*sigh* ... ok one last time... PROGTFO

I am a Portland man, born as a Portland baby, raised as a Portland child, floundered as a Portland boy, in the end finding my way as a Portland man.  I have traveled here and there.  After all that I am, no matter where I go, a Portland man.  That is why I feel some sense of shame tonight.

Tonight is another reminder of for all of the forward looking, really wanting to do good this place has to offer, how easy it is to have it fucked all up by the simplest things.

Fluoride.

That's right, fluoride.  The city just took a vote on whether or not to start fluoridating the water.  The answer was close as makes no difference 60% no.  I am not surprised, I am not angry, I am not confused.  All I am is a little bit sad, and somewhat ashamed.  This is a fight we as a community have had several times in other guises.  We talk in terms of choice vs mandate, and safety vs risk.  But really the talk is couched terms for us vs them, seen vs unseen.  The words of elite vs masses, individual vs community.

Let me try to explain.  As anyone who has seen a Netflix'd (how weird is it that Netflix becoming a verb?) episode of Portlandia knows, we are a strange little group.  Historical roots of natives, trappers, racists, loggers, shippers, miners, sailors, hippies, communes, and Californian refuges.  We forget that, alot.  Especially here in the population center of the state.  We forget that we are unique because of how many different groups that cant stand each other find ways to coexist for the most part.  Now yes, it helps that were are not a very racially diverse state.  And that most of the American Indians (as I am told is the current PC to say, as the treaties that were never honored are labeled as such) have moved closer to the reservations with the new casinos have left us ever whiter.  But it is also because we tend to give people space, and leave most people to themselves.  Oregon has a very strong libertarian streak.

Portland, or at least parts of it have very progressive and or liberal leanings.  Again news to no one I'm sure.  Which makes the cognitive dissonance painful to watch.  We will fight to impose manslaughter charges on a commune of Christian Scientists who refuse medical treatment for their children.  Then turn around and refuse vaccines for our own.  Demand mandatory minimum sentences for  crimes, originally violent, then non-violent drug crimes.  Then come back and pass medical marijuana laws.  Demand that our "historical" neighborhoods pass new codes to "keep their identities."  Afterwords refusing to fluoridate the water.  Us vs Them.  Me vs You.  Seen vs Unseen.

We never have the talk at the root of the issues.  How much of my choice do I give up on balance for the communities interest?  How much must the community adapt and meet My unique needs as an individual?  There is no easy answer.  Its fluid.  It depends on  place, time, subject matter, historical context.  No wonder we never have the big talk.  We are afraid of it.

One radio ad talking point from the anti-fluoride campaign speaks volumes.  "We have over 200 local doctors who oppose fluoridation.  Shouldn't you?"  Well... no.  We have almost 600,000 people in Portland proper, and almost 2.3 Million in the greater Portland Metro area.  A quick search on WebMD shows 1543 registers general care practicians in Portland.(http://doctor.webmd.com/local/oregon/portland.htm 5/21/2013 10:21 PM PST)  Not counting dentists, specialists, homeopaths, and various other healers that pepper our schizophrenic hills.  But using that 200 is only about 13%.  Oh by the way, the 200 number is not MD's, rather a large collection of various homeopaths, such as chiropractors, acupuncturists, and massage therapists.  Yes there are MD's proper in the group but its a small fraction. (http://www.opb.org/news/series/fluoride/naturopaths-and-acupuncturists-lead-list-of-medical-professionals-opposed-to-fluoridation/)

Why then does this point work on people?  Because its not about doctors, or peer review, or greater good, or personal choice.  Not really anyways.  Sure some of that colors the fringe of the decisions, but mostly its simply something much sadder.  Don't tell me what to do.  But you god damn better do it My way.

Sorry this is a long one both of my readers, but its going to get longer. I will try to make it worth it.

Lets look at the Seen vs Unseen.  I don't think most affluent people in this, or any other community truly understand the life changes that happen when you have no dental coverage, or dental support.   Simply saying "well I brush my teeth, so should you" completely misses the point.  Most working poor cant truly afford healthcare.  Even after many of the recent reforms have begun to kick in, even with the Oregon Health Plan, there just isnt the coverage for people with out money in a for profit system.  Those who have basic or limited medical coverage don't have dental coverage.  Dental is expensive.  There's more than just brushing twice a day.  There's catching small problems early, orthodontia to deal that as a species we are still evolving and many of us are born with more teeth than will fit in our historically smaller mouths.  Our diets as a society have changed, the poorest of us eat the worst food for us.  Because that's whats subsidized, that's how you get 2000 calories at $5 a day.

Those with decent health care and dental care dont understand the unique hell that is dental pain.  Sure they may have had a root canal done once, or braces, or have had a cavity filled.  They maybe even had wisdom tooth issues as many do.  But do they really know what its like to live with those symptoms untreated for weeks, months, years, or even decades?  God I wish I was speaking in hyperbole.  For the most vulnerable of us this is life.  Take the tooth ace, that tooth infection, the soreness from the decay.  Now let it fester.  Let it sit there in your mouth day upon day, week upon week.  You cant concentrate the way you should, the pain is becoming the background noise to your life, you dont notice it because its always there, only worse with certain food or drink.  So you avoid those foods and drinks.  You move away from whole, unprocessed food because it requires more mastication which hurts, hurts bad.  You move to processed smooth foods with have so much less of the nutrition you need, and alot of the nutritional garbage you dont.  Now the pain continues to get worse because you cant afford the dentists that you so badly needed years go.  Even if you go now the bill will be with you for years to come.  You are tired all time, both your mind and body feel like they are running on fumes.  So you self medication.  You take a cocktail of Advil and Tylenol, maybe something stronger you get from a friend, or left over pain medication from family.

How long could you live like this?  Honestly take a moment and think, how long before you broke down?  How long before you accept the debt to end it?  Or simply find new ways of adapting and self medicating?

I was one of these people.  I worked with these people.  This is the working poor that surround us.  Our cooks, our cleaners, our drivers, our gardeners.  These are the children of the working poor.  We never have the talk about the most good for the most of us.  Let alone the sacrifices the most comfortable of us should make to protect the least well off that our comfort is built upon.  Yes, there are some health risks with high levels of fluoride.  Same is true of anything really.  Too much vitamin E will give you cancer, too much sun will burn you, too much water will drown you.  And yes the amount that is too much is different person to person.  That's the whole point of having a pro-con discussion.  Being honest and weighing risks and benefits.  Of admitting that on the whole I might like everything about it, but this can be a piece of the puzzle.

There are so many peered reviewed studies showing the link between dental health and total health.


Fluoridation is not a magic bullet.  It will not stop tooth decay.  It as a tool, one that works.  It a piece of a complicated solution to a complicated problem.  But we are all children, and refuse to admit the place we are, the places we want to go, and the paths to get there.

But that's not what the fight was about.  The fight was about "Its not my problem, I have dental care, so don't force it on me."  The issue was never that hardest of us to reach are the ones who need the help the most.  It was never an objective study of decades of peer reviewed work.  It was Seen vs Unseen.  Me vs Them.  Elite vs Masses.

And that's why I am ashamed tonight.