Prime time problems

The TV droned on in the background of our cooking and chatting about the day. I wandered into the living room just in time to see a commercial for an upcoming program about an obese woman who lost some weight. A lot of weight.

Later, The Biggest Loser came on. I flipped channels, and every time I passed this show, I thought, "Shit, when did weight loss become a goddamn game show? Where's the healthy spin on that?" There were weigh-ins and disgusting plates of high-calorie temptations, insults and recriminations, but no details on body mass index, blood pressure, or emotional wellbeing.

Perusing Discovery Health, there were at least three programs about an obesity clinic, a group of doctors who do bariatric surgeries, and a story on Entertainment Tonight about Valerie Bertinelli's weight loss and the book that was just published about it. Is that really a book worth publishing? Aren't there more valuable wayas to use a printing press?

When America became a nation of overweight slugs, it was, initially, considered a health crisis. Now it's considered a sport, a medical drama, entertainment. What have we become as a culture? Seriously. Fat is prime-time entertainment both on network television and on cable, but nowhere has anyone metioned the underlying psychological causes of the problem, nor have they shown any compassion for those who are the subjects of these programs. Compassion is conspicuously absent.

I have a lot of fat clinging to my frame, yet I can't imagine my fat being the subject of a magazine article, book, sitcom, documentary, talk show, or reality TV. I prefer to be known for my brain capacity not my high circumference, but even if I were brilliant, I am still nobody and nobody gets press coverage for that.

Be afraid. Be very afraid.

Time management

It's 1:15 a.m. I'm awake, but not because of insomnia. In approximately 12 hours, I am scheduled to do a presentation at a professional conference. At least I didn't have to travel to this one.

1:15. In the morning. I haven't written the presentation yet. I haven't assembled the props yet. I haven't checked to make sure the projector will cooperate with my laptop. I haven't ironed something to wear because I have no idea what I will wear.

This is not a confession. The truth is, I am ambivalent about this presentation. The topic is a little obscure and we're scheduled in the last slot on the last day. It wouldn't surprise me if it turns out that there are more of us on the presenting team than there are in the audience.

I have hours of work ahead of me because, ultimately, I won't do this in a half-assed manner. It's not my nature. Still, I wonder. There are four of us presenting and two more assisting, yet, I'm the only one working on the content and PowerPoint. I asked for all sorts of things from the others on the team. I gave them 89 days to prepare. When it was time to put everything together, I had nothing from the other people. Nothing.

Maybe I don't care about the impression I make. I am actually pressured by something else: Reputation. I didn't keep a low profile for many years. I went to meetings and workshops and I presented at conferences. I helped plan conferences (I don't recommend that for the faint of heart or easily stressed). People know who I am and they know that I do good work, and damn it, I can't skate through this thinking nobody will notice if I phone it in. I took a two-year break from presenting at conferences, but I think I should have made that three.

1:15 (a little later). It wasn't procrastination. My job--the part I get paid for--has been increasing in workload for months. I am one person doing the work of two (maybe three), and there's still too much to do. There was no time to steal from the regular work to devote to writing the presentation.

I think I am precariously close to burnout.

There's no time for burnout. I have a presentation to finish writing.

I'm tired.

Win some, lose some

Mental health has been very much in the news for the past month or so. Some of the news has been encouraging, some has been distressing, and some has been chewy food for thought. Here are some of the highlights:

We win one. Finally.
In Washington, DC, this month, the economic bailout plan got a lot of attention. There was a provision attached to the bill that got far less attention, yet helped to bolster the chances for passage of the controversial legislation. The Mental Health Parity Law had been lingering, if not languishing, on Capitol Hill for 12 years. It was the personal crusade of the late Senator Paul Wellstone and Senator Pete Domenici. After Wellstone's death in 2002, Domenici continued to keep the bill in play with lobbying support from advocacy groups such as NAMI.

The health insurance industry fought this legislation tooth and nail. Ultimately, though, the tragedy that is the US economy presented exactly the right circumstance that made the law a reality.

Under the Mental Health Parity Law, insurance companies and employers will no longer be allowed to make a benefits distinction based on a patient's type of illness. Until now, insurers have been allowed to provide fewer benefits for mental illness, or, to charge more money for treating these illnesses than, say, epilepsy or asthma. Whereas hospitalization for a chronic heart condition might be covered for 60 days of inpatient care, a mental illness--with preapproval only--would max out at 25 days per year.

By making mental health care parity law, the government has also paved the way for lessening stigma through legitimization. It won't be quite as easy for insurers to make arbitrary decisions when doling out benefits to consumers of psychiatric and addiction recovery services.

And you lose some.
While listening to NPR the same week that the mental health parity legislation was in play, a story blipped by on the news so quickly, I had to Google it later to make sure I had absorbed the irony. I am sure this story made the news only because of and as a counterpoint to the mental health parity story.

Keeping in mind that health care in this country has little to do with compassion or patient wellness and everything to do with profit, this news gem sparkled like CZ under the bright lights of the Home Shopping Network.

Out west in Denver, the University of Colorado Hospital announced that it will no longer maintain inpatient psychiatric services. The 18-bed inpatient psych services ward sees approximately 750 patient admissions each year; by eliminating this department, hospital administrators say they can accommodate an additional 300 admissions annually. Hospital spokespersons stated that this is in no way a financial decision, it's just that other patients need the beds more than the psych patients do. Could that be the patients whose illnesses are more lucrative for that hospital?

Dr. Greg Stiegmann, vice president of clinical affairs at UCH, said that since the new facility opened roughly 15 months ago, the hospital has been at 100 percent capacity and finding spaces for patients has become increasingly difficult. Upon further reading, I was surprised to learn that University Hospital is a brand-new, billion-dollar facility. I cannot comprehend how, with a decade of planning, ongoing needs assessment, and years of construction, the people in charge of this hospital grossly underestimated how many patient beds the hospital would need at opening and going forward, allowing for population growth in the area.

So, what did the administrators do? They looked at the patients to determine which ones would be the easiest to jettison while allowing the greatest financial gain. The NPR story (which I cannot find!) included a blurb of an administrator stating that it is the hospital's hope that the affected patients will find care within their communities. Errrr....Would that be on the benches in the city's parks?

This story is happening all across the United States. According to hospitalconnect.com, government figures show that, nationwide, psychiatric facilities have decreased by more than 14% in the last decade. The number is expected to keep climbing.

Sometimes we shrug
From CNN: http://www.cnn.com/2008/HEALTH/10/21/Healthmag.suicide.increase/index.html
After a decade-long decrease, U.S. suicide rates have started to rise, largely because of an increase in suicides among middle-aged white men and women.

Overall, the suicide rate rose in the early 1980s, then dropped each year from 1986 to 1999. From 1999 to 2005, however, the rates have increased 0.7 percent annually.

In all, 32,637 people killed themselves in the United States in 2005, a rate of 11 per 100,000 people.

Too bad the newly-in-crisis won't be able to get help at the hospital.

It makes fire

My husband realized long ago that if we were all going to survive my time in graduate school, he would have to learn to cook. This was a bit of a tough thing to accept since up until that time, I had done all of the cooking. I was good at it. I was creative. My culinary skills kicked ass.

And then, I completely lost interest. It was really the start of the great downhill slide--a sort of canary in the coalmine neither of us could recognize. We both chalked it up to being over-scheduled, tired, and deeply entrenched in the pursuit of a master's degree.

My husband is a reasonably good cook. He's not all that creative or adventurous, and although he doesn't stray from a recipe very much, he can manage quite well and improvise as necessary. If it weren't for his willingness to cook, I would just eat peanut butter from the jar and go about my business. Some days, especially when I feel low, I wouldn't even make the effort to do that. This is something we both know from experience. During bouts of extreme hypomania, I tend not to eat at all.

Today as I returned from an off-site meeting, I stopped at the natural foods supermarket to pick up a lunch snack what you eat when it's technically too late for lunch). It occurred to me that I would be home long before my husband--something that almost never happens. It was time to shop in earnest. Tilapia, tomatoes, leeks, zucchini, risotto, and coconut crunch ice cream. Lovely.

I poached the fish with the vegetables and some broth. Served with risotto and Parmesan on the side, it was a delicious meal. I think my husband was in such deep shock, he didn't even mention that I forgot to buy a baguette to go with dinner.

It was comforting to know that I was able to remember what that large, boxy white appliance is in the kitchen. If you turn the knobs, it makes a clicking noise and then, like magic, it makes fire! I remember hearing that the stainless steel box under the counter will clean your dishes if you know which buttons to push. Frankly, I don't have much curiosity about this. I usually put my dishes on the counter or in the sink and when I come by again, they've magically disappeared. It's a pretty cool trick. Everyone should have a kitchen that works this way.

If only we could get the refrigerator to keep itself replenished...

I get edgy in October

Don't expect mood improvements until, oh, April or May. In lieu of actual blog posts, my life is being sorted out via email correspondence. My friend Jolie got this message yesterday. She insists I am worth the effort it takes to be my friend. I take comfort in that.

Sometimes I just totally hate my life. I don’t like my house (although I’m grateful to have one), my job wears me out, I can’t connect with people, and I don’t find the world to be a very interesting place anymore. I don’t believe I am inherently likeable; in fact, I think that even people who give me the benefit of the doubt find that the charm wears off rather quickly, and then they have to back-peddle to so they don’t get too entrenched. I have become a surface person.

Don’t ask me how I came to this conclusion. I mean, I’ve been here before. This started with me trying to talk myself into exercising. I dislike that idea so much that I get almost overcome with a feeling of resentment and rage every time I think about it. I resent doing things I loathe. It’s not like I haven’t tried to find an enjoyable form of exercise. Let’s see…walking, running, biking to work, biking around, mountain biking, hiking (which is just walking, but with more hills and no decent sidewalks), skiing, snowshoeing, swimming, volleyball, aerobics, aqua-aerobics, strength training with weights, Body Pump, yoga, kick boxing, step, machines, isometrics, anything a personal trainer can come up with, countless grueling hours on the elliptical trainer and Concept 2 rower, FitBall, Dance Dance Revolution, and of course, Pilates.

I wonder how many total hours I have spent overtly exercising. That leaves out things like home improvement, taking the stairs, gardening, etc. For the first nine years I lived in Denver, it was normal for me to spend 15-20 hours per week working out at the YMCA. I hated every minute of it. Sometimes I would just break down and cry in the middle of a workout. It’s not like I went in with a negative, you-can’t-change-my-mind attitude. It was quite the contrary. My attitude was more like, “I’m desperate to find something that I can tolerate for sustained periods of time. Something that will show results in weight loss and body size. Please.”

Do you know why I hate to exercise? It isn’t an attitude problem at all. It’s this:

• I hate pain. All exercise demands a significant degree of physical discomfort if it is to be effective;
• I hate to be hot. My skin does not tolerate sweat very well.
• All exercise that I have tried has been mind-numbing in its tediousness . Nothing bores me faster, with the exception of sports on television, particularly football, basketball, and golf.

The argument for exercising anyway for the sake of good health is not lost on me. You know, however, that health is not a carrot I try to grasp; I just want the ectomorphism that has always been promised but never achieved. I am too frustrated to put in the effort for something that is never going to happen. That’s where the resentment comes in. I don’t see the point of putting in so much effort and experiencing so much pain and boredom for what amounts to nothing more than a year or two tacked onto my life. If I even make it to old age.

So, after having all of that roll around in my head all week, I realized that I’m just too negative, lazy, and superficial for anyone to care much about me, let alone like me or want to spend time with me.

Yes, yes, I know, Jolie. You like me. My husband might like me. Joanna probably likes me, but I haven’t heard from her in at least six weeks, and that’s happening with increasing frequency, and it’s becoming harder and harder for me to believe I hold any significance in her life anymore. So, that leaves two people who like me. One lives far away and doesn’t spend enough time with me to really know how irritating I actually am. The other one is too busy doing home improvement projects, watching TV, and spending time with the dog to give me a true indication of whether or not he actually likes me.

I know we shouldn’t care if people like us or not. I’m not sure that I do care. I just want to be thin and to have a good haircut. I’m pretty sure that more people will like me then.

I think I can

No time to think. Barely time to sleep--good thing I don't need much.

Heavy workload, four off-site visits with refugees (in home), a report, plus a two-day conference, where I am presenting. Yes, presenting, although I haven't even drafted a rough outline of the presentation yet. I have to pull this together for five people, and none of us work in the same place, nor do we do the same thing. I am the lead presenter. What the hell was I thinking??

No chance to breath until approximately November...30. Maybe.

Can you hear the wheel squeaking?

Time, time, time

Not having time to sit down, focus, and write causes me almost as much anxiety and distress as not having time to get up and go to the bathroom. I find myself in these situations simultaneously on an almost daily basis lately.

It can't be healthy. Either way you look at it, I'm overly full, under pressure, and ready to burst. Or leak.

I'm no expert

Years ago, I moved my professional life out of the corporate world and firmly into the realm of the nonprofit. It really just means I get to work 70 hours a week for a lot less money.

One of the things I had hoped to leave behind in my corporate life was the entire concept of Team Building. Who has time to love their coworkers? We come to work, we do our jobs, we make adjustments as necessary. If only.

There is always that little group of rah-rah enthusiasts who want the workday to include oh-so-much more. Enter these terms: Goal Committee, Satisfaction Team, Professional Development.

For the past few years, I've managed to avoid any real participation on any "team," even those that were mandated. Last year, I signed up for a goal committee and just never went to any of the meetings. You may be shocked--shocked--to learn that my recalcitrant ways had no impact at all on life at my workplace.

This year I'm having trouble being quite so invisible. I have been assigned a role in professional development, whether I like it or not, and hiding is not possible. "May," the upper manager said, "You must teach a workshop for your fellow employees. We want this year's theme to focus on more effective use of technology."

I sat there feeling a little stunned. I hate being assigned any work above and beyond what I already do--see above sentence regarding the length of my work week, There didn't seem to be any choice involved on my part. There was no "would you mind," or "Can we get you to..."

The upper manager--a woman in her early sixties who has a permanent dark tan and who recently underwent multiple cosmetic surgery procedures (including a boob job)--coughed the raspy cough of a heavy smoker. "What tech topic can you share with your colleagues?" I offered up managing digital photo files, making the most of Outlook, and giving an overview of all things Google. Perpetual Tan with Smoker's Cough And Perky Boobs managed a stiff Restylane smile and said, "Someone told me you maintain two job-related blogs. We've put you down for blogging. Let me know what day and time you'll present, and include a short, written description of what you'll cover in your presentation. Oh, we're scheduling presentations for mid-week, between 3:00 and 5:00, from now until mid-December. I need your information later today."

I kid you not. Choice. I had so many, it was truly underwhelming.

And so it has come to be that in about a month, I will do a two-hour presentation on the joys, how-tos, and whys of blogging. I guess this means I need to get crackin' understanding all of those widgets and things I never use. I also need a good title. So far, I've come up with:

• Use free Internet space to shamelessly promote your commercial enterprise because you're too cheap to actually pay for Web hosting service.
• Blogging: The ultimate self-indulgent way to prove your own existence.
• Creating a blog: Please tell me you'll do more than just post photos of and write about your new grandbaby.
• Blog it out, babe: Therapy and self-help in the digital age.
• RSS, widgets, Twitter, and you: I have no idea, why are you asking me?

Oy. Maybe I'll think about this after I finish my monthly report, my quarterly report, and a major conference presentation that's coming up in two weeks. Who has time to blog?

Made it

Mom flew home today. All in all, it was an OK visit--not too stressful for me or for my husband. We tried to adapt as we went along.

I'm pretty sure my mother thinks we're boring. We hate sports, we don't have any money so we don't go out or do anything, and we don't shop much. My mother is a baseball fanatic, and her team is in the playoffs right now. Both of her teams, actually. I guess if the Phillies play the Rays, her head could explode. We were forced not only to watch baseball the whole time she was here, but also to listen to the sports station on the car radio whenever we went out. I was ready to open the car door and pitch myself into traffic on several occasions.

The weather was exceptionally shitty the whole time my mother was here. This is the express route to depression and irritability for me. I get claustrophobic. I detest crappy weather. I detest cold and damp and pissing drizzle and a sky so overcast my camera automatically engages the flash even though it's the middle of the day and I'm taking a picture outside. Blech.

My husband and I have been watching Breaking Bad. We missed the first season, but it's on AMC again. Tonight's episode had a compelling monologue about choosing not to prolong one's life just for the emotional satisfaction of others. The main character has cancer but he doesn't want to pursue treatment because the cancer is guaranteed to be fatal anyway. His family is incensed by this decision, and in the aforementioned monologue, Walt explains that he just wants to choose for himself whether or not to artificially prolong his life.

My husband knows how I feel about this. I already told him many times that if I were to come down with cancer, I would not pursue treatment, either. I don't see the point of going through cancer treatment only to be left alive but bankrupt, homeless, and probably uninsurable when the next round comes along. I watched it happen to my grandfather and to someone I work with. Both died anyway. We all die anyway.

Deep, cleansing breaths (into a paper bag)

My mother is coming to visit . She'll be here through Sunday.

Must...not...lose...mind.....

It was agony

What is the worst possible anxiety that can be inflicted on May Voirrey, other than the possibility of bankruptcy? That would be photography where am not the one taking the pictures.

The email came on Friday, just in time for me to suffer near-crippling waves of anxiety for the entire weekend. The message said that as part of the Website overhaul, all staff would now be featured on the site with a picture and short bio. I read it and froze.

I don't let people take my picture. I don't shoo them away when they try--I get rude to the point of being outright hostile. Do not take my picture. Ever. Period.

I am not attractive, that is a point I won't belabor, however, I am really, really not photogenic. There is something about my facial structure that may not look freakish in person, but in photographs looks almost deformed. It's bad. I have reached a point in my life where I am no longer willing to play along nicely as if it doesn't bother me. It bothers me a lot. I don't want anyone to control or share any images of me. And now I'll be on the Internet.

I feel a little sick to my stomach.

You could do a Google image search on my name or any user name I've ever used online, but you won't get any pictures of me. I've been especially careful about this. There are no pictures of me in conference catalogs, published articles, or on blogs, forums, or anything else. Now I'm going to be exposed and vulnerable. Here's how the last 24 hours went. Yesterday, I sat down and sent an email to my boss, begging her to understand my discomfort and aggravated fear. Here is what it said:

Is there any way around having my picture taken and plastering it on the Website? Why are we doing this? My stomach is in knots over this. I don't even have a staff ID because I can't bear to have my picture taken. I let my passport application expire because after agonizing over the photograph issue and then going to three places to have the pictures taken and retaken, I was still embarrassed and sickened by the camera's objectivity in showing the unflinching reality of my physical form.

A good personality cannot be captured in a photograph; this leaves nothing more than a still image of flesh and bone structure to show who we are. When we see others in person, we can filter out the physical in exchange for focusing on the animated being, as well as on conversation, personal history, and personality traits. Whereas we can subjectively filter out the realities of homeliness and obesity, the camera does not. Real life lets us create meaning through context, but a photo of a homely woman that is removed from that context is just a photo of a homely woman.

I don't like this idea of being one Google Image Search away from being looked at in a very restricted visual context. It's hard enough for me to leave the house every day knowing I can't be invisible. I really think you should go with the Ugly Betty picture.

No reply. I got up earlier than usual today and tried to get my hair to be something other than flat and disheveled. It took a long time, so I had abandon the rest of the beauty routine and take my makeup with me. I did manage to get my contacts in. I was really out of practice, so I was surprised it went as well as it did.

When my boss came in, she pulled up a chair in my office and said that she wouldn't force me to have my picture online, but she wanted me to know that I "look just fine," and that I would be the only person whose picture would be missing from the "Meet the Staff" page--there would only be the bio. She said it in a way that implied this annoyed her--it would cause a huge flaw in the design. I pointed out that we don't sell anything or have a client base, so it's not like putting our pictures online was going to benefit us in any way.

All day, coworkers asked how my picture came out. It got annoying. I went into the restroom and quite literally poured makeup onto my face. First I slathered on a generous layer of silicone skin prep goo that makes skin just as flawless as Barbie's. Then I poured a couple of tablespoons of foundation onto a sponge and sort of washed my face with it until it was smooth and streak-free. I had my contacts in, but since they aren't bifocal, I couldn't really see to do my eye makeup. I just aimed the pencils and brushes in the right direction and hoped for the best. Mascara was particularly difficult, so I just kept putting it on until I could see it without the bifocals. The lash curler was an awful challenge, but I managed. The finishing flourish was dark lipstick blotted off and followed by a slick of lip gel.

None of it helped. I just looked like frumpy me with a lot of color and no visible pores.

As I entered the main office, one of the women said, "Well..Oh! Look at you! Makeup. Don't you look nice?" It didn't look garish. If it had, I never would have emerged from the ladies' room.

I told the kid who's doing the photography that he had to work very, very fast, and I would only let him take one shot. No trying again and again, no multiple poses, no re-dos. I also had to tell him that I just cannot smile on demand, which is why I never smile in posed pictures. If I try to smile when that's not what I feel, it comes out as a weird grimace.

I stood in the appointed spot and said, "OK, go. Be quick." Click click click. "OK, that was three." I walked away from the photo spot.
"May, I'm not finish--"
"You're finished. I hope you got what you need."

My stomach hurt and my mouth was dry. My picture was going to be online with my name attached, meaning anyone looking for me would easily find a picture showing my deterioration. It still makes me feel a little queasy.

Later in the day, I walked past the budding photographer's desk. He said, "May, do you want to see your picture? It's OK." I just kept walking and said what I've been trying to say: "No."

It's that kind of mood

Things that irritate me a lot lately...

• Finding what I've been looking for when shopping, only to see that there is no price on it or anything else even remotely like it. I don't even ask anymore. No price, no sale.
• Websites that blare music or other sound as soon as the home page loads.
• Advertising on the floor of the supermarket.
• Handling fees. Just add it to the shipping and be upfront about the cost.
• Unreliable, irresponsible people.
• Powdered coffee creamer.
• Freezer burn on new ice cream.
• Cris Angel.
• David Blaine.

• Discovery Networks' bizarre, dedicated programming obsession with cult-like Christian families that have like 18 or 19 children.
• Political attack ads.
• Sarah Palin (would someone please get that woman a voice coach).
• Anything election related.
• A dozen subscription cards stuffed into a magazine that I already subscribe to. This irritation is compounded by renewal notices that come in the mail six months before the subscription expires.
• Great West insurance.
• Greed.

So much to do

My mother is coming to visit in a few days. Work is overwhelming. My house is, well, dusty. To put it mildly. There's tumblefur rolling down the hallway.

I need at least 30 hours in every day. This week would be a special case where I need maybe 36 hours in a day.

Earlier today, my husband and I ran into a couple we used to socialize with. We stopped doing that when I got sick and decided there was nobody I wished to socialize with at all. Period. It was a weird encounter. More on this later as I am still processing.

Where is that box of Swiffer refills?