I am the liberal elite.

Well. These last 24 hours have been a real shitshow, huh?

I’ve had a lot of discussions today and inevitably I end up making the same confession: I am the liberal elite. I’m exactly what Trump has railed against. I’m the person who disgusts the Republican party (well… I’m one of the many people who disgust them, let’s be real here).

My undergraduate degree is from one of the most liberal colleges in America. At one point while I was a student, Fox News went through a period of referring to us as “The University of Havana North.” (Sidebar: Oh my god, YouTube, I’m so glad you exist and that you’ve retained this clip for a decade. Thank you, interwebs. My grandmother called me after this aired, shrieking “Do you know what Bill says is happening at your school?!” Sure do, Gram. We’re loving it. We had t-shirts made and everything.) In my initial draft of this post, I claimed that we were the MOST liberal, but according to this Washington Post piece, we’re merely in the top ten, with 30 registered Democrat professors to every 1 Republican; Brown is kicking our ass at 60:1. Slipped a bit in the ten years since I graduated, I guess.

In 2004, when George W. Bush was reelected, I was safely on campus. I was surrounded by peers, by like-minded individuals who were all equally distressed over the results of the election. For context, Columbia has always scheduled fall break to coincide with election weekend, and many people used that break to travel by bus to New Hampshire or Pennsylvania to campaign in swing states. It was in the early days of social media – we still called it “The Facebook” and the newsfeed was over a year away from its first primitive rollout – so we relied on cable news and T9 texting as we huddled around TVs in dorm lounges. I remember that I had a show opening the following week and valiantly tried to motivate my cast to rehearse through the early poll closures, but that quickly got abandoned. I have crystal clear memories of sitting with my cast that night in John Jay lounge. People cried. Some got angry. We all tried to process it however we could, but we did so from the safe cocoon of our campus in Morningside Heights, where everyone was feeling the same disappointment and frustration. We were just a bunch of sad lions in a sea of blue.

For the past 24 hours, I have found myself liking, commenting, and reacting to posts from college peers, many of whom I have not seen or spoken to in years. I feel a kinship with them because of our common history. In many ways, my Facebook newsfeed has felt like a return to that safe space on 116th Street. I have heard others talking about the hatred and vitriol they’re seeing, but here in my universe, I’m seeing intelligent, thoughtful, insightful reflections on what we’re all going through. People are scared, yes. They’re angry. They’re hurt. People have been expressing their feelings so eloquently, but I’m not seeing hatred. I’m not seeing ignorance. I’m not seeing retribution. Here in our virtual bubble, we are trying to shine a light on what’s happening in America today, and we’re trying to make sense of it and figure out how we proceed from here.

People want to pick up and move forward, but not in a spirit of resignation. They’re embracing the belief that every single one of us can make a stand in any number of ways. We have to live with the results of the election, but we don’t have to go quietly. These friends know that money speaks, so they’re sharing well-vetted organizations who would benefit from donations and who will carry forward our ideals in the face of a conservative onslaught. HRC the candidate may have lost, but HRC the organization – the Human Rights Coalition – could use your support. Women may not have control of the White House, but for now we still have control of our bodies and our wallets, so let’s support Planned Parenthood while it’s still available to us. My fellow members of the Liberal Elite have suggested ways to volunteer and get involved, to donate our time and to make an impact. They’re looking ahead to 2018, to strategy for the midterms, and bringing peers together to mobilize.

So yes, I feel especially proud today to declare myself part of the liberal elite. I recognize my privilege. I am a straight, white, middle class woman with degrees from two Ivy League universities who is gainfully employed with job security and full benefits. I’m going to weather the storm. And if I were the type of person who could look around and say, “Well, I’m good. Carry on,” then we’d be done here.

But I’m not that person. I never have been. I wasn’t raised that way. I was raised to value human life, to show compassion for every person I encounter. Believe it or not, most of my values come from my Christian parents (Catholic dad, Episcopal mom). I come from a family with very strong roots in faith, and while I don’t currently retain any ties to a religious organization, those values don’t go away. That’s right, Trump supporters! You can be liberal AND have faith! I’ve even read the Bible – and I still keep a copy of on my bookshelf! But here’s the thing that sets us apart: my values don’t really look like the conservative Christian values I hear so much about. My values tell me that we are all equal, and that we are all deserving of respect. I was raised to believe that if I have the ability to help someone, then I should help them, whatever form that takes.

And so, through this dumpster fire of an election, this member of the liberal elite is going to use her privilege to speak the fuck up. I will not sit idly by and let people spew hatred and vitriol. I will have the hard conversations. I will call out racism, bigotry, intolerance and hatred when I see it. I will do everything in my power to make this world a safer place for the people who do not share my privilege. Who’s with me?

Is this really the best we can do?

Day three of the #DDdailygratitude challenge and already, I’m inspired to share one of my posts in a longer blog form! Unfortunately, the motivation stems from all of the frustration and anger that ultimately turned into my gratitude for the day.

I’m scheduled for a resting metabolic rate test (also known as an oxygen uptake exam, or an indirect calorimetry test) next Friday, but I need to get pre-authorization because many health plans won’t cover the exam. I have been at a weight plateau since April despite working out regularly and monitoring my diet, and so my doctor wants to do this test so that we can better calibrate my nutrition. Basically, we’re checking to see the rate at which my body burns calories while I’m completely at rest, to make sure that my metabolism is behaving the way it should be. The results of this test will help me to make sure that I’m eating enough to support my energy output in my workouts, while still maintaining an appropriate calorie deficit to get my weight down.

The pre-authorization turned into a circus. Aetna couldn’t authorize the test without the appropriate CPT code. The doctor’s office didn’t know it, and billing had to transfer me four times before they could answer my question. Spoiler alert: the Google result for the code was correct and I could have saved myself a whole lot of hold time. When I called Aetna a second time, they gave me a benefit policy code to look up, but basically told me “We won’t cover this, unless your doctor says it’s medically necessary.” However, they couldn’t tell me what “medically necessary” means. Last I checked, the very act of referring me for the test could be considered my doctor deciding this was medically necessary… but I digress.

I looked up the benefit policy to better understand what was going on, and that turned out to be a very, very bad idea. You can find it here in full, if you’re interested. Basically, I would qualify for weight loss medication, no questions asked, but they won’t cover this test because it’s still considered “experimental” or “investigational” for weight loss. Mind you, the benefit goes on to acknowledge that medication works in conjunction with calorie restriction and exercise, and also that weight loss from medication is usually temporary…. but it has the studies to back it up, so it’s all good in their book. However, this test apparently isn’t considered sound science, so Aetna’s having none of it.

A quick PubMed search turned up an article titled “Indirect Calorimetry: A practical guide for clinicians,” which

“Measurement of energy expenditure is the most accurate method to assess energy needs. Indirect calorimetry remains a gold standard in measuring energy expenditure in the clinical settings… To achieve the highest quality of patient care, we should strive for patient-specific nutrition support regiments. Indirect calorimetry offers a scientifically-based approach to customize a patient’s energy needs and nutrient delivery to maximize the benefits of nutrition therapy.” [Nutr Clin Pract. 2007 Aug;22(4):377-88]

Meanwhile, a systematic review of energy expenditure studies, published in Obesity Reviews in 2012, turned up this endorsement of using indirect calorimetry to get more accurate information for patients:

“Today, many health professionals including dietitians typically use prediction equations because of ease of use, low cost and decreased participant burden, but emerging evidence is reflecting great disparities between predicted and measured energy values… The level of inaccuracies of prediction equations that are commonly used in clinical practice may potentially impact patient outcomes… As health professionals seek to improve their quality of service and provide appropriate nutrition care to prevent clinical morbidity and mortality, measuring energy requirements through IC [indirect calorimetry] may be the direction of the future.” [Obesity Reviews, 13: 753–765. doi:10.1111/j.1467-789X.2012.01000.x]

(In case you’re wondering, this is what happens when you’re someone who is naturally curious, who enjoys learning about interesting topics, who believes in doing the research on her own health, AND who also happens to work in academic publishing. Doctors either love me or hate me. There’s no in between.)

So, basically, I was in a really bad place when I called my doctor’s office for the third time today. I had a phone number from Aetna, and I needed my physician to call and make the case for medical necessity, so I’m not on the hook for $200. And that’s when today’s moment of gratitude stepped in.

daily gratitude day 3.jpg

The woman I spoke to this third and final time was so kind. She took down all of my information, and she reassured me when she let me know that she processes requests like this all the time. My doctor is at a conference through Monday, so she told me she’d share the message then, and she also promised to follow up with me herself Monday afternoon, even if she didn’t yet have an answer, just so I’d know where things stood at that point. She listened. She cared. It was so unlike every other conversation I had experienced so far today, and I was so grateful to her, I burst into tears. (What can I say? It’s been a long week.)

It’s a sad commentary on the state of our health care in this country that I had to jump through so many hoops today, and an even sadder commentary on human behavior in general that I felt so surprised and relieved to finally experience a little kindness.

We’ll see how this all plays out. I’m probably going to move forward with the test either way, just to know exactly where my metabolism stands, but I’d feel a hell of a lot better if it didn’t set me back $200. More to come!

In the meantime, it’s not too late to jump on this Daily Gratitude plan. Thanks to @thedaydesigner for pulling this together, and for making awesome planners – check out their website here. I love that they offer free printables so you can see how the layout works for you before ordering the full planner. I’ve been using their Daily Planner printable for almost a month and I love it, and I can’t wait to order my 2017 Planner!

Create your own joy

The world happens around us, every day. It happens around us and sometimes, it happens to us. There are any number of things that are totally outside of our control, and sometimes, those things are pretty terrible.

You know what’s totally within your control? The ability to create your own joy. You can give yourself permission to seek out joy. That’s allowed. It should even be encouraged.

picmonkey-collageI spent the weekend on the Cape, borrowing my cousins’ incredible home for a much-needed break. I took Friday and Monday as work-from-home days so that I could have some time to myself, to get some much-needed mental clarity and peace. For the weekend itself, friends came up from New York and drove down from Boston to spend Halloween in Provincetown. We got to be very stereotypical New England tourists for the day on Saturday, and when night fell, we dressed up in costumes, broke out the booze, and celebrated the holiday in truly ridiculous fashion. It was something of a social experiment, throwing together two separate sets of friends who had never met, but it turned out great and the weekend was a success.

Leaving the Cape yesterday for the long drive back to Boston, I found myself reflecting on how grateful I felt for the past few days – grateful to the family who let me use the house, to the friends who made the journey to the Cape, to the job that gave me the flexibility to work remotely, to the universe for giving us amazing weather. The key, though, is that I didn’t sit around and wait for these things to fall into my lap. I asked whether the house would be free at any point this fall; I asked my friends if they wanted to spend a weekend away. I created space for this weekend to happen.

If I don’t make a conscious effort to create space for joy, then yes, it’s really easy to let everything else overwhelm me. That’s the thing about stress, about exhaustion, about bad news and difficult experiences: they creep, they spread, they entangle you. You can let it happen, or you can do something about it. I’m choosing the latter; I’m choosing to invite in the light.

To that end, I’ve decided to participate in a Daily Gratitude challenge for the month of November. I’ve been using (and loving!) the Day Designer planner printables, and the company sent an email out this morning with a link to their free daily gratitude journal printable. They shared a blog about how to make gratitude a daily habit, and they’re encouraging followers to share their daily reflections on social media with the tag #DDdailygratitude.

joy-gratitude-quoteI’ll be sharing my daily gratitude posts on Instagram at @beingyourchange, and where appropriate I may expand them into a longer post. I’m hoping this will help to keep all of the dark-and-nasties at bay, while keeping me focused on the sources of joy and light in my life.