Cold Spaghetti

Well, it won’t be booze unless you’re in NOLA and I can justify why it’s made by a New Orleans artist, but it will be free. Friends, new and old, please leave a comment so I can include you in my gift-giving to celebrate Cold Spaghetti’s 5th year and to pay tribute to New Orleans 4 years after The Thing by sending something from a New Orleans artist. (Go to the link and leave a comment there.)

Also! It’s that time again! Just Posts are here and Alejna and I would love your nominations for the August Round Table. For more information, please visit the Just Posts page.

By my count, the number of times a mother should be prepared to pass out when her child breaks a limb is 6, depending on how much she plans on re-telling stories from any part of the process. No matter how many broken bones, blood, or carnage you’ve seen.  Apparently, all of that is inconsequential when you’ve birthed the hurt kid.

Included in that count of six are two incidents during the casting process.  But don’t worry, fellow Mom.  You’ll get through it.  Then you can bring your kid home and melt his or her medicated brain.

While Paul attended a meeting a the kids’ school, I tried to redeem my lousy constitution for my son’s injury by helping him decorate his cast to his heart’s desire.

Will’s heart’s desire = Transformers.  And Star Wars.

Transformers seemed easier.

I printed out the Autobot decal and cut out the negative space to use it as a stencil.  It turned out alright, not as clean as I’d hoped due to the holes in the surface of the cast.  But, it was cool enough to pass at school.  (And cool enough to trump the little heart I added near his hand.)

After school today, the painting continued.

Will painted the women’s reproductive system.

(He said it was a stage with a king and queen performing.)

Paul painted, too.  Intently.

Kate bonded with yellow ochre.  And gave *Jazz Hands*!

While they painted, I prepared for Will’s next cast request.

Luke’s X-wing fighter.

Unfortunately, part way through the painting, Will reached over and swept his hand across the cast, smearing the whole thing.  (I had walked into the kitchen to get more paint.)

There was a lot of fixing and repairing.

Did you notice little R2?  (Look very closely.)

Here is a view of all three: the Autobot decal on his upper arm, the X-wing on his forearm, and the tiny heart near his thumb.

Did I earn enough cool Mom points to last me awhile?  I figure I need to save up when I can.

Cold Spaghetti is now five years old. My first post was written August 26th, 2004 — then on another site — and would move twice before ending up here in its own special domain.  I’m blushing as I admit this, but there is a lot of unfinished business on this site. One of my post-dissertation project-dreams is to re-vamp it, clean up old posts, set tags and labels, and properly archive everything in a cool kind of way (after all, it’s the closest I’m going get to cool).  That is how I’m getting through, you know… making all sorts of PLANS for what I’m allowed to do AFTER the dissertation.  Those AFTER plans?  They are BIG PLANS, let me tell you!  Life changing, earth-shaking plans!  In fact, I love to talk about the PLANS so much, that all the other stuff, like getting to AFTER, can fall to the wayside.  Oof.  If I’m going to make November, it may be time to raise the bar.  What do people do to finish a book, I wonder?  What drastic measure or extra-cool incentive helps others?  Should I deny myself chocolate or wear a chastity belt or something?   (Suggestions welcome.)

This week also marks the date of my inaugural post (granted, a cross-post, but a post nonetheless!) to NOLAFemmes — a website written by New Orleans women about New Orleans issues important to women. It’s a great site for information about local artists, events, and politics — and a good way to get an idea how the women of our city are healing our collective wounds, raising our future citizens, and carrying on life in this difficult, but beautiful place.

Most importantly, this week holds another anniversary in these parts. That of Hurricane Katrina and the Federal Flood. I don’t want to wax on about those pivotal events, only to say that we’re still here. The real work of recovery, of looking at our past and future and determining how to heal our inequalities, is just beginning. There is so much opportunity and hope; it is a really exciting time to be in New Orleans.

In honor of both events, I want to share the NOLA love. I’m hoping for comments from folks that read but haven’t commented before… just a lil’ shout out. I confess that since moving to coldspaghetti.org (two!) years ago, I haven’t been tracking traffic and I have no idea who is visiting or from where. (See, I wasn’t kidding about not being on top of the website.)

Make a comment here between now and September 1st — particularly if you’re new to coldspaghetti or never commented before — and I’ll send a NOLA-themed gift from a NOLA-based artist to one repeat commenter and one new commenter.  Selections will be made via random number and I’ll announce names on September 2nd.

Glasses raised to joie de vivre — no matter where you are!

Via Exodus, I found the photography of Dulce Pinzon, and her “Real Life of Superheros” photography collection.  The exhibit showing Latin American immigrants in their everyday lives in jobs that are often overlooked… with a twist that highlights their important work and contributions.

If I start now, maybe by Christmas I’ll be caught up on all the thank-yous we owe for the past week. To say that we are humbled by how our friends have supported us through all the craziness is an understatement.

Re-entry to the U.S. after time abroad has historically been hard on us… job layoffs, yellow-jacket attacks, coughing fits that lead to popped-out ribs, identity theft, car failure, malaria-like illness with hospitalization… those are the sorts of things that welcome us back to the States. We figure it’s karma at work. That we have been so lucky in work and travel abroad that things have to go wonky at home in order to even out the karmic balance.

This time back found both of us with mild-but-annoying respiratory crud and Kate not quite over a sinus infection. Kate and I worsened, we saw a medical provider and were treated. Then we were exposed to the flu and took steps to ensure no one would unintentionally bring illness into the kids’ school. Then Will broke his arm. Then he broke out in hives so suddenly and completely, with swelling to his face and lips, that his pediatrician encouraged a fast trip the ER (after 4 hours of waiting without treatment, Will’s face swelling subsided and they left without being seen). Somewhere in all of this, it became clear that my lingering crud was not only failing to improve, but getting worse. So yesterday I saw our new primary care physician for a magical breathing treatment that made Every Difference. Other key moments within all the above were our work hours, finding strange black dust on Kate’s bed from the wall (we don’t thing termites, but what…?), my leaving my wallet in the parking lot of the local grocery store, and the truck clutch giving out mid-intersection (close call).

But the real story is how many people have rallied around us.  So many people have sent well-wishes via phone and email.  Paul’s Mom was here to help with Kate while Paul and I cared for Will and his injury.  Emmy and family brought Will a beautiful made-by-kid-hand card, a huge sack of candy and the biggest darn lollipop I’ve ever seen.  Gwen sent Clare’s dry-arm pouch.  Ann Marie brought red beans and rice with sausage and brownies.  Kathryn brought artisan pizzas, quiche and eclairs.  Ecoee and Melody brought a bag of games and made fabulous make-your-own burrito dinner… with cupcakes. 

No really, check this out:

I know.  I KNOW!

Paul and I are so incredibly thankful and feel so completely and totally speechless.  We look forward to returning each favor.  (We’ll step up our culinary skills for it, promise.)

Also?  We are surrounded by the most wonderful, giving, thoughtful people.  Thank you.

Recorded last spring.  On a day she was sent home from school due to illness (tummy troubles).

Kate under normal circumstances is simply impossible to capture in modern video techniques.

Will seemed perky this morning and asked to go to school. We brought him, with pillow to keep his arm up. An hour later, the school called, he was uncomfortable and out of it, and he was ready to go home. (FAIL.)

After dropping Will off at school, I went to Rouse’s to get snacks for my workshop today. I felt very on top of things, running early, getting food for everyone, and having somewhat of an idea of what I was going to do. Until I was out in Kenner, almost to the meeting site, when I realized my wallet was missing. (FAIL.)

After a panicked stop at a coffee shop for a phone book and a call to Rouse’s, who had my wallet, (WIN!), the truck clutch gave out in a major intersection. (FAIL.)

Thankfully, no one hit me, I survived near collision, and managed to figure out how to drive it the rest of the way. (WIN!)

—

At the advice of Paul, I managed to drive the car home. The conversation went something like this:

Me: “I almost died.”

Paul: “I think the problem is due to engine heat.  You should be able to drive it home.”

Me: “What, to the morgue?”

Paul: “Really. It’s happened to me a bunch of times. It should be fine after sitting for a few hours, as long as you don’t drive it for too long.”

Me: (Silence.) “Well, okay. But how long is too long?”

Paul: “I dunno. Just don’t drive it long enough for the clutch to start to stick again.”

Me: (Silence. Pondering if I should write a quick will?)

—

Things perked up big-time when Emmy and kids brought treats for Will.  Will had just woken up from a 5 hour nap (hello, drugs!)  I’m not sure if he even remembers there was candy involved, but he hasn’t put down the card Ana made for him for one second.

One may think that this video is showing Will on drugs, but in truth, the meds had worn off.  (He trips even heavier when heavily medicated.) This is just Will being Will.  He’s telling me about teeth, why the fall out, and what holds them in until they fall out… with a surprise at the end.

He was so proud of himself.  Even though he had to jump up to reach them, once his hand held, he swung  across those monkey bars with confidence.  When other children approached, he kindly demonstrated the hang and swing, dutifully encouraging others to try, too.  But then, that’s just our sweet guy.

Finally he complained that his hands were hurting.  He showed Paul his palms, which were beginning to show signs of blisters.  “Maybe you should take a break?” Paul suggested.

“Just one more time,” Will said.

And he jumped and grabbed the first bar with his right hand.  But before he could grab the next with his left, he slipped in mid-swing, coming down on his left arm.  He jumped up in a scream so fast Paul said it was as if Will’s body had bounced on the pavement.

—

Paul, the parent with experience in broken bones, was extra helpful to Will while we went through the ins and outs of x-ray, exams, and setting the splint.  Among Paul’s finer stories: the pain of x-rays, discomfort while sleeping, itching, and gross things that come out of casts.  Still, that’s probably better than what my face looked like when I cut off the make-shift magazine cast that held his arm from playground to hospital.

Both bones are broken in his left arm, a little above his wrist.  The ER at Children’s was terribly busy, so we didn’t get to see the x-rays.  He’s in a hard splint until the swelling goes down and then back to the orthopedic for more x-rays and setting later this week.

I’m so glad Harry Shearer gets it.

He spoke compelling at today’s Rising Tide, poignantly describing the how New Orleans lost the media battle regarding the city’s story of Katrina, the Flood, and recovery.  He’s absolutely right, of course.  Read any article about New Orleans’ recovery and go to the comments; they are ripe with misinformation, sweeping falsehoods, and complete hatred towards this city and the people within it.  The reason it’s important for the people of New Orleans to continue to tell the story is because, somehow, the facts are still not understood: that this city was destroyed in a man-made disaster, a Flood that occurred when a Federally-funded agency failed to perform as it had been designed to perform because it was never built correctly.  And I can’t believe we still have to say this, again, but FOR THE LOVE, this city is NOT below sea level!  Can we move on now, please?

(See some video of Shearer’s speech here.)

—

A last minute cancellation resulted in my being a member of the Health in New Orleans panel (versus its moderator) — along with two well-known, established mental health professionals.  One is consistently named a Top Female Achiever in the City for her well-respected work with the police mental health crisis unit; the other, a psychiatrist and medical director for a large local non-profit.  I was an out-of-left-field addition to this group… I don’t have one primary affiliation with one organization, my scientific perspective is a bit different (public health), and I’ve spent nearly 4 years volunteering and researching how clients and health promoters navigate the waters of New Orleans social systems.

I wasn’t intimidated by the other panelists, but I definitely wanted to take the conversation to other places that I didn’t feel it was going (or maybe could not go).  Instead of sticking to questions and topics that had been pre-arranged, the my fellow panelists opened the talk to the floor to do a large Q&A.   What followed were a lot of discussions about local services, which I don’t find particularly useful in this type of venue: the panel wasn’t envisioned as a laundry list of mental health services for a reason, because people tend to not remember those sorts of specifics.  (If you want to list services or achievements or whatever, bring a resource guide and pass out copies.)  Panels, I feel, should build on that sort of available information.  A more productive conversation may be one that discusses how we can supplement existing programs.  As an example: what can be done to better support families to care for their loved ones transferred to facilities an hour or more away with the closure of NOAH?   Or maybe a discussion of the sorts of a strategies we all can use to handle our own stress and mental illness outside of seeking professional providers?   In my thought, the power of a group like RT is when you excite the room — after all, these are folks who write and read and write some more — so I think it’s important to try and throw out big issues.  Let people get charged up and see what types of good actions come out.

I did try to throw in a few cents — pointing out that health is so much more than access, more than doctors and medicines.  We are resource-poor in New Orleans, without a doubt, but focusing on access and getting more providers and opening more clinics and getting more people health insurance is ultimately a disservice to the people of New Orleans.  I’m not saying these things aren’t important.  I’m saying that in the end, these are not the factors that create healthy lives.  What does create healthy people are the more difficult, more sensitive, more POLITICAL realities of our lives.  Our physical living environments (FEMA trailers, polluted properties, abandoned structures, proximity to blighted areas), our work environments (are we respected? do we have benefits and fair pay? do we feel useful?), our school environments (are our children eating healthy lunches? are they learning? do they have pride in who they are?), our streets (can we exercise without fearing for our safety? are children safe walking home?), and our neighborhoods (can we buy affordable healthy foods close to our home? is there a clinic nearby to see a doctor for non-emergencies? can we get a medicine when we need it?)  All of these factors contribute to our health: they create stress, they weigh on our hearts and minds, and when not addressed in comprehensive ways, they make us sick.

And, since the feeling of having no control over your life is a key part of mental illness, (as mentioned by a panelist) perhaps involvement in some of the issues above on a community level would help individuals find more purpose and agency in their lives.  Just a thought.

But that’s not all.

And here is where I am embarrassed.  My one note, the one thing I most wanted to discuss, maybe even the most important thing to discuss within the context of health and New Orleans, did not get mentioned.  I didn’t know where to put it in without sounding like the crazy loon in the armchair throwing off the conversation… so I waited for a question from the audience that would let me bring it up.  Unfortunately, it didn’t come.  So I didn’t say anything about the issue of race and class… and neither did anybody else.

Which is a shame because we cannot consider the scope of health challenges of any kind within our city — access, stress, mental health, behavioral concerns, nutrition, whatever health issue one can think of — without discussing race and class.  Race and class shape any health experience regardless of the location.  But in New Orleans, it is a paramount issue.  For one, before 2005, New Orleans was the only city in the country that had a defined two-tier system with separate and (un)equal medical facilities for the haves and have-nots.  What has not returned post-Flood are those services for the have-nots.  So what isn’t being said is that the reason these services aren’t here, or are being taken away, is because they are for a population that many do not want here in the first place.  The rest of us work away at putting money and resources into community clinics (whose funding is not indefinite) and outreach and signing individuals up for public services — but how effective can we be in the long run if we never take a step back and look at the big picture?

In the panel that preceded ours, John Slade mentioned that the movement to re-open Charity Hospital was gaining support because Uptown whites were having to wait longer in medical facilities for treatment and were unhappy with the current desegregation of the system.  Although flip, I think his comment speaks to an important truth… at the heart of our health concerns about access, treatment, and who gets care are long-held ideas about race and class.  Until we address those base realities and histories with honesty, I’m not sure we can build a solidly healthy community — no matter how many top-of-the-line medical facilities we open.

My silence on the issue is not because of lack of interest, thought, or evidence.  Either I’ve become so apathetic that I’ve lost the ability to hold faith in anything (a distinct possibility) or I’ve smartened up — after awhile, you just have to face the fact that the dining room table is never going to respond.

Then, this past week, we were faced with situations that necessitated medical attention. The first occurred while in Pensacola, where we visited a walk-in clinic that was part of the medical center Kate was unexpectedly born in 3 years ago; the second took us to an urgent care center favored by many in our area as one of the best around.

The differences were distinct and pronounced in every respect.

At Pensacola’s Baptist Medical Center, both Kate and I were seen by a friendly, good-natured, respectful, and competent provider who gave both of us very thorough exams with no ounce of hurry.  Kate had a chest x-ray to check out some wheezing heard in her lungs.  We had several pharmacy prescriptions filled.  The kids played in a children’s area.  And, all of the above happened within a 2-hour time frame.

Then, over the weekend, one of the kids who was staying with us at the beach tested positive for Type A influenza (aka: H1N1 flu).  The testing occurred on Sunday, with Will’s first day of school Monday, the next day.  We couldn’t send him to school until we knew that he was without flu — and in the interest of due diligence, needed to show that the rest of our family were not harboring flu as well.  Both Kate and Will had some fever on Sunday afternoon, and on Monday morning, all four of us were showing fever.

Despite pre-arrival calls to the one clinic that would see all four of us, and despite filling out all paperwork before our arrival, we waited for over an hour and a half in the open waiting area.  It was not particularly busy.  When we did see a nurse, she was secretive in her assessments (if you take a measure, you share it with the client, and you most certainly do not hesitate in reporting it), and was incomplete in her evaluation.  I had good reason to believe that some of the equipment was showing measurement error and one of the machines even broke during use.  We heard the doctor insulting us from the other side of the door.  When we finally did get seen, they did not provide the service we requested, I had to correct an inaccuracy the physician made regarding influenza, and in the end, they prescribed medicines the CDC specifically advises against for H1N1 flu treatment and prevention.  From start to finish, the whole thing took about 4 hours.  Note: we did not take the extra 2 hours it would have taken to fill the prescription.  (Buying a house is faster and involves less paperwork than filling a prescription in New Orleans.)

In short, we tried to do the right thing so that Will could be cleared to attend school.  In the process, we paid a gross amount of money, lost precious work hours, were insulted, and came away with poor treatment advice.  Such is the nature of health care in New Orleans.

Yes, without question, the health care system in the United States is incredibly broken and dysfunctional.  Our country is among the worst in the developed world in virtually every indicator of health.  Without question, it’s bad.

And in New Orleans?  Whether from lack of providers, lack of resources, lack of compassion, or apathetic frustration (all of which are factors) — it’s even worse.

—

A few months ago, I was asked to help on a survey that a local agency wanted to do regarding experience with the health system.  It was being put together last minute, by well-intended people who were driven by a need to show the dysfunctions within our medical services.  Surveys in New Orleans are incredibly difficult post-Katrina (if not impossible) because we simply do not know how many people are here, particularly within marginalized, minority populations.  Still, this organization had a group of health students coming from a respected northeastern University during their spring break, and these students wanted to “help” by doing whatever “survey” this group could concoct.  Upon investigation, I discovered that the students were under no supervision from their institution, had no IRB approvals despite the sensitive nature of the questions they were wanting to ask within high-risk groups, and (most alarming) felt no ethical conflict about any of the above.  These things would be in-excusable for work done in their own city, but in New Orleans, a place known to be low on resources, it was seen as perfectly acceptable by both these students (who, frankly, should have been trained to know better) and the local organization.  In short, the idea was that it was fine for New Orleans to accommodate lower standards of research and be accepting of unethical inquiry simply because we are resource-poor.

I withdrew from the survey and advised the organization to put the students to work finding information that was needed for an area benchmarking of services.  The students protested that it wasn’t a good enough use of their time and proceeded with the survey… which grew into a monster so unethical and alarming that I pondered reporting it to their home institution.

All people deserve ethical treatment in research, no matter how resource-poor they or their communities may be.  I do not feel that this is negotiable on any level.  What does that say about us when we decide which kind of people get respect and value in a health inquiry and which do not?

—

How we can talk about health without talking about ethics?  About what it means to be human and the ways in which our society should reflect how we define humanity?  Isn’t that the point?

I do not know how ethics have left the conversation of health care.  How, in our debate of it, we have forgotten to discuss what is right, what is the most human response.  But it isn’t there.  And in New Orleans, ethics is not only ignored but deliberately surpassed as an annoying step one can causally eliminate.  As if the people here are so desperate and pathetic that we should be thankful for any “help” we can get.

It is beneath us to compromise ourselves, no matter where our community stands in recovery, no matter where our society stands in development.