National Black Dog Day

Twitter informs me that it’s National Black Dog Day!

So, here’s a handy list of ways to celebrate:

  • If you have a black dog, give them extra scritches and extra treats. (If your black dog is a metaphor for mental illness rather than an actual dog, taking good care of yourself counts as a treat.)
  • If you don’t have a black dog, visit an animal shelter and pet one.
  • If your life is incomplete without a dog, consider adopting a black one.  They get overlooked at shelters and are more likely to be euthanized.
  • If your life (and bed) have all the dogs they can accommodate, you can still look at all the adorable black dog pictures on the hashtag.

Still Hanging in There

Trigger warning for pet illness and death

This past few weeks has been profoundly awful. Right on the heels of the relative’s medical emergency that I mentioned in my last post, we lost not one, but two, pets to serious illness.

My cat Thomas was 21 years old, which is an exceptional lifespan for a cat. (That’s not nearly as comforting as you’d think, now that he’s gone.)  He was at the vet only a couple weeks before, and everything checked out fine.  Then, one day, I was working at home, and he was meowing a lot.  He had always had a very tiny meow for a large cat, but this sounded particularly pitiful, like something was wrong. He was standing on the chest freezer, where we feed him and our other cat Haley.  (Sassy had her own spot on the bookshelf, because she got meds daily with her food.)

He had food, so I gave him water.  I noticed he was wet, which freaked me out a bit.  I made sure it wasn’t blood, and it didn’t smell like urine. (In hindsight, he had probably laid down in a wet spot on the floor.) I was worried enough that I asked Matt to come home and check on him.  Matt got him to the vet, and we found out that he had a mass in his bladder and his kidney numbers were off the charts. It was likely cancer, but they couldn’t be sure without more tests, which often don’t produce clear results.  Even if it was a bacterial infection, the prognosis wasn’t good.  So, we took him home and tried to spoil him rotten for a couple days prior to the euthanasia appointment. He wasn’t eating.  Initially, he liked water with tuna in it, but he soon lost interest in that too.  It was pretty apparent that he was done.

I’ve had Thomas for 13 years, so this was incredibly hard.

Meanwhile, Sassy’s kidney issues had gotten worse, and we started her on a kidney diet. Her thyroid numbers were also a bit wonky, and we were trying to get that correctly medicated. Last Thursday, we had her at the vet for bloodwork, and she went downhill so rapidly that they first wanted to keep her overnight for observation and IV fluids, and then didn’t think she’d make it through the night.  We didn’t want her to suffer, and we didn’t want her to die alone, so we made the awful decision to euthanize her.

These were the second and third time I’ve had to do this with a pet. The first was in some ways easier because we found out shortly after we started fostering Luna, an elderly beagle, that she had a heart condition that would eventually be terminal.  So, we quickly shifted gears from fostering in order to find her a forever home, to puppy hospice. She had several good years with us. Thanks to excellent care from a veterinary cardiologist, her heart condition stayed stable for some time. Unfortunately, when she developed cancer, the heart condition meant she wasn’t a candidate for surgery.

With Luna, our goal was always to give her as much good time as we could. I won’t pretend I didn’t get attached, because of course I did.  And I sobbed inconsolably at that final vet appointment. But there was such a long time when we knew we’d have to say goodbye soon.

With Thomas, I knew his age meant that we wouldn’t likely have him much longer, but he was in good health for so long, and the illness came on so quickly. It was a complete shock, totally out of nowhere.

With Sassy, we knew she wasn’t in great shape, but we were treating her as best we could, and the vet was taking care of her.  Again, things seemed generally stable until there was a sudden, rapid decline.

I don’t have any real point to this story, except that cancer sucks, age and mortality suck, and you should probably go hug the people you care about, and the animals you care about if they’re the sort of animals that like hugs, substituting scritches or belly rubs as appropriate.

Food and Diabetes, or, People are Weird

A relative of mine had a recent health scare, and it turns out he has diabetes. Now that he knows about it and is treating it, he’s doing much better, thankfully.

One of the things that struck me when people asked what had happened or how he was doing was how quick people were to insert their own assumptions about food and health. One of his coworkers swung by my workplace to drop off a get-well card, and made comments about how he would have to start a whole new way of eating. Um, maybe? I don’t actually live with him so I’m not aware of what his diet was like before, and also I just don’t know what to say to that.

Like, yes, diabetes is influenced by both diet and genetics. Someone with a genetic predisposition who eats one way is more likely to get it, and sooner, than someone with that same genetic predisposition who eats differently. But that’s a far cry from saying that every diabetic person on the planet “did it to themselves” or from knowing that a newly diagnosed diabetic needs to make drastic dietary changes, without even knowing how they were eating to begin with.

Of course, it goes back to that just world fallacy that undergirds so much prejudice. If a health problem is the patient’s fault, then other people don’t have to worry that it will happen to them. Even if it does happen to you, there’s a weird comfort in taking the blame on yourself, because if you caused it, then there’s a chance you can fix it. On the other hand, if the cause is that your number came up in the genetic lottery, and your prize was a shiny new chronic illness, that feels a lot scarier, and a lot less hopeful.

I realized how strongly it was affecting me when I found myself feeling scared of eating anything carb-heavy. The diabetic relative is an in-law, not a blood relative, so their having diabetes has no bearing on how likely I am to end up with it, but it reminded me of the history of diabetes in my own family tree.

But that fear is counterproductive. Agonizing over every bite of food I put in my mouth might reduce my carb intake, therefore reducing my blood sugar a bit.  Or, it might ramp it up, because that fight or flight response prompts your body to make stored energy–fat and glucose–available for use. That’s super useful if you’re being chased by a tiger, but less useful for fears you can’t physically run away from, like worries about food and chronic illness. Between the lack of an actual tiger to run away from, a little black yippy dog of anxiety who was already prone to excess worry about being attacked by tigers, and a metabolism that’s already a little dodgy in terms of handling sugar, the overall effect of the stress might be worse for my blood sugar than the “evil” carby food that stress was trying to protect me from.

So, I remind myself that the only time I should be this worried about a single instance of eating or preparing food is when I’m doing home canning.  (Clean everything and follow the USDA directions, because botulism will kill you dead.) A donut, by contrast, will not kill me dead. A donut every day might increase my chance of ending up with diabetes, or mean that I get it sooner than I otherwise would. But even at that, it would depend on everything else I was eating that day.  Did I eat the donut at the end of a meal with protein and fat in it?  Did I eat the donut and then go for a half-hour bike ride?

I’m trying to exercise more, in ways that are fun and sustainable. I’m trying to avoid stand-alone carby snacks. This isn’t really a hardship, because I’d rather have fruit and cheese than a handful of potato chips. And I’m trying to manage my own anxiety by not letting other people’s worries about food and mortality into my brain.

The Just World Fallacy and the Joy of Feeling Superior

One of the things that struck me recently about both fat hate and homophobia is that they seem really rooted in the need to have someone to feel superior to.

A friend posted about the recent UMC decision to move in a more anti-gay/anti-trans direction, and how disappointing it was, and a mutual acquaintance felt the need to crow about how happy he was about the decision and how great it was that the UMC was being faithful to the Bible and not being fooled by “wolves in sheep’s clothing” who want to water down the holy text.  (I didn’t ask him his feelings on mixed fabrics, oaths taken in court, or lending money at interest.)

Fred Clark, at Slacktivist, has posted extensively on this phenomenon, where people feel better about themselves by imagining a horrible enemy to compare themselves to. Fred refers to it as “Satanic Baby Killers,” which covers the satanic panic of the 80s, anti-abortion hysteria, and any number of other attempts to create an evil “Other” to feel superior to. As you’d expect, the individual gloating about gay people being thrown out of ministry also enjoys spreading made-up stories about Democrats supporting infanticide. Because, Satanic baby killers.

It’s terribly convenient to have a comically evil enemy to oppose and be offended by, because it makes you a paragon of virtue by comparison, even if you’re not terribly virtuous.

A lot of fat hate seems to work the same way. Someone is fortunate enough to have the culturally favored body type, but admitting that that’s largely due to chance doesn’t really give them the opportunity to feel superior to other people. So, they stroll around both the internet and the physical world, randomly yelling at anyone who dares to exist while fat about how horrible they are.

So, where does the Just World Fallacy fit into this?  Well, if you admit that body types and sexual orientations aren’t chosen or the result of sin, then you have to acknowledge that the way our culture treats fat people and LGB people is profoundly unfair. And, if there’s no fairness, then that capricious mistreatment could happen to you, too.  *But* if you pretend that you have nobly and morally taken good care of your body and avoided the temptation to lust after members of your own sex (ignoring that it wasn’t very tempting for you, being straight and all), then you can rest assured that bad things will happen only to those evil people over there, and not to your virtuous self.

Your Fat Friends Are Not Acceptable Collateral Damage

I really like Your Fat Friend’s take on pretty much everything. Yesterday, she talked about the colossal example of both fat hatred and missing the point that is the #MarALardass hashtag.

I sat at my laptop, a lifelong fat person and a lifelong progressive, watching it all unfold. My stomach sank, turning in on itself, as thousands of anti-Trump tweets targeted him not for his racism, xenophobia, transphobia, ableism, misogyny, proud history of sexual assault, destructive policies, bold power grabs, or the vast and serious harms he’s causing in communities across the country and around the world. Instead, they posted pictures of his belly, his buttocks, his double chin. Photographs that didn’t look fat enough were enhanced to look even fatter. One person after the next — people with equality and ally in their twitter bios — took aim not at Trump’s actions, but at his body.

I understand the temptation to snark on Trump for his body.  The man is so vain, so fake, and so hypocritical in the way he rates women on a numerical scale while he’s a geriatric fat dude with a spray tan and a bad hairpiece. It’s low-hanging fruit, an easy way to get laughs.

But, as Your Fat Friend points out, it’s also beside the point.  Obama wouldn’t have been a worse President if he’d been fat, or older, or balding. Trump’s flagrant xenophobia, obstruction of justice, and blatant authoritarianism wouldn’t be any better coming from a thin guy with a real tan and most of his own hair left.

And, let’s be realistic. None of this hurts Trump. He likes attention. He enjoys the hell out of pissing people off.  Calling him names is fighting exactly the way he wants to fight. That is, if you even reach his notice. Random people on Twitter aren’t going to accomplish that.  Media figures he already hates might, at least briefly, but he’s got his fake national emergency, rallies to whip his cult following into a frenzy, a busy Fox News watching schedule, and golf to keep him occupied.  He might also pretend to do his job on occasion.

You know who it does hurt? The good and decent people who share a body type with him, who now know just how much you hate them.  All the people whose eating disorders will magnify the ugly things you said about being fat and make it that harder for them to actually eat anything today.

You want to hit Trump where it hurts? Take away his access to power.  Call on your senators and representatives to impeach the motherfucker already. Protest at the White House. Donate to groups that are suing him, like the ACLU. Work with people who share the same goals you have —even if you don’t find them attractive— rather than wasting their time and emotional energy by turning them into collateral damage in your game of grade school insults.

Fat Healthcare

Ragen Chastain has another excellent piece on the way thin people often receive evidence-based care, while fat people with the exact same condition get a prescription for weight loss. Even when the means recommended to obtain weight loss are riskier than the original condition.

A lot of the time, this seems to be less about an objective assessment of risk, and more a way to ascertain who “deserves” treatment and to hold people’s health hostage in order to force them into compliance.

Take knee surgery, for example.  Ragen points out that it’s pretty obvious that nobody’s prioritizing our health…

 when a fat person who actually needs knee surgery is told that they can’t get it because knee surgery is too dangerous, and then they are given the recommendation to have stomach amputation surgery, which is far more dangerous with far worse possible side-effects.

But if it has less to do with the actual risks and complications of the actual surgery, and more to do with viewing fat people as lazy and immoral, and therefore undeserving of care, it makes a lot more sense.  Horrifying, frustrating sense, if you happen to be a fat person who would like to actually get the medical care you need.  If someone’s thin, they’re seen as worthy, but a fat person has to lose weight first, to prove themselves deserving.

There’s also a ridiculous amount of paternalism in medicine, where rather than listening to a patient’s issues, doctors seem to want them to shut up, do as they’re told, and go away as quickly as possible.  This is exacerbated when stereotypes make the doctor see a given patient as “less than” and therefore even less competent to know what they need.  Fat is one example of this, but it also applies to every category of oppression that a doctor can tell by looking at you or infer from your chart. A big part of the terrible maternal mortality rate among black women seems to be from doctors simply dismissing their concerns.

As a white, college-educated woman without any visible disabilities, I probably get brushed off a lot less than a black, visibly disabled fat woman, or than someone whose queerness is more visible than mine because their spouse is the same gender they are.

And yet, it still took 3 different doctors and months of trying to get treatment for hypothyroid. It should have been so very simple.  I was cold and tired all the time, I’d gained a lot of weight despite no change in eating or activity, my TSH was high, and I had a nodule on my thyroid.  It would have been simple if the overseeing doctor hadn’t overruled the PA’s decision to start me on Synthroid.

Nobody ever actually explained to me why this decision was made.  Now, thinking about oppression in healthcare, I have to wonder if the problem isn’t just doctors not listening to patients, but also male doctors blowing off the opinions of female staff, including PAs and nurses, even when those staff interact with the patients more than the doctor does.  It’s hard not to see sexism when the female PA is all set to treat your problem, then the male doctor who you’ve never interacted with swoops in and changes everything without even telling you why.  My mom and my mother-in-law, both nurses, could probably tell enough stories about male doctors being arrogant, sexist, and wrong to fill several volumes.

From there, I went to an endocrinologist who was convinced that my hypothyroid wasn’t causing my symptoms, but had no idea what was, and recommended weight loss.  It was this same endocrinologist who found the nodule and saw nothing at all contradictory about needing to biopsy the nodule and not treating the hypothyroid.  To make matters worse, the biopsy was incredibly painful *and* inconclusive.

At that point, I called it quits with this practice and went to Johns Hopkins.  I had a family member with thyroid issues who was pleased with the care she got there, so I drove two hours to every single appointment.

They put me on Synthroid after the first appointment.  When they went to biopsy the nodule, there was nothing there to biopsy.  After being on Synthroid, it had gone away on its own.

Being on Synthroid was like magic. I could finally get warm.  If my feet brushed my spouse’s leg in bed at night, he didn’t yelp and jump out of bed from the cold.  I didn’t have tons of energy, but I had enough to get through the day without drinking ridiculous amounts of coffee. And my weight stopped skyrocketing upward. All it took was for someone to take me seriously and treat the symptoms I was having, rather than treating weight loss as a panacea or brushing off my concerns without so much as a suggestion of what might help.

You are More than Your DNA

Some of the trans people and allies I follow on Twitter have been targeted for harassment by people with an inflated sense of their own importance who are on a mission to make everyone define gender by their terms.

Their terms are nebulous, depending on whether they want to acknowledge the existence of intersex people and how honest they are about the complexity of biology, but usually they boil down to DNA.  Specifically, chromosomes. Seriously, if someone’s Twitter handle is something like REALWomanXX, just block and run away.

The argument is that DNA is the “real” arbiter of sex, because it can’t be changed. Internal identity, the actual hormones in someone’s actual blood, even the genitals that the anti-trans crowd is usually so obsessed with, those can all be “faked” but DNA is “real.” (It’s also not true that DNA doesn’t change. Not that that nuance is captured in the middle school biology anti-trans bigots favor, because it’s not nearly simplistic enough.)

Setting aside the fact that the idea of DNA as an unchangeable blueprint is based on a false idea of DNA, this would be a completely backwards argument even if DNA were totally unchanging. The pattern or description that remains static while the object it describes changes isn’t some holy grail of eternal truth. It’s an outdated document that no longer reflects the as-built system.  I write technical documentation for a living, and if I were ever to say, “My docs are right, it’s the system that’s wrong,” I’d be laughed right  of the meeting.

As another example, architecturally, my house would be described as a ranch. It’s a long single-story rectangle with a low pitched roof. Presumably, somewhere there’s a blueprint that shows this layout in detail.

But, let’s say I won Powerball and did massive renovations, turning it into a completely different style.  I’m a big fan of Victorian houses, so let’s say I turn my ranch into a Queen Anne Revival. I add a second story and a gabled roof, a massive porch with columns, and a tower. I replace the vinyl siding with wood siding painted in bright Victorian colors. The whole thing is intricately ornamented.

If I’m then giving directions to my house and say, “It’s a two-story Victorian house, and it’s dark green,” no reasonable person would brandish the original blueprints in my face and insist that my house was *really* a ranch.

That’s not to say, of course, that trans people  need to have any particular surgeries or take any particular hormones for their identities to be valid. It’s just to point out the absurdity of any kind of “DNA essentialism.”

Architectural styles have some complexity and nuance, of course.  A house doesn’t necessarily have to have every single element of a style in order to be an example of that style, and there can be variations within that style.  If you add onto a ranch or pull design elements off a Queen Anne, there will be debate about what style the newly remodeled house is.

Human biology has even more complexity and nuance than architecture. Lots of people with XY chromosomes have penises & testes. Some people with XY chromosomes, however, have vaginas and uterii.  Some of those have even given birth (some with the aid of fertility treatments, others without).  It’s not really certain how common it is for people to have the “wrong” chromosomes (that is, ones that don’t match their primary and secondary sex characteristics) because people generally don’t get their chromosomes tested unless they’re already having issues of some sort.

Almost everything we learn in school about human biology should really be preceded by “usually.” *Usually* these chromosomes and these body parts go together, but not always. Add in psychology, and it gets even more complicated, because identity doesn’t reside in your DNA.