In “Blackface/Yellowface/*face” Wheelchair Dancer muses about identity politics, performance arts and disability culture:

Despite years of discrimination and oppression and despite a history that is as appalling as the histories of other minoritized groups, there is no performing arts context for disability face. And even though exaggeration of certain physical aspects of certain impairments, there (perhaps fortunately) has not been a systematic reworking of these localized moments into a “tradition.” Any attempt at disability face would look like a party costume. And that’s kind of the impression I get when I see non-disabled types acting disabled roles.

So, over to you. What would disability face look like? Would you be able to distinguish disability face from disability drag? What would disability drag look like (and here I really do mean *drag,* as opposed to *dress up*). Could PWD with one impairment drag another? Could you drag your own impairment? Or would it have to be non-disabled people dragging disability? When does drag become disability face?

Could there really be a set of performances of disability in which we can separate an actor dressing up as disabled in order to create, with some degree of verisimilitude, a disabled role (because you *know* there are no disabled actors who can do this kind of stuff) from someone in disability face? Would it have to be literally a “face” to be disability face?

Other posts by Wheelchair Dancer on the intersection of race and disability include this, this, this and this.

Cross-posted at The Gimp Parade

The latest Disability Blog Carnival is up at Andrea’s Buzzing About, where the theme is “A Few of Our Favorite Things.” Check it out, or look through past carnivals.

Connie Kuusisto hosts the next one at [with]tv on Thursday, January 10, with submission deadline the Monday before.

Image description: Blue text lies over a line drawing of a old-fashioned back brace that look like an elaborate, longer corset. The text reads “the Disability Blog Carnival — a bracing event.”

Cross-posted at The Gimp Parade

Something odd just happened to me.

I have anxiety around the phone. From talking to other people I know, it seems like this isn’t rare. Mine’s gotten worse recently, like a lot of my other anxieties. I *can* make phone calls, and there are kids of phone calls that are easier for me to make than others. For instance, anything spontaneous is easier than anything that I know in advance I have to do. I can call person A to be social for ten minutes, but it’ll take me hours to work up to checking in with person B to confirm that they’re coming to an event, and even when my anxiety problems weren’t bad, it would take me days to work up to calling someone I didn’t know to interview them cold for an article. Once I’m on the phone, I feel fine. I’m charming, I’m funny, I’m articulate. I *like* talking to people, even people I don’t know. The anxiety is around the act of calling itself. I don’t know why. It parallels the anxiety I’ve had in the past year or so around leaving the house. I like being around people and crowds once I’m out, but the act of leaving — and the act of calling — are a barrier for me. Sometimes it’s a barrier like a membrane that I can push through with just a little bit of teeth-gritting and concentration, and sometimes is a big solid wall. There are people I have no or little anxiety around calling, but also places and people I have increased anxiety around calling - for instance, the doctor.

After my medical problems this summer, I’ve had a lot of problems with anxiety and the doctor’s office. My blood pressure goes up to really scary levels when I go in. I have anxiety attacks. My heart rate accelerates so that when I’m resting it’s as high as it should be when I’m doing arobic exercise. All my terror over possibly having multiple sclerosis, I’ve mapped onto the medical facilities themselves.

This anxiety has gotten better in some ways — if I go in to see a familiar doctor, for instance, my blood pressure won’t skyrocket — but it’s still present.

Anyway, one of the byproducts of this is that I don’t call the medical office. My [male] spouse does. If we leave it to me to call, then I will find ways to avoid it or to forget, or I will have insomnia before I have to call (and my mood problems tend to be complicated by lack of sleep), or I just won’t call. And then I miss appointments. No one wants me to miss appointments.

This is one of the things we do in the distribution of labor in our marriage. If I were talking from a feminist standpoint, which I generally do, I would say that my spouse compensates for me in certain ways and I compensate for him in others. If I have anxiety around the doctor’s office, then he calls. If I suck at maintenance tasks because my head is always on global stuff, then he focuses on maintenance tasks like grocery shopping and getting us to appointments. If he can’t do time management for big projects or know how to do the emotional work of maintaining the network of our family and friends, then I do that. And so on.

If I were to talk about this from a disability rights perspective, which I generally don’t, I would say that my social anxiety causes me certain problems which I anticipate and compensate for by asking my spouse to be my caretaker in certain capacities. (I don’t know if I’m using the right terminology here… when I say a disability rights perspective, I mean placing my status as someone with anxiety problems in the foreground.)

Unfortunately, due to a cock up a couple weeks ago, despite the fact that I had my spouse calling, I *did* miss an appointment. We fucked up our records — mea culpa, except for both of us. I really don’t want to miss a second appointment despite the fact that I hate going in.

OK, now we get into fiddly stuff. Because I missed an appt, I’ve had my spouse call in to get a full list of all the times I’m booked to go in. In addition to all the real appointments, they gave us one time when I am actually, in fact, *not* booked to go in. Why? I don’t know. I assume someone just misread or misspoke. Anyway, we noted it down as a time when I had to go in — and that time was tihs morning. I was surprised that I had this appointment time because I didn’t know what it was for, but we assumed it was real.

Yesterday, I had the privilege of contracting strep throat, so we had to make an emergency appointment. We went in, I stopped at the desk to register for the appt, and asked her to confirm that I was coming in today as well. “I don’t see anything,” she said. “We have nothing in the books until January.” I said thanks –and because it had been odd that I’d had the appointment in the first place when I didn’t know what it was for, I started assuming that it had just been an error that anyone had told me about it in the first place.

Still, I wanted confirmation that I didn’t have an appointment and that the woman at the desk hadn’t been misreading my chart, so I asked my spouse to call this morning and make sure that I didn’t have an appointment. He learned that in fact there’s nothing for today, and that was that.

Only it wasn’t. After that, the scheduling people called back and asked to speak to me. A woman let me know on the phone that they usually released information to spouses about appointments, but they were no longer willing to release information to *my* spouse because of the kinds of questions he’d been asking, and I’d have to call myself. I explained why he’d been asking that question, the whole story about the phantom appointment — and she repeated her request that I only call about my appointments myself. “Okay?” she said. I, still strep-throated and half-asleep, said, “Um…” and tried to figure out how to say “No, that’s not okay.” Before I could figure out what to say, she said, “Thank you,” and hung up.

I was very upset. Foremost — stupidly — was embarrassment. Embarrassment that we’d missed the appointment a couple weeks ago, embarrassment that we had this phantom appointment which I knew would look strange and irresponsible to the scheduling people, embarrassment that I was bothering them, embarrassment at being called. Secondly, I knew that their request would cause us problems around my anxiety, and that the likely result was that I would end up missing appointments and missing care.

I don’t want to miss appointments or care. I don’t want my relatively uncomplicated problems to become major ones. I don’t want my phobia of the medical system to negatively affect my health.

I called back and spoke to the woman’s coworker, and explained my problems with anxiety. I explained why I needed my spouse to be able to call. I explained that it was okay with me that he did. I asked her to note in my file that he could call for me. She was friendly, and helpful, and she placed the note in my file, and she talked to me as if I was a reasonable, intelligent, responsible person, which I appreciate.

I know why the schedulers were upset and concerned. They were worried I had a stalker. As a feminist, I approve. I approve of the fact they were paying enough attention to be worried. I approve of the fact that they decided to act on that concern rather than remaining passive. I approve of the fact that they tried to find a way to solve the problem. I greatly appreciate that both were well-intentioned and friendly and helpful and good people.

However, I don’t think the way that they tried to act on their fear was the best way that they could have done so. There are several issues for me here:

1) Once they’d spoken to me about the problem, they knew that the person who had been calling was — as claimed — my spouse. They knew I knew what was going on, and approved. The issue then became not one of protecting me from a stalker, since there clearly wasn’t one and everything that was happening was going on with my understanding and approval. When they found tihs out — which did not seem to surprise them — they did not adjust their plan accordingly. The idea of a possible stalker became more important than the actuality of no stalker.

2) When speaking to someone who is clearly uncomfortable, saying “thank you” and hanging up is a great conflict-avoidance strategy. I heartily approve of this strategy for many occasions. However, in this case, it was a problem because of what I was unable to articulate to them off the cuff. If I had not called back, I would not have been able to tell them why it was a problem. If my anxiety were worse, I would have been unable to call back (this situation got covered under my nonphobia of spontaneous phone calls).

3) They didn’t consider disability when they called. It was off their radar.

There could have been other strategies for dealing with this situation. For instance, the only way that the schedulers ever know that someone is who they claim is that the person provides their student ID number. If I didn’t have an identifiably female name, and my spouse an identifiably male voice, then they would never know he wasn’t me. If they were concerned about protecting my privacy, we could have set up a password for my spouse to confirm his identity, or set up another layer of privacy to make sure that he was someone authorized. They have the ability to mark in my file — they could mark a couple alternate questions that would assuage their fears.

And of course talking to me itself was something that they could have used to assuage their fears. If they had approached the situation with open questions, I might have been able to explain what was going on — and possibly propose alternatives. Now, these women work in a college health center, an environment whch is very aware of sexual violence, and one in which many of the patients — by virtue of being young — aren’t totally able to act as mature adults. Further, this is a situation in which the schedulers are experts and I am not. They have to deal with medical appointments every day. I understand why they approached me with a decision and a plan, and if circumstances had been slightly different, it would have been a good idea. Unfortunately, they didn’t really consider that I was an expert on my own life — instead, they operated based on their assumptions about my life (that I was able to call, for instance). Again, I understand why this happened and know it was well-intentioned, but it misfired in this case.

I am grateful to have read some writing on disability rights in the past couple years. Knowing something about how the medical system creates problems for people who need caretakers to act on their behalf allowed me to contextualize what was going on. It allowed me to see what was happening as a systemic problem instead of an individual one. Having read about the social creation of disability allowed me to think about my problem not as just a failing in myself, but to consider all the ways in which the system is set up to accomodate “normal” abilities and lacks, and to punish deviance from that norm, even when compensating for that deviance is relatively easy.

If I hadn’t had a sense of these critiques, I would have focused on my personal shame at being unable to handle these situations without my spouse’s help. I would have castigated myself for being weak, and tried to force myself to act as if I didn’t have the anxiety. I know what the result would have been — I did not go to a single medical appointment last year. I never even got as far as booking one, despite how severe my depression became. Having access to the consciousness raising of systemic critique of ablism allowed me to look at a system instead of my personal problems.

My problems are mild, but they do interfere with my life. They’d interfere more if I was unable to use the solutions that I’ve set up for myself to cirumvent my problems. I don’t really consider myself part of the disabled community — I don’t think I have a right to, when there are people like Kay with much more severe problems. I feel about it sort of like I feel about cliaming an LGBT identity — I’m bisexual because I am sexually attracted to women, but my few relationships (only three) have all been with men. I don’t want to be disrespectful to people who have to deal with real problems of oppression. At the same time, disowning a disabled identity is clearly an ego-defensive manuever; I don’t want to think of my problems as being real problems. I don’t want to admit that I am not “normal,” or abled, or able to do everything that I expect of myself.

When I got off the phone with the woman, I started crying. I’m still feverish from strep, and was tired, and I’m sure part of my upset was just being weakened. But I was still astonished at the force of my reaction. I didn’t know why I was so upset. Now I’m starting to realize — it was the shame of having problems, and the fear of having been for a moment helpess and vulnerable before someone else.

Commenters, I’m vulnerable here. I ask you to respect that.

We have your son.We are destroying his ability for social
interaction and driving him into a life of complete isolation. It’s up to
you now…Asperger’s Syndrome

The NYU Child Study Center has a new public education campaign designed to create awareness of psychiatric disorders. Ads appearing in magazines and on NYC billboards and kiosks are mock ransom notes signed by specific psychiatric disorders: ADHD, Asperger’s Syndrome, autism, bulimia, depression and OCD. Here’s the ad for bulimia (Description: Cut and paste words from magazine text form a ransom note: “We have your daughter. We are forcing her to throw up after every meal she eats. It’s only going to get worse. –Bulimia” Below the note the ad says, “Don’t let a psychiatric disorder take your child” and gives info for the NYU Child Study Center.):

Text for the other ads reads:

We have your son. We will make sure he will no longer be able to care for himself or interact socially as long as he lives. This is only the beginning…Autism.

We are in possession of your son. We are making him squirm and fidget until he is a detriment to himself and those around him. Ignore this and your kid will pay…ADHD

We have taken your son. We have imprisoned him in a maze of darkness with no hope of ever getting out. Do nothing and see what happens…Depression

We have your daughter. We are making her wash her hands until they are raw, everyday. This is only the beginning…OCD

The NYU Child Study Center, celebrating its tenth year and the relaunch of its public information website AboutOurKids.org, says:

The idea behind the “Ransom Notes” is that, all too often, untreated psychiatric disorders are holding our children hostage. These disorders rob children of the ability to learn, make and keep friends and enjoy life.

“Ransom Notes” may be shocking to some, but so are the statistics: suicide is the third leading cause of death among young people ages 15 to 24, and serious emotional problems affect one out of 10 young people, most of whom do not get help. The strong response to this campaign is evidence that our approach is working. We understand the challenges faced by individuals with these disorders and their families. We hope to both generate a national dialogue that will end the stigma surrounding childhood psychiatric disorders and advance the science, giving children the help they need and deserve. We want this campaign to be a wake up call. Please join the dialogue.

And people are joining the dialogue. The Autistic Self-Advocacy Network (ASAN) has gathered 14 other disability rights organizations and issued a joint letter (.pdf file) calling for withdrawal of the ad campaign. (There’s also a petition for anyone to sign in support of the ASAN joint letter and appeal.) In part, the letter reads:

While the “Ransom Notes” campaign was no doubt a well-intentioned effort to increase awareness and thus support for the disabilities it describes, the means through which it attempts this have the opposite effect. When a child with ADHD is described as “a detriment to himself and those around him,” it hurts the efforts of individuals, parents and families to ensure inclusion and equal access throughout society for people with disabilities. When individuals with diagnoses of autism and Asperger’s Syndrome are told that their capacities for social interaction and independent living are completely destroyed, it hurts their efforts for respect, inclusion, and necessary supports by spreading misleading and inaccurate information about these neurologies. While it is true that there are many difficulties associated with the disabilities you describe, individuals with those diagnostic categories do succeed – not necessarily by becoming indistinguishable from their non-disabled peers – but by finding ways to maximize their unique abilities and potential on their own terms.

Individuals with disabilities are not replacements for normal children that are stolen away by the disability in question. They are whole people, deserving of the same rights, respect, and dignity afforded their peers. Too often, the idea that children with disabilities are less than human lies at the heart of horrific crimes committed against them.

The letter also notes that the ad campaign supports the idea that people with these psychiatric disorders — note that autism and Asperger’s Syndrome are labeled psychiatric disorders here — may be dangerous to others around them.

Does anyone else’s mind jump to Columbine-type scenarios when they see “children” and “hostage” linked? Mine did.

h/t to Stephen Drake at Not Dead Yet

Cross-posted at The Gimp Parade

Piggybacking on Amp’s report of recent NYT statistics on prisons and prisoners in the U.S. is the news that prisoner suicides in Massachusetts state prisons are nearly triple the rate in other states. From the first part of a three-part series in The Boston Globe:

Last year alone, seven inmates killed themselves, and another’s attempt left him brain dead; four have taken their lives so far this year.

Department of Correction officials say the suicides are random and unrelated. But a Globe Spotlight Team investigation of the deaths and detailed reconstruction of how they occurred found that they were far from random.

Most of the suicides came after careless errors and dangerous decisions by correction officials and the staff at UMass Correctional Health. And the trail of violence is far wider than the number of dead would indicate, as hundreds more inmates each year have wounded themselves or attempted suicide.

In fact, such incidents are soaring.

So common has it been to find a man with a makeshift noose around his neck that some correction officers have taken to carrying their own pocket tools to cut them down. The tally of suicide attempts and self-inflicted injuries - 513 last year and more than 3,200 over the past decade - tells a story of deepening mental illness and misery behind the walls of the state’s prisons, despite repeated calls for better training of officers and safer cells for mentally troubled inmates.

The entire series is here.

h/t to Liz at The Trouble with Spikol

Cross-posted at The Gimp Parade

Yesterday, a Canadian parole board in a prison near Victoria denied day parole to Robert Latimer. Latimer is the Saskatchewan farmer serving a life sentence for the second-degree murder of his 12-year-old disabled daughter back in 1993.

Some facts: Tracy Latimer acquired cerebral palsy from oxygen deprivation at birth. She was unable to walk or talk and had seizures every day, but she could smile, laugh and cry. She went to school each day on a bus, she could communicate likes and dislikes. She recognized the people she loved. Tracy had several surgeries and was scheduled for a fourth on the day of her death. (The back surgery she had to correct scoliosis and the complication afterward of a steel bar migrating in her hip sound identical to my own Harrington rod surgery experiences.)

On October 24, 1993, Robert Latimer placed his daughter, Tracy, in the cab of his pickup truck, connected a hose to the exhaust, ran the hose in the vehicle’s window and gassed his daughter to death. He hid the evidence and lied about her death until an autopsy revealed foul play. Then he confessed.

But he has never expressed remorse, which is why he was denied parole:

The parole board decided the 54-year-old Saskatchewan farmer had not developed any insight into his crime. Latimer insisted during his parole hearing Wednesday that killing Tracy was the right thing to do.

He remained unapologetic and angry at the legal system.

“The laws are not as important as Tracy was,” he said.

“I still feel don’t feel guilty because I still feel it was the best thing to do.”

While there’s always been a frightening and enraging degree of support for Latimer’s actions (which, interestingly, played out while Susan Smith was simultaneously being castigated for the murder of her nondisabled children in the U.S.), much of the fervor has been about the mandatory sentencing that required him to serve at least ten years in prison. The Canadian Supreme Court overturned a lighter sentence that failed to follow sentencing guidelines. He’s currently spent seven years in jail.

In an appeal to his conviction, Latimer contended that he “had the legal right to decide to commit suicide for his daughter by virtue of her complete lack of physical and intellectual abilities.”

Grant Mitchell, a lawyer representing disability groups in relation to the case, said yesterday:

“I think it’s really sad that he’s still maintaining that he committed no crime … that killing a member of his family was a private matter that the public had no business getting involved in. And I think it’s particularly concerning that when he was asked by the Parole Board whether he would do the same thing if another member of his family were in distress, he said he wasn’t sure what he would do.”

I agree with Mitchell. More importantly, I agree with the guilty verdict that holds Latimer accountable for murdering his daughter. I am less certain how much time in prison is appropriate, but since Latimer reportedly wished to use his day parole to spend time furthering the cause of euthanasia, I’m content that he remains in jail.

Cross-posted at The Gimp Parade

A Chinese woman by the name of Wang Fang declined a disability pension despite being born with feet that face backwards. This is news in Britain, if only, perhaps, so the intriguing pictures of the 27-year-old waitress and resident of Chongqing could be presented for the public to view.

Apparently, Wang’s visibly different feet automatically qualify her for a disability pension in China, but she’s refused both the “disabled” identity and the cash.

“I can run faster than most of my friends and have a regular job as a waitress in the family restaurant,” she says. “There is no reason to class me as disabled. I’m like everyone else - except of course that I put my shoes on backwards.”

Read the rest of this entry »

I wasn’t going to offer a Best of 2007 list of my posts this early because I’m an optimist and I like to think genius may strike me in the next three weeks. But for those who may be reading my writing for the very first time, here are five of what I think are my best blog posts of 2007. Plus a couple bonus posts.

Blind Rage and the legacy of Helen Keller — Because I originally began The Gimp Parade to review books about disability, and more importantly, because Blind Rage is a fantastic book by a disabled feminist about the world’s most famous disabled feminist.

I am tired — My expression of how last winter’s Ashley X debate affected me and the disability community online.

Miss Ability lays down on the job — Recently, feminist blogs have written about the beauty contest Miss Landmine Angola. Here’s my take on another beauty pageant for disabled women.

Anniversary — Escaping institutionalization — A personal story of perhaps the biggest drama of my life.

Is Roger Ebert a disability activist? — When I wrote this, I inadvertently prevented comments to the post, so I never learned what others think about Ebert’s “activism.”

Bonus link: Because language use came up in comments to my Alas intro post, here’s a blog entry on that general topic: Linguistically disabled?

And because sometimes I amuse myself, my best blog headline of the year: Yes, the road to hell is paved, but that doesn’t mean it’s accessible

I’d nominate Cilla Sluga’s post at Big Noise about Ruben Navarro as overall Blog Post of the Year.

Who would you nominate? And why?

Cross-posted at The Gimp Parade

Hi all. My name is Kay Olson (known in the past and in the archives here as Blue or Blue Lily) and I write over at The Gimp Parade about disability. I blogged here as a guest last year, but Amp has asked me to join Alas as a regular co-blogger and I’m thrilled to be here.

A little about me: I’m a 39-year-old Minnesotan. I live in the small rural town I was born in, though I went to high school in Naperville, Illinois, and got several college degrees at Arizona State during my 13 years living in Tempe. My degrees are in English, political science and public administration and wherever possible in my studies I explored minority or diversity issues — when disability wasn’t an available option, I studied race or gender or any intersection of these identities.

I was born with a rare progressive neuromuscular condition that falls under the umbrella of muscular dystrophies. I’ve used a wheelchair or scooter for all mobility since 1983 when I was in ninth grade, and for the past two years I’ve had a feeding tube, a trach and used a ventilator full-time for breathing. Technically, I am unemployed, but I spend much of each day with people employed to help me 24/7, training them, managing their care of my needs, helping with scheduling, medical supplies, etc. I am a source of income for two full-time LPNs and up to five part-time LPNs and RNs, not counting the agency I must go through for their state-paid assistance. I live with my parents in a house they were able to build with full accessibility in mind, though I very nearly ended up in a scary nursing home less than two years ago. As you might imagine, if you haven’t already visited my blog, I write a lot about my experiences with the medical community and how they are shaped by politics, bureaucracy and disability stereotypes and prejudice.

My hope here at Alas, other than writing coherently on a regular basis and learning from discussions, will be to bring current disability issues to a wider audience, put them into a feminist context when possible, and promote the writing of other disabled folks online. Mandolin’s lovely October post, “Feminism is not your expectation,” linked my blog as the sole example of disability in feminism but there’s an incredible variety of disabled feminist bloggers out there I’d love to see recognized.

So, although I don’t know if all these bloggers proudly identify as feminists, here is a list of some great disability bloggers that often speak to issues of feminism as well. Although this particular list doesn’t include any non-Western disabled bloggers and very few disabled male bloggers (the latter are either less likely to be making connections between being a woman and disabled, or I am less apt at seeing the connections they make), it is otherwise fairly diverse with regard to age, race, ethnicity, religion, sexual orientation and disability:

Ballastexistenz
Big Noise
Biodiverse Resistance
Diary of a Goldfish
Disability Culture Watch
FRIDA (Feminist Response in Disability Activism)
Ms. Crip Chick
Moving Right Along
My Private Casbah
Pilgrim Steps
Retired Waif
Screw Bronze!
Wheelchair Dancer
Writhe Safely

Thanks for having me, Amp.

Cross-posted at The Gimp Parade

From “My Right Wing Dad .net,” an oddly compelling blog of right-wing email forwards, a poem called “When I Whine.” I think Jerry Lewis would find this poem beautiful.

Today, upon a bus, I saw a girl with golden hair
I looked at her and sighed and wished I was as fair.
When suddenly she rose to leave,
I saw her hobble down the aisle.
She had one leg and used a crutch
But as she passed, she passed a smile.
Oh, God, forgive me when I whine
I have 2 legs, the world is mine.

And that’s just the first stanza. The poet hasn’t even gotten to the blind kid who thanks sighted people for being willing to talk to a person like him. Go read, if you dare.

From Inside Higher Ed:

While enrolled at Eastern Illinois, Manges says she saw a private counselor off campus to deal with her diagnosis of PTSD — a result of the sexual abuse she experienced from 1999 through 2000, when someone she knew not only abused her but also collected money from other men who did the same.

She was sitting in French history class September 5 when she could feel a flashback coming. Trying to leave but unable to exit the room in time, she collapsed before reaching the hallway.

“I don’t remember what happened because I was disassociating, but what witnesses said, what my professor said, is that I started sobbing uncontrollably, shouting, screaming. I was unresponsive; I was just lying on the floor,” Manges says. [...]

In a letter to Manges dated September 17, Eastern Illinois’ assistant director of judicial affairs writes that given Manges’ admission that she violated the two code of conduct standards prohibiting disruptive behavior during the September 5 “incident” (in other words, the in-class flashback), and “the seriousness with which the board viewed this incident, it is their recommendation that you be suspended from the university, effective immediately, for a minimum of an academic year through the Spring Semester, 2008, during which you would be prohibited from being on the campus without prior permission of the vice president for student affairs.” [...]

While what Manges says happened at Eastern Illinois may not be common, nor are such experiences uncommon, says Karen Bower, a senior staff attorney at the Judge David L. Bazelon Center for Mental Health Law. Bower says she routinely (more than once a month) gets calls from students who are forced to leave college for mental health reasons. [...]

“We have urged that schools not use disciplinary action for behavior that’s a result of mental illness,” Bower says — echoing Professor Smith’s sentiment that a judicial board hearing didn’t seem like an appropriate venue for addressing his student’s situation. [...]

“I think they think it’s objective, but discrimination based on conduct that’s the result of disability is the same as discrimination based on disability,” Bower says. “The use of the disciplinary system as a whole is really a way of removing students from an environment instead of finding out what kinds of supports and services they need to stay in school and be successful.”

In a 7/2 decision, the New York Court of Appeals has turned down Simone D., who had sued not to be put through electroshock again. (She’s had electroshock done to her over 200 times in her life).

According to the majority opinion,

At a hearing held on the petition, Dr. Ella Brodsky, a licensed psychiatrist and the person who administers the ECT at Creedmoor, testified that the appellant suffers from a “major depressive disorder, severe, with chronic features” and was incapable of making decisions regarding her own treatment. In fact, Dr. Brodsky asserted that during a meeting to discuss treatment, at which the appellant, her Spanish-speaking attorney, Dr. Brodsky, and the treatment team were present, the appellant refused to respond or even make eye contact.

Gee, the patient refused to talk or make eye contact during a meeting with the doctor who conducts torture on her. What could possibly account for that? Hmmmn….

A few points:

1) Electroshock, or ECT, Has No Proven Benefits.

The majority’s opinion relies heavily on Dr. Brodsky’s belief that electroshock is an effective treatment for Simone D. But the evidence that electroshock¹ has any beneficial effects is practically nonexistent.

For instance, Bonnie Burstow, an academic and psychotherapist, writing in the journal Canadian Woman Studies, reports:²

While minimizing the damage done, ECT³ promoters defend the use of ECT on the basis of its alleged effectiveness in alleviating depression and preventing suicide. And yet electroshock has no such special efficacy. In a rigorous double blind study, Lambourne and Gill found that a month after shock and simulated shock, shocked patients had not improved more than nonshocked. They concluded that shock does not produce a superior therapeutic effect and that its alleged effectiveness is due to placebo. Correspondingly, all the research on electroshock and suicide—for example, Black and Winokur—tell the same story: ECT has no effect on the suicide rate.

From a review of literature published in The International Journal of Risk And Safety In Medicine:⁴

Crow and Johnstone, in a review of controlled studies of ECT efficacy, found that both ECT and sham ECT⁵ were associated with “substantial improvements” and that there was little or no difference between the two. [...]

At the Consensus Conference on ECT, critics and advocates of ECT debated the issue of efficacy. The advocates were unable to come forth with a single controlled study showing that ECT had a positive effect beyond 4 weeks. Many studies showed no effect, and in the positive studies, the improvements were not dramatic…. The Consensus Conference panel stated in its report that ECT had no documented positive effect beyond 4 weeks. [...]

ECT is frequently justified as treatment of last resort in cases at high risk for suicide. [...] Despite the claims of advocates, research uniformly shows that ECT has no beneficial effect on the suicide rate. [...]

Some patients do feel “helped” by ECT. Often they have been so damaged that they cannot judge their own condition. They suffer from iatrogenic denial and helplessness. But should a treatment be banned when some people believe they are helped by it? In fact, it is commonplace in medicine and psychiatry to withdraw from use treatments and devices that have caused serious harm to a small percentage of people, even though they may have helped a very large percentage. The risk of serious injury to a few outweighs helping many.

In the case of ECT, a large percentage of people are being harmed, and there is very little evidence that many are being helped.

And of course, Simone D. doesn’t perceive herself as being helped by ECT at all.

So the first thing to understand about this decision is that it’s based on a false premise. The court’s assumption that ECT “works” and is beneficial, which formed the basis for their decision, does not have any empirical support in controlled scientific studies.

What has been proven beyond reasonable doubt is that ECT causes permanent damage to the brain. So Simone D. is being forced to have treatment that she finds painful and unhelpful, and which will permanently damage her brain.

What ECT brings to my mind this review of the book Madhouse — about Henry Cotton, administrator of a New Jersey asylum, who for decades forcibly removed teeth and other body parts from unwilling patients “for their own good,” and was much admired for this practice.

I don’t doubt that Dr. Brodsky believes she is doing good. But medicine, and in particular doctors at asylums, have a long history of doing grave harms to their patients in the name of helping them, based more on ideology than on evidence.

2. Most Electroshock patients are elderly women.

Multiple studies have shown that between two-thirds and three-quarters of patients given electroshock treatment — regardless of the diagnosis — are older women. From the activist website endofshock.com:

Why is it that women are disproportionately represented as electroshock patients?

1) This is a legacy of patriarchy, where women continue to be coerced, overtly or subtly into psychiatric treatment.

2) This is also a legacy of sexism, where “’masculine“ stoicism is valued and feminine” qualities such as emotional expression are classified as psychopathological. It is also related to sexism in that social and economic inequality is still a big factor in our society, and understandable stress reactions, sadness and confusion are interpreted as “symptoms of mental illness.”

3) Women, compared to men, are expected to be passive, and they may be punished or silenced for speaking out and complaining. When a woman is being considered for electroshock, one should ask, “What is important that she not remember and tell about?” Or “What is it that the others do not want to hear or look at?” Often it is abuse, always it is difficult or disruptive conduct that makes others feel uncomfortable or threatened.

4) Women are on average more open to getting help than men. In our psychiatric system, it is assumed that human problems and crises are due to biologically or genetically based “mental illnesses.” The primary treatment is psychotropic drugs, so women reaching for help get drugs, these drugs often do not help or actually worsen their situation; hence, the backup treatment of electroshock is brought into play.

5) Elderly women often cannot handle psychotropic drugs because of aging and infirmity, so are considered prime candidates for electroshock.

6) Women of perimenopausal may be experiencing depressive symptoms due to undiagnosed hormonal or endocrine changes.

Of course, the minority of patients who are young, male or both are equally important; electroshock therapy should be banned for all patients, period. But that doesn’t mean that we should ignore that this form of torture is practiced disproportionately against older women.

I expected that ECT would also be primarily used against lower-class and non-white women. However, according to Bonnie Burstow’s essay, “the primary target is middle-class white women.”⁶

3. Simone G. is a native Spanish speaker, but has not been offered substantial therapy in Spanish.

ECT shouldn’t be used at all, in my opinion; but even ECT defenders agree that if ECT is used, it should be a last resort. But — as the dissenting opinion by Judge Crane noted — treatment by a Spanish-speaking therapist was tried “for only a few weeks.” Simone G., through her lawyer, has requested that same-language therapy be resumed as an alternative to ECT, but this request has been refused.

Alison Hymes (whose mental disability rights blog is really great), writing in comments at the Mental Disability Law Blog, sums it up:

So they’ve caused her brain damage, documented in her record, tried psychotherapy with someone who speaks her language for only a few weeks, and they call this treatment? She doesn’t speak English but has no Spanish speaking MH staff, you think that might impact her mental health????

This is state sanctioned torture and brain damage. I thought NY was doing better than this a few years back. We need a stronger advocacy system in NY, that’s clear, and more rights for patients in treatment over objection hearings.

4. Who you can write.

Reclusive Leftist has the contact information for four New York politicians who should be emailed, faxed, called or emailed asking them to intervene on Simone G’s behalf.

(It’s via R.L. that I learned of Simone G’s case. She heard it in turn via Writhe Safely, which is annoyingly anti-feminist which I think is unfair to feminists (the post blames feminists for not knowing about an issue that has received zero media coverage; I think it would make more sense to blame the media) but I can totally understand why she’s pissed off, even though I think her anger is aimed a bit in the wrong direction. The Mental Feminist also has a post up.)

(Edited a bit to try and fix my phasing in the link to Writhe Safely. For the record, I don’t think she’s an anti-feminist at all. She seems like a cool person; I just disagree with how she wrote one post.)

1. Including “ECT” or “electroconvulsive treatment,” which seems to bear approximately the same relationship to “electroshock” that “intelligent design” bears to “creationism.” (back)
2. Burstow, Bonnie. “Understanding And Ending ECT: A Feminist Imperative.” In Canadian Woman Studies, aka Les Cahiers De La Femme, vol. 25 (1,2), p. 115-122. (.pdf link.) (back)
3. ”ECT” stands for “electroconvulsive treatment,” a form of electroshock. (back)
4. I’ve edited out endnotes and citation details from this passage. Citation: Breggin, Peter (1998). “Electroshock: scientific, ethical, and political issues.” In The International Journal of Risk And Safety In Medicine, vol. 11, p 5-40. (.pdf Link.) (back)
5. ”Sham ECT” refers to faking ECT treatment but not actually shocking the patient. It’s the equivalent of treating patients with a sugar pill rather than a drug. (back)
6. From Burstow, page 120: “Whenever a relatively new area is taken up, it is easy to assume that the identical structural dynamics that apply to other issues apply to this one. Indeed, I have heard feminists who know little about ECT claim that working class women and women of colour are in greater jeopardy of electroshock. As demonstrated in Breggin (1997) and numerous other sources, the reality is markedly different. The primary target is middleclass white women. While is it important to start theorizing why this is the case and theorize it with an antiracist and anti-capitalist awareness, it is essential that we educate with this reality in mind.” (back)

On a pandagon thread about socialized medicine, a commenter called Catty writes, “I know 2 die-hard libertarians that are now universal health care supporters. Funny how problems like multiple sclerosis and cancer can change people’s minds.”

I have always supported universal health care, but jesus fuck she’s right.

A couple weeks ago, I started having some strange symptoms. Last week, I went to the ER to speak to a physician, and she said the things I didn’t want to hear — namely, that my symptoms were consonant with two bad diagnoses: diabetic neuropathy and multiple sclerosis.

I have since been to my regular physician who is not nearly so concerned. I am still being checked for diabetes, but she’s holding off on the MRI to diagnose for multiple sclerosis for now. We’re first looking into other possible causes which are much more benign, such as hypothyroidism, advanced anemia, migraine, and anxiety.

I am an incredibly privileged woman. I’ve never been without health care. My health insurance is incredibly good. I pay $5 for doctor visits, and $5 for medications. I’ve always known that my health insurance was great, but I don’t think it’s ever really hit home for me how much uninsured people have to pay for their health care — not just going into debt, but going bankrupt, becoming homeless, and sometimes having to make the difficult decision to let themselves or their loved ones die from treatable illnesses.

Another commenter called Jodie relates the following story, “My 27 year old brother in law developed an intense headache on a Thursday, dx’d as brain tumor after an MRI, had surgery, went to intensive care, had chemo, and died prior to the next Thursday. Cost after insurance: $280,000 (at last count, I don’t think all the bills are in yet)… That bill was amassed in less than a week.”

Note: After insurance.

Other commenters discuss surgery for marrow transplants coming in at $250,000, refills for cancer drugs being in the thousands of dollars, a course of treatment for a major illness costing hundreds of thousands. Canadian commenters relate how relieved they are to live in Canada, after considering the ramifications of the major illnesses in their lives should they happen to have been American and uninsured. When a parent, a sibling, and another close relative are sick, often the whole family can’t find enough money to fund health care for all of them, even when they go into debt. They must choose bankruptcy or death.

Treatment for uninsured people is abominable. Uninsured people often have no choice but to obtain their health care through emergency room visits, which are phenomenally expensive. Pandagon commenters report paying $300-1,200 for emergency room visits, for things as routine as obtaining antibiotics for a bladder infection. One commenter notes that his $320 physical meant that he had to put off paying his bills for a month.

Facing debt, uninsured people often put off going to the doctor until their dieases have progressed beyond treatment. Worse, if they do go, they may be ignored. Pandagon recently reported incidents of uninsured people being left to die in hospital emergency rooms.

In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer.

“Thanks a lot, officers,” an emergency room nurse told Los Angeles County police who brought in Rodriguez early May 9 after finding her in front of the Willowbrook hospital yelling for help. “This is her third time here.”

The 43-year-old mother of three had been released from the emergency room hours earlier, her third visit in three days for abdominal pain. She’d been given prescription medication and a doctor’s appointment.

Turning to Rodriguez, the nurse said, “You have already been seen, and there is nothing we can do,” according to a report by the county office of public safety, which provides security at the hospital.

Parked in the emergency room lobby in a wheelchair after police left, she fell to the floor. She lay on the linoleum, writhing in pain, for 45 minutes, as staffers worked at their desks and numerous patients looked on.

Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone’s apparent indifference.

Arriving to find Rodriguez on the floor, her boyfriend unsuccessfully tried to enlist help from the medical staff and county police — even a 911 dispatcher, who balked at sending rescuers to a hospital.

Alerted to the “disturbance” in the lobby, police stepped in — by running Rodriguez’s record. They found an outstanding warrant and prepared to take her to jail. She died before she could be put into a squad car.

At the same hospital, in 2003, “20-year-old Oluchi Oliver waited hours to be admitted to the hospital with crippling stomach pains, according to his family. After 10 hours, he collapsed dead on the floor. No one noticed, his father, Akilah Oliver, said.”

I had a brief hiccup with my insurance coverage the day I decided to go into the ER, and it looked like I might not be covered at all. (Now, I’m covered by two health care plans.) I almost didn’t go in. My mother told me I had to go in, that they’d find a way to fund it if I were sick. We are extremely well-off for the United States, but I doubt that even we could find a way to pay $250,000 if I didn’t have insurance and needed a marrow transplant.

I’m watching my reactions as I read this Pandagon thread. I am so scared. I probably don’t have MS. I’m repeating this to myself as a mantra. My other mantra involves facts about MS. If I do have MS, I have all the indicators of a good prognosis. I am young, white, and female. If I do have MS, it’s extremely likely that I have the type that remits, instead of the type that progresses until you die. Hell, 15% of people who have MS never suffer a second attack.

And there are drugs! One of my fiance’s professors told him about two people she knows with MS, who were diagnosed in their thirties, and who now, in their fifties, have been kept symptom-free with drugs. I called one of my friends who is in medical school, and he told me to remember that both MS and diabetic neuropathy require lifestyle changes, but may not affect life quality.

Even in the worst case scenario, I’ll be okay. That’s not enough to keep me from worrying or being depressed, but it’s good news. Nevertheless, I’m a basket case as I wait for my blood test results.

I can’t imagine how much worse it would be if I didn’t know how I was going to pay for the medical expenses of my doctor visits, my blood tests, my MRIs, my visits with the neurologist and/or dietician. Without insurance, would I be able to afford those drugs that could keep the multiple sclerosis in check, preventing me from losing the use of my limbs, my speech, and my brain?

I don’t understand how anyone can oppose universal health care. A libertarian in that thread is spouting off strange talking points. Some are demonstrably false. Countries with socialized health care do not have more bureacracy than we do; they have less, because hospitals don’t have to deal with insurance claims. They don’t have longer wait times than we do. They don’t force patients into predetermined courses of treatment. The cost in taxes is more, but studies have shown that while taxes are higher in many countries with socialized medicine, the American middle class ends up screwed with their lower tax rate — because we have pay not only our taxes, but we also have to pay through the nose to privately fund things that countries like Sweden provide for free. We end up paying a huge amount more, just so we can claim that we have lower taxes.

One of his talking points is that he doesn’t feel he should be forced to help people who are less fortunate. Does he understand that he’s talking about people who will die without his help? Help that he will benefit from, because he as a middle class American would pay less if taxes were higher but provided more services? Someday, he may have a medical emergency, and god forbid he should be denied his insurance. He may bankrupt himself and his whole family. If he chooses to finish treatment, he might lose his home. We might force him, as we force others, to choose between the basic necessity of shelter, and death.

Meanwhile, he can’t even imagine those scenarios. Over and over again, he talks about the undue burden that would be placed on him if he had to help other people. He can’t imagine himself in their shoes. If he can imagine their pain, he doesn’t care. What a strange, frightening lack of empathy. What a limited view of the world.

My empathy is heightened right now, because of course this medical issue has me sensitized to issues of my own mortality. It’s odd to move from the life in which I thought of myself as healthy, to the life a few days later when I realize that I could have a progressive and debilitating illness.

I don’t want to be going through this. I want to feel safe and well again. Hopefully, my diagnosis will be benign, and soon I will be feeling safe and well again. Even if I have MS, I am sure that eventually my sense of weakness, fear and vulnerability would dull, and my illness would become just another part of my life. That’s another thing I’ve been repeating to myself for the past couple weeks. Studies show that paraplegics are just as happy one year after their injury as they were before it occured. People are amazingly adaptive; anything can become ordinary. If they are equally happy after that, then I will surely be equally happy even if my diagnosis is MS.

I am so amazingly lucky to be worrying only about my health. If I were worried that I was about to bankrupt my loved ones, and that I wouldn’t be able to afford life-saving care, this painful experience would become a constant waking nightmare. Any person who would wish that on other people is both monstrous and lacking in empathy.

Rachel’s Note:  This is reposted from my site, but I figured it should also be posted on Alas.   

Admin’s Note: Here’s my weak-ass contribution to blog against disablism day.  I’m in the middle of finals, but I figured I need to say something.  I guess I made one mini-contribution over at Hugo’s because I really disliked his response to Mr. Soul, but that is not really enough.

So let me just say at little bit since I have one hour left today. This is not edited or proofed, please read around my typos.

Most of what I know about disability issues I learned from my good friend Kate.  She posts around here and over at Alas sometimes.  Kate was by closest grad school buddy.  When were we up at school working in our offices until 11 PM, we’d have conversations about everything.  A big part of that “everything was sociology.”  I told Kate about racism research and she taught me about disability research (and we both already knew about feminism).  Kate taught me the academic stuff–disability vs. impairment, but she also taught me about the lived experience of disability.  Kate has a genetic neuromuscular disorder, and from listening to her tell me her story (or watching her live through it) I have changed the way I think about disability. 

One of the big issues we have discussed is the difference between having a visible or hidden disability.  Kate has a semi-hidden disability.  Sometimes a person may notice it, and sometimes s/he may not noticed the disability.  For people with hidden disabilities one of the big issues is coming out.  Who should people tell other about their disability?  When should they say something, and when should they be quiet?  This issue permeates many aspect of life–for example, dating.  When or how should a person tell their the boyfriend/girlfriend about disability?  Will the boyfriend/girlfriend run away or be uncomfortable?  Or what about your kids?  If a child has a hidden disability, when do you tell the child or the child’s care giver?  Or in the case of these genetic disabilities, should a parent test his or her child for the disability?  If the child does test positive, will the child face genetic discrimination?

I’m not saying people with hidden disabilities have any more trouble than those with visible disabilities, but I am saying that the way people navigate their social lives is affected by whether or not a disability is hidden or visible.  When most people think of disability, they think of the a person in a wheel chair (in fact, the wheel chair is almost a universal symbol of disability).  They don’t realize that the person sitting next to them doesn’t have a twisted ankle, but a neuromuscular disability.  They don’t know that their coworker has suffered with depression for years or that the reason their student leave in the middle of class everyday is because s/he has a back injury.  Many disabilities are like this–dyslexia, epilepsy, some vision or hearing impairments. 

Coming out about a disability can cause shame and fear that the person revealing the disability is “just looking for sympathy.”  Sometimes coming out about a disability means having to acknowledge an identity as a disabled person, and accepting such a label is not easy. (In fact, I think it is quite similar to coming out for people in queer communities.)

So I guess one of the things that Kate taught me is that many people with disabilities are not going to come out.  It is really risky, and it is incumbent upon all of us to make that coming out process easier.  I try to do this by including a disabilities statement in my syllabus.  Here is how it is worded:

If you have a hidden or visible disability, which may require classroom or test-taking modifications, please see me as soon as possible. If you require note taking, extra exam time, or any other disability related services, please be sure to call M. F. in the Disability Support Services Office at xxx-xxx.

It’s not perfectly worded, but I always mention it as a way to let my students know that I am conscientious about disability issues.  I also try to make it clear that I am aware that not all disabilities are readily apparent.

Ok, maybe it’s not so weak…..off to bed.

Over the years, I’ve frequently referred to the National Violence Against Women Survey’s statistics regarding rape prevalence.¹ And I’ll probably continue to refer to NVAW Survey: it’s probably the best measure that’s ever been taken of national rape prevalence in the USA. It used a large, random, nationally-representative sample; the survey included people “from a variety of racial and ethnic backgrounds”; and it asked about some things no previous national survey had effectively asked about, such as rape by intimate partners.

Nonetheless, there are important flaws in the NVAW survey, and in particular with how it measures rape prevalence. This is a first of a series of posts which will describe the flaws in the NVAW survey. This post will look at some general shortcomings with the survey; future posts will look at different ways the NVAW study may be both undercounting and overcounting rape prevalence, and at how the NVAW study does a particularly poor job of measuring rape prevalence among men.

1. The NVAW study needs to be repeated at regular intervals.²

Although there have been multiple good studies of rape prevalence done over the last twenty years, they each use different methodologies, making it impossible to use these studies to get a reliable estimate of how rape prevalence has changed over the years. Not all the studies are structured the same way; not all of them use nationally representative samples; not all of them use exactly comparable questions. As a result, we can’t use these studies to see if rape is increasing or decreasing over the years.

Read the rest of this entry »

1. A relatively brief summary of the NVAW survey’s findings can be read here. (back)
2. Shorter Amp: “The NVAW study is deeply flawed, and we need to do it more often.” :-P (back)

Amy at Feminist Reprise has a really interesting post about shopping while fat when she was trying to buy clothes for an interview. Even with the help of readers she couldn’t get anything suitable for less than $300:

Add to that the cost of my time (and Rebecca’s, and Heidi’s, and Pony’s) to do all this research. That’s for one outfit, for one interview. All of you who, if you had to, could trot down to Ross Dress for Less, TJ Maxx, Old Navy, The Gap, or best of all, a Goodwill in a ritzy neighborhood**, and find clothes in your size that would tell an employer that you’re a responsible, socially acceptable, employable adult–how much do you think you’d spend on an interview outfit? Anything close to $300? No? That’s thin privilege.

I think Amy has misnamed the problem. I’ve written in different ways why I find the term thin privilege problematic. But actually it’s not the way Amy uses privilege I disagree with as much as the ‘thin’ part.

Being able to easily buy clothes (and even more so op-shops) is something that many people take for granted. I can wear clothes from enough mainstream stores to make shopping for clothes reasonably easy, but there are lots of places I know I shouldn’t even bother looking in, and so I understand how much harder life would be if I was just a bit larger.

But my friend Betsy, she has real problems buying clothes. She’s small, and her body is an unusual shape. When she had an office job finding appropriate clothes was an expensive nightmare. She couldn’t buy a single pair of work quality trousers, she had to get them made up (luckily WINZ paid¹ ). She never found a suitable pair of formal work shoes — they probably don’t exist, and couldn’t be made. Despite this, despite the effort and expense, her manager told her several times that she needed a more professional image. Presumably it never occurred to the manager that this actually involved more than popping down to a ridiculously expensive store and buying more clothes. It never occurred to this manager that the standards she preached wouldn’t be available.

The experience of being able to find clothes that fit reasonably easily and affordably is something that many people take for granted.² To call this ability ‘thin privilege’ ignores the other reasons clothes don’t fit people’s bodies. I think it is really unproductive to divide these experiences — so if Amy is writing the story the reader can buy clothes because of thin privilege, whereas if Betsy was writing the clothes the reader can buy clothes because of able-bodied privilege.

I think it’s really important to name our problems right - and there are plenty of thin people who can’t find clothes that fit them. Those people (and their supporters) should demand that clothes are made for the people who wear them, rather than for profit,³ and we can all demand that our ability to do work is not judged by an appearance standard that some people will never be able to meet.

1. New Zealand’s social welfare system offers grants to people who are entering employment to buy suitable clothes. (back)
2. Of course there are other people who could theoretically buy clothes at mainstream stores or op-shops but can’t afford to buy clothes at all. (back)
3. My banner at that protest would all be about cup-sized shirts and togs. (back)

Hey folks,

I got this email on a list serve, and I figured I would disseminate this query to as many people as possible.  This sounds like a fascinating area of research that needs further development.  I’m not sure if he needs participants for a study, references to organizations and activists, or general literature on the topic.  Personally, I’m excited about this area of study because I have yet to see any thorough analysis of the intersections of race/ethnicity, gender, and disability.  If you can help him you can send an email directly, if you have general points of suggestions for the general audience, please feel free to put them in the comments section. 

From: A. Rahman Ford

arford@sas.upenn.edu

I am searching for literature regarding race and disability.  I seek to use such information to explore the intersection of disability and Black masculinity. Any information will be greatly appreciated.