Thursday, February 23, 2017

Band Review: Noname


Noname is a rap artist based in Chicago. She recently played Portland, supporting her 2016 album Telefone. I listened to her this week based on a blurb in the Arts & Entertainment section of The Oregonian last week.

The release date is significant, because she has been on the scene since 2010, contributing to other projects, including on "Lost" with Chance the Rapper in 2013 (the same year Telefone was announced). The blurb mentioned that, and I remembered that as I started listening and found the music hard to get into.

Noname uses some jarring notes and patterns. That can include a faint ring on "All I Need" that keeps me checking my phone, or an overlay of competing sounds on "Sunny Duet". This keeps the listener off-balance, rather than being able to settle easily into the music.

For someone who has taken so much time working out what she wants to say, I have to assume that is a deliberate choice. As repeated listening leads to familiarity the discomfort subsides, but before that you have heard.

As that happens I start to hear possible scat influences. I hear some quiet and lovely accents. I hear an undercurrent of fear because society is never safe for some people. There is still caring and beauty, but it is impossible to relax, depending on your skin color.

So yeah, the music shouldn't be relaxing. It reinforces what life is like.




Wednesday, February 22, 2017

Drug trade


We are currently changing some medications for my mother. I have mentioned how anxiety exacerbates her dementia, and we sort of got into a worse place. It seemed necessary to increase a dose, or change it, or add to it.

I read a lot, but in the realm of anxiety and depression and the meds that help them, most of what I know is from listening to people. One thing I have learned is that a lot of people have a bad reaction to Xanax. It makes them feel sicker than they have ever felt in their lives. Another thing I have learned is that doctors often want to try it first. I was not sure whether that was an issue of the doctors liking it because pharmaceutical reps give them nice things or insurance companies preferring it because it was cheap. It sounds like it is more the cheapness.

I agree that cost-effectiveness is important. For all the things that might make you feel uncomfortable about the pharmaceutical reps, I have benefited from medical samples and things that my doctor passed on to me. There is plenty of room for debate on whether health should be a business, but there's no question that it currently is.

That being said, when a patient is seeking relief, given the ramping up times and the weaning off times that are involved in starting and quitting the different drugs, giving them an extra month of feeling sick just in case the cheaper one might work seems to fly in the face of "First do no harm."

And I certainly didn't have time for it, so that was something that I was ready to fight for in our situation. I didn't start out fighting, but fortunately I know what all of the blood relatives are taking and who has had bad reactions to what, and good reactions. While there were other ways in which the transaction was not completely satisfactory, everyone was at least agreed that we weren't going to try Xanax. Knowing family medical history helps.

For example, if a sudden medical reaction set off a panic attack that brought a person's latent anxiety to the forefront (like maybe she'd always been kind of uptight before, but it was manageable), then it would be helpful to know that a genetically identical sibling's anxiety was being successfully treated with Zoloft; don't bother with the Xanax. That's what ended up happening anyway, but first, one extra month of sick.

However, that is not the only way in which knowing family medical history can be important. Hypothetically, knowing that the genetically identical sibling has anxiety could be a really good reason to not prescribe a medication like Wellbutrin (Buproprion), which seems to be really effective at pushing people over the edge into anxiety.

Maybe it wasn't commonly known at the time. I only found out because I started doing some research after the fact, but you would hope that the doctor would have known. Studies are not in complete agreement, but there are enough reports where it seems like a risk.

Of course, you also have to consider the risk from the other side. What is being treated? What happens if you don't take the medication? Wellbutrin is an antidepressant and smoking cessation aid. Smoking is very deadly, though you need to weigh that against increased risk for anxiety and for epileptic seizures.

However, this patient was not a smoker. She was prescribed it as something that could possibly help with weight loss. That's not what it's for, but over 6 to 12 months you can lose about 2.7 kg over the placebo group. That's almost 6 pounds! Except that she was not able to take it for even one month, because it made her really sick and brought on debilitating anxiety that required a lot of medication and time before things started becoming normal again.

I wanted that doctor fired. The patient disagreed and continues to go there, and nothing that bad has happened since, which I guess makes it all okay.

I believe in that case the problem is a belief that nothing else can be as bad as being fat. If the patient is desperate to lose weight, and the doctor believes that is the key priority to good health, it's simple logic. Aren't seizure and anxiety better than fat? Even only six pounds of it?

And thus we transition to the portion of the blogging where I will start writing about being fat. We'll start Monday.

ETA: Just found this: https://projects.propublica.org/docdollars/

Tuesday, February 21, 2017

Consumer advocates


Over the course of the long reading list, one common source of frustration was how often businesses or government entities will look right past your humanity. I am not a gadget, but I am also not a product. I don't want to be seen as a customer or a brand or anything where I get reduced to a market value. That will be explored further, but one book gave me a different take on seeing yourself as a customer:

The Day the Voices Stopped, by Ken Steele

I read it for hope. Depression, PTSD, and eating disorders were most common among my people, and there were some with bipolar disorder, but schizophrenia was relatively rare. There were still some cases, including with one of the girls I got especially close to. In addition, although schizophrenia can be more dramatic in how it distorts reality, there were still a lot of distorted perceptions with the eating disorders, and dangerous voices inside their heads with the depression. It was important for me to know that could stop.

The book was very affirming in that sense, but there was another lesson that I am starting to understand now. Steele's experiences - often horrific - led to him becoming a mental health advocate, and it was centered on treating the mentally ill as consumers rather than patients.

It sounded odd to me at first; there are illnesses being treated. However, thinking as a consumer instead of as a patient focuses on choice, and it means critical analysis on the performance of the doctors.

Let's go back to that friend who was sure that the talking cure was the only real remedy for depression, and that medications were only valuable for the assistance that they could provide on the way to a cure. At the time I thought that meant his issues were probably more traumas that he needed to work out, rather than any chemical imbalances - all of which seemed reasonable based on other things that I knew about him.

I have since had two other thoughts, neither of which really contradict the first thought. One is that I suspect this is what his therapist told him, influencing that belief. Also, if he could believe that, then his therapist was working out for him.

I am glad for that, but it is not automatic. I read an article a couple of years ago that I can't find now, but it was about one young woman's attempt to find the right therapist, and it took her four or five attempts. Sometimes the therapist was at fault, like the one that was romantically interested in her (huge red flag). If you are trying to heal from abuse, an excellent therapist whose features or voice are similar to your abuser may not be able to get very far. But also, maybe you just need someone who used a different method, or doesn't have a prejudice against the religion that is important to you, or someone with a different perspective.

There are a lot of different ways that things can work out. Timing can be a factor. I know someone who tried desensitization therapy. It was not working then, but over time she was able to build up strength for the stressful activity; maybe it can be sped up for some people and not others. The human mind is a complicated part of a complicated species.

That frustrates people. Dear friends will tell you that you need to get over something, and try practicing tough love on you. It might help, but it might not. People who have had success with one type of therapy will be sure that it's what you need, but may be ignorant of many contributing factors that affect how it will work for someone else. And your doctor will go by many past patients, which may not work for you.

Ken Steele faced a lot of terrible side effects over the years. Some of that was probably due to the medication still being developed; we have more and better options now. He was at times harmed by doctors not listening when he would tell them how a certain medication made him feel. That's why patients need to be able to fire their doctors. That's why it helps to be able to think as a customer.

There have been some advances in mental health parity, but there are shortcomings in coverage for physical health too. There is also a line drawn between physical and mental health which can be somewhat illusory.

I looked into becoming a home healthcare worker for my mother. I was told that her needing supervision was not enough; she would actually need to require help getting dressed and feeding herself and things like that. I know of other cases where admittance into a home that is needed due to dementia is not covered because it is only affecting the mind. These are issues that cause real distress for families, and they are also ones where the patient cannot be their own advocate.

That may seem like a case where a consumer mindset won't help, but believing that things can and should be better may be easier for someone remembering that the people you are dealing with are being paid for their answers. They are employees. Maybe you need to go up a level to a supervisor. Maybe you need to push for consumer protection and broader offerings.

I am thinking now of someone in treatment for anxiety and depression that has become debilitating and who is not making much progress yet. I do believe in that "yet". Maybe she needs more time, or a different combination of medications. Maybe she needs to change care providers.

There can be a lot of hassle involved in that, so success is going to require two things. One is that belief that improvement is possible. For all of the pain out there, I see improvement all of the time. If one path is not working, it does not mean there is no hope for you. It may mean that you need to change directions.

And because there can be so much hassle and discouragement, there should be support. Reaching out and trusting can also be hard, but we can all work on making that easier. We can be more understanding. We can be more informed on how things work. We can be kinder. We can listen to hear the things we don't know, instead of trying to make everything fit into our comfort zone.

We can be there for each other. And we need to.

Related posts:

Monday, February 20, 2017

There are four lights


I have never watched any of the "Star Trek" series regularly, but I have seen various episodes and many of them have made strong impressions on me. The strongest has probably been "Chain of Command".

I haven't even seen the whole thing. I missed the mission, and Picard's capture, and most of the torture, but I remember seeing that final attempt to break him. His torturer knows they are about to take Picard away, but he still has to try. For all the pain that has come every time Picard was asked to say that there were five lights, he has insisted (accurately) that there are four. More pain. Now there is the promise of comfort or pain for the rest of his life, and all he has to do is say that there are five lights. Then there is that interruption where Picard learns it was all a lie, and he is free. Before he goes, though, he has to say it one more time, in a feral, primal shout:

"There are four lights!"

That scene was memorable, but what drove it home for me was the next scene, where Picard is discussing it with Troi. He admits at that point that he could see five lights.

I had been thinking about it more, so I looked it up. Of course it was inspired by 1984.

I do think of it because of the frequent shameless lies. It's not even so much because of the administration lying, which was expected, but because there are people who believe it.

I remember a change within the last few years where people would start giving Lincoln's suspension of habeas corpus during the Civil War and Japanese internment during World War II as examples of how it could be okay to set aside civil rights. Somehow the thread had been lost that these were bad ideas that we regretted.

That went along with my confusion about how people were still listening to Breitbart. They had been shown to lie and edit video multiple times before Planned Parenthood. Anyone remember ACORN and Shirley Sherrod? They were such exaggerated, mustache-twirling caricatures it should have been obvious anyway, unless you were eager to believe it. Maybe that was the problem.

I do think of that, but there is something else more personal for me. I think about the scene over and over again with my mother.

For all of the memories that she has lost, her personality is still there. I see it in her stubbornness at times, but also in her worry. She usually doesn't believe this is home, so she worries about where the pets are. If they are here, do we have food for them? Mainly she worries about my younger sisters, because she keeps thinking there is another set. She gets frantic about the two that are missing.

I try really hard to reassure her that she is at home and she has her children with her and that everything is fine. Sometimes it works, sometimes she gets really sad, and sometimes she gets mad and fights it. That's when I feel like a Cardassian sadist, trying to break her and strip her of what she knows. I am trying to make her see the fifth light.

She feels like she is fighting for her sanity; at least that's how I interpret the desperation that I sense. But what I am trying to tell her is true; if she could accept it and remember it, there should be some relief in it. Ultimately, it's just terrible for all of us. It's not every moment, but it's a frequent interruption and is full of pain.

Putting all of it together, there is a note of fear for me as well. It is frightening how easily truth can be lost. In that light, maybe it makes sense that my Sunday blog just finished an examination of the Constitution and is starting a deep examination of the Savior's life and teachings. Maybe I am afraid that I only think I know some things.

If that is the case, apparently I still believe that I can know them. I still believe that I can count and see lights.

Friday, February 17, 2017

Band Review: Wesley Willis


I have gotten really emotional listening to Wesley Willis,

I'm sure it hit harder because of other things that are going on, with questions about reality and medication that will be dealt with more in some of the non-music posts.

I first saw Wesley Willis recommended by Face the King, though Berwanger mentions him a lot. There wasn't anything that would give me a context for who he was, also an artist, also schizophrenic and known for his obscene phrases and bestiality references that were a way of fighting his demons as he personified them.

That gave me concerns about listening, largely about whether I was even up for listening to a lot of profanity and bestiality references, but also worries about whether it was exploitative (a common concern for many critics). It started out okay, with me avoiding certain song titles, and then really turned around with Rock n Roll Will Never Die.

That is my favorite of his albums, for multiple reasons. I love the cover, with his art in the background and a really happy looking Willis in the foreground. Given the joy that rock gave him, that feels appropriate, and then the songs started reminding me of the joy that rock shows give me.

The tracks are repetitive - musically and lyrically. The music repeats because it was usually pre-programmed tracks from his keyboard. That works. I have played with Casios and Yamahas and they had tracks I would just listen to sometimes. I knew they were formulaic, but it was a formula that worked.

(Actually, there are parts of the musical and vocal delivery that remind me a bit of zydeco artist John Delafose, which makes me wonder how Willis might have been different if he had been in New Orleans instead of Chicago.)

The lyrics made me think more. If the crowd roared like a lion at multiple shows, well, that does happen at multiple shows. At smaller shows you do get to meet the band a lot. I don't know if jam sessions after are common - maybe that was specific bands or venues or maybe you only get to go to those if you are a musician, but yes, there are things that are the same. It doesn't make the thrill less sincere or enjoyment less real. Some people worry about describing it in a way that is new; Willis used familiar words but he used them sincerely.

That was when the repetition of commercials jingles started to make more sense. A lot of them become earworms and blend with the soundtrack of parts in your life. The Pontiac one - yeah, my brain repeated that one at odd moments too.

One of the last songs I heard was "Outburst". It has a different backing track. His vocal delivery is different, despite some familiar phrases. It makes sense for it to stand out. The other songs are real, but they are either about fun things or playful about bad things. "Outburst" is serious and real and heartbreaking. Getting kicked out of the art store and faced with a potential ban goes beyond embarrassment because of the importance of his art to him. It's worse than getting thrown out of church (which also happened).

Paired with "Chronic Schizophrenia" on Rush Hour, it feels like a greater opening up. It makes you wonder how much more someone has to take. Then you get the answer because that was 2000 and in 2003 leukemia killed him, so there you go. (And it's long ago enough that there wasn't a big web presence, but I am including some links about his art.)

There are laughs in the songs - "Cut the Mullet" comes to mind ("Do something about your long filthy hair") - but there is a lot of sadness too. That is probably aggravated by only learning he even existed fourteen years after his death. There is also relief that he had an outlet. He made something, and it was real, and it's still out there. His voice was raised and heard.


Thursday, February 16, 2017

Band Review: Redd Velvet


Redd Velvet is a blues singer who was also featured in Touré's Smithsonian article.

When I was searching for links, Wikipedia popped up first (very normal with Google searches) with a first line visible saying she was best known for her unconventional entrance into the music industry. I mainly used that search to find all of the links that appear below, but I also had to check into that.

"Unconventional" in this case seems to refer to starting her own label instead of signing a conventional contract, which would have been an option after winning the Memphis Blues Challenge with her band. It may mean relocating to Memphis to start her blues career after gospel experience and classical training. It could also mean working as a nurse and being a social activist while she does her music on her own terms.

That makes it less surprising that she became the first blueswoman to create and host a radio talk show, or that the opportunity came from her social networking posts. Her Youtube channel does not have a lot of music, but there are many posts of her speaking her mind, and clearly, she has plenty of mind and plenty of will to express.

I am not sure how I feel about the advice. It seems a little judgy and possibly overly invested in respectability, but a lot of it seems sensible too. I smiled to hear her mention that she had cleared using "bitch" with her mother before one session, and also to hear her mention that Smithsonian article and hoping good things would come from that.

Being more conventional could have worked out too. Redd Velvet has a smooth and soulful voice, easy to hear on songs like "From Me To You" and "Wouldn't You Like to Know".

Taking the conventional contract and label support might have paid more, but you never know. Getting people to pay for music has been a challenge for many artists, and the label always takes their cut first. For someone who clearly values her independence, this seems like a good path.





Wednesday, February 15, 2017

The geopolitical landscape


"The manner of the country makes the usage of life there, and the land will not be lived in except in its own fashion." - Mary Austin

I read that quote when reading about the Dust Bowl, but it came to mind as I was remembering Amsterdam: A History of the World's Most Liberal City by Russell Shorto.

Shorto reviews the history of the city itself, and how Dutch settlers in New York (formerly New Amsterdam) influenced the development of the United States government. I read it because so many of the girls I wanted to help were Dutch, and I thought knowing more about their country might help. It ended up teaching me more about my country.

Regardless, one of the key points was that the democratic and liberal nature of Amsterdam was largely influenced by the watery land. Establishing the dikes and drainage required a communal effort, where everyone had to work together. That could have led to a greater sense of equality and community spirit.

I have some messy related thoughts. One is that - despite the high costs of ignoring the manner of the country that led to the Dust Bowl - we have managed to ignore the manner of the land a lot now. We can get away with it because so many people are not directly involved in agriculture and they don't see it. Nutrient levels in foods have gone down, commercial feed lots are horrible in terms of the waste and the health of the animals, and it all includes over-reliance on fossil fuels with those accompanying problems.

(The documentary King Corn or book The Omnivore's Dilemma are good starting places, but there is a lot of information out there. The issues are easy to ignore, but you don't have to.)

Subsistence farming did not have to have these issues; they come up when there are people trying to get rich. I am more aware of this after studying child labor and racism and slavery. Two key industries where slavery grew were tobacco and sugar. Both require a lot of labor, and one person is not going to make great profits; that requires multiple people who can be abused. Sugar requires a larger initial capital investment, which added limitations to who could get involved, but getting started in tobacco was relatively easy when people could be bought and used cheaply.

Changing agriculture could do a lot for the environment and for human health, and getting more people involved in growing things could help. Even with a sense of working for the greater good, it would be possible for that to be a largely solitary practice.

However, we may be at a point where we can feel our need to work together and unite.

I know people who feel they do not know enough to contribute. I may be part of the problem there, with all of my reading lists and things. The thing is, I like reading and I like knowing stuff - that is a natural path for me to take. It's not the only one.

You can learn things from articles. You can learn things from other people. You can learn things from classes and voter pamphlets. And you do not need to know everything to be able to know that some options are better and worse. When I said I wanted everyone to vote - no matter how much I disagree with their choices - I meant that. We should all be participating and we can all participate.

There are people who will decry that, because so many people are stupid and we are better off with them not voting. In general, the people who put forth that kind of thinking are in favor of some pretty harmful policies. Of course they don't want people voting, and since they are already tearing people down through legislative and corporate means, why not also tell people they are stupid? Maybe they will believe they deserve everything bad that happens to them.

I will never be able to support this. Yes, people can be stupid and intractable and petty and malicious. They can also be generous, kind, self-sacrificing to the point of heroic and very good.

Since the election, I have seen some people who were always kind of trivial before start to really care. People who have never protested or contacted a representative before have now. There are imperfections, but I am sure there were many imperfections amongst the early Dutch people pulling land from water.

Working together can help us learn to appreciate each other. It can help us spot the goodness in each other, and it can develop more goodness.

I never thought much about the motto "Stronger together" when it was first chosen, but I keep seeing more and more how true it is.

That makes the election results more tragic, but it also points to the best path ahead.

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