Tag Archives: barriers to access

Depending on narcotics

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IMG_0172I take six medications. Five of them — the antiepileptic, the antidepressant, the non-narcotic pain killer, the muscle relaxer, and the oral contraceptive — are covered through a mail-order service. I receive a 90-day supply in my mail box every three months. No hassle. If a prescription runs out, my doctor is notified electronically, he then sends the new script electronically, and everything proceeds as normal with absolutely no additional step required of me. The only thing I do is click on the check-out button on the web site every three months. That’s it. No calling. No physical piece of paper to pick up. No wait at a retail pharmacy. Just a click and several days’ wait.

There’s one other medication I take. That medication serves the exact same purpose as all five others: it relieves my pain so that I can get on with my daily functions. I take it regularly, just like all five others. I have been taking it regularly for over five years now for the same reason. But this medication is not covered by the mail order service, because it is not considered a “maintenance medication” — despite that it fills the exact same maintenance role all five others fill, just by a different mechanism.

So for this medication, I am only allowed a 30-day supply at a time, and no refills — a brand new script each fill, which requires my doctor’s input each time. I have to call my doctor no sooner than the exact day it was filled last month, unless it falls on a weekend in which case I might get away with calling up to 2 days early. Then I have to call back a couple days later to see if the script has been written. If it has, it is printed out, and I have to physically walk in to the office, stand in line to see a receptionist, have them take a copy of the script with my photo ID, sign and date the copy, and walk out with the script. Then I have to physically take it into a retail pharmacy, wait in line, hand it to the pharmacy technician, then wait the required time for it to be filled. If there are no problems with my insurance, I then must physically present myself and pay for the prescription. Then I can walk out the door with my medication.

(And this is the process with a doctor who’s relatively friendly about the matter.)

It is quite a different process and one overflowing with “veto points” — points at which any party involved can cause any sort of problem and stop the whole process up. Maybe my doctor is on vacation and won’t be back for two weeks. He is the only one in my clinic who will write this script. I can’t call earlier in anticipation of his absence; they will not write the script before the last runs out. In that case, I’m stuck until he comes back. Maybe the system spits out some sort of error, like the one I received today: I was told the script must be written by my original prescriber. Which is this doctor. So now they have to go back and ask for the script all over again, and he isn’t in til tomorrow, and it’s not guaranteed to go through smoothly then. There have been other errors.

Maybe the insurance says no. For any number of reasons; I’ve dealt with prior authorization errors, quantity limit errors, errors because my insurance has suddenly decided to list me as living in an assisted-living home and cannot fill a prescription if I am. Maybe the pharmacy hits a snag, like the time they would not fill a written prescription until 2 a.m. that night because the insurance company said so, even if we paid out of pocket without billing the insurance.

And I’m going to keep running into these issues, and I will run into new errors every few months. I may have solved the last problem, but there’s always something new to pop up. I can never rely on this medication being filled on-time. It simply does not happen the majority of the time. No matter how diligent I am, how patient I am, how clearly and politely I explain myself — or how despondent I get, how emotional I get when telling them but I cannot work without this medication, and I don’t have leave on this job, and I can’t afford to be fired for missing work. Or whatever other pickle I’m in at the moment. It doesn’t matter. I do everything right and there will still be regular problems in getting my medication filled on time.

I’m sure, by now, you’ve figured out that this particular medication is a narcotic pain killer — hydrocodone (generic for Vicodin). I take it for chronic pain. I have been taking it for over five years this way, with the doses varying between one-and-a-half per day and three per day. And the only medical trouble I have ever had on it is when there was an excessive delay in refill during a bad pain flare and I got to go through the withdrawal for two weeks. (And I can tell you from experience: hydrocodone withdrawal is nothing compared to Effexor withdrawal.)

Narcotic pain killers can be a valid option for chronic pain patients. They fill a void left by other treatments which still aren’t effective enough to address our symptoms, which can easily be disabling. As you can see, I take plenty of other medications. But if I want to be able to get up and do something, I still need the pain relief the hydrocodone provides. So I take it. Because I like to be able to get up and do things. Like make the bed in the morning and feed the cats and make myself lunch and possibly run errands. Or — you know — work. Those silly sorts of things.

Here’s the thing, though. In both common culture and the medical industry, chronic pain patients who take these medications to be able to perform everyday, ordinary tasks that currently-able people take for granted — like bathing or showering or washing dishes or dropping their kids off at school — are still constructed as an addict just looking to get high.

You could almost kind of expect that for the narcotics. Most people do not understand the distinction between addiction and dependence. (Which is, basically, the distinction between taking a medication for a medical purpose so that you can go on living your everyday life, vs. taking a medication when you have no medical need so that you can escape from your everyday life.) This distinction exists for a reason; developing a tolerance for a medication is not a bad thing in and of itself, and must be weighed against the benefits that medications brings to the person.

Addiction calls to mind, though, a life being torn down. Addiction calls to mind a person who is seeing the detriment of a drug outweighing the benefit. A person whose life is falling apart because of the drug.

A chronic pain patient taking a narcotic pain killer under the close supervision and guidance of a knowledgeable doctor is exactly the opposite: sie is a person whose life is coming back together because of the drug.

But this image is not easily shaken in people’s minds. And so the chronic pain patient is reimagined as the addict. Hir behaviors are twisted to fit the common conception of the addict. If sie ever lets out a drop of disappointment at having problems with accessing this medication which is helping to put hir life back together — that is seen as drug-seeking behavior. And if sie lets out any sort of relief at the feeling sie experiences after taking the pill and having the crushing weight lifted from hir muscles — that is seen as “getting a high.” Heaven forbid sie show any emotion beyond just relief — like perhaps pleasure or happiness — at being able to perform everyday functions again. And any moodiness or other undesirable behavior can be easily attributed to hir “addiction.”

What’s strange, I notice, is that this reimagining is applied not only to chronic pain patients who take narcotics — but to any chronic pain patients who takes any pain relieving drug.

Take, for example, the anti-epileptic I take. It is not a narcotic. It cannot be abused — that is, if you do not have a neurological pain disorder, it will not do anything for you. You can’t use it to get high, get low, or get anything — except a couple hundred dollars poorer every month.

The only way this pill does anything for you is if you have some sort of nerve problem. And even then, the effect isn’t a “high.” Rather, it levels your pain threshhold — brings it closer to “normal.” No artificial mood effects, no giddiness, no lift. Just level.

And I still see this medication treated very similarly. Patients who take it are described in the same terms you would describe a drug addict.

And it’s just one of many. Any drug that relieves pain for a person with chronic pain will be painted in the same strokes.

At issue, here, is the conventional wisdom that our pain is imagined, that it has no real basis, or even then that it isn’t as bad as we make it out to be. That is the belief that feeds this twisted construction.

Because if you are imagining your pain, there is nothing legitimate you could be getting out of that drug. And if you aren’t getting anything legitimate out of it, but you’re still taking it — and getting upset when you don’t have it — well, that’s classic addict behavior, isn’t it?

If our pain were recognized as real and legitimate — if those messed-up-in-so-many-ways Lyrica commercials didn’t start out with “My fibromyalgia pain is real!” — this wouldn’t happen as much. Because if our pain is real and legitimate, then it is real and legitimate to seek relief for it.

(Of course, that assumes that pharmaceuticals are accepted as a real and legitimate way to relieve that pain.)

But people are going to have trouble with that. They don’t want to accept our pain. They don’t want to admit that it is real. They want to keep believing that it must be imagined. Because then, they can comfort themselves, in that murky area beneath our conscious thought, that they would never end up in our situation. They could never end up with any sort of medical condition. And if they did, well, they know how to do everything right, so they would never be affected by it.

This is why they scoff at our assertions that our experiences are real. This is why our conditions are jokes to a great many people. This is why “fibromyalgia is bullshit” has been the leading search term to my blog. This is why they seek so desperately to deny that these drugs — any drug — could be having a legitimate effect on us. This is why they treat us like addicts. Because they can see how we might reasonably be having real pain, and they can see how these drugs might reasonably be legitimately relieving it, and they can see how we might reasonably be upset if we are consistently denied access to the one thing that allows us to live our lives the way we want to.

And if all that is reasonable, then — shit — they could wind up in the same place someday. And none of their can-do bootstrap individual determination could magically get them out of it.

Addicts we are, then.

Recommended Reading for October 20, 2009

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In the blogs:

Sins Invalid IV: Possibly NSFW:

Sins Invalid is a force to be reckoned with. Make no mistake about that. I’ve been to 3 of the 4 shows, some of them more than once. I can tell you: Sins is a force to be reckoned with.

Sins describes itself as a “performance project on disability and sexuality that incubates and celebrates artists with disabilities, centralizing artists of color and queer and gender-variant artists as communities who have been historically marginalized from social discourse.”…

To get at these questions, I want to impose a perhaps artificial distinction between disabled sexuality and crip sexuality. I may come back to that in a separate post, but, for the moment, it is just a division that allows me to get at some important ideas; it is not a philosophical position to which I am committed.

Learning to be a mother not possible for the learning disabled:

The Mirror tells us of a mother who is facing having her baby taken away from her after it is born. Yes, that’s right, the mother isn’t even a proper mother yet and already social workers have decided that she is unable to properly care for the child. Why? Because she has learning disabilities. You know what? So do I. Learning disabilities do not mean someone is unable to care for a child. They mean that someone needs assistance with learning, not that they’re unable to learn.

The fact that social workers have pre-determined that a mother-to-be isn’t qualified to be a mother because of her disability smacks of the legacy of eugenics. Eugenics was the late 19th, early 20th Century movement that was based on an interpretation of Darwinism to “improve the races”. One of the things that resulted from this movement was the forced sterilisation of people, mostly women, who were regarded as “imbeciles” on the theory that imbeciles beget imbeciles. Interestingly, imbeciles were only found among those that society had deemed as unworthy, such as working-class prostitutes or children in orphanages.

In the news:

Wheelchair-bound man left halfway up Mount Snowdon [Lauredhel wrote about this story yesterday]:

A WHEELCHAIR-bound man suffered mild exposure after being abandoned halfway up a mountain by a group of charity climbers who gave up carrying him.

The 31-year-old man was left sitting on the steep and rocky Llanberis Path by the rest of his party of six, who were martial artists on a charity climb of Mount Snowdon in North Wales, the TimesOnline reports.

“The poor bloke was sitting there in his wheelchair for quite a while,” climber Dave Morrell, who witnessed the incident, told the TimesOnline.

Disabled Woman Stranded in Flat for Six Weeks:

The 77-year-old is crippled by osteoarthritis and cannot walk more than a few yards. She relies on a mobility scooter to get around.

But she was left stranded in her flat while a lift was replaced at the complex.

She couldn’t even get her scooter out of the building to visit local shops and had to rely on her daughter, Celia Roussel, to carry out day-to-day errands.

Worse was to follow because, after the lift was repaired, she was told that the scooter could not be used in it because of a problem with “weight distribution”.

Disorder Inspires Teachable Moments:

” ‘Tricho’ is Greek for hair, and ’tillo’ means pulling,” she says, referring to information and pictures on poster boards that her mother, Liz Murphy, holds and flips when cued.

Hats are the linchpin for Brogan’s outfits because they help her deal with her trichotillomania, a compulsive hair-pulling and skin-picking disorder. Brogan doesn’t struggle with skin picking, but she started absentmindedly pulling out her hair, one strand at a time, primarily in the crown and on the left side of her head, when she was in middle school.

Now she travels to middle schools to educate students about the neurobiological-behavioral disorder. She visits cosmetology schools, too, because getting a haircut can be sensitive for someone with “trich,” as the disorder is often called.

Oh hey, Google started a blog that links up all their accessible web-design stuff. I get a bit frowny at “it’s not just for PWD”, as though a large percentage of the population (35% of people over 35 in my province) isn’t a good enough reason to do something, but I suspect that’s just trying to sell it to people who are resistant to that idea.

“What can I do?”

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Access is an all-consuming endeavor in a disabled person’s life. I love that the disability community learned to frame it that way: it emphasizes that the problem is not the person, their body or their condition; the problem is society’s indifference.

Many accessibility solutions are structural; they require collective action — constructing spaces such that wheelchairs can be used within them; hiring interpreters and providing caption services… these are not actions that can be undertaken by a single person.

What is unfortunate about this, though, is that it relieves the fully-abled individual of hir responsibility to hir disabled counterparts. It means the fully-abled individual can safely get away with never thinking about disability, and the connection between societal access and hir actions specifically, at all. Sie never has to consider how her attitudes and behaviors very really shape the environment of hir peers. Sie never has to stop and think, how does what I am doing affect those around me, and how can I change that to make things better for them?

When all solutions are collective, your own actions become invisible. Your contribution to the world around you becomes invisible. The power you hold over other people becomes invisible. Your status as part of the problem becomes invisible.

So let’s be clear — YOU ARE PART OF THE PROBLEM. And there is no instant solution, no magic words that can make that “go away.”

But what can you do?

I thought of what I think is an illustrative example the other day.

When I was attending college, I had a lot of walking to do — at least a mile from my dorm to each class, and of course the walking in between. It was exhausting, and it was one of the major factors that led me to drop out the first time.

One of my classes was on the sixth floor of the humanities building. Another was on the fifth floor of the math and science building. And I had several choices on how to reach those points:

1. The elevator.

2. The escalator (in the math building).

3. The stairs.

Here’s the irony: the only accessible solution was the stairs.

I have a physical disability. That disability is also invisible. I can climb stairs, but when I do it precludes any remotely physical activity (up to and including sitting upright) for a couple days, compounded the more flights I have to climb.

This was not teneble, not when I had to do this three times a week, and that doesn’t even include the energy required to walk to the building in the first place, to sit in the hard uncomfortable chair for an hour taking notes, and the energy I needed to do the home assignments, projects, and studying necessary for the class. And that doesn’t account for my four other classes!

So: Why couldn’t I use the elevator?

Well, because everyone else was using the elevator — so many people that there was a long line and usually a 15-20 minute wait before you could step foot in one.

Again, I have an invisible disability. I could have pushed to the front of the crowd every day, jostling my way through dozens of people to weasel my way in the door. And that would have made me kind of an asshole, you know?

So what do I say? “EXCUSE ME, I’M DISABLED, I NEED TO GET IN.” And everybody would turn to look at my lanky eighteen year old body, with no visible deformities, no mobility aids or other assistive devices or personal aide or caretakers, having walked in the front door just fine. And then everybody would be thinking that I was kind of really an asshole.

Complicating things is that at the time, my severe anxiety was undiagnosed and untreated. There was no way I could have even squeaked out a humble “excuse me,” much less forced my way through the crowd, much less shouted for all to hear that they needed to get out of my way and give me “special treatment.” Oooh, how I loathed special treatment. It made me feel like I was, you know. Disabled. Not normal.

Anyway.

This crowd existed in front of every elevator in every building on campus. Not all of the people waiting at that elevator were healthy enough to take the stairs. There were surely others with invisible illnesses like me, and others yet who just weren’t in the greatest shape, and so on. But the majority of those folks took the elevator because it was there. And those folks are the ones who made my life, and my participation in society, that much harder back then.

So: Why couldn’t I use the escalator?

Here’s a different problem. A lot of kids used the escalator. An escalator, as you know, is basically a revolving set of stairs that moves upward, so that you don’t have to do any climbing to get up to the next floor.

But here’s the problem. Everyone who took the escalator? Walked up it.

Everyone.

Now, if I wasn’t going to be climbing the stairs, why the hell would I go and climb the escalator? The entire point is to spare me that climb, right?

But I couldn’t use it that way. If I stood still on a single step, that would clog up the line of kids studiously climbing, climbing. They were narrow enough for two small people to stand side by side, but then not everyone is small, and we also had to carry our bulky book bags and such with us. So if one person stays still, there is a bottleneck effect — only a trickle of people can squeeze through, and everyone else gets stuck behind you standing still.

Assuming everyone in that crowd is healthy, someone who stands like that and creates that kind of jam is, again, kind of an asshole — right? So what was I supposed to say? “I’m disabled, sorry.” While everyone stares at the back of my entirely healthy-looking body for the next few minutes.

Right.

So: what was I left with? Well. The stairs were pretty free. Maybe I could have started to carry a cane, just to visually signal to people that I was sick. Even though I didn’t need that cane and wouldn’t know what to do with it. Do I hunch myself over, tousle my hair and do my best to act like I’m ninety years old and barely hanging on? Just so people would maybe, just maybe, believe me?

Or maybe… maybe everyone else involved could have stopped and thought about how their actions were affecting other people. Because I sure as hell wasn’t the only one facing this dilemma.

Just because the elevators and escalators existed did not mean they were therefore accessible to the people who needed them. Because accessibility is more than structural. It also counts on the actions of each individual.

Yes, you are part of the problem. There are times where you are in the way, where your actions are creating difficulties in someone else’s life. And you probably can’t even see it. But, you know — maybe you would — if you started looking.

Time and Energy, or Lack Thereof

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This amazing post and its follow-up by Anna at Trouble in China (she is also a contributor here, as you may have noticed) got me thinking. [In the interest of full disclosure, my Shakesville post is in there as an example of the problematic nature of inclusiveness.]

Whenever I mention my personal blog in, say, a contributor’s or artist’s bio, I nearly always include the qualifier “sporadically updated.” Regular readers will know that this is partially my style–the dash of self-deprecation–but it masks something else. Namely: I very rarely have the energy to write a whole blog post, to respond to comments, or, hell, to comment on other blogs with wit and insight. This does not mean that I do not exist. It only means that I, quite simply, don’t always have the mental or physical energy to contribute to a medium that is, by and large, designed in favor of the non-disabled.

Before the inevitable questions of “why don’t you just quit?” arise, I keep and have kept blogging for a very specific reason: I cannot just give up. Certainly, there are better writers out there than me. There are better blogs. I have blog friends who are more articulate, more stylistically clever; some of these folks who blog more, or have more readers. Yet I know that the blogosphere is a bit wicked in that one is only as good as her or his last post (to use a worn cliche). Some of us can crank out quality posts nearly every day. Many of us cannot.

I often cannot keep up with a ‘sphere in which other voices–more able voices–have the luxury of time and actual emotional/physical energy to blog. The conspiracy theorist in me wants to chalk this up to the blogosphere’s–and to a lesser extent, the internet’s–design as yet another space where able-bodied folks can “fit,” and can be “productive” in terms of number and quality of posts. For all the talk of the internet as a utopia where one is free to not be embodied, the same old shit seems to keep coming up, along with the big ol’ Cthuluphant in the room: that the world is designed for able-bodied (and preferably white, straight, middle-class, and male) individuals. Productivity, fitting in, responding quickly: These are things that non-able-bodied folks may not be able to do, whether because of issues of time, energy, ease of access, or many other factors. What happens when one cannot type because of searing pain in her hands, wrists, arms? What happens when one finds that he is too brain-fogged to write a post, much less comment on an existing post that many other people have already commented upon? When one is confined to bed because of nausea or all-over pain that forces her to lie for hours, staring at the ceiling, doing nothing because it’s all too much? What happens is that much-needed voices are not part of the conversation. They are lost, but not because they are not there.

This is shameful. There is no other word for it.

Do I know where to begin in pursuit of a solution? No.

Does anyone? I am not sure. I would like to hope that someone does, but I remain unsure.

We’re here. You just might not know it, yet.

Originally posted at Ham.Blog

Recommended Reading for October 15, 2009

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Another busy day for me, so again, this is quick! (I’m coming to you from the past!)

In the blogs:

Reminder! Liz Henry is hosting the Disability Blog Carnival! Submit your links to be included!

Getting her privileged little way:

I was out yesterday with my sister, mother and nephew in Walmart. They walked away for a moment and while I was alone looking at something on a shelf , a woman pushing a large cart came toward me sideways. Instead of asking me to move, she banged the cart into the side of my wheelchair.

I’ve seen this type of rude and boorish behavior before. I was in her way and she is – well – able bodied. Never mind that there were half a dozen other people – also able bodied- who could have moved out of her way. She saw the wheelchair and I was the one in her way.

Two Hospitals to Address Access to Care for Patients with Disabilities [US]

Under a new agreement between the hospitals and the advocacy groups, the hospitals will survey and remove physical/architectural barriers to care, purchase accessible medical devices and equipment (including mammography equipment), review and modify hospital policies, provide appropriate training to staff. The hospitals must regularly report to patients and their advocates on the progress they are making. According to the Globe, advocates hope that the changes to be made at these facilities will serve as an example for hospitals across the country.

Seriously, I have ranted more than one in my own space about wheelchair inaccessibility in hospitals. My biggest pet-peeve is inaccessible waiting rooms. Don’s is people demanding he stand (that wheelchair is not for show), and then baby talking to him. Fun times.

The Etiquette of Menstrual Concealment Preserves Pain as well as Secrecy:

Kate Seear’s newly published study about the diagnostic delay in treating endometriosis finds that menstrual etiquette rules and the culture of concealment are among the most profound causes of the delay between the first experience of menstrual pain and the diagnosis of endometriosis, which then opens avenues for relief through either surgery or medical treatment. The delay is non-trivial: research estimates an average delay of 8 years in the UK and 11 years in the US. Reasons for the delay include minimizing of menstrual pain by doctors, family members, and others, and women’s inability to distinguish between ‘normal’ menstrual pain and abnormal pain, and, Seear argues, the social sanctioning women experience when they talk about menstruation in general or menstrual pain in particular.

I was thrilled to learn that the Disability Studies Lecture Series at Temple U will be available on line in both text and audio.

I’m not just concerned, I’m utterly appalled:

A trial is set to begin in Northern Victoria, in which 30 Australian Aboriginal participants will undergo gastric banding. Because you know, banding has worked for the ‘white population’ so let’s experiment on the blacks and see if it works for them too. And that is practically a direct quote. I shit you not

In the news:

Via UnusualMusic: A Fatal Cultural Gap: Depression Among Minorities

Major depressive disorder is a common disease, occurring in approximately three out of every 20 people in the United States.

However, members of minority communities, especially first-generation immigrants, often express their illness in a manner that is different from their white counterparts, which makes it more difficult to diagnose depression in them, said Dr. Russell Lim, who teaches cultural psychiatry at UC Davis School of Medicine.

“We (who are trained in Western medical schools) are defining depression though our cultural lenses,” said U.S.-born Lim. “A cultural psychiatrist, on the other hand, looks for less specific signs” than those outlined in medical textbooks.

Second Shift for the Sick

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(Originally posted November 2008 at three rivers fog.)

I had always meant to expand upon this topic, but never found the right words for it, succinct and meaningful. But, well, that’s not exactly my style either.

My job situation is still shitty, and I’m currently part-timing at a retail pharmacy as a cashier. (Sample day: Mid-20s white guy “discretely” [read:blatantly] takes a picture of me on his cell phone as I am kneeling down assembling a battery display; someone shits in the toilet paper aisle [seriously! a person! took the time to unbutton their pants and all!]; I set alarm off while fetching pushcart from back room.) “The injustices of retail,” I said to my coworker, as I nursed the scratch on my finger from pushing that toothpick in a little too hard.

But honestly, I still do, and always have, appreciated working with the public. It’s the kind of thing that reeks a little too much of bullshit to say in an interview (“Really! I love when people show visible surprise at the revelation that I can do third-grade math!”) but, well, it’s true. I like people. I am, fundamentally, the kind of person who likes spending time with people (though my severe social anxiety always masked it). I’m not a butterfly by any means — good God, I can’t stand parties, pubs, or the mall at Christmastime, and I always need time to recharge after any extended social time — but I do enjoy interacting with a variety of different people, and there are days I go home smiling because of it.

Today I met a man named Robert. He stopped by to ask how long a sale price on a can of Folgers was supposed to last, and we ended up chatting for a good ten or fifteen minutes — the line piled up behind me, but I didn’t give a damn. Robert was in a wheelchair, for whatever reason, and was there to pick up his medication, whatever it was. He got his “paycheck” on the third of every month, and only the third (read “paycheck,” there, as Social Security disability check) but right now he was fighting with Verizon, who apparently shorted him half a hundred dollars worth of minutes on his phone, and he was going back-and-forth with them to get the situation righted, and anyway he wouldn’t be able to come back for his coffee til then. I was nodding and exclaiming the whole time as he was describing how much fighting he had to do — to get his transportation to the doctor, to work, to the grocery store; to get his medicine filled correctly and on time; to keep his welfare benefits flowing smoothly (there is apparently a very common mistake that gets made on his account every couple months, and he then has to make a dozen calls here and there to get things patched up, and then a few weeks later some new worker makes the same mistake again, and…) etc. etc. etc.

God did I identify, and I didn’t have to deal with the half of what he did. The fatigue and the worry and the energy and the stress and the wasted time — and when I related as much to him (having by this point unfolded my stool and sat down over the counter) he laughed it off — “Oh hell, I’m used to it by now — doesn’t bother me.”

I hope I never get to that point. No one should ever have to get to that fucking point. No one should ever have to spend half their waking hours, no fucking exaggeration, correcting other people’s mistakes just to keep the basic necessities of life covered — and then getting attitude from those same people for being a pain in the ass to deal with.

This is a serious time sink for the ill and disabled. It is time that could be spend — you know, maybe working? bootstraps and all — could be spent writing, could be spent playing board games, or taking a bath, or spending time with loved ones, or going out to eat — or any number of other things that are totally productive, constructive, positive things to do — which, to varying effect, do make contribution to wider society.

And it’s a lot of time. This is why I call it the second shift: much like the second shift of professional women, who arrive home from work to do the domestic work their husbands do not do: this is a disproportionately larger share of time spent fighting, always fighting, pushing determinedly (or tiredly) through near-constant resistance.

Resistance — truly the best word for it — it is as though “normal,” “healthy” folk are able to move throughout the world uninhibited, like pushing your hand into thin air — but sick people, disabled people must move through a world which is set up to prohibit their full participation — like pushing your hand into a thick heavy bog.

That is privilege. The ability to swim through your sea with nary a care, completely obliviously unaware of the freedom of movement you are so fortunate to have, while the rest of us have sand bags tied to our limbs, anchors roped round our waists, our feet set in cement blocks… and to look back at us and ask, “What’s taking you so long?”

It’s exhausting. I cannot convey in words how exhausting the fight is. Always on the defensive, always saddled with the knowledge that your basic needs require a struggle, while everyone else’s basic needs are pretty much a given so long as they put in at least a half-assed drop of effort. It’s not even just time spent, it’s energy.

Look at it this way. How do you build muscle? You subject your muscles to resistance, just enough to create thousands of tiny little tears in your tissue, which your body then, with rest and nutrition, repairs — which leaves you stronger.

But this does not mean that all resistance therefore makes you stronger. Because the more you pile on, the more tiny little tears you make. And the less time you have to rest, to eat and drink well, to tend to your bodily health, the less of those tiny little tears get repaired. And you find yourself, now, with millions of tiny little tears, and not enough time or fortitude to repair even only the thousands you had before this overload.

Which means you don’t get stronger. You get weaker.

“What doesn’t kill you makes you stronger.” What unadulterated bullshit. And it has the bonus effect of implying that those who do not feel stronger after a difficult incident, those who feel fatigued and despondent, those who see themselves as in a worse place than they were when they started — it implies that those people are choosing their fate. It implies that those people get something out of their misery.

Say, all you sick people out there: does any of this sound familiar?

Robert and I wrapped up our chat — turns out he lived in Anaheim for awhile, and also attended Cal State Fullerton; what a small world! — and I moved on to the next customer, affecting the smile and the sing-song customer service voice. Hi! Do you have your [Pharmacy Name] card with you today?

But it was nice, if only for a moment, to connect with someone. To, prompted by the unspoken invitation of a new friend, reach down into myself, and connect with the real person deep inside.

Maybe our struggles make us stronger; maybe they make us weaker. It doesn’t matter. We work with the tools we are given, and we still make something whole and beautiful, something worthy, something satisfying. Why do we have to come out of every fight bigger and “better”? Why can’t we be broken and hurt? Why can’t we cry, why can’t we curse, why can’t we be angry and disappointed and let down sometimes?

Right — because we wouldn’t want to make the rest of you face up to the damage you do to our lives. We wouldn’t want to “burden” you, wouldn’t want you to have to do anything to maybe reduce a little bit the fighting we have to do to live our lives. We wouldn’t want to make you have to think about how your actions and attitudes affect other people — wouldn’t want to make you uncomfortable.

When we are allowed to be angry, to be sad, to be bitter and disappointed, we are allowed to be human. When we are denied these emotions, we are denied our humanity. We are denied the full range of human experience.

It is fundamentally unfair — to weigh a person down disproportionately — to pile more and more shit atop their back — and then to grow indignant when that person lets out a sigh under the pressure — much less looks straight at you and lets rest the responsibility where it belongs. But this is how we treat each other — immigrants, queer folk, the disabled, those of color, the poor and disadvantaged — because we are fundamentally uncomfortable owning up to our own power.

Life would be so much better if we realized how much power we all have over each other — and how much power everyone else has over us — our interdependency. It is the concept out of which disability grows. And life would be so much better if we could look at this fact and see, not

scary,

or

unknown,

but

opportunity.

Recommended Reading for October 12, 2009

recommended reading, , , , , , ,

Blogs:

The Invisible Crutch:

I’ve decided to build an invisible crutch from things that constitute abled privilege, without repeating too much of what is in McIntosh’s list (so read her list, and substitute “disability” for “color” for many of those things).

1. I can, if I wish, arrange to attend social events without worrying if they are accessible to me.

2. If I am in the company of people that make me uncomfortable, I can easily choose to move elsewhere.

This month’s Disability Blog Carnival will focus on Disability & Work:

Here are some suggested starting points: What work do you do? How’s that going? Do you get paid for it, or is it volunteer work or something you do because you just love it? What blocks you from employment? If you’re employed, what could be better? Do you want a paying job, or do you feel you contribute to society just fine without one? What unpaid work do you do that you value or that others value, for example, emotional support in relationships? If you’re a family member, friend or ally of a person with a disability, what thoughts do you have on work and employment? What’s the employment situation like for PWD in your country or region ?

Health Care & Vulvodynia [U.S. specific]

One of my concerns about health care reform in the US is how it will impact sexual & reproductive health, the domain in which vulvodynia and other pelvic pain conditions are usually classified. As far rights directly related to reproduction and abortion in particular, it’s looking grim. My hope is that patients with pelvic pain conditions will be covered adequately as well. This may not seem like the most pressing issue, since, frequently, sexual health problems will not be directly responsible for death. There are some definite exceptions, notably AIDS, and cancers.

For a few moments, I feel guilty thinking about sexual health in light of other deadly, catastrophic illnesses…

But then I remember that it’s not fair to minimize the very real suffering & misunderstanding that I and other pelvic pain patients go through. And I remember how hard it is to convince others, including doctors, of how very real it is & how difficult it can be to get an effective level of care.

Fat Hatred and Disability on the Cleveland Show:

Sidewalks that are functional for an able bodied person are not necessarily useable to someone in a scooter. Poles that can be easily navigated when they are stuck in the pavement, are not necessarily easy to move around in a scooter. Often curbs are not turned down. Sidewalks are carelessly blocked off by cars hanging out of drive ways, and let’s not forget those who think that they don’t have to shovel their walkway in the winter. My personal favourite are those that believe the scooter rider should always yield when faced with a pedestrian on the sidewalk.

My Use of Ableist Language:

I can’t tell you how many times throughout my life that I have used the phrase “that’s lame” or “don’t be lame” in my life. It’s been a part of my vocabulary since grade school. I wasn’t really aware of the exclusionary and offensive nature of the word until college. That’s when I made the connection between the word “lame” and it’s association to people with mental disabilities.

In the news:

McDonald’s in row over mobility scooter [New Zealand]

McDonald’s is yet to deliver on a promise to say sorry to a woman who was denied service in a drive-thru, because she was on a mobility scooter.

Margaret Todd says she could not squeeze her scooter through the front door of McDonald’s in Blenheim, so had no option but to head round to the drive-thru.