Once upon a summer afternoon, Miss Melody Joy was looking around her parent's Xfinity On Demand to see what she could watch, since she was already all caught up with her shows. \
At 15 or 16, Miss Melody Joy was already tuned in with her body's biological processes and relatively obsessed with anything related to S-E-X. Not just the act of sexual intimacy, but also the biology of puberty and sexual maturity, social mating mores across cultural lines, gender roles, feminism, relationship management and the biological result of heterosexual intercourse and luck (babies) and the lifelong affect of that result.
So when she found a show titled 17 Kids and Counting she enthusiastically selected and started playing an episode with an interesting synopsis. 7 years later she isn't too sure what that episode was, but it did lead to a lot of shame-marathons (it was a REALITY TV SHOW and she thought she was much smarter than that) when her parents and solitary younger sibling were not present. Usually in the middle of the night. That summer afternoon was a bit of an anomaly.
Only 5-6 episodes were available at a time On Demand, and she wanted to learn more about this cheery christian family with tons of kids spanning the ages of 2 to their early twenties. They were all relatively good looking, very well groomed and nice hair which was something Miss Melody Joy was not familiar with in regards to fundamentalist Christians She knew they probably loathed homosexuality (a bisexual, Miss Melody Joy finds this to be irritating), Harry Potter (another thing she obsesses over) and freedom of female thought. This did not stop her wanting to learn more. They were like shiny foreign trinkets, snapshots of a world that she never before imagined.
By googling the Duggars Miss Melody Joy learned about Christian Patriarchy, Quiver-full The Pearls, Goddard and various christian homeschooling networks. The strangest thing, however, was that she learned all these things from women who left the movement. Wives who converted to CP/QF then left when they saw how it was damaging their children (with or without their husbands). Wives who grew up in the movement, followed the teachings, had a courtship and children but then left (with or without their husbands). Daughters who ran away from home after rejecting the wrong suitor.
A pagan/atheist (She thinks it just averages out as Agnostic with magical leanings), these were things Miss Melody Joy had no experience with. Her father grew up Puerto Rican in a Roman Catholic church, and left Catholicism after his confirmation with a resounding threat to HIS father over dropping out of High School if he was not permitted to transfer to a public school. Apparently racism is alive and well in Catholicism, as the nuns who taught the High School were harsh and bigoted towards Puerto Ricans in the 70s and 80s. Miss Melody Joy's mother frequently told stories about going to a different denomination church every available mass because membership to one ministry meant awesome youth dances, while another had a great hymnal that the family loved and the third offered a brilliant youth group. This all came to a head with Miss Melody Joy's aunt got very sick and all three leaders came to visit her. Apparently her aunt played it like a fiddle and the whole family was not shamed for going to so many different houses of worship.
Miss Melody Joy herself had never been a part of any church or religion. Her first experience with religion was witnessing a family friend sit Shiva when she was 7. Her first experience with religious services was a Jewish/Catholic wedding that was painfully long when she was 11. She thought the breaking of the glass was cool, even though no one could explain the symbolism to her. Her second service was a Catholic service when she shadowed a girl in a Roman Catholic High School she was thinking about applying to. She accidentally took communion because she didn't know what to do. Being 13 is awkward. She was baptized either Methodist or Anglican, the family can't remember. She was just baptized to be baptized to appease grandmothers and ward off bad luck.
Her family's apathy towards religion and learning more about American Evangelicalism and the CP/QF sub-movement solidified into an anti-religion sentiment. She could not abide a group that permits or even endorses child abuse (the Pearls), taking away life decisions for daughters and sons (mostly daughters though) AND homophobia, misogyny (weaker vessel her foot), and xenophobia. Yea, xenophobia. Apparently not enough white Christians were banging and popping out babies so the racist misogynists started this movement to offset the "plague of godlessness" read: Dark skinned, non-Christians. She casually embraced her pagan leanings but found all organized religion to be suspect.
But, problem! She kept dating CHRISTIAN BOYS. She would happily and benignly start a relationship, open about being a feminist and being bisexual and the boys would pass the jerk tests and she would figure they were, at the very least, non-practicing. But no! Sooner or later, after she made one too many snide jokes about religion, the young men would bring up that they were, in fact, Christian. And believed it all too! Flabbergasted, as she already felt like she was in love, she would start re-analyzing her beliefs. She'd read the bible, find Christian-run blogs and take stock of every single thought and feeling brought up by Religion. And it was always consistent. The art is gorgeous, the rites are stunning, the platitudes are nice but the foundation is fundamentally flawed. You don't move into a building with crumbling supports just because the hardware is artisan and it shows.
For unrelated reasons, those relationships would break up. She was a teenager after all. She wouldn't need to try. Until recently. But thus comes the Universal Unitarian church!
UU is so far from American Evangelicalism that it may as well be on a different planet. It's progressive, peace-oriented, and isn't really Christian anymore. Unitarianism was the first form of it, which was a progressive Christian denomination at its time, but it later evolved to be UNIVERSAL and for spiritual, community-based groups who crave the spiritual structure a church offers without the ethical dilemmas and hypocrisy. While people who identify as Christians are present, it is actually Humanists who dominate the pews at a whopping 46.1%. Earth/Nature centered comes in second at 19%, Generic "Theist" at 13% and THEN Christians at 9.5%. It's mind-boggling. And it's exactly what Miss Melody Joy can sign up for if, for whatever reason, a spouse desires to have church and it's attached community a major part of adult and parenting lives.
And there is zero risk of homophobia, misogyny and xenophobia. That's a huge plus.
Sunday, December 16, 2012
Friday, December 14, 2012
ADHD and the ADHDer: Chemical Pathways and Brain Development
AN: X-post from my tumblr, kittyunfiltered.tumblr.com.
A big problem that I think plagues many ADHDers is self-identifying what is the disorder and what is us. Even at 22 and medicated, I still have a lot to learn about myself and the disorder. Where it stops and I begin is a nonexistent line, both personally and medically.
A long-held theory behind the disorder's etiology is that a person with ADHD has a chemical insensitivity in the dopamine-reward system. This chemical insensitivity in the DRS lends a hand in the inattentiveness, impulsiveness and hyperactivity because it is/we are under-stimulated and these actions "hit the button" hard, allowing us to feel good/pleasure/accomplished. This may explain the high prevalence of drug addiction, eating disorders and self-injuring behaviors in the ADHD population since all those things have a way of immediately and strongly stimulating the pleasure and reward centers of the brain. Controlled amphetamine drugs (like Adderall, Ritalin and Concerta) up-regulate the DRS, sensitizing it to dopamine, and allowing for "normal" behaviors in medicated ADHDers. However, when an ADHDer is medicated with a controlled amphetamine there is still a strong chance the person is going to present with symptoms still.
Recently published long-term studies indicate that for whatever reason, ADHD brains develop on a vastly different timeline or at different rates than non-ADHD brains. The NIH indicates that on the most part these regions start and stop developing later than neurotypical children with one notable exception: The motor cortex, which develops 2-3 years sooner/faster in ADHDers than neurotypicals. The motor cortex controls gross- and fine-motor control, and the adjusted timeline for its development means that a 5 year old child with ADHD has the motor control of a 7 or 8 year old neurotypical child. There are a lot of sociological implications for this, but it would derail the further explanation of ADHD brain development.
As a whole, however, the ADHD brain is around 3 years "behind" neurotypical brains, and the individual breakdown of each region of the ADHD brain can be on average of 1 to 5 years behind the neurotypical timeline. The most notable region that takes 5 extra years (if at all) is the frontal lobe that controls executive function. It should be fully developed by 25, but it is not fully formed until at least 30 for the ADHD brain.
Keep in mind that these are numbers derived from longitudinal studies and are averages. Since I don't have the ability to dig up the original research article I can't tell you if these are means, medians or modes, but a basic understanding of statistics means that there were probably outliers in these studies, which means that there could have been a small number of the 231 participants that fell on extreme sides of these timelines - ADHD individuals with NO delay in brain development (which would indicate that they may have had just a dopamine-reward system problem or weren't ADHD to start with but had a different behavioral disorder) and ADHD individuals who took much longer to develop in certain regions than where most of the data fell. And since most research articles correct for these extreme outliers, the data can be very skewed without knowing its p-level or CE and how it relates to the outliers. And since these studies had around 231 ADHD individuals in an estimated population of 300 million people world-wide with ADHD, the actuality of these findings may be good but there is still a strong shot at the numbers being off.
It DOES show, however, that (A) ADHD can't just be fixed by medication until you are at the very least 30 when the brain is finished developing structurally and actual neural connections are present in similar numbers as the neurotypical population (B) It can be very hard, if impossible, to see the difference between what is the disorder and what is the person.
Are we dotty or is it the lagging neural connections leading to "immature" statements? Are we forgetful or is it the delayed frontal lobe development? Am I creative or are they segues caused by abnormal neural activity? And then keep in mind that while the cerebral cortex seems to be developing differently, the other parts of the brain are right on schedule with everyone else. This means that this delayed schedule can mean bizarre things for our brains when the hormones of puberty come in to play, as the hypothalamus is beholden to no one in this case. It's not just that we are somehow delayed a few years in these areas of executive function, but the actual development may be occurring in a soup of endocrine craziness that it was never intended to be in.
And it is still not fully studied! There seem to be a whole bag of neurological differences in the ADHD brain, since it appears that how our hemispheres "talk" to each other differs in ADHDers, despite controls for age. Even though we're however-many years old and "3 years" behind, our brains may still be different than our developmental cohort.
All this data makes me wonder about myself. This across-the-board difference in structure means that it's not just ONE "flaw" but many, and some of them are resistant to medical intervention. I have ADHD. My brain is fundamentally different from anyone without the disorder. I not only struggle with interacting with people who are neurotypical, I actually get on best with ADHDers than any other type of neuroatypical individual. I am under the impression that this isn't necessarily common in all neuroatypicals. Do autistics understand and feel satisfied by companionship with other autistic individuals? Do clinically anxious people feel relieved and refreshed by communicating with groups of other anxious people? Do schizophrenics feel like they can "speak their native language" with other schizophrenics?
Maybe they do. Maybe because I'm not reading and consuming blogs and articles written about, for and by these people I'm not seeing that they are feeling a similar way about themselves, their cohort and their disorders that I do about myself, my cohort and my disorder. Maybe all neuroatypicals feel that intense relief and freedom when meeting someone of the same "type" like I do when meeting other ADHDers. Maybe all us neuroatypicals feel a little shafted that the thing that makes them so different is so a part of who they are that no matter what treatment you attempt it won't clear up like bacterial pneumonia does when taking antibiotics. Maybe all us neuroatypicals resent that their whole self is pathologized while realizing that this "disorder" is negatively affecting how we engage and achieve in society as a whole, and damaging our chances for long-term relationships that resemble any sort of happy and health. And maybe that duality in thought has all us neuroatypicals chasing our tails, trying to figure out who we are, and the faint distinction between that and the disorder.
My ADHD Story
AN: X-post from my tumblr, kittyunfiltered.tumblr.com.
I was officially diagnosed with ADHD when I was 15. I had been struggling with ADHD since I was 9, when school assignments exceeded my natural intelligence and I couldn’t coast on that, while I had been showing symptoms since I was five years old.
It took me that long to get officially diagnosed because my parents were reticent to medicate me with the amphetamines on the market. They thought that it was just my personality and that teachers were too keen on homogenizing their classrooms. Later, they did believe I had the disorder but thought that since I was able to do so well in school the years previous I “just had to try harder.”
“Just try harder” is one of the most harmful statements a youth with ADHD could hear. ADHD has kept me from sticking with all sorts of groups and activities I am deeply interested in. ”Trying harder” had never worked, and left me with a lot of self-loathing. I couldn’t measure up, no matter how much I tried harder. I could never live up to the potential others ascribed to me, no matter how much effort I put into my studies. I would test in the 98th percentile yet my GPA could never pass a 2.5. That 2.5 was hard won, but no one could see that.
I discovered that many teachers had told my parents that they suspected I had ADHD when I was 13. Given an explanation for all my difficulties and a way to finally conform to these impossible expectations I advocated for myself for the next two years. After a particularly terrible outburst in my high school chemistry class my parents finally caved and I was taken to the doctor and diagnosed immediately.
The change was astounding. After a month of my new medication, I started getting straight As. However, I also suffered from terrible side effects of said medication and eventually was overcome with amphetamine psychosis, which left me with horrible hallucinations and delusions. I eventually stopped taking medication for two years and muddled through the first years of college relatively okay.
After two car accidents I had to start medication again. This was a different medication that, while leaving me with fewer side effects, did not leave me with as many amazing grades.
The thing with my experience with ADHD is that medication can’t fix everything, or that it can cause more troubles than it’s worth. It’s a stop-gap, and the troubles it doesn’t solve have to be managed, and that management is incredibly difficult. I’ve had more problems explaining my symptoms and disorder to people than I’ve had with my actual disorder. People don’t understand it at all, or refuse to despite quantifiable evidence.
If there is one thing I want to share with my administrators and professors, is that “trying harder” it is something that I cannot do. I am trying as hard as I can, often to much emotional detriment. The stress involved with keeping up is utterly overwhelming. I would kill to have the people in charge of my education understand this.
Why I Write
This self-involved post is brought to you by recent introspective contemplation over the volume of and reasons for my writing.
I recently have advised many of my peers and friends that they need to journal. Not just write but journal. These people have many personal issues they feel are impossible to understand and navigate and the initial pieces of advice usually include this tip. To me, journaling is the first and best way to understand yourself, your relationships and ultimately your life.
The moment I feel overwhelmed by my thoughts and feelings related to any situation I take to my (admittedly hipster) moleskine journal and start writing. It starts with why I'm writing - "I feel a weird sense of doom" or "I'm upset and don't really know why" - and then I start describing what has been going on in my life. This is often a bullet list and when I hit something that seems to carry more emotional weight I really go into detail on what is going on related to that and it helps me pick out the concerns I haven't really acknowledged and how I feel about it all.
Once I feel like I put down all the immediate thoughts and feelings related to the situation I start really analyzing those thoughts and feelings. If life and studying psychology have taught me anything it's that your thoughts and feelings typically aren't so superficial as what first comes to mind. There are whys and hows that can be dissembled so the root of the bad feelings can be confronted and dismissed. I say dismissed because while whatever crisis I may be hip-deep in, the feelings that are informing my actions may be (and usually are) guiding me down a less than beneficial path. To better function, it's best to dig out the inner truths that are fueling the negative feelings and therefore actions and tell them to sod off.
For example, I have a lot of school anxiety and I always seem to be in the middle of an academic crisis. Some of it is ADHD and related executive function issues, but a lot of it is a deeply entrenched belief that no matter how well I succeed in school I won't use whatever skill I'm learning because I won't be alive to use it. This incredibly dark and morbid belief is fueled by a long and abiding history of suicidal ideation and behaviors. I'm not ashamed to admit this because it's reality for me, and I'm working on it. But it does lead to a seemingly unavoidable apathy towards my academic responsibilities which then results in poor grades and a deep panic because of the conflicting knowledge that I WILL need this information and I DO need to succeed so my life will be easier - even though part of me hasn't fully accepted the reality of having a future.
This is a very dramatic example, but I wouldn't be aware of the root of my cycle of apathy - poor grades - panic - frantic compensation - success without years and years of journaling. I have many pages spanning countless journals, blogs and years dedicated to me agonizing over this flaw in my functioning before I came to the epiphany that unveiled this inner truth.
And this is connected to my writings that aren't journal entries, because everything a person writes really should (and usually is, for me) be a mirror you can study your inner self in, or a snapshot of your heart and mind at that point in time. Themes the author utilizes are indicative of their concerns, of inner battles they're fighting. The poetry I write typically reflects the cadence of how my mind thinks. Even academic papers can be a source of deep reflection because if you (ideally) pick subjects relevant to your life, you may encounter a fact or develop a thesis that helps illuminate a part of yourself that you didn't understand or acknowledge before.
Writing is frequently ugly, because feelings are ugly. They're messy, they make people uncomfortable, the really strong ones can steal your breath away and leave you on your knees. Writing takes those feelings and refines them, makes them linear and universally understood. And if you're really really good at writing, a work you actively pour yourself into can still take a reader's breath away and leave them on their knees. I'd like to develop my writing ability so my work can do this. It's been a goal kept close to my heart long after I shelved writing as a career. I would love to have an essay published by a discerning publication, to be recognized at least once As A Real Writer. But, like cartooning, I know I would destroy myself pursuing it without a fall-back or a day job that meant something to me. Hence nursing.
But that may be an excuse I've formulated out of cowardice. I haven't properly analyzed by love of writing and my refusal to make a career out of it. I am satisfied when I put together a public blog post that is clear and concise, and exhilarated when a post gets any sort of recognition. I post my "brainy" posts on tumblr now because it's easier to get to a sympathetic audience. I have ADHD posts there that get a fair bit of recognition from re-blogging and likes which is so nice. I know someone has read them, and saw truth in them. It's almost like being in a professional publication!
I recently have advised many of my peers and friends that they need to journal. Not just write but journal. These people have many personal issues they feel are impossible to understand and navigate and the initial pieces of advice usually include this tip. To me, journaling is the first and best way to understand yourself, your relationships and ultimately your life.
The moment I feel overwhelmed by my thoughts and feelings related to any situation I take to my (admittedly hipster) moleskine journal and start writing. It starts with why I'm writing - "I feel a weird sense of doom" or "I'm upset and don't really know why" - and then I start describing what has been going on in my life. This is often a bullet list and when I hit something that seems to carry more emotional weight I really go into detail on what is going on related to that and it helps me pick out the concerns I haven't really acknowledged and how I feel about it all.
Once I feel like I put down all the immediate thoughts and feelings related to the situation I start really analyzing those thoughts and feelings. If life and studying psychology have taught me anything it's that your thoughts and feelings typically aren't so superficial as what first comes to mind. There are whys and hows that can be dissembled so the root of the bad feelings can be confronted and dismissed. I say dismissed because while whatever crisis I may be hip-deep in, the feelings that are informing my actions may be (and usually are) guiding me down a less than beneficial path. To better function, it's best to dig out the inner truths that are fueling the negative feelings and therefore actions and tell them to sod off.
For example, I have a lot of school anxiety and I always seem to be in the middle of an academic crisis. Some of it is ADHD and related executive function issues, but a lot of it is a deeply entrenched belief that no matter how well I succeed in school I won't use whatever skill I'm learning because I won't be alive to use it. This incredibly dark and morbid belief is fueled by a long and abiding history of suicidal ideation and behaviors. I'm not ashamed to admit this because it's reality for me, and I'm working on it. But it does lead to a seemingly unavoidable apathy towards my academic responsibilities which then results in poor grades and a deep panic because of the conflicting knowledge that I WILL need this information and I DO need to succeed so my life will be easier - even though part of me hasn't fully accepted the reality of having a future.
This is a very dramatic example, but I wouldn't be aware of the root of my cycle of apathy - poor grades - panic - frantic compensation - success without years and years of journaling. I have many pages spanning countless journals, blogs and years dedicated to me agonizing over this flaw in my functioning before I came to the epiphany that unveiled this inner truth.
And this is connected to my writings that aren't journal entries, because everything a person writes really should (and usually is, for me) be a mirror you can study your inner self in, or a snapshot of your heart and mind at that point in time. Themes the author utilizes are indicative of their concerns, of inner battles they're fighting. The poetry I write typically reflects the cadence of how my mind thinks. Even academic papers can be a source of deep reflection because if you (ideally) pick subjects relevant to your life, you may encounter a fact or develop a thesis that helps illuminate a part of yourself that you didn't understand or acknowledge before.
Writing is frequently ugly, because feelings are ugly. They're messy, they make people uncomfortable, the really strong ones can steal your breath away and leave you on your knees. Writing takes those feelings and refines them, makes them linear and universally understood. And if you're really really good at writing, a work you actively pour yourself into can still take a reader's breath away and leave them on their knees. I'd like to develop my writing ability so my work can do this. It's been a goal kept close to my heart long after I shelved writing as a career. I would love to have an essay published by a discerning publication, to be recognized at least once As A Real Writer. But, like cartooning, I know I would destroy myself pursuing it without a fall-back or a day job that meant something to me. Hence nursing.
But that may be an excuse I've formulated out of cowardice. I haven't properly analyzed by love of writing and my refusal to make a career out of it. I am satisfied when I put together a public blog post that is clear and concise, and exhilarated when a post gets any sort of recognition. I post my "brainy" posts on tumblr now because it's easier to get to a sympathetic audience. I have ADHD posts there that get a fair bit of recognition from re-blogging and likes which is so nice. I know someone has read them, and saw truth in them. It's almost like being in a professional publication!
Monday, November 12, 2012
Transitioning and how I cope with it
The thing with ADHD is that transitioning, that is; switching tasks, locations or topics quickly after hyperfocusing/perseverating is painfully difficult. I'm not even hyperbolizing. My brain feels weird, I feel unsettled and my nerves are jangly. There is a very real physical response to switching gears, and it's icky.
What helps me (when I remember) is writing down my thoughts. Beyond the webz and my innumerable blogs I have a moleskine journal. My diagnosis diary! When I'm unable to use my diary (exams, w/e) I've been known to write down my twisty tangled thoughts on any available scrap of paper because the process of transitioning makes my head a hurricane of half-formed thoughts and to-do lists. Writing down these thoughts, concerns and lists brings order back to my scrambled brain. I also find it to be a type of meditation.
The act of writing, with a pen and piece of paper, is hypnotic. This thread of suspended pigment flows out of this nub in my hand onto this semi-absorbent sheet of cellulose and some how, through the magic of human ingenuity, it represents my thoughts and feelings. The dual act of physically ordering my thoughts and marveling over the process of writing eventually leaves my brain quiet. I can almost hear "Om" at the end of a particularly satisfying scribble session.
Why yes, I have already written in my journal. And then I meta'd the fuck out of it by writing about writing in my journal in another journal.
Also: compartmentalizing. Compartmentalizing helps ADHDers a lot. Even if it doesn't make sense to neurotypicals, if how you personally organize your thoughts and stories makes sense to you, GO FOR IT. It's your damn physical representation of your brainspace. Do what you want with it.
What helps me (when I remember) is writing down my thoughts. Beyond the webz and my innumerable blogs I have a moleskine journal. My diagnosis diary! When I'm unable to use my diary (exams, w/e) I've been known to write down my twisty tangled thoughts on any available scrap of paper because the process of transitioning makes my head a hurricane of half-formed thoughts and to-do lists. Writing down these thoughts, concerns and lists brings order back to my scrambled brain. I also find it to be a type of meditation.
The act of writing, with a pen and piece of paper, is hypnotic. This thread of suspended pigment flows out of this nub in my hand onto this semi-absorbent sheet of cellulose and some how, through the magic of human ingenuity, it represents my thoughts and feelings. The dual act of physically ordering my thoughts and marveling over the process of writing eventually leaves my brain quiet. I can almost hear "Om" at the end of a particularly satisfying scribble session.
Why yes, I have already written in my journal. And then I meta'd the fuck out of it by writing about writing in my journal in another journal.
Also: compartmentalizing. Compartmentalizing helps ADHDers a lot. Even if it doesn't make sense to neurotypicals, if how you personally organize your thoughts and stories makes sense to you, GO FOR IT. It's your damn physical representation of your brainspace. Do what you want with it.
Tuesday, November 6, 2012
Names are Power, and other reasons why words are important.
Back when I started proactively treating my issues AAAALL the way back in July (/sarcasm) I started a journal I called my "Diagnosis Diary" because I like alliteration and I didn't want to call it my "Diagnosis AND TREATMENT Diary" because too many syllables.
One day I was copying the DSM-IV criterion for ADHD, MDD and PTSD and while I was reading PTSD for the first time I was a little confused about its "physical" quantifier for trauma. I started talking about it to the troubled friend I wrote about before and she stopped me after I said "So I was writing in my Diagnosis Diary..." and said that I should focus more on the treatment than the diagnosis since that's what matters.
The thing is, being diagnosed and knowing they're real is a huge part of my treatment. I spent so long worrying and wondering that I was making it all up that having a trained, educated person with doctorates and professional degrees tell me that "No, this is real, you're not making it up, these feelings, thoughts and actions are because of what happened, you have XYZ because of it" is so intensely soothing. I can hold on to it like it's a solid object and focus on it, knowing it's real.
"I'm not a liar. I'm not trying to be a special snowflake. I'm not making mountains out of mole hills. I'm not over-reacting, or being dramatic. This is REAL."
That is the confirmation my Dxs give me. In the way of my metaphysical beliefs go, names are powerful. Having the sets of symptoms and traumatic experiences classified and named gives me power over them. With my education I may resent having the physicality of my synapses pathologized, but that does not eclipse the power having a name, a diagnosis, gives me.
Once I explained this to my friend she got it completely, however I'm left feeling a little distanced from others. I had the name of my DIARY criticized? MY DIARY? It's like someone pissed in the sacristy.
Ah well. I can't win them all.
One day I was copying the DSM-IV criterion for ADHD, MDD and PTSD and while I was reading PTSD for the first time I was a little confused about its "physical" quantifier for trauma. I started talking about it to the troubled friend I wrote about before and she stopped me after I said "So I was writing in my Diagnosis Diary..." and said that I should focus more on the treatment than the diagnosis since that's what matters.
The thing is, being diagnosed and knowing they're real is a huge part of my treatment. I spent so long worrying and wondering that I was making it all up that having a trained, educated person with doctorates and professional degrees tell me that "No, this is real, you're not making it up, these feelings, thoughts and actions are because of what happened, you have XYZ because of it" is so intensely soothing. I can hold on to it like it's a solid object and focus on it, knowing it's real.
"I'm not a liar. I'm not trying to be a special snowflake. I'm not making mountains out of mole hills. I'm not over-reacting, or being dramatic. This is REAL."
That is the confirmation my Dxs give me. In the way of my metaphysical beliefs go, names are powerful. Having the sets of symptoms and traumatic experiences classified and named gives me power over them. With my education I may resent having the physicality of my synapses pathologized, but that does not eclipse the power having a name, a diagnosis, gives me.
Once I explained this to my friend she got it completely, however I'm left feeling a little distanced from others. I had the name of my DIARY criticized? MY DIARY? It's like someone pissed in the sacristy.
Ah well. I can't win them all.
Tuesday, October 23, 2012
I'm not in it for the money
I'm a nursing student at my university. Yes, I got in! How wonderful! But by now this is old news. The nursing program is very comprehensive, and I take part in hands-on, supervised training with a group of 5 other girls at health care facilities. This training is called "clinicals" and the places we work/learn at are called "clinical sites."
The first seven weeks took place in a long-term nursing home, or rehabilitation center. It was a sad, disorganized, under-stimulating place. Today I started at an actual hospital, but we are still focusing on rehabilitation care. In the TCU, or transitional care unit, there are puzzles, books and magazines for the patients to entertain themselves with. The unit is on the fourth floor, so the many windows allow natural light to come in. The public rooms are warm and inviting, like a picture from a Better Homes & Gardens fall issue. There are sconces that provide indirect, soothing light. There are framed artworks and photographs on the walls, and fake plants that provide an aura of life and ease. Since today was an orientation day where we got to know our new clinical instructor and familiarize ourselves with the unit, I did not meet any patients or see what their rooms were like. However, I can tell that this site is of a much higher quality from the previous, and the patients are probably better cared for, and comparatively much more satisfied with their standard of care. It probably helps that the hospital is a MedStar hospital, which tend to have much more stringent procedures and repercussions for failure than "normal" hospitals.
This sets the scene for the following conversation I had with my cohort. We were in an empty dayroom (which had a piano, wide-screen television and a tall bookshelf with very many different kinds of books!), gathering up our possessions we had stashed behind armchairs and other furniture. Our instructor had left the room to speak to someone who works on the unit, and for whatever reason the election had come up.
Of course I am voting for Obama, and I vote whenever I can, not just every four years. I voted in the mid-term elections in 2010, and I will be voting this season. Yes for gay marriage in my state, Yes for the DREAM act in my state, and Yes for the various other issues that look more like they are measures against in-state corruption than things I am typically aware of. I'm sitting on the fence for allowing more gambling in my state. There are many good arguments for it, while the arguments against it lean more to untruths about rising crime rates, increased prevalence of gambling addiction and not-in-my-backyard statements from those who would live near the new, second facility that is slated to be built. I'm leaning more to "yes" than "no" but I feel uneducated about it so I can't say for sure yet.
This discussion led to my peers stating that they didn't pay attention and don't care for politics and policy. I, doing that feminine thing where I explain away my perceived weirdness, give a brief run-down on why I have to care (Hispanic, immigrant family, been on welfare, military lifestyle and possession of a uterus generally indicate a high prevalence of new or existing legislature that dictate my life). One girl stated that she was worried about Obamacare, how it would "mess things up for us." This was probably a different feminine thing where she aligns herself with another girl to show allegiance and equality. I, of course, didn't recognize this until just now.
I jumped in with a synopsis of how my maternal great uncle had just died after living with stage IV kidney cancer for six years, and the NHS (National Health Service, the UK single-payer health care system) had taken excellent care of him and his pain, and how the NHS had generally done great things for that entire half of my family. There were statements that this was more an example of how it would help patients, which I responded to "But isn't that the point?" There were murmurs and comments that it was also more medical care than nursing care, which was countered with "There are nurses in the hospitals giving him meds. There are nurses visiting him at his home to help care for him. Nurses are very involved in this kind of care." The girl restates a previous point about how it was still the patient side of things, and I burst into an impassioned speech:
"But that's what matters!" I start "If [Obamacare] helps patients, who am I to complain? I'm here to help people. I'm here to help people who are injured, ill, who are hurting and need care. That's what I want to do, that's why I am here. I'm not in it for the money, if I was in it for the money I would be doing something completely different. Patient care comes first, I want to help them, they need help and I am for anything that encourages this. That is the entire point."
The entire exchange was unsettling. I genuinely don't care how much or how little I could earn a year, because I will be doing something incredibly important. The thought that anyone would go into medicine or health care without a dedication to the needs of a patient is sickening to me. The fact that American health care is so miserable at providing consistent, timely basic care across the board is something to be ashamed of. The fact that 90% of Obamacare's provisos are to protect patients and require these basic needs are met is shameful. We should be doing this anyway, regardless of time constraints and staffing. Health care is not an easy job, it is not simple work. It is involved, exhausting and heavy with responsibility with pay that does not reflect the amount of work and dedication put into it. Entering the field with a basic disregard for these widely known facts is patently irresponsible. This work is hard. It is unforgiving. And it is so because of how important human actions play into the success of each patient's case.
I don't find myself to be very intelligent, or wise. I don't think I know everything about anything, and I doubt my own mindfulness and intuition often. Despite this, I am so deeply sure that my analysis of the field I am dedicating myself to is correct and obvious that I'm shocked and appalled that my peers do not recognize these same truths.
The first seven weeks took place in a long-term nursing home, or rehabilitation center. It was a sad, disorganized, under-stimulating place. Today I started at an actual hospital, but we are still focusing on rehabilitation care. In the TCU, or transitional care unit, there are puzzles, books and magazines for the patients to entertain themselves with. The unit is on the fourth floor, so the many windows allow natural light to come in. The public rooms are warm and inviting, like a picture from a Better Homes & Gardens fall issue. There are sconces that provide indirect, soothing light. There are framed artworks and photographs on the walls, and fake plants that provide an aura of life and ease. Since today was an orientation day where we got to know our new clinical instructor and familiarize ourselves with the unit, I did not meet any patients or see what their rooms were like. However, I can tell that this site is of a much higher quality from the previous, and the patients are probably better cared for, and comparatively much more satisfied with their standard of care. It probably helps that the hospital is a MedStar hospital, which tend to have much more stringent procedures and repercussions for failure than "normal" hospitals.
This sets the scene for the following conversation I had with my cohort. We were in an empty dayroom (which had a piano, wide-screen television and a tall bookshelf with very many different kinds of books!), gathering up our possessions we had stashed behind armchairs and other furniture. Our instructor had left the room to speak to someone who works on the unit, and for whatever reason the election had come up.
Of course I am voting for Obama, and I vote whenever I can, not just every four years. I voted in the mid-term elections in 2010, and I will be voting this season. Yes for gay marriage in my state, Yes for the DREAM act in my state, and Yes for the various other issues that look more like they are measures against in-state corruption than things I am typically aware of. I'm sitting on the fence for allowing more gambling in my state. There are many good arguments for it, while the arguments against it lean more to untruths about rising crime rates, increased prevalence of gambling addiction and not-in-my-backyard statements from those who would live near the new, second facility that is slated to be built. I'm leaning more to "yes" than "no" but I feel uneducated about it so I can't say for sure yet.
This discussion led to my peers stating that they didn't pay attention and don't care for politics and policy. I, doing that feminine thing where I explain away my perceived weirdness, give a brief run-down on why I have to care (Hispanic, immigrant family, been on welfare, military lifestyle and possession of a uterus generally indicate a high prevalence of new or existing legislature that dictate my life). One girl stated that she was worried about Obamacare, how it would "mess things up for us." This was probably a different feminine thing where she aligns herself with another girl to show allegiance and equality. I, of course, didn't recognize this until just now.
I jumped in with a synopsis of how my maternal great uncle had just died after living with stage IV kidney cancer for six years, and the NHS (National Health Service, the UK single-payer health care system) had taken excellent care of him and his pain, and how the NHS had generally done great things for that entire half of my family. There were statements that this was more an example of how it would help patients, which I responded to "But isn't that the point?" There were murmurs and comments that it was also more medical care than nursing care, which was countered with "There are nurses in the hospitals giving him meds. There are nurses visiting him at his home to help care for him. Nurses are very involved in this kind of care." The girl restates a previous point about how it was still the patient side of things, and I burst into an impassioned speech:
"But that's what matters!" I start "If [Obamacare] helps patients, who am I to complain? I'm here to help people. I'm here to help people who are injured, ill, who are hurting and need care. That's what I want to do, that's why I am here. I'm not in it for the money, if I was in it for the money I would be doing something completely different. Patient care comes first, I want to help them, they need help and I am for anything that encourages this. That is the entire point."
The entire exchange was unsettling. I genuinely don't care how much or how little I could earn a year, because I will be doing something incredibly important. The thought that anyone would go into medicine or health care without a dedication to the needs of a patient is sickening to me. The fact that American health care is so miserable at providing consistent, timely basic care across the board is something to be ashamed of. The fact that 90% of Obamacare's provisos are to protect patients and require these basic needs are met is shameful. We should be doing this anyway, regardless of time constraints and staffing. Health care is not an easy job, it is not simple work. It is involved, exhausting and heavy with responsibility with pay that does not reflect the amount of work and dedication put into it. Entering the field with a basic disregard for these widely known facts is patently irresponsible. This work is hard. It is unforgiving. And it is so because of how important human actions play into the success of each patient's case.
I don't find myself to be very intelligent, or wise. I don't think I know everything about anything, and I doubt my own mindfulness and intuition often. Despite this, I am so deeply sure that my analysis of the field I am dedicating myself to is correct and obvious that I'm shocked and appalled that my peers do not recognize these same truths.
Subscribe to:
Posts (Atom)
