A Chat with My Therapist

by Callum Lee

Like many Generation Z’ers with emotional baggage, I see a therapist on the regular. It’s not like one of those movie scenes, where I’m sitting on a straight-backed leather couch or lying on an uncomfortable settee and my therapist is across from me, rapidly scratching out notes. We meet on Zoom these days, her at her office and me from the comfort of my home, and I just rant. For however much I pay her, I feel pretty comfortable spilling out all my deepest, darkest secrets, but it’s more than just that. I’ve been seeing her since my first year of college when I was a disordered mess of panic and rage, and she’s seen how I’ve grown out of that persona. She’s been with me through all the housekeeping, but I don’t know much about her.

So, when I was tasked to write about a healthcare professional, I thought about her. Why send cordial emails to a doctor I barely speak to (I rarely see my primary physician), when I could just shoot my therapist a text? Seeing the person I interviewed on the semi-regular made it a lot easier to ask questions, the first of which being; “What do you do and why do you do it?”

She’s a licensed psychologist that specializes with families, children, couples and gender and non-binary people. As for the why, she expressed an interest in psychology in high school, when she had the opportunity to take classes at the nearby university of Cal Poly Pomona. During her undergrad at UCSD, she wanted to pursue veterinary practices, but decided the exact sciences of chemistry weren’t for her. She then switched to psychology, which was when her cousin was diagnosed with schizophrenia, a mental disorder that affects a person’s ability to think. This diagnosis motivated her to research with a psychologist studying schizophrenia and health, where she fell in love with research and decided to pursue a PhD.

It’s been a long journey ever since of working with different practices, and when I asked her why specifically she decided to cater to LGBTQ+ clients, she had this to say.

“I had a friend that began to identify as transgender while we were in a faith community. The community indirectly did not feel safe for my friend and they were struggling with their mental health and living situation. They lived with us for a couple years.”
Over the call, I can hear her voice struggle with emotions when she exclaims: “The tears, the snot on my shirt and my shoulders are always there, and it always reminds me and gives me a deep well of empathy for gender and non-binary people.” When it comes down to it, there’s no better reason to be a therapist, and I can tell she takes pride in what she does. She’s been changing lives like mine ever since.

Homecare Will Change Moving Forward

Home health has been here long before what we now know as modern medicine. Even before there were organized hospitals, medicine people of the town / village were making house calls for the sick and delivering babies. Let us define the 21st century vocabulary of home health: Home health is or maybe was defined as “Care in a wide range of health care services that can be given in your home.”  Medicare.Gov. The home healthcare provider is a practitioner who checks on a person’s welfare daily, weekly or a few times a month with a myriad of services that range from medication, physical therapy to helping with daily functions like bathing. These services have changed the way we think of healthcare in the modern age. The discussion on changing healthcare always starts with affordability and ends with access. Let us talk about how that access has changed via technology which may play a key role in increasing affordability.

Now that we are in the pandemic period of COVID-19, new information on using technology and revitalizing home services is key.  Just like food delivery services have been around for generations, the pandemic has forced us to rely on these services more. Thus, more delivery services are faster and easier. What was once viewed as a  convenience became a transport of necessity that changed personal habits, public perception, and an increase in investment in new technology.

In addition, the pandemic has fostered awareness of telehealth services since in March and April of 2020, most hospitals decided to limit the entry of non-emergency patients to stop the spread of the virus and conserve resources.  People who needed to check in with their practitioners had to think of other ways to communicate face to face. As corporations hopped on screen calls, schools had kids logging onto the web for class, telehealth became the access point for medical professionals for a one-one dialogue. In addition, care facilities started to increase the technical aptitude both for the infrastructure and the staff.

 At the University of Wisconsin Health, Dr. Pete Newcomer, Chief Medical Officer,  states that telehealth was “minimal” before the pandemic but now  he sees it at 30% of patient visits. Madison.com   The demand for people to converse has not changed, but the method of communication has transformed how it is viewed and distributed to the market.  With the Biden Administration’s new plans for a $400 billion investment into “home – or community-based care”, there is going to be more discussion about access, communication and how technology will be at the forefront. Let’s start a new definition – one defined by people, structured in communication and lives in health.

By Dane Flanigan

CEO ultraHealth Agency

Could Genetic Testing Be Part of Your Next Job Application?

As genetic testing advances, results may predict not just health but personality and intelligence, raising ethical questions about the applications of such information.  

From video calls with doctors to watches that sense irregular heart rhythms medical technology has become increasingly personal. And it doesn’t get any more personal than examining DNA- the essence of every person and what makes them unique. Genetic testing has come a long way since its initial use in the 1950s. It can provide a wide array of information about individuals’ health by looking for mutations in DNA. The results may empower people to seek treatment, adopt healthier habits, and better prepare them for the future. 

A large portion of testing determines individuals’ risk for having, developing, or being a carrier of a genetic disorder. Patients may require genetic testing if they have a family history, belong to an ethnic group at higher risk, or if they present symptoms and their physician wants to confirm a diagnosis. Depending on the reasons for the test, the results are used differently. A positive diagnostic test may mean starting a treatment plan. A carrier test may be useful before having children, especially for heterosexual couples that suspect both partners are carriers.  

Another type of testing used in family planning is preimplantation genetic diagnosis (PGD). This looks for markers of diseases and disorders in an embryo giving parents knowledge about their potential children. PGD has been at the center of much controversy especially for those that believe life begins at fertilization. They make points similar to those used in anti-abortion arguments, that not implanting an embryo disregards or devalues “the sanctity of life.” However, U.S. laws and health policy do not confirm this belief as they progressively place greater moral status on embryos, fetuses, and newborns as they develop. State laws vary in how late abortions may be performed, illustrating that earlier stages of development are viewed differently from later stages. 

Opponents also object to this type of genetic testing believing, over time, the selection of certain traits will lessen genetic diversity. Advocates for those with disabilities endorse this argument, adding that selection also discriminates against those with disabilities sending the message people with them are less valuable or less desirable. Parents may choose to fertilize one sex of embryos if they have a family history of a sex-linked disorder. Those against PGD argue parents will begin selecting based not just on “health” but preference for one sex over the other. They claim this will lead to selection based on other preferences such as appearance, “talent, personality…even though it is not technically possible at this time.”  

While not possible yet, advances in genetic testing have started conversations about what tests may look for in the future and the applications of such results. Discrimination based on genetic testing was a real concern before the passing of the Genetic Information Nondiscrimination Act (GINA) in 2008. The law focuses on protecting people in two key areas of life- employment and health insurance. But one article in the Oxford Academic Journal of Law and the Biosciences explores how more accurate and precise testing may lessen protections in both areas to the benefit of some and detriment of others. For example, “there is some evidence that certain genetic variants are correlated with world-class athletic performance.” Those wishing to become professional athletes may want to have genetic testing to see if they have a variance that would make them more appealing to teams. Similarly, professions that value intelligence and empathy may utilize genetic testing if it advances to predicting such traits. Empathy has proven to be an essential skill in healthcare professions. Medical schools and hospitals could look at results before admitting students and residents. 

Tests may also work against people predicting liabilities rather than assets. In high-risk situations such as driving a school bus or flying planes, employers “may have a legitimate interest in genetic factors that would, hypothetically, significantly increase the chance of suffering an epileptic attack.” However, if genetic information was more widely used and publicized a case could be made for accommodations and protections for those with “liabilities.” Similar to the Americans with Disabilities Act, employees may continue to work but with modifications made to their environments. 

Allowing the use of genetic information in one protected area could have devastating consequences in the other. Some may argue those who have a genetic condition use healthcare services more and therefore should contribute more to the cost of those services through higher premiums. This raises similar points about selecting job candidates. These practices would discriminate against those with perceived or possible disabilities. But unlike choosing job candidates, this concerns profits not safety. This system would punish people for something outside of their control based on possibly inaccurate results. Furthermore, despite certain, outdated arguments against, healthcare is a basic human right. As stated by the World Health Organization (WHO), “When people are marginalized or face stigma or discrimination, their physical and mental health suffers. Discrimination in health care is unacceptable and is a major barrier to development.” Putting barriers to care will not create a healthier society, it will only push those that cannot access care further from the help they need. 

Currently, genetic information is protected. Those wishing to be tested should not fear potential discrimination. While there is still room for error, testing provides useful information for patients and their doctors. A good way to gauge if testing is necessary is by talking with family members, writing down what conditions they have, when they were diagnosed, and what symptoms they experience. Health professionals can then use this information to determine the best course of action. It may include genetic testing or simply earlier and more frequent screenings. Additionally, knowing family history can encourage other preventative actions patients can do on their own, like exercising regularly and maintaining a healthy diet. Since some of these conditions are multifactorial, environmental improvements and lifestyle changes can have a positive effect.