I don’t want to talk about gun violence

Two things happened in the last week: 17 students at a Florida high school were killed by a 19 year old; and the policeman who killed Deborah Danner, a 66-year-old black woman with schizophrenia, in her own apartment, was acquitted of wrongdoing. Both of these situations involved someone with a gun killing someone who did not have a gun.

Both of these events were very upsetting to me, as was much of the response to them. If you are a member of that poorly defined group “people with mental illness” and are feeling isolated, stigmatized, and afraid for your own life right now in a culture where 1) all gun violence is blamed on “people with mental illness”, and 2) gun violence committed against a person with mental illness is considered totally fine, I see you and I’m right there with you.

I don’t want to write this post, but I feel I have to say something. It will probably be disorganized, because my brain is disorganized right now. I have so many thoughts about this, it’s hard to say anything. I’m furious for all the children who’ve been killed or traumatized by a school shooting; I’m furious for Deborah Danner and her family and all the mentally ill people who’ve been killed or traumatized by police violence; I’m terrified for my own child who is in a public school as I’m writing this. The fact that he’s so young makes little difference; who’s to say the next shooting won’t take place at a preschool?

A stranger came up to me a few days ago in a parking lot and asked if I would support armed security guards in schools. I said I would not. I don’t think more guns is the solution to this problem. I know that seeing an armed guard walking around my son’s school would make me feel less safe, not more safe.

I do support the teenagers who are marching and staging lie-ins right now to advocate for gun control, and I hope that in the future, they will be part of a movement to take back the government from the NRA and corporations and politicians.

“But you claim to be an anarchist! We can’t let the government have all the guns!” Excuse me, our government has nuclear weapons. Nobody with any number of semi-automatic rifles is going to win an armed conflict with the government.

This is what happens with violence, is that it escalates, and it escalates, and it escalates. You arm yourself, your opponent gets bigger and scarier weapons. So you get bigger and scarier weapons, and your opponent does too. That path leads to violence and death, not a just society. Those of us with radical ideals need to look for other, more subversive means.

No, I am not for more and more guns. I am not for unregulated, individualist vigilante “justice”, nor am I for a militarized police force without accountability to the people among whom they move. I do not support a registry of mentally ill people as a way to determine who can own a gun, and I do not support your second amendment right at all costs.

Part of this problem is a problem of trust. We all feel it, I think. I certainly do. We don’t trust each other. We don’t trust our neighbors. We don’t trust our government. Therefore, many people feel that they need guns in order to defend themselves against each other.

In a just society, I think, all gun users would be accountable to their communities. The guns would be communally owned, and the local community would decide which individuals might use them. The community would decide: the people that know each person, and are at risk for being shot by each person, would make that choice as a group, and would bear the consequences of their choice.

In this vision, any police that existed would also be gun users accountable to their communities.  If a policeman used a gun in a way that his community – not a judge – considered irresponsible, he would at the very least not be allowed to use a gun anymore.

If we could build strong, self-regulated, self-governing communities with shared political and economic power, how might our relationship to guns be different?


Some thoughts on Medicaid work requirements

This morning, the Trump administration announced that states that wish to impose work requirements for Medicaid recipients may do so. This is not at all surprising, but it is disturbing.

Now I’m not interested in the actual motivations of the people running the show, given that they are A) morally hopeless, and B) so deeply loathsome that one cannot even use garden-variety insults to describe them without feeling sorry for the object or body part being compared to them (I mean, really, what did an anus ever do that was so horrible?). However, the argument they offered for it is pretty interesting, so let’s talk about that.

You might think it would’ve been all about how they were concerned with reducing the deficit (you know, that thing they just increased last month with their giant tax cut for rich people). Actually, their motivation, according to them, is purely charitable: they are going to increase the mental well-being of poor people by making their health care benefits dependent on their employment status. Yes, really. Somebody said that with a straight face in front of reporters.

‘”Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries [by making it harder for them to get health care], and today’s announcement is a step in that direction,” said Seema Verma, the administrator of the federal Centers for Medicare and Medicaid Services.’

‘”Productive work and community engagement may improve health outcomes,” Brian Neale, the director of the federal Medicaid office, said.’

‘”This is not, as some would have you believe, a punitive action aimed at recipients,” said [Republican Governor Phil Bryant]. “It will actually help this population reap the rewards of a good job [or of a really crappy one that pays poverty wages and treats them like toilet paper, since that’s probably the only kind of job they’ll be able to get].”‘

NYT article

(bold portions are mine)

While there will be exemptions for children, elderly people, and people who are considered legally disabled, this requirement (in states that choose to implement it) will add an additional bureaucratic hurdle and make health care inaccessible for people who are not “legally disabled” but are nevertheless unable to work at the jobs actually available to them. In many cases, these will be people with mental conditions and/or health problems that are disabling but don’t meet the official criteria for disability. Withholding health care from these people is both immoral and counterproductive.

But oh! The administration is allowing for volunteer work and other forms of “community engagement” to fulfill the work requirement. So what’s bad about that? What’s bad about getting people engaged in their communities?

Well, nothing … I mean, community engagement is good. Work is also good. Not looking at the systemic obstacles to engaging in work and one’s communities, while simultaneously threatening people with poor health and maybe death if they don’t engage in those things, is not good.

What’s really toxic about this whole thing is its view of the person.

First, although Verma refers to “the soft bigotry of low expectations” of those who oppose who work requirements for Medicaid, it is those who support them who really have low expectations. They expect that people do not want to be active in their communities; that people do not want to work; that people do not want to be meaningfully occupied. I strongly suspect that most people actually do want these things, and that in most cases of unemployment and disengagement it is not a lack of desire that interferes or even necessarily a lack of ability, but a lack of opportunity.

Thus, Republicans are ostensibly trying to address a problem that doesn’t exist (lack of motivation) while ignoring the actual problem (lack of opportunity), which is largely a product of their own economic policies.

Furthermore, the belief that community engagement can somehow be measured by the government (this by people who claim to believe in less government), that one’s contributions to society can be quantified and deemed worthy or not worthy of medical care, is so toxic I am coughing on the fumes right now.

I believe that everybody should be housed, fed, clothed, and provided medical care, to the extent possible in a given society, because they are people living in that society. And then – THEN they can give back. Not the other way around. Take care of people’s basic needs, and they will seek out mental and spiritual fulfillment in the form of work and caregiving and volunteering and art and science and dialogue and meditation, and in so doing they will enrich their communities. It’s Maslow’s hierarchy of needs, people! The foundation is those basic, physical needs on which life depends. Family, self-esteem, creativity, risk-taking, all builds on that foundation. You can’t turn the pyramid upside down and expect it to balance.

What do you do when the government hates you (sing to tune of “Drunken Sailor”)

This administration – actually, the entire GOP with few exceptions – has been, and is, conducting a systematic campaign to dismantle protections and supports for people with disabilities. Of course, they have other targets as well – immigrants, people of color, Muslims, LGBTQ. But I’m going to focus on the disability aspect, because it doesn’t get as much attention, and of course, it has a very immediate effect on my life.

Let’s look at a list of changes the administration has made, or attempted to make, specifically targeting disabled people:

  • Block grant or per capita caps on Medicaid (attempted)
  • Allow health insurance to discriminate against/price out of the market people with preexisting conditions (attempted)
  • Destabilize the insurance markets so that only people with preexisting conditions will remain buying full insurance packages, at unaffordable prices (accomplished by executive order)
  • Cut Medicaid by trillions of dollars (in process – budget resolution passed by House and Senate)
  • Cut Medicare (in process – budget resolution passed by House and Senate)
  • Cut SSDI (in process – budget resolution passed by House and Senate)
  • Cut SSI (in process – budget resolution passed by House and Senate)
  • Weaken IDEA by getting rid of established guidelines for implementation (accomplished – rescinding of 72 Dear Colleague letters relating to special education)

Regarding the last one – the rescinded letters are already in the process of disappearing from the department of education’s website. You can find a list here: Dear Colleague Letters  Since last night, many of the links to the letters have become unavailable. There’s a good chance that by the time anyone reads this blog post, they will all be gone.

Remember when the White House page on disabilities mysteriously disappeared?

I wish I could muster up a bitter joke about all of this, but truthfully I see no humor in it. There’s nothing funny about the people in control of the government having it out for you and your child. There’s just a continual ebb and flow of anger, grief, and fear, and a persistent chill.

The White House says this is about trimming away unnecessary bureaucracy. That’s not what it is. I dislike bureaucracy as much as anyone (maybe more than most, since I have to deal with it every day in the medical and school systems), but this is simply a stripping away of protections and supports from a particularly vulnerable population. A population that has fought hard, for decades, to have these protections in the first place.

I can’t get my brain around this level of selfishness, greed, lack of empathy. Sometimes I find myself staring into space asking no one in particular “Why do they hate us so much? Why?”

In reality, they probably don’t even care enough about us to hate us. Hatred expends too much energy.

Not a fan of #MeToo

Trigger warning: Ironically, this post is about the need for trigger warnings.

My Facebook feed was flooded yesterday with “Me too” posts. Some had no details, others were graphic and triggering. Really the whole thing was triggering. I’m not sure what this campaign is going to do, other than trigger some already traumatized women to relive their experiences and/or become depressed. Or maybe it’s just me.

Yes, sexual abuse, harassment and assault is rampant. Why is the onus on women who’ve experienced these things, and survived them, to open up to the world about it in a very exposed, impersonal forum like Facebook or Twitter – possibly upsetting other survivors in the process? Who does that really help?

Don’t get me wrong. There’s bravery in sharing one’s story. There are survivors out there doing powerful advocacy work.

But this kind of viral media campaign isn’t that. Most of the women (and MEN – why aren’t male survivors being encouraged to join in?) who I personally know have complex PTSD from ongoing abuse, did not post, or simply copied and pasted the original post. Probably because to do more than that was too triggering. Or maybe they don’t want everyone to know what happened to them (and you know what? That’s OK too!).

Is it just me? I looked at my feed again this morning and immediately felt the panic and depression setting in …

Who is this helping? Who is it supposed to help?

And please, if you’re going to do this and post details, PUT A TRIGGER WARNING.

The opioid crisis scares me – but not for the reasons you think.

I’m very concerned about the rhetoric I’ve been hearing around the opioid crisis.

People who use opioids for chronic pain have been talking, for a while already, about doctors suddenly cutting their dose, dropping them as patients, or subjecting them to questioning every time they need a prescription refilled, due to the new guidelines and restrictions. As the opioid crisis is proclaimed to be a national emergency, people who live with disabling pain are being stigmatized as addicts and drug-seekers, even by the medical establishment on which they depend.

While there are some valid questions about whether opioids are the best way to treat chronic pain, this is absolutely the worst way to address that issue. Better ways would include improving access to medical marijuana and to therapies like acupuncture and biofeedback that are proven to reduce some types of chronic pain. But even if we were to do those things, there would still be some people who need opioids, and they shouldn’t be shamed for that.

But it’s not just about chronic pain. It’s also about acute pain – particularly acute pain in people with mental disorders and/or histories of psychiatric care. Like me.

When I read or hear things about doctors prescribing “a week’s or month’s worth” of Percocet after a major operation when a few days’ worth “should” have been “enough” – I think of the aftermath of my c-section. I had a particularly nasty type of c-section after a prolonged and painful labor. I was prescribed two weeks’ worth of Percocet, and I took every precious pill. And I needed every one.

I was also on high-dose ibuprofen, but the Percocet was what made the difference between functioning and not functioning. The Percocet meant I could get in and out of bed, with help, without fainting from pain. The Percocet meant I could walk without feeling like my abdomen was starting to tear open. The Percocet meant I could take a shower without ending up in a sobbing huddle on the floor (although I was still close to that at times). And it meant that I could visit my newborn son in the NICU, hold him, and pump milk for him.


I did not become addicted to Percocet. But according to articles like this one, I was highly at risk of doing so, because I have a longstanding mood disorder and I had severe postpartum depression after my c-section.

Furthermore, I currently take a benzodiazepine (low dose, PRN) for acute anxiety, and combining opioids with benzodiazepines increases the likelihood of an overdose.

All of which makes me wonder. In the future – as reaction to the opioid crisis intensifies – if I were to have a serious accident, or another major surgery, would I be denied an opioid medication, because of my history of depression? Would I be under-medicated for pain, because of my responsible use of a prescribed anxiety medication?

I am NOT suggesting that it’s not a good idea to label things or to warn patients about the danger of using both drugs at the same time. Awareness is good. Increased availability and quality of mental health treatment would also be good, not just for people who are already addicted, but for those who are at risk of self-medicating with pain medications because their insurance won’t cover a decent psychiatrist.

You know what else would be good? An economy that doesn’t constantly punish people by making them work longer hours for less pay and less benefits while their living expenses steadily increase, only to see their jobs one day disappear.

A caller brought up the economic aspect of the problem on an NPR program I heard last week. Bertha Madras, one of the five members of Trump’s commission on the opioid crisis, responded that the solution to difficult conditions is to work harder (because that worked for her), and that we have to change “a culture that normalizes chemical coping”.

Which, to me, sounds like a call for more stigma. Let’s stigmatize the poor so that they work harder. Let’s stigmatize addiction more. And how do you deliberately stigmatize “chemical coping” without worsening stigma for people who take psychiatric medicines, especially ones with addictive potential?

What I fear is a world in which a postpartum woman can’t hold her newborn because of poorly controlled pain, and is stigmatized as a drug-seeker when she asks for something more effective, because she has a psychiatric history. And I wish someone would talk about that.

Why poor people have iPhones

This post is dedicated to the asshole doctor who said on the radio this morning that Medicaid patients can afford copays because he sees them using iPhones in the waiting room.

Full disclosure: I don’t have an iPhone. I have a cell phone from the Paleolithic era which has never heard of the internet, takes smeary pictures that may or may not be images of human beings, and has absolutely no clue what to do with an emoticon. This is because I love-hate technology. I do have an iPad, sort of. The iPad, which was given to me by a relative, who bought it used, appears to be one of the first iPads ever made. Half the apps don’t work on it. I use it to entertain my autistic son during doctor’s appointments (it has some of his favorite videos downloaded) and to access the internet during his surgeries/hospital stays. It also serves as our family’s camera. My laptop is only a little bit broken; as long as the screen is at a certain angle, it works just fine.

I have, however, worked alongside other poor people who do have iPhones and I think I may be able to offer some explanation to those who are confused by this phenomenon. (Not that I’m the first person to explain it, but whatever. Obviously it needs to be said over and over.)

First of all, some people buy themselves an iPhone while employed and then lose their job and have to apply for Medicaid. The organization that instantly confiscates iPhones from people who’ve just lost their jobs or otherwise encountered hardship has not yet been invented, although I’m sure someone somewhere is working on it.

Other people, like my former coworkers, still have their jobs; their jobs just don’t pay them much of anything. Often, they are single moms (for a variety of extremely legitimate reasons). Sometimes they’re also supporting grandchildren or extended family. They are putting food on the table (possibly with help from SNAP or WIC), they are paying rent (possibly with help from Section 8), they are (mostly) paying the utilities, but paying for medical care is just beyond them. They are stretched to the financial breaking point. At any given time they are likely to have all of $3 in their checking account – if they have a checking account.

So what are these people doing with iPhones?

For many people, an iPhone serves as a cell phone AND a land line AND a computer AND a camera. Phone and internet are basically essential to maintaining a job in our society, and it’s actually cheaper to have an iPhone than to buy all of those things separately. The iPhone might be a gift or a hand-me-down from a relative, they may have bought it used from a friend, or it might be something that they thought about and decided was a good investment for their family. The iPhone might be the thing that helps them stay awake during 12 hour night shifts, or allows them to communicate via FaceTime with their teenage kids when they have 36 hours of back-to-back shifts at different jobs. (Yes, people do that. It’s insane, it’s probably dangerous, but they do, because they’re trying to survive and take care of their families.) And finally, handing that iPhone to their child might be the thing that saves their sanity on days when they feel utterly, utterly exhausted, and yet they still have to drag their children to an appointment with a shit doctor who is judging them from the moment they step into the waiting room.


I have things to say, I just can’t access them past all the rage. So, all I can really say is that with regard to myself, my son, and various other people that I love – I feel that our right to exist, to live, our worth as human beings is under attack by the government right now.

Shocker? Maybe, maybe not. I’ve just never felt it so keenly. I guess that says something about my own privilege.