Namo amitabha Buddhaya, y'all.
This here's a religious establishment. Act respectable.

Thursday, January 29, 2015

Under The Rocket's Red Glare

The other night, Joan and I went to a classical music concert.  Well, technically I guess it was a romantic-modernist music concert, if you understand that the romantic period in classical music began in the 1830s and died about 1940, and everything after that is modernism.  (Otherwise we'd be in post-post-post modernism by now, and that could get confusing).  Anyway, the ensemble is called The Dallas Winds, and they're pretty amazing.  At least, I think they are.  Another thing about romantic-modernist music; sometimes it fails to sound like music and just sounds like--sound.

But they seemed like they knew what they were doing, so I'm going to just say they were pretty amazing.  They get paid for this, after all.  To get paid for playing an instrument--any kind of orchestral instrument--you have to be pretty amazing.  There's only so many jobs, and all of them are filled, and the music schools churn out new kids every year, all young and eager and out for blood, and you have to sort of wait for someone to die to get a chance to audition for one, and if you ever wondered why clarinet players turn up dead at such an alarming rate, well, now you know.

Incidentally, and this actually does bear on what I'm going to tell you, Joan's been having a lot of trouble with her knee.  The one she had the surgery on back in 2009.  It's got permanent arthritis in it now, there's not a whole lot anybody can do about it apart from replacing the knee, which is just Right Out, and some days she just sort of limps around with a cane and hopes she doesn't have to stand up too fast, or without help.  Naturally, the day of the concert was one of those days. I dropped her off in front of the venue and went to park the car, then walked back through a maze of twisting streets, positive I'd lost the car for all time.  Turned out I'd also dropped her off in front of the wrong venue, so she'd had to walk down to the right venue, with the cane, and--yeah.  This evening was not starting off well.

But we got inside, and we had pretty good seats right near the stage, and the seats were comfortable and kind of fuzzy.  Upon sinking into hers, Joan said, "I hope you're going to help me up."  Yeah, sometimes if the seats are too low it's hard for her to struggle back out of it again.

Which was just about the time that the wind ensemble struck up "The Star-Spangled Banner."  Of course.  We're in Texas; it's probably a state law that every concert starts with "The Star-Spangled Banner." And by this time, all the other seats around us were filled in, so in order to get over to where I could pull Joan up out of her seat, two or three people would have had to move.  So Joan didn't stand up for "The Star-Spangled Banner." Which I didn't think was a problem at the time.  I mean, it's probably not a state law that you have to stand up for "The Star-Spangled Banner" if you can't get up.

Unfortunately, there was this guy behind us.  I think you know the type.  Old and loud.  Well, in his seventies, anyway, and he'd been expounding at a pretty high volume about a number of things before the concert started.  Of course he was right behind us.  And of course he took issue with Joan not standing up.  And of course he had to yell, loud enough to be heard over very loud music, "What's the matter with you?  Won't you stand up for your country?"

Or words to that effect.  And Joan said, "I can't."  And he didn't hear her, of course, what with the shouting and the music, so I stuck my head between them and said, "She can't stand up without help, sir."  And he grunted something that I'm sure wasn't terribly complimentary, and by then the song was over and we all got to sit down.  And so the concert started.  And I miss most of the first piece because I'm wondering how I'm going to get Joan out of her chair now.  If she manages to get on her feet without help, am I going to have to lean over and explain to this guy about her arthritis and the cane and so on?  Is that any of his business?  Or should I just let him yell, "Oh hey, you can stand up now..."

Well, as it turned out, he didn't.  We snuck out early and missed the last piece (by some guy named Hindemith).  But really, the whole thing was kind of disturbing.  I can't imagine that anybody in a wheelchair ever gets asked why they aren't standing up for "The Star-Spangled Banner."  Or anybody with crutches for that matter.  But a cane--well, it's not very noticeable, I guess.  And the whole thing got me thinking about people with invisible disabilities.  Take, for example, people with disabled placards in their cars.  Not all of them are obviously disabled.  Some of them look perfectly fine, but they probably have something wrong with them that you can't see.  Nerve pain, maybe, or multiple sclerosis.  And they have trouble getting around.  You have to jump through a lot of hoops to get those placards, figuratively speaking (if memory serves, they didn't want to give Joan's mom one because she didn't have a driver's license and therefore, according to logic, never got in a car.  I guess it didn't occur to anybody at the DMV that somebody else might pick her up and take her somewhere once in a while.)

Take people who are mentally ill.  You may not be able to tell who they are, because they look just like everybody else, but there are some people who have a lot more trouble getting through the day than the rest of us.  They probably don't have disabled placards, but some of them have mornings where they can't get up and nights when they can't get to sleep.  They may have wildly fluctuating energy levels and some days they just hide in the house because they can't cope with the human race.  I don't think most of y'all would yell at someone for not standing up for "The Star-Spangled Banner."  Well, maybe you shouldn't give somebody a hard time and call him or her lazy if he can't make it in to work today.  Maybe that's just the way it goes sometimes.

Anyway, I'm sure there are classical concerts that don't involve having to disclose your entire medical history to a complete stranger.  And I'm sure we'll go back for one of those.

Tuesday, January 27, 2015

Mini-Post: Complaint to the Department of Transportation

For the record, I just submitted a complaint to the Department of Transportation, which is responsible for drafting regulations involving airline safety and security.  Here's my submission:

I am concerned about the airlines' seeking to put more and more seats into the same (or smaller) amount of space. Average seat width, once a reasonable 19-20" in the 1980s, has dropped to 17" (16" on Southwest) while the average human hip span is now 20.6" in the United States.  Meanwhile, the average pitch between rows, once between 33 and 34" in the 1990s, is now down to 30" (28" on Spirit).  Not only is there now insufficient room for the average person, but airplanes are so crowded that I believe there could be serious injuries or deaths if an airplane ever had to be evacuated in a hurry.  In the interests of safety and comfort, please consider regulating the minimum amount of space in a row, the pitch between rows and the minimum seat width.  Please also consider a regulation that all armrests, including the armrest at the end of a row, be liftable to facilitate an emergency evacuation.

If you'd like to go forth and do likewise, you can copy my paragraph wholesale. Here's the Web site.  Note, you can't do this anonymously. They do want to know who you are:

I'll let you know if they come back with anything interesting.  Like "Doug Parker* said we couldn't do that."

*CEO of American Airlines

Friday, January 23, 2015

Your Sad Story Welcome Here

Hello and belated Happy New Year and welcome to Buddhist in the Bible Belt. If you're a regular around these parts, you know that this blog publishes every Thursday, approximately, with the occasional special bulletins and mini-posts. We're all about things Dallas, things legal, things wacky and, oh yeah, Buddhism. And wacky Buddhist legal things that happen in Dallas.  You can contact me by commenting below, and you can follow me on Twitter, @jenstrikesagain. In case of an emergency, oxygen masks will drop from the compartment above your seat. Please secure your own mask before you assist your child, or someone acting like a child, or maybe Rick Perry. That it? I think that's it. Okay:

For God's sake, don't tell anybody, but I actually wrote a letter to an advice columnist yesterday. I don't normally do That Sort of Thing. I am not, as a rule, the sort of person who writes to advice columnists. I'm more the kind of person who reads advice columnists, mocks their advice, makes fun of the people who write in to advice columnists and occasionally leaves snarky remarks in the Comments section. Nonetheless I wrote to an advice columnist, because after having this problem for most of the last 45 years, I have finally come to the conclusion that I may never solve it.  And while Tarot cards are great for solving some problems, they're annoyingly vague a lot of the time.

Here's the issue. Ever since I was a child, people have walked up to me and Just Started Talking. And by people, I mean total strangers. It doesn't matter if I'm alone or out with friends, attending some gathering or just at a Starbucks trying to get some writing done. I can be just sitting there, minding my own business,and somebody will drop into the chair next to me, heave a big sigh and start telling me his (it's usually a guy) life story. Joan and I used to joke that I have a tattoo on my forehead that says "Your Sad Story Welcome Here." But, like so many other things, It's Not Funny When It's Happening.

I have no idea why this happens. Not a clue. My friends tell me that I'm a good listener, and that I have a calming effect. In short, that I soothe people. That's nice, I guess, but I hope it doesn't mean I have some soothing mandate because I'm about to have the tattoo removed, permanently.

The reason I wrote to the advice columnist is that I have finally, after forty odd years, gotten fed up.  It happened last weekend at a Starbucks. Twice. I was there with a group, kind of on the periphery (it was a sizable group) and the lady in charge was talking.  Then the woman sitting next to me decided she needed to tell me all about the novel she was writing.  So I missed the first half of whatever the lady in charge had to say.  I'd finally gotten a sentence in edgewise (something like "Excuse me but I'm listening") when another woman came in, sat down next to me, and began expounding that God told her to come to this meeting and she wasn't sure why but there must be a reason and maybe I was supposed to help.  So I missed the second part of whatever the lady in charge had to say.  And I wanted to be at this presentation.  I was actually interested.  That's why I didn't get up and leave, which is usually my first defense.

It's been a week and I'm still smarting.  I have, as they say, had it.  So I've been trying to come up with alternative strategies.  Joan suggested I try raising a finger (not that finger) or a hand, like a cop saying "Stop," and saying something like, "I'm trying to listen" or "I'm working" or "I'm in the middle of a conversation with my friends, here, and you're kind of intruding."  Good thought.  And I can think of plenty of other breathtakingly rude things to say that might permanently offend someone from wanting to talk to me, but unfortunately they're breathtakingly rude, and, well, I'm not trying to be un-Buddhist-y in public.  But I did have an idea that might just work.  It's maybe time to dig out my old friend, Public Embarrassment.

I got this idea from airline flight attendants.  I dunno if you've noticed, but if a passenger starts to get uppity with a flight attendant, the first thing he does is get LOUDER.   The idea, of course, is to get other passengers to look over there to see what's going on.  Usually it works, and the passenger in question, shriveling up under the glare of excess eyeballs, quits being an asshat and does whatever the flight attendant's telling him to do. Sometimes it doesn't work, the passenger gets louder, the flight attendant gets louder still, and the whole thing ends with the police being called. But that's kind of rare and there's usually alcohol involved.

So here's what I'm thinking.  I try once, with the upraised hand (or finger) to say, "Excuse me, I'm listening" (or working or trying to save the free world from imminent destruction by some supervillain's death ray).  Once. If he/she doesn't shut up, I will STart TAlkING LOUDER until everybody's staring at us. I'm definitely not above Making a Scene.  In fact, there are times it's the best way to solve a problem. Case in point: Walking with my then-girlfriend in an outdoor mall right before Christmas. Some guy came up to us, wanting to take a survey. We said no, politely.  Then we said no, less politely.  And then when the guy continued to follow us, I turned around and said, "SHE SAID NO.  BUZZ OFF."  The whole place came to a screeching halt for a second, the guy with the survey slunk away, and then life went on as usual.  As long as you know that all the people staring will by definition also be staring at you, and you're okay with that, this works. (And just incidentally, the guy with the survey caught up with us later and apologized.  So you just never know.)

So why did I write to the advice columnist, you ask.  Well, two reasons.  One, is I'm not sure how polite it is to Make a Scene, even a small one.  Second, in case it doesn't work.  Because I gotta have some kind of winning strategy in place before the next time it happens, or I'm likely to tear the head right off the shoulders of some poor innocent fool who just wants to know the time of day.  And that would definitely be un-Buddhist-y.  Cheers, all.

Saturday, January 17, 2015

Stomach This

In case y'all missed it, the FDA recently approved a medical device that, like previous devices (the ear staple, the copper bracelet, the lap band) is supposed to help you lose weight. This sucker is by Entero and it's called the VBLOC or vagal blocking device.  The idea, as I understand it, is that you have this thing installed inside of your abdomen and it then emits a signal that is supposed to confuse your vagus nerve.  (Hence the term vagal.  That sounded mildly dirty when I read it the first time.)  The electric signal will then temporarily disrupt the nerve conductions from the stomach to the brain and vice versa, which will then make you not hungry.  Supposedly, if you are not hungry, you will not eat, and therefore will lose weight.

HA HA HA HA HA HA--Sorry, just trying to stop laughing over here.  Where in the everloving fuck did these scientists get the idea that fat people eat because they are hungry?  I mean, I realize I can't speak for all fat people, but me, and the ones I know, eat because we're anxious.  Because we're sad.  Because we're happy (glass of champagne and some chocolates).  We eat pretty much for any reason at all, or no reason at all, and we eat more than we should.  Being hungry has nothing to do with it.

Now, before you jump all over me about personal responsibility and willpower and blah blah blah, I'd like to suggest that it's not only fat people who eat when they're not hungry.  Most of us do.  We are a country, and perhaps a species, of celebratory and emotional eaters.  In fact, when was the last time you were hungry?  Not just feeling like it was time for a meal but stomach-growly, headache-pending, ready-to-eat-a-live-chicken hungry?  I'd venture to say never.  Or at least not since you were a teenager (kids inhale food between twelve and nineteen so they can fuel those growth spurts and the sudden development of gonads).  In fact, I'd venture to say most of us are never hungry.  Why should we be?  Most of us eat three times a day, or at least every three or four hours.  That's really not enough time to get very hungry.

Which is why I predict that this new VBLOC is dead in the water.  We're used to eating on a regular schedule, not when we're hungry.  It's also not going to help that the device is only "recommended" for patients over 18 who have a BMI of 35 to 45 and an obesity-related illness (though, as fat people can tell you, if you're overweight, your doctor will tell you that any illness is a weight-related illness.  Sore throat?  It's because you're fat.  Bad knees?  It's because you're fat.  Terminal cancer?  It's because you're fat, but don't worry, you'll lose lots of weight on your way out the door.)  It also doesn't help that you have to have two surgeries to install this thing; one to put the "pulse generator" in your chest and another to stick the business end up against the vagus nerve near your stomach.

But here's the kicker; it doesn't actually work.  The manufacturer had a double-blind study (what if they threw a double-blind study and nobody showed up?) in which all the participants lost weight.  Everybody had the device implanted, but in about half, it wasn't turned on.  The people with the devices turned on lost a whopping 8.5% more weight than the people who didn't have the devices turned on.  Sounds impressive, right?  Sure, except we're talking an average of 16 pounds lost for the people with the device turned off, and 24 pounds lost for people with the devices turned on. That's a difference of eight pounds.  Eight pounds for two major surgeries, risk of infection, a hospital stay and a weird foreign object permanently lodged in your chest and stomach.  Eight pounds isn't even statistically significant, folks.  And here's the thing, the participants in the survey all lost weight because they were staying at a hospital and doing a diet and exercise program.  Eat less food and exercise more and you are guaranteed to lose weight.  However, only about 4% keep it off for more than a year.

Meanwhile, back at the ranch, 1 in 6 Americans don't know where their next meal is coming from.  In Texas, the ratio's more like one in 5.  They're calling it "food insecurity" now, which I guess sounds better than "hunger."  It means there aren't enough groceries to last the month.  That the last few days before the paycheck, you might be having dinner with the homeless or not having it at all.  The technical definition of "food insecurity" is "the condition of being unable to provide adequate food for a healthy life for all members of a household due to lack of money or other resources," but what it basically amounts to is hunger.  And let's not forget that around the world every day, 21,000 people die of hunger or hunger-related illnesses every day.  Every day. That's one every four seconds.  That's one town the size of Minot, North Dakota, per day.  Almost eight million people a year.  But hey, the Pope still thinks that people shouldn't use birth control.

Anybody want to invent a medical device that can cure food insecurity?  Like maybe taking the money this stupid thing must have cost to develop and market and, I dunno, feeding India for a year or something?  Just asking.  Y'all have a nice day, now.

Friday, January 9, 2015

When Just Saying No Isn't Enough

When I was about eleven, I started to have the symptoms of what eventually became hardcore sinus problems.  At the time, though, it was just a constant runny nose and getting every cold and flu that came around.  After missing more than the usual amount of school, I got taken to a specialist.  The specialist decided, using the best in late 1970s medicine, that what I needed was cortisone injections in my nose.  You know what cortisone is, right?  That white creamy stuff that you rub on your skin and it stops itching? Yeah.  They took a giant syringe of the stuff and injected it into the blood vessels of my nostrils.

Have you ever had a shot of novocaine at the dentist's office?  That's kind of what it felt like. Only with liquid fire.  When you go to the emergency room, they ask you what your pain is like on a one to ten scale.  This was, oh, about eleven.  But I'd had it pounded into my head for years by then that One Does Not Make A Fuss Unless It's An Emergency (which it wasn't; pain is not an emergency.  A severed artery--now, that's an emergency).  So I didn't make a fuss.  I had three injections over three weeks, I think, and my head didn't explode, even though I felt like it would.  And remarkably, the stuff did work.  I didn't get sick as many times that year.

The next year, when it came time to have another round of liquid fire injections up the schnoz, something was different.  I'd turned twelve, for one thing.  I'd evidently grown a pair, for another.  Anyway, I announced I didn't want to have the shots again.  My mother was surprised, but not upset; she just called the doctor and told him I didn't want to have them.  The doctor said (this was back when doctors actually talked to you on the phone) that I'd get every cold and flu that went around.  My mom covered the receiver with her hand (this was also before hold buttons) and said, "He says you'll get every cold and flu that comes around."  I said that was fine.  So I didn't have the shots, and I got every cold and flu that went around.  Maybe not the choice everybody would make, but no liquid fire in my nose made me very happy.

The next year we'd moved and I saw a different allergist.  This one told me that I'd actually been very lucky; plenty of people got those sinus injections in the wrong artery and went blind for life. And incidentally, I was getting every cold and flu that went around because I had malformed sinuses, not because I didn't have cortisone injections.Then about 25 years later, I had sinus surgery and now I only get sick once or twice a year.   So happy ending, kind of.

Good thing I didn't live in the grand old state of Connecticut, whose Supreme Court ruled today that there's nothing wrong with forcing a 17-year old girl to have chemotherapy against her will (sedated and strapped down, according to some articles).  And that a parent can lose custody of a child for failing to follow doctor's orders.  Now, a lot's been written about this case, so I'm not gonna get into a big discussion about whether or not this girl should have chemo.  Of course she should.  She's sick. Chemo will probably help her.  No argument about that.  But just because you should do something doesn't mean you have to do something.  Plenty of adults, when offered chemo, turn it down.  Sometimes they try other treatments and sometimes they don't.  Sometimes they die of cancer, but sometimes people die of cancer anyway.  The point here is that the state is literally and physically forcing this girl into chemo, nine months before her 18th birthday, at which point she could walk out of any hospital in the United States AMA and flip her oncologist the bird on the way out the door.  And there are a lot of unanswered questions here.  Ferexample, what's the difference between eighteen and, say, 17 and 3 months?  Why should a 17-year-old, who can get birth control and have an abortion without a parent so much as being notified, not be allowed to say "no" to a certain medical treatment? And most important as far as the subject of this blog post, when can a parent legally refuse medical treatment on behalf of a child?

Well, if you're in Connecticut, the answer is essentially "never."  If a doctor recommends treatment and you (or you and your kid) decide that you don't want to do it, you can lose custody of your kid and the treatment can be applied by force.  We've seen this before in the Justina Pelletier case (Justina was also from Connecticut, though she was incarcerated in Massachusetts).  And all the places that this can go are absolutely guaranteed to keep you awake at night, if you're a parent.  Or even if you're not.  I'm not, and this stuff drives me absolutely ballistic.

Ponder this: Your kid's been diagnosed with a mental illness.  Your doctor has prescribed a drug that, I don't know, among other things makes him projectile vomit, or get dizzy and fall down.  He doesn't want to take the drug because of the side effects, and you don't want him to either (cleaning up vomit does get old occasionally; trust me on this, I have three cats).  So when you tell the doctor you're refusing the drug, are you now a criminal?  A bad parent?  Does it make a difference if there are other drugs that might work just as well, but the doctor's giving you the one where he gets the kickbacks from the pharmaceutical company? And how would you even know that? I don't imagine a whole lot of parents have read up on psychopharmaceuticals, though frankly, more of them should.

Okay, well, maybe it's not the same in every circumstance.  Maybe the state can only force your kid into treatment in life-threatening circumstances.  But let's just say that your teenage son is overweight.  Your doctor thinks he should have bariatric surgery (which is a risky proposition for an adult, never mind a kid, and which requires all kinds of aftercare essentially for life).  Now, can you say no and suggest the kid instead try a better diet and more exercise?  Or, because obesity can kill you (just like life, which is unfortunately terminal), are you now required by law to say yes?

This is particularly galling because of a thing called the "mature minor doctrine".  Some states have determined that if you think like an adult, talk like an adult, and make decisions like an adult, you can choose your own medical treatments in limited circumstances.  Usually you see this kind of thing when a kid has, say, a facial deformity, and wants to have it surgically corrected.  Sometimes the parents say no, either because of cost or because of some misguided religious thing about the deformity being a "mark of sin".  Anyway, courts have been known to step in and say that the kid can consent to his own surgery.  It's the same logic used when an underage woman wants to have an abortion. Some states view pregnancy itself as an emancipating condition that puts the decision in her hands. (Others, like Texas, say she has to have consent from her parents--or prove to a judge that she's "mature" enough.  Because if she's not mature enough, you know, she should become a mom and fulltime caretaker of a tiny helpless human being.)

The Connecticut court considered the "mature minor" argument and rejected it wholesale.  Among other things, they said no mature minor would promise under oath to get chemo and then run away from home to avoid it.  (Conveniently absent from this argument was the part where, while she was under oath and being asked to make this promise, the minor in question was also told she'd be allowed to go home if she said yes--and she was incarcerated in a hospital room at the time.  I think that's called "consent under coercion", which renders it essentially meaningless.) But even if she was a mature minor, Connecticut law didn't recognize such a thing, so she had to have the chemo anyway.

Which, I think, amounts to, "You aren't doing what we want, so we're going to force you to do what we want, because we can do that."  Look, most people in this kid's situation would opt to have the chemo.  If she has it, she has an 85% chance of surviving at least five years (which isn't the same as being "cured", but is pretty good odds).  But this kid is not most people and she said no. What was more, she discussed with her mother and her mother agreed that it was her call.  However, the opinion of the court seems to be that it was the mother's job to force her to have the chemo, and since she didn't do it, she had to be punished by losing custody of her daughter.  It seems like the overriding theme here is, "Do what most people would do, and we'll leave you alone; do something different, and boy are you in trouble."

So why is this such a big deal, you may ask. So a court can force a kid to have chemo.  Well, there are plenty of situations where medical care is inflicted on adults because they are seen as not being competent enough to refuse it.  DNRs are ignored; people are placed on ventilators even though it says clearly in their living wills that they don't want one; brain-dead pregnant women are kept on life support on the small and dwindling chances that their fourteen-week-old fetuses might make it to viability (update: it didn't). Women are told by their states that they must submit to a medically unnecessary vaginal ultrasound before they can have an abortion (state sanctioned rape, in other words).  I could go on, but you get the idea.  It's rapidly becoming more acceptable and legally permissible not just to have access to medical care, but to require it of some people. Usually poor, dark-skinned people. And children. And women. Which seems to be a theme.

In closing, civil rights need to begin at the skin.  I want an amendment to the Constitution stating that the right of persons to be not-messed-with shall not be abridged.  And I think seventeen is plenty old enough to accept or reject chemotherapy.  Because, seriously, they let you drive when you're sixteen, and then you're not taking just your own life into your hands but the lives of every other driver around you. And driving is a lot more dangerous than chemotherapy.  I'm just sayin'.