Clarissa's Blog

I was that proverbial kid who always stood alone in a corner during recess and it still hurts 35 years later, so when Klara started kindergarten I was worried if she would make friends.

“What do you do at recess?” I asked in a trembling voice on the third day of class.

“We play rau-raus [kittens],” she said. “One kid is a pink rau-rau, another is a striped rau-rau, the third is a fluffy rau-rau, etc.”

“And you? What kind of rau-rau are you?”

“Oh, Mommy, I’m not a rau-rau.”

At this point, of course, my heart sank. My poor kid! She didn’t get chosen to be a rau-rau! Every one of my childhood traumas inflamed at once.

“Then what are you, honey?” I asked in a small voice.

“I’m the owner of rau-raus. I choose who will be my rau-rau today and tell them what to do.”

“And they agree to it?” I asked, stunned.

“Of course. Everybody wants to be my rau-rau.”

“And who invented this game?”

“I did, of course.”

I was the kind of kid who dreamt of being picked to be somebody’s rau-rau just once (and of course nobody ever picked me). It didn’t even occur to me to dream of being the lucky bastard who gets to pick rau-raus.

My whole childhood I wondered where the girls who get to pick who’s a rau-rau come from.

Now I know.

Here is one of the many reasons why the line about how Oxycodone is not addictive because it has a time-release mechanism that prevents the user from experiencing a high.

Oxy users aren’t looking for a high. A lack of one is reassuring to them, making them miss the signs of addiction. They know that drug addicts experience euphoria, so if there’s no euphoria, there’s no addiction. But that’s a trap.

What Oxy gives you isn’t euphoria or intense physical pleasure. It makes you numb. It makes you not care at all. I took it once without knowing what it was and, wow, it freaked me out completely. Because all of a sudden, I just didn’t give a fuck. My baby started crying and I felt nothing. I didn’t feel good. I just felt nothing. I can easily imagine a situation where that feeling is more precious than any high.

When it started happening to me, I had the mental acuity to understand that it wasn’t OK. I asked N to stay with the baby while I locked myself in the basement, hoping that the vile shit would leave my system soon enough. But again, I can see how for many people this effect would not even be recognizable as drug-induced. For people experiencing anxiety, this drug would be a godsend.

In 1986, Russell Portenoy and Kathy Foley published a study of 38 cancer patients who used opiate painkillers. Only two grew addicted, and they had previous histories of drug abuse. The rest remained addiction-free. To support this study, Foley and Portenoy cited, in a footnote, a 1980 letter to the editor of NEJM by one Dr. Hershel Jick titled “Addiction Rare in Patients Treated with Narcotics.” Portenoy and Foley never meant their study to be taken as an endorsement of prescribing opioids for any pain to any patient. They believed – and this is currently considered not controversial – that some brains are more addiction-prone than others. While some people can smoke 1-2 cigarettes a week for years and never get addicted, others get hooked and have to suck down two packs a day or they have no peace. Only after spending a serious amount of time with a patient, argued Portenoy, can a doctor know if there’s a likelihood of addiction. When you are working over a period of time with a cancer patient, this is feasible. But without asking these questions and studying the whole history of the patient, you can’t decide that opioids will not be addictive.

Of course, the pharma companies that wanted to make money disregarded these nuances and decided to use Portenoy’s, Foley’s and even Jick’s statements – without their knowledge or endorsement – to make an argument that opioid painkillers were not addictive, period. Of course, it was a complete misreading of what Jick actually said in his letter. One single number was extracted, ripped out of all context, and used carelessly and irresponsibly. Plus, it wasn’t even an actual study. It was just a letter to an editor cited in a footnote! But it became the central part of every Purdue Pharma pitch for prescribing more opioids. Most people who cited it thought it was a study, an actual scientific paper. In scientific papers, actual scientists referred to it as “an extensive study” and “a landmark report.” But it was not. It was in the “somebody said something to somebody in some context” kind of thing. Jick himself is adamant that he never said or intended to say that opioids are not addictive when prescribed as outpatient medication for chronic pain. He’s not happy at all about being misrepresented and used for nefarious purposes like he was.

If you are not shocked at this point, then you must be very jaded. And yes, we’ve seen all the same tactics in the COVID era.

At first, Portenoy and Foley thought they were doing important work, standing up for patients’ rights. But then gradually a consensus started to form (egged on by regulatory institutions, politicians and their pharma donors) that pain was being severely undertreated, unnoticed and unaddressed in America. Curiously, this wasn’t happening anywhere else on the planet, even though prohibitions on prescribing opioids casually and for daily little infirmities exist everywhere. This was, by the way, the time when this utterly ludicrous practice was instituted in the US healthcare of asking patients to rate their pain at a scale of 1 to 10. It’s moronic because, of course, a self-involved drama queen will screech “eleven!” whenever she has a minor scratch while a more stoic individual will say 2, even when there is real pain. What people SAY they feel means exactly that, it’s what they say. As a gauge of reality, feeling is not a great indicator. “I feel that I’m a man” is not a description of existing reality, no matter how much I might want it to be.

Between 1998 and 2005, over 900 pain clinics that studied non-medicalized treatment of pain went out of existence. Their patients were now on opioids. Insurance companies reimbursed for pills because “pain” was no considered a vital sign (no matter how subjective it is). They were not reimbursing any non-drug-based therapies. It became generally accepted in the medical profession that if a patient kept coming back for larger doses of painkillers, he wasn’t addicted. He was simply not getting prescribed enough.

OxyContin came out in 1996. The FDA allowed Purdue Pharma to claim that Oxy was less addictive because its timed-release formula supposedly allowed for a delay in absorbing the drug. This “time-release formula” became the centerpiece of the company’s aggressive marketing strategy. There’s a time-release mechanism, so you don’t get a rapid high, so it’s not as addictive. Should I list the problems with this claim or are they easy to figure out?

Purdue aggressively targeted doctors to convince, bribe and bully them to prescribe Oxy for moderate and minor pain. It also put a cute warning sticker on the packaging of Oxy, telling patients that crushing the pills will make them more potent. Not to give anybody any ideas that might get them hooked, eh? Just a fair warning from the goodness of their hearts.

Purdue sales manager for West Virginia, William Gergely, described in South Florida Sun Sentinel the sales pitch as follows: “They told us to say things like it is ‘virtually’ non-addicting. That’s what we were instructed to do. It’s not right, but that’s what they told us to say . . . You’d tell the doctor there is a study, but you wouldn’t show it to him.”

The “study” was, of course, the same old footnote based on a letter that said something completely different.

OK, this is already the size of a master’s thesis. I can go on if people want, but do they? There are other places where this story was told a lot better than I’m telling it.

I’m now going to read several mystery novels and fluff like that because after The Siege of Krishnapur and Go Tell It on the Mountain in close succession I’m experiencing a profoundness overload.

I thought I was deep but these writers are so much deeper. I feel like beelining it to Sephora to reconnect with my vapid consumer side.

This is a classic of American literature that I read for my book club. Baldwin is extremely talented, and this is a great, great novel. I don’t think it’s possible fully to appreciate it or even understand it if you aren’t a very religious Christian. This is African American literature of the early 1950s, and the novel is set in the 1930s, so of course, religion is everything.

I grew up in an atheist country, and I feel a huge, gaping hole inside myself and my culture in the place where the characters in Baldwin’s novel have religion. It’s something so central to American culture, and eradicating it isn’t going to lead to a nice place. The characters in the novel suffer but they live. The only character who has no faith and despises Christianity kills himself because there’s nothing for him in the world.

The characters in the novel are Pentecostal, which is obviously extremely different – much more exuberant and outwardly oriented – than Orthodox Christianity. I’m not into it but it’s described so beautifully in the book that it’s impossible not to feel attracted to it.

There’s strong evidence that on the eve of his death in 1953 Stalin was plotting a new war. He knew it wasn’t a good time. The country was still in ruins after WWII. People were hungry. A massive new purge was going to be needed to stamp out the feelings of freedom in the soldiers who had returned from the war. Nationalism in the republics had been allowed to manifest to motivate people to fight the Germans. It was going to be necessary to put the brakes on all that. Stalin also knew that Americans were richer, happier, much better fed, and farther ahead on the nukes. Fighting them was. . . not the best idea ever.

But still he prepared. Because there was a much more important factor than all of this. It was his age.

Stalin was getting old. He knew this was his very last chance to fulfill the dream of a lifetime, his most important goal. Even a bloody dictator is a person. He has dreams and he doesn’t want to face death knowing himself to be a loser.

It was easy to guess what he was planning. His closest collaborators figured it out and were terrified. Not because they cared about the survival of millions (they didn’t) but because they cared about their own. They knew that Stalin liked to precede a war with a massive purge of his inner circle, and they didn’t want to die. I don’t know if they conspired to kill him but what’s undeniable is that when Stalin had a stroke – whether it was natural or drug-induced – they left him lying on the floor for hours and didn’t get him medical help. For a 70-year-old stroke victim, this is a death sentence. Couldn’t have happened to a more deserving fellow, of course.

So when people ask if Putin is really going to start a war, they have to remember that he’s getting on in years. He’s no Stalin but he’s a person without a profound spiritual life, let’s put it that way. This is somebody who has no lower bulb in his hourglass (I had a great post about the hourglass a while ago.) He can’t approach old age philosophically any more than a cricket can.

Recently, Putin started making references in his speeches to death and afterlife. So mortality is on his mind. “If I have to die, then all of you should, too” is not an impossible conclusion to reach. There have been cult leaders who have done just that. It’s a miracle that Stalin died before getting there.

I’d like to say, ha ha, it’s all empty sabre-rattling but. . . I just don’t know. Putin might freak out and go nutso boom-boom in his dotage. Let’s hope the bastard didn’t get a bad diagnosis recently and that his Viagra didn’t misfire in one of his famous orgies.

After Putin croaks, the problem doesn’t disappear. You still have 140 million people armed to the teeth with nukes in a mega-meltdown. Putin is a feature, not a bug. Just like Stalin. If you know what a narcissistic injury is, this is a whole culture with a gigantic narcissistic injury. Rage is inherent to the nature of the injury.

What is it with suggesting work meetings for evenings and weekends? It’s particularly annoying that it’s an association of feminist scholars that’s doing it. We are supposed to be aware of the existence of motherhood. What am I supposed to do with my kid on a weekend or in the evening? Put her in my pocket? Even if I could find a way to get rid of her, I don’t want to. My time outside of work hours belongs to her, and that’s the way I want it.

I am yet to meet a male colleague who’d try to get me to meet on a Saturday evening. It simply never occurs. Also, Zoom is teaching people bad behaviors. They think that if you can meet on Zoom, then everybody should be available outside of work hours. Why am I supposed to work outside of M-F 8 to 4? How is this normal and why are we doing this to ourselves?

My friend left her husband because he was abusive. He beat her and raped her for years. Then, he started getting abusive towards their little girl in weird, sexualized ways. (Bit her on the neck, leaving teeth marks, for example).

So my friend left him. The ex continued being abusive. Not physically because she wasn’t there any more but he stalked, threatened, appeared out of nowhere to make threats. He once appeared at my parents’ house to threaten me. A huge burly guy. (No, I didn’t call the police because Canadian police were always extremely passive and uninterested until COVID. Now they have found their calling.)

The last time I saw him was at my friend’s funeral. She died of cancer. The ex got aggressive with me while we stood over her body. I’m sure he has some story in his head about how he’s a victim in this situation and was forced to do what he did. I’m also sure he’ll be abusing somebody until he’s in a coffin.

At least, I never heard anybody justify him. Yeah, but he felt threatened, yeah, but it’s his upbringing, yeah, but he was provoked. Thank goodness, we’ve evolved past that.

With Russia, though, we haven’t. Since 1946 globally and since forever locally, we are sitting and wondering, will they start a war? Will they get peeved over something? Have we done something to provoke? Has someone else done something to provoke? Are they feeling threatened? Upset? Maybe the time has come to stop doing it, is what I’m trying to say. There’s a great relief attendant on realizing that nobody is causing the abuse except the actual abuser.