A proud gay man lives his adult life with his male partner or husband, not a wife and kids. Gay men do not support a constitutional amendment to prohibit same sex marriage. Gay men do not vote against long-overdue legislation that would protect gay men and lesbians from discrimination in the work place (the Employment Non-Discrimination Act or ENDA).
On the other hand, repressed, hypocritical, right-wing politictions with homosexual tendencies behave exactly as Senator Larry Craig (R-Idaho) has done in the past two months and throughout his political career. How ludicrous to believe that one of the hundred or so most powerful people in the United States was intimidated by a Minnesota beat officer into confessing to a crime he didn’t commit.
In a “he said, he said” case such as this one, Senator Craig could well have denied the officer’s interpretation of the several easily misunderstood actions the Senator reportedly took in the airport bathroom. Moving from one stall to another? No toilet paper! Tapping one’s foot toward the next stall? Groovy muzak! Waiving at your stall neighbor under the divider? Those crazy Idahoans are so friendly!
Of course, unlike most closeted men with homosexual tendencies caught soliciting sex in a public restroom, Senator Craig thought he held a trump card, literally, his business card. He waived it at the officer like the “Get Out of Jail Free” card in Monopoly. Too many nameless and unheralded closeted men with homosexual tendencies have not had that card to play and hundreds, actually thousands, have lost jobs, families and – through suicide – their lives as a result of similar arrests. If Senator Craig hadn’t lost his nerve, if he had stood tall and claimed that as a U.S. Senator it was his God-given right to have sex in any bathroom he saw fit….Well, let’s just he could been immortalized as the patron saint of all closeted men with homosexual tendencies. What a missed opportunity!
Though Larry Craig is clearly correct when he says he’s not gay, he was a wrong about another thing. Larry Craig claimed his arrest cast a “cloud over Idaho.” This is not true. Idaho is a beautiful state with crystal clear skies and lakes. What he cast was a big shameful, shroud-like cloud over the conservative right-wing in this country, which is just as homosexual as any other segment of the population, but refuses to accept the honesty and pride of being gay.
Tuesday, August 28, 2007
Thursday, February 8, 2007
We Love You Whoopi!
I’m posting here two posts I made in the last few days to the Gay Men’s Health Summit listserv. There is a big discussion about current ads featuring Susan Sarandon, Whoopi Goldberg, Amanda Peat and Rosie Perez that lovingly admonish the gay community for using crystal meth and barebacking. Some men on the list criticized the ad campaign as ineffectual and offensive – rich straight (?) female actors telling gay men how to live. Others thought it useful that celebrities with some credentials in the gay community publicly expressed their concern about continued HIV transmission.
Post 1:
In several settings I've been in over the past year (perhaps starting at the MSM and HIV pre-conference summit in Toronto this summer) it seems we're at another crossroads of sorts. The holistic camp (of which this listserv was birthed) says we need to affirm gay culture, provide healthy outlets, nurture discussion and support the development of a Zeitgeist that values gay men, and gives them hope and reason to take care of themselves and each other. The public health camp (where I work, if not reside) continues to stress the complicated interaction of risk factors - the putative pandemic of childhood sexual abuse, depression, and substance use disorders - that may fuel risky behavior. The former group finds solutions in institution building and messages of reassurance and affirmation and the latter group continues to see specific intervention - on the Internet, through individual and group counseling, and other psycho-educational interventions that will succeed given the "intervening factors" affecting people's ability to hear the message.
The struggle between the two camps seems to focus on resources - the groups have very different ideas on how best to spend money. But perhaps even more so there seems to be a bit of antipathy between the two groups regarding the fundamental view of gay male culture and whether it is "sick" or not. Ironically, a lot of us, including me to some extent, who have argued for a holistic, gay male health approach to HIV, now find ourselves in a somewhat contrarian position - wondering who these folks are who are suddenly expressing this public concern about the gay community. It is true that Whoopi and Susan have been allies for a long time, but there is something peculiar in the way they are not standing next to us and advocating for us to the straight community but have "turned around" and are now facing us and speaking directly to us, publicly, and telling us to get our act together. It's unnerving - like we collectively as gay men have been caught with our pants down by a caring maternal/big sister figure. Literally.
I'm not sure where we go from here, except that I would guess that, despite the odes to the goodness of this fine campaign as shared in the Gay City News article, these ads will have about as much impact on the rate of HIV transmission as President Bush's "surge" will bring calm to Bagdad. I think perhaps the greatest challenge will be at the local institution level, where many gay community centers and health centers are struggling to make holistic models work, while more targeted interventions - with their high cost and the inherent difficulty in finding those of us most at the margins and most at risk - fall by the wayside.
Post 2:
After excoriating celebrity worship somewhat, I remembered last night that for many years, one of the things that put a cap on my drug use was hearing Katherine Hepburn many years ago (on Dick Cavett maybe?) talking about why she was against drugs. She said in her very Kate way, "When I speak to someone I want them fully there, right in front of me, looking me square in the eye and completely cognizant of what I'm saying." Whoa!
So why do I still think it's right to be skeptical of this campaign? Kate's remarks were spontaneous (I assume) and not paid messages intended to preach to anyone in particular. It was just hearing an interesting perspective from someone who, at the time, I respected a lot. I think we have a responsibility to think critically about each campaign because there are limited funds to do this, so if these messages help 3 people, it's not okay, it's a waste of resources. However, who knows for sure? They may help more than I think and perhaps more among younger folks. It will be interesting to see the evaluation results.
In any case, I keep coming back to the same point in my mind. Those of us working in HIV prevention are engaged in really hard work. Most gay men avoid cum in their ass. A few don't give a fuck about it. And some on the margin let it happen - but they mostly do so because they are on the margin for a variety of reasons and not easy to find, reach and, ultimately, prevent the fateful moment. HIV transmission is a rare occurrence, relatively speaking. There are just lots and lots and lots of sex acts that create too many opportunities for this transmission to occur. My hat really goes off to Jim Pickett and others who have worked like crazy to get anal microbicides funded, researched, and on the shelf so gay men would have another tool to use to reduce that risk even further.
In loving brotherhood,
Stewart Landers
Post 1:
In several settings I've been in over the past year (perhaps starting at the MSM and HIV pre-conference summit in Toronto this summer) it seems we're at another crossroads of sorts. The holistic camp (of which this listserv was birthed) says we need to affirm gay culture, provide healthy outlets, nurture discussion and support the development of a Zeitgeist that values gay men, and gives them hope and reason to take care of themselves and each other. The public health camp (where I work, if not reside) continues to stress the complicated interaction of risk factors - the putative pandemic of childhood sexual abuse, depression, and substance use disorders - that may fuel risky behavior. The former group finds solutions in institution building and messages of reassurance and affirmation and the latter group continues to see specific intervention - on the Internet, through individual and group counseling, and other psycho-educational interventions that will succeed given the "intervening factors" affecting people's ability to hear the message.
The struggle between the two camps seems to focus on resources - the groups have very different ideas on how best to spend money. But perhaps even more so there seems to be a bit of antipathy between the two groups regarding the fundamental view of gay male culture and whether it is "sick" or not. Ironically, a lot of us, including me to some extent, who have argued for a holistic, gay male health approach to HIV, now find ourselves in a somewhat contrarian position - wondering who these folks are who are suddenly expressing this public concern about the gay community. It is true that Whoopi and Susan have been allies for a long time, but there is something peculiar in the way they are not standing next to us and advocating for us to the straight community but have "turned around" and are now facing us and speaking directly to us, publicly, and telling us to get our act together. It's unnerving - like we collectively as gay men have been caught with our pants down by a caring maternal/big sister figure. Literally.
I'm not sure where we go from here, except that I would guess that, despite the odes to the goodness of this fine campaign as shared in the Gay City News article, these ads will have about as much impact on the rate of HIV transmission as President Bush's "surge" will bring calm to Bagdad. I think perhaps the greatest challenge will be at the local institution level, where many gay community centers and health centers are struggling to make holistic models work, while more targeted interventions - with their high cost and the inherent difficulty in finding those of us most at the margins and most at risk - fall by the wayside.
Post 2:
After excoriating celebrity worship somewhat, I remembered last night that for many years, one of the things that put a cap on my drug use was hearing Katherine Hepburn many years ago (on Dick Cavett maybe?) talking about why she was against drugs. She said in her very Kate way, "When I speak to someone I want them fully there, right in front of me, looking me square in the eye and completely cognizant of what I'm saying." Whoa!
So why do I still think it's right to be skeptical of this campaign? Kate's remarks were spontaneous (I assume) and not paid messages intended to preach to anyone in particular. It was just hearing an interesting perspective from someone who, at the time, I respected a lot. I think we have a responsibility to think critically about each campaign because there are limited funds to do this, so if these messages help 3 people, it's not okay, it's a waste of resources. However, who knows for sure? They may help more than I think and perhaps more among younger folks. It will be interesting to see the evaluation results.
In any case, I keep coming back to the same point in my mind. Those of us working in HIV prevention are engaged in really hard work. Most gay men avoid cum in their ass. A few don't give a fuck about it. And some on the margin let it happen - but they mostly do so because they are on the margin for a variety of reasons and not easy to find, reach and, ultimately, prevent the fateful moment. HIV transmission is a rare occurrence, relatively speaking. There are just lots and lots and lots of sex acts that create too many opportunities for this transmission to occur. My hat really goes off to Jim Pickett and others who have worked like crazy to get anal microbicides funded, researched, and on the shelf so gay men would have another tool to use to reduce that risk even further.
In loving brotherhood,
Stewart Landers
Thursday, February 1, 2007
Health Care Proxies
If you read my first blog, you may notice that my training in law and planning would not necessarily lead to a career in public health. My father, Irving Landers was a podiatrist who practiced in New York City from the 1950s till his death in 1973. My maternal grandfather, Benjamin Rose, was a barber and healer. So, perhaps the health care field was in my blood, despite my academic choices. The other thing that happened was the AIDS epidemic, but that’s not what I want to talk about today.
I want to talk about health care proxies. In part, this is because my partner and I have a dear friend whom I call J. who suffered a massive stroke three weeks ago. It was a hemorrhage that bled in the back of her brain into her cerebellum and onto her brain stem. J. is totally disabled and able to communicate somewhat with eye blinks, for the very short amount of time each day that she is able to be awake.
J.’s health care proxy document directed that life sustaining treatment, also referred to as "heroic measures," not be used to sustain her if there was “no reasonable likelihood of recovery from severe mental or physical disability.” It was also said in the document, that she wanted to die with dignity. The neurosurgeon and neurologists at Mass General agree that J. is likely to remain severely disabled as a result of the stroke damage.
Despite this, her health care proxy took almost three weeks to discontinue life support. It was unclear exactly why the proxy waited this time. Perhaps to wait and watch J.’s progress for a period of time, just in case. She also waited, perhaps, a reasonable time to help family and friends adjust to the shock of what has happened.
It seems to raise a number of issues around health care proxies that I never thought of, even though I’ve had one in place for almost a decade.
Look at different language and be as specific as possible. The language on many proxies is very general and can be interpreted in many different ways. Would you accept ventilators and feeding tubes if there is a chance you could recover in a year? Do you want to be kept alive for a month regardless of circumstances, just to make sure no one pulls the plug too quickly?
Talk to your health care proxy. This is a most critical part of implementing a health care proxy that I’ve never heard discussed. This isn’t surprising as there is a lot taboo and inhibition in our culture about discussing disability and death. It’s just something for which many people can't find the language or setting or emotional strength.
First, we should talk about what exactly we do and don’t want – should we be resuscitated if we are having a heart attack? Would we stay alive with a 20% chance to recover? 5%? 1%? What if we wouldn’t have our full mental facilities? Slightly reduced mental facility? The mental faculty of someone with mild retardation? The mental facility of a five-year old? A ten-year old? One can never cover every situation, but a frank discussion could help provide guidance to the proxy should they ever, heaven help, become your voice.
Second, in the worse case scenario, a health care proxy does need to be prepared to remove a ventilator and feeding tube, if that is your wish. It may seem macabre to ask your dear friend if they would be willing and able to do this for you, but this is what you are potentially asking them to do when they agree to be your proxy. For many people their closest loved one is the right person for this task. For others, it may be someone who is trusted but not necessarily the most beloved person to you in the world.
Having a health care proxy document and asking someone to serve in that role is hard to think about, but something most folks over 40 should have in place. One of my colleagues, when I described the situations with J., said that perhaps there was something to the old way - when doctors, not family members, made these decisions. I don’t think we can or should go back to that time, but I understand the attraction to that idea.
I want to talk about health care proxies. In part, this is because my partner and I have a dear friend whom I call J. who suffered a massive stroke three weeks ago. It was a hemorrhage that bled in the back of her brain into her cerebellum and onto her brain stem. J. is totally disabled and able to communicate somewhat with eye blinks, for the very short amount of time each day that she is able to be awake.
J.’s health care proxy document directed that life sustaining treatment, also referred to as "heroic measures," not be used to sustain her if there was “no reasonable likelihood of recovery from severe mental or physical disability.” It was also said in the document, that she wanted to die with dignity. The neurosurgeon and neurologists at Mass General agree that J. is likely to remain severely disabled as a result of the stroke damage.
Despite this, her health care proxy took almost three weeks to discontinue life support. It was unclear exactly why the proxy waited this time. Perhaps to wait and watch J.’s progress for a period of time, just in case. She also waited, perhaps, a reasonable time to help family and friends adjust to the shock of what has happened.
It seems to raise a number of issues around health care proxies that I never thought of, even though I’ve had one in place for almost a decade.
Look at different language and be as specific as possible. The language on many proxies is very general and can be interpreted in many different ways. Would you accept ventilators and feeding tubes if there is a chance you could recover in a year? Do you want to be kept alive for a month regardless of circumstances, just to make sure no one pulls the plug too quickly?
Talk to your health care proxy. This is a most critical part of implementing a health care proxy that I’ve never heard discussed. This isn’t surprising as there is a lot taboo and inhibition in our culture about discussing disability and death. It’s just something for which many people can't find the language or setting or emotional strength.
First, we should talk about what exactly we do and don’t want – should we be resuscitated if we are having a heart attack? Would we stay alive with a 20% chance to recover? 5%? 1%? What if we wouldn’t have our full mental facilities? Slightly reduced mental facility? The mental faculty of someone with mild retardation? The mental facility of a five-year old? A ten-year old? One can never cover every situation, but a frank discussion could help provide guidance to the proxy should they ever, heaven help, become your voice.
Second, in the worse case scenario, a health care proxy does need to be prepared to remove a ventilator and feeding tube, if that is your wish. It may seem macabre to ask your dear friend if they would be willing and able to do this for you, but this is what you are potentially asking them to do when they agree to be your proxy. For many people their closest loved one is the right person for this task. For others, it may be someone who is trusted but not necessarily the most beloved person to you in the world.
Having a health care proxy document and asking someone to serve in that role is hard to think about, but something most folks over 40 should have in place. One of my colleagues, when I described the situations with J., said that perhaps there was something to the old way - when doctors, not family members, made these decisions. I don’t think we can or should go back to that time, but I understand the attraction to that idea.
Thursday, January 25, 2007
Welcome To My Blog
My name is Stewart Landers and today my health is fine. This is no small feat as I have been living with HIV since 1985 and am also a cancer survivor (Burkett's lymphoma, 2003). Do not fear, Landers Health Report will be more than an update on my health. My work has been in the field of public health since 1983 and I am now a senior consultant with John Snow, Inc. based in Boston, Massachusetts. Previously I've worked for the Massachusetts Department of Public Health HIV/AIDS Bureau, the Boston Department of Health and Hospitals (now called the Boston Public Health Commission) and Fenway Community Health.
My background, however, strictly speaking, is not in public health. I was trained as a city planner at MIT in the 1970s and as an attorney at Harvard Law School in the early 80s. My passion throughout my life has been activism on behalf of lesbian, gay, bisexual, trangender and intersex (LGBTI) individuals. I've been lucky enough to be able to combine my work life and my passion and I hope that comes through in my posts. The recently deceased Eric Rofes, a leader in gay activism and health issues, always preached that being part of a movement was a wonderful way to give meaning to one's life. I think he hit it on the head.
Pieces of my work can be found scattered around the internet if one googles my name, so this blog will provide background and context for the work I've done plus a chance to offer commentary on the issues in my field and just about everything else. My partner and I are news junkies and I have lots of opinions on what is going on in this country that may find an outlet here.
Please don't hesitate to send thoughts or comments. I'll certainly read and will try to respond to all serious ones.
My background, however, strictly speaking, is not in public health. I was trained as a city planner at MIT in the 1970s and as an attorney at Harvard Law School in the early 80s. My passion throughout my life has been activism on behalf of lesbian, gay, bisexual, trangender and intersex (LGBTI) individuals. I've been lucky enough to be able to combine my work life and my passion and I hope that comes through in my posts. The recently deceased Eric Rofes, a leader in gay activism and health issues, always preached that being part of a movement was a wonderful way to give meaning to one's life. I think he hit it on the head.
Pieces of my work can be found scattered around the internet if one googles my name, so this blog will provide background and context for the work I've done plus a chance to offer commentary on the issues in my field and just about everything else. My partner and I are news junkies and I have lots of opinions on what is going on in this country that may find an outlet here.
Please don't hesitate to send thoughts or comments. I'll certainly read and will try to respond to all serious ones.
Subscribe to:
Posts (Atom)
