Psyched Out

My Master's Social Work student organization threw a campus election party. Technically it was bipartisan but even most Republican social workers wanted a social worker elected president. :)

About a third of the people attending were African American. I was literally jumping up and down and laughing in gratitude and relief when California was confirmed and Obama became the President Elect. But my joy was NOTHING compared to the heartfelt ecstasy of my AA peers. There were hugs, tears, shouts, prayers of thanksgiving, dancing, wide eyes, cell phone calls to grandparents and relatives overseas and siblings and friends, quotes and an electricity in the air that I have never felt before and never expect to feel again.

Hope. Vindication. Thrill. Community. Idealism. Commitment. Patriotism.

Because Democrats can be patriots too.

Yes we can.

Help! Wellness fever has overtaken my workplace, an outpatient psychiatric agency for the severely mentally ill. It is promoted and funded by the manufacturer of one of the atypical antipsychotics which certainly cause significant weight gain without a change in eating habits, and appear to kindle diabetes in people with genetic or health elated predisposition. (ie: I wouldn't take them if I had pancreatitis). The wellness program and its medical supporters claim that both weight and the majority of chronic illnesses can be cured and/or entirely prevented by diet and exercise. As you are well aware, this is simply untrue and not evidence based in the least. My agency touts itself as evidence based, but nobody is looking at the evidence.

For example, one of our nurses presented on "diabesity" in a mandatory meeting. She claimed that the CDC (which she cited on a slide but did not recognize by initials or full name when I cited the finding there that "overweight" BMI is correlated to lower mortality than "healthy weight") proved that 70% of people die from entirely preventable chronic diseases. I asked what diseases those might be, and she said diabetes, hypertension, asthma, cancer and heart attacks are all preventable by a healthy diet and exercise. I asked her for citations or even verbal scientific sources, and she had none, just kept spouting misinformation. I clarified that she was saying that all heart attacks are preventable in this way, and she said yes. I pointed out that every heart quits beating at some point, and that this is in fact not preventable. At all. She just ignored me

Then the pharmaceutical rep introduced their new wellness program, which we are expected not only to enroll in ourselves, but enroll our patients in as well. And everything suddenly made sense. It's a liability defense ploy. If the pharms can convince patients and judges that diabetes is really the patient's fault, and that they did their best to cure them of their evil, underserving ways, they can "prove" in court that the evidence regarding diabetes and it's related consequences are not the medicine's effect, but a personal failure. And...you guessed it! The wellness program is run not by health clinics or professionals, but by a marketing company.

So I emailed the facts (from the very CDC research she cited) to my agency coworkers, especially emphasizing that rising obesity has no correlation with, let alone causation of diabetes. Indeed, as weights have risen, diabetes rates did not change at all from 1988 - 2000, the latest year analyzed, although "obesity" tripled. I also pointed out that there is no evidence from the CDC that diet and exercise have any effect on chronic disease incidence or prevalence. The CDC study that she was referring to showed that 70% of people do die of chronic disease, but there were neither claims nor evidence that these diseases are preventable by exercise and diet, or by anything else for that matter. Chronic disease causing 70% of deaths is good news, since we are no longer dying of malnutrition, infections or infectious diseases, pregnancy and childbirth, diarrhea and other conditions that cause most deaths in poorer countries. It may just mean that people are living long enough to get these (mostly) diseases of aging.

Anyway, this week the newsletter was all about the wellness program. It included tips on how to "prevent" high blood pressure, like avoiding stress (for social workers?!) and eating right and doing exercise 90 minutes a day, excluding any movement related to work and home maintenance. So I sent an email with the American Heart Association research showing the most effective way to "prevent" hypertension is to avoid the misdiagnosis that affects up to 75% of Americans due to miscuffing. I demonstrated who needs an adult large cuff by letting people know that if they wear a medium or larger tee shirt they need a large cuff by AHA standards. I added that this means anyone whose upper arm is wider around than a standard coffee mug.

I received disciplinary warnings for providing the evidence. I was told that it was unprofessional, and that people might feel bad if they miscuff or present inaccurate data at meetings. (Wah! Maybe they should!) And that their medical provider status is more important than the actual scientific evidence from reputable sources. I never claimed medical expertise of any kind, just presented what the CDC and AHA research show. I finally agreed not to to comment publically on the wellness program or to correct misinformation to avoid a written warning.

It makes me sick inside, but I need my job so I can feed my kids more than I need to express my scholarly values, I guess.

The local news at 11 just reported a sting in my area to arrest men who went to a house to "have sex with" a thirteen year old boy or girl (no women showed up to do so apparently, but this was not mentioned). Naturally I immediately fired off an email challenging this language:

"I'm watching your 11 pm news cast, and I have to point out that it is impossible for a man (or woman) to "have sex with" a child. Any sex act with a child is rape, since they are incapable of giving consent. Please change your reporting language to reflect this important truth. This is not inflammatory language, it is simply accurate. Thank you."

I only saw the news because my dad is visiting. I never watch it when he's not here. Maybe it's my civic duty to watch and send this email every single time rape is described as "sex" whether the raped person is a child or an adult. And it's not "alleged rape" either - a rape has occurred, only the identity of the rapist is "alleged."

I sort of thought I was living in the twenty first century and not the nineteenth.

Also, I have to give a shout out to my neighbor Yolanda. Her daughter Marissa is my daughter Katie's best friend. She went along with us to hold Katie's hand while she had her ears pierced tonight. It was dark when she asked if she could come and I told her to ask her mom, and she asked me to walk her over. She said, "My mom told me not to walk home in the dark alone because of stranger danger and the rapist across the street with a red car." (I think that this is a great rule for a six year old who weighs maybe 40 pounds soaking wet. Adult women should be able to walk wherever they please in the dark, because they can weigh their risks.) I am SO FRIGGING HAPPY that another parent called a "child molester" what he is, a rapist.

Most of my psychiatric social work colleagues object when I call "child molesters" rapists. I think it makes them squirm inside. Which it should. Molestation is a euphemism of the worst possible kind. Rape should not be prettied up verbally so we get comfortable talking about it, especially where children are concerned. I would no more say a child was "molested" than that a woman or man was "interfered with." Social workers are like priests, we hear everything, and it's often not easy to handle the degree of evil some people are capable of.

I have a patient whose dad raped her starting when she was ten and continued until he impregnated her at thirteen, at which point her mother and the courts had to believe her - the DNA matched. (I am bound to confidentiality, but there are so many little girls out there in the same situation that this doesn't break it.) Her dad spent a few years in prison. And I mean less than five. For raping a ten year old over and over, until she was thirteen - well, actually until she was fifteen, because CPS didn't see fit to take her out of the home where her dad repeatedly raped and impregnated her and her mother KNEW, while the trial was pending for two years and he was "free on his own recognizance" as the saying goes.

HINT TO CPS: A scumbag who rapes his ten year old until she is thirteen and gets her pregnant doesn't HAVE any FUCKING recognizance. And then there are parents who sell their three year olds for sex in order to smoke a pipe of crack or ten a day. Social workers hear everything. Sometimes I wish I didn't, but most of the time I'm glad that I'm there to tell, sometimes as the first person the victim/survivor can trust. I feel that my knowing about all this evil does the world good in some small way. I am a witness. I can call the deniers and the minimizers on their horrific shit and the consequences of those cover up phrases and actions. Just to clarify, I don't think rape is "better" when an adult experiences it, not at all. But child rape makes me, universalist though I am (I think of heaven, if it exists, as an ER, where the sickest souls are treated first), hope at times that there's a hell.

Writing about liking to sing, however enjoyable, is not what I want to do with this journal, so I'm taking another stab at it. The class discussion stayed focused on respect in different variations. _Crash_ was largely about the need for respect toward one another. Respect can overcome prejudice. Disrespect fuels it. The two qualities are symbiotic, with prejudice leading to disrespect, and disrespect leading to prejudice. One of my clients trains business people about her home continent's different cultures and the expectations and interpretation of behaviors in each. She was telling me about the "eight second rule", which as it turns out is not how long an M&M can be on the floor and still be edible, but a tendency to form our opinions about each other in the first eight seconds. We had an interesting discussion about how social workers and medical workers have to constantly combat that tendency, and how much practice and awareness it takes to do so. This class is helping me explore my biases and prejudices and reminding me that the eight second rule can lead me to places I can't go if I want to be a responsible and respectful social worker.

Actually, who I am is "A person who thinks of what she really wants to say five minutes later when class is over." :)

I recognize that this isn't unique, but it is frustrating even so. The real problem was how many things I like about myself. Coming from where I've come from, that is definitely against the odds. But it is true now, though it wasn't true for most of my life. And recognizing that "problem" was a joy.

I think if I had a do-over I'd say that I am a singer. Insofar as I have religious feelings, I feel them when I hear music or sing. Other things about me have changed a lot, but I've been passionate about music ever since I can remember. Even before I can remember, actually. At 18 months old I started crying when Bach's Minuet in G was turned off in the middle, and my uncle and aunt turned it back on when they realized I was humming it. Earlier on I sang before I talked. I'm told that I did a great playpen rendition of the Doors' "Come On Baby Light My Fire." Also "Chain of Fools." While dancing with the aid of holding on tight to the edge of the playpen because I couldn't stand on my own yet. I used to make up operas starring our fox terrier Charlie and, naturally, myself. Charlie played a supporting role, because I had to sing his part for him. And make him dance on his back legs by lifting up on his front legs. When my little brothers were old enough to replace Charlie, I directed all of us in musicals based on fairy tales like Goldilocks (I got to be Goldilocks AND Baby Bear - I was a bit of a prima dona). Later on we would learn songs on records and perform them for our parents, and we were FINE on Neil Sedaka's "Breaking Up Is Hard To Do." We even choreographed it.

So it isn't a surprise that my mom was embarrassed and punished me for being a "show off." Working class white people in my part of Iowa did NOT embrace the performing arts. It took a long time to get over the shame, but nothing stopped me from singing when I let my guard down, and humming without knowing I was doing it. One time we were at my Great Grandma Ruth's, and she was sick, and I was singing in the next room. When my mom and grandma shushed me, Great Grandma asked them to turn the radio back on and find out who the singer was. Did I gloat inside? You bet I did! Nothing could stop me from listening all I wanted to, though. I could and can listen to any piece of music I know in my head, even complex pieces like symphonies and madrigals. When I was bored in school, I would just listen to whatever was on my internal soundtrack instead of the lesson. Don't worry, our class is too interesting for that!

I didn't have the right kind of voice for classical music or opera, which disappointed me until I discovered Celtic music in college. I was spellbound. And my voice was PERFECT for folk. Song's not in your range? Just transpose it! Which I could do with no effort. This was bad in chorus, but great in folk. And coming from an abusive background, the stories of betrayal and violence and true love and parted families or lovers resonated. Anger frightens me in person, but I can sing about it and kind of process my own feelings. Celtic music lays it all out there, just like blues and soul and gospel, which I already knew about and loved. My college roommate Lavonne and I listened to Steve Winwood's "Bring Me a Higher Love" about three times every day. And sing along with gusto and volume. I'm surprised we didn't break the tape. Or our RA's spirit. At least we weren't as bad as the guy upstairs who decided that he needed to learn to play Wagner's entire Ring Cycle on the recorder. Flat. At every hour of the day and night.

I know that this must seem like a big digression with little to do with class, but after nearly eight years of twins and work, grad school is for ME. I'm rediscovering myself in major ways as well as discovering other people's viewpoints and experiences. I love my twins, and my husband, and my job. But I miss parts of me that I have set aside since late in my pregnancy. Relationships require compromise when they don't require outright sacrifice. These yield high dividends in love and joy.

But oh is it sweet to stretch my wings again.

I think I'll sign up for that Open Mic in January.

I'm looking forward to my diversity experience and group presentation on Rwandan refugees in Grand Rapids.

But what I mostly took away tonight was _Crash_. It's one of the best movies I've ever seen. Definitely the best movie about the impact of racism: _A Time To Kill_ wanted to be this movie, and I enjoyed...well, enjoyed is definitely the wrong word. I appreciated _ATTK_ and it was good. But _Crash_ took the documentation and exploration of racism to a new level. Racism is more than just Black vs. White, or ethnic differences or straightforward and blatant prejudice. Crash captured the complexity of both external and internalized racism. It built up relationships then twisted and even destroyed them. And restored some. The reason I was crying so hard in the scene where Elizabeth is raped, then Lara is nearly shot was that the entire movie to that point hit me each time. There was also a resonance for me with the "successful black sheep" theme involving Graham, for personal reasons.

Maybe I'll be able to add more later, but if I type anymore now, I'll spend all night crying. And I can't do that.

Because right now I need to go hug and kiss my kids.

I encountered a lot of sexism and classism growing up working class in a wealthy suburban school district. They compounded each other. Even the most obnoxious administrators and counselors at least conceded that working class boys could benefit from education, the same was not believed of we girls. "You don't need physics to have babies!" quoth my principle when refusing to approve my schedule. "You are cheating and I'm giving you an F." said my history teacher when I wrote for a "what would your life have been like in ancient Greece" essay that it would have been short, given that I only survived birth because doctors had worked out a few months before that blood transfusions could reverse the effects of Rh Factor incompatibility in newborns. And that I was an oldest daughter, who would've been pretty much guaranteed to be exposed, a victim of infanticide, even if I had survived birth. And my academic counselor's observation that "You won't need those college track courses to work at [local factory] so why take them?"

How many Descartes' and Curies have died young picking cotton too slowly and being whipped to death? How many Shakespeares and Angelous have spent their lives mopping floors and writing poetry in secret if they even got the chance to learn reading and writing? How many Beatrix Potters and Mileva Einstein-Marics are still not given credit for their mathematical and scientific accomplishments, regarded as "sounding boards" instead of collaborators, amateurs instead of professionals, incapable of serious intellectual endeavor and valued only as sexual or nurturing peons based on their gender alone?

I am not claiming genius, or comparing myself to those beacons of knowledge. I'm just questioning how much better off we would be, locally and globally, if institutionalized racism and classism and sexism and materialism weren't still the order of the day.

I didn't learn about white privilege from a class or assigned readings. I learned about it from my fun and friendly and brilliant and beautiful college roommate Lavonne. She was from Chicago and we had almost everything in common. Except white privilege. Lavonne was African American. Being friends with her changed my life and my perception of myself. I had mostly identified myself by class, but hanging around Lavonne made me acutely aware of my whiteness and the many things I took for granted that she could not. Like not being followed by security in stores. And having food servers skip over her to ask me what I wanted. And being able to get my hair wet if it rained. Which I usually did, because Lavonne would confiscate my umbrella if an unexpected fall of rain happened. :)

When people are new to the fat acceptance movement, they often say that fat phobia is "the last acceptable prejudice." Sometimes I get sick and tired of enlightening them, but I keep on doing it. To honor Lavonne. Even though I had to drop out of college after my second semester and move back to my home town, and we lost touch, I will never forget what I learned from her and honor it.

I have to say my main response to the discussion tonight was that wow, are people ignorant of really basic US history. I don't expect people to know about the plague that killed 90% of the eastern coast's Native Americans, so that settlers were able to just move into the dead people's towns complete with already built houses with already planted corps and stores of food. High school classes never teach kids about it. Or most of the harrowing details of the slave trade, starting with our old buddy Christopher Columbus. Chris and his sailors enslaved inhabitants of the societies he "discovered." And just don't get me started on "discoveries" of places and things that everyone already living there knew all about - hint: if someone who already lives there is guiding you to it and showing you, you haven't discovered anything. Much like being shown Einstein's theory of relativity in seventh grade does not mean that I, Mary Heil, have discovered relativity. Back to Columbus, he ordered the slaves' hands cut off if they failed to give over their daily quota of gold. Even children. And there's always the failure to discuss the abandonment of the freed slaves after the civil war, with repracussions now.

But I have to draw the line at "The Founding Fathers were fleeing religious persecution."

First of all, the religious persecutions of the "pilgrims" who settled Plymouth (150 years BEFORE the Founders were twinkles in their mothers' eyes)consisted of fines equivalent in price to speeding tickets today. Just like today, if you didn't pay your ticket you might end up in jail for a couple of days. And these folks were rich - they usually went to "jail" at a boarding house instead of a real jail with poor people. It wasn't exactly the Inquisition. When you consider that people could be and routinely were hanged for stealing food when they had none to feed their children, it really puts that "persecution" in perspective. And any amount of religious persecution the pilgrims suffered pales beside religious persecution of slaves. Nobody in England was getting gang raped and whipped to death for practicing her religion, but slaves could be and were. Calling fines persecution is an insult to African Americans and First Nations people.

This is not and was deliberately meant not to be a "Christian nation." Roughly a fourth of the Founders were NOT Christian. Which is why the Constitution/Bill of Rights emphasizes religious freedom, abolishes a national religion and a includes a requirement that there be no religious test for political office. The Founders were pissed off because could be survielled, searched and stolen from by British soldiers, imprisoned indefinitely without charges (England STARTED habeas corpus in the 1215 Magna Carta, but ignored it in colonies) and taxed outrageously without representation in parlaiment, meaning that they had no legal recourse to protest and right these wrongs. They were not fleeing religious persecution. Most of them weren't fleeing anything, they had been born here.

Okay, I need to put the kids to bed. Rant over.

Except to say that King George the Second of the USA has pretty much restored all of the depredations that the Founders rebelled against.

Expect this Journal entry to be somewhat disorganized and random. I'm having all kinds of different responses to the experience of application, admission, financial aid and now at last the first week of class. This is my first class in 11 years, and I'm overjoyed to be in grad school. After being the first person in the history of my extended family privileged to attend college and earn a Bachelor's degree, I'm aiming to be the first of many generations to come to have a Master's degree as well.

I earned my psychology BS at a competitive and very serious program in a huge research oriented public university. I can count on one hand the number of times I heard a joke in class and more than slightly smiled. Spending an hour and a half in class belly laughing nonstop is quite a contrast. I love it though, and it confirms that GVSU is the perfect school for me. Of all the imaginings of what grad school would be like, I never envisioned gasping-for-breath laughing playing a part!

I have worked pretty hard at cultural competency in my social work practice as well as life in general. I recognize that my life as a middle class white woman is extremely privileged in most ways. Most of the white people I encounter either don't recognize or completely reject white privilege. I don't have to dress up to be accepted as a peer by most people. I don't get speeding tickets if I drive through the "wrong" town/part of town at 1mph (or 0 mph) over the speed limit. I can travel to rural Michigan areas without fear. Recently a work friend moved to Caledonia, and an African American work friend said sadly that she won't be able to go to the new house, because it might not be safe for her.

I live in a white flight neighborhood and cherish the diversity my twins are growing up with. I grew up in an all white school district in Iowa. My twins' schoolmates are of every race, and it definitely helps them naturally learn that all people deserve respect and civil rights.

Last summer I went to a "neighborhood meeting" of all white renters and (mostly) landlords airing their mostly racist grievances, except one AA woman. She attended and pointed out the total lack of police service her small son received when a teenager pushed him off his bike in front of an officer in a SQUAD CAR 10 feet away who didn't help the child. Nobody but me seemed to believe that her six year old really encountered any discrimination. After several people complained fearfully about "gang activity" I had to explain that 5 black boys laughing in a front yard is NOT a gang, any more than 5 white boys. The police at least backed me up on that one. I have a good deal more in common with my mostly African American neighbors than with most local middle class white people. I share the working class background, the experience of being poorer than most of my classmates growing up, and many of the same non-CRC values such as expressing emotions openly.

When we needed to find a daycare provider fast while the kids were 3, the white sitters in our area were all kind of anal retentive. One said that she made the (preschooler) kids walk at least three miles a day regardless of the weather. Another told us that our twins must have been lying to us when they reported that their immediately-fired babysitter spanked Teddy on the bare bottom for a peeing accident on the carpet, and that J--- "broke my penis." She said, "Oh, kids will make those things up to get out a situation." One even criticized our barely potty trained son because "You should stand up to pee, like other boys. Boys don't sit down like girls." Hello, sexism! Love that implication that being like a girl is a bad thing. Brenda, our African American daycare provider since then, is a degreed early education teacher who worked Head Start programs for over ten years before having her youngest child. We're really lucky she decided to stay at home with Dontrell, because Katie and Teddy have really benefited from her care and education. They were more than prepared to start kindergarten.

I still have a lot of areas to work on, though. I know very few people of Asian descent or immigration. I'm vaguely aware of very different family structures than are typical in other Michigan families. I know not to lump all Latinos together, but I don't know much about different Latino populations. I despise corporate welfare thriving while most of my clients can't afford medication or safe housing with their disability income.I am prejudiced against rich people, and aware that I need to work on this. One example and I'll stop writing! This is from a recent post I wrote on my blog:


Privelege Overflowing Like A Shit Filled Toilet


I work with a new client who has gone from making six figures and having three jaguars to being on disability ($1300/mo). He comes from an EXTREMELY wealthy family in the richest suburb in my state. His siblings are emotionally supportive and one of his brothers is his payee, but they don't help him financially at all despite stunning personal wealth. Someone in the hospital told him and his sister that my agency would pay for all his medication, which is a blatant falsehood. Now he and his family are FURIOUS. They refuse to believe that medical providers are not liable for providing him free medication. The sister's husband is a malpractice attorney, and they keep threatening to sue. I'm silently thinking, "Knock yourselves out. Nobody has a responsibility to pay for his medication except him. I personally hate that, but that's the way it is until we have universal health care."

I explained that I don't like it when homeless and indigent people can't get the medicine they need and live in fear and anxiety and depression and psychosis. I don't like it when it happens to formerly wealthy people either. I used my standard social work line, "All the people I work with are equally important to me." This works for both people who have self esteem trouble or depression (meaning "You are just as important") and with extremely entitled or narcissistic people (meaning "You are not more important").

So I spent an hour and a half of my life that I'll never get back saying "no" to people who would not accept that because basically nobody has ever said no to them before in their whole lives. Among the things said to me (followed by my internal reaction in ALL CAPS just to demonstrate how I was screaming replies in my head while apparently patient and calm.)

"This is just reverse discrimination."

UM, HELLO, THERE IS NO SUCH THING AS REVERSE DISCRIMINATION.

""If he were a black woman he'd get his medication from you for free." I did raise my voice a little saying, "Absolutely not!"

ABSOLUTELY NOT. AT LEAST A THIRD OF MY PATIENTS GO WITHOUT DESPERATELY NEEDED MEDICATION BECAUSE THEY ARE POOR BUT DON'T QUALIFY FOR MEDICAID OR MEDICARE. RACE AND GENDER ARE NOT RELEVANT IN THAT AREA. NOBODY GETS SPECIAL TREATMENT OR SPECIAL SERVICE FROM ME, INCLUDING YOU. SORRY IF HEARING NO AND COPING WITH IT IS NOT A SKILL YOUR PARENTS TAUGHT YOU. IT'S OFTEN HARDER TO LEARN IN ADULTHOOD.

"I didn't think we had welfare anymore."

YEP, THAT WOULD BE THE EXACT PROBLEM YOUR BROTHER IS HAVING AS WE SPEAK.

AND YOU'RE THE FUCKERS WHO VOTED TO DISMANTLE OUR SOCIAL SAFETY NET. YOU'RE ALSO THE ONES WHO VOTED IN AND INVESTED IN FOR PROFIT HEALTH CARE AND INSURANCE. AND THEN VOTED RESTRICTIONS FOR PERSONAL BANKRUPTCY WHEN THOSE FOR PROFIT MEDICAL BILLS MORE THAN DOUBLED IN COST, MAKING THE MAJORITY OF FILERS DECLARE BANKRUPTCY BECAUSE OF MEDICAL BILLS.

"[Psych hospital] and Community Mental Health and you are liable if you don't give him free medications and he gets sick again. You are responsible for guaranteeing his well-being."

HE IS RESPONSIBLE FOR HIS OWN WELL-BEING. BLOOD KIN, WHEN THEY EXIST, GENERALLY STEP UP TO THE PLATE AND HELP THEIR DISABLED LOVED ONES. IF YOU WON'T, NOBODY ELSE CAN. DID I MENTION THAT YOU'RE THE FUCKERS WHO MADE DAMN SURE OF IT? BY DESTROYING THE ALREADY MEAGER SOCIAL SAFETY NET. REAGAN, BUSH, W AND YOU ARE TOTALLY RESPONSIBLE FOR THIS SITUATION.


Okay, venting over! Time to go to bed. :)

Mental Illness and Murder

Contrary to popular belief, homicide due to mental illness is declining, at least in England and Wales:

The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise.


I have no doubt that in England and Wales, where there is universal health care and mentally ill individuals are able to take their medication because it is affordable or free, homicides committed by MI people have declined.

I've been a psychiatric social worker for 15 years, and I can tell you EXACTLY why other industrialized countries have lower rates of murder by severely mentally ill people - universal healthcare with parity between "physical" and "mental" illnesses. (Since all "mental" illness is actually physical, there should be no distinction made.)

Even US statistics show that mentally ill people are LESS violent than the general population when treated with medication. But effective antipsychotics tend to cost $800-2000 per month. Even the "wealthiest" people on SSI Or SSDI (disability) have entire incomes under $1200/month. Those $1200/month folks made six figures when working, BTW. The typical disabled MI person gets $200-500/ month for rent, food, medicine, utilities, transportation, and physical care necessities such as soap and shampoo and toilet paper. Even the lowest income medicaid recipient usually has a a monthly "spend down" (like a deductible) often EXCEEDING their actual monthly income. Living expenses are not considered when figuring spend down either. And medicare folks don't fare much better, their medicine is paid for (with a copay) for several months, then they hit a "donut hole" where medicare doesn't pay another cent until they have spent $2000-10,000 of their own income on the medication before medicare kicks back in. Again, living expenses are not considered and the demanded contribution often exceeds the person's actual income. You do the math.

Most mentally ill people, especially those who have hurt others when off medications, desperately want treatment. Virtually every murder by a mentally ill person is caused by all of us neglecting them and refusing them necessary healthcare. We can court order violent people for mandatory treatment all we want, but if they can't afford the medicine they aren't GETTING effective treatment. Even the most violently criminally insane person effectively has NO access to the treatment that would control their symptoms and prevent tragedies. Until we change that, innocents will suffer and die. And we will all be culpable.

I work with a new client who has gone from making six figures and having three jaguars to being on disability ($800/mo). He comes from an EXTREMELY wealthy family in the richest suburb in my state. His siblings are emotionally supportive and one of his brothers is his payee, but they don't help him financially at all despite stunning personal wealth. Someone in the hospital told him and his sister that my agency would pay for all his medication, which is a blatant falsehood. Now he and his family are FURIOUS. They refuse to believe that medical providers are not liable for providing him free medication. The sister's husband is a malpractice attorney, and they keep threatening to sue. I'm like, Knock yourselves out. Nobody has a responsibility to pay for his medication except him.

I explained that I don't like it when homeless and indigent people can't get the medicine they need and live in fear and anxiety and depression and psychosis. I don't like it when it happens to formerly wealthy people either. I used my standard social line, "All the people I work with are equally important to me." This works for both people who have self esteem trouble or depression (meaning "You are just as important") and with extremely entitled or narcissistic people (meaning "You are not more important").

So I spent an hour and a half of my life that I'll never get back saying "no" to people who would not accept that because basically nobody has ever said no to them before. Among the things said to me (followed by my internal reaction in ALL CAPS just to demonstrate how I was screaming replies in my head while apparently patient and calm.)

"This is just reverse discrimination."

UM, HELLO, THERE IS NO SUCH THING AS REVERSE DISCRIMINATION. THERE IS MUTUAL RACISM, BUT THAT'S NOT DISCRIMINATION.

""If he were a black woman he'd get his medication from you for free." I did raise my voice a little saying, "Absolutely not!"

ABSOLUTELY NOT. AT LEAST A THIRD OF MY PATIENTS GO WITHOUT DESPERATELY NEEDED MEDICATION BECAUSE THEY ARE POOR BUT DON'T QUALIFY FOR MEDICAID OR MEDICARE. RACE AND GENDER ARE NOT RELEVANT. NOBODY GETS SPECIAL TREATMENT, INCLUDING YOU. SORRY IF HEARING NO AND COPING WITH IT IS NOT A SKILL YOUR PARENTS TAUGHT YOU. IT'S OFTEN HARDER TO LEARN IN ADULTHOOD.

"I didn't think we had welfare anymore."

YEP, THAT WOULD BE THE EXACT PROBLEM YOUR BROTHER IS HAVING AS WE SPEAK.

AND YOU'RE THE FUCKERS WHO VOTED TO DISMANTLE OUR SOCIAL SAFETY NET. AND YOU'RE ALSO THE ONES WHO VOTED IN AND INVESTED IN FOR PROFIT HEALTH CARE AND INSURANCE. AND THEN VOTED RESTRICTIONS FOR PERSONAL BANKRUPTCY WHEN THOSE FOR PROFIT MEDICAL BILLS DOUBLED IN COST, MAKING THE MAJORITY OF FILERS DECLARING IT BECAUSE OF MEDICAL BILLS.

"[Psyh hospital] and Community Mental Health and you are liable if you don't give him free medications and he gets sick again. You are responsible for guaranteeing his well-being."

HE IS RESPONSIBLE FOR HIS OWN WELL-BEING. BLOOD KIN, WHEN THEY EXIST, GENERALLY STEP UP TO THE PLATE AND HELP THEIR DISABLED LOVED ONES. IF YOU WON'T, NOBODY ELSE CAN. DID I MENTION THAT YOU'RE THE FUCKERS WHO MADE DAMN SURE OF IT? BY DESTROYING THE ALREADY MEAGER SOCIAL SAFETY NET. REAGAN, BUSH, W AND YOU ARE TOTALLY RESPONSIBLE FOR THIS SITUATION.

Okay, venting over.

8/9/74 - *

I was six and had my tonsils removed in a vain hope that it would help my asthma. I was still pretty groggy from the anasthesia, so a nurse was holding a cherry popsicle while I eagerly swallowed to numb the pain.

My parents and the nurse where all captivated by the TV. The nurse pushed the popsicle a little to far and VOILA!

I threw up during Nixon's resignation speech.

My Democratic, union member parents were thrilled. So was the nurse, and pretty much everyone on the peds unit, all union. People kept on sticking their heads in the room and saying, "You know, I wanted to throw up too!" I was a hospital superstar!

So I've lost 31 pounds unintentionally after starting a medication that typically causes weight gain. Not so for me. Some of you are likely aware of the effect SSRIs for depression have on libido. Eradicate it. It's possible to have sex. It can feel nice when it happens. But there's not a shred of desire most of the time. Something that was a delight before, that you wanted and looked forward to and initiated at half a chance just isn't interesting anymore. There's no desire.

That's what happened to my totally moderate and intuition driven appetite for food. It's just gone - disappeared entirely. I am mildly hungry when I wake up. I get my cini minis and coke "breakfast of champions" and then I just don't get hungry. Around ten at night I get mildly hungry. I eat a frozen entree and go to bed. My shorts are literally falling off. I had to exchange them once for a smaller size, and a couple of weeks later THOSE are literally falling off. I can't exchange those, I've worn them. I had to buy safety pins (which incidentally they don't even pretend is a baby item anymore, it's shelved in the miscellaneous aisle)to pin them on my body.

Naturally the weight is all coming off my hips, proportionately small, instead of the SHELF OF FAT above my belly button. It's like the biggest muffin top ever. And it has never gone away. When I couldn't afford food other than rice for a year and got bronchitis and pneumonia and couldn't afford my asthma medicine and walked five miles each way to work and weighed 140? Still there. Nice big twin pregnancy belly? No cute preggo belly for me - still there. I completely accept my body and love a good many parts of it. Including an eraser sized mole on my left forearm, which sort of tells me that I'm ME - it's a little spot of uniqueness. Medical staff have offered to remove it because they could technically get away with a melanoma "biopsy" due to the size. I've always said no thanks.

Now, I'm nowhere near losing my supersize cred. I still weigh 275. I don't imagine that loss of appetite is going to take me out of my set point range. I have bunches of coworkers counting points and having a biggest loser type contest. And I think I've lost more weight than any of them. I just don't talk about it to them. Kind of like I can't join in the women's social ritual complaining about husbands. "Wow, my husband would never do that! You married an asshole." is not in the script. :)

I admit that I'm enjoying it. I can feel the difference in my dance-induced osteo-arthritic knee. I can fit into a pair of bright beach print capris I love again. If I lose another ten pounds I'll probably be able to shop for pants at Target. My shirt size is never going down due to my nice strong linebacker shoulders. I've never been the kind of fat activist who would pass up a legitimate and low side affect treatment. You know, one that doesn't cause weight gain like dieting does. Being fat is part of my identity, but if it were treatable I would happily take a pill, just like I take one for depression, which many consider "character building." Uh, yah, fuck that.

I don't see one coming down the pike in the next hundred years anyway. Phenotypes are had to medically hack. Look at Michael Jackson. Besides which, I am no more likely to be less at risk of high blood pressure because I'm a socially acceptable weight, than Michael J is as an African American, regardless of how much he has lightened his skin and changed his nose. Because cosmetic changes do not trump genotype. Attempts to increase and decrease height have mostly been failures, and when they work the side effects are usually grave problems themselves. Weight is as heritable as height, and runs in biological but not adoptive families. It's not about food intake, it's about the natural and healthy variation in body size. People can look at Danny DeVito and Kareem Abdul Jabar and accept that HUGE healthy variation. Tall people have more strokes. Short people die when airbags deploy and smother them. Life only ends in one way - death. And it is too short to obsess about appearance when there are people to love and good work to do and fun to be enjoyed.

Cast you mind back to the year 1997. Before the world wide web really got on its feet. Before the DotCom bubble. Before Y2K (remember Y2K?) Most believe that dowries were an ancient tradition left behind when we carved a country out of colonial territory. Not so, my child.

In 1997 the custom of a dowry was alive and well in my parents' living room. The blueberry muffins had been consumed, the bird stuffed and safely in the oven and since we were all adults we had slept in late and waited for the food preparation before approaching the Christmas tree. For an all adult Christmas there were a LOT of presents on the tree skirt and overflowing onto the wooden floor. This gave rise to curiosity and fear that the haul wouldn't fit in our cars for the trip back home.

Now,despite my Venus of Willendorf figure (which was never criticized at home)I dated steadily through high school and my extremely prolonged work-wait-go back for a semester of my college career, then do it all again. My family didn't like my first boyfriend, largely due to the fact they had no idea that HE was preserving my virginity because we both wanted out of our birthplace. We shared the fear of an unwanted pregnancy that would doom us to stay. He was the one putting on the brakes though. I was all "what comes next"?! As an adult I became belatedly grateful for the care and probity of my high school boyfriend. He went off to college and broke up with me that Christmas, presumably because he wanted to broaden his horizons with a grown woman. I didn't understand why at the time and was heartbroken.

Less than a year later I found the (I thought) love of my life. We got engaged, we got busy at a hotel, where the staff thought we'd just gotten married. When we left, the hotel sign, directly on my mom's route to and from work, their big message board said "Congratulations Mary and ------!" I completely freaked out. I was actually scared to go home. Thanks to common names and the fact that mom was not going to notice a sign she passed every day, the maelstrom I was expecting never formed. I lied about our date activities and as far as I know she never doubted me. We were engaged for about 48 hours when he called me from the marine boot camp he had joined without talking to me about it. I wrote letters faithfully because I just couldn't break up when the poor guy was in boot camp. He came home hating and scorning women. It took too long for me to realize that he had changed forever, but when I broke up with him I really thought I could never love again.

Soon after my 19 year old brother had an asthma attack and was dead on arrival at the hospital, driven in by his frat brothers when the ambulance didn't come. Medical staff resuscitated him but he was brain dead. My boyfriend of the time and I felt happy just dating, with no plans to get hitched. I wanted children, he didn't, so we dated in a gloriously carefree manner. My parents did like him but my mom didn't understand why I would date someone I didn't plan to marry. "If you don't want to get married you should break up and play the field." Things turned sour when my brother's recovery was beyond hope, and my boyfriend who was Ba'hai thought my grief was excessive and self indulgent.

I got engaged again to a guy who turned out to be a jerk, but love is blind.. My mom and dad really liked him, he was a rich computer guy and outwardly pretty impressive. I moved across the country with him when he got a new job. Three months after our engagement he dumped me after I had already come back from a Christmas trip back home. I got my old job back, and my friend's only question was, "What day this week would it suit you to be picked up?" When I returned a few months later to move my belongings, my friend found the "Mary pros and cons" list that he'd left in plain sight. I wasn't even tempted to look.

My mom convinced my dad to pay off my college account, and I was able to return to school in earnest. I still had to work 60 hours a week while attending full time, but I got to go straight through to graduation this time. I met my husband on the Internet through a bulletin board (sort of like a list serve now). He was in grad school, I had my busy undergrad/work schedule. We lived 22 hours apart. Neither us had time to date in person, but passionate love letters can be sent 24/7. When introduced my family ADORED him. Which brings us back to Christmas 1997 and the dowry.

I admit I was greedily looking at all the gifts spread across the floor. We passed out presents one at a time. I got a sweater, Ed got the top of the line fastest modem around. Brother got a modest gift certificate to Best Buy, Ed got an obviously expensive watch. Dad got new slippers, Ed got a new down parka. Mom got a blue dress that reminded my parents of one dad gave her when they were dating, Ed got an electrical gadget that I forget specifics on. There was a second round of presents, after which a bunch of presents remained. Ed got them all. The only dowry gift Ed didn't get was a fine young goat.

I can only assume it worked, because on the Fourth of July ed proposed to me in the midst of the fireworks. We have the happiest marriage around, too. Maybe dowries SHOULD come back into style. Worked for me!

This campaign cycle has been a dream come true in its way. Many excellent candidates, two front runners whom I respect and like. The Democrats? With two impressive candidates late in the race? Will Rogers is doing the snoopy dance in his grave.

We need to undo the damage the Bush administration has done. Starting with restoring friggin HABEAS CORPUS to our rule of law. Following the Geneva Conventions and the joining the world court so that we can put American war criminals behind bars. Although I can see the reluctance, since the court frowns on war profiteering and invading sovereign nations unprovoked. Lying to start a seemingly endless war. Oh wait, we won the war in Iraq four years ago, President Bush said so. There is no war against Iraq - we Americans are all culpable for a brutal military occupation blatantly torturing captives and targeting civilians.

I am glad Barack Obama is our nominee, because he has unfailingly voted against war, military occupations in Afghanistan and stealing the lives of countless civilians, both living and the dead. And Barack nearly always takes the high ground in any manner of competition.

I would like to wrap up with a request - a unity ticket with Hilary Rodham Clinton as Vice Presidential candidate. Please consider making this Democratic campaign doubly historic and doubly strong.

So July has been pretty spectacular for me. I was asked to contribute to a best-selling author's next book. I was asked to audition for a lead singer in a wedding/funeral band - not my style, but a very nice compliment. I found an experienced vw mechanic who does side work who fixed my driver side window, which has not been able to open for over a year. The dealership wanted $270 just to LOOK at it. Then $400/window. Three were broken. We don't have TWELVE HUNDRED to pay to the dealership. Carl did the job for $185/window. So we are getting one replaced each month.

Then there's grad school. The whole process has been so easy that I'm worried that I've missed something important and they'll say I can't start. Every time I get mail from the university I have a sinking feeling that this is going to be the letter that breaks the bad news to me. And of course they are all mundane.

And the financial aid system is so simple and straightforward that it seems too good to be true. File your FAFSA when doing your taxes, it is automatically sent to the school. When you are accepted, the financial aid is managed by that department. A few weeks later you get an award letter that shows the amount approved and you drop an email to confirm that you need that aid. You sign a promissary note online and go through entrance counseling at the aid website and take the most obvious quiz ever written. Twenty questions which basically all have the same answer - yes, this is a loan and I know I have to pay it back. There's a HINT on several questions, the funniest being the hint that lists the four kinds of repayment types, when the question is how many types they are. So if you can count to four, you're golden. A few weeks after that get a university bill with nothing due because they automatically apply your aid and direct deposit the difference into your checking account.

Back when I started college (in the 80's) you had to get student loans on your own through your credit union or bank. In my freshman year the person in charge of submitting the paperwork didn't do it, so I never got my aid that year, and the credit union would not replace the aid amount with their own loan. One time I got my aid check saturday and got a notice Monday that congress had passed a bill that retroactively canceled it and I had to return the whole amount. Good thing that school's registrar office was closed on the weekends, or I would have been totally screwed. I withdrew from classes, worked hard and saved for another semester out of pocket.

Th difference is amazing and it seems a little *too* smooth.I'm getting financial aid that covers tuition, books, permits, and supplies with room to spare and save for the summer term.

I hate this quasi-paranoid feeling, waiting for the other shoe to drop. I'll believe I've really made it when the money's in the bank and the first week of classes goes by uneventfully.

I sing the twins to sleep every night. PS2boy said:

"Mama, no one sings better than you."

This has set a plan in motion to hide all vocal-inclusive music from his knowledge.

Then he can't change his mind. :)

Hellokittygirl has started singing along on The Cuckoo. She can't carry a tune in a bucket, but she LOVES to sing. Which is more important, in my book. I'm not sure if it's just her age and in a few more years she'll be able to sing on pitch. I'm definitely going to look into instruments and lessons. Everyone on DH's side can play various instruments. On my side we're all singers who are hopelessly incompetent with instruments, possibly because of the "fuck this 'learning to play' thing, I can sing it right away by ear and transpose it to my range without trying" factor. The partly bitten off right index finger doesn't help much either. Surgery saved the hand, but that finger is not what it used to be. I have trouble double clicking, let alone playing a string instrument.

*

Ed and I did a JP courthouse wedding for insurance reasons. We both took a couple of hours off work and a couple of best friends. As I was about to leave work, one of my favorite supervisees asked where I was going, and I casually said "I'm getting married, and I'll be back at about 3:00. When I returned there was a bottle of champagne at my workspace. The marriage vows were very moving, to my surprise. We kissed and went back to work.

Then we had the big church wedding, funding courtesy of my mom's modest inheritance. She immediately told me she wanted spend every penny on my wedding. Her mother was a cruel and abusive person, both of us had PTSD from being in Grandma's care. I'm very aware that I was an awful teen and both of us had mental illness, and psychiatry was not on my parents' blue collar radar. So our wedding planning and splurging reflected a mom/daughter love story. One of my best friends is one of the best seamstresses in Chicago, so THE DRESS was central to this. It put $2000 in my friend's pocket for designing and making a custom, unique dress for me. We sat down and had a long talk with Julia and she sketched out a few ideas. First I wanted to wear my mom's dress, but it didn't fit my shape. And my mom had bad associations because her mom got the cheapest dress possible instead of one that my mom wanted. Julia awesomely asked, "How about we include some of the wonderful lace and make it part of of the dress. Donna, how would you feel if you could rip the dress apart for me and just give me the lace?" My mom was glowing at the suggestion. So we sat in the hotel room and with my grandma's abusive "present" and ripped it it apart in malicious glee. I can't find the words to express how healing it was, bonding us together and drawing us closer. If you can exorcise a dress,then that's what we did. Mom and I picked out the cloth for the new dress. It took a long time, Julia assured me that when I saw the right fabric, I would just KNOW. (sort of like with the groom). And I did, cream brocaded roses. I am what one of my queer friends calls a "heterosexual dyke" - no make up, no hairstyling beyond a single braid, knew more about cars than Ed, resolute feminist, not shaving because I damn well have the right to be a mammal. Julia noted that Ed brought out my lurking "girly" side, so she sketched up a renaissance-sexy-fifties-silk and brocade dress. Then she made it come true. My mom drove four hours to every fitting and we had a blast together. We shopped for food and cake, looked at reception places, picked favors and flowers.The process broke down emotional walls and healed much of the pain we had inflicted on each other when I was a teen.

It was a good thing we did all the planning together, because the day before my wedding mom had a stroke. I lied to her to get her to the hospital and held her hand during painful procedures. I missed the rehearsal and dinner. I missed greeting Ed as he got to Chicago. I missed my mom at the wedding. We were going to to cancel the ceremony, but mom could shake her head "no" all though her speech was gibberish. She tried to check out against medical advice to come to the wedding, but Ed's mom Ruth talked her out of it. when no one else could, because she alone could understand the anguish of missing her daughter's wedding. Someone put a cell phone on the alter so that my mom could hear the wedding. And I had fought against videotaping the wedding ("A wedding is a sacrament, not a sitcom.") and my brother finally convinced me. Because he won that argument, the whole wedding party was able to go straight to mom's hospital room so she could see the wedding on video immediately. So we missed part of our reception as well. We wanted to cancel the honeymoon, and our friends and parents convinced us that mom was out of danger and we could keep in contact on the phone. So we went but with heavy hearts.

Mom died in 2006, the day she was discharged from the hospital after several months in a coma due to a one in three million disease. The doctors had said that mom was not sick anymore and just needed nursing home and rehab for the paralysis from being in a coma for so long. She was transferred to the nursing home and literally a few hours later she died alone.

Ed and I have an extremely happy marriage and twin raising enterprise. She missed their first day at kindergarten.

I still miss my mom every day.

I just got my Masters of Social Work acceptance letter today. It is dated the day after my interview - I guess my feeling that I aced the interview was right. I'm so happy I could burst. Everyone was telling me I was a shoe-in, but I was still unsure of myself. I'll write more later when I can think straight again. :) :) :)

When I called to schedule this morning, they wanted me to come in TODAY! So I explained to my boss, canceled appointments and rushed home to get ready. I'm VERY glad I got all my shopping done yesterday! I put on my new dress, pearl necklace and dress shoes, dug my purse up from the depths of the coat closet and had time for a hair style before the meeting. I'm TERRIBLE at doing my hair, and they stylist even made it look a little "fallen" as if I'd done it this morning. *grin*

The interview itself started with a case study, which fortunately for me was mental health based. Having actual social work experience was very useful for that little challenge! Then they took me to a big table in the back and I sat there alone wondering if ten people were really going to interview me. It was festive though, there were two bunches of balloons and an empty punch bowl, looked like they were going to have a party and lent a congenial atmosphere to the department.

The head of admissions came and introduced herself and said, "I'm taking you to a little room where we're going to put you on the hot spot." In fact, the interviewers were challenging but supportive. They listened carefully without interrupting and asked follow up questions. They asked me to reconcile my desire to do research with my Cs in math, and I just told them that I know it's a weakness, and that I definitely need a research partner who is good with math, but I know this about myself. I did tell them that I have depression and it contributed to my switch from case manager to floater. I hope that doesn't disqualify me, but I don't think it will.

They transitioned from asking questions to explaining the course of study, a double masters with Public Administration and the global learning program which lets students take study trips to nations around the world. At that point they both slipped and said "when" instead of "if", with the head adding "IF" with a smile and a bit of a twinkle in her eye. They complimented me on several of my answers and said they were impressed with the passion in my social justice essay.

Overall it was a great experience and I'm glad I had no time to fret about it. I feel very good about the interview and I will be surprised if I am not accepted, which is way more confident than I've felt to this point. I'm off to buy stationary for thank you notes!

I HAVE AN INTERVIEW!!!!

Luckily, my phone was dead so I got the message just now, after the work day. I'm sure I would have sounded like a blithering idiot who just won the lottery. Now I can call back pretending that I have some sort of calm dignity. She won't SEE me bouncing up and down while I schedule.

I have the hugest grin on my face right now!

Now I have to go shopping for a dress or suit.

My husband forwarded me the following blog post. This is the clearest example I've ever seen of undiagnosed paranoid schizophrenia. Note the intelligent, cogent and rational description of this unfortunate person's life in the past five months. This shows the degree to which altered perceptions can affect the ill individual. One of the least understood things about psychosis is that the perceptions are real, just faulty. People feel the puffs of air and see the skin color changes and can't tell delusions from the truth. There is absolutely no qualitative difference for most folks. It takes most people with schizophrenia years, even decades, to learn which perceptions are correct and which are symptomatic, and it amounts to memorization of the symptomatic content. The perceptual reality of the symptoms never goes away unless medication successfuly eradicates it. This poor person is sleeping on a desk in the living room because they are so afraid of the bedroom now.

I noticed something that I share with this person. Since the onset of the muscle problems I analyze every glitch of my body as potentially part of what is going on. I'm hot a lot of the time now - is it related to the muscle problem, perimenopause, or a side effect of my new medicine? Are those muscle twitches normal? Have I always had them and just never paid special attention? Everything is potentially part of the experience of illness (or in this person's case, perceived torment.)

I'm quoting this in its entirety. I would love to offer a gentle but firm explanation of what it going on to the individual, but comments are closed. Most of the comments were cruel, but a few were kind and sensible. I hope this person has loved ones around to help them get treatment.


This article describes harassment and barrage of assaults I have been
experiencing on my body during the past five months.

I am an American citizen, an immigrant of Middle Eastern origin. I
have been living in the US for 35 years; I am non-religious; my
politics tend in general towards left-of-center. Around the beginning
of the Iraq war, years 2003 and 2004, I expressed on Internet forums
- mostly on this site - my opposition to the Iraq war in strong
language and talked about George W. Bush in unflattering terms which
are commonly heard now but were not so commonly heard then.

The precise beginning date of the series of events I will talk about
is uncertain because only towards the end of November 2007, I realized
that I was being drugged and walked backwards in my mind and traced
the start of this approximately to the beginning of that month ...



To explain: During a normal night of sleep, one goes thru a process.
The precise instant one falls asleep is not clearly marked to one's
own consciousness but one is aware of the different stages of sleep
one goes thru during the nite. There are periods of deep sleep and no
apparent consciousness, and periods of dreaming and times of semi-
awaking and becoming aware of such things as the bed and sounds coming
from outside etc and then falling asleep again and going thru these
stages possibly several times. And in the morning, because of the
awareness of having gone thru these stages, we are aware of time
having passed thru the nite.

By contrast: I have been operated on under general anesthesia two
times. The experience of general anesthesia is not like sleeping at
all; it is total absence of awareness; one might describe it as
destruction of time; it is as if one did not exist during the time
while one was under.

Somewhere towards the end of November, I said to myself, I am not
going to sleep; I am being knocked out. This had been going on for
several weeks but it did not hit my consciousness because the
possibility of such a fantastic thing as noxious gases being injected
into my living space was so totally outside the horizon of my
expectations.

Because, if somebody had talked to me a year ago in the way I am
writing now, I would have said this guy sounds like a paranoid nutcase.

Going back to the past four months, unfortunately, I have not kept a
diary and can only give an account of events in inexact time specs.

I believe the assault on my body started with a test on me as a guinea
pig of a "sleep gas". This is only one of the things I have been
subjected to in the past 4 months. Let me list them:

1) First, more details on the "sleep gas": Once I became aware of
it, I paid attention to how it worked. A typical situation: I am
walking around totally awake and not tired, then I sit down to watch
TV for a bit in my usual spot on the couch. I may or may not feel a
faint draft of air on my face; then, quite suddenly, I feel tired and
sleepy. Then, the effect depends on how I respond to this. If I take
this as a signal that it is time to go to sleep, I actually do go to
sleep and this is what I had been doing the earlier weeks of
November. (Parenthetically, throughout most of my adult life, I
suffered from insomnia and going to sleep had been a big struggle for
me, that is, until November 2007!)
If, on the other hand, I quickly get up and move away from the
spot on the couch, the effect dissipates; I am back to being awake and
untired again! Now, in my experience, this is a neat trick. One
might shake oneself out of sleepiness with coffee and cold fresh air
etc but tiredness does not go away so easily.

2) Now the waking part: I seem to breathe cold air, or more
precisely, I experience what feels like a splash of cold air on my
face and this is followed by palpitations in the chest. This is how I
was woken up. Also, this is how I was prevented from resting.
Another typical situation: I come from work eager to read a
magazine. I set up my pillows on the bed to rest against. Then, the
light blinks, I feel the cold air against my face followed by the
palpitation in the chest. I get up and leave the bedroom.

3) When I was still using my bedroom, I remember waking gasping for
air and running to the window and being able to breathe only with my
face out the window. It was as if something other than air had been
filling my lungs. This happened only for one or two times after which
I stopped using my bedroom. For the past 2-3 months, I sleep in the
living room on my desk; this puts my head on a level against the open
window and I use a fan to drive in fresh air from the outside against
my face.

4) "Dirty air": Not that I can see the dust or anything but I feel
an accumulation of gunk in the back of my throat and on my tongue.
During the times I was subjected to this particular torture, the furs
on my cats were covered with a shiny gunk and they kept licking their
tongues.

5) A particularly severe attack: I believe it is administered via an
injected gas; it may start with something like the bursting of a
bubble on my temple. Followed by a sickness lasting from a few hours
to a day. Symptoms: finding myself forced to breathe fast, numbness
on the extremities, for long periods afterwards, feeling my lungs
constantly with discomfort on each breath and chest pain that
sometimes take over entire one half of my chest.

6) Equally severe, administered via my car (not in my townhouse).
Burning in the lungs, pain with breathing, feeling as if I am about to
faint. This also lasts several hours. And I actually have a sample
of the substance that caused this. I found an object that looked like
a piece of sponge in front of my garage. I picked it up; it was
covered with a soot-like powder. I brought it near my nose to see if
it had a scent. Subsequently, for several hours, I experienced the
above symptoms with one additional symptom: the skin on my finger
turned white in an area the size of a dime where I had touched the
stuff. This was not a case of the skin being covered with dirt or
powder; the skin itself turned white and remained so even after
washing for several hours. I imagine, about half a dozen times, such
a piece of sponge was placed on my engine allowing the piece to burn
with the heat of the engine with the vapors wafting into the passenger
compartment. In one of these occasions I had a movie theater staff
call the medics and they found nothing except that my pulse rate was
and stayed at a high level. This was attributed to my being excited
even though I was not so.

7) Tinnitus: Ringing in the ears. Now, this is not internally
generated. I believe this is achieved by some sort of electomagnetic
wave or near-inaudible sound wave. The reason: the effect is
localized to specific spots I tend to occupy in my home, for example,
sitting in front of the computer. If I move away quickly when the
ringing starts, it subsides over half a minute to a minute of time.

The general strategy seems to be not to throw all of these at me at
the same time but to sort of alternate between different types of
torment.

I never thought I was that important but somebody seems to have seen
it fit to spend an awful lot of concentrated effort and money to
displace me. All these occurrences are not the work of an ordinary
person and the team that is harassing me has access to locksmith
expertise, veterinary expertise, electricians' expertise and and air-
conditioning expertise. I will spare the reader details on all of
these areas for now.

The overall goal seems to be to drive me away and, if that fails, to
drive me crazy, and if that fails, to make others think me crazy if I
start to talk about this admittedly fantastic stuff that is happening
to me.

There are other effects that are difficult to distinctly describe.
There is a lot here that I have not written about. This has been my
life in the past four months. There are days when it feels like I am
walking around feeling drugged and wearing a helmet of a headache. It
may just be a general unwellness resulting from living under torture.

...it turns out not to be true!

We started the twins in swim lessons a couple of weeks ago. I got jealous because I love playing in the water and swimming. So yesterday I bought a family pass when we went swimming. And a minor miracle happened.

In the water, I can be active and play with my kids like I used to. For two hours with a few rest breaks. We played tag and monkey in the middle and raced across the all shallow pool, with me handicapped by only walking and not swimming. And it was FUN!

I love exercise under these conditions. It's mild and not aerobic, but it's a few more hours of exercise than I've been getting for months. I'm gonna use that family pass until the lifeguards get sick of seeing us. :)

I'm way behind on this fatosphere discussion, but I wanted to comment on it.

I don't believe that there are "good fatties" - we are all, by simply existing, transgressive in a way that our society is extremely keen to punish. Fat is portrayed as sinful, out of control, non-conforming and willfully unhealthy. We are the "welfare queens" of the aughts, lazy and expensive and contributing nothing to our country.

We are a diverse community, of course, and not a monolith of bad traits as we are portrayed. Through chance and choices we have various levels of health, and that's true of any group of humans. There is value in challenging stereotypes, and very fit fat people do that because the stereotypes are false and reality is complex.

If anyone is a bad fatty, I am. I eat whatever I please whenever I please, until I'm full and sometimes till I'm stuffed and sleepy. I haven't even tried to diet in years, because for me as for 90% of people they made me gain weight. I seldom exercise anymore because of the muscle thing. My favorite activities are sedentary, and I have no plans to change that. I loathe athletic pursuits, and hate virtually all forms of exercise. My PTSD used to give me awesome pain tolerance because I would just dissociate, but now that I've recovered I'm a wuss. I hate pain, and exercise hurts. I'm a size 32 pushing 34. i'm a smidge under 300 pounds. I AM the headless fatty in news reports, except my head is attached to my body. And it has a double chin!

What's more - I don't give a shit. I love myself just the way I am. Do I wish I had a lot of choices in clothes like thinner people? Sure I do. Do I wish I were a good athlete (noting of course that not all thin people are athletes)? Sure I do, more ways to entertain myself would be cool. Does my weight exacerbate the muscle thing and the dance injury in my knee? Of course, that's physics. Would I enjoy blending in and not facing discrimination based on my weight? Yes, I would. And yet I like myself and feel like a lovable and competent person despite being fat. Because I am. And that's not going to change.

My birthday has been great so far.

I took the day off work which is doubly fun because the last day of the month is always hectic and I end up working way late, and today I would have been stuck in pouring down rain.

I slept in til noon.

I read all my blogs.

I am having time ALL ALONE, a luxury beyond description.

While I slept, my house was cleaned for me. Getting a house cleaner has meant less money for restaurant meals or birthday gifts, but it makes daily life unbelievably better.

I have a deliriously happy life, one that I could never have dreamed could be this happy.

It's not perfect - my mom and my brother Mike and my friend Brandon aren't here to share it, but it's as good as life gets I think.

Even the rain is positive, because it's a glorious spring rain driving away the snow. As good as sunshine, it it's way.

I am blessed.

As I was discussing addiction with respect to benzodiazepenes with Ed, I stumbled on a great truth that may lead to obesity war success. You see with opiates and benzos and nicotine there are large groups of people who can take them socially and never become addicted. In fact, addiction is very infrequent and there is evidence that some people become addicted more easily than others. And eating food is EXACTLY like abusing nicotine and opiates and benzos. We know that ostracizing people works on addictions, and obesity is simply an ADDICTION TO UNNECESSARY FOOD. Funneling billions into the war on drugs and tobacco has ended addiction in people who matter to politicians. But how can this apply to an EPIDEMIC of obesity?

The war on obesity will make everything okay by eliminating the "socially obese" who are only fat when they go dancing, have surgery or experience panic attacks. The socially obese only gain weight to fit in and be cool. Like the "weekender" cocaine user, they can cut an lean and mean figure in a power suit during the business week, while BALLOONING into fatness for relaxation and fun after work and on weekends. It's scienterrific fact that FAT IS CONTAGIOUS to people who don't live with the obese "index" person, just as influenza is contagious to friends who live across the country but not to members of the "index" person's own household.

The socially obese, like social smokers who can take or leave tobacco products, simply need to be convinced that they can stop eating permanently with the support of medical professionals. And they need motivation. Americans are far too accepting of obesity. We coddle the obese by legalizing businesses that sell them clothing that fits and even food itself. We respect their dignity by never including their faces in photographs of their shameful, disgusting bodies in the media. We protect them from embarrassment by excluding them from the public eye in the movies and especially politics. And the radical "fat acceptance" advocates aren't grateful, even when we make an exception and legitimize their view by letting them debate obesity experts like Meme Roth on national television.

Social obesity must be stopped. People who become obese to fit in need the strongest possible reminders that obesity is a TRAGIC CHOICE taken up to gain social approval. We must emphasize that eating is a choice and they can stop if they really want to, and don't fall for peer pressure to remain obese. Only hatred can improve their health.

Thanks to all of you who have given me support online and off. It has cheered me up quite a bit.

I have my disability placard and I'm grateful for it. I only use it if I need to because no other parking spots are reasonably close. I still feel better for the most part fighting the physical decline instead of giving in to it. The fight just keeps getting harder though. As I contemplate possibly not being able to walk anymore I appreciate more than ever the independence it brings and the blessing that it is.

I went to my psych NP and so far the cross taper is going well, although there's no sign that the muscle thing is getting better. Unfortunately, I can't just decide to stay on this class of medicines and be physically disabled, it turns out. J is concerned that they might affect my smooth muscle as well as skeletal. Which includes my heart muscle. :( She did say that it is too soon to tell. At least I've got a proven record of not getting addicted to benzos when I took a modest dose for three years. They didn't prevent anxiety like the atypicals do, but they did treat it effectively.

I'm struggling with doubts that the medication is the real culprit, and wondering what the next step is in searching for a diagnosis. I need to bring up the scooter issue with my PCP, but I'm still afraid that he'll think I'm hypochondriac or lazy because I'm fat. Maybe I'll just have Ed come with me. I hate that I feel like I need someone to vouch for me, but that's the reality. It sure throws my feminism for a loop though. I suppose that if Ed were in the same condition he would want me there. I do think Krista is right that there is medical discrimination toward middle aged women, especially if they are fat.

I haven't written about the muscle pain and immediate fatigue lately, but they haven't gone away either. I just don't like to focus on it. My PCP Dr. Armstrong told me last time I went that we might never know what is causing it. I guess I sort of felt he had given up on me, so I stopped going. He sent me to an neurologist last fall but I had a completely normal exam and the neuro didn't seem to *listen* to me very well. I told him about muscle pain of a seven-of-ten-scale after about two minutes of movement such as walking, carrying, holding or standing, and he suggested a fifteen minute long bicycling test to see if my muscles would act funny. I felt like crying. I was too embarrassed to point out that in this condition I wouldn't be able to tolerate exercising that long. He told me I have an umbellical hernia that needs surgery base on the fact that my muffin toppy belly pooches up when I go from lying to sitting. I can't imagine having a foot long hernia with no pain at any time, it just doesn't make sense.

Anyway, we took a vacation to New Mexico for Christmas and the travel really wiped me out despite the fact that I buckled and asked for wheelchair escorts at each airport. I'm glad I did. I was exhausted during the whole trip, and it took at least a week to recover physically when we returned. I feel like I'm ninety. I worked with a physical therapist for five weeks without improvement.

I feel like I'm in the middle of a fixed delusion about conspiracy and nobody can believe what I say or accept my reality. I've entertained the notion that my pain tolerance is just decreasing with age or fatness, but no other person I know of my weight or age seems to be having these problems. I've asked my NP/Psychiatrist for a disability placard, and she's signing off for one. She thinks it is the risperdal, so I'm switching to seroquel. She doesn't know if this would get better if I stop risperdal, but she thinks it may stop progressing.

So here I am, 18 months after I started having trouble with my 45 minute workouts. At this point I get burning muscle pain and cramping sensations (but not spasms) in my legs and back when standing or walking for over a minute. I get cramping in my arms if I hold the phone, or carry a water bottle or push a grocery cart. Sometimes my legs or feet cramp for a long time after a short walk of maybe thirty yards from the parking lot to my desk. My muscles also get stiff more easily, making it doubly painful to walk after resting. I am often exhausted at the end of the day. I have to sit down to sautee mushrooms because I can't stand for the four minutes it takes without significant pain that forces me off my feet. I have begun sitting in inappropriate social circumstances where everyone else is standing. At the psych hospital's nursing station, or in an AFC home where a client is touring. I'm in enough pain walking that I look longingly at mobility scooters and wheelchairs online.

I'm losing my ability to stand and walk and nobody knows why. It seems to be getting worse again, and I'm starting to fear for my job, which is periodically active. Nobody knows why. None of the tests come back abnormal. All the evidence says that I'm making it up, but I'm not.

It's starting to feel like a slow nightmare I can't wake up from.

I know I sound like a whiney toddler, but sometimes I just have to say it or I'll burst.

Documentation of necessity and progress are vital to our continued ability to help our clients. This requires specific description of the psychiatric condition and a complex understanding of progress that is unique to health care. Think in medical terms - progress is not a simple matter of continued improvement, like it is in other endeavors. Compare our work to keeping a person in respiratory distress alive. Interventions promote progress regardless of the severity of the condition or response in the patient. Medical progress is made when the patient is cured (rare), assessed, correctly understood/diagnosed, stabilized, prevented from relapsing, prevented from declining more than they have, recovered from an existing bad outcome, hospitalized for more intense treatment and in the worst case scenario given the best treatment possible until death (rare for us). Our interventions help clients make progress through continued stability at any severity of baseline, mitigation or prevention of symptom or substance abuse relapse, referral to more intense treatment and assistance in recovery from a bad outcome. Progress can be slow and is seldom sudden and earthshaking. Sometimes progress is improvement, yes. But more often it is standing still (maintaining stability) or taking two steps back instead of ten, and sometimes it is falling off the cliff then putting the pieces back together. Suggestions for documenting progress follow.

Opening – What is happening today, with an emphasis on the positive. If you are working on a problem that won’t seem to go away, it’s known as following through. Following through is very esteemed by readers. An intervention is positive when it is presented as identifying improvements to be made, for example. Anything can be phrased positively because you can put a problem in terms of how it is being addressed. You can present a client’s urge toward self harm positively in terms of a worse situation in the past or in terms of what you did to help identify it and act to help them cope or get appropriate inpatient care.

Analysis – Put what is happening now in context of the whole, emphasizing progress made over time. Mention the day’s goal and how it was either met or re-evaluated when surprises cropped up or exchanged for a more pressing goal. Mention the bigger goal that this is part of and pick a time frame that shows progress or work toward solutions. Mention the person centered goal as well and how today’s goal moves you toward it. You determine the time frames and contexts, so you are always able to put this in a positive manner as well. You are never truly stuck because you are always assessing, monitoring, linking to resources or treatment,introducing interventions or building on previous interventions.

Conclusion – How today leads to tomorrow or simplifies the goal or does something to help the client. Once again you choose the details and can direct the focus and attitude. Think of this as the main idea about progress you want the reader to come away with.

Over at Shapely Prose, Dr. Sheila Addison is looking for recommended reading for a class she is teaching on size acceptance in family/marriage therapy.

This was my input, and I encourage you to head over there and add your own!

Kate Harding's "Don't You Realize That Fat Is Unhelathy" and "The Fantasy of Being Thin" are definitely two of the best introductions to size acceptance I've ever read.

"Big Big Love" is an excellent book dealing with sexual relationships and self acceptance. I think in Marriage and family counseling you would come across a LOT of entitled fat hatred on the part of partners and parents who are not fat. Or parents who are fat and fantasize that they can "save" their child from fatness by shaming them and telling them nobody will find them attractive. Seriously, any partner who feels justified in harassing or leaving someone based on weight (no matter how acceptable and encouraged fat hatred has become) has issues of their own. They might also just use weight as the best tool to push the partner away so they aren't the "bad guy".

Fat?SO! Was also very formative for me, long before there was a fatosphere. Junkfood Science articles are extremely rational and evidence based analyses of the cultural hysteria that is the obesity epidemic and the science showing that fat is not the killer it is purported to be.

The best thing to emphasize is that fat people are no different from thin people or other social groups subject to prejudice (positive or negative). You cannot tell anything about a fat person by looking at their body. NOTHING. As with other groups, make no assumptions about your client and instead listen to them. If there are deep issues with eating or body image, they will emerge. The fact that they do not usually indicates that there are none, not deep denial. If someone tells you they eat less than their thin friends, believe them. If someone tells you that his insecurities as a father have little to do with size and everything to do with the way his parents *treated* him for his size, believe him. If food and size never come up, don't force the issue. If you must address weight because it does come up,do so in an accepting manner that is HAES and size positive. Keep things about psychological and behavioral issues and stay out of medical issues. Frame weight in terms of other prejudices to clarify how hurtful and unacceptable mistreatment of fat partners/parents/children really is. If you wouldn't say it about race or religion, it's prejudice and you're behaving rudely.

Krista has been commenting here for a little while, and this weekend I got a chance to read her blog too. She linked to her best friend's blog, and her best friend had reposted this. Please take the time to read it. You won't be sorry.


A lot has been said about how to prevent rape.

Women should learn self-defense. Women should lock themselves in their houses after dark. Women shouldn't have long hair and women shouldn't wear short skirts. Women shouldn't leave drinks unattended. Fuck, they shouldn't dare to get drunk at all.

instead of that bullshit, how about:

if a woman is drunk, don't rape her.
if a woman is walking alone at night, don't rape her.
if a women is drugged and unconscious, don't rape her.
if a woman is wearing a short skirt, don't rape her.
if a woman is jogging in a park at 5 am, don't rape her.
if a woman looks like your ex-girlfriend you're still hung up on, don't rape her.
if a woman is asleep in her bed, don't rape her.
if a woman is asleep in your bed, don't rape her.
if a woman is doing her laundry, don't rape her.
if a woman is in a coma, don't rape her.
if a woman changes her mind in the middle of or about a particular activity, don't rape her.
if a woman has repeatedly refused a certain activity, don't rape her.

if a woman is not yet a woman, but a child, don't rape her.
if your girlfriend or wife is not in the mood, don't rape her.
if your step-daughter is watching tv, don't rape her.
if you break into a house and find a woman there, don't rape her.
if your friend thinks it's okay to rape someone, tell him it's not, and that he's not your friend.

if your "friend" tells you he raped someone, report him to the police.
if your frat-brother or another guy at the party tells you there's an unconscious woman upstairs and it's your turn, don't rape her, call the police and tell the guy he's a rapist.

tell your sons, god-sons, nephews, grandsons, sons of friends, daughters - tell everyone it's not okay to rape someone.

don't tell your women friends how to be safe and avoid rape.
don't imply that she could have avoided it if she'd only done/not done x.
don't imply that it's in any way her fault.
don't let silence imply agreement when someone tells you he "got some" with the drunk girl.
don't perpetuate a culture that tells you that you have no control over or responsibility for your actions. You can, too, help yourself.


If you agree, repost it. It's that important.

A certain person who shall remain unnamed but whom I happened to marry about ten years ago told me he had a picture of me and turned his laptop around to reveal this.

A couple of FACTS are called for here.

1. Hours after I am peacefully dreaming, this unnamed person is typically still on the internet.

2. My charms and beauty would have remained entirely unknown to him if it hadn't been for someone being wrong on...well it wasn't exactly the internet as we know it.

Before the world wide web, back in the mists of time, when dinosaurs roamed the earth there were scarcely known rooms called student computer labs, exclusively in the actual computer science building. There were computers there, unlike in dorms or libraries or apartments. And those computers could link to electronic bulletin boards through an ill defined process that non-computer people did not worry their little heads about. It came to pass that the university upgraded and would actually sell the monitor, keyboard and 300 baud modem to students. Amongst all the men buying them was the occasional nubile woman taking an assembly back to her apartment. There she could read intelligent and not-so -intelligent discourse on all manner of subjects, and give her own pithy responses.

In the course of time a misguided user named Skullhacker wrote a post so mind-numbingly ignorant that one such woman could not help correcting him. When she hit enter and returned to the forum, she found a remarkably similar response to Skullhacker. "What an intelligent person!" she thought, "I must high five them!" So she did. It emerged that this intelligent person was male. And lo, he did not ask her what color her panties were. This passed for gentlemanly behavior on what would become today's internet. So she continued X messaging him when she was online. Intellectually stimulating and amusing conversations followed, and those conversations became more stimulating over time.

A day came when the pair decided a telephone conversation would be enjoyable and smoother that X messaging. And lo, the man asked the woman if she was really over eighteen in a frightened and disapproving tone, the which concern pleased the woman and helped her believe that she was not speaking to a predator. And she offered to send a copy of her driver's license before they spoke again, and the gentleman said no, that was okay. The woman and the man continued their long distance telephone conversations, and there was much rejoicing in the AT&T billing department.

Time passed, and hesitant planning for a meeting in person ensued. The man was visiting friends up north over New Year's, and the woman was house sitting in a big city a few hours away. The woman made many dampened braids in her waist length golden hair, the better to lure the man when her hair was let down into a mass of waves. And it worked. And they attempted to get it on, but the friend's refrigerator made loud banging noises and they were afraid it would wake other people up, and they did not want an audience, and besides they were nervous.

And they traveled to the big city to house sit together, and life got better until Trent the Bondage Kitty made his appearance. And the big city was FUCKING COLD with temperatures below zero and famous winds. So they had little to do besides snuggle and make an occasional shivering one block journey to Boston Chicken for sustenance. And Boston Chicken turned out to be SO ROMANTIC!tm They decided that they were fond of each other in the face of glaring evidence that they were both already head over heels in love, in an attempt to be prudent and cautious.

They returned to their now lonely homes. They wrote and called. They visited when they could afford it. The man moved back north to be about eight hours away instead of 22. The woman moved to the big city to be about three hours away instead of eight. That year he came home with her for Christmas and her mother bestowed upon him a dowry of clothing, watches and a higher baud modem. Soon the man proposed on one knee under the fireworks. The woman danced around and said yes.

And ten years later all the man can do is mock the woman playfully for obsessing over the internet.

Bastard. :)

I love you Sweetie! Thanks for reminding me how we met.

I changed my template to a less stodgy appearance. I like elegance and all, but I also like fun and goofiness, so the polka dots seemed to fit. Hope you like it, I sure do!

Riolriri at She Dances On The Sand pleads to know if she is the only person opposed to bariatric surgery in children. This is my reply.

You are not alone.

I am uncomfortable with any cosmetic surgery in children who are not severely disfigured. I think surgeons should wait until teens are at least at the age of consent. I think ethical ones do.

When it comes down to it, though, other cosmetic surgeries are not as dangerous as bariatric surgery. They do not have a 2% perioperative mortality rate (within 30 days of surgery) 4.6% mortality within a year. They do not cause beri beri, with permanent neurological damage. They do not cause peripheral neuropathy. They do not limit the amount of fluid one can drink when exercising or feverish, promoting dehydration. They don't cause chronic vomiting and malabsorbtion of what does stay down.

These surgeries are extremely dangerous for even adults, but adults have a right to mutilate themselves if they want.

Parents should not have free reign to mutilate their children for the sake of appearance. Hell, I oppose circumcision on this ground. And circumcision doesn't cause devastating malnutrition which can stunt growth and result in lifelong neurological damage.

For details on the actual mortality risks of obesity as opposed to bariatric surgery, see this brilliant post from Sandy on Junkfood Science on the actual risks of dying from obesity.