Friday, May 29, 2009

Two Dad Deal: An Aberration Story

Moral hypocrisy also plays a heavy part in this particular dilemma.

One of the key goals of Aberration Nation is to evoke plain ole' thinking. It turns out that thinking is a much harder and scarier activity than I ever imagined. It must be because a disturbing amount of people form opinions based on what someone else told them to think once upon a time. Perhaps it was their parents, teachers, friends, or the broader culture squeezing in around them. Busting out of preconceived notions and small ideas can be overwhelming. For some, living like a programmed robot turns out to be a much more convenient option.

This inability to think for oneself has become a major thorn in my creative and intellectual side. I grew up being told exactly how to think and what opinions were the right ones to have. The consequences of questioning those directives created a dense barbed wire fence caked in misconception, guilt, and grief that I eventually had to fight my way through step by step. Now that I'm safe on the other side, I feel compelled to think through issues on an individual level, and I hope you will as well.

Going against the grain isn't easy, particularly in cultures where thinking in and of itself seems to be a crime. I still struggle to muster the courage after all these years. In fact, a sign in my laundry room has the word Courage written across it. Each day I take a moment to read it and remember why I hung it on the wall. There are many issues that I'll be contemplating for a long time; my decisions don't come quickly or easily.

What better topic to evoke down and dirty, gut-wrenching (and downright sinful by some standards) thinking than gay civil rights? My guess is that reader opinions are mixed on the issue. Today's post is about a gay rights topic that pulls at my heartstrings: adoption. You see, once upon a time, I got myself into a jam. Miss foot-loose-fancy-free-deep-thinking-Louisiana-college-senior found herself with a huge pregnant belly and the heart-wrenching option of giving up a child for adoption. Smart, determined, and full of spunk, I knew I could make it work. So I decided to parent the kid myself rather than risk handing it over to parents who might somehow love it less, mistreat it, or abuse it. I gladly sacrificed what I had left of my own youthful independence and late-sleeping M.O. to prevent that scenario.

Even then I knew that all parents are not equal. I came to the conclusion that one good parent is better than two bad ones, and that no matter what anyone (in my 1980's southern Bible-belt Junior League culture) thought or said about me and my situation, we would survive. I married my husband a few years later, and over the years, have come to realize that absolutely nothing but love truly makes a family.

If heterosexual parents are not equally capable of great parenting, why can't there be some good gay and lesbian ones out there? If I'd been forced to give up my child for some reason, I would have preferred that someone like my guest today, author David H. Burton, and his partner raise her rather than some of the heterosexual parents I've come across through the years. The bottom line is that every child deserves to be truly and honestly loved, protected, and cared for.

Perhaps reading about David and his partner's love for their three adopted sons will perpetuate additional thought on this critical cultural topic. I haven't stopped thinking about it since I read his touching responses to my interview questions. Does this thoughtful, creative man and the one person he loves most in the world deserve to be fathers? The Children's Aid Society and the Canadian government think so.

Forget what anyone has ever told you. Make your own decision and let us know your thoughts (leave a comment).

You are one of two fathers for three adopted sons. Why did you and your partner decide to adopt? Do you believe the motivation differed from traditional adoptive parents?

My partner and I have been together for 12 years. In the very early stages of our relationship we both knew that we wanted children and talked about it openly. After we had bought a house and settled into a quiet, suburban neighborhood (where there seemed to be a rather abnormally large percentage of gay/lesbian couples) we decided to begin the journey, as it were. We attended a course called Daddies and Poppas that explored the various options for gay men that want to adopt. Of the options that were available (i.e., surrogacy, co-parenting, international adoption, private adoption, adoption through the Children's Aid Society, etc) we decided to go the adoption route through The Children's Aid Society (CAS). As for the motivation, I think it differs for a lot of people. We both grew up with siblings and knew that we wanted children and I don't think it was any more complex than that, really. I know that factors like sterility/infertility are often a factor for heterosexual couples that adopt, but that obviously wasn't the case for us. :)

What was the process like? Did you and your partner encounter any barriers? If so, how did you handle them?

We live in Canada, so the actual process for adoption with CAS is the same as any married or common-law couple. I should mention, though, that as a result of being a same-sex couple we were barred from international adoption since only Canada and the U.S. allow same-sex couples to adopt. That limited our options obviously, but I'm glad that we went through CAS. There are a lot of children that need love and a good home, especially older children. I wrote about this particular topic on my blog. There's a special place in my heart for older child adoption. :) Back to the point. The process is lengthy, as once you submit your application to CAS you wait until they slot you into their orientation course. The wait can be upwards of 1.5 years. The course is about 9-10 weeks of classes and a simultaneous home study with an adoption worker. You basically have to divulge your entire life (relationships with family members, your spouse, financial status, etc.) as part of the home study. You have to be honest about everything, because it's not just about being upfront about your lifestyle, but also about what you are willing to accept in an adopted child. You have to be brutally honest since CAS's focus is to find the right home for each child. As for barriers other than international adoption, there are none in this country that I can think of when it comes to adoption for same-sex couples. I suppose that same-sex couples might be concerned around adoption where a birth mother gives up her child and wants to choose the adoptive couple. In this case, I'm sure there are worries that they might not be chosen, but quite honestly we know a same-sex couple that the birth mother chose over other couples. She wanted her child growing up in a progressive home!

Can you describe your family for us? What make it the same and what makes it different from traditional families?

Our family is as follows: we have 3 boys and they are birth siblings. They were between the ages of 6-9 when we adopted them. My partner and I are both in our 30's and we have a Basset Hound that the boys adore. Really, the only significant things that differentiates us from other families is that there are two dads. In the beginning, the boys called us by our first names, but after a couple of months they were quite ready to call us something more appropriate. Considering their ages, we let them decide and they came up with Dad and Daddy. The boys do tend to get a few questions around having two dads, but they are quite proud of the fact now. The other day, our middle son had a friend over at the house and he turned to his friend and said, "See, I have two dads!", as if the friend hadn’t believed him. The other parents and the school have been nothing but supportive, offering books and other resources to help if we needed it. We do have to correct some people when they mention having a mother, but we take it all in stride. People make a lot of heterosexist assumptions in general and you learn to correct people politely. I make a specific point of doing it in front of the boys since I want them to be proud of their dads and not to feel ashamed of it. I refuse to be ashamed of who I am. And they think it's great! I think the best statement they came up with was "I have two dads because they chose me." Enough said, I guess!

Can you describe a typical day?

Chaos! LOL! Just kidding. Although I do have to say that the change from just the two of us to house full of boys was significant. The biggest thing is routine. It starts with making lunches, breakfast, feeding the dog, getting ready for school, etc. We both work and I get home early to pick up the boys. From there, it’s homework, dinner, etc. We try to have dinner as a family and sit together and talk about the day. We also like to spend time with each of them at bedtime, reading to them, etc. We're big on having family time and individual time and the boys thrive on it. I think it helps to develop a stronger and faster bond with them. And laughter is huge in our house. A lot of it! We also try to set up routines on the weekend with special treats that the boys look forward to. We love our weekends!

Do your sons understand the nature of the love between their two fathers? How do you explain to this to them in a way that they can understand at an early age?

I think in the beginning it was a little foreign to them, but they adjusted very quickly. They completely understand that we are a couple and we emphasized that from the get-go. What's interesting is that it has re-shaped their own conceptions about having a partner. Our middle guy wants to marry Mario at the moment! (from the Mario & Luigi video games)

Have your children experienced any social issues due to having two fathers? If so, how have you helped them cope?

Not at this point other than questions around having two dads. We've prepped them ahead of time by having very straight-forward dialogue about the potential for issues to arise (i.e., name-calling, etc). We used a number of books that show diversity in families to show that there are all kinds of families and that having two dads is simply one variation. From what we have seen so far, they seem quite well grounded on this matter.

We all have concerns for our children as they grow up. What are your main concerns? What are the top three messages you hope to instill in them on their way to manhood?

We're really big on respect for women and ensuring that they see women as equals. We hope that our boys will grow up treating all people with respect, and not just tolerating difference, but celebrating it. We've also tried to teach them about non-violence and finding mutually acceptable means to settle differences rather than resorting to violence. We don't want them growing up glorifying guns. I think with some of these qualities instilled in them, they will grow to become wonderful partners and well-respected men in society.

There are always folks ready and willing to tell us how to live our lives—how did you find the courage to move beyond those barriers and create a rewarding life for yourself?

I grew up as the son of a Jehovah Witness, and then, when my father was ex-communicated, a born-again Christian. The church I attended was non-denominational, but filled with hypocrisy and judgment. I never felt right there and the messages of intolerance I received as a child and a teenager were anathema to me. At around the age of 16 I stopped going to church and never returned. My father continues to be a born-again Christian and has had to, himself, deal with the fact that I'm gay. He's actually been extremely supportive of me and my partner over the years, but I think it has been difficult for him. As for my own growth, I came out at the age of 20 while away at university. I've never looked back.

What do you feel are the most damaging misconceptions about same-sex adoption? Has this improved over the last five or ten years?

The biggest misconception about same-sex adoption is around the "influence" that we, as same-sex parents, might have over our children. I've never bought into it. My parents are straight, yet I turned out gay. That said, I've heard that children of same-sex parents grow up to be more accepting of differences in people, which is always good. As for improving over the last decade, I think that society's views, in general, have become more tolerant towards LGBT people, in addition to same-sex adoption, but I think there is still some ways to go.

Love is love is love. I get so frustrated by some of the push-back same sex couples get about adoption when I know how many crappy parents there are out there, and how many children just need someone to love them. Why is it that people fail to support providing that love to these children?

Fear - plain and simple. We fear the unknown. And what we fear we try to control. Moral hypocrisy also plays a heavy part in this particular dilemma. People pick and choose from their religion to try to force others to live their lives a certain way. And that goes for a number of issues throughout history - slavery, the subjugation of women, etc. There is a really good article posted by Libba Bray over at livejournal. Her father was gay. And as she says, "They are scared. And fear breeds mistrust and intolerance. Often, when people feel that the times are uncertain and they are uncertain of their place in that shaky world, when they feel powerless over the economy or random violence or gender roles or their children, their spouses, etc.—what I call the Talking Heads moment: “And you may say to yourself, Where is that beautiful house? And you may say to yourself, My God, what have I done?”—they feel genuinely threatened in the way that a child who feels threatened will dig in his/her heels and refuse to cede ground because it feels, in that moment, like ceding the self. It is their fear of themselves, really, of their tenuous grasp on an unpredictable world, that is writ large in such legislation. “Well,” they might argue. “At least I can control this.” They need an enemy to fight. A dragon to slay so that the world will be put right again. A sacrifice to offer the gods that they might be spared."

For those of us who may have same sex couples or families living in our communities, what’s the best way to explain what can be quite confusing to our kids? I have my own methods but would love to hear your thought on this?

Explain that there are different kinds of families. Right from the start. There are children that are raised by: one mom and one dad, a single parent, a grandmother or grandfather, two grandparents, two moms, two dads, an uncle or an aunt, etc. Get books from the library on different families and on ones that show gay and lesbian parents. One of my favorites is AND TANGO MAKES THREE by Peter Parnell and Justin Richardson. It's the true story about two male penguins that raised a chick in New York's Central Park Zoo. For a lot of kids, if an animal can have two dads, then it's okay. And if you hear your children using terms like gay or fag, correct them. It's no different than using a racial slur.

If you could say anything to the world about your family and the love you have for your children, what would that be?

Wow. Well, nothing can take the place of the love I have for my children or for my partner. As each day goes by I love them more. Their antics make me smile, their jokes make me laugh, when they say "I love you, Dad" it brings joy to my heart, when they come home from school and see me at the door and yell out, "DAD!" my heart leaps, when they ask me to keep reading to them at bedtime I love to indulge them, and when they give me a hug and kiss goodnight my day is complete. I live for my family. They are my life. What else is there, really?

What do you think?

Monday, May 25, 2009

NOTE TO ... The New Yorker

I've been traveling quite a bit lately. A few months ago I achieved US Airways Silver status and began receiving automatic upgrades. Yahoo! During my recent domestic flights, I’ve noticed that I’m often the only woman in first class. Although lacking scientific considerations, surely this says something about our culture and the equality of women in 2009. Interestingly, as I sat representing my kind on a flight last week from San Juan to Philadelphia, I read your article on Helen Gurley Brown (11 May 09 issue). This is a woman who (no doubt) has spent plenty of time in first class.

Ahead of her time, Ms. Brown challenged the rock hard notion that woman and men inherently differ. Growing up in Louisiana (just beneath Mrs. Brown’s self professed hillbilly Arkansas hometown), those crater-sized differences were brainwashed into my psyche with all the cultural fuel power of Southern-style Bible-thumping and debutant ball hopping the state could muster. Those insidiously distorted beliefs became a key factor in separating me from the men in my life in ways that were detrimental to both my self esteem and my ability to form healthy relationships.

Ms. Brown was busy celebrating female libido, intelligence, and earning power at just about the same time my hometown culture was needling me to stuff it all up into one gigantic closet and run in the opposite direction. If I failed to squelch what was on their list, heaven forbid that in a fit of rage, or simply to teach me a valuable lesson or two, God might strike me down with all kinds of punishments. Cosmo was certainly not welcome in my childhood home; no evil materials allowed. The messages I grew up with caused me to view my body as an object men would exploit, tarnish, use, and devalue if I allowed it to happen. Men were my enemy and I was to assume the worst in them as this would be the best way to protect myself. Seeing a beautiful, busty woman in a sexy red cocktail dress on the cover of Cosmo at the local Piggly Wiggly (a grocery store) didn't have a "thang" to do with it.

So, as Ms. Brown was climbing her way hand over fist to the top, I was struggling to understand how I could possibly be cherished by the very monsters I longed to know, touch, and love. My instinctive feeling that they were actually beautiful creatures full of mind-bending mystery seemed to reflect upon my own bad nature. "God forgive me for doing that, or loving this one, etc," I used to pray, assuming that any kind or loving words, gestures, or interest from men was part of the plot to bring me down. I was failing miserably! And being the sensitive, creative young "thang" I was, the sincerity I saw in the best of them confused the hell out of me. Was I to believe or not believe I was worthy of any kind of genuine love and caring? Now I realize that this distorted view of men subtlety shaped all my interactions. Even the greatest men look bad when you peer at them through a scum-covered lens. Men may behave like they're from Mars, but when all the masks, thick skin, and cultural influences are stripped away, they're only human after all.

In a culture promising salvation, I was damned to become an adolescence filled with shame, guilt, sadness, powerlessness, and grief. The issue at play was not only the objectification of women, but its sly underbelly of pigeonholing men, and the inherent danger of viewing all human interactions through a sexual eye. We all have bodies (duh!) that serve crucial multidimensional purpose, but to focus on the flesh as the overarching specification of who we are is a dire mistake. The human body and its machinations are one aspect of who I am regardless of my gender. Of course, it all works together but putting gender at the top of the attribute list has become one of the most devastating cultural messages of all time.

I finally realized that men and women actually share the same internal emotions when, as an adult, I watched my six nephews grow up. As these cute little guys cried, giggled, and grew angry over some of the same things I did at three, seven, eleven, and thirteen, I finally saw the shared emotions of humanity. The youngest will be thirteen this summer, and the oldest now plays college football. The football player is 6’3’--strong and bright--the kind of guy I could have dated as a young woman. The same kind of young man I mistakenly viewed as inhuman and out to get me. Now I know that men cry, feel, and are capable of loving long and deep. The only craters between us and them are those carved out by our own insecurities, our lack of understanding, and the cultural messages we allow ourselves to accept. Jerks come in all shapes, sizes, and sexes. The key is seeking out those who aren't based on the stuff inside.

I applaud Ms. Brown for stepping to the front of the cultural stage and screaming, "This is who and what I am!" at the top of her lungs. The message she has consistently provided addresses the flip side of the unjust stereotyping of men. If men can cry, feel and love, then women can seek power, crave sex, and control a destiny that is both positive and filled with fascinating adventures, including great men. Her strong will and accomplishments are all the more impressive knowing she was a child of Arkansas. She’s practically from my neighborhood! Whether or not you or I agree with every point she's made over the years, her lifetime achievement supports induction into the Aberration Nation. She has celebrated her womanhood while also viewing herself inherently the same as her male counterparts, deserving of every accomplishment she could heap upon herself whether it was a top notch career, a fascinating man, or a seat in first class.

All hail to the quintessential guilt-free woman!

To read more about the life of Helen Gurley Brown, pick up Jennifer Scanlon's book, Bad Girls Go Everywhere. To read The New York Times review, go here.

Friday, May 22, 2009

Aberration Nation News Flash!

Two special blog events are coming to Aberration Nation in June!

We'll read teen aberration stories and we'll hear from a former teen runaway. It's tough enough just being human, but being a teen has powerful challenges that often set both our emotional and mental adult paths in motion.

I once heard a "grown-up" say this during a discussion about a teen suicide attempt, "What could she possibly have to be so upset about?" Well, I was plenty upset as a teen! I wish I'd had more outlets to express myself and understand that I wasn't the only one struggling. So who better to reach out to with aberration stories of hope, emotional equality, and love than teens? And how better to help adults remember and understand our teens than to read how they're feeling about their own aberrations, and those of the folks around them?

TEEN-errations ...

A new recurring blog post, TEEN-erration Nation will debut on Aberration Nation in June. I recently visited the Mark Twain Intermediate School for the Gifted and Talented in New York, New York. At that time, I invited the 8th grade creative writing students to submit either an essay about their aberration(s), or to interview someone else about an aberration they have. Several of these submissions will be posted on Aberration Nation during June to kick off TEEN-erration Nation as a recurring blog post.

If you’re a teen, have a teen, know a teen, or teach teens, please let them know about this great new addition to Aberration Nation. I’ll need more teen submissions so submit away. One talented kid will win $100.00 for writing the best piece submitted in June. Watch for more details on this. Anyone who submits will be entered in the TEEN-erration Nation contest. Go here to contact me.

On Being Lisa: The Life of a Teenage Runaway

Lisa Morguess has so many aberration stories that she deserves a three-part series! Her inspiring story, beginning with her experiences as a teenage runaway and ending with the courageous support of her cancer-stricken hubby, will also be posted throughout June. You’ll want to read about this invincible woman. Visit her blogs here and here if you'd like to take a look now.

Subscribe to Aberration Nation and you'll be sure not to miss these upcoming posts!


Tuesday, May 12, 2009

Gasping for Air: An Aberration Story

Now I focus on the wonderful gift of just being alive and it has changed my life.

I've always thought that drowning, basically smothering in water, would be the worst way to die. At least if I burn to death, I can still scream. I can open my mouth in a wide and agonizing circle and let my animal nature escape for one last moment full of blaze and glory. For me, suffocation brings to mind all the metaphors of a life not fully lived ... squelched, under a thumb, in a box, misunderstood, twisted and prodded and poked into molds often created by culture, society, dysfunctional families, caustic or abusive relationships, and even religion.

A long-suffering loneliness sits deep within those who feel unable to express their individuality. Like those who suffer from serious respiratory illnesses, they often grasp at whatever they can find--to just breathe. It's this suffocation of life that frightens me the most; in my circuitous head, such a condition represents a tragedy worse than death. We will all experience death, a natural progression of biology, but some of us will fail to experience or celebrate our distinctiveness. In the end, death isn't always the real catastrophe.

And so--me and my new friend, Max Kai, are here to suggest that you can't just sit back and wait for someone to pry your lips open, punch you in chest, and get that sucker going. It takes personal bravery and determination to bust through the walls of suck life builds around us.

With all these metaphors swirling in my head, coupled with my own chronic allergy-related coughing thing that chokes me up from time to time, I can't imagine how folks like Max must feel. Max has Pulmonary Fibrosis, a lung disorder characterized by a progressive scarring--known as fibrosis--and deterioration of the lungs, which slowly robs its victims of their ability to breathe. Approximately 128,000 Americans suffer from Pulmonary Fibrosis, and an estimated 48,000 new cases are diagnosed annually. It claims the lives of 40,000 people each year--the same number as breast cancer. There are currently no effective treatments or a cure for Pulmonary Fibrosis.

One thing I particularly admire about my new friend Max is his intensely positive attitude in the face of such a suffocating disease. He's lived through the sad outcomes of seeing the glass half full but was ultimately able to tap into the overwhelming positives he still has. For Max, the turning point came when a close friend suggested that he study the Japanese martial art of Aikido.

Aikido was developed by Morihei Ueshiba as a synthesis of his martial studies, philosophy, and religious beliefs. Aikido is often translated as the Way of unifying (with) life energy or as the Way of harmonious spirit. While I'm about as far away as one can get from being a martial arts expert, this small amount of information about Aikido suggests that a its powerfully combined focus on physical, philosophical, and religious balance can only result in great outcomes.

You struggle with pulmonary fibrosis. Can you explain what it is and how it impacts your health?

Pulmonary Fibrosis is newly understood. It's basically an autoimmune disease that impacts the ability of the lungs to function properly. Over time, the lungs deteriorate and you essentially strangle to death.

When and how were you diagnosed?

I was basically born with this thing. At nine years old, I was diagnosed with asthma. The disease evolved throughout my life, as did knowledge about it, until I finally received a correct diagnosis.

How did you cope as your life progressed?

So little was known about it when I was younger. It screwed up my life in a real bad way--mentally, physically, and emotionally. When I got older I found drugs and alcohol. WOW! Speed and coke helped me to breath, and the alcohol helped me come down from the high. With that said, I lost both my kids and my marriage. It was a sad way of life that took me through many years of hell.

Has your struggle with pulmonary fibrosis changed your view of yourself and life in general?

Well, after all my struggles and negative thinking, I finally came to a realization. I thought, "What the hell? I can still breathe!" Now I focus on the wonderful gift of just being alive and it has changed my life.

You are into martial arts. Tell us about that.

After having a stroke, I stopped self medicating. Then I got a doctor who prescribed Singulair and Advair which, in my opinion are both killers (might as well have coke). About this time, my friend of 11 years, Ruth suggested that I try Aikido. I took the plunge at her Dojo and got a green belt and now go at my own pace. My doctor always says, "Max, you're dead and don't know it." I love that message. I've been at this for five years now with no alcohol or drugs. I feel great!

How have martial arts helped you cope with your health challenges and with life in general?

Aikido keeps me amazingly focused on the positives around me. It gives me positive, achievable physical and psychological goals.

Does a less than perfect health profile have to keep us from accomplishing our goals? How do you keep moving forward?

To those who live in Fear, DON'T FEAR! I'm alive because I want to be alive! Believe me, I know fear very, very well. Once I got used to it, it dropped away, and its power over me was gone. No more doctors -- all gone for me. And I must stress me because I chose a holistic health approach. My Aikido partner Ruth got me involved in Waiora. Seolite and the other nutrition products are helping me.

Things get easier when you decide to take control of your own life. Remember the movie, Highlander? There can be only one! You're the One! Don't let anything stand it your way.

What would you say is your life motto, and why?

"YOU ONLY LIVE TWICE" - Ian Fleming. It means that you only live twice. Once when you are born and once when you look death in the face. These are the words I live by. I will not waste my days trying to prolong them! I shall use my time.

Tuesday, May 5, 2009

Aberrations Praised on Young Money

I recently joined the Eat, Read, Laugh Book Club in Langhorne, Pennsylvania to discuss my novel Aberrations--their April book club selection.

Laura Tirello, a Life and Career Coach, was one of the twenty-five or so women who read Aberrations, and joined me for two-hours of book discussion, eating, and laughing. Laura was so touched by Aberrations and my ten-year-never-give-up effort to complete the novel that she decided to write about it in her blog on YoungMoney.com.

I'm truly honored to be featured on Laura's blog and hope you'll pop over to YoungMoney.com to check out what Laura has to say about Aberrations!

Now ... just need to get Aberrations into Oprah's Book Club ... It could happen!

Friday, May 1, 2009

In Pain: An Aberration Story

I saw the tremendous lack of education on the intersection of law and medicine related to controlled substance prescribing ...

According to leading medical, legal, and psycho-social experts in the field of pain medicine, mainstream media has failed to accurately portray the rising US tide of addiction to prescription pain medications. The media has blamed seedy clinicians, as well as dangerous medications and their associated greedy manufacturers. Experts in the field of pain believe the media has overlooked the critical points that (1) addiction is a major genetic disease to be appropriately understood and monitored, and (2) that pain is real and unending for many Americans who need power-packed drugs to maintain a bearable quality of life.

Consider this scenario: twelve people sit around a table all night drinking wine with their dinner but only one is an alcoholic. Alcohol, restaurants, and wineries do not an alcoholic make just as physicians, pills, and big pharma do not a drug addict make. So if clinicians or pharmaceutical companies are off the hook, who the hell is at fault? To begin combating the current epidemic of abuse and diversion, we must first determine where the insidious truth lies. Only then can we, as a society, begin to properly dissect the issue and address root causes.

These highly regarded experts gathered on March 21st at the New York Marriott Marquis to speak at a symposium on emerging practices in opioid prescribing for chronic pain. As a consultant, I sat in the audience representing a small specialty pharmaceutical company based in the UK. My nearly twenty years of pharmaceutical industry experience and science degree provided the appropriate amount and type of brain cells necessary to fathom both the specific messages of each engaging presenter and the overarching battle cry to their own kind—clinicians and attorneys must pull together in new ways to not only help protect patients and society, but also to protect themselves.

It just so happens that I’m also a writer. The following points not only amazed me but also sent my writing wheels into a major spin as I sat wide-eyed, nursing my complimentary Starbucks coffee and cubed cantaloupe. By show of hands, the alarming number of clinicians who:
  • did not have solid educational exposure to specialty of addiction medicine,
  • did not consistently use standard assessment tools for identifying patients who may be at high risk for abuse or diversion,
  • felt they could identify a risky patient simply by looking at them—counting tattoos, bling, and other such markers,
  • did not include or fully consider familial and/or environmental patient aspects when assessing abuse and/or diversion risk,
  • did not have a solid comfort level with the science and practice of risk management.
Like addicts, you can’t identify a snarly physician based on looks; however, the Marriott clientele surrounding me appeared to be bright, sincere folks from all over the country. Most seemed suited for a Norman Rockwell. Okay, so one guy had tattoos. But this was generally not an audience filled with evil, devious doctors on the make. Their collective voice reflected a sincere need to know and understand more about the cornucopia of narcotics they channel through our neighborhoods, towns, and cities with the genuine intent of helping those who suffer. The group as a whole did not wear the smell and edge of drug dealers, blatant nor subtle, yet they were just the kind of super nice professionals who risk getting handcuffs slapped around their wrists every day due to an alarmingly poor understanding of the law and art of addiction medicine.

Jennifer Bolen, Esquire, brave and bold with an edgy sharp voice and wit, was there to inform them about the laws around prescribing controlled substances. Bolen was a prosecuting attorney for many of the landmark cases against clinicians that established the laws they now must dance around. She also happens to suffer from chronic pain. Oh, how the writer wheels turned as I watched her energetically shout at the dumb-struck geniuses eager for her every word. I could easily picture her intimidating a crumbling witness in one of the many Supreme Court cases that molded the laws used against the very folks she now advocates for. And to top it off, her smile was contagious!

I couldn't resist inviting Jennifer to join the Aberration Nation. After all, I'm addicted to great stories.

When you first developed your chronic pain, how did you cope?

I just kept going and tried not to think about the pain in my body. Over time, however, the pain was so distracting that I could not focus on my work and my relationships. I have a pretty strong personality and belief in God, so I asked for strength and began figuring out a way to get help.

As an attorney, you are devoting your time to helping education physicians and attorneys about the history and current laws around prescription pain medications. How did you become so involved in this effort?

I was working as a federal prosecutor and took my responsibilities very seriously. I saw the tremendous lack of education on the intersection of law and medicine related to controlled substance prescribing, and I began lecturing at the invitation of several key physicians who have served as my mentors through the years. I decided that the government's approach to placing investigations of physicians and pharmacists with the basic drug lawyers was misplaced and, at times, tantamount to the criminalization of negligence, so I left to strike out on my own and join forces with the physicians who wanted to achieve balance in pain management by treating pain and using medications where indicated and, at the same time, taking reasonable steps to prevent abuse and diversion. I have never looked back.

One of your children has issues with substance abuse. How has this impacted your opinions about prescription pain medications, and your professional work?

I see both sides of the balance scale. When I adopted my son, he came with a genetic predisposition to alcohol abuse and began struggling with this problem late in high school and again after returning from Iraq. As a US Marine, he was hurt and his pain problem became chronic. His mixture of alcohol and controlled medications is very disheartening, but he has taken the very brave step of asking for help in his own way. I do not go easy on him, and I expect that there will always be hurdles for him and our family. He's a human being with a tangled medical and mental health history. His medical caregivers need to recognize this and set boundaries and enforce consequences if he cannot be responsible with his medication. His challenges encourage me to remember the multifaceted nature of the under treatment of pain in our country, and the tremendous difficulties clinicians face in identifying and treating substance abuse problems. Our current health care system does not really support medical professionals in the way it should in this area. And, more governmental involvement is not the answer--in my opinion.

Do you feel that there is a stigma associated with taking prescription pain medications, and if so, do you believe this is a fair for those who truly need them?

Yes, there is. You're using the phrase "prescription pain medications." I use the phrase "controlled medications." Most health care professionals, including pharmacists, use the term "narcotics," which is a law enforcement term used to define the effect that a certain class (opioids/opiates) of controlled medications has on an individual. This tells you a great deal about the stigma. I have to sign an agreement to take my medicine properly before I can get my controlled medications. Yet, I do not have anyone really bugging me about my noncontrolled medication usage patterns and my compliance with the treatment plans surrounding them. I take a blood thinner, coumadin, which can be dangerous to others and to me. No one seems to care about that, but there is a greater likelihood of me experiencing a problem with my blood thinner (blood too thin = brain bleed; blood too thick = more clots) than with my pain medication--at least for me because of my medical history.

With regard to your own struggle, has being forced to live with chronic pain brought you growth or expanded understanding of the world around you? Despite the pain, how has it changed your life for the positive?

I do not think like this. I do not think of myself as a pain patient or someone forced to live with chronic pain. I'm getting better at taking care of myself, and I'm happy most days. I use the "down days" to think of ways I can do something to make a difference, or to just stand (figuratively) for a bit.

I have learned not to fight myself over the little things--so what if I cannot wear heels; so what if I cannot ride horses as much as I used to--I can still train them from the ground and still teach other riders and be with them; so what if I have to use a cane from time to time to assist me with standing for long periods or just walking through an airport. I'm still me. I'm still alive and kickin' and very thankful for this.

If you could say anything to those struggling with chronic pain, what would you say?

Be true to and with yourself about your pain condition and treatment needs. Make sure you address the emotional aspects of pain with your healthcare professionals and be very, very careful that you do not use your pain medication to treat your feelings. I have never done this, but I understand how hard it is to feel down and want to do or take something to stop the downward spiral that follows some days. Be very honest with yourself and your healthcare professionals, and remember that as patients we have a tremendous responsibility to handle our medications responsibly--in the way we use and store them. There are many very good healthcare providers who will treat pain, but they have a great responsibility--legally and professionally.

We need to ensure that we do not do anything to present barriers to their continued involvement in our care or the care of others like us.

Of note, next week Jennifer and I will both be attending the 28th Annual American Pain Society Meeting in San Diego.