Wednesday, April 24, 2013

To sleep, perchance to dream: insomnia and an uneasy relationship to big pharma

I am a terrible sleeper. Without soporifics, it takes me hours to fall asleep. I wake up constantly. I have vivid nightmares. Insomnia is its own special hell. The day after not sleeping for 24 hours, everything is kind of punchy and frenetic. By day three, I bust into tears for no reason. Luckily, this hasn't happened in years.

In Washington, I had been on different types of sleeping aids for years, but I always felt hung over in the morning, never fully awake. In one case, I was sleeping 14 hours a day. The doctor recommended just lowering the dosage of that particular drug. I passed. Not sleeping at all was a better option than playing a drugged Briar Rose.

Before my friends who swear by holism get their panties in a twitch, I had also tried sleep hygiene, melatonin, valerian, warm showers, cold showers, hot toddies, acupuncture, exercise, meditation, and anything other suggestion, whether it seemed remotely feasible or not. It felt like failure on my part that none of these methods worked. I just wanted to sleep.

Then my doctor in Texas introduced me to Ambien. It was, hands down, the best drug I have ever tried. I woke up the next morning and it was as if the world had been drenched in technicolor. I had slept the entire night. I kept thinking to myself, "If this is how other people sleep all the time, no wonder they are always happy." In my earliest memories, I grew up in a house of snorers and I would while away the early morning hours listening to the chorus of snoozers (including, a one point, a basset hound). I had no idea what sleep could be.

And everything seemed to be going well. I was more productive and more pleasant to be around. My dissertation research had just begun and anything seemed possible. I had the side effects that people are warned about - eating in my sleep with no memory of it was the least of my concerns. I had amnesia from the time I took it in the evening until I woke up the next morning. The problem was that I wouldn't immediately go to sleep after taking it. Luckily, my partner, with the patience of a saint, kept an eye on me and didn't let me get too crazy. The high (or low, depending on your perspective) point came when I swam in the pool fully dressed. It's not as crazy as it sounds, as Texas summer nights are still warm and my partner was babysitting me. After that, however, we decided I should not be allowed to leave the house.

I had trouble scheduling overnight trips without a chaperon. There were at least two women-only leather events I missed out on because they involved camping out. I just couldn't be trusted to make decisions on my own after I had taken Ambien. The amnesia and strange behavior really freaked me out at the beginning. I brought it up with my doctor and he said it was normal. I wondered if this was what it was like to go senile. My partner would have conversations with me, or we would watch TV, and I'd not be able to remember anything. After I had been taking it every night for a year, I learned to embrace the zen-like state between medication and sleep. I know I enjoyed the things I was doing in the moment, even if I couldn't remember the specifics the next day.

After two years, I noticed I was starting to have trouble remembering things during my waking hours. People would ask about my childhood and I just couldn't remember things about the school I went to or who my favorite teacher was. I did not connect this with my Ambien, as it had always affected my short term memory, not my long term one. This was particularly problematic, since I was in the final stages of writing my dissertation. I had to constantly refer back to notes to get even a page written. I couldn't remember the names of authors I had cited a thousand times. The point was driven home to me on one of my job interviews when someone asked me what, in my past, had made me want to tell stories. I had no answer. I made something up. I started talking to my doctor, wondering if I was having early onset Alzheimer's. My mother's memory was poor but she was never diagnosed with anything before her death from cancer at 54. Unfortunately, my tendency toward sanguinity underplayed my concerns, making it seem like this was a tad disconcerting but not the descent into madness I was fearing.

Fast forward to Cleveland. Part of what I hate about moving to a new city is getting a new doctor. I went for the introductory visit and in the course of the exam, explained that I was having cognitive difficulties. She said I was just getting older (I am 35!) and should expect not to remember things the way I used to. At a different point in our interaction, she flipped out that I was on Ambien, especially because I took it every night. She explained that there had been "fatal consequences for sleep partners" and that she could not let me continue to take it at the dose I was on. I freaked out. Sleep is so important to me. The idea that she was going to mess with that pissed me off and made me defensive. But she wouldn't give me a perscription. She halved my dose.

I tried it for a week, but I wasn't sleeping, again. She gave me a perscription for anxiety medication to take a bedtime instead. Angry and bitter about not sleeping, I tried it. It took me hours to fall asleep. I woke up constantly. I took a higher dosage to compensate for that and was groggy in the morning. However, I stopped being stupid. I could remember a phone number for more than 3 seconds. I could recall watching movies with my sister growing up. If my doctor had only suggested to me that it was the Ambien that was causing my memory problems, I would have been more enthusiastic about giving it up. She was worried I'd kill my partner, but not that I couldn't remember which preposition to use when writing.

I miss good sleep. I'm not willing to trade my memories for it though. It just frustrates me that it took switching to a new doctor before someone better informed than me thought to take me off of it, even if it was not for the reasons I could articulate. It is terrifying to be told, at my age (or any age, I suppose), that my memory loss was just part of growing older, especially as it was happening so rapidly.

Like any addict, I enjoyed the benefits of and yet felt held hostage by my drug. I feel betrayed that my previous doctor had me on a high dose for years, rather than the weeks recommended by the FDA. I hate my dependence on big pharma for the ability to make it through the night.

'Tis a consummation
Devoutly to be wished. To die to sleep,
To sleep, perchance to Dream; Aye, there's the rub,
For in that sleep of death, what dreams may come,

Saturday, April 13, 2013

BDSM exceptionalism

If you haven't been able to tell from reading my blog, I love the kinky people I work with. I think kink can be liberating, life-affirming, hot, transcendent, and a hell of a lot of fun. The people I know are generally good people. Of course there are some people I don't get along with, but it happens in every group. In my time in the community, however, I didn't meet any psychopaths or fundamentally disturbed people. When talking about BDSM to straight folks, the overwhelming urge is to talk about how similar most aspects of most social interactions are to mainstream America. This can do a disservice to the queer potential of kink.

Before I open this can of worms, let me state unequivically that I support the right of people to marry whomever they please and to have that union recognized by the state. I benefit from that privilege and it would be hyprocritical to take any other stance. However, queerness offers a unique perspective from which to critique the institution of marriage as the perpetuation of heteronormativity and, in most cases, patriarchy. I am not suggesting that every marriage supports these qualities, but on the whole, the Human Rights Campaign has focused all its energy in proving that gay folks are just like everyone else in every way except who their romantic partner is and deserve to be married. For this reason, they are willing to throw "bigamists and drug addicts" under the bus in their effort to prove that they pass some moral muster. (I'd link to the fundraising email I had from them disavowing their association with those types but I cannot lay my hands on it at this second). In my experience in the queer community, in Texas, where there were no civil unions, much less marriages, people were creatively negotiating relationships. It sucked that they are denied human rights and penalized through taxes and other ridiculousness. But, their status as outsiders allowed them to evaluate whether they wanted all the baggage that comes along with the "institution of marriage," including unequal gender roles and expectations of monogamy. They formed families, raised children, supported households, and made meaningful lives in ways that sometimes reflected heteronormative partnerships and sometimes could be the furthest thing from it. In my ideal world, the state would recognize all of these partnerships, whether they are two people, forever and ever, or a collection of polyamorists that transition in and out of each others' lives.

In some circles, the kinky community is eager to prove it is mostly like the mainstream for a number of reasons, including reducing stigma and lowering the risks that come along with being a stigmatized group, including social ostracism, loss of child custody, or arrest if a person is outed. There seems to be the belief that if the community reaches a critical mass, mainstream society will have to accept them. The cynic in me would like to point out that racism would serve as an example that this strategy doesn't work. In my experience, it is predominantly het groups that aim for popularization (while maintaining that sexy, exotic, edginess). The queer group I worked with was more willing to take lessons learned from radical erotic experiences as a platform to question hegemony.

I waffle on the question when my work comes up in the course of normal conversation. If I perceive a person to be conservative, I try the "just like normal folks" route in order to avoid confirming their worst suspicions and shutting down productive conversation about the power of sexuality and community and ritual. In more "liberal" settings, I find myself making the case for kink as anything but normative. This is complicated, since there is no one singular kinky community. Like any people grouped together by certain traits, these are all individuals with their own histories and social positions to take into account. Despite the relatively small size of the population in Texas, there were several different groups with diverging perspectives on the role of kink. People filtered between groups freely, but generally strongly identified with a single group as their home base. So in some cases, it was true that traditional gender roles were not only accepted but reified, racism was left unquestioned, and just about everyone voted Republican. It is easy to make the case that they are the mainstream, except for the beating and public sex. At the same time, there existed spaces where gender was unmoored from the physical body and power was constructed and deconstructed in ways that challenged hegemonic ideals.

If my bias isn't apparent already, I preferred the latter. I enjoy the disruptive potential of radical sex. So if you find me telling you that BDSM clubs really are just like church (and I believe this is true), you should check with me about how I feel about church. For some groups, I mean Presbyterians. For others, I mean Voudonists.

Thursday, April 4, 2013

How can you sell yourself?

When I was a dancer, I had several women (mostly professors) ask me, "How can you sell yourself like that?" I knew what "like that" meant - why would I want to get paid to be naked and sexual for strangers? The snarky answer is that it was better than doing it for free. But what tripped me up was the "yourself" part of the equation. I didn't feel like I was slicing off bits of organs for purchase. Many critics of prostitutes and porn stars and other sex workers focus on how sexuality is identified as "the self." I'd venture to say that many of the people who pose that question to sex workers (and I'm inclined to say female sex workers, although if there are any male sex workers who have had a similar experience, I'd love to hear about it) would not ask that same question of a physical therapist or a psychiatrist. Seeing a physical therapist is a sensual experience that involves touching in intimate ways, although general not pleasurable. Massage therapy may come closer to sex work, but people are very big on the "professionalization" trend toward licensing so that everyone knows they are not *that* kind of masseuse (no happy endings here). Then psychiatry - a good portion of my time was spent making people feel comfortable and valued. I was, as one of my friends refers to her therapist, a "pay friend." But "selling yourself" means having sex for money. Other forms of intimacy for cash don't count. I'd like to think of myself as a complete human who, at one point, sold varying levels of sexual access to my person. Leave that whole "She gave herself to him completely" romance innuendo bullshit at the door, please. I was always more than my pasties and t-back.

But I have been thinking about how one sells one's self.

Being a Marxist, I tend to rely on the notion that what employers should pay you for is your labor. However, working for the municipal government in Texas, I learned that what my employers were paying me for was my time. I was expected to be productive while I was at work, but even if there wasn't anything for me to do, I had to breathe their air until it was time for me to go home. In some ways, they were purchasing my availability, which is very different than paying me for my labor. Macro-economic perspective on the shift to a service economy inserted here.

Now I am back in the university system, whoring myself out in my favorite way - professional anthropology! I don't have any set hours - the job just has to get done. Sometimes this means I work ten hour days for a week at school and sometimes I work five or six hours a day from home. I get paid to do intellectual work (macro-economic perspective on information economy here) and I bet none of those snitty women would dare ask me how I felt about selling myself now, even though I tend to over-identify with my smarts rather than with my sex.

On the other hand, a dear friend has recently begun working at a corporate retailer after an extended, involuntary absence from the labor market. It was the only job available and like a trooper, they took it. As they were explaining to me the expectations of the job, I began to think about what corporate employers are buying from you. This person was required to submit to a drug screening (even though the most dangerous thing they will be doing involves moving boxes by hand). I found myself feeling self-righteous on their behalf. They don't even use drugs, but how could a corporation bully its way into your personal life, the life you lead outside of the labor (or even time) they are paying you for? But in order to get a job, they had to pee in a cup to prove that their personal habits weren't a liability to this national company. Proving morality with piss -  there's a Andres Serrano joke in there somewhere. I know others have made the argument that this type of surveillance is a form of discipline (good god, I love Foucault) but it creeps me out even more that it is a corporation disciplining its employees, like Big Brother in the form of the State wasn't horrifying enough. At least the State sometimes pretends that the welfare of its citizens matter more than profits.

The small humiliations that go along with my friend's new job may sound familiar to anyone who has worked in retail - wearing an apron (and who are we kidding, unless one is a blacksmith or a shoe cobbler, an apron is not unisex, making it more humiliating for men and reinforcing the role of service for women), having no control over their schedule, no health benefits for 3 months (and exceedingly poor benefits at that), no vacation or sick leave until January 1 of next year, being treated as a potential thief or a witless idiot as a matter of course, and (for some reason, this one really gets me) only having a half hour for lunch, non-negotiable. They get to enjoy all these perks while making a little more than minimum wage. The company has bought their time and labor during work hours and even the right to police this person's behaviors outside of work for less than it takes to maintain one person at 133% of the federal poverty level.

When I sold sexuality, sometimes it was because I felt like I had to. I needed rent or tuition. But I never felt like I was selling myself. Looking at what we expect from workers in a service economy, I think that metaphor might be better applied to how corporations such as this one treat their employees. How can they get away with demanding employees sell themselves (their time, their social behaviors outside of work) like that? And for that little money? I was always a stripper, even when I wasn't at the bar, but my autonomy was my own and I felt fairly compensated. I don't think my friend feels the same.