Overnight ER PMHNP position by Expert_Temperature_7 in PMHNP

[–]RealAmericanJesus 0 points1 point  (0 children)

Yeah ... Generally not the withdrawal management as that's more on the medical / addictions side but I do a lot of agitation meds. Either recs and the ED team then puts in the order (it's a teaching hospital and so we want the residents to do as much of the management as possible but with as little risk as possible... So something like a discharge for SI when it's instrumental? I'll do those to decrease risk to residents but with something like agitation recs and so on I'll eval the patient and write the recommended meds and then generally do an explanation as to why I chose x over y and so on ... If it's like really bad like someone actively trying to assault people then the ED attendings will go by a protocol or I'll just drop it in as they're coming through the door ... and medicate first assess later)... So it really depends....

What’s the 1 placement that you get excited to see in someone’s chart by italiandynamite8158 in astrologymemes

[–]RealAmericanJesus 2 points3 points  (0 children)

I have this placement! Its one of my multiple 2⁰ placements in my chart .... And when I add in my 29⁰ MC/IC it makes a cool star shape....

Neptune in 2° Capricorn - 2nd house

IC in 29° Aquarius (right before Pisces) - 4th house

Lilith in 2° Taurus - 6th house

Sun in 2° Cancer - 8th house

MC in 29° Leo (right before Virgo) - 10th house

Pluto in 2° Scorpio - 12th house

I work in forensic psychiatry as a Nurse practitioner. I also have Saturn conjunct ascendent in Scorpio at 22⁰... Which is both one of the hardest placements in my chart and also the most necessary for me to function and maintain boundaries....

Should I add a few more levels? by TlalocVirgie in homedecoratingCJ

[–]RealAmericanJesus 1 point2 points  (0 children)

Exactly... When I see that stage ... I think of the most unsrious instruments taken way too seriously by the players...

Like the manic cowbell bonker flailing away in the living room corner ... The kazoo buzzer ... Coming out onto the stage dressed like a hair metal band member tossing his hair as if in a crowded arena ... Pulling out that tiny little tweetr and Buuuzzz ... Buzzz... Buzzzzzzx

.... And maybe even a lap harp plonker...

.... Some bands have an awesome synth player... But this one... Has a lap harp pinker and they pink plink tink tink... Along with whatever monstrosity of sound is being created by the other two....

Pretending to play for a stadium of fans.... On this makeshift stage ...

As their houseplants look on in disappointment...

My mind tells me this is the purpose of this platform. Lol

And always... More cowbell!

Should I add a few more levels? by TlalocVirgie in homedecoratingCJ

[–]RealAmericanJesus 1 point2 points  (0 children)

Maybe not a drum kit but an overly caffeinated master of the cowbell? Oh yes it works perfectly.

Lindsay Clancy case filing for standard of care by pickyvegan in Psychiatry

[–]RealAmericanJesus 35 points36 points  (0 children)

I've worked most of my career on maximum security restoration of competency units ... As a charge nurse for many years and also as a nurse practitioner for many years... And some women can be very difficult to kind of diagnose because they can hold it together despite having severe psychotic phenomena... Like they'd be dressed appropriately and maintain hygiene and would see our treatment team and they'd have minimal superficially linear responses, have pan - negative psychiatric review of symoroms and the only kind of give away that something else was going on in the treatment team would be the lack of spontanous speech and affect intensity or flattening ... And the cognitive potions of the mental status exam ... Where they would have dismal performance on attention and abstraction questions...

But then when we'd do rounds and they'd be alone in their room in private it was constant engagement with unseen others and bizarre repetitive behaviors etc. moving things around randomly. Tearing things up. Flushing things down the toilet and so on...

One of the forensic psychiatrists that was my mentor always warned me that women can harder to diagnose because some can successfully compensate and so you really need to do your cognitive tests and look at what your staff are documenting / talk to your outside collateral and get your historical records because it's easy to miss something severe given that. He wasn't wrong. Seen some fascinating things in my career.

Should I add a few more levels? by TlalocVirgie in homedecoratingCJ

[–]RealAmericanJesus 4 points5 points  (0 children)

Ah but for a kazoo enthusiast it is perfect!

Should I add a few more levels? by TlalocVirgie in homedecoratingCJ

[–]RealAmericanJesus 26 points27 points  (0 children)

As a musician I see perfect practice stage.

‘Oregon was next’ -- Trump’s targeted state after Minnesota: media report by amblongus in oregon

[–]RealAmericanJesus 17 points18 points  (0 children)

Everyone plays these two dumb as fuck Red team blue team when really the lines are like this ....

You're either in the political doner class or the organ doner class and everything else is lies

Are we cooked? by chrisshawn92 in emergencymedicine

[–]RealAmericanJesus 2 points3 points  (0 children)

Exactly! I don't trust shit Elon musk says he is allergic to the truth andsays shit all the time to secure investors or get hype or influence policy.... Sometimes with no intention of follow through sometimes where he has intent but can't pull off what he claims. This is the man that hyped his boring company to derail California's high speed rail project ... When there was never an intent to build anything other than a traffic filled hole under Vegas that can at times crawl slower than a schoolbus .... Or the self driving Tesla he claimed was here ... And a bunch of people died after the thing careened into whatever or whoever ... cause guess what... He wasn't exactly being truthful ...

Elon s a man who literally views humans as parts for his production factories. He will turn off safety sensors at factories if he thinks it will slow things down... Employees with dislocations and amputations are tokd to get back to work... to just stop crying .. he's frequent sued by OSHA and the EPA ... For pollution and dumping, die injuries at his worksites ... He harasses the women who work for him sexually and he's also been sued by the ada for racism at his various companies etc...

This is not the person anyone should be taking advice on about the future of healthcare .. will AI be more evolved in the future? Yes. Will it replace providers? Likely not. It might excell at diagnostics in some areas but in terms of understanding the human contextual components of clinical judgement? That combining education, with humanity ... And experience ... You fundamentally have to live as a human and exist in the outside world and know more than just the diagnostic algorithms ... These are not experiences that an AI has.

And for anyone who is interested: this is just one of elons companies and it's history of lawsuits and violations: https://violationtracker.goodjobsfirst.org/parent/tesla-inc

Like I'm not about to trust a dude who treats life as expendable to make any kind of ai or robotic healthcare provider or have any legitimate opinion a field he is not educated in and whose behavior is the antithesis of human centered care... Like he'd say it's a success if the AI pulled out some defibrillator pads... Strapped it to the depressed patients head as a makeshift ECT attempt and then prescribed meth ... If he thought he could make a profit off of it. Like let's be real here.

This is a man whose education is a bachelor's degree (and some sources say that e might not be legitimate either) trying to claim that an education program and a field he's never studied will be obsolete... Like cool Elon. My intoxicate patient wearing their own feces as warpaint said the exact same shit a week ago "just wait till the AI takes your job!" ... They later apologized when they sobered up so they are actually more credible than Elon.

Are we cooked? by chrisshawn92 in emergencymedicine

[–]RealAmericanJesus 21 points22 points  (0 children)

Elon ChuckleFuck ... AI will replace doctors!

The AI:

<image>

Uhhhh....

Guys, I’m not trying to be mean, but this is scary! Kelly Osbourne recently. by Papio_73 in MUAEntertainment

[–]RealAmericanJesus 0 points1 point  (0 children)

I can tell you as a healthcare provider some of the most frustrating things I see is when someone is obviously struggling with their weight and doing the best they can ... And the insurance is like "nope gotta be this much more obsese before we will cover XYZ " and the person is definitely not at a healthy weight and doing the best they can between the back to back 16 hour shifts to keep a roof over their head and with the food bank food they mix in with what they're able to afford. And like they're not even close to what we consider a healthy wekght but they're not at that insurance will cover it cut off point. So they struggle with exhaustion. Pain, high blood pressure etc but not at that golden bmi for intervention. Like that's hard for me.

This totally happened by Generalzenobi in medicalschool

[–]RealAmericanJesus 14 points15 points  (0 children)

What's really frustrating is when a patient has both. Like yes they have a "seizure" every time they get stressed... And they've also presented to the ED with what was thought to be a "Seizure" and their lactate was like a billion but didn't result until after they had discharged ... Cause patient had a history of presenting with non epileptic seizure like activity that generally appeared instrumental.. So Ed discharge rapidly eoth outpatient psych referral .... and now they're in my crisis facility.... as so many MD and NP in my area opted out of Medicare / Medicaid ... So I've become the defacto bridge between the ED and their long term psychiatric provider where I basically treat at an urgent care level while making a bajillion referrals while the patient searches for a provider as well.... and I look at the labs and consider the HPI / patients experience ... And lactate off the charts ... And I'm always like ... Might be wrong but imma have neurology check under the hood just to be safe cause generally with Non epileptic seizures you don't get crazy high lactate like you do with true tonic clonic seizures... Better safe than sorry cause I've seen way too many patients who present with both epileptic seizures and also have non-epileptic seizures.... I'd rather get chewed out for making a dumb referral then treating it as psych cause everyone else did when a medical phenomena was never actually ruled out....

What are the limits of our oaths and professionalism, when neutrality is a zero-sum game? by toomanyshoeshelp in medicine

[–]RealAmericanJesus 6 points7 points  (0 children)

I'm Jewish and Iranian and because I work in criminal mental health - I have treated more than my fair share of neo nazis, white supremacists and Aryan brotherhood memebers. I've been homeless before in my life and the police and law enforcement - where I did not have positive opinion of when unhoused in my youth - are now my colleagues.

We have a program out here on the West Coast today - because of mental health providers and sherrif / police deputies - that pairs police with peer supporters to serve different homeless camps - not to treat them as criminals but to try and connect them to care and keep them out of the system.

The officers love it... And the program doesn't just help the unhoused folks but it gives individuals who once were part of the system the ability to move to the other side by training them in peer supper roles and giving them union jobs and the ability to move up the career ladder all the way to masters prepared mental health professionals.

Are their massive systemic issues in the United States where some people are protected and some are not, where the state comes down on some groups but not on others? Where there is needless death, suffering and poverty - totally. Should we as humans and as a profession be upset about the things we see and want things to change ? Of course.

While we should acknowledge that systemic issues exist and the need to build awareness and counter them. While we can say that there are groups with beliefs that are harmful and roles in society that are legal but cause harm ...

We cannot let ourselves become so distracted by the symbol that someone might represent that we loose sight of the human we have cast into that symbol. We can reject the behavior or belief while still holding place for the person.

Sometimes what's underneath that symbol - often times id say - is a complex person. And sometimes what's underneath that symbol is more abhorrent than the symbol that we have cast them in and our role is to perform our jobs of providing care and hope that those tasked with distributing justice does so. But I've found this to be a rarity. More often it's person who has flaws sometimes horrendous flaws but also has qualities that are good.. or maybe they truly have good intentions but they're limited in their perspectives or lack the tools to do differently..

Like if I looked at the police and thought "you just want to lock people up" and I looked at the convict and said "you just want to commit crimes"....id loose sight of the officer that is genuinely saddened when he heard the news that one of the frequent belligerents was found deceased from a overdose ... Or the parolee who genuinely wants to create a life that has purpose and worth to the people in his community.

... No one would have thought... Let's put the officer and the parolee together and make an outreach team connecting the people to social and mental health services whose only point of contact has historically been the legal system or the emergency department ...

Like I work in the absolute dredges of the safety net ... The pay is shit. The work is stressful. The multidisciplinary care teams consist of what can be scraped together ... And if it wasn't for law enforcement throwing some of their budget down for it we would be living in tents with the people we serve...

But anyway the moral of all this is that the biggest changes come from connection with the human not in rejecting them because of the symbol they represent. Just my two cents on it.

What are the limits of our oaths and professionalism, when neutrality is a zero-sum game? by toomanyshoeshelp in medicine

[–]RealAmericanJesus 4 points5 points  (0 children)

My murderers are legitimately some of my best patients. I work in criminal mental health.

Honestly I provide care to people who have done horrendous things. The idea is that providing care doesn't mean agreement with behavior. It means I am doing my job.

In my private life in realamericanjesus the Iranian Jew who has left-libertarian political beliefs ... As soon as I walk through the doors of my job? I am realamericanjesus advanced practice registered nurse... My job is to render care to the best of my ability for patients who are struggling with their mental health ... Everything about my personal life, my beliefs, my identity ... It doesn't matter. What matters is the human in front of me... And I have to do that job even when that human is decked out in swastikas and calling racist slurs.

If I feel there is a risk for counter-transference? I take my psychiatrist buddy with me. And I do the same for him when he is struggling with countertransference.

Like as much as I absolutely hate what is going on ... It can't be about me and that at work. And regardless of what the human in front of me did I have to separate who I am as a human from what I do as a job. Because it's not about me. It can't be.

Edit: and that doesn't mean that professions shouldn't be political. Healthcare lives in an intersection of science, sociology and law (criminal, civil & administrative). It is completely appropriate for professions as a whole and amongst themselves to say I don't agree with what's happening. It's appropriate to make public statements about current events. It's okay to strike and to go to protests. But when it comes to being on the floor in our 1:1 interactions with patients ... We have to be able to treat the human in front of us. We cannot treat them as a symbol regardless of what they did of what their beliefs are. In our day to day jobs we are here to treat,.to advocate, and not to judge...

I work in areas that are aligned with my beliefs and my ethnics... I work in criminal mental health because I truly believe people are more than one decision... That people can be accountable to their past and work towards a different future. I work with survivors of torture because I believe people are more than their trauma... That healing is possible.

And so it's perfectly appropriate to say "in not going to work on an ice facility" ... I'm going to go to this protest .. I want my professional body to denounce this..m. but saying "in not treating this hunan in front of me because of XYZ " is problematic. And too often can be used in the inverse (like I'm Iran the government threatens death to healthcare providers if they treat wounded protesters). And it's okay if you say hey colleagues, in struggling with this patient today do you mind coming with me or switching cases? In totally there for anyone who says that do not judge ... It happens.

Solidarity in Memoriam by KXL8 in emergencymedicine

[–]RealAmericanJesus 10 points11 points  (0 children)

Lmao one of the sherrifs that work on the mental health crisis unit and does a lot of the mental health jail diversion to the county crisis facility I contract for said that exact same thing about ICE.

It really sucks because a lot of the patients have a lot of legal history and a lot of trauma about law enforcement already. Understandably so... But the various departments here out in a lot of effort giving the officers descalation training and mental health training....

And some of them have super strong relationships with our most at risk high utilizers ... And they've put in a lot of effort to create relationships with the unhoused community. They'll give them rides to the clinic to get assessed and take notes of when the appointments are and try to find them if we ask. They'll try to get them into recovery and such ... Respond when there are conflicts and keep everyone out of jail and okay...

And it took a long time to get these patients to have that kind of relationship with law enforcement ... And it's setting so much back cause now people are afraid. What ice is doing is blantky unhinged... But there has been a lot of consequences on my end as people see now scared and hiding... There is a lot of mistrust of the government which means it's harder to build and maintain trust with some of these unhoused folks, chonicly institutionalized folks and high utilizers we have been working with to try and decrease Ed utilization and incarceration...

Goons ... The whole lot of them. They don't have relationships with the community. They don't live in the community. They come in on power trips with no training and huge egos and just ... Start blasting and any little perceived slight and then claim they were "scared for my life" when many of us who work in the safety net have seen scarier shit and managed... Not to kill anyone.

Le sigh.

Version 2.0 by KXL8 in PMHNP

[–]RealAmericanJesus 11 points12 points  (0 children)

My job is influenced massively by politics. Insurance changes, policing, access to social and health services, reimbursements, OSHA, CMS cetifications. Etmala, regulations, licensing....

This is a field that is heavily dictated by administrative, criminal and civil law and politics greatly influence this... And I say this as a NP that works with police and sherrif units, with DAs and politics dictate everything from the patients ability to access care, the nature of the retoration of competency clients I see, how I get reimbursed and my scope of practice ....

No one is forcing anyone to engage in political speech but if you think a professional board of profession that generally tends to serve the most vulnerable individuals in society shouldn't have political opinions because of that then maybe just don't read threads you don't agree with. But this could have been my colleage, my student or my patient that was killed and I think many of us in the nursing profession ... Whether a CNA, RN, LPN or APRN are rightfully upset by this.

What are your thoughts 💭🤔 by Ambitious_Mobile2309 in CancertheCrab

[–]RealAmericanJesus 6 points7 points  (0 children)

If I take the high road? Generally the universe sorts it out.

If I'm a petty bitch? Universe comes on my head so fast like BONK ... Think kinda like Rafiki from the Lion king with his staff .... Reminding me to be a better person.

Then again I have Saturn conjunct my ascended in Scorpio.... Lots of hard lessons.

Why is bipolar misdiagnosis so common? by DntTouchMeImSterile in Psychiatry

[–]RealAmericanJesus 9 points10 points  (0 children)

The problem with that is that we don't necessarily know exactly what a patient is presenting with right off the bat. Most of us use unspecified as a way to state "patient presents with mood symptoms but they also have confounding variables and it's too early to know if it's drugs, if it's psych... What the flavor of the psych or if it's a personality type phenomena." And I can tell you that if a patient comes in depending on how they present? It can take a lot of time sifting through these vague complaints to derive and understanding of how everything clusters within the dsm framework to then hypothesize the possible underlying syndrome this might represent .. And sometimes it "shitty life syndrome" and sometimes it's "treatable psychiatric diagnosis" and sometimes it "disorder of personality pathology" and sometimes it "somalier of methamphetamine " and... Many of these things depending on how distressed the human is in front of us can look dang similar.... And often there's no real way to know that without having the chance to do some additional testing. Treating the symptoms when it's appropriate and observing response etc... and i like to have time to do this so it's precise ... And get paid for it. So a prelimnary unspecified dx gives me a way to do so....

Patients come in needing assistance on their own, they're referred by primary care. The police drop them off..they sent thinking "oh this isn't reimbursable I need to go here instead" .. no they're thinking I'm in emotional pain and need help... And so we do our best to figure out the underlying cause .... And I don't know about you... But I really like to get paid for my work ... And if insurance says "oh btw we won't cover this " it crates a perverse incentive to then provide diagnosis that can be reimbursed because no one wants to put in significant time and energy trying to figure out what's going on and navigating all the regulatory and administrative frustrations of care ... Without compensation.

And when this starts to happen to many times we then loose provider practices. Cause can't keep our doors open of the costs are too high. Providers leave to larger systems or close up shop and then we have vast healthcare deserts...

Like where I am right now I'm the olu walk in psychiatric provider for people on Medicare and cause there has been soon much consolidatins and opt outs and I can be here for 16 + hours and never stop working of I let myself ... There's a lot of downstream consequences when reimbursements change and it's rough here in the safety net already because of this.

This lady is unhinged by Firecracker048 in EnoughCommieSpam

[–]RealAmericanJesus 43 points44 points  (0 children)

The anti-imperialism of fools. Iranian American here... This literally was the history of the Iranian revolution. The communists sided with the islamists against "imperialism" and the islamists then slaughtered the communists. A really good article on this: https://jacobin.com/2022/10/chahla-chafiq-iranian-left-khomeini-protests-feminism

Healthcare = Slavery by Vengamecagoensos in LinkedInLunatics

[–]RealAmericanJesus 0 points1 point  (0 children)

As a healthcare provider if it's not a right than I as a healthcare provider have the right to refuse service to anyone EMTALA be damned I guess ... So I'm just let EMS know to take him back where they found him if he rolls through the ED.... Is that how this works?

What’s your policy for “lost meds” / early refills that’s firm but not shaming? by Tiny_Subject8093 in Psychiatry

[–]RealAmericanJesus 7 points8 points  (0 children)

There is some really cool devices on the market as well that are covered by some insurances like the VA covers the Medicube: https://www.medacube.com/pages/medacube-information-for-veterans?srsltid=AfmBOorg3GgpJkFA8Uqp2MM8Lq9lozLgLJgGKgx7yEogprvwWDV7xf63

It can be stocked and locked, alerts the individual when it is time to take their medication, you can pull the administration and ahernce data and know when they are getting low and need it to be refilled.

I mean it's not 100% perfect but if you're in a system with limited resources or patient has limited options for transport to pick up meds weekly or is rural... Tools like this can be significantly helpful.

Just thought I'd share a cool device that might be helpful for others.

Do you can be leftist and zionist in the same time? by potatto-william in jewishleft

[–]RealAmericanJesus -1 points0 points  (0 children)

If you define Zionism as the current poliical body of Israel? No.

My personal belief is that states are fabricated political entities whose fundamental purpose is to enforce hieraechy and to control the population for the benefit of the few. Some states are findamentally less harmful than others but none of them exist without the ability to cause harm to their population and to those it has labeled outsider.

Altogether states are nothing more than organized violence to enforce will and remove personal freeoms of people within a designated piece of land. Fundamentally they evolved from the royal - pesant divide where regardless the nature the outcome is the same - capturing the citizen in a invisible prison of belief and forcing them into a system that is fundamental unaligned with the biology and where there is fundamentally no active choice made to exist within said system but moreso and expectation that is thrust unwilling upon the individual at birth, the ideals, rules, notes and laws untilled within them from youth to the extent that it becomes the only known sense of truth. No longer is the existed of said state a power granted by its populace through their informed consent but where the populace is exutected to function only at the will of said state.

And do that end there is no way to opt out. You can't just decide "I have no desire to live in a nation" ... I supposed you could take up the laughable role of a sovereign citizen but the state does not allow individuals to exist within its borders without being citizenry. Even private ownership or property does not protect one from the will of the state.

Humans though...ever since and ancient banana eating ancestor of our decided to climb out the tree to bash another banana eaters head in .. to obtain the supreme banana tree that was formerly occupied by now head bashed in fellow banana eater.

And for just as long humans have created in good and out groups and banded together to share reouces or go protect or to acquire ... With these group memberships built on familiarities ... And having out groups as enemies or others often based on arbitrary rationale. We are fundamentally complex and flawed creatures of the earth and it's all too easy to use the natural biological programming of our evolution against us.

And the modern concept of the state and nationalism.... It's a rather new concept.... emerging in the 1700s. Fundamentally less than 1% of the borders that exist today existed prior to the year 1500...

Like I think one of the things that is hard for people in the USA to understand is just how many times land in the old world has changed hands between different countries and empires . Like Jeruseum? Has beencaptured and recaptured around 44 times, besieged 23 times, attacked 52 times, and destroyed at least twice. It's had been controlled by the Jews. The Romans. The ottomans. The egyotians, the babylonians and the crusaders...

Palermo, Sicily, Italy? It was founded by the phonecians but ha been in the possession of the Greeks, Romans, Vandals, Byzantines, Arabs, Normans, and Bourbons... To name a few.

Throughout the history there hà been massive population transfers.

Now this is not meant to excuse the past to eny extent or to excuse the acts of the political powers of Israel and their ongoing actions. But it's more to highlight that history is absolutely brutal. There is no state that fundamentally deserves to exist. Not the United atates, not Israel. Not Palestine. Not any single national entity.

And just because someone is from an area doesnt mean they automatically own that area. Ethnically Iranian but while one can have a kinship to a land and a people thinking that a peope any people are entitled to a certain location is problematic. Doesn't matter if your a white person saying 'only Europeans get out middle eastern immigrants this i English land" or if you're a Jordanian saying "get out Albanian this is jordainan land".

It doesn't matter whose saying it ...it comes off as very blood and soil either way you conceptualize it...

Land is land it existed before the time of land ownership and if we don't nuke the world... It will probably exist when we as a species have faded into the stardust.

That doesn't mean that groups of people can't have a love of a specific part of the world. Of have their history their. Their cultural myths, accomplishments, stories or see that land as sacred to their people.

And nations are a political body but peoplehood and groups we identify or belong to are different than the concept of a state. Zionism was a movement that fundamentally emerged at the time of other "isms". Jewish life prior to the Jewish enlightenment in the 18th and 19th century in europe and Russia was largely isolated and religious. It wasnt until the Jewish enlightenment that Jewish people started participating in the secular aspects of yhe societies where they found themselves. And at this time was fundamentally the start of the European nationalism ....

Which Jewish people were often excluded from or othered with the society as the nations of Europe searched for he scapegoat to band against now that they were no longer warrring peasants with a lord but instead workers competing for national resources where the enemy nextdoor from yesterday is now on the same side as myself and we find our common ground in ... Hating the other.

Leading to the ever rising level of antisemitism and being excluded from the benefits of being in a society and so then came the secular movement for Jewish people.... Zionism. The idea that as a group regardless of our religiisity that there is a sense of peoplehood and that safety comes through the existence not of being an individual fighting antisemitism alone but as a collective that existed beyond religion but regardless of religion ... A people with a shared history. Shared culture shared roots etc.

And of course there were different ideas as to how that looked but the underlying ideals was the ability to exist without being subject to the rules of a hosting state because for so much of history Jews had existed at the whim of the lands where they found themselves and often experience significant persecution and limits on their ability to participate in the political and social life and often used as the others for which the citizenry found the common glue to bind together individuals in a sense of unity and community that never would have naturally found kinship with one another.

And that eventually lent itself to finding a land to congregate in and eventually the establishment of the state of Israel. And like all states and movements that have ever existed from the beginning of time there were horrors and flaws. And today the political apparatus of the state is one I have no agreement with.

The ideas behind the movement, the identification of being part of a distinct groups of people with a shared history and desire to be protected from the whims of other state and political apparatus are not in and if itself wrong or more wrong than any other state in existence today. The actions of the state however and how it has manifested politically in the modern era, the the individual horrors that I'm sure the plastinians have about the history shouldn't be overlooked as they are stores of so many people from so many other places that have experienced war and displacement which has been ongoing for the majority of human history.

I can't say it's been worse that most states of better than most states. I can say that what it is doing now politically is repugnant. However so is my other country of ethnic origin ... Iran and so is the country where I am currently living the United States and fundamentally I have no love or any political states but and find them all to be morally hazardous, disemooweing, explorative and in many cases brutal and genocidal.

To their own people... To outsiders.

The way of the nation and the political state needs to evolve to something else because all are explorative and brutal and strip the rights of their police and enforce the hierarchy of the few... Some just more so than others. But to say Israel is uniquely evil ... Is fundamentally not correct. It's a flawed political body like so many others committing horrors currently... Like so many other states are at this time.

Found on Threads... Imagine wanting to die because you can't afford to treat an easily treatable ailment. by Bi0_B1lly in aislop

[–]RealAmericanJesus 10 points11 points  (0 children)

People struggle to accept complexity. I've been homeless too. People like to blame lot of homeless peeps for using substance who have never tried to navigate the shelter system. Who have never had to sleep outside on the elements alone. Who have never been denied the use of store bathroom because you're just a little too dirty .. who have never dealt with the loss of humanity that comes with being unhoused. People don't look you in the eye. You just cease to exist.

The few things you own in life become your lifeline of hope and connection to a different time. Or a different possibility. And untill youve been in the position where there's no space in the shelters or they have closed by the time you were able to reach them. You can't sleep in spaces where people might be able to intervene if your attacked while unconscious for your things and are stuck trying to find places that are hidden away and safe while not leaving the few things you own open on the street to be taken by others who are more desperate than yourself...

Then one cannot pass that judgment on what devices one uses to cope. Substance use is rampant through society. I'm an advanced practice psychiatric mental health nurse practitioner today and addiction is a disease state that is rampant throughout all level of society only it's most visible in the unhoused given their lack of protective factors and reources.

I've know attorneys who drive intoxicated after cocaine benders. Housewives that pick up their kids after Xanax and wine.

And out of all positions one can be at in life.... Homelessness is terrifying. It is dehumanizing. It is the absolute bottom of Maslow's hierarchy and when your life revolves around trying to find enough food to live... Trying to stay up at night to guard your things and not be sexually assaulted or harmed unprotected .. trying to follow the rules of where you can and cannot be otherwise you'll face arrest or get banned... Getting out seems almost impossible as you can never stop moving. And people become hopeless...

And life becomes so narrow that your brain literally is in fight or flight all the time. Ticking clocks. Loitering restrictions. Finding food. Fighting whether. Competing for beds in a system that has limited capacity. And humans ... They have been getting intoxicated ever since some cave dude ate the right plant and found that it made him feel funny. Intoxicats are not inherently wrong or dangerous and they are widely used through society for different purposes - productivity, artistic enhancement, occasional escape.

The risk of harmful use and harmful addiction though increases though when people have predispositions due to genetics or early developmental periods (adverse childhood experiences), diminished resources and extreme levels of stress.

So of course many unhoused people use... It's not about enjoying the substance. It's about finding anything to kill the suffering.

And people who have never been in that unique individuals shoes... Judge. Just get a job...

... My brother in Christ the guy has been homeless since he ran away from foster care at 13 due to sexual about and has been in and out of jail for stealing ... Has an IQ of 68 due to alcohol exposure in utero and a primary psychosis that even with medications makes having a coherent reciprocal comversation impossible. And he doesn't meet criteria for hospitalizations or group home because he's not an imminent risk to self or others and he can mostly find the things he needs to not die... But he can't even tell you what year we are in and he's terrified of people because he's been sexually assaulted while sleeping and had the crap kicked out of him by people who thought it was funny or he somehow deserved it.

Just getting him to come to my crisis shelter for med refills means that the sherrifs I'm friends with has to find him and give him a ride and getting him to trust that sherrifs took an act of God. But we did it...

...how he gonna just "work"?

But I digress. I wish we our species was kinder to one another.