Tag Archives: sexism

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Liar, liar

Liar, liar, pants on fire, nose is as long as a telephone wire.

Trigger warning: sexism, child abuse, dating, US culture. Kinda not tame.

The last guy I date, only we don’t date, is a liar.

It is a bit into Covid. He knows I’ve had three pneumonias and he texts. “Are you worried about this?”

“Heck, yeah. Of course.” Then I ask if we can talk on the phone.

We start doing distanced beach walks and talking. Talk, talk, talk. At first he has to lure me out.

“Want to go for a beach walk?”

“I dunno.”

“I made lunch.”

“Oh, then yes!”

He points out that I have food insecurity. He is annoyingly correct. By the end of any meal, I am checking to see if there is food for the next meal. It is automatic and dates to when I was a toddler.

We compared abusive childhoods. Really. Back to toddlers. He finally says, “You win.”

“What?” I am not trying to win.

“Your childhood was more abusive than mine.”

I think various unprintable words.

I start noticing lies. They are stupid lies, as far as I am concerned. They shut me up over time because there really is no reply except, “Uh, why are you lying? I am not believing any of that.”

He says he is really really smart. Ok, fine. He says he can read my mind. I do some attempt at a girlie modest shy face which probably more resembles a grimace. But he is deep in his dream lies and honestly, notices me less and less. When he says he can read my mind, I know he can’t, because he’d be horrified by the swearing and laughter.

He is the smartest one in the room, though, he says modestly, often people don’t realize it. I nod and keep looking for calcedony nodules, aka agates. He’s better at finding them than me. I am automatically competitive, but that’s on an upper level of my mind. At the deeper level I could care less.

I also do not care if he’s trying to impress me with his smarts. My feminist level laughs hysterically and thinks nasty nasty nasty thoughts. But I have a deeper level that can love most people. I keep that stuff hidden and I know he can’t read it. Though I can read him: not his mind, but my inner psychiatrist gets involved and wants to know, why does he lie? And he’s lying to himself, not me. I don’t believe a word, but I am interested. What is the goal, here? Why lie?

He had a perfect marriage. I can’t control my expression on THAT one. Uh, doesn’t exist, hon. Why THAT lie? It starts to sort out. Well, in a way it was perfect. Perfect for him. Not perfect for his wife. She was super super depressed. Guess none of that was his fault. Our absolutely sexist culture. And now I know why he is hanging out with me. I am depressed. But it is situational and temporary. I need to close my clinic and I still have a year on the lease. And I will go work temp doctoring, but it is risky. I may get pneumonia a fourth time and it could kill or disable me. So I cannot take the risk of closing early and paying off the lease as a temp. I have to work the year out and I am really down. He is looking for a depressed woman and I seem to fit the bill. And I am a doctor. Who better for a really smart male to control than a woman who is smart enough to become a doctor (but not as smart as him).

Well, it all blows up after a year. I close my clinic, go work as a temp, and keep walking in to rooms where patients have their masks off. It only takes me five week to get bad Covid, even though I am masked and even though I ask the clinic manager, the nurses, the medical assistants to have people keep their masks on. I am down and this time I need oxygen.

Pneumonia for me comes with tachycardia and the opposite of brain fog. The tachycardia makes me drop ten pounds in the first week and wires my brain like a rocket. I wake up in the morning anxious like that cartoon of the cat attached to the ceiling with all four paws and fur all on end.

He says, “Pneumonia makes your brain go faster.”

I say, “Nope.”

“No? What do you mean?”

I say, “My brain is the same speed as it always is. But when I have this, I can’t hide it.”

“I don’t like that idea at all.” Yeah, that is the moment when our relationship is done. By him, not me. For one thing, I am no longer depressed. For another, he is the smartest person in the room. But. My brain might be faster. He says, “I can follow what you say, but you don’t even take a breath when you switch from one topic to another and I can barely keep up.” Yeah, well, sorry. That’s why I bloody well hide it most of the time. Because our culture dislikes smart women A LOT. It’s okay, barely, for a woman to be a physician, but men don’t want to date them. They wouldn’t mind screwing them. My maternal uncle told my mother that he was looking for a wife, “But I don’t want a woman who is smarter than I am.” My mother snarled about my uncle for weeks. Go, mom.

So this guy was a liar. But maybe I was a liar too. I shut up once he started lying and I shut the gates and doors of the vast garden and jungle that is my mind. No entry to people lying to themselves. There is a public garden in my mind that they can visit, but the rest is closed, hidden, contains the entire ocean and the deep trench, and maybe the universe.

And I haven’t dated since. Because I can’t stand that the virginal disney princess girl mythos in our culture feeds the sexist child abusive Epstein and all the men with him. And bloody well don’t say, “But there are some men that aren’t like Epstein.” Yeah? Well then why aren’t they fighting the Epstein crowd to the death with guns and knives. Until all the men are protecting all the children, all the girls and all the boys, and the gay folk and lesbians and trans and different races and yeah, I expect you to model Kwan Yin and protect EVERYONE from being abused. Meanwhile, men can stay the heck away from me. And yes, you can substitute a lot of swears for the word heck.

For the Ragtag Daily Prompt: tame. I think this is not a tame subject.

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Hormones and rabbit holes

Medicine is confusing right now. Ok, it is always confusing because we try to base it on science and science is always changing. There are always special areas that are currently a mess. Hormones!

I speak to a patient recently who is female, premenopausal, and is getting hormone replacement therapy for hot flushes and not sleeping well from an outside source. The person wants me to order hormone tests. I do order hormone tests but not the ones she has in mind. I test a TSH, thyroid stimulating hormone, to see if she is low or high in thyroid.

She is thinking of me testing estrogen and progesterone and other related hormone levels. The party line from gynecology MDs and DOs is that these are not useful tests because women’s hormone levels are so varible. However, there are lots of naturopaths out there and functional medicine MDs and DOs who will test levels. Why is the patient asking ME to test them? Most of those naturopaths and functional medicine providers do not take insurance and charge cash. Also, insurance may not pay for them anyhow because the party line is that they aren’t useful. Why would the cash providers check levels? One reason is CASH. Another is to prescribe “bioequivalent hormone replacement”. Sounds natural, right? Well, the natural thing was for the hormones to stop at menopause and all of the hormones are either made in a laboratory from plant pre-estrogens or from pregnant mare urine, so bioequivalent seems to imply natural but it really isn’t. Pills do not grow on trees, they are made by humans in laboratories.

However, I question party lines, and off I go down the hormone rabbit hole. The current guidelines are that female hormone replacement, after menopause, should be lowest dose possible and only for a maximum of three years because of the increased risk of breast cancer. This doesn’t address my question: does premenopausal hormone replacement count as part of those three years? I may need to ask gynecology. I don’t think it counts. A woman is postmenopausal when she has had no periods for a year. Or had her ovaries removed. Or if she’s had a hysterectomy and still has her ovaries, a yearly follicle stimulating hormone and lutienizing hormone test. Both tests rise when the ovaries stop making hormones and eggs.

Also, there is another caveat. We know that when men are on opioids, the opioids can suppress their hormones and lower testosterone. Here is a paper: https://pubmed.ncbi.nlm.nih.gov/31511863/. Half the men studied in multiple studies had low testosterone when on chronic opioid therapy. 18429 subjects (patients) in 52 studies. That is a lot. Women studied? NONE. What? Yeah, none. Why? Here is part of the answer: about a decade ago I worked with the UW Telepain group and asked the head of the UW Pain clinic a question. “If opioids lower hormones in men, do they in women too?”

His reply, “I don’t know.”

“Have you ever tested a woman?”

“No.”

“Isn’t that sort of sexist?”

“Yes.”

So here I am, rechecking a decade later, and we still don’t know if giving women chronic opioids messes up their hormone levels. It would be more complicated and difficult to check women. We might have to do individual hormone baselines or something in premenopausal ones, say, 2 weeks after menses. Remember that for most of the history of medicine, clinical drug trials were only done in men, because, well, sexism. They said women could get pregnant. Yes, but then we gave the drugs to women who could get pregnant. Also, postmenopausal women can’t get pregnant. The whole thing seems stupid to me.

There is an interesting new finding here: https://neurosciencenews.com/estrogen-t-cells-pain-28548/ . Apparently in women, estrogen and progesterone work on receptors at the base of the spine to reduce pain signals using T cells, part of the immune system. The article says this doesn’t happen in men, but they were studying mice. The male mice didn’t seem to have worse pain after estrogen and progesterone were blocked. The female mice were in more pain. But wait, estrogen and progesterone are produced in men as a by product of making testosterone. Less than women, until menopause. Then the 70 year old man has more estrogen and progesterone than his postmenopausal wife. The article says that they don’t know why the receptors are in women and female mice (um, my intuitive guess would be childbirth and micebirth, right? Men don’t do that and women giving birth to a child after the first one sometimes say, “WHY did I want to do THIS again?” I think those receptors are so that women and mice can get through more than one pregnancy.) Now I need to read the article again because maybe men and male mice don’t have the receptors, even though they do have some estrogen and progesterone. Maybe they just don’t have enough estrogen and progesterone.

Maybe we can’t figure out women’s hormone because men aren’t smart enough, heh, heh. Yes, that is sexist right back at all those historical figures who didn’t study women.

At any rate, that still doesn’t answer my two questions: does premenopausal hormone replacement count towards the three year total beyond which hormone replacement increases the risk of breast cancer? And does chronic opioid treatment lower women’s hormone levels?

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For the Ragtag Daily Prompt: hormone.

I took the photograph of a Port Townsend rabbit in 2011.

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pig

This is a pig. It’s a pig in my house. I don’t remember where I acquired it.

I can’t tell what gender this pig is. I can’t tell and I don’t care and honestly, I am tired of gender. Don’t care.

So how about a language change. Instead of he/she has the balls/ovaries to get it done, I am going to say he/she has the genitals to get it done.

Because, see, I don’t care which kind of genitals they got, as long as they can get it done.

So there, gender warriors, I got the genitals to change my language.

Peace out.