Marginal Notes

Questionnaire for Canadians on Medical Assistance in Dying

Remember to give 5 minutes or so to provide feedback to the federal government on assisted dying legislation. You can access the questionnaire here.

 

I have been an advocate for disability rights for years and I have lived as a disabled person most of my life as I had significant health issues since birth. I believe many of the proposed safeguards just limit access to medically assisted dying rather than truly protect vulnerable people.

 

The best safeguard is in creating a society that values and embraces the differently abled, the aged and those who are very ill. This means helping everyone to engage in meaningful work and valuing their unique gifts. It means making the health care system less horrific to navigate, cutting down on the drastic waiting times for test results; and lack of government and employer support of people raising children or caring for a sick sibling or parent.

 

To me, the most important questions and answers are:

 

SECTION C:

 

1) Yes; current safeguards are adequate/effective; 2) a, b, c and e -- Not important at all; d) Very important: Making sure the person requesting MAID is aware of all the means available to potentially relieve their suffering, including health and social support services is very important.

 

SECTION D:

 

1) Yes and 2) Yes (although in both cases, I think indicating a desire to proceed with MAID in a PERSONAL DIRECTIVE would be ideal, but I do not think this should be required per the legislation.

 

Cleary, the questionnaire reflects pertinent issues that have been raised in the Courts and the media like the "reasonably foreseeable" clause and the issue of advanced consent.

I am worried that few people will consider the implications of question 'e' which asks if there should be:

"Mandatory consultation with an expert in the person’s medical condition and circumstances (for example a gerontologist, psychiatrist, or social worker), in addition to the already mandatory 2 medical assessments."

Many people would be quick to agree that there should be a mandatory consultation with an expert in the person's medical condition, but such legislation could be a terrible barrier to access for people with rare illnesses. There might simply not be a true expert in the field in the person's area. Moreover, of the very few experts in certain fields, none may be willing to participate in the process.

I myself have Common Variable Immunodeficiency (CVID). I was provisionally diagnosed by an allergist and an internal medicine specialist in 2007 and commenced treatment -- specifically, monthly intravenous immunoglobulin therapy (IVIG). In 2012, a pediatric immunologist at the Alberta's Children's Hospital ran a series of tests and confirmed my diagnosis. It was not until 2014 that I was evaluated by a specialist in adult primary Immunodeficiencies. It was a long battle to get Alberta Health Services to hire such a doctor at a hospital in Calgary. I know what it is like to have to fight for one's life and fight for access to experts. It would be awful if suffering was compounded for those with rare illnesses because they were forced to have an expert involved no matter how highly improbable that might be.

I ask that you consider how access to MAID will be affected if a seemingly innocuous criterion becomes part of legislation? Please share with your network so we can generate some awareness and discussion of this issue!

The Calgary 2010 Municipal Election in the Context of Neoliberal Urbanism

With the Calgary 2010 Municipal Election fast approaching, I think it's worthwhile to develop a context in which to consider the issues and the candidates.

In 'Municipal Malaise: Neoliberal Urbanism and the Future of Our Cities,' Fanelli and Paulson discuss neoliberal restructuring of Canadian cities:

The 2008 Annual Report by the Federation of Canadian Municipalities, written when the Federal government was pulling in nearly $14-billion in budget surpluses, paints a grim picture of the coming collapse of Canada's municipal infrastructure. The report found that Canada has used up 79 per cent of the service life of its public infrastructure and has set the price of eliminating the infrastructural deficit at $123-billion. While that figure is already large, the chronic underfunding of municipal projects appears much worse when framed not in terms of the cities we have, but the cities we want to live in: the funding gap would have to take into consideration a range of issues including poverty and affordable housing, environmental protection, urban redesign and renewal, and expansion of the arts, cultural centres and other public spaces. Of course, fiscal crises in our cities are nothing new; the last three decades have been characterized by increased service demands, population growth, tax-shifting, pressures brought on by amalgamation, and federal and provincial offloading. Yet the ongoing recession has become a pretext for consolidating and intensifying processes of “neoliberal urbanism.”

 

Neoliberal urbanism broadly refers to a range of punctuated and uneven urban processes taking place in the communities where we live and work. This includes the privatization, restructuring, and elimination of public goods and municipal services; the shifting of the cost of maintenance of public resources onto the working class; the increasing precariousness of work; the devolution of responsibilities onto local governments without matching fiscal supports; the scaling of regulatory capacities upwards to regional or international institutions (characterized by little transparency, accountability, or public consultation); the reining in of the power of municipal unions and community groups; the scaling back of social entitlement programs; and expansion of so-called “public-private partnerships” that aim to create new zones of accumulation and shift a significant part of the responsibility for urban governance to corporations.

...

Yet our cities, time after time, are taking it on the chin. While the federal and provincial governments have a variety of relatively flexible revenue sources (such as income, sales, corporate, resource and import taxes – tools which remain at their disposal, whether or not they choose to use them), only 8 cents on every dollar collected go back to Canada's municipalities. For our cities, property taxes remain the major source of funding, and from this, they must provide for their public utilities, public works, parks and recreational facilities, waste management, transit services, public housing, and a whole range of other social and community services and local initiatives. However, since the 1980s successive governments at both the federal and provincial levels looked to ‘correct’ their budget deficits by transferring greater amounts of fiscal responsibility onto municipalities, without providing for additional fiscal capacities. This process, commonly referred to as service ‘downloading’ (or the ‘devolution revolution’), expanded the fiscal requirements of cities without any increases in revenue sharing or generation. This is particularly clear in the fiscal crisis of Canada's largest city; if, as some have argued, Ontario represents the pre-eminent neoliberal province, Toronto has likewise come to epitomize municipal neoliberalism at the urban scale.

Describing the Toronto case, the authors write:

Decades of growth on Bay Street, coupled with the casualization of employment (particularly in the low-wage service sector), have taken their toll on Toronto's poor. To make way for gentrification, the homeless and low-income populations were forced out of the urban core long before the recession. Toronto's official unemployment rate stands at 9.5 per cent, but the 'real' number – including those who need more work than they can find just to make ends meet – is much higher. With more than 180,000 tenants living in poorly-funded public housing, and another 70,000 on a ten-year wait-list, welfare caseloads have risen nearly 25 per cent when compared with 2008. People of colour, women, single-parent households, the differently-abled, students, and seniors continue to fair far worse as their skills are apparently ‘uncompetitive’ given the need to maximize profits. The criminalization of poverty and homelessness, however, continues full steam ahead with the Toronto police force's operating budget skyrocketing from $541-million in 1999 to $855-million just ten years later (roughly 35 per cent more than the rate of inflation). Austerity does not, apparently, extend to the need to patrol the gentrified urban core. This can hardly be understood as anything other than a transfer of resources from the maintenance of public goods to the publicly-funded protection of private ones.

I invite readers to read the full text of the article to see how Toronto, Vancouver and Ottawa have downloaded costs onto citizens by increasing property taxes, increasing service fees such as parking and transit costs and privatizing services. Another common thread is the undermining of unions, especially those representing civic employees and lay offs of these workers.

For a discussion of Calgary, I recommend Miller's book chapter - 'Modes of Governance, Modes of Resistance: Contesting Neoliberalism in Calgary.' He discusses the decline in public revenues at the provincial level with the implementation of the flat tax and changes to the royalty regime. He notes that provincial transfers of public revenues stood at 21.9% of total municipal revenues in 1988, but dropped to 15.9% by 2001, despite increased municipal responsibilities.

How do we respond? Fanelli and Paulson suggest:

 While we certainly need to be pushing the burden of the fiscal crisis onto the capitalist class and off the backs of workers, and we can (and should) argue for greater commitments by the federal and provincial governments to alleviate the fiscal crisis of the cities, it should be clear that the management and funding of Canada's municipalities is fundamentally broken.

Fixing them requires a new kind of broad social movement unionism, and a great deal of collective capacity building in order to bring together workers, social justice activists, and community groups. In short, we ought to stop treating cities as the backbone of capital and treat them as the places that most of us live, work and play. Our collective struggles have tended to take the form of demands of the city, while they ought to be based in class consciousness – and urban consciousness – and demand instead the opportunity to restructure the city to serve our needs rather than those of capital.

With the onset of 2010 Calgary Municipal Election, we need to use our understanding of neoliberal urbanism to frame our understanding of issues and solutions. Public services in the city are inextricably tied to provincial and federal funding and the influence of corporations. 

Both ImagineCALGARY and Vibrant Communities Calgary offer policy papers on issues ranging from sustainable planning to a living wage. In my view, these initiatives are far superior to The Better Calgary Campaign which places less focus on social, economic and environmental justice.

I believe it would be beneficial for these initiatives to work with a campaign at the provincial level such as Join Together Alberta. This would allow for the building of a citizen's movement making synchronized demands at both provincial and local levels.

Ultimately, we need change at the provincial level before we will seen any meaningful change in the City of Calgary. Climenhaga makes a strong case that the Alberta NDP should emphasize an urban agenda. For instance on the issue of social services, Climenhaga writes:

When Tories cut social services, who pays? Urban taxpayers, that’s who! We pay more for policing, health care, basic services required just to keep our fellow humans from freezing to death. We pay in crime, run-down neighbourhoods, foregone business opportunities and illness, physical and mental. And ever-higher municipal taxes, of course. Rural-based, rural-focused parties like the Conservatives don’t really give a hoot. By speaking up for social services and an end to downloading costs as city issues, the NDP would be speaking up for urban taxpayers, safer cities and a better life. They'd also be fighting for the socially disadvantaged, which is as it should be.

As the 2010 Calgary Municipal Election approaches, we need identify and support candidates who can stand up to corporations and who can explain to people that the imagined savings of the flat tax only lead to higher taxes and fees in the city. We need people who envision Calgary as a place to live as opposed to a place for sale.

With a provincial election expected in 2011 or 2012, we can hope for the strong presence of MLAs who will fight for the necessary legislative changes needed to support cities in becoming more inhabitable places for citizens!

 

Additional Resource:

Calgary Democracy website developed by Grant Neufeld

Hysterical Women and Our Wildly Amusing Thoughts on Consent and Pelvic Exams

I have chosen to write this blog entry after failed attempts to get the mainstream media in Calgary to follow up on Andre Picard's article on pelvic exams that are reportedly performed on women under anesthesia in spite of a lack of explicit consent.

In October of 2009, I had exploratory surgery during which several large growths of endometriosis were found on my uterosacral ligaments and, subsequently, removed through cauterization.

I first experienced the intense pain of endometriosis in September of 2007; it seized my body for a couple of weeks and then disappeared overnight. An ultrasound was done but nothing was found.

In October of 2008, the pain returned with fury. I was in and out of the E.R, had multiple pelvic exams, a CT scan and, still, nothing was found. I was sent home with morphine. I attended classes and wrote my final papers for the semester pressed with pain and foggy with narcotics. Most fortunately, the pain subsided mid-December and my health was returned to me for a period of time.

In June of 2009, I began to experience intense pain near my tail bone. Again, I was in and out of the E.R. Now that the pain was manifesting in my back, I was repeatedly sent to the minor emergency department with the assumption that I had a back problem in spite of the fact that I had a clear bone scan. Again, I was put on narcotics and left to wait for an MRI that was not scheduled until October. When I finally got in to see my OB/GYN, he was reluctant to perform surgery because my pain was not consistent with the "Carnett's Test." (Incidentally, the academic literature describes this test as a tool in diagnosis but little research has been done on the predictive value of the test.)

I told my OB/GYN that I would find another surgeon to perform the surgery if he did not. He agreed to the surgery, scowling at me as he popped into the reception area where I was filling out the necessary paper work.

After my surgery, my OB/GYN came into my recovery room and apologized for his skepticism; he noted that my endometriosis was too deep for him to feel in a manual exam before skulking out of the room.

Like many other women, I was angered when I read Andre Picard's article in the Globe and Mail which revealed that many women are given pelvic exams under anesthesia in spite of a lack of explicit consent. Picard reports on Dr. Wainberg's research in Calgary:

When Dr. Wainberg took a position as a resident at Foothills Hospital in Calgary, she decided to study the issue further. She and fellow researchers polled 102 women who were patients at the Calgary Pelvic Floor Disorders Clinic.

The results – reported in The Medical Post and in the Journal of Obstetrics and Gynecology – are as fascinating as they are troubling.

Dr. Wainberg and her team found that fewer than one in five women were aware that a student might do a pelvic exam in the operating room. At the same time, 72 per cent expected to be asked for consent before such an exam was done.

The patients – unlike medical educators – seem to be quite clear on the concept of informed consent.

What is particularly troubling is the medical professions quick defense of the current guidelines which state:

As pelvic examination under anesthesia is a component of most pelvic surgeries, consent for pelvic examination by medical trainees is contained within consent for a surgical procedure.

Rather than taking Wainberg's study as evidence that the current guidelines are not sufficient for the process of informed consent, medical professionals are providing knee-jerk defense of current practices. For instance, Dr. Wilson, head of Obstetrics and Gynecology at the University of Calgary, writes:

In Calgary, patients give written consent for medical students to be involved in their surgical care, including medically necessary examinations, and patients are specifically informed before surgery, by the surgeon, that they may be examined by a trainee. If a patient objects, their wishes are honoured.

A medical student can only undertake a pelvic exam if the exam is required as part of surgery and the student is part of the surgical team.

Dr. Sara Wainberg's paper discussed women's attitudes to pelvic floor examinations being undertaken by medical students, in relation to consent. The concern expressed by a number of scholars is whether implicit consent for pelvic-floor exam under anesthetic, by a trainee, as recommended by the Society of Obstetricians and Gynecologists of Canada guidelines, is sufficient.

Certainly, surveys of attitudes and beliefs can lack validity. For instance, there may be little correlation between one's beliefs about their abilities in mathematics and their performance on a math quiz.

But, here's the thing - attitudes are a pretty critical measure of the success of informed consent. If a bunch of women were not aware that they were agreeing to pelvic exams by medical students then they were not properly informed.

On the issue of informed consent, it is the person who is doing the consenting whose beliefs are paramount. Clearly, women do not realize that they are consenting to medical students performing pelvic exams. Indeed, in my case, I had upwards of ten pelvic exams in a year before arriving at exploratory surgery. As a layperson, I did not imagine a pelvic exam would be part of the surgery- had we not arrived at surgery because pelvic exams were not providing answers? Also, I am confused about the "medical necessary" component of this language. If my surgeon performs the medically necessary exam, aren't subsequent exams by students redundant?

My anger has less to do with the pelvic exam itself, but the notion of "implicit consent" and the reaction from some medical professionals, including dismissive remarks about women's "attitudes." Maybe, if my attitudes and beliefs were given more weight in the first place, my pain would have been taken more seriously and I would have received treatment sooner. My experience with endometriosis sure as hell reinforced my formerly shaky belief that: I am the expert on my own body.

Given the historical mistreatment of women by the medical profession and ongoing societal violence against women, one would hope that both the national association and local medical departments would choose to pay a little more attention to women's beliefs and attitudes, as well as our explicit demands for respect of our boundaries.

Let me conclude with some of the comments on Picard's original article that I found on an internet discussion board for medical students in Canada:

I've done bimanuals on patients during gyne surgery, but they are usually consented for an "exam under anesthesia" as part of their surgery. I've never seen them done unnecessarily, and they are almost always indicated prior to any gyne surgery. It's never a "parade of medical students" it's only those who are scrubbing to assist (so usually a resident and a med student. I do agree though that there should be more explicit consent, and women should be told that an exam will be done after they are anesthetized by the surgeon and assistants.

And,

So, in the context of pre-operative and intra-operative evaulation, a vaginal exam is invasive, yet OPEN SURGERY isn't?

This guy is an a55hole.

And,

as a few people have mentioned, the issue is not with the pelvic exam itself, but with the lack of consent.

i don;t know how many of you have been present when a woman is consenting for gyne surgery, but honestly, how often have you heard the surgeon mention that a pelvic exam is done while she's under anaesthetic? I've never heard anyone explicitly say this (let alone mention the fact that the exam will be done by the surgeon, 2 residents, and one or two medical students). Usually it's like "risk of bleeding, infection, perforation, converting to open, etc etc"

i've felt uncomfortable doing these in the past (though never declined to do one). i'm not going to be an obs/gyne, so knowing whether the uterus is ante or retroverted is not useful knowledge really. besides, we get to do pelvic exams on AWAKE, CONSENTING patients as part of our rotation anyway.

i agree the article promotes some fear-mongering, but it's not without it's merits. if it was my mother or girlfriend going in for surgery, i wouldn't want my classmates doing unnecessary pelvic exams.

Clearly, there are is a lot of confusion - whether the exam is less invasive than the surgery itself or whether doctors know that pelvic exams are routinely part of pelvic surgeries is absolutely irrelevant to the issue of informed consent.

Do women realize they are consenting to pelvic exams under anesthesia?

It appears that women do not realize that they are consenting to medical students performing pelvic exams and current guidelines and practices fall short of achieving informed consent from women undergoing medical procedures.

I strongly suggest that the Society of Obstetricians and Gynecologists of Canada revise their guidelines and educate students and doctors about this issue. Clearly, "implicit consent" is not amounting to informed consent. Moreover, it seems that a larger discussion is needed about respect for patients, appreciating women's expertise on their own bodies and recognizing patients' rights to set their own boundaries as ridiculous as they may seem to some students and doctors.

Alberta Government Fails High Risk Populations and Puts Public at Risk

The Alberta government initiated its H1N1 vaccination program on Monday, October 26 with no priority given to high-risk groups. On Tuesday, it opened one clinic at the University of Calgary for high-risk groups only with students, faculty and staff of the university being able to use the clinic after the first 48 hours of service.

To remind people high-risk persons fall under one or more of the following six categories:

• Pregnant women.
• Children from six months to five years of age.
• People who live with children under six months old.
• People under 65 with underlying medical conditions.
• Immuno-compromised people and those caring for them.
• People living in remote and isolated communities.

I myself fall under two of these categories. I have a primary immune deficiency called Common Variable Immunodeficiency and I suffer from additional underlying medical conditions: severe allergies and asthma. Moreover, I am two weeks post-surgery and recently finished a course of antibiotics for treating an infection that developed following surgery.

Having NOT been informed that the province was running out of vaccinations, I chose to wait until I had received my blood infusion (or immunoglobin replacement therapy) on Thursday before braving the H1N1 lines. My reasoning was simple: my immune system is strongest following replacement therapy which I receive every four weeks so I would be more resistant to a virus (of any kind) that I might contract amid the crowed clinics.

Today, I arrived at the so-called high-risk clinic at the Olympic Oval at 10:30 a.m. Once I found the back of the line, a security guard briskly approached me and told me that I could not line up for the vaccine because no more people were being taken. I explained to him that I am at very high-risk and just had a blood infusion yesterday. He rudely told me and others that had begun to come behind me to leave.

I then went to the clinic at the Brentwood Mall. Here, those of us who were past the "cut-off point" were kindly told that we could stay in line but that they could not guarantee that we would receive the shot.

I wished that I had gone to Brentwood first which is closer to my home. I believe that if I had not gone first to the "high-risk" clinic, I would have been in line at Brentwood well before the cut off point.

This afternoon, I was interviewed by CBC Calgary in an attempt to shed light on the dangers for the general public of not prioritizing the vaccination of high-risk groups. By not vaccinating those most susceptible to the flu, we quite simply risk more cases of the flu and increased likelihood of it spreading. Moreover, in the case of persons with chronic illness, they will likely have longer hospitals stays. They may take longer to recover from the swine flu and the underlying conditions that put them at risk in the first place may be exacerbated leading to longer hospital stays and/or more frequent trips to emergency rooms.

I should note that many of the people who receive similar treatments to me can simply not stand in lines. Would you expect a chemo patient whose immune system has been wiped out to stand in line? How about a guy suffering from liver failure?

The Alberta government has failed to take measures to vaccinate the most vulnerable populations and in doing so has put the entire public at risk. It will not only mean less medical space and care for everyone who contracts swine flu, but every person who needs medical attention and hospital care. How will we cope with sports injuries, car accidents, and other medical emergencies?

Vaccinating high-risk populations is much more than compassionate care; it is about a pragmatic and strategic approach to reducing cases of the swine flu; controlling its spread; and reducing its impact on the overall well being of Alberta, including our health care system and our economy.

Dr. Judy MacDonald of Alberta Health Services appears on television asking high-risk groups to come forward. We have and we have been turned away. People who do not fall under high-risk are not staying home and, frankly, it is understandable. People want to feel safe.

The only way that high-risk groups will get vaccinated is by opening more clinics with longer hours. Please call on the Alberta government to open more clinics; earmark a portion of vaccines for high-risk populations; and create a vaccination strategy that is logistically sound and accounts for accessibility issues, including the impossibility of standing in any length of line for some pregnant women and some chronically ill people.

UPDATE: On Global Evening News, Ron Liepert actually had the nerve to blame Albertans who are not "high-risk" for long lines and failure to vaccinate high-risk groups, arguing that the message has been all along that the clinics were to first serve high-risk populations. Really?! It seems to me that the opening of a "high-risk clinic" at the Oval on Tuesday signaled the failure to plan for high-risk groups and sent an implicit message that the other four clinics were open to those who are not in the high-risk category. Indeed, Liepert may want to have a chat with his bud Stelmach who told the Calgary Herald that "many of the waits are due to the fact that the province is giving all Albertans first crack at the shot, not just high-risk groups. He noted in other provinces where long lines haven't been an issue that the vaccine is only to be offered to high-risk groups for now, while the general population must wait."

Have the decency to take ownership, Liepert, and not blame ordinary Albertans who are looking out for loved ones.

Links:

"Calgary H1N1 Clinics Close Lines Early" via CBC

Related Video Clip

Can the NDP Overcome Its Identity Crisis and Lead Us Toward a New Economic Order?

I am another disillusioned NDPer...

When will the party leadership consider that the best defense may be a good offense?

I fear that Laxer's prophecy for the federal NDP will manifest in next election:

The move this week to vote confidence in the government was wrong-headed. The NDP has abandoned the high ground to the Liberals on the central question of who is leading the fight against the Harper government. From now on, the Liberals will vote against the government at every turn in parliament, and the NDP will have to prop up the Conservatives until the changes to EI it favours are passed into law. (Gilles Duceppe has announced that the Conservatives won’t be able to count on him for future votes.)

By the time the next opportunity to defeat the government comes along in the winter or spring, the Ignatieff Liberals will be rhetorically entrenched on the high ground----substantively they offer nothing----while the NDP is reduced to a minor player whose job is to sustain the Harperites who loath social democrats.

The coming months are going to be difficult ones for Canadian families and communities as the rate of unemployment rises and the bite of the economic crisis is more deeply felt.

The Harper government is set to lose the next election. Had the NDP stuck to its role as the unwavering opponent of the Conservatives, the party could have gained enormously. More important, the party could have offered the country the prospect of real change.

Meanwhile, in Alberta, we are constantly in a state of reaction...discussions of coalitions continue...

Our own health care discussions are framed by the hegemonic rhetoric of scarcity and efficiency. Likewise, environmental discussions are divorced from economic policy.

The global recession siren calls; economics should be at the heart of discussions relating to all policy spheres.

In Alberta, it is time to seek citizen control of our coveted natural resources. Fund health care and, once we resuscitate the system, we can move on to rehabilitation and efficiency. My guess is that many of the problems of efficiency would be resolved simply by adequate funding...Imaging having MRI machines, and the like, for quick diagnosing - swift treatment means less sick people returning over and over again to their doctors' offices and emergency rooms!

The federal NDP might also speak with increased confidence regarding its position on Afghanistan when Alberta's not fueling the U.S. department of defense.

My Medical Reality and My Medical Drama

Once again, I am trapped in an ill-functioning body...essentially trapped in my home as I consume Percocet and Morphine while on the emergency outpatient waitlist for an MRI.

How long is the "emergency" outpatient wait? A mere two months. Enough time for me to go crazy with pain; to develop an addition to morphine; to lose out on work and school.

The so-called "free market" is not good for the overall economies of regions, but for lining the pockets of an elite few. Indeed, the National Post of all sources reports that the economic cost of waiting for health care in Canada was nearly $15 billion in 2007, according to data released by the Canadian Medical Association.

Advanced capitalist economies suffer from the crisis of overproduction - privatized medical sectors are niche sectors for profit not unlike those that Naomi Klein describes as disaster capitalism.

So, what do I do when my life is put on hold? I wait.

Ironically, five seasons of the medical drama "House" has been providing a distraction; a way to get through the painfully slow hours of each day.

Of course, there is a stark contrast between medical drama and medical reality. While I cannot even get access to essential diagnostic imaging, the doctors on "House" search the homes of patients, speak with their peers, and take all necessary means to make the patient well again.

When I do find the medical drama resonating with my own reality, it is not in such a good way...

In season 1, the episode "Role Model" presents an African American senator who has an infection in his brain and is misdiagnosed with AIDS when he gets a false positive on an HIV test. Once a second HIV test comes back negative, the doctors eagerly throw out diagnoses.. Let's just say that when the rare illness that solves a medical mystery on "House" turns out to be your own diagnosis, you know things are bad.

But, on a lighter note, I have really grown to love the show and crush on Hugh Laurie...or, more specifically, Dr. House.

In "Stalking Dr. House," Lily Burana of Salon declares her love for Laurie, while noting that he is popular among a subset of women:

I know I'm not the only one. In fact, I think it's safe to say that Laurie has become the zeitgeist obsession for the smarty-pants set -- partly because of the obvious lures (talent, wealth, looks) and partly because unlike, say, Clooney or Farrell, he's a good lust object for those of us who fancy ourselves "above" such fixations. He has that refined air, that admitted tendency toward melancholia. He's soulful, clever, quirky yet out of reach. Add a touch of sexual ambiguity for good measure, and every alterna-doofus wants to be Laurie's own personal love pony. (Or have him be theirs. Objectification -- it's a big tent!) Laurie is the grown-up version of your teenage Morrissey crush, perfect for those of us who sexually imprinted on this type of hunky British gloomster in adolescence.

In my opinion, Burana shifts too easily between House and Laurie.

I don't want this guy - the British celebrity.

 

I want this guy - the brilliant, disheveled, dark-humored, scruffy, endearingly vulnerable, cane-wielding diagnostician.

 

In any case, it seems that "House Mania" is rampant. You might want to check out this You-Tube video of "House" bloopers in which Laurie interestingly retains his American accent even in his screw ups. From there, you should be able to find the various tributes to Laurie's sex appeal.

What else?

Not much. Obviously, blogging will continue to be sporadic.

Get These Motherfuckin' Pets Off This Motherfuckin' Plane

This issue has raised controversy on my Facebook page, so I thought I'd bring it to the blog.

 As reported by the Edmonton Sun, Canada's two major airlines are now allowing pets in the cabins of planes which likely will eliminate air travel as an option for people with severe allergies and other health issues:

Karen Petcoff doesn't want to think about being on the same airplane as a cat.

  The Scarborough, Ont., mom, whose 16-year-old daughter Gillian also suffers from asthma, is looking at booking a trip to Vancouver this summer but her asthma and severe allergy to felines means she is too scared to book with WestJet or Air Canada.

"Within minutes, my chest will tighten up and I find it difficult to breathe," said Petcoff, 47, describing what happens if she happens to be anywhere near a cat or even a cat owner with cat dander on their clothes.

Air Canada recently announced it would allow pets in the cabin areas of flights.

The policy took effect on Canada Day. WestJet also allows pets in cabins.

The pet-friendly airlines have allergy sufferers like Petcoff shaking their heads and health advocacy groups like the Canadian Lung Association stepping up their public relations battle against the pets-on-board policies.

Yesterday the Canadian Lung Association launched its online campaign to get the airlines to reconsider allowing pets in the cabins.

The association is calling on Canadians to pressure Parliament to take action and rule that pets should only be allowed to be transported in heated, pressurized luggage compartments of planes.

According to the association, airline passengers who suffer from severe allergies to pets, asthma or Chronic Obstructive Pulmonary Disease would be at risk of having their attacks triggered by pets in the passenger cabins.

  According to the association, it's possible the animals on planes could trigger a potentially fatal attack in asthma sufferers.

"Profit is taking a front seat and public health is taking a back seat," said spokesman Cameron Bishop.

"From our perspective you don't have to trade one off for the other."

Air Canada spokesman Peter Fitzgerald said many airlines around the world allow pets in cabins and Air Canada will do whatever it can to accommodate passengers with allergies.

When I was a little kid, I had to miss almost every birthday party because my friends had pets. The couple of times that my parents gave in, I ended up in the hospital for weeks. Still, I got to see Disneyland and later the countries that my parents came from.

I have had my chance to see parts of the world, but there are so many sick kids out there who will not be able to travel by air if pets are allowed in cabins. Do these kids who regularly go for allergy shots, blood infusions, and other rough treatments not deserve a nice trip?

Would you deny a sick kid a trip to Disneyland?!

Please send an email prepared by The Canadian Lung Association asking the federal government to disallow pets on planes.

Link:

Say No To Pets on Planes!

Alberta is a Community That Cares

In mid-May, I intended to blog about the Friends of Medicare rally at the Alberta Legislature that took place on May, 2009 and drew the support of thousands of protesters but apparently not that of the mainstream media.

Today, I write about this important citizen's movement in the wake of information that the government intends to downgrade rural hospitals and after yet another painful experience at the Foothills Hospital in Calgary on my journey with chronic illness.

My condition is called CVID - it essentially makes it difficult for me to fight bacterial and viral infections. On May 29th, I went with dread to the Foothills Hospital on the sixth day of struggling with a stomach flu that literally left me unable to keep even liquids in my system. I can tell you that by the fifth day of the episode, I knew that I was in a serious state and needed hospital care but I am actually scared to go to a hospital in Alberta after all of the terrible experiences that I've had with the health care system. Fortunately, I have an incredible family that urged me to go to the emergency room and bore the painful wait in the E.R. waiting room with me.

Before I continue, let me note that anyone who knows me well knows that I am incredibly tough and can handle a great deal of physical pain and discomfort...

I lay in the E.R. waiting room for 8 hours (which is standard in my experience) writhing in pain, having to haul my body to the washroom with diarrhea, shivering with cold and breaking down sobbing in front of dozens of people. Adding to the nightmare, was the guilt of exposing my parents who are in their 70s to this mayhem. (I recently broke up with my partner who is truly the most supportive man that I have ever encountered, so believe me that I was missing him terribly too.) Also adding insult to injury was the business channel being broadcasted loudly throughout the 8 hours, including disgusting attack ads from the Harper camp against Ignatieff. (Do I really need to see the propaganda of the ideologues who crawled out of Alberta to try to destroy the rest of Canada while I lie in the third-world-like conditions that their provincial counterparts have created?!)

And, then there was just the terrible anger and sadness and desperation as I lay there so ill and glanced around the room and saw so may others struggling...And, don't think that I am the only one who is angry. The conversations that I could overhear in my dazed state were punctuated by remarks that the Conservative government of Alberta has destroyed our health care system and demonstrates an offensive disregard for its citizens. How, people asked, could the richest province in Canada fail to provide basic medical care for its residents?!

At about hour 7, a nurse at the triage desk put an IV in me with saline and gravol. I was then sent back out into the waiting room. As someone who regularly receives infusions, I was not made less uncomfortable by the IV but I am not sure the other patients and relatives waiting felt very reassured. When the saline solution finished draining in roughly an hour and my blood began backing up through all of the IV tubing, I would say that all the bystanders were pretty freaked out.

Fortunately, my bloodiness got me a ticket into the E.R. beds...And, trust me, the poor conditions and the malcontent does not end there. I believe the Foothills Hospital has signs that say something along the lines of "just because we don't have a room for you, doesn't mean you're not being treated as a regular patient." The nurses and doctors are clearly over-worked and struggling to do their very best in spite of the conditions that make it so much more difficult to do their jobs. In my journey with illness, I have encountered the occasional nasty medical practitioner who you can quite obviously see is overwhelmed by his or her work conditions. But, for the most part, I am absolutely amazed by the emotional and physical stamina that these people exhibit to care for people in such substandard conditions.

I was fortunate to receive exceptional treatment by both my nurse and doctor. In less than 12 hours, they were able to stabilize me with medications and a few more bags of saline solution to hydrate me. Both were caring and kind...just like the people in the waiting room who seemed so dismayed to see me left out there is such a disastrous state.

There is a myth among the Left in Canada that Albertans are a bunch of spoiled, Conservatives. As a native Albertan, I would argue that we are a collective of people who care deeply for each other; who want the Conservative government out, but who do face obstacles of democracy that have been brought about by a powerful oil corporation lobby among other factors. I would also suggest that people have become somewhat hopeless over the years and certainly living in a place where you can't even get proper medical treatment leaves people in a mode of survival that is not conducive to participation and democracy.

Still, people continue to resist and come together as a community...

As someone who is often in the advocate role, I want to thank Friends of Medicare and all my fellow Albertans who rallied at the Alberta Legislature when I was too ill to attend in early May. I cannot fully convey how much your advocacy lends a sense of support, community and hope as I struggle in this health care system. I offer you my deepest gratitude.

I offer my readers a good video clip of Brian Mason speaking at the rally and photos for people to enjoy. This display of democracy in action must be celebrated. Alberta will take its health care system and its government back!

Link:

Friends of Medicare

Related Blog Entry:

Sickening: From Illness Identity-Marketing to Health Care Solidarity

Blood Money

I've been watching HBO's 'True Blood.' It is dripping with sex, rage and down-and-dirty life.

It is a strange show to watch for someone who receives blood infusions. In the narrative, Japan has invented synthetic blood so vampires have 'come out of their coffins.' Synthetic blood is commodified and sold as a beverage called Tru Blood so that vamps can subsist without feeding on humans. Likewise, vampire blood which is acquired by violently draining vampires is sold as an illegal drug called V Juice which seems like an ecstasy and acid kinda combo that makes people hyper-sensitive, euphoric and sexed up.

What I find strange is that synthetic blood plasma already exists. And, human blood has already been commodified for sale. Contrary to Canada's Blood Services, in the United States blood is not "in you to give," but in you to sell. Indeed, reports suggests that sales of blood plasma have gone up with the recession. I find it kinda freaky that I am literally getting some poor mothafucker's blood.

In any case, here is a worthwhile excerpt from a socialist take on the vampire trend via Socialist Worker:

VAMPIRES ARE everywhere: House of Night, Twilight, Southern Vampire Mysteries, Night Huntress, Savannah Vampire Chronicles, Guardians of the Night, Blood Ties, Being Human, Demons, Let the Right One In...

Ever since Bram Stoker's 1897 novel Dracula, vampire stories have exerted a consistent fascination, but the seemingly limitless list of contemporary versions is remarkable. The legend of the bloodsucking "undead" provides a potent and flexible metaphor within the rapidly changing political currents of our time.

Stoker's Dracula is rich in contradictions. It is a "St. George versus the Dragon" Christian allegory ("dracula" derives from words meaning "dragon" and "devil"). It is steeped in British imperialism's orientalist fascination with the mythical East, which represents both the evil antithesis of the West, but also the irresistible lure of forbidden desire.

The figure of the centuries-old count, inhabiting a gothic castle in Transylvania, feeding on the local peasantry, expresses bourgeois distaste for aristocratic decadence and parasitism. But the vampire offers an equally apt allegory for capitalism: the soulless boss who bleeds workers dry. (Think of Thievery Corporation's song "Vampires," dedicated "to the world banking system.")

...

TODAY'S VAMPIRE has been tamed and is more romantic heartthrob than scary monster. In a culture where youth is revered and death feared, such an embodiment of immortality is enthralling. But beyond this common factor, the 21st century vampire assumes diverse ideological guises.

Stephenie Meyer's Twilight series books are overtly conservative. The teenage heroine Bella Swan is painfully self-critical (she sees herself as ordinary, uninteresting, clumsy and plain), and worships the superhuman vampire Edward Cullen, who is richer, older (by almost a hundred years), more experienced, physically stronger and uncannily beautiful. She thus feels undeserving and insecure, convinced first that he despises her, and later that he will abandon her.

The central theme is abstinence: No drugs, no alcohol and no biting before marriage. The "good" vampires are "vegetarian," feeding only on animals. The plot turns on the question of whether vampires possess souls.

Judging by the books' immense fan base among teenage girls (which certainly can't be accounted for by their literary merit--as Stephen King puts it, Meyer "can't write worth a darn")--the series taps into something in that demographic, even though the author came of age in the 1980s, and Bella's strangely insipid world lacks many markers of modernity.

They do offer a compelling story of true love that conquers all, and imaginatively eroticize chaste displays of affection. But their popularity seems symptomatic of an era where women's rights have suffered such setbacks that a generation of teenage girls sees sex as danger, and identifies with a relentlessly self-abasing heroine willing to sacrifice everything for her boyfriend.

It is telling that Bella's worst nightmare isn't death by vampire or werewolf, but that she will get old and ugly while Edward stays eternally youthful and beautiful. The bite of the vampire trumps retinol or botox.

"Post-feminists" argue that the Twilight series is popular because young women crave "traditional romance." But this can't account for the matching popularity of other series like the House of Night novels by mother and daughter team P.C. and Kristin Cast.

...

BUT OF all the current vampire tales, the one that best captures the political sea change of the post-Bush era is the HBO series True Blood by Alan Ball (doing for the undead what he did for the dead in Six Feet Under) based on the Sookie Stackhouse novels by Charlaine Harris. Unlike the self-righteous Twilight and earnest House of Night, True Blood is also very funny and irreverent.

Since Japanese scientists have invented synthetic blood (Tru Blood comes in O Neg or A Neg and is best microwaved), vampires are in the process of "coming out of the coffin" to take their place in civil society.

The opening credits are exhilarating: a rapid series of disturbing, inspiring and bizarre juxtaposed images from the deep South--civil rights marches, Ku Klux Klan gatherings, sexually objectified female bodies, a decomposing fox carcass--to the accompaniment of Jace Everett's haunting song "Bad Things."

Anna Paquin plays the (telepathic) waitress Sookie Stackhouse, who, impatient with the narrow horizons of the backwoods town of Bon Temps, La., and frustrated with the petty-minded prejudices of her workplace, welcomes the first "out" vampire in town.

After a series of brutal murders, suspicion inevitably falls on the vampires, who face constant discrimination (in one of the many witty details, a church sign reads, "God hates fangs"). In a reversal of the standard crime formula, here the police are one-dimensional, incompetent and bigoted, while the quirky and complex protagonists are the regular working-class townspeople.

While the series flirts with stereotypes, this is in tension with the superb script, and in season one, the two main Black characters, Sookie's friend Tara and the gay short-order cook, Lafayette, have the best lines. In the first episode, Tara, who is reading Naomi Klein's Shock Doctrine, quits her job at a store called Super Save-a-Bunch. She explains, "I can't work for assholes," to which Sookie replies, "When did you get to be so picky?"

Confronted in a television interview with vampires' proclivity for violence, a member of the American Vampire League replies, "Doesn't your race have a rather violent history of exploitation? At least vampires never owned slaves or exploded nuclear weapons."

Vampires have come full circle: once representing the threat posed to bourgeois society by the oppressed (the colonized, women), in True Blood they represent a refuge for the oppressed from the monsters lurking within capitalist society itself.

Watch it. If nothing else, it's freakin' hot.

Links:

'Blood Types' by Helen Scott, Socialist Worker

'Recession Indicator: Paid Blood (Plasma) Donations Rising',  Naked Capitalism

Me and My IVs

...still writing papers so blogging is still sub-par to the less-than-interesting-anyways entries that I dish out these days. Oh well.

I recently updated my Facebook status to:

1. Get to the doctor. 2. Finish last paper of this freakin' degree. 3. Suck it up and write the petition against U of C hosting Condi Rice. 4. Resume data collection and finish my thesis. 5. Become a vigilante.

One of my cheeky friends commented: "Do vigilantes make priority lists though?"

To which, I was able to offer the following response: "You would not be taunting me, if you saw me get in a fight in the blood infusion room last week. Some guys were saying that the non-Western world needs to realize that it will continue to get its 'ass whooped' and then went on to suggest that we privatize health care. I spoke up...One started swearing at me. I was very close to pulling out my IV and stabbing him with it. If there weren't sick people around (besides us), he would have been a dead man. But, yes, I suppose the same 'ol, same 'ol, average vigilante does not make priority lists."

What I didn't mention in this Facebook exchange is that I HAVE pulled out my IV before. Last fall, I was stuck in emergency for close to a day (which eventually ended up to be a series of days) and I was waiting over two hours for the nurse to remove my IV, so I finally decided to take it out myself. I learned quickly that there is a very good reason to get the cotton dressing over the injection site AS SOON AS the IV is removed. Otherwise, a LOT of blood gushes from your vein. Fortunately, I was heavily medicated and managed to find a bunch of cotton dressing and the bleeding stopped with about five minutes of applied pressure. After I cleaned the blood off of the floor, one could hardly tell that an "incident" had occurred.

The nurse was so unaware or jaded from her Third-World-like working conditions - yay, Alberta health care system - that she either did not realize or care that I removed my own IV. 

Anyway, when I returned home that night and lay in bed super ill, I suddenly began to get paranoid about how IVs work. I kept thinking: "How come there was no needle to pull out? Where is the needle? Is it still in my arm? Oh my God, they will be so angry if I have to go back and admit what I did. OK, wait, the needle just gets the IV in...Is that right?"

Fortunately, I found a website that night for nurses which had a discussion topic on tips for removing IVs. (Yes, it is scary that these nurses are not getting the tips from senior nurses on the job!) 

I was relieved to realize that the needle itself is only used to insert the plastic tube. So, for all of you who have always wanted to know how IVs work, there you go - mystery solved.

Mmm...OK...hopefully this final paper will be a little more captivating than this so-called blog entry. Over-and-out.