This has been an interesting week for me. Two stories have really caught my eye. One is of the Josh Duggar story about alleged child sexual assault and the other is about a kid in Canada who has plead guilty to a number of offenses, including swatting* (mostly) female gamers who had turned down his ingame friend requests.
*If you're not familiar with the concept of swatting, it's the act of tricking a 911 dispatcher into believing a critical incident is happening at someone's home or business. This can range from bomb threats to false reports of murder and hostages being at risk. This is a very dangerous situation, where residents are often alarmed to find a small army of well armed officers swarming their home where there is no actual danger present
The thing that ties these two stories together for me, the Duggar story (you can google it, I'd rather not rehash it here) and this angry kid who put others at risk for denying his friend request, is that I also recently read a great blog post that was a missive for parents of boys and what mothers and fathers can teach their sons about consent. It was pretty powerful and moving, and as the other of a girl, I can only hope that most parents are approaching their boys with the same mind. The blog post is here: What I Will Teach My Boys
When I linked the blog on the Book of Faces, a comment was made about how the Duggars didn't teach this to their son. But the truth of the matter, I believe, is this: no parent believes that they are raising a rapist. Or a swatter. Or a racist. I don't know any parent who, when you ask about their hopes for their child, responds with "I really hope that he hates and abuses women" or "I really hope that she judges entire groups of the population based on their skin color."
Look, I get it, we're all trying to do the best we can. We all have our biases and our judgments we make of other people and other groups of people. And our kids pick up on those biases. We may not think of ourselves as racist or homophobic or sexist, but we might say or do something we don't realize is hurtful, and our kids see nothing wrong with it.
And they internalize it.
And then, sometimes sooner and sometimes later, they externalize it.
Look, there are plenty of things I watch myself about when I'm around my kid. While I like to keep my language PG or better, I'm not always great about it. While I like to control my anger, I'm not fantastic about it. I'm human. But I would rather hear some choice four letter words slip from my daughter's lips than a racial or homophobic slur. I'd rather she express her anger with a shout here or there than a punch or a kick.
I struggle with controlling my anger daily. DAILY. That's not an exaggeration. I get angry at clean clothes on the floor, at toys tossed aside, at that selective hearing kids have, at her whining when things are clearly just not all that bad. I've slipped, and I'm not proud about it. I've made disparaging comments about my own body. I've expressed my anger in unhealthy ways. My kid has seen it. If I could take it back, I would. If I could trade all the precious things I own to clear her experience of my own failures as a mother and as a person, I would. In heartbeat, never doubt that.
The one thing I can say honestly, though, is that I have never feared talking about these issues with her: about how people get angry sometimes and lose their cool. How being angry doesn't justify acting out or throwing something across the room. We've talked about how hard it is to be honest, to be fair, to be in control. We've talked about how it's easier sometimes to yell or to lash out at people. And we've talked about how good it feels to be included and loved by a group of friends. And that need to be included sometimes leads us to make bad choices: to tell a joke that puts someone else down, to pick on someone who's an easy target, to do something you know is not okay when it comes to respecting body boundaries and autonomy.
Some would say that it's too soon, too grown up for her, after all, she's only nine. But at 9, she sees it already every day: kids picking on other kids, ideas of what is an acceptable body, alliances on the playground, and what her teacher refers to as "girl drama," among other things. She's heard foul language, she's watched TV that was maybe a little too scary or grown up for her. But she's also learned how to be compassionate, how to stand up for the undefended, how to accept people for who they are. She's learned to encourage her friends when their test scores are better than hers, rather than trying to tear them down to make herself feel better. She's learned to cheer for winners, even when they beat her (although that's a really really hard one we have to keep working on). She's learning to be a gracious winner (again, another tough one).
All of those amazing things she's learning and becoming aren't because we told her to be that way. It's because we have to try to be that way around her. We have to say things like please and thank you. We have to hold doors, to drive graciously (oof), to be good examples. We have to expose her to people with diverse points of view, with different traditions, with different examples of normal and allow her to see that we love those people and that it's okay not to look like or think like everyone else.
I sincerely hope and pray and believe that I'm not raising a racist. Or a homophobe. Or an abuser. But the only way I can be sure is to not only display normal, acceptable behavior, but also to point out bad behaviors (even in myself) and encourage her away from them. I have to be explicit about the things I've done wrong and what others have done wrong, and I have to be brave enough to admit when I've made mistakes and try to be better.
It's not enough to strive for the good. I have to admonish the bad, even in myself.
Friday, June 5, 2015
Monday, April 27, 2015
Just a Check Up
As you know. Or maybe you don't, I'm a primary care physician. Our office is obviously not your typical doctor's office, we are a Direct Primary Care (DPC) office. Here's the quick and dirty on how it works.
We file no insurance claims. You may have insurance (and about half of our patients do), but we won't file a claim for your visit, you have to pay it out of pocket. There are 2 choices for that:
--You can pay as you go: Our current price for an office visit is $68 for non members. It doesn't matter if you're a new patient or established patient, if you're not a wellness member, then it's $68 plus whatever labs or procedures you may require. Most of our labs are either $34 or $68 (we try to keep it pretty simple).
--You can become a wellness plan member. Wellness plan members pay a $20 scheduling fee for their office visits and get a number of services that are discounted or included in the price of membership. This includes the lab work for the complete physical, strep test, urinalysis, ECG, cryotherapy (freezing skin lesions), annual flu shot, etc. We also often waive other fees associated with shots or biopsies or laceration repairs, etc. We're awesome like that. Patients can buy the plan either by paying a monthly fee or paying a lump sum (the latter is a better value, by the way). The current 2015 price is $45/month or $499.
You may have already heard of offices doing something like this, and you know it as concierge medicine. This is not the same as concierge medicine. It's more like concierge medicine's younger, less expensive cousin. Concierge medicine usually costs several thousand dollars a year, gives you unfettered access to your physician at any hour by phone or email, and your physician only has a very very small number of patients that she cares for (maybe 200 or so, instead of 1500 to 2000 in the standard physician office). There are some aspects of either type of care that cross over: email interactions, telemedicine visits, longer visits, etc. But a concierge practice often will file insurance claims for visits, in addition to the monthly or annual fee (the average is around $200 per month, but some high end practices can charge up to $20,000 per month or more). In direct primary care (DPC), there are no insurance claims filed by the provider for visits.
Now, I tell you all of that so I can tell you this: once you're an adult, you might want to stop calling your doctor's office to schedule a "check up."
The problem with this line of thinking is that, other than for a child, I have no idea what a "check up" is. Certainly with small children and infants, there are a number of well-child checks that are indicated at 2, 4, 6, 9, 12, 18 and 24 months, and then annually through adolescence and puberty. Those are often referred to as check ups, which makes sense, as you're checking in to make sure a child is hitting all of his benchmarks for development (and getting vaccinations). We also take the opportunity at those visits for anticipatory counseling: talking about bike and water safety, risks associated with smoking and alcohol, answering questions about reproduction and STDs, reviewing possible dangerous behaviors.
However, for an adult, we're not developing anymore, so to speak. We've finished puberty and we're adults. That isn't to say that we don't change or develop problems as we age. We start encountering new issues like blood pressure, diabetes, cholesterol, reflux, arthritis, not to mention the various acute infections and injuries we all may sustain at some time or another in our life.
In my experience, patients often call our office for a "check up" because they either want to be seen for one of two things:
--There's a new problem, one that's usually been going on for a while (belly pain, headaches, skin changes, fatigue, etc). It's a new problem, but not exactly acute, like a sinus infection.
--The other thing people asking for a check up really are asking for is a physical. In these cases, especially for someone who hasn't been to the doctor in years, often it's because a friend became ill, an uncle had a heart attack, a parent was diagnosed with cancer, or a life insurance physical showed an abnormality and the person wants to be checked out. Something has spurred that person to make an appointment to make sure that he is "okay."
Most people don't realize that the differentiation matters, but to your doctor, it does. For a problem or sick visit, we're going to focus on the problem at hand. This may require lab or xrays, but it's very focused on that one problem. For a physical, the approach is more broad and the questions are going to be aimed and screening for common problems or chronic illnesses. Our approach is different, the visit goals are different.
In our office, I am pretty convinced that most people who call saying that they want a "check up" but not a physical are trying to avoid the price difference ($68 for a single office visit vs. $499 for a physical/wellness program). In a traditional office that files insurance claims, the difference can mean 100% covered preventative visit (your physical) versus a visit where the patient pays a copay or even the cost of the visit if she has a high deductible plan.
What's my point? Well, my point is that when you call your doctor's office and want to be seen, be clear about what you want. Are you ill? Are you having a problem you want addressed? Make that clear when you make the appointment. Or are you just more interested in general screening for things like cholesterol, sugar, blood pressure, kidney and liver function? If that's the case, then schedule a complete physical. This differentiation means that you and your doctor both have the same goals in mind for your visit.
The problem is that if a patient calls for a "check up" appointment, the implication is that there are no problems or concerns and it's just a screening visit. I've even had appointments with patients where they made it clear it was just a "check up" and then called back a week later to complain that I hadn't fixed their back pain or their belly pain that they did not tell me about. Be upfront with your doctor about your concerns and your goals. We can't read your mind, and as much as we want to remember every detail you've told us, sometimes we just don't.
Look, most of us are busy and we're on a budget. We don't like to waste time or money, or at least most people I know don't. So make the most of your time with your doctor. When you request an appointment, be honest about your expectations: are you concerned about a specific problem? If you are calling because you want a "check up" be honest with yourself and with the scheduler. Because that's what you're probably really asking for and calling it by a name may seem to give you a cheaper price, but it won't be the same thing, and ultimately you will be disappointed.
We file no insurance claims. You may have insurance (and about half of our patients do), but we won't file a claim for your visit, you have to pay it out of pocket. There are 2 choices for that:
--You can pay as you go: Our current price for an office visit is $68 for non members. It doesn't matter if you're a new patient or established patient, if you're not a wellness member, then it's $68 plus whatever labs or procedures you may require. Most of our labs are either $34 or $68 (we try to keep it pretty simple).
--You can become a wellness plan member. Wellness plan members pay a $20 scheduling fee for their office visits and get a number of services that are discounted or included in the price of membership. This includes the lab work for the complete physical, strep test, urinalysis, ECG, cryotherapy (freezing skin lesions), annual flu shot, etc. We also often waive other fees associated with shots or biopsies or laceration repairs, etc. We're awesome like that. Patients can buy the plan either by paying a monthly fee or paying a lump sum (the latter is a better value, by the way). The current 2015 price is $45/month or $499.
You may have already heard of offices doing something like this, and you know it as concierge medicine. This is not the same as concierge medicine. It's more like concierge medicine's younger, less expensive cousin. Concierge medicine usually costs several thousand dollars a year, gives you unfettered access to your physician at any hour by phone or email, and your physician only has a very very small number of patients that she cares for (maybe 200 or so, instead of 1500 to 2000 in the standard physician office). There are some aspects of either type of care that cross over: email interactions, telemedicine visits, longer visits, etc. But a concierge practice often will file insurance claims for visits, in addition to the monthly or annual fee (the average is around $200 per month, but some high end practices can charge up to $20,000 per month or more). In direct primary care (DPC), there are no insurance claims filed by the provider for visits.
Now, I tell you all of that so I can tell you this: once you're an adult, you might want to stop calling your doctor's office to schedule a "check up."
The problem with this line of thinking is that, other than for a child, I have no idea what a "check up" is. Certainly with small children and infants, there are a number of well-child checks that are indicated at 2, 4, 6, 9, 12, 18 and 24 months, and then annually through adolescence and puberty. Those are often referred to as check ups, which makes sense, as you're checking in to make sure a child is hitting all of his benchmarks for development (and getting vaccinations). We also take the opportunity at those visits for anticipatory counseling: talking about bike and water safety, risks associated with smoking and alcohol, answering questions about reproduction and STDs, reviewing possible dangerous behaviors.
However, for an adult, we're not developing anymore, so to speak. We've finished puberty and we're adults. That isn't to say that we don't change or develop problems as we age. We start encountering new issues like blood pressure, diabetes, cholesterol, reflux, arthritis, not to mention the various acute infections and injuries we all may sustain at some time or another in our life.
In my experience, patients often call our office for a "check up" because they either want to be seen for one of two things:
--There's a new problem, one that's usually been going on for a while (belly pain, headaches, skin changes, fatigue, etc). It's a new problem, but not exactly acute, like a sinus infection.
--The other thing people asking for a check up really are asking for is a physical. In these cases, especially for someone who hasn't been to the doctor in years, often it's because a friend became ill, an uncle had a heart attack, a parent was diagnosed with cancer, or a life insurance physical showed an abnormality and the person wants to be checked out. Something has spurred that person to make an appointment to make sure that he is "okay."
Most people don't realize that the differentiation matters, but to your doctor, it does. For a problem or sick visit, we're going to focus on the problem at hand. This may require lab or xrays, but it's very focused on that one problem. For a physical, the approach is more broad and the questions are going to be aimed and screening for common problems or chronic illnesses. Our approach is different, the visit goals are different.
In our office, I am pretty convinced that most people who call saying that they want a "check up" but not a physical are trying to avoid the price difference ($68 for a single office visit vs. $499 for a physical/wellness program). In a traditional office that files insurance claims, the difference can mean 100% covered preventative visit (your physical) versus a visit where the patient pays a copay or even the cost of the visit if she has a high deductible plan.
What's my point? Well, my point is that when you call your doctor's office and want to be seen, be clear about what you want. Are you ill? Are you having a problem you want addressed? Make that clear when you make the appointment. Or are you just more interested in general screening for things like cholesterol, sugar, blood pressure, kidney and liver function? If that's the case, then schedule a complete physical. This differentiation means that you and your doctor both have the same goals in mind for your visit.
The problem is that if a patient calls for a "check up" appointment, the implication is that there are no problems or concerns and it's just a screening visit. I've even had appointments with patients where they made it clear it was just a "check up" and then called back a week later to complain that I hadn't fixed their back pain or their belly pain that they did not tell me about. Be upfront with your doctor about your concerns and your goals. We can't read your mind, and as much as we want to remember every detail you've told us, sometimes we just don't.
Look, most of us are busy and we're on a budget. We don't like to waste time or money, or at least most people I know don't. So make the most of your time with your doctor. When you request an appointment, be honest about your expectations: are you concerned about a specific problem? If you are calling because you want a "check up" be honest with yourself and with the scheduler. Because that's what you're probably really asking for and calling it by a name may seem to give you a cheaper price, but it won't be the same thing, and ultimately you will be disappointed.
Saturday, April 4, 2015
Losing your friends
I got hit with a sledgehammer this week. I didn't realize it when it happened. Sort of like when you knock your arm on the door handle and don't realize how much it hurt you until a few days later when you see a really, really ugly bruise. Or no bruise appears but that place on your arm is unreasonably tender.
That's what happened to me.
My mom called me this week. Granted, I get a little nervous when I see a Montana area code on my phone. My dad had a stroke 5 years ago. We've had ups and downs since then, and secretly whenever my phone rings and it's a 406 number, I fear that it's "the call." If you're an adult, you know: that call when your mom calls to tell you that your dad is in the hospital. Or worse.
This time it was worse, but it wasn't my dad.
If you have known me for any significant period of time, you know that when I was 13, my 15 year old sister, Kate, died. In the wee hours of a February morning in 1985, my brother woke with a sore belly, asking my mom for help. She went to the kitchen to get him some Pepto Bismol, the universal remedy for all sick children everywhere in the 80s. While she was in the kitchen, she heard something in our garage. She walked through the kitchen door that led to the garage, and she saw something that I can't even imagine: the car running, the garage door dow, and her 15 year old daughter in a heap near the open driver door. My heart catches in my throat just writing that. As a mother, I can't imagine it.
She hit the garage door opener button to open the door, and she ran to the car, turning it off, all the while yelling for my dad. Before she could tend to her unconscious daughter on the floor, she passed out. My father called 911. He moved my mother inside the house and tried to revive my sister. EMS providers arrived.
In the meantime, I was downstairs, sleeping on a pull out couch bed with my best friend at the time, Amy, who had come to spend the weekend. Amy and I had become friends when our family lived in Laurel, MT, about 20 miles from Billings, where we lived at the time. When we moved from Laurel to Billings when I was in 4th grade, we would often spend weekends at one another's homes. This weekend, Amy was spending the weekend at our house. I was roused from sleep by an EMS worker who was checking my vital signs. He was telling me my sister was sick and that we needed to wake up and come upstairs. I stumbled on the stairs (probably because it was 4am and I had just been shaken from a dead sleep), so I got carried up the stairs and set on our living room couch and placed on oxygen. From my vantage point, I could see the lights from ambulances, I could hear large fans blowing in the garage. More importantly, I could hear my mother from her bedroom down the hall yelling and crying. "She's dead, isn't she? I know she's dead. Oh, God."
I had no idea what was happening. None.
To make an already too long story shorter, my sister died that night.
But this isn't about her. It's about her best friend. Marge Nicholson. She lived about 2 and a half blocks over if you took the trails. Kate and Marge were friends through junior high and high school Marge had an awesome Ford Cobra. It had a badass stereo. No, seriously, it was badass. Marge loved bands like Twisted Sister and Bon Jovi, and Ratt. She had all of their albums on cassette and blasted their music from that green sports car daily.
Kate rode to school with Marge every day. When I started junior high as a 7th grader, Kate and Marge were in 9th grade. True to form, I wasn't allowed to be seen with them. But I still got to ride to school with them. I think my mom made them take me along: if Kate didn't have to ride the bus, then neither did I. Once they moved into the high school, my junior high was literally on the way. So I still got to ride with them. I went from being the "stupid little sister" who should keep her distance to the cool kid getting a ride to school with high school kids in a badass car with a very very loud stereo. It was, I felt at the time, the one cool thing about me as an 8th grader. I had older friends who were awesome
Then, that night happened. Kate died. Everything changed. After a week of being out of school, when I came back people looked at me differently. I'm not sure if it was real or imagined, but I was different. Something was gone. I was that girl whose sister died. The 'cool kids' who had tortured me for being fat, for being a nerd, for being smart? They laid off. But the weight of being the girl whose sister had died, maybe even killed herself, was worse. I'd rather be the fat, smart nerd, somehow.
But in the coming weeks, some things happened. They were things that I didn't realize were important to helping me recover, to feel normal. Marge still gave me a ride to school every day. She asked me to come over and hang out with her occasionally (something she'd never done outside of Kate being there).
She took me with her to cruise the strip, as everyone who has lived in a small town has done on Friday or Saturday nights. She was interested in how I did in school. She asked me to come with her to clean out Kate's locker. We sat on the floor of that high school in the middle of the day. We cried over papers, pictures, books. We hugged. On the drive home, we saw him: the downtown Roller Skater. There was this guy in my home town who would put on brightly colored clothes (usually short shorts and a tank top), his headset and his skates and would just skate. He skated on the sidewalks, often doing dance routines to songs only he could hear. Stopped at a red light, he skated up past the car we were sitting in. We were raw, and I mean raw. We had cried our eyes out, were emotionally spent to the point where we could do nothing but ride in silence, ever aware of the box of Kate's high school experience in the back seat like a boulder weighing down the car and slowing our lives as we drove home. And the Skater flowed past us, arms and legs putting on his own gorgeous ballet for no one's benefit but his own. He reached up and grabbed the "Don't Walk" sign bar, and pulled himself up, while still dancing, and Marge and I? We lost it. We laughed, we watched, we missed the light turning green, but we couldn't bring ourselves to hit the gas: we had to watch this man literally dancing to the beat of his own drummer. He lifted us out of our mire into laughter and joy.
Over the next few years, Marge was my friend. She took me to my first 'R' rated movie, the Breakfast Club. She let me have my first real glass of wine (not the sips I got of my parents' glasses at holidays, but a whole glass poured just for me). She just loved and accepted me. I never, ever, not once in a million years would have accepted it or understood it. If you had asked me who my best friends were in junior high and high school were, until recently, I wouldn't have even thought to name her as one. It never occurred to me how much she anchored me, healed me, accepted me in ways none of my other friends could. They hadn't lost someone like I had. But Marge did. She understood. She'd lost a sister, too.
I regret every day that I never told her how integral she was to me staying sane for so long after Kate died. Every. Single. Day.
I regret it more now because of that call I mentioned earlier: Marge died earlier this week. Cancer. Fucking, goddamn cancer. Not only that, but the 2nd time for her. Seriously, what the actual fuck? Marge was a mother, a foster mother, a sister, an aunt, a wife, a friend. She was amazing. She loved in such a deep and wild and unabandoned way. She was, in a word, amazing.
And now she's gone. And the world is less, so very very much less for losing her.
And so am I.
So, Marge, I hope you get Wi-Fi in heaven, because I need you to know this one thing: you kept me sane, you loved me, you made me feel normal in a time when no 8th grade girl feels normal. Thank you, a million times over. Thank you. Rest well, dear friend, and I know when you meet God, he will say to you, "well done, my good and faithful servant."
To read her obituary, please click here
That's what happened to me.
My mom called me this week. Granted, I get a little nervous when I see a Montana area code on my phone. My dad had a stroke 5 years ago. We've had ups and downs since then, and secretly whenever my phone rings and it's a 406 number, I fear that it's "the call." If you're an adult, you know: that call when your mom calls to tell you that your dad is in the hospital. Or worse.
This time it was worse, but it wasn't my dad.
If you have known me for any significant period of time, you know that when I was 13, my 15 year old sister, Kate, died. In the wee hours of a February morning in 1985, my brother woke with a sore belly, asking my mom for help. She went to the kitchen to get him some Pepto Bismol, the universal remedy for all sick children everywhere in the 80s. While she was in the kitchen, she heard something in our garage. She walked through the kitchen door that led to the garage, and she saw something that I can't even imagine: the car running, the garage door dow, and her 15 year old daughter in a heap near the open driver door. My heart catches in my throat just writing that. As a mother, I can't imagine it.
She hit the garage door opener button to open the door, and she ran to the car, turning it off, all the while yelling for my dad. Before she could tend to her unconscious daughter on the floor, she passed out. My father called 911. He moved my mother inside the house and tried to revive my sister. EMS providers arrived.
In the meantime, I was downstairs, sleeping on a pull out couch bed with my best friend at the time, Amy, who had come to spend the weekend. Amy and I had become friends when our family lived in Laurel, MT, about 20 miles from Billings, where we lived at the time. When we moved from Laurel to Billings when I was in 4th grade, we would often spend weekends at one another's homes. This weekend, Amy was spending the weekend at our house. I was roused from sleep by an EMS worker who was checking my vital signs. He was telling me my sister was sick and that we needed to wake up and come upstairs. I stumbled on the stairs (probably because it was 4am and I had just been shaken from a dead sleep), so I got carried up the stairs and set on our living room couch and placed on oxygen. From my vantage point, I could see the lights from ambulances, I could hear large fans blowing in the garage. More importantly, I could hear my mother from her bedroom down the hall yelling and crying. "She's dead, isn't she? I know she's dead. Oh, God."
I had no idea what was happening. None.
To make an already too long story shorter, my sister died that night.
But this isn't about her. It's about her best friend. Marge Nicholson. She lived about 2 and a half blocks over if you took the trails. Kate and Marge were friends through junior high and high school Marge had an awesome Ford Cobra. It had a badass stereo. No, seriously, it was badass. Marge loved bands like Twisted Sister and Bon Jovi, and Ratt. She had all of their albums on cassette and blasted their music from that green sports car daily.
Kate rode to school with Marge every day. When I started junior high as a 7th grader, Kate and Marge were in 9th grade. True to form, I wasn't allowed to be seen with them. But I still got to ride to school with them. I think my mom made them take me along: if Kate didn't have to ride the bus, then neither did I. Once they moved into the high school, my junior high was literally on the way. So I still got to ride with them. I went from being the "stupid little sister" who should keep her distance to the cool kid getting a ride to school with high school kids in a badass car with a very very loud stereo. It was, I felt at the time, the one cool thing about me as an 8th grader. I had older friends who were awesome
Then, that night happened. Kate died. Everything changed. After a week of being out of school, when I came back people looked at me differently. I'm not sure if it was real or imagined, but I was different. Something was gone. I was that girl whose sister died. The 'cool kids' who had tortured me for being fat, for being a nerd, for being smart? They laid off. But the weight of being the girl whose sister had died, maybe even killed herself, was worse. I'd rather be the fat, smart nerd, somehow.
But in the coming weeks, some things happened. They were things that I didn't realize were important to helping me recover, to feel normal. Marge still gave me a ride to school every day. She asked me to come over and hang out with her occasionally (something she'd never done outside of Kate being there).
She took me with her to cruise the strip, as everyone who has lived in a small town has done on Friday or Saturday nights. She was interested in how I did in school. She asked me to come with her to clean out Kate's locker. We sat on the floor of that high school in the middle of the day. We cried over papers, pictures, books. We hugged. On the drive home, we saw him: the downtown Roller Skater. There was this guy in my home town who would put on brightly colored clothes (usually short shorts and a tank top), his headset and his skates and would just skate. He skated on the sidewalks, often doing dance routines to songs only he could hear. Stopped at a red light, he skated up past the car we were sitting in. We were raw, and I mean raw. We had cried our eyes out, were emotionally spent to the point where we could do nothing but ride in silence, ever aware of the box of Kate's high school experience in the back seat like a boulder weighing down the car and slowing our lives as we drove home. And the Skater flowed past us, arms and legs putting on his own gorgeous ballet for no one's benefit but his own. He reached up and grabbed the "Don't Walk" sign bar, and pulled himself up, while still dancing, and Marge and I? We lost it. We laughed, we watched, we missed the light turning green, but we couldn't bring ourselves to hit the gas: we had to watch this man literally dancing to the beat of his own drummer. He lifted us out of our mire into laughter and joy.
Over the next few years, Marge was my friend. She took me to my first 'R' rated movie, the Breakfast Club. She let me have my first real glass of wine (not the sips I got of my parents' glasses at holidays, but a whole glass poured just for me). She just loved and accepted me. I never, ever, not once in a million years would have accepted it or understood it. If you had asked me who my best friends were in junior high and high school were, until recently, I wouldn't have even thought to name her as one. It never occurred to me how much she anchored me, healed me, accepted me in ways none of my other friends could. They hadn't lost someone like I had. But Marge did. She understood. She'd lost a sister, too.
I regret every day that I never told her how integral she was to me staying sane for so long after Kate died. Every. Single. Day.
I regret it more now because of that call I mentioned earlier: Marge died earlier this week. Cancer. Fucking, goddamn cancer. Not only that, but the 2nd time for her. Seriously, what the actual fuck? Marge was a mother, a foster mother, a sister, an aunt, a wife, a friend. She was amazing. She loved in such a deep and wild and unabandoned way. She was, in a word, amazing.
And now she's gone. And the world is less, so very very much less for losing her.And so am I.
So, Marge, I hope you get Wi-Fi in heaven, because I need you to know this one thing: you kept me sane, you loved me, you made me feel normal in a time when no 8th grade girl feels normal. Thank you, a million times over. Thank you. Rest well, dear friend, and I know when you meet God, he will say to you, "well done, my good and faithful servant."
To read her obituary, please click here
Thursday, March 12, 2015
Human Connection
The article is linked HERE
Effectively, what Hari is suggesting in his study of the war on drugs and the nature of addiction is something that some of us may have already intuited, but isn't broad or common knowledge: addiction isn't a moral issue or a disease issue, it's a human connection issue.
...this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It's not you. It's your cage.
I'm not going to rehash the entire article, and I'm not going to review the book (I haven't read it yet, but it's on my list of books to read, so I'll probably tackle it in the coming weeks). I looked at the references list for both the article and the books, and it's impressive. This isn't a sweet starry eyed hopeful writing to inspire a Utopia; this is a guy who spent a lot of time digging and learning and researching, both in animal and human studies and experience. He seems to have put in a lot of work here to delineate things that most of us dealing with addicts have already seen: that people who have solid human connection and their basic needs being met do not struggle with addiction the same way as those who do not.
What was particularly interesting to me was the timing of seeing that article. I listen to NPR in the morning on the way to work and Morning Edition is currently doing a series on "What Shapes Health." This morning's story was about a woman in DC who is in subsidized housing and the various issues that she faces with her own and her family's health. The story was actually about a program called Health Leads. Health Leads is an organization that seeks to link hospital patients (particularly those with poor resources) to the resources they need in their community: food, housing, employment, etc. In finding patients the necessities of life, patients' overall health quality improves. This leads to less strain on the healthcare system and reduction in cost of that care.
These two stories on the same morning for me just drove home again something that should be intuitive, but is ignored more often than not: people who are secure in their necessities of life such as food, shelter and community are healthier people. This applies to all fields of health, from addiction to diabetes, from chronic pain to hypertension. People with healthy souls tend to have healthy bodies.
Unfortunately, providing for people's souls (I don't mean proselytizing to them here) can seem expensive. And human beings are petty: why are you giving her that free house? No one gave me anything free, I had to work for it! Mooches! Leeches! Takers! It's hard to convince someone who is working hard and barely scraping by that someone else who appears to be doing nothing deserves help. We're a petty and petulant people. We're vindictive. We've bought into the garbage of God helping those who help themselves. We don't like to admit that if you give people help, they're more likely to help themselves once they have the resources and the education to be able to do that.
I'm not sure what my point here is a line taken from the HuffPo article: The opposite of addiction isn't sobriety, it's human connection.
So many people are concerned about their money being wasted for layabouts who are just milking the system (or at least that's the image they've been given), when they don't realize that those same people, once given the resources to get shelter, food, meaningful work (even at a subsidized cost) reduces the other costs to society in so many ways: less addiction, less crime, less strain on an already stretched thin healthcare system.
Perhaps we could all work a little harder on making those human connections, rather than squabbling over what it may cost to connect people and make them healthier. I cannot help but believe that healthy people create a healthy community. Healthy communities make stronger societies. But maybe I'm just too shiny and naive. And thank God for that.
Tuesday, March 3, 2015
Has The World REALLY Changed?
Today, a friend directed me to a blog post from pitcher Curt Schilling.
You can find the blog post here: The world we live in, man has it changed
I'll sum it up here: Schilling, if you're not familiar is a bit of a loud mouth retired pitcher. He's right wing, he's got some pretty unsavory political views (my opinion, obviously). The guy doesn't believe in evolution, and "joked" that he'd been snubbed for the Baseball Hall of Fame because he's a republican. Just giving you a little background.
However, he's also a parent and a proud one. His daughter was accepted to college, and like a proud dad, he tweeted that she was accepted to play softball at a school. He was then inundated with the slime. What I mean by "the slime" is the rude, suggestive and downright disgusting things that people feel they are entitled to say to total strangers, particularly when those strangers are public figures.
The problem isn't that people were rude and disrespectful to him, that he can handle and has been handling for years. The issue is that this was all aimed at his young daughter. The tweets range from "can't wait to date her" to graphic threats of rape, gang rape and murder. And they didn't just tweet them at Schilling. Oh no, they tweeted them at his daughter. And they sent them to her as direct messages.
Now, Schilling is shocked--shocked, I tell you!- that this sort of behavior exists in the world and that it would be directed at his kid, and that they'd say it right out loud like that. He's suffered the slings and arrows of being in the public eye as social media has developed over the last couple of decades. He's had insults and likely a few threats here and there hurled at home for a long time. And he's cool with that. The problem with this situation is that he's a dude. And until social media trolls unleashed their slime on a woman close to him, his daughter, he just didn't believe that people said things like that. What he seems to miss in this situation is that this isn't actually about him, it's about her. And the way we, as a society, treat her for being a her. And people have been treating her--us--pretty horribly for a long time.
Women who speak up in public places (like social media, politics, business, etc) get this sort of abuse and threats of violence (usually sexual violence) every day on twitter. EVERY DAY. If the whole gamergate fiasco taught us nothing, it was that. But GG was hardly the starting point for abuse of women in social media, it just got more play in the news. Lindy West wrote a piece in December 2014 that expresses this fairly nicely for The Daily Dot. She wrote the piece after her own experience of trying to report abusers and harassers on Twitter (spoiler alert: Twitter did almost nothing).
This isn't about one father trying to protect his daughter, it's about allowing all 'other' people, in this case specifically women, to speak and exist freely on social media. It's about believing women when they report the abuse. Note that Schilling was never threatened with rape, only his daughter. This is about the toxic masculinity that we teach men, about the way we devalue girls and women for being female, and about the way that it's okay for men (and boys) to view women as objects and tools. In this case, Schilling's daughter was literally used as a tool to offend and shock him by threatening her.
Believe it or not, social media is an extension of our own societal views (like it or not) being expressed publicly. It's not about these specific guys, it's about the way that we think it's okay for men to treat and interact with women. The language these days is more graphic, that I will grant you. However, the truth is that the only thing that's really changed about the world isn't that men say these things or how graphically they say them. What's changed is that they can say it so loudly and so publicly. Social media has given everyone a megaphone. A re-tweet or favorite by someone with more than handful of users allows these sentiments to be expressed over and over again, revisiting a trauma or abuse on an intended target.
Maybe the world has changed: women and minorities are speaking up and speaking more. And the abusive language is getting more graphic and more intense. But if a guy like Schilling can experience it, and hopefully use it to honestly evaluate what led to his daughter being used as a tool or an object, and he can stand up for those women and minorities and their right to speak without threat, then the world will continue to change for the better.
You can find the blog post here: The world we live in, man has it changed
I'll sum it up here: Schilling, if you're not familiar is a bit of a loud mouth retired pitcher. He's right wing, he's got some pretty unsavory political views (my opinion, obviously). The guy doesn't believe in evolution, and "joked" that he'd been snubbed for the Baseball Hall of Fame because he's a republican. Just giving you a little background.
However, he's also a parent and a proud one. His daughter was accepted to college, and like a proud dad, he tweeted that she was accepted to play softball at a school. He was then inundated with the slime. What I mean by "the slime" is the rude, suggestive and downright disgusting things that people feel they are entitled to say to total strangers, particularly when those strangers are public figures.
The problem isn't that people were rude and disrespectful to him, that he can handle and has been handling for years. The issue is that this was all aimed at his young daughter. The tweets range from "can't wait to date her" to graphic threats of rape, gang rape and murder. And they didn't just tweet them at Schilling. Oh no, they tweeted them at his daughter. And they sent them to her as direct messages.
Now, Schilling is shocked--shocked, I tell you!- that this sort of behavior exists in the world and that it would be directed at his kid, and that they'd say it right out loud like that. He's suffered the slings and arrows of being in the public eye as social media has developed over the last couple of decades. He's had insults and likely a few threats here and there hurled at home for a long time. And he's cool with that. The problem with this situation is that he's a dude. And until social media trolls unleashed their slime on a woman close to him, his daughter, he just didn't believe that people said things like that. What he seems to miss in this situation is that this isn't actually about him, it's about her. And the way we, as a society, treat her for being a her. And people have been treating her--us--pretty horribly for a long time.
This isn't about one father trying to protect his daughter, it's about allowing all 'other' people, in this case specifically women, to speak and exist freely on social media. It's about believing women when they report the abuse. Note that Schilling was never threatened with rape, only his daughter. This is about the toxic masculinity that we teach men, about the way we devalue girls and women for being female, and about the way that it's okay for men (and boys) to view women as objects and tools. In this case, Schilling's daughter was literally used as a tool to offend and shock him by threatening her.
Believe it or not, social media is an extension of our own societal views (like it or not) being expressed publicly. It's not about these specific guys, it's about the way that we think it's okay for men to treat and interact with women. The language these days is more graphic, that I will grant you. However, the truth is that the only thing that's really changed about the world isn't that men say these things or how graphically they say them. What's changed is that they can say it so loudly and so publicly. Social media has given everyone a megaphone. A re-tweet or favorite by someone with more than handful of users allows these sentiments to be expressed over and over again, revisiting a trauma or abuse on an intended target.
Maybe the world has changed: women and minorities are speaking up and speaking more. And the abusive language is getting more graphic and more intense. But if a guy like Schilling can experience it, and hopefully use it to honestly evaluate what led to his daughter being used as a tool or an object, and he can stand up for those women and minorities and their right to speak without threat, then the world will continue to change for the better.
Tuesday, November 11, 2014
Moving away
So, after a number of years of owning the domain but never really updating my webpage, I've decided to move my main blog/website to my domain at www.keelamonster.com
So there won't be much in the way of posts around here.
Certainly there are plenty of things I really like about Blogspot, but I figure if I'm paying for the domain I should be using it.
I may post an occasional update here and there to remind you to go to the other site, but this blog will be pretty quiet.
I haven't decided if I'm moving my "Insights from my kid" blog over or not, we'll see how it goes with this one.
So there won't be much in the way of posts around here.
Certainly there are plenty of things I really like about Blogspot, but I figure if I'm paying for the domain I should be using it.
I may post an occasional update here and there to remind you to go to the other site, but this blog will be pretty quiet.
I haven't decided if I'm moving my "Insights from my kid" blog over or not, we'll see how it goes with this one.
Saturday, November 8, 2014
Better a Diamond With a Flaw than a Pebble Without
There is an aphorism among philosophers, often attributed to Voltair whose poem, La Begueule contains the line "In his writings, a wise Italian, says that the better is the enemy of the good."
This refers to what is commonly known as the principle of the golden mean, or the middle between extremes. An excellent example from Aristotlean thought would be that courage is a virtue, but its extreme, recklessness, can be dangerous. I bring this all up because I've been thinking about it since Blizzard announced the upcoming release of their new first person shooter style, team oriented game, Overwatch.
You can see the cinematic trailer for the game on Youtube here.
You can see the gameplay preview also on Youtube here
There are a couple of great things people are saying about this game:
It's all new intellectual property (IP). No recycled Starcraft, Diablo or Warcraft characters. No more Azeroth, Sanctuary or Koprulo Sector. This is a whole new place, new story and new characters.
And it's gorgeous.
The characters are rich, the roles are interesting, and I, for one, can't wait to play it. Blizzard is getting some great and well deserved initial feedback after introduction of the game concept at this year's BlizzCon. The one thing that seems to have really resonated among the folks in the circles I follow is that there are so many female characters.
Blizzard isn't the first game studio to put women in the game, obviously. But they very obviously made an effort to include a variety of playable female avatars in this environment of controversy, particularly on the heels of the Assassin's Creed fiasco of "animating female avatars is hard." And all of the GG foolishness (which I'm not going to recap here).
However, an interesting counter point has arisen to counter the praise being given to Blizzard for these characters and it's a valid one. Look carefully at the 5 female characters in the poster. I'll show you three of them here:
So, here's the problem: All 3 women have more or less the exact same body type. Impossibly tiny waists, obvious chests, pretty sexual in the way that they stand.
More women characters, but only one female body. I won't lie, it is a bit disappointing.
While I completely understand that games are an escape and I want to be something different or unusual while I play a game, it's disappointing that in many games, even in WoW, my only female options are an ideal of somehow a perfect female body.
I will probably never look like that. And that's okay. I can say that, because at 43, while my body is far from a perfect ideal of the female figure, it's mine, and it's brought me this far. It's taken me a very long time, but I finally love this body, even with all its imperfections. I also love the things about it that are great, and the things I'm improving all the time. Body acceptance is an important part of self acceptance, we all get that. And I'm not asking for games to give me a chunky middle aged lady gasping her way through a battleground (that certainly wouldn't fit with the story in any way). But, given that Overwatch also includes a simian style male, a robot and a dwarf, I'd like to see that variability given to the female characters as well. I think we all would.
Look, my username is based on an archetype of the girl who isn't really interested in role playing games but wants to play in order to spend time with the boy she likes, so she plays a healer. It's a longstanding joke in our family: my boyfriend at the time convinced me to try World of Warcraft, told me I could be his healer girlfriend. Given that I'm a physician in real life and was his girlfriend (now his wife), it was sort of the perfect joke on an archetype.
But here's the greater point, I do not dismiss this game out of hand, and I think that neither should you or anyone else. I do not think that it should be used as an argument that there really hasn't been progress in gaming (as seems to be what I'm seeing on the tweets by some pro-GG, anti-SJW types). It's actually quite the opposite: there are female avatars that are playable and they play very different roles (not just healer girlfriends).
So, yeah, what I would say about this game is pretty simple: Blizzard missed the target, but they hit the tree. And that is powerfully, meaningfully important. In arguing "yeah but the body type is inappropriate, it sucks!" we would be allowing the perfect to be the enemy of the good. So very much time is spent focusing on the extreme, we're missing the common middle.
Is Overwatch perfect? No. Is it striving to get there? Yes. And the journey is as important as the destination in many cases: that's where the growth happens. That's where the ideas change. That's where we learn to work together as a team. This game, and by no means is it the first to do so, is helping to take us down this path, and should be lauded for doing so. Should it stay here? Of course not, but this is the start, and this race is a marathon rather than a sprint.
This game is what I would certainly consider to be a flawed diamond, but a diamond nonetheless.
This refers to what is commonly known as the principle of the golden mean, or the middle between extremes. An excellent example from Aristotlean thought would be that courage is a virtue, but its extreme, recklessness, can be dangerous. I bring this all up because I've been thinking about it since Blizzard announced the upcoming release of their new first person shooter style, team oriented game, Overwatch.
You can see the cinematic trailer for the game on Youtube here.
You can see the gameplay preview also on Youtube here
There are a couple of great things people are saying about this game:
It's all new intellectual property (IP). No recycled Starcraft, Diablo or Warcraft characters. No more Azeroth, Sanctuary or Koprulo Sector. This is a whole new place, new story and new characters.
And it's gorgeous.
 |
| here's the final poster for the game (obviously (C) Blizzard) |
Blizzard isn't the first game studio to put women in the game, obviously. But they very obviously made an effort to include a variety of playable female avatars in this environment of controversy, particularly on the heels of the Assassin's Creed fiasco of "animating female avatars is hard." And all of the GG foolishness (which I'm not going to recap here).
However, an interesting counter point has arisen to counter the praise being given to Blizzard for these characters and it's a valid one. Look carefully at the 5 female characters in the poster. I'll show you three of them here:
So, here's the problem: All 3 women have more or less the exact same body type. Impossibly tiny waists, obvious chests, pretty sexual in the way that they stand.
More women characters, but only one female body. I won't lie, it is a bit disappointing.
While I completely understand that games are an escape and I want to be something different or unusual while I play a game, it's disappointing that in many games, even in WoW, my only female options are an ideal of somehow a perfect female body.
I will probably never look like that. And that's okay. I can say that, because at 43, while my body is far from a perfect ideal of the female figure, it's mine, and it's brought me this far. It's taken me a very long time, but I finally love this body, even with all its imperfections. I also love the things about it that are great, and the things I'm improving all the time. Body acceptance is an important part of self acceptance, we all get that. And I'm not asking for games to give me a chunky middle aged lady gasping her way through a battleground (that certainly wouldn't fit with the story in any way). But, given that Overwatch also includes a simian style male, a robot and a dwarf, I'd like to see that variability given to the female characters as well. I think we all would.
Look, my username is based on an archetype of the girl who isn't really interested in role playing games but wants to play in order to spend time with the boy she likes, so she plays a healer. It's a longstanding joke in our family: my boyfriend at the time convinced me to try World of Warcraft, told me I could be his healer girlfriend. Given that I'm a physician in real life and was his girlfriend (now his wife), it was sort of the perfect joke on an archetype.
But here's the greater point, I do not dismiss this game out of hand, and I think that neither should you or anyone else. I do not think that it should be used as an argument that there really hasn't been progress in gaming (as seems to be what I'm seeing on the tweets by some pro-GG, anti-SJW types). It's actually quite the opposite: there are female avatars that are playable and they play very different roles (not just healer girlfriends).
So, yeah, what I would say about this game is pretty simple: Blizzard missed the target, but they hit the tree. And that is powerfully, meaningfully important. In arguing "yeah but the body type is inappropriate, it sucks!" we would be allowing the perfect to be the enemy of the good. So very much time is spent focusing on the extreme, we're missing the common middle.
Is Overwatch perfect? No. Is it striving to get there? Yes. And the journey is as important as the destination in many cases: that's where the growth happens. That's where the ideas change. That's where we learn to work together as a team. This game, and by no means is it the first to do so, is helping to take us down this path, and should be lauded for doing so. Should it stay here? Of course not, but this is the start, and this race is a marathon rather than a sprint.
This game is what I would certainly consider to be a flawed diamond, but a diamond nonetheless.
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