Happy Satan

They haven't got the hang of pronouns yet, everyone is a 'he' because that's what they're called even if I just referred to Grandma as 'she' in the previous sentence. They've only recently stopped saying 'Good boy, Mumma!' when I do something like wash my hands. They're pretty good with understanding different biology but, on a social and language level, they've never divided people into different categories based on that or gender identity. They do know that I'm a girl/woman, it's just that the term holds similar weight to saying someone is tall or short or mentioning the colour of the eyes, and they apply the terms inconsistently. Their default setting to people and language has been gender neutral.

It makes sense that they've got a shaky grasp of the whole concept: they're four. They're starting to spell out words and do some addition but also still learning how to correctly say my full not-mum name and understand that their dad was once a little baby in Nanna's 'tummy'. They'll probably keep referring to every human on earth as a 'he' for awhile longer.

But over the last few days they've started insisting that pink is my second favourite colour (it isn't) after purple (which they know is my favourite and will remind me of multiple times a day). They don't do this to their dad.

When I said 'it's a nice colour, but no it's not a favourite' there was genuine confusion from one of them. Awhile later, he asked 'Mumma, you're a girl?' I said I was, and he was quiet and thoughtful.

Later that night he told me pink is one of my favourite colours again. When I asked why he thinks that he could give me no explanation other than a confused 'it's pretty?'

I said 'It is pretty. Do you like it?'

Keep in mind pink was, very recently, one of his favourite colours. But he shook his head adamantly, eyes wide.

His brother thought about it too, and said 'Oh yeah, it is pretty! I love pink!' which confused the newly-pink-disliking twin further and you could practically see the gears turning in his head as he remained silent.

He's four. Last month he loved pink. He still loves cuddling his (very pink) rainbow kitty-cat fluffy toy and telling me how cute it is, so I doubt it's a genuine aversion to the colour. And he seems to be insisting he doesn't like it because it's 'pretty,' and assumes that girls must like it for the same reason.

We think he learnt it from one of the few days they're at kindy, from another four-year-old.

Only four and already being taught that prettiness and certain colours aren't for them, and are only for girls.

Then last night, as we were getting ready for bed, he casually said 'Girls are bad at swimming.' The same way he'll tell me 'Spinosaurus looked a bit like a crocodile,' 'octopuses have three hearts,' or 'a hexagon has six sides.'

I gently asked him what he said, he repeated it, and when I asked why does he think girls aren't good at swimming he said 'because girls aren't, boys are good at swimming.'

I told him that wasn't true, girls and boys can both be good at swimming.

He accepted it easily, just a happy 'Oh!' to receive new information. Smiling at me.

'Am I a girl?' I asked him.

'Yeah, you're a girl Mumma.'

'And do you think I'm good at swimming?'

'Oh, yeah!'

He was actually very excited with this revelation, that I'm a girl and good at swimming. He was happy to know girls aren't bad at swimming, this wasn't some inherent belief. And it definitely didn't form from his own experiences - we're Australian, the twins have never been swimming with anyone who isn't good at it. And I'm the one normally in the pool with them and I'm a good swimmer even by Australian standards.

I don't think it came from their kindy teachers either.

This is something else another four-year-old has said.

They're four. FOUR. And already sexism and toxic masculinity is creeping into their conversations, pressuring them to stop liking certain colours and pretty things, and to diminish the capabilities of girls.

I was worried about the manosphere influence my boys would be exposed to as they got older, and how to talk to them about that and the rising numbers of young men who think women aren't as smart as them and shouldn't be able to vote or work after marriage, etc.

I didn't think it would start in kindergarten.

And if my boys have heard it, the little girls in their class probably have too. Do they disagree with it openly? Internalise it? Will they mention it to their parents and have it corrected? (Did one of them hear it from their parents - it could be a little girl sharing it, this does coincide with two new girls joining the class.)

Just... what the fuck.

i'm in Ireland and the search for that bastards name is still blocked and hidden... the legnths the british go to defend and protect their instruments of colonialism and violence is beyond belief. no justice for the victims and yet every measure taken to protect David James Cleary and his fellow murderers.

The fact that we can put fluids into people via IV saves more lives than I can actually communicate. There are so, so many more ways to die when we can't do that. You can go from literally at death's door from an illness you have no other cure for, to Basically Fine, You'll Feel Icky A Bit Longer But You're Otherwise Fine and Your Own Immune System Will Work Now, from sterile saline into a vein.

Or even fucking subcutaneous, under your skin. It still gets into your system faster and bypasses any fuckery going on in your gi-tract.

But you want the other end?

I recently got the answer to a crapload of symptoms of mine and it turned out to be Crohn's. Ileal crohn's.

For most of human history there was literally nothing to do about this but hope and pray that your immune system didn't decide to rip ulcers and lesions in your digestive tract to the point where you bled out, or the point where parts of it died and killed you with sepsis, or enough to build up stricture bands of scar tissue sufficiently to cause impactions or any other really gnarly and unpleasant ways you can die because for some reason your body decides the walls of your digestive tract are the enemy and need to be dismantled cell by cell. (Including a fuckload of cancers caused by the constant damage to the cell wall.)

Even as recently as when most of the younger people reading this were small children, mostly all you could do about it was take corticosteroids when you were in a flare. And that was better than Nothing. But at the same time, corticosteroids have a potential laundry list of side effects and you want to take them as little as possible and for as brief a period as possible. And there wasn't a lot else.

I am on a medication with the proprietary name "Skyrizi" and the generic name risankizumab. It's made from taking antibodies from a non-human source and then modifying their protein sequences to be more similar to human antibodies, after which they modify them further in order to make it so that the literal only thing they do is go into my body and bind to something called "tumour necrosis factor" so that this will stop flagging my own goddamn digestive system walls for destruction by the rest of the immune system.

Please feel free to read that paragraph over again.

There used to be a common, horrific illness that sailors would get, which was mysteriously cured by limes. People know about this one, it's scurvy. But there are other horrible ways to be sick from vitamin deficiency that weren't considered curable at all, and people had no idea what caused them.

Rickets is a disease caused by vitamin D deficiency where your bones get bendy and grow in the wrong shape (it is most apparent in children). It causes permanent deformity and very easy fractures, along with debilitating pain and persistent dental issues. Historically, it was known that milk, and later, cod liver oil, would improve or prevent it, but the reason was not understood until the vitamin was discovered.

Wernicke-Korsakoff syndrome is a complication of alcoholism that leads to psychosis, dementia, and death if left untreated. Severe alcoholics used to just go completely mad before dying, basically. It ultimately results in permanent memory loss (retrograde amnesia), as well as the inability to form new memories (anterograde amnesia). It is caused by the fact that alcohol prevents the absorption of vitamin B1 (thiamine). It is treatable and preventable by giving the patient thiamine shots - if caught early, before permanent brain damage has occurred, it is fully reversible, although the underlying substance abuse issue still needs to be addressed to prevent recurrence.

Pernicious anemia is caused by vitamin B12 deficiency (in turn ultimately caused by an autoimmune issue causing poor absorption). It causes blood cells to be the wrong size and too few in number, resulting in dizziness and fatigue. It also causes neurological symptoms like tingling in the extremities, poor coordination, confusion, and, in late stages, dementia. There was no cure for pernicious anemia in the past. People would simply become anemic and die from it. That's why it's called "pernicious" - that's an old-fashioned way to say "insidious and deadly," named for its slow onset and then-incurable course. Now it is curable with vitamin tablets or periodic injections.

Cretinism, or, less stigmatizingly, congenital hypothyroidism due to iodine deficiency, is a developmental disorder caused by the inability of the thyroid gland to function properly without sufficient iodine. it causes short stature, intellectual disability, infertility, hair loss, and a large lump in the neck known as a goiter (i.e. a hypertrophic thyroid gland). It was historically associated with poor inland populations living far from the ocean (due to the protective effect of consuming seafood, which is naturally high in iodine). We now simply put iodine in table salt, and this disorder is virtually unheard of in regions where this is the case.

Neural tube defects are a leading cause of birth defects, infant mortality, and stillbirth. The most common nonlethal forms of neural tube defects include spina bifida, hydranencephaly, and encephalocele. These defects are caused by a failure of the embryonic structure that becomes the spinal canal to close properly during development, leading the central nervous system to have a distorted shape that may impair cerebrospinal fluid drainage and put pressure on the brain. In severe cases, e.g. anencephaly, the brain/spine essentially develop outside of the body, which is not compatible with life (anencephalic and iniencephalic babies typically die within hours or days; fetuses with more severe forms are usually stillborn if they are not terminated). The risk of these defects is drastically reduced by taking supplemental folic acid (vitamin B9).

Vitamin K is perhaps the most amazing one on this list. Newborns often have very low vitamin K levels due to the fact that it does not cross the placental barrier easily and is not found in high levels in breast milk. It is only produced by gut bacteria, which babies do not have when they are born, and it takes time for them to acquire the right flora from their environment. Deficiency impairs blood clotting, and in infants, can lead to brain bleeds and sudden, unexplained death. Tiny babies would simply die of brain hemorrhaging for no good reason at all. But if they're given a quick shot of vitamin K at birth, that doesn't happen.

So, my insurance has been trying to not cover my SNRI because it is new on the market and no generic available yet, so pricey.

I apply for a refill and the request gets locked for review. Again. For the 3rd time.

This time I call and immediately ask to speak to the actual doctor making these clinical decisions. Very politely. Must be a slow day because they allow it.

ME: [Teacher voice] I'm calling in regards to the SNRI you have placed a lock on. Why was this decision made?

DOC: Well, there are dozens of other medications on the market in that tier, and far cheaper for you and [insurer]. We have sent a request to your doctor to consider alternatives.

ME: I am aware of that. So, can you do me a HUGE favor and look up my prescription history really quickly and tell me how many SSRIs and SNRIs were only filled once in 2022 for me, showing they were poorly tolerated?

DOC: It looks like eight.

ME: Great job! Now, can you please look at my genetic test for psychiatric drug tolerance and tell me how many medications are listed in the safe category?

DOC: Two.

ME: Awesome! Now, can you tell me what type that other drug is that I'm not taking?

DOC: Yeah, totally, it's an MAOI.

ME: That's correct, you're really knowledgeable! Should I be taking something as dangerous as an MAOI with my other medications, or even just in general?

DOC: It's contraindicated for sure.

ME: It is! So true! So, last question since you've been incredibly smart and helpful. Is it less expensive for [insurer] to pay out for the medication knowing they already get a huge manufacturer discount anyway, or is it more expensive for them to pay for me to need potentially long-term inpatient psychiatric care?

DOC: I'll clear the code, ma'am and flag it as medically necessary. I'm sorry about this.

ME: I appreciate you SO MUCH. You have a great day now.