Read Like You Give a D@#n

IMG_3959Empathy is in short supply. Anti-empathy, racism, xenophobia, misogyny and all things ugly are being modeled and stoked by too many people and institutions—including, of course, the President of the United States. Effective resistance to all of this comes in many forms. It is not enough and is self-indulgent to be simply outraged. Fire and fury is not the answer. Do something: Read like you give a d@#n.

You do not need to read or re-read Ray Bradbury’s dystopian novel Fahrenheit 451, or review the history of book-burning, book-banning, author suppression and outright killing (as by Hitler during WWII), to know that books and the mind (and empathy) expanding knowledge they contain is powerful stuff indeed.

My beloved local library system, Seattle Public Library (SPL), has a gutsy and well-read patron who posted “Sh**hole Countries: A Reading List” on their BiblioCommons site. The SPL has added a disclaimer that the post and the list of recommended books is not a publication of the SPL, but kudos to them for supporting the sharing of diverse opinions and resources. Even if you happen to find the content of the brief post either too in-your-face or borderline offensive, be sure to look at (and hopefully read) some of the amazing books on the recommended reading list.

Of course, reading real literature (non-fiction, fiction, poetry, plays) does not necessarily build empathy and equity. Mind and heart expansion require having at least a doorway or a window or a crack in the walls of mind and heart for them to open and expand. But good books and reading them like you give a d@#n do have amazing, lovely, powerful, radical effects on not just the individual reader but also the world.

For the past three summers I have posted a summer reading challenge list of books that have a social justice, global, and health humanities bent. (See “Summer Reading Challenge with a Health Humanities/Social Justice Slant” from June 2, 2015; “Summer Reading Challenge 2016” from May 28, 2016, and; “Summer Reading Challenge: Global to Local” from June 11, 2017.) You don’t need to wait until the summer or a vacation of some sort to start reading real books, radical books, world-view changing books.

Navigating Towards Adulthood

IMG_3677.jpgWhat does it take to become an adult these days? What does it take for a young person experiencing homelessness to become an adult? And, is it true—as many adults now claim—that young people in general, housed and un-housed, are way too coddled and over-protected and kept in a nest of some sort (including an emergency shelter or transitional housing nest) for so long that they end up with arrested development?

I’ve been thinking about these and related questions. They matter to me in my roles as parent to one young adult and one adult (and newly married); as university professor working with hundreds of young adult students; and as a nurse practitioner and researcher working with teens and young adults experiencing homelessness.  Having personally survived a difficult adolescence and young adulthood (including a spiral into homelessness), I care deeply about doing what I can to help young people navigate this important and precarious time of life.

And the nest/arrested development comment above that includes emergency and transitional housing/shelter for teens and young adults? That comes from the fascinating assortment of reader comments to a recent Seattle Times article on the Doorway Project that I am working on. The article by Scott Greenstone, “A cafe where no one is homeless: one solution to youth on Seattle streets” (December 11, 2017), highlighted the story of Brad Ramey, a young adult age 25 years. A transplant from Alaska, Ramey stays at ROOTS Young Adult Shelter (for young people 18-25), takes classes at a community college, and during the day spends time in coffee shops and the public library to stay warm and dry. Many of the reader comments included some variation of “he is not a youth, he is an adult,” along with the tired tropes of “there are plenty of jobs to be had” and “more enabling services attract even more and ‘lazy’ homeless people.”

I find these comments helpful in that they voice biases, views, and misperceptions that are likely widespread. They may, in some cases, represent teachable moments, at least for people who are open to new information. For instance, it seems there is confusion as to the definition of “young adult.”  The World Health Organization uses the term “adolescents” to describe youth 10-19 years (or age of majority for a particular country), “young adult” for persons 20-24 years, and uses the inclusive term “young person” for individuals ages 10-24 years. There are no standard age definitions of “adolescent” or “young adult” in the US. However, the ACA provision for health care coverage of young adults on a parent’s health insurance policy is until age 26. I wonder how many of the negative reader commentators to the Seattle Times article were by comfortably employed and housed parents of young adults taking advantage of this ACA provision.

Our country’s social and class and race structures continue to exert large and inequitable effects on adolescent development and life trajectories for our young people. I recently read sociologist A.B. Hollingshead’s now classic book Elmtown’s Youth (New York: Wiley, 1949). about “certain significant relationships found to exist between the social behavior of adolescents and social stratification in a Middle Western community immediately before the effects of WWII were apparent locally.” (p. 3) I found this to be a fascinating book, especially in the vivid descriptions of social class (including inadequate housing and homelessness) and its effects on adolescent development, on what are now called adverse childhood experiences/traumas, and life trajectories—and in the fact that so much is the same if not worse 78 years after Hollingshead’s research. As he concludes in his book, “Those aspects of the culture which foster and perpetuate the class system over the against the ideals of official America, embodied in the Declaration of Independence and the Constitution, will have to be changed, if there has to be change, before Americans will face in practice the ideals they profess in theory.” (p. 453) Navigating towards adulthood is difficult under the best of circumstances. Navigating towards adulthood while experiencing homelessness and the traumas that often contributed to homelessness is exponentially more challenging. But not impossible.

ABCs for the New Year

IMG_3911A is for anger. It is necessary.

B is for brooding.

C is for chaos. It is necessary.

D is for deliver us from all things evil.

E is for everything good in the world.

F is for framing (and re-framing) the issue.

G is for grace. It is necessary.

H is for happenstance.

I is for a return to the improper first person because that is who we are.

J is for jerry-built or jury-rigged because that is what the journey of life requires.

K-L-M-N-O-P is for “keep learning more nonsense or perish.”

Q is for questioning. Everything.

R is for rest. It is necessary.

S is for solitude. It is necessary.

T-U-V is for the undoing of violence. Everywhere.

W is for “we may overcome some day if we work together.”

X is for xystus, that shaded walkway lined with trees where philosophical conversations       are likely to occur. And a word which gave me an excuse to consult the OED.

Y is for yes and for everything that is infinite.

Z is for a zeal for life and for all things social justice.

Now I know my ABCs (for the New Year resolutions), won’t you write your own?

Pets Rock

IMG_6141A week ago I lost my sweet corgi, Quinn. He was 14 years old and had been in my life (and heart) for over ten of those years. He came into our family as an early retirement (okay, failed) show dog from a Montana breeder since he had developed an auto-immune disorder. Quinn was my steady companion, my guardian (he had a ferocious ‘big dog’ bark to turn away any would-be home intruders—as long as they didn’t actually see him). He allowed me to sob into his fur after the death of both of my parents and the dissolution of my family of origin. He made sure I took regular breaks from my writing life in order to walk him and to meet the neighbors in the process. He helped define safety and love and the meaning of home.

I am reminded of the importance of pets to the mental health and well-being of people in general, but especially to those dealing with depression, loneliness, isolation, and homelessness. My patients tell me this all the time and a growing body of scientific literature supports these claims. Even the Centers for Disease Control (CDC) has a web page devoted to the health benefits of pets, although their links to additional information are broken. (Hopefully, “pets” has not become a banned word.)  Pet Partners, a pioneer in human-animal positive bonds and community-based pet therapy programs, has a list of health benefits of pets and animal therapy.  The National Institutes of Health (NIH) through MedlinePlus Health News has up-to-date results of research studies on the health benefits of pets, including the article “Hey, Single Folk: Adopting a Dog Could Lengthen Your Life” (November 17, 2017, by Robert Preidt).

Whenever I do The Meaning of Home values clarification exercise with groups of people—whether or not they have ever been or are currently home-less or un-housed—pets invariably rank up there with family members as the most important ingredients of home. Below, I include some of my favorite pet-related results of this exercise.

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Global to Local: The Doorway Project

IMG_3706Dream big. Take calculated risks. Be innovative and creative. Work collaboratively. Be open to learn from other countries and other communities and support the global to local connections. Dare to be labeled woo-woo. Remember nurse power!

Those are the lessons I have been learning—or relearning lately as I help launch the Doorway Project, a campus-community interprofessional innovative collaborative project aimed at reducing if not ending youth homelessness in the University District of Seattle. It is a form of public scholarship and includes creative data-gathering and design modalities including participatory community mapping, photo voice, and participatory digital storytelling videos. It’s final product will be a youth-centric human/community designed community cafe modeled after the amazing Merge Cafe in Auckland, New Zealand. It is ambitious and audacious and it just might work.

We have our kick-off and first pop-up community cafe and community participatory design activities this Sunday, December 3rd, noon-4pm at the lovely community center University Heights in the U District of Seattle. Here is an edited down 4-minute version of a longer interview I did today with our local U District public radio station KUOW 94.9 FM. Many thanks to them and especially to Producer Andy Hurst whose mother happens to be a nurse.

Solastalgia: Homesickness and Climate Change

BC642845-1D42-466F-870C-CC1456A62A08Population health effects from climate change are established scientific facts. Like anti-vaxxers (anti-vaccinators), climate change deniers are not only wrong-headed, they are dangerous to everyone’s health (and to planetary health). Case in point: beware of the pets of anti-vaxxers since many seem to be refusing rabies vaccinations for their cats and dogs/ see “Anti-vaxxers now refuse to vaccinate pets” by Nick Thieme, Slate, August 3, 2017; at the same time, global warming is increasing the spread of rabies among animal hosts such as foxes in Alaska/ see “Ecological niche modeling of rabies in the changing Arctic of Alaska” by Huettman, Magnuson, and Hueffer, Acta Veterinaria Scandinavica, March 20, 2017. And as a reminder, rabies in humans is almost 100% fatal (source: CDC).

The Centers for Disease Control has developed an excellent graphic depiction of the impact of climate change on human health, shown here:

climate_change_health_impacts600w.jpg

Of special note in this graphic is the fact that mental health impacts are shown twice, associated with both severe weather and with environmental degradation.

A recent (November 25, 2017) NYT article illustrates the mental health effects from climate change for people who live in Rigolet, Labrador. As Livia Albeck-Ripka states in the article “Why Lost Ice Means Lost Hope for an Inuit Village” there are increases in depression, substance abuse, domestic violence, and suicide related to the disorienting environmental changes and increased isolation for villagers. “An unpredictable environment means disempowerment,” she writes and links this with the stirring up of the intergenerational trauma of colonization for indigenous people. But she also points out that mental health effects from climate change and environmental degradation affect us all. She quotes Australian philosopher Glenn Albrecht as stating, “We weren’t around when the asteroid wiped out dinosaurs, but now we have humans in the 21st century who are trying to deal with a change to the world which is unprecedented.” Albrecht coined the term Solastalgia: “a form of homesickness one experiences when one is still at home.”

But what can we individually and collectively do about climate change and about the health effects of climate change? Perhaps the most important action is to become better informed and more civically engaged in respect to these topics. The Lancet has a good website: Tracking the Connections Between Public Health and Climate Change which includes a synthesis of scientific evidence in The 2017 Report of The Lancet Countdown. In the US reliable sources of information include the CDC (resources linked above) and the American Public Health Association (APHA). The APHA graphic “How Climate Change Affects Your Health” (included below) is a bit overly-busy and heavy on the gloom and doom (and curiously does not include mental health), yet could spur helpful discussion in certain settings:

Climate_Change_Overview

Another great resource that is geared towards a young adult audience is the Seattle-based environmental news site Grist, with the vision of working for “a planet that doesn’t burn and a future that doesn’t suck.” Their funny and informative (a good combination) “Ask Umbra” eco-advice column is worth following. Take a look at Umbra’s “21-day Apathy Detox” for great ideas on brushing up on civic engagement related to environmental justice and climate change. My two favorites are “Day 5: Read More Than Dead White Men” and Day 20: Art Brings Life to Social Movements.” 

Get involved. Do what you can to beautify and “green” the places where you work, live, and play. Work upstream for social and environmental justice. Bloom where you are planted. Those are some of the thoughts I’ve had this fall as I’ve been involved with this year’s University of Washington Health Sciences Common Book Changing Climate, Changing Health: How the Climate Crisis Threatens Our Health and What We Can Do about It by Paul R. Epstein and Dan Ferber (University of California Press, 2011).

In order to emphasize the what we can do about it, I’ve been part of a team attempting to green the ugly weed-filled concrete planters in the main courtyard at the University of Washington Health Sciences—a courtyard with entrances to the Schools of Nursing, Medicine, Dentistry, the UW Health Sciences Library, as well as the UW Medical Center. The photos at the beginning of this post show the planters in their current (dismal, depressing) state, along with my tiny (art project!) protest sign next to a fake flower “blooming” in a pot. Our team wanted to plant spring bulbs and a healing garden full of water-wise herbs like rosemary and lavender, as well as indigenous healing herbs and native wildflowers. We have had a seemingly endless series of meetings with people from the medical center, the health sciences schools, the building and grounds folks, and the UW Sustainability group. Something that would appear to be easy to do is not. As I understand it, the (ugly concrete/example of Brutalist “raw concrete” architecture) Health Sciences building where this courtyard is located, is crumbling and leaking inside, including in the rare books collection of the library. We have been told that we can’t plant anything until the courtyard infrastructure and water membranes are replaced, which would cost millions of dollars ($7.5 million to quote one reliable estimate).

This is a somewhat trivial problem when compared with other environmental issues affecting our most vulnerable populations, but it is a daily reminder of the negative mental health effects of environmental degradation—including from poor choices for our built environment and health institutions.

Me Too and Misogyny

img_1223Kudos to rad woman Tarana Burke who started the #MeToo movement that is helping bring to light (and to the town square) the rampant sexual violence especially against women and girls in our country (although boys and LQBT folks are also highly affected). I am all for thorough investigation/corroboration of claims of sexual violence—which is what has happened in the vast majority of recent cases. Being an ‘out’ woman with a history of sexual abuse/assault, it is heartening to find the cultural tide beginning to shift on this topic. More women and other marginalized people are feeling empowered to speak up about their experiences and are (mostly) being supported in speaking their truths. Of course, there will always be the narrow-minded, misogynistic folks (mostly men) who will be quick to dismiss these claims as “yet another case of women lying” or “recovered memories” or any of the other lame excuses they can come up with. As Ms. Burke reminds us, this movement is about amplifying (and supporting) the voices of victims of sexual violence. Misogyny is very much alive and un-well in our country.