Tag Archives: death

ETERNITY

by D Gregory Smith

Hate takes us down.
Hate takes us down all the time.
But if your hate takes me down,
it’s a very slippery slope.

If your hate takes me down
the people who see it
will be offended,
they will be motivated,
they will be ready-
for, that hate which takes me down
will not
take down the people
who love me.
The hate that takes me down
will raise me up higher
than you could ever believe.

And that’s the paradox.
You may hate me.
You may loathe me.
But when you take me down
and make me part
of your hate
it becomes something bigger
than just you and me.

It makes me immortal.

You and your hateful life will die.

In the end, hate gives you what you hate.
It is useless.

But not so Immortality.
Eternity is freedom from fear,
freedom from hate-
knowing that I am always safe-
even should I die.
~DGS

HIV Patients Lose More Years To Smoking Than HIV

by D Gregory Smith

Bad news for people with HIV who smoke: you’re losing twice as many years of your life by continuing your habit. And that’s not all. You’re also going to die at three times the rate of non-smokers with HIV….

Smoking

Smoking (Photo credit: Wikipedia)

From Science Daily:

Among HIV patients receiving well-organized care with free access to antiretroviral therapy, those who smoke lose more years of life to smoking than to HIV, according to a Danish study published in Clinical Infectious Diseases and available online. The findings highlight the importance of smoking cessation efforts in the long-term, integrated care of patients infected with HIV.

Marie Helleberg, MD, of Copenhagen University Hospital and colleagues estimated the effect of smoking on mortality, risk of death, and life expectancy, and the number of life years lost to smoking compared to years lost to HIV among nearly 3,000 HIV-infected patients treated in Denmark from 1995 to 2010. They also compared mortality associated with smoking between HIV patients and the country’s background population. Where HIV care is integrated and antiretroviral therapy is available at no cost, “more than 60 percent of deaths among HIV patients are associated with smoking,” rather than HIV, Dr. Helleberg said.

Estimated life expectancy differed significantly based on smoking status. A 35-year-old HIV patient who currently smokes had a life expectancy of 62.6 years, compared to 78.4 years for a nonsmoker infected with HIV. The loss of years of life associated with smoking was twice as high as that associated with HIV among HIV-infected patients. In addition, researchers found the excess mortality of HIV-infected smokers to be three times higher than that of individuals not infected with HIV.

Quitting smoking-along with increased exercise- are the two things people with HIV can do to extend their lives and overall health. I quit over three years ago. And yeah, it’s not easy. But it’s worth it.

So if you need a New Year’s resolution, it’s staring you right in the face. And if you need help, it’s readily available here.

Read the full article at Science Daily 

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Medicaid Expansion Likely To Lower Deaths

by D Gregory Smith

Medicaid expansion under the Affordable Care Act is contentious- mostly because Republicans don’t want to give President Obama any credit- for anything. But if this study, reported today by the New York Times, is any indication, not going forward could be deadly.

Senate Passes Insurance Industry Aid Bill

Senate Passes Insurance Industry Aid Bill (Photo credit: Mike Licht, NotionsCapital.com)

Into the maelstrom of debate over whether Medicaid should cover more people comes a new study by Harvard researchers who found that when states expanded their Medicaid programs and gave more poor people health insurance, fewer people died.

The study, published online Wednesday in The New England Journal of Medicine, comes as states are deciding whether to expand Medicaid by 2014 under the Affordable Care Act, the Obama administration’s health care law. The Supreme Court ruling on the law last month effectively gave states the option of accepting or rejecting an expansion of Medicaid that had been expected to add 17 million people to the program’s rolls.

Seems fairly reasonable. So why would anyone reject the expansion?

Medicaid expansions are controversial, not just because they cost states money, but also because some critics, primarily conservatives, contend the program does not improve the health of recipients and may even be associated with worse health. Attempts to research that issue have encountered the vexing problem of how to compare people who sign up for Medicaid with those who are eligible but remain uninsured. People who choose to enroll may be sicker, or they may be healthier and simply be more motivated to see doctors.

The New England Journal study reflects a recent effort by researchers to get around that problem and allow policy makers to make “evidence-based decisions,” said Katherine Baicker, an investigator on the study who served on former President George W. Bush’s Council of Economic Advisers.

“I think it’s a very significant study in part because of the paucity of studies that have really looked at health outcomes of insurance coverage,” said Karen Davis, the president of the Commonwealth Fund, a nonpartisan research foundation. “Actual mortality studies are few and far between. This is a well-done study: timely, adds to the evidence base, and certainly should raise concern about the failure to expand Medicaid coverage to people most at risk of not getting the care that they need.”

A Republican-appointed official calling this “evidence based”- will it be enough? Probably not. But the evidence is still there:

“So often you hear, ‘Oh well, poor people just shoot each other, and that’s why they have higher mortality rates,’ ” said Diane Rowland, executive vice president of the Kaiser Family Foundation, a nonprofit group. “In the midst of many claims about what Medicaid does and doesn’t do, it actually shows that it cannot only be beneficial for health, but in preventing some of the premature deaths of the uninsured.”

Janet M. Currie, director of the Center for Health and Well-Being at Princeton, said the new study, combined with the Oregon research, should help transform the Medicaid debate into one about dollars, rather than over whether covering poor people improves health.

“This says, well there is benefit to giving people insurance,” Dr. Currie said. “Maybe you don’t want to pay the cost, but you can’t say there’s no benefit.”

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MSU-Northern to Present ‘The Laramie Project’

by D Gregory Smith

Montana Actors’ Theatre will present The Laramie Project in Havre, MT on October 21-22, 27-29, and November 3-5.

The Laramie Project play originated from a series of interviews conducted by members of the Tectonic Theatre Project following the tragedy of Matthew Shepard which transpired on the outskirts of Laramie, Wyoming. The creators of the play aimed to shed some light on specific faults in society regarding homophobia and hate crimes. If you’re curious about this play, come watch The Laramie Project on one of the previously mentioned dates. Please be aware: the play does contain adult themes and may not be suitable for children or young teens.

The play will be performed in the MSU-Northern/MAT Theatre. It will begin at 8 PM nightly. The doors and backstage lounge will open at 7:30 PM. Adults can view the show for $15. Students and seniors will be admitted for $10 while MSU-Northern students will be admitted free of charge with current student I.D.

Local news story here.

INSPIRING

by D Gregory Smith

The death of Amy Winehouse has pulled a lot of press. But the reaction that touched me deeply was from someone unexpected- Russell Brand:

When you love someone who suffers from the disease of addiction you await the phone call. There will be a phone call. The sincere hope is that the call will be from the addict themselves, telling you they’ve had enough, that they’re ready to stop, ready to try something new. Of course though, you fear the other call, the sad nocturnal chime from a friend or relative telling you it’s too late, she’s gone.

His amazing essay (which should be required reading for anyone even remotely associated with the reality of addiction) is here.

At the very least, please read the last paragraph. It’s powerful.

What To Feel Upon The Murder Of A Murderer?

by D Gregory Smith

Like so many of you, I watched in horrified fascination as the Twin Towers were maimed and finally toppled, killing and injuring thousands of people and terrifying a nation. I also watched our president, almost ten years later, report that the man responsible for that action had been shot and killed in a raid on a compound outside of Islamabad, Pakistan. The President’s demeanor was appropriately somber and yet had hints of the triumphant. So many cliche`s come to mind:

Serves ‘im right.

An eye for an eye….
You reap what you sow.
Justice is done.
Mission accomplished.
He got what he deserved.
Hooray, Hooray it’s the First of May…etc.

I’m conflicted. As I watched the people gathering in front of the White House last night, I understood the relief they exhibited. I realized I didn’t want to understand the celebration.

On the one hand, the man was a terrorist, a murderer and a complete wacko. On the other hand, he was a human being- with all the dignity and flaws imbued thereof, and completely worth saving. Did he love? Did he show any kindness to another person? Probably.

Could he have repented for his actions? Would he?
We’ll never know.

This is not to impugn the sense of justice felt here- this man was directly responsible for the murder of thousands of fellow human beings. But if I rejoice in his death, if I celebrate it, am I giving up on the goodness of humanity I so profoundly believe in? Am I substituting revenge for justice? Is patriotism predicated on the murder of enemies? Is this the easy way out? Have I become the terrorist who has lost sight of the humanity of the people I kill?

Probably unpopular things to ask, but still, these questions haunt me.

Do they haunt anyone else?

Meth To The Madness

by D Gregory Smith

Edge New England has a great 2-part article on crystal meth and the gay community, highlighting work by Project Neon in Seattle and my friend Arnold Martin. I wish the author had spent more time talking about prevention, but on the whole, very informative.

 

Warning: pictures in the story may be triggers for former meth users.

They didn’t back-link the parts, so Part 1 is here, and Part 2 is here.

My Homily, World AIDS Day, 2010

by D Gregory Smith

(This is the text of the homily I gave at the interfaith World AIDS Day service at Grace United Methodist Church in Billings last night. The scripture readings were from Isaiah 43 and psalm 22)

I remember when World AIDS Day was different than it is now.

I remember when we gathered in the darkness with candles and listened to words and music that were designed to comfort- but we all knew that comfort was a luxury we couldn’t afford. We were terrified.

We remembered the dead. We hugged the living, and the very sick. We held the hands of people who couldn’t tell their own families that they had lost or were going to lose the most important person in their life. We cried.

Our grief and fear were the engines that drove us back then. We were sick of burying our friends. We were tired of trying to defend the ways we struggled to love. We were working hard to be responsible- to make safe sex cool. We fought to get programs and found organizations that would take care of the often very simple needs that the government couldn’t- or wouldn’t. And the fear- some of you can remember can’t you? It was an entity that lived in our midst, a specter of doom that we couldn’t shake.

Because the work seemed to be so overwhelming and the fear, shame and hopelessness we fought was exhausting, we needed our sorrowful mothers, our indignant sisters and our caring brothers, fathers and friends to carry us.  And carry us they did- often at great risk to their personal livelihoods and professional credibility.

There are people still doing this work because they remember the pain, remember the fear, and remember the exhaustion echoed in the psalm we heard tonight:

“My God, my God, why have you forsaken me?”

We remember. Especially tonight, we remember. We remember that we never want to see it again.

That is the purpose of memory. The pain of those memories has become our strength.

This is our Seder, I daresay our Holocaust.

Only, in this we are not bound together by race, by religion, by nation or even by faith. I think we are bound together by our naked humanity, our compassion, our memory and our hope.

Isaiah gives voice to the hope we share- and not in grand or exalted words, in very simple words actually.

“Do not fear. I have called you by name. You are precious in my sight.  I love you.”

Much like Isaiah, John Donne’s meditations on life, death and salvation in what have come to be known as the Holy Sonnets, show the majesty and humility in the ordinary. And like Isaiah, he works to remind us of a perspective that relies on the struggle of faith.

His familiar lines echo in our world today, where we can instantly see war and famine and suffering- even from opposite places on the globe- places that we have no context for, places that we can only imagine, spurred by the small glimpse on our television or computer screens. The question he asks more than 400 years ago, is still relevant today- Why do we fear?

Death, be not proud, though some have called thee

Mighty and dreadful, for thou are not so;

For those whom thou think’st thou dost overthrow

Die not, poor Death, nor yet canst thou kill me.

From rest and sleep, which but thy pictures be,

Much pleasure; then from thee much more must flow,

And soonest our best men with thee do go,

Rest of their bones, and soul’s delivery.

Thou’art slave to fate, chance, kings, and desperate men,

And dost with poison, war, and sickness dwell,

And poppy’or charms can make us sleep as well

And better than thy stroke; why swell’st thou then?

One short sleep past, we wake eternally,

And death shall be no more, Death, thou shalt die.

Death has only the power we give it. Now life, that’s the true power here. And the life that lives not only for itself, but also for the greater good. Or, as Donne would say, for the greater God.

This is the movement from the psalmist to Isaiah- despair gives way to the reality of God’s infinite love, protection and mercy.

The psalmist gives voice to the doubts and grief brought on by suffering.

Isaiah gives voice to the promise of love, of life, of joy brought on by seeing life as precious, and seeing our own perception as limited.

In short, these two proclamations give us the breadth of human experience. It would be easy to reflect on the pain, the suffering, the agony and the fear. But I think that what we need right now is to celebrate the spirit of life, of courage, of hope.

I think that’s what brings us here tonight.

We are here because we all believe that coming together lessens our pain, strengthens our resolve and renews our courage. We know that HIV is still infecting Montanans- too many. They are often young, they are Native American, and women. Many are not being tested because of the fear, the stigma and still more fear.

We are here because we need the habit of coming together. We need to be each other’s memory. We need to remember that we are not alone. To remind one another when we forget. To comfort one another when we are sad, to celebrate with one another when there is joy. To gather strength in the face of difficulty. To counter ignorance and fear with the truth and with compassion.

To be here now. To show up.

Woody Allen said “80 percent of success is showing up.” I think he had something there.

As a therapist, sometimes the only thing I can do for someone is to show up. To be there with them. To quietly see them for who they are- a precious person who may be lost in the confusion of pain and fear. And who won’t always be lost. Especially if they have someone to join them on the journey out.

It’s not about solving a problem or fixing anything.

It’s about being present and being awake.

My being present involves something a little different than it used to. HIV lives with me. It is a guest in my house. It is the guest I never openly invited, but nonetheless it sits in my living room, it gets into my refrigerator, hogs the bathroom and often makes me just want to go to bed and stay there.

When I was first told I had this “intruder” in my house, I felt strange. Somewhere between elation and anger. I really can’t be more specific. I do remember thinking I had to slow down. I had to stop and sit down and wrap my head around this.

I had to decide what to do. And for me, this was serious. This was the decision that was going to shape the rest of my life. I had to decide how I was going to treat this uninvited guest.

For me there were only two options: I could either hate it, or I could love it.

If I hated it, I would live my life as an angry man, always disappointed, always suffering, always asking “why me?”, never seeing truth, beauty or kindness. I would be causing most of my own suffering.

If I loved it, I would be free.

It was that simple.

And, really, what was not to love? This is my reality. Truth is love. Hate is suffering. And HIV is my reality. The sooner I make friends with it, the sooner I find out what it has to teach me, the sooner my own salvation becomes obvious. This is simply a virus, doing its job. It is not a moral judgment, or a sign of anything but reality.

It is often simply a microscopic sign of the reality that human beings will do almost anything to be loved.

So, I love my little guest. I accept my reality. To be honest, I’m grateful for him. (I’m not being sexist, it’s just easier to think of the virus as him, somehow) Without this home invader, I think it would have taken me a lot longer to wake up. I would have had a longer, more painful road to deeper awareness. I wouldn’t have so easily seen the love that surrounds me every day. I wouldn’t have been able to put up with all of the harsh judgments that people with HIV have to put up with.

I guess I see my role as very simple: I’m here to teach some people how to love better. If they can overcome their prejudice and love me, the gay, HIV+ former priest- they can love anybody!

And I get to learn how to love better in return.

I think there are three great reasons to gather here tonight: To remember, to be present with one another, and to choose love instead of hate. That’s the lesson.

But you get to decide how to love- that’s the human prerogative in all this. You get to decide how to use your gifts, how to stand up to ignorance, how to offer your heart in the face of anger and hatred.

From the psalmist to Isaiah, to John Donne to you and me here in this place the lesson is being passed down.

“Death, be not proud” because, Death, you are not the greatest thing there is.

The God who loves me is always here, even if, like the psalmist, I have my doubts. God is the one saying “I have called you by name, you are mine. I love you and the world is not big enough to contain that love.”

If we listen closely, we can hear the words of God in our own hearts: “Always choose love, even when it’s hard. I promise you will never regret it.”

Tonight, let’s vow to pay attention to that voice.

Choose love.

Even when it’s hard.

World AIDS Day: A Need To Remember

by D Gregory Smith

Because I think it’s still relevant, I’m reprinting (with a few updates) my column for World AIDS Day from last year. I may just continue to do so as long as it still makes sense….


Remember when World AIDS Day used to be important?

I do.

I remember December 1st as a day when people gathered in terror and grief with candles and tears listening to words that couldn’t begin to touch the pain and anger and sadness.

I remember when it was a time for all kinds of people to gather together, people that probably wouldn’t be in the same room for any other reason. At World AIDS Day services in the early Nineties, I remember seeing queer activists, quietly closeted gay men and women, Episcopal and Catholic priests, Native American leaders, Protestant ministers, atheists, nuns and agnostics. I saw elected officials, Republicans and Democrats, wheelchair-bound elderly, parents, children, nurses, doctors, cowboys, lawyers, accountants, little old ladies and, once, a rodeo clown. All coming together, all looking for comfort and hope and compassion among others who could maybe understand.

We don’t really do that now. And maybe it’s okay that we don’t.
Maybe it’s good that the terror I remember so vividly on the faces of  friends and complete strangers is no longer there. Maybe it’s good that people aren’t dying so fast and so painfully, isolated and afraid. Maybe it’s good that we’re not so traumatized by fear and grief and anger.

Maybe.

Is terror a good thing? Is a painful death beneficial? Is emotional trauma something to be longed for?

No. But I have to say, those scenes of suffering and bravery certainly helped capture the zeitgeist of the Eighties and Nineties. It helped keep AIDS in our collective consciousness. Drama and fear and compassion fueled activism and grassroots movements and the formation of community-based organizations. AIDS was overwhelmingly real. It was dramatic. It went to the Oscars, the Emmys, the Grammys and the Tonys. And it won. More than once.

So I’m not sure if it’s a good thing that HIV isn’t such a drama queen anymore. Not to say that I want people to suffer needlessly. I don’t. I just happen to think we’re not paying attention because it’s no longer hip, sexy, avant-garde and noble to do so. I think that our short attention spans need to be constantly reminded. And, there’s really not a lot of spectacular theatrics to grab our attention today. Well, not compared to the past.

But, trust me, it’s still there. There are some rather dramatic facts to consider:

  • People are still being infected. In the U.S. there are over fifty thousand new diagnoses a year. The CDC estimates that one in five persons with HIV doesn’t know it. That means they may not be protecting their sexual partners out of ignorance. That means more HIV.
  • Gay men, and/or Men who have Sex with Men (MSM) account for more than half of all new infections each year, and MSM is the only risk group in the country whose infections are increasing. MSM account for nearly half of all persons living with HIV in the United States today. Nearly half. And those are just the ones we know about. That means that for all the talk we hear about “AIDS is not a gay disease,” it is. That means sexually active MSM are having sex with HIV+ partners statistically more often than any other members of the general population- and being infected. HIV significantly and dramatically lives in the bodies of gay men.
  • HIV strains the budget of every state in the Union. So much so, that states have cut or are considering cuts in funding to drug assistance programs and other HIV support and prevention services. These services keep people alive at a cost of hundreds of millions of dollars a year. More money is needed with every new infection. That money comes out of your taxes.
  • People are still dying. Yes, the drugs help, and people with HIV are living longer lives, but the drugs don’t always work, and HIV mutates. Our immune systems are under a great deal of strain and one serious opportunistic infection can kill. I lost a friend just this year.
  • It’s not over. Families are still being traumatized and our community is being hurt by this epidemic. Here in Montana, with its relatively miniscule gay population, new members joined my HIV+ support group this year,  most are gay men in their twenties- kids, really. All facing a lifetime radically different than they had hoped for.

And those are just some of the many points to consider.

Is it good that people are no longer dying and suffering in such huge numbers? Yes.
Is it good that we no longer gather in great numbers, sharing strong emotions, standing hopefully resolute in the face of pain and suffering and memory? I don’t think so.

Personally, I need to remember these facts and these people, because they’re part of my history, my community, my country and my world. I need to be reminded that my compassion, my voice and my heart are all still relevant. I need to be reminded that I’m not alone, I need to remind others of the same thing. And I think doing it once a year is the least I can do.

That’s why I’ll be going to a World AIDS Day service this year. That’s why I’ll be wearing a red ribbon, holding a candle in the dark, listening to words of grief, bravery and encouragement. To remember, to remind, to regroup.

Because I still think it’s important.