Update:  I found this Berenice Abbott photo of  a NY railroad in the Met’s online collection, so you get an added treat.  If you aren’t familiar with Abbott’s work, consider this an invitation to “meet” her.

Today’s press release:  obesity accounts for 21% total US healthcare spending.

The Cornell study reports that an incurs medical costs that are $2,741 higher (in 2005 dollars) than if they were not obese. Nationwide, that translates into $190.2 billion per year, or 20.6 percent of national health expenditures. The study appeared in the January issue of the (31:1). Previous estimates had pegged the cost of obesity at $85.7 billion, or 9.1 percent of national health expenditures.

“Historically we’ve been underestimating the benefit of preventing and reducing obesity,” said lead author John Cawley, professor of policy analysis and management in the College of and professor of economics. “Obesity raises the risk of cancer, stroke, heart attack and diabetes. For any type of surgery, there are complications with anesthesia, with healing [for the obese].”

HT Dr. Grumpy

What does that have to do with addressing suicidality causes?

Many of the distressors associated with psychache have to do with social connectedness.  Social connectedness is intregral in the immediate environment. What comprises a healthy, socially conducive environment?

Natural green spaces: parks, trails, gardens and safe places to experience them.

That means sidewalks, bike trails, cleared paths.

Adequate lighting, places to rest, benches, beaches, tables.

Access to fresh, potable water.

Access to places that provide fresh, whole foods – grocers, restaurants, farmstands, foodtrucks, delivery services – at affordable prices.

Access to educational and entertainment media suitable for all ages, cultures and customs – that would be the public library via walking, bike and public transportation.

Access to clean, fresh air – via public health regulations, and state and federal regulations on pollutants.

See where this is leading?

Back to the pump handle  – public health measures provide the biggest bang for the healthcare buck.  It’s all about making a healthy environment – one which promotes natural interaction by people in a healthful and pleasing environment – the default mode.

If Lillian Wald were here today, she would be doing the very same things she did almost 100 years ago in New York City.

People who are obese are, for them most part, uncomfortable. But they are responding to  a culture of immersion in faulty food cues. Their suffering is largely preventable, and public health is the way to go.  Regulate food producers, marketers and manufacturers. Remove advertising for manufactured food products from TV and print sources.  Invest in public transportation, pedestrian and bicycling infrastructure and services.  Regulate clean air, water and substances pollution.

In the US, it is incredibly difficult to find public places and spaces which encourage natural civil discourse. Culture is built around commerce, and indeed, today, politicians refer to Americans as consumers and not fellow citizens. People speak of “going to the mall, hanging out in bars, and going shopping” much more than any other activity where they would naturally come into contact with others.  There are very few venues in which people can casually meet and interact with others.  Almost all communal gatherings in the US are passive – attending movies, concerts and other events require no interaction or active participation. People remain isolated and alone even among large crowds.

It’s not rocket science – it’s basic humane infrastructure and service.



Rough Collie

Image via Wikipedia

[N.B. This is an old post from a defunct blog whose title I had forgotten. Dumpling was a companion to Hobbes and a worthy sparring partner for Bluebelle, RIP, and a story for another time.]

Dumpling, a regal, clear thinking Collie and a little something-else mix, had suffered tremendously.

She was found on someone’s lawn, and she looked for all the world to be dead. In fact, the homeowner called the dog warden to “pick the dead dog up” from his yard. When the agent arrived, Dumpling was lying still, but had her eyes open and intently gazed at the person who picked her up and gently laid her in the truck.

At the noisy dog pound, something about those eyes – clear as glass and with a steady direct gaze, made the warden call an animal rescuer and tell a pretty big lie.

“Why, this is a pretty, middle-aged Collie girl.” “You’ll like her, just come and see.”

When the rescuer arrived at the shelter, she was directed to the first pen on the right, where a starved, ancient old dog lay in a fetal position. Her gaze didn’t even lift up to look around. She had the look of defeat – that look that says, “I’m done in this world.”

Horrified, the rescuer struggled to regain her composure and simply told that agent that she would adopt the dog immediately. She paid the fee, and then put away the leash to kneel down to the old, shriveled dog.

“Would you like to let me carry you to a pillow in the car?” she asked the Collie.

Gently inserting her hands under and around her, the rescuer discovered that each rib jutted painfully through the frail skin and worn-away coat.

Carefully, akin to holding a gossamer strand of glass, she lifted the Collie up and into her arms.

The hind legs dangled at crazy angles, and the dog’s spine seemed curved and bent beyond what any rules of nature would allow. The old Collie hung her head and showed no effort to help or to resist the move.

Even the dog warden watched silently and held her breath.

The worn out Collie was placed on a large pillow in the back of the SUV. In spite of the sunny autumn day, the rescuer turned the heat up in the car, and covered the dog with a soft blanket.

She murmured in whispers to the dog on the way home.

“What’s your name? What is a pretty name for such a beautiful soul? How about Dumpling? Would you like that?”

Glancing at the dog through the rearview mirror, the rescuer didn’t see any signs of movement. When they arrived home, Dumpling lay still and in the same position as when she was placed in the car. She was carried into the house and placed on another large pillow on a bed.

The phone call to the veterinarian went thus: “I think she’s given up and that she’s in incredible pain. Shall I bring her in to be euthanized?”

“Let me see how she does through the night and whether she tells me she wants to fight or to stop the struggle. Yes, tomorrow will be fine. See you then.”

The rescuer gave the dog some warm baby cereal and broth, and Dumpling weakly lifted her head with help and licked at it. She stayed passive while a lambswool coat was placed on her and while her overgrown claws were clipped and removed from the pads of her feet, where they had been embedded.

That night, she was placed on a large pillow next to the rescuer on her bed, and Dumpling went to sleep with the rescuer’s hand cradling her head.

In the morning, the rescuer bustled about, greeting the other animals and getting ready for the day ahead.

First thing on the agenda was to take Dumpling to the veterinarian to be euthanized.

Sadly she bundled Dumpling into the car, but she noticed that Dumpling was taking notice of her surroundings with that knowing, intent gaze.

During the ride to the clinic, the rescuer was already grieving for the dog who had endured such agonies, and she didn’t quite see Dumpling struggle to sit up and look out the window.

However, when they arrived, the rescuer did notice that Dumpling had moved herself and was trying to sit erect, although her hind legs splayed out from beneath her in odd angles. When she went to lift her from the car, Dumpling struggled to stand, and the rescuer noticed how hunched and distorted her back and legs were. But Dumpling insisted on walking unaided into the clinic.

The vet spent a long time in listening to her heart and to her lungs and looking at her back and legs.

He thought for a long while and said, “Why don’t we take this day by day and see what she tells us? Let’s start by taking a picture of her spine and legs and feeding her good groceries.”

When the X-rays were developed, the vet and the rescuer collectively groaned.

For every part of the spine from the ribs back to the tail had been broken and left to mend on their own. They had fused into odd angles, and that accounted for Dumpling’s strange sideways and crab-like walk.

“She has to be in pain, so let’s treat her with anti-inflammatories and see how she does.”

Dumpling also had several large tumors on her back and face, and her coat was almost gone over her hips and tail. She was placed into a large tub of warm bath water, and for the first time, she let out a whimper. Of relief of being able to feel some comfort or just to acknowledge the pain, she relaxed into the bath.

Over the next few weeks, Dumpling ate and ate, and she walked a little bit more each day. What a surprise when she climbed up steep stairs on her own the first time!

Since winter was fast approaching, and cold weather meant a need for more dog coats for the others, the rescuer planned a trip to the local big box pet store, where animals were invited to shop along with their people.

Dumpling now stood by the gate, always waiting to be invited to ride in the car. Since she had visited the vet so many times, and each visit resulted in feeling better and receiving treats, she loved the car, and the good times the rides brought for her.

This time, Dumpling was helped onto her favorite travel pillow and eagerly looked at the passing scenery. Before long, she was “whooping” to let the driver know that the route wasn’t the way to the vet. By the time they arrived at the store, Dumpling wasn’t at all sure about what was to come next.

She was carefully lifted from her pillow and placed on the ground. Wearing her prettiest collar and lead and sporting new and healthy hair coat on her back and hips, she sidled into the store and….

Hey! This place has dog stuff! And food! And people who pet you! And look over there…!

Dumpling carefully, oh so carefully, inspected each and every article found at Collie nose level. She greeted all of the other shoppers by coming up to say hello and placing a long Collie muzzle on their knee to pet.

She was careful to give not-so-friendly looks to other dogs, lest they interfere with her “shopping” experience.

However, her Collie upbringing prevented her from growling or being unfriendly with them. Her clear, intent, and wise gaze was eventually fixed on the food manager of the store, who came over to meet her. Apprised of her history, his eyes softened, and he offered her a treat which she graciously accepted.

After visiting with the songbirds and listening appreciatively to their warbling and trills, Dumpling was finally ready to check out with her rescuer. Discreetly and delicately for a dog missing most of her teeth, she placed her conveniently elongated muzzle into the rawhide bin and selected three choice pieces as they were waiting on line.

By now, the manager had shared Dumpling’s tale with other store staffers, and her feat at the rawhide bin did not go unnoticed. Applause was given to the now regal Collie who once again was interested in living and giving pleasure to those lucky enough to be near her. Dumpling accepted her due with grace and calmly deposited her treats on the counter.

But I wonder, who received the finest gift that day?

Wikipedia: hobbes definition: Thomas 1588–1679 English philosopher.

Hobbes and the Holidays

Rough Collie named Jack[N.B. This is an old post from a defunct blog whose title I had forgotten.]

Hobbes and I found each other when he was just a large puppy.

At that awkward age – adolescence –  when puppies look like dogs but definitely act like puppies; Hobbes had been given up by his owners. A new baby, and a new apartment, and Hobbes landed with a breed rescue group.

He was produced by an anonymous backyard breeder. You know, the ones looking to make a quick buck with any old dam and sire. You see their ads in the newspaper classifieds and now on the Internet. “Collies, tris and sables, AKC Reg. $150 Parents on premises.”

Translated that means, “I bred the first male I could find to the first female I could find. The American Kennel Club doesn’t care – all that the registration papers mean is that the family tree is known. Not that I give a hoot if it’s a good line of breeding. Vet care? That costs too much. Blind? How would I know? I need some extra cash for the holidays. And people always love puppies. What happens if they don’t get them altered? Why should I care what they do with them after they’re sold. Pet overpopulation? Not MY problem. I have RIGHTS, you know. This is AMERICA!”

And so Hobbes, his extra long collie muzzle ducking toward his tail, shyly allowed me to hoist him into my car and off for the ride home.

He was so shy, this tall, dark and handsome collie. I didn’t know that collies came in colors other than the TV issue “Lassie sable and white with a white stripe on the face.” But Hobbes had a rich dark brown coat with subtle highlights of sable eyebrows and sable legs and white stockings on his elegant and incredibly nimble feet.

By the time we arrived home from the foster family‘s house, Hobbes had crawled into the front seat and was leaning against my side very politely. We were fast friends as he bounded out of the car.

I learned of the official collie burp. It’s produced solemnly and with dignified presence. It’s subtle, yet distinctive, to purebred collies.

I learned of the fondness of a collie for a cool floor on which to luxuriate. Collies stretch from their noses to their tail tips, and Hobbes was masterful at his stretching.

And I learned of the collie’s absolute love and enjoyment of all things snow-related. Want to throw snowballs? Call a collie to be your partner. Snow Angels? Make that snow collies, too! Call a collie in from the snow, and you will find a collie with a large ball of snow attached to his nose. His face will have an open smile exuberance about it, or perhaps a hint of a pout for curtailing such wonderful fun!

Hobbes had an affinity to watch over his very own herd of cats, most of which were older and sedate. In the first Spring we were together, I have several pictures of Hobbes posing before newly blossoming daffodils, when in each subsequent picture; a tabby cat face a la the Cheshire Cat emerges from the yellow conga line of swaying daffodils. And then Sir Cedric Cecilwycke Tabby Cat (pronounce that with a “Thufferin’ Thuccotash” lisp), approaches the posing Hobbes for first a friendly nose to nose sniff, and then on the last frame, a very friendly full body cat rub on Hobbes, to which Hobbes is bent over Sir Cedric looking for all the world to be his biggest best friend and protector.

Later, when it became clear that a retriever Hobbes was not, the veterinarian checked his eyes and with alarming directness, instructed us to make an urgent appointment to see a referring veterinary specialist at once. He thought Hobbes was developing a large brain tumor at age two. I had visions of dealing with a very untimely demise of a much-loved dog.

At the visit with Dr. Wyman, the nation’s foremost canine ophthalmologist, I nervously held a calm and polite Hobbes during the eye examination. As he gently supported Hobbes’ long muzzle, Dr. Wyman, without anything other than sincerity, soothed to Hobbes, “You are SUCH a fine gentleman.” And I knew exactly what he meant.

There was good news and not so good news. Hobbes had not a brain tumor, but he was blind. And he had been since birth. In collies, there is a condition where the cells that hold the retina in place fail, that in mammals turn wavelengths into vision; Hobbes had failed to develop the supporting structure. And so with the retina fallen flat into the eye orbit, there was nothing on which the wavelengths to convert to vision. Dr. Wyman stated that categorically, Hobbes was blind and always had been.

I was giddy with relief. For this dog had already been through obedience classes and had passed with flying colors. Hobbes was titled as a CGC – Canine Good Citizen, and that, he was! How he knew where to place his feet and his body, I could never tell. But until his last day, he was unerring in his footing. He ran with the horses, avoided the goofy goats, and herded the chickens and rabbits, all without a single misstep.

Hobbes was such a gentle and sensitive soul, and he served as a greeter and big brother to uncounted animals who came into rescue and later the animal sanctuary that was founded in his honor. He was directly responsible for the rescue, retirement and rehoming of many animals that had been deemed unadoptable and un-savable.

Early on, Hobbes enjoyed car rides, and he went with me everywhere. As he gradually became more of a homebody, I often had to seek him out, as he stayed out of the general hubbub of younger and more energetic animals.

Over the past month, the other two eldest collies – both rescued from awful abuse situations and taken to high kill shelters, died after fading. Hobbes had been very connected with them, and I held my breath to see if he would survive his grieving for them.

We – the rescued dogs and I – celebrated his 13th birthday on December 22, and I knew that he hadn’t much time left with me here. Without much hearing left and with increasingly unsteady legs, he still enjoyed rooting for a passing bicyclist, but he was slowing a bit more each day.

On Christmas Eve, I insisted that he sleep inside, rather than on the three-season porch, as was his wont.

On Christmas Day, his gaze was unfocused, and his breathing was shallow and rapid. I knew that he was quickly leaving.

So with plenty of hugs and a liberal dose of tears, I released him to travel on and join his friends, Toby and Dumpling and Napoleon, as memories of exquisitely beautiful and sensitive souls. And on Christmas night, I buried his body next to his other collie buddies and planted daffodil bulbs to remind me of other times and gentle breezes and young collie cavorting.

I miss my dear friend terribly, and I am so grateful that I had such a wonderful collie friend in Hobbes, the throwaway blind collie. But how I long for just one more time to find a long collie muzzle resting on my leg, demanding a pat and a smooch.

Tonic Immobility

This is congruent with my experience and how I react now to stress:

When a rabbit or other animal is trapped by a predator, it will freeze and assess the situation. It might then flee or attack, what we usually call the “fight or flight response“. If that fails, a last-ditch defence mechanism is to go completely immobile, to play dead.

Researchers in Brazil now say that in times of grave danger, this same automatic last resort is also exhibited by humans and is experienced as a terrifying feeling of being “locked-in”.

Terrifying feeling is exactly right.  It feels as if it will never end and that I’m totally exposed.  A target.

…physiological evidence of “tonic immobility” in humans…. Participants who reported a strong sense of being paralysed, frozen, unable to move or scream, tended to show less body sway, higher heart rate and less heart rate variability.

Even reading about this phenomenon brings the terror regurgitating up to the surface. I also experience it as an overwhelming sense of dread.  It’s an incredibly large factor in low quality of life and suffering.  It seems to be an automatic/autonomic response, and I wish I could minimize it, but so far, no success.

One thing leads to another

A cartoonist gets thwarted belongingness but not the myth of attention seeking motivation.

Which leads to the inevitable discovery that there are also mental health professionals writing inane things on the web about suicide.

Which leads to the perceived importance of the components required for social acceptance – eg, belongingness.

For , honesty and kindness—which researchers describe as communion traits—are more important for relationships than intelligence and ambition, both considered agency traits, says Oscar Ybarra, professor of psychology. Agency traits help people attain skills, talent and status.

“Social life pressures people to view themselves as possessing high levels of communion traits and to ensure that others have this perception as well,” he said.

Which, in turn, leads to the other main factor in suicide – perceived burdensomeness: in this case, the perception of ill health:

Our findings provide initial evidence that perception of poor health is associated with a significantly increased likelihood of suicidal ideation and suicide attempt among adults in the community.

Which leads to the hypothesis that suicidality is minimized in societies which don’t use ostracism, have mechanisms for supporting and comforting those in ill health and who use kindness, honesty and inclusive humor in abundance.

National Distress Is A National Disgrace

I remember the Tuesday in September.  The morning was crisp, clear and with eye-watering bluest of blue skies.  I had already finished morning barn chores and was in the house having coffee, checking the net and listening to the tee vee.  For the next three hours, I watched the sky overhead where normally the aircraft were in their final landing pattern turnaround to the local metropolis’ airport gradually clear of all thing winged and rotored.  The silence and stillness was ominous and dreadful, even though the sounds of nature could finally be heard as intended.

The US on that day, could have moved forward by examining the hows and whys of terrorism.  It could have held steady on the solid bedrock of tolerance and inclusion, dignity and respect for all.  It could have made conditions permanently inhospitable to terrorism by not condoning and allowing bigotry, bullying and alienation.

But instead, the US was led by the nose in exactly the opposite direction by Dick Cheney, ostensibly the president in deed if not in title, George W Bush who never had a single edifying thought, but instead sought retaliation, retribution and revenge for deeds real and imagined, the Cabinet of fundamentalist Christians and lobbyist-tainted hangers-on – power and control mongers all, a Supreme Court which is firmly Corporatist and devoid of human decency, a media which is commercially bought and paid for to produce “what the viewer wants” – meaning what the viewer watches/reads that leads to advertising revenue, and a willfully ignorant citizenry which indeed paid attention to all of the above and neglected to apply critical thinking and adequate skepticism to the calls for war, violence, national paranoia, suspicion and a (permanent) suspension of the rights guaranteed in the Constitution.

Instead of building a welcoming and open society, we have let it go to wrack and ruin.  Instead of educating thinking productive citizens, we have trained a nation of gullible test takers.  Instead of building on the classical virtues, we have a nation of individuals that don’t know the first thing about voluntary cooperation, collaboration and compassion for the greater good and for our fellow humans.

We could have spent our dollars on research, new technologies, renewable energy, professional growth and development, infrastructure renewal and development and transportation growth.  We could have invested in our citizenry with healthcare, education, healthy-based communities and in the liberal and fine arts.

Instead, we have funded wars, terrorism, global arms, an enormous, off the books contracted spy industry, state-sponsored violence and government disruptions.  We have criminalized mental illness.  We have made prisons the largest growth industry in the US. We have made over one third of Americans too poor to afford necessary health care.  We have turned out a generation of Americans who are ill prepared to be engaged and informed citizens and who do not have the ability to be successful in a trade or profession.  We have neglected everything from the air we breathe to the food we eat, the water we drink to the ground in which our crops are grown.

We have gone from a two party political system to a one party, corporatocracy.  There isn’t any point in voting, as there is no one to vote FOR as a legitimate representative of the constituency.

We are constantly surveilled via cameras, data bases and undisclosed programs and organizations.  We are extolled to “see something, say something”.  Everyone has been made into an out group. We are prompted every day in many ways to be “alert, be aware” and be suspicious of everyone and everything around us.

On this day of reflection, I mourn for the lives lost on September 11, 2001, as well as for all of the lives lost in Iraq, Afghanistan, & Pakistan by both military and civilians.  I mourn for those affected by any act of terrorism.  I mourn for alienated people who react to ostracism with extremism.  I mostly mourn for the loss of the Republic.  Franklin said that it would last only “if you can keep it”.  But none of us did, and it’s gone.

What’s in its place is a worn out shell filled with a people made very weak and seemingly still without a will and the means to try to take it back.

This is a demoralized people, and more and more of its inhabitants are becoming hopeless about it because of their seeming helplessness and the betrayal by those who promised, hope, change, transparency and equality.

And as more citizens are deemed to be burdensome by politicians (failure to extend unemployment, criminalization of homelessness, retrenchment of Medicaid and SCHIP, the general promotion of ostracism), will the national collective perception of thwarted belongingness propel civil unrest or violence?

I bring this up because as the two fundamental conditions for people to choose to act on suicidal ideation, on a large scale, I wonder what actions people might take when these conditions become intolerable to bear. Kip Williams discusses the final phase of ostracism when coping has failed to produce re-inclusion and affiliation as resignation (ostensibly to one’s fate as permanently ostracized – ed).

This is when people who have been ostracized are less helpful and more aggressive to others in general,” he said. “It also increases anger and sadness, and long-term ostracism can result in alienation, depression, helplessness and feelings of unworthiness.”

Williams is trying to better understand how ostracized individuals may be attracted to extreme groups and what might be the reactions of ostracized groups.

“These groups provide members with a sense of belonging, self-worth and control, but they can fuel narrowness, radicalism and intolerance, and perhaps a propensity toward hostility and violence toward others,” he said. “When a person feels ostracized they feel out of control, and aggressive behavior is one way to restore that control. When these individuals come together in a group there can be negative consequences.”