For my brother, Joseph (1983-2021), in memoriam.

My little brother, Joseph, known affectionately by family as Jose, died at the age of 37 on Monday May 18th, 2021. It’s taken me this long to gather the strength to write about it. I’ve experienced a lot of horrible traumatic events in my life, rape, harrasment, assault, violence, incredible stress, but this is the worst of them. I think this may be the event that haunts me forever. It certainly has for the last six months. I wake up ruminating about it. I go to sleep at night wrestling with images of that weekend in Salem, Ohio. Conversations play out over and over again in my waking and dreaming life. This is what PTSD is, feels like, I get that better now. This is what millions of people around the world live with and struggle with. It’s grief but it’s more than that. It’s the feeling of learned helplessness and hopelessness. The cracking of my normally optimistic belief in the goodness of others. It’s the torture of “what ifs” and my brain trying to make sense of something that doesn’t fit with how I used to see the world. I am sharing here with the hopes that by breaking my silence I can help other people somehow avoid whatever set of things led to this tragedy, and also I hope that I can begin to heal, to find a path out of this darkness. There was no funeral for my brother, at least not one that I know of, so this is my chance to say a few words. 

Growing up the oldest child of three, a latch-key kid in the ‘80s and ‘90s, with two working, stressed out, and often abusive parents, I don’t remember a time when I didn’t feel like “momma bear” to my younger siblings. If you wrote a definition of a parentified child, it would be me. When begging my father to step in and protect me and my siblings from my mother’s rage, her waking us up for school when I was six, bright red face so angry that drops of spit hit my face, yelling at me at full volume, his response was “You have to be the grown up. She is not well”. My mother’s rage would come out of nowhere, seemingly unrelated to anything we were doing. Unless of course we were feeling distress or in need of comforting or in pain- that would definitely get us screamed at or hit. To our betrayal, my father would pretend to be empathic in private with us and then delight in our emotional pain when our mother would abuse us. I didn’t understand sadism at the time but do recognize that this is what that was now. My father would drive 90 miles an hour through the darkness and rain with me in the passenger seat, a glass of scotch on the console, delighting as I begged him in terror to slow down. This is sadism- delight in the pain and fear of others- particularly grotesque when it’s aimed at your own small children. It would take me more than a decade to realize that not only was my father telling me to be the “grown up” a completely unrealistic position to put a six year old in, but his infantilizing of my mother was also deeply misogynistic. In the blocks that I walked to first grade alone, I would try desperately to calm down enough to not look like I had been crying. I knew instinctively that I needed to hide the abuse in my home from my teachers and school and felt a deep sense of shame. I also vowed to protect my younger brother and sister the best that I could, to be the grown up.

I had a lot of things going for me that provided me some resilience. I was profoundly gifted, skipped the second grade, and scored highly on school exams and standardized tests without studying or even really paying attention in school. This counterbalanced the abusive and neglectful home life that I had, allowing me to do alright in school getting mostly As and Bs. Although I do wonder how much better I could have done if I had a supportive home life where my parents knew what our homework was instead of just raging if we didn’t do well in school. I also was fairly unmarred by my family’s history of mental illness. Depression, bipolar disorder, alcohol and drug addiction, and suicide runs on both sides of my family. I have struggled at times with short term bouts of depression but otherwise have been mostly ok. My brother was not quite as lucky as I was. He was smart and capable and fun loving, but was also hyperactive, disorganized, and had a hard time paying attention in school. If it had been the 90s and not the 80s, he certainly would have been diagnosed with ADHD. His grades suffered and my father was constantly berating him for it. Eventually my parents sent him to a military boarding school in the 9th grade where there was extreme abuse, hazing, and serious drugs. He talked about this experience with me and it was clear that this school was profoundly damaging to him. 

As a kid and teenager, sports and his natural athleticism provided an outlet and a boost for his self esteem. His daredevil nature and incredible natural balance made him extremely talented at skateboarding, roller hockey, and snowboarding. When I think of my brother, I think of him flying down a hill in our neighborhood or a ski slope, easily, masterfully, without a care in the world. As kids we had many fun adventures together- playing in the woods and creek behind our house, catching salamanders and turtles, running the neighborhood with other kids, building forts. I remember us running around indoor tennis courts, chasing each other, giggling goofily “you stole my cheese cake”, “no, you stole my cheesecake”. To my grandfather’s homophobic horror, and everyone else’s delight, I would dress my brother up in my ballet tutus and put on performances, twirling him around. My brother and I also had a fraught relationship at times. It was often one-sided- I don’t think he’s ever gotten me a birthday card or called me on my birthday- and he was very entitled- bullying me, insisting on watching what he wanted on TV, picking the locks on my sister and my doors with bobby pins and stealing from our piggy banks. I think beneath all of the petty fighting neither of us harbored any true animosity towards each other, however, and we loved each other, as two people with a long shared history do, as comrades, as siblings. 

Things went downhill for my brother pretty quickly when he was a teenager. After he came back from military school he got into using and selling crack and coke. He was in trouble a lot both in school and with the law. He started hanging out with friends with criminal records and they stole from my parents- TVs, laptops, cameras, and wrote checks from my parent’s checkbook forging my dad’s name. It was unsafe and scary in my home. We had a 19 year old with a record of armed robbery living with us for a while. I can still remember the smell of this guy’s cologne- it smelled like pure evil to me. Saying that my parents made bad parenting choices is an understatement when it comes to this period of our lives. But again I think there was some element of delight and power that my father took in me feeling unsafe in my home. I continued to be a surrogate parent, driving my sister and brother around, helping with homework, playing therapist for my parents’ intense and volatile marriage. I thought if I could just take on enough, be perfect enough, I could keep the walls from collapsing in on us. I remember pulling my sobbing little sister into my arms during particularly bad fights between my parents and whisking her away to my room to comfort her. 

I went away to college in another state for a few years and then took a technician position in a lab in San Diego before returning to Pittsburgh to start medical school in 2003. At that point my parent’s marriage was culminating in a dramatic parting and ugly divorce. My brother was 19 and had graduated highschool. That fall he got into a terrible car accident while speeding and drinking and driving. This didn’t surprise me since my father had been modeling speeding while drinking and driving since we were kids. The car accident left him paraplegic. He spent three months in the hospital attached to my medical school recovering from a spinal cord injury. I would go between classes and the hospital trying my best to help manage his care with the nascent medical knowledge that I was acquiring. He had super high fevers “of unknown origin”- meaning his doctors didn’t know why this was happening. We often weren’t sure if he would live. My mother at that time had developed a serious drinking problem- I think to deal with the guilt she was having over her affair- and had multiple suicide attempts. My sister asked to live with me in my studio apartment (she was in highschool) because my parents were so neglectful and the house was completely unsafe, and I agreed. My first two years of medical school were some of the most stressful years of my life- worrying about the health and life of both my brother and mother, being the pseudo-mother of a teenager with no money (we lived off of $15,000 in loans and the money my sister made waitressing), and trying to pass medical school. This was all happening while my father was off getting married to his fourth wife in Italy and honey mooning on African safari. My grandfather on my mother’s side also committed suicide during that time, by gun in his front yard. I had been trying to help him with his medication regimen for bipolar disorder and felt extremely hopeless that we failed to keep him safe. I was divorced from my emotions a lot of the time and I think that most of my classmates, besides a few close friends, had no idea what I was going through. At one point, one of my classmates did present me with a card signed by many of my medical school classmates acknowledging the difficult time with my brother in the hospital. It was like I was frozen and there was a wall of ice between us. I was grateful for the card but I was in such a dissociated place that I couldn’t connect with her or the moment emotionally. 

My brother eventually recovered after his car accident and left the hospital but became addicted to Oxycontin that he was prescribed for the pain of his injuries. He had also developed severe bipolar disorder with psychotic episodes. He at one time spent an entire year in an inpatient psychiatric ward following a psychotic episode where he thought he was “a sun god” and held his face to a hot burner on the stove as part of “ninja training”. I think it was a combination of things that led to my brother’s mental health decline- abuse, neglect, unlucky genes for mental health, the devastation of being such an athletic kid who could no longer walk, and opioid addiction. He spent years trying everything from snake oil remedies to magical thinking to no longer be “crippled”- his and my father’s words. I don’t think he had any way to feel self esteem after the accident. This is part of the toxic masculinity culture and ableism that was/is so destructive.

I tried extremely hard to help both my brother and mother in the years following those awful years, both from a medical perspective and emotional support perspective. I found treatments centers, and found relatives that would help my mother, I talked to doctors, I looked up medications, I drove both my mother and brother to rehabs and facilities. I went beyond burnout to some other world that exists beyond stress and carried the weight of the family world on my shoulders. It was practically impossible for me to both do this and complete my studies but I knew things were so much harder for my mother and brother than me that I gave it 1000% effort. In 2011, I graduated from the Pitt MD/PhD program, not coincidentally getting my PhD in neuroscience in the psychiatry department. I was both trying to help my family with their mental health at the same time that I was studying mental health disorders in the lab. After several decades of trying, I realized that I wasn’t able to fix any of it really and it had never been my place to do so. I had deep seated anger and resentment towards my parents for all of it. They had never taken any responsibility for what happened or apologized for any of the abuse, neglect, or broken promises. I went from going home every weekend in college to spend time with my parents, to only Holidays in grad school, to skipping Holidays eventually in my thirties. There was one Thanksgiving where I just couldn’t make myself show up anymore despite the great societal and family pressure of “family is forever”. I saw my brother, Joseph, only occasionally- once every year or two. His life never really turned around- he lived in assisted living homes- mostly watching movies all day. My father constantly complained that he was overweight and not ambitious- which was so far from my brother’s biggest problems and complete denial of his mental health issues. My father only really cared about what his children’s appearance or accomplishments said about him to the world. It wasn’t surprising that he could only focus on how my brother was letting him down in that regard, having no empathy for the bad hand my brother was dealt in life.

Jose had some ongoing physical health problems due to being in a wheelchair. He had recurring kidney stones, which my friend Michelle, a Urologist who went to medical school and University with me, would periodically surgically remove. He also had some bed sores on his back side because he would sit or lie for so long in the same position and couldn’t feel the pain because of his paralysis. I would follow along with his care long distance and make sure that he was ok and talk with my dad who primarily was taking care of his hospital appointments. So on Thursday May 14th, 2021, when I got a phone call from my dad’s wife, Paola, that my brother was in the hospital again, this time for surgical debridement (cleaning out) of bed sores on his back side, I was not particularly surprised. 

The pandemic years of 2020 and 2021 have been pretty intense and traumatic for a lot of people and a lot of people have had weird vivid dreams. I had been dreaming of my brother every few months for years. Always in my dreams he was walking, which is so strange given that he had been in a wheelchair for almost 20 years when he died. My brother was various ages in those dreams, and the dreams were never particularly eventful. He was just somewhere with me, walking around. In the first few pandemic months of 2020 I started to dream of boats and islands and harbors. The island dreams I think clearly were about isolation in lockdown, and I think they were also about intergenerational isolation. The boat dreams were always of people fighting on them. In the first boat dream it was just me and my brother. My parents were somewhere but not really around. My brother and I were about 8 and 5 years old, yelling at each other. The sound was turned off on the dream scene and I could see him yelling at me but I could not hear anything. Time slowed down in the scene as well and I was looking into his big green eyes on his tan face with a little kid nose, the kind you have before it turns into an adult nose. And it was a picture of innocence. Those eyes were the most beautiful, green, innocent little kid eyes that I’ve ever seen. Many months and boat dreams later, including pirate ships and other violent boats, I came to realize with the help of my Jungian analyst, that the ships were word play for “hardship”. This was the hardship that had been passed down through my family. 

I was very worried about my brother during the pandemic- especially with him living in an assisted living home. I kept meaning to call or stop by but never had plucked up the energy to do it. I had gotten the phone number and address from my dad’s wife in case I needed to check on him. I guess it’s a little woo to think the dreams were telling me to talk to my brother. But sometimes your subconscious puts together the pieces of things that waking you is trying not to think about or has some block to doing. Dreaming is without the “ego defenses” to get in your way of seeing clearly. I have felt tremendous despair about not being able to help my brother. There are so many things scientifically and medically that would have needed to improve for my brother to lead a “normal” life. We need better medications, better dual diagnosis treatment, better places for people with mental health issues to live. He needed therapy for his history of trauma and abuse and for creating a self image that wasn’t dependent on him being physically active and not in a wheelchair. He needed to not have my father in his life and definitely not as his primary support system. I know that it was impossible to help my brother and wasn’t my place even but I still feel tremendous guilt and hopelessness about how his life turned out. 

After his surgery for his wound debridement I talked to his nurse and talked to him on an ipad. He seemed ok and his nurse did not seem worried. He was stable. So I was confused and surprised when Paola, my dad’s wife, was telling me that she didn’t think my brother would make it. Paola has been one of the only people in my immediate family that has been kind and I am tremendously grateful for what she did to help me that weekend. I thought that it was just my father being dramatic in an effort to manipulate me to come there or to talk to the family as he had done many times before. But then I found out that they had withdrawn care and put him on hospice. This made very little sense to me because from what I knew of my brother’s condition, he was very, very likely to recover. Yes, he needed antibiotics, and possibly some months of outpatient dialysis, but he had no terminal conditions. I called Michelle, my friend who had performed his kidney surgeries, the latest one only one month earlier, and she agreed that it was shocking that they had him on hospice- his kidney function had been completely normal a month ago and would certainly recover. I talked to my brother again on the ipad and when tears started to stream down my face, he said “why are you crying Christin?”. I said “I just miss you”. He said “it’s not your fault Christin, it’s not your fault”. My family had just left him there, without any treatment, to die alone. 

I felt a rising sense of panic and that Friday, I set off to drive the 12 hrs to Salem Ohio to try and save his life. I called his nurses and doctors on the way there. The head nurse called me “honey” in this condescending tone to which I said “Do not honey me, I am a forty year old physician”. The woman in charge of hospice said what kind of doctor are you? Shocked I said “an MD, what do you mean?”. I could tell that my family had begun a campaign to discredit me to the hospital staff. I called all of my friends that could possibly help- lawyers and doctors in the middle of the night.  My friends were amazing and texting anything they could think of to get court orders to stop what was happening. I don’t know if I could have made it through many of the things in my life without the support of my friends. Everyone was appalled at my brother being placed on hospice. This would never had happened at UPMC or any major hospital with reasonable care. 

It’s only the second time in my life that I have called a friend in the middle of the night, the first time being in 2003 when my brother got into the car accident in the first place and I had been at a medical school Halloween party and needed a ride to the hospital to help manage his care- one of the most terrible and surreal nights of my life. My parents were in Russia trying to save their marriage and had left it partially to me to make medical decisions. My friend Eve saved me that night, woke up and drove me to the hospital where my brother was, and sat with me until six in the morning. 

On May 16th 2021, I arrived in Salem regional hospital just after the sun came up at six a.m. with birds chirping and nurses switching shifts. I had driven all night. When I got to the hospice floor where my brother was, my dad was waiting for me in front of the nurses station. “Please come into this room, we need to talk” he said in the hushed tone of someone about to tell you someone was dead, but I could see the malice in his eyes. I followed him into a glass encased side room. Immediately after the door closed, he started growling at me and I knew that he had just faked that my brother was dead to get me to talk to him in that room. “Admit it!” he snarled “he’s not going to recover”. I got up to leave the room, I wasn’t going to put up with this. I walked to the nurses station to try and see my brother. “You are not in charge here” my father sneered angrily at me and grabbed my arm. Of course this was about control, not about concern for my brother or for me. He then cornered me and said “you are not well are you?”. The nurse was giving me a look like she was sorry and about to call security. I sidestepped him and again tried to see my brother. I said “I drove all night to get here, he wants to see me, and I want to see him, can you just let me see him?”. “No” my father said “not without talking to me”. Then hospital security asked me to leave and I left in the elevator. I got out into the parking lot, devastated, and tried calling my therapist. My dad then called me on the phone and said that I could come back up and see my brother. 

I feel very grateful that I was able to talk to my brother that day. We got to say “I love you”, which is the most important thing you can say. There were many other things that I was not able to say to him or talk with him about including his wishes because my parents continually interrupted and tried to get me removed from the hospital. They had declared Jose incompetent for saying that Trump was president and for talking to jesus- which is ridiculous- he’s religious and half the country thought Trump was still president in May 2021. I have my brother on video being oriented x3 and capable to make his own decisions- this despite being on morphine and not being given antibiotics or dialysis. He had also been declared competent to make his own medical decisions just one month prior at UPMC by a board certified psychiatrist. My brother kept asking the nurses to turn down his morphine and they wouldn’t. They were intentionally snowing him. “Don’t worry” said one nurse who couldn’t have been more than 20 years old “we haven’t really turned it all the way up yet”. I was appalled. They were running a death squad. My brother being declared incompetent made my parents his defacto power of attorney as they were next of kin. His physician that weekend, who I think must have been a resident, initially agreed with me that he was competent. But when the power tripping hospice woman re-evaluated him, the resident demured. The hospice woman went into the room alone with my brother and I could hear him yelling “stop scaring me! stop scaring me!” outside of the door. 

Michelle, my brother’s Urologist,  got on the phone with the resident and told her that she thought he would recover to no avail. Normally, in a reasonable hospital there would be a a psychiatrist’s evaluation and a panel that decides whether someone is competent and treatment would continue until these judgements were determined. They would never just stop treating a patient without these evaluations in place. This hospital didn’t have a psychiatrist at all. I tried to get my brother transferred to Cleveland clinic for a proper evaluation but they wouldn’t take him because of his hospice status. “It’s not my fault” the resident yelled down the hall at me over her shoulder. “It is your fault” I shouted back. “Grow a spine” I thought, “you are murdering my brother”. My brother did not know he was on hospice and clearly wanted to live. He stated this multiple times and I also have this on video. No one discussed his wishes with him. My sister and mother refused to talk to me during the weekend, stonewalling me. “I don’t understand the medicine” my mother excused in the tone of a fifteen year old girl. My dad said “are you going to take care of him?” to me- making completely clear that he was killing my brother because he no longer wanted to take care of him. “Yes” I said “of course I’ll take care of him, just treat him”. This was to no avail. My family eventually would not let me into the hospital. The security guards were super nice to me, thanking me for going willingly out of the hospital, and like everyone else “were just doing their jobs”. 

I called more than thirty law firms to try and get power of attorney that weekend. None were open on the weekend. My parents did not let my brother talk to his friends who wanted to get plane tickets or drive to see him. Finally Monday morning, as I lay in a hot hotel room in Salem Ohio, my dad’s wife texted or called me (I was in so much shock that can’t remember which) that my brother was dead. My parents and sister never called or texted. My sister, who is a journalist, tweeted out a “what a great sister in a tragedy spin article” and how grateful she was to be there when he died (secret daggers at me who they would not allow in the hospital) just moments later. She used the murder of my brother to try and twist the knife in me- something that completely blows my mind in its callousness. This was before I had a chance to tell any other family or friends. People that were close to my brother found out about his death from Twitter. They had no funeral. I lay in the sweaty hotel room with the broken air conditioner, unshowered, in a cocoon of deadness. My cell phone rang and it was a Salem lawyer finally getting back to me to ask questions about taking on my case. “He died” I said. The lawyer was still trying to get me to give details of the case “Oh yeah” he said “we sue Salem Regional Hospital all the time” in a voice connoting how bad the hospital is. I couldn’t talk or move, I just lie in a sweaty cocoon of bed sheets for hours and hours frozen. 

When I finally drove to Pittsburgh the next day to stay with friends in my initial shock of grief, my friends said “your parents lost two children that weekend” without me even having to tell them that I had decided to cut off all ties with my immediate family. They knew. How could my family ever come back from killing my brother? Things were irreparably damaged. My dad sent me an email saying “someday I would understand” and “letting go of the past will let us move on” and “please don’t abandon your family”. Someday I would understand? That you killed my brother? He said this in the manner of “someday sweety, you will understand why we couldn’t let you go to that party”. I am forty years old, I am a professional, I have an MD and a PhD, and you murdered my brother in a horrible death trap of a hospital. No, I don’t think that I will ever understand. At least not in the way that you are saying. I might understand your malignant narcissism better, transgenerational trauma, how to fix the healthcare system so this doesn’t happen to others. These things I hope to someday understand better. I understand that I need to fill out paperwork to get my own power of attorney in place so that you never make medical decisions for me. I understand that it is unwise to ever get sick in a place without a major hospital in the US. I understand that I’m done with the gaslighting, and in order for me to heal, I need to stand in my truth. My heart is beyond broken for so so many reasons.

I love you Jose, and it’s not your fault either. I’m sorry that I couldn’t save your life and I would give anything in the world to change that. You will always, always, be in my heart. 

Love, your big sister, 


On the inherent evil of a hierarchical system and why “fragility” is an intrinsic feature.

The problem with a hierarchical system is that one person’s feelings of worth are dependent upon superiority over another person. That “lower ranked” person must feel less worth in this system for the “higher ranked” person to have worth. Conversely, the “higher ranked” person must feel less worth if they aren’t “better” than “lower ranked” people. The two people can never feel equally worthy at the same time. In other words, someone or many people must always feel bad or feel lesser.

We talk about fragility– “fragile male ego” or “white fragility” and I think this can’t be addressed without addressing first the very problem with a hierarchal system. Fragility is the flip side of the evil hierarchical coin– and it is aptly named– it’s a weakness– it’s the part of the system that drives oppressors to feel like they have to oppress or lose something themselves. If they aren’t better, then they aren’t worthy. It’s a zero sum game.

I have long felt that hierarchy was inherently “wrong”– I actually think that it and its “yes man”, money, are the root of 99% of suffering in the world. People defend hierarchy to me in a lot of contexts subtle and not so subtle. They wouldn’t outright defend racism, misogyny, classism, homophobia or ableism in this day and age– but these are just specific cases of the general– hierarchy. People do defend capitalism, hierarchical polyamory, nationalism, control over children until a ridiculously late age (18), superiority of married people, intellectual elitism. All of these things are other flavors of hierarchy that we just haven’t fully turned our gaze towards.

I think most often of hierarchy in terms of feminism because that is the flavor of inequality that I am most familiar with. But it is just one flavor of hierarchical oppression amongst many. Most people have experienced some form of systemic oppression. I think of the qualities that historically have been desired in women or thought to be feminine and all of them require us to be lesser, weaker, smaller. Ladylike- demure, quiet, thin, agreeable, young, servile. And the flip side of what is leveled at women– most often powerful women– ambitious, angry, mannish, old, tall, castrating. “Ambitious”– that is what one journalist leveled as a supposed criticism at our current Vice President, Kamala Harris, just last fall. How can you possibly be Vice President of a country and not be ambitious? You can’t. Basically if being ambitious as a woman is disqualifying, then women can’t be in any position of power. Just last month some guy on LinkedIn accused me of being “opinionated” before he thought better of it and removed the comment. “Opinionated”– yeah I have opinions and it is generally a good thing to have opinions– and here you are on a professional networking site telling me not to have opinions?

I think about it in terms of partnership for myself and wonder if I am just doomed. To require equality and respect in partnership in a world that is hierarchical is in some ways setting myself up to be alone. Over and over I find myself in some zero sum competition with a partner or a partner’s partner. “The battle of the sexes”– classic. In my, only slightly more progressive world– “the battle of the partners”. Why does my success have to feel like a measure of their failure? Why are we measuring ourselves against the people we are supposed to be in partnership with instead of against our own goals and aspirations? Every time I try to get away from it, I find myself back in it in some sneaky way. It feels like a struggle, a problem, an inherent condition of the society I live in that I don’t know how to fix. I can choose love or I can choose success and self-respect but I can’t have both. I think what it must have been like living in earlier eras, the utter hopelessness of that time. Sylvia Plath’s suicide was thought to be rooted in feminist hopelessness to some degree and I see how she felt that way.

I think we can’t fix systemic oppression without first entirely throwing out hierarchy. We need to start seeing the world through the lens of equality and without stereotyping people into stacked boxes of worth by race, gender, nationality, class, or orientation. Equality doesn’t mean that everyone is equally good at everything but it does mean that everyone is equally worthy. People are inherently worthy of love and respect. Regardless of what “boxes” they fall into they should have equal opportunity to pursue their dreams without damaging someone else’s fragile sense of worth. We need to tare down nationalism, capitalism, and systemic hierarchy of all kinds in order for everyone to be less fragile. Just look at this Pandemic– we have to cooperate globally to survive. We have to stop worshipping at the altar of royalty and supremacy and start worshipping at the altar of humanity and intrinsic worthiness of all beings. It’s essential for our survival.

The Competition

Over and over again I am not chosen. Over and over again I want real love. I have been the wife and the mistress. I have been the girlfriend to beautiful women. I have been the daughter to a jealous mother. I have been the best friend holding a place for an eventual husband and kids.

Men stay in sexless relationships and flirt with me. They don’t choose their partner, they don’t choose me, they don’t choose themselves.

Men have stayed with me and flirted with others. The glacial divide widening. They don’t choose me, they don’t choose another, they don’t choose themselves.

Women tell me they love me. They love me, just less than they love men. I become the competition. They claw out my eyes in spite of the words “poly” or “triad” or “partner” or “love”. I become part of their Faustian bargain. An unwilling, unwitting, participant, in a religion I don’t even believe in.

And so I feel rage. At the bottom of that rage is the deepest sadness. The sadness of never being chosen. Or maybe just never being connected with. Never being seen. Of having my heart ripped out by men and women alike. By friends, lovers, partners, parents, siblings. Of people competing with me in a contest I didn’t sign up for and don’t want to participate in.

So I lay down in the middle of the road and let the cars run over me. You win. Everyone wins. I’ll just be here becoming flatter. Eventually my clothes will meld into the asphalt. And people can run over me for all of eternity in their race to win the competition.

The empty meaningless competition.

Present Board

2019 was a rough year. It was strewn with relationship carnage. I said goodbye to three partners and my entire “polycule”, which was about 60 people and included a lot of friends. I filed a harassment order against an upstairs neighbor who was threatening me with violence. And I moved twice. Most painfully, I ended relationships with three immediate family members, both of my parents and my sister. I think I hit a breaking point. Enough was enough and it sort of all happened at once. I was tired of being taken for granted, walked on, not appreciated, abused.

The Winter Holidays of 2019 were searingly painful, numbing, and I almost didn’t make it through them. On New Years Eve 2019, my metamour from my last remaining partner gave me a one card tarot reading. While I don’t really believe in tarot readings, I have become fond of them as a tool for self-exploration and learning more about other people in group readings. That NYE night, I drew “the World”, which is basically the best tarot card I have ever heard of. It literally talks about Nirvana. Below is the card and the description.

“The World card in the tarot deck has a dancing figure at the center. The dancing figure on the card has one leg crossed over the other and holds a wand in either hand. She symbolizes balance and evolution in movement.
The green wreath of flowers that surrounds the central figure is a symbol of success, while the red ribbons that wrap around it are reminiscent of infinity.

To encounter the World in your cards is to encounter a great unity and wholeness. It symbolizes the moment when the inner and the outer worlds – self and other – become a single entity. In some traditions, this state is described as enlightenment, or nirvana. There is a recognition that the individual self is profoundly linked with all other things, and that we all dance and sway along the flow of life to one rhythm. Not only do you hear this rhythm, but you participate in it – following the dips and the rises, the joys and the sorrows.

The meaning of the World card is fulfillment, achievement, and completion. This shows that all the efforts that you have been putting in place are starting to pay off. It reflects that you have completed a major milestone in your life and you have built the resilience to withstand challenges. The World may indicate completion of a long-term project, study or any other major event in your life.

The World card shows that you have a desire to give back to the community in various ways. You have a commitment to make the world a better place because you understand that everything is connected.”

So then there was this global pandemic in 2020- you all may have heard about it- Coronavirus? Well, at first it seemed pretty incongruous with a tarot card about “nirvana”. But I actually think maybe there is some bittersweet correctness about all of this— me getting out of my little academic corner and out into the wider world, having a compulsion toward service in the best way I can be of use- helping people navigate the waters of this pandemic, connecting and reconnecting with friends and family around the world. I definitely have been following the dips and rises. And I do see how everything is connected especially with the news and “becoming purple” politically. I do feel aligned with what and where I am supposed to be maybe for the first time in my life. Who knew that place would be out of the ashes and into a pandemic and from a pandemic into the world.

So tonight I made a vision board. Except it’s not manifesting a future I want. It’s actually a vision of what is. It’s part memorial, part lessons learned, part feelings. I guess I am envisioning exactly what is and I’m sharing that with the world.

It also comes with a sound track- Philadelphia Mix— I live in Philadelphia now, with a former partner and good friend. In a little bubble. For the present moment.

Happy Pandemic Friday.

A case against “Karen”. Her dual roles in calling out racism and silencing powerful feminist women are impossible to untangle.

“Karen” has become a very popular internet meme stereotyping a particular “type of woman”, most often used in reference to middle-aged upper-middle class white women wielding their privilege to promote violence against people of color. This is absolutely a problem in society and has insidious historical roots in white women falsely accusing black men of rape in order cause lynchings. The quintessential example of this has been Amy Cooper who this past May, called the cops on a black man (an action that we have seen can endanger his life ie. George Floyd) because he asked her to put her dog on a leash in Central Park. Cooper was video taped saying “”I’m taking a picture and calling the cops,” “I’m going to tell them there’s an African American man threatening my life.”. This is awful and this idea needed/needs to become conscious in the mainstream in order for people to alter their behavior.

However, “Karen” and more generally names for women in general has another purpose. That purpose is to legitimize misogyny and silencing of women. In particular, it’s to silence powerful feminist women who have done nothing “Karen-like”. The quintessential example of this is Jess Phillips, member of the UK parliament and shadow prime minister of domestic violence and safeguards. A vocal feminist, MP Phillips was subjected to rape threats and was stalked at her home after objecting to International Men’s day. A tweet calling her “shadow Karen of domestic violence” received over 11k likes on twitter. MP Phillips has been championing protections for victims of domestic violence during COVID-19 and while she has been called “Karen”, she has no accusations of racism to the best of my googling.

This alternative use of “Karen”, to silence powerful feminist women, criticizing them down for being unaccomplished, unattractive, and annoying- the usual barrage of physical and double-standard personality insults hurled at women (none of which have anything to do with racism) is illustrated in the top definition of “Karen” from the Urban Dictionary:

“The stereotypical name associated with rude, obnoxious and insufferable middle aged white women. Karens take everything wrong with the typical over entitled western woman and crank it up by several thousand percent. They are a mutated subspecies that descends from the Soccer Mom, and have many of their traits. Such as a short temper, a crown bowl haircut, an unnecessarily large SUV to take her kids to soccer practice and be a menace on the road, etc etc.”

The “Karen” meme is now a staple of white male rage against women with most twitter hashtag users falling into this demographic. It also has been championed by white guy comedian, Dane Cook (notoriously misogynistic) and a vitriolic viral rant by a guy on reddit against his ex-wife (r/FuckYouKaren).

Here are some choice quotes from Dane Cook:

  • “weakness” is his favorite quality in a woman (twitter)
  • He advised audience members to “go fuck a dirty whore. That’s the best therapy.”
  • He reminisced about that time he “chainsaw-fucked” a “disgusting whore’s cunt.”
  • He talked about how girls would do anything for him “because I’m me.”

I implore us to give up on “Karen”, especially on her hair style and her age, and have a conversation about racism that doesn’t have the dual purpose of legitimizing and inciting violence against women. It detracts from the message and creates further destruction.

People don’t like it when you give up your privilege.

People don’t like it when you give up your privilege.

Why would you do that? they say.

You had so much privilege. So many people would want that. And you, you can have it.

You can be the THING that everyone values. You were on track to have so many accolades by such a wide number of people.

You must not be ok. You must just be having a hard time… right?

I am ok, I say.

The struggle is real. It’s real for everyone. But that doesn’t mean that I’m not ok.

If I wasn’t struggling, I wouldn’t be learning.

And… I don’t want to be a THING.

The price of those accolades is steep.

The price is self-actualization.



 To become more and more what one is. To achieve the full realization of one’s potential and of one’s true self.

To be what the average person in the ruling class thinks everyone should be, is not to be me. It would be quite the coincidence if the real me was exactly that.

I could be that THING, but I don’t want to be.

I want more. I want more interesting.

I want to struggle. I want to learn.

I want to be surrounded by people who are ok with me not being a THING. More than that, I want to be surrounded by people who are happy that I’m not a thing.

People who are happy that I’m me.

Regardless of my privilege.

Anyway, what could be more privileged than self-actualization?

You have to get through all of Maslow’s other needs to get there- physiological, safety, belonging and love, esteem.

Maslow was a demanding dude.

I wonder what people are going to say when I try and level-up into self-transcendance?

“In his later years, Abraham Maslow explored a further dimension of motivation, while criticizing his original vision of self-actualization. By this later theory, one finds the fullest realization in giving oneself to something beyond oneself—for example, in altruism or spirituality.

He equated this with the desire to reach the infinite.” 

At that point, it probably won’t matter to me.

Learning to not feel compelled to defend my personal decisions from the judgements of others, is part of the journey. I would guess.


Trevor Noah killing it with a piece on black women not being given the credit they deserve. Did you know that black women started BLM? It was these ladies pictured above.

Black women also helped to start Me Too and a black trans woman catalyzed the stonewall riots. Black women were also silenced at Martin Luther King rallies. This is why I keep talking about Mayor London Breed of San Fran because despite being one of the only sane and smart leaders during this pandemic, no one knows who she is.

Misogyny is not just about violence or harassment, it’s often about not being given credit where credit is due. This is a huge problem in the professional world for women and far worse for black women. And I learned a new word:



the specific hatred, dislike, distrust, and prejudice directed toward black women (often used attributively):misogynoir attitudes and comments;The media’s erasure of the contributions of black women to the project was called out as an instance of misogynoir.

It sounds so sexy for such a shitty thing.

US Breaks 150,000 COVID deaths this week: a perspective in graphs and some simple calculations predicting a very dire August.

(sorry for the formatting, I am still getting the hang of this blog world)

So this is the overall state of things according to the database I believe is the least corrupt at this point (more on the incredible corruption in death and case reporting later). It’s 4:35 a.m. and I can’t sleep. All the dying going on might be something to do with it. And all my nurse and doctor friends in the hospitals dealing with things I can’t even imagine- war time things- battle ground things- stress, and exhaustion, and fear for their own lives, and the lives of their patients, and the lives of their families. You get numb at a certain point, except I’ve never been good at that particular thing- the numbness.

But I was going to talk to you about numbers. So let’s do that. 154 thousand deaths is a lot of deaths and unfortunately, I think we are just ramping up. It’s going to be a very gory August. We may be starting to level off in terms of daily new cases at a really shocking number if you put it in perspective, 68k new cases a day. If you recall back in March when Italy (and then New York City) hit the 30k total cases mark and we were panicking?— well now we are more than doubling that total number each and every day. It’s a little hard to imagine but the below graphic might help.

One way I think about predictions or models (more to come on the epidemiological modeling failings during this pandemic), is pretty simply using just same basic logic. People like to get fancy with R0 etc. but I have found that to be pretty useless in this case in making accurate predictions. I am planning a full out review article on this so I won’t get into all of that right now but walk with me through a simple way of thinking about things that has been very accurate in predicting for me.

We have all had experience with ratios in elementary school math- I think that is pretty relevant here since we don’t know that much about this virus and how to model its spread. We can use ratios to predict the future of what will happen based on the past behavior of the virus. You can see that the rough peak of daily new cases back in April was a little over 25k/day in the US. The current peak is ~75k. So more or less, we have 3x the cases that we had then. Things have not changed much since then in terms of relevant parameters- Trump keeps going on about testing being higher but most insurance is not covering testing for asymptomatic people still and the percent positive rate keeps going up so I’m going to ignore that for the time being. We also have no reason to believe that the virus itself has gotten any less deadly by mutation and any advances with drugs or treatment in hospitals is cancelled out by hospitals being very overwhelmed and very understaffed at this point. So, for the sake of argument- lets say apples to apples with case numbers. Now lets compare that with daily deaths– to predict the upcoming daily death rate.

So because deaths lag behind cases (due to the time it takes people to die, deaths to be reported, and certificates signed off on)– the deaths are just rising now- no where near their peak. So that takes me back to ratios– if the peak of daily cases back in April was 1/3 of what it is now then we would expect the peak daily deaths to be 3x its former peak. Its former peak was ~3k/day so I expect that in August we will see ~9k/day people dying. That’s about 300,000 people in one month 30 days x 9k/day:( I’m not sure the US understands that that’s about to happen. Schools opening is ludicrous.

Of course, there is some room for noise here and these are rough calculations. But I think my logic is sound and my predictions have been right so far in this pandemic. So I’d say buckle up, it’s going to be a rough month. The only sunshine on the horizon is that I do really think herd immunity will/is happening- ahem NY being all pale and not increasing I will get to that grand reveal later this week.

Trump re-tweets quack doctor’s video endorsing Hydroxychloroquine and not wearing masks. YouTube, Facebook, and Instagram respond by removing her video as fake news.

Trump re-tweeted the viral video of a Houston area “doctor” he called “spectacular” and “an important voice”.

In the video, Dr. Stella Immanuel, promotes hydroxychloroquine as a sure-fire cure for the coronavirus. She claims to have successfully treated 350 people “and counting,” including older patients and some with underlying medical conditions. “You don’t need masks, there is a cure”. She also believes in “alien DNA” and “demon sperm”.

Trump is once again trying to kill vulnerable people with fake science news.

“Facebook, Twitter and YouTube began scrubbing their sites of the video of the doctors on Monday. Conservative news outlets, groups and internet personalities shared it. Facebook said the video is “sharing false information about cures and treatments for COVID-19,” according to spokesman Andy Stone.” source:

Hydroxychloroquine has no evidence for being an effective treatment for COVID. In fact, according to recent publications in highly respected medical journals, it’s likely dangerous both for the liver and the heart (hydroxycholoroquine-nah-says-nejm). In fact, the US FDA has warned against its use in any further clinical trials.

For reasons that aren’t clear to me, Donald Trump, and co-conspirator Brazilian President, Jair Bolsonaro, have been obsessed with Hydroxychloroquine since the beginning of the pandemic. Bolsonaro, who recently tested positive for COVID himself and claims to take the drug, has been turning a blind eye to the now (at least) 89,000 Brazilian deaths (certainly underreported).

Hydroxycholoroquine? Nah says NEJM

Officially, (if you needed official confirmation), as published in the highly regarded medical journal, NEJM, a study finds hydroxychloroquine is completely ineffective in treating COVID. In fact, it could be harmful- some people taking the drug have more heart and liver problems.

“Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. “

“In this open-label, multicenter, randomized, controlled trial involving hospitalized patients with confirmed mild-to-moderate Covid-19, a 7-day course of hydroxychloroquine either with azithromycin or alone did not result in better clinical outcomes as measured by a seven-level ordinal scale at 15 days. There was also no effect on any of the secondary outcomes. Occurrence of any adverse event, elevation of liver-enzyme levels, and prolongation of the QTc interval was more frequent in patients receiving hydroxychloroquine with azithromycin or hydroxychloroquine alone than in those receiving neither agent.”

In the supplements:
Drinking methanol, making masks out of wet wipes, snorting hydrogen peroxide, using handkerchiefs that are red in color, vaccinating yourself with an injection of a mixture of amphetamines cocaine and nicotine, drinking cow urine, carrying a “5G usb key” to shut out the mobile phone waves, or applying a cotton ball soaked in violet oil to the anus—- all of no benefit for COVID but may have other positive affects.