Poets, sharks, and invasions of medical privacy.
Separate items. No poetic sharks invading your doctor's office.
Tele-what-now?
When I meet with my therapist in person, rarely does she suddenly freeze. Rarely is her mouth out of sync with the sound of her voice. And rarely is she merely a floating head inside a box. Almost never. So that’s different than the internet teletherapy I’ve been doing since March.
“Telehealth” and “teletherapy” are still novel enough that the Substack spellcheck doesn’t recognize them (nor does it recognize Substack, strangely). Maybe I could put hyphens in there but how exhausted do I wish to be? Anyway, distance therapy is here to stay and, as so often happens, the technology arrived way ahead of a reasonable approach to managing it.
Several regulations on te-le-thera-py have been eased during the pandemic. The net effect is that a lot more people have had access to therapy at a time when it’s desperately needed. Now, as the vaccine spreads and Gandalf receives it, the question becomes whether the temporary easing becomes permanent. That is certainly the wish of healthcare providers and lobbyists because more people can be seen in an easier way. And it sounds great too if you don’t have time to schlep over to see someone, especially if you’re not feeling so great.
It’s easier for long-distance therapy to be covered under Medicare, Medicaid, and CHIP. So that’s a big win for patients. But then there’s the issue of discretion. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is the privacy law that enforces controls on patient information. It serves as protection for you as a patient and also the reason for a lot of forms you fill out at the doctor. HIPAA has been relaxed during covid, allowing therapy on more platforms like Zoom and Google Hangouts.
And the thing about places like those is that we constantly strike a deal with them: their service for our data. Google has built an empire on knowing about people and monetizing that knowledge. If you don’t think Zoom and Facebook are doing the same thing, you better go back to thinking school.
At the same time, you have the growth of app-based companies like Talkspace, which provides...something... - I’m not sure if you can call it therapy- through text. Up until 2018, Talkspace even said in the user agreement “This Site Does Not Provide Therapy. It provides Therapeutic conversation with a licensed therapist.” And the company has run into a lot of controversy over lax privacy practices.
This 2016 article in The Cut talks about how Talkspace therapists aren’t mandatory reporters for things like child abuse and suicidal ideation. A regular therapist is required to make a call if you say something to indicate you are putting yourself or someone else in danger.
So is less regulation the answer? Or will it create more problems? Which way should we be going with this?
Poet. Knows it.
I have the honor of living across the street from the poet Patricia Kirkpatrick. She’s as brilliant a neighbor as she is a poet. The other night, Jill and I “went” to a “reading” in celebration of Blood Moon, Patricia’s new book of poems.
It was wonderful, of course, because she’s our friend and the poems were beautiful. I honestly don’t know how people make poems. I know all the words and all it is is words but it just seems like alchemy to me. Like sorcery. I couldn’t write a good poem if my life depended on it, although if we lived in a world where death threats operate like that, I have to wonder what has happened to society.
Patricia had a brain tumor some years ago. Here’s a poem she wrote (from her website):
IN EXTREMIS
You don’t get everything back.
Is today morning or night? The radio voice says
the composer is changing the place home is.
When they try to put a tube down her throat,
the woman beside me sobs. Nurses probe
a vein as she thrashes, call the Hmong translator.Once a boy told me, in Laos he sat in a tree
all night. Father pay me dollar for every man I’m shooting.
When there’s water to cross, the fish, caught,
get needled through gill slits. Down the dark hall,
machines bleat at each bed. Eyes open and shut: flashes,
detachment, vitreous gel. Her son, seven years old,
comes after school, peels oranges, watches football,
changing the place home is.
At the reading, Patricia said she hasn’t written anything since the pandemic started. Not even on her calendar. I’ve written plenty in all directions but barely a dent in the things I wanted/needed to. Patricia’s admission made me feel relieved for myself and sad for both of us.
This was meant to be a short item in the newsletter but I had too much to say. And yet I have a hard time writing. And that is a thing called HUH.
I feel fine going for a swim, actually
My son and I watched Jaws last night. Highlight:
(some fishermen had a close call with the shark after dumping meat in the water)
DEPUTY: So then Denherder and Charlie sat there trying to catch their breath and figure out how to tell Charlie’s wife what happened to her freezer full of meat.
MY SON: Freezer full of meat? That’s a horrible thing to call his wife.
It occurred to me how Trump is the mayor wanting everything to stay open so the economy will thrive even though there is something deadly out there. The shark is covid. The beachgoers are the general public. Roy Scheider is Fauci. Dreyfuss is medical research.
r/interesting
Researchers are examining changes in the use of language on Reddit during covid to determine the state of mental health.
From CNET:
In a study, published in The Journal of Medical Internet Research this month, the group used machine learning to analyze the text from more than 800,000 Reddit posts coming from 15 subreddits devoted specifically to topics like health anxiety, bipolar disorder, schizophrenia and depression, spanning from January to April. They also looked at 11 non-mental health subreddits like parenting and personal finance.
They found not only that anxiety surrounding health increased across subreddits, regardless of topic, but that there's reason for concern among specific mental health groups whose situation might be complicated or exacerbated by the hardships brought about by the pandemic.
From the study itself:
We found that support groups related to attention-deficit/hyperactivity disorder, eating disorders, and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses.
Studying Reddit in this way is really interesting and I think it could be incredibly effective. The group being studied isn’t a cross-section of society but there’s so much information in there that it must be a gold mine for a good analyst.
As for me, I got two clear possible roads to go down for my next podcast home. I intend to have that sorted by 12/31 at midnight. Happy new year to me. And you. And sharks. Also poets.