My Version of Holiday Spirit
I can’t believe this year is almost over. It has been both a rollercoaster and also so profoundly stagnant. Personally, 2020 was always going to be a Big Year just because I was graduating from college and moving to a ~different phase of my life~ but now here we are barreling towards the close of this chaotic year and I don’t know when I’ll actually feel like I have closure or feel like I’ve fully processed everything that went down.
New Year’s Eve is usually my favorite holiday because I love arbitrary temporal landmarks, but I’m not sure how this one will feel. 2021 is sort of promising, but I’m scared to be really hopeful because I am tired of being disappointed. The bar is not on the floor, it’s somewhere in hell at this point.
Anyways, I know people are likely doing their holiday shopping around now, so a few things I’d like to flag for y’all, and please do share with others:
1.) Try using Bookshop.org for books instead of Amazon. They support independent booksellers! Alternatively, try your local independent bookstore. I don’t want them to die, they’re the perfect setting for your cute first encounter with your future spouse. ;)
2.) Check out Choose Love, a shop where you can purchase essential items for refugees like a child’s coat, medical care, hot food, and mental health support. When borders closed due to the pandemic, it left millions of migrants and refugees in complete limbo.
On the subject of charitable giving, remember that the holidays are a particularly difficult time for people who are food/housing-insecure, people who live alone, vulnerable populations, etc. etc. and even more people now because of COVID. Consider making a donation to your local food bank ($ > food because food banks can get bulk deals) and/or homeless shelter. Also, imagine getting your period and not having menstrual products? You can tell men dominate our politics by how little attention is paid to how essential menstrual products are. Organizations like The Period Collective, Helping Women Period, and I Support the Girls work on this.
Another great way to give is GiveDirectly, which provides unconditional cash transfers to randomly selected families that qualify for SNAP.
3.) A way to help with your time rather than your money is your local mutual aid group (I found this map by AARP, but lots are also on social media like @mutualaidhou). Also, there are programs that match up volunteers to lonely people (often old people) for a chat.
Still figuring out what this newsletter is… // Follow-up
I said I’d be less essay-y but apparently this is just how the US education system has formatted my thoughts after all these years. In case you missed it, last week I thought about how we can frame climate change, healthcare, and COVID restrictions more positively, and before that I talked about how the behavioral biases of the second wave are different than the first. Dr. Elisabeth Rosenthal, author of An American Sickness (a book that ground up all my faith in the US healthcare system and spit it out in an incredibly informative manner) and EIC of Kaiser Health News, put out an op-ed in the NYTimes going the opposite way than I have been thinking… “It’s Time to Scare People About COVID.”
But maybe we need a P.S.A. featuring someone actually on a ventilator in the hospital. You might see that person “bucking the vent” — bodies naturally rebel against the machine forcing pressurized oxygen into the lungs, which is why patients are typically sedated.
(Because I had witnessed this suffering as a practicing doctor, I was always upfront about the trauma with loved ones of terminally ill patients when they were trying to decide whether to consent to a relative being put on a ventilator. It sounds as easy as hooking someone to an I.V. It’s not.)
Another message could feature a patient lying in an I.C.U. bed, immobile, tubes in the groin, with a mask delivering 100 percent oxygen over the mouth and nose — eyes wide with fear, watching the saturation numbers rise and dip on the monitor over the bed.
I have wondered if HIPAA didn’t exist, and you could see more pictures of patients on ventilators and patients dying with a nurse in full PPE holding up an iPad for them to see their loved ones, would the story about COVID be more compelling to people? There was a tweet I saw early in the pandemic from Disability Twitter (can’t relocate unfortunately, the nature of Twitter sometimes) that essentially suggested that people are not as afraid of being hospitalized as they should be because most people have the privilege of having not experienced hospitalization and chronic illness. Thus, they can’t even project themselves accurately into that situation. You kind of get a combination of this idea and also optimism bias in all those “I didn’t think I’d get it / I didn’t realize how painful it’d be…” types of stories. I wonder if the ads Rosenthal suggests would still be dismissed as fake or overblown by COVID-19 skeptics.
This week, there wasn’t anything going on in the news cycle at all, so I figured I’d just think about alcohol. Nope, nothing, not like 17 states filed amicus briefs for Texas’s case on throwing out the election results, not like the first vaccines have been administered… Also every now and then I just think about how much hinges on the Georgia runoffs and truly embody the “everything is fine” dog on fire meme. Sometimes it’s nice to think about something less timely, so…
The Titular Piece // Third Thing
Alcohol holds a huge, pervasive, and very interesting position in our culture. When I say “our,” I am mostly referring to the US since that’s the culture I’m most familiar with, but I would say it’s similarly true in London in my very limited experience (they really do love their pubs). I may be particularly sensitive to it (and also biased) because there is alcoholism in my family, and I’ve seen how people brush aside the beginnings of alcoholism as normal behavior. Honestly, it is hard to tell sometimes what a healthy relationship to alcohol is. College is so widely considered the time to drink too much, but I have definitely encountered people who I would be a little worried about. The NIH’s National Institute on Alcohol Abuse and Alcoholism reported that in 2018 when surveyed, about 55% of college students ages 18-22 consumed alcohol in the past month, and about 37% engaged in binge drinking (defined as 5 or more drinks in 2 hours for males, 4 or more for females). Approximately 9% of college students are estimated to meet the criteria for Alcohol Use Disorder (AUD). But most people chill out a lot after graduation, presumably. Hopefully. Many people might be toeing the line too closely. And I do think that the aggressive drinking culture at colleges is for sure tied to the drinking age being 21. Our associations with drinking must be shaped by how many of us spend 18-21 drinking bagged wine in sticky-floored dorm rooms with other 18-21 year olds instead of in a bar or restaurant, or with our parents, with food. Surprise, making things illegal doesn’t prevent them from happening, it just makes them less safe and harder to measure! I wonder if we’ll ever fully learn that lesson as a society! To be fair to us young people, Millennials drink less than their predecessors, and Gen Z drinks even less, so it’s not like we’re the problem children unless you’re writing one of those horribly inaccurate get-off-my-lawn “Millennials/Gen Z killed [insert thing we definitely didn’t kill]” articles.
I think that alcohol occupies a strange position in our culture in that we know it’s not good for us, and people make many jokes about the damage they’re causing their livers, but it’s still extremely popular as a hobby, and for some it’s almost an entire identity. I’m thinking of wine moms and frat bros, and men who won’t shut up about IPAs. Alcohol is not treated at all like cigarettes, our other legal and unhealthy substance, potentially because the turning point on anti-smoking efforts was the confirmation of second-hand smoke effects, which makes the victim of a smoker’s actions other people. But there are lots of consequences, personal and public, for too much drinking. Maybe Big Alcohol has better lobbyists than Big Tobacco.
We are what we drink (or don’t drink)?
In many ways, alcohol culture can reflect broader social tensions. It’s more than just a pastime. Going back to wine moms, there’s been some interesting analysis on this: Ashley Fetters wrote in The Atlantic about who wine moms are, and how a wine mom may be the rejection of the all-encompassing “perfect mother” identity of generations past and a joking acknowledgement of the stress of parenting today, and how wine moms are perhaps implicitly asking for more than wine:
“In the long term, “maybe what wine moms—and moms of other social classes, and non-drinking moms—need isn’t a supersized glass of alcohol, but social support,” Jacobson said. “In the form of affordable child care, paid-family-leave wages, equitable wages, and, of course, an equitable division of labor at home.” Reforms such as these are, of course, not as easily accessible as, say, a chilled rosé, nor do they lend themselves to rallying cries quite as catchy as “Less whine, more wine.” But if all parents had that kind of support, then maybe “wine mom” wouldn’t be such a loaded term—and moms could enjoy the occasional glass of wine in peace.”
It’s strange and sad how this may be the manifestation of our lack of support for parents, and also feels resonant with our general tendency to utilize humor to cope with the very depressing issues we face (for evidence, see most of our memes at this point).
Alcohol culture has also had quite a past with religion, specifically Christianity. There’s the temperance movement and teetotalers of the 18th, 19th, and 20th centuries of course. Not all of them were religious but many were and described drinking as a sin. A more subtle example is the fact that liquor stores still close on Sundays in Texas and some other states.
A more wild example that I learned about and still think about a lot is the relationship between religion and Fetal Alcohol Syndrome (FAS). A paper by Elizabeth Armstrong and Ernest Abel published in 2000 examines records of FAS and shows how moral panic influenced the pathologization and shame surrounding drinking while pregnant. To be clear, truly excessive drinking while pregnant is likely to affect the fetus severely and FAS is a real medical syndrome. What Armstrong and Abel get at, however, is how conservative Christian moralizing affected how medical journals, public health organizations, and the public understand and think about drinking while pregnant. Several of the papers most heavily cited to show that women drinking while pregnant caused birth defects involved women who did drink but were also more likely to be of lower socioeconomic standing and were at higher risk for a variety of other maternal health concerns. The real risk is largely concentrated among women who are poorer and women who already regularly abuse alcohol. While the US is generally adamant that no amount of alcohol is safe during pregnancy, most European countries are fine with low-to-moderate. We have not seen an epidemic of FAS there.
Generally, we drift very easily towards moral absolutism on basically every issue, which leads to unhelpful shaming and blaming and inaccurate line-drawing. Women already receive so much unsolicited advice and unnecessary judgment on everything ranging from how we dress to how we parent.
The authors close on this idea, “If we hope to reduce the incidence of this birth defect, we must reconstruct the problem not as a moral panic, but as a moral imperative to find and help those women most at risk of adverse outcomes.” This is an important approach to keep in mind. People are going to do the wrong thing sometimes, the world is complicated. We should be trying to inform and help them rather than blaming them. Messing up once should not make you tainted forever, or make you a bad person. This applies to addiction and drug use (I haven’t even mentioned D.A.R.E. and the failures of drug education), unsafe sex, and even COVID protective behaviors like social distancing.
Oh, you don’t drink…?
I personally do drink, but not very much, mostly because I have the worst alcohol tolerance of anyone I know. As a result, it’s not that enjoyable to me and I don’t do it very often, but I am acutely aware of how not drinking in a social drinking setting throws people off. My favorite comedian who I will never shut up about, John Mulaney, even has a bit about this:
“You need to know 2 things if you’re thinking about quitting drinking: The first is, that when you stop drinking and you still go to parties where people are drinking, they will have NO idea what to offer you. Like, once people start drinking for the night, they forget everything that isn’t alcohol. Like I’ll show up at a party and they’ll be like, “Hey everybody, alright we got Coronas in the fridge. And oh hey Mulaney! Would you like, like an old turnip that we found in a cabinet? Would that be good for you? Would you like that? I know you don’t drink. Or my girlfriend left a NuvaRing in the fridge? Would you want that? Would that be good for you? I know you don’t drink…”
I have been guilty of assuming that if someone doesn’t drink they must be religious or I might assume they’re stricter or judging everyone for drinking, or in college I feel like someone would often ask “Why?” like you had to have a good reason why you didn’t drink. Occasionally, I have agreed to drink not particularly because I wanted to, but because I was in a social situation where I felt like it would be easier if I just did. It’s not that I ever thought anyone was going to shame me or directly pressure me, it’s more that I hate uncomfortable situations and so I will do my best to avoid them.
I don’t actually know whether the frequent jokes about alcoholism and comments about alcohol really affect those who are recovering alcoholics, but I don’t imagine it makes staying sober any easier. Also, it seems way easier in many circumstances to avoid exposure to illegal drugs once you stop doing them than avoiding exposure to alcohol. I could see how all the joking about alcoholism might make it hard to come to terms with when drinking becomes an actual problem and knowing when to seek help.
Obligatory Pandemic Discussion
I have been thinking about how the past nine months have affected alcohol consumption, and also how we talk about it. Alcohol consumption has risen significantly in the past several months. In March, UK alcohol sales were up by 22% and in the US they were up by 55%. The RAND Corporation found that the overall frequency of alcohol consumption has increased by 14% among adults over age 30 compared to the same time last year.
I have heard many jokes, potentially just factual statements, about drinking all day and drinking as a coping mechanism for how the whole world is falling apart. In a time of massive mental health crisis resulting from the pandemic and lockdowns, I wonder about our relationship to alcohol as more than just social lubricant or for relaxation. I know that many people are just kidding, but I also know that many people are drinking significantly more as a coping mechanism for all that 2020 has brought upon us. It just feels strange how accepting we are of this self-medication that could signal so many deeper problems.
Like I said before, I basically never drink alone, and feeling drunk isn’t that pleasant for that long, but as a pretty anxious person, I do see the appeal of how alcohol loosens you up, sort of lifts the weight from your shoulders for a bit. It’s a nice feeling. But I wonder if the short-term experience of that less burdened, more fun version of ourselves prevents some of us from doing the emotional and introspective work of really coming to terms with all the baggage we’re coping with. Obviously all the therapy in the world won’t make you feel ~drunk~ but maybe we would be better. This tweet takes a very critical stance that I’m not sure I entirely agree with, but I think it is something worth contemplating when we think about how protests about reopening the bars is probably about more than just the bars. Our society is not really structured in a way that helps people live meaningful, fulfilling lives.
This is not me suggesting that everyone needs to stop drinking or anything. Life without risk is also life without pleasure, and we do lots of unhealthy things. Sometimes drinking is really just about having fun, I know that. You can’t say that drinking doesn’t occupy an oddly central role in our culture though. The tweet above has had me thinking about the ways we have in recent decades shredded local social bonds and communities, how the Internet has isolated us and changed our perceptions of selfhood and identity, and sometimes drinking as an activity stands in as a distraction or a watered-down version of connection where you don’t actually need to be as vulnerable when you’re around other people, or a way to cope without really processing what you’re trying to cope with. A lot of that probably goes back to the late stage capitalist dystopia we’re living in where we are valued and value ourselves for our productivity outputs, not the fact that people drink alcohol. That’s a different newsletter though, someday.
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Thanks for making it to the end! If you thought this was interesting, I’d be honored if you subscribed for more of me thinking about other third things and/or shared this post with friends. :)
I’m linking here some of the relevant readings:
The Many Faces of the ‘Wine Mom’ by Ashley Fetters on the whole “wine mom” persona and unpacking the various interpretations and manifestations of it.
Millennials Are Sick of Drinking by Amanda Mull on the shifting trends surrounding drinking for the younger generations and its potential relationship to our attitudes towards other drugs.
Fetal Alcohol Syndrome: The Origin of a Moral Panic by Elizabeth Armstrong and Ernest Abel. I’m obsessed with this paper, as you can tell from how long I spent talking about it. I had to read it for Medical Sociology class originally, and it really resonated with me regarding the social construction of illness and realizing just how intertwined medicine is with sociocultural factors.