Monday, March 29, 2021

Death Wish

Here's something no one ever talks about, but which is critically important: the subtle but enormous difference between being suicidal and occasionally (or even often) wishing you were dead and/or fantasizing about death. 

From the moment we're born, the saying goes, we are dying. Death and self-awareness of death are a feature, not a bug, of the human condition, and yet death remains taboo. Few people seem to get this. Almost no one (not even your therapist) wants to hear you say: "No no no. Let me EXPLAIN. I don't want to KILL myself! I just want to be DEAD sometimes. See?" 

Awkward silence.

No. No, they don't see. They put their fingers in their ears and sing "lalalala," or perhaps write heartfelt and well-intentioned texts asking if you're OK, or if you're seeing a therapist, and interpret your macabre musings on the Joie de Mort (TM) as a Cry for Help (TM).

Ok first of all, of COURSE I am not OK. No one is OK. Not really. I am not now, nor have I ever been, OK. And of course I am seeing a therapist. Anyone who can see a therapist should, because really, life is one long, difficult struggle punctuated by thin slivers of incandescent joy that hopefully suffice to create a sustainable bridge from one crippling misery to the next. To the extent I'm crying out for help, I'm only doing so in chorus with everyone else on earth, and then only just by sheer dint of existing.

Yes, this is dark I know. But I am a Russian Jew. My epigenetics are dark and hairy.

Anyway, being suicidal and fantasizing about death are two very different things. People are uncomfortable talking about the latter for fear it will lead to the former, but that's really not true. At least not for me, and I'll use myself to illustrate the point.

For as long as I've been alive, I've dreamed of being dead. Sometimes these dreams felt like a wish, sometimes like a curiosity, but never an intention to actually kill myself. 

Since I'm not religious, I've always assumed death is a lights-out type situation where you return to whatever state of sensory-deprived blankness you existed in before you were born. Wherever you were when that daguerreotype of Abraham Lincoln was taken. That place. I come by this line of thinking honestly: my mother was an orphan by 11; her parents' deaths from cancer mysterious enough to propel her to a career in medicine that she calls a "mission," and that she continues to practice at almost 76. 

Like me, my mother is an atheist. We used to walk hand-in-hand, wending our way through old weedy New England graveyards on summer vacation, pointing to the tiny, weathered headstones of the babies who perished from rubella and other now extinct diseases (thanks, vaccines!)

I'd wonder in these moments what it was like to be a little baby 150 year-old skeleton underground in Vermont. Later I would read about famous literary suicides: Sylvia Plath with her head in the oven. Virginia Woolf weighted down by her own mind and the stones in her pockets, walking step by step into the frigid River Ouse until her petticoats billowed up around her elbows and she sank down to the muddy bottom, finally freed by the water's current from her debilitating depression. The soft dive of oblivion. The sensory deprivation tank of eternity.

How easy, I think, and yet how incomprehensible would it be to do this! To step off the building's ledge and watch the asphalt with its white crosswalk stripes rush up to meet you. To jump down into the cavern of the Brooklyn-bound A-train. To walk into the river. To swallow all the pills. The sheer impulsivity and irrevocable consequences of the act stand in such stark contrast to the long effort and investment that goes into living and constructing a life, that the paradox seems unfathomable. 

I know people whose parents and/or children have committed suicide. Since I am both a parent and a child, I would never in a million years commit suicide. More than anything else, it's my guilt and sense of duty to the people in my orbit and the causes I care about that prevent me from voluntarily submitting to the sensory deprivation tank of eternity. 

But that doesn't mean there aren't days and times I have not wanted to be dead. To the contrary, there have been many such times. 

Accidentally copying someone on an email they shouldn't see. The day I was unconstitutionally fired. Being in childbirth. Every time I have to read something the State files in my lawsuit. Responding to Reply Guy (TM). Every couple hundred times someone tries to shame me on the internet. When Jared Angel (almost not his real name) refused to hold my hand in 8th grade. Yes indeed, there are many such times. There will be many more between now and What Lies Beyond (TM).

I did 23&Me. Having long ago relinquished any claim to personal privacy, I happily paid a dystopian corporate gene farm $181.99 plus tax to harvest my DNA only to learn about rando Aunt Phyllis in Boca and that I was carrying a "variant" (the PC term for "mutation," I guess) for Parkinson's disease. They said I have a one in four chance of getting Parkinson's instead of the usual 1 in 100. My scientist cousin told me that while the mutation variant was real, the data extrapolated from it was not.

I was disappointed. 

Part of me leaped ahead--again in my mind--to the later stages of my inevitable and brave battle with Parkinson's; from the part where I'm co-hosting a benefit with Michael J. Fox in a ballgown to the part where I'm too demented to distinguish my own excrement from a Twix bar. The part where my life just spirals into one long, confusing acid trip in a pair of Depends that becomes someone else's problem to change.

Might that be easier? Easier, I mean, than just continuing to plod through life hour by hour with my proverbial boots in molasses? Day in and day out, suffering every possible indignity, most self-inflicted? From being called "unsuitable" in a federal court case to being back-sassed by my children to checking my spam folder to being unable to match a single sock to its mate in a seven-foot pile of laundry? 

Well, yes. It would be. It would be a lot easier. But the only real choice is the harder one.





Wednesday, March 17, 2021

My Cousin Dana Explains the mRNA COVID Vax

Explanation of mRNA vaccines for OHM readers


About Me: I am Dana Bakalar, Libby’s cousin. I am a neuroscientist, not a vaccine or virus researcher, though I do work in molecular biology. I think I am pretty good at science communication and wanted to encourage people to get the COVID vaccine by explaining the whole deal in a way that humans can understand. 


QHow does COVID work?


AWhat the virus does is stick a copy of its genetic material, RNA, into your cells. It gets in using the spike protein like a key, then makes your cells copy the virus. It hijacks your cell’s normal factory for making shit and makes it make lots of virus, then you have COVID. 

 

QWTF is mRNA?


A: RNA is the messenger, the note copied from your DNA. Hence the m, “messenger” RNA. Your DNA has the instructions for the shit your cells need to make, which gets copied into a temporary note by a copying mechanism called RNA polymerase. The note gets passed into the cell and gets read by a little cellular factory called a ribosome, which uses the instructions to make a protein. After the note is read, it is broken down, crumpled up and tossed in the cellular trash like a note in middle school reading “Do you Like me, circle Y/N”.

 

QSo what’s an mRNA vaccine?


AThe vaccine is messenger RNA, the note part. It’s basically a fake note that we stick in there to pretend that the DNA says to make this protein (“Will you make this protein, circle Y/N?”), like if the middle school note is signed “Trevor” but it’s actually from Heather, who is fucking with you.


In this case, the COVID mRNA vaccines are telling your cells to make a part of the virus. NOT the part that can make you sick, but the little key (spike protein) that the virus uses to unlock your cells and get inside. Once inside, the virus can make you sick. The protein made by the vaccine CANNOT.

 

QThen why do people feel shitty sometimes after the vaccine if it can’t make you sick?


AYour immune system has a bunch of cells whose job it is to patrol for invaders, like the principal roaming the halls of the school. It sees this protein, which is definitely NOT supposed to be here. Holy Shit, it goes, WTF is THAT?? DOES IT HAVE A HALL PASS???? All of the proteins that your body is supposed to make have a hall pass, but this thing Doesn’t Even Go Here, and it looks real weird, so the immune system jumps into action and rallies the troops. It makes antibodies which can stick to the spike protein and fuck its shit up. 


Also, it remembers that shit, in the form of T-cells and B-cells, immune system guys which remember the protein and are ready to jump into action when/if they see it again. This process is hard work and involves creating an immune response, which is the same thing that happens when you get sick for real. So you get inflammation, maybe a fever or a headache. 

 

QCouldn’t this create some crazy run-away immune response and kill us? 


A: They thought it might, which is why they did all these clinical trials. Turns out it doesn’t. The mRNA itself breaks down really fast, and there haven’t been issues with people having extreme immune responses. 

 

QWill I be a mutant??


AThe vaccine cannot change your DNA, so nope. mRNA is a note from DNA, not to it. No superpowers for you. 

 

QIf the vaccine works, why don’t YOU just get it? Why do I have to?


AThe vaccine is pretty good, but not perfect, and some people are vulnerable. 


You know how when you are taking the Metro or Subway or whatever and a bunch of stations are out of commission, it becomes a total bitch to get where you are going? That’s what we are going for here. We need to stop the virus from travelling so it can’t kill your grandma. 


COVID is very contagious, each person can transmit it to more than one other person: there is more than one other stop the virus can get to from your stationThe goal here is to shut down the stations by getting people vaccinated. If the train stops at Vaccination Station, the virus will just languish on the platform and die, infecting fewer people.


This is important because there are some people for whom the vaccine does not work, or to whom it can’t be given, like people who are very sick, babiesor people whose immune systems fail to make the t-cells that would recognize the virus next time, like people being treated for cancer or who have organ transplants or whose immune systems suck because they are very old or have some other immune system thing like diabetes or lupus or celiac or thyroid issues. If the train line to them is open, they are likely to get sick. We need to fuck up the travel network!


If only some small portion of people get the vaccine, then we have way more stations still open. That’s way more new infections. Some of these will be your grandma or your sick spouse or your friends or your friend’s baby. If you don’t get the vaccine, the virus can get to them more easily. 


But if YOU get the vaccine, they are safer. So when I ask you to get the vaccine, it isn’t primarily to protect a vaccinated me, but to protect people who cant get it. 


Scientists estimate that we need about 72 percent of people to be vaccinated or to have had COVID to stop it from travelling at all. 

 

ConclusionGet the vaccine please





 

Saturday, March 6, 2021

This is MATRICIDE.

“Do you know what that means?” 

No answer, or at least none that was audible over the lip of the foreboding ski run known as “East Bowl Chutes.”

“It means MURDERING YOUR MOTHER!”

In 16 years of living in Alaska, I have assiduously avoided any ski run (or other mountain feature) with the word “chute” in the name. Do you know what a chute actually even is? I know you think you do, but let me tell you anyway. 

A chute is “a vertical or inclined plane, channel, or passage through which objects are moved by means of gravity.” And that is exactly what I don’t need at my age: extra gravity. 

Not post-ACL surgery, when I manage to rupture discs in my sleep. Not when each passing day brings my nipples that much closer to my belly button. Not when an encounter with gravity means a fight with Aetna, probably. 

At 43, gravity is no one’s friend.

I prefer runs with names like “Fuzzy Duckling” and “Featherbed.” My 13 year-old daughter Paige, on the other hand, who’s been on skis since she could walk, is happy to bomb down “Insane Asylum,” “Satan’s Man Tits,” and “Jeffrey Dahmer’s Dinner.” These are not the names of actual runs at Eaglecrest, but they should be.

“It’s easier if you TURN, Mom,” Paige said as I side-stepped with trepidation down the precarious “chute.” 

Alaska will kill you if it gets half the chance. This much I know. And while I’m happy to be on the front page of the ADN for suing the governor, I refuse to be a headline because of an avalanche, hypothermia, bear mauling, shelf ice melt event, or other wilderness mishap. No sir. I’m not trying to be that woman born in the Bronx only to die a cautionary tale for would-be Chris McCandless types. 

No fucking thank you.

Paige, on the other hand, was born here, and it shows. I didn’t learn to ski until my muscle memory was well into dementia territory. Growing up, skiing was an expensive, obnoxious hobby for rich people. Here in Juneau—especially in a pandemic—it feels like one of few routes to sanity. But even I have my limits.

“It will be fun!” She said. “You can DO THIS, Mom,” she said, knowing that I’m all about leading by example and modeling the confronting of one’s fears for my children.

But not via THE GATES OF HELL.

“Wait. Do we have to go through the gates? I don’t go through the gates.” 

The “gates”—with their little red ropes and disquieting warning signs—are what seem to separate the wheat from the chaff of skiers. Well, I’m perfectly happy to be the chaff (whatever that is),if it means I live to blog another day.

Spoiler: We went through the gates. 

“Isn’t this FUN, MOMMY?!”

“You’re trying to kill me.”

“You just finished the hardest part!” A cool mom friend of mine encouraged me as she swooshed passed us gracefully, a plume of powder in her wake, braids bouncing under her helmet REI-catalogue style. (This particular mom, it should be noted, has also tried to Alaska-murder me on many occasions, so I greeted her reassurance with a healthy dose of skepticism).

Who even invented this ridiculous sport? Who thought it would be a good idea to strap gigantic boards to human feet, point them down a snowy mountain, and be like ... “GOOD LUCK!” 

Bizarre.

Anyway, I didn’t die, as evinced by the fact that I both took this picture and lived to blog about it. Paige’s next attempted matricide will have to wait for kayaking season.




Monday, March 1, 2021

Why Our Pain Matters

Last week I saw a tweet from an OB/GYN on Twitter questioning the lack of routine sedation options for women during Intrauterine Device (IUD) insertion and removal, and I was immediately transported to the worst physical pain I had ever experienced: having my cervix manually dilated during childbirth. It was by far the worst pain in a very long, painful induced labor with my daughter that ended in a C-Section, and ultimately the worst pain of my life to date.

I was lucky to have competent and compassionate care from everyone involved in my labor and delivery, and I consider myself to have a high pain tolerance. But this particular procedure made me cry actual tears of pain in a way that I hadn't since childhood. While not the same thing as an IUD insertion or removal, I’ve hesitated to get an IUD after experiencing someone monkeying around with my cervix.

Here's what Planned Parenthood--one of the best organizations in the country for accessible birth control and one that I support with my own wallet--says about the pain of IUD insertion:
How does it feel to get an IUD put in?

People usually feel some cramping or pain when they're getting their IUD placed. The pain can be worse for some, but luckily it only lasts for a minute or two.

Some doctors tell you to take pain medicine before you get the IUD to help prevent cramps. They also might inject a local numbing medicine around your cervix to make it more comfortable.

Some people feel dizzy during or right after the IUD is put in, and there's a small chance of fainting. You might want to ask someone to come with you to the appointment so you don't have to drive or go home alone, and to give yourself some time to relax afterward.
I posted something on Twitter and Facebook to start a conversation about this, and take sort of an informal poll of people's pain in IUD insertion and removal, which involves manipulation of the cervix. 

Perhaps a third of the people who contributed to this conversation said it was painless, but about two-thirds said it was the most excruciating pain of their lives. Many described humiliating experiences of being told to “suck it up” and having the discomfort undersold to them, both before, during, and after the procedure. Some worried that the conversation itself could discourage folks from accessing effective birth control (which is the last thing I want to do).

But I think it’s still important to talk about women's (and trans men with uteruses) experiencing pain in reproductive procedures and birth control. I think it's important that we ask the question why people are made to endure the kind of pain that would never be tolerated for a second during a dental procedure or a vasectomy. I don't recall a dentist ever telling me to suck up any pain. I recall being given options for three different types of anesthesia for every dental procedure I've undergone.

So why is routine sedation like this not more common in IUD insertion and removal? I'm not a doctor, so I really don't know the answer. I'm really just posing the question, because I think at least some of the reason is plain vanilla misogyny.

I get that it’s become fashionable to blame The Patriarchy™️ for everything, but that’s because we live in a patriarchal society, and that fact infuses and informs every aspect of our lives, from the wages women earn to the research, time, and attention devoted to our healthcare. Reproductive health is an obvious flashpoint for this, regardless of the gender of the medical provider (or so says my informal poll).

I think as a society we subconsciously want to punish women for their sexuality. We want them to fight and suffer for reproductive autonomy, and we want them to feel pain and humiliation for seeking it out. We want them to associate sex with violence, trauma, and pain. Or, at a minimum, we are indifferent to it. Again, none of this is necessarily conscious. But it’s a reality that is reflected in the lived experience of countless women.

We need to at least entertain the possibility that this is the real reason why this procedure is so brutal for so many. Although it’s a small thing, acknowledging and addressing the very real pain of IUD insertion and removal is one way to chip away at a deeper form of medicalized and societal misogyny.