Category: Health

Health/Lifestyle
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Going Public With Alcoholism

by Fran Johns

(This first appeared on Huffington Post)

Bottles

I am, among other things, an alcoholic.

When describing myself list-wise, alcoholic would probably come after writer, wife, activist, mom etc; but I am still, and in a very public way, an alcoholic. It’s the business of being public that puts me at odds with a lot of my fellow alcoholics. But I haven’t had anyone complain, and I am increasingly certain that going public isn’t such a bad idea.

Most alcoholics have very good reasons for keeping their anonymity. Outside of AA meetings their addiction — conquered or not — could cost them jobs, friendships, reputations. I lost some of all the above in my drinking days, but letting people know that those days are behind me poses no identifiable risks.

At six years alcohol-free, I moved to San Francisco in 1992 to marry the old friend known ever since as my Final Husband. I had to make a choice: Spend the rest of my life saying “No, thanks, I don’t care for one right now,” or, “You know, I’m an alcoholic. I can’t handle the stuff.” If I chose the latter, I figured I would soon not have to say it very often, if at all. I chose the latter, and never looked back.

The Final Husband, a man who does love his cocktail hour martini (gin, of course, up with a twist) and a good wine with dinner, bought into the plan. He would have far preferred a wife who would join him in wine appreciation, but took my word for the fact that I am an addict and vowed to support me. For the first several years of our alcohol-bifurcated union, he quietly took a bottle of non-alcoholic wine to cocktail parties so I could be comfortably unobtrusive. (This led to one rather hilarious episode that has become a favorite family story: From across the room in a crowded party thrown by one of San Francisco’s impeccably elegant hostesses, I once spotted a gentleman filling his lady friend’s glass from my non-alcoholic wine bottle. Unable to dive over the crowd to intercept, I watched as her pleasant smile turned to a disbelieving grimace and she set the glass down rather abruptly on a nearby table. We have imagined all manner of repercussions from this incident, but thought better of telling the hostess.)

From the beginning, I worked hard to craft comments that would not come across as judgmental or argumentative. Those were mild-mannered remarks like “I was a ‘social drinker’ for a long time but my drinking changed and became very bad for me.” Or, “Some of us can handle alcohol and some can’t. I really can’t.”

But I also fought hard against the common, almost reflexive attitude that being alcohol-free must leave my life barren and deprived, supremely dull. So I tried to say things like, “Whoa. I hated feeling like my words and thoughts were not super-sharp.” Or, “I really love waking up in the morning without feeling blurry, let alone hung over.” In the land of perpetual cocktail events, wine etiquette and Nectar-of-the-Gods believers, living outside that culture is generally assumed to be the worst of all worlds. I took the attitude that I’m delighted to see others enjoy themselves with alcohol, but for me, being without it is far more of a delight. Unadulterated joy, as a matter of fact. My comments at least carried the weight of demonstrated truth.

After the first few responses of shock and disbelief, my new friends on the Left Coast fairly quickly adapted to this strange situation and joined me in laughing about it all… or soon, ignoring the issue completely. I never imagined that it mattered to anyone but me. But here is why I suspect being public about being alcohol-free does indeed matter, and perhaps more of us should consider doing that.

One day I received a Valentine that reinforced my conviction about having taken the right course. It was from a woman I had known, though not intimately, for several years; we had frequently been together at concerts and parties. She is bright, pretty, accomplished in many areas, widely admired and respected. If anyone had ever suggested to me that she had an issue with alcohol I would have scoffed in utter disbelief.

The Valentine included several brief lines. She said she was sober now. She said I had influenced her to try that route to new life. Over the years I’ve gotten several other notes, like the email that just came, wanting to make sure I saw John Skoyles’ essay in the New York Times Sunday Review “about his coming of age with the bottle. I am 14 years plus now,” she wrote. “I have you to thank.”

It may be mid-summer, but that’s the best Valentine’s gift I’ve ever received.

 

Abortion/Feminist Collection/General interest/Health/Healthcare/Reproductive rights/Women
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Should Abortion Be ‘Rare’?

by Fran Johns

This first appeared on Huffington Post

Beware the Rare-word.

Many of us — fiercely pro-women, fiercely pro-choice — bought into the “keep abortion safe, legal and rare” mantra of several decades back. It was, in fact, a useful mantra — until it was sunk by the potential anti-women interpretation of the word “rare.” The endless focus on the ‘rare’ word at times approaches the “it-depends-on-what-the-meaning-of-the-word-‘is’-is” hubbub.

In defense of both sides:

Make abortion rare! By supporting universal contraceptive coverage. By supporting Planned Parenthood. By expanding education. By reducing unplanned pregnancies in all ways that empower women and reduce violence against women.

But get rid of the ‘rare’ word. It is, apparently, sending the wrong message. Jessica Valenti covered the issue well in a recent piece in The Guardian, citing two leaders in the area of women’s reproductive justice. One is Dr Tracy Weitz, co-founder and former Director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. In a paper published in 2010, Weitz wrote that “rare suggests that abortion is happening more than it should, and that there are some conditions for which abortions should and should not occur. It separates ‘good’ abortions from ‘bad’ abortions.”

None of this — ‘good’ abortions, ‘bad’ abortions, whether or when there should be abortions — is anybody’s business but the woman involved. Only she and her physician can know the circumstances, and the circumstances of no two women are the same. So if the ‘rare’ word is clouding the issue, let’s dump the rare word.

Valenti also quotes Steph Herold, Deputy Director of the Sea Change program, who says abortion needing to be rare “implies that abortion is somehow different than other parts of healthcare. We don’t say that any other medical procedure should be rare.” Sea Change is working to remove the stigma attached to abortion and other reproductive issues, a laudable, and monumental task. More than a few of the women who share their stories in Perilous Times: An inside look at abortion before – and after – Roe v Wade speak of suffering almost as much from the stigma attached to this most personal of women’s issues as from any physical harm, real or feared. While breast implants, sex-change details and erectile implantation (among other personal decisions) are fair game for cocktail party conversations, when is the last time you heard anyone volunteer information about her abortion? One in three women have an abortion; we Do Not Talk About It.

But here is the fact: There are bad abortions. They happened before 1973; they are happening today.

A mother of two physically challenged toddlers, pregnant with a third in 2014, unable to get to the nearest clinic — which is hundreds of miles away and impossible to access (despite the famous comment made by Texas Judge Edith Jones that it’s easy to go 75 mph on those flat roads) — punctures an interior organ trying to self-abort the old-fashioned way. She lives, but this is a bad abortion.

A desperate teenager in the rural midwest manages to get what she hopes is the right abortifacient through an internet site. Wrong drug, wrong instructions, wrong outcome. She gets to an ER before she bleeds to death. She lives, but this is a bad abortion.

This writer, pregnant from a workplace rape, overcome with shame and sheer terror, managed to find a kitchen-table abortionist in 1956. It was a bad abortion. We thought those stories were ended in 1973 when abortion was made legal and safe. But they are being repeated daily in this country, the land of the free; every one of them speaks of a bad abortion.

Women are suffering and dying again today from bad abortions, or because they are being denied access to safe, legal care. Whatever it takes, whatever words we use, the lives of those women are worth fighting for.

 

caregiving/compassion and choices/Death and Dying/General interest/Health/Medicine
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Wise Words from Doctor Turned Patient

by Fran Johns

Bob-baldric

Not every doctor gets an extended view of what his or her patients experience. But one who did – and has shared both the experience and its message(s) is a recently recovered friend and end-of-life issues colleague of this writer, Robert Liner, MD. Liner spent 20 years as an Ob/Gyn with clinical and teaching positions, principally at Mt. Zion Hospital in San Francisco, followed by 20 years in private practice of prenatal diagnosis and gynecologic ultrasound. Among his exhausting list of interests and endeavors are piano lessons, playwriting, poetry, working to publish an illustrated lullaby — and serving on the Leadership Council of Compassion & Choices of N.CA. (And occasional adventures into designing menswear, such as a reincarnation of the ancient ‘Baldric‘, modeled above, which Liner feels makes a lot more sense than the necktie.)

Not long ago, though, all of these – plus a simultaneous major house move and recent new marriage to longtime lady friend – were severely complicated by a bout with life-threatening illness.

“A year ago, on my sixty-ninth birthday,” Liner wrote in an article that recently ran in San Francisco Medicine, “I checked into Kaiser Hospital for work-up of a chronic cough, back pain, severe anemia and a low-grade fever. Believing that patients often overreact to symptoms and seek medical attention prematurely, I had let things go a bit far. I’d been easily fatigued and a bit short of breath, but when a couple of days prior to my hospital admission my wife saw me leaving food on my plate at a favorite restaurant, she insisted on taking me to the ER. I told her this would be an abuse of ER resources but, once there… watching two units of blood being transfused into me, I brilliantly arrived at (the same) conclusion: I was seriously ill.”

Liner covers the days of his hospitalization with openness and humor: “Generally, when getting medical care, I avoid mentioning that I’m a physician. Even experienced providers sometimes have steadier hands when not aware they’re administering to a physician. Or, for that matter, to a malpractice attorney.” (You can read the entire, illuminating piece in the current issue of San Francisco Medicine. It is a significant message to physicians, and an informative and reassuring message to anyone facing hospitalization.)

Liner emerged from more than six months of chemotherapy, radiation therapy and “a lot of drugs” with his B-cell lymphoma in complete remission and a low percentage chance of recurrence. But in addition to the firsthand lessons for physicians and patients about illness, he offers a powerful lesson for all of us about dying – since all of us, patient and doctor alike, do eventually die. Liner and his wife faced that possibility throughout a 36-hour period in which it seemed likely that his disease would, in fact, be terminal; they faced it with “a profound sadness.” But he explains:

“There was nothing irrational about that sadness. Patients who are genuinely terminally ill and who seek physician aid in controlling the time and circumstances of their deaths should not be thought of as irrational or pathologically depressed. If, unexpectedly, my lymphoma recurs, the prognosis would be ‘dismal.’ If that happens, I believe it should be within the scope of ethical, legal medical practice for my doctor to provide me with a lethal prescription – a key to the exit.

“Physician aid in dying is something distinct from suicide. The disease would be killing me. No compelling state interest here. No slippery slope. Only a decision to be made by me as a patient, along with my family and my doctor. As a physician and as a patient, I see this as a fundamental liberty interest and as sound, compassionate practice of the art of medicine. Of, course, where my death is concerned, I’d rather skip the whole thing.”

Wouldn’t we all.

 

 

Abortion/Health/Medicine/Reproductive rights/Women
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Vessel: New documentary, powerful voice

by Fran Johns

Working with Women on Waves – the organization determined to make safe abortion available around the globe – is not for the faint of heart.

Vessel, a new documentary currently being shown around the U.S., traces the progress of Women on Waves from its beginning more than a decade ago and through its now sister organization Women on the Web. That progress winds through angry protest mobs pushing, shoving, shouting “Murderer!” “Go Away!” and worse, and throwing eggs (and worse.) The women of WoW, mild-mannered though they may appear, retaliate by cutting the ropes of police boats attempting to tow them away, going nose-to-nose with burly guys on protest lines and breaking the seals of locks placed on their supply cabinets.

Meanwhile, the movement steadily grows.

Women on Waves was founded in 1999 by Rebecca Gomperts, MD, MPP, who was trained in both medicine and visual arts in her native Amsterdam, the Netherlands. (It doesn’t hurt, for the film, that Gomperts is also attractive, articulate in several languages and highly photogenic.) As a young Ob/Gyn Gomperts traveled – one might say trained – with the Greenpeace ship Rainbow Warrior as its doctor and an environmental activist. While sailing in South America she was struck by the numbers of women suffering from lack of access to reproductive health services and safe, legal abortions – and inspired by their stories to start Women on Waves.

The group built a clinic-in-a-box, loaded it onto a ship and sailed into such unwelcoming ports as Morocco, Portugal, Spain, Poland and eventually scattered cities around Africa, Central and South America. The strategy was to anchor 12 miles offshore in international waters, where local authorities had no jurisdiction. Local authorities were seldom pleased. Gomperts was often on land, hanging banners announcing the phone number for pregnant women to call, drumming up press – usually unfriendly press – agitating the authorities and spreading the word, smiling pleasantly in the face of incredibly hostile opposition.

Once the medical abortion procedure using misoprostol became widely available and safe, if used as directed, Women on the Web began its own ambitious program of making the procedure available through the internet. And safe abortion slowly gained through changing laws.

The movement has one simple goal: to reduce the number of deaths from unsafe abortion. It is the same goal that motivates every other reproductive justice organization, from the Center for Reproductive Rights to ACCESS: Women’s Health Justice to NARAL Pro-Choice America.

But the film ends with a litany of places where poor women (if you’ve got money, you can manage to find a safe abortion somewhere) remain at risk for lack of access to safe abortion, notably including much of the U.S. Watching it in the U.S., where abortion has been legal since 1973, and being reminded again that women here are suffering and dying today, is sobering, and indescribably sad.

The sadness comes from hearing the same, tragic stories that first inspired Rebecca Gompers, and some years ago inspired this writer to create the book you see at the right. They come through the voices in the film:

“I’m scared to death.”

“I tried hitting myself in the stomach…”

“My family would disown me if they found out.”

“Can you help me?”

How can we be ignoring these voices in the United States today?

 

 

 

Abortion/contraception/courts/Healthcare/Politics & Causes/Reproductive rights/Supreme Court/Women
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On Making Abortion “A Thing of the Past”

by Fran Johns

This first appeared on Huffington Post

“One day our country will be abortion-free,” says Pro-Life Mississippi board member Tanya Britton.

Rose Mimms, Director of Arkansas Right-to-Life, wants to “make abortion unthinkable.” Read: impossible.

Texas Gov. Rick Perry’s stated goal is “to make abortion a thing of the past.”

We have been here before. None of the above zealots are old enough to remember exactly what it was like, but I could describe for them the time when abortion was unthinkable, impossible and illegal and the country was what Britton would describe as “abortion-free.” It was only legal-abortion-free, of course, and this is what that was like:

Women died. By the untold thousands. They died of sepsis most often, a singularly terrible way to die. They also died of things like puncture wounds, desperately trying to end what was a torment to their bodies and souls. They had found themselves with unintended pregnancies – most often caused either by uncaring and irresponsible husbands or by inexcusable acts of rape, incest or circumstances over which the women themselves had no control.

Women of means died less often; they could generally access a safe abortion, even if it meant traveling to a more enlightened country than these United States. Primarily, those who died had little money and less power; often they already had more children than they could care for. Those who denied them the right to an abortion did little or nothing to help them care for present or future children.

So here we are again.

Abortion opponents can make it impossible, unthinkable, illegal; they cannot make it a thing of the past. Because women desperate to end unwanted pregnancies will always, always, always find ways to do so. Some of them, as is already happening, will die trying.

At least Britton, Mimms and Perry are honest about their goals. Others continue to obfuscate. Hobby Lobby and Conestoga Wood Specialties would have the Supreme Court believe that their corporate religious sensibilities are offended by employees’ having the right to terminate a pregnancy before it actually begins, since they equate contraception with abortion. In state after state laws are being passed that are medically unnecessary, scientifically inaccurate, and constitutionally illegal, all in the name of “protecting women” or “protecting the rights of the unborn.” In reality, every law is designed as another step toward making abortion “unthinkable,” impossible and again illegal.

Until they can make it illegal again, making it inaccessible is enough. Again, women of means are seldom being harmed; women without money or power are suffering and dying.

It is not possible to “end abortion.” Not even religious extremists in other countries are able to do that, even though in many countries religious extremism attempts to rule women’s lives. Every day, women in Kenya and Afghanistan die trying to end unwanted pregnancies.

As George Santayana put it, “Those who cannot remember the past are condemned to repeat it.” Unless we remember the tragedies women faced when abortion was “a thing of the past,” we will be condemned to watch those tragedies return.

Women will die.

California/caregiving/End-of-Life/Health/seniors
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The Intriguing Invisible Audience

by Fran Johns

The questions were sharp, incisive. The comments were poignant, sometimes wrenching, sometimes funny. But the really funny thing was that I couldn’t see a soul in the audience.

This was a recent talk and group discussion with the Senior Center Without Walls. I was on the phone in my living room, the moderator was somewhere else, and some 20 to 30 seniors – most of them old, if unseen, friends by now – were sitting comfortably in their San Francisco Bay Area living rooms. Who knew?

This particular discussion dealt with end-of-life issues, although I got in (with advance permission) an introductory plug for Perilous Times: An inside look at abortion before – and after – Roe v Wade, and my current soapbox about preserving reproductive justice. I talked briefly about my longtime involvement with Compassion and Choices, about the work of that excellent organization, and the multiple benefits of considering one’s own mortality before one’s own death is knocking at the door. From the various phones came personal tales – “My husband died exactly as he wished…” “one member of the family wanted to contradict what (the dying person) explicitly wanted…” And questions about what C&C can do (counsel, advocate, support) and even – every nonprofit representative’s favorite: “Where can I send money?”

Audience members come and go at will, during Senior Center Without Walls discussions, and the pretty constant beeping that heralded the comings and goings made the entire event feel like a free-wheeling open house. Which is, in fact, not far from the truth.

Senior Center Without Walls participants play bingo, read plays, join support groups for everything from low vision to LGBT issues, bird-watch (guided help with identifying the birds seen from your window) and share in adventures that range from armchair travel to sing-alongs.

I hope they learned a little from this discussion leader; I learned a LOT from the scattered seniors of Seniors Without Walls.

 

 

 

Abortion/Health/Politics & Causes/Reproductive rights/Women
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Hanging out with a hero

by Fran Johns

http://images.huffingtonpost.com/2014-05-29-20140522_171056_216.jpg

I first met Willie Parker three or four years ago, researching my then work-in-progress book Perilous Times: an inside look at abortion before – and after – Roe v Wade. Couldn’t believe his generous affability and apparent fearlessness in the phone calls and emails we traded, his willingness to be quoted, identified, you name it — despite the obvious dangers facing abortion providers in areas of the country where opposition is fierce and hostility strong. It matters not to Willie Parker. He is dealing with real, live women and the injustice they face when denied control of their own bodies.

Fast forward to May, 2014. In an earlier email exchange the remarkable Dr. Parker had mentioned being briefly in California around this time and hopefully having a chance to meet. I held him to that, and managed to get him over for a visit. Here’s the report of that visit that appeared just now on Huffington Post:

It’s not every day you get to hang out with your hero.

For anyone invested in reproductive justice today, Willie Parker, MD, MPH, MSc, is at the top of the hero list. My own such list is long, thanks to the many people I’ve met in recent years who are tirelessly at work keeping justice alive for women everywhere — but Willie Parker is #1.

Parker holds degrees from Harvard and the Universities of Iowa and Michigan; has served as Medical Director of Planned Parenthood of Metropolitan Washington DC, Associate Medical Director of Family Planning Associates Medical Group in Chicago and Assistant Professor of Obstetrics and Gynecology in the John A. Burns School of Medicine at the University of Hawaii. His list of writings, honors, accolades and nonprofit board jobs is longer than my hero list, but in Real Time he is simply Willie. A man who believes ferociously in a woman’s right to make her own decisions, whatever her race or socioeconomic status, whatever her unique circumstances and needs.

This does not make Willie Parker an “abortion on demand” physician. Once the fetus has the possibility of survival — with or without “extraordinary support measures” — he will not perform an abortion. But Parker believes in a woman’s right to make her own healthcare decisions and to control her own body, and knows it is women of color and women without money or resources who are most often denied these rights. That’s where the complex issue becomes a simple matter of justice.

Parker sees what he does — which is, provide abortions up to 24 weeks and six days — purely through the eyes of the woman who seeks him out. She is usually a woman of color, African-American or Latino. More often than not she is someone who already has more children than she can care for. Sometimes she is still barely more than a child herself, unmarried, abused by a casual acquaintance or a favorite uncle. She has a story.

Once the woman with a story — and an unintended pregnancy — reaches Willie Parker, she’s in a safe harbor. He listens to her story, calms her fears, holds her hand.

Such women may be safe, but the abortion provider is decidedly not. Especially when he’s a big, affable, outgoing, very dark-skinned, gray-bearded guy like Parker.

“I sort of hide in plain sight,” he laughs. Walking around in casual clothes and a friendly grin, as he customarily is, he hardly looks the part of a multi-degree, high-powered physician. It was probably little comfort to the white, business-dressed reporter leaving a building with Parker recently when the latter remarked with a smile, “If they’re coming after the doctor, they’re gonna shoot you.”

Parker, grounded in Christian tradition and secure in his faith, says he is uniquely blessed by the certainty of knowing that his core moral, ethical and social beliefs come together with his education and skills. So yes, he will go right on being a very public advocate for reproductive justice — including the current fight to preserve the one remaining abortion clinic in Mississippi — and no, he’s not worried about personal danger.

“I don’t think about how I’m going to die,” he says. “I think about how I’m going to live.”

This is what makes hanging out with Willie Parker such a lovely way to spend an afternoon.

Abortion/California/Health/Healthcare/Reproductive rights/Women
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Can 70% of us be wrong?

by Fran Johns

Depending on which poll you read, anywhere from 55% to 70% of the people of these United States believe that abortion should be safe and legal. At the high end of that percentage are those who believe Roe v Wade should remain the law of the land.

How, then, could we be where we are? Today, more than half of the states have restrictions that effectively deny many women access to safe and legal abortion, never mind the Constitution.

Reproductive justice organizations, though, are far from caving.

Donna Crane, Vice President for Policy, NARAL Pro-Choice America, recently met with groups of supporters in the San Francisco Bay area to go over details of all this, and to reassure supporters that “although these (restrictive state laws) keep happening and we are losing ground, we’ve not lost power.” That power, Crane says, comes from the solid, and growing, percentage of people who want to keep abortion safe and legal and believe it is a woman’s right to control what happens to her own body.

“The public,” Crane says, “is not the problem. The problem is that our opponents have figured out how to get their way: they have switched (from working to overturn Roe v Wade) to the state legislatures. And there is a disconnect with American values.”

Crane outlined the dramatic increase in TRAP laws (Targeted Regulation of Abortion Providers), state regulations designed to put unnecessary burdens on abortion providers – but not other medical professionals – as a way to drive doctors out of practice and to make abortion care more difficult and expensive to obtain. Anti-choice measures in the states have increased from 18 in 1995 to a cumulative total of 807 by 2013. They include such requirements as unnecessary hallway widths in clinics, forced untrasounds, repeat visits and forcing physicians to lie to their patients. That’s just to name a few.

To this writer, none of this is about one side winning and the majority losing, it’s simply about justice. Anybody, anywhere with money and resources can access safe and legal abortion. But if you’re poor, down on your luck, living in a remote or impoverished area, and you want or need to terminate an unplanned pregnancy? Forget it. Legislators don’t have time for you; you probably don’t vote much. Politicians don’t care about you; you aren’t funding their campaigns. Anti-choice forces don’t care about you, only about your fetus. For you, there is no justice.

NARAL, however, has your back. Now we just need to get the rest of the 70% out front.,

 

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