Tag: 2017

Keep Calm and Carry On

Today, we know that poster as a, well, poster, of quintessential Britishness. It is simply another of our twenty-first century truisms, not unlike checking oneself before wrecking oneself. Yet this phrase has a far darker history.

In 1940, war hysteria in the British Isles was at its zenith. To the surprise of everyone, Nazi forces had overcome the Maginot line and steamrolled into Paris. British expeditionary forces at Dunkirk had faced large casualties, and been forced to abandon most of their equipment during the hastily organized evacuation. In Great Britain itself, the Home Guard had been activated, and overeager ministers began arming them with pikes and other medieval weapons [10]. For many, a German invasion of the home isles was deemed imminent.

Impelled by public fear and worried politicians, the British government began drawing up its contingency plans for its last stand on the British Isles. Few military strategists honestly believed that the German invasion would materialize. Allied intelligence made it clear that the Germans did not possess an invasion fleet, nor the necessary manpower, support aircraft, and logistical capacity to sustain more than a few minor probing raids [5]. Then again, few had expected France to fall so quickly. And given the Nazi’s track record so far, no one was willing to take chances [3].

Signposts were removed across the country to confuse invading forces. Evacuation plans for key government officials and the royal family were drawn up. Potential landing sites for a seaborne invasion were identified, and marked for saturation with every chemical weapon in the British stockpile. So far the threat of mutually assured destruction has prevented the large scale use of chemical weapons as seen in WWI. However, if an invasion of the homelands had begun, all bets would be off. Anti-invasion plans call for the massive use of chemical weapons against invading forces, and both chemical and biological weapons against German cities, intended to depopulate and render much of Europe uninhabitable [4][7][8].

Strategists studying prior German attacks, in particular the combined arms shock tactics which allowed Nazi forces to overcome superior numbers and fortifications, become convinced that the successful defence of the realm is dependent on avoiding confusion and stampedes of refugees from the civilian population, as seen in France and the Low Countries. To this end, the Ministry of Information is tasked with suppressing panic and ensuring that civilians are compliant with government and military instructions. Official pamphlets reiterate that citizens must not evacuate unless and until instructed to do so.

IF THE GERMANS COME […] YOU MUST REMAIN WHERE YOU ARE. THE ORDER IS “STAY PUT”. […] BE READY TO HELP THE MILITARY IN ANY WAY. […] THINK BEFORE YOU ACT. BUT THINK ALWAYS OF YOUR COUNTRY BEFORE YOU THINK OF YOURSELF. [9]

Yet some remained worried that this message would get lost in the confusion on invasion day. People would be scared, and perhaps need to be reminded. “[T]he British public were suspicious of lofty sentiment and reasoned argument. […] Of necessity, the wording and design had to be simple, for prompt reproduction and quick absorption.”[1]. So plans were made to make sure that the message is unmistakable and omnipresent. Instead of a long, logical pamphlet, a simple, clear message in a visually distinctive manner. The message, a mere five words, captures the entire spirit of the British home front in a single poster.

KEEP CALM AND CARRY ON

The poster was never widely distributed during World War II. The Luftwaffe, believing that it was not making enough progress towards the total air supremacy that was deemed as crucial for any serious invasion, switched its strategy from targeting RAF assets, to terror bombing campaigns against British cities. Luckily for the British, who by their own assessment were two or three weeks of losses away from ceding air superiority [5], this strategy, though it inflicted more civilian casualties, eased pressure on the RAF and military infrastructure enough to recover. Moreover, as the British people began to adapt to “the Blitz”, allied resolve strengthened rather than shattered.

German invasion never materialized. And as air raids became more a fact of life, and hence less terrifying and disorienting to civilians, the need for a propaganda offensive to quell panic and confusion subsided. As the RAF recovered, and particularly as German offensive forces began to shift to the new Soviet front, fears of a British collapse subsided. Most of the prepared “Keep Calm” posters were gradually recycled as part of the paper shortage.

With perfect historical retrospect, it is easy to recognize the fact that a large scale German invasion and occupation of the British Isles would have been exceedingly unlikely, and victory against an entrenched and organized British resistance would have been nigh impossible. The British government was on point when it stated that the key to victory against an invasion was level-headedness. Given popular reaction to the rediscovered copies of the “Keep Calm” design, it also seems that they were on the mark there.

The poster and the phrase it immortalized have long since become decoupled from its historical context. Yet not, interestingly, the essence it sought to convey. It is telling that many of the new appropriations of the phrase, as seen by a targeted image search, have to do with zombies, or other staples of the post-apocalyptic genre. In its original design, the poster adorns places where anxiety is commonplace, such as workplaces and dorm rooms, and has become go-to advice for those under stressful situations.

This last week in particular has been something of a roller coaster for me. I feel characteristically anxious about the future, and yet at the same time lack sufficient information to make a workable action plan to see me through these troubling times. At a doctor’s appointment, I was asked what my plan was for the near future. With no other option, I picked a response which has served both myself and my forebears well during dark hours: Keep Calm and Carry On.

Works Consulted

1) “Undergraduate Dissertation – WWII Poster Designs, 1997.” Drbexl.co.uk. N.p., 23 Jan. 2016. Web. 11 May 2017. <http://drbexl.co.uk/1997/07/11/undergraduate-dissertation-1997/>.

2) “Dunkirk rescue is over – Churchill defiant.” BBC News. British Broadcasting Corporation, 04 June 1940. Web. 11 May 2017. <http://news.bbc.co.uk/onthisday/hi/dates/stories/june/4/newsid_3500000/3500865.stm>.

3) Inman, Richard. “Fighting for Britain.” Wolverhampton History – Wolverhampton History. Wolverhampton City Council, 13 Dec. 2005. Web. 11 May 2017. <http://www.wolverhamptonhistory.org.uk/people/at_war/ww2/fighting3>.

4) Bellamy, Christopher. “Sixty secret mustard gas sites uncovered.” The Independent. Independent Digital News and Media, 03 June 1996. Web. 11 May 2017. <http://www.independent.co.uk/news/sixty-secret-mustard-gas-sites-uncovered-1335343.html>.

5) “Invasion Imminent.” Invasion Imminent – Suffolk Anti-invasion defences. N.p., n.d. Web. 11 May 2017. <http://pillboxes-suffolk.webeden.co.uk/invasion-imminent/4553642028>.

6) “Large bomb found at ex-Navy base.” BBC News. British Broadcasting Corporation, 22 Apr. 2006. Web. 11 May 2017. <http://news.bbc.co.uk/2/hi/uk_news/england/hampshire/4934102.stm>.

7) Ministry of Information. CIVIL DEFENCE – BRITAIN’S WARTIME DEFENCES, 1940. Digital image. Imperial War Museums. n.d. Web. 11 May 2017. <http://www.iwm.org.uk/collections/item/object/205019014>.

8) “Living with anthrax island.” BBC News. British Broadcasting Corporation, 08 Nov. 2001. Web. 11 May 2017. <http://news.bbc.co.uk/2/hi/uk_news/1643031.stm>.

9) Ministry of Information. If the Invader Comes. 1940. Print.

10) RAMSEY, SYED. TOOLS OF WAR;HISTORY OF WEAPONS IN MEDIEVAL TIMES. N.p.: ALPHA EDITIONS., n.d. Print.

Kindred Spirits

This weekend I spent my time volunteering with a charity which represents people who suffer from one of the many chronic diseases and disabilities at a local barbecue cooking competition. This came about because one of the competitors’ daughters was recently diagnosed with the same disease as I, and so wanted to invite someone to advocate and educate. What’s interesting is that his daughter is approximately the same age that I was when I was first diagnosed.

Being diagnosed at that particular age, while not unheard of, is nevertheless uncommon enough that it gave me momentary pause, and in preparing to meet her my mind this week has been on what I ought to tell her, and moreover, what I wish I could tell a younger version of myself when I was diagnosed. She was, as it turned out, not greatly interested in discussing health with me, which I suppose is fair enough. Even so, I have been thinking about this topic enough that it has more or less solidified into the following post:

I could tell you it gets easier, except I would be lying. It doesn’t get easier. People might tell you that it gets easier to manage, which is sort of true inasmuch as practice and experience make the day to day stuff less immediately challenging, same with anything. And of course, technology makes things better and easier. Not to be the old man yelling at the whippersnappers about how good they have it nowadays, but it is true that in the ten years I’ve had to deal with it, things have gotten both better and easier.

The important thing here is that over the course of years, the actual difficulty level doesn’t really change. This is depressing and frustrating, but it’s also not that bad in the big scheme of things. There are a lot of chronic diseases where things only get worse with time, and that’s not really the case with our disease. We have the sword of Damocles hanging over our heads threatening us if we mess up, but if we stay vigilant, and get nothing wrong, we can postpone that confrontation basically forever.

It means that you can get to a point where you can still do most things that ordinary people can do. It’s more difficult, and you’re never not going to have to be paying attention to your health in the background. That’s never going to change. You’re going to be starting from an unfair disadvantage, and you’re going to have to work harder to catch up. Along the way you will inevitably fail (it’s nothing personal; just a matter of odds), and your failure will be all the more spectacular and set you further back than what’s considered normal. It’s not fair. But you can still do it, despite the setbacks. In fact, for most of the important things in life, it’s not really optional.

Whatever caused this, whatever you think of it, whatever happens next, as of now, you are different. You are special. That’s neither a compliment, nor an insult. That’s a biological, medically-verified, legally-recognized fact. People around you will inevitably try to deny this, telling you that your needs aren’t any different from those around you, or that you shouldn’t act or feel or be different. Some of these people will mean well but be misguided; others will be looking for a way to hurt or distract you.

If you’re like me, and most people, at some point, you too will probably try to tell yourself this. It is, I have been told, an essential part of adolescence. Futile though it may be to say this then, and believe me when I say this that I mean it in the nicest way possible, that I must declare: whoever these sentiments come from, whatever their intentions, they are straight up wrong. You are different and special. You can choose how to react to that, and you can choose how to portray this, but you cannot change the basic fact. That you are different is not any reflection on you or anything you have done, and accepting this is not any sort of concession or confession; on the contrary, it reflects maturity and understanding.

It follows that your experience and your path may not be the “normal” one. This is neither good nor bad, but simply reflects the special circumstances which exist as a matter of fact. The fact that everything is that much harder may mean that you have to pick and choose your battles, or get extra help on some things, even if those things seem normal and easy for other people. This is to be expected, and is nothing to hide or be ashamed of. People around you may not understand this, and may give you a hard time. Just remember, as I was told when I was in your shoes: The people who matter don’t mind, and the people who mind don’t matter.

Angry in May

I am angry today. I don’t like feeling generally angry, because it’s usually quite draining without being actually fulfilling. Yet I feel rather compelled to be angry. I know several people who feel near or on the brink of desperation because of recent events regarding healthcare in particular and politics in general. I want to help, but there seems to be increasingly little I can do. I myself am somewhat worried about the future. In the wake of all of this I feel that I have the choice between being paralyzed by fear or being motivated by anger. The latter seems like an obvious choice.

The beginning of May is a time of a number of small holidays. April 30th marks the real end of the end of World War II, with the suicides of Hitler and company in Berlin and the transfer of governmental power to Reichpräsident (formerly admiral) Karl Dönitz, who would authorize the unconditional surrender of Nazi Germany on May 7th, known as VE Day in the west, and celebrated as Victory Day in the now-former soviet bloc on May 8th, due to the time difference between London and Moscow (and a few mishaps regarding paperwork and general distrust of the Soviets). Depending on where you live, this is either interesting trivia, or a very big deal.

Victory Day in Russia is one of the really big political occasions and is celebrated with an accordingly large show of military force. These parades are a chance for Russia to show off all the fancy toys that it will use to annihilate any future such invaders, for ordinary people to honor those they lost during the war, for old people and leftists to pine nostalgically for the halcyon days when the Soviet Union was strong and whippersnappers knew their place, and for western intelligence organizations to update their assessments on Russian military hardware. This last one has caused problems in the past, as miscounts to the number of bombers and missile launchers (the soviets were cycling them to up their numbers) led to the impression that a bomber and later missile gap existed between the Soviets and the US for most of the Cold War.

Speaking of bombastic parades, the First of May is either known as an occasion for maypole dancing, or for massive demonstrations with masses of red flags. Prior to the 1800s, May Day was something of a spring festival, likely originally associated with the Roman festival for the goddess of flowers, Flora, which took place on the first official day of summer. As Roman paganism fell out of fashion, the festival became a more secular celebration of springtime.

In 1904, the Sixth Conference of the Second Internationale declared that the first of May would be a day of protest for labor organizations to demonstrate, in memory of the May 4th, 1886 Haymarket Affair in Chicago. Subsequently, May Day became something of a major event for labor and workers’ rights groups. This was solidified after the formation of the Soviet Union (they seem to be a recurring element here), which, as a self-styled “workers’ state”, made May Day celebrations a big deal within its borders, and used the occasion to further sympathetic causes abroad.

This caused something of a feedback look, as governments taken in by anti-communist hysteria sought to either suppress (and thus, in many ways, legitimize) May Day demonstrations, or to control such demonstrations by making them official. Thus, in many countries, 1st May is celebrated as Labour Day (generally with the ‘u’). In 1955, Pope Pius XII declared May Day to be a feast day for Saint Joseph the Worker, in counter-celebration to labor celebrations.

May the Fourth, is, of course, celebrated as Star Wars Day, for obvious reasons. Historically it has been the day that I dress up in full character costume for school. Unfortunately, this year I was too sick to actually attend school, in costume or not. I was also recently informed that in Ohio in particular, 4th May is recognized primarily as the anniversary of the Kent State Massacre during the Vietnam War. To quote the friend who explained it to me:

So today is May 4th, affectionally known by most as Star Wars Day. That is what it used to be for me until I went to Kent State. Now May 4th is a day of remembrance. Because today in 1970, the National Guard opened fire on a group of students peacefully protesting the Vietnam War and killed 4. It has become a day for the entire campus to go silent, to walk the memorial, to relect on how important it is to speak up about what you believe is wrong. Politics is not always elections. Sometimes it is holding a candle at a memorial of people killed by the government. Sometimes it is remembering and refusing to forget. Either way, it is action. That is one of the most important lessons I have learned at Kent State.

The opening days of May have for some time now been a time of year when I typically pause and reflect. Having several small holidays- that is, holidays well known enough that I am reminded of their passing, without necessarily needing to go out of my way to prepare in advance -have helped add to this. Early May is typically long enough after cold and flu season that even if I’m not back in the thick of things, I’m usually on my feet. It’s also after midterms and standardized testing, while not being yet close enough to final exams that I can feel the weight of all my unfinished work bearing down on me in full force. Early May is a lull when I can get my bearings before hunkering down for the last act of the school year and hit the ground running for summer.

So, where am I? How am I doing? How am I going to come back into school roaring?

I don’t know the answer to any of these questions. There are too many things up in the air in my life, both at the micro and macro level. I feel uncertain and a little scared. And I feel angry.

Inasmuch as I have any real self confidence and self worth, I pride myself on my intelligence. I like that I can recall off the top of my head several different holiday occasions in the space of a fortnight, and succinctly explain their historical and cultural context. I enjoy being a know-it-all. I loath the unknown, and I detest the substitution of hard facts for squishy feelings. I consider these principles integral to my identity and personal value, and find it difficult and troubling to envision any future where I do not possess these traits, or where these merits are not accepted.

The Antibiotic Apocalypse and You

Following up on the theme established inadvertently last week: I’m still sick, though on the whole, I’m probably not feeling worse, and possibly arguably marginally better. In an effort to avoid the creativity-shattering spiral that happens when I stop writing altogether, this week I will endeavor to present some thoughts on a subject which I have been compelled to be thinking about anyway: Antibiotics.

A lot of concerns have been raised, rightfully, over the appearance of drug-resistant pathogens, with some going so far as to dub the growing appearances of resistant bacteria “the antibiotic apocalypse”. While antibiotic resistance isn’t a new problem per se, the newfound resistance to our more powerful “tiebreaker” drugs is certainly a cause for concern.

In press releases from groups such as the World Health Organization and the Centers for Disease Control and Prevention, much of the advice, while sound, has been concentrated on government organizations and healthcare providers. And while these people certainly have more responsibility and ability to react, this does not mean that ordinary concerned citizens cannot make a difference. Seeing as I am a person who relies on antibiotics a great deal, I figured I’d share some of the top recommendations for individuals to help in the global effort to ward off antibiotic resistance.

Before going further, I am compelled to restate what should be common sense: I don’t have actual medical qualifications, and thus what follows is pretty much a re-hash of what other experts have given as general, nonspecific information. With this in mind, my ramblings are no substitute for actual, tailored medical advice, and shouldn’t be treated as such.

Before you’re put on antibiotics

1) Stay home when you’re sick

This one is going to be repeated, because it bears repeating. Antibiotic resistant strains spread like any other illness, and the single best way to avoid spreading illness it to minimize contact with other people. Whether or not you are currently infected with antibiotic-resistant illness; in fact, whether or not you even have an illness that is treatable by antibiotics; staying at home when you’re sick will help you get better sooner, and is the single most important thing for public health in general.

2) Wash hands, take your vitamins, etcetera.

So obviously the best way to deal with illness is to avoid spreading it in the first place. This means washing your hands frequently (and properly! Sprinkling on some room temperature water like a baptism for your hands isn’t going to kill any germs), preparing food to proper standards, avoiding contact with sick people and the things they come in contact with, eating all of your vegetables, getting your vaccinations, you get the picture. Even if this doesn’t prevent you from getting sick, it will ensure that your immune system is in fighting shape for if you do.

3) Know how antibiotics work, and how resistance spreads

Remember high school biology? This is where all that arcana comes together. Antibiotics aren’t a magical cure-all. They use specific biological and chemical mechanisms to target specific kinds of organisms inside you. Antibiotics don’t work on viruses because they aren’t living organisms, and different kinds of antibiotics work against different diseases because of the biological and chemical distinctions.

Understanding the differences involved when making treatment decisions can be the difference between getting effective treatment and walking away unharmed, and spending time in the hospital to treat a resistant strain. Antibiotic resistance is a literally textbook example of evolution, so understanding how evolution works will help you combat it.

Public understanding of antibiotics and antibiotic resistance is such a critical part of combating resistance that it has been named by the World Health Organization as one of the key challenges in preventing a resistant superbug epidemic.

4) Treat anyone who is on antibiotics as if they were sick

If someone is on antibiotics and still doesn’t feel or seem well (and isn’t at home, for some reason), you’re going to want to take that at face value and keep your distance. You can also kindly suggest that they consider going home and resting. If you become sick after contact with such persons, be sure to mention it to your doctor.

If they’re feeling otherwise fine, you want to treat them as if they were immunocompromised. In other words, think of how you would conduct yourself health-wise around a newborn, or an elderly person. Extra hand-washing, making sure to wipe down surfaces, you get the picture. If they’re on antibiotics preventatively for a chronic immunodeficiency, they will appreciate the gesture. If they’re recovering from an acute illness, taking these extra precautions will help ensure that they don’t transmit pathogens and that their immune system has time to finish the job and recover.

5) Never demand antibiotics

I’ll admit, I’m slightly guilty of this one myself. I deal with a lot of doctors, and sometimes when I call in for a sick-day consult, I get paired with a GP who isn’t quite as experienced with my specific medical history, who may not have had time to go through my whole file, and who hasn’t been in close contact with my other dozen specialist doctors. Maybe they don’t recognize which of my symptoms are telltale signs for one diagnosis or another, or how my immunology team has a policy of escalating straight to a fourteen day course, or whatever.

I sympathize with the feeling of just wanting to get the doctor to write the stupid prescription like last time so one can get back to the important business of wasting away in bed. However, this is a problem. Not everyone is as familiar with how antibiotics work and with the intricacies of prescribing them, and so too often when patients ask for antibiotics, it ends up being the wrong call. This problem is amplified in countries such as the United States where economics and healthcare policies make it more difficult for doctors to refuse. This is also a major issue with prescription painkillers in the United States. So, listen to your doctor, and if they tell that you don’t need antibiotics, don’t pressure them.

Bear in mind that if a doctor says you don’t need antibiotics, it probably means that antibiotics won’t help or make you feel any better by taking them either, and could cause serious harm. For reference, approximately one in five of all hospital visits for drug side effects and overdoses are related to antibiotics.

It should go without saying that you should only get antibiotics (or any medication, really) via a prescription from your doctor, but apparently this is a serious enough problem that both the World Health Organization and the Centers for Disease Control and Prevention feel the need to mention this on their patient websites. So, yeah. Only take the drugs your doctor tells you to. Never take antibiotics left over from previous treatment, or from friends. If you have antibiotics left over from previous treatment, find your local government’s instructions for proper disposal.

If you are prescribed antibiotics

1) Take your medication on schedule, preferably with meals

Obviously, specific dosing instructions overrule this, but generally speaking, antibiotics are given a certain number of times per day, spaced a certain number of hours apart, and on a full stomach. Aside from helping to ensure that you will remember to take all of your medication, keeping to a schedule that coincides with mealtimes will help space dosages out and ensure that the antibiotics are working at maximum efficiency.

Skipping doses, or taking doses improperly vastly increases both the likelihood of developing resistant pathogens, and the risk of side effects.

2) Take probiotics between dosages

Antibiotics are fairly indiscriminate in their killing of anything it perceives as foreign. Although this makes them more effective against pathogens, it can also be devastating to the “helpful bacteria” that line your digestive tract. To this end, most gastroenterologists recommend taking a probiotic in between dosages of antibiotic. Aside from helping your body keep up it’s regular processes and repair collateral damage faster, this also occupies space and resources that would otherwise be ripe for the taking by the ones making you sick.

3) Keep taking your antibiotics, even if you feel well again

You can feel perfectly fine even while millions of hostile cells linger in your body. Every hostile cell that survives treatment is resistant, and can go in to start the infection all over again, only this time the antibiotic will be powerless to halt it. Only by taking all of your antibiotics on the schedule prescribed can you ensure that the infection is crushed the first time.

Furthermore, even though you may feel fine, your immune system has been dealt a damaging blow, and needs time to rebuild its forces. Continuing to take your antibiotics will help ensure that your weakened immune system does not let potentially deadly secondary infections slip through and wreak havoc.

4) Stay Home and Rest

Is this message getting through yet?

If you are on antibiotics, it means your body is engaged in a struggle, and it needs all of your resources focused on supporting that fight. Even the most effective antibiotics cannot eliminate every hostile cell. You immune system plays a vital role in hunting down and eliminating the remaining pathogens and preventing these resistant strains from multiplying and taking hold. In the later stages of this fight, you may not even feel sick, as there are too few resistant cells to cause serious damage. However, unless all of them are exterminated, the fight will continue and escalate.

Ideally, you should stay at home and rest for as long as you are taking antibiotics. However, since antibiotics are often given in courses of fourteen and twenty one days, this is impossible for most adults. At a barest minimum, you should stay home until you feel completely better, or until you are halfway done with your course of antibiotics, whichever is longer.

If you do return to your normal routine while taking antibiotics, keep in mind that you are still effectively sick. You should therefore take all of the normal precautions: extra hand washing, wiping down surfaces, extra nutrition and rest, and the like.

5) If you don’t feel better, contact your doctor immediately

Remember: Antibiotics are fairly all or nothing, and once an illness has developed a resistance to a specific treatment, continuing that line of treatment is unlikely to yield positive results and extremely likely to cause increased resistance to future treatment. Obviously, antibiotics, like any course of treatment, take some time to take effect, and won’t make you feel suddenly completely better overnight. However, if you are more than halfway through your treatment course and see no improvement, or feel markedly worse, this could be a sign that you require stronger medication.

This does not mean that you should stop taking your current medication, nor should you take this opportunity to demand stronger medication (both of these are really, colossally bad ideas). However, you should contact your doctor and let them know what’s going on. Your doctor may prescribe stronger antibiotics to replace your current treatment, or they may suggest additional adjunctive therapy to support you current treatment.

Works Consulted

“Antibiotic resistance.” World Health Organization. World Health Organization, n.d. Web. 28 Apr. 2017. <http://www.who.int/mediacentre/factsheets/antibiotic-resistance/en/>.

Freuman, Tamara Duker. “How (and Why) to Take Probiotics When Using Antibiotics.” U.S. News & World Report. U.S. News & World Report, 29 July 2014. Web. 28 Apr. 2017. .

“About Antibiotic Use and Resistance.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Nov. 2016. Web. 28 Apr. 2017. <https://www.cdc.gov/getsmart/community/about/index.html>.

Commissioner, Office Of the. “Consumer Updates – How to Dispose of Unused Medicines.” U S Food and Drug Administration Home Page. Office of the Commissioner, n.d. Web. 28 Apr. 2017. <https://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm>.

NIH-NIAID. “Antimicrobial (Drug) Resistance.” National Institutes of Health. U.S. Department of Health and Human Services, n.d. Web. 28 Apr. 2017. <https://www.niaid.nih.gov/research/antimicrobial-resistance>.

Ode to the Immune System

Context: I’m sick. When I’m sick, I get bored without being able to write properly. Consequently, I tend to write shorter things, like songs. Here’s a about how certain parts of the immune system work. To the tune of “The Red Army is Strongest” AKA “Red Army, Black Baron”, AKA “That song from the Comintern faction in Hearts of Iron IV“. Enjoy.

The deadly virus and the harmful germ
Are gathering a great dark storm
But without regard for the the malady
The immune cells defend the body

So see the macrophage, begin the war to wage
Take its enemies hand to hand
Then it engulfs them with its deadly rage
As it makes the body’s first stand

Hear great cry of the brave neutrophils
As they charge forth into great trouble
As without regard for the the malady
The immune cells defend the body

So see Dendritic Cells, ring out their warning bells
Awaking the nearest lymph gland
And activating the T and B cells
As it prepares the final stand

Watch the B lymphocytes turning the tide
Making antibodies well supplied
As without regard for the the malady
The immune cells defend the body

Now the new mem’ry Cells, in the lymph nodes shall dwell
As others die by their own hand
The body stands down, as now all is well
As it survived the final stand

Once Upon A Time

Once upon a time in a magical kingdom in Florida, a certain tourist hub instituted a policy for guests with disabilities. This policy, known as the Guest Assistance Card, allowed those who were familiar with its existence and could justify its use, powers unseen to mere mortals. With one of these mystical passes, a disabled guest and their party could avoid the long lines which plagued the kingdom. Although this could not heal the guests’ wounds, and could never make up for the challenges faced by these people in everyday life, it offered the promise of an escape. It kept true to the dream of a magical vacation unbound by the stresses and turmoils of everyday life.

Unfortunately, in a storybook example of why we can’t have nice things, there were evil-doers with poison in their hearts, who sought to abuse this system and corrupt it for everyone. Shady businessmen would rent their grandparents in wheelchairs to rich families craving the awesome power to cut lines. Eventually it became inevitable that the kingdom had to close this loophole. When it did so it shattered the hearts of many a handicapped child and their families.

Alright, I think you’re all caught up on the backstory here.

Though it disappoints me greatly that it came to this, with the level of abuse being turned up in tabloids and travel blogs, it was inevitable that Disney would have to end this program. As one who has used it myself, I will be the first to admit- it was overpowered. But from the impression I got from the guest services folks, that was part of the point. The point was never to get to the lowest common denominator necessary to adhere to federal anti-discrimination laws. The point was to enable these guests to enjoy their vacation. To enable magical moments which, for some of these kids, might never happen again.

There are many reasons why, for a long time, Walt Disney World was the default Make-A-Wish Foundation (and similar) destination, and this approach to disability is one of those reasons. The new program which replaced the GAC is workable- it basically works as a sort of on the go fastpass, giving you a return time equal to the listed standby wait minus ten minutes, after which you can go through the fastpass line at your leisure. But it is mundane compensation rather than a magical silver lining to living with disability. It is a crutch rather than a tricked out motorized wheelchair.

I don’t blame Disney for this change in policy. I know how some of the people were using the GAC, and they really had no choice. I do blame the ringleaders of these black market operations, and the people who paid them. As far as I am concerned, these people are guilty of perfidy, that is, the war crime of abusing the protections of the rules of war (such as feigning wounds) to gain an advantage. As for Disney, I am disappointed, but understanding.

I wish that this fairytale had a more appropriate ending. I wish that I could say that the evil doers faced poetic justice and were made to wait in an endless line while having to listen to the sounds of children crying and complaining about waiting. Unfortunately, this did not happen, and these few bad apples spoiled the bunch.

On 3D Printing

As early as 2007, futurists were already prophesying about how 3D-printers would be the next big thing, and how the world was only months away from widespread deployment. Soon, we were told, we would be trading files for printable trinkets over email as frequently as we then did recipes and photographs. Replacing broken or lost household implements would be as simple as a few taps on a smartphone and a brief wait. It is ten years later, and the results are mixed.

The idea of fabricating things out of plastics for home use is not new. The Disney home of the future featured custom home fabrication heavily, relying on the power of plastics. This was in 1957*. Still, the truly revolutionary part of technological advancement has never been the limited operation of niche appliances, but the shift that occurs after a given technology becomes widely available. After all, video conferencing in the loosest sense has been used by military, government, and limited commercial services since as early as World War II, yet was still considered suitably futuristic in media up until the early years of the new millennium.

So, how has 3D-printing fared as far as mass accessibility is concerned? The surface answer seems to be: not well. After all, most homes, my own included, do not have 3D printers in them. 3D-printed houses and construction materials, although present around the world, have not shaken up the industry and ended housing shortages; though admittedly these were ambitious visions to begin with. The vast majority of manufacturing is still done in faraway factories rather than in the home itself.

On the other hand, perhaps we’re measuring to the wrong standard. After all, even in the developed world, not everyone has a “regular” printer. Not everyone has to. Even when paper documents were the norm rather than online copies, printers were not universal for every household. Many still used communal library or school facilities, or else used commercial services. The point, as far as technological progress is concerned, is not to hit an arbitrary number, or even percentage of homes with 3D printers in them, but to see that a critical mass of people have access to the products of 3D printing.

Taking this approach, let’s go back to using my own home as an example. Do I have access to the products of 3D printing? Yes, I own a handful of items made by 3D printers. If I had an idea or a need for something, could I gain access to a 3D printer? Yes, both our local library, and our local high school have 3D printers available for public use (at cost of materials). Finally, could I, if I were so disposed, acquire a 3D printer to call my own? Slightly harder to answer, given the varying quality and cost, but the general answer is yes, beginner 3D printers can now be purchased alongside other hardware at office supply stores.

What, then, have been the results of this quiet revolution? One’s answer will probably vary wildly depending on where one works and what one reads, but from where I stand, the answer as been surprisingly little. The trend in omnipresent availability and endless customizability for items ordered on the internet has intensified, and the number of people I know who make income by selling handicrafts has increased substantially, but these are hardly effects of 3D printing so much as the general effects of the internet era. 3D printing has enabled me to acquire hard protective cases for my medical equipment. In commercial matters, it would seem that 3D printing has become a buzzword, much like “sustainable” and “organic”.

Regarding the measuring of expectations for 3D printing, I am inclined to believe that the technology has been somewhat undermined by the name it got. 3D printers are not nearly as ubiquitous as printers still are, let alone in their heyday, and I do not expect they will become so, at least not in the foreseeable future. Tying them to the idea of printing, while accurate in a technical sense, limits thinking and chains our expectations.

3D printers are not so much the modern equivalent to paper printers so much as the modern equivalents of fax machines. Schools, libraries, and (certain) offices will likely continue to acquire 3D printers for the community, and certain professionals will have 3D printers, but home 3D printing will be the exception rather than the rule.

The appearance of 3D printing provides an interesting modern case study for technologies that catch the public imagination before being fully developed. Like the atomic future of the 1950s and 1960s, there was a vision of a glorious utopian future which would be made possible in our lifetimes by a technology already being deployed. Both are still around, and do provide very useful services, but neither fully upended life as we know it and brought about the revolutionary change we expected, or at least, hoped for.

Despite my skepticism, I too hope, and honestly believe, that the inexorable march of technology will bring about a better tomorrow. That is, after all, the general trend of humanity over the last 10,000 years. The progress of technology is not the sudden and shiny prototypes, but the widespread accessibility of last year’s innovations. 3D printing will not singlehandedly change the world, nor will whatever comes after it. With luck, however, it may give us the tools and the ways of thinking to do it ourselves.

* I vaguely recall having seen ideas at Disney exhibits for more specific 3D-printing for dishes and tableware. However, despite searching, I can’t find an actual source. Even so, the idea of customized printing is definitely present in Monsanto’s House of the Future sales pitch, even if it isn’t developed to where we think of 3D-printing today.

Me vs. Ghost Me

My recent attempts to be a bit more proactive in planning my life have yielded an interesting unexpected result. It appears that trying to use my own My Disney Experience account in planning my part of our family vacation has unleashed a ghost version of myself that is now threatening to undo all of my carefully laid plans, steal my reservations, and wreck my family relationships.

Context: Last summer, I was at Disney World for a conference, which included a day at the park. Rather than go through the huff and puff of getting a disability pass to avoid getting trapped in lines and the medical havoc that could wreak, I opted instead to simply navigate the park with fastpasses. Doing this effectively required that I have a My Disney Experience account in order to link my conference-provided ticket and book fastpasses from my phone. So I created one. For the record, the system worked well over the course of that trip.

Fast forward to the planning for this trip. Given my historical track record with long term planning, and the notable chaos of my family’s collective schedule, it is generally my mother who takes point on the strategic end (I like to believe that I pick up the slack in tactical initiative, but that’s neither here nor there). Booking our room and acquiring our Magic Bands naturally required to put names down for each of our family members, which, evidently, spawned “ghost” accounts in the My Disney Experience system.

This is not a particularly large concern for my brother or father, both of whom are broadly nonplussed with such provincial concerns as being in the right place at the right time, at least while on vacation. For me, however, as one who has to carefully judge medication doses based on expected activity levels over the next several hours, and more generally, a perpetual worrier, being able to access and, if necessary, change my plans on the fly is rather crucial. In the case of Disney, this means having my own account rather than my “ghost” be listed for all pertinent reservations and such.

The solution is clear: I must hunt down my ghostly doppelgänger and eliminate him. The problem is that doing so would cancel all of the current reservations. So before killing my ghost, I first have to steal his reservations. As a side note: It occurs to me belatedly that this dilemma would make an interesting and worthwhile premise for a sci-fi thriller set in a dystopia where the government uses digital wearable technology to track and control its population.

All of this has served as an amusing distraction from the latest sources of distress in my life, namely: Having to sequester myself in my home and attend meetings with the school administrators by telephone because of a whooping cough outbreak, the escalating raids against immigrant groups in my community, neo-fascist graffiti at my school, and having to see people I despise be successful in ways that I never could. Obviously, not all of these are equal. But they all contribute to a general feeling that I have been under siege of late.

While reasonable people can disagree over whether the current problems I face are truly new, they certainly seem to have taken on a new urgency. Certainly this is the first time since I arrived back in the United States that immigrant communities in my local community have been subject to ICE raids. Although this is not the first time that my school has experienced fascist graffiti, it is the largest such incident. The political situation, which was previously an abstract thing which was occasionally remarked upon during conversation has become far more tangible. I can see the results in the streets and in my communications with my friends as clearly as I can see the weather.

I might have been able to move past these incidents and focus on other areas of my life, except that other areas of my life have also come under pressure, albeit for different reasons. The school nurse’s office recently disclosed that there has been at least one confirmed case of Whooping Cough. As I have written about previously, this kind of outbreak is a major concern for me, and means in practice that I cannot put myself at risk by going into school until this is resolved. Inconveniently, this announcement came only days before I was due to have an important meeting with school administrators (something which is nerve wracking at the best of times, and day-ruining at others). The nature of the meeting meant that it could not be postponed, and so had to be conducted by telephone.

At the same time, events in my personal life have conspired to force me to confront an uncomfortable truth: People I despise on a personal level are currently more successful and happier than me. I have a strong sense of justice, and so seeing people whom I know have put me and others down in the past be rewarded, while I myself yet struggle to achieve my goals, is quite painful. I recognize that this is petty, but it feels like a very personal example of what seems, from where I stand, to be an acutely distressing trend: The people I consider my adversaries are ahead and in control. Policies I abhor and regard as destructive to the ideals and people I hold dear are advancing. Fear and anger are beating out hope and friendship, and allowing evil and darkness to rise.

Ghost me is winning. He has wreaked havoc in all areas of my life, so that I feel surrounded and horrifically outmatched. He has led me to believe that I am hated and unwanted by all. He has caused fissures in my self-image, making me question whether I can really claim to stand for the weak if I’m not willing to throw myself into every skirmish. He has made me doubt whether, if these people whom I consider misguided and immoral are being so successful and happy, that perhaps it is I who is the immoral one.

These are, of course, traps. Ghost me, like real me, is familiar with the Art of War, and knows that the best way to win a fight is to do so without actual physical combat. And because he knows me; because he is me, and because I am my own worst enemy, he knows how best to set up a trap that I can hardly resist walking into. He tries to convince me to squander my resources and my endurance fighting battles that are already lost. He tries to poke me everywhere at once to disorient me and make me doubt my own senses. Worst of all, he tries to set me up to question myself, making me doubt myself and why I fight, and making me want to simply capitulate.

Not likely.

What ghost me seems to forget is that I am among the most relentlessly stubborn people either of us know. I have fought continuously for a majority of my life now to survive against the odds, and against the wishes of certain aspects of my biology. And I will continue fighting, if necessary for years, if necessary, alone. I am, however, not alone. And if I feel surrounded, then ghost me is not only surrounded, but outnumbered.

Ne Obliviscaris

How accurate is it to say that you will never forget something?

Obviously, not terribly. After all, “never” and “always”, being infinite, are not generally applicable on a human timescale. And, even if we assume that forgetting can only occur by the act of a living person, the nature of human memory over extended time periods makes “never forgetting” a rather unfulfillable promise.

This week represented a fascinating, if bittersweet, milestone for me. As of this Wednesday, I have been disabled for a majority of my life. The dramatic saga of my diagnosis was one such event which I have committed to “never forgetting”, even though I know that this task is impossible. In some respects, I feel as though I have already failed at this task. Promises made to me and to myself about not letting this label define me or limit my grand endeavors have proven impossible.

They tell you, when you’re dealing with a disability or a chronic disease, that you can’t let it define you or limit your options; that meeting a certain medical or legal definition doesn’t make you any different from your peers. While the thought is nice, I have increasingly found that mindset to be idealistic and impractical. Having your options limited is pretty much the definition of disability, and accepting that isn’t pessimism, it’s being realistic.

Whenever I take an unmodified psychiatric assessment, it always flags me for possible risk of depression and/or anxiety, with a healthy dash of obsessive-compulsive and paranoid symptoms. This is because I answer honestly on questions like “I feel different from my peers” and “I am sick a lot”. The fact of the matter is that I am objectively different from my peers because my body does not function within normal parameters, and I am sick a lot for the same reasons. Devoid of context, these statements might indicate a problem. Upon explaining that, yes, I do experience great everyday stress, because I have to cope with artificially supplementing missing organ function, most doctors agree that my apparent pessimism is completely justified, and in fact, represents a mostly-healthy means of coping with my present situation. After all, it’s not paranoia if your statistical chances of dying are vastly increased.

As for the issue of defining myself, it is my experience that people generally define themselves by the struggles they encounter and how they meet them. For example: if a person’s lifelong struggle is to climb Everest, I do not see why they should not describe themselves as a climber. For my part, my greatest struggle by far is staying alive and keeping my body from annihilating itself. This may seem relatively simple as a life struggle to the perfectly healthy and the uneducated, in the same way that climbing an oversize hill may seem like a simplistic goal for someone unacquainted with proper mountains.

To me at least, having someone tell me I can’t let my illness define me tells me that person has never really had to deal with serious health problems. Because taking proper care of oneself is a defining struggle. I am proud of the fact that I have managed to keep my body alive despite several key systems giving up on me. I am proud that I have managed to keep myself in a state that I can actually participate in life, even if my participation might be different from others’.

And yes, I understand that what is meant is that I ought not let my issues engulf the entirety of my existence- that I ought to still have non-health goals. But trying to plan goals completely independently of my health is setting myself up for failure. No matter how hard I try, no matter how much I will it to be so, I cannot change my basic physiological requirements. At best, I can try to make my personal and health goals work in harmony, but this does require me to let my disability set the boundaries of what challenges I undertake.

Yes, I can still run a marathon. But I couldn’t step outside and do it today. Not only would I fail, but if I persisted against medical advice, I might even die trying. Dealing with my health means I have to plan and make compromises. I can’t be completely single-minded about these kinds of goals because my health requires constant focus. Lying to myself, or having others lie to me, doesn’t help, and only increases the chance that I’ll feel worse about my situation. Accepting this, in effect, letting my disability define my boundaries and dictate my life, is the only way I will ever be able to move beyond it and start accomplishing other goals.

Revisiting the Future

A little less than three years ago I was on a seven day cruise on the Disney Fantasy. It was New Year’s Eve, and our ship had just passed into the Bermuda Triangle. The live show that evening featured the tribulations of a trio of teenagers coming to grips with the fact that they could no longer reasonably claim to be mere children, and would soon have to enter the dreaded “real world”. It struck a chord with me, even though I was still a couple years younger than the protagonists, and graduation seemed far off. Still, it was the first time that graduation, and the world beyond it, truly struck me a genuine, personally relevant concern.

Despite little of immediate, lasting consequence occurring on that particular cruise, I have nonetheless come to consider it something of a turning point in my life. About this same time, it began to become undeniably apparent to all interested parties that the school’s strategy towards my disability of masterly inactivity would most likely not be sufficient to assure my timely graduation. At the same time, I began to solidify my own doubts that the school administration would prove capable of overcoming its bureaucratic inertia. In short, it became clear that following the “normal” path would not end with my triumphant graduation and ascension to the most prestigious colleges with a full scholarship, etcetera, etcetera, as I had previously planned.

Shortly after we returned home, I began to receive fliers from various academic institutions. I chuckled at this, feeling appropriately flattered that they would deign to waste the cost of postage on one such as myself, yet nevertheless regarding their outreach as premature, and not of genuine concern. After all, with the delays which the school had made in processing various transfer credits from my online classes, it was suddenly unclear what my graduating year ought to be listed as. How could I give serious consideration to such far-off problems when I could not even confirm my graduating date?

My eighteenth birthday, which I had previously imagined would mark the milestone of my victorious conquest over public education, and the commencement of my proud campaign into the “real world”, was spent, like so many other days of my life thus far, in a hospital bed, struggling for survival. Although I knew that such an occasion ought to merit some manner of recognition and self reflection, given my circumstances, I was too preoccupied with the difficult task of evading imminent death to give much thought to the future. I promised myself, as indeed my parents promised me, that once I had recovered, and these temporary troubles with my schoolwork had been dealt with once and for all, that we would have a grand celebration for my birthday. Nothing came of this promise; indeed, I have not had a proper birthday party with a guest list and presents since.

The last day of my fourth year of high school was bittersweet, to put it mildly. On the one hand, summer meant a welcome reprieve from the daily stress of regular classes (by this point, most of my actual academic progress was being accomplished at home with the assistance of a tutor, and this would not change), and a temporary truce between myself and the administrators who, during the school year, sought to harass me daily over my apparent lack of progress. On the other hand, it was the last day I would see any of the friends I had made in school. They, unlike myself, had been able to keep their heads down, and stick to the normal path. They had graduated. All of them were college bound, and excited about it. Despite my efforts to be empathetic, I could not bring myself to subject myself to attending the graduation ceremony that I could not participate in.

Shorty before that day, I had resigned myself to the fact that I was going to remain in high school for an indeterminate period. Neither I nor the administration could come up with an estimate for my completion, owing to missing or misplaced records on their part. Guesses ranged from three months to four years. With no new data, and a history of disappointment, I gave up on guessing. With no graduation date, I could not make plans for college. With no plans, I had nothing to look forward to. Working mainly from home rather than subjecting myself to the degradation of school, the days and weeks began to meld together. With no real future to look forward to, I gave up on the future altogether.

This may sound like a purgatorial dystopia. And indeed, it was. I joked about this much with my friends over text messages. Yet I would be remiss if I didn’t last say that it was also quite liberating. With no change from day to day, I could stop worrying about anything beyond the present moment. After all, I had total job security. There was always plenty of schoolwork to ensure that I never had energy to make use of any free time I might have. There was no petty social drama; no conflict of any kind. So long as I had no expectations, I could never be disappointed. It was a dystopia alright, and a perfectly executed one at that.

Yet, within the last two weeks, something has changed. Last week, my special education case manager contacted me regarding some manner of questionnaire meant for outgoing seniors. My natural response was and remains to ignore it. If it is important enough, they will get it to me another way, and if it isn’t, I’ve just saved myself a great deal of effort. Still, this bears relevance if for no other reason then because it is the first time which they have recognized me as a senior, and on track to graduate. The same week, I received a mass email from the guidance department (where they got my address in order to spam me remains a mystery) regarding generic scholarship offers. Suddenly, it seems, my tranquil little dystopia is under siege from the “real world”.

After years of doing my utmost to avoid imagining a future outside of a weather forecast, I am suddenly being made to explain my life plans. A younger, pre-cruise version of myself would be excited. Things are back on track. Things are getting back to normal. Except, things can never go quite back to normal. Trying to relive past fantasies is a fool’s errand, and trying to navigate the coming future by the plans a different me made many years ago, or by whatever cookie-cutter claptrap the administration may find in their self-righteous self-help books, will only end with me facing the same problems as now five years from now.

Imagining a realistic future which is completely independent from both the administration and my own childhood fantasies is both difficult and daunting. Indeed, given the nature of my disabilities, and the apparent track record of my forecasting abilities, it begs the question whether a future plan which extends beyond my next quarterly hospital visit is even knowable in any meaningful capacity. Given that I cannot say with any absolute confidence that I will even still be alive in five years, does it really make sense to speculate on what a life for me might look like?

Coincidentally, on that same cruise which seems simultaneously so recent and so distant from me, I saw for the first time the filmic adaptation of “Into the Woods”. While I shall endeavor to avoid spoilers, suffice it to say that the theme of planning for the future, and having said plans go awry does come up. Indeed, one of the songs, arguably my favorite of the lot, focuses on the dilemma faced by one of the protagonists when pressed into a snap decision which has the potential to radically affect her entire future. The conclusion she reaches is to avoid the dichotomy altogether, and to keep her options open rather than back herself into a corner. It turns out to be the correct decision, as both alternatives collapse in the long run. This is interesting advice, which I think I shall endeavor to apply to my own like situation.

So, what can I say about my future? Well, I can say that even though I may not be absolutely confident in a specific graduation date, that I will most likely graduate from public school in the next year or so. I can say that I would like to continue my education and attend university, even if I do not yet know where and precisely how I will make attendance work, or how I will be able to apply given the problems with my transcript. I can say that I intend to travel and learn about other places, people, and cultures, as traveling and learning have had an undeniably positive impact on my life thus far. I can say that I intend to continue to write and speak about my experiences.

But perhaps most importantly, I can say that my path will not be the “normal” one, and as such, it is perfectly acceptable to not have every detail planned out. Just as I can learn without a grade, and have a positive role without having a neatly defined career, so too can I have a future without having a plan.