Support

I first saw this Willow tree in “all its glory” when we first moved here in 2015

I really love living in Anne Arundel County. When we first moved to our “forever home” in 2015 (worthy of this auspicious title because we finally found an affordable and accessible home), this Willow tree was huge! Located on a nearby farm that I drove by every single day, this tree shaded a large area of pasture that 10-15 cows called home. You can tell by the size of the original trunk how massive this tree was in its prime.

I do not know if my admiration and affection stemmed from the fact the tree was simply beautiful, or that it bordered this idyllic version of a small farm reminding me of my childhood. Regardless, I became really attached to this tree. I passed it on the way to work and on the way home from work. It was hard not to get distracted by which cow or calf was scratching its bovine butt or shoulder on the trunk of this tree as I drove by each day.

One day I noticed that the owners had added some wooden supports on one side. I had noticed the tree had a slight “lean” to it all along and was curious about the farmer’s attempt to provide assistance against the “lean”. After twenty minutes of “googling” Weeping Willow trees, I discovered that their shallow root system can mean a tree can be at risk in high wind areas or areas with high water tables. I was actually surprised the farmer chose to do this as the effort provided support, but certainly was not aesthetically pleasing. It was the only provisional shade in the pasture, so perhaps the owners sought to prevent a problem before it happened. In this way, the farmer insured necessary relief from the heat of the day for the small herd.

Wouldn’t ya know, last Fall “something” happened to this tree. I didn’t see it happen so could only guess as the trunk was split and the vast majority of the tree lay in pieces on the ground. It made me very sad. Don’t ask me why, but I was a little weepy about the broken Weeping Willow! Over the next week I noticed branches being cut and hauled away. I was surprised to see the core trunk of this once stately giant with graceful crown of “weeping” branches still intact. In fact, it continued to be supported.

I like to think this survivor tree held some kind of sentimental value to the farmers. Perhaps it was a more pragmatic reason such as Willows grow quickly and it provided necessary shade to protect the cattle on a day with unforgiving heat and humidity. Still, I prefer thinking it was for heartfelt reasons they chose to do what they could for this “little engine that could” tree.

I watched all winter. Each day I drove by and thought this tree is DEAD and DONE. Much to my surprise, this Spring the tree began to grow again. It looks a little awkward and perhaps even unsightly with the obvious man-made supports in place. Yet it sprouted new branches with blooms and then leaves. I have a feeling this tree is going to surprise us all.

Anne Arundel Community College, like other schools nationwide, was forced to move all instructions online this Spring. Is it because I’m late-deafened that I really prefer interacting with my students face-to-face? Maybe. I know plenty of instructors with normal hearing that were dismayed by the daunting task of providing an engaging learning environment.

Many teachers provide a little blurb in their syllabus and perhaps a “3 minute mention” about accessible options, assistance and supports, and disAbility services. I realize it is likely because my heart beats within the chest of someone who lives with disAbilities and chronic conditions, but to me the issue should not be mentioned once and then never again. For one thing, there are numerous conditions that do not classify as a disability yet students still benefit from support. There are mental health diagnosis and physical chronic conditions that may make it difficult for a student to be “all in” during classes.

This is why I talk about it… WEEKLY. I remind students to come to me if they need support. Perhaps they need a face-to-face meet in my office. After quarantine, it may mean they needed a Zoom call so that they could talk. Prior to the social isolation restrictions in place, I used the ‘RED PAPERCLIP‘ system. My students have nameplates that they toss in a folder at the end of class. If the red paper clip on the back of their name plate was moved to the top, I contacted them via email and we set up a “text meet”, office hours conference, or FaceTime call.

After Spring break turned into a 3-week long, panic-filled transition period for instructors, I thought long and hard about what to do in place of my “RED PAPERCLIP‘ system so that students could still let me know they needed my support for something. These “somethings” included things like:

  1. A 2-3 day extension on a due date
  2. A pep-talk
  3. A listening ear
  4. Further information about the details of a project if the written instructions alone were not enough
  5. Resources and/or connections to virtual mental health practitioners (I’m a teaching psychologist and not a counseling psychologist).
  6. Resources for food, shelter, etc.
  7. Advice and discussion about transfer decisions
  8. Extra credit opportunities
  9. AND MUCH MORE

So what to do if I didn’t have nameplates turned in after class and a visual check of red paperclips? Mid-semester I could only come up with staying in close contact (every couple of days) via email, reminding them of my availability and desire to assist. Do you know during the last 8 weeks of the semester, I received a half dozen texts from students who only sent a picture of a red paperclip? I received OVER a dozen emails from students with “red paperclip” in the subject line of their email. It made me smile. Well… it was a weepy smile, but a smile nonetheless.

For whatever reason, the farmer down the road from me, decided to support this willow tree. Will it ever be self-supporting again? I can’t answer that. Yet with support, this weeping willow provides something needed and necessary to a small herd of cattle. It is growing back quickly. Who knows what it will look like next year? Perhaps it provides some sentimental value to the owner as well. What I can tell you is that without the man-made supports in place, this tree wouldn’t have had a chance at a comeback.

My students know that I get “having a bad day”. I don’t allow them to abuse it but they know they can email me for some additional supports or “course grace”. I am also very transparent about my own good days, bad days, and having to push through ON a bad day. You see? I want to model good self-care. I also want to model the strength required to ask for assistance. Heck, I am “fiercely independent” using cochlear implant, captioning apps, service dog, and cane. However, I have learned there is no shame in asking for assistance. In fact, there is strength in asking for assistance and support.

Do you have people in your life right now who need support? If you don’t, you aren’t looking. We all need some support at different times in our lives. It may be a small “help”, but it can mean the world to someone at a time in their life when they just “need a little something”. I also encourage you to learn to ask for support. I assume many of you who are long-time readers of “Hearing Elmo” have disabilities or chronic conditions. Having extra challenges doesn’t mean you aren’t capable of helping others. It also means that you may need a little support from time to time. Learning to ask in a cheerful, matter-of-fact way goes a long way in positive advocacy. I have learned that many friends, colleagues and even total strangers do not know HOW I need support unless I inform them. It may sound like:

“Excuse me, could you pick up that credit card that I dropped? My service dog has trouble with that unless it is on carpet”.

“The automatic door button doesn’t seem to be working. Could you open and hold the door for me?”

“My fingers are particularly numb today. Do you mind picking up the papers at the end of each row?”

“The elevator in this building is not working today. Can you walk a few steps in front of me as I descend?” (Finn, my service dog, does all the work. However, I need a visual peripheral block to keep from feeling wobbly).

“Can you talk into my phone so my app can caption your voice? There is so much background noise in here I cannot hear you”

“Do you mind carrying my tray from the register to a table? With leash and rolling bag in hand, I cannot manage carrying that safely”.

I have never NOT had someone willing to help.

So keep an eye out for leaning willow trees. Pay attention to any “red paperclips” on the face of or in the body language of someone you meet. In small (and sometimes large) ways, we can make a difference.

L. Denise Portis, Ph.D.

©2020 Personal Hearing Loss Journal 

 

The Right to Die (Part 2)

Please review Part 1 as an introduction to this post. Thank you!

This is one of the most difficult posts I have ever written. I wanted to provide some background prior to providing both opinion and scholar resources.

I am an adjunct faculty member in the psychology department of a local community college. I teach 4 classes a semester, am a faculty advisor for 2 student clubs, am active in the Social Justice Collaborative, and provide internal professional development workshops on campus. I currently serve as the chair of our county’s Commission on Disability Issues. One of the student clubs I represent is actually an active chapter of Active Minds, a national organization whose mission is to raise awareness and work towards suicide prevention at a grassroots level by educating college-aged students. I say all of this not to “toot my own horn”, but to make it clear that to melife is precious. I have worked and continue to work hard to do my part in preventing suicide and helping to erase the stigma associated with mental health illnesses.

Therefore, it may come as a surprise to you that I am also passionate about right to die issues. I have a very focused viewpoint on that, however, and I appreciate your seeing me through to the end of this post. I apologize for the length but I want to give you all the information I have so that you can make an informed decision about your own stance. Rest assured, if you disagree with what is provided here, you may feel free to comment at length in the comment section. I value your input and opinion.


If you follow this blog, you know that I have repeatedly shared how visible and invisible disability and chronic illness go hand-in-hand with mental health diagnoses such as mood disorders (Major Depressive Disorder and Dysthymic Disorder) and anxiety disorders (Generalized Anxiety Disorder, Panic Disorder, OCD, PTSD, etc.). You can view some of these posts at the following links:

Try to See Each Other Out There

We Are Not Given a Good Life or a Bad Life

A Prisoner of Stigma

Sometimes it Takes Work to Stay Positive

If you watched the HBO video link in Part 1 of this series, you know that one of the stories followed the choice to “die by choice but with dignity” of a lady with a lifetime history of mental health illness. As a person who acquired disabilities later in life, I have been open and honest about my own struggles with panic attacks and depression. There were times in my life where suicidal ideation was an everyday challenge. I have been on medications for nearly a decade and have seen a counselor on and off most of my adult life. It is not my belief that people with mental health diagnosis be allowed to die by choice. With a “whole person” treatment plan to address hopelessness and depression, an individual may  recover from mental health illness, or at least manage the symptoms to provide a happy and successful life. Perhaps they aren’t “cured” but their Dx can be managed . I am not in favor of providing end-of-life measures to these individuals.

I am so glad someone was there for me to dissuade me from a poor choice at a low point in my life. Life is precious to me. My life is precious to me, because I recognize the unique opportunity I have as a psychologist and person with disability, to help others discover their own value. Suicide prevention and erasing the stigma associated with mental health illness are important issues to me. It is the beat of my heart.

Having said all of that, because of my work in the disability community I have discovered a subset of this population that deals with a different set of challenges. These are people who live with chronic and debilitating pain, with no cure and no medication that completely alleviates their suffering.

When I get a headache, I take a pain reliever and my PAIN IS RELIEVED.

My mom had hip replacement surgery in August and December of 2019. The worse pain she experienced was treated with prescription opioids and later ibuprofen and HER PAIN WAS RELIEVED.

My 3rd service dog was neutered this week. He was given a post-surgery pain reliever and it appears HIS PAIN IS RELIEVED.

My point is that many people deal with chronic pain. Many of those individuals take pain relievers to alleviate or manage their pain. Some take medications that can be addictive and must weigh the variables of potential addiction to remain pain free. Some people resort to a still somewhat controversial choice of medical marijuana (although why anyone would be judgmental of that is beyond me).

Let us think about a subset of chronic pain sufferers. There are people who live with chronic, excruciating pain who have no options for real pain management. These folks have tried it all. Legal and illegal pain management options have been exhausted. Because of the nature of their disease and diagnosis, they still live with terrible and debilitating pain.

There are numerous studies that tell us that these individuals are at high risk for suicide. Some studies suggest that in the U.S., 1 out of every 10 successful suicides are an individual who lived with chronic pain (Petrosky et al., 2018). It is tough to study suicide in chronic pain sufferers, as they often have comorbid mental health diagnoses as well. (This topic has been covered by Hearing Elmo extensively… see links above). Sometimes the drugs used to treat chronic pain have side effects of depression and mood swings. In a comprehensive study, Racine (2018) found that chronic pain IS a risk factor for suicide; however, although mental health issues can be treated, pain may not be managed well at all.  Sullivan (2019) a researcher in pain management and suicidal ideation, suggests that those with pain not managed by medication, corrective surgery, or holistic therapies also struggle with sleep disturbances as they may find it difficult to relax to the point of being able to sleep. Pain + depression/anxiety + sleep deprivation = a high risk for suicide. Doctors are not only tasked with helping patients discover “what is causing my pain?” but also the request to “please fix my pain” (Sullivan, 2019). What is a doctor and patient to do with the latter cannot be addressed?

This next paragraph or so I may lose you if you haven’t watched HBO’s “Right to Die Debate” episode. Again, I request that you view this video above at the first link. I think very few people argue within the “Right to Die” battlegrounds against those who are living in pain and have a terminal disease. Some of these individual’s stories were highlighted in the video segment. Less understood (and I argue that we are less likely to support someone) is the argument of individuals who are not terminal yet living with chronic pain.

I have heard the arguments of many who continually refer back to the fact that LIFE IS PRECIOUS. Many of us have bounced back from very low points and now enjoy life and participate in our communities. I have no answers for those who ask “how can we support anyone’s efforts to deliberately end life if we view life as valuable?”

I have a friend who is like a sister to me that is currently awaiting SSDI appeal and lives with debilitating pain. I have talked with her when stabbing pain robbed her of the ability to speak or sit up straight. This is only evidence of the acute pain that hits her without warning. She lives with chronic pain always and I only notice because the overall fatigue and helplessness is a constant shadow in her eyes. She has seen numerous specialists.  Not just in her county and state, but seeking help from specialists in renowned hospitals across our country. She has a pain disorder that has been dubbed “The Suicide Disorder” because of the large number of people who have unsuccessfully tried to manage their pain and simply chose an end to a battle they could not win.

Do I value my friends life? Of course I do. Does she value her own life? I have never met anyone who appreciates and values life as much as she does. It is evident in her own struggles and perseverance as well as her art (she is a photographer). She has struggled with the desire to end her pain in a dignified and supported way. She hasn’t stopped fighting. To date, she continues to fight at great sacrifice.

My goal in writing this 2-part series on this heavy issue is simply to motivate you to put yourself in someone else’s shoes. I am not advocating easy access to life-ending means for MOST people. I do believe we are naive to believe that all pain can be managed successfully. I think we are ill-informed if we believe people can live this way long term. I do not pretend to have the answers. What I do know is that we should be discussing these issues and allowing individuals living with chronic pain to facilitate these discussions. Respect them, love them, and honor their choices. Can we value life and do any less?

L. Denise Portis, Ph.D.

©2020 Personal Hearing Loss Journal

—-

Petrosky, E., Harpaz, R., Fowler, K.A., Bohm, M., Helmick,C., Keming Yuan, M.S., and Betz, C. J. (2018). Chronic pain among suicide decedents, 2003 to 2014: Findings from the National Violent Death Reporting System. Annals of Internal Medicine. 2018(169) 448-455. doi: 10.7326/M18-0830

Racine, M. (2018). Chronic pain and suicide risk: A comprehensive review. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 87B(20) 269-280.

Sullivan, M. (2019). What do we owe patients with chronic pain? Pain Medicine 20(5) 878-881.

The Right to Die (Part 1)

I want to handle a sensitive topic and do so with some open and honest dialogue. Before I do that, I highly recommend watching the following video (captioned). Yes… yes, I know! It is nearly 30 minutes long but that is why I am splitting this topic into two posts. The first, a video that I believe does a terrific job of pointing out all of the arguments. Next week I will write about this and provide my 2 ¢ as well as provided peer-reviewed research on this important issue.

For now, please watch and take notes. Please feel free to comment as I never fail to learn from you as well.

 

L. Denise Portis, Ph.D.

©2020 Personal Hearing Loss Journal

Darn it, I am STRONG

 

I’m no Super Hero, but I am strong!

You have “stuff”. I have “stuff”. Y’all? We all HAVE “STUFF”.

I am — who I am — because of “my stuff”. Your own “stuff” may not define you but it certainly shaped the person you are. It is a wee bit aggravating, however, when someone says “You are such a Super Hero or an inspiration” because of who I am as a person with disABILITY. It’s not that I don’t want to inspire someone. I hope my adult children and grandchildren think I am worthy of imitation and example. I also want to instill in them (and others) their special value because of who they are all because they are here,

on earth,

within our community,

making a difference where they can.

This Doesn’t Mean…

I am not grateful for all God has allowed in my life to make me the woman I am. I want to encourage. I want to be a good example to others. I want to make a difference. This does indeed mean that I am grateful for my disABILITIES. My hearing loss has taught me about communication and about visual cues about the soul of a person. My balance disorder has taught me to take special care, that every step and turn should not be done impulsively. My cane has taught me to lean on something sturdy to provide a 3-point foundation. My service dog has taught me to pay attention and to have confidence in something with far keener senses than I have. I am grateful for my disABILITIES. Yet, I want to inspire, encourage, and don super hero capes because I am a strong woman.

Your stuff may not be disABILITY. Maybe you are a member of a diversity group and the challenges that has presented has strengthened once weak character muscles. Advocacy and inclusion awareness activities have broadened your scope and influence. You are strong because of it.

Maybe that you are a single parent, a survivor of a serious illness, domestic violence, recovered addict, or live with other invisible or chronic illnesses, have made you the strong person you are.

I’m currently staying with my mother who is recovering from a 2nd hip replacement. A North Carolina sister-friend contacted me and we were to have lunch today to catch up. It’s raining, like… a LOT. This means my balance is wobbly, my tinnitus is roaring, and I’m feeling particularly shaky. My friend texted me early (knowing the state I am likely in right now) and suggested a (quite literal) raincheck for lunch.

Does this mean that I’m weak… today? No. I may have to make smart decisions to keep myself safe and avoid likely falls and concussions, but this does not make me weak. I am still strong. It simply means that today my strength is manifest in my practice of good self-care. I can wobble and be strong by making smart decisions to take care of myself.

Challenges not Limitations

Each of you have something that makes life a challenge. Whether it is something physical, spiritual, emotional, or cognitive, we all have challenges. I don’t like the word “limitations”. I prefer to think I am not limited in any way. Instead, I have challenges that exercise my muscles to make me strong. It might mean different choices. Perhaps it means a “raincheck”. I may have to ask for assistance from my service dog or even a person. I am not limited. I simply have challenges. These challenges make me strong.

This post began with exposing something everyone already knows. We all “have stuff”. Your own “stuff” presents challenges, but those challenges make you strong.

This doesn’t mean that you may occasionally feel overwhelmed. It doesn’t mean that there is anything wrong with the fact that at times, you just want to give up. That’s where the rest of us come into the picture. We need each other. We need to support each other. We need to celebrate with each other. If you haven’t seen the now viral video of Miss Nigeria going bananas with genuine glee at the “win” of her friend Miss Jamaica, you have missed out. You can view it here.

I want to be the kind of support and help to YOU, that I don’t hesitate to respond with questions from people who follow my blog or who know about my work in the disABILITY community. I want to celebrate every win you have. I also want to assist when you do not win, and I want to stand in the gap for you when you simply need someone to care. Blogs, vlogs, online support groups, and social media platforms have become a valued network and access to “Miss Nigerias”.

Hey… I totally get feeling all alone on my own little island, crippled by my MIND about my own disABILITIES. It happens. We buckle, hole up, and lick our wounds. Friend, please don’t stay there. Look for the resources and help easily found in a vast array of fully accessible environments. Indeed, we all have “stuff”. We also need each other.

L. Denise Portis

©2019 Personal Hearing Loss Journal

“We Are Not Given a Good Life or a Bad Life”

“We are not given a good life or a bad life. We are given a life. It’s up to us to make it good or bad.” (Devica Fernando)

“We are not given a good life or a bad life. We are given a life. It’s up to us to make it good or bad.” (Devica Fernando)

I believe one of the most self-destructive things a person with disAbility can do is to compare themselves to other people. I have even heard people with disAbilities compare themselves to other people with disAbilities… seemingly weighing “who has it worse“. Y’all? I have done this myself. Believe you me – I get it.

I think people who live with chronic illness or disability do this for one of two reasons:

  1. They are trying to remind themselves they are better off than “so-and-so”
  2. They are trying to discount the perseverance and courage of another because there is “no way they can understand YOUR life” because you have things much worse.

Let me start with the first one.

If you have “stuff”… physical, emotional, and mental challenges, don’t ever compare yourself with someone else also struggling. This is especially dangerous if you end up invalidating your own difficulties. The life challenges you deal with are just as legitimate and real as those faced by other people.

Frankly? Every person you know is fighting a battle you may – or may not – know about. This is the reality of life. Those of us “dealing” with life’s challenges were not given a good life nor a bad life. In spite of what I’ve heard others bellyache, not even God is at fault for your “good or bad” life. As Ms. Fernando stated, “It’s up to US (emphasis added) to make it good or bad”.

So (temporary) pity parties are not allowed? Well of course they are allowed. They are also

expected

normal

even beneficial.

You just can’t stay there wallowing in self-pity. If you believe in the power of “psyching yourself up”, simply do so by focusing on your own life and don’t compare yourself to others. It’s OK to not be OK. It’s not OK to think you should be OK, because compared to others you’ve got it pretty good. The struggle is real and we all have struggles.

Before I leave this point, allow me to just say that I am “born again” about sharing and caring with other people who live with chronic illness and disAbility. We can learn from each other. My greatest “teachers”, those who by example or explanation, coached me to try a different approach, a new assistive device or tool, or to adopt a new mindset to help me succeed.

The second point can be much harder to avoid. As a person with disAbility (late-deafened) and chronic illness (Meniere’s disease), I sit in meetings with my peers feeling frustrated when someone makes a really lame excuse for not doing something well or refusing to take on a responsibility. I think, “Well for love of cracker jacks, who goes around saying they couldn’t complete a task or responsibility because they are just to busy?” (Yes. I really think this LOL).

Who am I to say that someone without VISIBLE disAbility or chronic cannot use “busy-ness” as an excuse? Maybe they are dealing with something you do not know about. Maybe…

Their child has an unhealthy addiction.

They are scrambling to make room for their ailing mother who can no longer live alone.

Their most significant, personal relationship just imploded.

Their doctor wants to see them to re-take a medical test.

At the community college campus where I work, inclusion is the word of the day (and week, month, and year). Yet inclusion – includes – people who seemingly do not fit into a defined diversity group. Diversity implies all the ways we are different. I don’t know anyone breathing who isn’t different in some way. Inclusion, means to universally INCLUDE.

This past week I retired my 2nd service dog from Fidos For Freedom, Inc., specifically from working with me in the classroom at AACC. We started a major demolition and construction project this summer. Unfortunately, after working nearly 3 months on desensitization, Milo is unable to cope with the loud noises and “mini earthquakes” to focus on his job and assist me. I taught two classes this summer (Developmental Psych and Intro to Psych) and they were the hardest classes I have taught to date. I have had the assistance of a service dog in the classroom for 14 years! (Milo will continue as my partner in all other areas and is not retired full-time as of yet). Having to carry all of these assistive devices to work just to be independent in picking up things I’ve dropped or walking without wobbling, has been an emotional, mental, and physical challenge for me.

A couple of weeks ago during one of the breaks I offer (as it is a 4-hour class!), I ran into a colleague who teaches in a different department. I know her well enough that when I said, “Hey! How are you doing?” she answered honestly.

“My life is hell. This is the hardest summer session I have ever taught.”

I will admit my first thought was a flurry of reverse-prejudiced “OH BRUTHER” rationalizations.

I mean… she is healthy and athletic, and in her prime. She has tenure. She is well respected. Her expertise is valued. How is it that SHE is having the toughest summer? She doesn’t have any disAbilities or chronic illnesses! There I went with a silent “eye roll” and judgement simply because the things I was dealing with in adjusting without a partner were so much more IMPORTANT than anything she could bellyache about!

I immediately (mentally) slapped myself up side the head (though likely would have benefited from the real deal), and instead asked, “Well gee! What has been going on?”

Come to find out anything that COULD be going wrong in her life, was indeed going wrong. Her teen daughter was hospitalized and put in long-term care for depression. It came from out of nowhere and no one in the family had seen any warning signs. Early in the summer, she nearly lost her to suicide. Add to that long-term plumbing issues, car troubles, financial woes, and an internet stalker (I kid you not) rounded out the “list”.

Nope. This fellow teacher does not have any disabilities that I am aware of, nor any chronic illnesses. Yet, she too, has been struggling all summer and doing her best to cope. She, like me, chases down and hog-ties that professional smile to paste on right before entering a classroom. She is distracted and suffering from insomnia. She has cried many tears. Embracing true inclusion has taught me to recognize that her struggles are just as real as mine are. I love what Jordan (2011) said in the Diversity Journal: “Inclusion involves bringing together and harnessing these diverse forces and resources, in a way that is beneficial. Inclusion puts the concept and practice of diversity into action by creating an environment of involvement, respect, and connection—where the richness of ideas, backgrounds, and perspectives are harnessed to create business value.”

My colleague’s “stuff” looks different than my own “stuff”. It’s still STUFF. Encouraging and supporting everyone, benefits, well… EVERYONE. No one has everything going for them; a life without problems, fears, or struggles. However, everyone has something going for them.

Everyone.

Denise Portis

©2018 Personal Hearing Loss Journal

 

Shot Down as a Volunteer

One of the big motivators to “finish” while working on my Ph.D., was simply knowing I would again have time in my schedule to do some volunteer work. I suppose it makes sense that many people believe that folks with disabilities or chronic illness are unable to participate in volunteering, community service, and areas of ministry. It has been my experience (27+ years) that people with disability seem to know their limits better than people who are able-bodied. This isn’t always true, obviously, since many of us who identify this way HAVE signed up to do more than we are physically, emotionally, or mentally, able to do. I have, however, met more people who know their limits within the disability population, than those who are able-bodied and habitually over-extend themselves.

Imagine my disappointment and surprise when numerous pleas to allow me to be involved in “extra curricular life” activities, were shot down again and again! I tried very hard to put myself in the “shoes” of the decision-makers and could see perhaps how they might think I have limitations that may interfere with my ability to be “on time and available”. I know it has been nearly five years since I was really able to immerse myself into various community roles as a result of the time and energy required to finish my degree. Maybe it has been an “out of sight/out of mind” reaction?

Regardless, I spent a couple of miserable weeks trying to figure out why I continued to be ignored by the decision-makers in places where volunteer teachers, trainers, and workers were needed. I decided to nix that miserable feeling and look for “other” and perhaps “new” areas to spend some of my non-work hours.

I’m so glad I did.

I am gearing up to initiate on an-campus chapter of Active Minds at the community college where I work. I am very excited about it and believe students will benefit from having a chapter and student group on campus. It will take a good number of months to generate the student body support needed, but I am willing to work hard to see it happen. I would have never LOOKED for something new like this if I had not found other doors closed to me.

Can Do Attitude

Ms. Amado at the University of Minnesota explains that people with disabilities can and should seek to volunteer in their communities as they receive the same benefits other able-bodied volunteers receive. Social inclusion (community membership and friendship), contribution (happiness and satisfaction), developing marketable skills and job opportunities, networking, and status/reputation, are all benefits volunteers receive (Amado, 2001, p. 28). So why do people with disability often struggle to find volunteer opportunities?

Sue Bott, director with Disability Rights of the UK, believes some of the barriers to volunteering are false assumptions. “Rather than thinking about what they can offer, organizations tend to imagine some of the perceived problems having disabled volunteers will cause them” (Hudson, 2013). Rak and Spencer (2016) encourage organizations seeking volunteers to improve the representation of people with disabilities. “Educate stakeholders about the benefits of volunteering and being part of civic, and other community based groups in improving the quality of life of persons with disabilities” (Rak & Spencer, 2016, p. 1705).

This all sounds great, right? Unfortunately, there are very real barriers to people with disabilities even if they find an opportunity to be involved. Transportation can be a significant issue, as can weather-related mobility barriers. One area of need and “very accessible” opportunities, includes mentorship. The disability community has taken very real and positive steps FORWARD, as the result of mentors making a difference. The American Association of People with Disabilities explains the importance of mentors with disabilities:

  • The influence of mentors. Although the family was the most commonly cited influence on employment for the participants, professionals such as college professors, service providers, and employed individuals with disabilities, including benefits planners and community leaders, were also commonly mentioned.
  • The power of mentors with disabilities. The participants in this study were driven to be self-sufficient through the influence, motivation and modeling of other successful people who have disabilities. The mentoring relationship took many forms, from one of general exposure to people with similar disabilities, to a support group, to a close individual friendship. Regardless of the form of mentoring, the effect on the participants was cited as a major factor in their successful transition to work.
  • Support of peers. Many of the participants attributed their drive and success to the mentors they had in their lives. In some cases, peer mentoring occurred in the form of a support group of individuals with similar disabilities.

I know mentors with disabilities that spend numerous hours online, making a difference in the lives of others by being a mentor, coach, or advocate. There are numerous ways to be involved. Even “blogging” is a significant area of service and support. Many mentors with disabilities started out by simply writing about their struggles, successes, and life as a person with disability.

Has a door of opportunity been closed to you? Look around. I guarantee that other open doors are there. We simply have to find them, and walk through! Good luck!

Amado, A. (2001). Impact: University of Minnesota. Retrieved July 30, 2018, from https://ici.umn.edu/products/impact/142/over3.html

Hudson, S. (2013). The Guardian: Is it too difficult for people with disabilities to find volunteering roles? Retrieved July 27, 2018, from https://www.theguardian.com/voluntary-sector-network/2013/aug/14/disabilities-difficult-volunteering-roles

Rak, E. C. & Spencer, L. (2016). Community participation of persons with disabilities: volunteering, donations and involvement in groups and organizations. Disability Rehabilitation, 38(17). doi: 10.3109/09638288.2015.1107643

L. Denise Portis, Ph.D.

©2018 Personal Hearing Loss Journal

Chronic Pain (Part Two – Link to Part One Below)

Photo by Deb Marcus
July 3, 2018
All Rights Reserved

Hearing Elmo welcomes back Deborah Marcus, frequent guest writer at Hearing Elmo with “Part 2” of Chronic Pain. If you missed the first part of this topic, please click the link provided below.

——————————————————————

It has been about 6 weeks since I posted the first piece on my experience with chronic pain. Chronic Pain – Part 1       A lot has happened in that short period of time, a direct result of this sharing. I’d like to spend a little time today looking at one critical component, that of my report of having gone into a really dark place, wondering if I am truly “done”, and needing to reach out for support to deal with thoughts of planning my suicide. Soon after the piece was posted at Hearing Elmo, I spoke by telephone with a long-time friend. I’ll call her KS. She, too, lives with chronic pain, and through much trial and error, figured out the plans of action that allow her to live as full a life as her physical limitations allow. She is one of the few who I have been comfortable talking about my pain over time, at least in part because I know that she will understand on a level deeper than many who don’t live with chronic pain are able to do. I was also there for her for a number of years as she was working through her own “how do I live my best life” process. So, it should not have shocked me the fury with which she expressed finding out that I had reached such a deeply dark place and did not reach out to her. “I’m not angry with you!” she screamed into the phone. I’m not exaggerating, she was really upset with me. I understood why, and I hate hurting anyone, least of all a dear friend, but I found myself feeling forced to defend my decision not to reach out to her at a critical time. In fact, I reached a point at which I had to tell her to step back, because I was feeling shaky and scared by her reaction to how bad things had gotten for me. I’ve no doubt that it was precisely this that made me choose not to reach out to her at a critical juncture. She was able to honor my need to bring down the intensity, and had some extremely useful things to say regarding my inability to look after myself, to honor the fact that I deserve just as much care and support as the many that I have provided the same for over the years in my human services work. In fact, she and I met through our shared work, and we served many of the same clients in the community. It was a time that I was much more at my peak performance, and it’s true, I went to the ends of the earth to advocate for and support these individuals. Suddenly she shouted at me again, but this time she said: you’re still behaving like you have to hide your illness from your mother! Stunned, it took me a moment to realize what she was saying: she remembered a long ago conversation, of how I spoke of the fear in which I once lived, of having to ever tell my mother, my abuser, that I was ill and unable to act as her proxy, the public “family face”. On the occasions that this happened, I would end up with my head knocked against the porcelain bathtub, or screamed at until I wore her spittle. The episode of being pushed backwards down a flight of stairs may have triggered the facial nerve pain that has been an increasingly problematic issue in my life, but I carry with me the struggle to act in accordance with the words which I speak, that I believe I have the same rights as anyone else to good self-care. No doubt this has contributed in part to my struggles with depression throughout my life, the depression which I called everything else but that until a couple of years ago.

Photo by Deb Marcus
April 21, 2018
All Rights Reserved

Our culture still has a long way to go to acknowledge mental health as just as integral to a strong, stable society as physical health. There is some movement, but there are deeply ingrained stigmatizing messages against those who struggle with depression, anxiety, and other behavioral health conditions. Almost daily, I see posts on social media that casually “joke” at the expense of those with mental illness. Jokes about how doctors decide who is crazy and needs institutionalization, memes reflecting how someone’s Facebook posts let others know that the person has stopped taking their medication. All we have to do is substitute mental health issues with physical and we can readily see how stigmatizing these messages are, and how easy we find it to make fun of those with mental illness. There are many resources dedicated to addressing stigma. The National Alliance on Mental Illness is a great one. This is a link to some suggestions on how those of us with mental illness can work towards dismantling stigma: NAMI-Stigma

What to do with this complex blend of body memory, the physiological damage alongside the profound shift in my psyche due to messages deeply internalized? It’s interesting, because I have had several rounds of counseling over the decades. I have not been oblivious to what was done and in many ways, how I have been affected by my experiences. I’ve done hard work, processing what happened, growing stronger and more confident with every therapeutic intervention. Truly, I have, and yet I still carry significant markers that create unnecessary roadblocks towards health and healing.

Photo by Deb Marcus
February 24, 2018
All Rights Reserved

After KS and I finished our talk, I promised myself not to shut down, but to really think about what she had said. Here is one of a number of elements critical to managing life with chronic, severe pain: having someone who will call you on your shit, but because they love you, not because they want to cut you down. If you can’t be that person for yourself, my experience tells me that it has to come from others. I couldn’t deny the truth of what she said, that without being conscious of it, I have been terrified of admitting—to myself, to others who count on me to be the strong one—that I am in trouble. There had to be this intersection of things getting this bad with a friend stepping forward to call me out, in order to recognize what was happening. In the lingo of 12 step recovery programs, I have a very low bottom. I hit it, and thank the heavens I bounced and didn’t not shatter and scatter to the wind. Having reached a point where something has to give, I committed to certain actions. I had to make a plan, which has been hard to do lately. I found resources that offered tips to guide my thinking and action. Here is one: http://www.mentalhealthamerica.net/taking-good-care-yourself. I have found a counselor to meet with for a few sessions, and if this is not the right one, I will continue to explore. I will pursue disability benefits. This is an arduous, challenging process with a most uncertain outcome. I’ve known in my heart that I have barely performed at work anymore, and my world has shrunk by such measures, the walls touching my sides, that I can barely breathe. If I can obtain that support, I may have the residual energy to figure out where to go from here, what other options may be available to try to better manage my conditions, to have a better quality of life. Deep inside, I still have a lot to give, but I know I can’t be of any use to anyone, least of all myself, in my current state.

If any of this resonates with you, or if you have found strategies that have worked, I welcome hearing from you.

Deb Marcus – Guest Writer at Hearing Elmo

The Selfless Practice of Self-Care

It’s strawberry season! My little city just had a strawberry festival, and although I was not able to attend (there was a torrential rain), my husband picked me up some strawberries as he knows my fondness for anything “berry”.

Lately I have been thinking about “self-care” a good bit. I recently made a choice to not do something on behalf of someone I care for and I knew (from their reaction and words) how much I disappointed them. With strawberries on hand (and no dried beans or walnuts as the illustration normally requires), I decided to re-do the illustration with some different elements. I had rice, almonds and now strawberries. Hey… you work with what you have, am I right?

I hate disappointing people. Especially people I really care about and enjoy being around. I have only recently earned a self-awarded “certificate of self-care advocacy”. My normal response to being asked to do something I cannot do, should not do, and will sacrifice my health/mental health to do was “sure! No problem!” and a default. It’s hard to practice self-care at times, because others misunderstand and may believe you are being selfish, self-pitying, or lack compassion for others. I have learned to “stick to my guns”, but it doesn’t mean I don’t recognize and feel another’s disappointment in me. The flip side? I am not disappointed in myself.

My Re-Make of an Old Illustration

So let’s say the grains of rice are all the little things we do each and every day. They are choices to spend 5-10 minutes doing “this or that”. They are relatively unimportant tasks that if left undone, the world does not implode.

The almonds are more important things. I’m going to call my “nuts” family <grin>, close friends, advocacy groups, work and professional life, and community service/faith practices.

The strawberry is me. This big, luscious (- hey… jus’ sayin’) berry includes my physical health, mental health, emotional well-being, and spiritual well-being.

In the jar on the left <points up>, I filled my day/life with all the inconsequential things first, then the “nuts” in my life, and finally me – a big, beautiful strawberry…

… that doesn’t fit.

The jar on the right has the berry going in first. The rice and nuts settle around it just fine. (Yes, I measured and each jar has equal amounts of rice and almonds). If you look carefully, not only did everything FIT, there is some left-over room at the top.

Mayhap poorly illustrated, the point is that if you do NOT put yourself first everything will NOT fit.

Ya gotta NOURISH to FLOURISH

Folks with disability have a hard time with self-care. Let’s stop and discuss possible reasons:

  1. They feel guilty already because they may require another’s assistance and time to do normal tasks.
  2. They rarely have 50/50 friendships. They fear they will be labeled as “takers” and not “givers”.
  3. They fear a lack of control over their lives. Instead, they sacrificially try to help others first, ultimately hurting themselves.
  4. They want to be useful and have a life of purpose.
  5. They believe to say they cannot do something admits defeat.
  6. They work WAY to hard trying to live up to the accomplishments or abilities of someone else who shares their diagnosis but not their life. (No two people are alike).

One of the hardest lessons I’ve learned is that I cannot live a life with purpose and make a difference if I do not take care of myself FIRST. It’s not selfish. It’s selfLESS. If I do not take care of myself, I am useless and unable to do anything at all for anyone else. I have made the mistake of saying “yes” to something with too high a price tag, only to suffer for days, weeks, or months physically, mentally, emotionally, and spiritually. When I practice good “self-care”, I am actually able to do MORE for others.

Now you may be thinking that’s all fine and dandy, but if I am saying “no” to things in order to protect my energy levels, health, and mental health, aren’t people going to really stop seeing a person with disability who CAN have a life of purpose and instead see someone DISABLED?

Not if you handle turning down requests the right way.

You can’t babysit your niece this weekend because you know you need some extra rest? Ask if you can babysit with a 7-10 day notice so that you can rest up in ADVANCE and help with babysitting.

You (and others) were asked to volunteer for a community service opportunity that would mean an entire day of being in a big crowd? (With Meniere’s disease, I can only take so much jostling). Ask if you can donate snacks for the breaks. Ask if there is anything you can do behind the scenes.

Work is having a “walk a mile in her shoes” event. (Everyone wears heels and walks a designated route and distance to support rape, sexual assault, and domestic violence programs and survivors). Y’all? I can’t walk 3 feet in heels with a balance disorder, let alone toddle, stumble and do face-plants all the way around a track with my colleagues. This doesn’t mean I can’t: Invite others to participate, give extra credit to students who participate, volunteer to hand out bottles of water (and bandaids-snort), and cheer along the side-lines. 

Let’s say you really like visiting with a person and care about them a great deal. However, what if they have baggage (in the form of spouses or intimate partners) that may accompany your “person” who is toxic to you and everyone you know? Offer to meet with the friend for a one-on-one lunch or visit. You set the safe boundaries and ultimately enjoy your time with them.

Work related requirements: I have learned that if a meeting or activity is required and yet will not be fully accessible to me (hearing, space to move safely, etc.) to request accommodations WITHOUT APOLOGY. However, then I work hard to be fully invested and participate with enthusiasm. 

In closing, I wanted to share a final thought. This one I am still working on and currently fail to do it right more than I do it wrong.

Don’t apologize for practicing self-care.

I worry too much about what people think I suppose. I tend to TMI (too much information) after declining an invitation to participate in something and make excuses when none are necessary. I’m trying to learn not to say:

I’m sorry I can’t help with that. I know I’m letting you down.

and instead say,

I know myself well enough I cannot do that safely. I am trying to practice self-care. May I do “this (fill-in-the-blank)” instead?

Develop a self-care plan. Chart out (it helps to see it, I promise!) what you can do in a day and what you can do in a week. Stubbornly defend your right to say “no” to something when your chart is already full. Y’all? Don’t scratch out that necessary NAP to do a task for someone else instead. If your nap is needed to re-charge, make it a priority.

Take care of yourself! (A great article on what self-care IS and IS NOT – CLICK HERE).

L. Denise Portis, Ph.D.

© 2018 Personal Hearing Loss Journal

I Would Rather Walk with a Friend in the Dark, than Alone in the Light

fullsizeoutput_8d0

I would rather walk with a friend in the dark, than alone in the light — Helen Keller

I graduated from Walsh High School in a rural area of Colorado in 1984. Fast forward 34 years <wince> and I am graduating again with now my final degree. In 1984 I was a healthy young woman with a moderate hearing loss in one ear. In 2018 I am a middle-aged woman in a perpetual state of getting healthy <wince>, profoundly deaf (and “hearing again” as long as I am wearing my bionics) and an adult with disability from Meniere’s disease and Post Concussive Syndrome.

It may surprise you to learn that I am happier and healthier (emotionally and psychologically) than I was at the age of 18. Life has been hard – and continues to be, but doesn’t everyone experience that in some form or fashion? My challenges have made me who I am today.

The 2018 Denise, has found a life worth living by embracing my unique challenges and focusing my life and energy in the disability community. Oh yes! It’s hard sometimes… dark even; however, I am amongst friends, fellow warriors, super heroes, and advocates.

May I just say, “THANK GOD FOR THE INTERNET”? There are numerous research studies that support that the Internet has connected, educated, and created a platform for advocacy for those with disability. The community, the friends I have found over the last 34 years has made every challenge I’ve shouldered worth it. Most of the people with disabilities I have come to know have different challenges and diagnoses. Yet all work hard to experience the best quality of life they can. We use a variety of accessibility tools, medications, assistive devices, and medical procedures to maximize every opportunity while insisting on a productive and meaningful life. We are stubborn. We believe in self-care. Our priorities tend to be the things that really matter. Some of us are Spoonies.

My dissertation, something I have become quite passionate about, revolves around the theory that traumatic events and diagnoses do not have to destroy a person. As a matter of fact, a wealth of research (my own included) supports that these events can stimulate growth – the foundation of Posttraumatic Growth studies.

This doesn’t mean that I do not have bad days. They happen. Those bad days are something you recognize and experience as well. Yet I have learned that walking in the dark and challenging path of life with disability with all OF YOU, is far better than any walk I took on the lighted, well-tended path alone.

My challenges are progressive. Do you know that doesn’t even bother me? I’ve learned how resilient I am and I have learned to:

  1. Reach out to my community when needed for support
  2. Ask for advice and work-arounds
  3. Find new ways of doing things
  4. Rely on a loyal service dog for minuscule but necessary tasks I was too afraid to bother others with
  5. Believe in myself
  6. Pray hard – but work harder
  7.  Never stop learning
  8. Believe the future is accessible
  9. Stand with others
  10. Be vulnerable and open about the good and the bad

uphill-battle

I’ve also learned to CHOOSE HAPPINESS and to do my best to spread that message. It may seem like a difficult choice some days, but cognitive psychologists agree that if you deliberately change your thinker (your chooser), it will change your feeler, and show in a change in your behavior. It is amazing what “choosing happiness” can do to your personal outlook. Don’t be afraid to embrace the days you scream and cry and cuss up a storm (sorry mom). Those days will happen as well. I have learned though that if my focus is positive advocacy and choosing happiness, those screaming days are few and far between.

I’ve always admired Helen Keller. This intelligent and gifted woman had neither sight nor hearing. Yet Helen learned that her life “in the dark” was pleasantly full of like-minded friends and associates. She knew the value of walking in the dark with a friend. I hope you can learn to embrace that mindset as well.

L. Denise Portis, Ph.D.

©2018 Personal Hearing Loss Journal

Chronic Pain – Part ONE

Welcome to guest blogger, Deborah Marcus, long-time friend (sister), fellow advocate and writer, and professional photographer. It is always great to have guest bloggers on Hearing Elmo because although I have lived with disability for 27+ years, I do not and cannot understand chronic pain conditions as it is not something symptomatic of my own challenges. I have always been thankful for that — for one thing I am a wuss. I have loved and admired Deb for a long time, in part because I consider her a warrior woman who DOES live with chronic pain. This is part ONE of a multi-part posting. Follow up posts in the future will link to this one so that her story chapters will remain connected.

What persuades me to step back from the ledge? What worked yesterday, today, what will work tomorrow? Those who live with chronic, severe pain or illness are familiar with these questions.

I have lived with disability for much of my life. Hard of hearing from a relatively young age, severely so through my 20s and 30s until I began to hear again at age 42 with cochlear implants, I am no stranger to the need to make adjustments. I have lived with other disabling conditions, too, which unlike hearing loss and deafness are largely a product of the external forces of trauma and abuse. At 54, I have lost count of the moments when I’ve told myself “keep on, keep on”. As a result of physical abuse which once took the form of being sent down a long flight of stairs, backwards and head first, I have experienced increasing challenges with my vestibular (balance) system. Once a series of intermittent episodes of vertigo, my imbalance is now chronic. For over two years now, I have not had a minute where my equilibrium is not in a struggle with the space around me. Along with this is a condition that I have managed to cope with for 38 years, for which I had no name until recently. Three years ago I wrote a short piece describing life with trigeminal neuralgia. Things have changed regarding my TN status since then, but it’s instructive to see where I was at that time: https://visionsofsong.com/2015/07/10/into-the-sunshine-living-with-trigeminal-neuralgia/

It is not the only pain condition I live with, but it is the most distinctly life-altering. About six months ago, I realized that the medication treatment that was giving some relief wasn’t doing much anymore. Trying different medications and doses brought no help. I spoke with my doctor, who referred me to a hospital that does high volume work in the areas of gamma knife radiosurgery and microvascular decompression, the only two procedures currently advised for my condition.Both procedures have a relatively high success rate for trigeminal neuralgia, 70 to 80 percent depending on various factors. After consultation, in early March of this year I underwent the gamma knife procedure. After a week’s time, I felt some improvement, which was incredibly uplifting for my mood, which had reached new lows. Knowing that it can take a couple of months to see the full effect, I hung in on the bad days, rejoicing in the better days in between, and anticipating further improvements. In the past couple of weeks, I have not been doing well. This past week has been terrible, and I have found myself bursting into tears as much due to despair as to the pain levels. My world, which was shrinking due to severe, chronic facial pain, was beginning to open up a bit, only to feel shrunken once again. I can’t decide which is worse, not thinking there would be anything that could really help bring my pain levels to manageable levels, or trying something that may in the end prove to be a failure for me.

The depression I have been managing somewhat successfully stepped to the front of the line. I became obsessed with the idea of planning my death. Not yet planning my death, but finding the idea of planning it out, by suicide, an intriguing possibility. Why? Why now, when I’ve lived with physical and psychic pain for so long, does it seem like now might be a good time to end my life? What makes one moment better than another, or none of them the right time? As much as I have dealt with depression to varying degrees throughout the years, I don’t recall a moment exactly like the one I had this week, thinking that maybe I’m done, really and truly. I felt that if I expressly stated that to anyone close to me, they would call in the big guys on me, which I do not want. Besides, I’ve been feeling like I’m wearing out the handful of good, caring people in my life with my challenges. I did not want to burden them with such thoughts. I knew that I could call the National Suicide Prevention Hotline (found here https://suicidepreventionlifeline.org/) and opted to use the chat box to communicate rather than the phone. It took a little while to get to the front of the line, but I wanted to see what would happen. As a Mental Health First Aid instructor, I know what it’s for and recommend it often. I wasn’t sure if it made sense to call since I wasn’t sitting by the computer with a gun or a bottle of pills in my hand. I recognized my need to reach out, and am glad that I called. The person on the line didn’t tell me much I didn’t know, but I could tell they cared that I was struggling, and that meant a lot. At the end of the call, they ask for some feedback. One of the questions has to do with feeling hopeful/hopeless. I was able to say that I felt a little less alone after this brief conversation. It got me thinking about how much, and yet how little I need. I suspect this dichotomy is true for many of us. I can only share from my perspective, and from what I’ve teased from things shared by others over the years.

There has been a fair amount of discussion lately regarding the intersection of childhood trauma and health outcomes. If you would like to look at this in some depth, you may consider starting here, though there are many other resources: https://www.ucsf.edu/news/2016/10/404446/undoing-harm-childhood-trauma-and-adversity

As a survivor of (and sometimes thrive-r in spite of) sexual and physical abuse, having undergone several rounds of therapy to figure out how to cope, I did not immediately make the connection between my physical challenges and what I had experienced while growing up. The mind-body connection was happening in spite of my limited insight. Oh, I understood that my mood could be connected to my experiences, but pain? Not only acute pain, or pain that is persistent due to an event, but pain in parts of the body that were not injured, or if they had been, were still in pain long past when the bodily injury had healed. I have been handed and thrown off a diagnosis of fibromyalgia twice in 12 years. No fibro for me, thank you! It’s that diagnosis they give you when they don’t know what’s wrong, is what I would tell folks. If sounds so…hopeless. I know some who live with this diagnosis, and they find ways to make a good life for themselves. It felt like being saddled with one more thing that I didn’t want to carry.

But trigeminal neuralgia, that’s something they can tie to an event. In some cases it develops post-shingles. In others, trauma can be the culprit, and again, we suspect that is the case for me. I have been more comfortable talking about this severe and persistent pain condition than any of the others, yet there is no denying that all of what I experience is intertwined within me, and so perhaps the only way through all of this is through all of it. Still, I haven’t figured out what to say to myself to want to keep on during the worst moments. I think I put every penny I had on this horse winning the race, with the radiosurgery giving me significant relief for a while. If it doesn’t, I’ll need to see if I can find another message that is meaningful, to keep on, keep on.

I welcome feedback, and aim to follow up with another piece on the topic of chronic pain, disability, and the reconstructing of a meaningful life.

Deborah Marcus

https://visionsofsong.com