THE BATTLE BEFORE US

Courtrooms are battlegrounds where society’s bullies and the oppressed clash, where the victims of abusers seek recompense, and where parties cheated by scalawags seek retribution. … Justice depends upon an array of factors including the prevailing case precedent, the skills of the legal advocates, and the merits of each party’s claims and counterclaims.

― Kilroy J. Oldster, Dead Toad Scrolls

The litigation process is rife with peril. The courtroom is a crucible in which irrelevancies, innuendo, falsehoods and deflection are burned away leaving only … the truth. A skilled attorney well versed in the art of cross examination looks upon an adverse witness as a snake. Through artful questioning, the attorney wields the scalpel of his wording so adroitly, making an incision here, a shallow cut there, that the witness, like a snake, more easily sheds its skin of subterfuge so that only the truth is left.

And yet, when the stakes of litigation are so incredibly high, when the very existence of an organization is at stake, when the needs of our families suffering from mental illness are the predominate issue, we must embrace that which is in the best interest of those who are suffering … and dying. And since the stakes are so incredibly high, life and death, our soul must first look for honorable resolutions. We embrace the translated words of the Chinese general, Sun Tzu in his treatise, “The Art of War,”:

“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”

Sun Tzu is referring to a balance of power. He wisely suggests that, at all times, you should make the option of avoiding conflict, or surrendering during conflict, appear more appealing for your enemy.

So too, an honorable resolution was offered to the National Eating Disorder Association in the recent class action lawsuit. In fact, even before the lawsuit was filed numerous communications (at least 15 emails) with NEDA were made attempting resolution. A cordial one hour discussion occurred with NEDA’s interim CEO. Settlement offers were made. No counter resolutions were offered. And so, litigation was filed. Even still, for the sake of the community, early resolution was again attempted.

During the past few months, an honorable resolution through mediation was offered to NEDA. An olive branch. Mediation is a private opportunity in which all parties air the strengths and weaknesses of their case and a skilled mediator utilizes this information to attempt settlement of the case. The process is confidential. A settlement which would lead to hope for those families who are so suffering from this disease.

And so, mediation was scheduled for March 11. After this date had been agreed upon, an alleged “conflict” arose with NEDA’s representative and NEDA asked to reschedule. Another date was set, this time April 2. And again, because of an alleged mistake by the attorneys retained by the insurance company for NEDA, mediation will not occur. And with that, hope for an expeditious resolution faded away.

With the federal court demanding progress, with the hope of resolution through early mediation extinguished, we surely must now go to war. And to war we will go. With courage. With strength. With the facts and law on our side. With absolute resolve.

In litigation as in war, you achieve victory by engaging in a relentless, aggressive, well-orchestrated and carefully designed plan to obtain victory and deprive your opponent of the initiative. You make your opponent pay a price higher than it expected for choosing the path of war.

So, war it is. In litigation, an attorney has the power of the legal system at his/her beck and call. Issuing subpoenas for relevant documents not just from the named parties but also from third parties and witnesses. Deposing people who may have information of relevant facts. Uncovering lies. Exposing fear, arrogance, greed and collusion. Discovering facts which support long held suppositions. Where necessary, including third parties as possible liable parties. Hundreds of hours spent on the process. The uncertainty.  The unexpected. For example, did United Behavioral Healthcare dare to consider that in the Wit case, it would lose its ability to control its own claims process and possibly have to pay attorneys’ fees exceeding $3o million dollars?

The greatest truth to embrace, the truth that keeps one focused through this great process is the reality that people who suffer from eating disorders will undoubtedly benefit from this challenge. Families who suffer from this disease may find comfort and greater opportunities to heal. Fraud, and those who perpetrate it will at long last be exposed.

And yet, we must continually be looking forward, always forward. We cannot look back at those who have died from this disease. But, we can help those who still suffer. THAT is what this lawsuit is about. Saving lives. That is the absolute reality which keeps one focused, which guides one through the turbulent days, weeks, months and years which lie ahead. Saving lives.

And so, “Once more unto the breach dear friends, once more …”

NOW BEHOLD, THE AWFUL PRICE OF TREASON!

Mel Gibson’s epic 1995 movie, “Braveheart” told the tale of one of the Scottish rebellion led by William Wallace against King Edward I and England. The movie did take some liberties with facts and portrayed King Edward I rather harshly. It also included the largely factual torture and death of William Wallace who was found guilty of treason against the Crown.

Immediately before the start of his torture, Wallace is given the opportunity to repent and if he did, he would receive a merciful death. When he refuses, the executioner yells to the leering crowd, “Now Behold, the Awful Price of Treason!” Wallace is tortured in a particularly gruesome manner and killed.

So too, our friends at United Behavioral Healthcare (“UBH”) are facing their own calls to repent. And like William Wallace, UBH is refusing and is having to face the consequences for its own acts of treason.

In prior articles, the importance of the Wit, et al v. United Behavioral Healthcare case to the mental health industry was explained. To briefly recap, a federal magistrate judge certified that the case could continue as a class action thereby impacting as many as 50,000 insureds of UBH. Then, on March 5, 2019, that judge issued a sweeping ruling holding that UBH on a class wide basis, violated its fiduciary duties to its insureds, ran its treatment guidelines through its finance and accounting departments, and improperly denied payment for necessary treatment. The ramifications and remedies for this bad faith conduct were yet to be determined.

In order to try to minimize the damage, on September 13, 2019, UBH made an announcement regarding new level of care guidelines for treatment of mental health disorders. UBH “voluntarily” stated that it would be implementing and enforcing guidelines developed by third parties to guide payment/treatment decisions for their insureds. According to UBH, they changed their prior level of care guidelines because the L/C/E “guidelines have been externally validated; that common language drives improved care and the six dimensions provide a more holistic view of acuity and chronicity of behavioral condition, thereby promoting more appropriate care for patients and a better overall experience.”

For some reason known only to God and broccoli, UBH failed to mention that they also presumably changed their guidelines because a federal court decision held their prior guidelines were grossly deficient if not outright fraudulent and the Sword of Damocles was hanging over their heads.

That Sword has now dropped.

In November 2020, Magistrate Judge Spero issued a 99 page ruling setting forth the “Awful Price” UBH must pay for its “acts of treason.” That ruling is embedded here:

https://www.courtlistener.com/recap/gov.uscourts.cand.277588/gov.uscourts.cand.277588.491.0.pdf

The first indication that UBH’s “Awful Price” would be steep is contained in the first sentences of the order:

This case arises out of pervasive and long-standing violations of ERISA by United Behavioral Health (“UBH”). UBH denied mental health and substance use disorder treatment coverage to tens of thousands of class members using internal guidelines that were inconsistent with the terms of the class members’ health insurance plans. UBH engaged in this course of conduct deliberately, to protect its bottom line. To conceal its misconduct, UBH lied to state regulators and UBH executives with responsibility for drafting and implementing the guidelines deliberately attempted to mislead the Court at trial in this matter. After the trial, the Court found for Plaintiffs.”

UBH must now reprocess 67,000 claims it denied for 50,000 people from 2011 to 2017. The Court entered a permanent injunction against UBH requiring UBH to evaluate claims using independent guidelines developed by professional mental health associations instead of its internal guidelines, which it had previously used to protect its bottom line.

The injunction requires UBH to use the Level of Care Utilization System (LOCUS), Child and Adolescent Service Intensity Instrument (CASII), and Early Childhood Service Intensity Instrument (ECSII)—assessment tools developed by the American Association of Community Psychiatry (LOCUS) and the Academy of Child and Adolescent Psychiatry (CASII and ECSII)—as well as criteria developed by the American Society of Addiction Medicine.

This injunction is effective for the next ten (10) years.

The injunction also requires that UBH personnel be trained in the use of the court-ordered medical necessity criteria.

On January 27, 2021, the Court appointed Mr. Douglas Young as Special Master to oversee UBH’s claims process and to ensure UBH applies the new standards, created by professional groups including the American Society of Addiction Medicine and the American Association of Community Psychiatrists. Mr. Young has the authority to retain attorneys and assistant administrators, to engage one or more psychiatrists to engage in the claims process. UBH has the privilege of paying for all costs and expenses of the Special Master. The Court has already authorized the Special Master to retain  and engage psychiatric consultants.

The last matter to be decided by Judge Spero is the amount of attorney’s fees to be awarded to Plaintiffs’ attorneys. The Plaintiffs’ legal firms are requesting approximately $28,000,000 in attorneys’ fees and approximately $1,500,000 for reimbursement of costs and expenses. It should come as no surprise that UBH is vigorously challenging an award of fees.

It should also come as no surprise that UBH has already filed its appeal to the 9th Circuit Court of Appeals with its opening brief due March 29, 2021. The case has been placed on the calendar for oral arguments in August 2021.

The Wit case should embolden medical and mental health providers to more aggressively push back against all insurance benefits providers. In any appeals of treatment decisions, the Wit case should be cited and argued. The Austen Riggs Center, in Massachusetts reports that it has won more appeals of denied treatment since the 2019 ruling, which it cites in its responses to insurers.

UBH turned its back on its insureds and those persons and their families who suffer from mental infirmities. That is, if they ever cared to begin with. The “Awful Price of Treason” that UBH must pay is not so much the amount of attorney’s fees it will have to pay or the dollar amount in damages it will pay,  but the fact that a court was forced to step in and take control over the manner in which UBH conducts its business and how they process their claims, an integral part of its business. That price will reverberate for years.

Our families, our loved ones who die as a result of this disease will be heard. And for those who do not listen, the price that will be paid will echo through eternity.

THE WEEK THAT WAS

Last week was eating disorder awareness week. And yet, the week was unlike any other prior “eating disorder awareness” week. Events transpiring in 2020 shook our nation to its core. And similarly shook common sense out of many organizations. Small but vocal aspects of society called for dismantling law enforcement. Socializing our communities. Destroying certain aspects of our history. Cities burned. Every type of “ism” called out as being reprehensible. Social justice run amuck leaving behind reason and logic.

Perhaps moreso than any other mental health community, the eating disorder community fecklessly rushed headlong into the fray. Last week, organizations and persons under the NEDA umbrella embraced anecdotal stories discussing black mental health matters, insights from the LBGTQ+ community, voices from the higher weight community, caregivers.  Organizations and persons conducted virtual yoga classes, talked about implicit bias and systemic oppression, thin bias, inclusivity and diversity. Ableism, healthism.

The following is a list of some of the “lessons and insights” that were spewed forth by persons under NEDA’s umbrella during the week:

  1. Some advocates opined that they wished the default in healthcare was that everyone was diagnosed with disordered eating.

2. Simply living in a diet culture equals living with trauma.

3. We are all victimized and oppressed by diet culture.

4. Everybody has a destructive relationship with food.

5. Society has formed its opinion of eating disorders by looking at someone’s “skin and bones in a hospital getting treatment.” [direct quote]

6. Atypical anorexia exists only because of fat phobia.

7. If we provide treatment to persons with the “most privileges” it doesn’t help persons with the “least privileges.”

8. Treatment providers tell thinner patients in front of fat patients that fat patients are “disgusting.”

9. When we are looking at genders, there are an infinite number of genders.

10. A person can try to shape themselves into being a man and a woman at the same time and that they can be neither.

11. We can impress upon ourselves that “toxic binary” is the only framework we have when it is not accurate for the population when we have so many genders.

12. That media portrays eating disorders with the most extreme version as the thin white woman and that’s not fair.

13. Apparently, another “privilege” is having a really good treatment team.

14. When we’re creating recovery, when we’re creating treatment, when we’re creating policies and guidelines they need to be made for the most marginalized person and that is the person who suffers from every marginalized identity.

15. We don’t need to be making recovery guidelines for cis white heterosexual men and women because they are just the top of the privilege chain.

16. We must envelope marginalized identities who are absolutely more at risk because they’re more likely to go under the radar and more likely to be ignored and gas-lit by families and medical professionals.

Those were the highlights of NEDA’s contributions to 2021 eating disorder awareness week.

We also listened to discussions concerning a lack of BIPOC and LBGTQ+ therapists and treatment professionals. We heard about a lack of treatment options for BIPOC and LBGTQ+ persons. Treatment that is too expensive. Treatment that is not equally available to all. These were and are certainly legitimate issues. However, these issues are societal in nature and are not unique to the eating disorder community. These broad based societal issues do not make eating disorders a social justice disease. They are being discussed by every other mental health and medical advocacy community.

Oppression of marginalized persons permeates society at large. The same issues are being discussed pertaining to admission to private schools, universities, job opportunities. Because the issues of race or sex or gender discrimination impact not just society in the United States as a whole, but is present on a global scale, it is certainly not unique to eating disorders and its community. But, we fail to address that point.

We also failed to focus on the issues unique to eating disorders.

No generally accepted treatment standards? Ignored.

Clinicians not collaborating with research doctors? Ignored.

Issues inherent with private equity ownership? Ignored.

The importance of dads in the recovery process? Ignored.

The incredibly high mortality rate of anorexia? Ignored.

No research based bills pursued in over eight years? Ignored.

Those are issues unique to eating disorders. All ignored.

And this past week, one can’t help but wonder why NEDA chose to ignore these issues and intentionally attempted to erase the line separating broad based societal issues from issues particular to the eating disorder community. What motivation could NEDA possibly have for undertaking this action?

Some people are aware that NEDA’s future will be determined by a federal district court judge and a jury based in Dallas, Texas. A lawsuit that when it reaches its inevitable conclusion, could result in NEDA dissolving. One of the allegations is that NEDA surreptitiously changed its mission to emphasize social justice and political issues without disclosing this information to its donors. That the person leading this vainglorious charge not only did not trust the medical community but believed they are doing tremendous harm. If NEDA continues to portray itself as the voice for families suffering from eating disorders, it has the absolute, non-delegable duty to be open and transparent with its donors regarding its changed mission. NEDA failed to comply with this duty.

One only needs to consider the line-up of social justice activists NEDA paraded during eating disorder awareness week and the topics discussed. Contrast that with the absence of  educating the general public of the dangers of each type of eating disorder and how best to combat them. When that comparison is made, NEDA’s agenda comes more into focus.

As NEDA invited “everyone to have a seat at the table,” an obvious omission became clear. NEDA posted a graphic, “Who’s at Your Table?” NEDA included, “Someone Who Makes You Smile,” “Someone You are Proud of,” “Your Recovery Hero,” and of course, “Favorite Body Liberation Activist” as well as a few other entities. So what is missing?

Perhaps, “Your Family Member Who Loves and Supports You.” In fact, the importance of family in the recovery process, the positive aspects of Family Based Therapy, parents, siblings are not just missing from this Table Graphic but were largely absent the entire week. Except for a very nice attempted save by the Caregiver group on Thursday, the incredible importance of the family structure was not only not discussed in detail, but was not discussed at all. And one must wonder why. Our families are the ones who are suffering.

And if you are a dad, forget it. You are merely a cis, white heterosexual binary person basking in the glow of your privileges and not deserving of mention or respect.

One must wonder how we have gotten so far off base? Isn’t the end goal the same for everyone, that is, eradicating eating disorders? Shouldn’t we all be working toward that end goal?

How did we let personal agendas sabotage this end goal? Are the jealousies, insecurities, fear and ego that permeate some of our perceived leaders so great, that they cannot listen to new ideas with interest and open minds?

Some incredibly intelligent, passionate people employed by companies with great financial resources have been driven out of the eating disorder industry or have left in frustration. Why? Why do we continue to get no research funding from the federal government? Why the dysfunctionality?

If an entrepreneur decided to bequeath $10 billion to the eating disorder community and industry with just one provision … that the eating disorder industry need only come to a mere consensus on developing generally accepted treatment standards and the most effective way to spend those proceeds, would we be able to?  Would the REDC/EDCoalition, iaedp, NEDA, AED, and Equip be able to look past all differences and accomplish this? I think we all know the answer to these questions.

No accountability. No demand to perform or perish. No demand for excellence. Little, if any collaboration. Little, if any transparency. No agreed standards of treatment. Ignorance of how companies outside of the eating disorder industry could assist in developing treatment protocols. Jealousy. Insecurity. Greed. Ego.

Sansón Carrasco, The Knight of Mirrors has arrived. And like Don Quixote, the eating disorder community fails to recognize their own metaphorical reflection in Sansón’s behavior as well as their physical reflection in the mirrors on the armor.

And our children continue to die. In fact, I challenge any so called leader in the eating disorder community to find a way to meet with any mother, meet with any father of a child who has died from eating disorders in the last year. You look them in the eyes and talk to them. Ask them what worked … and what did not.

Then, you tell them you are doing your best. You look into their eyes. And you tell us all what you will see. And then look at your own hands. And what do you see Lady Macbeth?

MEN’S GROUP

He who masters the power formed by a group of people working together has within his grasp one of the greatest powers known to man.”
― Idowu Koyenikan, Consultant and Author

This year’s eating disorder awareness week is coming to a quiet ending. And once more, I am left with the impression that fathers, husbands, grandfathers, boys, and male siblings for the most part continue to be largely ignored by the eating disorder community. Let us look at some facts:

By way of example, in the last 7 years at iaedp’s annual conference they have had 418 educations sessions. Only 3 were specifically about boys and men.

Toward the end of 2020, Project HEAL announced a change in its mission to, “We’re committed to anti-racism, anti-oppression, gender equity, and taking action to create justice.

NEDA has a history of excluding dads and men. From paying lip service to a bold, new program, a “Dad’s Initiative” approximately nine (9) years ago, and then mothballing it before its launch, to generally excluding boys and men in its “Everybody Has a Seat at the Table”  theme for its Eating Disorder Awareness Week.

It should come as no surprise that Men have been, as a matter of course, excluded from leadership positions in the eating disorder organizations. Of the 41 leadership positions listed in the top eating disorder organizations, 37 leaders are women and 4 are men.

There are numerous research studies indicating that the father–daughter, father-son relationship is incredibly important in the recovery process. And yet, this important part of the puzzle is being largely ignored by the eating disorder community.

However, there is at least one residential treatment program which has a monthly session of exclusively men. It is led by a male psychiatrist employed as a Medical Director at that eating disorder residential treatment program. This past year, I had the privilege of appearing as a “guest speaker” at one of these sessions. That week, it was attended by 40 men.

With no script prepared, I just began to talk with them. Of my past experiences. Of theirs. Nothing rehearsed. The questions and comments began to come from the dads and husbands. A few of them reached out to me afterwards with their stories of strength and resiliency. I was also advised that one dad, in a counseling session the very next week was more engaged and interactive than he had ever been before.

After consulting with a number of medical and mental health treatment professionals, we decided that this type of Men’s Group on a national scale was not only very much needed, but could be the foundation to allow men, dads, husbands, sons, grandfathers and siblings to find their voice, to become more active in their loved ones recovery. For men to understand that they are not alone. That a shared brotherhood exists and binds us all.

And so, I reached out to a number of treatment centers to ascertain whether they would support a Men’s Initiative. A program that would involve the participation of the dads, the husbands, the siblings of their patient population. If so, we would simply ask that they circulate information of these meetings which we would supply to them. That was it. No financial commitment. No long term commitment. No formal recognition or public statements indicating their commitment.

We stated that the educational and information session would be led by a male medical doctor and conducted once a month, probably on a Sunday afternoon via Zoom and would include an open discussion on eating disorders, father’s and husband’s, sons and sibling’s roles, providing a forum so men knew they were not alone and giving them a safe place to talk and share their emotions and thoughts.

The response was immediate and overwhelming. In the first 48 hours, EIGHT (8) treatment centers not only stated they would be involved but thought the initiative was very much needed and could provide an invaluable service.

By working from the ground up, by approaching men directly, by providing a safe place where their self-awareness, strength and passion can grow, where men will know they are not alone, perhaps the seeds of something mighty can find root … and start to grow.

In the next week or so, information will be released discussing this initiative in much more detail and welcoming participation.

Dads, husbands, sons, siblings, for far too long have been left in the shadows. No longer. For the sake, for the love, for the lives of our loved ones, our beloved children, wives, parents, our voices will be heard.

We will stand tall with all of the knowledge, courage, strength, passion and intelligence at our command.

Our loved ones demand nothing less.

A 4% Chance of Helping 1/3 of 1%

In the last Congressional session, the EDCoalition aggressively pursued the SERVE Act. It is also supporting the new SERVE Act which was recently filed. The Supporting Eating Disorders Recovery Through Vital Expansion Act (SERVE) Act sought to, and seeks to expand TriCare, allowing military family members over age 20 access to eating disorders care, and ensures servicemembers and their families have access to comprehensive eating disorders treatment nationwide.

It is admirable that the EDCoalition would focus on our military and the eating disorder needs within that community. My father was an Air Force pilot. Among other planes, he flew the F86 Sabre jet, the U.S.’s first swept wing fighter. I have a nephew who at 30 years old, is a Captain in the Air Force stationed at the Pentagon. I have two uncles who proudly served. And yet, with regard to eating disorders, the number differential between civilians and military personnel who suffer from this disease is staggering.

If the numbers are to be believed, 30 million Americans have or will have an eating disorder in their lifetime. There are currently approximately 1,400,000 active United States military personnel. The EDCoalition estimates that up to 8% of military personnel suffer from eating disorders. That would be 112,000.00. However, that number may be a bit high. The Armed Forces Health Surveillance Branch states that between 2013 and 2017, 1,788 active-duty troops were diagnosed with an eating disorder.

Whether you use the figure of 1,788 over five years or 112,000, both numbers pale in comparison to 30,000,000. 112,000 is approximately 1/3 of 1% of 30,000,000.

Certainly, there are aspects of Tricare which need to be amended. Stopping treatment in residential treatment centers for mental health issues including eating disorders at age 21 is nonsensical. With some persons serving in the armed forces for decades, this age limitation certainly needs to be amended.

In the past, Tricare on its website stated that it did not cover residential treatment care for eating disorders. That is no longer the case. On August 7, 2020, the U.S. Government Accountability Office issued a position letter on Tricare and eating disorders.

https://www.gao.gov/assets/710/708697.pdf

As one can readily tell, Table 3 in that Report provides a comprehensive list of Network and Non-network treatment facilities where eating disorder treatment is covered. This Report also states, “DOD [Department of Defense] is examining ways to improve its screening of eating disorders in the military as well as to identify possible ways to prevent such conditions in the military.”

The Report also states, “… DOD recently expanded the available research funding for eating disorders in its Peer-Reviewed Medical Research Program (PRMRP) with the goal of obtaining more comprehensive information on prevalence of eating disorders in the military and exploring ways to improve diagnosis of and treatment for the condition. In addition, the PRMRP is funding opportunities for research identifying biological and environmental risk factors associated with eating disorders, which could inform efforts to prevent or reduce the prevalence of these conditions. For example, one recently sponsored PRMRP project is developing an eating disorder screening tool for use with veterans and the military population.”

It is gratifying to see that at least one entity is pursuing research funding.

Military Veterans in Congress

With regard to Congress, military veterans constitute a strong and influential presence. The following military veterans served in the 116th Congress which just concluded:

• 96 total veterans in the 116th Congress.
• 30 were Democrats, 66 were Republicans.
• 19 served in the Senate, 77 served in the House.
• 48 served in the military after 2000.
• 21 served in the military in the 1960s or earlier.
• 19 were first-time lawmakers.
• 7 were women.
• 50 served in the Army, Army Reserve or Army National Guard.
• 17 served in the Marine Corps or Marine Corps Reserve.
• 17 served in the Air Force, Air Force Reserve or Air National Guard.
• 13 served in the Navy or Naval Reserve.
• 1 served in the Coast Guard

That constitutes about 18% of all Senators and Congresspersons with representation in both major parties. With such a strong presence, one could presume that support for eating disorder bills impacting the military would be relatively low hanging fruit.

How the EDCoalition fared with SERVE Act in the last Congress.

With regard to the SERVE Act, we can rightly presume that our military veterans serving in Congress would support this bill. However, the facts indicate otherwise.

The following table indicates the Military Veterans in Congress and whether they supporting the SERVE Act.

DistrictPartyNameServiceEraSERVE Act Score
GA 9GOPDoug CollinsAF Reserve2000s-2010sNo
WY SenateGOPMike EnziAir Force1960s-1970sNo
SC SenateGOPLindsey GrahamAir Force1980s-2010sNo
PA 6DemChrissy HoulahanAir Force1980sNo
VA 5GOPDenver RigglemanAir Force1990sNo
OR 4DemPeter DeFazioAir Force1960s-1970sNo
TX 36GOPBrian BabinAir Force1970sNo
MS SenateGOPRoger WickerAir Force1970s-1990sNo
OH 6GOPBill JohnsonAir Force1970s-1990sNo
GA 11GOPBarry LoudermilkAir Force1980s-1990sNo
UT 2GOPChris StewartAir Force1980s-1990sNo
NE 2GOPDon BaconAir Force1980s-2010sNo
CA 33DemTed LieuAir Force1990s-2010sYes
IL 16GOPAdam KinzingerAir Force2000s-2010sNo
GeorgiaRepublicanJohnny IsaksonAir Force1960s-1970sNA
FL 16GOPVern BuchananAir NG1970sNo
PA 10GOPScott PerryArmy NG1980s-2010sNo
OK SenateGOPJim InhofeArmy1950sNo
KY SenateGOPMitch McConnellArmy1960sNo
MA SenateDemEd MarkeyArmy1960s-1970sNo
RI SenateDemJack ReedArmy1970sNo
AK SenateGOPTom CottonArmy2000s-2010sNo
IN 4GOPJim BairdArmy1960s-1970sNo
TN 7GOPMark GreenArmy1980s-2000sNo
CO 6DemJason CrowArmy1990s-2000sYes
FL 6GOPMichael WaltzArmy1990s-2010sNo
FL 17GOPGreg SteubeArmy2000sNo
KS 2GOPSteve WatkinsArmy2000s-2010sNo
NY 11DemMax RoseArmy2010sNo
AK (House)GOPDon YoungArmy1950sNo
GA 2DemSanford Bishop Jr.Army1960sNo
IL 1DemBobby RushArmy1960sYes
MN 7DemCollin PetersonArmy1960sNo
NJ 9DemBill PascrellArmy1960sNo
NY 15DemJose SerranoArmy1960sNo
NC 1DemG.K. ButterfieldArmy1960sNo
CA 5DemMike ThompsonArmy1960s-1970sYes
NC 3GOPWalter JonesArmy1960s-1970sNo
VA 3DemBobby ScottArmy1970sNo
TN 1GOPPhil RoeArmy1970sNo
TX 11GOPMike ConawayArmy1970sNo
LA 3GOPClay HigginsArmy1970s-1980sNo
TX 1GOPLouie GohmertArmy1970s-1980sNo
SC 2GOPJoe WilsonArmy1970s-1990sNo
FL 2GOPNeal DunnArmy1980sNo
NV 2GOPMark AmodeiArmy1980sNo
AR 1GOPRick CrawfordArmy1980s-1990sNo
KY 2GOPBrett GuthrieArmy1980s-1990sNo
OH 8GOPWarren DavidsonArmy1980s-1990sNo
IL 15GOPJohn ShimkusArmy1980s-2000sNo
NY 1GOPLee ZeldinArmy2000sNo
FL 18GOPBrian MastArmy2000s-2010sNo
IL SenateDemTammy DuckworthArmy NG1990s-2010sNo
IA SenateGOPJoni ErnstArmy NG1990s-2010sNo
SC 4GOPWilliam TimmonsArmy NG2010sNo
KY 5GOPHal RogersArmy NG1950s-1960sNo
NY 2GOPPeter KingArmy NG1960s-1970sNo
AR 3GOPSteve WomackArmy NG1980s-2000sNo
OH 15GOPSteve StiversArmy NG1980s-2010sNo
MS 1GOPTrent KellyArmy NG1990s-2010sNo
HI 2DemTulsi GabbardArmy NG2000s-2010sNo
KS 1GOPRoger MarshallArmy Reserve2010sNo
MD 4DemAnthony BrownArmy Reserve1980s-2010sNo
OH 2GOPBrad WenstrupArmy Reserve1990s-2010sNo
LA 5GOPRalph AbrahamCoast Guard, ANG1980s-2010sNo
KS SenateGOPPat RobertsMarine Corps1950s-1960sNo
CT SenateDemRichard BlumenthalMC Reserve1970sNo
IN SenateGOPTodd YoungMarine Corps1990s-2000sNo
AK SenateGOPDan SullivanMarine Corps1990s-2010sNo
IN 6GOPGreg PenceMarine Corps1970s-1980sNo
TX 3GOPVan TaylorMarine Corps1990s-2000sNo
ME 2DemJared GoldenMarine Corps2000sNo
CA 8GOPPaul CookMarine Corps1960s-1980sNo
IL 12GOPMike BostMarine Corps1970s-1980sNo
MI 1GOPJack BergmanMarine Corps1970s-2000sNo
AZ 7DemRuben GallegoMarine Corps2000sNo
MA 6DemSeth MoultonMarine Corps2000sLead
PA 17DemConor LambMarine Corps2000s-2010sNo
CA 50GOPDuncan HunterMarine Corps2000s-2010sNo
WI 8GOPMike GallagherMarine Corps2000s-2010sNo
CA 24DemSalud CarbajalMC Reserve1990sNo
MI SenateDemGary PetersNavy1990s-2000sNo
FL SenateGOPRick ScottNavy1970sNo
CA 39DemGil CisnerosNavy1990s-2000sYes
NJ 11DemMikie SherrillNavy1990s-2000sYes
VA 2DemElaine LuriaNavy1990s-2010sYes
PA 14GOPGuy ReschenthalerNavy2000s-2010sNo
TX 2GOPDaniel CrenshawNavy2000s-2010sNo
TX 22GOPPete OlsonNavy1990sNo
DE SenateDemThomas CarperNavy Reserve1960s-1990sNo
IN 8GOPLarry BucshonNavy Reserve1980s-1990sNo
MD 1GOPAndy HarrisNavy Reserve1980s-2010sNo
CA 20DemJimmy PanettaNavy Reserve2000sNo
IN 3GOPJim BanksNavy Reserve2010sNo
MS 4GOPSteven PalazzoMarine Corps/Army1980s-2010sNo
AZ SenateGOPMartha McSallyAir Force1990s-2010sNo

In the Senate, of the 19 Senators who are military veterans, their support, or the lack thereof, was unanimous. Not one of the 19 Senators who served in our military supported the SERVE Act.

In the House of Representatives, 8 Congressmen and women, including the lead Congressman supported the SERVE Act. That means sixty-nine (69) Congresspersons did not support the SERVE Act.

With eating disorders allegedly being more prevalent within our military personnel, it is perplexing that our Congressmen and Congresswomen who previously served in the military, did not uniformly support the SERVE Act. So, out of fairness we should consider the other politicians in Congress and their outlook on not just the SERVE Act but on the other initiatives supported by the EDCoalition.

Congress and the SERVE Act

Our friends at the EDCoalition assemble a scorecard for Senators and Congresspersons. Each time a politician either signs a letter showing support for a bill, or introduces legislation they co-sponsored or legislation they voted directly for relating to eating disorders, they receive a positive check. A grade of 0 through 4 is then assigned to each check, with o points indicating no support and 4 indicating support. (There are other ways to increase the score such as being the sponsor and introducing the bill). Naturally, if a politician has not indicated any support at all, they receive a score of zero.

The EDCoalition makes it clear that, “It is important to note that the legislative efforts listed on this scorecard reflect a combined effort from the eating disorders community, and not solely EDC-led initiatives.”  Presumably this refers to NEDA and the REDC who pay the same lobbyist, Center Road Solutions.

The EDCoalition then listed fifteen (15) bills, resolutions, letters and initiatives they supported. One would be justified in assuming that if the bills had merit, politicians, especially those who previously served in the military, would support in theory, if not practice, those bills.

The EDCoalition issued its most recent scorecard on December 15, 2020. To say the numbers are disturbing would be charitable.

In the Senate, of the 53 Republican Senators, FORTY-SEVEN (47) received a score of ZERO. This indicates no support whatsoever for eating disorder bills and resolutions. And lest one think that Republicans alone are forestalling bills on eating disorders, of the 45 Democratic Senators, TWENTY-SEVEN (27) received a score of ZERO. Of the two, Independent Senators, both had a score of ZERO, including Senator Bernie “Mittens” Sanders.

Of the Democrats in the Senate, the following well known Senators had a score of ZERO: Cory Booker (D) NJ, Elizabeth Warren (D) MASS, Diane Feinstein (D) CA, and our current Vice President Kamala Harris (D) CA.

In the House of Representatives, the numbers are equally alarming. Of the 199 Republicans, one hundred sixty-eight (168) received a score of ZERO.  Of the 235 Democrats, ninety (90) received a score of ZERO. Of the Democrats in the House, the following well known Congresspersons had a score of ZERO: Adam Schiff (D) CA, Maxine Waters (D) CA, and Henry Cuellar (D) TX. Two members of the Democratic Socialist “Squad” registered scores of ZERO; Rashida Tlaib (D) MI and Ayenna Pressley (D) MASS. Two other members of the Democratic Socialist Squad, Alexandria Ocasio-Cortez (D) NY and Ilhan Omar (D) Minn each registered scores of one (1).

Apparently, eating disorder bills are being ignored by both conservative Republicans on the far right and liberal Democrats on the far left. To date no stand-alone eating disorder bill has ever made it out of Committee for debate on the House or Senate Floor. No eating disorder bill emphasizing research funding has even been introduced for eight (8) years.

With so many politicians from both sides of the aisle ignoring eating disorder bills, at what point is the community justified in demanding explanations and accountability. Even though the concepts of accountability or “perform or perish” are alien to the eating disorder community, when faced with such an overwhelming display of ineptitude and incompetence, are we not justified in looking at alternative ways of accomplishing goals?

As we saw last week, appropriations for funding of research of mental health issues are usually submitted through the National Institute of Mental Health (“NIMH”). NIMH makes funding requests to be included in the annual federal Appropriations Bill. 

Statements from the EDCoalition that “meaningful progress in eating disorders treatment and intervention will only be realized to the extent we meaningfully invest in its science” ring hollow since their words are not backed by its conduct. Research means Progress. Progress means Hope. Hope begets Recovery.

As shown last week, Congressional bills have on average, a 4% chance of being enacted into law. That means we are looking at a 4% chance of success on a bill that will have an impact on 1/3 of 1% of people who suffer from eating disorders. AGAIN, THAT IS A 4% CHANCE OF HELPING 1/3 OF 1% OF THOSE WHO SUFFER FROM EATING DISORDERS.

The subject matter of bills and the subsequent lobbying efforts on those bills are dictated by those who provide the financial resources for those endeavors. So, as our families continue to suffer and our children continue to die, aren’t we entitled to transparency and honest answers to the questions of who is supplying the funding for these foolhardy ventures, who is making the decisions to pursue certain bills and why isn’t crucial research funding being pursued?

It is an absolute certainty that if an organization, like NEDA, solicits donations from the general public and as part of its solicitation efforts it represents that “… It’s time we stop treating them [eating disorders] as vanity illnesses and put serious effort into research that can help us broaden the understanding of what eating disorders are and who they affect.” … “The more funding allocated to eating disorders research, the quicker we can learn more about what causes them — and the quicker we can save more lives.” that organization has the absolute, non-delegable duty to advise its donors what specific legislative initiatives it is pursuing. Especially when that organization collaborates with other entities and jointly pay lobbyists a six figure revenue stream. As the EDCoalition publicly stated, “It is important to note that the legislative efforts listed on this scorecard reflect a combined effort from the eating disorders community, and not solely EDC-led initiatives.”  Undoubtedly, this refers to NEDA and the REDC who pay the same lobbyist, Center Road Solutions.

Suppose that an organization solicits donations representing to the public in general and the eating disorder community in particular, that said donations are going toward crucial research on eating disorders but in fact, those donations are not being directed toward research based Congressional bills. Then presume that same organization conspires with other organizations, pools their funds to pay a single lobbyist to pursue bills which not only are not research based but do not pertain to the vast majority of people who suffer from this disease. If these facts are proven, then it is axiomatic that all organizations and persons participating in this subterfuge should be held accountable.

Difficult questions need to be asked. Transparent answers to these difficult questions must be demanded and can be voluntarily made. But, we cannot expect that. So, if transparent answers are not voluntarily given, they can always be discovered during sworn, deposition testimony or in a court of law.

And in a lawsuit through discovery, there is a much greater likelihood than 4%, that the answers sought will be at long last uncovered.

RESEARCH FUNDING EVERYWHERE AND NONE OF IT FOR US

Shepherding a bill through Congress, from introduction through being enacted into law is incredibly difficult. Between 2001 and 2015, nearly 74,500 bills were introduced in Congress. However, only 2,345 became law. This equates to approximately four percent (4%). That number is actually high when you consider bills that become law are often changed, sometimes materially, from their introduction to passage.

If bills you support, like the Nutrition Care Act (H.R. 3711), the Serve Act (H.R. 27670) or the Eating Disorders Prevention in Schools Act (H.R. 6703) are not signed into law during a legislative session, when a new Congress is seated in January of odd numbered years, your bill dies. Bills need to be reintroduced anew, are renumbered and the process begins again. That process is daunting and complicated. That was apparent even back in 1976 when Schoolhouse Rock first aired its iconic, “I’m Just a Bill” episode.

As for eating disorders, enactment of bills into law is non-existent. Introduction of bills which emphasize research into eating disorders has been completely abandoned. And yet, that in and of itself is curious since all persons recognize that in order to diagnose and properly treat this illness, the highest priority must be research.

In September 2019, EDCoalition president, Chase Bannister, made the following remarks before the National Institute of Mental Health National Advisory Mental Health Council:

“This mortality rate underscores the severity of this illness, as it is common for individuals with eating disorders to have co-occurring medical and behavioral health conditions, increasing the complexities of proper intervention and treatment.”

“Proper intervention and treatment for any condition requires an investment in research.”

“Amongst all psychiatric conditions, … funding for eating disorder research remains among the most discrepant from the burden of illness they represent.”

“Meaningful progress in eating disorders treatment and intervention will only by realized to the extent we meaningfully invest in its science.”

That same day, the ED Coalition issued a press release stating in material part: “For too long, research funding for eating disorders has been an order of magnitude away from what’s necessary. Meaningful progress in eating disorders treatment and intervention will only be realized to the extent we meaningfully invest in its science. We call upon NIH – and all who make or shape policy – to invest in eating disorders research. To do what’s necessary.”

With this universal understanding, it is particularly perplexing to see that bills emphasizing funding for the research of eating disorders have been completely abandoned by the EDCoalition. The last such bill was introduced in Congress in 2013. Eight (8) long years ago. And that is perplexing and is the basis for many questions which need to be asked … and transparently answered. Answers we know that will never be voluntarily forthcoming.

First, appropriations for funding of research of mental health issues are usually submitted through the National Institute of Mental Health (“NIMH”). NIMH makes funding requests to be included in the annual federal Appropriations Bill. Without its passage, federal programs are not funded and government run agencies and organizations cease to operate.

Prior to the 2021 Appropriations Bill being signed in late December of 2020, NIMH submitted to the United States Senate an “Explanatory Statement for Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Bill, 2021 Summary of Budget Estimates and Committee Recommendations for Fiscal Year 2021.” This was a  281 page document. The document made requests and recommendations regarding funding research for mental health issues to be included in the 2021 Appropriations Bill.  For example, requests were made for the following:

$300 million increase for Alzheimer’s and dementia research funding at the National Institutes of Health (NIH), including $15 million to fund and implement the BOLD Infrastructure for Alzheimer’s Act (P.L. 115-406), and advances the Improving HOPE for Alzheimer’s Act (S. 880/H.R. 1873);

$8.48 billion for the National Science Foundation (NSF), with $6.91 billion (a $169 million [2.5%] increase) dedicated to research and related activities. 

$6.015 billion for Substance Abuse & Mental Health Services Administration (SAMHSA) an increase of $133 million which includes:

  • $757.5 million for the community mental health services block grant, including a NEW $35 million block grant set-aside for crisis services, a NAMI priority;
    • $24 million for the National Suicide Prevention Lifeline, an increase of $5 million

$500,000,000 to the National Institutes of Health for research related to opioid addiction, development of opioid alternatives, pain management, and addiction treatment at the National Institute of Neurological Diseases and Stroke and the National Institute on Drug Abuse.

$52,344,000 for Autism and Other Developmental Disorders program for this program which supports surveillance, early detection, education, and intervention activities on autism and other developmental disorders, as reauthorized in the Autism Collaboration, Accountability, Research, Education and Support [Autism CARES] Act of 2019 (Public Law 116–60).

$41,619,000 for University Centers for Excellence in Developmental Disabilities for the University Centers for Excellence in Developmental Disabilities, a network of 67 centers that are interdisciplinary education, research, and public service units of a university system or public or nonprofit entities associated with universities.

As for eating disorders? In this 281 page Recommendation Report, the only reference to eating disorders appears on page 115 and states as follows:

Eating Disorders.—The Committee commends NIH for supporting multi-Institute research on the chronic, fatal, and serious mental illnesses encompassing eating disorders that affect 30,000,000 Americans during their lifetimes, and its association with other conditions such as diabetes, infertility, heart disease, post-traumatic stress disorder, substance use, polycystic ovary syndrome, and tooth decay. The Committee recognizes that eating disorders are a deadly bio-psycho-social illness and that multiple research topics must be explored to understand, prevent, and treat eating disorders, including psychosocial issues; health disparities and food insecurity; environmental factors such as weight stigma; the complex interplay of metabolic processes; and maternal health. The Committee encourages NIH to continue to support a multi-Institute approach and to report on current research efforts related to the prevention, diagnosis, and treatment of eating disorders in the fiscal year 2022.” [emphasis added]

No specific funding recommendation.

No recommendation for specific grants or grant amounts.

No recommendation for a financial commitment.

No specific funding for research into the biological and genetic causes of eating disorders.

Although the Committee stated that it commended NIH for supporting multi-Institute research on the chronic, fatal, and serious mental illness known as eating disorders it did not recommend any specific funds be appropriated for research.

So where did this language come from? [Apologies for ending a question with a preposition.] A little digging results in the answer to this question. This language came from a March 2020 letter addressed to the Chair and the Ranking Member of the Committee on Appropriations Subcommittee on Labor, Health & Human Services and Related Agencies. The letter was signed by forty-three (43) Congresspersons. A copy of that letter is attached here:

Despite the fact that this letter contains no requests for funding of research, I am confident that our friends at the EDCoalition stood on the sidelines, and as is their wont, “applauded or praised” this worthy endeavor.

But once again, a mental health illness which is believed to impact nine percent (9%) 0f the United States population is excluded from specific federal funding.

A mental health illness which is believed to result in one death every fifty-two (52) minutes is excluded from specific federal funding.

Admissions from the EDCoalition that “meaningful progress in eating disorders treatment and intervention will only be realized to the extent we meaningfully invest in its science.” And yet no research based bills are pursued by that organization which presumably results, in part, in NIMH making no specific financial recommendations for eating disorder research in fiscal year 2021.

On the other hand, those Congressional bills which have a four percent (4%) or less chance of being passed and which, even if passed, will not impact research, await! The death toll rises. And even still, there is no demand for accountability.

In the next article, we will explore the “Congressional Scorecard of the EDCoalition,” apply it to the EDCoalition and look at what the future may hold.

A Legacy

I don’t really care if people forget me. My legacy wasn’t about me. It was about everything I could do for another. When that sinks in…well you try a little harder. You dream a little broader. Your heart stretches a little farther and you find that you can’t go back to the same place and make it fit. You become a person of ideas and seek out your own kind. And then it happens: One day you discover that staying the same is scary and changing has become your new home.” 

Shannon L. Alder, Author

When I googled the phrase, “do not try to create your own legacy” the following links first appeared on page 1:

“You Can Make a Difference: 7 Ways to Create a Legacy;”

“How to Think About Building Your Legacy;”

“10 Ways to Build Powerful Legacy Now;”

“How to Build Your Legacy;”

“7 Great Quotes on Leaving a Legacy;”

“Your Children are Not Your Legacy;”

“5 Ways a Legacy Driven Mindset Will Define Your Leadership;”

“5 Simple Steps to Build Your Legacy;”

“How to Build a Legacy;”

“The Basics of Building a Legacy – Cultivate What Matters.”

Obviously, either my google skills need significant refinement [a veritable certainty] or a search about not trying to create your own legacy is so counterintuitive as to be non-existent. After all, don’t most people believe they can write their own legacy, they are masters of their domain, lord of the manor and king of the county? People WILL remember them a certain way! Isn’t that what most people desire?

Life events over the course of the past year or so have brought into focus the fragile nature of existence, the lives we touch and how we are perhaps remembered. In October 2019, my elderly father passed away. In September 2020, my elderly mother passed away. In November 2020, my slightly older brother passed away. In January 2021, my younger brother nearly passed away after suffering a massive heart attack. A beautiful granddaughter being born in November 2020.

A reminder that death comes for us all. Everyone dies. But, not everyone really lives. Can we dictate what people think of us while we live, let alone after we are gone? And should we even try? If we focus a great deal of time and attention in attempting to establish our own legacy, isn’t that by its very nature, the very essence of egocentricity and is in fact, counterproductive to establishing a memorable legacy?

Is a life so focused on trying to build your own legacy as inane and shallow as those people who today, go forth and loudly proclaim themselves patriots? That seems to be the height of self-identification and is almost exclusively a self-created label. After all, a person’s actions and conduct may to one group of people be seen as daring and noble. To another group, that same action and conduct may be seen as foolhardy and damning. King George VI certainly did not see George Washington and the other founders of our nation as patriots but as traitors.

So, what do we spend our life trying to build? What will be our legacy? Will we be remembered at all by future generations and if so, for what will we be remembered? Is that even important? And can one bold, daring act tear apart and even tear down a perceived established legacy? Or many years from now, is that one bold, daring act looked upon by future generations as singularly courageous?

Recently, a few people advised that whatever “legacy” I thought I was trying to establish in the eating disorder community would forever be tarnished because of my involvement in the class action lawsuit against NEDA. Another person stated that she doubted that organizations would collaborate with me again on any matter. If that is the case, it would be unfortunate that a community could act from a place of fear and insecurity by placing personality differences and differing viewpoints over the advancement of a common cause. That unfortunate point of view is also exacerbated by the reality that those people are basing their actions upon a faulty premise.

The fundamental misunderstanding with their line of thinking is … I am not concerned with and am not trying to establish a “legacy.” I have not been an eating disorder advocate for my entire life. In fact, had my daughter recovered, like many other strong men before me, I would have left behind this dysfunctional community and never looked back. In a heartbeat. But, that was not to be my fate.

I believe too many people in the eating disorder community are more concerned with trying to establish their own legacy. They seem to be trying to accumulate power and they demand respect. They believe they have paid their dues and it is their time now! They place their own ego over the needs of families and people who suffer, and die from this disease. They fear progress not generated by them. And the more they try to accomplish their self-important goals, the further away they get from achieving anything of substance, let alone greatness. And whatever legacy they so desire continues to elude them. Perhaps they have forgotten, or perhaps never knew a fundamental foundational element about legacies.

There is a prescient line from a movie entitled, “Star Trek – First Contact.” One of the main characters, the inventor of warp drive was explaining that his vision of a device that would change humankind was inspired not by noble thoughts and altruism, but by his lust for money and pleasure. In response, another character responded, “Someone once said,  Don’t try to be a great man. Just be a man and let history make its judgments.”

So, how does history make its judgments on legacies? What conduct does history embrace or shun in carving and shaping a person’s legacy?

Are legacies made by those persons who lead organizations blindly and with little vision and compassion? Or, are legacies made by those late night phone calls when a young person suffering from an eating disorder reaches out to you because you are a safe place for them?

Are legacies made by people who loudly proclaim that their views on counseling and social justice are the only correct views and if you do not agree with them, they ostracize and in some cases harass you? Or, are legacies made when a young person, mostly recovered from her own battle with eating disorders, with tears in her eyes, looks you in the eyes and tells you that you are her second daddy?

Are legacies made by persons who on the outside may project a façade of confidence and intelligence, but on the inside their soul is gripped with fear and insecurity and they live their daily existence so afraid that their pain will be discovered? Or, are legacies made when a mother, with tears in her eyes, tells you that she believes you saved her child’s life because now her child is recovering and has a chance at life?

Are legacies made by persons who are looked upon as knowledgeable simply because of their longevity in the community and because people like them? Or, are legacies made when a young woman who was in treatment with your daughter contacts you, tells you that your daughter was so important in her recovery, that she just had a baby, and she gave your daughter’s name to her child as her child’s middle name?

Are legacies made in the broad light of day for all to see and admire? Or, are legacies made in the quiet of the night where only you and one other person know that on that night, that one blessed night, one more life was saved?

I know I am not erudite enough to supply meaningful insight into any of those questions. I do believe that a soul doesn’t explain its purposes or the path it directs you to follow. Instead, perhaps our true legacy lies at the end of that path. Perhaps, when we try to get off that path, our legacy is pushed further away. Perhaps when we try to force our way down that path sooner, to “make things happen,” our legacy fades even further away. Perhaps when our focus turns to the self, to our ego, to our own self-aggrandizement, our legacy remains out of reach.

What is your legacy? Again, who can possibly know that? But, is it possible that we get closer to what our legacy could be by simply getting out of own way, by performing simple acts of love and kindness with no expectation of acknowledgement or reward? By living in a place of service to others with grace and humility? Now, make no mistake. There will be those necessary times which demand a warrior’s mentality. Times which demand great and mighty deeds. Times which require a soul filled with strength and courage. Times which demand decisions made intelligently and decisiveness. But after you wield that sword, one must return to that fundamental place of humility and service to others.

As for my legacy … I will remain just a man. And let history make its own judgments.

DIVERSITY AND INCLUSION

“The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.”

“Our lives begin to end the day we become silent about things that matter.”

We must learn to live together as brothers or perish together as fools.

                  Martin Luther King, Jr.

Today we pause to remember Martin Luther King, Jr. A dynamic Southern preacher who came to be the face of the civil rights movement in the 1960s and beyond. He is oft quoted (as above) and represents the very best of diversity, equity and inclusion.

Diversity. Equity. Inclusion.

Three words which are being bandied about with great frequency in the eating disorder community. Seemingly every eating disorder organization now includes a Diversity, Equity & Inclusion Committee.

Diversity. Equity. Inclusion.

How do those three words intersect? After all, what is diversity without inclusion?

For that matter, what do those words even mean in the context of a serious, deadly mental illness like eating disorders? We are not addressing those terms in the context of being able to sit on a bus. We are not addressing those terms in the context of admission to a school or university. We are not addressing those terms in the context of greater representation on corporate boards of directors or partnership in law firms or accounting firms.

We are addressing those terms in the context of a deadly mental illness, an illness with biological and genetic components. An illness that claims a life every 52 minutes. Life and death. The highest stakes possible.

Today, many organizations in the eating disorder community are racing head long into political correctness to see which one can virtue signal the most. Some are choosing to include pronouns after their names believing that illustrates how enlightened and inclusive they are. Some organizations publicize how they are expanding their membership and committee involvement to include greater representation among African Americans, Hispanics, LBGTQ and other minorities. All are commendable and worthy actions. All are needed actions.

No rational person can argue against the fact that the mental health industry in general, and the eating disorder community specifically, need many more African American, Hispanic, LBGTQ and other minority counselors, therapists, doctors, psychiatrists, psychologists and other medical and mental health professionals.

No rational person can argue against the fact that medical and mental health services must become more available and more affordable to the African American, Hispanic, LBGTQ and other minority communities.

To further those ideals, I am embedding an article from National Council of Non-profits. This article sets forth practice pointers; questions to consider when establishing a D&I action plan; Resources for your learning journey; Resources for Non-Profit Employers; Diversity on Boards of Directors and for Grant makers and includes other useful information:

https://www.councilofnonprofits.org/tools-resources/why-diversity-equity-and-inclusion-matter-nonprofits

These are incredibly complex issues which involve and impact all aspects of life … from education, to healthcare, to access, to education, to treatment and research funding, to the family structure and society in general. And because these issues are so incredibly complex, to provide real life, workable solutions which will better society as a whole, we need the greatest thinkers and leaders from all walks of life, who are well versed in and have ideologically diverse backgrounds and experience. And therein lies the breakdown in the mental health community, particularly the eating disorder community.

Most of the eating disorder organizations are dominated by women who identify politically with the very far left. Women of intelligence. Women of passion and drive. Women who have controlled and monopolized the eating disorder community from its inception. And in the present drive to be more diverse, they are looking for women, people, and non-binary persons of different races, creeds, or sexual orientation. African-American persons. Hispanic persons. LBGTQ persons. Trans persons. Non-binary persons. A veritable rainbow of persons. All commendable. And yet despite this drive for diversity, these organizations seem to be only seeking persons who all think, believe or have the same ideals, ideological mindset and political views. If you are politically far left with a far left mindset, you are welcome. That ideological mindset is cast in stone.

However, if you do not have that mindset, not only is a place at the table not open to you but you are subject to being ostracized and in some cases, fingers are pointed at you as part of the problem. Despite the fact that eating disorders intersect between medical and mental health issues, one person in the eating disorder community publicly stated, “Public health in this country is getting it so wrong. Those of us who have done the work around our internalized biases no longer trust the medical establishment to actually help us. This is no space for white, straight and thin folks to jump in.”

One organization likened eating disorders to intersecting with oppressions like racism, ableism, healthism, ageism, homophobia, transphobia, classism and more. When one delved further, white male privilege was included in the list of “isms” harming people with eating disorders.

And therein lies the problem and begs the question … How can an organization or leaders in a community preach the necessity of diversity and inclusion, when their very actions dictate that diversity without inclusion is not only acceptable but is the right path to take? They ostracize and exclude persons of different ideological intellects simply because, they think differently.

In 2015, Somalian born, Dutch American activist, Ayann Hirsi Ali authored an OpEd article in The Harvard Crimson in which she stated the following:

“Diversity. It is a principle that today’s society values greatly—a sign of virtue, moral progress, and greater social inclusivity. 

Yet somehow we have got so caught up in the pursuit of diversity that we have drifted away from the core of what it was all about, the core of liberalism: the individual.

Instead of struggling and campaigning for the freedoms and rights of the individual, some of us seem more focused on the freedoms and rights of the group.

The greatest overarching identity that liberalism exalts above all others is humanity. We should be fighting for the individual not simply because he or she belongs to this or that minority, but because we are all human.

The identity politics of our time has created a language of political correctness that sometimes verges on censorship. We have allowed the voice of the group, or whoever claims to represent the group, not only to speak for the individual, but sometimes to shout down the individual if his or her story does not fit with an approved narrative.

As a black woman and an immigrant, I am all for diversity. Who isn’t? But I care more for individual freedom. For, in a truly free society, our group identities should diminish, not increase, in their importance.

That, not the entrenchment of historic differences, should be our goal.”

Greater societal inclusivity. Standing up for the rights of the individual. Diminishing group identities. Listening, then trying to understand, and in some cases, embracing the ideas, passion and vision of those who may be ideologically different. Instead of attempting to quash the ideas and resources of those whose thoughts and vision differ from ours. That doesn’t mean you are wrong. To the contrary, it shows greater wisdom, foresight and vision.

Eating disorders are an incredibly complex medical/mental health illness having biological, genetic and societal aspects to it. As such, one wonders why all interested parties, organizations, persons, and leaders cannot band together as one since we all share one common goal, that is, saving as many lives as possible. Why can’t we put away our egos, our own insecurities, our hubris and fears and remember what we are working toward. We certainly don’t have to like each other, but if an intellect and resources we currently do not have or are not making best use of are presented by ideologically different persons, how can we possibly turn down those resources?

The activist, Leigh Morrison in an article in The Inclusion Solution, stated as follows: Next time you encounter an activist action that you may view as “unproductive,” I invite you to ask yourself: why might this person or group see this action as necessary? What privileges do I hold that may prevent me from fully understanding their experience or decision? What may I need to reflect upon or learn more about before I can respectfully engage in thoughtful and informed discussion about this topic? 

And on the day we remember Reverend Martin Luther King, Jr., we remember his words:

“The soft-minded man always fears change. He feels security in the status quo, and he has an almost morbid fear of the new. For him, the greatest pain is the pain of a new idea.”

“Courage is an inner resolution to go forward despite obstacles; Cowardice is submissive surrender to circumstances. Courage breeds creativity; Cowardice represses fear and is mastered by it. Cowardice asks the question, is it safe? Expediency asks the question, is it politic? Vanity asks the question, is it popular? But conscience ask the question, is it right? And there comes a time when we must take a position that is neither safe, nor politic, nor popular, but one must take it because it is right.”

SO 2020, “HOLD MY BEER” [and a look at a massive heart attack]

The overused punch line, “Hold My Beer” is believed to have its origins in the 1990s and involved those “lovable,” Southern rednecks. The comedian Jeff Foxworthy, who turned redneck jokes into a cottage industry, included this one in his 1996 book, “No Shirt. No Shoes…No Problem!”: “What are a Redneck’s famous last words? Simple. ‘Y’all watch this!’

25 years later, we widely use “Hold My Beer.”   The background of the joke is in essence: Someone does something outrageous and then someone else says “hold my beer” as a prelude to doing something even more outrageous.  Its popularity exploded “on the line” (thank you Vince Vaughn), as the expression became associated with so-called “fail” videos, showing people attempting wildly misguided and foolhardy stunts.

With regard to 2021, some have used “Hold My Beer” in a light-hearted fashion while fervently hoping that 2021 does not exceed the many disasters which defined 2020. Everyone knows someone whose life has been upended by Covid-19. Either they had it, had a friend or family member who had it or knew someone who died from it. We all know someone whose business was detrimentally impacted by Covid-19. We cancelled our traditional family holidays or get togethers. We missed going to our places of worship. And for some of us, in 2020, the dark specter of death appeared to mercilessly claim our loved ones.

In 2020, for me, death did not take a holiday. Instead, it hovered in a cruel manner insinuating itself in its attempt to claim the last vestiges of humanity and hope. On a quiet Friday night in September, death came quietly and peacefully to my 90 year old mother. She had been in a rehabilitation center since February. Since March, the only people she saw were her fellow tenants and healthcare workers. Then came that phone call in the night, “Mr. Dunn, we just found your mother in her bed. She was non-responsive.” And you are left remembering the person she was, the person who nurtured you before dementia began to take her memory.

October marked the first commemoration date of my dad passing. It also marked the fourth commemoration date of my beloved daughter passing. But, death was not through with its insidious plans. On a calm, early November afternoon, I got that call from my older brother’s wife. The pain, the fear, the anguish reverberated as she told me that my older brother had a massive heart attack while at home. A few days later, we watched over him as his heart beat for the last time.

Afterwards, we tried to go back to our daily life …while picking up the pieces from the carnage that death had left. At year end, we tried to believe the worst was behind us. We tried. And before 2021 was even one week old, the specter of Death reappeared, mocking us, grimly laughing at us, taunting us with, “Hold My Beer.”

Almost two months to the day when I got that phone call from my older brother’s now widow, on Tuesday January 5, 2021, I received a call from the wife of my younger brother. The number was a Las Vegas number I did not immediately recognize. I heard a sobbing female voice. Between those sobs of terror, I hear, “Jim had a massive heart attack. He’s in the hospital in surgery right now.”

I am one of the few people who still refer to my younger brother as James … not Jim.

So, yes, my younger brother, almost 2 months to the day my older brother died of a heart condition, had a massive heart attack. I was told he had 100% blockage in one heart ventricle. This past year, naturally being a Dunn, he didn’t tell anyone he had been having minor chest pains as a result of not getting enough oxygen in his system. “Just rub a little dirt on it, you’ll be fine.”

Paramedics arrived. Their worry and anxiety could not be hidden. On the frantic drive to the nearest hospital, calls to the doctors at the nearest hospital were made by the paramedics. Wheeled into the emergency room, twelve (12) medical professionals began to work on him, desperate to save his life.

Have you ever wondered what a massive, heart attack looks like? When one of your ventricles is 100% blocked? Well, it looks like this …

If you are fully aware and alert, you feel agonizing pain in your chest, you feel death begin to sink its icy claws into you. You hear the medical professionals surrounding you, reassuring you, and encouraging you to stay strong, it will only last a few more minutes … and then inexplicably, you may slowly begin to feel yourself start to breathe. In fact, just five (5) minutes after they start to perform life-saving medical procedures, if you are lucky, your clogged heart starts to look like this …

The medical professionals continue to reassure you, just a minute or two more and then … you breathe easier, you feel life begin to flow back into you. Just thirteen (13) minutes after they began to work on you, the blood flow into your heart begins to look like this …

Your pain eases. Your breath starts to come easier. Visions of your older brother dying start to recede. You dare start to believe again that your two children will not live the rest of their life without their dad. The reality hits. Your life can begin anew. And perhaps, in that brief period of time, your soul will find you. And your new journey will be embracing the reality that your soul’s purpose will be revealed to you. You may have dragons to slay … or your own demons to face. But, you are here.

Facing mortality does that to us. Yours or your loved ones. Mortality. Life and Death. It is so uncomfortable to face, to discuss, to try to grasp the finality of death.

Death. The manifestation, the reality, the most glaring sign of our failure. Especially with regard to eating disorders. If the United States Deloitte Report on Eating Disorders is accurate, the mortality rate among people suffering from eating disorders is far worse than what we previously thought. With the highest mortality rate belonging to people who suffer from anorexia nervosa.

Parents of children whose lives were ripped from our loving arms are shunned in the eating disorder community. The stories we could tell, of what worked, what did not work, stories that could provide new, incredibly strong insights into this disease, go untold. Journals of its victims go unread by eating disorder professionals. We remind you of your own failure. To ignore us and the voices of our loved ones who have been taken is bad enough. But, we now know that some individuals and organizations in the eating disorder community use us as fund raising ploys to attempt to fill their own coffers. Individuals and organizations too craven and cowardly to embrace transparency as they blindly race to the bottom of the political correctness barrel.

We are the uncomfortable reminders of your failure.

Our own mortality hits us all in different ways. Family members taken. Family members on death’s door. Beloved children taken from us. Our own mortality.

You have an incredible opportunity to listen, to learn, to grow. To go beyond your own perceived limitations so that more lives can be saved. You can embrace this opportunity to learn … or suffer the consequences if you do not.

MY ETERNAL BELOVED

My Eternal Beloved,

Christmas is once again upon us. And this year like no other.

Four years and 8 weeks ago, you were taken. The light of your existence was extinguished. And yet, I pray each day that you are soaring higher and farther beyond all human comprehension. I pray that you are seeing, and living, incredible experiences that we, on this earthly plain cannot possible fathom. That you are surrounded by peace, by love.

This year is so very different than past years. In the past 14 months, you have been joined by my dad, your “Paps.” In the past two months, my mom, your “Mams” has joined you. (I hope you are being nice to her and not pulling the practical jokes you loved so much!) And in the past 6 weeks, my loving brother, your “Uncle Chuckles” is with you. (Now with him, pull all the practical jokes you want!). But, in our world today, a world so caught up in fear, and anger, and bitterness, the sting of missing you is greater than ever before.

At the same time, an incredible bundle of joy, a new life arrived at just about the same time your Uncle Chuckles left. Your niece, my granddaughter, Riley Emilia came to us. In fact, I held her for the very first time about one hour after I was told that my brother’s condition was fatal, that he was in essence already gone. And the tears came, uncontrolled and relentless. A combination of the greatest love and the deepest pain enveloping me at the same time. But also, seeing my son differently, perhaps for the first time. And although already a loving dad to a now, incredible 9 year old Spitfire (who by the way, reminds many of you and the fighting spirit you have), this new life seems to have rejuvenated him soulfully. There is now a calmness within him. And I am seeing an aspect that either I could not, or would not see before.

He remembered how decorating the Christmas tree was something that you and I held dear. How we adorned the tree and then spent hours stringing popcorn and cranberries. So, he brought his loving wife and Riley to my house and helped decorate the tree this year. I rediscovered the difficulty in decorating the tree with one hand while holding a baby against your chest. And the time that we held so dear, the joy of seeing our tree come to life, came to life in a different, sacred way this year. Who knows, perhaps next year we will reprise another tradition we had … driving out to East Texas and finding our tree at a Christmas tree farm.

But now, my son, your brother, has asked, has burdened me with a task so incredibly difficult, that I will need to summons all the willpower, courage, strength and resolve I have.  With Kennedy, my other granddaughter now being 9 years old, my son believes it is time she got to know you, her Aunt Morgan much better. So he asked me to go through your journals, the very repository of your struggles, your fears, your hopes, your strength, your anger, your love … and find inspirational passages and pages which defined the very best parts of you. To assemble them in a booklet and give it to Kennedy as a Christmas present.

Your journals are a sharp reminder of your struggles, your hopes and in some ways, my belief of my own failures. He was asking me to undertake an onerous burden. I also believed that he did not truly have an idea of how difficult this was going to be, that some wounds were not meant to be reopened. I was wrong about that too.

Two days ago, he called me and we started talking about this task. When I told him how taxing it was on my soul, he replied, “I know it must be. But dad, perhaps you need that.” You see Morgan, sometimes wisdom comes to you from unexpected places in the most unexpected ways. And you simply must leave yourself open to embracing that wisdom. So, as I assemble Kennedy’s book, there are moments of laughter, moments of tears and moments of admiration as I read once again, the incredible strength, the incredible character, the depth of wisdom, and yes, your fears, your hurt, your pain and how you courageously poured out your emotions, thoughts and feelings onto those pages. And I am reminded anew of how and why you inspired so many.

Oh Morgan, what a community in which I have been immersed. The eating disorder realm. There is so much anger, fear, hurt and yes, some hatred. So much dysfunction. Sometimes it seems like some of the leaders have lost sight that this is an incredibly deadly disease, a disease that claimed your life, and are more concerned about their own power, their perceived legacy. And you are constantly being joined every day by others who succumb. But, at the same time, there are also incredible persons of great character, intelligence, wisdom, faith, compassion and humanity. Persons, like you, who inspire others to lift themselves, to challenge the status quo, to embrace the endless possibilities of what could be.

My beloved daughter, physically you are not here with me. But many times I feel your presence and know you are with me. Help me to continue to grow, to become a man, a daddy of whom you would be proud. When I stray from the path, help me find my way back.

Tonight, at 11:31 p.m., I will again light a candle for you. One candle to illuminate a room of darkness. One candle to guide me. One candle to sustain me. One candle to give hope. One candle to give, and receive love.

Merry Christmas my beloved daughter. I love you.

Your Daddy