What I See…

Alex Pagliuca
12 min readFeb 21, 2020

We started two wars, did unspeakable things, and killed over a million people, because 3,000 Americans were killed. 20 years later, we’re still involved in military operations in numerous countries, because those 3,000 Americans died.

It’s patriotic to support that 20 years long effort that we’re told is about recompense for those 3,000 Americans, and the protection of the rest of us still living. It’s unpatriotic, we’re told, to question how sensible or reasonable it is to continue that effort, putting more people’s lives in danger all these years later, after regime changes, upheavals of epic proportions and the like. We have at least recognized that combat experience is among the things most likely to produce PTSD, even when we have really been dragging our feet to recognize the many other experiences that can as well.

Now, we’re being shown evidence that our healthcare system is killing 68,000 Americans a year because the insurance industry has to MAXIMIZE profit. Right now, not only are the shitty, white nationalist, nativist terrified goons, who barely understand capitalism as they defend it trying to prevent saving those 68,000 Americans lives, there’s a whole barrel full of the corporate cock sores in the Democratic Party trying to prevent those 68,000 Americans from being recognized as more valuable than corporate profit. They are going to spend over a billion dollars to make sure a vampire of an industry can continue living off of our blood and suffering, my blood and suffering. It’s amazing that in the divided nation we live in, there’s so much bi-partisan agreement that continuing to just allow 68,000 Americans to die for the profit motive of the insurance industry. Of course, no one will say, “Well, it’s fine. We need to protect their profits. Too bad.” Really though, so many of the arguments made have to begin from there to even get to the point of being arguments. Lots of distractions are thrown around, but that is the reality behind it.

We’re also told it’s unpatriotic and un-American to ask questions about the kind of system which allows 68,000 Americans to die so that someone else can make some money. We’re told repeatedly that the proposals of other ways to organize our health care system are socialist or communist and will lead to mass executions in Central Park (one of the greatest things to ever emit from the maw of Chris Matthews). The reality being, we’re already having something quite similar to mass executions, resulting in the deaths of 68,000 people annually, so a few folks can make more money. Let’s be clear, those 20 year wars, all those lives, the blood, the suffering and pain resulting from them, that was over one incident involving the deaths of 3,000 people. This is an annual death count of 68,000 people, who are dying so someone else can add some lines of profit to their ledger. It was a horrible incident, and I am not in the camp that was not happy to hear Osama Bin Laden was dead. I would have liked a trial, because that’s closer to actual justice and we as a nation may have learned important things from it, but I’ll take dead. That was all about his place in that incident and those 3,000 deaths.

And y’all keep telling me that I’m the one with the mental health problems. We as Americans, call this politics. I’m supposed to fight through to “recover” from a severe and chronic mental illness in order to participate in and contribute to the exact everyday mechanism that continues to allow that to be something we don’t recognize a hideous and sadistic. Right, that’s the goal of my mental health, and one of the significant measures of my mental health, how well I can go about the daily actions of contributing to and being a part of that.

“Starting over means you get to make things anew, the way you want your life to be.” I’ve heard this a lot lately. Well, you know what? Even if I thought I could rebuild my life, again, and have some confidence that another acute episode a few years from now wasn’t going to tear it all down… Why the fuck would I want to begin to contribute to this shit? Because one of the things central to making this gruesome and sadistic “political reality” is the rest of us either suffering in poverty or terrified that one unfortunate turn of luck will put us in poverty, so that we never have the time to really take a step back and consider that there is an argument being made that the profit of very few is worth the cost of those 68,000 lives, and just what that says about the society we live in and generally, are fighting to keep.

If not for Medicaid, I would have no treatment right now. I went a number of years without treatment because I couldn’t afford insurance, it’s a significant part of what got me here. Instead, I spent those years toiling and laboring with the constant promise of some security right around the corner. I was very suddenly able to afford the most very basic insurance when Obamacare came along, which more or less meant I was able to afford to have insurance, but was not able to afford to use it for anything but the most basic of services. The following year, I actually did make a little more money, and suddenly, between making a bit more money and whatever deal was made with insurance companies, my prospective premium was $300/month. Now, along with my making a bit more money came some general misfortune that mean what that raise went to was insuring I was not homeless. There was no room for an insurance premium the size of a payment for a new car.

And so, I spent the next year and change trying my best to manage symptoms that I saw starting. I didn’t want to go use any of the community resources for mental health because I was after all not making a terrible living, and I felt like doing so was just a slap in the face to the people who weren’t doing as well as I was, like I would be taking up resources that someone else needed more than I did. I could’ve stopped eating decently for a few weeks, so I could afford to pay out of pocket to see someone, you know not bought that $7.99 frozen fish as a way to treat myself like I had value… I could maybe have stopped doing anything that was good for the relationship with my partner, like going to plays or whatever… Basically, I could have stopped doing any of the things that were genuinely good for my mental and emotional health in order to be able to afford to have someone tell me I needed to pay attention to and protect my mental health. The amount of my thought life and energy that has been dedicated to attempting to care for my own mental health and not also put myself in financial danger, social derision and the like is something anyone without a severe mental illness can’t even begin to comprehend. Even when I am in the best place of mind, it’s something I have to constantly monitor and manage.

But, you know, the unfortunate thing about being mentally ill is that you can know you’re off, but you don’t necessarily know how and your estimations of how much, those are unreliable. What happens in my head is that my estimation is either far too critical or not critical about the right things. I lost my job, out of a combination of me getting slowly stranger as time was going by and having had a real terrible season, where the business just wasn’t making enough money. I wasn’t making the business enough money to continue to justify my employment and existence.

That’s life, right? That’s just how it is. Luckily, because the season had been so bad, I’d bought a car in order to drive for Lyft and Uber to try and make some extra money. So, I was driving Lyft and Uber, more or less non-stop, in order to continue to be able to afford to live in my place, pay the car payment which now had to not only pay for itself, but everything, and let me tell you how great that 70 or 80 hours a week in car by myself or with strangers who could be of any variety of human being, was just exactly what my mental illness needed to really take things up the next level.

Did I mention I’d also just signed a lease on a new place with my partner and spent the entirety of what little savings I had, including cashing in the only retirement account I had, in order to do be able to afford to do that? We moved in together, ready for our new start, as my mental illness was really just taking off, and within the first few months, the car shit the bed and the engine was shot. At that point, all of the self hate, the insecurities born of having acculturated into masculinity screaming around inside my own head had all the proof they needed to be real.

That battle has been going a year or so now. What has essentially been non-stop, urgent stress that wasn’t just produced from being mentally ill has been a number of years. It’s part of the reason the acute episode was able to happen. The treatment I’ve received has helped to take the urgency out of a lot of the worst that happens inside my head. It doesn’t change the reality of things though. I’m still fighting to become “well enough” to be able to find my way into somehow being “okay” enough to go about the daily regime that is built on a foundation which renders people like me without value, and expendable. Friends and loved ones can tell me they value me, and I believe it and appreciate it, and I love and value them, but that doesn’t change the reality either. That reality is that I’m fighting to be able to have a place where I am also spending a good deal of my time being worried or terrified about my financial well being, which is really the whole of whether or not I can survive, while also somehow trying to manage a mental illness which creates a near constant din of suicidal drive. Again, the treatment has made that suicidal drive less urgent, it means it’s just a low hum in the background, often.

There’s the question which sometimes comes up as someone attempts to employ “tough love.” “Why do you think you should be special? This is what everyone has to deal with, why shouldn’t you?”

First, not everyone has to deal with this. There are parts of my everyday existence which are absolutely beyond the experience of the majority of the human race. Not that I’m suffering the most or that there aren’t people who suffer more than I do, because there are, for sure. I’m extremely aware that many people deal with things much like what I do, and also have to contend with racism, sexism, homophobia, abusive family history’s, lack of the kind of th level of support I have and so many other things. That’s part of the point, and part of why I try to be vocal about those things, even when I’m not in a personal space where I can do much other than be vocal. It’s not just about me. It’s about the millions of other people who are fighting their own battles, and the 68,000 who are dying every year because the rest of you refuse to understand that this is the case. I’m honestly a bit surprised it’s not more than 68,000. I’m very, very aware that I’m not special and I get perilously close to being one of those 68,000 every few years.

The fact that I haven’t killed myself is an achievement. Few people want to hear it or believe it, but be sure, it’s patently amazing that I haven’t killed any of you who find us all so disgusting, inept, unlovable, useless, and are among the direct or indirect forces which continue to render us expendable. Those truths do not make me special either as there are millions of us who can claim the same. I do often wonder if maybe sacrificing a few of the more vocal among those who are profiting from our expendability or are still telling the story that we are, might not be a good beginning to turning things around a bit. But then I remember, many of those people, the majority of Americans really, have had to find a way to get around facing the reality that their ability to live the lives they do, and to have whatever safety they do is predicated on how many more of us are treated as either useless or less than human. It’s something hidden right out in the open.

Most people have families members, friends or people they’ve known relatively well have to navigate something like this. The difference between someone like me and a family member or friend or co-worker is that most often, they’ve had time to find their way into the ranks of the valued and productive. For those whose struggles have begun in adulthood or have reached acute stages in adulthood, they’re worth trying to keep in the ranks. Those of us who’ve basically never really been able to prove we can be in the ranks, with any amount of stability, well, we don’t quite qualify for humanity.

The reality I see, from where I stand, is that dead would have been better. If any of the more dangerous escapades I’d engaged in as a young man had ended my life, it would have been better. If the people who happened to have been responsible for planting the seeds that grew into this mental illness had killed me, it would have been better. That is blasphemous to say. I know. It’s the truth though. “This will pass” you will want to say, which is true in a relative sense, because it will pass momentarily, and then it will be back.

I’m existing daily, going through the exercises of what is prescribed as the way to “better,” and I don’t know that the “better” I’m being asked to walk toward and fight for is worth it. Part of what makes me who I am is that I can’t really ever turn off the fact that I realize what it means to have the arguments we have about health care. It means there is a significant number of Americans, among whom are some very powerful people who are basically arguing that it’s fine for 68,000 people to die so someone else makes a bit more money. I get how my being “better” and going on with the daily grind that is required to survive contributes to that reality.

That “better” isn’t at all attractive to me. It just means I assign the place I now occupy to millions of other people, and then I act like that is somehow a victory. In reality, I have to go ahead and take my place in that, to get to what to me is “better” and what I know would actually be the way to mental health and wellness for me is still not available in the society as it is built. I don’t know I can reach a place of wellness that affords me the ability to manage the constant knowledge of what I’m contributing to, and the daily necessities it takes to even just get to a point where I have a skill that is both marketable and is something I believe would be bringing dignity and human respect into the lives of people who are often denied it because they’re overlooked.

The “better” for me, and for my overall well being isn’t allowed, because 68,000 people a year have to die so someone can make a bit more money. That I know, and that is why dead would have been better. My well being is completely at odds with the requirements we make of each other to live in community and society, because the community of this society will mock the fact that I won’t act like the community and society isn’t responsible for it.

I’m also willing to bet I’m not special in the sense that this is very much a part of why we’re seeing suicide rates rising among so may different demographics. Step back and think about it, do you really not think there aren’t a whole lot of people who understand what it is to have this kind of argument about that level of death and the pain and misery which accompanies it, and profit? Do you seriously not think that same underlying idea isn’t intruding into the lives of millions of people who don’t have severe and chronic mental illnesses, but are being faced with the reality that this is the society they live in? How many of them are on the receiving end of being the expendable thing that profit is paramount to? How many of them are realizing their everyday lives are a central part of what makes that reality continue to be able to exist?

Nah, it’s the nastiness on the internet, that’s the problem, right? It’s not that the nastiness on the internet is an outgrowth of that reality, that can’t possibly be it. Just, for a second, think about what kind of dehumanization and degradation can be hidden when the fact that we’re having an argument about whether 68,000 lives or the insurance industries obscene profits is more important, and we don’t even fully recognize that is the argument we’re having.

This is what I see, and I understand this is who we are, and I am not inclined to believe that “health” is found in making my place in that and that death would have been better than having spent so many years trying to and being miserable and in pain, and causing so main others pain.

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Alex Pagliuca

Tired, weary human. Excavating the geography between trauma, masculinity, mental health, and their social expressions. Anti-racist, anti-sexist. Learning.