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After Two Teen Suicides Last Year, How Will Summit County Address an Ongoing Mental Health Crisis?
Longreads Pick
“A tragic stretch in April 2020 shone a light on the mental health issues facing the mountain community. With the new school year set to start, area residents are continuing to heal while asking themselves how they can learn from the past.”
Author:
Source:
5280 Magazine
Published: Aug 1, 2021
Length: 19 minutes (4,821 words)
The Racist Healthcare System that Failed JaMarcus Crews
Posted by 
Krista Stevens
Krista Stevens 
Getty Images
JaMarcus Crews’ mom was diagnosed with Type 2 diabetes while she was pregnant with him, making him more likely to develop the condition himself. As Lizzie Presser reports at ProPublica, he worked hard to manage his health after being diagnosed as a teen. He did everything right, everything they told him to do. He watched what he ate. He exercised. He lost weight. He drove hours and hours, sometimes having to borrow gas money to attend life-saving dialysis after the disease progressed. His only mistake? Putting his trust in a system that was set up to fail him as a Black man with Type 2 diabetes.
A race-adjusted equation was also at play in JaMarcus’ case. The formula calculates kidney function by looking at what’s called “estimated glomerular filtration rate,” or eGFR. Creatinine is plugged into the formula along with age, sex and race. Doctors must note whether their patient is “Black” or not. By design, the equation assigns healthier scores to those who are listed as Black, because at a population level, a few studies found that this was more precise. With little investigation into why this might be the case, it was just accepted. That inflated score can mean a longer wait for a kidney because eGFR must drop to a certain level before you can start accumulating time on the transplant waitlist. The best-case scenario is to get a new kidney before needing dialysis, to avoid weathering the side effects of the machines. But those transplants are given on a first-come, first-served basis, and Black patients are less likely to get one.
The researchers and physicians behind the original formula, developed in 1999, wrote that Black patients had higher creatinine levels because “on average, black persons have higher muscle mass than white persons.” The assertion that Black bodies are different from all other bodies keeps company with generations of racist ideas that have infiltrated medicine, some of which were used to rationalize slavery. Researchers who developed the equation acknowledge that race is an imperfect variable, but even though they have updated the formula, they continue to adjust for race. The vast majority of clinical laboratories in the United States use such formulas today.
Dialysis is corporate healthcare on steroids: For-profit companies dominate the market, reap their revenues from Medicare and lobby hard against government reform. DaVita and Fresenius recently spent over $100 million to fight a ballot initiative in California that would have capped their profits, much of which are derived from taxpayer dollars, arguing that the initiative would lead to a shortage of doctors. They have lower staffing ratios and higher death rates than nonprofit facilities. And studies have found that patients at for-profit clinics are less likely to reach the transplant waiting list; they are 17% less likely to get a kidney from a deceased donor. Purnell, the Johns Hopkins epidemiologist, said the whole system is broken as long as corporate dialysis, which is financially incentivized to keep patients, is in charge of steering them to the better treatment of transplant: “Why would I walk into a Nissan dealership to tell me about a BMW?”
Dialysis facilities are responsible for transplant referrals, according to federal regulations, and JaMarcus’ DaVita social worker was assigned to educate and support him. When he was first assessed, a couple of weeks after he began, she wrote that he was suitable for referral and she would get him one when he got insurance. JaMarcus qualified for Medicare within three months. But more than a year later, he still hadn’t been referred.
By 2015, JaMarcus had a new DaVita social worker, Robbin Oswalt, who attributed the delay to a different prerequisite: “He is interested in getting a transplant referral if the Dr. approves after his wgt loss.” JaMarcus had lost 108 pounds since he started dialysis, and his body mass index had been hovering around the University of Alabama’s limit for months. At the time, he didn’t know that his height had been mistakenly entered into his DaVita records as 5-foot-11 — an inch and a half short of his actual height. Their incorrect number was then used to calculate his BMI, which made it look to his doctor that his weight was disqualifying, when it wasn’t.
To Make a Building Healthier, Stop Sanitizing Everything
Longreads Pick
” For years scientists have sounded the alarm that our disconnect from the outdoors is linked to a host of chronic health problems, including allergies, asthma, depression, irritable bowel syndrome, and obesity. “
Author:
Source:
Bloomberg Businessweek
Published: Dec 16, 2020
Length: 16 minutes (4,113 words)
The Alarmist: Is One of the Pandemic’s Loudest Scientific Voices Helping or Hurting Public Health?
Posted by 
Seyward Darby
Seyward Darby AlexSecret
How should scientists balance the need to raise the alarm about a health threat with the complexity and methodical pace of research required to understand that threat? How do you weigh potential harm done versus good achieved when deciding what to tell a frightened public? These aren’t new questions, but in 2020, they’ve come into sharp focus. No one embodies them more fully than scientist Eric Feigl-Ding, a Twitter sensation for his urgent threads about the coronavirus pandemic. Perhaps you’ve read some of his viral tweets — the most famous ones begin with phrases like “BLOODY HELL” and “HOLY MOTHER OF GOD.” In less than a year, his following has grown from 2,000 to more than 250,000 Twitter users. Jane C. Hu profiles Feigl-Ding for Undark, asking whether he’s the town crier the internet needs or just another purveyor of disinformation:
Even when his public exclamations are technically accurate, Feigl-Ding’s critics suggest that they too often invite misinterpretations. In a thread about the first study of a COVID-19 outbreak on an airplane, for example, Feigl-Ding failed to mention the important caveat that researchers suspected all but one case occurred before people got on the airplane. In another, Feigl-Ding appeared to summarize a Washington Post piece on a coronavirus mutation, but omitted crucial phrases—including the fact that just one of the five mentioned studies was peer-reviewed. It wasn’t until the sixth tweet in the thread that Feigl-Ding mentioned the important detail that the “worrisome” mutation doesn’t appear to make people sicker, though it could make the virus more contagious.
To Angela Rasmussen, a Columbia University virologist, this represents a pattern. “[T]his is his MO,” she wrote in an email. “He tweets something sensational and out of context, buries any caveats further down-thread, and watches the clicks and [retweets] roll in.”
Such critiques of Feigl-Ding’s particular brand of COVID-19 commentary are by no means new, and previous articles—in The Atlantic as far back as January, for example, New York Magazine’s Intelligencer in March, the Chronicle of Higher Education in April, and in The Daily Beast in May — have explored questions about his expertise in epidemiology (his focus prior to COVID-19 was on nutrition) and whether his approach to public health communication is appropriate or alarmist. But as his influence has grown, and as the pandemic enters a much more worrying phase, critics have continued to debate whether Feigl-Ding, for all his enthusiasms, is doing more harm than good. Some complain that Feigl-Ding’s army of followers can be hateful when other scientists publicly disagree with his tweets. Others say that Feigl-Ding himself has been known to privately message his critics—a tack that some found unwelcome.
For his part, though, Feigl-Ding says many of his critics’ disagreements with him have come down to a difference in style. “Sometimes it’s a matter of a philosophical approach about tone: Should I say ‘whoa’ or ‘wow?’” he said
How Iceman Wim Hof Uncovered the Secrets to Our Health
Longreads Pick
“In a world addicted to comfort, it isn’t easy to convince a vast audience that what they really need is to take teeth-chattering swims and ice baths—but Hof has managed to do this.”
Author:
Source:
Outside
Published: Oct 12, 2020
Length: 19 minutes (4,900 words)
Purging the Unhealthy Value System of the American Literary World
Posted by 
Aaron Gilbreath
Aaron Gilbreath AP Photo/Ross D. Franklin
When searching for a publisher for her sixth book, Janice Lee realized she had internalized more of the commercial publishing economy’s value system than she wanted. In a brilliant essay for Vol. 1 Brooklyn, Lee interrogates the way America’s cultural values push against her own values and have influenced her behavior, and she narrates her efforts to dismantle the dominant linear idea of progress, success, artistic development, and “making it” that many of us writers inherit. The concept of success, even the subtler concepts of big versus small presses and breakout novels, are wrapped up in authors’ self-worth, desire for external validation, past trauma, and capitalism, which has turned art into products and human beings into resources. This is a searing, crystalline essay, as practical as it is beautiful, and in it, Lee’s cut a path for other writers who want to free themselves from indoctrination. “It is difficult to see how we are restrained by our own internalized oppression,” she writes, “and then, to blame the systems we participate in when we don’t feel supported, understood, heard, seen.” She asks: What if books were bridges and not products? Can’t they be something other than commodities?
How can we all heal from the trauma of a publishing industry that is just another extension of white supremacist capitalist patriarchy? How might we move beyond the myths of meritocracy and the capitalist paradigms where legitimacy and success are so closely linked, casting so many of us as undeserving, mediocre, invisible? Publishing “success” often looks like the escape we are looking for, especially when we have trained our entire lives to survive in this system. Everything has taught us that this is how we survive and get ahead, to jump on the train and go along with it, along with everyone else, and so when we get left behind, we feel shame and humiliation, we think that we must have done something wrong, that perhaps someone forgot about us or made a mistake. There has to be another way. We have to be more conscious of the ways in which we have all internalized publishing supremacy, the harm of unconsciously assigning more worth to books or authors that have had more commercial success, of using language that feeds the idea of linear progress and hierarchy.
America’s Largest Health Insurer Is Giving Apartments to Homeless People
Longreads Pick
“There are more than half a million homeless in the U.S., about a third of them unsheltered—that is, living on streets, under bridges, or in abandoned properties. When they need medical care or simply a bed and a meal, many go to the emergency room. That’s where America has drawn the line: We’ll pay for a hospital bed but not for a home, even when the home would be cheaper. Jeffrey Brenner is trying to move that line.”
Author:
Source:
Bloomberg Businessweek
Published: Nov 5, 2019
Length: 14 minutes (3,717 words)
In Sickness, In Health — and In Prison
Posted by 
Mia Armstrong
Mia Armstrong Najeebah Al-Ghadban for The Marshall Project.
Mia Armstrong | The Marshall Project | August 2019 | 9 minutes (2,400 words)
This article was co-published with The Marshall Project, a nonprofit news organization covering the U.S. criminal justice system. Sign up for their newsletter, or follow The Marshall Project on Facebook or Twitter.
Niccole Wetherell and Paul Gillpatrick were engaged in 2012. The state of Nebraska has prevented their wedding ever since.
Wetherell is serving a life sentence for first-degree murder, housed in a prison about 50 miles away from her fiance, Gillpatrick, who is serving a 55-to-90-year sentence for second-degree murder.
The pair, who met in 1998, have come to accept they cannot marry in person. Instead, they want to wed via video conference, and they want an end to a prison policy that forbids Nebraska inmates from marrying each other except in “special circumstances.” Wetherell and Gillpatrick argue they have a “fundamental right to marry.”
In June, U.S. District Judge Robert Rossiter affirmed that right. The case is now in appeal. But the legal precedent Rossiter cited has a quirky history that involves an infamous co-ed prison, an impromptu wedding, a soon-to-follow divorce and a U.S. Supreme Court decision.
That decision, Turner v. Safley, established how courts should weigh the constitutionality of prison regulations, and has formed the legal basis for prison weddings across the country—most often between one incarcerated person and someone on the outside. It opened the doors for a niche industry of officiants who specialize in prison weddings. And its clear articulation of marriage as a fundamental human right was even cited in Obergefell v. Hodges, the landmark Supreme Court decision that in 2015 affirmed the right to marriage for same-sex couples.
It all started in 1980 at a prison in Missouri. Read more…
Maintaining Mental Health as a Rescuer in the Grand Tetons
Posted by Krista Stevens
Krista Stevens Getty Images
As a climbing ranger in Grand Teton National Park, Drew Hardesty is one of those charged with rescuing lost and injured hikers, runners, and climbers. When things are good, he’s putting his life on the line, dangling 50 feet below a helicopter, harnessed to a survivor. When things get bad, he’s one of the ones who brings home the bodies. When we think of outdoor adventure gone wrong, we often think of the victims — those who died on a climb, on a trek, on a run. At Outside, Hardesty shares a little about how deeply death on the mountains affects the rescuers and how they cope with repeated trauma.
He had been on his share of body recoveries. “Sure, man,” he said. “I get it, I’ve been there. We’ve all been there.”
“This one was different,” I said. “Two women on the ledge. It was obvious they had injuries incompatible with life. We had to climb up through blood in the chimney to find the last gal. I’ve picked up plenty of others—friends even—but this one felt … different.”
Karl Marlantes describes conversations like these in his 2011 book What It Is Like to Go to War. Marlantes was a young Marine lieutenant in Vietnam and noted that none of his men ever wanted to talk to the chaplain, because the chaplain had never seen what they had seen. But another soldier, the sergeant, was in his third tour in Vietnam. And one by one, the men would steal back to his tent to talk.
Mental health is like physical health. Both can suffer trauma. Each can take weeks, months, or years to recover from. Sometimes we never recover at all. Mental trauma can affect different people on the same rescue or recovery in very different ways. We may walk through terrain where we conducted a body recovery or see someone in a crowd who you’d swear was the person from the body bag. Bob Irvine, a Teton climbing ranger from 1963 to 1995, says he can’t walk through the range without seeing places where people have died. On the flip side, another climbing ranger, George Montopoli, who began his summer Teton climbing career in 1977, told me not long ago that for every place he sees a body recovery, he sees another place where we made a rescue. For a time, I too could only look at the mountains and see death and injury. I know countless widows around these mountains.
The alpinist Will Gadd recently told me: “If you only see death in the mountains, then you’ll never go there.” I know this is how we are wired. We embrace things that nourish us and give us joy, and we avoid things that cause pain and sadness. But the mountains bring about joy, and they bring about sadness. They remind us of the eternal link between life and death—we can’t have one without the other. Understanding this connection is fundamental to our own resiliency. So is talking with others who hold similar experiences. This is often referred to as peer-to-peer counseling. Another crucial part of the path is finally shedding the stigma of mental health and suffering.
In the Tetons, at the end of a rescue or body recovery, we’d often wander over to the porch at the large cabin in the meadow just south of Jenny Lake. There’d be a bottle or two on the porch, but often it would go unopened. We’d look past one another, tell a joke about death, look up at Teewinot, listen to Cottonwood Creek and the rustle of wind through the leaves. Sometimes we’d tell stories. What was important was that each of us had been there; we all, in another way, had blood on our hands—we had all shared the same experiences. While always offered, we didn’t need the chaplain. We needed each other.
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