Tag Archives: discrimination

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the tide going out

I am thinking about the term “white trash” and choices.

Is “white trash” a discriminatory term? A derogatory term? Is it a type of person or is it a “lifestyle choice”? Or is it a sum of choices?

A friend tells me that it is not discriminatory. Not an insult. A lifestyle. Then the friend says, “Some people would assume that I am white trash because I live in a trailer (manufactured home) and don’t own my own land. I rent.”

Would this person be white trash to you? Does it make a difference if they are male or female? Over 60? Under 30? Single? Have children? Would you feel differently about a single male parent than a single female parent? Would you feel differently if they are widowed instead of divorced?

And at what age do we become responsible?

If I am a child growing up in a household with alcoholism, verbal abuse, parents with mental health issues or grave illness or abandonment, where is the line where I become responsible for myself?

I surveyed my smokers for years, what age did you start? The men mostly said age 9. There was more cultural pressure on women, but the youngest started at 11 or 12. And then the horrific stories, where the parent is offering whiskey to a child under 10. My sister and I wandered around peoples’ houses in the dark when we were under ten. She was three years younger. I was a kid who did not trust adults and was careful. Scared. So we did not get into drugs or alcohol and I hated my father’s unfiltered camels. My parents would not touch illegal drugs, thankfully. I took care of my sister, but we were entirely unsupervised in barns and houses and outside….

I think that our teens are making choices at far younger ages than parents want to admit. I see parents check out when the child is fourteen or even younger. Teens who are nearly living at friends. Teens who already seem lost. And sometimes the parent is wrapped up in a divorce or a parent is sick or dying or a parent is in jail or abandons the family.

What age did you make choices? Did you make good ones? And is white trash hate speech? If you made bad choices, were you able to change later on?

What is the line between free speech and hate speech? And what is the line between love and enabling?

I am still searching….


Over the Rhine: Fool and Let it fall

For the Daily Prompt: rhyme. No, it doesn’t rhyme. But I am thinking of the phrase: no rhyme or reason….

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Wall

This is for photrablogger’s Mundane Monday #94.

And bravo for this blog: https://safarfiertze.wordpress.com/2017/01/30/all-that-we-share/

and the Danes: https://youtu.be/jD8tjhVO1Tc  .

My paternal grandfather arrived as an immigrant from England. My father’s mother’s father was an immigrant from Scotland. My maternal uncle traces our family back to the Mayflower: immigrants.

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Bruise, muscle and bone

I asked an older patient recently, “What is a bruise?”

She thought about it and said, “I don’t know.”

A bruise is blood, bleeding. Old blood changes color and is reabsorbed by the body as it heals. But where does that blood come from?

Any tissue in the body can bleed. Even a tooth, if broken into the center.

So what is bleeding for MOST bruises?

Muscle. Muscle, muscle, muscle, tendon, ligament, fascia, occasionally bone if broken and internal organs can bleed as well.

Somehow we entirely fail to teach this, at least in the US.

If you fall, or like my mountain biking daughter, hit something, your body will bleed. I tried to train the mountain bike team to carry an ace wrap and use it any time they hit something hard with an extremity. I pretty much failed. Why do I want an ace wrap and why use it immediately?

Trauma or hitting something hard causes bleeding. The more the muscle and tissue bleeds, the more swollen it gets. Usually the peak of bleeding and swelling is at about 48 hours after the injury. By then the body is sending immune system cells and repair cells to fix the trauma. It is swollen, red, hot, inflamed and painful! If we ace wrap our ankle or foot or elbow immediately, the bleeding stops faster. Wrap it, ice and elevate to keep the bleeding down. The torn muscles are held in their normal position, the bleeding stops more quickly, there is less swelling, less redness, inflammation and pain!

Our acronym is RICE:
Rest
Ice
Compression
Elevation

There are things that you can’t ace wrap: don’t ace wrap your neck or ribs and if it’s bad trauma to the head, neck, chest or abdomon, go to the emergency room! But even then, ice and compression help. First check airway, breathing and circulation, that the heart is beating if you happen on a trauma. But then try to use pressure on bleeding.

Do not put heat on a bruise for that first 48 hours. Why? It bleeds more and swells more. The exception may be if you do much more exercise than usual without a localized injury: hydrate, stay away from alcohol and a hot tub or hot bath may help. The hydration and hot water help the muscles relax and wash out the CK, creatine kinase, the protein from tiny muscle traumas that make us “stiff”.

The I in RICE used to mean ibuprofen as well. However, ibuprofen and aspirin and naprosyn are all blood thinners, so they may help with pain and inflammation, but may make the bruising worse. Acetominophen is not a blood thinner and also doesn’t do as much for inflammation, but it may be a better choice. It does help with pain.

In her third year of mountain bike racing, the Introverted Thinker had a quarter size bruise on her knee after a race.

“Are you going to do anything about that bruise?” I asked.

“No, it’s small.” she said.

“Ok.”

Two hours later: “Mom? Would you look at my knee?” Now the bruise is the size of an orange.

“Hmmm. What are you going to do about that?”

“I think I might ace wrap it and ice it and put it up for a while. Where is the ace wrap?”

Good plan. It didn’t get any bigger.

I see the handouts from the emergency room given for back pain and they are terribly misleading. It shows the spine and talks about the discs. 99% of the back pain I see is NOT a disc: it is the six layers of back muscles, and complex web of tendons, muscles and ligaments that hold the spine together and let us move in very complex ways. I pull my Netter Anatomy out daily in clinic and show people the six layers of back muscles.

What happens after a muscle is torn and bruised and bleeding? The muscle cramps up to stop the bleeding and attempt to keep from being torn more. No, I don’t like muscle relaxers much as medicines and they are useless long term. For sleep only right after injury. I am not talking about major trauma, but back pain and injuries.

If the muscle heals in the cramped position, it won’t work right any more. It can form scar tissue. It takes about six weeks for a muscle or ligament or tendon tear to heal and during that time we need to gently stretch the muscles without tearing them, so that they heal in the right position. Once they are healed in a scarred position, it’s more work to rehabilitate them, but it can be done. Physical therapy, massage therapy, chiropractor, acupuncture, but the most important work is done BY the patient, not TO them. I can’t fix it with pills. Yes, it is work.

You can bruise bone too. Ow. The surface of the bone is living cells and the bones are continually torn down by osteoclasts and rebuilt by osteoblasts. The bone can be bruised without breaking. Again, 6 weeks to heal, little kids faster and 90 year olds kind of slow.

Take care of your muscles, ligaments and tendons, and they will take care of you.

 

I took the photograph on the first Mad as Hell Doctors tour for health care for all in 2009. I will be marching again today:  WE ARE ONE NATION! HEALTH CARE FOR ALL! NO DISCRIMINATION!  MEDICARE FOR ALL!

 

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The introverted thinker walks away

We go to our first parent teacher conference for our daughter. Kindergarten.

“Your daughter is unusual.” says the teacher.

“Mmmm.” I say.

“She is unusual on the playground. At recess. She will play with the other girls. But not if they are mean to someone. Not if they start ganging up. And it doesn’t matter who it is. She will walk away and play by herself.”

“Good.” I say.

“The other kids are realizing that she won’t tolerate any mean talk or ganging up.”

We make appropriate appreciative parental noises.

“She is influencing them. She doesn’t argue, she doesn’t say anything, she just walks away.”

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Advice to a college daughter

I am submitting this to the Daily Prompt: Careful.

I talked to a young woman recently who left the college that my daughter is going to.

And then I gave my daughter advice.

“If you are attacked or assaulted, sexually or otherwise, do not go to the campus police. Go to the city police. Or better yet, a State Trooper.”

Because, you see, the Campus Police work for the school. It is a conflict of interest.

If you are attacked, get a friend. Have them help you get to the City or State Police. Have them record your initial story on their cell phone. Have them photograph any injuries, torn clothes, you crying while you tell them. If you are raped, have your friend get you to the City or State Police and then to an emergency room for a rape kit. This is documentation of your story. Write out what happened the next day. Keep all of it. It is admissible in court. Name names. Tell every word that you can remember that the other person said. Try to figure out if there are any witnesses.

Because too many men lie. Men lie in our culture and the system dismisses what women and girls say, dismisses domestic violence, dismisses assault, dismisses rape. You do not want to be Cosbyed or Trumped. You will not stand for it. None of us should stand for it.

Fight back. Stand up. We will not tolerate this culture and we will make it stop.