Posted in Developmental disability, Developmental disability service system, disability rights, HCBS, Self-advocacy

Birthday card from another universe.

Close-up photograph of a small orange salamander in what looks to me like the forest floor of the California redwoods. Titled “Morning Walk,” by Sandy Gardner, 2008, card by Greentree Designs.

Whoever chose this card cared about me.

They cared enough to choose an extremely meaningful picture for me on the birthday card. They didn’t have to do that.

The bithday card was not this year, my 39th birthday.

With the dates written, it would have to be my 37th or 38th. If I’m doing the math right.

Things were already hitting the fan in a huge way at that point. I was being hurt by some of the same people who signed the card.

But back then, there were still enough people who cared about me as a human being and treating me like as a human being (or in some cases, at least, appearing to) that things were just… different.

Reading it was like reading a postcard from a universe I barely remember.

A universe that was already disappearing by the time the card came.

But there was a time, if I was hospitalized, Howard would take extra time to visit me in the hospital and help me get better and go home, and help me with the transition home, and give extra help to keep me out of the hospital, and extra help to make up for the fact that you never go home healthy and often need some extra support.

There was a time when they didn’t treat my second mom like she’s made of poison. To the point they won’t allow my caregivers in the same house as her for longer than 5 minutes, and have gone to great lengths to lie in order to avoid having to deal with her, because she complained about their medical neglect and they never forgave her.

But there was a time.

There was a time when some people tried to help me. Even case managers.

There was a time when things mostly worked.

There was a time when people’s efforts to help me were not thwarted by the office people at every turn.

There was a time when many people in the office were actually helping me.

Mind you.

The system was never good.

But it was never like this.

This card was signed by seven people.

They didn’t have to get me a card.

They were being nice. They were treating me like a human. Some of the time.

It’s different now.

It’s different now.

I don’t understand.

I don’t understand.

It’s different now. That’s all I know.

Posted in Developmental disability, Epilepsy, Temporal Lobe Epilepsy

Time hates me, I think.

Image description: Salvador Dali’s painting, “The Disintegration of the Persistence of Memory”, with a graphic of a brain superimposed, the temporal lobes highlighted in yellow, and lightning added to the temporal lobe of the brain. The Dali painting involves a grid of blocks, a beach scene, a dead fish, and a bunch of melting clocks.

The world has just started. It’s as if I have a tiny window and everything else is white. The past is white. The future is white. Lots of things are white, blank, and scary or confusing. I don’t know where I am or how I got here, but I’m used to that. The one thing I’ve got going for me is that somehow, this has happened enough times that I have some inkling what to expect out of the world.

Even with all these resources, I’m scared, but I try not to show the fear in front of most people. I spend my entire life hiding how little I understand. The way the world disappears regularly. And how I seem to be born over and over and over and over and over again. Not just once. But every time life starts from nowhere. Life starts from nowhere a lot.

My imaginary friends are me in the past and me in the future. That sounds a lot more egotistical than it is. It’s more to do with being very isolated.

Time is not my friend.

Time confuses me.

I don’t feel time most of the time.

And when I do, it’s scrambled or running backwards or sideways or something.

These are not small things.

In fact.

I’ve just found out how much of my life this is.

It’s a lot of my life.

More than I was willing to admit to myself.

What I tell you about when it comes to disability is not the same thing as what is going on. I don’t mean I’m trying to deceive anyone. It’s just that I have a lot of different labels. And I don’t respond to them all the same. And I don’t respond to them all in proportion to how they affect my life.

This affects every inch of my life every inch of the way every inch every inch every inch.

I can’t explain.

I keep trying, I can’t.

I can’t explain the sheer distance between the expected shape of how thought works. And then me, over here, experiencing utter weirdness.

And I try so many ways.

I could tell you stories from my life that illustrate things.

I could try to explain what things feel like.

I could give a very clinical, medical-style description of something that for me is not a medical experience.

The last is the easiest unfortunately, because unlike the others, it comes with a template.

I know how to talk about epilepsy.

I don’t know how to convey epilepsy to someone who doesn’t have it.

And by epilepsy I mean epilepsy the significant developmental disability, here.

There’s lots of kinds of epilepsy. I might tell you about it at some point, but if I go into clinical medical talking mode, I won’t get out of it enough to make the rest of this post.

I have kept wanting to make this post.

Because it’s fucking important.

Okay another thing also, so…

This is the version of epilepsy that is a developmental disability.

I am not the only person in my family to have seizures starting in early childhood. One of my first memories is a seizure. Maybe I’ll tell that story later as well.

So many things that could get me sidetracked.

But I don’t know how to say the main thing.

Which is that epilepsy has affected every shred of my being.

And that it may be a medical diagnosis but it is not a medical experience.

And it doesn’t stop when the seizures stop.

That’s the thing. Okay. So I guess with this post I will try to get one point across. That may focus me enough to write this. I’ve been having real trouble writing lately.

So the point is — how much this affects me, and what it means for epilepsy to be a developmental disability.

One day I should also tell the story of how they figured out I had it. But for now I will just say — the first time I saw a neurologist, in my life, temporal lobe epilepsy was on the table as a diagnosis. So it is the first developmental disability with a name that I was ever given a diagnosis of. I was 12 or 13 when they first saw me and started trying to tease out what was going on. Which was not simple by then because things aren’t.

When I say that I have multiple developmental disabilities. TLE is one of several diagnoses I’ve been officially given. Childhood-onset TLE is a developmental disability, and in my case it probably has had more effect on my life than any other developmental disability. Childhood-onset TLE, especially without adequate treatment, can lead to permanent changes in the brain. This can lead to massive losses of cognitive skills, and even create an intellectual disability or other cognitive disabilities that were not there to begin with. This can be permanent even if you get the seizures under control.

That’s how much it can affect your life.

But it frustrates me to describe it this way. I want to tell you what it’s like. What my life is like. As a result of this. And I want to tell you what abilities are affected, because it’s important. It’s important to tell people but it’s also important because I need to keep track and my memory sucks donkey balls sometimes1.

Now I’ve spent so much energy on writing about memory that I can’t even remember where I was going with this.

Oh yeah.

So.

This affects everything.

Everything.

Can’t emphasize enough on the everything.

The kind of TLE that is a developmental disability basically has… a whole range of effects. There’s the effects of having the seizures. Which… I didn’t realize it until recently, but I think I have seizures almost every day, even now. I just didn’t know that some of my seizures were seizures.

When you have seizures every day or more, then the seizures are going to affect your everyday cognition.

When you have complex-partial seizures, which are my main type of seizure. Then you have all kinds of weird experiences. But you don’t know what they mean or what they are. They feel like just part of your life. This can include things like emotions that come out of nowhere and have a strong effect on everything. It can also include other things that would normally be considered psychiatric, like hallucinations and things that resemble psychosis or dissociation.

Those are direct effects of the seizure. But seizures also make your mind not work quite right afterwards, usually. And the recovery time can take a lot longer than the seizure did. So there’s also, if you’re seizing very often, all the effects of being post-ictal.2

There’s also the long-term effects of brain damage caused by uncontrolled seizures. Which is a whole lot of cognitive and memory problems, personality changes, and all sorts of things.

And there’s the confusion of all this happening without really understanding what’s going on. And all the emotional effects of that, as well as emotional effects of the seizures themselves. Which I haven’t even gotten into the half of it.

So anyway.

Just to say — this affects everything.

And it’s biting me in the ass right now. Including my sheer lack of understanding and knowledge of my own condition here. It’s not that I understand nothing, but I’ve never really looked into it as far as I should have, so there’s big gaps in my knowledge.

But everything I find out is telling me this is a huge part of my life.

And right now what’s biting me in the ass about it is medications. I’ve worked really hard at doing my own meds. But I’m simply not capable of some parts of the timing. And that turns out to be behind a lot of my med errors, when I’m the one making them. Anyway, I ended up completely screwing up my med schedule and having to get help every single day to be able to follow the schedule. It’s not that I don’t want to, it’s that my lack of understanding of time meant that I was taking some meds too much, some meds too little, and some meds not at all, and the ones I took were at the wrong times.

It’s not that I have no sense of time. I mean, I pretty much don’t. But it’s not just that. It’s not just having no sense of time, it’s having anything from no concept of time, to a very weird concept of time. Which makes it extremely difficult for me to do anything involving scheduling, timing, sequencing, and so forth. Like with memory, there’s some things about time that I’m actually pretty good at. But unlike with memory, really most of anything at all involving time is screwed up for me in some major way.

So anyway, as a developmental disability, temporal lobe epilepsy straddles this weird thing of medical condition, cause of brain damage, cognitive and emotional and personality things, etc.

I think one of the biggest effects for me has been the way my abilities and experiences are always in flux. What I know, what I understand, what I can do, is always, always changing, and I’m beginning to realize that at least some of that is due to seizures or the effects of having had seizures for so long.

At any rate, I no longer have the ability to even follow what I’m trying to write about in this particular post, so I’m going to post this as-is, and just be aware that there’s a lot I want to say connected to epilepsy, some of which may be unexpected, and I’m just trying to give enough background information to make it make sense.

I also suspect some connection between seizures and delirium for me, but I don’t know what the connection is. I just know I’ve never had a significant delirium that didn’t involve at least one really obvious seizure or clump of seizures somewhere during whatever illness got me delirious in the first place.

But this kind of multiple-post string of things to write is really hard for me, so I can’t guarantee any posts on the matter ever again. Or I might post fifty things today. I just don’t know.

I can tell you though one thing — a reason I am having trouble posting is the memory resets. It’s enough work trying to get through the day with a short-term memory that keeps resetting itself several times a week, and that’s what’s going on right now. It’s just hard to get a lot of writing done in this state.

I wish I could do this better. I can’t.

But this is one of my other developmental disability labels.

I’m scared to talk about it directly in some ways. Especially because of the way people make a lot of very weird judgements about temporal lobe epilepsy. In particular, they tend to pathologize your basic experiences of certain things. Like if you have religious or spiritual beliefs, suddenly it must be because you’re epileptic, it can’t be for the same reason that most of the human race has religious and spiritual beliefs. (Actual research into religious beliefs connected with temporal lobe epilepsy, suggests that when it does affect belief, it can result in extreme atheism just as much as it could result in extreme Christianity or something.)

But, I’ve got to talk about it directly in order to talk about other things. So this is my first post of what I hope is many that I can then use as background for the post I really want to make. (I have two separate posts that require a lot of background information like that, and I’ve been trying all year to write the other one with no success.) But we’ll just have to see what happens.

With my limited posting ability I also really want to post things that are important to me, not just medical information. I mean — important to my humanity. But there are important things about this. And I have to post what I can post, or I won’t post anything. So I’m posting this. Incomplete and rambling and everything. Ruti Regan, a colleague in disability rights, has written some things about being able to post things that aren’t exactly what you wanted to write but that are good enough. I’m trying to learn that particular skill, maybe I’d post more if I didn’t want to get everything exactly right.

So. Again. We’ll see.

But yeah. Me and time? Do not seem to get along. I am mostly oblivious to time, but time frequently kicks my ass, and the ass-kicking aspects of time make it obvious that time or something like it must be happening even if I don’t perceive it much.


1 A Few LOT OF Notes On Memory

To add some detail and clarity here on the memory suckage: Memory is not one thing. I don’t have a good memory. I don’t have a bad memory. I have a memory that is good in some areas and bad in others.

Procedural Memory

My best area is procedural memory — what most people call muscle memory, although it can involve more than just motor skills. It’s stuff you can do on autopilot, whether cognitively or physically. You can tell I have good procedural memory because it’s the kind of memory used for touch-typing, which I excel at.

Procedural memory is also used for playing the violin, which I was so good at in childhood that my doctors explicitly considered it a savant skill. (Savant syndrome is another developmental disability label I’ve been , I seem to collect labels without trying.) I’d have trouble arguing with that given that I was in the junior high orchestra in first grade and first chair first violin by the time I was seven. I don’t retain that skill with the violin, I got out of practice basically. But to have had it at all requires good procedural memory. I have been typing at 120 words a minute since I was 12 years old. So, obviously, procedural memory is just fine, even possibly better than fine.

Deliberate and Conscious Stuff

What gets more shaky is anything involving deliberate or conscious recall. In those areas, it swings both ways. Basically, if something triggers a memory — something reminds me of something — then my memory is fine. Like, as good as anyone else’s, sometimes actually better. But if it doesn’t…

That’s where my memory falls to pieces. Trying to remember things. Then, I have a much, much worse than average memory. As in, I’ve been tested, it’s bad. I test as having pretty significant short-term memory loss in both verbal and visual memory tests.

And like, you know how people always say, “If it’s important, you’ll remember”?

NO.

I don’t know how most people work. But here’s an example of something I didn’t remember:

I have decals on my wall at home. They are a tree with a cat sitting in the branches. They are high up on the wall.

They got there because I was standing on the bed. I am not steady on my feet and a mattress is a precarious thing to walk on at the best of times. This was a bad idea, but it’s the sort of thing I do. Sort of like my mom climbed a ladder with a chainsaw, dropped the chainsaw, tried to catch it, and sliced one of her fingers in half. I do that kind of thing too — I forget my own safety when I’m thinking of something else I want to get done.

So I was alone, trying to put decals on my wall, and I fell.

Next to my bed was a rocking chair.

I somehow fell so that my side hit the rocking chair’s arms hard. I cracked several ribs.

Then I got back up and started working on the wall.

Then a staff person came by. I’ll call him Jack. It was his first day of training and he didn’t know me. He was supposed to shadow another staff person, I’ll call her Jill. But she wasn’t there yet.

So I asked him to help me. I couldn’t reach the highest parts of the tree. I’m short and my osteoporosis has made me even shorter. Jack is tall. He was able to reach the top of the tree. So he got right up on the bed and started helping me.

Jill walked in.

She looked at me.

She looked scared.

She ran into the kitchen and came back with dexamethasone, the steroid I was taking for adrenal insufficiency back then. She gave it to me. Then she asked me what happened.

Only then did I remember either that I fell, that I’d broken bones, or that such an injury always results in a dip in my cortisol levels. (One reason adrenal insufficiency is so often diagnosed in the ICU or the morgue — what often happens is someone gets injured and then experiences an adrenal crisis as a result of the injury, which is then life-threatening, which leads to a diagnosis whether you survive it or not.)

I would not have remembered at all without Jill. It was just about the most important thing I could have told anyone right then. And I didn’t remember. Only Jill specifically asking if I’d been injured, jogged my memory. Without her, I would not have remembered in time to avoid an adrenal crisis. As it was, as soon as my dexamethasone kicked in I was pretty much fine.

Just Plain Weirdness

There are ways in which my memory isn’t good or bad as much as it’s just plain weird. It has odd qualities to it. That’s the kind of thing that makes it clear some of my memory issues are epilepsy-related.

For instance, memory resets.

They happen. My memory just — I wake up and everything is new, and then it takes awhile for me to be able to remember outside this tiny bubble in time.

Short and Long Term Memory

Most people when they think of types of memory think of short term and long term memory. Short term is recent. Long term is more distant. They’re handled separately in the brain and having problems with one doesn’t necessarily mean having problems with the other.

According to someone I know who has a lot of experience with people with developmental disabilities (but is not a doctor, so…), she strongly suspects that I have trouble with the process that transfers short-term to long-term memory. She says I do it slower than usual.

When I tried to look up information about this short-term to long-term memory transfer problem online, I found out this is a known memory problem in people with temporal lobe epilepsy. Go figure. We think this is probably behind the memory resets .

Memory in General

So basically, my procedural memory is great, my conscious deliberate recall (access to memory, is how I see it) is terrible, and all the rest of my memory is somewhere in between.

My pattern of memory problems is pretty common in people with temporal lobe epilepsy, especially people who didn’t get treatment young. It’s more complicated than I just described it, but this is the basics. I just don’t want anyone to get the wrong idea and think that my memory is either better than it is or worse than it is. Parts of my memory are average, parts are above average, but I do have major memory problems and they affect every part of my life.

Oh also, one reason I don’t like discussing my memory problems is because people think if you have memory problems then you can never remember anything. No, I remember some things, some of the time, and in some ways my memory issues are simply a more extreme version of the way most people’s brains handle memory.


2 Post-ictal just means the way a person is after a seizure. In my case, that usually includes some combination of cognitive problems, nausea, pain, and sleepiness.

Posted in Developmental disability, disability rights, Self-advocacy

I need time. This is about accessibility.

Momo walking in front of a bunch of clocks with a tortoise.
Momo walking in front of a bunch of clocks with a tortoise.

I need time.

It takes me time to understand things.

It takes me time to make words.

It takes me time to respond to things.

To make medical decisions, I need the time to have a two way conversation with the doctor.

I need time.

Nothing changes this.

Shortcuts and attempts to speed it up slow it down more.

I literally walk faster than I run.

My brain is the same way kind of.

I get there. But I need the time. If it seems fast it’s because I’ve done it a million times already, many of them slowly.

Many times people assume based on the end product.

So if I have a complex thought they think it’s a fast thought.

I get to complex thoughts slowly usually.

Or they look complex. But they’re actually simple. But they translate as complex when they combine with language. Or people think lots of words means complicated. It doesn’t. It can mean I had trouble finding the right ones.

At any rate if people think they see complicated thoughts they often think that means fast thoughts. Or they think if I type or move fast I think and understand fast. Or they think fast in one context means fast in another.

None of those things are true.

I do best with things outside of what most people think like.

To get usual types of information and respond and have it be meaningful I need time. Lots of time. I get there but it takes a lot of extra time whether anyone sees that time or not.

To make it look fast I have to take dangerous shortcuts that harm me or confuse me.

I get confused easily.

I am good at not showing it. I suspect anyway. Sometimes.

But I get confused a lot. And it takes me time.

All of this is disability related.

I have developmental disabilities. I have cognitive disabilities. I have physical disabilities. All of these things are part of it in their own ways.

I usually tell people if you think of me as having a brain injury I make more sense. It’s the easiest analogy most people are likely to be familiar with.

But really as labels go I can identify a lot cognitively with people with dementia, stroke, brain injury, intellectual disability, epilepsy, autism, learning disabilities, developmental disabilities, and lots of other things. Some of which are labels I’ve received or qualify for and some aren’t, but there’s cousinhood going on big time even when I don’t. Cognitive kinship.

It’s the way thinking works and the obstacles we face in the outside world that determine our similarities and differences, far more than what diagnosis someone decided to give us.

That’s one reason I don’t like communities based in a single diagnostic label. I’d rather seek out familiar people wherever they can be found. And there’s something degrading about being told that it’s the labels the medical profession decided to give us that determines whether we find that kinship. That’s one reason the developmental disability self-advocacy community insists on labels as less important than in some other disability communities. We’ve found a kinship based on common experiences and common values and desires among other things. And we prefer that to being divided up by other people’s ideas of categories. And we’ve had our categories used to erase our humanity. We have lots of reasons.

Most people with developmental disabilities have cognitive disabilities of some kind. And many of us, for many reasons, take time to figure things out, time to respond, time.

This is not just a personal request. It’s about accessibility. Accessibility isn’t just about what people want. In many places, including here in the USA, it’s the law.

Accessibility is a disability rights idea.

It has to do with the fact that societies plan for some people to be there, take for granted that some people will be there, build everything physical and social around the strengths and weaknesses of that kind of person. And then other people aren’t planned for or taken for granted and there’s all these obstacles to our participation in society. We are the disabled people.

Accessibility is about making it possible for everyone to participate by removing those obstacles and barriers that shouldn’t be there, and by building things in ways that make it as easy as possible for us to be there and participate and be part of things.

That isn’t the world’s best description but I’m trying. Most people if they’ve heard of accessibility they’ve heard if things like curb cuts and wheelchair ramps and elevators. Things that apply to physically disabled wheelchair users mostly.

Cognitive accessibility is different. Most people haven’t heard of it. Many physically disabled people who are big on physical accessibility don’t even believe in it. It’s part of ableist bigotry against cognitively disabled people.

But it’s huge. Just like physical access it can be life and death.

And for many cognitively disabled people, TIME IS ONE OF OUR BIGGEST ACCESSIBILITY ISSUES.

You need to give me time to think. Time to understand. Time to respond. Time to have a back and forth conversation. Time to put things together. TIME.

And the time needs to be without pressure. Without judging me for needing more time. Without making me explain why I need time. Without treating me as demanding. Without acting like your time is so utterly valuable that to give me even five seconds is a giant favor. Without acting like cognitive accessibility is a favor at all. Without all kinds of bizarre conditions in order to qualify as worthy of your time. Without treating me like I’m asking for special treatment. Without using the fact you gave me extra time to demand other things of me later.

None of those things are how real accessibility works. Because all of those things treat me at best like I’m only welcome under certain conditions. Like I’m only welcome because you’ve decided you want to be nice to me today. That’s not welcome. And it’s not accessibility. A wheelchair ramp that disappears and turns into a staircase whenever a wheelchair user feels grouchy isn’t access either.

Time isn’t always easy to come by. But we can’t just make our brains run the standard way. We need more time than usual. Or we need the time we have used different than usual. Or something.

Not getting enough time is such a common obstacle to access for such a huge and diverse group of people. Yet time is rarely seen as an access barrier. And when people bother to give us the time we need, it’s treated like a favor. Or like something that isn’t actually necessary. Something that wouldn’t be a problem to take away. And it’s our problem if we can’t keep up.

I’m dealing with huge timing issues in the hospital. It affects everything from comprehension to communication. It’s interfering with some of the most basic parts of my medical care. I’m getting exhausted, scared, and discouraged trying to cram my abilities into a speed that’s impossible for me. And half the time I’m not even getting the time to explain what I need when it comes to time: people force the conversations so fast it distorts communication at best and they can’t even tell it’s happening.

I’m not the only one. I had a roommate who communicated complex thoughts when we were alone but couldn’t get three words out around family and staff before they’d all decide what she was thinking. That’s a lot of things including lack of respect, but part of giving her respect was giving her time.

Meanwhile I’m always getting lectured on how I don’t respect people’s time because I make timing mistakes directly related to being disabled. >_< From people who rarely give me time enough to understand or respond right to anything.

People turn my access requests into weapons against me. Requests for time become ways to paint me as demanding or entitled. If I’m granted time, people will later explode at me if I still don’t understand.

“I GAVE YOU A WHOLE HOUR OF MY TIME AND I’M NOT ANSWERING ANY MORE QUESTIONS!” A doctor who was paid for an hour of consultation about choices between different styles of feeding tube. Later he happened to be assigned to me for a totally unrelated procedure and apparently the “favor” of his paid time meant he couldn’t answer a simple routine question any patient would ask. All I needed to know was whether I was getting Propofol during the procedure. Instead he wouldn’t even listen long enough to find out what I was asking. And I got shouted at just before a stressful procedure taking place in a room that gives me PTSD flashbacks every time I see it. I ended up with somewhat dangerous cortisol issues all because he happened to be the same doctor paid to spend an hour with me once.

People go out of their way to tell me what a hassle it is to give me any of their time at all. Even when they’re paid good money for it. The same people go out of their way to insist I don’t value their time enough. Often based on a false equality. But also based on rules I can never predict or follow because they require cognitive skills I don’t have.

This leaves me in the permanent belief that my time has no value at all. But that everyone else’s time is worth something close to infinity.

Mind you, until recently, using words or ideas like “time being worth something” would never have occurred to me. I’m still not sure it sits right in my head. And I’m not sure if it not sitting right is for a good reason or not. It just isn’t a way I think of time. Not the way they seem to mean it. Of course I barely understand time at all. But this way still confuses me.

But I do understand the concept of everyone always has to take time for me. And that this is a huge waste if their time. Because I’ve heard that my entire life.

I don’t actually buy the idea that my trouble processing time makes me a bad person who doesn’t understand the huge value of everyone else’s time. Or a person who needs to be condescendingly taught about such things. Because that just doesn’t pass any of my mental smell tests. But the way I’ve been treated and what I’ve been told leads me to feel that way.

So one barrier to access for many of us is time. But an additional one is the belief that we barely deserve the time we get, don’t deserve more, and are just taking away from everyone else’s much more important time. These add together until we get less time and lower quality time (like when the person spends the whole time letting you know you inconvenienced them), when we need more.

I need time.

But this is more than a personal need. It’s an accessibility issue. It changes how I’m able to participate in society. Right now it’s messing up my medical care. It’s a huge important deal, not an afterthought. And I’ve rarely met anyone with developmental or cognitive disabilities where time wasn’t an obstacle to access.

So giving us time, when it’s possible, isn’t a favor. It’s an access issue. And be real careful declaring it impossible, because there’s usually a solution. A lot of the time when people say it’s impossible they really mean it’s not important to them or they’ve always planned their time with a lack of time for us just built in. I only mentioned possible because there’s some people with cognitive disabilities whose own time issues make it hard for us to do this for someone no matter how hard we try. But for most people that isn’t a problem. And there are often solutions when time is limited. You just have to start from the assumption this is both important and possible.

Time is certainly important to those of us who need more of it. And it’s an accessibility issue just as important as wheelchair ramps, curb cuts, or Braille. It seems like such a little thing but nobody wants to give it.

Posted in Being human, Developmental disability, Developmental disability service system, disability rights, HCBS, Self-advocacy, Values & Ethics

Good agencies make people better, bad agencies make people worse.

Something I haven’t been able to say, but is finally possible to say pretty clearly and directly. Here’s a very simplistic way of describing how to tell a good agency from a bad one:

Insert people as staff or management or whatever other jobs there are.

See if they treat their clients better, worse, or the same just by being there.

I don’t believe in “good guys” or “bad guys”, let alone something as simplistic as being able to tell by what color hat someone’s wearing. But sometimes you have to simplify things to communicate them. Like most people, I like to think of myself as a decent human being. And here I am wearing a black hat. It’s my favorite of my own hats, like the ones I bought for myself. Most of my favorite hats are actually brown and inherited from my dad. Make of that what you will.

A good agency will, by the way it’s structured, encourage people to behave with respect, responsibility, and ethics.

A bad agency will do the opposite.

A bad agency will make it so that it requires a great deal of effort to behave like a decent human being even if you’re trying really hard to do so.

A good agency will make it so that the average person will go in and do better than they otherwise would have.

A good agency will make it so that someone going in with malicious intentions will find it hard to act on those intentions or last long within the agency if they manage it.

Put simply: A good agency will make it easy to be good and hard to be bad. A bad agency will make it easy to be bad and hard to be good. Good agencies bring out the best in people, bad agencies bring out the worst in people.

A very good agency will change many people with malicious intentions for the better, through means that are themselves good. A very bad agency will change many people with excellent intentions for the worse, through means that are ethically muddy at best and outright evil at worst.

All of this is simplistically worded. But hopefully you know what I mean. I’ve spent a long time struggling to find words for this. I’m still not there yet. Life is more complicated than a cartoon version of right and wrong. But a good place makes it easy to do the right thing and encourages everyone in that direction, and a bad place does the opposite. Even if it’s never that simple. Which, of course, it isn’t.

But I’m excited that I’m able to even say this much.

Because I’m getting sick of having to add disclaimers to everything I say about HCBS or medical services like “I know there’s good people here, but…” Of course there’s “good people” here. There’s every kind of people everywhere. But that isn’t what makes an agency good or bad. Also, I genuinely don’t believe in the existence of ‘good guys’ and ‘bad guys’ so all of this is an oversimplified way of describing things anyway. But to be able to describe this at all is an enormous relief.

Also, this is one aspect of how agencies operate. This is one aspect of what makes agencies better or worse. And this is a description of a tendency, not something that’s written in stone and never changes.

But it is something.

And I was able to say it.

And given how difficult writing is lately, that feels pretty good. It also feels good to finally be able to say this without practically having to write a novel to do it. I’m tired of having to constantly reassure people that I understand they are often coming in with good intentions, that calling an agency bad is not the same as making everyone who works there ‘bad guys’, or that I don’t even believe in good guys and bad guys in the first place. And never being able to even get to a discussion of what’s happening.

I’m not good at summarizing even at the best of times. But here’s a tl;dr summary to the best of my abilities:

TL;DR: Good agencies make it easy to do good things and hard to do bad things, regardless of what kind of intent and knowledge you come in with. Bad agencies make it easy to do bad things and hard to do good things, regardless of what kind of intent and knowledge you come in with. I’m aware how oversimplified this is, but I have had a lot of trouble writing anything suitable for blogging despite many ideas of things to write. So I have managed to describe one small piece of how to tell if an agency or organization is, generally speaking, a good place or not or somewhere in between. And I’m glad I was able to do that.

Posted in Developmental disability, Developmental disability service system, disability rights, HCBS, medical, Self-advocacy

Best hashtag ever: #GetYourBellyOut

#GetYourBellyOut is the best hashtag ever,

I’d better backtrack.

I had an ISA meeting.  That’s Individual Support Agreement.  At the last second, they brought a Surprise Administrator.  That is what I am calling the lady who showed up at the door to the meeting even though I’d been told that the only people present would be Laura (my DPA and soon to be adoptive mother) and my two case managers.  Surprise Administrator (SA for short) was someone who works in the Howard Center administration.  Surprise because they didn’t tell me she’d be at my ISA meeting until she was at m

The ISA is Vermont’s version of a person-centered plan.  It, of course, just like in other states, does not have to be either a plan or person-centered to qualify as a person-centered plan.  The meeting was certainly not very person-centered.  It degenerated into a shouting match mostly.  And a lot of it was the Surprise Administrator telling me that I was off-topic.  At my own ISA meeting.  When attempting to explain my ISA goals.  Which were “off-topic” because they didn’t like

So it was good that there was a moment of comic relief in all that because otherwise it was just a shitshow that went nowhere productive.

This moment of comic relief came at an unexpected time.

I had defined my first goal as survival.

I meant it.

I actually had specific, concrete actions I wanted taken in order to get to that goal, but the Surprise Administrator was busy telling us that this was impossible.

So at some point an exchange very close to the following took place between Laura and the Surprise Administrator:

Surprise Administrator: Survival isn’t a goal.
Laura: Yeah it is!
Surprise Administrator: It’s a vague goal.
Laura: What’s vague about it? If her heart keeps beating…
Surprise Administrator: Yeah but some people define survival differently than others, like some people define it as being hooked to all kinds of tubes and vents and stuff.
Me: (silently but firmly pull shirt up to show two feeding tubes and an ostomy bag)
Surprise Administrator: OH MY GOD I DON’T NEED TO SEE THAT PUT YOUR SHIRT BACK ON RIGHT NOW!

After the amount of sheer bullshit that went on in that meeting, I can’t even try to make myself feel bad about the amount of giddy, giggly, juvenile pleasure I got out of that incident.  Especially given how sleep-deprived I was at the time.

So later on I discovered the best Twitter hashtag ever: #GetYourBellyOut.

It’s the complete opposite of the Surprise Administrator’s hashtag, which I imagine would be #PutYourShirtOnMel.

The idea is people with ostomy bags are supposed to pull up our shirts, take selfies, and post the pics on Twitter under the hashtag #GetYourBellyOut.

It was started by a guy with a colostomy.  The point is to reduce shame and stigma around colostomies, ostomy bags, stomas in general, etc.  It’s mostly about colostomies but can apply to anyone with similar things.  My ostomy bag goes over a healing jejunostomy stoma after the tube was removed, and I’ll continue to need an ostomy bag to catch the bile until it heals.  Which could be months.

So this is the picture I posted to #GetYourBellyOut:                                               

#GetYourBellyOut

Which is basically, in the above picture, roughly the same sight the “PUT YOUR SHIRT BACK ON” comment was inspired by.

I’m just… highly amused there’s a hashtag for exactly what I did spontaneously out of frustration.

Anyway here’s a Get Your Belly Out website for Crohn’s and Ulcerative Colitis.  I don’t have either of those things, but I love their website picture, which is a bunch of bare bellies with stomas and ostomy bags! 

STOMA BELLIES!

I’m a huge fan of anything that makes people realize that bags, tubes, holes in weird places on the human body, and the like are a normal part of life for a lot of people. And not a cause for excessive bellyaching (oh come on, I had to say it) about having to see it…

Posted in Developmental disability, disability rights, Self-advocacy

I’ll take the ‘dirty’ dick jokes rather than the ‘clean’ r-word jokes, thanks.

I watch a lot of standup.  I watch good standup, bad standup, everything in between.  I just watch standup whether I like it or not.

And I vastly, vastly prefer the comedy that allows for dick jokes and other things that aren’t considered ‘clean’.

Obligatory hot dogs…

Because it’s less likely to seriously offend me.

Because people with intellectual and developmental disabilities are acceptable targets of ‘clean’ comedy.  So when they get rid of all the dick jokes and all the stuff that’s socially unacceptable and ‘dirty’, they’re left with acceptable targets.

Which includes me.

And no, hating r-word jokes is not the same as censorship or not being able to laugh at myself.  I laugh at myself, and at disability, all the time, to the point it makes a lot of nondisabled people really uncomfortable.

The issue is that most r-word jokes are hate.

They’re not meant in good fun.

They say “You’re not a human being.”

It doesn’t matter if you cloak that message in humor, it’s never okay.

The primary targets of the r-word are people with intellectual disabilities.  But it has a broader range than that — it’s aimed in general at a group of people who are harder to define.  Anyone who can be easily mistaken for someone with an intellectual disability, certainly.  And anyone who’s been, in the imaginations of most people, sort of lumped together as this blob of people who aren’t really human beings.  That includes most people with developmental disabilities, some people with cognitive disabilities, and, as I said, it’s a group whose borders are fuzzy and indistinct.  But we’re all lumped together under the r-word in the imaginations of the people who use it.  It’s not a diagnosis, it’s a slur.

And I don’t use the word slur lightly.

To me, for a word to be a slur, it has to be a word that contains within it the notion that the people targeted by it are not really people or human at all.

It can’t just be an insult that’s often thrown at a particular group of people.  It has to be more than that.

The r-word is probably the slur I have absolutely the least tolerance for.

People have been calling me the r-word since I was a child.

My voice sometimes has ‘that tone’ in it that people associate with the r-word.  A sort of ‘dullness’.  People imitating my voice have always taken advantage of that.  And they imitate my posture and mannerisms as well.

By the way it’s very fucked up to have a common mannerism associated with people like you, be the actual American Sign Language word for the r-word.

But you don’t need to speak ASL to use our mannerisms and tone of voice against us.

And yes — people used the r-word on me even when I was technically classified as gifted.  In fact, they told me “Gifted is just what they call [r-words] to convince them they’re doing well in school when they’re really going to special classes.”  I’m not the only person I know with developmental disabilities who was told this growing up.

I was also told I looked like a [r-word] as a way to get me to behave more normally.  It didn’t work.  I never had any idea what they were talking about.  (I also got called “blind” and “psychotic” in similar circumstances.  There was always a tone of complete disgust, like I was a dog who’d just shat on the table at a fancy dinner party or something.)

At any rate, r-word jokes aren’t funny.  At least, not the ones I’m talking about.

And the fact that they’re considered perfectly acceptable for ‘clean’ comedy to the point they seem more common there than in the ‘dirty jokes’ kind, says a lot too much about the society we live in.

R-word jokes are an expression of hate, not an expression of humor.  It’s not just the word, it’s the way it’s used.  It’s the acceptance that those of us targeted are not human beings.  It’s the knowledge that every time someone accepts this kind of hate into their mind, people like me are at more risk of bullying, abuse, hate crimes.  And that most people don’t even register it as hate.  Even though it’s some of the most horrible and dangerous hate I’ve ever seen.

Sacha Baron-Cohen says, “I am exposing.  I am airing prejudice.”  The only problem is that the people [who] are laughing, are not laughing at the prejudice.  They’re applauding the prejudice!  When the joke is “Throw the Jews down the well, kill the Jews” it’s not funny.  But even if it was funny, they’re applauding it.  

Abraham Foxman, “The Last Laugh”

I agree with a lot of the people on “The Last Laugh”.  It’s a documentary about where the line is between acceptable and unacceptable topics for humor.  I don’t think there’s unacceptable topics for humor, but I do think there’s more and less acceptable ways to handle them.  And a lot of it depends on who is saying the joke, how they are saying it, and what they are saying. 

And when I talk about r-word jokes, I’m talking about people without any of the disabilities covered by the r-word making jokes at our expense.  Telling a joke that has real-world consequences and hiding behind “It’s just a joke” is both cowardly and dishonest.  And I feel like there’s a tradition among comedians to hide an immature impulse to do whatever you’re told not to do, behind some kind of pretense of moral nobility.

Give me a good dick joke any day.  Seriously.  Sex can be funny.  Hate isn’t.  At least, expressing hate is not funny.  Tell some good jokes about asshole comedians who think hating people with I/DD is ‘clean’, though, and I might laugh.

Posted in Developmental disability, Developmental disability service system, HCBS

My assessment scores, for reference purposes.

Howard Center has several divisions.  There is Mental Health, which it is best known for.  There is also Substane Abuse.  There is Children and Family.  And then there is Developmental Services, DS for short.

I get services through Developmental Services, through a Medicaid waiver program called the Home and Community Based Services (HCBS) program.  In the state of Vermont, to get developmental disability services you must have either autism1 or an intellectual disability or both, and have limitations in certain life skills.

So proving the autism diagnosis wasn’t hard, but they wanted a current assessment of my life skills. So I was 24 years old, almost 25, when this assessment was done. It was done using the ABAS, the Adaptive Behavior Assessment System, the “Adult Form, Rated By Others,” meaning that my staff person (who had worked for me for 3 years at that point and knew my skills very well) rated how often I could do a long series of tasks listed. She asked specifically about whether it should be as I do with or without assistance, and was told to rate me as without assistance so they could get a true estimate of my abilities. My case manager from Easter Seals was there in the room the whole time. I was too nervous to even look at the test so I just sat there doing nothing. The test basically asks how often a person successfully does a series of specific tasks, from always/often to rarely/never.

An important thing to understand about this test is that it is supposed to test your abiliities as they are applied to the real world.  That’s why it asks how often you actually do these things.  Because it’s not about whether you have a theoretical understanding of something, it’s about whether you can actually do it.  At least, that’s how the test is meant to be applied.  Obviously it’s subject to the interpretation of whoever’s filling out the forms.

So these are the scores I got in the different areas.

First are the scores in each specific skill area. These are out of a scale that runs from 1 to 19, with 10 being average, and 1 being the least capable in this area and 19 being the most capable.

  • Communication: 1
  • Self-Care: 1
  • Self-Direction: 1
  • Community use: 2
  • Home living: 2
  • Health & Safety: 2
  • Leisure: 2
  • Social: 2
  • Functional Academics: 3

They then divide that into three areas:

  • Conceptual: 5
  • Social: 4
  • Practical: 7

Conceptual has a possible score between 3 and 26, Social has a possible score between 2 and 51, and Practical has a possible score of between 4 and 64.

Then you’re given a Composite Score that sums everything up.

  • Composite Score: 47

The composite score is from a range of 40 to 120.  My score is in the lowest percentile range for this test which is given only as <0.1.  The numbers are meant to mirror the numbers on IQ tests, so 100 is average.

It’s also important to know that at the point in time this test took place, I was much physically healthier relative to now.  The majority of the stuff I couldn’t do, that this test measured, was due to cognitive disabilities related to developmental disabilities.  I did not suddenly and recently become unable to do these things because of physical illness or disability.  I have been unable to do these things for quite a long time.

As far as how I see the accuracy of the test, I think it was pretty accurate.  There’s only one area that I find misleading, and that’s the communication area.  I got the lowest score possible for communication.  This didn’t make sense to me, or to the tester given that she had a coherent conversation with me.  But I asked my staff person what happened, and she told me that the test just happened to ask questions about the parts of communication that, especially at the time, I was the worst at:  Small social nicety words.

So things like please, and thank you, and hello, and things like that.  And while I’ve gotten better with those, at the time I really did never say those things to anyone.  So she had to mark it down as rarely/never.  So even though I was a writer, I got the lowest communication score it was possible to get.  But I can’t say it was totally inaccurate, because for what it measured I really didn’t say those things.  But it gives a very misleading idea about my communication skills, that the test didn’t even bother to clarify how well a person did things other than really basic words.2

The rest of the test just seems pretty accurate to me:  Left to my own devices, I can do very little for myself.

The important thing here is that this was documented back in 2005 by Howard Center.  As part of the intake process.  So acting like I am suddenly capable of doing these things, or acting like my difficulty doing them is new and entirely due to physical disability, goes against stuff they have in their own files about me.  I mean, in order to get into HCBS services in Vermont I had to prove both that I had a developmental disability of the sort they serve in Vermont, and also that it limited me in a certain number of life areas.  And this was the limitation part.  And it definitely showed that I was very limited in every single one of the life areas tested.

And there are specific reasons for that, but that’s a topic for another post.  I just want to document the fact that my inability to do this crap is well-documented and was known to be related to cognitive developmental disabilities thirteen years ago, so none of this should be a surprise to anyone.  Nor should the fact that skills training was tried extensively in California and didn’t take.  And all the other things they used to know and have conveniently forgotten.

Also I hate assessments.  They make me feel like a collection of deficits.  It’s a very icky and medicalized feeling.  Like having the important parts of you disappear like they never existed.  No depth.  But I’m glad I have documentation of this nonetheless.

 


1 By which they mean any label connected wth autism, so Asperger’s and PDDNOS count, unlike in some states.  Which is not as much of a moot point as you’d think, because people still have old diagnoses from before the DSM-5, and also large parts of the world don’t use the DSM and have not merged all the diagnoses into one.

2 There’s a larger problem at work here that I don’t want to get too distracted by, but is huge: There’s an assumption out there that skills run in a line from basic to advanced, and that you have to have the basics before you can do the advanced stuff, and that everyone progreses by first learning the basics, then intermediate level, then advanced.  And that everyone progresses along the same line, with the same set of skills, and so forth.

Which makes absolutely no room in the world for the fact that there are many people who learn skills in a totally different order.  Or who can do something advanced but not the basics, like my friend who is severely dyscalculic and spent her childhood in remedial math because she couldn’t do arithmetic.  Then a teacher found out she was obsessed with division by zero (which her teachers thought meant that she really didn’t grasp math) and told her to take that and run with it, and she reinvented the foundations of calculus.  And got out of remedial math for good.

There’s lots of people who learn things in a different order.  And there are actual disabilitis that cause a person to do something that seems advanced without being able to do the basics at all.  This often confuses people.  For instance, there are people with autism-related language disabilities that cause them to use very long words but have trouble with “simple” language.  And the very long words convince people that they have no language problems.

So it’s actually totally in keeping with that kind of thing that I failed a communication test that tested “easy” stuff, at the same time I was writing long eloquent articles on the Internet.  I really couldn’t do those “easy” words in conversation.  So I feel like the test was accurate to the specific things it tested, but misleading as a test of overall communication because communication is a lot more than those supposedly “easy” parts.

 

Posted in Developmental disability, HCBS

Enjoying something doesn’t make it okay.

Nor does it make it okay to hurt someone because they enjoy what they’re getting to do while you’re hurting them.  (Note:  Throughout this post, remember that anything that happens to me is happening to other people, and that’s one of the reasons I write about these things.  And as usual I’m not asking for anything that any other client doesn’t deserve as well.)

I had a recent and very surreal meeting with some people from Howard Center.

One of the many surreal moments came when Lauratried to bring up the issue of medical neglect within the recreational services I was getting.  I was part of a community garden.  I needed help maintaining my plot.  I could do some things but not others.  Anyway, they basicaally made me do things a person with severe osteoporosis and autonomic dysfunction should never be made to do, with regards to bending, lifting, and heat exhaustion.

The woman from Howard’s response was a bewildered “But I thought Mel liked gardening.”

Yeah.  I like gardening.  I don’t like bending clear to the ground with a stress fracture in my vertebra and recently healed rib fractures all over the place.  Nor do I like not being able to take breaks to avoid heat exhaustion without all assistance with the garden stopping for the day.

And yeah I actually did enjoy getting on the ground and getting my hands in the ground and all that.  Even when it was bad for me.

It doesn’t mean that what they did to my body was okay.

cropped-512-gardening-02.jpg

That is a picture of me doing something I loved doing and was proud of.

That is also a picture of me being forced to do something in a way that was physically dangerous to me.

These things are not contradictory.

In fact, it’s very common in human services for them to go hand in hand like this.

The fact that I enjoyed gardening doesn’t make it okay for them to insist that I garden in a way that’s unsafe2 for me or get no chance to garden at all.

Actually, the fact that I enjoy it makes it worse that they did this.

Because they can use what you enjoy in order to get you to do things the way they want you to do them.  Even at the risk of great harm to yourself.  Because you’re way more likely to agree to do something like this if you enjoy the activity in question.

So.  No.  My enjoying it doesn’t make what happened okay.  It makes it worse, if anything.  You shouldn’t have to risk broken bones and heat exhaustion to get any chance at all do things you like doing.  But that was the choice I was given.  And it’s not okay.  It’s far from okay.

Real Social Skills has a good post on a related topic (which I can say from experience with behavior mod, is true even when you do enjoy it, it can still be harmful):  Appearing To Enjoy Behavior Modification Is Not Meaningful


1 Laura is:

  • My durable power of attorney for healthcare
  • Frequently my cognitive interpreter at meetings
  • Someone who helps me advocate for myself and is much more effective at it than I am
  • My ‘second mother’ (and eventually will legally adopt me), has served in a semi-parental role since I was 17.  (Doesn’t replace my parents, but has helped them out a lot.)

So she’s there at a lot of important meetings.  One of the most important things she does for me is cognitive interpreting:  She helps me understand what other people are talking about, and helps them understand me even at times when I’m unable to get language across.  This is a form of interpreting that most people don’t even know exists.  Sometimes also called English-to-English interpreting when it happens in English.

The fun part is when she says what I’m thinking, I verify that she’s indeed said what I’m thinking, and she’s told that she couldn’t possibly know what I was thinking because the other person couldn’t tell what I was thinking.  If the other person could tell that well what I was thinking, I probably wouldn’t need a cognitive interpreter so badly.

2 Because people seem to use ‘unsafe’ to mean anything from dangerous to uncomfortable these days, let me clarify that I mean dangerous.  Heat exhaustion is dangerous, especially when you have autonomic dysfunction.  Broken bones are dangerous.  Broken bones when you have adrenal insufficiency are especially dangerous.  This wasn’t subtle.

Posted in Developmental disability service system, HCBS

The apparent dignity in being a slob, and the terrifying catch-22 on the other end.

When you’re a slob, you don’t have to tell anyone that the reason you never did laundry in 9 months is because you didn’t know how despite being taught just as well as your brothers.

When you’re a slob, you don’t have to tell anyone that if you don’t change clothes for weeks or months on end it’s because dressing yourself has always ranged from difficult, slow, and exhausting to impossible depending on the circumstance.

When you’re a slob, nobody has to know that you actually don’t know how to shower, no matter how long you stay in there and go through the motions.

When you’re a slob, people think you’re gross but they don’t think you’re incompetent.  They think you’re the sort of person they don’t really want to smell, but you’re neither disabled, nor like some of the spoiled brats you went to school with who could’ve taken care of themselves but always had someone to do it for them so never learned.

When you’re a slob, people think you make bad choices but they don’t think you’re pathological.

When you’re a slob, people find you sort of relatable as a human being still.

When you’re a slob, and only a slob, they don’t tell you that you can’t live on your own and need your civil and human rights taken away for your own good.

There are other consequences to being a slob, mind you.  But sometimes it’s easier to be a slob in other people’s eyes — someone who’s made a choice, even if one they think is lazy and morally wrong — than to be a retard.  And I’m using that word advisedly, because that’s the word they’re thinking about you, not something sanitized and pretty.

And when you’re a slob, you can convince yourself you’re in control of all this, even if you’re not.

But seriously.  When you’re a slob, you get to be a human being.  Sometimes it’s just easier to say, “I’m a slob,” “I’m such a procrastinator,” “I don’t care about my appearance,” “I’m so gross,” whatever, keep it relatable, keep it human, but it’s a lie.

Because I don’t actually want to live in unsanitary living conditions.  I don’t want to laugh it all off over and over again.  I don’t want to watch my remaining functioning crumble out from under me because I’m physically and cognitively unable to keep my environment uncluttered enough to function.  These are not situations I have ever wanted.

But I’ve endured them.  Over and over again.  Allowing people to believe what they will.

For so many reasons.

So I could retain the dignity of being considered merely a flawed human being and not a walking pathology.

So people wouldn’t declare me too incompetent to live on my own.

So many reasons.

And then I’ve watched a friend with a developmental disability get told that the infected ulcers on her legs were the result of a “lifestyle choice” — both by Howard-Center-appointed testers who refused to acknowledge she was unable to bathe herself, and by VCIL who at the time catered to wheelchair users and she “only” used a cane — and I’ve wanted to spit nails.

Because that’s the fucking flipside, the catch-22 of being a slob.

Is they can just call you a slob when they want to deny you help you need.  Help that may be at the level of survival, like it was for my friend with her infected leg ulcers.  Like anyone would be so much of a slob that they’d get infections on their legs and go to the trouble to seek help to get services to get help bathing.  That’s not how it happens, people.

But all these things have a catch-22 angle to them.

Admit you need help and they’ll ‘help’ you right out of your right to live in your own home.

Insist on your right to live in your own home and they’ll hold you to impossibly high expectations and try to deny you help and call it a ‘lifestyle choice’ when you can’t do the things.

Be a slob and be denied help because slobs don’t need help they just need a kick in the pants for their laziness.

Admit you’re not a slob and if they believe you, you might be shunted into a nightmare world against your will.

There are no right ways to be developmentally disabled around here.

And I’m hearing horror stories.  About people suddenly being pushed to do things on their own they’ve never done before.  And if they manage it even once even for a little bit, they’re told they don’t need help, sent on their way, hours cut partially, or cut out of services altogether.

There are no right ways to be developmentally disabled around here.

We aren’t supposed to exist anymore.  We’ve become too inconvenient.  We’re the reason their agencies even exist, we’re the reason they have a paycheck, but we, ourselves, as people, as messy human beings who need their assistance to survive, are too inconvenient.  So they’re Xing us, one by one.  Or trying.  We need to resist Xing with everyting we’ve got.

For the time being, I'm still here. Big, fat, hairy, smelly (the VNA is short-staffed, I can't frigging help it), and all. And I intend on remaining.
For the time being, I’m still here. Big, fat, hairy, smelly (the VNA is short-staffed, I can’t frigging help it), and all. And I intend on remaining.

Posted in Death & Mortality Series, Developmental disability service system

When powerful people don’t care if you live or die…

umbridgewithteajpg
Dolores Umbridge might be the ultimate representation of Nice Lady Therapists at their utter worst…

This post is part of my Death & Mortality Series.  Please read my introduction to my Death & Mortality series if you can, to understand the context I write this in.  Thank you.

Not all of my thoughts on death and mortality are purely personal.  Although this is certainly born out by personal experience, this is much more in the ethical/political realm than my personal relationships with Death itself.  And is just as important to the whole picture of how I approach death and mortality, and one reason I’ve been so reluctant to post my actual experiences of Death being a benevolent and friendly force.

If you are disabled.  If you are cognitively disabled.  If you are developmentally disabled.  There are people who literally do not care one way or the other if you live or die.  And there are people who actually kind of wish you’d die — some more fervently than others.  And there are people in positions of power who will either fail to act in ways they would normally act, or actively push things a little more in the direction of your death (sometimes obviously, sometimes more passively with plausible deniability).  And to be unaware of this is to be unaware of serious danger.

These people can work in the medical profession.  Many do.

These people can work in agencies that are supposed to give you support.  Many do.

These people can work in any major position of power over you.  Many do.

And I’m not talking about serial killers, although they take full advantage of some of these situations in all kinds of ways.  I’m talking about people who mostly think of themselves as kind of normal.

But they can still kill you with apathy, indifference, and even varying degrees of malice.

My developmental disability agency just announced to me last night things that confirmed the warnings I had been receiving from friends that this kind of thing was at work right now.  They want me suddenly doing things I have never been able to do even at my physically healthiest (and they have ample documentation of my inability to do these things), things they have been doing for me for thirteen years without incident until my DPA filed a medical neglect complaint against them.

This is part of an attempt to railroad me into a service model (which requires moving out of my own home and would not get me any better care) that they prefer for me.

This is part of retaliation for filing the complaint, before which there was no talk of railroading me into this service model.

But they know.  Perfectly well.  That I was struggling to stay alive and stay out of the hospital with the amount of services I was getting.  (I have had recent unexpected cascade-effect complications from a surgery and have been going alkalotic at the drop of a hat.  Long story.  But it’s taken everything I have and every skill I have to stay out of the hospital and alive as long as I have, and I’ve been back in the hospital since Friday.)  And they knew that the reduction in services caused by a staff vacation/staff shortage contributed to my ending back up in the hospital.  They knew all this.

Then they sent me a letter saying I am no longer entitled to have anything done for me, that I must physically participate in everything.

They know, in detail, that this is not possible for me.  They know, in detail, that this would be dangerous for me on multiple levels even without a severe, acute health crisis.  They have documentation of every single reason in more detail than they probably care to know, that even moving my body through the motions is physically dangerous to me.

They know these things.

So the only conclusion I can reach when they insist that these things happen anyway, is that whether I live or die doesn’t matter to them.

The fun part is if I do die, I’m sick enough they’ll probably get away with it even if they’re very culpable in the events leading to it.

But my friends have been telling me I might not live out the year the way this agency has been treating me, when I probably would otherwise.

When I say I accept death, it does not mean I accept THIS.  This isn’t death that just happens.  This is some toxic combination of apathy and malice, and the worst part is I don’t know precisely where it’s coming from.  But people have warned me about it just before this happened.  And when I spoke to medical professionals about it, they told me this kind of thing is very real and something to always keep in mind.

So this is happening.  Now.  I am in the hospital.  And I got a letter that started out with a basic “Sorry you’re in the hospital” thing and then a “But we’re gonna try to make you do shit that’d probably kill you or land you back in the hospital to try” thing.  Which makes the “Sorry you’re in the hospital” part feel completely phony.

I was starting to feel a little better and look forward to going home sometime soon, maybe not as soon as I’d like, but soon.  But I can’t go home to being expected to physically do crap I couldn’t safely do on my best day.

And I can’t stress how much someone at some level is perfectly aware what this means that they are asking this of me just now.

And that they don’t care the risks to me (even if they think it’ll just push me into accepting their bullshit program) tells me they really don’t care deep down if I live or die.  Because people who care if you live or die don’t dangle you over a cliff (or even pretend to do so) to get you to do what they want, even if they think they have a good hold on you.  Ever.

And the fun thing is even if you see this, and even if those around you see this, and you see the patterns enough to know what’s happening, you can’t necessarily tell who precisely they are.  They may be someone you never meet directly.  But people who explicitly range from apathetic to malicious abour your continued existence are out there.  And unfortunately in our culture of familial and caregiver benevolence, nobody who hasn’t seen it for themselves wants to believe it, even though it’s something well beyond commonplace.

So you can’t always just point to an Umbridge.  Even if there’s an Umbridge, or a small army of Umbridges.  (Umbridge got into this post because someone referred to this, after reading the letters, as “Dolores Umbridge-level fuckery”.)

And for the record, accepting death as a whole does not mean I accept this kind of death for an instant.  If I die because I’m expected to do crap I’ve never been able to do and is now physically dangerous for me to even be walked through the motions of, that’s not just dying because I’d die anyway.  And there’s a huge difference.  And I hope I don’t have to explain that difference to anyone.  I’ve long said that dying because I’d die anyway is fine with me, but dying out of someone’s apathy or stupidity or malice will leave me the world’s most pissed-off ghost.  If I had any intention of being a ghost, which I don’t (not sure it’s possible but very sure that trying would be destructive).  But you get the idea.