Iconoclastes

Jun 28

When Doctors Discriminate →

andreashettle:

avioletmind:

THE first time it was an ear, nose and throat doctor. I had an emergency visit for an ear infection, which was causing a level of pain I hadn’t experienced since giving birth. He looked at the list of drugs I was taking for my bipolar disorder and closed my chart.

“I don’t feel comfortable prescribing anything,” he said. “Not with everything else you’re on.” He said it was probably safe to take Tylenol and politely but firmly indicated it was time for me to go. The next day my eardrum ruptured and I was left with minor but permanent hearing loss.

Another time I was lying on the examining table when a gastroenterologist I was seeing for the first time looked at my list of drugs and shook her finger in my face. “You better get yourself together psychologically,” she said, “or your stomach is never going to get any better.”

If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.

I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”

I never knew it until I started poking around, but this particular kind of discriminatory doctoring has a name. It’s called “diagnostic overshadowing.”

According to a review of studies done by the Institute of Psychiatry at King’s College, London, it happens a lot. As a result, people with a serious mental illness — including bipolar disorder, major depression, schizophrenia and schizoaffective disorder — end up with wrong diagnoses and are under-treated.

That is a problem, because if you are given one of these diagnoses you probably also suffer from one or more chronic physical conditions: though no one quite knows why, migraines, irritable bowel syndrome and mitral valve prolapse often go hand in hand with bipolar disorder.

Less mysterious is the weight gain associated with most of the drugs used to treat bipolar disorder and schizophrenia, which can easily snowball into diabetes, high blood pressure, high cholesterol and cardiovascular disease. The drugs can also sedate you into a state of zombiedom, which can make going to the gym — or even getting off your couch — virtually impossible.

It’s little wonder that many people with a serious mental illness don’t seek medical attention when they need it. As a result, many of us end up in emergency rooms — where doctors, confronted with an endless stream of drug addicts who come to their door looking for an easy fix — are often all too willing to equate mental illness with drug-seeking behavior and refuse to prescribe pain medication.

I should know: a few years ago I had a persistent migraine, and after weeks trying to get an appointment with any of the handful of headache specialists in New York City, I broke down and went to the E.R. My husband filled out paperwork and gave the nurse my list of drugs. The doctors finally agreed to give me something stronger than what my psychopharmacologist could prescribe for the pain and hooked me up to an IV.

I lay there for hours wearing sunglasses to block out the fluorescent light, waiting for the pain relievers to kick in. But the headache continued. “They gave you saline and electrolytes,” my psychopharmacologist said later. “Welcome to being bipolar.”

When I finally saw the specialist two weeks later (during which time my symptoms included numbness and muscle weakness), she accused me of being “a serious cocaine user” (I don’t touch the stuff) and of displaying symptoms of “la belle indifference,” a 19th-century term for a kind of hysteria in which the patient converts emotional symptoms into physical ones — i.e., it was all in my head.

Indeed, given my experience over the last two decades, I shouldn’t have been surprised by the statistics I found in the exhaustive report “Morbidity and Mortality in People with Serious Mental Illness,” a review of studies published in 2006 that provides an overview of recommendations and general call to arms by the National Association of State Mental Health Program Directors. The take-away: people who suffer from a serious mental illness and use the public health care system die 25 years earlier than those without one.

True, suicide is a big factor, accounting for 30 to 40 percent of early deaths. But 60 percent die of preventable or treatable conditions. First on the list is, unsurprisingly, cardiovascular disease. Two studies showed that patients with both a mental illness and a cardiovascular condition received about half the number of follow-up interventions, like bypass surgery or cardiac catheterization, after having a heart attack than did the “normal” cardiac patients.

The report also contains a list of policy recommendations, including designating patients with serious mental illnesses as a high-priority population; coordinating and integrating mental and physical health care for such people; education for health care workers and patients; and a quality-improvement process that supports increased access to physical health care and ensures appropriate prevention, screening and treatment services.

Such changes, if implemented, might make a real difference. And after seven years of no change, signs of movement are popping up, particularly among academic programs aimed at increasing awareness of mental health issues. Several major medical schools now have programs in the medical humanities, an emerging field that draws on diverse disciplines including the visual arts, humanities, music and science to make medical students think differently about their patients. And Johns Hopkins offers a doctor of public health with a specialization in mental health.

Perhaps the most notable of these efforts — and so far the only one of its kind — is the narrative medicine program at Columbia University Medical Center, which starts with the premise that there is a disconnect between health care and patients and that health care workers need to start listening to what their patients are telling them, and not just looking at what’s written on their charts.

According to the program’s mission statement, “The effective practice of health care requires the ability to recognize, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence is a model for humane and effective medical practice.”

We can only hope that humanizing programs like this one become a requirement for all health care workers. Maybe then “first, do no harm” will apply to everyone, even the mentally ill.

The author of the novel “Too Bright to Hear Too Loud to See” and a co-editor of “Voices of Bipolar Disorder: The Healing Companion.”

Reblogging because this is the sort of thing that needs signal boosting the heck out of it. Probably many of the people who see this in my Tumblr are people who already know from first-hand experience as a patient. Probably most of the people who even know my Tumblr exists are not in a position to perpetuate this problem (because they aren’t doctors).  But I figure if more people get info like this circulating, maybe eventually someone in a better position to reach more doctors with this kind of information and open serious dialogue about how to address the problem will come across this.

Until then, at least a better informed patient population can, I hope, be in a better position to advocate for themselves—if not always as individuals then perhaps as groups.

I lost a roommate who suffered from depression and serious drug allergies, was disabled and obese despite having almost constant migraines and low appetite, because the doctors just labeled her “drug-seeking”, “hypochodriac” and “non-compliant with diet” - when she had serious cardiac problems, and ultimately died of a heart attack at age 40.

Random doctors scare the shit out of me, because I’m fat and disabled. ER doctors scare me most of all.

Jun 05

ecosynchronous:

ecosynchronous:

PROTECT and DEFEND trans women

if you put trans women in danger because you can’t help running your fucking mouth, you are the ENEMY and will be ERADICATED

if you are a cis person who scrolled past this without reblogging because you don’t feel like it’s a necessary message for your other cis friends to see, i want you to know you’ve made it that much harder to trust you

Jun 05

pickkled-ginger:

hey guys do me a favour? Reblog if you think disabled people can cosplay. I actually got shit at a convention once for being a disabled cosplayer. so…

Jun 05
What’s more important: conforming to an arbitrary dress code, or getting an education?  Apparently Mrs Rodgers thinks it’s the former.
Are we raising people or drones?

What’s more important: conforming to an arbitrary dress code, or getting an education?  Apparently Mrs Rodgers thinks it’s the former.

Are we raising people or drones?

Jun 05
May 27

vampmissedith:

When I was a freshman, my sister was in eighth grade. There was a boy in two of her periods who would ask her out every single day. (Third and seventh period, if I remember correctly.) All day during third and seventh she would repeatedly tell him no. She didn’t beat around the bush, she didn’t lie and say she was taken—she just said no.

One day, in third period, after being rejected several times, he said; “I have a gun in my locker. If you don’t say yes, I am going to shoot you in seventh.”

Read More

The worst part? Girls in our society are taught to handle rejection, to expect it. Boys aren’t. Boys are taught to punish rejection, especially if it comes from a girl.

May 27

tumblr's kinda shit for people with stalkers →

soozblog:

sqbr:

kriegor:

+ since it’s evidently National Stalker Week on the world wide web, this seems like an appropriate time to promote that web 1.0 relic livejournal, and its more modern sibling, dreamwidth, because i’m sick of seeing my mentally ill+trans friends…

All of this. I came to Tumblr because it’s supposed to be the “in” thing, the latest and best, blah, blah.  But I don’t enjoy it, I hate its commenting system, and it’s privacy and filtering settings are non-existent.

LJ/DW do it better, and have gone through all the censorship and filtering stuff.  Plus, communities are awesome for fandom and interest groups.

May 17

I hate fuckheads

A person “T” I follow here and on Twitter has been driven away by abuse and asshole behavior. (Note: I’m not mentioning her name because I don’t want to bring more shitheads down on her, not because I want to erase her.)  Her mentions were full of trolls, her articles were plagiarized by journalists and academics without even acknowledgement, much less permission or PAY. She could say “red”, and have an assload of trolls up in her face about how she “hates blue”, yada, yada. She is a good enough writer to attract lots of followers, but they all brought trolls with them.

She isn’t the only Black or woman who has been harassed off of the internet. People since usenet have asked me why I maintain a pseudonym - cases like hers and others are why.  Because people can’t be civil and non-abusive, the world loses voices like hers, burned out dealing with the fucking detritus of the online world.

Racism and sexism are real on the internet. Used to be I didn’t really pay attention to what race a person was - it wasn’t important to who they were as a person to me. But people’s experience in living in a structurally racist society does affect them, does them harm, and so gives PoC a real incentive to look askance at white people, women an incentive to question pronouncements by men, and LBGTQIA people a cause to wonder about the agenda of cis-het people.

So now I need to notice too - so I can avoid land mines, and not hurt people by accident. I don’t mind, I don’t want to hurt people by unthinkingly blundering around with my cis(sorta) white privilege. After all, I can get burned by others with het, Christian, male, able-bodied, thin, young privilege too. So I keep aware of intersectionality (a concept first developed by Kimberle Crenshaw).

Is it really too much to ask of my fellow whites to be considerate of another person’s life and experiences? Is it just “toooo haaaard” to try to have empathy, to try to imagine what the life of someone less privileged is like, day in, day out, and be considerate of them?

When people shed more tears about fucking chickens meant for the dinner table than black people being routinely shot by vigilantes and cops, there is just something very fucked up. Seriously, vegan hypocrites, if you can empathize with a farm animal bred for the table, but can’t empathize with a fellow human being, there’s something seriously wrong with you. (Yes, I’ve seen tweets and articles like this.)

If it’s too much for you to care about how what you say affects others when you barge into their posts and mentions, then please, get the fuck off of the internet.  You are not competent to talk to other human beings.

Apr 01

quote Robert H. Richards IV, a wealthy heir to the du Pont fortune, has been spared prison after being convicted of raping his three year old daughter. Delaware Superior Court Judge Jan Jurden sentenced the admitted serial child-rapist to probation on the ground that he “would not fare well” in prison. The case echoes the affluenza scandal in which a judge spared a rich child a prison sentence after he had killed four people on the grounds that he was so rich that he couldn’t distinguish right from wrong.

Rich, admitted child rapist granted probation because he “would not not fare well” in prison [trigger warning] - Boing Boing

This judge and prosecutor should be disbarred, and Robert H. Richards IV should spend the rest of his life in jail. This is a disgusting and reprehensible miscarriage of justice.

(via wilwheaton)

Grrrrr! Who cares how well he “fares in prison”! He didn’t much care for the welfare of his own Three Year Old Daughter when he RAPED her!

Apr 01

quote In California, a police officer who ejaculated on a woman he’d detained at a traffic stop -and threatened to arrest her if she took action against him- was let off even after admitting what he’d done. Why? Well, the victim was a stripper on her way home from work. In officer David Alex Park’s 2007 trial, Park’s defense attorney argued that the woman “got what she wanted” and that she was “an overtly sexual person”. The jury (composed of one woman and eleven men) found Park not guilty on all counts.
Similarly, a judge in Philadelphia ruled that a sex worker whom multiple men had raped at gunpoint hadn’t been raped at all -she’d just been robbed. The victim, a twenty-year-old woman, who’d worked for an escort service and obtained clients via Craigslist, had agreed to certain sexual acts with the defendant for a set amount of money. But he lured her to an abandoned piece of property and pulled a gun -then more men started showing up. When a fifth man was invited to assault her, he instead helped her get dressed and leave because he saw that she was crying. But municipal judge Teresa Carr Deni insisted that what happened to this woman wasn’t rape -it was “theft of services”.
“I thought rape was a terrible trauma,” Deni told a Philadelphia Daily News columnist. “[A case like this] minimized true rape cases and demeans women who are really raped.”
Women who are “really” raped. You can’t get much clearer than that -a sex worker just doesn’t classify as one of these victims.

Jessica Valenti - The Purity Myth (via misandry-mermaid)

That rapist was re arrested like 4 days later for a similar crime…and that judge was re-elected.

(via christel-thoughts)