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Wednesday, December 25, 2024

Judging the Judges: A Special Comment

Posted by fxckfeelings on September 14, 2009

The not-MD here: Now that an actual health care bill is almost upon us, I thought this would be a good opportunity to ask my writing partner, as an actual health care provider, for his take on how we can improve health insurance.

We don’t like to get political, and everyone’s entitled to their own views (at least I think so—he’d probably tell you you’re just wrong), but this is not an entry about politics; at its core, the health care debate is about health care, and as a doctor, not a Democrat or Republican, this is his medical point of view. We’ll return to normal cases on Thursday.
Dr. Lastname

One thing you learn as a parent is that there’s never enough time, money, or resources to provide perfect safety and security for your family. Worse, if you hold yourself responsible for providing it, you’ll go nuts the first time something goes badly wrong and you can’t control it. You’ll blow everything on something that can’t be helped, feel like a failure, and have nothing left, financially or emotionally, for those who need you.

As such, compromising on how you spend your resources is as much a part of good parenting as is nurturing, although it often makes you feel terrible. So it is with health care systems.

Democrats sometimes emphasize the nurturing part of this process, our shared humanitarian desire to provide more care, while Republicans sometimes emphasize the tougher part of this process, our desire to make sure that treatments work and are well delivered. But at the heart of good management there is always an unavoidable need to make good compromises, and that’s what I think needs more attention and reform. Not fewer denials from the insurance companies, but denials that are more fair and decided upon more ethically.

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Medication Under Consideration

Posted by fxckfeelings on September 10, 2009

No matter what your illness, medication should never be your first option for treatment. Everything you put in your mouth, from aspirin to spinach, has risks attached, so you should always proceed with caution before you add chemicals to the mix. Then, once on medication, most people are eager to get off it as soon as possible, but that has its own set of risks, as well. If you make your health the first priority, then the choice of whether or not to medicate won’t become risk-free, but it will become clear.
Dr. Lastname

Before I got treated for depression, my marriage was rocky, but not doomed. I would be irritable and lethargic, which was tough for my husband to deal with, but mostly he was concerned and caring, and he was glad when I decided to get help. Now I’m taking medication, which has helped a lot in stabilizing my moods and keeping the black clouds away. The downside is that my meds have also, surprise, made my sex drive disappear, and this is doing way more harm to my marriage than my depression ever did. My husband isn’t a creep—he’s put up with a lot, and has always been supportive—but I can tell that there’s a distance growing between us. It’s different now that I’m the same old me but not interested in him physically, as opposed to a crying mess who wasn’t interested in him but also couldn’t get dressed in the morning. Is there anyway to not be depressed and not be libido-less? My goal is for both me and my marriage to be healthy.

Equating a happy marriage with a lusty sex life (as does every magazine in the supermarket checkout line) is dangerous, because it directly links the state of your union to something you don’t actually control.

If you could control it, you wouldn’t be writing to me in the first place. More than that, the fact that there are so many sex therapists should tell you how limited your control is (as is theirs).

That’s what the word therapy means in ancient Urdu: doing something that may or may not help for a problem you don’t control but think you should. And if therapy fails, then you’ve got a bad marriage because you’re libido-deficient.

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Luck Is A Curse

Posted by fxckfeelings on August 10, 2009

Some people find themselves suddenly, inexplicably cursed by a life of hardship and pain, while others cruise through a blessed existence of acclaim and luck. Truth is, of course, that the person in pain isn’t doomed to constant misery, and lucks brings its own peculiar, unavoidable hardship; thankfully, everyone of us, in one way or another, is fucked. It’s where we go from there that makes the difference.
Dr. Lastname

Just a few years ago, in my early 20s, I was a fun, outgoing law student at a top tier school, on the cusp of beginning a promising career in a competitive field that I loved. But then, out of no where, my health fell apart. Without getting into it, I was diagnosed with a rare, chronic disease that causes me so much pain and fatigue that even the simplest tasks have become arduous. I had to drop out of school, move back home, and learn to deal, not just with the physical pain of everyday life, but with feelings of failure and being a complete loser. All my old friends are moving upwards and onwards, like I was once set to do, and all I can do is take it slow and try to cope with this new, brutal reality. Plus, because my disease is rare and not physically obvious (I look healthy), several friends and even family members have decided that I’m not sick, but that I just buckled under the competitive pressure of my law career or that I’m just lazy, and am using a fake disease as an excuse. They say things like, “my joints hurt, but I go to work everyday,” and I just want to curl up and die. Between my own disappointment and their cruel judgment, I’ve withdrawn from social interaction almost completely for a year now. My goal is to not completely isolate myself from the world and maybe even start to enjoy some social interaction again despite feeling self-conscious and experiencing such dismissive attitudes from others.

It’s good that you want to get out of your self-imposed solitary confinement—living like that’s unhealthy, even for people who are physically healthy to begin with—but attaching the enjoyment of social interaction onto your goal is not so hot, especially when you’re suffering from a disease that seems to make enjoying anything nearly impossible and gives prospective friends a case of the repulsive willies.

Problem is, despite your best efforts, enjoyment is out of your control, and if you make a big effort to extend yourself socially and run into crap, you’ll feel like a stupid failure and personally rejected, when, really, it’s your standards that are the problem. Yours and everyone else’s.

A better goal is to work at not taking your pain and isolation personally while working out rational standards for what it means to cope with them.

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