Category Archives: Health

Another Headache Day

Yesterday was another headache day. I am going into the museum on Wednesdays and Thursdays, but I left after lunch yesterday. My head was hurting so bad, and I just couldn’t stand the thought of being there all day. I went home and went to bed.

A week from Monday (September 21), I will have my first Botox treatment. I’m praying that it helps. I really need some relief from these headaches. I have not had a headache free day in over four months. It hasn’t been a constant headache, but they come in waves of intensity.


Neurology Appointment

On Friday, I had an appointment with my neurologist about my chronic migraines. I’ve been going to the Dartmouth-Hitchcock Headache Clinic for nearly a year now. The initial visit took about two hours’ worth of questions. My doctor did a full medical history, especially concerning my headaches and completed a neurological exam. She decided that I would start taking the Emgality injections once a month. It usually takes 2-3 months for the medicine to get into your system and start working. I was on Emgality for 6 months. The frequency of the headaches did improve; I went from having a headache every day to having 3-4 a week. For my neurologist, a 50 percent decrease was insufficient progress, so it was decided that I would switch to Aimovig, another injectable that I took every 28 days. With the Aimovig, I saw no improvement; in fact, I went back to having a headache every day. Not only was it ineffective against the migraines, but the side effects were excruciating. Aimovig is known to cause severe constipation, and some days the stomach cramps were worse that the headaches. Maybe that’s TMI, but I am just being honest.

When I met with the headache clinic’s nurse practitioner on Friday, I discussed the issues with her, and she determined that I would be taken off the Aimovig. However, since I did not respond sufficiently to the Emgality and the Aimovig was completely ineffective (both medicines are calcitonin gene-related peptide inhibitors), she believed that the third CGRP inhibitor, Ajovy, would likewise be ineffective. Furthermore, the anti-seizure mediation that has proven effective for migraine prevention is also out of the question because they all contain sulfur, and I am allergic to sulfur-based medicines. Therefore, the next option is Botox injections. There is one problem though. Aimovig has a half-life of 3-4 months, so it will be a while before my digestive tract returns to normal.

My first Botox treatment is scheduled for September 21 and should take about 20 minutes. The doctor will give me 31 injections in seven key areas of the head and neck. Each injection will contain small amounts of Botox that will go into shallow muscles in the skin. According to what I have read, it can take up to six months to see the maximum benefit from Botox. I will have to drive down to the clinic, which is about a 50-minute drive, every twelve weeks. The appointments cannot start for at least another month because it will take at least a month for the insurance appeals to be approved, hence the September 21 date. We already know that the insurance company will deny the initial request for the procedure. They have denied all of the migraine medications I have been prescribed, and my doctor has had to make appeals. Thankfully, all of the appeals have eventually been successful.

The fact that the procedure has to be appealed to the insurance company and is not automatically granted is one of the greatest failings of the healthcare system in the United States. Thankfully, Obamacare did require health insurance companies to cover preexisting conditions. Before the Patient Protection and Affordable Care Act, i.e. Obamacare, was passed in 2010, most insurance companies would not pay for my migraine treatments because I had previously been diagnosed with migraines. I cannot understand how it is legal in the United States for an insurance company, whose claims officers do not have medical degrees, to determine if you can have the treatment that a doctor prescribes. This is, in my opinion, the greatest failure in the healthcare system.

When I was young, I had frequent migraines, but I do not remember having headaches every single day. Since I have been an adult, I have a headache nearly every day, sometimes they would be so debilitating that I could not function. Through all of it, I was expected to continue my studies in college and graduate school. I was expected to work through the pain. If I took off every time, I had a migraine, I would rarely be able to work. Even if I took sick days for the most debilitating migraines, I would burn through my sick leave within six months. 

I have soldiered on. I’m not saying that for sympathy; I am just stating a fact. Besides the migraines, I have suffered through some pretty awful treatments. When I was on Elavil, an antidepressant with sedative effects, I suffered from night terrors. If you have never experienced night terrors, you are very lucky. In my experience, I would wake up, but I could not emerge from the nightmare I was experiencing. My mother always told me she would have to fight me to wake me up, and it was very upsetting for her, as I would be screaming for her but never know she was already there. This was a very traumatic experience for a kid. I’ve already told you about the depression effects caused by Ativan. Those were just two of the preventatives. When I took the triptans to relieve my headaches, I often felt like I was having a heart attack with severe chest pains and arm pain. The one time I tried Imitrex, it intensified the headache so much that I dropped to the floor and just cried. Sometimes, the treatment is worse than the chronic migraines.

So, I will try the Botox. I pray that it will give me the relief I crave. I don’t know what other options are out there. I feel fortunate that I have the Headache Clinic at Dartmouth-Hitchcock nearby. There is one at the University of Vermont too, but the one at DH is considered the best in the area.


Depression and Anxiety

Jeremy Ryan is a fellow blogger and new reader to this blog. His blog is called, New Homo Blogo. There is a link to his blog in the sidebar. This past Monday, he posted about his depression. It got me thinking about my own journey of depression. I’ve talked about depression a few times here, but I’ve never said a lot about when it started or how it progressed over the years.

By now, all of you know I’ve suffered from migraines my entire life. When I was a teenager, I was prescribed Ativan to help control them. Most doctors will only prescribe Ativan for a week or two. Taking this drug for more than two weeks can lead to dependence, tolerance, addiction, and withdrawal symptoms. It can also worsen depression if take for long periods. I was on the medication for over two years. At the time, I didn’t realize I was also suffering from depression and anxiety due to either not understanding my attraction to guys and/or not being able to come to terms with being gay. I knew I was different and not the most masculine kid; all the bullies at school reminded me of this daily. Then there was my father who hated having a “sissy” son. I remember one time I accidentally grabbed the electric fence around our property, and I screamed. I got into trouble not for touching the fence or being where I shouldn’t have been; I got into trouble because I screamed “like a girl.” Touching an electric fence hurts like hell, and it’s very difficult to let go once you do. While you might think my dad would have been concerned whether I was all right or not, the truth is, he only cared about how I reacted. I know I was yelled at and probably got a spanking because of it. There were numerous instances like this of him wanting me to be more “manly” and not embarrass him.

As someone who was already struggling with anxiety and depression, Ativan worsened my symptoms. I had been taking this potent drug for too long. Eventually, another doctor realized how long I’d been on the drug, and slowly weaned me off of it. This new doctor understood the harm the drug could do. But I still had a small handful of the pills. One night, when I felt I couldn’t take it anymore, I took all the pills hoping to end my misery. Thankfully, it did not work, but it did make me terribly sick; I vomited all night long. After that, the depression got worse. I still didn’t know how to deal with my sexuality or fully understand I was gay. So, I poured myself into studying to get a scholarship and to go away to college which I did.

College was not too bad. I began to deal with my sexuality. I discovered the internet and did a ton of research on being gay and what it all meant. The local Barnes and Noble also had gay books, fiction and non-fiction, that helped. I was finally able to admit it to myself, but it wasn’t until graduate school when I told anyone else. Graduate school was tough and did not help my anxiety and depression. Plus, I did not know how to ask for help. I was poor and in debt. When money issues came up, when I didn’t know how I was going to afford my next meal, when bill collectors called, I would become paralyzed with fear. These money issues would continue to plague me for years especially once I had to start paying off my massive student loans. 

After getting my master’s degree and completing my PhD. coursework, I desperately needed a job. The problem was Mississippi used to, and may still, have a law that says if you are a graduate student on assistantship, you can only work within your academic department, and only for 20 hours a week. Since the stipend was less than minimum wage, I continued to depend on student loans to live while also getting an additional job outside of the university. When my assistantship ended, I either needed a permanent job or I needed to move back home. But there was one major problem: this was in the middle of the financial crisis of 2007–2008. I applied for dozens of teaching jobs; all but two cancelled their searches because of budget cuts. I did get interviews for those two, but I wasn’t hired. I had one option left: move back home. So, that’s what I did. 

I continued applying for jobs while trying to finish my dissertation. I had a regular routine. I got up each morning, had coffee and breakfast then sat at my computer to research and write. I took a break for lunch then back to work. Around 4pm or so, I cooked dinner for my parents so it would be ready when they got home. While my parents knew I was gay, that had come out a few years before, I was essentially back in the closet living at home. This would not be good for anyone’s mental state. They’ve never accepted my sexuality. I was also struggling with my dissertation committee chair assigned to me when my original chair left for another university. We did not get along. He questioned everything about my dissertation and made my life a living hell. I kept my deadlines, but he wouldn’t keep his. When I would get feedback, it was always unnecessarily harsh and disheartening. At times, I couldn’t continue writing because I was waiting and waiting for his feedback. I got so depressed I would just burst into tears at the slightest thing. I had never gotten along with my dad, and we fought constantly which didn’t help. One day, when my mom came home from work (she was a nurse), I broke down crying, and told her how depressed I was. The next day, she talked to the nurse practitioner she worked with; the NP prescribed Prozac to help with the depression. And it did help.

Things, however, continued not to go well with either my dissertation or my job search. I was stuck at my parents very rural home, and rarely went anywhere. It drove me crazy. At some point, I started blogging in my free time; I was bored, and it relieved some of my stress. I was mailing off application packets once or twice a week. The postmaster at the small-town post office knew I was applying for jobs. One day, he told me a local private school was looking for a history teacher. His wife was a teacher there, and as the postmaster, he knew everything that went on in that town. Since the other job applications were going nowhere, I applied at the private school, got an interview, and got the job. I found a place to live and moved out of my parents’ house. Thus, began a five-year nightmare. I was working so hard and was so tired, my cat and I took a nap every day after I got home from work. The kids, the parents, the headmaster were all awful. Each day was horrible. Also, during these five years, I lost my beloved Grandmama and my sweet cat who was so special to me.  Fortunately, though, it wasn’t all bad. I did make friends with some of the teachers. But, if the school had found out I was gay, I would have been fired immediately so I constantly lived in fear. As for my dissertation, I tried to finish it, but due to the problems with my dissertation advisor and having two jobs (teaching full time at the private school and part time at a local university), I was unable to complete it in the maximum number of years allowed.  

After about two years in the house I was renting, my landlady decided she no longer wanted to rent it out. I had to move. After my Grandmama’s death, my aunt, who had cared for her, was now living alone and not taking it well. I had been going to see her every Wednesday to make dinner and give her some company. When I needed a place to live, I ended up moving in with her. My aunt didn’t try to micromanage me like my parents had so I was able to discreetly date a few guys. That’s when I discovered the downside to Prozac: sexual disfunction. Most of the time, I could get erect, but I was not able to have an orgasm without difficulty if I could achieve one at all. A friend suggested I talk to my doctor about switching to Wellbutrin; it did not have the same side effect. That helped. The Prozac had not been working as well for my depression anyway, so the change was doubly beneficial.

The school finally got a new headmaster, and I thought things were improving. There was no indication the new headmaster didn’t like me, but apparently, he secretly did. After five years of teaching there and becoming more popular with many of the students and parents, not to mention creating a highly successful drama club, the school hired a football coach who could “teach” my classes. So, the headmaster gave this new coach my classes and didn’t renew my contract. I was devastated, and on the job search again. This time, I chose not to focus on teaching, but to do something else with my history degrees.

It has turned out mostly for the better. I found a new job in faraway Vermont. I would be living 1,100 miles from my family, my boyfriend, and all my friends. Getting far away from my family has allowed me to be more open about my sexuality, but a long-distance relationship was not going to work with my boyfriend. We broke up. Little did I know just six weeks after moving to Vermont, my world would come crashing down. I had a friend I talked to everyday. He was one of the few gay friends I had; we talked about anything and everything. We texted all the time. He was the last person I talked to every night and often the first person I heard from in the morning. He was there for me when my Grandmama died and when my cat died. He had become a major part of my life; I loved him like the brother I never had. At Thanksgiving that year, he had met his boyfriend in Dallas. As he was driving back home, he had a fatal car crash. I learned about it from another friend of his. I had been frantic all day because I had not been able to get in touch with him. I knew he would text if he was ok because it was my birthday. No text ever came. I got an email from a friend of his saying he had died in a car crash on his way home from Dallas. As I read the email, I began to cry uncontrollably. My friend Susan had known I was worried about not hearing from him. I emailed her with the sad news. She immediately called. I just sobbed on the phone.

Because I was still in the evaluation period of my new job, I could not take time off to grieve. I remember sitting at my desk the next day and crying all day long. I cried for weeks. When I went home to Alabama at Christmas, I made an appointment to see my doctor. I explained what was going on and was prescribed the drug Abilify in addition to Wellbutrin. It helped enough that I could at least stop crying all the time. One problem with Abilify though, was after being on it for a while, I realized I would become very emotional, very easily. I would tear up over the slightest thing. I didn’t feel depressed so much as I felt emotional.

Susan got me through a lot of that too. I would regularly talk to her on the phone; she became my lifeline. No one else understood the relationship I had with my friend. She did, and she was a great comfort. When I tried to tell my mother why I was so sad, she just told me sometimes friends die. She offered absolutely no comfort. My best friend in Texas had a new child so she was too preoccupied for me to lean on. Susan became a best friend, and now we talk almost every day. I will never be able to fully thank her for all she has done. She truly saved my life. I had lost the will to live, and she offered me hope and comfort.

Eventually, I got a new cat, Isabella. This was another saving grace. Cats can do so much to alleviate sadness. She doesn’t really cuddle, and she comes to me only on her terms, but she will lay on my hip if I’m lying on my side; that’s as close to cuddling as she gets. Most of the time, though, she is within a few feet of me. That, however, has changed a bit since I’ve been working from home. I think she’s getting a little tired of me. She also hates the air conditioner. So, she’s been spending time in other rooms. With Susan’s help and Isabella’s companionship, I was able to get off the Abilify. The hyper-emotionalism I had felt with it has gotten much better.

I still feel sadness when I think of the losses I’ve suffered in the past few years. When I think of my Grandmama, the friend I lost, or even my cat, I miss them all greatly and do sometimes feel overwhelming sadness. Now, though, I can think of them and remember the good things, and not just feel the loss. For a long time, I couldn’t talk about any of them without tearing up. I doubt I will ever be completely “cured” of my depression. Presumably, I will continue to take medication for it. It’s always close to the surface, but the overwhelming sadness only happens occasionally now.  

If you’ve never suffered from long-term depression and anxiety, you are a very fortunate person. It’s hard to describe what a person goes through. Different people have different symptoms. Some of the common depression symptoms are:

  • Anger, irritability, or aggressiveness
  • Feeling anxious, restless, or “on the edge”
  • Loss of interest in work, family, or once-pleasurable activities
  • Problems with sexual desire and performance
  • Feeling sad, “empty,” flat, or hopeless
  • Not being able to concentrate or remember details
  • Feeling very tired, not being able to sleep, or sleeping too much
  • Overeating or not wanting to eat at all
  • Thoughts of suicide or suicide attempts
  • Physical aches or pains, headaches, cramps, or digestive problems
  • Inability to meet the responsibilities of work, caring for family, or other important activities
  • Engaging in high-risk activities
  • A need for alcohol or drugs
  • Withdrawing from family and friends or becoming isolated

Not everyone who is depressed experiences every symptom. Some may experience only a few while others may experience many. Over time, I have suffered from most of these symptoms. The most important thing to know is that depression and anxiety are real. And aside from getting and taking the proper medication, the best help you can have is love and support from those around you.


Melancholy

I think that most people who read this blog know that I have had a long struggle with depression and anxiety. It is something that I have struggled with since I was a teenager. As a general rule, the medicine I take helps to control it, but there are days when, for whatever reason, it doesn’t seem to work. Yesterday was one of those days. I was just down. I felt like I wanted to cry for no reason. These days aren’t something I experience on a regular basis, but they do happen.

It can be difficult for people to understand what it’s like to have anxiety and depression, especially if you are like me and try to hide it from most of the world. Generally, people who have anxiety or depression disorders display significant disruptions in their ability to work, go to school, or participate in social functions. But with my anxiety and depression, although those disruptions are not as apparent, they still can occur. There are days when I shut down almost completely. Many people don’t see signs and symptoms of my depression, because I am usually able to manage my daily activities. With the exception of a few friends, I tend to suffer in silence. To the outside world, I appear to be fine and even excel at accomplishing tasks and goals, but inwardly, it is a much different story. I have a fear of being seen as weak, and I don’t want to be pitied. 

Each January at the university where I work, we have a Staff In-Service day. It’s supposed to be an employee appreciation day that provides the staff the opportunity to get “out of the office, socialize, develop skills, and meet new people.” They claim it is a fun day that consists of a keynote lecture, workshops, lunch, and prizes. I hate it. I often teach one of the classes, so I don’t have to go to one of the other stupid activities. One year, the keynote address was by a guy named Eric Karpinski, a.k.a. The Happiness Coach. What a crock of bullshit he was! He said that when people have days like I had yesterday when I was feeling depressed that most of this depression is self-inflicted. He also claimed that through the power of positive thinking that we can do away with depression and anxiety on our own. We just needed to think positively, cheer up, and smile. This may sound friendly and supportive to someone, but it is oversimplifying the sadness associated with depression.

Someone who is depressed can’t force their depression away by just thinking positive thoughts and smiling. In my opinion, Karpinski’s claim that depression was our own fault and that positive thinking can be used to cure yourself is insulting. The people in charge of that years Staff In-Service day were flooded with emails of people who let them know just how insulting this guy was. You can’t just wish away depression. As much as you’d like to, it just isn’t possible. It’s like when our orange dictator says that COVID-19 is going to disappear like a miracle just because he says it will, or when he says, “If we didn’t test so much and so successfully, we would have very few cases.” It will still exist dumbass, just as depression will still exist. Even when medication is largely effective, there are still going to be days when the depression pops up. It’s always there.

So, what I am trying to say is that if you know someone with depression don’t say to them “Cheer Up!” Your well-meaning exhortations to “cheer up” or “smile” may feel friendly and supportive to you, but they oversimplify the feelings of sadness associated with depression. Just as someone who is depressed can’t force their brain to make more serotonin, they also can’t just “decide” to be happy. While there are certainly benefits to practicing positive thinking,  it’s not enough to cure someone of depression.


Wear Your Damn Mask! 😷

Why can’t people just do what they are asked to do? Americans especially always try to buck the system. If they are asked to do something, they just ignore it if it inconveniences them. A lot of Americans have a problem with authority and don’t get me started with that. I saw it every day when I was teaching, and those are the people who are growing up and refusing to follow directions. Their parents never made them, because quite honestly, the parents didn’t want to follow the rules either. Too many people think they are the exception to the rule. Of course, it doesn’t help that we don’t have a president who will set the example. Instead of doing what he should do, the president makes the wearing of masks a political issue. He idiotically believes that those who wear masks are doing it in protest of him. We wear masks because we want to save our lives and the lives of other people. Fuck! It makes me so mad.

The U.S. is “not in total control” of the coronavirus pandemic and daily new cases could surpass 100,000 new infections per day if the outbreak continues on its current trend, White House health adviser Dr. Anthony Fauci said Tuesday. Fauci told senators in a hearing held by the Senate Health, Education, Labor, and Pensions Committee that “I can’t make an accurate prediction but it’s going to be very disturbing,” The number of new cases reported each day in the U.S. is now outpacing that of April, when the virus rocked Washington state and parts of the Northeast, especially the New York City area.

Why can’t Americans (and you know which ones I’m talking about) quit being selfish and wear a fucking mask? 

News Flash: It’s not going to kill you to wear one, but it might kill you or someone you love not to wear one. Get with the fucking program!

P.S. I apologize for the strong language in this post, but I am just so angry about the issue of people not wearing masks.


A Quick Message

Some of you have emailed me about various things the last few days. I wanted to let you know that I will respond, but I have been very busy in the last few weeks. Also, I am adjusting to my new migraine medicine. My neurologist switched me from Emgality, which was helping a little but not enough, to Aimovig. The problem with switching medicines, is that it takes at least two months to begin to work. Because of that, I have been having increasingly more intense migraines as the new medicine takes effect. I’ve had some days when I’ve actually worked from bed and in a dark room. I’m hoping this will start to change, as I’ve been on Aimovig for over a month now. So please excuse the time it’s taking to email responses. Hopefully, I’ll be able to catch up soon.


Past Tense

Sisko and Bashir in the Sanctuary District

“Star Trek” is a sci-fi universe with a positive outlook on Earth’s future. The United Federation of Planets uses its Starfleet armada of spaceships for humanitarian and peacekeeping missions. Many of the storylines are allegories of contemporary culture. I will repeat what I said yesterday: from the very beginning, Star Trek has held a firm belief represented by the symbol representing IDIC: infinite diversity in infinite combinations. I agree with the idea that Star Trek can teach us so much about what humanity can become. However, Star Trek often had to deal with the problems of the past to create this future Star Trek universe. As was well-established in the Star Trek universe originally envisioned by Gene Roddenberry, society had to go through Hell before reaching a state of utopia, and the episode “Past Tense” from Star Trek: Deep Space Nine is part of an examination of that Hell.

“Past Tense” shows what the United States was like in the 2020s through the lens of the 1990s. The year is 2024. Sisko, Bashir, and Dax find themselves trapped 300 years in the past confronting one of the darkest hours in Earth’s history. The time period is best explained by Sisko who teaches Bashir about 21st century history and the Sanctuary Districts:

Sisko: By the early 2020s, there was a place like this in every major city in the United States.

Bashir: Why are these people in here? Are they criminals?

Sisko: No, people with criminal records weren’t allowed in the Sanctuary Districts.

Bashir: Then what did they do to deserve this?

Sisko: Nothing. They’re just people without jobs or places to live.

Bashir: So, they get put in here?

Sisko: Welcome to the 21st century, Doctor.

Bashir comments to Sisko, “21st century history isn’t one of my strong points. Too depressing.” Bashir would definitely be horrified at the way the United States government and other governments around the world have dealt with COVID-19. But back to the episode, the conditions of the Sanctuary Districts lead to an event known in the Star Trek universe as the Bell Riots. As Sisko explains to Bashir, “The Sanctuary residents will take over the District. Some of the guards will be taken hostage. The government will send in troops to restore order. Hundreds of Sanctuary residents will be killed.” The dialog between Sisko and Bashir continues:

Sisko: I sympathize, Doctor, but if it will make you feel any better, the Riots will be one of the watershed events of the 21st century. Gabriel Bell will see to that.

Bashir: Bell?

Sisko: The man they named the Riots after. He is one of the Sanctuary residents who will be guarding the hostages. The government troops will storm this place based on rumors that the hostages have been killed. It turns out that the hostages were never harmed, because of Gabriel Bell. In the end, Bell sacrifices his own life to save them. He’ll become a national hero. Outrage over his death, and the death of other residents, will change public opinion about the Sanctuaries. They’ll be torn down and the United States will finally begin correcting the social problems it has struggled with for over a hundred years.

The riots over the death of George Floyd and others killed by police may be the start of a change in American history like the Bell Riots were in 2024. We can only hope. In 1995, when this episode aired, who would have predicted that only a few years before the fictional Bell Riots, the United States would see nationwide protests on racial injustice?

Ira Steven Behr, executive producer of Star Trek: Deep Space Nine and one of the story creators for “Past Tense,” was inspired to come up with the idea for the Sanctuary Districts through his real-life experience in the early 1990s. In an interview for a Season 3 DVD special feature about “Past Tense,” Behr said:

I was down in Santa Monica one day, and there [were] all these homeless people there, and it was a beautiful day, the ocean, sky, sun, and homeless people everywhere. And all these tourists, and people up and about, and they were walking past these homeless people as if they were part of the scenery. It was like some artist had done some interesting rendition of juxtaposition between nature and urban decay right there in front of me. And the fact was that nobody seemed to care, at all. And I said, ‘There has to be something about that, where does that go? How far do you take that?’ And that evolved into the idea for concentration camps essentially for the homeless.

Dax and the Wealthy Businessman

Behr also stated there is a subtle examination of racism in this episode. When Dax is discovered, she is treated like royalty and taken in by a wealthy San Francisco businessman, but when Sisko and Bashir are found, they are treated like criminals. Of this situation, Behr said, “The simple fact is, a beautiful white woman is always going to get much better treatment than two brown-skinned men.” We see the contrast between the life of the wealthy San Franciscans Dax meets, and the discarded people of the Sanctuary Districts whom Sisko and Bashir encounter.

At the end of the second part of “Past Tense,” Bashir asks Sisko, “You know, Commander, having seen a little of the 21st century, there is one thing I don’t understand: how could they have let things get so bad?” Sisko replies, “That’s a good question. I wish I had an answer.” And, it is a good question. We may not have Sanctuary Districts, but we still have massive inequality. There are serious problems in the United States which our current president has made worse. Trump has highlighted inequalities and injustices in the U.S., at least for some of us. Alternatively, Trump supporters relish the inequalities, because for them, it means someone is less fortunate than they are. It’s the same reason that poor white men who owned no slaves fought for the Confederacy during the Civil War. As long as there were slaves, they weren’t the lowest social class. It was a similar situation in the Civil Rights Movement. Poor whites favored discrimination and segregation because it put them above black people. The same is true today with Trump’s followers—many of whom would rather suffer from the damage done by Trump to the nation’s economy, healthcare status, and many other issues rather than to allow equality in America.

When the episode aired, it received some criticism for being too preachy, liberal, and “soapbox like” something which disappointed Behr, who felt the show had important things to say, and treated a serious situation in a realistic manner; “We’re not going to solve anything with two hours of TV. The homeless are still there. The problem hasn’t gone away. But maybe just one person saw this and started to see the problem in a different way.” The real 2020s may not have Sanctuary Districts, but there are segregated sections to every city; whether they segregate the rich from the poor or blacks from whites or whatever the dividing line is, we still live in a society segregated by race, income status, and a host of other perceived differences. We continue to have homeless and displaced persons. We need to do better.

I will say this though, through most of the Star Trek universe, LGBTQ+ issues were rarely, and never directly, dealt with. Yes, Commander Riker of The Next Generation did fall in love with a nonbinary individual, and Jadzia Dax did have a same-sex kiss, and there were a few other instances, but none dealt with LGBTQ+ individuals. When Voyager and Enterprise premiered, rumors circulated there would be an LGBTQ+ individual on the crew of those ships; it never materialized. It wasn’t until Discovery that we see fully-fledged LGBTQ+ individuals in the marriage of Paul Stamets and Dr. Hugh Culber, plus the character of Jett Reno. I also recognize in Star Trek Beyond Sulu is seen, ever so briefly, in a same-sex relationship which was done as a homage to George Takei, the original Sulu. The Star Trek universe is becoming more inclusive of the LGBTQ+ community, but it’s been a long time coming.


Migraines

For the past two nights, I have had really bad migraines. I seem to be fine during the day, but once evening hits, the pain begins. A lot of times, I can just brush off the pain and go about my business the best I can, but these have made it hard to even fall asleep at night. I’ve had to just turn off all my lights and be quiet. I haven’t even turned on the TV in the evenings.


The Symbol of 2020: The Mask

The mask is the COVID-19 pandemic’s defining symbol, and probably will be the defining symbol of 2020. In America, the medical mask used to be confined to operating rooms and hospital dramas. It is a public health device but also has revealed itself as a mask in several different perceptions. It has become a political symbol: an object signifying a person’s politics and their relationship to truth itself. A bare face is what registers as a choice. 

To its supporters, mask-wearing is a visual expression of civic duty, an affirmation of scientific authority, and a show of respect. To its critics, it is a sign of weakness, emasculation, and deceit. Many Americans accept the medical benefits of masks, and for those who do not, their rhetoric corresponds with racist ideas about Asian cultures where wearing a mask in public has long been normalized. 

Among the maskless ranks is R.R. Reno, the editor of the conservative religious journal, First Things, who tweeted, “Masks = enforced cowardice,” and Donald Trump, who said, “Somehow, I don’t see it for myself.” Brett Hume tweeted a picture of Biden wearing a mask on Memorial Day saying, “This might help explain why Trump doesn’t like to wear a mask in public. Biden today.” It was a childish thing to say. “This macho stuff,” Biden said after Trump retweeted a jab at the candidate’s own mask. “It’s cost people’s lives.” For people who refuse to wear masks, the implication is that people who choose to wear masks are not just protecting themselves — they are attacking the president and his supporters. 

Ironically, in 1918, when the Spanish flu pandemic coincided with World War I, many Americans wore masks as a symbol of their patriotism, and their effort to curb the spread of the disease to protect soldiers who were about to enter the battlefield. San Francisco, along with other Western cities such as Seattle, Juneau, and Phoenix, passed laws requiring masks in public. Violators could be ticketed, fined, and imprisoned. Even so, protests against wearing masks were plentiful in 1918. San Francisco saw the creation of the anti-mask league, as well as protests and civil disobedience. People refused to wear masks in public or flaunted wearing them improperly. Some went to prison for not wearing them or refusing to pay fines. Within weeks, however, as the number of cases and deaths decreased, recommendations and even regulations to wear masks were relaxed and then eliminated. Because of this, cases spiked again around Thanksgiving, and another surge occurred into the New Year. These second and third waves were the deadliest. However, in many places, there was no appetite to enact another set of mandates. Removing those orders, and then trying to re-implement them a second time, proved to be exceedingly difficult. By then, the patriotic fervor that influenced compliance had waned.

Historians and scientists at the University of Michigan and the Centers for Disease Control and Prevention have studied the efforts of trying to contain the Spanish Flu of 1918. Comparative analysis of data from several American cities during the 1918-1919 influenza pandemic provide incontrovertible evidence of the effectiveness of the kind of restrictions we are living with today. Cities that imposed expansive closure orders early and maintained them for the duration of pandemic conditions suffered significantly lower death rates than those cities that did not. While protestors in 1918 fought against the hated mask, their act of gathering, which was entirely legal at the time, was helping to spread the disease.

Wearing masks is a collective declaration of a serious disease recognizing that behavior of an entire population must change. In this sense, the seeming omnipresence of masks in historical photographs from 1918 reinforces the message that preventing transmission is a community effort requiring substantial behavioral change. Wearing masks means accepting that community welfare supersedes individual preferences. It should not be a political issue. Instead, wearing a mask should follow the maxim that is found in many religions and cultures often known as the Golden Rule: treat others as you want to be treated. 

One of the sanest voices in the government’s response to the pandemic, Dr. Anthony Fauci, has called for a cautious approach to reopening the US and implored Americans to wear face masks in public. Fauci said, “I want to protect myself and protect others, and also because I want to make it be a symbol for people to see that that’s the kind of thing you should be doing.” He went on to say that while wearing a mask is not “100% effective,” it is a valuable safeguard and shows “respect for another person.” His comments are at odds with Trump’s push to have America quickly return to normalcy.

Trump seems unwilling to fight the coronavirus rationally instead claiming it will disappear “like a miracle.” It’s as if taking the disease seriously is an indictment of his presidency. By dismissing the threat and banishing its visual cues, Trump also shields his own reputation and protects his personal vanity. While everyone who refuses to wear a mask might not be pro-Trump, they all have two things in common: selfishness and ignorance.  These two traits seem to be glorified by part of the American public, and that is just not acceptable.


Headaches and Insurance

On Tuesday, I had an appointment with the Headache Clinic at Dartmouth. I first went about six months ago, so for the past six months I have been taking monthly Emgality injections, which are very painful, by the way. Anyway, before I started taking the Emgality, I was having a headache seven days out of the week. Since the medicine kicked in, it took almost two months to begin working, my headaches have dropped to about four a week. Obviously, this is an improvement, but not the kind of improvement the clinic wants to see. In my appointment on Tuesday, the nurse practitioner who does all the follow-up visits talked to me about switching to Aimovig and/or Botox injections. Aimovig is another auto injector like Emglaity, but supposedly easier to use, not that Emglity was hard to administer. She asked which I would prefer. I have never been too keen on the idea of injecting poison into my body, so Botox is not something I really wanted to consider. Also, it’s thirty-one shots in the head, and I don’t like needles. However, I am getting desperate. I have dealt with headaches my entire life, and I just want some relief. I asked the nurse if I would be taking Aimovig and Botox or just one or the other. She told me that they would prefer that patients try both at the same time. Though research is being done on the combined effectiveness and not much information exists about this yet, it is believed that they work well together to prevent migraines. Here comes the caveat: very few insurance companies will pay for both treatments at the same time. She advised that I call my insurance provider and ask if they would cover both simultaneously.

Let me begin by saying that I hate insurance companies. They are crooked and cheap. They are always trying to cut corners and not pay for treatments advised by doctors. While my friends in other countries will say that the United States needs universal healthcare, and I am not going to argue with that, the US government is so colossally incompetent and corrupt that I am afraid it would actually be worse than the current situation. Considering that a large number of people were stupid enough to elect Donald Trump, how can I have faith that they would ever support truly universal healthcare? I just don’t believe it is possible in the greedy, capitalistic economy of the United States.

Now that I have given my rant about insurance companies, I will tell you what happened when I took the nurses advice and called my insurance company. Right off the bat, I got am idiotic computer giving me vast amounts of useless information that I did not ask for. So, I finally asked to be connected to an operator. I was given their pharmacy department. Finally, a live person! So I told her about my neurology visit and what had been recommended and asked would they cover both treatments. That’s when I began to get the runaround. I was told by the customer service representative that they had not received a preauthorization  request for the Aimovig and therefore could not tell me if they would cover it or not. I already knew they would probably cover one or the other, but I wanted to know if they would possibly cover both. The reason I knew they would cover Aimovig or Botox is because when I was first prescribed Emgality, their reason for the initial denial was that I had not tried Aimovig or Botox first. Then she proceeded to tell me that Botox is a medical procedure and does not fall under her department, and I would have to talk to a representative from the medical department. So, she transferred me over there. I went through my explanation again. Again, I was told that he could not tell me if Botox would be covered because they had not received a preauthorization request. So I explained to him again that I was not asking if they would just cover Botox, but would they cover both treatments simultaneously. Again I was given the spiel about the Aimovig was covered by the pharmacy division and Botox was covered by his divisions, and he had no way of knowing if they would cover both since they would have to be requested separately. He told me to have the Headache Clinic request a preauthorization for both treatments.

At this point, I gave up on talking to the insurance company since they were obviously not going to tell me anything. So, I did as he suggested and called the Headache Clinic. This is when I got really annoyed. I was given a clerk to speak to and explained what I was calling about. I told her I needed them to request both treatments before they could tell me if both would be covered. She took down the message, and then had a nurse call me back. This was not the nurse practitioner I had spoken to earlier that morning. The nurse reviewed my chart and told me that it did not mention the Botox treatment and therefore the nurse practitioner must have decided against that course of action. I tried to explain that before she would order the Botox and the Aimovig simultaneously, that she wanted me to talk to the insurance company. I was basically told the since it was not in the chart, I needed to forget about it for now. When I tried explaining again, she finally said she would make a note of my call and ask the nurse practitioner, who would call me back. Do you think I have gotten a phone call back? No. While I like the people at the Headache Clinic, they are really bad about returning phone calls.

As it stands now, it appears that I will only be taking the Aimovig. Here’s what worries me, I was told by the pharmacy that by changing medications, it would take two to three months for the new medicine to begin working. If they had been able to schedule the Botox, the effects would be immediate and the botox would be working its magic while I waited for the Aimovig to begin working. I had been told that a Botox appointment would not take long to get scheduled because with the pandemic, they had a lot of appointments open. I am writing all of this because I had a major debilitating headache yesterday and was really hoping for a treatment that would work. Now, I wait.