Category Archives: discrimination

by

Daily Evil: A is for Anger

Welcome to April Blogging from A to Z.

A friend of mine died in February. She has known me since I was born, because she was in college with my parents. In fact, my father got arrested for having her graduation party, though it was thrown out of court. Knoxville, Tennessee, in 1963, and the problem with the party was that it was mixed race. Luckily there were no drugs and no minors drinking. I was the youngest minor, age 2. My mother was left with me, terrified that she could be lynched.

Anyhow, this friend is an artist, like and unlike my mother. I spoke to her daughter-in-law a few days ago and she says she is in the anger stage of grief. Yes, I know what she means. And new grief brings up all the old grief. How annoying. March 29 was the day my little sister died of cancer, so that all comes up too.

I keep reading that we should be positive. I hate it and I disagree. Sometimes we can grieve and go through stages of grief. Anger can be an indication that we are in a bad relationship or that we are being mistreated. Sometimes it is connected to old past anger, though, that needs to be cleared out. Have I succeeded with that? I don’t know.

Is anger evil? I do not believe any feelings are evil. Acting on them may be evil, but it’s complicated. Feelings are information, part of our senses. This doesn’t mean that we always interpret things correctly, so sometimes we need to check. “When you said this, I interpreted it this way. Is that what you meant?” I usually have to wait a week if I am upset about something, so I can have the feelings calm. I get better and better about not acting on anger. I do not mind feeling it.

A is for Adam and Eve as well. This is one of Helen Burling Ottaway’s etchings, titled “First Valentine”.

For the process of making an etching, read here. This is from 1982, number 29 out of 35, a limited edition each run and signed by the artist.

by

You will be labeled

If you get sick
with something the doctors don’t understand
you will be labeled
unstable
mental
bipolar
crazy.

They will try to drug you.

How do you tell
when they are right
and you are crazy
brain on fire
and when you aren’t?

Don’t ask me.
I’m a Family Practice doc
and I’m rural
and I’m a girl.

I’m the one they make fun of
in the medical schools.
“The rural doctor
transferred this patient.”

Yes we did.
Because we knew it was something
different
that needed more
than we had
in our small town
in our small hospital.

Once a neurosurgeon says,
“You are transferring the patient
because it’s Friday
and you don’t want to work
on the weekend.”
“She needs an MRI,” I say
“and we don’t have one.”
and transfer her anyway.
I call two days later.
After the MRI, she is in
the operating room
for a tumor in her spine.
He doesn’t call me back
but I hope he remembers.
I certainly do, after years
and years.

If you get sick
with something the doctors don’t understand
you will be labeled
unstable
mental
bipolar
crazy.

by

Theme for April: Daily Evil

I have been thinking in a desultory manner or perhaps not really thinking about the A to Z April Challenge. I want to have a whole month of my mother’s fabulous art, but what is my theme? Mothers? No. Women artists? No. Discrimination against women artists? Sigh, no. Oh! I read an article yesterday about how the negative and nasty headlines get the major clicks. Today I read another very nice kind blog post about putting something nice into the world. So that gives me my theme! My mother’s art and daily evil impulses.

Impulses, not actions. Don’t we all feel those nasty impulses? Now I am interested in my own theme: how does that tie into my mother’s art? You don’t know? I don’t know either, but I know that many of us have complex feelings about our mothers. You might too. What does her art reveal or what does it trigger in me? And you get to enjoy her art, while you react with prim or gleeful horror at the Daily Evil Art Impulse.

Happy April!

______________

The first photograph is of one of Helen Burling Ottaway’s watercolors. It is signed, matted and shrink wrapped. Date: 1996. She died of cancer in 2000. I do not know the title, but this is Lake Matinenda, in Ontario, Canada. My maternal family has land there and I have gone there since age 5 months.

For the Ragtag Daily Prompt: placid. Heh.

Ooooo and later:

by

Race

Embiggen my heart, Beloved
Embiggen all the hearts in all the people
so when they see race on a form,
they write “human” and mean it.
The distinctions fall away.
We are not afraid any more
that another human is other
and will take something away from us.
We each slide over on the crowded bus
and say, “Here. There is room for you, here.”

____________________

For the Ragtag Daily Prompt: embiggen.

by

As I was going to Washington, DC

As I was going to Washington, DC

I met insurance CEOs who said “Whee”!

500 Insurance CEOs said Weeee!

Have ten insurance plans EEEEEach!

Every plan has it’s own website!

Every plan is different, password for each site!

Every plan refuses coverage for different treatments, right?

Every plan demands prior authorization, doctor’s office up all night

If they refuse chemotherapy the doctor has to fight?

Prior auths, treatments, passwords, plans

Insurance companies, all those demands

As I was going to DC

How many passwords will I need?

______________________

For the Ragtag Daily Prompt: snail.

I was pricing health insurance in case I get well enough to work more. I can get an $800 a month with a $8000 deductible or a $1435 a month with a $2000 deductible. I would very much like to work part time treating Long Covid. But, ironically enough, looks like I can’t afford health insurance. It costs more than the malpractice would. Ironic, huh? It’s not like we need doctors. (I do not have a medical release yet anyhow, but time to do research. It’s making me gloomy.)

You know, if we do get Artificial Intelligence, it will take one look at the United States Medical non-system, decide we are insane, and wipe us out.

And honestly, when I was working for the hospital clinics, I thought the most brilliant person in our office was the woman who could extract a prior authorization from so many insurance companies. I would send the referral to print and half the time she would have it authorized by the time the patient got to the front desk. And why do we waste all that brilliance on giving health insurance companies a profit of 20 cents out of every dollar? That is $20,000,000 out of $100,000,000. Looks worse with bigger numbers, doesn’t it?

Physicians for a National Healthcare Program: https://pnhp.org/.

by

Small wounds

Small wounds over and over.

“The band is invited to Arizona. We’ll be on the radio. And I am trying to set up a recording.”

She keeps her eyes down. Tries not to hope. She has time, she could take time off. She has saved so much vacation, hoping. They would have to have someone stay with the kids.

“It’s going to be a great trip. I haven’t spent anything from the last big sale yet, been saving it for something like this. I was hoping we could record.”

She is wiping the counter slowly, over and over.

“That sale was amazing, just when I needed it. Debts paid and caught up.”

She works in the local government. Steady. It gives them health insurance. Secure retirement. Nothing spectacular. She turns to the sink, to rinse the cloth. The counter is clean enough. She isn’t going to think about it any more.

“That is great.” She tries not to hate the band. “At work–“

He is behind her and hugs her. “You are so great, here for me. We are going in three weeks. February. Perfect time for Arizona, I can’t wait for some sun.”

She tries to feel comforted by his hug and yields to it, as always. She is silent.

“Now make sure you don’t let the kids talk you into giving them too many things while we’re gone.”

She nods.

He kisses her head. He lets go and gets his guitar and coat. “Have a good weekend. I have to practice.” He is headed for the trailer, in the next county, alone for the weekend, to immerse in music.

She turns and watches as he leaves.

by

The happiest day of his life

When I was a preteen, I got my first Spiderman comic book. I was enthralled. A hero who had powers, but had a grandmother, responsibilities, made mistakes, felt guilt and confusion. I wanted this, not the princess crap. I did not want a prince to ride in and carry me off. I did not and don’t trust princes. The wedding being the happiest day of a woman’s life: what the hell? Is it the happiest day of the man’s life? If not why not? It’s important to the woman to be married to her love but not the man?

And anyhow, the Disney movies were very consistent. There were no good Disney Queens. The good ones died in childbirth, or were absent, or their ship went down. The stepmothers were evil. The princess career ended with marriage. Pregnancy either kills you or turns you evil. Actually, sex turns you evil if you are a female. That was the very clear Disney message judging by the animated features. Virgin girls are pure princesses but there are no adult female role models for years and years and years. By my preteens I wanted to drive my own wagon: I was not going to be taken care of, controlled, or left poor and with small children through divorce. I would have a career and children.

What IS the happiest day of a man’s life? Do we have any map of that? When they are promoted? When they buy twitter? When they are elected President? When they get married? Why do we have a happiest day for women (and is it the marriage or the sex?) but not for men?

In the romance novels, the man is usually older, “experienced”, rich, and has a reputation for seducing women. The woman is often a virgin, or she has a child because there was an evil man who she thought loved her, or the older man got her pregnant and she never told him. She knows it is true love because she is pure and yet is overcome by lust, so it must be true love. Snort. I have always thought this is stupid and silly. So men in the novels are experienced, have sex with lots of women, and then are carried away by lust that turns out to be true love with this woman? What about all the others? Did they think it was true love too? Or were they “bad” women, who had lust without true love? Impure, not virgins, not a “good” girl. Seems pretty confusing to me. Often the virgin gets pregnant because, hey, she is carried away by uncontrollable love, so of course she would not think about birth control. What is the experienced man thinking? Hey, let’s get this one pregnant, I’d like to pay child support? Oh, he’s carried away by uncontrollable love, but really now, you’d think after all that experience that he would use birth control. Apparently the rich experienced older seducer males are all morons when struck in the heart by true love. These books should be burned, really.

Anyhow, I was suspicious of the princess story and I wanted my own horse and armor and sword and I’ll fight my own dragons, thank you! I was much more interested in the super hero story, even though the superheroines were still pretty lame and likely to get killed off. Oh, and girlfriends get killed off. Gwen dying from fear during a fall: give me a break. Yuk. Made me glad she was dead if she was that much of a weakling. At least she couldn’t reproduce. I liked Mary Jane a whole lot more: feisty.

I wanted to be a superhero and still human, not a princess.

So what is the happiest day of a man’s life?

_____

The cat is Boa, not Sol Duc. Boa died at age 17 right before Covid-19 started.

by

Qia and the dark

This story is part of a series about a Balint group for angels. Balint groups are groups for physicians to get together and talk about cases that bother them. This often means facing their own biases and discriminatory feelings. I wrote this in January 2022. The current estimate of Long Covid is 10 to 30% of non hospitalized people. Which is huge and terrifying.

___________________________

“And really, it looks like at least half the population will get Omicron. The question,” says Qia, “is how much Long Haul it causes. If it causes 30-50%, like Delta, we are in serious trouble.”

The angels are silent.

“Do you think it will?”

“I am hoping for under 10%.” says Qia. “But of course I do not know.”

Silence again.

“Why do you go to WORST CASE?” snaps Algernon. His wings rustle.

Qia blinks at him slowly.

She thinks about it. “It is the safest place to start.”

Algernon frowns at her. Another angel slowly nods.

“If I start in the worst case scenario, I can face it. I have to think about it, work through it, plan for it. Then I can back off and hope for one of the less horrific scenarios.”

“You are WEIRD.” says Algernon.

Qia is annoyed. Her wings go bat and blood red.

“Word.” whispers a very young angel.

“WHY?” snaps Qia, “WHY NOT face the worst?”

“Most people never do,” says the moderator.

“What?” says Qia.

“Most people never face the worst. They don’t want to. They are terrified. They are scared. They do things to avoid thinking about it. They skip that step and just go straight to hope.”

Qia glares at her. The moderator smiles and her wings go black as pitch.

“We aren’t PEOPLE. We are ANGELS.” says Qia, nearly snarling.

Algernon laughs. “Yeah, well, some of us do not want to think about the worst either. That is Gawd(esses) job.”

Qia is doubly pissed off to be crying. “No, we have to think too.”

“Qia, I agree, but it is hard.” says the moderator. “That is why you have the job you have. Because you are willing to go straight to the dark.”

Qia has her face in her hands.

The angels surround her, soothing, and start to sing.

by

Conspiracy is easier than vulnerability and grief

“Our culture faces a flood of conspiracism” says the Atlantic Monthly.

My great Uncle forwards an article that says we are tracking along stages as we did to WWII.

I write back. No, I say, we are tracking towards WWI.

Because of Covid-19.

The problem with the pandemic is vulnerability and grief. It is difficult to be mature enough to accept vulnerability and grief. It is easier to find someone to blame and go after them. We can’t burn a virus, we can’t hang it in effigy, we can’t take it to court and give it the death penalty. Many people are terrified and do not want to feel vulnerable and do not want to grieve. So they fall into conspiracies: it is safer to believe that the pandemic is a lie, that alien lizards have taken over the US Government, that it is the fault of a country making it on purpose, or a race, or a religion. It is easier to believe that nanocomputers are being injected with the vaccine than to think about the number of dead. It is easier not to think about the number of dead, the terrifying randomness, to believe that this only affects people with preexisting conditions, or people who God wants to smite, or people the lizard aliens hate. Or that the whole thing is a lie.

We are mimicing the late 19 teens and early 1920s very well. A world pandemic. We have a war, that is not a world war. This time we have bombs capable of destroying current life on earth. We’d be left with tardigrades and those bacteria who live in the deep trenches in boiling water where the earth’s crust is thin. At least one of my friends thinks this might be a good thing.

We have just reached 8 billion people.

In London, the Black Death had a 50% kill rate in the 1400s. Half the people that got it died. It changed the world. Pandemics change the world. In this pandemic the death rate is about 1% or a little more. However, 10% to 30% of the people with Covid-19 have Long Covid. Today, Johns Hopkins says we are at 635 million people who have gotten Covid-19. 6.6 million or more are dead from it. Then we have between 65 million and 195 million people with Long Covid in the world.

We don’t know how long Long Covid lasts. We don’t know how to cure it. We do not know if we can cure it or if people will get better. We do not know, we do not know, we do not know.

Which is also terrifying. So the conspiracy and someone to hate or some group to hate or someone to fight is safer for many people.

Do not go there. We must grieve. We must help each other. We must face fear and not give in to it. We must not fall into the trap of the charismatic leader who will give us villains, who will lead us into a World War to distract us from our grief.

And from there into a world depression. Remember, the Roaring Twenties end with the worst depression the world has seen so far. Let us not repeat it, let us not beat it.

Peace you and blessings.

by

Navigating disability

I am having an interesting week regarding disability. Maybe it will make me a curmudgeon.

A woman says, “It must be difficult to be disabled, with your lungs.” I wear my oxygen to sing in chorus. I did the concert without the oxygen but had to drop some held notes at the end. I get goofy when I am hypoxic. I also write really strange rhyming songs when hypoxic, which I recorded.

I reply, “Well, my mother and father and sister are all dead, so by comparison I am doing well.”

She looked horrified. “ALL DEAD?”

“Yes.” I said.

Mother at 61, father 75 and sister at 49. Cancer, emphysema, cancer. I am so lucky that I don’t smoke and have always disliked sodas and thought that addictive things were very dangerous for me before I started college.

I also attended a Roam Echo Telemedicine yesterday, about Long Covid. WOW. It was EXCELLENT.

https://hsc.unm.edu/echo/partner-portal/echos-initiatives/long-covid-fatiguing-illness-recovery/

Yesterday’s program was given by an attorney, discussing disability. She was describing how the chart notes can damage a patient’s chances of obtaining disability and she gave us forms to help us document disability successfully.

She put the number of people with Long Haul Covid at 30% of the not hospitalized people.

Thirty percent. That is HUGE and damaging. I have heard numbers from 10-30%.

There were also physicians attending the Roam-Echo program who have Long Covid and are realizing that they can’t work to the level they did before. Some can’t work at all.

The panel recommended neuropsychiatric testing if the patient is having any trouble with memory or executive function or brain fog. Document, document, document.

Not only that, the previously taped programs are linked to the site above. So I can watch the rest of them. It is FREE and I get Continuing Medical Education from it.

I trained in Family Medicine from 1989-93 in medical school and residency 1993-96. When I was in school I got virtually no training on how to do disability paperwork. Or even how to tell if someone is disabled. The truth is that people do not want to be disabled. In our culture it is shameful and anyhow, social security disability is often $1000 per month. Try living on that. Unenviable.

It turns out that I am lucky or smart or some weird combination. I bought disability insurance way back in medical school and paid $1000 per year for 29 years. I used it twice before 2021. I was on bed rest for 3 months of preterm labor. My insurance doesn’t kick in until I have been off work for 3 months. I wrote them a letter and said I expected to return to work six weeks after having my child, unless there were complications. The company paid me for an extra week. I called them and basically they said, we are so happy to have you return to work that we do not care.

The second time was after my third pneumonia. Strep A and my lungs and muscles were trashed. Both burned like strep throat. It hurts. I was out for six months and then worked half of my usual for another six months. Really I was working about 1/4 of a regular Family Practice Physician. I was seeing 4-5 patients a day and then sleeping for 12 hours, exhausted. A “normal” load is 22 or more. Which is not really sustainable with today’s complex patients, but that is another essay. I had chronic fatigue, MECFS, as it’s now called, but I was in denial. I never got past 8-10 patients a day for the next seven years. I was also running my own small business and had continual hostility from the only hospital in the county. I was one of three independent practitioners. I really do not understand why they thought my tiny clinic was a threat, but whatever. They could grow up.

From 2014 to 2021, I asked any patient with upper respiratory symptoms or a cough to wear a mask for the visit and I masked too. I explained that if I got a fourth pneumonia, I would be disabled for Family Practice medicine. I hoped it wouldn’t happen. I masked the people with allergies too, because after all, you can have allergies AND a cold. When Covid-19 hit, my patients just rolled their eyes and wore the masks. I only ever had one man, a new patient, object. “I won’t wear a mask,” he said.

I said, “Sir, you don’t have to. But I won’t see you without a mask, so please leave and go to Urgent Care.” This was in my waiting room.

“You mean that!” he said.

“Yes I do. I get pneumonia, so that is a firm policy.”

He put on the mask.

I closed the clinic in early 2021. Covid-19 hit us too hard and we were a shoestring clinic anyhow, with 8-10 patients a day. I went to work in the next county. I kept walking into patient rooms where people had their masks off. I had pneumonia in five weeks.

So it goes.

My disability insurance is paying. I did have to hire an attorney to get the company to explain the policy rules clearly. I don’t speak legalese, I hate it, and I think that insurance companies will use any loophole they can find to get out of paying. So far I am lucky to have navigated this. Now I have to look over my policy again, because some policies change after two years of paying and they don’t have to pay if you can do ANY paid employment. It’s pretty clear that I can’t. I went for a beach walk yesterday and then crashed for a two hour nap and then slept 8 hours last night. Any labor, walking OR brain, will crash me. ME-CFS sucks. I think we will have a handle on it in another decade and it’s clear that it is an immune system response. Too late for my employment, though. Ah, well. I got 30 years in. I was annoyed because I was NOT planning to retire yet. I keep running in to people who say, “How do you like retirement?” “I didn’t retire. I am disabled by my fourth pneumonia and grumpy about it.” “Oh,” they say. I should do the social thing, “Love it!” but I’ve never been good at that anyhow. I joke that I tell the truth because I am often not believed, so why bother to lie?

At any rate, 10 or 30% of the people who have had unhospitalized Covid-19 is a huge number of people, and we do not know how long Long Covid will last or how to resolve it. Stay tuned. I hope it is less than a decade, but it will be a little while yet.

Prayers and blessings for all.

The photograph is the really beautiful agate I found yesterday. For the Ragtag Daily Prompt: curmudgeon.