Advocacy, Entitlement and Knowing When to Complain: The Rights of Poor People

Advocacy, Entitlement and Knowing When to Complain: The Rights of Poor People

If you are new to this blog, you may not know that I was in an accident about two years ago that resulted in a broken nose and concussion as well as other injuries. The concussion was not one of the “good” kind, meaning, I have still not completely recovered.

This deterioration in my health caused me to run through my savings and unemployment benefits in California and have to rely on others. Finally, I am privileged to benefit from my mother’s having space and a generous heart, allowing me to move in with her in St. Louis about 18 months ago.

Missouri, however, is not a great place to live if you are indigent. This post is the third in a series about my experiences here. This third one is on poor people’s rights. The second was on food for indigent people in Missouri (published February 16, 2016, http://wp.me/p2bP0n-1BL). The first one was on health care (published February 9, 2016, http://wp.me/p2bP0n-1By).

This post is important because it looks at the underlying issues that make a difficult situation (being poor) worse or better for each person. The intersections of perceived or claimed race/ethnicity, perceived or claimed gender, perceived or claimed social class, perceived or claimed age, home/best language, physical and mental health and (dis)abilities, perceived or claimed religion, perceived or claimed sexual orientation, and economic status in the city of St. Louis, Missouri, USA, in the mid-20teens, can adversely influence, improve or neutrally affect one’s experiences every moment.

“Intersectionality” is an important part of understanding how poverty impacts each person and family differently. Therefore, in this series, I need to bring in the politics of social identity. We all have to learn to address these overlapping oppressions and unfair treatments to help ourselves understand how everything is NOT actually “equal” regardless of the similarities in two people’s incomes.

intersectionality
Intersectionality includes all of these components of one’s social identity.

It’s not “all good.”

It doesn’t have to be this way.

It ISN’T what it IS “naturally”: people and then institutions run by people make things this way and create/perpetuate systems that keep them this way.

Missouri is one of the worst places to be if you’re poor, but it’s not even the worst by any standards. Your experience all depends on the other components of your social identity. If you’re believed to be a white male, seemingly in good health and able-bodied, perceived to be heterosexual, assumed to be Christian, speaking mid-Western-accented English like a native, have at least some college education and otherwise seeming to be a USA “mainstream” guy between the ages of 25 – 65, you are going to be much better treated and fare better even when you’re poor than if you do not claim or cannot pull off having others believe you have all or any of those social identities.

If you’re also not a felon, have a place to live (a legal address) and (the use of) a car, you’re probably not going to be poor for very long.

Unless you’re obese. Unless you’re smelly. Unless you’re an addict. Unless you’re perceived to be “not one of us” in whatever way “us” is defined: then, you’re in some trouble. But, even with those cards stacked against you, as a poor assumed-to-be-white & -Christian with some education who speaks adequate English and can pass for straight and male and under age 65, you’re still going to be better off than anyone who isn’t.

no isms allowed

Change one aspect—gender—and things automatically get much worse. Change two—ethnicity/race and gender—and you’re doomed.

Check this out, from Everyday Feminism, June 20, 2015 by Carmen Rios “These 5 Statistics Prove That We’re Feminizing Poverty (And Keeping Women Down in the Process)” http://everydayfeminism.com/2015/06/feminizing-poverty/
— “Despite the overall poverty rate declining in America, 18 million women remain below the poverty line.”
—“Women are poorer than men in every state, regardless of education or geographic location. And for women of color, elderly women, and LGBTQIA+ women, it’s even worse.”
—“The poverty rate for Native American, Black, and Latina women is almost double the poverty rate for white women.”
—“For women, and especially women of color, the fight to raise the minimum wage to $10.10 or $15 is very personal—and could be the difference, for them, between barely surviving and finally thriving.”
—“…over a lifetime, women lose an average of $434,000 to the wage gap.”
—“One of the most important aspects of intersectional feminism is the understanding that when we fight for the most marginalized women, we liberate all women along with them.”

And, from other sources (see below) that add in education and other factors to race/ethnicity and gender with income levels:
—“White households take home between $10,000 to $20,000 more per year than their Black counterparts in every age bracket”
—“Enrollment in ‘high poverty’ schools for Black children is 41 percent, 38 percent for Hispanic children, 31 percent for American Indian/Alaska Native and a mere six percent for Whites.”
—“Even when Black and minority children attend mixed schools, they are more likely to be tracked into remedial or basic classes while their White counterparts take advanced, honors level courses.”
—“70 percent of students arrested or referred to law enforcement for school-related infractions were Black or Latino.”
—“While people of color only comprise about 30 percent of the US population, they account for 60 percent of those imprisoned.”
—“There is no such thing as unbiased, unpolitical education.”
—“People with ‘Black’ or ‘ethnic-sounding’ names are less likely to get callbacks for interviews.”
—“Blacks are more likely to be born into poverty and are less likely to escape it.”
—“Whites are 2-3 times more likely to make it into the middle class in their lifetimes compared to their black counterparts.”

poverty-is-violence
from http://iamarevolutionary.wordpress.com
Poverty IS violence. It has to stop.

Find a well-vetted nonprofit that advocates and works to end poverty and understands intersectionality and contribute, volunteer, blog about their work! Here is one: http://www.results.org/

Good news! We made this mess; we can clean it up.

Mandela quote about poverty
Nelson Mandela, Audre Lorde, Martin Luther King, Jr., Angela Davis, Gloria Steinem and so many more have spoken out about the nature of the human-made elements of our social and political systems and the oppressions they systematize.

WE are the ones who must advocate, complain, recognize that we are entitled to better and that so is everyone else, and ACT!

—Do not sit by and watch passively when others are mistreated, disrespected, unfairly scheduled or managed, especially when you are in any position of better privilege: it is your DUTY to advocate whenever you are able.
—Write letters, blog, make phone calls, picket, march, show up and let those in power know you are not satisfied with the “status quo.” Be specific.
—VOTE! It is your DUTY and responsibility as a USA citizen who can vote (if you are one) to use that right in EVERY election. It is the LOCAL elections that most affect people who live near you, and regional and state office holders who make laws that affect us all. Federal elections matter, too, but not as obviously or as immediately.

WIN_20141104_095753 I VOTE! And, as of early March, I am working as a election-day supervisor at a local polling place!

—THEREFORE, do not ignore bond issues, council and mayoral elections, county positions, state office holders’ elections and only vote on presidential ballots. ALL VOTES MATTER!

Want to know more? Have a read:

From October, 2015, inGenere.it: “Intersectionality. Putting together
things that are often kept apart” by Jeff Hearn
http://www.ingenere.it/en/articles/intersectionality-putting-together-things-are-often-kept-apart

From February, 2015, NPR: “Study: Black Girls Are Being Pushed Out of School” by Karen Grigsby Bates
http://www.npr.org/sections/codeswitch/2015/02/13/384005652/study-black-girls-are-being-pushed-out-of-school

From February, 2015, the the Frisky: “18 Things White America Needs To Reconcile To Truly Become Colorblind” by Tiffanie Drayton
http://www.thefrisky.com/2015-02-26/18-things-white-america-needs-to-reconcile-to-truly-become-colorblind/

If you appreciated this series, please reblog/share it, comment, ask to be a guest blogger and contribute your own point of view or write on a related topic: http://www.sallyember.com

This third post was on advocacy and intersectionality (published on February 23, 2016, http://wp.me/p2bP0n-1C2).
The second was on food for indigent people in Missouri (published February 16, 2016, http://wp.me/p2bP0n-1BL).
The first one was on health care (published February 9, 2016, http://wp.me/p2bP0n-1By).

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Food Stamps and Food Issues for Poor People in St. Louis

Food Stamps (SNAP, EBT) and Food Issues for Poor People in St. Louis

If you are new to this blog, you may not know that I was in an accident about two years ago that resulted in a broken nose and concussion as well as other injuries. The concussion was not one of the “good” kind, meaning, I have still not completely recovered.

This deterioration in my health caused me to run through my savings and unemployment benefits in California and have to rely on others. Finally, I am privileged to benefit from my mother’s having space and a generous heart, allowing me to move in with her in St. Louis about 18 months ago.

Missouri, however, is not a great place to live if you are indigent. This post is the second in a series about my experiences here. This one is on food for indigent people in Missouri. The first one was on health care (published February 9, 2016, http://wp.me/p2bP0n-1By).

This post is about the government-subsidized “food support,” formerly called “Food Stamps,” now called “SNAP” for Supplemental Nutrition Assistance Program.

snaplogo

What makes Missouri so bad for poor people? For one thing, this state is very Republican-dominated. Despite many of the speeches given by congressional and senatorial representatives from this party, their votes speak loudly: they keep lowering the amounts poor people can receive in all types of assistance and have repeatedly voted to reduce food support. This state also still calls its program “Food Stamps,” but adds “SNAP” so people will know what it is. http://dss.mo.gov/fsd/fstamp/

Missouri’s unfortunate and lethal combination of machismo, arrogance, obstinacy and ignorance have caused millions of Missourians who cannot afford to buy sufficient amounts or types of food for themselves and/or their children to go without food, especially near the end of each month’s benefits period (the food money runs out). Not only are the benefits woefully and abysmally low, even at their highest levels, they arrive in one lump at the beginning of each monthly period. Even the best budgeters can’t make insufficient funds last throughout a month.

“Missouri is among states where legislators this year have considered bills that would curb welfare benefits” and continues to demonstrate its disdain for the poor, blaming the victims and putting economic pressure on the weakest of us to try to shore up the state’s failing budget. The Democratic Governor, Jay Nixon, vetoes these bills, but then the “representatives” usually have the votes to override his vetoes. On it goes, this heinous battle for who can sink the lowest first. http://www.huffingtonpost.com/2015/05/04/missouri-welfare-restrict_n_7209458.html

Missouri and other state SNAP programs are now in the computer age. SNAP currently issues a debit-type card to recipients which is an EBT (Electronic Benefits Transfer) unit that looks a lot like any other debit card. I’m sure this has alleviated a lot of the embarrassment many users had previously felt when producing their pink paper food stamps at the grocery check-out line. Now, we kind of “blend in,” putting our card through the same reader everyone who uses credit or debit cards uses to make our payments.

SNAP to health
from http://www.snaptohealth.org

Except when we don’t. Most times, even when I tell the register operator that I am using an EBT for SNAP, they punch in the wrong codes and it doesn’t work. Or, they do it correctly, but neither of us knows exactly how much the receipt total will be for until the card is used (SNAP card users get to avoid paying the tax on food that others pay). Worse, there is no way prior to being in the check-out process for a user to know exactly how much is left on the EBT to use.

Here is a typical process for me.
—I get in line (can’t use the self-service machines for EBT/SNAP)
—I put my food on the conveyor
—I get to the card reader while the register operator is still scanning my food so that I am sure to mention to him/her that I am using SNAP
—S/he nods or otherwise acknowledges that I told him/her this (important to get confirmation: they often do not hear me or don’t know what I mean)
—I put my EBT card through the reader.
Hopefully, it reads my card correctly (doesn’t always) and
—I press the right buttons (always confusing, since the buttons are arranged differently in every card reader I’ve seen, so far: not always using the same colors designating the choices or putting the choices in the same position)
—We get to the end of the food scanning
—S/he presses whatever buttons (not always correctly) to accept my EBT card as payment
—I either do or do not have sufficient funds on the card to pay for this amount of food (which I only know at this point)
—If so, we proceed and I am done
—If not, we have to start over with the reader, putting only the amount I actually have into the register operator’s process to take only that amount from my EBT
—Then I have a choice: pay in cash or use a debit card (if I have the funds) for the rest, or put the rest of the food back/don’t take it home.

I think it’s obvious that this process is not quick, or at least, not as quick as using cash or a debit/ credit card. When the lines are long, I dread getting into one because these “delays” cause impatience to arise in those in line behind me. I have a fairly thick skin, so to speak, so I don’t care about how impatient people are. We all have to wait, sometimes.

However, others do care about others’ opinions, so it makes many SNAP users anxious to go through the check-out process, as you can well imagine. Many times, when I was more flush, I gave the SNAP users in lines ahead of me some money when their EBT cards were shown to carry insufficient amounts for the entire purchase and the users clearly didn’t have any cash or funds to cover the rest of the food.

Confession: I was less likely to offer money when the purchases of the SNAP user seemed “frivolous” or “junky” to me. Awful judgment call on my part and really, none of my business. But, at the time, I felt quite high-and-mighty, telling myself I was “doing them and their kids a favor” if they didn’t get to bring home that sugary or salty treat. Why, I wonder now, does anyone believe we suddenly have the right or ethical duty to pass judgment on someone’s food purchases simply because they’re poor? We leave all the horrible choices of the middle- and upper-class to themselves, so why do we believe we are entitled to assess those of the poorest among us?

News flash; poor people are not stupider, less informed, less competent or any other judgment the better-off can levy just by being currently without enough money. Money does NOT make anyone smarter, more informed, competent or anything else, automatically. We all know plenty of wealthier people without a clue, don’t we?

In other horrible news, SNAP makes us “re-qualify” every year even if our benefits are for a two-year period. This means recipients are able to be—and, in my case, I was—penalized if we earn even a little bit of money. My SNAP benefits were reduced by half (and were insufficient to begin with) when I reported that I had earned some income from freelance proofreading/editing and doing occasional childcare, even though the total earned was less than $1000/month and more often, not even half that. Look at the chart below for how low these monthly benefits are for an entire month and picture this: you have ONLY this amount to pay for all food for 4.3 weeks (30 – 31 days):

Family size: 1 2 3 4

Maximum benefit level: $155 $284 $408 $518

So, if you’re math-impaired, consider these actual figures:
—the individual SNAP allotment comes to about $36/week, or $5.14/day per individual.
—For a family of two, it comes to $33/week/person, not even $4.70/day, which is LESS per week than if you’re on your own.
—For a family of three, usually one parent and two children, they get only $32/week/person, which is $4.53/day per person!
The larger the family, the less the family gets per person.

What is the logic, here? That kids eat less than adults? Incorrect, unless they’re under 7 years old.

Or, maybe they live in a fairy-tale land, in which they believe larger families can buy “in bulk.” Well, that only works if a family has enough money in hand to purchase the larger amount of chicken or rice or beans, which they often would not have, since the total amount provided by SNAP and workers’ wages is insufficient. When a family doesn’t have enough money to buy food, how can anyone buy MORE food per grocery visit?

Doesn’t work.

Over the last 2 years of my own experiences as a poorer person but one who has many resources others do not have (a great and safe place to live, family members to help me, a car, higher education and advocacy skills, among the best) and seeing these SNAP figures, above, I understand the motivation that spurs poorer people to become criminals just to make ends meet. Why the hell not?

I’m not advocating a life of crime, but I certainly can empathize the reasoning better, now.

When our government fails to support those in the most need, what are the needy supposed to do?

Meanwhile, some help is better than none. How can people get fed, then?
—If a family has young children or the mother is pregnant, that mom and kids can also get further food support (very restricted, but food and juice, nonetheless) from WIC (Women and Infant Care) and (minimal) cash from TANF (Temporary Aid to Need Families, formerly known as “welfare”).
—If one is disabled and/or a senior, one can get Social Security disability and/or retirement benefits to supplement these paltry SNAP monthly allotments.

For basic SNAP information and links to your state’s SNAP website: http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap

Good news! Many health food stores, farmers’ markets and alternative grocery stores now accept SNAP.

we accept SNAP

However, the poorer among us face an entirely different problem that I personally don’t experience (that good fortune is due to my being able to live with my mom). Those who live in “high-poverty” areas now often inhabit regions that have become what are known as “food deserts”: because the larger chains and independent grocery stores refuse to locate or stay in these neighborhoods, there is literally nowhere to go grocery shopping. If you live in a “food desert,” you are screwed. Bad enough that you already have less means (no car, no money for gas), horribly skimpy SNAP funds and little time (those who do have jobs work hourly and must show up on time and leave when they’re scheduled to leave, period). You now are somehow also supposed to travel great distances (often when there is no viable public or any public transportation, so how are you going to accomplish that?) to get to a decent, fairly priced grocery store or to get anywhere that sells any fresh food at all.

People who live in “food deserts” can sometimes purchase food that is close to where they live, but it is usually from “convenience” stores or gas stations’ stores. Their “food shelves” and “hot bars” are typically stocked with low-nutrition, high-fat, high-sodium, high-sugar, deep-fried or microwavable, high in “empty” (simple) carbs, over-priced options only: no fresh fruit, no fresh vegetables, not much good protein, almost no complex carbs and very few choices that are even close to being healthy.

YOU might be able to help change this! https://www.dosomething.org/facts/11-facts-about-food-deserts Help populate “food deserts” with good food sources and/or bring better public transportation to these areas.

And, just when you thought things couldn’t get much worse, now it’s 2016. SNAP recipients between ages 18 – 49 stand to lose what little SNAP benefits we do get if we aren’t working “sufficiently,” but more of us than ever still need SNAP and many cannot work or work “sufficiently.”

Want to know more? Have a read:

From January, 2016, Cleveland.com: “Over 1 million face loss of food stamps over work requirements”
http://www.cleveland.com/nation/index.ssf/2016/01/over_1_million_face_loss_of_fo.html

From January, 2016, American Enterprise Institute: “Are SNAP benefits really too low?” by Angela Rachidi
https://www.aei.org/publication/are-snap-benefits-really-too-low/

From February, 2016, the Times-Picayune of Greater New Orleans: “Despite ‘recovery,’ more Americans using food stamps, at a higher cost”
http://www.nola.com/politics/index.ssf/2016/02/despite_recovery_more_american.html

Next in this series, February 23, 2016: Advocacy, Entitlement and Knowing When to Complain: The Rights of Poor People http://wp.me/p2bP0n-1C2

This second is on food for indigent people in Missouri, published on February 16, 2016, http://wp.me/p2bP0n-1BL.
The first one is on health care, published on February 9, 2016, http://wp.me/p2bP0n-1By.
The third post is/was on advocacy and intersectionality, (to be) published on February 23, 2016, http://wp.me/p2bP0n-1C2.

My Experiences with being Indigent in Missouri: County/Federally Funded Clinics

My Experiences with being Indigent in Missouri: County/Federally Funded Clinics

If you are new to this blog, you may not know that I was in an accident almost two years ago that resulted in a broken nose and concussion as well as other injuries. The concussion was not one of the “good” kind, meaning, I have still not completely recovered.

This deterioration in my health caused me to run through my savings and unemployment benefits in California and have to rely on others. Finally, I am privileged to benefit from my mother’s having space and a generous heart, allowing me to move in with her in St. Louis about 18 months ago.

Missouri, however, is not a great place to live if you are indigent. This post is the first in a series about my experiences here. This one is on health care for indigent people in Missouri.

What makes Missouri so bad for poor people? For one thing, this state is very Republican-dominated. Among other horrors, this means its idiotic legislature refused to approve the expansion of Medicaid in 2013, 2014, 2015 or 2016 for the new USA health care systems (Affordable Care Act, or “Obamacare”) that some other states, like California, were smart enough to utilize.

Missouri’s unfortunate and lethal combination of machismo, arrogance, obstinacy and ignorance have caused millions of Missourians who cannot afford even the minimal payments (over $200/month plus co-pays, for me) to be without any health care or insurance if we are not over 65 and/or disabled or under 18, because these the only groups Medicaid and Medicare cover in Missouri at this time.

St. Louis is somewhat Democratically dominated, which means some of its legislators and leaders applied for and received federal and state funds to create a health insurance “work-around,” called “Gateway to Better Health.” https://www.stlgbh.com/programoverview

GBHLogoAlt5

They are quick to tell us that this is NOT an insurance plan because it is not “portable” excerpt for emergencies, and even then, not so much. What it does do is entitle its few qualified users to avail ourselves of its paltry network of federally qualified health care clinics located within St. Louis County and surrounds.

The closest clinics in these networks to where my mom lives are minimally (with no traffic) about a 30-minute drive in any of three directions, and only one houses the pharmacy (the furthest one, of course). I chose the one that was “closest,” which is about 28 minutes from our condo. It is in Ferguson.

Yes. That Ferguson.

Despite having been only a few months since the demonstrations, riots and protests surrounding the murder and announcement of the appalling lack of indictment of the murderer of Michael Brown, I decided to utilize this clinic solely because of its location. However, I didn’t understand until I got there that Ferguson is very spread-out, geographically. This clinic is not located close to the site of any of the disturbances. Even so, this clinic has an unarmed (at least, no visible gun) guard. I found out later that all the clinics have guards; the pharmacy has two.

Prior to this set of experiences, my only contact with federally qualified health care clinics had been as a volunteer reception clerk/translator for the Jewish Community Free Clinic in Sonoma County (no guards) in the mid-2000’s which served many farmworkers and other newly arrived immigrants with little English and no health insurance, and as a co-writer of a grant to start a regional clinic in southwestern New Mexico in the early 2000s (which was funded and is still running but which I never visited because I moved to California before it opened). I had never been a patient in such a clinic before 2014.

Here are some of my experiences as a patient, 2014 – 2016, in the Betty Jean Kerr People’s Health Center on West Florissant, in the city of Ferguson, and the main BJK PHC clinic in St. Louis city on Delmar Boulevard (to access the pharmacy). http://www.phcenters.org/

Some are positive, many negative, some neutral.

Let me start by saying I am grateful for many aspects of this stop-gap health care coverage (NOT insurance), such as:
—- to have access to three necessary prescription medications at no or low-cost (the BJK PHC pharmacy does not carry my alternative thyroid medicine, even though CVS does)
—- to have a clinic to go to when I need to check on my health status for chronic conditions (hypertension, hypothyroid)
— to have regular blood work done and reviewed to make sure my medications are the right dosage and are working (hypertension, hypothyroid; very nice and competent phlebotomists whom I found out are NOT clinic employees but located on site from another agency; the internist never discusses my results with me at the time and rarely provides any follow-up from these results until three months later, so what is the point of that?)
— to get a referral from my “primary care doctor” (whom I saw four times, then switched away from because he was awful) to a neurologist to continue my care and get further diagnoses/prognoses for the after-effects of the concussion/Traumatic Brain Injury (very useful)
— to have another colonoscopy procedure (I turned 60 in 2014, and since my grandmother had died of colon cancer, I was supposed to have had my second check-up last year but had missed it due to having moved and having had no health care for a while) (thankfully, clear)
— to have a biannual mammogram (thankfully, clear, but the technician was rough with me and cut my skin which caused a stubborn infection that took months to heal)
— to have a triannual pap smear and gynecological check-up (thankfully, all clear as well, but with an awful ob/gyn who insulted me and treated me disrespectfully; won’t be seeing her again; see below)
— to have a dental check-up and cleaning (thankfully, no problems) up to twice a year (I have gone twice but the second visit was horrendous and did not result in my having services; see below)
— to have a clinic to go to when I need to check on my health status for acute conditions (which I haven’t done and probably would not use it for, since I use homeopathics and herbs for most viruses and infections).

Here is the main problem: this clinic (and probably many others like it) are health care “mills.” They get reimbursed for procedures, not time. If doctors order blood work, diagnostics that require machines or surgery to provide the data for the diagnoses, like urinalysis, the clinic gets paid for each component. If they just talk to a patient, very little money comes to them.

So, guess what?

These doctors order a lot of unnecessary diagnostics:
annual X-rays for dental patients even when we don’t need or want them and national and regional guidelines do NOT recommend having X-rays every year any more for anyone without serious dental problems that require them (I do not have any serious problems, luckily); they would not give me an exam, a cleaning or a polishing of my teeth because I refused to allow X-rays 12 months after the first set were done
blood work every three months to “qualify” me for my prescriptions even though the results are NOT used to determine whether I receive them nor what dosage to provide for me; I cannot get my prescriptions refilled unless I submit to these blood tests
urinalysis every three months even though I have no symptoms and have had none for problems that these diagnostic could analyze and I never hear about the results then or later; however, patients are not allowed to use the urinalysis rest room while still in the waiting area, and because many of us need to use the rest room while we are waiting for our appointments (which are never on time), we therefore, can’t provide a usable sample by the time we are called
annual mammogram (which I will not do that frequently, since biannual or triannual are now recommended for my age group and health status) and annual pap smear (ditto) when national and global guidelines do NOT recommend doing these so often for any women without history of cancer
X-rays for muscular problems which show nothing, since X-rays cannot show muscles well; my former internist insisted I get an X-ray prior to getting any other diagnostics when I told him I was having pain in the muscles and nerves of one hip; my bones are fine and have been for many decades, but he wouldn’t listen to my patient-provided information at all (another reason I ditched him); then he “forgot” to order the other diagnostics for six more months (two more visits; another reason I switched internists last fall)

Is it relevant or irrelevant that I was one of only two Caucasian-looking people in the entire clinic— staff and patients included—for all of my 10 visits, to date? FYI, the actual population of St. Louis County, demographically (2010 and updated census) is: 70% “White,” 24% “Black,” about 4% “Asian,” 3% “Hispanic,” and about 1% “other.”

How significant is it that I have to wait more than 20 minutes every time I go, even when my appointment is supposedly the first one scheduled? For about 5 minutes or fewer per visit with my internist, I have to be at the clinic for over 2 hours, mostly waiting: between blood work and being seen, urinalysis and being seen, nurses checking my vitals and being seen, etc. Who, besides those who are under- or unemployed or on salary (and wouldn’t be here, then) has time for this insult to our value?

The doctors I have seen are almost without exception disrespectful to the patients: they don’t listen to or regard the information I provide with careful consideration.

For example, even when I told him I had no interest in getting any unnecessary medications, even for pain, this internist insisted on putting unnecessary and unwanted prescriptions into my record and making those recommendations in a print-out they gave me after each visit (which I did not fill).

Worse, the ob/gyn doctor was mean-spirited in her language (which I won’t repeat here) when describing my genitals and tried to scare/threaten/shame me into getting an unnecessary procedure. Luckily, I am informed and I remembered what my previous ob/gyns had told me about my body, so I felt fine about ignoring her, but what if I hadn’t been so fortunate?

Third, and what prompted this blog post, the dentist was horrible. This dentist insisted that I get X-rays. I told her that I didn’t need or want them after only one year since the last set and that the current guidelines agreed with me. She then adamantly refused to clean or examine my teeth if I did not agree to having these unnecessary X-rays. She claimed this was the clinic’s “policy,” but when I asked to see this supposed policy in writing, she refused to provide it. She then went to get the guard, who threatened to call the police if I didn’t immediately leave. According to him, even though this was during my appointment time, this dental chair was “needed for another patient” (!?). I told them both I was not leaving until they showed me this X-ray requirement in writing.

They started yelling. I yelled back. Despite my lack of fear and not feeling intimidated, I was finally so disgusted and frustrated that I no longer wanted her or anyone else there even to touch my teeth.

I left.

What kind of “health care” clinic tries to force unnecessary procedures, medications and diagnoses on its patients and then threatens us when we refuse to comply?

peopleslogo2

USA federal clinics, I now know. So do many others. Want to know more? Have a read:

From May, 2015, New Yorker magazine: “Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?” by Atul Gawande http://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

and, from the MinnPost, also in May, 2015: “How an ‘avalanche of unnecessary medical care’ is harming us — and what can be done about it,” by Susan Perry
https://www.minnpost.com/second-opinion/2015/05/how-avalanche-unnecessary-medical-care-harming-us-and-what-can-be-done-about-

And, right here in good ole’ Missouri, August 13, 2015: “Missouri Hospital Agrees to Pay United States $5.5 Million to Settle Alleged False Claims Act Violations”
http://www.justice.gov/opa/pr/missouri-hospital-agrees-pay-united-states-55-million-settle-alleged-false-claims-act

Furthermore, recent nation-wide problems: “Top 5 Healthcare Fraud Cases in 2015”: http://www.medicfp.com/top-5-healthcare-fraud-cases-in-2015/
This is so awful: “Even though the amount of money recovered in 2015 is impressive, that is just a drop in the bucket for the amount of healthcare fraud that occurs, and is never reported or recovered each year. The U.S. spends over 3 trillion dollars on healthcare benefits each year, and according to a recent FICO study, roughly 10% of healthcare expenditures are fraud. This means that our country loses over 300 billion a year to healthcare fraud, nearly 1 billion dollars every day!”

From Florida to California, including almost every state, here the “worst offenders of 2015”:
http://www.healthcarefinancenews.com/slideshow/biggest-healthcare-frauds-2015-running-list

Users, beware.

Next in this series: Food Stamps and Food Issues for Poor People in St. Louis http://wp.me/p2bP0n-1BL

This first one is on health care, published on February 9, 2016, http://wp.me/p2bP0n-1By.
The second is/was on food for indigent people in Missouri (to be) published on February 16, 2016, http://wp.me/p2bP0n-1BL.
The third post is/was on advocacy and intersectionality, (to be) published on February 23, 2016, http://wp.me/p2bP0n-1C2.

Linda Ronstadt’s Rendition of Desperado Burst my Grief Dam

Some of you know I that in April recently suffered a concussion and broken nose and am still recovering. The injury impacted my frontal lobe and deeper parts of my brain were also affected. One ongoing issue has been that, except for brief, mostly mild occurrences (often apropos of nothing), I have been unable to experience much beyond irritation or fatigue.

Mostly, I feel upbeat, sunnily similar, day after day. I’m not apathetic or depressed, but the variety of emotions I experience has been vastly curtailed, as have their intensity.

If you knew me before this, you’d be shocked by my lack of affect, particularly by my lack of sadness or other reactions to the series of shocking (to my life, system, and existence) events, Lemony Snicket -style, I have endured because of and directly after this accident, including a forced cross-country move in August.

About a week ago, during a discussion that became more of an argument with my son (a more frequent occurrence, he believes, since my fall), I heard him say how “different” I am, now, and I cried. Hard. That’s the first actual cry I had had in more than eight months.

To his surprise, I thanked him for upsetting me “enough.” I explained how important this was, that he and I had a strong enough connection that his criticism could penetrate my blandness, piercing all the way to the fear and loss beneath the façade. He was gallant and supportive (great young man).

Since then, I’ve been waiting for what I thought would be inevitable crying jags or other bouts of sadness, but nothing. Until yesterday, at the pool.

There I am, swimming laps in the “cold” pool next to the warmer “walking” pool, which was simultaneously having a water aerobics class to music. Usually I ignore the music, meditating and getting into the lap rhythm, glad when I can’t even hear it as my ears go beneath the water at every stroke. I was turning to go back for one last length when the strains of Linda Ronstadt’s cover of the Eagles’ Desperado pierced my meditative trance and got my attention, bringing my momentum to a dead stop, at the wall.

Linda Ronstadt’s Desperado in Atlanta, 1977

I stood up (luckily, this was the shallow end) and realized I was trembling. I listened to the song, transfixed by my reaction. I began to cry, then to sob. I happened to be in a corner of the aqua center that no one was inhabiting at the moment; two other lap swimmers continued, unaware of my sudden catharsis.

I let it happen. I could hardly have stopped it, anyway.

A kaleidoscope of images and concomitant emotions captured my inner eye: a young Linda juxtaposed with her now-Parkinson’s Disease-ridden, no-longer-singing older self; my former California cottages, in locations I sorely missed; my younger self and some of my former loves, particularly the ones this song reminded me of, unrequited (luckily, as it turns out, but heartbreaking, nonetheless); my former spiritual community’s center and its pond, also a place I missed tremendously; my spiritual teacher, whom I missed most of all. People, places, inchoate yearning and losses spun by, each one intensifying my sobs.

The dam had burst.

dam

My shoulders shaking and my face wet, I climbed out and began to make my way to the locker room. I hadn’t realized how much the silencing of Linda Ronstadt’s amazing voice had upset me and I was overcome by the magnitude of my heretofore unexpressed grief for the rest.

I had to stop walking because I couldn’t see through my tears. Leaning on the back of the water slide, hidden by its bulk from the exercisers, sobs took me over again. I felt grateful even amidst this onslaught, knowing this uncontrollable crying was a great sign of healing even as my knees buckled from the pain of my grief and loss. There wasn’t anyone walking by, so I could have my bawl without having to explain or have some well-meaning person try to quell it, erroneously believing that the cessation of my tears would be a better outcome.

I let them flow, heaving and shuddering until they subsided. As my feelings ebbed, I thought of how fortunate I am that mine are the types of injuries I am likely to recover from completely. Many are not so lucky.

I walked on shaky legs into the locker room, hiccuping and smiling. Having a wet face in that part of the locker room is unremarkable; even red eyes can be explained by being in the pool. I smiled murkily at a few fellow showerers and stepped into a stall.

As soon as I turned on the water, more tears came with the spray. “Good,” I thought. “Let ’em come.”

By my suffering and through my relief, may all beings benefit, becoming as healed and happy as possible.

For more information about Traumatic Brain Injuries, my experiences and research, check many other post on my blog: http://www.sallyember.com/blog

Linda Ronstadt’s Rendition of Desperado Burst my Grief Dam

Some of you know I that in April recently suffered a concussion and broken nose and am still recovering. The injury impacted my frontal lobe and deeper parts of my brain were also affected. One ongoing issue has been that, except for brief, mostly mild occurrences (often apropos of nothing), I have been unable to experience much beyond irritation or fatigue.

Mostly, I feel upbeat, sunnily similar, day after day. I’m not apathetic or depressed, but the variety of emotions I experience has been vastly curtailed, as have their intensity.

If you knew me before this, you’d be shocked by my lack of affect, particularly by my lack of sadness or other reactions to the series of shocking (to my life, system, and existence) events, Lemony Snicket -style, I have endured because of and directly after this accident, including a forced cross-country move in August.

About a week ago, during a discussion that became more of an argument with my son (a more frequent occurrence, he believes, since my fall), I heard him say how “different” I am, now, and I cried. Hard. That’s the first actual cry I had had in more than eight months.

To his surprise, I thanked him for upsetting me “enough.” I explained how important this was, that he and I had a strong enough connection that his criticism could penetrate my blandness, piercing all the way to the fear and loss beneath the façade. He was gallant and supportive (great young man).

Since then, I’ve been waiting for what I thought would be inevitable crying jags or other bouts of sadness, but nothing. Until yesterday, at the pool.

There I am, swimming laps in the “cold” pool next to the warmer “walking” pool, which was simultaneously having a water aerobics class to music. Usually I ignore the music, meditating and getting into the lap rhythm, glad when I can’t even hear it as my ears go beneath the water at every stroke. I was turning to go back for one last length when the strains of Linda Ronstadt’s cover of the Eagles’ Desperado pierced my meditative trance and got my attention, bringing my momentum to a dead stop, at the wall.

Linda Ronstadt’s Desperado in Atlanta, 1977

I stood up (luckily, this was the shallow end) and realized I was trembling. I listened to the song, transfixed by my reaction. I began to cry, then to sob. I happened to be in a corner of the aqua center that no one was inhabiting at the moment; two other lap swimmers continued, unaware of my sudden catharsis.

I let it happen. I could hardly have stopped it, anyway.

A kaleidoscope of images and concomitant emotions captured my inner eye: a young Linda juxtaposed with her now-Parkinson’s Disease-ridden, no-longer-singing older self; my former California cottages, in locations I sorely missed; my younger self and some of my former loves, particularly the ones this song reminded me of, unrequited (luckily, as it turns out, but heartbreaking, nonetheless); my former spiritual community’s center and its pond, also a place I missed tremendously; my spiritual teacher, whom I missed most of all. People, places, inchoate yearning and losses spun by, each one intensifying my sobs.

The dam had burst.

dam

My shoulders shaking and my face wet, I climbed out and began to make my way to the locker room. I hadn’t realized how much the silencing of Linda Ronstadt’s amazing voice had upset me and I was overcome by the magnitude of my heretofore unexpressed grief for the rest.

I had to stop walking because I couldn’t see through my tears. Leaning on the back of the water slide, hidden by its bulk from the exercisers, sobs took me over again. I felt grateful even amidst this onslaught, knowing this uncontrollable crying was a great sign of healing even as my knees buckled from the pain of my grief and loss. There wasn’t anyone walking by, so I could have my bawl without having to explain or have some well-meaning person try to quell it, erroneously believing that the cessation of my tears would be a better outcome.

I let them flow, heaving and shuddering until they subsided. As my feelings ebbed, I thought of how fortunate I am that mine are the types of injuries I am likely to recover from completely. Many are not so lucky.

I walked on shaky legs into the locker room, hiccuping and smiling. Having a wet face in that part of the locker room is unremarkable; even red eyes can be explained by being in the pool. I smiled murkily at a few fellow showerers and stepped into a stall.

As soon as I turned on the water, more tears came with the spray. “Good,” I thought. “Let ’em come.”

By my suffering and through my relief, may all beings benefit, becoming as healed and happy as possible.

For more information about Traumatic Brain Injuries, my experiences and research, check many other post on my blog: http://www.sallyember.com/blog

#Injuries to the #Mind, #Brain and #Psyche that Cause Difficulties with #Meditation

I have been noticing, since the fall that injured my brain via a #concussion in early April, that I have had unusual and unique (to me) difficulties with meditation (and life) ever since. Add to this several other “injuries” to my mind and psyche due to: disastrous #heartbreak; a difficult #move cross-country (i.e., getting rid of almost everything, going far away from my spiritual/ meditation teacher and spiritual community/ sangha to relocate to my childhood hometown); long-term, chronic #unemployment; disappointing #ebook sales (due to my having been incapacitated during key #marketing time after my accident); unexpected and painful changes to my #health; turning 60, which have led to my noticing many other problems with my #meditation practice in the last several months that I’ve never had before this (I’ve been meditating since 1972 and doing this practice since 1999).

I think, under these circumstances, which would put me over the top on any stressors test, I am doing quite well. However, I want to meditate, not just do well. Why does my mind keep skittering away from my focus when I try to meditate? What is happening in this brain/mind of mine? I have done many retreats, some as long as eleven weeks, and never had anything like these problems before. My talks with other meditators without brain injuries confirmed that only we injured seem to have these types of difficulties.

But, why? And, what to do about them?

I kept hearing this quote as I continued my attempts:

meditation better than nothing

I pray that this is true….

Since I am a life-long researcher and the internet provides endless opportunities for me to look for “answers,” I looked around for others’ stories, cautionary tales or suggestions. I wanted to find more injured meditators I could commiserate with or teachers who could offer me advice.

What did I find? See below.

Not surprisingly, when I looked for links between “stress” and “meditation,” I found millions of links (17,700,000) referring to the help that meditation provides us when we’re stressed. Meditation for stress reduction, managing stress, alleviating stress, etc., abound on the internet and elsewhere.

NOT ONE article or study to be found that discusses how stress impacts meditation. Really? Really.

Here was my “path”:
“Searches related to meditation problems life stressors” which then provided these other key word strings:

  • meditation for stress

  • meditation for stress relief

  • guided meditation for stress

  • meditation for stress and anxiety

  • meditation for stress management

  • meditation depression

  • meditation for stress or sudden shock

  • meditation for stress and anger

Frontal lobe meditation before and after

image from: http://www.paramyogaindia.wordpress.com

I also tried: “Searches related to impact of stress on meditation,” which yielded about 6 million results, but always in the reverse: how meditation helps with stress.

Okay. I must be going about this all wrong. I tried the verbal “OKAY GOOGLE” command and asked: “OKAY GOOGLE: Why am I having trouble meditating?”

I got 1,020,000 results, but these all revolved around problems “beginners” have with “monkey-mind,” or problems many have with setting aside time, being consistent, staying with meditation once they start, etc. I couldn’t look at all one million results, but the associated key word strings confirmed my suspicions: OKAY GOOGLE still did not understand my problem.

Google did offer other choices (some quite hilarious, under the circumstances):

“Searches related to why am I having trouble meditating”:

  • i am having trouble pooping

  • i am having trouble getting pregnant

  • i am having trouble sleeping at night

  • i am having trouble breathing

  • i am having trouble breathing and my chest hurts

  • i am having trouble swallowing

  • i am having trouble breathing deeply

  • i am having trouble logging into my facebook account

I even tried getting more specific with OKAY GOOGLE, asking: “Why does my concussion make it hard for me to meditate?” This query led me to even stranger associations than before, including recommendations for those with concussions to meditate to help heal from their concussions.

Huh?

I don’t know whether to be flattered or to cry when this also had my own article from my blog post in May as the number 3 listing among 11,000,000 results:

concussion | Sally Ember, Ed.D.

sallyember.com/tag/concussion/

May 2, 2014

If I’m one of the “experts,” here, we’re all in trouble.

Don't follow me I'm already lost

image from http:///funny-pictures.picphotos.net

So, I was going to give up on finding “help” but then I tried this search string: “research meditation frontal lobe injuries” and hit the jackpot.

First, this quote (unattributed) kept appearing: “Meditation is a frontal lobe activity,” which affected me deeply. My accident, for those who don’t know, involved my hitting a wall face-first, breaking my nose and impacting my forehead, behind which is the frontal lobe.

Here are some selected quotes from the best article I found, from the UK, that clarifies a lot about the functions of the frontal lobe, its effects on and participation in the activity of meditation, and many other aspects of my experience: very illuminating and helpful.

Case study on function of the frontal lobe

“The frontal lobes play a major role in the regulation of our emotions and behaviour as well as planning, decision making, social conduct, and executive functions. They are vulnerable to damage… [and] are thought to be our emotional control centre [sic; UK spelling] and home to our personality.”

“The frontal lobes are vulnerable to injury and damage due to their location at the front of the skull and their ample size. Magnetic Resonance Imaging studies have revealed that the frontal area is the most frequent region of damage following brain injury (Levin et al., 1987). Statistics show that there is no other component of the brain in which impairment can cause such a wide array of symptoms (Kolb and Wishaw, 1990).”

This began to intrigue me, especially the part about the “wide array of symptoms,” which I can attest to experiencing. Some of my “symptoms” have seemed to be unclearly connected to the concussion until I read more of this article.

“The frontal lobes are involved in problem solving, spontaneity, memory, language, initiation, judgement [sic; UK spelling], impulse control, social cognition (Benson, 1996) and sexual behaviour. Motor function is also seen to be controlled by the frontal lobes (Leonard et al., 1988).”

I have noticed my balance is off, my proprioceptors are off, my sense of security on my feet is reduced, but until I read this, I wasn’t sure if I was suffering from a bit of PTSD and wariness about falling again or actually having trouble. The latter, I believe now, is the case.

“Broca’s Aphasia has also been linked with frontal lobe damage (Brown, 1972). It is supported that frontal lobe damage has an effect on memory and attention (Stuss et al., 1985).”

Ding ding ding: points for all. Unfortunately.

“Mesulam (1986) pointed out from his studies, that some people who have suffered frontal lobe damage show impairments in their everyday life; however they show little or no impairment on clinical neurological assessment tests….[One injured patient was] unable to make decisions and plan…often unable to make simple everyday decisions, such as which toothpaste to buy, what restaurant to go to, or what to wear even after endless comparisons and contrasts Damasio (1985)….This may be characterised as a failure of future memory, the ability to encode delayed intentions, and act on those intentions when the appropriate time arrives.”

Usually I am extremely decisive. Even when there are complex factors, even when I feel ambivalence: before this accident and its injuries to my brain, I was considered a person others could rely on to make the choices they could or would not make. Since then, I have had hesitation, confusion, bewilderment, inability to weigh costs and benefits and many other unusual reactions to being asked to choose even the simplest things. Now I know the reasons for this befuddlement. Good.

“Interestingly, some patients who suffer from frontal lobe damage often do not show any defects on neuropsychological tests. However, when observed in unstructured real world settings, patients frequently demonstrate cognitive difficulties, neurobehavioral symptoms, and deficits in their executive functions.”

I would say, without a doubt, that the most severe deficit to my executive functions has been first my complete inability and then my reduced ability to meditate, since meditation has become the foundation for all the thinking, choosing and behaving in my life via values, personality and habit changes.

TBI as a puzzle

image from: http://www.brainline.org

I can see ways I’ve regressed since the accident and these are disturbing in deep and superficial ways. I’m more impatient, more quick to anger, easily provoked to sadness or hurt. I hide it from those close to me but take it out on customer service representatives of mega-corporations which happen to provide terrible service. Not proud of this at all.

“Studies have found high frontal lobe activation during meditation (Herzog et al, 1990; Lazer et al, 2000).”

IF I COULD MEDITATE, I would, also. I miss meditating so much. But, now I know a bit more about the reasons for my difficulties.

I hope this post and the rest of this article (link, below) help others in similar predicaments.

http://www.ukessays.com/essays/psychology/case-study-on-function-of-the-frontal-lobe-psychology-essay.php#ixzz3ClAyyWOc

Keep trying, keep going: got to believe it will improve.

I’m also going to see if I can talk (or video chat) with my meditation teacher some time soon. I need something.

A quote from Thich Nhat Hanh is what I plan to contemplate until my meditation practice gets back on track.

Thich Nhat Hanh quote

The Latest Research on Traumatic Brain Injury (#TBI): Causes, Diagnostics, Treatments

While waiting at my neurologist’s office for my second appointment (at which I was cleared to return to regular activities, unrestricted, like WRITING MY BOOKS! YIPPEE!), I read a fascinating article, “Tracking Traumatic Brain Injury: What New Biomarkers May Reveal About Concussion Over the Short and Long Term,” by Gina Shaw, about the latest and greatest advances in Traumatic Brain Injury (#TBI).

Having suffered a “mild-to-moderate” #concussion myself on April 6, I have a keen interest in all of these topics.

The links and website for the article and magazine are below. First, my favorite parts are summarized or quoted, here. [There were no images with the article, so I went and found some (Thanks to Google images!).]

1. “Despite years of research into traumatic brain injury (TBI), the tests currently available to neurologists, emergency physicians, and other experts can’t reliably identify who has sustained a TBI after a blow to the head, and who has not.” [emphasis is mine]

2. “Damage to neurons occurring after a mild to moderate TBI–called axonal injury–is not revealed on these [CT] scans.” [emphasis is mine]

The image I found, below, is generated by one of the latest diagnostic tools, Diffuse Tensor Imaging, or DTI (see #6, below).

TBI Diffuse Axonal Injury

image from trialexhibitsinc.com, “Diffuse Axonal Injury (TBI)”

3. “‘Some studies indicate that having had even a “mild” TBI in early or midlife may increase the risk for dementia in late life, probably at least twofold.'” states Ramon Diaz-Arrastia, M.D., Ph.D., Fellow of the AAN [American Academy of Neurology], director of clinical research at the Center for Neuroscience and Regenerative Medicine at the uniformed services University of the Health Sciences in Bethesda, MD. [emphasis is mine]

4. Even a mild to moderate TBI causes an Axonal Injury = one that disrupts the brain’s structure and chemistry on a cellular level. [emphasis is mine]

TBI Amyloid Plaque over time

image from http://www.alzforum.org, “Amyloid plaques in a cross-section of TBI patients.”

5. 2013 research shows that the same plaque (made of amyloid, a brain protein) that is distributed widely in the brains of and that causes dementia in Alzheimer’s Disease (AD) is found at the site of a TBI, even a mild one. Some researchers are using the anti-amyloid drugs given to AD patients on TBI injuries to avoid or lessen the likelihood of later dementia.

6. There is a new type of MRI called Diffusion Tensor Imaging (DTI) that is promising for seeing the neurological damage caused by TBIs in ways no other diagnostics are currently able to do. This will also aid in detecting where an injured person is in their recovery.

DTI of mild TBI

image from http://www.adlergiersch.com, “Advances in Neuroimaging in Detecting Brain Abnormality in ‘Mild’ Traumatic Brain Injury”

The article describes many other “in the field” (literally, athletic fields, for one) diagnostic tools about to become widely available to determine the extent or presence of a TBI in someone who was knocked on the head.

Read! Share!

http://journals.lww.com/neurologynow/Fulltext/2014/10030/Tracking_Traumatic_Brain_Injury__What_new.16.aspx

http://www.NeurologyNow.com