The New Yorker Protocol:

The New Yorker Protocol:

Surviving the Surveillance State

December 4, 2022
by Rose C.

Portland ranks among the Top 10 Most Surveilled U.S. Cities, according to Cybernews. Atlanta tops the list.

We live in a world where surveillance is a fact of life. Any encrypted software product may be backdoored, and even if it is not, you have no guarantee that the person on the other end does not have spyware such as keystroke monitoring or screen video capture running on their system. Encryption enthusiasts and amateur hackers, no matter how valiant, simply cannot compete with a nation-state in this game. Cf Pegasus.

Sneak and Peek, or “No Knock,” Warrants have been around since the Patriot Act was passed in 2001, but they receive scant attention from the media. What they mean is that you may have your home searched, and items removed from your home, without any official notice from law enforcement. Ditto for electronic files. If you file a FOIA request and the investigation in which you are named is still ongoing, you will not receive any confirmation that a warrant exists. (Pat Eddington, Cato Institute)

The most frightening aspect of these warrants is the potential for planting false evidence. The second most frightening aspect is the potential for planting surveillance devices for tracking and listening — as if cell phones were not effective enough.

Nothing to Hide?”

Like roughly 2/3 of the U.S. population, I reside within the 100-mile “border zone” where Border Patrol agents are granted additional authorities and the Constitutional protections of the Fourth Amendment no longer apply. You may think all of this is irrelevant if you are a law-abiding citizen.

The problem is that who you know can get you put on a list. It can also make you a target. To put it another way, we all know somebody who has a cousin who is a drug dealer.

Laws in this country are changing, and not (in my opinion) for the better. Roe v. Wade is gone, and civil rights for gays and lesbians may soon disappear as this country takes a hard shift right. Remember ICE? Children in cages? Forced sterilizations?

Come 2024, they may all be back.

If you don’t feel like being a freedom fighter, if your first priority is keeping your family safe and saving for your children’s college tuition, I am not here to judge. Just remember that in a world where power rules in place of law, abuse of that power is an inevitable consequence.

Get in a traffic accident with somebody employed by the surveillance state? What if one of them rapes your daughter? Or your son? When a large class of individuals are above the law, nothing good will come of it. This is especially true when the same individuals fear consequences from their actions. They tend to lash out and do everything they can to harm and intimidate witnesses and injured parties.

I am not an America-hater. Far from it. The country I grew up in gave me 40+ years of freedom in its purest form: freedom to explore, to create, to love and befriend those I chose, to work as much or as little as I liked. Freedom to just be. I am a GenXer. I don’t mean to talk like a crusty old-timer, but I believe I’ve seen this nation at its absolute best.

Or maybe the best is yet to come.

Nothing is fixed. Nothing is certain.

The combined 2022 budget of Homeland Security, the Department of Justice, and the 17 different United States spying agencies (of which CIA and NSA are only two) is over $150 billion. For comparison, that is roughly one fifth of the Department of Defense 2022 budget of $742B. But remember, the DOD budget covers submarines, fighter jets, aircraft carriers, helicopters, tanks, nuclear weapons, and anti-missile defense systems, not to mention an active network of bases around the world. That’s a lot of people and hardware.

What exactly are we paying for? This remains largely unclear. Marijuana is now legal in 19 out of 50 states, but the DEA’s funding continues to grow. If you were an officer monitoring wiretaps and running undercover operations in Colorado or Washington State, where and to what were you reassigned? And as far as truly terrifying threats to health and safety, the surveillance state could be doing a much better job. We read about mass shootings in the news practically every week. It failed to prevent the violent attempted coup at our nation’s capitol on January 6, 2021. 

Your tax dollars at work, my friends.

Government salaries range from $20K (GS-1) to $147K(GS-15) — much less than the equivalent in the private sector. If we assume that wages (including benefits) average $100,000 per year, we would expect that the surveillance states employs as many as 1.5 million people in the United States. Keeping in mind, that is not accounting for slush funds to be distributed overseas, or James Bond style gadgetry, server space, or the cost of buildings and operations. But if we slash that number in half, that is still one federal domestic spy for every 440 U.S. citizens.

And that’s a lot.

Regarding terminology, “federal domestic spy” includes FBI informers, often recruited under duress or experiencing economic hardship. It does not include state or local police forces.

I am an extremely law-abiding citizen. That has protected me to some extent, but not completely. Somebody who has cheated on their taxes or who runs a warez server with their friends is at high risk of being “turned” and pressured by law enforcement to inform on others and further widen the surveillance network.

If you wish to minimize the risk that a conversation will be overheard, consider the New Yorker Protocol.

The New Yorker protocol consists of three simple steps:

  1. Assume good intent. I am not interested in contact with people for purposes of criminal profiteering (drugs or other contraband) or with groups that instigate violence. My philosophy is nonviolence except in the case of self-defense. I am only interested in working with people who share these values.

  2. Confirm receipt as soon as possible. If somebody emails you asking to meet for coffee, say, “Hey, I got your email. Swamped right now! Will be back in touch to coordinate a time.” If somebody you know leaves a signed, sealed note taped to your front door with instructions to communicate only by dropping messages in yonder hollow tree, then by all means, drop them a note asking, “Did I get the right tree?”

  3. Allow up to 90 days when making a major decision. Depending on the stakes involved, this might be anything from agreeing to meet somebody for the first time for coffee to participating in civil disobedience or leaking a story to the news media. If you feel certain of your course of action sooner than that, of course it is ok to let the other person know. Likewise, if you know you are not down for whatever the person is asking, don’t feel that you need to respond at all. The basic courtesy of acknowledging receipt (Step 2) is enough.

Two of these three steps come directly from the New Yorker writer’s guidelines for submitting unsolicited short fiction manuscripts. I was so taken with these guidelines (in particular, their clarity and brevity) that I submitted a short story almost on the spot. I don’t expect that it will get published, but I do appreciate that 90 days after sending it in I am free to re-submit wherever I like. I also appreciate that immediately after emailing my story as an attachment, I received an auto-responder email acknowledging receipt.

The New Yorker protocol should by no means be restricted to clandestine activities. I consider it an effective strategy for social and business networking as well.

Creating an expectation to observe and respect these simple guidelines is an essential first step to initiate an effective communications process that is platform- and technology-independent and minimizes surveillance risk.

 

 

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

A Space for Healing

A Space for Healing

Did you know domestic violence is the leading cause of homelessness for women? Rose Haven is a trauma-informed day shelter for women, children, and marginalized genders. Its new space opened on March 8, 2022, after nearly two years of operating from tents in the COVID era.

PDX Local interviews Liz Starke, Development Director for Rosehaven.org.


As a day shelter, what services do you offer?

Rose Haven is a safe place designed with a trauma informed lens where you can go during the hours when many overnight shelters are closed. We offer a secure mailing address, access to meals, showers, restrooms, clothing, first aid, financial assistance and one-on-one advocacy for our guests. Most importantly, we offer community and dignity to a population facing extreme stigma and isolation. Currently, Oregon has the second highest rate of literally unsheltered people in the country- that is our neighbors living outside, in cars or in tents. All of the night shelters are full with wait lists, so we play an important role by bridging the gaps in services and offering help to all those folks not lucky enough to get a shelter bed. For example, if we had 40 beds that would mean we could help 40 people, in our model we are able to serve thousands of women and children a year.

 

Rose Haven Day Shelter for Women and Children
 
What is the story of Rose Haven? How did it get started?

Rose Haven has been an important resource for women and children experiencing trauma in Portland for 25 years. We were founded in 1997 as a program of Catholic Charities after our founding director, Sr. Cathie Boerboom conducted a survey where she walked the streets of Portland and asked women what they needed. The overwhelming response was a safe place to go during the day, where they could take their children and access resources. Twenty-five years later we are still offering programs based off of our guests’ self-defined needs; offering a low-barrier and accessible community resource center where women can meet physical and emotional needs, access social services and find community. Although not a religious organization, Rose Haven operates under the Good Shepherd value system which embodies “Compassion”, “Individual Worth”, “Reconciliation” and “Zeal”.

 

Rose Haven Day Shelter for Women and Children

What special challenges do women and children face when they are homeless?

For women, it is especially dangerous to live outside and constantly be exposed. Women are sometimes referred to as “the hidden homeless”, because they go to great lengths to stay out of sight and not look vulnerable in order to stay safe. Domestic violence is the leading cause of homelessness for women, and unfortunately once they are outside they are even more likely to experience violence. This is why a sanctuary specifically for people marginalized by their gender is so important, because otherwise these women have to face their predators just to receive help in a co-ed space.
 
How have your mission and service offerings changed in the era of COVID?
COVID made our jobs really hard, but ultimately forced us to move into our dream home. Prior to the pandemic, we were functioning out of a very cozy ( some might call it cramped) church basement…where we were serving about 3,700 people a year- about 100 people a day! Needless to say we couldn’t socially distance in that space – so we had to make the really hard choice to push supply distribution to the sidewalk in order to keep our guests safe. For nearly two years we served up meals and clothing on the sidewalk, even doing first aid under a tent. Our guests only came inside to use the restroom, take a shower or meet one on one with a social worker – and for many this was their only opportunity to come indoors at all, as many agencies closed entirely during the lockdown. We knew Rose Haven was needed now more than ever before, and we had to expand. We launched a grassroots fundraising campaign and with the support of the community we opened our new home for the haven on March 8th 2022. We now have a beautiful 10k square ft facility that was designed with a trauma informed lens so our guests can feel at ease and heal when they are here. The visibility of our new location has brought attention to the issues our guests are facing and given them a home they can feel proud of.
 
What is the number one thing that people in Portland can do to make life better for our neighbors without homes?
Be compassionate. The most dangerous thing our guests face is stigma and isolation. They tell me they feel invisible and on display at the same time. It is so much easier to walk right past a person that is starving in front of you if you think of them as “other” than yourself. For example when you think of someone who is going through a hard time as a homeless person, rather than your neighbor that does something on a subconscious level to separate you from them. Unfortunately as more people are displaced, more of us know someone in our personal circle who has fallen on hard times, but we are not defined by our worst moments. I think the more we can do to bust myths (such as the magnet myth- which is the idea that people move out here to become homeless, when the truth is more than 80% of chronically homeless folks in Multnomah county went to high school here) and humanize our houseless neighbors, the better off we will all be. Just be kind to each other, and don’t be afraid of people if they are sick or hungry. Sometimes a smile can really change someone’s day, especially for someone who is used to being ignored or having people cross the street to avoid them.
And of course, support your local nonprofits however you can! Donate money or supplies, or volunteer your time. We can’t do this work without the support of the community!

Rose Haven Day Shelter for Women and Children

Get involved at www.rosehaven.org.
Portland Confidential: What It Means to Be a Hacker

Portland Confidential: What It Means to Be a Hacker

by Rose C.

Writing this at a time when sadly, I will not be able to stay in Portland, my chosen city, for very much longer. I won’t bore you with the details. My apartment has ventilation and habitability issues. I thought for a long time that I could mitigate the poor air quality with houseplants, fans, and open windows but it’s no longer practical. Not with winter coming on.

I hope to keep PDX Local going strong, though. I will always be a Portlandian in my heart. One of these days I will get around to putting up formal writers’ guidelines. In the meantime, if you have a story, wherever you live, feel free to get in contact and pitch. Unsolicited submissions are also welcome although we don’t print every story that is sent our way.

Anyway, back to today’s chosen topic.

Lesson #1 – Hackers are never as cool as they think they are. As I once wrote to the leader of my Hackerspace in an email, “Hackers think they are cool. Everyone else thinks we are dangerous criminals.”

Rami Malek notwithstanding. His character on Mr. Robot will always be cool, at least to me.

 

Lesson #2 – Not all hackers are criminals. Ummm, probably not even most. We do tend to think that laws around media piracy are for other people, and freely share audio, video, game, and text files whenever we can. There is so much corporate censorship already in the world that we often feel justified in going down this road. As for me personally, I don’t steal media or make unauthorized copies. I am extraordinarily law abiding.

Hackers like me, who refrain from breaking the law, are sometimes known as whitehats. I prefer the term “lawful and ethical hacker,” because it has no racist connotations. (Criminal hackers used to be called blackhats.)

This has less to do with the chances of getting caught and more to do with the fact that I am an artist as well as a programmer. I believe that creative work should be compensated, and that creators deserve the opportunity to make a living. When only wealthy trust fund kids have the opportunity to write memoirs or play in bands, we know that something is wrong with our universe.

 

Lesson #3 – IF YOU CALL YOURSELF A HACKER, YOU WILL GET HACKED. Certain people view the label as an invitation to test out your defenses. It can’t be helped.

It may not be anything bad. Maybe just a little spyware, or a Bitcoin miner hidden unbeknownst to you on your computer. Or it might be more severe. So be careful about using the term lightly. Many hacks can be prevented, but as long as people write new software, there will always be new vulnerabilities.

Back when I ran a web hosting company, I asked my former sysadmin what he thought about the slogan, “Your money back if you get hacked.” He wouldn’t go near it. While he was working part-time for me, he was also a VP managing cybersecurity and automation for a major national bank. You would have to assume he knew what he was talking about.

I don’t practice pentech, as hacking techniques designed to crack and illegally break open other peoples’ systems are known. So if I’m not pirating music and movies, and I also don’t try to break into other people’s systems, why do I call myself a hacker?

 

Lesson #4 – Hackers hack. It’s what we do. What I mean by hack is simple. We like to build things with electronics. Honestly, I would probably pay good money just to have the opportunity to keep doing this type of work. Collaboration, and with it the ethos of Free and Open Source Software (or FOSS) is also key to our worldview. We have our own language, and our own “in jokes.”

Here’s one you’ve probably seen before. The only other form of creativity that comes even close to being this collaborative without being rigidly hierarchical is music. That is probably part of why enjoy seeing live bands and being part of the Portland music scene so much; unfortunately I can’t carry a tune or play an instrument so I had to learn to code instead.

Still learning, actually. And probably will be for life.

Originally published on December 6, 2022. This post has been modified from its original version.

Bluetooth Vulnerability

November 26, 2022. By Rose C.

I am concerned because while I was in Phoenix, AZ earlier this month I encountered a dangerous piece of malware allowing an outside entity to take control of a phone.

The thing that complicated matters was that my cell phone locked up on me. Nobody ever touched it — I hadn’t clicked on any links recently or installed any new apps. It just went dark, with a tiny bit of purple visible. Occasionally it would come back to life, but not reliably.

The source of this vulnerability is almost certainly Bluetooth. I recommend turning off Bluetooth on your phones as a precautionary measure.

The Myth of Bioequivalence

The Myth of Bioequivalence

Download as PDF


If you or someone you love lives with bipolar disorder, please take the time to read this article. Also be aware that abrupt discontinuation of medication carries serious risk of relapse. Always consult with a doctor before changing your medication.

Why Generic NTI’s Are Unsafe

A Statement of Facts

Introduction

In the World War II historical drama The Imitation Game, Alan Turing and his team manage to decode a radio transmission warning of an imminent Nazi attack to an ocean freighter. They are anguished, knowing that if the British Navy acts upon their warning, it will tip off the Nazis to the existence of this newly developed ENIGMA decoder machine, potentially resulting in far greater loss of life. The information they have gleaned is too dangerous to be used.

Public discussion of the issues with the safety of generic Lithium raises a similar paradox.

For many patients, there is no good alternative treatment available. Reports that the drug was unsafe would cause many patients to abruptly stop taking the drug, putting them at high risk of withdrawal symptoms. While the issues surrounding the safety of generic Lithium are well-known to clinicians and pharmacists, they may be hesitant to raise the alarm in the media because the consequences to patients from abrupt withdrawal may be even worse.

Yet over the border in Canada, a safe and effective prescription may be obtained for approximately $30 US per month. Closer to home, new laser measurement techniques make routine quality screening possible and affordable for every prescription filled–if there were only a market incentive to make this technology widely available.

All Lithium prescriptions in the United States have been generic since Eskalith (formerly manufactured by GlaxoSmithKline) was discontinued in 2008. The drug, still widely used to treat bipolar disorder, is on the World Health Organization’s list of essential medicines and is the 205th most commonly prescribed drug in the US. Over 2.6 million Lithium prescriptions were filled in the United States in 2019. 

The problems with the generic drug supply in the US have been well documented in such books as Bottle of Lies: The Inside Story of the Generic Drug Boom, by Katherine Eban. This New York Times editorial does an excellent job of summarizing Eban’s main arguments.

However, the pitfalls of generic Lithium are even more severe, due to the drug’s narrow therapeutic range.

For a Narrow Therapeutic Index (NTI) drug like Lithium, the dosage required to be effective is very close to the amount that is toxic and potentially fatal. This poses a problem for the FDA’s current drug regime, known as bioequivalence, because the strength of generic medication in each dose is permitted to vary between 80% and 125% of the prescribed dosage.

This means that an individual who is prescribed a safe-but-high dose of Lithium (for instance, 1500 mg daily) might in fact, on any given refill, find themselves taking a daily dose of 1875 mg… a dose high enough to cause symptoms of Lithium toxicity and organ damage.

End “Lithium Roulette.”

Taking daily medication should never be a gamble. But that’s exactly what people experience when taking Lithium, one of the oldest and most trusted medications for treating mood disorders. Lithium is only available in generic form in the US, and FDA regulations allow the actual dosage of generics per pill to vary between 80 and 125% of the prescribed dosage. This “one-size-fits-all” approach, known as bioequivalence, ignores the fact that certain medications, such as Lithium, require precision dosage. Dosage fluctuations produce toxicity at the high end of the range, and trigger withdrawal symptoms and relapses at the low end. As far back as 2010, the FDA voted to tighten the allowable dosage standard for Lithium and other Narrow Therapeutic Index (NTI) drugs, but these recommendations were never enacted. It is time to hold healthcare providers and generic drug manufacturers accountable.

Abstract

This document describes an issue with drug safety which has played a role in more than 20,000 deaths in the United States since 2008. If not addressed, it will unquestionably result in many more deaths. Because these are deaths by suicide, they tear apart families and bring anguish to loved ones like nothing else

  • The vast majority of these deaths are preventable. 
  • Improving the quality, safety, and dose consistency of generic Lithium is inexpensive and attainable with current technology. 
  • Bureaucratic apathy and medical negligence are to blame for the current crisis.

Once prescribers, psychiatric associations, and generic drug manufacturers are held accountable, those affected may be able to receive compensation and rebuild their lives. Most important of all, an essential and lifesaving medication may again be made safely available in our country.

Witnesses

I am aware of three doctors, all MDs with years of experience in the practice of psychiatry, who may be contacted to provide testimony that generic Lithium is unsafe.

Slide from FDA Meeting

The FDA recommended stricter bioequivalence standards for Lithium as early as 2010.

Source: https://fda.gov “Quality and Bioequivalence Standards for Narrow Therapeutic Index Drugs,” p. 24. An archived PDF file for this presentation may be viewed and downloaded here.

Midway through the first term of the Obama administration, the FDA announced its intention to adopt stricter standards for generic Lithium and other drugs with similarly narrow therapeutic ranges. In 2010, an FDA committee voted 11-2 that the current bioequivalence standards were not sufficient for Narrow Therapeutic Index drugs [including Lithium] and it was suggested that the standards need to be stricter.

Sadly, we find no evidence or public record showing that these recommendations were ever enacted. Faced with little public awareness of the issue, lack of professional engagement and interest from doctors, their professional associations, and other potential “watchdogs,” it would appear that the FDA never followed through with their stated intention. Under the Trump administration, public discussion of changes to bioequivalence standards ceased altogether.

Here is a firsthand account of what this type of Lithium poisoning looks like:

“…two years ago, my nurse practitioner (psych) discontinued my Depakote and started me on Lithium due to unrelenting depression. I was okay for three days on the 300 mg twice a day, but when I increased it to 600 mg twice a day, according to her instructions, I became very ill, very suddenly.

I was so ill I didn’t recognize it myself and never attributed it to my change in medication. I was totally confused, couldn’t walk in a straight line, and was vomiting several times a day. I know now the green haze that I saw is due to Lithium toxicity but thought it odd at the time.

Needless to say, I had to go to the ER and they kept me in. I had Lithium poisoning and had five times the level in my blood. Nearly died. I was very sick indeed for two days in hospital, then released home with two new diagnoses: hypertension and kidney disease which are now being treated with medication, but not welcome diagnoses at all.”
– Sally Alter, on
Quora.com

The author of the post does not realize it, but the symptoms she describes are entirely consistent with being prescribed generic Lithium at the high end of the current dosage range allowed by the FDA. It is especially telling that she was able to tolerate Lithium at an earlier period in her life and encountered no problems. 

Prescribers who know of these risks and do not inform their patients, insist on the necessary blood tests, or advocate for stricter standards are in violation of their Hippocratic Oath.

Lithium toxicity, while the most dramatic byproduct of the current negligence in bioequivalence standards, is only the tip of the iceberg. 

Bipolar disorder affects about 5.7 million adults in the United States, and the fatality rate is staggering–as high as 20 percent. Nearly 12,000 lives are lost to bipolar suicide each year. Lithium remains the first-line treatment for many individuals experiencing bipolar disorder. We see evidence of its declining effectiveness in the population at large. Success rates of 70 to 85% were once expected with lithium for the acute phase treatment of mania, however, lithium response rates of only 40 to 50% are now more common. 

Using the most conservative assumptions possible, we should assume that over the past 14 years, generic Lithium was a factor in at least 20,000 of these deaths.  This figure is derived from 12,000 bipolar suicide deaths per year x 12 years x reported Lithium usage rate of 14.3%  =  20,592 deaths. For data on rates of Lithium usage for patients in the United States from 1996-2015, see https://pubmed.ncbi.nlm.nih.gov/32739706/

This estimate is low, since it does not include those people who discontinued generic Lithium after experiencing toxicity or relapse.

Why would generic Lithium be a culprit?

Because variation in dose strength leads to relapse.

Relapses lead to acute mood swings: bouts of psychotic mania and extreme depression that may themselves lead to suicidal actions, or to the words and actions that destroy relationships, marriages, and careers. Even if the first relapse does not kill somebody, it may leave them dangerously isolated and vulnerable. The effect is to decrease an individual’s belief in the effectiveness of medication and increase stigma in the population at large. 

“There is no cure for bipolar illness” is one of the most harmful and misleading statements ever coined. For many individuals, including myself, name-brand Lithium with precise dosage was effectively a cure. Now it can only be obtained by venturing outside the United States.

Let’s go back to our hypothetical individual who is prescribed 1500 mg daily of Lithium. Data suggests that the risk of symptoms from abrupt Lithium withdrawal actually exceeds the risk from the untreated disorder. Dose variations in generic Lithium means someone could go from 1875 mg to 1200 mg in dosage over a single refill–enough to cause withdrawal symptoms. 

How often does this happen? Remember that Lithium is a maintenance drug. Even if a significant fluctuation in dosage happens with only one drug refill out of 10, if you are bipolar and taking generic Lithium, the odds are that this “yo yo effect” will happen to you at least once every year. If you have a relapse, you will likely wonder what you did wrong and blame yourself, never realizing the role played by drug manufacturers and clinicians who knowingly allowed an unsafe product to remain available to consumers.

My Story

In 2018, I was about to embark on the seed round of fundraising for my social media and cryptocurrency startup. We had a great product and a terrific founding team. Everyone involved was optimistic about our chances. One of our early investors asked me to apply for life insurance. I was surprised to learn I did not qualify, due to the high death rate associated with my diagnosis. I was healthy and under a doctor’s care. It made no difference.

Being unable to obtain what it is known as “Key Man” insurance meant that my hopes of launching a venture-backed tech startup were dashed. I turned my passion and energy towards wellness coaching instead, hoping that I could make a difference and model a successful outcome for individuals struggling with mood disorders. 

Operating with almost no name recognition or word of mouth, I quickly connected with a large pool of coaching clients. The experience was rewarding, but it also made me aware of the shortcomings of our mental health care system–in particular, the issues surrounding generic mood stabilizers. 

My frustration with the treatment options available to persons with mood disorders led me to eventually close my practice. I did not wish to profit from a system that was so seriously broken. I was committed to working with doctors and licensed clinicians, and would only see clients who already had a doctor and/or therapist. However I did not feel I could be honest about the risks associated with drug therapy without a scalable, accessible solution at hand.

Conclusion

If you are prescribed Lithium, you should expect to have your blood drawn several times each year in order to determine whether your Lithium blood level is in the therapeutic range, or whether the serum level is too low or too high. That is what is entailed when prescribing and monitoring a potentially toxic drug with a narrow therapeutic range. The experience is painful and inconvenient, but medically necessary. Dosage fluctuations have transformed this established medical procedure into an empty ritual.

This is not an issue of side effects or isolated incidents of poor quality control. This is an issue of systematic negligence which has rendered one of the most important and trusted treatments for a life threatening disease to lose its effectiveness, and in some cases be worse than no treatment at all. Because of the risks from abrupt Lithium withdrawal, those most directly impacted cannot even safely cease taking the medication. We are looking at a situation where a serious and well-known safety issue was ignored for over a dozen years. Care providers, drug manufacturers, and professional associations who should have been motivated to act on behalf of patient safety instead did next to nothing. Apathy and inaction led to death.

Many people have experienced Lithium toxicity and preventable manic or depressive episodes due to negligent bioequivalence standards, but the most tragic harm rests with the individuals who have lost their lives, and with their families. Potentially, the pool of people harmed includes anyone with a family member who took generic Lithium and then had one or more episodes before ultimately committing suicide. These stories number in the tens of thousands. Practices, prescribers, professional associations, and generic drug manufacturers all bear responsibility.

Stigma is a major factor that keeps successful, high-functioning bipolar people from organizing for better care, more research, and treatments that actually work! We remain closeted and are busy living our lives until the moment when illness strikes us down. Earlier in this document, I alluded to an anecdote from Alan Turing’s life. Readers may be aware that Turing died by suicide, driven largely by homophobia and repression from the British government. Unless you have actually lived through prejudice, it is very difficult to comprehend the experience of being hated and shunned for something you cannot control. This was certainly the hardest lesson for me to learn as a wellness coach. I had never before had to face hatred head-on.

This barrier of ableism may be the greatest challenge to restoring justice and safe standards for an irreplaceable medication. I believe it is surmountable. Lives are at stake.


 

If you or someone you know is in crisis or experiencing suicidal thoughts, please call 988 or contact one of the many Crisis Resources listed on our site.

Download as PDF

 

Portland Confidential: Coming Out as Genderfluid

Portland Confidential: Coming Out as Genderfluid

Still pretty femme here.

This post first appeared on Medium on January 3, 2017. It has been edited from the original version.

 

Gender nonconforming while a Scorpio

by Rose C.

I went to a queer support group here in Portland and, for the first time ever, asked the people in the group to call me Jack.

And they did!

And I was blown away. It kind of made my night. I was inwardly beaming. Having trouble paying attention to others’ heart-rending stories, I was so inwardly thrilled to be recognized as Jack.

Me, a large-breasted girl with painted fingernails, longish hair, full lips, and a sweet, heart-shaped face. I was Jack! I had claimed some essence of my masculine self, and people had listened.

Not sure what to do about pronouns and the rest of it. Genderfluid and trans. “They/them” works nicely, for those that bother to ask. I’m not getting tied up in knots about this. I mean, I still carry a purse.

Where this goes next, I have no idea. But here is a bit of backstory.

Last Monday night I decided to try an experiment. There was this young dude (30, great body, worked out all the time) who had expressed an interest in me that was more than purely professional. About a month and a half ago we ended up making out past 2 AM in some downtown bar whose name I don’t even remember. We took an Uber to his place but stopped just short of having sex.

I wanted to think through my current relationship, long distance and already polyamorous in theory, and decide whether I really wanted to open it up to somebody new. I also figured I should get re-tested for STDs, just to be safe.

The answer I came to was emphatically, yes. So last week I sent Young Dude a text to see if he wanted to catch the Warhol exhibit in town. Four hours later, we ended up eating vegan mozzarella at a punk rock dive bar, then singing karaoke (my performance was unimaginably bad), then back to my place. The night was comically ill-timed (the smell of burning rubber alerted us that the tea lights were melting the blinds, even though not directly in contact) and a cold shower almost gave my date hypothermia.

The interesting part of the experience was that even though I knew I might be getting laid that night, I made no special effort to femme it up. Legs remained unshaven. I wore out the same bulky black hoodie that I wear everywhere. This was intentional (even though I did clean up the apartment some, with the thought that somebody might be coming back).

I decided, just that once, to act like a man — which is to say, just be me.

No special outfit, very little makeup.

This is me at 40, folks. I wanted to not apologize for it or cover it up. I wanted to see what would happen. No regrets.

Face it: my body will probably never look the same in lingerie as it did five years ago. I lost a lot of weight after my divorce — got to experience about seven years of having pretty much my ideal body. But then one day, metabolism and time catches up with you. You start to wonder, what exactly does the future hold in store for average looking women in their forties and fifties who don’t have kids?

I am viewing this unavoidable process of aging as an excuse to explore my more masculine side. Which is weird, because I really love my body. I can’t imagine having chest surgery. I could fantasize about a deeper voice, chest hair, all the other effects of “T”. (And yes, I’ve done the research about transitioning in midlife.)

I have no idea how other people experience gender. I just know that I almost never feel like a girl. Even when I did femme it up, it felt like a costume, or a video game avatar. A really fun and sexy costume, but something contrived and separate from the essence of who I was.

I know that I’m also a very nurturing and empathic person, and that those traits put me in the bucket of “feminine.”

But then… this is also me. Leader. Builder of things. Entrepreneur. Somebody who prefers to call shit like it is and isn’t afraid of conflict. Somebody with an unflagging code of loyalty to my peeps, even when they don’t return the same. Somebody whose idea of a perfect evening is just having two beers with a buddy. Really. That’s it.

Interests: comics, rock and roll music, computers, science fiction.

I think about why I have so many more guy friends than female friends, and it’s easy to just chalk it up to women being busy with children and partners, or women’s internalized jealousy and mistrust of other women.

But sometimes I wonder. Maybe something is clicking for me on a deeper level. I’ve never been a tomboy, never been super butch although I did shave my head in my early 20s. I’ve only ever been with two women in my life.

I feel dorky for embarking on this “voyage of self discovery” at the cusp of middle age. But I also feel like to try and fit a mold I outgrew sometime in the last few years might be literally dangerous to my health.

I had plenty of years to play the “cute girlfriend.” Am I now going to be the “less cute girlfriend?”

I guess for me the essence of masculinity is being perceived for my talent, strength, and ability rather than for how I look or my relationship to others. It has very little to do with having a penis or chest hair. And yet, projecting this self while outwardly feminine can be threatening to some.

I have thought about this shit for years, but never expressed it publicly before. I don’t know where it will lead. At this point in my life I am used to feeling like an outcast, even while deftly maneuvering professional and social situations and keeping casual acquaintances at arm’s length. Adapting a less traditional gender presentation might change that. It might make me, finally, a bit less closeted in my multifaceted “otherness.”

And honestly, that might be a change I am looking for.

Gardening Tips to Help Feed Your Family & Community

Gardening Tips to Help Feed Your Family & Community

by Beverly Nelson

Growing a garden can be a great way to spend more time outside, learn valuable new skills, and even reduce your family’s grocery budget. Furthermore, you can also help feed those in need in your community simply by growing fresh produce in your backyard.

Remember that whenever possible, it’s better to shop locally. Buying from small and local businesses helps support the entire community and promotes a sense of shared responsibility. Look for who is helping to get the word out in your area, like PDX Local in Portland OR.

Steps to Starting Your Garden

If you’ve never planted a garden before, you might be confused about where to begin. Whether or not you’re a green thumb, getting acquainted with the soil and the various types of produce has huge payoffs. But first consider these ideas as you set out on your gardening venture.

  • Building raised garden beds will help you protect your crops from tunneling pests.
  • To plant, tend, and harvest your vegetables, you’ll need some durable gardening tools.
  • Test your soil to see what level of acidity and nutrients you’re dealing with, then address high or low levels with appropriate treatment, such as adding nitrogen.
  • Once you have all of the tools and supplies you need, you’re ready to plant. Follow the helpful tips below on growing vegetables, herbs, trees and more!
  • Tend to your garden each day to ensure that your plants are healthy and promptly harvest fresh vegetables.
  • If you’re stumped on where to begin, consider hiring help from a local gardener or landscaper. You can survey backyard landscaping companies to help pave the way for your garden.


Preserving Your Delicious Harvest

It’s possible to plant and grow just enough in your garden for you and your family to consume, plus a little for friends, too. But if you end up with more fruits and vegetables than you know what to do with, these methods will allow you to preserve them so that they don’t spoil.

  • Canning your surplus vegetables is a great way to keep them fresh for months.
  • Incorporate your canned vegetables into one of these healthy recipes!
  • Stock your freezer with frozen fruits and vegetables for soups and other dishes.
  • Whip up homemade jam to make your breakfasts taste a little sweeter.

Serving People in Need

Food insecurity exists in every community. In addition to selling your produce at the local farmers market for a discount of what the grocery store charges, here’s how to ensure that your extra produce goes to the people who need it most.

  • Offer to drop off your extra produce and some non-perishables at one of Portland’s community food pantries.
  • Encouraging your children to help you distribute food to vulnerable people can teach them about the root causes of poverty and other forms of injustice.
  • Host a food swap to exchange produce and canned goods with your neighbors!
  • Consider working with others in your neighborhood to establish a community garden where people can tend their own plots and share fresh produce.

Gardening on a Small Scale

Perhaps all this sounds great but you’re looking around at your small apartment and thinking there’s no way you can maintain a garden in such a small space. Think again! Granted, you obviously can’t feed an army in a small space, but there are plenty of people who maintain successful gardens from apartments.

When you begin your garden, you may have to go through some trial and error as you learn the ropes. But when you’re cooking up delicious dinners with your veggies and helping your neighbors put food on the table, you’ll be happy that you took on this rewarding project!

PDX Local is an all-volunteer organization dedicated to helping get the word out about important community resources and small business. Call 971.412.2493.

Photo via Rawpixel

A Resource Guide to Help Seniors Who Don’t Have Relatives Nearby

A Resource Guide to Help Seniors Who Don’t Have Relatives Nearby

If you have parents or grandparents who live far away, you may be worried about the fact that you can’t help them with daily tasks. Luckily, there are many ways to help your senior loved one maintain a great quality of life, even if you can’t be there yourself to provide hands-on care. Read on for resources that can help the elderly in everyday life.

Find Tools to Help Your Senior Loved One with Important Financial Decisions

Finances are often a primary concern for persons in retirement. Make sure your parents or grandparents are managing their money wisely with some helpful tools.

  • If your loved one needs ongoing support, use a long-term care cost calculator to determine the expenses.
  • Your senior loved one may want to sell their house to cover the move to a nursing home. Use the RedFin calculator to figure out what they’ll make if they sell.
  • Make sure they have the essential estate planning paperwork done.
  • Provide practical tips to help them save in retirement, like downsizing.

Leverage Technology to Help Your Loved One Navigate Everyday Challenges

Technology can make life easier and more enjoyable for seniors in many ways.

  • Get them a senior-friendly cell phone to stay connected.
  • Provide them with a smart assistant so they can do things like adjusting lighting and music hands-free.
  • Invest in a medical alert system with fall detection to bring you both peace of mind.
  • Find innovative ways to connect from afar, like virtual game nights.

 

Connect with Third-Party Providers to Ensure Your Loved One’s Needs Are Met

 

When you can’t provide hands-on help yourself, knowing there are others nearby to assist can bring you and your parents or grandparents peace of mind.

 

  • Find a senior-specific transportation service to help them get to appointments.
  • If cooking is a hassle, get a meal delivery service for them.
  • For seniors who need more hands-on support, get a caregiver.
  • If they are struggling with mental health issues, connect them to a virtual wellness practitioner. PDX Local offers a roundup.

 

Living far away from your senior loved one can be emotionally and practically challenging. However, there are many resources and tools to help you care for them from afar. Let the above guide inspire you.

GALEXI

GALEXI

Your outfits are great. What gave you the inspiration?
Our spacesuits are just average clothes on our planet, Issia.
I felt that by sharing our customs, I could further inspire our listeners. Silver is transcendent!
And we’ve been heavily influenced by David Bowie, Bjork, T-Rex, Prince and Devo. Hence, outifts.??

How long have you been making music, and how would you describe your creative evolution?
I grew up going to a German Polka Club every week. So I was dancing to waltzes and polkas for most of my adolescence.  I didn’t start to work fanatically with music until my thirties.
Jo, however, has been singing since the crib. Legend has it she learned how to escape her cradle so she could re-load the stack of records.
Our creative process usually starts with a pad or synth progression just to get things rolling. I send that to Jo and she creates a melodic and lyrical story based on the mood. We work together to shape it into a song often with at least 15 iterations until we get it right.

I noticed you list both a Priestess and Scientist on your website. Do you believe it is possible to harmonize spirituality and rational knowledge in our current era of information overload? Can music play a role?
Yes!  Music is a perfect example. There is a concept that science and spirituality are separate but in fact, they are the same.  Look at Kirk and Spock! ? Whether the technology is Bach or today’s software, music inherently blends math and spirituality. To be more accurate, music IS the math of spirituality. On our planet, we’re able to heal disease with music. It’s a wondrous place!

What is the hardest thing about making music in quarantine?
There were so many challenges this year! Where to start…It was hard being separated from each other. I went from having weekly rehearsals to having to work remotely with The Priestess. We did lots of Zoom meetings. I think the limitations pushed us to grow our online fanbase and of course, we had to grow emotionally.

Your new single is called “I Won’t Dance for You.” Do you think music venues and dance clubs will be able to recover in Portland over the next year, or will it take longer for the scene to recover?

I love going to see live music and I so hope it recovers. Live music is so magical! Transformational. So I hope so and soooooon.  I love to watch the people dance! It’s sad to see some of favorite venues closed. I’m still sad that La Luna and Satiricon closed. Some places are holding on like the Alberta Rose—and we can support them now. Here is the link: https://shopalbertarose.square.site


If you had to choose, would you rather share a rocket ship with Ziggy Stardust, Barbarella, or Sun Ra?

So hard to choose! All great options. But Barbarella because there might be a hot tub and shag carpet!

Follow Galexi on Instagram and Facebook, and at www.galeximusic.com.

How to Work Remotely in Oregon

How to Work Remotely in Oregon

By Kelli Brewer

Feeling hesitant to head back to your frontline job in 2021? You’re not alone! In fact, Oregon employers in restaurant, lodging, and other customer-facing industries are facing unprecedented hiring challenges in the wake of the pandemic.

If you’re ready to start working again but don’t feel safe returning to a frontline job, remote work offers a solution. However, there are a few things Oregonians should know as they prepare to go remote.

First up, your rights as a worker in Oregon.

  • Have questions about your rights during the pandemic? Learn how to handle common employment scenarios during COVID-19, including what to do if you’re being asked to work in unsafe conditions.
  • Oregonians should also understand their rights as a remote employee, such as entitlement to breaks and overtime pay.
  • S. veterans who qualify for Protected Veteran Status have additional rights under the law.
  • Employee misclassification is a major problem in the remote workforce. Learn what distinguishes employees from independent contractors and what to do if you believe you’ve been misclassified.

Wondering the best way to start working from home? Try one of these strategies for going remote.

  • While some companies are sticking with remote work, others are calling employees back to the office. Read this article for strategies on how to ask your boss for an exception.
  • Rather than fight an uphill battle with an inflexible employer, some workers are leaving for remote-friendly companies. Many leading employers in Oregon have embraced remote work so you’ll have plenty of options.
  • Veterans should consider remote civil service jobs. Qualified military veterans receive hiring preference for civil service positions in Oregon.
  • Workers can also strike out on their own as freelancers. To assess your freelance earning potential, research the going rate in your field — for example, freelance graphic design prices — and factor overhead costs and self-employment taxes to estimate take-home pay.

Are you thinking of starting a home business in Portland? Starting a business offers greater growth potential than freelancing, but there are a few things to know first.

  • Businesses are required to register with the City of Portland and Multnomah County. Home-based businesses may also need a Home Occupation Permit.
  • Zoning may limit what type of business you can operate from your home. Homeowners and renters can check their neighborhood’s zoning at portlandmaps.om.
  • Starting a business after military service? Oregon Veterans Mean Business provides advising, training, and support for veteran business owners. Veterans can access this program at four locations in the state.

Frontline jobs aren’t the only way to get back to work in 2021. Remote work offers safety, flexibility, and opportunity for Oregonians. However, telecommuting has challenges of its own. From knowing your rights as a remote employee to understanding home business regulations, the resources we have shared can help you navigate remote work in Portland.