25 January 2016

"Clean Room" #4 by Gail Simone

Clean Room #4 by Gail Simone
"Turn That Frown Upside Down"

Gail Simone - Writer
Jon Davis-Hunt - Artist
Quinten Winter - Colorist
Todd Klein - Letterer
Jenny Frison - Cover Art
Rowena Yow - Associate Editor
Shelly Bond - Editor
Clean Room is created by Gail Simone
32 pages/$3.99
Date of Publication: 22 January 2016
Suggested for mature readers

I spent this past weekend with three of my friends holed up at a cabin in Somewhere, KY (I didn't care enough to bother finding out just where we were). Knowing we were likely to be snowed in and not even leave, I decided to take along some reading material, including all four issues of Clean Room, partly because I had just bought issue #4 the night before we left and hadn't yet read it and partly because I'd hoped at least one of the others might pick it up so we could talk about it. That may have been the perfect setting for reading this issue!

Issue #3 made clear that Astrid Mueller isn't just turning her clients' demons against them. She's searching for something or someone, and now she's found it. Her interrogation with this "entity" is only partially illuminating; we learn that this is the same thing that struck Astrid with a car when she was a child (shown in issue #1), but not much else. I had previously surmised that Astrid's Clean Room operation was constructed for the purpose of engaging these demons, so at least that's confirmed.

I had also previously theorized that her followers who had committed suicide did so by being goaded into it by demons released after their Clean Room experiences, and the end of this issue also seems to confirm that. Although, there's something about that demon's wording ("I'm supposed to help you kill yourself!") that suggests issue #5 may reveal some disharmony between the demons. One would expect Chloe not to be killed off five issues into this book. though it's admittedly hard to guess along with Gail Simone!

I got a laugh out of story page 9, panels 5 & 6. Chloe rejects Killian Reed's attempt to recruit her for spin control:
Killian - "Chloe? Please pick up. This is childish."
Chloe - "Dear Ms. Reed...fuck you, fuck your favor, and fuck Astrid fucking Mueller! How's that for childish?"
Killian, to Capone - "She's thinking it over."
It's an old gag, but when used properly it's still a good one. Killian Reed's no-nonsense persona so far makes the moment very nearly "warm" in its way, giving us a glimpse into the human being beneath the ruthless bodyguard. She continues to be the character who intrigues me the most in this book.

When I read Simone's run on Batgirl, I periodically made mention of how that book read as a monthly, rather than as a graphic novel serialized over several issues. That storytelling sensibility is just as present here with Clean Room. I haven't yet felt that any issue has been padded with filler to stretch out a simple story. Instead, each issue has been engrossing and interesting all on its own, and left me piqued for the next.

As for Jon Davis-Hunt's art, Simone gave him quite a lot to handle this time. There's the sex mural on story page 3, panel 3, which is repeated all over story page 4. Story page 7, page 2 has what is a simple shot of just a TV newscaster's talking head against a backdrop of a skyline, but what makes it such an impressive work is that we see a champagne flute smashing into the screen. There are several layers here: the flute, the cracking screen, the telecaster's face, and the backdrop, including station logo. It's a deceptively complex image, the kind that no one is going to approach Davis-Hunt at a show and request he sketch for them, but it's a testament to the skill he's developed so far.

Speaking of art, one of my friends has developed his skills and talent in that area over the course of his entire life and showed me on Saturday what I could do with the wash element of my sketching pencils. He recreated Chloe's face from Jenny Frison's cover to issue #3 and then had me brush over it in places. He gets all the credit for this image; at best, I just get credit for not ruining it!

20 January 2016

Those Darlins - The Farewell Tour at Zanzabar

Those Darlins
Tuesday, 19 January 2016
Zanzabar | Louisville, KY

Those Darlins first came to my attention in 2009 when "Wild One" was included in a free digital sampler I got from iTunes. I couldn't tell you who or what else was in that sampler, but "Wild One" grabbed my attention and refused to let go. Before the song finished playing the first time, I was already searching to see what else they had released. Their sound was that immediately interesting. That was their only single at the time, though it did have a B-track: a cover of Ernest Tubb's "Drivin' Nails in My Coffin". I noted that they didn't revise the gendering of the lyrics, leaving the sweetheart who said they were through as "she".

I couldn't decide: were Those Darlins celebrating or subverting? After awhile, I came to understand that they were doing both. It isn't a mockery sort of subversion; they genuinely care about the tapestry of artists who have come before who have influenced them. But they had clear notions of what they wanted to contribute to that tapestry, which is the distinguishing element of artists from entertainers. I was invested, and have remained invested ever since.

Unfortunately, Crohn's managed to sabotage every single show they played in Louisville after I became aware of them. In 2013, they played Zanzabar a week before my birthday. I intended to go see them then, but of course, stupid guts ruined that, too. It was dispiriting to learn that they have decided to disband, which made it all the more imperative that I finally get to see them live.

Though my guts finally cooperated, I did have to be tested in the afternoon for glaucoma. Being cleared of that made seeing them all the sweeter. When I mentioned the pairing of being cleared of glaucoma and seeing a concert to one friend, she asked if I was seeing Willie Nelson. Aside from being what I consider a fairly witty pot joke, it turned out that the show would have prompted me to think of Willie anyway. Willie was the first concert I ever attended by myself, back in 2002. He played for what seemed to be ages, rarely pausing between songs. In fact, Willie would start strumming the next song while the Family was still winding down the last.

That was very nearly the pace that Those Darlins sustained throughout their generous two-hour, 25-song set last night. One song after another, hitting pretty much everything I hoped to hear except "The Whole Damn Thing". During the encore, Linwood Regensburg asked if anyone had any requests. I shouted for it from my perch at the bar, but to no avail. That's the closest to disappointment that I got the entire night.

It wasn't just the quantity of songs that impressed me; it was the quality. A place like Zanzabar, as cozy and likable as it is, isn't designed for full band musical performances. For the most part, though, I could hear clearly each instrument and Jessi Zazu's leading vocals all night long. (Nikki Kvarnes's vocals weren't as audible from where I sat, which may have been attributable to simple geometry related to where I was seated more than anything on their end.)

Being the nerd I am, I brought along a little memo pad to track the set list throughout the show. I missed a few songs, partly because a woman seated next to me struck up conversation halfway into the show. As reasons for missing a few songs go, that's one I can live with. After awhile, she went out to smoke and I returned to giving the show my undivided attention. Thankfully, Jessi Zazu was gracious enough to tweet me the song titles I missed:

[You'll find the entire set list on setlist.fm here.]

My first perception of Those Darlins was one of intimidation, if I'm being entirely honest. They struck me as the kind of artists who cared about the integrity of their work, and not one bit about being approached by anyone for anything. I couldn't have been wronger about that second point! I watched as the band mingled not only with their family and friends, but with fans in the time leading up to the start of their set. I had brought the jacket to my vinyl copy of Blur the Line to get signed, but it seemed intrusive to hit them up for signatures then so I refrained. After the show, Jessi came to the merchandise table and she kindly signed it. She has one of the most delightful smiles I've seen in awhile, exuberant and warm -- the antithesis to the image I initially had of her and her bandmates.

I don't think it was entirely just me, though. Though the instrumentation on each song was impressively faithful to what I had come to know from the studio recordings, I noted that Jessi's vocal phrasing had evolved. Most noticeably, she wasn't as forceful on aggressive lines. It struck me as a mark of maturation, trusting the song enough to not punctuate her delivery of its lyrics so firmly. This isn't to suggest that she was muted or even mellow; her passion never wavered at any point in the show. I would liken it to watching a thrower evolve into a pitcher, still bringing the heat but also learning finesse so as not to rely on power alone.

What comes next for Jessi or the other Darlins, I have no way of knowing, but I know this: When they close the book on this band at the end of their Farewell Tour in Nashville on the 29th, they'll be leaving something that I as a fan hope they're proud of having done. They elected to create their own label so they would own their music, knowing they were sacrificing the kind of marketing support that a big label could have provided, because they cared that much about their music. They have evolved as writers and as performers as organically as artists can, having made along the way music that has been thoughtful, raw, vulnerable, witty, comforting, and just plain fun. I'm sorry I missed all their other shows, but I'm thrilled that I finally got to one here at the end.

24 December 2015

"Clean Room" #3 by Gail Simone

Clean Room #3
"Good Things and Celebrity Deaths"

Gail Simone - Writer
Jon Davis-Hunt - Artist
Quinten Winter - Colorist
Todd Klein - Letterer
Jenny Frison - Cover Art
Rowena Yow - Associate Editor
Shelly Bond - Editor
Clean Room is created by Gail Simone
32 pages/$3.99
Date of Publication: 16 December 2015
Suggested for mature readers

It occurs to me that the last time I've written anything for this blog that wasn't about an issue of Clean Room was my 4 October post about George Strait's Cold Beer Conversation album. I've had thoughts for numerous other blog posts; just little focus and commitment to writing about them. I mention this partly because I think it's a testament to how interested I've been in this book.

Chloe leaves Astrid Mueller's headquarters and runs afoul a despicable gas station attendant when her credit card is declined for being reported stolen (from a dead woman, no less). She's surprisingly rescued by Astrid's bodyguard, Killian Reed. Simultaneously, someone has broken into Chloe's home and is confronted by three of her protective neighbors. That, unsurprisingly, does not end well for the neighbors.

Gail Simone justly takes pride in the creepiness of her stories, and this is probably the creepiest of the first three issues of this book. Someone trying to open a door into the restroom is disconcerting enough anyway, at least for me. I become instantly defensive if I hear someone trying to open the door. I associate a locked door with security and someone trying to get through that locked door represents a threat to that security. I suppose there's something to the contrast between a clean room and restroom, but I suspect chiefly this sequence was set where it was simply because Simone understands how vulnerable many of us feel in a restroom.

[Side note: During Tuesday night's Depression & Bipolar Support Alliance meeting, someone talked about how important it was to her to have windows in every room, to let in sunlight, including bathrooms. I didn't voice my dissent, as I'd already done that with someone else a few times, but just for the record: NOPE. Windows have no business in a bathroom. None whatsoever. I identify as hypervigilant (as opposed to paranoid), and the last thing I want when I'm indisposed to react to something is a point of access someone or something else could use.]

Later, on story page 16, Joe Wei's Clean Room vision is about some kind of "Abduction. Possession. I don't know." At the bottom of that page, we see some thing erupt violently from inside a woman's abdomen. I haven't checked with Simone to confirm, but I'm choosing to believe this is her sadistic way of acknowledging me and my experiences with Crohn's disease, just as Dan O'Bannon wrote the famed chest-bursting sequence in Alien as an allegory to his own experience with the disease.

Aside from preying on themes that scare me related to my guts, one story device that I've always been a sucker for is when someone's allegiance is called into question. For that, Killian Reed is the most interesting character in "Good Things and Celebrity Deaths". She clearly wasn't after Chloe to harm her (or at least, only to cause incidental harm, per her proposal on story page 18, anyway), yet she also does nothing to indicate that she's even contemplating betraying Astrid in any way. On the contrary, she makes clear on story page 19, panel 2: "Astrid thinks you have potential. Maybe she's right. But if you try to hurt her, well...then you get the tire iron." Admittedly, I may also be fascinated by Killian because I can't imagine sitting across the table from someone saying to me what she said to Chloe on the previous pages!

I'm only half-kidding about believing myself responsible for this restroom/bloody abdomen business, but I feel more confident guessing that Killian's surname Reed is a nod to Twitter user Natalie Reed, another fan of Simone's who I like to think of as a pal of mine, too. Natalie doesn't strike me as having a whole lot in common with Killian so far, though it's not as though I've gotten to know either all that well so far.

I'm glad that I took the chance on issue #2 after issue #1 left me with trepidation, because I'm growing increasingly interested in the mystery of the Clean Room as well as in its characters. Right now, I think I'm more interested to learn more about Killian than Astrid, but both fascinate me.

This was the first issue of the book in which Jon Davis-Hunt's art was colored by someone else; Quinton Winter. Coloring is a more delicate matter than I think is generally realized until you've gotten used to a specific collaboration and then encounter a new colorist's work. To Winter's credit, this issue not only remains consistent with the aesthetic that Davis-Hunt established on his own, but it looks terrific, period. This book has a clean look to it, with panels and pages having enough detail that they conjure our real world but not so much detail that they feel cluttered. I don't often find myself going back through an issue of anything just to sort of take in the artwork, but I did that with this issue. Davis-Hunt's facial expressions are pitch perfect for this story, and I credit him with a lot of the humanity that comes through...because God knows, Gail Simone is doing everything she can think of to cloud that humanity!

Clean Room, you're off probation. I'm officially committed to reading you.

25 November 2015

"Clean Room" #2 by Gail Simone

Clean Room #2
"Spring Cleaning, Part Two"

Gail Simone - Writer
Jon Davis-Hunt - Artist & Colorist
Todd Klein - Letterer
Jenny Frison - Cover Art
Steve Cook - Logo Design
Rowena Yow - Associate Editor
Shelly Bond - Editor
Clean Room is created by Gail Simone
32 pages/$3.99
Date of Publication: 18 November 2015
Suggested for mature readers

I was left uncomfortable by the first issue because of its disconcerting suicide content, and I wasn't entirely sure whether I was going to continue with this book. Obviously, I did decide to pick up the second issue because that's what this post covers. I was tentative about it, but for the most part felt more at ease this time. Maybe it's because I went into this issue with an idea what I might find, or maybe I was just feeling more stable the evening I read this one.

The crux of this issue is that Chloe confronts Astrid Mueller, throwing down her questions and accusations, and in turn is introduced to the titular Clean Room. I appreciate that Chloe's resolve wavers early. It appears to be attributable to some special effect that Astrid has on people. My reflexive reading of this is that it's not so much the creation of self-doubt as it is a magnification of existing self-doubt. I like that our intrepid protagonist might actually not be entirely sure of herself, despite such a clear cut reason to go after Astrid.

When we finally see the Clean Room, in a double splash page on story pages 11 and 12. It looks a bit like if HAL had designed the Danger Room, stark and oppressive despite being so seemingly open. This is, of course, also how the room appears to affect people in it, such as Dwight Fennister. Fennister is the kind of character that Gail Simone crafts as well as anyone else writing in any medium; on story page 13, we're given every reason to sympathize with him and to feel protective of him, as Chloe does. The last panel on that page of Fennister staring directly at us, his hands folded and desperation on his face, may be the most striking image that Jon Davis-Hunt has illustrated for either issue.

Three story pages later, we are betrayed by the truth of his heinous past. Chloe's outrage gives voice to our own. By introducing him as she did, Simone took what is ultimately (probably) a throwaway character and used him to elicit a visceral emotional reaction that I don't think would have been there otherwise. Atrocious as his acts were, I wonder if we've become so accustomed to such things in the news, much less entertainment, that Fennister would have provoked me much if he'd been presented differently.

The top panel of story page 18 has Astrid coldly dismiss Chloe's insistence that she couldn't just let Fennister go: "I am not law enforcement, Chloe. I was looking for something else." Chloe believes that Astrid has shrugged off Fennister's confession, having deemed him "clean", but I expect we're going to see Detective Markos find his mangled corpse at some point, tormented into killing himself by the hallucinations that appear to be developed in the Clean Room. That, in turn, begs the question what it is that Chloe will eventually find out about her deceased fiance, Philip, that preyed on him so much that he killed himself. We know now that Astrid doesn't directly make someone suicidal; rather, they are killed by the manifestation of what is "cleaned" from them. This is rich ground for storytelling, because it gets at themes of morality and the shades of gray where monsters can become sympathetic and heroes become soiled.

My chief qualm at this point is that I feel put off by how this book is being played up as some sort of demented fun. To read some of the blurbs about this book, it sounds like something from the tawdry milieu of A Nightmare on Elm Street when it's more in keeping with, say, The Blair Witch Project (or, for those who've seen it, Antichrist). This isn't a book to gawk at, but rather one to allow to get under your skin. In any event, I'm more committed to reading issue #3 at the end of #2 than I was to reading #2 at the end of #1.

25 October 2015

"Clean Room" #1 by Gail Simone

Clean Room #1
"Spring Cleaning, Part One"

Gail Simone - Writer
Jon Davis-Hunt - Artist & Colorist
Todd Klein - Letterer
Jenny Frison - Cover Art
Steve Cook - Logo Design
Rowena Yow - Associate Editor
Shelly Bond - Editor
Clean Room is created by Gail Simone
32 pages/$3.99
Date of Publication: 21 October 2015
Suggested for mature readers

Hey, remember when I used to blog about comic books? It's okay if you don't, Dear Reader; I have a hard enough time remembering when I used to read comic books. Depression has diminished my enthusiasm for several things for quite some time now, comics being one of the more conspicuous casualties. Detached as I've become, though, I've continued to follow Gail Simone through Twitter so I've known about Clean Room for awhile now. My depression led me to nearly three months of outpatient treatment, including a week of inpatient treatment in the middle, and that's pertinent to my experience reading this issue.

See, all I knew about this book was that it was written by Gail Simone, and that it was dark, dark, dark. The blurb atop the cover of this first issue, from scribe Scott Snyder, is a perfect microcosm of the buildup that I've vaguely followed: "The work of a master storyteller writing at the peak of her (black, twisted) powers." I got a kick out of those black, twisted powers in Batgirl, particularly in the form of Simone's New 52 Ventriloquist and companion Fergie. I suppose that's the kind of black, twisted storytelling I thought I was getting myself into, and I was wrong, wrong, wrong.

The crux of Clean Room is that a star of the self-help world, Ashley Mueller, may be responsible for destroying the minds of her more devout followers. Our lead protagonist is Chloe Pierce, who lost her fiance Philip to suicide she's certain was prompted by Mueller's book. It's a pretty straightforward situation that's both plausible and ripe for exploration, and as a premise it's one of the more interesting ones I've heard about for comic books in awhile (though, admittedly, I've not kept close tabs).


You probably already made the connection, but I don't think I was ready for this issue's suicide content. I'm generally okay discussing the subject, and I can even be unsettling for others in how casually I can discuss my own ongoing suicidal thoughts and urges. That said, I was unprepared for story page 9, in which Chloe attempts to commit suicide by combining Cabernet Sauvignon with prescription medication overdose on her way to drown. My go-to plan for ending my life is also overdosing on meds (in 2011, I was going to pair them with Old Whiskey River), so the fourth panel on that page startled me.

Likewise, there's the caption box in panel 1 on story page 13: "I lost my fiancé. I lost my baby." That was the first intimation that Chloe had been pregnant; this, too, is a very sensitive subject for me, having coped poorly for a decade now with a miscarriage. Or panel 1 on story page 16, in which Philip's surviving friend Michael holds a finger gun to his head while discussing the effect that Mueller's book has had.

These things are supposed to be upsetting, of course. I know that Simone is far too understanding and sympathetic to go in these places for shock value; I might suspect that of another writer, but she's above reproach. I don't fault her for going in these places. I just don't know that I'm in the right place to go there with her at this time. I've yet to decide whether to continue with Clean Room. The next issue will be published on 18 November, so I've got several weeks to sift through things and steel myself for it, should I elect to keep going. I could also, of course, buy issue #2 but hold off on reading it if I don't feel up to it immediately.

Lest I forget, I do want to mention the art. Jon Davis-Hunt's interior work feels tonally perfect for this kind of storytelling, conveying a real world aesthetic without being photo realistic. Hallucinations are jarring because they so loudly disrupt that otherwise recognizable world. I confess I'm lukewarm about Jenny Frison's cover, though I admire how unconventional it is - particularly for a first issue. I've seen the solicited covers for the next three issues, and they're each terrific. For readers who aren't as tentative about the content as I am right now, Clean Room should prove as visually arresting as its narrative.

04 October 2015

"Cold Beer Conversation" - George Strait

George Strait
Cold Beer Conversation
Produced by Chuck Ainlay and George Strait
Album Release: 29 September 2015 (iTunes and Walmart CD)

My enthusiasm for music has been tumultuous over the last ten years or so, partly because my feelings about things have evolved so artists and songs that I once enjoyed have stopped speaking to me while I've found new voices to appreciate. Throughout it all, though, a handful of artists have remained entrenched and George Strait is among them. I checked online not a week before Cold Beer Conversation dropped to see if there was any news about his next album and found nothing, but then this past Tuesday came and brought with it an email alert that there was, in fact, new Strait music to be heard!

Aside from being such a surprise, Cold Beer Conversation also caught my attention for other things. Firstly, there's the striking album art cover, unlike anything else in Strait's discography. This is actual, you know, art rather than one of the few publicity photos he reluctantly poses for every few years. Secondly, this is not being given a full wide release from the outset; the digital version is exclusive to iTunes and the physical CD to Walmart. Lastly, this is the first album in Strait's discography since the 1992 soundtrack for Pure Country not co-produced by Tony Brown. Instead, Chuck Ainlay has stepped up from engineering to work with Strait.

I'll readily admit I was apprehensive about the change, chiefly because the two albums I looked forward to most last year, Garth Brooks's comeback Man Against Machine and the live album recording from Strait's own final regular tour, The Cowboy Rides Away: Live from AT&T Stadium, were mangled by clumsy engineering. To Ainlay's credit, though, Cold Beer Conversation has a crisp, clear aesthetic that breathes comfortably. Strait's vocal range has diminished a bit over his last several albums, though it's something that isn't as apparent unless you're familiar with his older material and in any event, his skills as interpreter are second to none. He knows how to turn a phrase and find humor and poignancy alike in his easygoing manner, and thankfully the instrumentation and background vocalists complement, rather than compete with, him.

What made Cold Beer Conversation exciting to go into as a listener was also knowing that Strait's touring days are over, and with them quite likely his efforts to court mainstream radio. "What will he record now that he's making music for himself?" was what many of us wondered. The answer may just be as simple as the song "It Takes All Kinds" (written by Strait with his son Bubba Strait, Bob Regan, and Wil Nance) - a Western swing romp the likes of which used to be his stock and trade but seemed to have stopped being so overt somewhere along the way. Plain and simple, this is a fun album. I think we have to go all the way back to 2001's The Road Less Traveled to find the last time he cut an album with this kind of energy and lightheartedness.

The references to drinking that pop up on most of the songs wear thin, though at least by being titled as it is, this album lets us know before we hear a single note that we're going to encounter them. Admittedly, part of my reaction to that is that my drinking days are behind me (thanks, guts) and I've spent time in the company of people who have addiction issues, but also I think a lot of mainstream country listeners have endured such a glut of songs about getting party-drunk that it's not even entertaining anymore. It just feels played out as subject material, though at least these are songs about casual drinking rather than celebrating a frat lifestyle.

My only genuine sore spot is "Cheaper Than a Shrink" (Bill Anderson, Buddy Cannon, and Jamey Johnson), a tune about how getting drunk is cheaper than - and maybe even more effective than - therapy. It's dismissive of not just psychotherapy, but by implication, those who turn to it for help with their mental health issues - and for those with addiction issues, its ignorance is even more insensitive. Even this, though, I'll concede is a fun sounding song. I think if it had been presented more seriously, perhaps in droning melancholy, I'd be outright angry over it but as it is, it's easy enough for me to shrug it off as misguided.

Overall, though, Cold Beer Conversation turned out to be enjoyable. I don't know that it would be my album of choice to introduce someone to Strait (Ocean Front Property and Carrying Your Love with Me are still my go-to's), but for someone who was already a listener, I'd certainly encourage them to splurge. It's a nice little pick-me-up, and a welcome addition to my library.

05 August 2015

Professor Morgan Broadhead, 11/30/1939-8/2/2015

Photo taken by me on our last day in Barbados.
Morgan is holding a postcard I had everyone sign.
I was crestfallen to be informed by one of our mutual friends that Morgan Broadhead, a former professor of mine whom I was fortunate enough to also claim as a friend, passed away on Sunday. I ran a quick Google search to see what I could learn. I got to the end of the obituary and saw that he had requested there be no funeral service, no visitation. I laughed. That was precisely how I would have ever guessed he would have wanted things, and I know it's because he knew how many lives he impacted and touched over the years, and how great a fuss we all would have made over him, gathered in one place. He was far too humble for that sort of thing.

Well, unfortunately, one of the things I learned from him was the concept "Obedezco pero no cumplo" - "I obey, but I do not comply", an accepted way for a seafarer to respond to royal decree, the idea being that by the time the orders had been delivered so far out at sea that things had changed and that compliance with the specific directive would not have been favorable. So, respectfully, I will obey my mentor's wishes not to organize or attend a formal service, but I will not comply with his wish not to make a fuss over him.

In fact, the closest to celebrating I know of him doing was there for a few consecutive years, he and his lovely wife Ann would host me for a combined birthday dinner; his birthday was the day before mine. Ann would cook something warm and delicious - I remember her hot brown being particularly wonderful - and we would sit in their kitchen or living room with a bottle of wine and have the storytelling equivalent of a guitar jam for the evening. Morgan's sense of humor was sarcastic but without the undercurrent of meanness that seems to characterize everyone else's sarcasm.

He was also whimsical; I remember one occasion after a symposium on evil, the three of us and my then-girlfriend (whom I met through them) went to dinner. When asked a name, Morgan gave not his own name or that of anyone in the party, but a name plucked from the annals of history. Ann digressed how embarrassing it was when he first started doing that with her, but that she had acclimated. I sometimes try to think of a clever pseudonym to give when someone is taking my food order, and I owe it to Morgan to feel that it's okay to do something like that. One of his favorite names to give was Vercingetorix, the Gallic leader who opposed Julius Caesar. (One of my classmates had that as his middle name, so I found that particularly amusing.)

I took five courses taught by him; World Civilization I & II, Latin American History I & II, and of course Cross-Cultural Studies in Barbados in 2000. I learned a great deal from him, but it was far more than a matter of absorbing trivia and footnotes about bygone eras. He was, for all intents and purposes, my de facto mentor.

Morgan took me under his proverbial wing early in our first course together. I can't recall now what the assignment was, but he made a point to praise my writing. When I expressed to him my intention to become a history teacher, he was thrilled. He was the first history instructor who ever taught me to get away from trivia and focus more on the big picture; that it was less important to know exactly who was present when something occurred than it was to understand why we still discuss today that it occurred at all. I've never cared for the marketing phrase "making history come alive", but it's fair to say that through his tutelage I came to understand how the discipline of history is not static.

When I still envisioned myself taking over a classroom one day, it was unquestionably Morgan I had in mind as my template for how I wanted to conduct myself. He held firmly to his expectations and standards for all of his pupils, but he was also so genial that I think we all wanted to meet them regardless of what they were. Reflecting on him now, I see him as having been a lot like Dickens's Fezziwig:
"Why! Is it not! He has spent but a few pounds of your mortal money: three or four perhaps. Is that so much that he deserves this praise?" 
"It isn't that, Spirit.He has the power to render us happy or unhappy; to make our service light or burdensome; a pleasure or a toil. Say that his power lies in words and looks; in things so slight and insignificant that it is impossible to add and count them up: what then? The happiness he gives, is quite as great as if it cost a fortune."
It really felt that way for me. I studied numerous courses under numerous instructors over the years, and few wielded their authority as benevolently or as encouragingly as did Professor Broadhead. I felt him actively rooting for each of us to have our own epiphanies and successes along the way. He was one of those rare, special people who truly wanted everyone else to succeed in life.

His commitment to that ideal was not restricted to being passive, either. He made himself available to all of his students during lengthy office hours, though far fewer took him up on the offer than he hoped each semester. He taught courses at the prison, because he believed strongly in the role of education in creating new opportunities for a part of our community many would just as soon never help again. Morgan rejected that cynicism, and added to his full workload each semester for years to see to it that the inmates who shared his optimism had as fair a shake as he could create for them.

More than once, he remarked how of all the students he ever taught either at Jefferson Community College, the University of Louisville, or the prison, that it was the prison students who consistently asked detailed questions about the assigned reading. "You read the book?!" he would laugh, incredulously, because the rest of us - and I embarrassingly include myself here - were too privileged to read the textbook more than was absolutely necessary. We skated by on his lively lectures; the inmates delved into their assigned readings with more dedication, and I know without ever having met a single one of them that they did that because they believed that he believed in them.

It's easy to talk of valuing things like redemption, but awfully easy to excuse ourselves from participating in someone else's. Morgan Broadhead believed in people. He wanted them to succeed. I haven't gotten into a classroom, but I truly hope that I've lived up to the example he set for me in other ways over the years.

I've discussed often the impact that going to Barbados with the Broadheads in 2000 had on me, including a spattering of pieces in this very blog. Mine was one of seven groups fortunate to have that experience. There is something of a brotherhood of us Barbados Bound alumni, a fact that I was reminded of just a few months ago when a friend of a friend spied my Barbados Sea Turtle Rescue Project baseball cap and began chatting with me that she had taken the course in a subsequent year. Our specific experiences varied, but the impact that our time there had on us was very much the same.
Morgan introducing to us Winston Farrell, poet laureate of Barbados, and my friend who broke this sad news to me.
Our penultimate night in Barbados, I asked to say a few words to everyone. I had begun those two weeks quite a different person from the one who was getting ready to leave. I knew that in all likelihood, we would lose track of one another (this was before MySpace or Facebook, mind you), but I was also prescient that we would all find that a part of ourselves remained there in that island country. I won't presume to speak for Morgan's spiritual beliefs - a subject we never discussed - but I feel reasonably comfortable saying that there will always be a part of him there, not unlike the Ragged Point Light House shown at the bottom of this writing. He offered guidance when I and countless others needed it, and if there's a greater calling than that, I don't know what it is.

On the last day of class I had with him as my instructor, he shared with us the one piece of advice his mentor had given him. I'm not sure how it fits into this memorial, but I feel compelled to pass it along just the same:

"When you get into things that took place in your own lifetime, it's time to shut up." Maybe it will mean something to one of his myriad other former students who didn't get to hear that from him for one reason or another.

Ragged Point Light House in Barbados, 18 May 2015. Photo taken by me.

21 June 2015

"About a Thousand Days Ago..."

More than anything else I have ever written, this is the one that has been the most difficult and taken the longest - to confront, to write, to share. What follows was first written almost a year ago, and shared in small increments with my inner circle.

TRIGGER WARNING: This post contains sensitive subject content, though it is discussed as ambiguously as possible as I could manage.

I was in elementary school. I want to say first grade, but I could be wrong about that. The guidance counselor came to class one day. She had a couple of puppets. She made one do the moonwalk dance. That was a big hit with my classmates. I laughed along because I knew it was the appropriate reaction, but I was oblivious to pop culture and had no idea what the moonwalk dance even was. I've never confessed that to anyone before, so that's our ice-breaker, Dear Reader.

I immediately liked the guidance counselor. Like most of the faculty at that school, I felt that she actually cared about us students and wanted us to have a good experience. I found it easy to talk with her. That hasn't always been the case for me over the years.

That day, her talk with us was about inappropriate touching. She gave us the standard talking points about the offender being to blame, not the victim; about the importance of reporting such an incident to our parents, teachers, or other trustworthy adults until we found one who would listen; and about owning our agency to tell someone "No". As tended to happen in the classroom, I had the sense that most of my classmates were partly absorbing what was being discussed and mostly just waiting for the clock to run down.

I remember when the talk was over that I quietly approached the counselor. I had something to discuss.

She arranged for me to visit her in her office, across the hallway from the main office. I'd only ever been sent to the main office once. I was summoned to the principal's office along with a few others. I was terrified as I walked down the corridor, wondering what I could possibly have done wrong. It turned out that I simply had an overdue library book. Due dates have loomed large for me ever since.

"You know what you were talking about in our class?" I would have begun. "About a thousand days ago, something happened." I paused and did the math in my head. I knew there were more than three hundred days in a year and I was backtracking in my mind. A thousand days was actually a reasonable estimate. Whether I was just procrastinating or trying to show off my math skills, I couldn't say. It was weird because I hadn't planned to start out that way at all. It's just what came to me. I was as surprised as she was that I was trying to work out how many days ago the incident had taken place. Brains, right? Whaddya gonna do?

Given how outspoken I've been about things like sexual violence, I don't think this post is going to be all that much of a surprise to anyone who's paid much attention to me over the years. It's probably been pretty obvious that something once happened, and everyone has been too polite/squeamish to ask.

I have had one policy since I came out from behind the anonymity of a screen name: I don't share things that involve and affect other people. That ties my hands about what I can share with you now, Dear Reader. Your imagination has already told you the nature of what I shared with the guidance counselor that morning. I will only say this much: What happened was with someone older that I should have been able to trust. My guidance counselor was the first person I ever told about the incident.

What struck me at the time, and stands out especially today, was how attentively she listened to me. If she was skeptical, she never let on about it. On the contrary, I felt certain that she did believe me. When I hear of survivors talking about not being believed, it upsets me to know that they were cheated out of at least that much. I just took it for granted that she would listen as she did. I was much older when I found out that I had been lucky in that respect.

The counselor initiated an investigation. She contacted my parents. I spoke with my mom about it. I don't remember anything from that conversation except wanting it to be over. The offender gave an entirely fabricated alternate account of events and insisted I simply had an overactive imagination. It was the early 1980's, so that's where the investigation ended. My guidance counselor was the one to tell me that's what came of the investigation, and that she was furious about it but that she had no authority to do anything else.

In some bizarre way, I felt as though the entire thing was resolved tidily; something happened, I complained, someone asked about it, a reply (lie) was presented and it was dropped. Life: 1, Travis: 0. Like most children, at one point or another I'd been admonished for being a sore loser, so I resolved that I would just move on. What else could be done, anyway?

Of course, what I had overlooked was that actually living with the experience - including the reporting, sharing, and investigation process - would continue the rest of my life. Whenever I hear of such things, the immediate reaction is usually bloodthirsty calls for the offender to be executed as cruelly as imaginable. Somehow, that would make things okay in the minds of a lot of people. I, on the other hand, have gone more than thirty years with no such punishment doled out in my name. It's taught me that vengeance ("justice", if it makes you feel better) isn't the path to healing. I've had to work on that on my own - and largely, I do mean on my own.

I've carried this for most of my life. I sandbagged every conversation I had in my youth about such things, denying that I knew anything more than anyone else. I would leave the room if a TV show or movie started to even talk about sex, much less sexual abuse. I agonized every time someone would use the term "rape" to refer to something as trivial as the convenience fee of their concert ticket. I took some odd solace in knowing that no one with my kind of experience would use such a word in such a way and that meant they had been spared. That was the only way I could get through those moments without lashing out.

It's hard to develop a healthy sense of self when you're made to feel defensive about your own body so young. I wouldn't even swim without a T-shirt into my adulthood. Everyone just assumed I was self-conscious because I was scrawny and I was fine letting them have that misconception. Every day for more than thirty years now, that childhood incident has been on my mind. It's often one of the first things I think of when I wake up and one of the last to cross my mind before I fall asleep.

The whole world is a trigger. At a group sleepover in the late 90's, a friend brought over a tape of several episodes of South Park. One episode was about a character who was upset that his father hadn’t molested him, satirizing how many people were finally starting to come forward about surviving such things. Anything I may have said or done the rest of that night was some kind of defense mechanism because I had retreated inside myself so far that I was oblivious to anything else. I freak out any time I see a lazy parent carelessly send a child to a public restroom unattended. I've never chosen to watch a single minute of that show since and I can't even stand to hear about it. I don't care how clever or poignant a specific bit is; I immediately go back to that night and how I shut down completely because keeping this to myself was the most important thing in the world.

I usually share personal things publicly because that's part of how I claim ownership over the experience and blah, blah, blah. It’s part of my "shoot the hostage" approach to bearing burdens. The truth is, I don't want ownership over this. I never did. I'm hopeful, I suppose, that somehow this will let me put some more distance between it and me. I don't know whether it can or will, but that's my hope.

*     *     *     *     *

Ordinarily, I would be flattered to hear that someone read something I wrote and then began to open up about something in their own lives, but I beg you, Dear Reader: If you have a life experience like this one, please resist any sort of impulse to share that experience now. Take your time. YOU get to decide what, if anything, you ever share - with whom, when, why, where, and how. It took me three years to even talk about it in the first place and more than thirty to finally begin sharing it in waves with my inner circle.

06 June 2015

Who They'd Be Today, Age 9

I've rarely made mention of this publicly. In fact, I've seldom even discussed it beyond a superficial layer with my inner circle. In 2005, my then-fiancee and I lost twins in a miscarriage. Today, 6 June, would have been their 9th birthday. Their due date was on a Tuesday. I remember that because a Star Trek DVD compilation set collecting all the Q episodes was scheduled for release that same day. I had filed away the idea as something to maybe try to remember to either buy or have someone pick up for me that day to put back and watch with them when they were old enough. I saw some kind of "this is why we don't play tricks on people" morality lesson to it, but mostly of course, I just liked the idea of instilling Trek from the outset.

I remember sitting down with one of my professors at the University of Louisville that semester in his office. It was my second course under him. I came to him at the outset of that semester to discuss the logistical matter of being a student with Crohn's - something I hadn't been diagnosed with when I took the previous course with him. He could not have been more gracious or accommodating, which was understandably quite a relief. I remember chatting with him about the pregnancy when we found out about that.

"Oh, wow...I just realized, my kids will actually be able to throw in my face that I'm from another century!" I mused.

Dr. Beattie amended that: "They'll be able to throw in your face that you're from another millennium!"

That's why he was the professor and I was but the student.

Not having a meaningful relationship with my own dad, I had a great deal of anxiety over becoming one myself. I only knew the things I wanted to try to avoid screwing up, but no idea what constructive things I wanted to do or how to go about doing them. Like others with whom I discussed the matter, Dr. Beattie expressed confidence that I would find my way. He'd graded my previous work for him at the C-level, and my later work for him at the A-level, so I figured he was qualified to have some idea about my room for improvement in general.

Of course, I never got the chance.

I should know the exact date of the miscarriage, but I don't. I only know that we had been at dinner with friends in the evening, and by the middle of the night, the same ER physician who had told me a few months earlier that I very likely had Crohn's disease was offering soft condolences to us. The next few weeks were (and still are) a blur. I didn't want to interact with another person in the world. Some intruded anyway. I did what I could to either excuse myself or rush them out. I felt no remorse then or now about shunning them. I prefer to lick my wounds in private, no matter what impression you may have taken from some of the things I've shared here over the years, Dear Reader.

When I eventually checked back in with my professors and accounted for my absences, they were even more compassionate and accommodating than they had been about the frequent intrusions of Crohn's into my performance. I only had two assignments for Dr. Beattie that semester, and I'd already completed one of them, so there was nothing for me to try to make up for him; just lectures to try to cover. I met with him one afternoon when I finally had it in me to resume my studies. He glossed over some of the key concepts, but he downplayed that and instead tried to engage me about how I was processing my grief.

He could not have been kinder or more sensitive - unlike some of those who took it upon themselves to show up at our apartment door. I think one of the things I appreciate most about that conversation was that he didn't seize on it as an opportunity to launch into a sales pitch for whatever views he held. Never once did he say anything about how things "happen for a reason", anything about "God's plan", how the rest of my life couldn't stop because of it, or any of the other banalities that inundated me at that time. He didn't make me feel like he was somehow morosely excited for something "big" to talk about to fill his day - which, I hate to say, was how a few others made me feel at that time.

My then-fiancee and I never really discussed it beyond our shared frustration about not being left alone as we had requested of everyone. I remember at least once locking myself in the secondary bedroom and refusing to reemerge until our unwanted visitors had left. Maybe it was interpreted as rudeness or a lack of appreciation for a show of support. I don't know, and I don't give a damn. When I finally felt I had rebuilt my fortitude, I resumed work and school. I did what I could to make myself go through the motions. My heart wasn't in anything, but as long as my mind wasn't on anything, either, then that was what I considered a "good" day.

This pain lay dormant for years, unaddressed. I knew it was hard enough on my fiancee/wife, and I was certain the last thing she needed was for me to bring it up while she was still trying to process it on her own. I always kind of thought eventually we would come back to it, but for one reason or another, we never did. Some of you might interpret this as some kind of machismo on my part. I never felt it was that, but rather the most compassionate way I could think to handle such a devastating matter. I don't know how she healed, or if she did at all, and I truly regret that. I should have been more active about checking on her. Maybe not in the immediate aftermath; like me, she prefers to face the worst of a storm on her own. But certainly between when it happened in 2005 and when our marriage collapsed in 2011, there was time and I let it slip away.

One consequence of keeping my pain to myself is that it became a dormant time bomb within me. It was always there on my mind, but my coping mechanisms made it manageable. At least, until I finally began to sift through everything that the collapse of my marriage brought to the surface. I came to realize that compartmentalization had run its course.

You know that Kenny Chesney song, "Who You'd Be Today"? It came out in September, 2005 and it absolutely crushed me. That was only six months after George Strait released "You'll Be There". To this day, I have a reflexive need to retreat into myself and sob inwardly whenever I hear - or sometimes, just hear about - either song.

Last Spring was excruciating for me. When I was at C2E2 in Chicago, just seeing all the families with young kids tore me apart. I kept looking at the ones who seemed to be nearly 8 years old, wondering what my own twins would be like. Surely, I would have introduced them to the works of Beverly Cleary, as a longtime fan of Ramona Quimby. Who would their favorite characters be? Would they be into superheroes? Would they be DC or Marvel kids? Star Trek? Star Wars? What new characters and such would appeal to them? Harry Potter, perhaps? How many hours would we spend playing the assorted LEGO video games? Would they want to cosplay? Could we do that as a family, like the foursome I saw dressed as Green Lanterns, or as The Incredibles?

I can tell you without any sense of shame that I took a lot of Klonopin that weekend. I didn't even care what the bottle said about how far apart I was supposed to space each pill; the moment I felt the last one begin to wear off, I popped another. I also holed up in the Press Lounge as often as I could. The physical toll my emotions took exhausted me and I needed as much solitude as I could muster. (Remind me sometime to discuss how much more lenient the average person is about accommodating physical health matters than they are about mental health matters.)

Just a week later, my friends hosted their annual Derby party. No sooner had I walked into the kitchen than I was face to face with the newborn son of two of my newest friends. I got to hold him for a little while. It was simultaneously soothing and heartbreaking. I could not have been happier for the couple themselves; they're the kind of wonderful people who are easy to root for, and root for them, I do. I spent an hour or so with another newborn, who napped in my arms in a recliner, so that both his parents could try to socialize instead of trading off baby-snoozing chores. That, too, was an amalgamation of peace and turmoil. I think sitting by ourselves in a quiet room helped to make it more palatable for my tumultuous emotions.

A month later, mutual friends introduced me to a young woman the likes of which I had never dared imagine existed in real life. She brazenly approached me about sensitive matters. Anyone who knows me well at all would have been stunned by how comfortably I indulged her, but I just had a feeling that I needed to open up to her. When I shared with her how hard June was for me, between the twins's birthday on the 6th, and Father's Day (the 14th last year), she took it upon herself to organize a symbolic funerary service on my behalf. I was, of course, reticent. Discussing the matter with someone I just met was pushing it; this was something far more delicate.

I asked her pointblank, staring into her eyes, "Can I trust you with this?"

She pledged to me that I could, and to her credit, she made good. She had me write by hand a letter to them. Me being me, I wrote two; one that I read aloud in front of her and two of our mutual friends who kindly attended the day with us. The other, I asked to read to them privately. She had gathered several stones and asked me to select one per child, each of which went into a lovely decorated shoe box. Into the shoe box, I placed both handwritten letters.

One of my other friends had brought a spade and was prepared to dig an appropriate hole for the box, but I insisted on doing that myself. I've buried each of my pets over the years, and it's important to me that I be the one to do such digging. I feel as though I've shirked my duty to my loved ones if I don't do it myself. I dug, not paying the slightest heed to what the dirt was doing to my all-black clothing or dress shoes. The organizer had selected pieces for each of those of us in attendance to read aloud. She selected for me Rudyard Kipling's poem, If. She herself sang "This Little Light of Mine". I was entirely unprepared for the power of her singing voice. If I hadn't lost track of her over the intervening year, I would organize a Kickstarter to try to get her to go into a studio and record an a capella version of that song. I can't hear any other performance of it, and have told iTunes to skip any such versions when shuffling my library.

It was eight years late, and only a symbolic service, but I cannot emphasize enough how much peace it has brought me. It still hurts. It will always hurt, and I wouldn't want it to ever stop hurting, to be honest. But thanks to the sensitivity and support shown to me over the years by everyone from Dr. Beattie to this remarkable young woman who flitted in and out of my life in the span of two dizzying weeks last June, I feel I've finally got a healthier handle on that pain. Today will always be difficult for me. I will always have those unanswered questions: Did we lose them because I was unfit to be a worthy parent? (After all, I could scarcely keep up with a bunny rabbit at the time.) Was it something preventable we missed? How, or when, should I have broached the subject with my wife? What if I found myself in that situation again? Could I separate the years of anxiety and fear from what should be the joy of something new?

These things, I may never know. Sometimes they still overwhelm me. Thankfully, though, I've benefited from some wonderful support going back to the epicenter of when we lost them up through last summer when I finally had the kind of confrontation that I didn't realize I needed. I've tethered myself emotionally to that symbolic service the last year, today more than most.

I don't know whom I've mentioned or alluded to here who may ever see this post, but in case you're one of them, please know that I know I owe you a tremendous debt of gratitude.

Thank you, from the bottom of my healing heart.

Note: I received more consolation and help over the years, including the compassion expressed to me by my other history professors at UofL: Dr. Bruce Tyler and Dr. Lee Shai Weissbach among them. I don't wish either to feel slighted, as they also each made that period survivable for me.

29 May 2015

Cognitive Reapprasial, Behavior Therapy, and Women

That I should be concerned with matters of mental health treatment should come as no surprise to you, Dear Reader. Recently, two different articles have come to my attention. I'd like to share and discuss them here. (Spoiler alert: Since this is my blog, that's what's about to happen.)

The first article is An Experimental Study on the Effectiveness of Disclosing Stressful Life Events and Support Messages: When Cognitive Reappraisal Support Decreases Emotional Distress, and Emotional Support Is Like Saying Nothing at All, written by Anika Batenburg and Enny Das, edited by Daniel Houser. This piece was published online 22 December last year on PLoS One, which bills itself as "a peer-reviewed, open-access journal".

What Batenburg and Das explored is whether there is the answer to the $64,000 question, "How can we best support others in difficult times?" They identified three support messages (i.e., what you say to be helpful): cognitive reappraisal (dissecting things), socio-affective (emotional support and comfort), and "no response"; matched with two kinds of disclosure conditions: cognitive reappraisal and emotional disclosure (sharing emotions).

For their study, they had half of their participants write "about their deepest emotions about a current most stressful event that affected them and their lives"; the other half, "about positive and negative consequences of a current most stressful event, their perceptions of the stressful event, challenges and opportunity arising from the event, cognitive reappraisal of their coping strategies and their positive thoughts about the stressor". All participants were given fifteen minutes in which to write. (I hope the latter group had more than fifteen minutes just to read their instructions!)

The thinking was that the emotional disclosure group (the one sharing their deepest emotions) would benefit more from socio-affirmitive support messages, and that the cognitive reappraisal group would benefit more from cognitive reappraisal support messages. Seems a bit obvious, right? If you're sharing emotions, you want someone to offer comfort; if you're trying to work things out, you'd rather have someone offer some perspective to help you do that.

Except, it didn't go that way.

It turned out that both groups benefited more from cognitive reappraisal support messages. In fact, socio-affirmitive support messages weren't all that noticeably more helpful than no response at all. To be honest, I'm not surprised by this. I don't find "there, there, it'll be okay" helpful in the slightest. If anything, socio-affirmitive support messages often convey to me that the other person is at best naive about what I'm facing. They don't understand what I'm going through, and the best they can offer is to try to mollify me. I don't have any higher threshold for being patronized than the next person, so I find this kind of support fairly useless.

I take it for granted that anyone I feel close enough to that I would come to them during a crisis wants me to feel better. That is, after all, why I go to them. This isn't to say that I'm dispassionate, or that I'm somehow above being comforted on an emotional level. Just last week, for instance, I sought out one of my friends and just asked her for a hug. I outright sobbed for several minutes. I needed that. It's rare for me to seek that kind of support; so rare that I think even members of my inner circle will be surprised to read about that.

The participants in the Batenburg and Das study engaged in "expressive writing", explained here:
"Lepore, Greenberg, Bruno, and Smyth suggested that expressive writing enables three important underlying mechanisms to cope with trauma; directing attention to the stressor and related emotions, habituation to the emotions, and cognitive restructuration."
I've worked diligently over the years to align my speaking voice with my writing voice, and I think those with whom I converse regularly will attest that having a verbal conversation with me is a lot like what it's like to read something I've written. (It's just more interactive and I'm funnier in person.) If expressive writing leads to those three coping mechanisms, then it stands to reason that expressive talking (if such a thing is recognized) would also lead to them. That's precisely why I share what I share, whether privately or publicly in this blog. I'm an expressive dude.

That brings me to the second article that caught my attention last night, How bias in mental health care hurts women, from the lab to the medicine cabinet, written by Erin Anderssen and published Tuesday on the Canadian website, The Globe and Mail. Anderssen makes a compelling argument that mental health care has done very little to recognize the sex-specific impact and needs of women with mental health concerns. She covers everything from the higher incidence of heart problems related to depression in younger women down to the fact that even most of the lab rats used in research are male.

The key specific matter addressed by Anderssen is that in Canada, mental health is treated primarily through pharmaceuticals rather than therapy. That's certainly true here in the United States as well, and I imagine that's true of most countries. Just taking the pills isn't enough, she argues, and my own anecdotal experience can attest to that.
The disorders most commonly diagnosed in women – depression, anxiety and insomnia – are also the ones most likely to respond to therapy, an approach that women are significantly more likely than men to prefer over drugs.
Drawing on commentary from doctors and researchers, Anderssen makes clear that therapy is the most prudent form of treatment for women with mental health issues. At present, though, the attitude toward therapy continues to regard it as some kind of luxury indulgence rather than a necessary form of treatment. For instance, she cites a pilot program in New Brunswick that offered twelve weeks of peer support to women with postpartum depression. Only 12% of the women treated by the program were still depressed when it concluded. Despite the success, the city rejected funding a full version of it at $142,000 a year.

I find discussing most anything in monetary terms disgusting, and particularly something like mental health, but even if we're to reduce the matter to dollar signs, "the cost of providing peer support would be roughly half the amount of the average hospital stay for a woman with postpartum depression," says the doctor discussing that program. Maybe the problem is that the New Brunswick city council didn't include enough women. I don't know, and Anderssen doesn't say, but we know that most legislators are male, and most of them consistently display detachment from issues that are women-centric. The most obvious proactive solution there is to elect more women to office.

Or there's the example Anderssen gives of insomnia, which "is diagnosed twice as often in women as men. It has a circular relationship to mental illness: People with it are five times more likely to have anxiety and depression, and having it makes you more likely to be depressed and anxious." Research shows that cognitive behavior therapy is even more effective in treating insomnia than are sleeping aids, but it isn't nearly as readily available. Women over 65 years of age are twice as likely to be prescribed sleep aids than are their male counterparts. These sleep aids are understood to cause quite a few falls and fractures among the seniors taking them, which costs Canada something like $2 billion a year. Anderssen notes that a forthcoming study projects that if even 20% of the seniors who fall can be kept from doing it - which cognitive behavioral therapy is shown to accomplish - that alone could save Canada "hundreds of millions".

So if the argument is that therapy is expensive, my response is, "Duh. You know what else is expensive? Treating all the things that arise because a patient didn't receive therapy."

Now, back to Batenburg and Das, who reported that two-thirds of their participants were women. In the section on Limitations and Future Research, they recognize this as a limitation. However, the 2:1 ratio of engagement is consistent with the figures cited by Anderssen about incidence of mental health in women as well as response to therapy treatment. They note that
"...It could be that gender has an effect on moderators of the psychological process, such as personality traits or coping strategies. For example, a meta-analysis focused on gender differences in coping showed that females cope by engaging in social relationships and they try to create change (in cognitive and actual terms) more frequently than men do. On the other hand, males rely more often on stress reduction activities or they tend to distract themselves (i.e., diversions)."
If cognitive reappraisal is the more effective means of support messaging, and if women respond more favorably to therapy, then it seems to me a no-brainer that mental health systems need to get past the obsolete idea of therapy being some kind of self-indulgence for those who can afford it. (On an entirely selfish note, my hope is that as we expand access to therapy, that I can get in on it myself.)

28 May 2015

Look! A Poll! →

I should have thought to write this post sooner, but I didn't. If you look to the right of this very sentence, Dear Reader, you'll see a poll atop the sidebar. I'm looking for feedback about the kind of content that you want to read here. I lost my self-confidence about writing last year, and while I've yet to restore it, I've accepted that you can't get out of a slump sitting on the bench. The only way out is to get out there and just keep swinging until you hit your way out of it. (Also, my doctor all but formally ordered me to return to writing and despite what she may think from time to time, I really am a compliant patient!)

Polling ends in just a few days, but you don't have to have an account or sign into anything in order to vote. Just click the boxes that cover your interests and that's all there is to it. Easy peasy.

12 May 2015

Crohn's Disease, Isolation, and Driftin'

My favorite Hank Williams song is "I'm So Lonesome I Could Cry". Not only are its lyrics rich and vivid and not only does Hank sound appropriately mournful, but there's a deftness to its title that I don't think is as fully appreciated as it ought to be. The song could very easily have been "I'm So Lonesome I Could Die". Same syllables, same rhyming sound. But if it had been "Die", the song would have felt hyperbolic, even if everything else in that recording remained exactly the same.

Admitting that you're so lonesome you could cry, though, conveys biting harshness. It doesn't even matter how prone to crying you may be; what matters is that you know where your breaking point is, and Hank is telling you he's just about there and it's because of how godawful lonesome he is. There's a duality to the song. Maybe we empathize with him, because we know what it would take to make us cry. Maybe, though, we feel he's the one empathizing with us, because he knows what it would take to make him cry, and here he is singing a song about it on our behalf. Does it matter? Not really. The point stands that it's the word choice of "Cry" rather than "Die" that gives the song its heft.

I've been fighting a Crohn's flare for five weeks now. After a few days of realizing it wasn't going to subside, I started a Prednisone taper, which typically does the trick. It brought a little relief on the first couple of days, when the dosage was strongest, but by the taper's end, they had become just a few more pills in my nightly regimen. Two weeks ago, I went in for IV treatment: steroids, antibiotic, anti-nausea medication, saline, and vitamins. I was thrown off at first because the physician who saw me wasn't my regular one, but at least she trusted that I knew my condition and didn't treat me like a WebMD-obsessed hypochondriac like a lot of doctors regard patients these days. I felt better that evening, though I was in and out of the bathroom until the next morning and I slept most of the next two days from exhaustion.

I'd been given a second Prednisone taper to begin after the IV treatment, hoping that the extra boost of the fluids would help the pills finish the job they couldn't on their own. Again, though, the Prednisone failed. I spent almost all day in bed on Sunday, alternately sleeping and writhing in pain. I returned to see my doctor in the morning. This time, we took images to see what was taking place inside me.

That's what I looked like on the inside, if you were to look right up (or is it down?) through me. At the top is a thing that looks like a snake's skeleton. That's my digestive tract. What we learned from that and a blood test is that a decade of Crohn's has essentially permanently damaged part of that area. This current flare isn't being caused by inflammation, which is why the steroids failed but the IV treatment that included an antibiotic brought me relief. We did another round of IV treatment this afternoon.

I sat there in a puffy chair in a room all by myself while my cocktail was delivered to me a drop at a time. I'd brought my iPod and played the Quantum of Solace soundtrack. Originally, I picked it because one of the few things for which I've had any enthusiasm at all of late has been Bond and I think I've only played that soundtrack maybe twice since I bought it.

Then again, though, maybe subconsciously I picked it because the last time I was hospitalized was in October, 2008 just a few weeks before Quantum opened here in the U.S.

I've avoided hospitalization throughout the intervening years largely through a combination of being vigilant about monitoring my condition and maintaining what I suspect most would regard as a low quality of life. I've contemplated myself just where I fall between "existing" and "living" on many occasions. There's a chicken-and-the-egg relationship between my physical and mental health, and I have a hard time sorting out which is responsible for a given funk like the one I've been in since late March/early April.

The last time I was hospitalized, I had my wife with me every step of the way. She was fiercely protective, and having worked in various capacities in the medical field over the years, she knew the language and protocols well enough to be my ambassador, my translator, and my guardian all in one. I could focus my energies on recuperating while she asked the questions I didn't know to ask, or the ones she knew I wanted to ask but was too miserable to put forth myself.

Sitting there today with IV fluids running into my left arm and James Bond music piped into my ears, it dawned on me how truly lonesome I felt. During one of my hospitalizations in 2008, I used up a great deal of energy fending off an aggressive gastroenterologist who wanted to start slicing and dicing on me and berated me for not being on Remicade. He ran a Remicade clinic, which he reiterated a few times. I never heard a physician concerned for my health speaking; I only heard a relentless salesman who had power over me. Ironically enough, it was the surgeon who agreed with me about my approach to give my treatment time to work before cutting into me.

Dr. Remicade also insisted my appendix needed to go while I was being cut on anyway, incidentally. A decade later, I still have it. If/when the time comes that I have it removed, I might ask if I can keep it. Take it to a taxidermist and get it turned into a trophy of some kind, maybe. I haven't thought it out yet.

If dealing with that guy was as exhausting for me as it was seven years ago when I had a devoted defender at my side, how can I possibly get through it on my own if it comes down to being hospitalized again?

It isn't that there's not another person in my life who cares about me or wouldn't try to be there for me. I've said for years that if I've only ever done one thing right in my entire life, it was surely to have surrounded myself with truly wonderful people. I have an enviable inner circle. It's not an exaggeration for me to say that I probably have more Friends than a lot of people even have Acquaintances. I've got so many Friends these days that it makes incredulous my insistence that I don't confer that title casually, but I really don't. Anyone I have designated a Friend has earned their stripes over the years.

But there's only so much that even a Friend can do when you're hospitalized.

They can check in on you, whether in person or remotely, of course. They can tell you they're thinking of you and they hope you get better soon, and of course they do. They can say that if you need anything, just to ask them, but there's no way to ask of them what you really need, because what you really need is to not be so lonesome you could cry.

That feeling can hit you at any time during a hospital stay. It can be when you first wake up and realize you're still there. It can be during breakfast when the patient in the next bed gets scrambled eggs and you get literally nothing because you're not allowed to eat or drink anything beyond the sip or two it takes to wash down your pills. It can be when you want to murder the scrambled-egg-eating patient next to you because he insists on watching Judge Judy as loudly as the TV will go...so that he can nod off and snore through it. It can be when the nurse comes in and you ask when someone will come by to tell you what the game plan is and they have no idea. It can be when you realize your hair is absolutely gross because of how long it's been since you showered.

It can also be when you start trying to outline the possible and probable courses that your health will take in the coming minutes, hours, and days. What if something goes wrong? What if it goes right but it just doesn't work? What if I'm in far worse shape than anyone realized? It gets uglier from there in a hurry.

The point is, that feeling of lonesomeness can - and does - strike at any time. Your Friends are on the outside, living through their hectic but scheduled daily lives. They're dashing to work in the morning, picking up kids in the afternoon, trying to attend meetings, practices, performances, tend to household errands, and even carve out an hour somewhere in all that for themselves to decompress. They can't be expected to burst into the room like the Kool-Aid Man just before you agree to a course of treatment that makes you squeamish because the physician has succeeded in wearing you down with his bullying. There's only a quantum of solace in knowing they would if they could.

I was asked earlier if surgery had been discussed with me at this point regarding my current flare. It scared the hell out of me.

I'd already recognized the possibility and even shared my anxiety over it with a few Friends, but somehow being asked about it pointblank spooked me even more. I'm not even ready to have someone ask me if surgery has been discussed. How would I go into it, if that's what it comes down to at the end of the week? (See: Three paragraphs up.)

Friday, 15 May, will mark the tenth anniversary of when I was told by an ER doctor that I "likely" had Crohn's disease. Being an ER doc, he wasn't allowed to diagnose it, but he was pretty sure and it turned out he was right. I'd been misdiagnosed with merely having GERD a year before that, and had suffered through symptoms for a year before even that, but I regard 15 May as my Crohnniversary.

I brainstormed months ago about "celebrating" (defying) the occasion by trying to get together as many Friends as possible to do something I enjoy that Crohn's has kept me from doing nearly as much as I would like. I settled on mini-golf. I truly love mini-golf, particularly at night. On a mid-May evening, it would still get dark early enough for the excitement of nighttime while still being warm enough to be comfortable.

I haven't formally canceled the outing, but it's almost certain that I'll have to. Even if this current antibiotic treatment works as hoped, these episodes are exhausting. If it doesn't work as hoped, I'll almost surely cry.