Six Lessons I learned about “Friends” on Facebook

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1. People who “friend” you probably don’t think of you as a real-life “friend.”

Even though, you’ve shared your most intimate life experiences and feelings with them, and photos of your children and grandchildren, they could block you, unfriend you or ignore you in an instant, and never look back. I know. They could also place you on a restricted list so that you don’t see a thing about their lives, all the while you are sharing everything with them. More “friends” than you think- will do all of that (oddly, mostly “friends” you’ve met on-line). If you think of a “friend” as someone who is with you during the ups and downs of life- be careful about being “friends” with them on Facebook; and be afraid of anyone who says they don’t have the time to listen to something you’re going through. Being successful, garners more “friends;” and I have been (successful). Being not so, will strip them from you; and right now I’m not. If you’ve friended people who are only a whimsical flick away from the “(un)friend” button, be careful. The good news is that nothing that is done can’t be undone. You always have the option of “unfriending” them, or even blocking them, although, that’s been against my definition of how to treat people. You’ll have to find your own way forward. Just remember, their definition of a “friendship” is not always yours.

2. So when you “accept” a friend request, or ask for one, think about what the definition of a “friend” means to you, and does the person “fit” that definition?

Is a “friend” someone you chat with on Facebook over political opinions? Is it someone you’d meet in a restaurant for a drink? Is it someone who could come to your block party? Is it someone you’d let on your porch? Is it someone who would be invited into your living room? Is it someone who would seek you out to spend time with? Is it someone who would be there for you if you were in trouble? More than all of that, is it someone who would take time to work things out with you if there were miscommunications? Could you talk to them about your feelings? My definition would hugely weigh on the latter third of these, which caused me so much angst. My definition did not match theirs. To me, there’s a cavernous difference between an “audience” a “contact,” and a “friend.” Pain can only come from assuming the former two are the latter

3. If you find that you must censor yourself or be cloying to retain friends. Don’t do it.

Your real friends will accept you as you are, if you do not cross boundaries. By that I mean, you respect your friends’ beliefs, and you allow them to be themselves. I am of a certain religious variety, by choice. Some of that choice has to do with the religion in which I was raised, and some had to do with the current political situation. I remained a Christian and do not wish to hide it. It’s personal, mostly, although occasionally it comes up on Facebook, mostly when others are in distress. It’s complicated- I wish it weren’t. But it works for me. It did not work for others. The weird thing is, I happen to be attracted to atheists, probably due to their more evidence-based/reasoned approach to thoughts/challenges. I may have to change that approach or find friends who accept me.

4. Is your friend developing a following to sell a thing or a service?

Wow, this is a big one. As I developed friends who had something or a service to sell, I saw it only as a good thing. They were developing and thriving- and that was good, right? That was my feeling until most communications involved selling their wares. Then, I began to wonder- was I was a friend or a target audience? Even being an audience would have been okay, but only if the “friendship” thing was real. As time went on, and the friendship-sharing dissipated, and the ad posts increased, I felt worse, which clarified which side I was on.

5. Do your “friends” get together and not offer to include you?

I have a lot to say about this. Looking at posts of a happy get-together of very admired people has been a constant source of pain/feeling like “the outsider”/never in the “in” group, for me. This mostly includes women who get-together for some reason. It’s like high school and not being one of the cheerleaders (I quit sophomore year) or a jock or connected to one. I looked at a post recently that included many people whom I’ve communicated with almost daily. I doubt they would have considered asking me to come to their get-together, even if it had been around me geographically (and there are many that have been). And they didn’t. And it opened my eyes. What you see on-line, on a person’s page, is not what is going on behind the scenes. Remember that. It was comfortable for me to believe that friend- or public-posts were the reality. They were unfortunately not, which brings me to my final lesson.

6. Learn to protect yourself.

Because of the above lessons, and because I am loath to “unfriend” people, I started a new Facebook account. That meant saving over a decade of writing and photos (after Open-Salon folded many of us joined), deleting my account, and moving to a new site. I announced it. I asked who still wanted to be in contact probably three times, in public posts, on two accounts, and got maybe 12 responses. After I moved, the people I was unsure about no longer wanted to be friends (trust your gut). One blocked me even when I tried to provide comforting words during a tragic situation. Another unfriended me after friending me again. For a person (me) trying to extract myself from former toxic or empty relationships it was like déjà vu all over again. And it hurt. I’m tired of hurting.

After reading this, you probably think that I must be a horrible person. What must I have done to make so many people dislike me? You’ll just have to trust me, I’m not a bad person and work hard to be a good one. I also work very hard on friendships- on any relationship, really. I am a good friend who you could come to for help, consolation, conversation and fun. My home was always open.

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My lesson from this is to remove myself from the computer, and from Facebook, and seek out true relationships in real life. So, my goal is not to be on Facebook much from now on, except to keep a record of important life events. I’m not one for the telephone, but maybe I’ll have to work on getting over that. Phone or in-person conversations will become my main mode of communication. In person is better- because there’s nothing like the human touch. Hugs are good.

And even though I tried, I couldn’t hug anyone virtually, really, despite emojis.

I'm too old for this

Dominique Browning wrote a piece for the New York Times titled, "I'm too old for this." It resonated. Not just the first part of the article about the deterioration of our looks at 60, but mostly the latter part of the article on the freedom to ditch old baggage and suffocating expectations. She was finally going to be herself. The idea of living light and right always perks me up. Then my family intervened.

And the rains came.

I'm not "chatty." When I do talk, I talk too loud. I think too deep. I care too much. In writing, particularly on Facebook, where developing thoughts should never be written lest a misunderstanding occur, I write them, hoping for a connection, or someone on the receiving end to help me grab my thinking and move forward. I always intend to be meaningful, and most of the time caring (except for incidents where hate speech is involved- but that is a different topic for another time).

Apparently, I should just shut up. Basically, that's what I think I'll do.

How does this jibe with the, "I'm too old for this" freedom we are supposed to have at a certain age? It doesn't, at least not if you care at all about what others think, which is basically the point of the article.

You shouldn't care. And I do. I do a lot.

 

Looking for a clear view

I worry about this because it means my development is stunted, and I'll never be free. I believe in my heart I've done the right thing. But, I'm shamed. I retreat and apologize. Then feel awful, because I've reconstructed the incident to be what I'm told it was. But, it wasn't. At least for me.

Not that many months ago, I sat with one of my mentors in Sri Lanka sharing lunch. He spoke about his attempts to not speak negatively. But, he said that whenever he opened his mouth, judgments came out. His answer was to meditate and be mute.

I'm with him. And I wish others would come along.

Life Post Car Accident

Nowhere to Turn: The Misery of a Failed Health Care System

The first months after our son James' car accident in July 2012 were dreadful. He was involved in a head-on collision that required an hour to remove him from his vehicle using the “jaws of life.” His crushed face required extensive reconstruction, a spinal tap to relieve cranial pressure and weeks of one-on-one care in the surgical ICU. After he was discharged from the hospital, months of fretful family caregiving followed, with long stretches of paralytic inactivity in between (me on the couch and Rich, my husband, in the recliner). We were in that state of shock for such a long time that I thought we might never recover or that the "new normal" would be dark and fraught with peril at every turn. However, at some point, the jagged edges of our lives began to ease and we all seemed relatively well, except for one looming issue.

We found that we were facing the payment of a large chunk of James’ surgeon’s bill, made impossible to ignore by the $11,080 statement we received routinely every month in the mail. Why were we burdened with this? Because unbeknownst to us, the surgeon called to be a part of James’ trauma team that night was “out of network” and charged more than what was “allowable” under our insurance plan. Should this matter in an emergency? Should we have been required to find another, less costly and thus insurance-approved surgeon and risk an inferior outcome that could literally impact the rest of our son’s life?

During the initial months of my s/low functioning, I began repeated attempts on two fronts to either get the remaining fee paid by our insurer or forgiven by James' surgeon, which is typical in these situations. I was consistently repelled by both. My technical appeals and the “statute of limitations” expired with the insurer, because the process was stalled for a year, and we were left with a bill that the surgeon refused to write-off that will take us 9 and 1/2 years to pay. We will be close to retirement age by the time Dr. ABC gets his money. How did this happen? We had what we thought was good insurance (Blue Cross and Blue Shield of Louisiana), a supportive employer (The LSU System/LSU AgCenter) and a sympathetic physician? Here is my story.

Approaching the Insurer:

My first approach was to argue that the insurance company's reimbursement rate for the surgeon's bill was inadequate- literally, by about 1/3 of the amount he had charged. I had to force myself to fight with the insurer for our financial health, considering the weight of the worry I was carrying. Nevertheless, Blue Cross was my first target because, after all, this wonderfully skilled surgeon had rebuilt the left side of my son's face and likely saved his life. Anything he charged seemed to me like it should be paid. I had several frustrating phone conversations with Blue Cross and Blue Shield with me pointing out their "denial errors," – e.g., "the surgery was not dental surgery therefore it is covered by your policy,” etc. A lawyer friend suggested I call the Louisiana Insurance Commissioner and ask for help, which I did. The Commissioner's office was very responsive and empathetic but said that although they recommended our insurer pay the full fee, they could not help us, because they did not have jurisdiction over our case. Why? Because we did not have "health insurance."

What? No, insurance?


No. No, insurance.

Apparently, unbeknownst to us, the LSU System/AgCenter is self-insured. However, I told them, I remember we chose the Blue Cross and Blue Shield of Louisiana Plan (and Ochsner before that, and Humana before that- both of which were cancelled) from among many insurance plans presented to us during annual enrollment. Right? In addition, what about the Blue Cross Insurance Card I carried around and presented to doctors and hospitals when members of our family needed medical care?

Apparently, that card also had the name of the Office of Group Benefits on it, and that meant something (which is now explained on the back of the new cards issued to us- “Blue Cross and Blue Shield of Louisiana provides administrative services only and does not assume any financial risk for claims.” Was that there at the time of James’ accident? No.). What that meant was that BCBSLA was just a “third party administrator,” or more specifically, just the creator of the terms of the plan, and the claims processor. However, claims are actually paid by the LSU System's Office of Group Benefits.

It was at this point that I discovered that the entire LSU System is self-insured, but in order to find that out, I was told, "you have to ask questions."

Information explaining the meaning of a third party administrator, or that LSU is self-insured were not written on any of the materials we received from our "insurance plan," or any insurance plan offered by the LSU System that you choose, including in the contract containing the terms of the plan. It is not discussed by any of the representatives from the insurance companies that visit LSU to tell you about their company, and their "company's policies" (that you should be sure to sign up for).

At about the same time, I wrote a letter to Blue Cross and Blue Shield of Louisiana, which apparently constituted my first appeal, and their response was to send my letter to the LSU Office of Group Benefits, and to refer me to the terms of our "BCBSLA contract." The long and the short of that line of inquiry was that even though the contract stipulated that (elective) out of network physicians, like ours, were paid only 70% of their fee (with an out of pocket maximum per individual of $1,000), 70% of the fee was not paid in our case (nor was the $1,000 out of pocket minimum honored).

Apparently, another sentence in the contract says that payment will only be made according to the "BCBSLA allowable fee schedule," and our surgeon, Dr. ABC charged more than their “allowable fees.”

Where do you find the BCBSLA fee schedule? Well, it is not listed in the contract, or anywhere else I have been able to identify.

Approaching the Employer:

After appealing to the Office of Group Benefits for help and being turned away -after they had an executive meeting on the subject of our claim (after a long delay, because, “everyone quit”)- I did discover that the Office of Group Benefits had paid 100% of the "BCBS allowable charges," because James' accident was an "emergency." However, again, what they considered "the allowable fees" were approximately 2/3 less than what Dr. ABC charged, or $5,836. At about that same time, I learned that the terms of the BCBSLA contract stipulate a one-year statute of limitations. In the state of Louisiana, contracts for insurance have a statute of limitations of up to 10 years, unless otherwise stipulated. Ours was stipulated. I was running out of time.

Approaching the Physician:

We approached Dr. ABC a number of months after the accident, in a physician's visit with James, as he was unhappy with, and depressed about the way his eye looked, and the amount of discharge draining from it. Approaching Dr. ABC seemed like the next reasonable step, because soon after the initial surgery, Dr. ABC told Rich that he would wait at least six months to do additional surgeries on James, because his face had to heal; but not to worry, that he would get everything the way he wanted it, because "insurance would pay for everything and future surgeries would not be considered elective." By the time we got to that appointment, Dr. ABC had received my letter to Blue Cross and Blue Shield of Louisiana, so knew that we were at a stalemate with Blue Cross, payment-wise. He even complimented me on it. But, in the discussion that ensued, his attitude toward additional surgeries literally did a 180; he did not seem to remember that he had suggested James could or should have any additional work. In fact, he cautioned James against seeking perfection.

"You don't want to get into that trap," he said.

Rich did phone Dr. ABC and confront him about his change of attitude about additional surgeries, to which Dr. ABC replied that there must have been a miscommunication. What we learned from that visit and subsequent emails/phone conversations was that his office had opted out of being a preferred provider for Blue Cross due to numerous disagreements over payment amounts; and that Blue Cross, as a policy, literally, will not speak to out-of-network providers. To wit, we tried to have a three-way phone call-- Blue Cross, Dr. ABC's office and me- that was unsuccessful, to say the least.

Blue Cross would not participate.

When we again tried to speak to Dr. ABC directly, his office staff said that he was not involved in billing discussions. The message was clear-do not attempt to contact him again. I had hoped that both the insurer and the physician might help us resolve this issue- but, communications amongst the three of us proved to be an impossibility.

The onus for determining what is a fair charge/code/price/reimbursement was on the insured or the patient- individuals who know the least about the system or where to locate relevant information. The bottom line for insurance companies is that if you are a "preferred provider physician" you will write-off any remaining amount that is not paid by the insurer. Dr. ABC's office was not a preferred provider, but we practically begged him to forgive the remaining amount. The response? His billing office told us specifically and emphatically that they do not do that because they "would go broke." Mind you, a good portion of Dr. ABC's practice is elective, plastic surgery.

Research- What was this surgery worth?:

My next step was to go back to what I knew best- and that was research, and research methods. Were the codes submitted by Dr. ABC's office for payment "reasonable?" If they were reasonable, were Blue Cross's "acceptable reimbursement amounts" reasonable? The law stipulated that I could request James' medical records/the codes -they were provided to us by the hospital claims department, the physician's office, and the insurer. So, billing codes in hand, I looked up everything I could find on facial reconstruction CPT/ICD9 billing codes- what codes were used for which procedures, and how to code to get reimbursed the greatest amount, etc. I found the American Medical Association website and their recommended payment amounts for medical codes by state. What I found was that the amounts charged for Dr. ABC's procedures by Dr. ABC's office, under the codes he submitted ($17,900~), were both incorrect and in one case many times higher than what was recommended. I also discovered that "Blue Cross" or the "Office of Group Benefits" had paid more than two times ($3,800~) the amount for the main surgical code (21182) as was recommended by the AMA ($1,900~). When I talked to Dr. ABC's office staff about the AMA recommended reimbursement amounts- they pointed out the small print on the website, which said that amounts stated therein might vary by physician and region. When I asked which coding book they used-- they told me The Physician's Coding Guide—(which book recommended a payment amount for the 21182 code from $6,395 to $7,941)-- but I simply could not find it anywhere.

When we discussed their mistake on the main code- they quickly investigated it and determined that, yes, in fact it was incorrect, which they wanted to rectify with the insurer through an appeal, immediately, (which they said would reduce their charge on the main code to $7,900). At the same time, they finally looked at the other codes for other procedures that were on James' bill, and stated that the codes recorded were not those that they had submitted (inferring that someone else changed them). They wanted to change/correct those too, because of something about the insurer thinking that they "bundled" codes when they did not. Fixing this misunderstanding would increase the reimbursement amount (which they said would reduce our $11,080 bill by $1,500 or to $9,500).

This critical look at the billing codes by Dr. ABC's office happened, finally, almost a year after the accident. Despite our calls/emails/visits/complaints no one made a point to try to assist us. Their response over time was to refer us to their billing department and try to put us on a payment plan. A few months later, Dr. ABC's office received the denial of their appeal from The Office of Group Benefits/Blue Cross dated the very day that the Statute of Limitations had run on our claim, 7/11/2013.

At that point, they called and again tried to put us on payment plan. The futile and emotionally draining breakdown in the system had run its course. Under extreme duress, my response was that I would not pay, and asked them to refer our bill to a collection agency, as I had heard collection agencies would at least negotiate the fee amount. Rich’s later communications with Dr. ABC's office determined that they do not refer bills to a collection agency. They have their own.

Where are we now?:

As I said, we are now on a payment plan that will take us over 9 years to payoff. The payment booklet is hidden from me somewhere in the house. Without any other recourse, Rich agreed to their proposed plan and is paying on schedule and on time. I cannot be involved..

During the final phone call my husband had with Dr. ABC's offices, they said that if Blue Cross would have accepted their appeal we would have actually owed more (uh, they were the ones that coded that main code incorrectly, which is why all of the codes were resubmitted). I wrote them an email explaining that we wanted to know the amount Blue Cross would have paid if they had agreed to the code changes that would have corrected the bundled payment misunderstanding. I flatly said that the other coding mistake was their fault and should not be calculated in the amount we owed.

I did not expect a reply. I did not get one.*

Dr. ABC might be a great surgeon but there is something missing if he does not demand that his employees show compassion and assistance toward his patients. In the end, money trumped humanity. All three members/pillars of the system failed miserably.

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*Well, I guess I did receive a reply from Dr. ABC's office:

Our most recent bill now says that the amount we owe is $10,180, rather than the $9,580 reduced amount, even though in 8/5 and 10/23 emails Dr. ABC's office said they would decrease the amount of their bill, and not increase the amount due to their error (which I pointed out). This pretty much exemplifies how we have been treated by James’ surgeon’s office. At some point I will call and question/argue with them about this. It will be in the new year-- the on-going effort and affront/assault by his office is exhausting. Merry Christmas.

The Phone Call in the Middle of the Night

Our son's car after a head-on collision 

I am not awakened when the telephone rings at 11:30 on a Saturday night. My husband is and is filled with dread, like he is always filled with dread when the phone rings at that hour. But, he knows that as soon he hears what the caller has to say that everything will be okay. It's always okay. But, this time, everything is not okay. He wakes me gently and in the softest voice says, "Get dressed. James has been in a car accident." That is the only part of the conversation Rich can remember -- "a car accident"-- even though I ask him about it over and over again because I think there must have been even one more word that will tell me my son is safe. He can't remember.

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I tell myself stories on the drive to the hospital about various accident scenarios that could have happened that might be somewhat serious, but not all that serious. I tell myself he had a safe car. It had airbags. It was older, but well maintained. It had good tires. Didn't we just replace the tires? This was an early Saturday night for him so what's the worst thing he could have been doing? He did not drink and drive. Did he? He almost never drove on the freeways. Did he? So, what's the fastest he could have been driving on a side street in this rain-- thirty or forty miles an hour? Is that right? And I pray in that very quiet car, in between the conversation that I'm having with myself in my head, and the questions I ask my husband out-loud about the phone call. But, then we hit the main street just outside of our subdivision that will take us directly to the hospital. It has been under construction for months, but open. Now it's barricaded. Ambulances, police cars and flashing lights are everywhere. And I know. Rich turns the car around. I don't remember the rest of the drive to the hospital.

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Rich drops me off to park the car. I hurry into the Emergency Room entrance and am met at the door by a nun, a couple of nurses and an ER doctor. This frightens me. They shepherd me into a cold waiting room with green walls, blinding florescent lights, vinyl tile floors, and molded-plastic chairs and I say to myself, it's like this because people vomit in here.They say something I don't remember. I sit down opposite the door and am left to wait with the nun, who repeatedly asks me if I'm okay. I say, "I don't know." I notice that she does not touch me. I realize I feel like I'm made of sand, no steel, and think, "that's why she doesn't touch me, she thinks I will fall apart or hurt her." Rich finds me. I tell him I'm waiting on the trauma physician. Our eldest son and his fiance arrive, and Daniel asks, "He'll be okay? Won't he, Mom?" I am the mother and my role is to say that everything will be okay. This time I say, "I don't know." I realize I haven't moved in my chair. I wonder if I've spoken any of the words out loud that I think I have. I close my eyes and pray.

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A police officer appears and seats himself opposite me, and says that our son, heading south bound, and the first of two vehicles traveling north bound, collided, which caused James' car to recoil to the right. When he tried to steer back onto the road, he over-corrected directly into the path of the second north bound car. I think to myself, "He was just going home." The officer tells me it took him an hour to cut James from his car. I remember Rich saying, "Jaws of Life." I think to myself, "So this happened at 10:30 at night?"And I wonder why I didn't know that this was taking place less than a mile from our house? Aren't mothers supposed to sense when something happens to their children? I didn't even have a twinge. I feel crushing guilt. Then I realize that I don't know if I could have lived through the hour it took to free him from his car and I thank God for not knowing. Then I feel ashamed for not wanting to be with my son. There is some talk about the condition of the road: a curve, the road construction, a transition from gravel and blacktop to cement. It is unclear who crossed the line. There was no sign of intoxication. James may have been speeding. I look up and lock eyes with the officer, and he says, "But, that could have been just a matter of perception." I nod. The other two drivers walked away. There were no witnesses. There was no time to break; therefore, no skid marks. The crash will not be investigated. I thank the officer for cutting my son from his car and for not placing blame on him. Whatever the outcome, I don't want James to have to live with the blame.

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The trauma doctor comes in and methodically runs down a long list of possible injuries including brain, neck, and eye damage resulting from the profound impact to the left side of my son's face; his beautiful face. The doctor stops mid-list to look at me because he realizes he has forgotten to tell me that my son is not dying. The only thing I truly understand is that the bones in his face have been shattered. He has swallowed and inhaled a great deal of blood. They are inserting a ventilator to breathe for him, and a tube to drain the blood from his stomach. They will place him in an induced coma. We won't know more until tomorrow after a head-to-toe scan when the specialists are called into assess his condition. They ask us if we want to see him but warn us that we probably do not. Rich does; and emerges from the ER and folds in on himself, sobbing. I feel guilty for not going into console my son.

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Go home and sleep, they say, there is nothing you can do.

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I do go home and take a Valium, which allows me to sleep for a couple of hours. Then I wake. I wonder where I am, what happened and why I feel like someone died. Then I remember. I rise very early and go to see my son in the Surgical ICU.

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This was followed by weeks in the hospital with family and friends, praying with and talking to James while he was in a coma; comforting him when he woke-up sobbing because he thought he was dead; watching him thrash in restraints, while being weaned from the ventilator; trying to console him because his eyes were swollen shut and leaking bloody spinal fluid; preparing him for major surgery to reconstruct his face just five days after the accident; suffering with him while he dealt with the pain after the surgery, which, according to the trauma doctor, "is like the accident all over again," but without the benefit of the coma or the medications they could have administered to him while in it.

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James was very lucky. He suffered no optic nerve or neurological damage. His blood levels returned to normal as his spleen healed. The hole between his nasal passage and brain repaired itself after the 6 hour surgery by a team of 3 maxillofacial surgeons to drop what was left of his nose back in place and reconstruct it, his cheek, and the bones that support his eye socket. All told, the surgery included 2 cranial bone grafts, 10 plates and 60 screws.

The lead surgeon called-in specifically to operate on James' unique set of facial injuries was trained at our "charity hospital system," which is considered to have the best emergency medical training in the country. He told us that he had seen and repaired the most egregious of facial traumas, including those in the days before airbags, and many due to bullet wounds. However, James' injuries were worse. Every time he picked up a bone, there was another broken one to take its place.

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Our "charity hospital system," which has served the poorest of the poor for the last 200 years regardless of ability to pay, is in the process of being dismantled in favor of public-private partnerships. Earl K. Long, our Baton Rouge facility will be shut for good in 2013. Charity in New Orleans, the largest hospital in the system, was destroyed by Katrina and hasn't yet been rebuilt. This year, in the face of staggering Medicaid cuts, it was proposed that an additional 6 hospitals be downsized to 10-bed "shells" and another in Lake Charles that served 78,000 people last year, closed. In 2005, this 10-hospital safety-net served a total of 650,000 individual patients, which is approximately equal to the number of uninsured Louisianians, according to the 2010 Census. Where will people without health insurance get their treatment in the future? Considering that our state has officially decided to opt out of the Medicaid Expansion portion of the Affordable Care Act, I would imagine that our poor (we have the sixth and second highest poverty rate for adults and children in the US, respectively) will seek their care in emergency rooms.

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Otherwise they will go without. They're used to going without.

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James is home now, with boots on two multiply fractured feet, a swollen, asymmetrical face, and a weepy, decidedly smaller, misaligned eye. He'll need more surgeries but they can't start for another 6 to 9 months or until the swelling fully subsides. He has tried to reconstruct the day of the accident but can't remember a thing after two in the afternoon. He was on his way home from visiting his girlfriend-- a waitress at a pizza place. The receipt she retrieved shows he had a pizza and a beer. Photographs reveal an obviously totaled vehicle, with a front-end demolished to the extent that just a sliver of a space remained on the driver's side. We wonder how he fit into it. The engine dropped just like it was designed to do so that it did not crush his legs. All front and side airbags deployed. There was blood, but less than you would think. We don't know why his facial injuries were so severe. We don't know who or exactly what factors caused the accident. The accounts of the other two drivers, traveling together, differ, and James hasn't given a statement because he can't. The police and the car insurance companies have closed their investigations.

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James is trying to accept that he will probably never know what happened.

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We struggled; especially in those early weeks to support him while he grieved over his injuries and the loss of his looks. I enlisted the help of a therapist, because my parenting skills seemed at-best inadequate and at-most inconsistent. I am trying to squelch the anger in my voice, stop looking for instant solutions, and stop saying, "You were so lucky." James has decided to defer his scholarship and sit out fall semester. He retained his room in the rental house he shares with friends, although he has yet to move back in. He doesn't want to go out or socialize. Most of his time is spent in on-line gaming or watching television. He goes to bed late and wakes up late. He says he wants to take an on-line course. I try not to ask if he's registered. His recovery will be at his own pace, not mine.

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We are taking a semester and sometimes a day at a time.

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About six weeks after the accident, I was driving to work when I abruptly veered off to the side of the road and turned off the car. It took me a few minutes to steady my breathing and pry my hands from the steering wheel. It struck me that I had forgotten to make sure that James was still covered under our health insurance policy. He is 21 and I knew that adult children are only covered on their parents' policies until the age of 23 as long as they are enrolled in college full-time. It was too late to revisit the decision about James returning to school. Even if we could enroll him, he just wasn't ready. I had visions of us forcing him to take classes and then trying to make him study for them so that he wouldn't lose his scholarship. How else could we possibly pay for these bills we keep receiving for tens of thousands of dollars, and which, so far, have been paid in-full by our health insurance company? We couldn't buy him an individual policy because his injuries resulting from the accident would be considered pre-existing conditions. No insurance company would have him. Stories about families who had to file for bankruptcy after events like these flooded my mind. I tallied up what we could retain and what the court would take from us. I had just started a new job after being laid off from a healthcare company last year. We were still digging ourselves out of debt. Then I remembered that I did not have to worry about any of that because of the Affordable Care Act (ACA). Adult children up to the age of 26 were now covered under their parents' health insurance policies, period, no filing of school registration materials, no more bureaucracy; I had forgotten that I hadn't had to file school registration materials with our insurer for the last two years. It's almost unbelievable to me that a very short time ago, the ACA had almost been repealed.

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To be honest, when I first heard about the ACA's coverage of adult children, I didn't think much about it; in fact, I thought it was insignificant, sort of a public relations carrot to dangle in front of the masses to appease them while they waited for the substantial provisions to go into effect in 2014. We were professionals with advanced degrees, had always worked, and had always had health insurance. Our eldest son, the one who does have preexisting conditions found work after his MBA and has health insurance. James wouldn't have any problems because there was no doubt that he would be in school and therefore would be covered under our policy; and if he wasn't in school and even if he wasn't employed, we would just buy him an individual policy (I hear they're supposed to be cheap for people his age and that, "the market" takes care of that). He was perfectly healthy -- the one child's insureability I did not have to worry about.

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We are about ready to go to one of James' many doctors' appointments; and despite all that has happened, I feel grateful, or maybe "lucky" is a better word. We were just lucky that James' accident occurred during a period of time when this little piece of the Affordable Care Act was in effect. Due to a complex set of factors, including the timing and outcome of a Supreme Court opinion, we could easily have been on the losing end of this situation. Lucky. So lucky.

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We need to make sure that everyone is just as "lucky."

Let's support our hard won healthcare legislation. Let's help our president to help others to be as "lucky" as we have been.

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When I'm Unemployed

I haven't written a post in a very long time, probably because of the confusion cluster associated with (my former) work and my slow slide and then abrupt drop into the cesspool of unemployment being laid off which technically began in early December December 5th to be exact (yes, Happy Birthday and Merry Christmas to me). I'm handling this a lot better than I thought I would I'm not nearly as bitter as I normally would be, considering that I do not do well am usually immobilized when I am not employed (and lookie here, I'm writing and not even hate mail to former colleagues). However, I'm finally old enough "ancient enough," something not lost on my former employer when they decided to send me a waiver of an age discrimination claim to sign in order to receive the pittance they call my severance payment to figure out how to stave off any negative emotional consequences that black hole of depression, which means that, I have remedied that pain in my ass pain-in-my-psyche by a pain-in-my-(literal)-neck-and arms, which I'm thinking about using to file a workman's compensation claim so that I can really stick it to my former employer I prefer, by the way.

Due to expert advice from busybodies Facebook friends and coaches of all sorts, looking-for-the-good in the not-so-good has become a mask I put on every freaking morning part of my new life.  And because I like to catalog things, I've created a list of the truly horrible consequences benefits that come from being unemployed useless. So, here is the beginning of what might become a very long list of stuff, depending on the length of my leisuredom my positive take on the five benefits of being unemployed. So far it:

1. Allows me the flexibility to work at any time of the day or night that pleases me sleep in, not shower, and work in my pajamas all day until my husband begs me to wash myself if I want him to sleep in the marital bed;

2.  Gives me the freedom to go out for lunch at a nice restaurant at whatever time I would like and for as long as I would like (wait, I don't have the money to eat out anymore so I chew on Kraft cheese food, something that could remind you of Brie if you hold your nose) and with whom I would like (let's face it, there's noone to eat with because everyone else has a valuable career they're chasing and my former co-workers can't stand me);

3. Allows me to spend quality time with (gripe at) my husband, children and mother (if you can't kick your family when you're down, who can you kick?). 

4. Gives me the satisfaction of hearing from numerous recruiters and potential employers about what a wonderful career I've had and how much money they would like to pay me if only I would consider their offers (who am I kidding, all I receive are rejection letters, and sometime email notices telling me that I've already applied for a certain job 3 times).

5. Having the satisfaction of spreading the benefit of my experience to not-for-profits doing volunteer work (screw that, I couldn't be elected to my neighborhood board, even though there was a dearth of applicants).

So, here you are, proof that tough experiences produce profound growth incredible suffering and  the space to give back a waste of talent.

Check back later for more tidbits from this incredible learning experience. I would bet that they never stop coming.

What is your Dream-Life?

After looking at pictures of a friend's life in Africa and pictures of what seemed like a daily safari, a question crept up on me and it hasn't let me go. The question was: What would your perfect life be, Denese, if you had it to fashion all over again? I know that I am a 53 year old captive, by my own design by the way, of my family life here in Louisiana; but still, it's a question I have to ask as I go forward on this journey, which might last another 30 or more years.

Here are a few of the things that come to mind:

1. I need to live on or within steps of the water, preferably the Ocean or Gulf, but rivers and lakes will do;
2. Give me a walking/biking and skating path outside my door to trip about on in the early morning after I wake;
3. Let me walk or if I have to drive, give me an ultra short drive to my dry cleaners, favorite coffee shop, restaurant, library and bookstore;
4. I need to live within walking or mass transportation distance from cultural activities, like the theater, opera and art museums; Please save me from suburbia and/or commutes and the strip malls and concrete avenues that come with them: they depress me;
5. Let me gather with like-minded individuals who understand there is a need to focus on things that count (e.g., fair treatment and rights of human beings, poverty, racism, adequate nutrition, happiness) and not things that don't (like issues that are manufactured by isms, including but not limited to anti-gay marriage);
6. Bless me with meaningful work paid to a degree that I can support myself in the present and in retirement, with a little left over to help my kids/grandkids/friends. Even when I'm old, give me the opportunity to contribute and be rewarded for what I give;
7. And let me live in a place where "community" is possible. To know the bonds of friendship, conversation, shared food and drink over a long span of time is priceless. No matter the amenities of the physical space where I live, that's something I don't want to give up (again).

Please help me to find such a place not only in Oregon in the summer, but in Louisiana for the other 9 months out of the year. I've waited an awfully long time (18 years) to realize these dreams that are central to who I am. I've put in my time for everyone else and I think I'm due.

This is still my country & I'm fighting for & celebrating it

For the last 10 years or so I feel like I've been fighting a battle to reclaim the heart and soul of my country (one person at a time). In this effort I spend an inordinate amount of time:

• arguing with bloggers who think that the individual mandate in health insurance reform is unconstitutional. 
• wrangling with co-workers who think that we should be able to do whatever we wish, even if that means shirking our responsibility to shoulder our own weight (and sometimes a little bit extra if we can) in the social contract we call our society.
• debating with folks who claim that they don't owe their neighbors anything.
• and tangling with those who think that the middle class should support public goods and services but exempt corporations and the rich from those same responsibilities.

I'm tired of lecturing people who don't have compassion for their fellow human beings. A lot of good it does. But, you already knew that.

No argument I can drum up, no matter how persuasive, is going to convince my increasingly Libertarian-minded friends and family that they should do anything for anyone else unless they choose to do so at any specific period in time. This apparently leaves out supporting legislation for assistance of any kind because someone else might not want to give in the same way or in the same amount that I do. My question is, "When will your act of benevolence occur, when you're passing the plate during Christmas services?"

This brings me to what has become my biggest fight of all-- maintaining my Christian orientation. Many of the people who thrum the drumbeat of Individual Freedom, State's Rights and Anti-Federalism are Christians. I am one of the few people I know who still labels herself a Christian. Most of my compassionate friends have abandoned Christianity because of that community's move towards conservatism, individualism, anti-multiculturalism, anti-minority, anti-poor and anti-anyone or anything that is not successful. Since when were vulnerabilities considered weaknesses-- or an abandonment by God?

Buddhism is much more appealing to people who think like me, because of the philosophy's concept of Oneness. I was brought up with this concept in my Christian home, but honestly, I am hard pressed to find it articulated in mainstream Christian circles today. I think this is because you can't market it very well with the self-obsessed.

So, what am I to do? I could get "with the program." Honestly-- I get the idea of reaping rewards for belonging to the right (religious/ethnic) group. It's an easy spirit to groove to: tantalizingly simple and self-affirming. It's great being right and therefore chosen and living a life of abundance without guilt. I've had a lot of success in my life so it's easy to correlate the two (success and Christianity, that is).

The truth is that my conscience won't let me do this, which is unfortunate because it would sure be a lot easier if it would. You see, I *know* that in large part I've gotten to where I am because of  our family resources, the color of our skin, and the hearts of my parents and in-laws who have lifted us up with consistent emotional and financial support over so many years. I can't imagine not having a family to bail us out of too many doctor bills or tuition payments (for grad or preschool). I don't know what we would have done as a young family without my parents buying us a mattress, bringing us a chicken, or buying me a dress for graduation.

I know everyone doesn't have the support I do.

So helping others with health insurance, which I consider a necessity-- no, more than that, a fundamental right-- is one of the easier decisions I've made. Plus, I can live with myself. I sleep at night.

So, Happy Independence Day from a Patriot who will keep on fighting.