We Need To Stop Calling Them “Invisible” Disabilities

I’ve noticed that it’s common to say things like “he has a so-called ‘invisible’ disability” with the scare quotes around disability and the phrase so-called as a qualifier. I’m assuming this is done to signal the speaker or writer’s understanding that there’s really nothing about an actual disability that is invisible, especially to the person struggling to cope with it.

But I think we need to up our game a bit with this business of disclaiming the idea that a disability can be invisible. I’m thinking we need to either quit using the expression at all, or brazenly interrupt the conversation in order to pontificate on the real problem, which is that the person with the disability is being judged as unreliable in some sense.

To my view, the problem with this class of disabilities is not at all that they are invisible in some way, but that they are mostly visible to just one person, and that person is just assumed for some reason to be an unreliable witness. The issue at hand is one of patient credibility, not disability “invisibility”.

Now, this is actually not to say that all patients should be simply believed without question. I could say a lot more about that and plan to in a future post, but for now I’ll just clarify that what I’m mainly asserting in this post is that if the problem of these so-called “invisible” disabilities is ever to be solved, it must first be properly understood, and in this case that means recognizing that the core issue is really one of witness credibility or reliability.

As I see it — for now, and until I encounter the sort of evidence that might help me change my mind — the “invisibility” thing is just a distraction.

A Better Way To Handle The Malingering Problem

Here are my current thoughts on what I see as a much better way to at least handle the malingering problem. I wish I could say I think it could solve it entirely, but that’s probably not realistic. People are people, and some people seem utterly incorrigible. But even if the following cannot totally solve the malingering problem, the basic gist strikes me as quite promising, and at the very least I think that pondering this sort of approach out in the open could be productive and eventually lead to whatever the best solution(s) may be. Anyway, here’s what I’m thinking:

  1. Insurance companies should not be allowed to make any of their own claim payment decisions. That is just asking for trouble. Their job is just to design and sell policies, collect claims, etc.
  2. The decision to pay or deny claims should be made by a neutral party, whose job it is to collect the relevant information and make the decision.
  3. Doctors should have the right to prescribe a medical leave, and given such a prescription, the initial, default decision should be to pay the fucking claim. This is totally consistent with the core principle of our Justice system to assume innocence and demand proof of guilt. It is also consistent with the way FMLA claims are processed, where’s it is primarily the doctor who decides.
  4. The doctors should be held accountable for their decisions with random audits, and if the auditors discover evidence of fraud on the part of either the doctor or the patient, that evidence should be brought to the appropriate investigative authorities.
  5. If insurance companies and investors don’t like the profits they can make under this system, they should go into a different line of business. This will motivate the establishment and development of suitable non-profit alternatives.

Aside from putting a lot more power in the hands of doctors to provide the kind of care their patients need, it will also reduce the risk of “fox” bias in the decisions regarding which “chickens to eat”. It will also lower the risk of accidentally punishing an honestly but “invisibly” disabled person for being punished for the fraudulent behavior of others.

I’m sure that a lot more could be said about the above, but I think that’s a good place to start.

Skepticism as Curiosity

Little boy looking at the ground through a magnifying glass

Image found here.

Although I see myself as a skeptic, I’ve never liked that term. It always has a taint of disparagement, and I always feel like I need to explain it, or make jokes like “Don’t worry, it doesn’t seem to be very contagious.” It often seems to be used like a synonym for disagreeable, or party-pooperstuffy, stodgy, closed-minded, old coot, etc.

For me, skepticism is quite the opposite of all that. To my view the word skepticism is more like a synonym for curiosity — an urge to push past my current knowledge and understanding of the world. As I see it, to be a skeptic is nothing like being closed minded. On the contrary, it means to open one’s mind to alternatives, to free oneself from excessively rigid or mindless ideological over-commitments, and to stubbornly refuse to clutter up one’s own nervous system with a tangle of complicated, contradictory, and unnecessary opinions — what we might call belief pollution.

But that doesn’t mean I have no beliefs or opinions, of course. In fact, I seem to have so many of these that I’ve even created this blog as a place to document them. But my blog isn’t just a place for me to put my opinions. As I experience it, writing is actually a better way to think, and the process of a writing a blog post is also the process of formulating, scrutinizing, testing, reformulating, re-scrutinizing, revising, and in general indulging my often relentless curiosity regarding the way my own mind works.

In this way I am skeptical of even my own beliefs.

 

 

Without Luck, We Cannot Hope To Solve A Problem If We Don’t Understand It

Light bulb

Image found here.

One of my favorite problem-solving or solution-finding heuristics was articulated by Nobel Laureate Herbert A. Simon as follows:

“…solving a problem simply means representing it so as to make its solution transparent.” — Herbert A Simon, The Sciences of the Artificial.

To the extent that understanding a problem and representing it are more or less the same thing, and taking luck into account, I think Simon’s core principle can be reasonably and more colloquially paraphrased as:

 Unless we get lucky, we cannot hope to solve a problem if we don’t understand it.

 

A Fix for Facebook’s Birthday Obsession

Solution_to_those_robotic_FB_BD_wishes

Tomorrow is my annual birthday (yup, Halloween), and as much as I genuinely appreciate the annual barrage of well-meaning Facebook birthday wishes, at the end of the day I find it all to be a lot more trouble than it’s worth. So here is my solution, which I hope you will find useful. It consists of two parts:

  1. First, I don’t wish anybody a happy birthday on Facebook — not even my own wife. That’s right, you understood me correctly, whenever Facebook tells me it’s somebody’s birthday, I deal with it outside of Facebook.
  2. Next, the day before my birthday, I post a feisty but festive message (see above for an example) on my timeline asking folks to not post birthday wishes on my Facebook page.

That’s it! Hope it works for you too!

Thought Furnace

Furnace

Image found here.

The first time somebody remarked to me explicitly about how much thinking I do I was 16 years old. It was a sunny, hot afternoon in June, the Summer before my senior year in high school, and Renée [not her real name] and I had been lounging and chatting in the swimming pool of an inn owned by her parents. I had just achieved completion of the sort of relentless, protracted, exquisitely detailed, unwittingly rude, professorial monologue we aspies are known for when she grinned and said “Wow, you really think a lot!”, followed up a couple of hours later with an unexpected “I love you”. I wasn’t quite sure how to respond to that last surprising announcement, so after a clumsy hug we said goodbye, and then she climbed aboard a bus to New York City and disappeared from my life.

She didn’t die or anything like that, but we never spoke to each other again. And although I’ve always thought it was simply one of those things that happens, it has really just now occurred to me that it may actually have been my own fault we lost touch. I know I never contacted her after that, and since I hadn’t told her that I loved her in return, she may have felt too vulnerable to risk contacting me. That sounds a little tragic, I suppose, but the birth of my twins a few years ago caused all my regrets — about losing Renée and in fact anything at all — to evaporate, at least all those that had accumulated prior to their birth; because had any of it been different (due to the Lorenz butterfly effect of chaos theory), they almost certainly would never have been born. Yes, of course, perhaps I would have had different children, but I’m in love with the particular children that I have. So if losing Renée played even an infinitesimally tiny role in bringing them into this world, then I’m quite at peace with that. In any case, over the years I have thought now and again about Renée; and I recently learned from a mutual Facebook friend that she’s still alive and well out in California somewhere, in fact running a world-famous annual art festival. That makes me feel happy for her.

Too Much Thinking

Over the decades, one consistent reminder of her has been the occurrence about once per year of roughly the same remark, made by some new person in my life who has finally gotten to know me well enough to bear witness to the fact. Although it’s usually stated more bluntly — something like, “bro, you think too much!”

And it’s true, at least sometimes. On occasion I can get so deeply absorbed in thinking that I can hardly do anything else, or at least, anything else that requires thinking. When that happens it’s like I lose total control over my own mind. I use different images to convey what this is like for me.

Sometimes I say it’s like my mind is a pit-bull, in that once it gets its jaws clamped around some topic, idea, or problem it’s nearly impossible to pry those jaws apart. Sometimes I say it’s like my mind is a locomotive, or maybe a horse that has busted out of the barn and is racing across a field. I think my favorite image is that of a furnace — ablaze between my ears, which blasts and roars and broils over whatever idea, topic or problem my brain has selected for cooking that day.

Generally speaking, if I’m not sleeping then it’s a good bet that I’m thinking more or less intensely like this about something, and in the rare moments where I’m not, even then I’m obsessively shopping around for my next obsession.

Losing My Marbles

Every so often my mind’s pit-bull latches its jaws onto a topic with unusual ferocity, in which case I describe it as “losing my marbles”, and I believe these more extreme manifestations qualify as autistic meltdown, although my own meltdowns differ somewhat from the traditional version in a couple of ways. For one thing, it seems I retain full executive control over most of my own observable behavior — which is to say there is really almost no particular observable behavior that I feel irresistibly compelled to do (rock, scream, bang my head against a wall, pee on the floor, etc.). I think the only exception to that rule is the actual thinking itself, which really feels to me like it’s just happening automatically, and even though I can force myself for brief moments to think about something else, the moment I relax my guard the horse is off and running again across the exact same field and in the exact same direction (so to speak).

Also, autistic meltdown is typically described as an intense response to feeling overwhelmed by sensory stimulation (sights, sounds, etc.), but for me it’s different. Although I do recognize in myself a couple of mildly anomalous patterns of sensory experience, those never provoke meltdown.  For me meltdown is an intense response to feeling overwhelmed by a problematic situation. What happens is that first I detect that I’m trapped in some no-win predicament — “between a rock and a hard place”, as they say, with no path to success, “doomed to fail”, etc. — and then what happens is that “my thought-furnace ignites” and I begin to think, and to think a lot, as Renée put it that day in the pool, although she had only ever observed a relatively mild form of it.

Solution Cooker

And what is all this thinking about? Well, generally speaking it can be about whatever happens to engage my sense of curiosity at that time, but when it comes to a true meltdown event, the topic at hand is quite specific: I am trying to figure out how to rescue myself from the predicament that provoked the meltdown. For me, autistic meltdown is fiercely goal-directed. When my thought-furnace cooks, it is cooking up solutions.

However constructive it’s hoping to be, when I look back at the flotsam and jetsam that pollutes the wake of my life’s course, I’m forced to admit that all of this thinking can be quite destructive.  For example, in recent years such intense thinking has caused me to forget to give my daughter the anti-seizure medication she needs to take twice a day. I’ve also forgotten about running bathwater, only to be reminded of it 45 minutes later, after 100 gallons or so had already spilled out into the hallway. And numerous times I’ve had to quit jobs or even been fired because I couldn’t stop myself from thinking about something long enough to get any work done.

But even my everyday, non-meltdown, baseline autistically obsessive thinking can be destructive, at least over time — something like the way a river running over rock can eventually carve out a canyon — because unless the people in my life wish to talk about whatever it is my brain happens to be focused on at that particular moment, then I find it quite difficult to concentrate on whatever he or she imagines we are discussing. Pretty much everybody who relies in some way on my being able to shift my attention to their needs has to struggle with the fact that I’m usually lost in thought, living in my own little autistic la-la land, and that can take it’s toll on any relationship.

I think sooner or later Renée was going to realize this about me, and I probably would have lost her one way or another. And actually, now that I think of it, maybe that’s what she was trying to tell me in the swimming pool that day, and why I never heard back from her.

 

#MeToo Madness

So, first of all, yeah, me too.

But in my opinion this #MeToo campaign is totally unscientific, which means that whatever we think we’re learning from it is most likely wrong, if not trivial.

It also means there’s an excellent chance it will all backfire and lead to more sexual abuse, not less, so there’s that too.

On the upside, it certainly took the heat off of Trump for a few days, allowing him to relax and focus on his golf game.

And of course, all of our good intentions no doubt fixed a few potholes on the road to Hell.