Category Archives: Women’s Health

Getting an Abortion is the Same Thing as Getting a Tattoo (not really, but kind of)

I actively avoid talking about abortion (for the most part) because there’s too much of a risk that I’m going to have to explain why I believe we need to reframe this conversation as a human rights argument rather than a feminist issue. It’s a boring conversation.  See, I believe that a person should have the right to decide whether or not she wants an abortion/ terminate a pregnancy/ kill her unborn child/ get pregnant just for the fun of getting an abortion. I believe this because I believe that people should just be able to do whatever they want to the only thing they have total ownership of- their physical body. It shouldn’t be a women’s right to choose, it should be a human’s right to choose.

The only thing we have complete autonomy over is our body (For the purpose of this post, “body” includes the concept of the two-track, that is, that the body and mind/consciousness are integrated). You can’t deny that we are born into everything that we are- you had no choice in what you were born into. This is a pretty heddy concept, and its application is personal, spiritual, and political.

Ok, so try to follow me here: the only thing we are born with that we have 100% control over is our physical bodies. As infants we learn and choose to move our bodies, associate and experience love and happiness through the action of eye contact and coddling from others, cry and experience all the sensations that comes with that cry, etc. This is the human condition- the subjectivity of ourselves. Everything else we are born into and have no control over. We don’t have control over where we are physically born into (ie: Upper Middle Class America vs. Village in Nicaragua). We don’t have control over the family and living situation we’re born into: whether there are other kids in the house, or whether there’s a dog, or whether we having loving parents, or whether we have no loving parents. The ONLY thing we have control over is whether or not to wiggle our toes, to run around, to continuing being.

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From “obvious child” which is a good movie about abortion, i guess. i am in love with jenny slate for real tho.

So, if all that we have complete control over is what we can or can’t do in our subjective physical and cognitive experience, then shouldn’t everyone have a right to do whatever they want in those domains? Can’t we agree on the idea that we all deserve to live in a society where we can maximize our autonomy to the highest degree? To live in a society where we can cut our hair if we want, tattoo our bodies if we want, get a liver transplant if we want? Get a vasectomy if we want? And if you were born into this thing called life as a woman who is able to do this bodily function called reproducing, then shouldn’t the same principle apply and shouldn’t you be able to choose whether or not you want your body to reproduce?  

Right?

I’m not trying to minimize pregnancy to the same thing as getting a tattoo… but in theory… it kind is. Shouldn’t you decide whether or not you want to be pregnant?

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Oprah being intersectional and humancentric ❤

This is where I think 4th/intersectional feminism needs to step up and recognize that the women who have worked hard before us, those that made abortion a feminist issue because it was an issue that needed to be elevated in order to help push for women’s rights, did us good. Now though, the political and cultural environment has changed greatly and intersectionality means promotion of expanded inclusivity. Which means we need to use our similarities (Ie: being a freaking human) as strengths. Before, the act of choosing to have an abortion has been a women’s issue, because it affects women’s bodies, but this line between gender needs to eventually be broken in order to have an equitable way of understanding our political and cultural landscape. Now that women have more rights than ever, the way to making a better world is by changing our thoughts about the world, which I think means respecting everyone’s subjective experience. And it also means moving away towards the language which has kept us separate (Woman’s Right to Choose) to an inclusive way of understanding the issue on a broader scale (Human’s Right to Choose).

So yeah. I guess I just wrote this because it’s important that we get to do what we want to our bodies and I kind of just want to be able to get all the abortions I want for the heck of it.  

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Reflections on Growing as a Motherless Daughter

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Today is the 25th anniversary of my mother’s death. I had just turned 5 three weeks before she died in the hospital from cancer. My memories of her are scarce and sad, and I can count on one hand the actual number of times I remember her presence in my life. All of my memories are of her sick. I remember more of what happened the days after her death. Like on the day she died (or maybe it was one of the following days?), when I heard church bells ring and my half-sister (I am the only offspring of my father and mother) telling me that my mom now had her wings in heaven. Or the day that I went back to daycare after my mom’s death, and the teacher had told my classmates about what happened, and all the other little kids not knowing what to say to me. This type of response, not knowing how to react to me when people found out that my mom died when I was young, is typical of my life.

As a teenager, I would harness this uncomfortability from others for my own humor, as my own way to try to normalize the inevitable awkwardness that comes with the answer to questions about my mother that she was dead. I would automatically reply to the  “I’m so sorry”s with “it’s okay, you didn’t kill her”.  Or I’d make jokes, like that my mom is lazy and lays around all day… I guess these are coping mechanisms, even if they are a bit dark. I still think I was a funny kid. Anyways, I learned early, and had it exemplified throughout my life, that I was different, and my difference made other people feel uncomfortable, awkward, and sad. So I internalized this, and this unfortunately became part of my identity.

For years I didn’t think much about my mother, and that word, “mother”, still doesn’t have much of an emotional connection to me. As I’m growing older, and my friends have started to lose their own mothers, I realize my connection to my own mother is based on her absence in my life, and that’s okay. I have learned about my own strengths through my motherless experience, and there are anecdotal characteristics which undoubtedly connect me to her life. For instance, how I take pills- I put them way far back on my tongue. My dad is always astonished at this, as this is how my mom apparently took pills. So in ways like this, I am connected to her. I’m reminded how much I look like her every once in a while from people who knew her, which used to bother me, because I wasn’t her. But now, I realize that my resemblance to this dead woman that they loved might be comforting and a reminder of her life.

It has taken me YEARS, wait, scratch that, it has taken me DECADES to figure out my identity, to figure out my purpose, to figure out what it meant to be a girl, a young lady, and now a woman, without a mother. I tell my clients who have experienced any childhood trauma this: when you are a kid, and something crazy happens to you, like you lose your mom, your experience for the rest of your life is different than the other kid sitting next to you who didn’t lose their mom (or who wasn’t molested, or who didn’t witness family abuse, or who didn’t have an addict parent, etc. etc. etc.). So your experience of life is going to be based on an understanding of the world that is totally foreign than the norm. However, through examining your life, and working towards a goal of self-actualization, this experience can eventually be transformed into a “superpower”. Your perspective of life is different, perhaps a little wider, than others. Cultivating this power to see things differently, and to understand that your experience is different, is a long process, but the end result will serve you greater than the damage the loss caused.

I had a conversation with my father last year, and I don’t remember exactly what we were talking about, but something along the lines of him wishing that I had a mom to help me plan my wedding, and he felt sad about it. My response was that I had accepted my experience of not having a mother in my life years ago. I don’t know what it is to feel maternal love, and that’s okay! I’ve always known that I wouldn’t have a mom to help me pick out prom dresses or give me advice about boys or help me with whatever other things moms typically do. I think this still made him feel sad, but at least he could understand that my motherless experience is my experience- it is who I am.

I don’t really know why I felt the need to write (and share) this. I guess 25 years is a long time. I feel really sad for my friends who have lost their moms in the past few years. I also have always felt a strange and strong connection to other people who have lost their parents, or who were abandoned by their parents, especially if they were young when the loss happened. Growing up, I knew no other motherless daughters, so my identity was always mine for creating, exploring, and forming. As a kid, I would wish I had someone who could understand my motherless experience. I now can realize what an opportunity this is for me- to experience life in my own unique way, to understand that I have an understanding of the impermanence of life deeply rooted in my soul, as a bedrock of who I am, because it is my first memories.  I’m still growing as a motherless woman and forging an identity without a mother, and that’s okay. I know now that maybe my experience can help others, and even if not, I’m lucky to have a superpower of seeing life in a way that many others can’t fathom. And that’s a good thing.

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#METOO and Challenging the Patriarchy

I recently broke my number one rule about social media usage: don’t engage with people who aren’t willing to hear a different point of view. I took this stance about a year and a half ago and it’s been pretty beneficial to my mental health. I often see things posted on social media that irk me because I believe them not to be true, but I need to step back and recognize that the poster believes what they posted and that’s okay. Unless someone is soliciting feedback, I won’t engage, so most the time I brush off stupid facebook posts as just that- stupid. Now listen, I love talking about things I’m passionate about, and a large part of my interests are all things intersectional-feminism. I love engaging in real discussion IRL (this is one of the reasons why I miss graduate school so much), or as a proxy I will respond to comments on my blog or to direct messages, but these occurrences are few and far between lately. My practice of not engaging with people on Facebook has strengthened my own beliefs and values because I take the time to learn as much as I can about an issue so that I can write a cohesive and well thought-out blog post. Another one of my digital media rules is to write my blog with the only expectation being that it is self-serving to me. If other people read it, that’s way super cool, but the point of my blog is for my own catharsis, a placeholder for the discussions I often don’t get to have face to face.

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What a gross fat f*ck

So lately, all this stuff about Harvey Weinstein and the the #metoo campaign has got me a little bit optimistic because I think this is perfect timing to push for real pro-feminist measures, like Affirmative Consent. I know some people (mostly men from my observations) found all the #metoo posts surprising, but I think most women were pretty chill about it, since sexual harassment is part of the woman experience. I think the #metoo campaign has been pretty successful in getting the conversation really rolling, and opening up a lot of people’s eyes to the enormity that is sexual harassment and misogyny behavior.

This brings me to the stupid Facebook comment-discussion I had. Basically, the person was saying that if the victims of Weinstein knew about his predatory behavior than why did they choose to go to his hotel rooms? I tried to explain my understanding of what this might feel like, based on my own worldview and experiences as a woman. I tried explaining to this person that there still continues to exist a hierarchy in male/female relationships, not in all arenas, thank God, but in many areas and aspects of life. It’s sad and antiquated, but unfortunately they exist. I tried explaining how I could imagine that this power relationship probably continues to exist in Hollywood culture (just as these abuses are able to exist in any closed system that is self-serving), as it’s been passed down from generations before. Women still do not have equal power in a lot of institutions and systems, and Hollywood seems to be one..Weinstein’s behavior was normalized by never being questioned, and therefore it was validated and allowed to continue. Weinstein’s victims probably experienced cognitive dissonance when they were walking to the hotel room, but they were in the weaker position in this power imbalance where saying no had worse consequence than being coerced into sex.

I related this to my own experiences of dealing with this imbalance in male-female relationships. When I was 19, I worked full time in the service industry where the assistant manager was a creep. This assistant manager used to make offhand comments and would buy our uniform blouses a size too small. I would be as cold-shouldered as possible towards this man, but I watched many other female co-workers put up with him constantly making innuendos, hitting on them, commenting on their bodies, etc. I couldn’t stand up to him, because I needed my job, and I was in a work-culture where this behavior was tolerated. He made my schedule and I worked basically the same hours as he did, so had I tried to stand up, I knew there would probably be retaliation. I knew that it was wrong that I had to put up with this behavior, but I also knew that it was normalized and if I wanted to keep my job or at least keep my job as stress free as possible, then it would be best that I keep my mouth shut. Happy ending: he was eventually fired for other reasons. But here’s a takeaway: I didn’t even really realize that this was that big of a deal. Because it was totally normal and I had experienced instances like this before in my short life then, and I have continued to experience power inequalities over the next decade.

The person I had the facebook disagreement seemed to be most offended when I insinuated that he was victim blaming. He said that we don’t leave our cars unlocked in shady neighborhoods and then expect people to be shocked or feel bad for us when our car is stolen, and therefore we shouldn’t be shocked or feel bad for the women who went willingly to Harvey Weinstein’s hotel room since they knew his reputation. I explained to this person that I could understand his frustration about this seemingly double standard of accountability. Then I let my emotions get the best of me, and told him that I could understand how it’s hard to not blame the victim in these situations. I knew that this would stir the pot, but I felt it necessary to call out what his argument deduced to. The is a difference in these two examples based on their context- one exists without a power dynamic, one exists within a power dynamic. The problem isn’t Weinstein in this case, it is the SYSTEM that supports and normalizes this behavior which is the larger, overarching perpetrator. Patriarchy is the real problem, and even though these women knew about Weinstein’s reputation, they were still in a system that enabled such coercion.

See, this is the intersection that I care about in this whole thing. It’s not the sensationalism that there are so many abuses in Hollywood against those in lowered powered positions, which is horrific in itself, it’s the fact that we live in a Patriarchal society where such abuses of power can take place. Calling out abusers can be extremely empowering for victims, which is why I think the #metoo campaign has been so successful. Sadly though, acknowledging that sexual abuse is rampant will not change its pervasiveness if we continue to live passively in this system that supports inherited power relations between genders.

Our entire world history is a patriarchal one, and we’ve only just began to shift the locus of control on the continuum of power towards a more balanced society. Women haven’t even been voting for 100 years yet. Too often I observe areas where we are stuck in ingrained ways of thinking, and the solution is to reexamine these beliefs! Moving from a Patriarchal society to a more inclusive and intersectionally just one is going to take work, and it is going to take the type of momentum that the #metoo campaign had 100 times over. We have to reexamine how our society understands our own values, and then change our beliefs and behaviors based on these principles. And guys, we can do it. If we can all begin to envision a world where gender hierarchy doesn’t exist, then we can have a world where gender hierarchy doesn’t exist.

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Healthcare is Confusing Part III: The Uninsured and Serious and Terminal Illness

So, this is one of those mega questions that I think all of our discussions about how we pay for and organize healthcare should boil down to: How does someone who is uninsured pay for treatment for serious, progressive or terminal illness? Guys, this shouldn’t be a hard question. The answer should reflect the value and theoretical framework that our healthcare infrastructure is based on. But, no surprise here, this is not the case in America. Our currently healthcare system is not based on valuing health, but on valuing profit. American healthcare is concerned more about money made than lives saved, and the answer to this question isn’t easy or simple.

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I mean, it’s not that crazy of a premise these days. 

I’m a social worker at a free clinic for those who are working but are uninsured or underinsured. Rita (not her real name) came into my office a month ago. She had short, gelled and spikey brown hair, stood about 5’4” and couldn’t have weighed more than 100 pounds. She was wearing short sleeves that showed off her barbed wire tattoo around her right bicep and a faded rose on her left arm. She didn’t have an ounce of fat on her, and looked closer to 25 than her actual age of 45, with the exception of her tired eyes. She was the assistant manager of a local 24-hour gas station and once refused to give up her drawer to a man who was robbing the store. This didn’t surprise me.  Rita reminded me of a few tough women I’ve known in my life, a few women who have been through some real hardships in life, and I immediately liked her- I immediately cared about her.

As soon as she sat down, Rita warned me that she was “a bitch”, and started to tell me about herself. She just moved back to the city a year ago after spending the past five years with an abusive boyfriend, living in a trailer park in rural Pennsyltucky. Once she got the courage to leave, she moved into an apartment in a housing project that her elderly mother and deteriorating aunt lived in so that she could help take care of them. She loved her job as the assistant manager, especially finding and firing the “scumbag thieves” who stole from the store during their shift.

Rita’s gynecologist, who is a volunteer at our clinic referred her to me. “I found out two days ago have cervical cancer and I don’t have insurance”. My heart dropped. I asked her how she was dealing with this news, which she replied that she couldn’t do anything but keep up her normal routine. She hadn’t told the few people she had in her life- her aunt, mother, and co-workers, and wasn’t planning on telling them anytime soon. She had no support group and was trying to figure out what to do on her own. She explained further that she didn’t have insurance from her job- she started as part time and once she moved to full time status they never offered her health insurance. She would be able to enroll in two months when her job offered open enrollment, but even then, the actual coverage wouldn’t start until January 2018. The cancer was progressing fast and her doctor needed to start treatment now.

I didn’t know what to tell her. I knew she made too much to qualify for Medicaid, but I didn’t want to discourage her. I told her to go home and I would call her as soon as I could with a solution. The truth was that I had no idea what the solution would be and was overwhelmed thinking about how this woman who was so full of life was going to die because she couldn’t afford stupid insurance.

Luckily, the answer in this case scenario came easily enough. Pennsylvania’s Medicaid program contracts with The Healthy Women Program which offers a medical assistance to women diagnosed with breast or cervical cancer. The paper work was simple enough- send in 2016’s tax filings, proof of income for this year, and proof of the cancer. I made phone calls all day, and by 5:00 I was able to tell Rita that I had begun her application for medical assistance. I spoke with a representative from the managed care company, who The Healthy Women Program sub-contracts, after I filled out her application and was informed that the processing time would be 5-10 business days. I spent the next day completing the application for Rita, getting all of her paperwork in check, and pestering the Healthy Women Program to send the final application to the County Assistance Office for final approval. I checked in with Rita throughout all of this, and she was a fucking warrior. The weekend went by and Monday morning, Rita told me that her doctor informed her that she was going to need to get a procedure done ASAP and start treatment for the cancer- apparently, the cancer was worse than they originally thought. When I got off the phone with Rita, I got in my car and drove to the County Assistance Office to see what was going on with her application since no one had returned my phone calls. Luckily, I was able to speak with a reluctantly kind case worker and I pleaded for her to expedite Rita’s application. The case worker told me that they didn’t expedite any applications and she couldn’t talk to me at all about Rita’s application due to confidentiality, however the caseworker asked me for Rita’s phone number and called her right there to finish the application process. This caseworker didn’t have to do this, and I am so grateful that she listened to my pleas.

Rita was able to get medical assistance and started treatment by the end of the week. I’ve been keeping in touch with her, and she’s still working even though she’s really tired. She’s going to take FMLA, but wants to wait until she absolutely needs it. The cancer is progressing, but she’s not letting this get her down. I keep telling her that she’s a warrior, and she ends each phone call with thanking me for saving her life. I don’t know if Rita is going to live, but I’m so grateful that she was able to get treatment- it’s the happiest ending I could realistically picture of this scenario.

This wouldn’t have been a happy ending if Rita had a different type of cancer or any other serious or terminal illness. There wouldn’t have been a happy ending if Rita lived in a different state that didn’t have a program like the Healthy Women Program. Not to toot my own horn, but Rita was lucky to be referred to me- had she not had someone who was familiar with the confusing systems of American healthcare, and someone who would advocate for her, I guarantee her application wouldn’t have been processed so quickly. Rita got lucky that there was a program that could help her, and see, that’s the problem right there. No one should have to be “lucky” enough that their progressive illness is one of the few that is covered by specialized, state-administered, programs. Someone who is diagnosed with cervical cancer in Arkansas should be able to receive the same healthcare as a person who is diagnosed in Pennsylvania. People who are dying should automatically be eligible for medical assistance and obtaining this assistance shouldn’t be as complicated as it is now.

So, what is the answer to what happens to people who are uninsured and are diagnosed with a serious, progressive illness? There’s a small chance that there may be a specialized program to help pay for their specific illness. There’s also a small chance that they will be picked as out of thousands of other applications for a scholarship, grant, or charity care from large non-profits and foundations. There’s also a small chance that magic Jesus is gonna skateboard down from the heavens to lay hands and miraculously cure the person immediately. The more likely answer is that they person suffers and then dies. People who are uninsured are already unhealthier than those who are insured. Poor people are at a higher risk for serious illness than the middle class. People who are uninsured aren’t able to access preventative care, and thus will more likely have poor and deteriorating health. This is all such a bummer and such a fucking problem. This is the huge question that should be answered based on a collective value, but there are very few people of power who will admit that America healthcare values money over health. I don’t know what the answer is, and I pray that I don’t have to help anyone else in Rita’s situation who isn’t as lucky as she, but I know that I will, and that that patient is on their way.

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Healthcare is Confusing Part II: The Opioid Epidemic

I live in Northeastern Pennsylvania, an area that has been affected by drug addiction and rampant alcoholicism for as long as I can remember. I personally know more people who have died from drug overdoses than any other type of death. And almost all of these people were under the age of 35 when they died. I lost one of my best friends to a heroin overdose in 2008 when she was only 19 years old and a freshman at Penn State University. I lost a close family member to an overdose in 2011 who left four children and two grandchildren (along with many others who loved her creative and beautiful spark). My response to all of this is: Heroin (and prescription opioids) really suck.

There is no clear answer on what will end this “epidemic”. People are quick to make judgement on what should be done based on their personal worldview, which can be dangerous when forming any opinion. Recently, DAs have been charging people who have provided drugs that caused a person to overdose with homicide and manslaughter. I’ve been hearing the rallying cry crescendo over the past few months- “DEATH TO DRUG DEALERS!”.  In my opinion, although this may dissuade a few people to stop selling drugs, it isn’t the answer. And holding someone responsible (the person who sold the drugs) for the person who overdosed decision is an area that has the potential to create a dangerous precedent. We don’t hold gun owners responsible for people who kill themselves, right? We don’t jail Nabisco executives for those who died from diabetes or other sugar-causing illness, right? Now don’t get me twisted, I don’t think that we should be okay with people selling illegal drugs (or selling legal drugs illegally), but holding them responsible for this epidemic isn’t going to stop it, because it’s not looking at the real problem, the dangerousness of addiction, the availability of opioids, and both the lack of availability for drug and alcohol treatments and effective models to help people live sober lives after they’ve been addicted to drugs.

So what does the opioid epidemic actually look like? Someone only needs to visit the twin cities of Northeastern Pennsylvania, Scranton and Wilkes-Barre, to see an example of an area affected by addiction. People used to line up at a walk in Ready-Care clinic at 7am in downtown Scranton in order to be the first to get their script for Suboxone, a medicine akin to Methadone, which acts as the bridge between addiction (originally created for treating heroin addiction) and sobriety. The problem with Suboxone is that Suboxone has a high-risk potential for abuse, like all opioids. And, like all opioids in impoverished, rust belt cities, it is easy to get.

A few years ago, one of my friends was struggling with addiction to Suboxone and other opioids. Instead of the constant worry about getting in trouble for buying these drugs illegally, she wanted to get her own prescription for Suboxone. She also wanted to eventually get off of Suboxone, so having her own prescription would hopefully help her start the journey to living life without opioids. I ended up giving her a ride to a different walk-in clinic (about a mile from the one that people used to line up in front of), that appeared innocent and legitimate enough from the outside, but was actually just another pill-mill for those who wanted Suboxone. While in the waiting room, I spoke to a few other patients who were there for their “check up” with the doctor. I was told by one young man who was waiting for his routine check up to get his prescription filled, that all I needed to get a script of Suboxone for myself was to schedule an appointment (if I didn’t have insurance, that would be okay too, because the clinic had really good payment plans) and make sure I had some type of opioid/opiate in my system because they would give you a drug test. As long as your drug test came back showing that you had an opioid or opiate in your bloodstream to prove that you were addicted to an opioid/opiate, then they would start you on Suboxone. Easy as pie.

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Suboxone wrapper I found in my yard. It’s everywhere.

I was in shock. That’s all I needed to do? Just take a Vicodin or Percocet or whatever and bam!- I would have a script for a month for my own Suboxone. This really troubled me. My friend who I brought to the clinic was proof of how easy it was to get a script of Suboxone. That’s all she did- took a drug test that showed she had opioids/opiates in her system and she was all set. No more worrying about buying drugs illegally because now she could buy them legally. No type of psychotherapy or AA/NA attendance was required and her appointment with the doctor lasted less than 10 minutes. It was clear that this Ready-Care only cared about keeping their waiting room packed with drug seekers than actually trying to help these patients dying in addiction.

Now that was a few years ago, and I do know that the clinic where people used to wait in line outside was raided by the FBI and two doctors were charged with Medicaid fraud, conspiracy, theft by deception and insurance fraud for submitting false claims. They also directed unqualified people on their staff to write prescriptions for controlled substances. I guess this is  a start for holding prescribers accountable, but I’m not sure how much that will dissuade other doctors from over prescribing opioids and opiates. And as far as I know, the other clinic where I took my friend is still operating as a pill-mill.

The Center for Disease Control lists the number one group of people most at risk for heroin addiction are those already addicted to prescription pain relievers. We know that people who become addicted to their pain pills turn to heroin when they no longer can get their medication. To personalize this a little- think about all the people who used to wait outside the walk-in clinic I mentioned above that got raided. Once that raid happened, and those doctors were charged with fraud, the people who were dependent on getting their pain pills or Suboxone there had to find a new way to get their drugs- and when the medical institutions won’t provide them, there are drug dealers with heroin that will do the trick.

The Center for Disease Control lists the number one step for preventing heroin abuse by reducing prescription opioid abuse. The CDC calls on doctors to implement better prescription practices. Now this seems pretty logical, right? If doctors know how to better understand pain and treat pain in ways that don’t involve medication, or at least limited use of medicine, then of course the number of people abusing opioids and opiates will drop. However, I have observed that this is a real point of contention for doctors.

Back in May I held a panel discussion about opioid abuse in NEPA, with the focus on speaking about solutions. I had the Scranton Police Chief Graziano, Democratic State Senator for the 22nd District, Senator John Blake, and two direct practitioners who work with opioid and heroin abuse in our area- Doug Albertson and Ricardo Horn. The panel was very well attended, and I was so happy to get so many different people in a room together to talk about one of the biggest issues in Northeastern PA.  However, when the discussion started to move towards prescription practices, an attendee decided to take over the panel and made sure that those in attendance knew his opinion on the matter. He walked right up to the podium, took the microphone away from the professional moderator, and went on a rant for about 10 minutes. What he had to say really opened my eyes to the need for better prescription practices. He was a surgeon who works for a small hospital in rural Pennsylvania. His tirade included blaming the audience, and not physicians, for people abusing opioids (that didn’t go over too well- any “you people”, literal finger-pointed statements don’t tend to bring positive discourse). He went on and on about how doctors aren’t the problem, and that it’s the people who don’t throw out their unused medications who are the real contributors to the opioid epidemic. He went on to say that when patients want opioid prescriptions, he will give it to them, because he can’t risk having a patient fill out a patient satisfaction survey negatively. tBut again, he reiterated, that it wasn’t doctor’s faults for overprescribing pain meds.

I very rarely get mad. I’m a pretty calm person, and my anger has always manifested in sadness or self-destructive behaviors towards myself. But I can say truthfully that when that doctor took over my panel that I worked months on organizing, that I spent countless hours researching the epidemic in order to write the best discussion questions that I could, well, I was really mad. After his initial tirade, he continued to stand at the front of the room next to the panelists until I had to walk up and ask him to sit back down. After I calmed down a few days later, I was able to look back on the experience and saw how this doctor is a perfect example of what is wrong in our medical milieu when it comes to prescription practices. He refused to see himself, and fellow doctors, as adding to the problem in any aspect. He diligently defended himself, although there was no reason to do so- he was never under attack, in front of about 100 people. My theory now is that he needed to absolve himself by taking over my event. And I think this is where the real problem lies. No one likes to be wrong, especially when it comes to a serious issue like opioid addiction. No one wants to take any type of responsibility for being a potential factor that is adding to the problem. This doctor refused to see the part he and fellow doctors played in over-prescribing opioids, and that sucks. I really had to question the ethics of this doctor as well- he was more concerned with getting a positive patient satisfaction survey back than the safety of his patient.

The blame game doesn’t work. The doctor blamed everyone but himself for adding to the opioid epidemic, and I see a lot of doctors and physicians unwilling to look at how it might be beneficial if they changed their prescribing practices. Nothing changes if nothing changes, and that’s a scary fact when we’re talking about people’s lives. There is no easy answer to fixing the opioid crisis, however we must start to be honest about what works and what doesn’t work. This applies to all things healthcare (and I guess, all things in everything). We aren’t going to make any progress in reducing the amount of people addicted to opioids/heroin until we examine to why it’s so easy to get addicted in the first place.

Pill bottle

“You just got your wisdom tooth pulled? Here’s 45 vicodins, make sure you take them with food and fill out a positive patient survey, let me know if you need anymore!”

I think a good place to start to try and figure out how to combat the opioid crisis is what the  CDC recommends- looking at how we prescribe pain pills. One thing that I found very surprising and alarming is the minimal education students receive in med school about addiction. The Association for American Medical Colleges and the Liaison Committee on Medical Education (the accrediting body for Med Schools) have no clear requirement of hours for studying addiction. This is also true for other health provider trainings and education. I recently spoke to a physician assistant student who is in her last year whether she had any training on addiction or working with people with addiction. She told me that she thinks there might have been one lecture on the subject, but she couldn’t remember it. This is a big freaking problem.

We need our doctors and medical providers to understand addiction on a micro level, on a direct-practice level. They need to treat addiction and be aware of the potential for addiction risk in their patients. Medical schools need to increase and mandate hours of learning focused on addiction in their curriculum. Although opioids are obviously a money maker for Big Pharma, my hope is that one day we can treat addiction and pain in a holistic approach. Studies on mindfulness have recently shown how practices like mindful breathing and meditation can be effective for treating pain and in helping guide people towards a life without pain meds and addiction. Teaching patients about the risks of the medicine the doctors are prescribing can also be helpful so patients know what they might be getting themselves into. I hold a hope that one day healthcare in all of its aspects will embrace a holistic approach and look at how integrating the mind, body, and soul into treating pain is more effective than writing scripts after scripts for opioids.

When will any of this happen? When will we see any change? When will the line graph finally show a decline in overdoses and addiction? The answer is, I don’t know. But I think the only thing we can do is hold our prescribers accountable. How we do this is isn’t clear yet. But at least the conversation is starting, and that’s a good place to start.

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Healthcare is Confusing I: Medicaid 101

By far, one of my least favorite policy areas, one that I knew very little about until recently, one that I am only now really putting the time and effort in to understanding, is Healthcare. A little under a month ago I started my first post-graduation job and am now gainfully employed as the social worker/social care coordinator at a free clinic in Wilkes-Barre, PA. Thank you sweet, sweet universe for this job, I was getting a little nervous there for a while.

So, as it happens, when I graduated I was pretty positive that I didn’t want to be a medical social worker. I am overwhelmed by understanding my own chronic medical issues, I have some anxiety about hospitals, I hate, hate, hate blood (vasovagal syncoper here) and most bodily functions, and healthcare in general is fucking confusing and difficult to understand and navigate. BUT HOW THE UNIVERSE HAS A SUPREME SENSE OF HUMOR and here I am, the new social worker for a free clinic that only has like 5 people on payroll, but a reliable cohort of volunteer doctors, dentists, hygienists, nurses, and receptionists (but if you wanna volunteer, we need you). I actually love working at this clinic so far, even though it can be a little scary to think that we’re one of the only places that is available to working people who don’t have insurance. Luzerne County has a population of about 318,500 with an uninsured rate hovering around 14%... which means that about 44,600 people are uninsured in the county. That’s a lot of people who can’t get sick.

And within the short three and a half weeks that I’ve been employed, I have had meaningful experiences helping people see a dentist when their faces are writhed with pain from a toothache, the kind of pain that has kept them from sleeping over the past week, and I’ve gotten to help them get rid of some of the anxiety they’ve been plagued with not knowing how they would get help for their tooth without having health insurance.  I just started working with a woman from a religious sect that emphasizes the importance of motherhood, and she has been having fertility issues. I am determined to help her find a way for fertility treatments, even if she and her husband are at the 200% of federal poverty levels (PS: Here’s a spreadsheet of resources I’ve been putting together concerning fertility scholarships and information) So far, this seems like the job that I’m supposed to be at.

Anywho, I joined the mostly defunct Vox Weed’s Book Club, and the first book was “An American Sickness”. I read this May-June, and it really opened my eyes to the atrocities that have been able to take place under the guise of “better treatment”, when in all reality these treatments are overpriced and often unnecessary. Healthcare costs has become a burden to many, many people, including myself, so I figured now is the best time to really explore and learn as much as I can about the Healthcare Policy in the USofA. I meant to have this post out a few weeks ago when all the hubbub was happening in the Senate, but alas, life has been freaking busy lately. I figured though that it’d might be helpful if I did a little series on healthcare related stuff, since I’ve taken on the task of learning as much as I can about all things Healthcare. So hopefully this is helpful.

SO I thought I’d start with explaining Medicaid, what it is and what it does, and what the healthcare bills that were floating around would have done to these programs that legit keep people alive everyday.

doctor free use

“So Mr. and Mrs. Smith, we can’t help you because PA no longer covers pregnant women under Medicaid, but I can show you some helpful DIY blogs that can show you how to deliver your baby yourself”

  • All of the healthcare bills were an assault on Medicaid. Well, Chelsea, what exactly is Medicaid? Is it the same as Medicare? Or like, isn’t it kind of like Medicare? Or wait, isn’t Medicaid actually a part of Medicare?
    • Guys, no. And listen: I didn’t know any of this shit until very, very recently. This shit is complicated to learn about and its freaking boring. BUT THIS SHIT IS IMPORTANT. Okay soooo Medicaid is a FEDERAL program ADMINISTERED by STATES. So, what this means is that Medicaid gets money from the FEDERAL government (when we pay federal taxes, most of our money goes to building bombs, some of it goes to helping sick people by way of Medicaid). So how Medicaid’s financing structure is set up now is in a way that it can respond to need of the states (ie: say, one state coughPENNSYLVANIAcough has a growing elderly population- Medicaid responds to this need by allocating more money to cover the costs of taking care of the people who need nursing homes so we don’t have to worry about Nana dying alone on the street in the gutter).
  • OK- so who gets Medicaid? Back in the day, Medicaid was called Medical Assistance. I wish It was still known as MA because that would be way helpful for people learning the difference between Medicaid and Medicare, two terms that only differ by 2 letters. ANYWAYS. Medicaid differs by states in who they cover (this is what I mean when I say that it’s ADMINISTERED BY THE STATE), but it has to cover some percentage of low income people, pregnant women, people with disabilities, and the elderly in some capacity. This is a federal rule that all Medicaid programs have to subscribe to (what I mean when I say it’s a federal program). Ok. Moving on. You know when you hear about “states that expanded Medicaid under the ACA”? That actually translates to “States that widened the eligibility so more people could be covered”. So basically, how Medicaid is intended, is to help the most vulnerable of our society when they are in need of medical assistance. There is federal oversight, and states can decide on whether or not they want to expand who they cover.
  • What the healthcare bills proposed is that Medicaid could be covered under a block grant given to a state. A block grant is a set amount of money given to a state by the federal government and then the state uses it to administer a program. Congress would figure out how much money to give to each state. How they figure out this amount or what they will base it on is unclear. This is a problem in itself, because if there is a finite amount of money, then there is going to be difficulties deciding who will be eligible for coverage. Or, if the federal government says that states still have to cover the same people, the cost of their services will either need to have a lower reimbursement rate (fat chance), which will cause less doctors to take Medicaid, and cause a higher case load for those that are willing to take the lower reimbursement. Or, like I mentioned, States might just change who is eligible for health insurance (Medicaid) and figure out who’s life is more “valuable” (aka, cheaper to cover). For example, states will have to choose between situations like covering a 19 year old with cerebral palsy who is born to a single mother who makes $15,080 a year as a housekeeper at the local Hilton (that’s the current salary of someone who makes the federal minimum wage, working 40 hours a week, for 52 weeks, with no vacation, before taxes, and before other expenses) or the 87 year old woman with dementia, who needs 24 hour nursing care, who’s loved ones and family has all died off. These are the legit questions that we’re going to have to ask ourselves. It’s really fucked up, yo.

                Even though the bills seem currently dead (thank you, Senators Collins, Murkowski, and McCain for having a sliver of integrity and belief in bipartisan democracy) we know that nothing in the Trump administration is ever actually dead. Staying informed about the actual policies is what is the most important right now, and I hope that this helped demystify at least a little bit about Medicaid and the need to protect from block grants.

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Open Letter to Wilkes-Barre Township Police Department

wb township pd

Dear Captain Clark, Officer Godlewski, Patrolman Capparell, and the entire Wilkes-Barre Township Police Department,

I am very concerned about your lack of understanding of why posting a picture of a clothed man asking a topless woman, who is hiding her breasts with her hands, for a high five is in poor taste. I am worried about the character of the police force in Wilkes-Barre Township and am in disgust that by all accounts of the media’s reporting on this, that the Wilkes-Barre Township Police Department refuses to recognize why this type of behavior is unacceptable. I am shocked that you refuse to take in mind how sexually abused victims in your township feel and how their reluctance to report abuse is potentially heightened because of your inability to empathize.

It is not a matter of being “offended” by the meme. It’s a matter of missing the point of why posting the picture in the first place was wrong. It’s a matter of balking at people who disagree and instead of listening to why people are “offended”, offering up only other distasteful and dismissive responses to legitimate concerns. It’s a matter of not recognizing that there already exists a hierarchical relationship between victims and police officers, especially victims of abuse and police officers, that creates burdens to people seeking help.

Police officers are on the front lines in times of crisis and have the heavy and respected responsibility of helping those in vulnerable situations. Rape victims, sexual assault victims, child sexual abuse victims, these are all the types of people who need the services of police officers. Officer Godlewski mentioned in the Citizen Voice article that Facebook may be acting like a deterrent for criminals to commit crimes because they don’t want their faces plastered all over the internet. Well, the content you have been posting recently also acts as a deterrent for a different population, as now I, along with many other people I know and social service providers, do not feel comfortable around or referring abused clients to the Wilkes-Barre Township Police Force. I feel less safe around Wilkes-Barre Township Police Officers.

Your defense that you are not always going to please everyone and that the department’s utilization of social media is an opportunity to humanize the force is, in all actuality, extremely depressing and discouraging. The message you send online is that the Wilkes-Barre Police Department is a frathouse of sexist, chauvinistic, “good ole boys”. Your lack of willingness to listen to the people who saw the meme and expressed their concern is disturbing for the fact that you are police officers- you are the men and women who are supposed to help victims! Not help contribute to stigmatizing sexual assault and abuse victims!!!

I recognize that you have by far one of the most dangerous jobs in the world, and I am grateful for your service. Police officers are real life heroes. However, your police force recently has significantly change my opinion about the motivation of police officers and their understanding of victims’ issues. The worst part is, I have a feeling that you will read and ignore this letter or mock it, and won’t take responsibility for your actions. Your lack of apology and dismissiveness towards the situation speaks louder than any social media post.

 

Sincerely,

Chelsea T. Collins

Throop, PA

chelseataylorcollins@gmail.com

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It’s “International Women’s Day” For A Reason

international-womens-day

Just remember, it’s International Women’s Day, not United States of America Women’s Day.

A good measure of how individualistic we are as a country is demonstrated by our response to “International Woman’s Day” (which happens to be on Wednesday March 8th). I bet all the money in my bank account (roughly $112.23) that on International Women’s Day this year someone you know either posts online or says outright in conversation that women already have equal rights and that feminism is basically useless in a society that most claim to be utilitarian in nature. These ideas can’t be further from the truth, and I beg to claim that although American utilitarian virtues can eventually mobilize globally, we need straightforward approaches to making the world a better place for women, and to be confined to our borders as far as our actions go is both uneducated and harmful. We need to start thinking across borders and focusing on how we can help our sisters in countries that have yet to recognize the rights which we are afforded here in USA.

MLK famously said “An injustice anywhere is an injustice everywhere” or something along those lines (an injustice to anyone is an injustice to everyone? Is that the quote?). Anyways, that’s true. If there are shitty things happening across the globe, it is shitty to all of our human experience. So how do we react to this? What are we obligated to do when we hear that there is still female genital mutilation happening in African tribes? Or that in the Democratic Republic of Congo, rape is a common instrument of war?  How about the fact that honor killings continue to take place or that China practices femicide, purposely murdering baby girls after their born or aborting fetuses once the mother learns that she’s pregnant with a female child.

honourkilling protest

Women and men protesting honor killings, which are still commonplace in some areas of India. An honor killing is when a woman is killed if her family is unable to pay a large enough dowry or if she somehow shames her family and husband. It’s not uncommon for a woman who is raped to be murdered by her family in an honor killing. 

We have to think past what we are afforded and imagine this picture of life on a mass scale. Thinking big often gets me laughed at, but I’ll take it. I’d rather be laughed at imagining a better world then succumbing to the idea that the world has to be an awful place.  I also will argue that it is worse to pretend that atrocities don’t exist than to learn about them and ignore them. If you know these practices are happening, and you aren’t doing anything about it, how is it different than if FGM was happening in Kansas, rather than Africa, and you chose to ignore it? It’s not different. It might make us feel shitty that we aren’t actively working for an NGO, trying to educate tribe leaders to not pass down the custom of FGM, but not everyone can do that. There are other ways to act that are beneficial to making the world a better place for women.

So what can you do? 1.) Educate yourself and those around you. When people start to moan about International Women’s Day and how women have rights in America, tell them a little bit about why it’s so important that we think about this on a global level. Technology and communication has allowed us to become a global society, so we ought to start thinking about all aspect of society as such.

2.) Donate $5 right now to some type of womencentric organization. Here’s a few:

Planned Parenthood

Catherine McAuley Center

Working Group on Women’s Peace and Security

RAINN

Scranton Women’s Resource Center

3.) Educate yourself a little more. Make a commitment to follow one issue this year that you care about. I recommend using https://iwpr.org/ to find and follow efforts you care about. it’s also my current dream to work here, fyi if anyone knows anyone here who is hiring  ❤

 And if anyone comes at you about “International Women’s Day”, remind them that it’s not called “United States of American Women’s Day”.

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4th-Wave Feminism

find-4th-wave-logo-copy

4th wave feminism really isn’t that radical

There isn’t a ton on the internet about fourth wave feminism, so I wanted to throw my idea about this subject out there. I think this is especially important right now in our political context.

I wanted to write a little bit about this because I’ve encountered some third-wavers who believe it is sexist for a woman to not vote for Hillary Clinton. They believe that electing the first female to the white house will help conquer goals within their doctrine of third wave feminism

Under my belief, definition, and values of fourth-wave feminism, voting for a woman just because she is a woman is sexist.

Side Note: While searching the internet, I found more anti-women content in regards to fourth wave feminism. I forgot that there are people out there who are truly sexist to the core, which is so crazy to me.

Here’s my values as an American fourth-wave socialist feminist:

  • All genders and sexualities are equal
  • The 1st, 2nd, and 3rd wave feminists paved the path I walk on today.
  • Whoever is better fit for a job should get the job.
  •                 If there is a fitness test to be in first line of combat, and a woman fails it, then she shouldn’t be granted special opportunity to be in the first line. This only brings down the whole team.
  •                 If there is a man and woman who interview in front of a board of all men for an executive position, and the woman has a better work history and is the better candidate, than the woman should get the job.
  • Women need to support women
  • Men need to support women
  • Men and women have equal parenting rights. Men need to be just as responsible for their children as women.
  • A transparent patriarchy still exists which influences everything- our entire system of government, social norms, values, and all aspects of daily life.
  •                 This patriarchy is constantly changing and is symbiotic in nature to women’s advancement
  • There should not be an assumption that women want a family, to be mothers, or any other institutionalized gender roles
  • Women need to learn to validate themselves based on their minds, not their appearance. This underlining assumption of visual judgement needs to be destroyed so that it is not carried into future generations.
  • Men need to validate women based on their minds, not their physical appearance.
  •                 True progress will begin when women are not silently objectified by men and women
  • The goal of feminism if to have an equal playing field for men and women. Once we get to this point, feminism will no longer exist because there will no longer a need.
  • Feminist efforts cannot progress unless classism, racism, and all social conflicts are included in the efforts.

 

Ok. Short and sweet. Just thought I’d throw this up here since I’ve been thinking about it a lot lately.

feminism-red-fist

solidarity with other social justice issues is the only way 4th wave feminism can progress

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N.C.’s HB2 is Nasty, Smelly, Diarrhea Bullshit.

pepto bismol

NC Republicans and Gov. McCrory should provide everyone in NC a bottle of Pepto for all the bullshit they’re causing.

I can’t take this dumb transgender bathroom shite anymore. North Carolina’s HB2 “Public Public Securities and Facilities Act” AKA the Bathroom Bill is trying to make an issue out of a NON-ISSUE. This bathroom law isn’t about keeping sexually deviant predators from raping little girls, it’s about allowing businesses to actively discriminate against transgender people. Technically, in North Carolina, it is a LAW to discriminate against transgender people.

Anyone who is sporting the argument “I don’t want some ‘man in a dress’ coming into the ladies room and preying on young girls” is ignorant and insulting to the rest of humanity who aren’t idiots. I have to take a strong stand on this. It’s really bothersome and the amount of shit that trans people already have to deal with is so immense that I’ll never be able to comprehend. At least let them use the bathroom in peace.

I recently had the opportunity to attend The Commonwealth Medical College’s Fourth Annual Transgender Health Conference and it was really eye opening. As far as statistics go, transgender women of color experience the highest rate of being the victims of hate crimes and murder. Transgender people attempt suicide at rate of 14.1% as compared to the general population of 1.4%. Dare I say that there is an epidemic of suicide in the transcommunity that can be prevented with just a little bit of education for the rest of the general population?

Do you know a transwoman or transman? You probably do and don’t even know it. I’m so proud to have an aunt who is transgender and is an active advocate for the trans community. She is so intelligent, the highest ranking transwoman veteran(!), is beautiful, and a woman.   (Here’s her being dope af on MSNBC) If someone like her, who is a woman, is forced to use the men’s room she could be put into a very dangerous situation. I wouldn’t be surprised if there is an overlap in ignorance between the people who are pro-HB2 and perpetrators of crime against transgendered people. Really, how safe do you think transpeople feel already? And then to be forced into an intimate area, surrounded by people of the opposite sex?

I grew up in men’s bathrooms. My father raised me and if my dad couldn’t find a stranger woman who looked nice enough to take me to the bathroom (which in hindsight is probably more dangerous), then the only option would be for my dad to take me into the men’s room. I’m not psychologically fucked up from seeing men pee in nasty urinals as a little girl. As an adult woman, I have used the men’s room if the ladies room line is too long and I have yet to be assaulted in a public bathroom.

And what about the dudes who ate too much at Taco Bandito and make a gross mess in the bathroom? Do you want to see some pretty lady walking in and having to use the stall you were just in? I mean, how nasty is that? So freaking gross.

isis king

Do you really want beautiful Isis King to have to experience the dangers of using a mens room?

So what else is in HB2? Well, along with the bullshit bathroom stuff there is a provision that municipalities cannot raise the minimum wage to be HIGHER than the state’s current minimum wage of $7.25. HOW CRAZY IS THAT? Say you live in Random City, N.C. and the city votes and agrees to raise the minimum wage to $10.00, well you can’t because that’s against the law. Fucked up.

I’m a fan of the boycotts happening against HB2, but that isn’t enough. Educate yourself and others around you. Don’t be afraid to ask questions if you don’t know something. To willingly stay ignorant is as bad as active discrimination. Email Governor Pat McCrory and tell him to overturn HB2. Sign this Change Petition. Email all of the House Republicans in NC because they ALL voted in favor of HB2. Watch this really telling episode of Brothers that touches on public bathroom issues. Do whatever you can do. As my baby boy Senator Sanders likes to say “Change never comes from the top down, only from the bottom up”.

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