Woden's Day Thing, 5/25/22
All The Things
Soundtrack: LXST CXNTURY, “THE HORROR OF BEING”
First off, thanks to everyone who got in on Brothermouth’s new designs for T-shirts, mugs, and occasionally hoodies. (Don’t forget that Gutter-dwellers can get 10% off in perpetuity with the discount code BUTTHOLE.) I’m still giving away one free item to a random paid subscriber at the end of the month.
Brothermouth started this design store as a kind of idle pursuit to have someplace to put his ideas without any direct effort to tell anyone about it, which has had exactly the results you’d expect. Hooking him into my small efforts with The Gutter have motivated him to think harder about it, for the two of us to collaborate with designs (he is absolutely the visual artist, but I have at least some design experience to offer), and for him to be more prolific, so- good stuff.
Today is Fathermouth’s last day here at Mouth Farms. He’s been increasingly restless to leave, tied down mainly by a month of follow-up medical appointments related to his original heart surgery and the emergency pacemaker sitch, but they were finally all over and done with as of yesterday. We’re headed to his favorite local giant steak place tonight, and then he’s off in the wee hours of the morning, the 4am road trip departure being a Mouth Family tradition since my inception.
He is departing healthier and more energetic than expected, but less certain of his future. Before the surgeries themselves, when he was simply here recovering from the absolute clusterfuck disaster of his vaccine injury and subsequent hospitalization in NY, he was laser focused on “I’m going to handle my shit here, sell the house in NC as soon as I get back, move to Florida, and… something.” But over the past 3 months he’s lived here, as his strength has returned he’s made road trips between appointments and realized- a state of mind he was in pre-COVID, when he was less depressed and isolated- that his ideal vision of life at this point is kind of being in a state of permanent viking (used here as a verb), travelling in a caravan between a handful of states on the east coast and midwest where various friends and acquaintances remain and using his home in NC as a base when the weather sucks.
This was all part of the long talk we had this morning, that ended just a few minutes ago, where I got the formal “thank you for letting me live here for 3 months, I know I’ve been a colossal pain in the ass” speech. Most recently, he visited NY to see some friends he hasn’t seen since COVID, and stayed at Mothermouth’s house, which marked a substantial moment as it was the first time they had interacted without me as a mediating presence in, well, decades. He expressed great relief that they were, at long last, “friends.”
So, life for Fathermouth will go on, in a semi-nomadic form as is his way. I have deeper and broader thoughts about the past 3 months and its context in my relationship with the man that is dad, but at the moment, it’s simply mission accomplished- he is back to being a reasonably healthy man for his age, with a functioning mind and personal agency, with plans for the future that are his to decide and pursue.
He will probably not get any kind of justice for what was done to him, but it thankfully doesn’t loom large in how he would like the spend the rest of his days. So I’ll just take the W.
This week’s Thing is shaping up to be long, and I still have a real article in the pipe from last week. I didn’t make the updates I had intended because I got surprisingly sick over the weekend. I strongly suspect I picked up something at the circus, where we spent 3 hours surrounded by children, who are gleeful germ bombs, and this is a totally normal part of life that requires no special fear, horror, or reorganizing of existence around. The same thing happens when I go to conferences. Be around a lot of humans, share germs.
I had nasty body aches and sinus headaches for about two days, with a fever yesterday and heavy upper respiratory congestion (I still sound like Kermit the Frog today but returned to work this morning) and no energy. As with pretty much every “vague respiratory thing” I catch that I even notice, it represented about 48 hours of somewhat debilitating symptoms and spending the whole day in bed.
But. Having all that time on my hands caused some introspection, and maybe this is worthy of a bigger piece later, but it’s fresh now, so.
As with a lot of these types of illnesses, they follow a curve- feel normal, feel icky, feel really bad, feel icky, feel normal again- and when my symptoms peaked, I briefly went through the mental inventory of, “well, what if this is something more serious? What then?” This wasn’t a hypochondriac panic of thumbing through WebMD or whatever the kids use these days to scare themselves and going, “yes, that’s it, I’ve clearly got Rhein Kaiser’s Skipping-Fever! I’m going to frog march around, eat a bunch of cabbage, then vomit organs and die!” It was just a simple, “what if I don’t shake this off like 99% of contagious illness?”
And at that moment, I realized I have developed what I would call- using a term I hate, hate, HATE using- a phobia.
Because when Fathermouth heard me go through a long coughing fit, spit out some pleghm, moan a little, and lay down, he crept into my room, and asked, “honey, do you want to see a doctor?”
And I said… “ABSOLUTELY NOT.”
I did not want to call a doctor, go to a clinic, or go to the hospital. I did not want to in the rain, or on a plane. With a fox, or in a box. With a fuss, or with Deez Nuts. I will not go get healthcare, man; I will not do it, Sam I Am.
I used to know a lot of people- mostly guys who had a kind of machismo thing around help-seeking- that would always loudly swear that they would never, EVER go to a doctor or hospital, and I would invariably think to myself (silently), “ok, sure, but if you end up with, like, cancer, or bleeding to death, or something you absolutely can’t fix with just grit and bed rest, you’ll go to a doctor because it would be stupid at that point and you don’t actually want to die just to prove you’re cool.”
But here’s the thing. I absolutely, positively, at the moment of “what if I have something more serious than a cold or sinus infection or flu or something” was NOT going to a doctor. And I don’t know that I would feel differently under any other circumstances.
I find myself legitimately unable to trust that I will not be abused or killed or end up like my dad, covered in my own filth and ranting and medicated into unconsciousness. I envision them first- more importantly than anything any human being could possibly do at that moment- strapping a mask tightly to my face, where my already strained breathing becomes nearly impossible, demanding to know if I’m vaccinated, putting me under some weird isolating condition which delays treatment by hours or a day, and then vaccinating me the moment I’m unconscious. I imagine any questioning of protocols, debating treatment course, or refusing any form of treatment to be seen as indication of a mental illness that calls for me to be drugged into oblivion without my consent. I end up permanently broken or dead, one way or another. My cause of death is listed as whatever my presenting problem was.
Or, fuck it, COVID, because that would really stick it to the stupid bitch.
I know. Crazy person shit. Irrational paranoia. Apparently I’ve gone fucking nuts and didn’t notice until now because I haven’t had to think about seeking healthcare myself.
Husbandmouth replied to all of this with, “well, I wouldn’t let them. If you were in the hospital I’d be there and I’d advocate for you, and I know what you want and don’t want.”
I pointed out that he has frequently and repeatedly described me as having been “the best advocate humanly possible” for Fathermouth during his travails, and asked how much happened to him that I had been unable to do a damn thing about, or even know about until after the damage was done.
To say nothing of all the people that simply weren’t allowed access, period, to their hospitalized loved ones in the past 3 years. Really, haven’t we figured out at this point that if an institution really wants to do something to you, they’re going to do it, and get away with it, at least in the short term?
Anyway, this is something I’m grappling with now- the realization that I actually, legit, am afraid of doctors and healthcare to the point that I think I would rather take my chances with a serious illness that I probably can’t do anything about through self-care. I’m aware that, on the face of it, that’s irrational by some definition. I don’t know quite what I’m going to do about it. Thankfully, at the moment, I can kick the can while I figure it out.
As always, your thoughts and perspectives on this matter are treasured.
We’re all aware there was a school shooting this week and children died. I don’t have anything useful to contribute, and maybe that’s the most valuable thing I can offer as someone with a (however tiny) public channel- to shut the fuck up when I can’t add anything to the conversation.
If anyone WANTS to know what I think, though, here it is. It is not useful or advisory or makes any claim to policy or science. No answers here. Just chatter.
Here it is: society is falling, more and more people are mentally ill, life is increasingly seen as a pointless, nihilistic exercise to a growing number of people (which may or may not themselves be mentally ill), and one way or another, these conditions result in death.
We locked up an increasingly mentally ill generation of youth for 2 years, destroyed their futures, covered their faces (seriously, look how much teen ‘artwork’ is on the internet of masked faces with the eyes crossed out), and bombarded them with fear porn WHILE silencing them and punishing dissent. Yes, you’re going to have violent explosions of hopeless self-destruction. Frankly, I expect we will see this sort of thing every fucking month for a generation or so.
I don’t believe it has anything to do with gun laws or access to guns or the length of barrels or stocks or scary black shrouds or whatever. For millennia, when our souls are dying or dead, we’ve killed each other brutally for no practical reason. You can “never let an opportunity go to waste” and use this latest one to legally disarm the public or otherwise exert tighter authoritarian control over a population, but again, when our souls are dying or dead, death is what happens- with guns, blades, fire, sticks, nooses, or bare hands. In your house, or with a mouse. Here, there, or everywhere- when I am well and truly damned, I’m going to kill you, Sam I Am.
There is not and has never been a policy solution to this problem. It is a feature of the human species and the human soul. When times are good and a society is healthy, this almost never happens, no matter how available or unavailable weapons are.
I hold a generally unpopular view that causes of death are not particularly important to my emotional response. If someone is what I judge to be a good person, or at least a relatively innocent person, I regard it as more tragic. I feel more strongly about the deaths of people I know better, the loss of whose lives I am better able to measure in the world. I imagine that this is actually the way we are all affected by death, but have a lot of weird social programming that requires us to pretend we don’t. I also know that humans invariably act in alignment with who they ACTUALLY are rather than who they pretend to be for social convention, when the chips are sufficiently down.
Innocent children have been dying because of the sickness of our society for quite some time. Some will be murdered, some will be neglected to death, some will starve, some will end their own lives, some will simply vanish from our awareness as though swallowed up by the earth itself. I don’t find any one specific death more outrageous than another- though I certainly would if it were my child.
That’s about all I can say about it. When we’re sick, people die, and we’re really fucking sick.
See you soon.
I was a police officer for a handful of years in Texas, in a suburb of a major metro area. In that time, I quickly learned that an extremely high percentage of the individuals I dealt with on a nightly basis were in some form of mental health distress. By this, I don't mean that everyone was mentally ill (although a very high percentage of these people had some form of mental illness or another), just that they were in some form of mental distress. When many of these people are placed under this stress, they would often times act out in totally irrational ways. Sometimes, this would take the form of substance abuse, sometimes in violence (very often times both).
In this regard, coping skills definitely don't seem to be the forte of a large number of people, which lends itself to a lack of impulse control (hence the binging on behavior-altering substances and then violence). Sometimes, this would bring certain people to the edge of a precipice toward suicidal ideations. With these individuals, and for all the rest who were experiencing full-blown psychotic episodes (almost every homeless person in my jurisdiction fell in this category), we had the option to place them in a psychiatric facility to hold them for 72 hours. During that time, they would receive care, treatment, and meds, then booted out the door promptly after 72 hours, to start the process all over again. There would be no follow-up care, and quite often, there would be no beds available in the limited number of facilities we could transport them to.
All of this is to say that our mental health care infrastructure is woefully inadequate to deal with the massive amount of mental health care needs in our country. Based on my own personal experience, if we could tackle even a chunk of this problem, I am convinced that not only would gun violence decline, but crime overall (especially violent crime) would decline. Case in point - my department implemented one person to serve as a "Mental Health Liaison". This person was a fully licensed and certified psychologist, who would follow up on any case we informed her about. As she became familiar with these cases, she would essentially be their follow-up care; linking them and their families to resources they may not have been aware of, and ensuring that they had some sort of plan for further care. We began to see a decline in the number of calls for service for the truly mentally ill individuals with whom we would come into contact with regularly. Since then, the department expanded this area, and they have been reaping the rewards. If coupled with an expanded number of available in-patient facilities, I think it would work wonders.
However, attacking the root cause of all of this mental illness in the first place would be the best strategy, but I truly don't have an answer for that.
At the risk of being derided, I am going to put in a good word for the medical community. In 1900 when medical care was all nostrums and vitamins and whatever, the lifespan in the US was 35. Much of that was child death, and much was infectious disease, but that is how it was.
The body is a complex instrument, and every patient is their own science experiment (a speech I have made thousands of times over the years). Things work for one patient, but not for another. It is a journey doctor and patient take together to reach the best possible solution.
As with any other profession/trade/calling there are better and less-good practitioners. I have separately written about the deprecation of US medical training by steering admissions toward demographics and social justice warrior scores instead of intelligence, passion, willingness to work, and concern for making patients better, so I will not repeat that here. There are still good practitioners, but now it is harder to identify them. (Yes, all medical schools and boards are now pass/fail because the entry requirements have been so watered down that if you posted scores you would realize how awful many of those passing are.)
But many doctors (and most over 40) are still generally wedded to doing the right thing for their patients to the best of their ability. In many ways sadly, as Prasad has pointed out, most doctors, especially today, have a primary qualification of "obedience" as one of their admission requirements. Part of this is necessary to survive the rigors of absorbing as much as one must, but there is little/no time spent in getting the bulk of the students to be inquisitive, statistics-savvy, etc. Doctors are taught that anecdotes have little value (correct, except vis-à-vis an individual patient) and that RCTs are the best way to divine truth. This has long been mostly true until they started lying in the RCTs (much evidence of this with COVID -- really makes some of us sad). So now it is very difficult to discern what is actually true while keeping up with all of the actual advances across a specialty that may impact the care of the next patient.
My greatest sadness about the whole COVID thing is not particularly that public health has taken a black eye from which it will not recover in my lifetime, it deserves it in spades. My real sadness is that good people like GM are now afraid of doctors.
Many/most of us are not out there to make your life worse; we have generally spent our lives (and endless 100 hour weeks) trying to do the best we can for you because your success is our success. You need to recognize the true villain here: the COVID stuff was so contaminated by the GOVERNMENT skewing reimbursement (if the government had not started paying hospitals so much to treat a certain way and to diagnose a certain way, almost nothing that you see would have ever happened) that it has dragged the entire health care system, including many of those of us that actually care, down with it. This is something that causes me great sadness every day. And it was so unnecessary. It is what you get when you let the government/corporations get between doctors and their patients. If we learn nothing else, we should start there.
Sadly, organized medicine was also captured by this, especially the AAP which should have a Nuremburg trial of its own, but all of those organizations now seem to be run by a handful of covidiot wokesters. That will not persist because most of us disagree, but it is an issue now and just making things worse.
Back to the point: There are a large number of areas where a trusted physician who cares about you and understands from where you are coming can do things you can never do poking around on the Internet. Plenty of smart people can learn lots by studying/reading -- I do not dismiss anyone because they are not credentialed. But there is a lot that comes from four years of science undergrad, four years of medical school, four years of residency and a couple years of fellowship, and then 25 years of practice, that you just cannot get from any number of (slanted) Google searches no matter how smart you are. Human intelligence is best at pattern recognition, often in ways the human does not understand, and that is something you gain after seeing thousands of patients over many years of school, training and practice. If you do not think that is pivotal to health, you are sorely mistaken. We physicians generally pick the person most likely to be able to use that input to reach conclusions that might elude us as our own physicians...there is a reason for that. And we mostly all try to do that ourselves for the sake of our own patients.
One of the other commenters pointed out how they cured their T2D. Most of those T2D cases would cure if the patient would lose 100 pounds. We all know that, but the number of people that will do that can generally be counted on the fingers of no hands. So you try to make things as good as possible with the person you have at hand. I always tell them that we could likely just do away with their BP/diabetes issues if they would lose substantial weight, but I cannot tell you how few patients will do that. And now that is called "fat shaming". It is so stupid as a health concept I cannot even opine or I will start spitting nails out of the screen. So I will spare you all the risk to your eyes from those spitting nails.
I am all for balanced nutrition and adequate levels of many substances, but have yet to see some vitamin/concoction/whatever be preventative/curative for everything despite the strong convictions of some of their users/purveyors. If the substance is water soluble, no harm in taking as much as you want, but I guarantee you will still die of something. So that may be part of any continuing solution, but it cannot be the beginning and end of all conversations. Those become just as constrained as the "only remdesivir/vent for COVID because I will pay you an extra $10,000 per case if you do that" conversations.
I would just suggest that throwing the baby out with the bathwater is bad health care for you and your family. There are plenty of doctors who will see things you do not, that have access to tools you do not, and who will do their damndest to make sure you get better. There are long lists of things that DO work and that have saved countless lives. I would certainly interview them carefully to try to separate the "I do what they tell me" from the "I think all organic will save you" from the "I will be honest with you and help you to the best of my ability, irrespective of what others are saying" practitioners.
I have yet to wear a mask (other than in the OR where it is mostly to stop us from getting splashed with body fluids) or to make my patients wear one. If there were science backing it up, I would be happy to do so -- it is not a religious matter to me. It is just wrong and many of us hate wrong. I give different spikeshot advice to 85 year olds and mothers of small children. Every person is an individual and that is what you hope you do as a physician: combine what you know/have learned about all of medicine and health with what you know/have learned about that individual for the benefit of that individual. That is why most of us went into medicine and you would be surprised by how many of us are still doing that.
Just one doctor's thoughts. Call me DoctorMouth...lol.