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Chronic Disease Politics

Day 658 and Time Perception

I don’t know about you, but my sense of time has never really recovered from the pandemic. Time got distended and warped in ways that were hard to appreciate at the time. I struggle to tell if I’m making progress or if I’m standing still.

If I’m really honest with myself, I started losing the thread on time when Trump got elected. I was one of those people for whom that fractured my reality a little. Not because I couldn’t conceive of him winning but because I could. That was my first moment where I felt like I was beginning to split from shared reality as I was so sure he would win and so desperately wanted him to lose.

Somewhere midway through Trump’s term, my health got fucked up. My sense of reality fracturing combined with my first taste of time being distended was when my health went sideways. As I stopped working somewhere in 2018 but it’s hazy. As I spent more and more time in hospitals, doctors offices and in bed, and less time at the office, the usual ways I used to tell time degraded further. Reality had already shattered so no reason not to let time shard too.

So I can’t entirely blame my sense of displacement from time on the pandemic. My sense of instability absolutely predates it by several years. By now much I couldn’t exactly tell you. Between my health and Trump I ended up a step or two off of consensus reality.

This did end up being lucky. As the pandemic was inbound I was prepared before it hit. I had tied myself so effectively into the immune system of the information environment I knew it was coming in December.

But I wasn’t entirely prepared for how much I’d up end my life as the second order effects of the pandemic kicked in. We did the first few months in an apartment, the first summer in a vacation house on the Hudson River and then decamped for my home state of Colorado.

It’s only just as we’ve decided to commit to Montana that my sense of unreality is easing a bit. We’ve got a home that we own and a set of preparations that makes it stable through some gnarly potential futures. So why isn’t the time dilation is easing? Why does it always feel like there is never enough time and also far too much time all at once? If anyone has the answer I am listening.

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Community

Day 639 and Act Local

I grew up in a hippie college town that was fond of bumper sticker activism. Showing off your sense of humor and your political priorities was a fun thing to do with your Subaru Outback in the late nineties and early aughts before Facebook and the rise of social media.

A classic of the genre was “Think Global, Act Local.” I found this example on Etsy. And no I’ve got no idea what charity it ties back into.

Think Globally, Act Locally Bumpersticker

Maybe it was just less cringe to have this sort of thing on your car before we all spent half of our days yelling at strangers on the internet. I personally remember thinking Visualize Whirled Peas (a band from Austin) was a hilarious way to protest American war mongering as a teen. Of course, I still wrote Amnesty International letters at the time.

Now I’m not even sure who to donate money to at the end of the year as institutional trust continues to break down. Thinking globally is often the source of much anxiety. Currency collapses and the threat of nuclear war from Russia might be throw backs, but doomscrolling and feeling helpless is too modern. What is old is new again but in more potent anxiety inducing form.

So it was a bit of a relief to enjoy the “act locally” part of the classic bumper sticker this morning. Our local volunteer fire department had a pancake breakfast. Now as an adult my husband and I live outside of a completely different college town in the wider surrounding Gallatin Valley.

The rural (as opposed to city) county fire departments operate with a lot of local good will. They have a professionally trained but all volunteer force and cooperate with other districts through mutual aid frameworks. Practically, that meant a lot of college students taking advantage of living at the fire station to offset their costs while deepening ties to the community. A pretty ideal set up for a tight knit rural community. We get talent and they get skills and housing during their college years.

But calling them volunteers makes it sound less professionally run than the reality. I was impressed with not only the depth of knowledge of the entire department but also just how well maintained all of the equipment clearly was. Sure they probably cleaned stuff before letting their neighbors come in for a visit but everything was so shiny and new. I came away feeling a lot more secure about making a 911 call.

Now maybe that’s just function of meeting the fire chief and chatting with EMTS. And that’s probably exactly why they host these pancake breakfasts. But after two hours of touring equipment, and talking to everyone from the Medivac helicopter pilot to the youngest college kid on the squad, I felt like this was a team that has its shit together.

Now I’m actually excited to vote for a bond issue to get another fire truck or two! But in the meantime we dropped a few twenties into the boot on the table.

Pancakes and a fire boot for donations to the county fire department.

Categories
Medical Preparedness

Day 630 and Sympathetic Nervous Response

One of the downsides of having any kind of medical bullshit is having to keep an eye on yourself. If you over do shit you’ve got no one to blame but yourself.

I’ve been doing a wilderness medical incident first responder course this week. I initially went into it slightly concerned with my ability to physically keep up given my ankylosis. I was easily the odd duck out in a group of former military folks, paramedics and wild land firefighters. If I’m honest I didn’t want to embarrass myself by showing too much frailty. I was already the only woman in the class. I didn’t need to be the cripple on top of that.

But over four days I’ve managed just fine. I did wound packing and splints. I did a number of incident scenario responses ranging from anaphylactic shock to heart attacks. I even did multiple mass casualty response drills. Today I managed one as a triage incident deputy and comported myself quite well.

I was feeling pretty cocky about how well I’d managed through the week. I was enjoying that sense of accomplishment right up until 5pm or so today when we had our last assignment of the day. We’d just finished up a drill with five patients who had been caught in a tornado. It was an hour of field work and triage outside. I was thinking alright maybe I’m getting the hang of thing. But no I was about to embarrass myself on one of the easiest tasks in the course.

It was time to pack up our own medical kits. We got a big baggie with all the supplies we could possibly need for our our first aid kits and dumped it out on the desk. Our instructor began going over all the items and how to pack them up into the bright orange brick that serves as your kit bag. I was doing my best to follow along but my brain was just not having it. I kept trying to figure out what items went where and how it was meant to go. And I was not remotely keeping up with the class or the instructions.

I’m starting to feel overheated and I’m struggling to concentrate. And it’s then I realize “oh shit I’m in a bunch of pain” and I realize I haven’t taken my pain medication for hours and it is starting to show. I just ran around in a big field doing triage for an hour. So I think to myself well I’m having a sympathetic nervous system spazz out. The pain and fatigue is sending me into fight or flight and I’m losing decent coordination and fine motor skills. I am becoming one of my own patients.

I didn’t finish packing out my kit. I had to excuse myself. I briefly considered if it would be funny to have a medical incident in a first responder course. But I was fully capable of treating my own acute stress response. I was getting worked up by an inflammatory response from my ankylosis and low and behold the pain in my spine was going to spike.

The end of the story is that I’m in bed and the non-steroidal anti-inflammatory drugs have kicked in. My pulse and respiration are fine. I’m no longer in fight or flight. And yes I’m a little embarrassed that packing a bag is what did me in. But on the other hand, that’s a very “Julie” way to learn a lesson.

Categories
Medical Preparedness

Day 629 and Working in Chaos

If you have been following along for the past couple of days you may have noticed I’m at a wilderness medical first responder course. I’ve been soaking up an inordinate amount of information. Part of the reason I am here is personal enrichment, but equally I am here because I’m working to understand chaos driven industries and the opportunities they present.

And the class is not disappointing. As we’ve have absorbed more skills and are moving further into the course, the chaos factor is being ramped up. The particularly enjoyable aspect of the specific course I am doing is that it is not just imparting book smarts. It’s designed to be much more hands on.

If it were a business school class they would probably refer to the methodology as case studies. But instead of ruminating on what you would do if you were management you are reacting as if you were the actual first responder on the scene. And the cases are getting more and more complex.

We started out with with the basics. We were deducing issues and imparting stabilizing treatments. But as we got more comfortable with figuring diagnostics and rendering basic aid the complexity ranked up. At the end of the day today we were presented with a car accident and four patients.

As we ran (literally) onto the scene we had to not only unravel what had happened but also treat several patients in varying degrees of distress. One of our patients didn’t make it. There was nothing we could have done. But we didn’t know that going into the scene. When we arrived we had no idea what happened and had to untangle the triage ourselves.

I was surprised at how challenging it was to leap into action. As the chaos of the accident presented itself our group of first responders had to decide on organizing ourselves and our resources. But the instinct is to simply begin rendering aid.

And that tension between acting and organizing in a crisis never goes away. You just get better trained at how to approach it. Working in the chaos is the job. I honestly thought I’d be better at it. Taking charge and working in uncertainty is something I enjoy. But as with any new skill, it takes work and practice. A certain amount of pressure is the only thing that teaches you how to work in chaos. And I’ve still got a long way to go.

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Aesthetics Community Preparedness

Day 628 and Intensity

If my brain is a sponge I think I’ve been sopping up more than I am designed to handle. But I am holding on and facing a lot of new information and acting on it quickly.

I’m at a wilderness medical first responder class. And I’m the odd duck out on the class. Everyone else is living with much harder realities than I do. They are the ones that fight our wars. Provide our security. Fight our fires. They keep up with where our most vulnerable live. It’s an on the margin make your best call world.

My body can feel that this reality is very different from what I live with and on different class and wealth bands. People that are more buffered from harsh realities often don’t want to face the costs of our lifestyles. But we are not in a morally neutral systems. And a lot of violence still happens on the margins.

I feel somewhat invigorated by the immediacy of decision making in these chaotic environments. If you are in a natural disaster like a wildfire your capacity to react calmly under extreme conditions is a given. So naturally we arm these people with more agency and skills as it’s a set of problems with a lot of nuance and grey areas too.

I am frankly exhausted even though I didn’t do anything that intense. I did some traumatic brain injury drills. And I worked on how to properly stint and secure broken bones if you are in the back country and need to hobble back in to society. I learned a lot about agency and context and the need for high emotional intelligence as you cope with those who are in need or duress.

I suppose with that in mind, it’s no surprise that I’d like to enjoy a good long night of sleep and a big breakfast in the morning. One has got to enjoy living when you have the chance.

Categories
Medical Preparedness

Day 627 and First Responder

My hands are stained blood red. Despite a good scrubbing, my cuticles definitely show that I spent time packing wounds today. Ok, fake wounds. And it’s fake blood. I am taking a wilderness medical incident certification course. And it is very hands on. Literally.

A firefighter packing compressed gauze into a femoral artery simulator

I got the opportunity to take a spot in a course that one of my friends teaches. I’ve got so much exposure to medicine after the last several years of health challenges that I’ve been yearning to upgrade my knowledge to something more practical than my own personal biohacking. So when Tom offered up a spot in his medical incident certification course for wilderness response, I said you know what fuck it I’m going to do it.

And I’m so glad I did. Not because I anticipate needing to apply a tourniquet in the back country of Montana. Or that I’ll be faced with packing a groin wound to stop someone from bleeding out when they are hours away from the hospital. Though I am glad I now know how. But because I think hands on experience with a rougher world is experience I need to do my job investing in an increasingly complex, chaotic and unstable world.

I was absolutely enthralled by the first day. It was me and a bunch of other much more experienced EMTs, paramedics and wildfire fighters. I also met a number of extremely savvy folks who special in fire and emergency incident response.

I was very much thrown into the deep end of first responder world and I’m not ashamed to say I “died” on the very first scenario test as I’ve got no idea what I’m doing. But I’m soaking up as much information as I can as fast as I can. Though not quite as fast as arterial blood gushes. Yet. Ask me on Friday if I’ve improved.

I couldn’t tell you precisely why I think this kind of hands on exposure to emergency response is so crucial but something deep in my gut says that I cannot possibly invest in a changing world without having some on the ground exposure.

The folks who are fighting our worst wildfires and responding to our most intense natural disasters know something visceral about chaos and the fragility of modernity that the rest of us do a lot to suppress.

Just casual conversations as we went through lessons and practice opened up my mind to new areas of opportunity. I found half a dozen blind spots I didn’t know I had. The world is much more chaotic than the media and our social channels let on. But it’s also possible to tackle them head on. We are not helpless. And it’s not hopeless. And I’m feeling fully empowered to deepen my relationship to chaos as I learn just when and where I have more agency.

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Preparedness

Day 626 and Learning

I’ve been slowly making my way through a Korean show on Netflix called Extraordinary Attorney Woo. It’s about a young woman with autism who has a gift for the law. It’s warm hearted and charming and a bit of a relief to watch if you have autism or are on the spectrum. I highly recommend it.

The show really pulls on my heartstrings. The episode I am currently watching features the struggles of 10 and 11 year old kids who are at after school academic centers. I won’t ruin the plot but a young man sets out to “liberate” the kids by letting them play. I found myself tearing up the show went about discussing the need for healthy playtime.

I hated going to school even though I love learning. I found so much of the pressures of school upsetting. Being inside, being around lots of people and loud noises, and just generally being obligated to things like homework and deadlines to be exhausting and anxiety inducing. I found myself tearing up watching these Korean kids in similar situations.

I was quite lucky to have a mother who sent me to Waldorf schools and even the occasional home school year. When I could pace myself I’d would rapidly out run the curriculum. I just needed breaks and playtime and my own opportunities to self direct. I hated discipline from the outside but had plenty of my own if given the chance to be self directed.

I’m still an autodidactic type as an adult. This week I am taking a wilderness medical incident certification course. I’ve got some strong sense that this is meant to wrap around some wider learning experience about the practicalities of living in a more chaotic world. It’s a bit of learning by doing. Some perspectives have to be unraveled first hand.

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Preparedness

Day 620 and AQI

I am in the throes of a horrifying migraine. The take two Imitrax and pray type. It’s also the nausea inducing type so I’ve not eaten all day. I feel awful. And it’s mostly not my own fault even though I often like to blame flares in symptoms on my own lack of discipline or purity in maintaining some Platonic ideal of lifestyle or wellness regimen.

It is fire season in the west and I’m sure some, if not most, of my migraine is tied to the horrifying air quality that is choking out thousands of miles of California, Washington, Oregon, Idaho and Montana.

An AQI reading of western America on September 12th at 3:48pm Mountain Time from PurpleAir

The AQI or air quality index in my neck of the woods is 160. Unhealthy for sensitive individuals is the coy and somewhat misleading phrase used. It means in practical terms visibility is so bad I can’t see the mountains a few miles away.

Montana is at the moment free of any major fires. Our colder temperatures, lack of pervasive fire beetle blight, and reduced density makes it statistically safer than the Colorado front range when it comes to total fire danger. But it’s no safer from prevailing winds and the pollution from fire in other states. In order to escape from it entirely I’d probably have to leave the continent.

I’ve obviously opted not to leave my home region of the mountain west even if I have accepted moving to a more northern and protected corner of it. But there is a certain existential “No Exit” sense I have with AQI and fire season in general. It may just be my lot in life. Maybe it’s everyone’s lot. To give up your homeland is a complicated fight. I expect for some of humanity it must involve either certain death or the prospect of great riches

Categories
Emotional Work Preparedness

Day 613 and Timing

It’s hard to look straight on at your desires. Why is it that some of your life arises from your priorities and focus, but others are just chances and circumstances?

The hardest part about looking face first at being responsible for yourself is that you are both in total control and not in any control. We want to live with willpower. We want to be people of purpose. And yet life is happy to show us how much it’s all just dumb fucking luck.

Because we are what we make time for in our lives. And if we don’t make honest time for ourselves how the fuck will we ever know what we actually want. If you let life idle past you that’s fine. Because that is the path of fulfillment all along. And in letting ourselves just be maybe we find entirely new reservoirs of resources.

I’m considering taking a wilderness first responder course. I’ve got other priorities for the fall but I also made a commitment to a resilient rural life. Somewhere in my own desires I may find that what I want can and does align with the rest of my life. That by opening up to something new I also see who I am more clearly. I believe they call it getting perspective.

Categories
Preparedness

Day 612 and Errands in the Apocalypse

A lot of preppers have fantasies about how they will come into their power with the fall of civilization. Their foresight will show them to be the stoic masculine leaders society always needed but were wrongly maligned in the feminized world of diversity capitalism. Needless to say I think this is quite silly even without the sexism and racism.

Total collapse scenarios are not your most likely outcome. Sure we all think about what it might be like. A safe society enjoys horror stories. Chances are much better you will experience a couple issues compounding on each other. A few cascade are enough inconvenience such that it fucks up your life, but not so much that your boss doesn’t expect you to go to work in the morning. And definitely not one where law and order breaks down so far that you can get away with shooting someone. The police can’t help you but in anarcho-tyranny they sure can hurt you.

My first taste of this was during Hurricane Sandy. Lower Manhattan lost power for close to 10 days. Gasoline shortages and food access became issues as some neighborhoods were in the dark. But enough of the city was fine, and enough institutions in dark zones like Goldman Sachs and the NYSE, had their own backup systems.

You as an individual might be fucked but the institutions expected your ass to show up for work. I had a girlfriend who had to walk from Greenpoint to Madison Avenue for a social media job. Can’t imagine anything more dystopian than having your corporate Twitter shitposting job require you to have a butt in a chair when your own home is without electricity and molding. Cyberpunk is here.

Today in Montana our air quality is an abysmal AQI of 120. Wildfires blowing in from western fires in Oregon have tinged the sky yellow. Apparently it’s worse in Missoula with a number sky of particulates trapped in the valley.

But it’s Sunday so I had errands to run. We were coming off having a houseguest with us so we needed to grocery shop. We had a prescription that needed picking up from the pharmacy. We live outside of town so we try to plan a bunch of stores per trip. It felt like the end times outside. You couldn’t see to the mountains. Visibility was limited. But damn it we’ve got work next week and the meal planning is done so we’ve got to keep going. Life finds a way. There will still be errands during the apocalypse so don’t get too hopeful about your cosplay.