvenient, unpleasant, and uncomfortable, and they need to be ditched, pronto. I won’t even insult people by saying that wearing them is “no big deal”. Obviously, to a lot of people, having to wear them is a big deal. Otherwise, they wouldn’t be putting up such a fuss. And I absolutely agree that people should have the right to express their negative opinions about the masks. In this situation, it’s more important to me that people simply cooperate and comply than have a good attitude. Having a shitty attitude is understandable, under these conditions. I’ll drink to that!

I’m also as tired as anyone is of all the virtue signaling and constant bragging about adherence to the rules. But we can’t ditch the masks until the virus is under control. And the more people protest and refuse to cooperate, the longer it’s going to take, and the crankier and bitchier I’m going to be. If that means people think I’m stupid, so be it. I think telling a truly stupid person that they’re “stupid” is also pretty stupid, isn’t it? 😉

I read that Texas Governor Greg Abbott has tested positive for COVID-19. As an official Texas resident, this is relevant to me. Abbott says he feels fine for now. He’s vaccinated and is getting treatment– Regeneron, which is what Trump got last year when he got the virus. It’s designed to keep people from getting really sick. But he’s been doing his best to keep allowing Texans to spread the virus as he also denies women the right to have abortions. I look forward to voting against him in the next governor run.

Ironically, here in Germany, things actually are getting to be more normal. Yesterday, there was a notice in our local Facebook group that our village is going to have its first wine stand since March 2020. Bill and I loved attending the wine stands during the spring and summer of 2019. We missed them last year. It’s awesome to see that they will be returning this week, although everyone has to bring proof of vaccination, testing, or recovery from the illness. But see, what I love about Germany, is that people seem to be more community minded and cooperative. And when people work together, things are better overall. This summer, we’ve enjoyed things that we missed last year. I’m glad to be in a place where people have compassion and common sense. It means we can dine out, travel to neighboring countries, drink wine in public, and maybe take in a concert or visit a museum. Those are activities that make life worth living.

I relate… what a lovely song this is! Right down to the glasses of wine and bathrobes! These are my kind of ladies.

I suppose the return of the wine stand is reason enough for me to be less crabby. I do like “Ladies Who Lunch”, though. I may try to learn that song today. The first time I heard it was when I was taking voice lessons. An older woman was learning it and our teacher, Ron, was advising her to be more of a “bitch” as she sang it. Now that I’m a legitimately bitchy middle aged woman who lounges in caftans and enjoys cocktails, it may be time for me to give it a go. Edited to add: Here it is– your own knotty singing this song.

I completely forgot about “Ladies Who Lunch” until I saw it performed in the awesome film, Camp. I first watched Camp when we lived in Germany the first time. I downloaded it off iTunes just for shits and giggles. Now, it’s one of my guilty pleasure films, whenever I need a pick-me-up. Actually, I get a little wistful watching it, wishing I could be young again and go to a musical theater camp. Ah well. Maybe reincarnation is a thing. On the other hand, I’m not sure I want to come back to this world.

Anyway… if I had any friends, maybe I would be a lady who lunches. I don’t have any friends. I just have dogs who adore me. They’re probably better company, anyway. They don’t mind that I have and express opinions, and they don’t care how profane I get. I hope the person who was offended by my “stupidity” is happy with his or her choices in life. I’m glad I’m not where they are, at least. And I hope I never encounter them again, since they think I’m so stupid. One wonders why a person would feel the need to leave a comment on such a “stupid” blog, anyway.

So here’s to making difficult and unpopular decisions. I’ll drink to that! I’ll drink to most things, especially nowadays.

This was shared by a Trump supporting friend. I am tempted to respond that I do, and I did, … and I am somewhat happier for it. I’m definitely healthier for it. But I don’t want to deal with people from my hometown who are still pining for Donald Trump. Seriously… I get being conservative, but Trump is a fucking moron.
If you haven’t seen Camp, you’re missing out.

Ooh… Edited to add! Here’s a response from Steve, the anal drip who called me stupid yesterday. He’s charming AND articulate, isn’t he? I definitely don’t think I’m the stupid one, so I think I will send his response to the round file.

Steve Jenkins6:21 AM (3 hours ago)
to me

Hey fuckhead…I was hoping one of you dumbfucks would respond…I forgot to save your site.

Since you are a fuck up, how does one fuck oneself?  I know you’re an expert even for a dumbfuck.

On Tuesday, August 17, 2021, 08:07:28 AM HST, I wrote:

Stay off my blog.

Go fuck yourself.

Standard
healthcare, musings

I’m tired of thinking about health…

A few days ago, I got drawn into a rather unpleasant online argument on Toytown Germany. Someone had started a thread about how healthcare providers in Germany are dishonest. Lots of people were lamenting about how dentists are crooks, and how privately insured patients get fleeced by physicians. Meanwhile, publicly insured people are treated with apathy.

I haven’t had a lot of experience with German healthcare providers myself, although I do know of some Americans who have chosen to have major illnesses treated by German doctors instead of the American ones at Landstuhl. I know someone whose wife got colon cancer and was treated with relative apathy by the military docs. She contacted doctors in Wiesbaden and they were quick to see and treat her. Now, she’s in remission.

Bill and I love our German dentist in Stuttgart. We haven’t seen him in two years, but he’s still the best dentist either of us has ever had. He is a hybrid, of sorts… Mom was German and Dad was American, so he knows both cultures. We’re hoping to see him soon for cleanings we desperately need, now that we’re vaccinated. But I can understand that some people have had bad experiences with German healthcare providers.

There was one person, though, who was crowing about how great American healthcare is. Frankly, I don’t see it. I mean, if you have access to great health insurance or you have money, sure… but for the rank and file person who isn’t insured or wealthy, I don’t think American healthcare is that great. For one thing, it’s very expensive, and you don’t know what you’ll have to pay, because prices aren’t regulated. I know of a couple of people who have gone bankrupt after having had car accidents or other unexpected medical emergencies, even if they have insurance coverage. There are many horror stories online about people who have faced financial ruin after hospital stays, particularly when the stays were due to emergencies.

Some people have looked abroad for their needs to be met. I know someone who had a whole mouthful of dental implants done in Costa Rica, because she couldn’t afford the six figures she was quoted in the States. I know someone else who went to Mexico for a Lapband procedure for the same reason; she paid a fraction of the cost of what that procedure would have run her in the United States. Of course, going abroad for healthcare can be risky and results differ. My friend who went to Costa Rica is very satisfied with the result. The one who went to Mexico later developed a life threatening infection that her health insurance wouldn’t cover, because she had the Lapband operation done in Mexico by a physician who wasn’t in network. And because the infection, while certainly in need of urgent treatment, was related to an uncovered procedure done in Mexico, my friend had to pay out of pocket to get the necessary antibiotics and related medical care to cure it.

Mental healthcare services in the United States are given very little coverage, even though conditions like depression and anxiety can cause physical health issues and impact the quality of life. They can also cause people to do drastic things that lead to tragedies. But try to get broad coverage for a mental health issue in the States. It’s not easy, particularly if inpatient care is indicated.

For another thing, the United States doesn’t actually rate that highly when compared to systems in other countries. If you look at the United States when compared to, say, France or Italy, or even Germany (which also isn’t that high ranking, but is better than the USA). you’ll find that it isn’t even ranked in the top 30 of 196 countries. A lot goes into determining what makes a great system, of course. Researchers look at factors such as infant mortality, life expectancy, the number of qualified medical providers available, mortality and morbidity, and how long patients manage to avoid being readmitted to hospitals after they’re released. Researchers also look at affordability, accessibility, and availability.

The United States certainly has a lot of excellent hospitals and some great doctors. But there are also many areas where healthcare coverage is poor, such as remote and rural locales. Some of those areas rely on telemedicine in order to help people meet their needs. Some healthcare facilities are also very poor, as are some providers. And then, there’s that pesky issue of people not being able to access healthcare because they simply can’t afford it. Those people are often the ones who end up going to the emergency room for routine care. It’s like doing your grocery shopping at a 7 Eleven.

So anyway, I pointed this out to the American healthcare system cheerleader. She came back to me with a rather nasty tone that didn’t suggest to me that discussing the issue further with her would be productive. So I signed off– inviting her to do her. It was kind of a snarky retort, but I just didn’t have the energy to get into it with a stranger over this subject, even though it’s something I know a little about, having studied it formally. Then, come to find out, she’s not even AMERICAN! She comes from Britain! And she fucking lives in Cologne! Maybe she has real experience with the US system, but I doubt she’s ever had to seek healthcare in a rural area of the United States. I could tell, though, that she wasn’t interested in another perspective, and frankly I just didn’t feel like going around with her. So I fucked off, although I did have a brief private conversation with someone else from that thread. She was kind and civil, so that wasn’t a bad thing.

Lately, I’ve found that I just don’t have the patience to engage with people online, particularly when they’re strangers. Maybe it’s me, but it just seems like a lot of people are just nasty lately. It could have to do with how on edge we’ve been, thanks to COVID-19 and the lifestyle restrictions it’s led to. Or, it could be because people have lost the ability to be civilized, thanks to being behind computer screens too much. It could also be a combination of both conditions. Whatever the issue is, however, I’ve found that I’m just not interested in discussing it anymore. I don’t want to talk or hear about most things related to health… or really, the pandemic.

Actually, now that I think about it, I don’t want to engage with people about other subjects, either. This morning, I ran across an article about Andrew Yang and New York City’s carriage horses and how so many people are divided about it. Personally, I think the people who are claiming the carriage horses are being abused are overstating things a bit. I’ve also realized that most of the people with opinions about the horses don’t actually know anything about horses, or the people who work with them. Here’s a good, balanced read about the issue.

I read so many comments from people saying the carriage horses should just be retired and sent to a farm somewhere. I just want to ask these people how they would feel if, one day, some well-meaning but ignorant person told them that they shouldn’t be doing their job anymore because it’s “cruel”. Suddenly, they lose their purpose… but how many people can afford to keep horses as mere pets? And is a life consigned to being sent out to pasture really as good as it seems? I spent a lot of time with horses earlier in my life. They like having jobs, particularly when they’ve been bred to do something. Also, some people who keep horses shouldn’t be keeping horses… like– I would rather see a horse pulling a carriage in New York City than wind up on a farm owned by a hoarder.

A lot of the folks who complain about the carriage horses don’t realize that unwanted horses are sometimes auctioned off and bought by people who send them to Mexico or Canada to be slaughtered. It’s currently illegal to slaughter horses for meat in the United States. So the kill buyers will send them beyond the borders on long haul trucks, where they don’t get rest, proper food, or water; then they die a horrible death. Since they are companion animals, they aren’t even really suitable to be turned into food, either. I started to write about that this morning, but decided I just didn’t feel like it. I didn’t want to get into it with the uninformed, and frankly it’s a depressing subject. So I clicked off the article and practiced guitar, instead.

It just seems like people aren’t interested in having a civilized discussion. Everyone has opinions, and everyone thinks his or her opinions are correct, and fuck anyone with a different view. Those with an alternative viewpoint are shamed, belittled, berated, and name-called. It’s frustrating and ultimately pointless to engage with those types, so I just let them win… and let the more energetic people deal with them. I’ve got more important things to do, like scrubbing my butt crack.

I was feeling this way last year, too. This was what I posted a year ago on Facebook…

People are getting nastier lately. Three times in the last week, friends of friends who don’t know me at all have jumped down my throat for posting something they take offense to. They don’t even try to understand before they snap. Instead, it’s shoot first, ask questions later. It makes me hesitant to post comments on other people’s posts, because I can get snarky comments from so-called loved ones just as easily. I sure don’t need them from total strangers who don’t even know me.

I think it’s sad, because in my experience, most people truly aren’t bad people. If you take a minute to think before you respond with nastiness, you might end up making a friend instead making someone think you’re an asshole.

A year ago, COVID-19 was new, and there was a lot of rudeness going around on social media. It hasn’t changed much this year, although now that we’ve been vaccinated, maybe I can find something to do besides hang out online. Here’s hoping.

Standard