Feeding tubes and weird ideas

My favorie BADD post: Tube-ageddon.

I haven't had much time to write anything here about the hell I went through getting my GJ tube. I had every indication for a GJ tube. I had gastroparesis so bad it was starting to affect my breathing, in a way that doctors said was likely to result in infection after infection until I died. From the emergency room onward, doctors were saying my best hope was to get a feeding tube.

Yet the pressure I got from doctors, while in the hospital for one of those infections, was to just keep getting infections, go home, wait to die. Most of them wouldn't say that outright. But some of them did. Some of them we confronted and they absolutely agreed that the only alternative to the tube was death — which could have happened to me by now, without the tube. But they still insisted on telling me not to get the tube, basically that I was better off dead than with a tube. We had to rally a bunch of people on the Internet to call the hospital before they suddenly changed their tune. My pulmonologist told me she could tell exactly when I started getting people calling the hospital, because the tone in my charts changed instantly to “let's get her the tube after all”.

Most people think of all feeding tubes as the same, all reasons for getting them as the same, and so they believe in false generalizations about their capacity to prevent lung infections, or indeed cause them. But they aren't all the same. They're all different, and the reasons for getting them are all different.

I have gastroparesis. That means my stomach is partially paralyzed. In my case it became severe before it was diagnosed last year and confirmed with testing this year. It's probably due to neuromuscular problems inherited from my mother, who has autonomic neuropathy among other things, a common cause of gastroparesis. My symptoms are similar to hers so doctors are assuming whatever we have is related. Anyway, it makes food remain in the stomach a long time. After awhile, this means that you can't eat very much and you drop a lot of weight. (I may still be fat, but they tell me by the end I was burning muscle.) by the end I was having trouble keeping down two small cartons of Boost a day, which isn't enough calories to live on. I was already on a liquid diet so there was no less food I could keep eating.

It also meant that the stuff staying in my stomach was riding up my esophagus again on gas bubbles formed by food sitting in my stomach for ages. I could feel it happening several times a day. I'd belch and food or bile would ride up with it. If this happened overnight, my bipap machine would shove the stomach contents down into my lungs from my esophagus. This began happening several times a week, and from January until March I had about five lung infections requiring antibiotics. I never stopped taking antibiotics, by the time one course was over I'd be on the next. Which is dangerous in its own right.

So when I showed up in the ER a few days after a CT scan showing what they called a “ground glass appearance”, they had no problem admitting me into the hospital, and even in the emergency room they were telling me if I wanted to live I needed a GJ tube. This wasn't news to me. They had been talking about a feeding tube since last fall, when one more nausea med added to the five they'd started me on, made me able to go home without one instead. I'd been discussing with my friends what kind of feeding tube served my needs best as a person with gastroparesis. And the GJ tube had always seemed like the best option.

A GJ tube is like a combination of a G tube and a J tube. Half of it goes into the stomach, which is a G tube. The other part goes into the first part of the small intestines, which is the J tube. The G tube gives you the ability to drain your stomach contents out into a cup, and dump them down the toilet. This means that if you do it often enough, you won't have anything building up in there and going up into your lungs. Right now, even bile and stomach acid can build up to dangerous amounts because of my stomach not emptying often enough, so I take acid reducers and I drain my G tube several times a day.

The J tube portion is the part that stuff comes in through. I eat through it. I drink through it. I get all of my medications through it. This means that nothing has to come in through my stomach. Which means we are bypassing the worst part of my digestive system. Not that the rest of my digestive system is wonderful. My esophagus is slow, my stomach is slow, and my bowels have been producing blockages since I was a teenager. But with liquid food going into my small intestine at a fairly slow rate (one feeding in roughly twenty four hours, I wasn't able to handle the twelve hour version without getting very sick) I seem to be able to handle things much better than when it was going in my stomach. I love it. It's so much easier than feeling horribly sick all the time.

I still take nausea meds, but half of them have been changed to PRN instead of daily. So daily I take Phenergan, Reglan (which speeds up my digestive system), and Marinol. And I can also take Benadryl. Lorazepam, and Zofran as needed. I used to have to take all six of those things every day, so this has really cut back on the amount of medication I need, which is good because every single one of these meds is severely sedating and it was badly affecting my ability to think straight. If I were still trying to eat, I would be taking every single one of those nausea meds at the maximum dose, and still wouldn't be able to eat enough to maintain my weight.

[Photo of me holding my tube. The J tube section is visible, the G tube is hidden behind my hand, and there's a little cloth thing from Trendie Tubies around the base, with owls on it.]

But I had to fight for this tube. Even though it was the only way to save my life. I had to fight against people who were certain I was better off dead. And I needed the help of a lot of people on the Internet, to do it. When I did get the tube, it was done without a working anesthetic. And even though the local anesthesia didn't work on me, even though I was yelling and screaming, they didn't stop to give me more, they just kept telling me that the Versed meant I wouldn't remember it later. Yeah right. It seemed like the entire process of getting the tube was one giant clusterfuck after another, and like people were making it as hard for me as they possibly could. (Later, when I had to get the tube replaced, we discovered that Propofol is the med, in combination with others, that really does the trick to keep me unaware of what's happening.) They treated me like a child, repeatedly expressing the fear that I would pull the tube out like young children often do, and blaming me when part of the tube got lodged inside me, probably as a result of over zealous physical therapy early on that was a clusterfuck in its own right.

But I got the tube and I couldn't be happier with it. I feel happier and healthier. After aspirating reflux several times a week for months, I haven't aspirated a single time in the month or so I've had the tube. My nausea is well controlled. My brain and body work better. Despite a couple complications since then, it's still the best thing medically that's happened to me in the past year. And I'm still alive, which even by now I might not have been if I kept getting infection after infection.

[The x ray showing the tube inside my body.]

Why did I have to fight so hard for it? I see two major reasons. One is that I'm perceived by medical professionals as someone whose life doesn't matter much, doesn't have much quality of life. I'm autistic, they read me as severely cognitively impaired, I am in bed all the time, they don't see that I enjoy living as much as anyone else does, and they make that decision somewhere in their heads without even noticing.

The other reason is the way medical professionals see feeding tubes. I've been trying to read the writing of nurses and doctors to find out their views on these things. Not just the horrible ones. The ones who snark at patients on their blogs. But the ones who think they're compassionate and sympathetic and good at their jobs. But in one area that makes no difference:

They all think of feeding tubes as the beginning of the end. They see getting a feeding tube as the first sign that your life as over. Possibly that you belong in a nursing home, as if anyone does. When I made out my living will, the first question of “Where do you draw the line where you want to stop living?” was whether I wanted to live if it meant I needed a feeding tube. They see people with feeding tubes as the first stop on the route to a living death. Other things they see that way are using a ventilator, having a trach, needing any sort of similar mechanical assistance to survive.

My friends see it a different way. They see me as some cool kind of cyborg, with the oxygen, the feeding tube, and the Interstim implant that prevents spasticity in my urethra, allowing me to urinate. They say the sounds my oxygen concentrator makes sound almost steampunk. But then all my friends are disabled, they see adaptive equipment as cool, and as a means to living, not a sign you're dying.

Medical professionals have been shown time and time again, to rate disabled people's quality of life lower than we rate our own quality of life. And yet time and time again, they see themselves as the experts on what our real quality of life is. One reason I try to keep my lungs and my guts in good condition is that as a person who is autistic and physically disabled, I know that if I ever got bad enough to need a transplant, I'd probably die. Because they would take one look at how I sound on paper, and they would decide my life wasn't as worth living as that of a twenty year old who wasn't disabled except for the effects of their lung problems or digestive problems. (Lung transplant is the end of the line for severe bronchiectasis. My bronchiectasis is mild, I'm working hard at keeping it that way. Transplant is also the end of the line for very severe gastroparesis combined with other gut problems. I'm hoping I don't get to that point despite severe gastroparesis. Given how hard it was just to get a feeding tube, which is the standard treatment when you start aspirating this much and being unable to eat even a liquid diet, I don't know that I stand a chance at making the transplant list should I need one.)

I also had trouble getting home. People were asking me if I belonged in a nursing home, or at least in twenty four hour care. I'm not sure why. It's not like it's hard to care for a GJ tube. It's unusual, but it's certainly easier than my old med regimen, which was truly difficult and time consuming. Now we just mix them up, put them in a syringe, and stick them straight into the tube. Easy. Eating is easier too, no more worrying I will throw up, and you only need to set up the food once a day and press a button on a feeding pump. But everyone has this illusion that it's incredibly difficult, and the VNA loves to take people with tubes and stick us in nursing homes claiming they can no longer care for us on the outside.

[The feeding pump on an IV pole with the food (Osmolite, low fat, high protein, no fiber) hanging above it.]

I still don't understand what the big deal is supposed to be. By the time you get a feeding tube, eating is really hard. Either you're having swallowing problems, or something is wrong with your stomach. In my case, my stomach was emptying so slowly that I was constantly severely nauseated no matter how little I ate, I was dropping weight way too fast, and I was aspirating reflux caused by all the food sitting around for ages. I was quite possibly going to die from repeated infections. How the hell is a feeding tube supposed to be worse than that?

I can't even begin to comprehend the fear of these things. I mean I literally can't do it. It makes no sense. It's all based in prejudice. It has nothing to do with the reality of a feeding tube.

I thought the worst part would be not being able to eat. The most I can do is drink a tiny bit of ginger ale, and I have to be very careful even with that. But I don't miss food. The feeding tube ensures that I am never hungry, and always have the nutrients I need. The only times I have ever started craving food, were two separate days where I spent all day at the emergency room unable to use my tube. Each time I came home and wanted to eat or drink something I didn't normally want to eat or drink. But when I'm getting food regularly, it's not a problem. I barely miss eating at all. I never even think about it. Even the vivid dreams I'd been having about all different kinds of food, all those months on Ensure, have gone away. My body seems perfectly satisfied with what it's getting, and it doesn't crave things unless I can't use the tube.

And it makes everything easier. Food is easier. Medication is easier. Absolutely nothing is any harder than normal. It's more like dealing with something easy and mechanical, than dealing with anything hard. We did learn the hard way to flush it with coke after every medication, because by the time there was a clog, you couldn't get enough coke in to dissolve it. So we are dissolving the clogs before they can even form, by leaving coke in for awhile after every single time we use meds. I've also discovered it's possible to reduce the pressure inside me — which can prevent the meds and water from flowing into me as easily — by relaxing my body, especially my rectum, and then everything usually flows in pretty easily. So there are a few tricks, but it has overall been much easier than my life was before I got the tube.

So what is so scary? I don't know. I can't find anything at all scary about this. It doesn't mean anything horrible. It means I'm alive. Being alive is a good thing. I don't fear death, but I only get one chance at life, and I don't want to die just because someone else has decided my life isn't worth enough to them. And so I'm very much interested in anything that will keep me alive longer, whether it's a feeding tube or any other “scary” device used for keeping disabled people around longer than used to be possible.

A lot of people I know have those devices, the ones that medical professionals think your life is over. Feeding tubes. Trachs. Ventilators. Catheters. Ostomies. Central lines. All those things that seem to scare people to death, even though there's nothing scary about them. They prolong life, not end it. And I'm furious at every single doctor who urged me to go home and die rather than get this feeding tube and get a chance to live longer. That is simply not their decision to make, and they were bound and determined to make it for me until I got enough people on my side to convince them that the entire world was watching the crap they were trying to pull.

I am going to work as hard as I can, to change hospital policy so that nobody gets pressured in the way I did. It's incredibly difficult to deal with pressure to die, when you're already sick and exhausted and have no energy to fight back. And they do it in sneaky ways, so that if I had been delirious or something, which I often am in the hospital, I might not have recognized what they were trying to do. My experiences are far from unusual, many disabled people have been encouraged to die rather than get a feeding tube, or a vent, or something else that would allow us to live. My mother, who has many of the same conditions I do, is going through a mess where doctor after doctor refuses to treat her or perform surgery on her, and she keeps having to go back to the Mayo clinic because they're the only ones who seem to be committed to making sure she can live as long as possible. And as a disabled senior citizen way below the poverty line, she gets the “your life isn't worth it to us” thing from at least three different angles. This stuff isn't unique to my life, the pressure to die is everywhere.

But most disabled people, like most people in general, prefer to be alive. Being disabled rarely changes that fact, not on its own. And the fact that anyone thinks we ought not to, that their pity goes so far as to be a death wish aimed at another person, is so disgusting I don't even have words for it. But they are the ones who are disgusted at my advance directive, which tells them to keep me alive no matter what. I can hear it in the sound of their voice when they ask me about advance directives. Advance directives are supposed to be about making your own choices, but the choice to live is the least respected among them. They would rather I not be here by now, rather I got my sixth, seventh, eighth infection until my lungs finally gave out. I refuse to give them the satisfaction. I love being alive and a tube doesn't change that one bit, in fact it makes my life better.

 

Posted with Blogsy

“I don’t know that person’s program.”

That's a sentence I've heard a lot. And when they don't say exactly that, they say things that mean the same thing. Usually in the developmental disability system, for some reason, although I can easily imagine it in other contexts.

What it really means:

“DD people aren't like regular people. When people do things to them that would be horrible if they happened to other people, there's always a logical reason that justifies whatever is happening. Staff and case managers rarely if ever abuse power. All of their decisions have the best interests of clients at heart. So if something looks terrible, chances are that there's a reasonable explanation behind it. I just don't know what that explanation is. And I likely never will, so I'm not going to judge.”

They say this when staff scream at an old woman with an unsteady gait every time she falls, and refuse to help her get back up or allow her to hold onto things for balance.

They say this when staff publicly humiliate a man who clearly has trouble moving to avoid obstacles, when he accidentally bumps into someone.

They say this when staff do their best to keep a boyfriend and girlfriend apart. Or when staff are okay with boyfriend and girlfriend, but balk at the idea that two women with intellectual disabilities have fallen in love. As if it's even their job to decide who can love who.

They say this when parents simultaneously put on a big public show of wishing their son could move out on his own like he wants to, but sabotage his every attempt to do so. Because they had planned out a whole life for him in the group home they run, and can't handle the idea that he doesn't want to live under their control the rest of his life.

They say this when a staff person kisses a grown man's leg and says “I kiss you boo boo aww betta!” in baby talk.

They say this when, in the name of integration, staff prohibit disabled people from speaking or socializing with each other. I just saw an instance of that last one, which is why I finally remembered to write a post on the matter.

They say this when we get outright tortured. Tied down. Skin shocked. Slapped. Pinched. Made to smell ammonia.

I wish I could upload the scenes from real life that play out vividly in my head. But like as not, people likely to say these things wouldn't consider me a reliable observer. They never do, when you start pointing out the truth. When you see yourselves as people. With all that this means.

Suddenly you are either too severely disabled to understand what's happening, or you're not disabled enough to grasp why treating people like dirt is necessary. Or both at once. And they'd much rather you were highly submissive, maybe even the really cool type of client who helps staff out by giving them information about other clients.

All of this requires seeing DD people as less than. It just has to. There is no other way to justify these actions towards us.

And I know how people see us. As in, I know what we look like inside their minds. Sometimes we're human — almost, anyway. Not quite. There's something vitally important inside every real human. And to them, we either don't have it, or are missing large chunks of it. So we go around in human bodies but there's pieces missing in our minds and our souls. Even people who don't believe in souls in any religious sense, still perceive something inside us as only partial.

I know this because this is one of those viewpoints that isn't content to stay in the minds of others. It tries to force its way as deeply into us as it can manage. Until many of us look in the mirror and see only part of a person.

I can't describe the violence that involves. It's horrible. And a whole system of relating to us, forces its way into our lives. It tells us that we are taken care of, that we can relax, go to sleep, almost. And then it suffocates from inside. There's no words for it.

I suspect the drive to say this about people comes from several places at once.

If you work in the system, there's not wanting to see yourself or your coworkers or people who could be you, doing something horribly wrong. Much less on a regular basis.

I also suspect a strong desire to trust the society they live in, not to do horrible things to people. Or at least, not to do horrible things to certain kinds of people.

A member of my family once told me that it took him a long time to believe what happened to me in mental institutions. He said that in order to come to terms with the reality of the abuse, he had to destroy a strong desire to believe that the society he lived in was safe and just. Him telling me that was far more honest than a lot of people are.

That desire to trust society gets in the way of understanding every kind of injustice. I am amazed that people trust a society that does its best to shut out and destroy all but a handful of people. But they do.

And not seeing us as quite exactly people, is the one thing that you can't avoid if you think like this. Because if you see us as people, you have to see what happens to us as dreadful. And you don't immediately, upon being told of the latest awful thing, say any variant on “I don't know that person's program.”

Posted with Blogsy

Making everything clear.

[Well not everything. I hope to write more posts going into detail on this topic. But this is the most general one I mean to make.]

I am not part of the Internet “social justice” community.

I am not part of the Internet “anti-SJ” community.

Both communities have, at different times, tried to claim me. At different times, I have joined in with both, knowingly and unknowingly.

But I can't be in either. Because they are both part of a larger pattern that does great harm.

Each one contains people who are there for sincere reasons. And also people who use these communities to play with power in devastating ways. But the way these communities work, even people's best intentions get turned around until they range from ineffective to destructive. I'm only going to be talking about people who join in for good reasons, because it's already obvious that manipulative power trippers and trolls are bad news, whether they're cloaking themselves in fake good intentions or not.

I can't be there. Not because I think I'm better than the very good people I know who are involved in both. Not because I don't care what is happening. I can't be there because I see what is happening, and if I join in, I will only be joining in with destruction.

I see what is trying to pull me in. I will not be pulled in. I will stand next to and apart from these communities. I will not fight against them, or, like Devil's Snare, they will only pull me in tighter.

The pattern works kind of like this: There is a monster. That monster runs around trying to devour everything in sight. When it can find nothing else to devour, it devours itself.

The whole thing is set up in a way where the only way to move forward is to find something to oppose and devour. There is never a point where the way you do things is good enough. You have to find more and more words and ideas to oppose. Words and ideas that mark who is in the know, and who is bad. These things constantly change. The monster never stops looking for more.

People are judged by how well they can keep up and remember these things. Even when people say it's a bad idea to just memorize everything by rote, that's what most people are actually doing, because that's what this culture encourages. Pretty soon, most people fall into a pattern of dodging and weaving, trying to say the right things, not say the wrong things. And above all not admitting it, because this culture simultaneously encourages this kind of behavior, and says you're wrong if you behave this way.

Within this culture, you stop noticing your surroundings. Instead, you see a network of lines representing various power dynamics, bad words and ideas, good words and ideas, and the way this community responds to them. You stop being able to see that this is not the only way to respond to injustice.

When people start noticing what is wrong, and wanting out, things twist around until they are absorbed into a different part of the same pattern. They fill the part of the monster that, in the absence of anything else to eat, turns around and begins devouring itself. And so people become part of the same thing they wanted to stop. And the fight between these two communities goes around and around forever, providing infinite food for the monster.

In this way, the pattern tries to pull in those of us who try and talk about it. It sucks people in until before they know what is happening, they are part of it. Few people intend to be sucked into either part of the pattern. People mean well, and are not stupid. But this is a whole pattern of connections between people, set up to perpetuate itself. And that pattern ends up hurting both the people caught up in it, and people outside of it, through the actions it encourages people to take.

It feeds on opposition of all kinds. It even makes things work so in the end, the only conversations that take place are arguments against this or that person, this or that action, this or that thing.

Which is why I will stand outside the pattern. I will describe the pattern. I will encourage more people to step outside of it.

But I will not set myself up in opposition to it, or else I will just be pulled in and become part of it. So I am outside of both pieces of the pattern, but I will not fight them.

And I will remind people, there is a huge world out here. There are other ways to do things. Not just my way, either. Lots of ways. You will always be welcome to step outside, to join me and many other people who live out here.

And, together or apart, we can find other ways to make a difference in the world.

[With credit to a friend of mine, who first characterized the pattern we were watching in terms of the self-devouring monster.]

Posted with Blogsy

This is not the post I started out writing.

The next disability blog carnival’s topic is intersectionality. Intersectionality is one of those words that does not slide completely off my brain, the way ‘monotropism’ does, but slides partially off my brain and is not a word I would ever use except in paragraphs like this one.

It is a word normally used by people within a very particular way of looking at oppression. And among people who may not be exactly within that category, but who take the word from those who are. I don’t even know the word for that category, although I can usually recognize it by the sorts of words it uses. As long as it is not too abstract, I greatly appreciate reading from things in this category. But I am not myself someone who can work within it (may have something to do with this post, which is in no way an insult to those who can work within it). Intersectionality refers to the way that being oppressed in more than one way at a time (such as being disabled and black and female) combines to make an experience more than just the sum of its parts.

I have spent all of the time since the blog carnival was announced, trying to write on this topic. The results in no way compared to some of the brilliant writing I have read from others. In fact, all they compared to were past efforts to write homework assignments I barely understood by plugging in words to a formula and straining my brain to the point of pain (rhyme not intended) trying to come up with more words to fill in the blanks.

I started out by listing the current categories I fall under when it comes to being subject to various forms of oppression: female, disabled, lesbian, mixed-class/poor, nongendered, and fat. Then I added a few notes under some of them.

1. (Disabled.) Specifically, I’m physically disabled, cognitively disabled, psych survivor/ex-patient/mad/etc. take your pick, and have chronic illness and chronic pain. All of which are sometimes lumped together and sometimes play out very differently from each other. And while these categories stem from the medical model, they also often reflect ways that even the political aspects of the disability communities have divided themselves, and thus become relevant as more than just medical categories.

2. (Mixed-class/poor.) Born middle-class, been poor by my country’s standards since adulthood. Because this has to do with disability, I am not the sort of fashionably downwardly mobile person I often read about who can always go back to the middle class or even the working class but chooses not to because it clashes with their values or wishes. I know enough from having talked to people who grew up poor and working-class that I’m quite aware I have plenty of middle-class privilege that can’t evaporate no matter what happens. My self-description as poor is not an attempt to erase that, but rather an attempt to convey the reality that I am subject to major classist oppression that will last the rest of my life no matter what choices I make. Permanent, involuntary downward mobility exists in the world, even if I’ve virtually never heard it discussed when people talk about classism. Which itself probably has something to do with the fact that disabled people are invisible, and that most discussions of classism seem to revolve around the struggles of the working class. And the fact that people expect class to be simpler than it is, either you are or you aren’t a particular class, when things are more complicated than that.

3. (Nongendered.) Neither cisgendered nor transgendered. Gender is a concept that, while I understand intellectually that it is greatly important for other people, is entirely absent and incomprehensible to me. I imagine that it must be some collection of aspects of a person’s identity that all cluster together in most people’s minds, whereas I’ve spent my life oblivious to how they are connected or why I would want to connect them, and innocently trampling all over people’s ideas of what it means to be masculine, feminine, or even any particular point in the middle. For more information, read Urocyon’s Gender, Sexuality, Identity, and Binaries or, if you can get it, the article “Growing Up Genderless” by Jane Meyerding in the anthology Women from Another Planet?

Then, I set about writing about how those things mixed around make life much more complicated. Most of the things I could come up with were the obvious: my status as what a friend called a “perpetual outsider” in single-issue, single-identity communities. Even in the autistic community, where I have found (unasked for and unlooked for) status, I have found no belonging. How could I, in a community where it’s impossible to go anywhere without hearing some other aspect of my life (even some to do with autism itself, since I am far from the right kind of autie) degraded, denied, and disparaged? Even the “status” has been given to a distortion of my life, not to who I am. And the same is true of the LGBT community, disability community, feminism, and all the others. I have only to walk into an LGBT community center to find a gay man who is inspired by my presence to tell me how he used to work in an institution where there were people who looked like me, where he would stand over the cribs of some of the inmates and ask (insert pained voice) “Why are you alive?” And who wants my sympathy for the agony he feels at the existence of disabled people. Seriously. This happened.

(For more on that kind of topic, see The Difference Slot, by elmindreda, who eventually left the autistic community over such experiences.)

The original thing I wrote was full of stories like that despite them just being the tip of the iceberg on this subject matter. And I grew more and more frustrated as I fit my writing into a formula that did not at all convey my thoughts. Then I decided I would rather write nothing at all than write what I didn’t mean. So here is what I do mean:

I can’t write a lot about intersectionality as a topic because I don’t ever not write about intersectionality as a topic. Every single piece of my life that I describe, is the life of someone who falls under multiple categories. I write about these things by becoming very specific and writing about things I do and experience. I write as one single instance of life and expect people to fill in the broader context on their own. And from that broader context, they can use it to think about situations that at first glance are nothing like mine.

The way I experience these things has no equivalent in words, that I know of. It is like being acted upon by a large number of separate gravitational forces that push and pull in a physical-seeming way. It’s possible to name specific forms of oppression that are recognizable to everyone, but the way I experience these things isn’t as simple as listing off sexism, ableism, etc. As with most of life, I experience a much higher degree of detail in these gravitational forces that push and pull on me, than there is in the words. So why divide them in the exact way that they are normally divided? Why say that there are six things, when you could say twenty, and why say twenty when you could say a hundred? These are just shorthand for the more complex forces at work in the societies we live in, and it is important not to forget that in these often hyper-abstract discussions. I understand very much why a common language is important, but sometimes it obscures as much as it communicates.

So I will continue to move through the world (and the bits of the world that are around me will affect me, and I will affect them) and write (when I can) about specific aspects of my life, all of which have something to do with this thing they call intersectionality, whether that’s the topic of the day or not. Because I don’t stop being all these different sorts of person, when I stop specifically naming them.

Breathtaking to behold: talking back to dismissal

One of my biggest interests is the study of how oppression plays out, and how it is resisted, among communities that most people would consider minorities. (Note: Minority in amount of power, not in amount of numbers. So yes, women count.) Not some sort of study of victimhood the way some people would paint it, but rather how people resist becoming victims.

It is breathtaking to behold communities where enough people have worked out the way things work, that when they are hit with the usual forms of sexism, racism, ableism, heterosexism, etc., they are ready for it. They have answers to the usual bothersome questions and comments designed to disempower them. Even if the people attacking them don’t understand those answers, they at least are told a lot of the same things by a lot of people.

It’s breathtaking because we haven’t reached that point in some of the communities that I work within, including the autistic community. It’s like we’re almost there, but not quite. So a small number of us end up sticking our necks out and a large number seem to either understand but not be able to articulate it, or else not understanding yet what’s going on.

This isn’t because we’re too autistic to understand (which is in fact one of those obnoxious power plays, rather than a reality), it’s because as a community we’re just not quite there yet knowledge-wise. It’s been like this for other communities in the past, it doesn’t have to be like this for us forever. I don’t always even have coherent answers to a lot of what goes on, because this is not easy work by a longshot, but I think it’s work worth doing.

What would be cool is if eventually we all just automatically understand what is going on when people say certain things to us, and from that understanding (plus some time for thoughts to congeal into words), know what to say and how to react. My problem half the time is understanding but not knowing the words.

But imagine that, if anyone ever told us…

…”You’re not really autistic.” or “You’re not really autistic enough.”

(“You just have Asperger’s,” “You’re too high-functioning,” “You understand your situation too well,” “You’re too articulate,” etc.)

…”You’re too autistic.”

(“You lack the empathy necessary,” “You couldn’t possibly understand,” “You lack theory of mind,” etc.)

…”You’re too much like children and confusing us with your parents, somehow.”

(“You’re just like adolescents rebelling against their parents without understanding why the parents know best,” “You’re just like small children who can’t possibly understand the adult world,” “You’re just like little children who want to do whatever you want and can’t understand why your parents don’t want you to do that,” etc.)

Etc.

…then there would be an immediate, coherent response to each one, explaining why this is not an okay way of treating us or viewing us, explaining how the misdirecting of other people when it comes to us works, explaining why this is not okay… voiced by enough of us at once that it would be harder to ignore than the current sporadic response to it.

We’re getting there. See Bev’s Are you autistic? and I repeat myself. But we’re not there yet. And it would be wonderful for a lot of us to work towards this until we are, until we can throw answers back at that stuff easily. Because I’ve been watching these comments thrown at self-advocates for ten years and they never truly change in substance.

[Note also that I’m not going to be taking comments that actually try to explain why those particular ways of dismissing us are actually real or good or right. So don’t bother. Because this blog is about how to work towards this kind of change, not about getting the conversation derailed by people who think we shouldn’t even be trying to.]

Information isn’t power on its own, unless it’s used in the right way.

First an explanation, as much as I can give, about the current situation and why I’m not blogging a lot:

I haven’t had either much to blog about or much capability of blogging lately. Mostly due to not having any time or energy left over, after a bunch of serious offline responsibilities, to take in more information and figure out what to do or say about it in any sort of public manner. I don’t like to post online just for the sake of posting. And I don’t have an ounce of energy or a second of time to waste, I have had to become much more streamlined than I already was. Which was pretty streamlined already.

I also don’t believe in saying anything when I have nothing to say, or when I don’t understand what I’m saying (that habit, which was once a survival thing, has long outlived its welcome and has harmed far more people than just me, and I’m sorry — and I do my best to avoid it at all costs, since nothing good ever comes of it). I do believe that in order to be able to do anything useful, I also need time when I’m not doing public writing, or a lot of public reading in a particular area. This is a brain thing. It works that way and I’ve never been able to stop it from doing so.

My ability to use language has always outstripped my ability to understand it, so more than most people I know, I really need a lot of seemingly unoccupied time to just figure out what’s going on around me. Eventually all the information settles into the back of my head getting more and more detailed as time goes on. Then, eventually, some event triggers a response that uses that information. Can’t pull that response out on purpose, it’s just wasted effort. And I now refuse to just repeat what someone else wants me to say (and I have had a lot of people tell me I really need to publicly talk about whatever their pet subject is, but since I can’t understand them, and/or can’t form words around them, then I can’t say them, end of story). But it will eventually show up when I’m least expecting it.

So some events today have triggered one of those responses. Don’t expect other responses forthcoming just because these ones exist. I still have from no time at all, to at most, two hours of ‘uptime’ for things like this per day, and that’s how it’s going to be for the foreseeable future. If anything takes up too much of that time with no useful return (and I’m the only one who can judge that against a lot of other things that are very important), I’m just not even going to respond. The stakes are too high, and that time is in too much demand already for other things. This is how it has to be, and it’s why I’ve taken on few to no online responsibilities lately.

Also, as I’ve noted many times before: Don’t assume this is about autism. I’m an autistic person, it doesn’t mean that everything I do or care about centers around autism and autism alone. As was pointed out to me again recently — I’m a person who applies values and skills I already have, to autistic people’s situations, as well as lots of other situations I happen to come across. Nothing about the world I currently inhabit has little walls around an “autism section” that I have to stay in.

Anyway, blogging is a way of getting information from one person to the next. It’s one of many ways, but it’s a way to do that. Getting information from one person to the next is a good thing as far as it goes and as far as it’s useful.

But it’s not the only thing required to actually get something done.

Right now, though, my problem is less with bloggers (since I figure, like me, they might be doing a whole lot in the offline world that I can’t see, and I know that, like me, many disabled people find themselves only able to do this stuff), than with organizations.

I’ve seen a lot of organizations in my life. I’ve tried to take part in a lot of organizations in my life. And I’ve gotten pissed off at a lot of organizations in my life.

Because a lot of people seem to think that all you need for an effective organization is some combination of good intentions, a nice website or office, nice letterhead, a board of directors following some utterly standard model of non-profit setups, some money, some office skills, and some means of getting information passed around between a lot of people (conferences, leaflets, newsletters, articles, little booklets, weekly meetings where people sit around and talk, etc.). Bonus points if you can find any rich or famous connections and hold fundraising events. Maybe some trendy liberal protests too, where you can hold up your sign that has nothing to do with the actual substance of the protest (if there was any).

And everything — everything — eventually boils down to that act of passing around as much information — especially proper information — as possible. And, how could I forget, lots of mutual ego-massaging, patting oneself and everyone else around you on the back just for being there.

It’s an entire culture. And it’s a culture I have tried to work within at times because sometimes it’s at least marginally better than doing nothing. But it’s a culture I feel immensely out of place within.

Because it’s empty. Scratch the surface and all the fluff just starts falling apart. There’s nothing left when you really need something done.

I’m one person, with limited mobility, limited energy, and limited time. But if someone asks for my help in an advocacy context, then I will do everything I can to actually help them in some sort of concrete way. The same as I would want if I were in their place. If I can’t help them, I will try my best to find someone who can.

And there’s the problem: Where do I look if I don’t know anyone personally?

I try to find groups of people who are united around the same problems that are happening to the person right then.

And most of the groups I find… they’re not into anything practical. They’re into passing information around in circles, and being very happy with themselves for doing so. And being all proud and weepy-eyed about its mere existence, which mostly just feeds people’s complacency, the same complacency that causes the scandalized growling of “We’re already doing something for you people just by existing, now leave us alone.”

(And thus, many people with far more time, energy, and power than I have, end up failing to use it at all for anything other than reciting the names of other organizations to people (with a hopeful “let’s get this person out of our hair” air), or repeating that, say, if they’re homeless, then a box of pamphlets on how to cook with equipment they don’t even have, would be just as good as a box of food. Wish I were exaggerating.)

The problem in most situations where immediate practical advocacy is needed, is not information. Yes, information is often necessary. No, information is not bad, in and of itself, it can be a very good thing. But it’s a means to an end. It’s not the end itself. The problem in most of these situations is things like power, money, and resources. Not endless workshops, pamphlets, and meetings about how bad the system is, with no actual move towards holding the system accountable for their actions and finding ways to get them to do the right thing.

And I’m in yet another one of those situations. Someone needs practical help navigating this mess, from people who are experienced in actually fighting against all kinds of injustice. But all I can find are these shiny feel-good liberal organizations who, as a friend put it, “…you, me, and [Jane] are too unimportant to be anything other than nuisances to them.”

(And I’ve found that even in organizations that somehow I’m now considered, usually by virtue of CNN or something, important enough to matter to, most of the people I care about aren’t, and are treated quite differently by them than I am. At least to my face. This is frustrating — I can still usually smell the scent of pseudo-organization on them, but it’s no longer as immediately obvious in their treatment of me as when I used to be nobody important to them. So I don’t always get the warning as fast or loud as anyone else does.)

It’d be nice if organizations were groups of people who all, individually, were involved as continuously as possible in making various things happen on a real-world level on a regular basis. And who came together to become more effective in numbers or in diversity of skills, or to learn from each other how to get things done in the real world, even how to use information to make real things happen for real people.

But most of the time they’re just groups of people who all decided one day “Hey, wouldn’t it be great to start an organization dedicated to our pet cause?” And who thought that starting an organization was the same as doing something. And it’s not — no matter how much money, love, dedication, information, and good intentions are poured into an organization, having the organization is not doing nearly enough.

I’ve said that in enough ways, and used up enough of the time that I’ve got to say it within, that I’m going to just leave it at that, even though I haven’t described everything I wanted to. I’ll now return to the regularly-scheduled silence for awhile unless some other situation leaps up and demands to make its way out of my fingers. I haven’t dropped off the face of the planet, just most of my life is not, and can’t be, online right now.