Dr. Gregory House and the Bad Decisions We Make Because Empathy

I was re-watching some old House episodes on Netflix recently, and there was an episode where one of the patients is a woman with heart issues caused by bulimia. I don’t remember the particular details of how her issues go from Super Mysterious Oh My God On What Is Going On to that specific diagnosis, but they’re not really important. What is important as we get almost to the end of the episode, past the point where we’ve developed some familiarity and empathy with this patient, and House ends up faced with the decision of whether or not to recommend that she be moved to the top of the list of those waiting for a heart transplant in spite of the fact that bulimia makes her a higher-risk candidate for it.

In the end, he has a Deep, Heartfelt Talk with her where she agrees to Do Better, and House decides not to tell the transplant board* about her bulimia.

This is the wrong decision. Putting this patient at the top of the list means putting other patients who need transplants just as badly lower down on the list. These other patients are, presumably, better candidates for transplants, meaning they have a better chance of surviving after they are done with the procedure. They are getting fucked over because of House’s decision. They may be just as in need as the woman in the episode, but House decides the best decision is to risk their lives so that this woman can get a transplant first. He makes this decision even though those other people are more likely to benefit from the procedure than she is. It’s the wrong decision, but it’s a narratively compelling one.

We want everything to be okay, we want this woman to be okay, and so it’s easy to feel like she should be moved to the top of the list because we feel for her and want her to be okay.

You never see the episode of House where he figures out that someone needs a transplant and signs them up for it and then that person dies because some other doctor and some other hospital decided that their riskier patient needed a transplant first. That aspect doesn’t help the narrative; it doesn’t allow us to feel good about the fact that this patient is someone we care about and we’ve just got to help her somehow. In real life, though, those other patients are just as real and just as in need as the one that any individual person might identify with any given moment.

Just because we feel for someone doesn’t mean that the people we don’t directly feel for as much aren’t important, or that they don’t thrive or suffer to the same degree. It doesn’t mean they don’t matter. It doesn’t mean we can disregard them in favor of the people close to us no matter what the circumstances are.

Which brings me to veganism.

Which brings me to the fact that if you are uncomfortable eating cats or dogs** but you are comfortable eating pigs and cows, your decision to eat the latter but not the former is irrational. It is the same type of irrational that I have just described in House. If you aren’t comfortable eating animals you might keep as pets but you are comfortable eating ones that you probably wouldn’t, you don’t actually care about how much suffering and/or death your decisions in this regard cause. You only care about it insofar as you, personally, feel empathy for it.

This is totally understandable in the same way that feeling empathy for the woman in the House episode and wanting her to be okay is totally understandable. It’s normal, it’s natural, it’s human, but don’t think for a second that it doesn’t mean a lot of suffering and death is happening purely on the basis of which creatures you think it’s adorable to have around and which ones you don’t.

*Or whatever the group of people who makes the decision is actually called.

**Personally, I would add “or people” to this list, but people seem less able to believe that animals can suffer as much as we*** do than they are able to believe that they suffer as much as “other animals” (in spite of the evidence that they do, in fact, suffer like we do), so I’ll leave that bit in this footnote instead.

***who are, you know, also animals

By ResearchToBeDone Posted in other

Thoughts on Changing Gender Presentation and Conventional Gender Stereotypes

I’ve been talking a fair bit lately about the implications of how my non-binary gender affects how I feel and interact with people. Since coming out, I have been experimenting to figure out what varieties of gender presentation are comfortable for me and which ones aren’t. I find myself gravitating toward more conventionally feminine styles of presentation.

I read a very TERF-y Tumblr post a while ago where the author said the reason she wasn’t okay with a lot of trans people was because she felt that, for example, if someone transitions to female and as such starts behaving in more conventionally feminine ways, that is reinforcing the misogynistic idea that to be a woman implies acting in those particular ways.

I don’t know how to feel about that, because the extent to which my gender floats toward female in a given day correlates with the extent to which I feel like expressing myself in a more conventionally feminine way, and the extent to which it floats closer to male correlates with the reverse. It is, quite certainly, a product of the conceptions of male and female with which I was brought up – conceptions that I am generally all about smashing. I feel compelled to ask and investigate the question of whether or not the way that I express my gender reinforces the idea that femininity and femaleness imply each other and masculinity and maleness imply each other, and what, if anything, that means for me.

I had a conversation with a non-binary AFAB friend of mine who expressed the reverse of my experience – feeling uncomfortable about the fact that their decision to no longer identify as female correlates with presenting and acting more masculine. Asking whether or not that implies that acting more masculine necessarily implies not being female, and what the feminist implications of that might be. It hadn’t occurred to me until we had that conversation that the experience from the other side of the coin might be very similar.

None of this is to say that I think this means either of us is wrong to present or identify in the ways that we do. Nor is it to say that anyone else is. I am grateful that I have known and listened to enough non-binary people to be able to ask these questions and still sit firmly in the “what I am doing is totally okay” camp. I do want to ask the question of what this all actually means about the people and concepts that are at play in all of this, though. All of these feelings and ideas don’t quite seem to mesh with each other, at least in the ways that I usually think about them, and I’m trying to figure out what I think and how I feel about that.

By ResearchToBeDone Posted in gender

Inside of Depression and Out, or: a Question I’ve Been Curious About for a Long Time

“What is it like to be sad when you’re not depressed?”

Have I ever known what it’s like to be just sad? There was a time before I even thought of myself as depressed where I looked back over my life and realized that I couldn’t ever remember a time when I’d been consistently happy. I don’t exactly think I’ve always been depressed, but I think I’ve always been too obsessed with doing exactly, perfectly right by everyone that I didn’t leave room to ever be satisfied with myself, which is a recipe, at the very least, for constant anxiety.

I know a little bit what it’s like, now. Because for a week or three after I started taking Wellbutrin, my brain changed. I had some days where I was anxious about stuff, but the anxiety was different. It was different and it wasn’t. It was exactly the same feeling that I’ve become rather intimately familiar with over the last quarter-century, give or take.

The feeling was just the same, but the difference, for me, was that suddenly it wasn’t attached to a narrative. It was still rather unpleasant, in the sense of, “Oh dear, this is quite unpleasant, I am not very much enjoying this at all!”

But that was it. It was just there, with me, and unpleasant.

On depression it’s different. It’s the same feeling, but is attached to this dark cloud of “This is the only way things have ever been or ever will be, and it will never get better, it’s all futile, and nothing will ever get better, but there is every possible chance it will get much worse.”. On depression, my brain forgets about the time between episodes. Thinking about the experience reminds me of the idea of state dependent memory, except that instead of being able to remember certain things when I’m depressed, I stop being able to remember anything but the other times I have been depressed. All the episodes and bad moments and hopelessness connect to each other and I can’t remember anything that happened in between. I can’t remember that anything has ever happened in between.

The difference between being sad or anxious or exhausted when I’m depressed and when I’m not is this. The feelings are just the same, but the narrative isn’t. Rather, outside of depression, there just isn’t a narrative. It’s just a feeling. Pleasant or unpleasant, it’s just it’s own thing. Inside of depression, it’s all connected in this tapestry of “This is how everything always has been and always will be.”.

So now I know.

As I get an opportunity to return ambient stress levels to within manageable parameters, I’m hoping I’ll get back to that place and have some time to get used to it. Fingers crossed.

Honing HabitRPG and the Practice of Being Generous to Myself

I have been using the online task-management-as-and-RPG-game called HabitRPG for a few months, now. I think it is absolutely fantastic, and I want to talk a little bit about why it is and what I do to help make it that way.

The number one thing that, for me, makes HabitRPG incredibly effective, is remembering to always keep my focus on my objective. My objective is to get me to do the things I want myself to be doing. That’s it. HabitRPG is a tool for getting things done.

It is emphatically NOT my goal to make it as similar to actual RPG’s as possible. I know people who have given up on the game on account of feeling overwhelmed when their tasks pile up, and decided it won’t work for them, and in most cases I think it’s because they are thinking about it the wrong way.

The last couple of months have been incredibly stressful for me. Adding 7 to 10 daily task goals on top of that stress is a recipe for even more stress, so I reduced the number of daily tasks I have to five, two of which overlap with two of the others. They are:

  • Take meds
  • Start work
  • Start work by 10 AM
  • Finish 80% of daily work by 4 PM
  • Finish all daily work

All of my other goals right now are either one time goals or in the habits column for multiple-times-daily tasks that you aren’t necessarily penalized for not doing.

It is usually pretty easy to complete these main five tasks in a day. That said, without the RPG game-ifying aspect, I can virtually guarantee I wouldn’t be getting work done as effectively. Again, the goal isn’t to make this hard; it isn’t to make this as much like an RPG as possible, it’s to get stuff done. The RPG elements are useful only so long as they help me to get stuff done.

When I first started using HabitRPG, I did not have “start work” as a goal. But it turns out that getting work done is pretty easy once I’ve started it; getting started is actually the hardest part. So I added starting as a goal. Later, I realized that having time constraints makes me a lot more likely to not put off that goal until late in the day, so I added the 10 AM requirement. If I start work before 10am, I get credit for both.

When things are less hectic and stressful than they are right now, here are some of my other goals:

  • not getting on my computer until at least half an hour after waking up
  • 30 minutes straight meditation before 5 PM
  • getting off the computer for at least 30 minutes within 30 minutes of finishing work
  • taking vitamins
  • getting to the gym
  • going walking for at least 20 minutes

Even when all of those goals are active every day, I am not actually required to complete all of them to get credit for all of them. Some of them have alternate success cases. For example, if I don’t finish my usual amount of work on a Friday because of either mental exhaustion or repetitive stress concerns, I give myself credit for the work goals anyway, in this case thinking of them as a reward for responsible, healthy decision-making.

Sure, it makes it easier. It also makes me do exactly the things I want to be doing.

Decisions like the alternative success cases sometimes make me feel like I’m cheating, which is why it’s so important to remember the cardinal rule: the goal is to get me to do the things I want myself to be doing. Nothing that accomplishes that is “cheating”. I want myself to be getting work done, but just as much as that I want myself to be making responsible mental and physical health decisions.

Multiple times daily habits consist of things like gaining experience for completing Pomodoro shifts, taking damage for ignoring Pomodoro shift breaks, gaining experience for completing errands, taking damage for working more than my normal hours (it’s a repetitive stress risk), several generic reward categories (minor task, medium task, and major task), and a few categories for things that I will only ever do once in a while, but am interested in encouraging myself to do: asking for support during difficult times, for example.

That last one is what I call a “multiple”, meaning one that I think is important enough that it merits more than one click when I do it successfully. The minimum reward for asking for support is three times the usual reward for a “hard” task. Is it cheating? Again: the goal is to get me to do the things I want myself to be doing. Nothing counts as cheating if it accomplishes that goal.

One of the other decisions I’ve made over the course of honing my HabitRPG goals to be as effective as possible is that I can’t be thinking about them every hour of every day. The cognitive load of keeping track of them takes a certain amount of energy, and thus it’s important for me to be careful how often and how greatly I am spending that energy. As such, all of my goals are disabled on weekends, and I generally do not give myself rewards for completing any tasks of any kind on weekends. Weekends are cognitive-load-free zone.

In addition to the weekend’s role, I have specifically chosen my daily tasks such that all of them can be completed by 5 PM. I had to abandon brushing my teeth in the evening as a daily goal because it meant I was necessarily concentrating on my goal list for the entire day, where my current setup means I am usually only concentrating on it during work hours.

Sometimes I give myself experience without any reason whatsoever. Really. This is my favorite thing about HabitRPG: it gives me a chance to practice being generous with myself. If I’ve accomplished something awesome, or I am enduring something difficult, I try to remember to treat myself to things. The problem with that in everyday life is that treating myself to things usually costs money or time that I may or may not have. In HabitRPG, however, that problem doesn’t exist. I have an infinite resource for rewarding myself for accomplishments and treating myself during difficult times, and I use it.

Is it cheating? Again, I say it’s not, because it helps me. As absurd as the idea that those little points, completely disconnected from any real-world application or tangibleness, have any impact on my day-to-day life, acquiring them makes me feel good. And feeling good is nice, and nice feelings mean less stress, which means less exhaustion, more energy, and as such more ability to get things done. All the while, it’s giving me a chance to practice being generous with myself; it’s giving me a chance to practice being that awesome boss who cuts you some slack when you need it, and is understanding when you need it.

There is one more multiple-times-daily goal I haven’t mentioned, which is the generic “good brain gardening” goal. I get to click this one whenever I practice good mental habits. If I start to beat myself up over something and then remember not to, I get experience. Here’s the kicker for me: sometimes I do feel like I’m cheating in the game. Sometimes it’s easy to get caught up in the idea that I should treat this more like a game with rigid rules, be a stern taskmaster, etc. Then I remember that the goal is to be getting stuff done and that the strict way of doing things isn’t actually nearly as effective as the more lenient, generous, caring, encouraging way of doing things.

Whenever I remember that, I give myself points. Good brain gardening points. And if the sense of “maybe I should be harsher/don’t deserve these points/etc.” persists, I get even more points for giving myself points in the face of that persistent nagging voice.

If you want, you could say that I cheat constantly and furiously at HabitRPG. But it sure as hell gets the job done, and it’s the way I honed this particular getting-stuff-done tool to be one of the most effective weapons I have against not getting stuff done. For me, generosity works better than rigidity.

If you decide to give it a spin, remember to never lose sight of your goal: to get you to do the things you want yourself to be doing. And practice being generous with yourself. At least that’s what works for me. Not to mention I can really use the practice.

How Do You Unplug From Stressful Things Without Unplugging From Awesome People?

So I’ve been incommunicado for a while due to a sudden and immense unexpected increase in life stress which will hopefully be over soon, although that will be just in time for me to have another long time where it will be most likely impossible for me to blog.

I have a question that’s important for me right now, though, in the interest of engaging in continuing self-care.

When you’re an activist-type person who knows and follows huge bunches of activists-type people, what strategies do you use to unplug from all of the horrible things going on in the world for a while? In particular, are there strategies you use to do that without also ending up mostly out of touch with those same people?

I think it’s great that the circles I run and are so full of people who are so conscious and conscientious about everything going on in the world around us, but there are times where the best thing for me, my situation, my anxiety, my depression, and my offense stress-induced chronic pain issues is to just take a break for a while. Sometimes the continuous stream of “oh look, more bigotry in media”, “oh look, my country is killing civilians for no reason again”, “oh look, global warming is horrible and everywhere”, “oh look, another person I used to look up to is actually a horrible bigot” on top of general life stress becomes overwhelming.

The thing about that is that taking a break from the stream of All the Horrible Things That Are Going On in the World basically requires unplugging from all social media, because people tend to use pretty much all of those to spread messages about what’s going on. So is there a way to disconnect from all of that without also disconnecting from the social circles and support systems in which you see them?

I can’t be the only one who needs to do this from time to time; what strategies do you guys use?

By ResearchToBeDone Posted in other

I am racist, and so are you.


Exactly this.

Originally posted on Being Shadoan:

And the sooner we both acknowledge this, the sooner we can begin to address the problem. So let’s talk.

“Wait just a minute here, Rachel. You’re like, the least racist person I know. You’re always sharing stuff about race and racism. You couldn’t possibly be racist.”

Here’s the deal. Racism isn’t just guys in white robes and Paula Deen shouting racial slurs. Racism is subtle, racism is insidious, and our culture is so deeply steeped in it that it’s impossible to grow up in the US and not be racist. It’s a kind of brainwashing: a set of default configuration files that come with the culture. It’s a filter, built up from birth, that alters our perception of the world. (Literally–racial bias makes people see weapons that aren’t there.) Racism isn’t just conscious actions; it’s judgements that happen so fast that we may not even be aware of…

View original 2,137 more words

By ResearchToBeDone Posted in other

Why and How to Spread the Message and Take Action on the Events in Ferguson

There is so much to say that everything still going on in Ferguson, MO, that I’m feeling overwhelmed figuring out what to say. More than anything, though:

Please be paying attention to this and spread the message that it is happening. Follow the reporters, follow the hashtags on Twitter, watch the live streams and the videos of what’s going on. This is tremendously important and significant portions of the media are ignoring it or spreading incomplete or inaccurate information about it.

Amnesty International is getting involved in a way that they never have inside the United States before, other countries are sending in their war correspondents to cover this, police are doing everything they can to keep the media from seeing what they are doing up to and including threatening to shoot and tear gas journalists, and arresting them, and protesters are doing what they can to make sure that what is happening is being covered (read: the police believe that the more people know about what is going on the worse it will reflect on police and the protesters believe that the more people know about what is going on the better it will reflect on protesters; the police do not want to be watched and the protesters do). Police are wearing their uniforms but removing their ID badges so that they are not individually identifiable. Media and children are being tear gassed.

Still, there are people who are unaware of all this. Make sure it doesn’t stay that way. Watch what’s going on, signal boost it, talk to people about it, retweet, re-blog, and repost stories about it. We cannot let these events go unknown or ignored. Spreading the message about what is going on in Ferguson is incredibly important right now, and everything any of you can do is important.

Here are some places to follow what’s going on:

Ways to take other types of supportive action:

If anyone knows of other resources they think should be added here, say so. 

On Mike Brown and the Ferguson Police Department (probably just a part one)

Note: this entry emphatically subject to my privilege disclaimer.

There is so much to say about the events that have been unfolding over the last week in Ferguson that I don’t know where to begin, but I feel a responsibility, particularly as a white person, to do what I can to talk about what has happened and is happening there.

Authors note: this ended up being a piece outlining what I feel is the practically incontrovertible evidence that Mike Brown’s shooting had no justifiable cause and that the police department’s actions and statements speak to a long history of extremely racist beliefs and actions. Knowing my usual readership, I imagine this is not a case it is necessary for me to make to most of you, but it is my hope that for any who still need the case made, this will help.

Let’s start with the beginning: a police officer shooting Mike Brown, an unarmed young black man, multiple times until he was dead. No one disputes that basic summary. Not even the police.

The police account suggests that Mike Brown struggled to grab the officer’s weapon. The witness accounts thus far released uniformly contradict that story. Witness accounts that the Ferguson PD have not felt it necessary to include in their investigation, even in spite of at least one witness explicitly volunteering their testimony to the police department.

The Ferguson PD have also said in a statement that Mike Brown was a robbery suspect.

Let’s start just with the above. The robbery suspect statement is bewildering. Why that matters in the slightest in situation like this is beyond me. Robbery is not a crime that carries the death penalty, and even if it was, the police are not in any way permitted to kill people suspected of committing crimes that might potentially carry the death penalty. The best possible spin you could put on the police department releasing this information is this:

“The officer did not kill an unarmed civilian for nothing, the officer killed an unarmed civilian because there was a possibility they had stolen something.”

This isn’t a defense. The killing is still illegal – it is still murder, and it reads like “we didn’t murder for nothing, we murdered for shoplifting”. The fact that they think this will work as a defense is, in my opinion, a testimony to their faith in the power of systemic racism. It is, by any reasonable standard, an appalling defense. It becomes even more so considering that the Ferguson police chief has stated that the officer who shot Mike Brown did not know he was a robbery suspect.

This begs the question: why even bring it up, if it has no bearing on how the police officer made his decision to kill? Why bring it up unless you somehow think that robbery suspect status retroactively justifies the extrajudicial killing of an unarmed citizen?

Then there is the fact that they have apparently no interest in interviewing witnesses to the shooting. It doesn’t matter in the slightest whether or not they think the witness accounts are likely to be true or false; if you genuinely want to find out the truth about an event, you interview the witnesses. The only reason for them not to do that, especially when witnesses have explicitly volunteered themselves to you, as far as I can see, is that they are not actually interested in the truth coming out.

Let’s take a step back, now, and look at the Ferguson Police Department’s record with respect to race. First, based on statistics provided by the Missouri State Atty. Gen.’s office, black people in Ferguson are much more likely to be subject to stops, searches, and arrests than white people in the same area. The rate of searches is particularly telling, because black people are searched proportionately more in spite of the fact that the data shows that searches of black people have yielded proportionately fewer discoveries of contraband than searches of white people.

These more frequent searches of black people in Ferguson are not happening because they are more likely to yield results. The data in fact show that they are less likely to yield results than searches of white people.

Outside of the hard numbers that suggest racism, we have past scandals in the area. We have the whistleblower originally known as “Lonewolf”, who was subject to continual harassment after revealing his identity to the public in order to file a complaint with the Equal Employment Opportunity Commission about a police sergeant. The sergeant, Hayes, “used ‘inappropriate racial references’ while issuing…orders”. He would reportedly do things like ordering officers to arrest black people in and around the S. County Shopping Ctr. as well as a nearby Walmart, and instituting “black days” where officers were specifically encouraged to “fill the jails” with black people. The whistleblower’s story was eventually corroborated by nine people interviewed in the subsequent investigation of Sgt. Hayes.

There is also the story in 2009 of the Ferguson police arresting a black man for a crime he didn’t commit. After they realized their mistake, the booking officer, instead of releasing him, escorted him to an already-occupied one-man cell, and refused to provide him with one of the unused sleeping mats (the sole bed being already occupied). The booking officer subsequently summoned some other cops, who proceeded to beat the man bloody, and then charge him with destruction of property for bleeding on their uniforms. As if that wasn’t horrifying enough on its own, it later transpired that the cops involved had apparently lost the security footage of the incident, and all of them testified in court that they had not, in fact, even gotten any blood on any of their uniforms (not that the situation wouldn’t have looked horrifying if they had, but I think the fact that they lied about even that illustrates the lengths they were willing to go to hold and abuse the victim).

In summary, without even getting to later police responses to vigils and protests in Ferguson, we have these facts about the shooting of Mike Brown: a documented history, both in government-provided data and in previous incidents with the local police that are matters of public record, of a culture of racism by the local police. We have the fact that the police have claimed to be investigating the shooting of Mike Brown in spite of not having made any effort at all to interview key witnesses. We have the fact that the witnesses that have come forward have consistently represented the incident differently than the police department. We have the fact that there are documented incidents of the local police lying in order to excuse or falsify justifications for the actions they take against black citizens, even when they know that they have no reason to take any action whatsoever against those citizens.

If you believe the Police Department’s accounts of recent events given the above, you are being mind-bogglingly naïve at best, though I would contend that a more sensible and more complete explanation is a combination of naïveté and racism. Even if you do believe police accounts of recent events, if you believe anything that they have said justifies the killing of an unarmed citizen, I can think of no explanation for that stance that isn’t steeped in racism. Personally, I believe that the fact that writing a post like this is even necessary, given everything that has happened in the last week, is a testament to the incredible power of implicit racism and the irrational fear that we as white people so often experience about black people. I hope all of this has given us all reason to ask serious questions about our own biases with respect to race; I know it has for me.

There is a lot more to say about everything that has happened in Ferguson over the last week, but I’m not going to try to fit it all in one post, in order to keep this the length of a blog post instead of the length of a book.

By ResearchToBeDone Posted in other