Fun fact about American health care: if I ever need an organ transplant, I’ll somehow have to hide my autism, depression, and anxiety from the doctors, or else I’ll be disqualified under ideas about quality of life. It’s really great to know how valued disabled and neurodivergent lives are.
So here’s a thing many people don’t know about me: I used to be a medical data analyst. (I still do it occasionally, but not as a full-time job.) It’s a pretty self-explanatory job: I took data - often in enormous datasets - and analyzed it to find patterns. (Obviously, we couldn’t associate these with individual patients; this was just after HIPAA had come into effect, and so this data was very heavily scrubbed to remove any identifiable information.)
One of the patterns I looked for was quality of life and quality of care for people with severe and persistent mental illness (SPMI). For our purposes, that meant major depression, bipolar disorder, general anxiety disorder, schizophrenia, borderline personality disorder, and “other SPMI” (I encourage you to not send me messages telling me how those categories are terrible, because a) it was ten years ago and b) I wasn’t in charge of the categories.) In particular, we looked at injury, illness, and death in people with SPMI, compared with the general population, while they were in the hospital and at certain intervals after they were released (30 days, 60 days, 90 days, 180 days, and 1 year).
People with severe and persistent illness were much more likely to become ill and/or die in the hospital or shortly after discharge than the “general population”. People with schizophrenia had nearly ten times the deaths while in the hospital, and twelve times the injuries and illnesses.
Just as telling were the notes associated with the patient records. There was a significant pattern in the terminology used. In patients in the “general population”, doctors tended to use the word “is”: for example, “patient is suffering from abdominal cramping”. In patients with SPMI, doctors tended to use the phrase “claims to be”: for example, “patient claims to be suffering from abdominal cramping”.
It was clear to us that medical professionals - in general, I know for a fact that there are doctors out there who don’t do this - were assuming that patients with severe and persistent mental illness were inventing some, if not all, of their symptoms - that the symptoms were not real, and therefore did not need to be treated.
And because of that, these patients were falling ill and dying at alarming rates.
This isn’t personal anecdotes. I spent more than a year analyzing this data - which came from actual hospitals in the United States - and finding these patterns. There’s a problem here.
(I would prefer not to give out the name I was using then in public here, but if you’re interested, message me privately and I’ll see if I can get you links to the articles.)
I* believe there is similar data on Developmental Disabilities. In policy discussions it is not uncommon to hear health issues, both mental and physical, attributed to the DD without investigating if it were accurate or not.
i want people to look at those stats on schizophrenia and memorize them
- me: *walks into a restaurant wearing all black and smudged eyeliner*
- me: *says "please" 800 times and smiles at small children*
so Gondor is geographically in the area of Italy
with Minas Tirith basically at Florence or Rome
and Tolkien explicitly and repeatedly associates Gondor with the late Byzantine empire; here’s Wikipedia’s description of Constantinople just before its fall in the 1450s—
Thereafter was little peace for the much-weakened empire; it continually fended off attacks from the Latins, the Serbians, the Bulgarians and, most importantly, the Ottoman Turks. The Black Plague between 1346 and 1349 killed almost half of Constantinople’s inhabitants. Far from being in its heyday, Constantinople was severely depopulated as a result of the general economic and territorial decline of the empire following its partial recovery from the disaster of the Fourth Crusade inflicted on it by the Christian army two centuries before. Therefore, the city in 1453 was a series of walled villages separated by vast fields encircled by the fifth-century Theodosian walls.
oh, and Gondor consists of a bunch of quasi-independent provinces who ostensibly answer to an absolute authority in Minas Tirith, but they’re much more concerned with their own boundaries and only send what armies they feel like sending; there is considerable linguistic, cultural, and demographic variation between the provinces and a history of civil war
also, high-ranking Dúnadan women traditionally wear their hair in sparkly nets
…I’m not saying Renaissance Gondor but Renaissance Gondor
sometimes i just need this on my blog again
— Jacob’s Ladder
today at therapy my therapist gave me a list of legitimate emotional rights and i think it would be helpful to share with everyone, especially people with bpd
- You have the right to need things from others.
- You have the right to put yourself first sometimes.
- You have the right to be the final judge of your beliefs and accept them as legitimate.
- You have the right to a right to feel and express your emotions or your pain.
- You have the right to your opinions and convictions.
- You have the right to your experience-even if it’s different from that of other people.
- You have the right to protest any treatment or criticism that feels bad to you.
- You have the right to negotiate for change.
- You have the right to ask for help, emotional support, or anything else you need.
- You have the right to say no; saying no doesn’t make you bad or selfish.
- You have the right not to justify yourself to others.
- You have the right not to take responsibility for someone else’s problem.
- You have the right to choose not to respond to a situation.
- You have the right to inconvenience or disappoint others.