Rebecca Warner's Blog, page 2

Who Do You Trust With Your Life?

Health Care Surrogate. Medical-system navigator. Caregiver. Advocate. Decision maker. Cast about in your mind and ask, “Who will be this person for me when I’m old, or if I get sick?”

Don’t assume your child will do it. It’s not a job that just anyone can do, or even will consent to do.  I was that person to my parents for almost twenty years. I have two older sisters, but my parents entrusted me with that job via a Power of Attorney and Health Care Advocate document, and my sisters were, ahem, generous in relinquishing all responsibilities to me. It didn’t seem to be more than a legal decree for several years, but then it became a part of my life from which I couldn’t be spared.

Here’s what was involved in my being a Health Care Surrogate: Through numerous hospitalizations, surgeries, rehabilitation, and care-facility navigations, I was the decision maker. I didn’t take the duties lightly. Everything was researched before decisions were made. That’s when I had the luxury of time—perhaps 24 to 48 hours. At other times, literal life and death situations meant on-the-fly decisions made with limited information. I had to ask questions and assimilate facts and probabilities that were given to me in shorthand because of the time constraints of the situation.

Unless you’ve had medical training, you’re flying by the seat of your pants, making decisions that are a culmination of facts that are foreign in context to what you know. Add to that hundreds of hours of vigilance spent in hospital rooms, all the while consulting with myriad medical personnel about everything from surgery to a tracheotomy to ports to ventilators to wound care to rehabilitation. A caregiver might experience repeated incidents of watching painful life-saving measures being visited upon her parents. Never-wavering attention to details that build the bridge to the next course of action is required, as is coordination of a care team, from surgeons to specialists to therapists to nurses to aides. Being a health care surrogate means fighting back when doctors tell you, “She’s had a seizure that’s put her deep in the woods and she isn’t coming out.” Or, “The hip-repair surgery went well, but with his complications of Alzheimer’s, Parkinson’s and diabetes, he won’t live more than a year.”  It means taking it personally and spending every ounce of energy and wringing your brain to mush from questioning, assimilating, sorting and finally, decision-making. Plus, being the one who will live with the consequences of your decisions.

As a healthcare surrogate, there’s the doubt that comes from realizing you can’t possibly absorb even a fraction of the knowledge that medical professionals are steeped in; as a result, you grasp just how vulnerable you’ve made your parents by handing them over to a system that’s designed to usher them, since they are “sick and old,” out the proverbial door of life. The system gives up, but you can’t. But inevitably, the decision is taken out of your hands. Death comes knocking again and again until the door is finally opened, and your only consolation is that you delayed the inevitable by keeping death impatiently waiting at the door.

Who in your life will do this for you?

It can’t be done effectively from a thousand miles away. It can’t be carried out via a two-minute phone conversation with busy doctors. Merely saying, “Do whatever you have to do to keep her alive and make sure she gets well,” isn’t enough. Not by a long shot. Which is why so many people without advocates who expect “the system” to act in their best interest, perish.

Consider the enormity of all a Health Care Surrogate must deal with, and ask yourself again, “Who will do this for me when I’m old and sick?”

I’m compelled to write this blog because this past weekend, seven years after I laid my father to rest, I was faced with a life-and-death situation that fell to me during a 24-hour period when a dear 90-year-old friend was rushed to the emergency room after becoming deathly septic. Her colon had been punctured the day before during a colonoscopy. Her son had been there for the procedure but flew home before symptoms set in. Her neighbor miraculously happened to walk through the door minutes after her collapse and called 911.

Because her children live far away, neither could be there in time to oversee all that came next. Her daughter called me to be the person to intervene. She and her brother are the best of children in regard to being involved in her care, but they were far away. A few years before, I volunteered to become the local person who would be there in an emergency. And when the emergency presented itself on Saturday, I was in my car within fifteen minutes, driving the not-so-local sixty miles to handle it.

And there I was, entrenched up to my eyeballs in a life and death decision on behalf of my 90-year old friend. Déjà vu crashed over me as I discussed with the surgeon, and my still-conscious friend, whether or not to have the surgery, given the Do Not Resuscitate (DNR) order on file. Every complication that could arise, every action that might need to be taken during surgery which would defy the DNR, every probability of danger and outcome, was discussed. We were pressed for time, but I took detailed notes which I quickly relayed in long emails, painstakingly typed out on my Android, to her two children, with no detail or nuance left out. I let them know their mother wanted the surgery. It was my responsibility to give them every known fact and probability of what that entailed.

When the surgeon stumbled over the stated directive of her DNA, with a back note of, “I’m not sure you won’t die anyway,” I stepped in to look my friend in the eye and clearly articulate her choices, which came down to: Surgery or comfort measures? I love this woman, which made it difficult, but I’d long ago learned that there’s no place for drama at such a time. Compassion, yes. Love, yes. But surgery was imminent if there was going to be a chance of saving her life. She stated clearly that she wanted the surgery. I could see the relief on the doctor’s face that somebody, anybody, was there to intercede. I wasn’t legally authorized or obliged to do so; I threw out the term “advocate,” and remarkably, not one single person in the hospital questioned my authority to be there. I dare say, if I had not been there, they would have leaned on the DNA, and she wouldn’t be here today.

My emails to her children conveyed the urgency and severity. Her daughter called me to say, “Stop! This is a life-saving measure and she doesn’t want that!” I held my phone to her mother’s ear so she could remind her of the DNR. Her mother said, “I can’t live with this pain. I want the surgery.” The daughter acted absolutely appropriately, and I’m glad she got the assurance she needed. Had she not been available, we would have gone ahead with the surgery based on my intervention in ascertaining that my friend wanted it.  And now that it was confirmed, it was up to me to see her through it. The daughter, meanwhile, would be taking a flight from London. The son, who had been there the week before, had a court case on Monday and couldn’t come. It was up to me to be there to handle every critical aspect of what was to come over the next eighteen hours until her daughter arrived.

I’m so relieved to say all went as well as it could, in every respect. The surgery took almost three hours. By the time I finished discussing her post-op care with the nurse and anesthesiologist/pain manager, it was midnight. I went to my friend’s apartment for the night and returned to the ICU at eight o’clock the next morning.

Finally, in the afternoon when she was sleeping and I knew her daughter would soon arrive, I left to drive the sixty miles home. My husband, who had lovingly supported me through twenty years of time-and-energy-devouring care for my parents, was as supportive as always. But he saw the toll that 24 hours had taken on me, mentally and physically. Since my father’s passing seven years ago, I have powered down. This was like running a marathon flat-out after not having even put on my running shoes for seven years. At sixty-three, I’m no longer in shape for such marathons. More such situations will occur with my friend, and I’m deciding I can’t commit to ushering her through them. It’s a damn hard job, and I’m just not willing to take it on.

So who will? In my experience, there are three things that drive a health care surrogate: guilt (wrapped in obligation), love or compensation. I don’t have enough of the first two, and I could never accept compensation.

Now, knowing the profundity of the job of Health Care Surrogate, ask yourself who in your life will take the position? Who will succumb to guilt or love in advocating for your care? Let me state as fact that just because you raised a child, that child may not be willing to care for you. I’ve seen it way too often.

If you think you will just compensate someone, it will be expensive. I once paid an RN who was smart enough to incorporate, ninety-dollars an hour to coordinate my father’s care after he broke his hip while I arranged my life so that I could fly down and take over. The bill was over two thousand dollars for those three days. Can you afford that?

And if you’re counting on medical system personnel to make decisions that are in your best interest, get real. What’s easiest, most convenient and most cost-effective will always win out.

Whom will you trust with your life when it hangs in the balance? Whoever you decide that person or persons are, discuss it with them in detail. Have a Health Care Surrogate Designation and Living Will in place. Tape a DNR to your refrigerator if you don’t want invasive and drastic life-saving measures to be taken when the EMTs arrive. Verbalize and document your preferences beforehand. Be specific in directives.

If you don’t have children, as I don’t, buy long-term care insurance. If you do have children, buy it anyway to save them from the financial burdens that can ensue. Decade-long assisted living and nursing home care for my father, who with his retirement benefits and Social Security didn’t qualify for Medicaid by a mere two hundred dollars, added up to over a half-million dollars.

Maybe you’ve been putting off this decision. You may be relatively young, and the necessity may seem years away. But a serious accident at forty can make you as vulnerable as a heart patient at eighty.

If you are childless or don’t have a good relationship with your children, you’ll need to press the issue of who, if anyone, is willing to take on this huge responsibility. Don’t wait to put a plan into action. Your life may one day depend on it.

IN THE CHURCH OF DR. MARTIN LUTHER KING, JR.: A REVIVAL OF SPIRIT

Have you ever had a destination in mind, but were waylaid, and ended up where you were really meant to be?

The 2020 Vision of Oprah as President

Oprah’s speech at the Golden Globes was the unchallenged highlight of the evening. There she was, an icon who was saying the words that had to be said, in a tone that resonated with strength, not rancor, and at a time when we most needed to hear them.

Friendships That Don’t Survive Politics

Hundreds of hours of enjoyable phone conversations, decades of sharing confidences and seeing each other through tough times, years of giving and receiving special notes and birthday cards, frequent visits and vacations that fostered closeness…these are the foundation for friendships that last a lifetime, right?

I certainly thought so, until 2016 became about Hillary vs Trump. The first casualty came about when I told a friend of 30 years—a white, privileged PhD—that I had gone to a Hillary and Michelle rally, a dynamic event I blogged about on Huff Post, and here. I knew she was a conservative, but this was her response:

“Whenever I see Michelle on TV, I thinks she looks like a gorilla.” And she laughed, a hateful laugh. I was stunned into a moment of silence before I lauded Michelle’s character and brilliance, then let her know how disappointed I was in her, and ended the conversation and the friendship with, “I’m going to say goodbye now.” I haven’t responded to her calls or emails since. It was my decision to end that friendship upon learning she was a racist. How could I not have known this before? I knew she didn’t like President Obama, but she’s a Republican and I put her dislike down to politics, not race. Even if it weren’t racism, it was extremely mean-spirited. Either way, I’m too defined to deny my own character, even to accommodate a 30-year friendship.

Another long-time friendship quietly ended, but in that case, I have no idea why. I suspect our opposing politics, which became more and more evident in my blogs, became too offensive for her to bear.

I began blogging for Huff Post in February, 2016, with a blog about being an older woman who was willing to wear a very short dress one last time in her life while in Las Vegas. It was fluff and it was published in the Fifty section.

The tone of my blogs changed as the 2016 year wore on and I saw the assault on women’s rights escalating, via the Republican political agenda. I am a long-time feminist, and I had some pretty strong opinions which I was able to express through my Huff Post blogs, and here on my Moral Infidelity blog. While some of my Huff Post blogs still dealt with women’s sexual and relationship issues, I became focused on political issues as the presidential election stakes got higher.

When I first started blogging, I would let my friends and followers know about each blog, and I would provide a link. As my blogs got more political, I culled the list to exclude those whom I knew would be offended. Though I had every right to express my opinion, and had a credible platform for doing so, I considered their views and felt that pushing those blogs on them would cause offense.

The one who quietly ended our friendship was very dear to me, yet I should have seen the signs when, after years of sending the perfect birthday card, she was “too busy” to get my birthday card mailed off, even weeks after my birthday. But I am a loyal friend, and if you are in my circle of friends, I will value you and give you the benefit of the doubt and even fight to keep you. So I sent her a loving Christmas card the following month as if nothing had happened. She called the day before Christmas as she was driving to her daughter’s home. We had a short but pleasant conversation. She asked about my blogging, and I said I had not sent her the link to my latest because I knew she wouldn’t like it. Honestly in relationships, right? She replied, “I can always find your blogs, Rebecca.”

And I suppose she had. In October, the month before my birthday, there had been the Hillary and Michelle blog, and another about the type of women who would vote for Trump. One blog of December 16, 2016 expressed my incredulity at Trump’s election. Another blog from January 4, 2017 conjectured the lengths Republicans would go to in making abortion illegal. In it I said, “Think this is far-fetched? Until November, 2016, so was electing a misogynistic, racist, xenophobic, p***y-grabbing, Russian-loving, alt-right supporting and frenetic-tweeting president.”

So okay, I admit, someone who voted for Trump might take offense.

A few weeks into the new year, I realized I hadn’t heard from that friend. I had emailed her once or twice during that time, but our preferred communication was laughter-filled Sunday morning phone calls. It occurred to me that she might have found my blogs offensive. If that were the case, there wasn’t much I could do about it. I left the ball in her court.

It’s now July, 2017, and there has been no communication from her. It was her choice to end the friendship, and though I’m pretty damn sure it’s about politics, I’ll never really know why she dropped out of a 20-year friendship without a word.

But you know, that’s her right. Just as I exited the friendship with the offensive racist, she exited her friendship with an offensive liberal.

In friendships, our mutual likes, interests, desires, ideas, philosophies and politics can’t hit on all cylinders all the time, but we have to be in sync most of the time to remain friends. For some of us, the 2016 election threw the equivalent of sand in our friendship fuel tanks, and our friendships sputtered and died.

Other of my friendships with Trump voters have survived, and I am convinced it’s because the positive elements we have brought into each other’s lives over many years outweigh our divisiveness on this one issue, though it is a major one.

It isn’t as if those friendships haven’t been tested before, though never in such a meaningful way. It’s impossible to be friends with someone for 20-40 years and not have a few disagreements. But if the roots go deep enough, they’ll withstand anything.

The roots of the lost friendships were, to my surprise, not deeply-enough embedded. When faced with the tsunami that was the 2016 presidential election, they couldn’t hold. But for those friendships that did hold, we are on solid ground.

Presidents come and go, as do friendships. Lasting friendships evolve, and it’s not always a comfortable process. But in the end, the friends who add value to my life are worth far more to me than any politician.

That said, I still wish they hadn’t voted for Trump.

How Low Can They Go?

It disturbing that with every stroke of his pen, Trump is pulling another plank from the platform that upholds the lower-and-middle classes of this country. From hobbling workers’ rights to decimating healthcare, his and the Republican’s policies are making it tougher for people to live with dignity and be fairly paid for their hard work. So many hard-won fights over so many decades are disappearing before our eyes–workers’ rights, women’s rights, LGBT rights, minority rights, healthcare rights.

Now the Republican-majority House and Senate are proposing a new healthcare law that guts the Affordable Care Act (ACA) and threatens to leave up to 23 million without health care coverage.

Those between the ages of 50 and 64 will see premium rate increases that will force many of them to forego insurance altogether. Whereas the ACA prohibited charging older people more than three times what young people were charged, the American Health Care Act (AHCA, aka Trumpcare) will increase that difference to five times as much.

The House Republican Trumpcare plan eliminates the income-based tax credits and subsidies available under the ACA, replacing them with age-based tax credits ranging from $2,000 a year for people in their 20s to $4,000 a year for those older than 60.

The Senate plan is different in that tax credits would vary by income at a lower eligibility level than under the ACA. Sounds good, right? But the credits are smaller because their value is tied to the cost of less-generous insurance than under the ACA. What does “less generous” mean? 

Currently, insurance companies are required to provide coverage for what the ACA termed, “Health Essentials.” These include:

Ambulatory patient services (outpatient care you get without being admitted to a hospital)
Emergency services
Hospitalization (like surgery and overnight stays)
Pregnancy, maternity, and newborn care (both before and after birth)
Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
Prescription drugs
Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Under the AHCA, states can waive essential health benefit requirements, allowing insurers to exclude coverage for health care products and services.

So while Republicans—and particularly Trump—are promising lower premiums, they’re also allowing the stripping away of basic services we’ve come to expect for our premiums. Take a look at that list again. Imagine not having coverage for prescriptions, laboratory services, or even hospital stays, and tell me how much “savings” one can really expect in paying for health care. The catch is, these services can be covered by health insurance companies, but for each covered service you “order,” you’ll pay dearly.

The proposed defunding of Planned Parenthood for one year will affect millions of poor women who rely on the Medicaid-reimbursed care they receive now. 97% of all services provided by Planned Parenthood include basic wellness and early intervention procedures. This, taken from their website, describes what they do to ensure women’s (and men’s) health.

Planned Parenthood health centers focus on prevention: 80 percent of our patients receive services to prevent unintended pregnancy.
Planned Parenthood services help prevent an estimated 560,000 unintended pregnancies in a single year.
Planned Parenthood provides more than 295,000 Pap tests and more than 320,000 breast exams in a single year, critical services in detecting cancer.
Planned Parenthood provides more than 4.2 million tests and treatments for sexually transmitted infections, including more than 650,000 HIV tests.
Planned Parenthood affiliates provide educational programs and outreach to 1.5 million young people and adults in a single year.

Planned Parenthood performs abortions–that safe, legal medical procedure–for women who are not ready, or equipped, to give birth. But what is so obvious to everyone but the Republicans is that if you don’t provide contraception for those who need it most, via Medicaid or health insurance mandates, then there could be hundreds of thousands of unintended pregnancies. With states enacting draconian restrictive abortion laws, shutting down clinics, and defunding of Planned Parenthood, the most vulnerable women become the most desperate.

The proposed plan makes deep cuts to Medicaid. It ends the Medicaid expansion provided under the ACA. States will receive less federal Medicaid funding overall. The Senate bill includes deeper Medicaid cuts than the House bill.

These cuts will throw hospitals, doctors’ offices and medical facilities into a tailspin. Expect to see rural-to-mid-sized hospitals close their doors, and doctors discontinue their practices. Expect to see exorbitantly higher premiums for those who are insured, because those folks will, once again, be picking up the cost for those who will no longer be covered by Medicaid. Until the ACA, those who were insured were subsidizing those who were not. Without Medicaid, those who are insured will be doing more heavy lifting than ever.

To explain why this is so, I’ll use my personal history with insurance.

I have made a health insurance premium payment every month of my life since I got out of college. I am now 62, and fortunate to be very healthy. I have had an individual policy for almost 20 years, and I have never had a hospitalization, surgery or disease. In other words, I’m a low-end health care product user. I liked the ACA insurance mandate (gone with this Republican plan) because everyone had some skin in the game. Even if they refused to buy insurance, they had to pay a tax. As a result, for the first time ever in my life, my health insurance premium actually went down in 2017!

It was only eight dollars a month, but my premiums had increased year after year until 2017, sometimes as much as 20%. When I got the dreaded annual letter from my insurance provider, it always said, “This rate increase is not due to your use of health benefits, but the use of health benefits by those in your area.” That practice stopped with the ACA, but for decades, I had subsidized those who used the hell out of their insurance, as well as those who didn’t have insurance.

Finally, with the ACA payments that were made to health insurers by the federal government, it wasn’t up to just me and other subscribers to keep subsidizing the costs. The ACA was a relief valve, and the curve flattened. It wasn’t perfect, but it was working!

Now that will be gone, and I can’t imagine how much my premiums are going to go up between now and when I am eligible for Medicare. But they will go up for everyone, because once again we’ll be subsidizing the uninsured. My insurance provider had originally anticipated 8% increases in 2018, but when the House bill passed, it revised that to 25% increases.

And who will benefit from these massive increases imposed upon the lower-and-middle classes?

The 1%. According to the assessment was made by the Joint Committee on Taxation, a nonpartisan panel that provides research on tax issues, two of the biggest tax cuts in Republican proposals to repeal the Affordable Care Act would deliver roughly $157 billion over the coming decade to those with incomes of $1 million or more. People making $200,000 to $999,999 a year would also get sizable tax cuts. In total, the two provisions would cut taxes by about $274 billion during the coming decade, virtually all of it for people making at least $200,000, according to a separate assessment by the committee.

Repeal-and-replace is a gigantic transfer of wealth from the lowest-income Americans to the highest-income Americans.

Maybe when enough of the lowest-income Americans—many of whom voted for Trump—get  huge increases in their 2018 premiums, they’ll wake up and realize that their president, their party, caused their suffering.

I just hope the Democrats ram this fact home and run on nothing but this issue during the 2018 election cycle.

How low can they go? We don’t know yet, but they are plumbing the depths of decency, and we can expect more muck to be heaped upon us as they do.

Scarlet Letter of Shame: “A” for Abortion

Empowered by the election of anti-abortion president-elect Donald Trump, states are pushing restrictive abortion legislation that is so ruthless, it’s beginning to take on the tenor of an angry mob with pitchforks.

Besides Ohio’s fetal-heartbeat legislation that would have made an abortion illegal after a heartbeat was detected (approximately six weeks) with no exception for rape or incest, there is the Texas rule that was set to go into effect December 19, 2016 that would require the burial or cremation of a fetus, whether aborted or miscarried, no matter what stage of gestation. Texas Governor Greg Abbott rationalizes the law thus: “I believe it is imperative to establish higher standards that reflect our respect for the sanctity of life.”

Imagine the shame and dismay a woman would feel being told (and I’m paraphrasing here), “The rule requires you bury or cremate your baby.” Not only that, she’s knocked to her hands and knees when she’s also told, “The cost for the funeral is your responsibility.” For the many women who are already struggling to pay for the procedure, this could be the toughest barrier to overcome. According to one estimate, the rules would double the cost of the procedure.

Women need anonymity and privacy when they undergo this legal medical procedure. The fact that their medical records are protected under HIPPA facilitates their ability to move on with their lives. But a public funeral (funeral homes would handle the burials) would open them up to public shaming and all the repercussions, including possible violence, that would follow.

Fortunately, on December 15, 2016, a federal judge temporarily blocked Texas from enacting that rule. But we haven’t seen the last of this legislation about burying a fetus.

At this point, I’m reminded of George Carlin’s question: Is a fetus a human being? As he pointed out, this is the central question of the controversy.

Two of the questions Carlin asks to determine if a fetus is a human being are:

1) If a fetus is a human being, how come the Census doesn’t count it?

2) If a fetus is a human being, how come if there’s a miscarriage, they don’t have a funeral?

Who would have dreamed that Carlin’s bitingly sardonic remark about a fetus funeral would have a very good chance of becoming actual law?

Current attempts to shame or scare women who are seeking abortions aren’t working well enough for Governor Abbott. For instance, the booklet, “A Woman’s Right to Know,” is reading material that Texas abortion providers are required to give every woman seeking an abortion. It could be categorized as pulp fiction, since it’s devoid of facts or reality and describes imaginary perils associated with abortions.

Here are some of the fallacies (okay, lies) a woman can expect to find in the booklet:

1) Terminating a pregnancy increases your risk of getting breast cancer.

Extensive studies and analyses have thoroughly refuted this myth.

2) Getting an abortion increases your risk of infertility.

Abortion procedures are extraordinarily safe and effectively eliminate the possibility that a patient will become infertile.

3) Getting an abortion causes women to have depression or thoughts of suicide, grief, anxiety, lowered self-esteemed, regret, sexual dysfunction, avoidance of emotional attachment, flashbacks and substance abuse.

There is absolutely no medical evidence to back this up. A new study just released by the University of California at San Francisco found that women who underwent an abortion were at less risk of adverse mental health effects (such as depression, anxiety, and dissatisfaction of life) than those who were denied an abortion because their pregnancy was further along than the facility’s gestational limit.

4) The booklet lists extremely rare occurrences that are meant to horrify, including injuries to the internal organs, blood clots or serious infections, hemorrhaging, emergency hysterectomy, injury to the bowel or bladder, embolism, and, of course, that silver bullet—death.

What the Texas booklet omits is that abortion is far safer than childbirth. The risk of death from with childbirth is about 14 times higher than the risk of death from abortion. And you can be sure that no abortion-provider booklet informs women of the medically-accurate difference in the definitions of fetus and baby.

Watch for this administration to dig in and encourage states to revisit the fetus-burial law. After all, vice-president-elect Mike Pence signed the same required burial law in his state of Indiana. Like Texas’s law, it was eventually blocked from going into effect by a federal judge for violating women’s right to choose.

But this is where we are, and it will only get much worse, especially when you consider that Pence also proclaimed, “I long to see the day that Roe vs. Wade is consigned to the ash heap of history where it belongs and we again embrace a culture of life in America.” He signed every anti-abortion bill that crossed his desk while he was governor of Indiana. Oh, and he has pledged to defund Planned Parenthood and divert those funds to health clinics that don’t provide abortions.

With the inescapable appointment of ultra-conservative, pro-life Justices to the Supreme Court, we’re barreling towards a future that puts women in danger of becoming what George Carlin eerily discerned about Republicans: “They believe a woman’s primary role is to function as a broodmares for the state.”

I would ask that you imagine this: From broodmare, it’s a short stride to legislating that women who have abortions wear the equivalent of Hester Prynne’s shameful Scarlet Letter… “On the breast of her gown, in fine red cloth, surrounded with an elaborate embroidery and fantastic flourishes of gold thread, appeared the letter A.” In Puritan New England, that stood for “Adulteress.” In our time, the A will stand for “Abortion.”

Think this is far-fetched? Until November, 2016, so was electing a misogynistic, racist, xenophobic, p***y-grabbing, Russian-loving, alt-right supporting and frenetic-tweeting president.

We can no longer take rationale and normalcy as givens. If you feel like you’ve been living in an alternate universe since the election, you’re about to enter the Twilight Zone.

The fight for women to have control over their own bodies has always been a tough one, but it’s about to get really nasty. Unless we fight back now by supporting those very effective organizations that are equipped to fight hard for women’s choice, like Planned Parenthood, NARAL, the Center for Reproductive Rights, and Feminist Majority Foundation, among many others, this freshly-empowered righteous mob won’t stop until we are, by law, forced to accept increasing increments of public shame as a form of punishment for asserting control over our own bodies.

We have a line of defense with these feminist organizations if we get behind them with our own equivalent of pitchforks—our dollars. As Gloria Steinem recently said, “We’ll have to be in full-out rebellion.”

Please click here for a list of pro-choice organizations that need your support to lead the rebellion. Pick one, two, three—as many as you can afford—and donate.

Follow Rebecca Warner on Twitter: www.twitter.com/rjiltonwarner

POWER SURGE: Hillary and Michelle Together

If I could still do a cartwheel, I would have done one  on Thursday, October 27th.  That day I stood for hours in a long line with my friends and thousands of others in anticipation of seeing and hearing two of the most admirable women of our lifetimes, Hillary Clinton and Michelle Obama. I saw two young girls doing cartwheels and on a patch of green grass in the huge parking lot at Lawrence Joel Veterans Memorial Coliseum at Wake Forest University.

And I wanted to join them! I wanted to express in a burst of youthful vitality my joy, exuberance and enthusiasm at being there. I was invigorated and cheerful, and as I watched those two young girls, I recalled being that young and limber and uninhibited in just popping off a few cartwheels when I needed an outlet for my boundless energy. Decorum, plus the fear of real physical injury, kept me in line, though I was experiencing a flood of glee and youth and hopefulness that belied my 61 years.

I was excited to think that those young girls were going to hear two of the most significant women in history promise a future that would protect their reproductive rights and their right to choose. They would be encouraged to envision a future that would offer an affordable education, quality healthcare and the opportunity for equal pay for equal work.

A tender nostalgia crept over me, but it was rooted in more than just my desire to turn a cartwheel. I had lived with each and every one of those assurances during my college years and throughout my professional career, and I had built a stronger life as a result of believing in them. Looking at those girls, I realized I wanted them to have everything I’d had.

I came of age at the beginning of the Feminist Movement, and I embraced women’s new-found freedoms that were hard fought for and won by women like Betty Friedan and Gloria Steinem. I graduated from high school in 1972, the same year that “I Am Woman,” the feminist anthem, was #1 on the charts. 1972 was the year in which it finally became legal for an unmarried woman to be prescribed birth control pills. That was followed by the Roe v. Wade Supreme Court ruling in 1973 that gave a woman the right to terminate a pregnancy for any reason she deemed important. Unlike generations of women before me, I could make love with the young man I dated throughout college without the fear of an unintended pregnancy that might derail my getting a degree. I knew I could then forge ahead into a meaningful, well-paying career. I knew I had choices.

I grew strong from the Feminist Movement because I was assured that I could do anything, be anything, and have anything I was capable of dreaming of and working for. It was about freedom of choice in so many areas of my life, and I took full advantage of those privileges and freedoms.

And now here I stood, 44 years later—a damn long time—excitedly waiting to hear the woman who will become the first woman president of the United States assure a crowd of 13,000 that rights so hard-won nearly half a century before, would be championed and strengthened under her presidency.

As inconceivable as it is that we are One Misogynistic Man away from losing freedoms, choices and hopes in 2016, it is a reality. The fiercest assault on Roe v. Wade since its inception is upon us.  As Hillary said in the third debate, “We’ve come too far to have that turn back now.”

Sure, it’s discouraging that we are still fighting a battle that was seemingly long ago won. But the ghosts of those who would “make America great again” have never rested. They have continuously risen like goblins from a graveyard to haunt us. They try to scare us with their undertakings to subjugate women’s rights, to escalate racism, bigotry and hatred, and to put white men back in the role of dominance and superiority that they found so comforting in the 1950s.

Standing between those ghouls who would steal our diverse souls is a woman whose time has come.  A woman who, at a most pivotal time, will become president of a country that was conceived in freedom and equality, but that has been weighted down with chains of bigotry and chauvinism for decades.

What I believe about the American Spirit is that it can only be pushed around, weighted down, trod upon and disrespected so long; but then, inevitably, that Spirit will emerge with a fierce roar, bellow “Enough!” and fight back with ferocity.

We are there now. We are ready for battle, and Hillary is our general, our collective voice. She, too, was in the thick of the Feminist Movement, and she used every advantage afforded women during that time to get a great education and use her formidable intellect and energy to make a better world for women and children.

Though she has been working tirelessly for decades, she is now coming into her ultimate power. She has, during this election cycle, lead the mother of all battles for strengthened rights and basic human dignity.

Some may say it is too late to establish a future that is even brighter than our past. But from the looks of hope, the voices of excitement and the charged emotions that infused the crowd, it was evident that there is a huge power surge behind the belief that we can, and will, be stronger than ever.

But as both Hillary and Michelle strongly emphasized, it happens with our votes. Michelle said, “Now we need to do our job, and get her elected president of the United States.” She reminded us that, “In this country, the Unites States of America, the voters decide our elections, they’ve always decided who wins and loses—period, end of story!”

Please, take that to heart, and take action. Vote!

I can’t remember feeling so inspired, so optimistic or as proud as I did listening to these two awesome and beautiful women! As they left the stage, I felt so invigorated that I did mental cartwheels, one after the other. That felt almost as good as the real thing.

 

The Fat Toad and The Foxes

Once upon a time there was a Fat Toad who sat at the very top of the highest hill of a Kingdom. He had very few neighbors at that great height, but those he did have were all male toads like him.

His view was one of beauty and wealth that incited never-ending desire, and when he looked down from his high precipice, he spied many objects of desire.

Like all Fat Toads, this Fat Toad had dry leathery skin, warts, short legs, crests behind his eyes, and parotoid glands to salivate over the objects of his desire.

Though his subjects included Gent Foxes, it was the lovely Maiden Foxes that were paraded before him, each hoping that her hunting skills for the best sycophantic guests and her cleverness in distorting the truth would please him enough to be invited to become a citizen of his Kingdom. Only those Maiden Foxes with the most beautiful physical attributes were invited to become citizens of his Kingdom, with initiation rites that included their pledged loyalty to his absolute power over them.

But the Fat Toad did not find pleasure in the Maiden Foxes’ hunting skills nor deceptive cleverness. He only found pleasure in the sleekness of their form, the shine of their pelts, the brightness of their eyes, and the shapeliness of their legs.

When the Maiden Foxes would try to impress the Fat Toad with their cunning and talents, he waved his Fat Toady hand in dismissal and instead demanded that they rise before him to display their physical prowess and beauty. It was only these traits that pleased his senses and fueled his lust.

Nevertheless, the chosen Maiden Foxes toiled to put their prowess on display, even as they were forced to cross their shapely legs and exhibit their perfect teeth, because only then was the Fat Toad appeased.

Most often in the Spring, when toads do breed, the Fat Toad would retreat to the glistening pools of water that surrounded his Kingdom, and begin calling females. To do this, he stretched out his dewlap, the fat and ugly pouch at his throat, to trill a song that would summon the Maiden Foxes to his cozy realm.

He would drool all over them, and then exert his unquestioned power to force them to do his bidding. The Maiden Foxes would afterwards descend from the top of the Kingdom, down to their lowly lairs, where they would silently lick their wounds and ready for the next encounter with the Fat Toad; for to do otherwise would mean banishment from the Kingdom that fed their families and their egos.

One Spring day in the year of our Lord 2016, a Maiden Fox who was one of the most beautiful in the Kingdom was summoned to the Fat Toad’s glistening hilltop pond. Several seasons before, she had been cast off her rock in the sun and pushed under a shadowy tree when she ran away from the Fat Toad’s sticky finger pads. The years passed, and she inched her way out of the shadows into the sun, only to find herself in the Fat Toad’s sites again.

But this time, the Maiden Fox refused to be bullied by the Fat Toad. Instead, she bared her fangs and raised her hackles, then reached into her Birkin and retrieved her ever-handy mirror, which she held up to him and declared, “You cannot command me to do your bidding! You are nothing but an ugly, Fat Toad!”

Back into the lower chambers of the Kingdom she descended, but she did not lick any wounds; for though she suffered humiliation, she had otherwise escaped unscathed.

But from that humiliation rose a great anger, and she vowed to topple the Fat Toad from his high perch. She growled out her grievances at the top of her lungs, until the volume of her roar reached every corner of the Kingdom.

Other Maiden Foxes, who had long despised the Fat Toad for his demeaning demands, climbed out of their lairs and entered the battle field to stand next to the brave Maiden Fox. They took up their loquacious swords and inflicted wounds onto the Fat Toad, slice by slice, until he was left bloody and crippled.

No number of denials and lies, which had always served him well, could resurrect the mortally wounded Fat Toad. Defeated, he was forced to crawl down from his powerful perch as he was pelted in a shower of shame. His place in the Kingdom had toppled, and his power was broken.

But he was a Fat Toad, who had gotten that way because all toads are predators and they eat a lot, and they will eat just about anything that fits in their mouths. So the Fat Toad stuffed his jaws with forty million insects, spiders, earthworms, snails and slugs that would ensure that he would always be among the fattest of toads. For Fat Toads are known to remarkably adaptable, and this Fat Toad, though older, uglier and wartier than ever, would certainly adapt.

And did the now-liberated Maiden Foxes pledge to Tell the Truth forevermore?

Unfortunately, no–that would be a Fairy Tale!

Busting the Myth of “For Women’s Safety”

 

Republicans claim falsely that abortion is a dangerous medical procedure for women. But the following facts presented by David A. Grimes, Author, Every Third Woman in America: How Legal Abortion Transformed Our Nation and former Chief of the Abortion Surveillance Branch at the Centers for Disease Control (CDC) tell the true story:

“Because of difficulty in accessing abortion care, desperate women are once again attempting self-abortion.

Before Roe v. Wade in 1973, an estimated 200,000 to 1.2 million illegal abortions occurred annually in the U.S. The carnage was terrible. Incomplete abortion was a leading cause of admission to gynecology wards across America. In the year when I was born, more than 700 women died this way. Around the world today, unsafe abortion kills an estimated 47,000 women each year. After the legalization of abortion in the U.S., the risk of death promptly fell to less than that from an injection of penicillin.

 

The scientific foundation for safe, legal abortion is incontrovertible. Within two years of Roe v. Wade, the Institute of Medicine had concluded that legal abortion improved the health of women. All major medical and public health organizations today affirm the health benefits of legal abortion; these include the World Health Organization, American Public Health Organization, American Medical Association, American Medical Women’s Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, American Psychological Association, and American Psychiatric Association.”

Those are the facts. Yet Texas governor Rick Perry called a special session of his Legislature to enact strangling legislation that would close all but a handful of clinics in that state―under the guise of “concern for women’s health.” That legislation included requiring the physician who performs abortions to affiliate with a hospital within 30 miles, and that all abortions take place in ambulatory surgical centers. This would require expensive construction and equipment standards that do not apply to all other outpatient facilities where other surgical procedures like liposuction and colonoscopies take place.

The 5th U.S. Circuit Court of Appeals upheld the law, and went so far as to say that it did not consider a 300-mile round trip for nearly 1 million women of reproductive age to be a substantial burden because that number was ‘nowhere near’ a large fraction of the state’s 5.4 million women of childbearing age.

In June, 2016, SCOTUS overturned Texas’ law. In the majority opinion, Justice Stephen Breyer wrote that the restrictions “vastly increase the obstacles confronting women seeking abortions in Texas without providing any benefit to women’s health capable of withstanding any meaningful scrutiny.”

Yet the law was originally passed with the arrogant expectation that people are naïve enough to believe it was for women’s safety.

Sadly, in great part, their expectation is met.

Several months ago, I had a conversation with a politically-conservative man, a man who is highly educated and is one of the most brilliant attorneys I have ever known. While discussing my novel, Moral Infidelity, which has fact-based medical data about abortions in its pages, I mentioned that Texas had only six abortion clinics and Mississippi only one, due to this draconian legislation. He asked, “But isn’t that for a woman’s safety?” It was hard for me to fathom that such an intelligent person could be so clueless; and if he were that clueless, just how many of those who are not as educated or well-read or informed as he, held that same erroneous belief?

When I told him that women are 40 times more likely each year to die of a colonoscopy than an abortion, he was stunned. But then the brainy part of him kicked in and he said, “Yes, because of sepsis.”

Another medical fact worth noting: Women are 14 times more likely to die from childbirth than from an abortion.

We need to have these two simple statistics at the ready to impart to people like my friend who parrot the Republicans’ (and FOX News’) lies about the dangers of abortions.

I have whittled my argument against such ignorance down to this succinct phrase:

“It is a medical fact that women are 40 times more likely to die of a colonoscopy, and 14 times more likely to die from childbirth, than from an abortion.”

Even the most avid anti-abortionists have jaw-dropping moments when they hear this.

And I must say, it feels pretty darn good to trump ignorance with facts. I freaking love medical facts.

Wendy Davis Vindicated!

With its vote of 5-3, the Supreme Court struck down the Texas abortion law that would have closed down all but a handful of abortion clinics in that state. With this ruling, a message was sent to all states that are legislating away a woman’s right to a safe and accessible abortion: Back. Off.

I vividly recall Wendy Davis’s filibuster. She became a hero to me. When she was running for governor of Texas, I asked a friend who knew her to get a copy of my book, Moral Infidelity, about a hypocritical pro-life governor whose mistress becomes pregnant, into her hands. Tucked inside was a personal note of thanks and admiration, and a check. My very first blog here was titled, “One Year Later, I’m Still Standing with Wendy.” When her book, Forgetting to Be Afraid: a Memoir was published, I bought it, read it, loved it and reviewed it.

I’m a Wendy Davis fan, okay?

Which is why, with this SCOTUS decision, I’m so thrilled that Wendy Davis is vindicated! She won then (the deadline passed for a vote on that draconian legislation) and she has won now. Sure, Rick Perry called a special session right after her victorious filibuster to ram through the law that was ruled on by SCOTUS; but Wendy paved the way for this Supreme Court decision.

The assault on a woman’s right to choose has been relentless for the last two decades. But with this decision, SCOTUS has breathed new life into Roe v. Wade. It’s now time for us to nurture it, strengthen it and support it like never before.

And that starts with those of us who have benefited from that law since it was passed in 1973.

Those of us who are over 50 have reached that comfortable age when we no longer have to worry about an unintended pregnancy. For many, the issue of reproductive choice has faded in importance. But for our daughters and granddaughters of childbearing age, it should still matter–now more than ever. We who became sexually active in the ’70s finally had protections in place to safeguard us from unwanted pregnancy.

Then with the Supreme Court ruling in 1989 on Webster v. Reproductive Health Services, the first assault on Roe occurred. It opened the door for states to start enacting stricter abortion legislation. It took a while, then states gained momentum. Yet generations of women who are of childbearing age did not seem meaningfully motivated to halt this persistent march back to the days of no choice. They’ve lived with the victorious results of a hard-won battle that raged through the ’60s and early ’70s. That is ancient history to them, but it isn’t ancient history to those of us who saw the battle being waged and first benefited from its accomplishment.

The Women’s Liberation Movement required organization, dedication, and unification to be recognized. The impetus for that kind of solidarity is not there today. The pro-life movement, on the other hand, has burgeoned and gained strength day by day. Fortunately, Planned Parenthood, NARAL, NOW, and stalwart politicians like Wendy Davis fought back on our behalf. They kept the fires burning when a flood of anti-abortion legislation was threatening to drown our right to choose.

At the age of 59, I’d had enough. I wanted to add my voice to the fight, and I wrote my first book, which was chocked full of abortion-related research but was entertaining and well written enough to win two awards. As I read, wrote books, blogged, and used podcast forums to keep women aware of the dangerous battle being waged against Roe, I wondered where the young women were who should be taking up the fight. I also wondered why more women of my generation weren’t speaking out more.

You may be one of those women, younger or older, who has been active and involved; but there are too many who have not. Perhaps it is because older women have become complacent, since child bearing issues are no longer relevant. Maybe it is because younger women don’t know about or can’t relate to the horrors of backroom abortions. They may know women who have had an abortion-a safe, legal medical procedure; but they don’t know women who died from a botched abortion.

It is time for women of every generation to stop taking choice for granted. Let’s acknowledge that it is up to us to keep birth control and safe abortions accessible. This is going to require the older generation’s involvement. Those of us who enjoyed virtually worry-free sex must educate younger women about how difficult it was when women had no access to birth control or safe abortions.

It is time for our generation to rekindle the torch of choice, and to pass it down. It is time for us, the most outspoken, inspiring and audacious women in history, to shake women of all ages out of their complacency. We are on the verge of having one of our peers, one of our generation, one who has been pro-choice as long as we have, become the first woman president! With that, and this SCOTUS ruling, the wind is in our sails!

Our legacy should be the empowerment of younger women in constructing stronger, independent lives that aren’t lived according to ideals imposed by men. It is our duty to encourage them to fight for the continued right of choice, so that they can in turn inspire the generations of women who come after them to do the same.

If Hillary Clinton is not too old to be president, we are not too old to take up this battle. The Republicans will not give up the fight, and we need to be united as never before.

Let us give the younger generation the benefit of our experience and knowledge. We lived it, so we can talk of it with intelligence and confidence. Let’s start by engaging our daughters, granddaughters, and young friends in meaningful conversations about what the loss of choice would mean for them. Let’s emphasize the value of their vote, and enlist their support of organizations that support a woman’s right to choose.

Let us not go gently into our golden years. Instead, let us reinvigorate and do what we can now to preserve a woman’s most fundamental right–the right to have total control over her own body.