Andanh.com

The Center for Disease Control and Prevention (CDC) recently declared sexually transmitted infections (STIs) an "epidemic," citing the 19 million new infections that occur in the US annually. Gonorrhea and chlamydia are the No. 1 and No. 2 most reported infectious diseases in the country. An estimated one in four people have herpes. Approximately 20 million people in the US are infected with human papillomavirus (HPV), and at least half of sexually active people will acquire genital HPV.

In March, the CDC announced that one in four teenage girls have chlamydia, HPV, herpes or trichomoniasis. Fifteen percent of that group had more than one. Among sexually active teenage girls, the number jumps to 40 percent. Most medical professionals were not surprised by the report; some have challenged it because the one in four ratio is generally assumed to apply to teens across gender.

Officials who presented the report at the CDC's 2008 National STD Prevention Conference stressed the importance of teens postponing sexual activity, sticking to monogamous relationships, using condoms and getting tested regularly. Dr. John Douglas, one of the CDC presenters, mentioned cultural complacency about the epidemic. "It's sort of impolite and still stigmatized to talk about STDs," he said. "We continue to have major national debates about the best way to educate the population. There continue to be extraordinary misperceptions about who's at risk for an STD."

Heather Corinna—a woman's health counselor, sexuality activist and the creator of Scarleteen (one of the first sexual health websites)—says such cultural barriers reinforce stigmas and misinformation. "That the releases even called sexually transmitted infections 'STDs' is telling, since for most, 'STI' is the preferred and more accurate term," she says. "The term 'disease' is really supposed to address an illness which is progressive, and most sexually-transmitted infections are not, particularly when treated."

Jen Slonaker, director of education for Planned Parenthood of Massachusetts agrees. "Calling it an STI is more accurate and helps to destigmatize it," she says. "'Disease' has very different connotations than 'infection.'"

And while it may sound like semantics, the effort to take the sting out of an STI diagnosis aids public health, according to Dr. Alfred DeMaria, director of Communicable Disease Control at the Massachusetts Department of Public Health (DPH). "It's not ethical from a medical standpoint to be judgmental about people's behavior," he says. "People aren't going to cooperate with you if you have a punitive or judgmental approach."

Massachusetts STI data focuses on bacterial infections, so it's not as thorough as the national study. The incidence of syphilis remains low (20 cases statewide in 2007), gonorrhea's numbers hover around 1,300, and chlamydia rates are climbing (10,674 cases in 2005 to 11,968 in 2007); all in keeping with national trends. While Massachusetts' rates for HPV, herpes and trichomoniasis are not available, DeMaria says the national infection rate for teens can be assumed to be true in the commonwealth. "They're really estimates. Of the 25 STDs out there, they picked the four major ones," he says. "But we have no reason to believe we're any different than the national average."

If so many sexually-active teenagers have an STI and probably will remain sexually active, how do we negotiate both public health concerns and social stigmas?

Corinna says it's a question of cultural attitudes. "I can tell someone I'm counseling that there is nothing dirty about them for having an STI all I want, but a lot of the time, I'm still in the minority opinion," she says. "Setting aside the more prevalent attitudes about STIs and those who have them—and understanding why attitudes of stigma are not credible and do harm—is a challenge for most people, especially young people."

Associating any disease with any community, particularly a marginalized one, is always dangerous. So, when the CDC report referenced a huge racial disparity among the women it surveyed (almost half of black adolescent females have an STI), researchers were careful to clarify their research. Douglas insisted race itself was not a factor. "The availability of clinics, transportation to the clinics, do you have health insurance to pay for your care when you get to the clinics? Do you have other competing life issues like unemployment and lack of child care and single-parent homes that may result in delayed seeking of care?"

Treating such a prevalent trend without stigmatizing a specific community can be tricky, but John Vincent, manager of education and prevention at Fenway Community Health Center, hopes we've learned from the past. "If you look at HIV, racial and sexual minorities are more impacted. This is driven by economic barriers, access to care, not an innate quality of those populations," he says. "We have to recognize trends, so we can divert resources where they're needed. But we have to do so in a way that doesn't stigmatize a community. And that's not an exact science. It requires a little bit of artistry."

Public health workers are hoping that Massachusetts' mandated universal health insurance will help combat inequities. Vincent says that because the mandate was established in January, the results aren't apparent yet. "But I can say anecdotally, it's very clear that people who got health insurance at Fenway at the beginning of the year are more likely to get testing than if they didn't have that," he says. "We encourage people to take advantage. Prevention is important, but wearing condoms and safer sex practices aren't universally fail-proof. So we tell people to get a full STD screening every six months. You should get tested often if you get laid often."

Many who are already infected must negotiate when to disclose that information to their partners. A niche of STI dating sites have popped up, among them, positivesingles.com, stdfriends.com and, perhaps the most inventively named, prescription4love.com.

Ricky Durham created prescription4love for his brother, who had Crohn's disease and never knew when to disclose his colonoscopy bag to potential partners. Durham says his site, which allows members to disclose conditions on their profiles, can relieve that anxiety. "If I told someone I had an incurable STD, chances are, they wouldn't want to date me anymore. They don't look at the person anymore, all they're thinking is 'I might get this,'" he says. "The benefit with this is there's nothing to reveal, it's not like, 'Oh my god, when am I going to tell them?'"

But Corinna says, especially with fairly benign infections like herpes and HPV, such sites raise concerns about segregating people needlessly. "Both those viruses will likely lose some steam due to how common they are and how much we're all exposed to them. HIV, obviously, is not at all benign. But with the right management tools and partner cooperation, transmission can be prevented. It's not rocket science," she says. "I think if people with any of those infections want to opt into those dating programs and feel more comfortable dating that way, there's no reason not to support that. Rather, it's forcing anyone into that, making it seem like that's the only way to protect people, and the messages those programs might purposefully or inadvertently send, that we have to be cautious about."Vincent says a culture has formed around HIV that doesn't apply to other STIs. "It's completely reasonable for HIV-positive people to enjoy the fraternal aspects of being in that population. There's something important and sacred about it," he says. "But I don't think that having HPV or herpes should limit who you date. It's not the same thing. To set anyone aside and say 'You should stay with your own kind' is potentially dubious ... but not universally so."

DeMaria says the DPH is trying to address STIs on many fronts. "How you get your hypertension treated is your business," he says. "The treatment of your STD is important to us, because you got it from someone and you can give it to someone else. That's what makes it a public health issue."

The DPH recommends Gardasil, the vaccine that can protect against some cancerous strains of HPV, for women 9-26 years old (it can't help people who have already been exposed to the virus). DeMaria says Gardasil is covered by MassHealth. "We provide it for girls age 9-18 who are on Medicaid or don't have insurance, because they fall under the Vaccines for Children program," he says.

The DPH has also offered anonymous partner notifications for syphilis, gonorrhea and chlamydia since the 1930s. "We have disease intervention specialists meet with a patient, talk to them about sexual partners and counsel them on how to talk to them," DeMaria says. "If they're uncomfortable doing that, DPH specialists will talk to the partners themselves."

DeMaria says adolescents have remained a priority over the years. In the mid-'90s, the DPH trained peer educators in Springfield. "They found a significant concern among young people, but a low level of understanding," he says. "Most of these teens wanted to know more, and wished they could talk to their parents." Now, the DPH is targeting teens with websites, like std411.com and yourhealthstyle.com. "It's a moving target. We're trying to adapt to the media that interests them," says DeMaria. "We're also working with colleagues in the Department of Education, trying to get more information across a variety of topics in school curriculum."

In 2006, 86 percent of secondary schools required some health education for students, and of those, 64 percent taught STI prevention to middle schoolers and 85 percent taught it to high school students. Drug and alcohol prevention, nutrition, fitness, mental health, violence prevention, HIV prevention, "growth and development," and pregnancy prevention were (in that order) all taught more frequently.

While the Department of Education (DOE) doesn't require health education in core curricula, it has created a comprehensive health curriculum framework, which explains that sex ed should "address decisions about abstaining from and postponing sexual intercourse. Knowledge about how to avoid sexually transmitted infections that endanger one's health and well-being as well as that of a partner is an important component of instruction. Communication skills can support such decisions."

Slonaker says not mandating a set curriculum creates educational inequities. "There's no standard for health or sex education across the state right now," she says. "We call it an accident of geography. Your district often determines how good your education is." Rep. Alice Wolf, D-Cambridge, has pushed legislation to make health part of the core curriculum in Massachusetts public schools for the last two years, but it stalled in the legislature and failed as a budget item.

State law allows parents to pull children out of any aspect of health curriculum for religious or cultural reasons, but exemptions are rare; 38 percent of principals reported no students had been exempted by parental request and 54 percent reported that 1 percent or less were exempted.

Last September, Gov. Deval Patrick didn't authorize a budget item for a $700,000 federal grant proposal for abstinence-only sex ed programming. The National Abstinence Education Association launched an ad campaign, claiming, "Deval Patrick Doesn't Want 11-Year-Olds Taught to Say 'No' to Sex."

According to the Sexuality Information and Education Council of the United States, studies indicate abstinence-only programs don't affect when teens become sexually active. Corinna says they also place dangerous value judgments on health choices. "So long as who does and doesn't have sex is given moral value, we've got another huge barrier," she says. "Since having an STI means that in many cases, sex was electively chosen, if those who choose to have sex are of lesser value than those who do not (or who do only in certain socially-sanctioned scenarios), then those with STIs will be doubly stigmatized."

Planned Parenthood of Massachusetts has been developing public school sex ed courses for 30 years. They're revamping their curriculum now, a 27 session, three-year program for middle school students, called "Get Real."

"We talk about abstinence as the only way to know that you're protected from STIs and pregnancy, then we talk about other protection methods, how condoms are the only method that's able to protect against pregnancy and STIs," Slonaker says. "If students think 'it won't happen to me,' or 'it doesn't happen in my school,' they're less likely to protect themselves."

The curriculum weaves relationships and communication skills into every lesson. "We encourage a teen who's going to be sexually active to be in communication with their partner," says Slonaker, "in all the different ways that may mean."

Slonaker says that education is the first step in normalizing and preventing STIs.

"We teach about how to protect oneself from an STI, then talk about the importance of seeking health services. If someone notices a change in their body, it's important that they're not afraid to go see a doctor," says Slonaker. "Knowing one in four teens have an STI, it's likely that someone in your classroom might have an STI. So it's important that the lesson isn't to shame them in any way."

Dear New Member,

You joined the ICA on Sunday. When you approached the desk you seemed very satisfied that the four-person membership you'd imagined and arbitrarily priced at $100 would be your gateway to a new world of sophistication. Never mind that no such offer exists, you were confident and self-satisfied. Working at this museum has taught me that condescension and entitlement thrive in the art world, so you'll fit right in. And despite your smug insistence that all of your friends were going to get in free with your $100 membership (which is actually $125 for two people, with a few guest passes), your petulant refusal to fill in a name for the second card-holder (you wrote "whoever I want"—very sophisticated), and your poisonous thanks when I handed you a temporary membership card (all which took quite a bit of time), you still left me and my co-workers with a few unanswered questions:We were wondering if the huge gap between your front teeth is responsible for your hilarious lisp. And if so, are they the aftermath of an accident, or are you consciously trying to look and sound like some terrible hybrid of Sylvester the cat and Ernest Borgnine? Also, does all the sand in your vagina make a swishy sound when you walk around? Finally, what's the climate like on the island of Dr. Moreau? From the way you behaved I could see you'd been wronged by culture in the past, but you aren't going to take it anymore. And if that meant charging into a museum barking demands like a female Tommy Lasorda and ruining someone else's day, so be it, right? Good for you. If there's anything our museum is lacking, it's obnoxious members with chips on their shoulders. Can't wait to hear from you again,

Your Visitor Services Representative

Send your anonymous gripes and grouses to letters@weeklydig.com, or to Dig Department of Gripes, 242 E. Berkeley St., 2nd Flr., Boston, MA 02118. Crybaby.

The New York Times unleashed one of the greatest, most devastating obituaries we've ever read last week. It was methodical and understated while remaining shockingly vicious, and it served as a reminder of how few journalists are actually trying when they set out to write.

So, the dead guy is Huntington Hartford II, heir to the A&P supermarket fortune. Even after he burned through his inheritance—so spectacularly that he had to declare bankruptcy—he was still on the trust fund teat, to the tune of half a million a year. OK, go for it: "Not content merely to be rich, he longed to be a writer and, more than that, an arbiter of culture and a master builder. But his ambitions were far greater than his reach."

Aren't they always? Dude built a museum the Times critic at the time derided as "a die-cut Venetian palazzo on lollipops," and filled it with, in the obit writer's estimation, "generally unremarkable" art. He sunk $7.4 million into the venture before abandoning it. But he managed to fail harder. Much, much harder. That's what death is for, you know—it's an occasion to employ florid language to remind the populace just how little you contributed to the world: "Costlier still was Mr. Hartford's makeover of Hog Island, in the Bahamas. After buying four-fifths of the place in 1959 and having it renamed Paradise Island, he set about developing a resort with the construction of the Ocean Club and other expensive amenities. Advisers persuaded him to stop short of exotic attractions like chariot races, but, over-extended and unable to get a gambling license, he ultimately lost an estimated $25 million to $30 million on the project."

YOU MIGHT remember David Blum. He used to be the editor of the Village Voice, before he was canned for being either an inveterate racist or for hiring a whole bunch of his illiterate former Columbia J-School students who then proceeded to break hot scoops like just how unappealing cerebral palsy sex can be. Remember now? Good.

So, Blum is now associated somehow—we didn't really care enough to find out how—with the New York Press, a paper that used to be brilliant until its marquee columnist got drunk, blew a deadline, and filed a revoltingly offensive story about how hilarious the Pope's upcoming death would be. All the Press's advertisers bolted, its writers followed suit soon afterwards, and now it's the type of paper that a spectacular failure like David Blum can call up and pitch thusly: "Hi, I used to have a job that kind of mattered but doesn't anymore. Any interest in having me soil one of the greatest journalists ever?" And the thing is, the Press is so hard up that, for them, that's a good idea.

So, as you may have surmised from the excruciatingly drawn-out setup, this one doesn't end well.

You wouldn't like being Gay Talese. It's hard work and the rewards don't seem very obvious to someone with a website and a password and high-speed Internet access, the ultimate vrooooom vroooooom vroooooom ... Remember vrooooom? No you don't, but that's okay because Tom Wolfe isn't New Journalism anymore, his old hats are old hat. Gonzo is the way of the world. Everyone writes in lower case. The world has abandoned traditional words and grammar in favor of shit that fits on a phone screen. Will u b there 4 a few mins? Meet u at ur apt 4 dinner? No time for apostrophes, my friend. Can't be bothered with articles. Won't. Fuck that. No point. By the clicking of our thumbs, something wicked this way comes.

Something awful? Got that part right.

TO THE LADY who brought Media Farm a bottle of vodka and a halfway vulgar T-shirt last week: You're a doll. Also: We think we're in love.

BECAUSE WE ALL KNOW the good folks behind Google News and Blog Search read Media Farm religiously (even though, so far, they have failed to bring gifts in the form of alcoholic beverages or "Boobie Inspector" T-shirts), we're throwing them a friendly tip right here. Here goes. It would probably be best if your robot stopped crawling the Stormfront White Nationalist Community's message boards for news items on Gov. Deval Patrick – or, as the posters there know him, "MA negro governor." We knew Patrick's executive office budget looks a little funny this year, but we'd rather hear it from the Herald, not from "LoKi1488." Cheers.

At some point, you've wanted that loud neighbor to keep quiet so badly that you considered lifting your finger to your lips and hissing a "Shh!"

But like me, you probably didn't.

Not long ago, I was studying in "The Quiet Room" at Emerson College. Two boys behind me seemed unaware of the room's moniker. Believe me: I tried everything. I picked up my cellphone, dialed a number and walked out of room to show that conversations were only appropriate in the hallway. I turned 90 degrees in my chair and narrowed my eyes. Nothing. I took my hands and covered each of my ears. Maybe they would take notice of the girl in the corner that used her palms as earmuffs. No such luck. I couldn't take it anymore.

"I'm sorry," I said as I leaned back in my chair, letting it rock on its back legs, so I'd look carefree and casual, despite the scolding words to come. "But do you guys mind keeping it down?" I felt my face flush. "It's just that this is The Quiet Room. And, there aren't really many places that are quiet at Emerson."

They stared, muttered a response. They quieted. Five minutes later they were speaking in whispers, the kind that hisses when pronouncing words with "s." Soon, their voices were slightly softer than the ones I'd scolded 15 minutes before. Fine, I thought. I'll deal.

You might be appalled at my actions. You might think I did the right thing. But no. What I did wasn't enough. Only shushing would've let them know how serious I was.

I concede—shushing is embarrassing. It infantilizes the perpetrator, forces them into submission. Shushing is considered so unhip that even librarians rebel against it. In 2003, librarian Nancy Pearl posed for a 5-inch action figure of herself for a line of novelty collectibles. Her mini-me librarian is advertised as coming with "amazing push-button shushing action." The feature caused Pearl's peers to blog about her being old-fashioned. Fellow librarians accused her of setting their profession back 30 years. But what's so bad about shushing?

Listen. You can try tapping the shoulder of the cellphoned woman on the T and ask her to be quiet. But the second you get off the train, she'll go back to her loud ways. Why not shush? The whole car will hear it, but chances are only those seated next to you will know you did it, and she'll get quiet out of humiliation. Chances are you'll win.

If librarians want to abandon their character trait then we, the people of Boston, should make shushing our own. Bostonians are known for being direct, no-nonsense folk. So let's use our bluntness to make this world a better place. Shush those on the T, in stores and at libraries who are intent on making their business yours. Together, we can bring back the shush.

There must be something in the water, because it seems like these days, comic books and variants thereof are cropping up faster than sugary cupcake bakeries. After meandering last weekend through the "Superheroes: Fashion and Fantasy" exhibit at The Costume Institute at The Metropolitan Museum of Art—imagine Thierry Mugler and Balenciaga pitched against bona-fide costumes from Iron Man and The Dark Knight—I witnessed new relationships come alive between the human body, a world of uncertainty and fantasies both dark and triumphant.

This sentiment seems also to weave its way through this issue of the Dig. The work of legendary comic artist Rob Stull graces our week's cover and the walls of Technical Skate Shop this weekend. In Union Square, Hub Comics dishes out graphic novels for legions of the curious. Arguably a modern superhero rooted in Hollywood, Indiana Jones kicks and fights his way against the baddies once again. But as much as the fictional adventures continue, reality pokes along with its requisite highs and lows: A sobering look at the national rise of sexually transmitted infections; the elated obsession over M83's newest album.

Not easy, this world. However, wearing a cape can never hurt.

CHRISTINE LIU | CHRISTINE@WEEKLYDIG.COM

Gated gardens

Great feature ("The Revolving Door," 5.14.08). The application to get a public garden in the Fens is a little ridiculous. It asks, "In the last five years, have you been convicted of a felony?" You've got to be kidding me. You can't have a garden if you're a criminal? "FGS does not discriminate on the basis of age, race, ethnic origin, religion or sexual orientation," but it does if you have a criminal record.

I guess that makes sense. Who KNOWS what kind of smack you could grow?

ANDY

VIA EMAIL

Well, we're younger than most twentysomethings

I've been irked by the ageism of the Dig for several years, I suppose ever since I turned "a certain age." Now I see it splashed across your cover, with a cartoon of a top heavy "cougar" ogling two decrepit hipster dudes. Among other gaffes, I've seen your writers dis Madonna (who's richer, more talented, and more physically fit than most twentysomethings), call attention to poor Lewis Black's impending 60th birthday (and he's funnier than most twentysomethings) and insinuate that older women attending the Boston Wine Expo are really hoping for a hot time with a young himbo with no palate.

Face it, everyone gets old, everyone dies, even tactless scenesters who write for the Dig. Get over yourselves.

BEEN THERE, DONE THAT.

VIA EMAIL?! GOOD FOR YOU!

Subject line: Dear privileged asshole from last week's letters

Dear Mr "Soooooooo Totally NOT-'PC'",

Yeah, I feel you. I hate it when The Liberal Media Conspiracy makes my white ass feel dumb by using "PC terminology bullshit" like the phrase "people of color" (letters, 5.14.08). It really gets my lily-white hackles up. When will those blacks be satisfied? First they don't want to be called "colored people," now they want to be called "people of color"?

God damn it, we all just got used to "African-American," when will it end?

Also, having done an extensive poll of Asians, Islanders, Latinos, Chicanos, Indigenous Peoples and all the other non-white inhabitants of this fair earth, I can assure you that not a single one of them has any problem being referred to as "black" or "African-American." In fact, they'd far prefer it to the patronizing, overly-PC, white-guilt-inducing term "people of color." See, those "blacks" are looking out for you.

Right on, my white brother,

A DORCHESTER-DWELLING WHITEY

VIA EMAIL

Errata: before you pack your bags and move to Iceland, let us give you the right url: icetourist.is (not istourist! Stupid!).

Protestors stormed the steps of the Statehouse last Thursday to advocate reforming the current Criminal Offender Records Information system (CORI). About a hundred supporters ignored the spring drizzle and marched from Bunker Hill Community College in Charlestown to the Statehouse. They joined about a dozen more athletic protestors who began the march in Worcester on Sunday walking 50 miles to Boston and sleeping in churches along the way. Complete with rally accessories like homemade neon signs and bullhorns, they chanted: "What do we want? CORI reform! When do we want it? Now!"

The march was organized by Neighbor to Neighbor Massachusetts (a grassroots organization devoted to building low-income communities), the Boston Workers Alliance (BWA), Ex-prisoners and Prisoners Organizing for Community Advancement, the Coalition for Social Justice and the Union of Minority Neighborhoods, to pressure the legislature to change the current CORI system.

"It prevents hundreds of our members across the state from getting access to jobs," said Carl Nilsson, a campaign director for Neighbor to Neighbor.

Under the current law, misdemeanors stay on a person's criminal record 10 years; felonies stay on for 15 years. The records are open for potential employers to see, and critics of the system say they are routinely used to deny jobs, loans and housing opportunities. In January, Gov. Patrick introduced a bill that would reduce the waiting period to seal a criminal record to five years for misdemeanors and 10 years for felonies. Protesters were encouraged by the legislation but they'd like to see Patrick up the ante.

Terri Hinton, a grandmotherly BWA member who has a CORI herself, wants misdemeanor records to be sealed after three years and felony records after seven. "It's really important we fight ... The Patrick bill is not good enough," she said. "A lot of people in the community suffer. They are afraid. Because they have a CORI, they have no voice ... If they did their time, why should they have to pay again?"

Aaron Tanaka, a director at BWA, listed the Massachusetts Bar Association and the Boston Globe among the movement's supporters. "We've been working on CORI reform for the past three years," he said. "Every day that goes by, someone is struggling."

Wilnelia Rivera, a member of Neighbor to Neighbor, added, "It's about jobs. We have a huge population that's being neglected. That's what keeps people off the streets, keeps them on track."

The Massachusetts Dental Society (MDS) held its annual lobbying day at the Statehouse last Wednesday. Practitioners spoke with legislators about pending bills that would expand dental care access to low-income families.

One bill would allow retired dentists to qualify for a volunteer dentist license. The bill just passed the Senate and is on the House calendar.

"It would remove a lot of hurdles for retired dentists becoming volunteers at free-care clinic centers," said Robert Alconada, director of government affairs at the MDS. "It would be like the regular dentist license except that the $240 biennial license fee would be waived."

The bill would also provide immunity for those volunteers, who usually don't keep their malpractice insurance after they retire, Alconada said.

"This bill would provide them protection to remove another hurdle," he said.

In 2000, MassHealth received more than 4,000 calls every month from members unable to find dental care. As of October 2006, 187 cities and towns had no dentists that accepted MassHealth insurance. In 2003, a statewide oral health survey of third graders found that 41 percent of low-income children had untreated decay and 14 percent of low-income children had pain or infection.

Another bill that the MDS is pushing would create a career ladder for dental assistants, with various categories meriting different levels of supervision from a licensed dentist.

"This bill will expand the duties that general assistants do and are trained to do, so that we can essentially treat more people," said Milton Glicksman, DMD, president of the MDS.

Sen. Harriette Chandler, D-Worcester, who proposed the bill, said it could fill the gaps in service to low-income patients. "We need to make sure more people have access to dental care," she said. "Expanding the workforce is one way to achieve that."

In an effort to address the state's dental access problem, last year the MDS launched Mobile Access to Care vans that drive licensed dentists around the state, providing free dental care to underprivileged children.

But Glicksman thinks communities need permanent healthcare providers. "Obviously you can't do everything on the van," he said. "So again it's about expanding the access, qualified access."

When Rachel Klein suffered a debilitating headache she couldn't diagnose, she did what anyone would do. She went to the emergency room. When she told the admittance desk she had a history of mental illness and listed the medications she takes, she received atypical care. After waiting for four hours, the first doctor who came to see her was a psychiatrist, not a physician. She was stripped down, injected with tranquilizers and restrained.

Klein, the vice president of Massachusetts People/Patients Organizing for Wellness, Empowerment and Rights (M-Power), lobbied in favor of the emergency room rights bill at the Statehouse last week. The bill—proposed by Rep. Ruth Balser, D-Newton, chair of the Joint Committee on Mental Health and Substance Abuse—would determine the rights of people with histories of mental illness in the emergency room.

Klein says doctors and the Department of Public Health (DPH) don't acknowledge the many reported cases of abuse in emergency rooms across the state. Charges of mistreatment include patient restraint, patient seclusion and being disrobed.

"At the lowest level, it's disrespect, but at the highest level, it's discrimination," Klein said, adding that the only recourse for improper patient care is to go to the hospital's complaint division or to the DPH, but those offices claim they can't do anything without procedures in place. This bill would provide those regulations.

Discussion on this topic has escalated in recent years after one psychiatric patient broke his arm while restrained and another died in the emergency room. The DPH and the Department of Mental Health (DMH) then formed the Emergency Department Workgroup to investigate over 21 claims of abuse in emergency rooms in an 18-month study.

Susan Stefan, a long-time proponent of the ER Rights bill, is currently representing a mental health patient in an emergency room discrimination case. She also wrote a book on the subject, entitled Emergency Department Treatment of the Psychiatric Patient.

"Hospitals and the DPH have to be told to regulate this area because they are so busy and they have so many obligations that no matter how well-meaning they are, it's not going to happen, except in response to the legislature's direction," Stefan said.

The DPH recognizes the need for increased quality of care for those with mental illnesses, but does not support the proposed legislation.

"Our position is that further legislation is not needed right now," Donna Rheaume, DPH spokesperson, told the Dig in an email. "We believe that the culture of care needs to change, not necessarily the regulatory environment."

Rheaume said hospitals are already subject to regulations from the Joint Commission on the Accreditation of Healthcare Organizations and Centers for Medicare and Medicaid Services with issues of restraint and seclusion. The DPH does not support piling more regulations upon these.

Stefan says poor treatment in emergency rooms can also be re-traumatizing for many patients. It could exacerbate an existing condition.

Klein says lobbying for the bill has had the opposite effect. "M-Power has really given me a voice on this topic," Klein said. "I feel very passionate about it."

State Treasurer Tim Cahill and Speaker Sal DiMasi both gave nods to the possibility of casinos in Massachusetts' future ... each in their own special way, of course, since legislators are like snowflakes. DiMasi conceded in an effort to speed up the budget process, while Cahill compared Massachusetts to Singapore. Yep. Either way, it might be a ballot question this fall. Start flexing your voting finger. PLUS 2

Transit officials keep talking about extending the Green Line to Medford, but we don't see 'em laying down the track! MINUS 1

Filene's Basement announced it will hold its annual "Running of the Brides" event at Hynes Convention Center in August. Groups of rabid bridezillas-to-be will race to grab bargain dresses from the racks, leaving men to guard their loot by sitting atop heaps of sequin-embellished, puffy, white dresses. That's a great look for you guys—we wouldn't lie to you. PLUS 1

A female Brighton resident yells "Everyone fuck me!" from her porch, with her naughty bits in full view. She's later arrested on charges of open and gross lewdness. Looks like someone could benefit from a trip to Good Vibrations ... MINUS 1

Obama challenges his image as a liberal elitist by taking over an old-school liberal elite's speaking obligation and addressing liberal elitists of the future at Wesleyan University's Commencement ceremony! PLUS 1

A Dunkin Donuts on Boylston Street passed their reinspection, after they failed in late April for breaking franchise agreement violations, including sale of expired donuts, employees not washing their hands and sightings of rodent feces. Mmm ... MINUS 1

Gov. Patrick is spending 80 percent of his executive budget on new jobs within his office. The new positions include director of grassroots governance (a $50,000 salary), grassroots governance liaison ($39,000), and director of new media and online strategy ($68,000). Patrick also plans to spend more than $450, 000 on a new office in Washington, which he claims will bring federal money to the state, and make up for all the spending he's doing. All this math is really confusing ... EVEN???

When you have to take a leak, you have to take a leak! A Cambridge man was arrested after urinating on a tree in Copley Square. When the man was spotted he immediately zipped up his pants and began speed walking until an officer caught up to him. The urinator's defense? "If I did take a leak ... it was only because I have diabetes." Good enough for us. PLUS 1

THIS WEEK'S TOTAL: PLUS 2

LAST WEEK'S TOTAL: PLUS 8

If our troops returning from Iraq and Afghanistan fail to get the support they need, the lingering trauma of combat could devastate their civilian lives.

Training, not a badge, makes a safe shooter

I have noticed that Speaker Salvatore DiMasi is supporting the state referendum on the casino issue, and that he has finally indicated his opposition to casinos, not just opposition to the way Gov. Deval Patrick presented the bill, without input from the...

Trim schools' building budgets

Parents, beware of teens' tanning

Arts can be a catalyst

In all the Memorial Day excitement you might have missed it, but over the weekend the Libertarian Party nominated former Georgia congressman Bob Barr as its presidential candidate. Barr was chosen on the sixth ballot in Denver, a far livelier and more...

Keep eyes open to stop arson

Baseball league president should step down

Counselors share compact's goals

My wife and I went to the ribbon-cutting ceremony for the reopening of the Corson Building (now the Corson Maritime Learning Center) in downtown New Bedford on May 16, only to find the large room on the second floor already full, so the closest we could...

Turbines of terror? Not really. Let me explain.

Recently Joe Cohen wrote two articles focused on the development of New Bedford's school budget. In both articles, the Global Learning Charter Public School was mentioned.