Monthly Archives: May 2013

Bad hit lit crit: Garbage

One of the few advantages of being stuck at home in bed has been the opportunity to do massive amounts of reading. Sometimes it’s hopeless, because when I’m really doped up even trashy movies go above my head. But I’m getting a little more coherent and have been reading more interesting material, thanks to the San Francisco Public Library’s extensive collection and generous hold policy, and Matt’s willingness to stop by and pick up whatever I’ve ordered. He suggested I write about some of these books and call it Bad Hit Lit Crit. For the name alone I thought it was worth it.

Garbology (Edward Humes)

Picking up (Robin Nagle)

Rubbish! (William Rathje and Cullen Murphy)

So this year has turned out to be less about bikes and more about waste. That’s primarily because I won’t be riding a bike for a few months while I’m recovering from the broken leg. However even while stuck at home I can try to minimize our garbage. It’s harder—every time the physical therapist comes over we end up with a pile of medical waste that goes to the landfill, and the post-injury reliance on takeout dinners isn’t helping matters either—but it’s certainly possible.

Something that has struck me ever since I joined the university zero waste committee is that everyone supports reducing garbage. When I mention my zero waste assignment people immediately tell me that they recycle a lot. That’s only a small part of what I think about when I think about waste reduction but the response is interesting. When I mention that we bike with our kids there’s about a 50-50 chance people will be concerned rather than supportive. But waste reduction is a totally non-controversial idea, even among people who fill up an extra-large garbage bin every week. It’s not obvious to me why. The US is a huge country with a lot of middle-of-nowhere: objectively speaking, it’s not likely we’ll ever run out of room for landfills, and judging by our actions, we have a lot of stuff that we’d like to throw away.  However nobody really seems happy about that.

Garbology, Picking Up, and Rubbish! approach the issue of waste from different perspectives. Garbology discusses the immense volume of waste produced by Americans and attempts to come to grips with how it’s handled. Picking Up follows one woman’s investigation of sanitation in New York City, which ends with her taking a job picking up trash in the city. And Rubbish! reviews the studies of the University of Arizona’s Garbage Project, which sorts through household waste and takes samples of the contents of various landfills. All of these books are fascinating.

There is an urban myth that dealing with garbage is a modern problem, which all of these books make clear is not the case. Despite the former existence of “rag and bone men” and other professions that recycled certain kinds of waste, there is ample anthropological and photographic evidence that waste was a massive and disgusting problem nearly everywhere until well into the 20th century. Garbage filled the streets and gutters of New York over a foot deep, and rubbish dumped into waterways was a persistent problem in multiple municipalities. Landfills are the source of most information about pre-literate societies. Until very recently, the idea of zero waste would have drawn blank stares.

An unnerving point made by all of these books is that despite the invisible nature of garbage collection, most households and businesses would collapse without regular pickup. Municipal sanitation strikes make this point fairly quickly (Picking Up). On average, Americans produce over 7 pounds of garbage per person every day of the year (Garbology). With our recent zero waste efforts our household could last for months if we had our own compost heap, but because we use municipal composting our situation would get ugly quickly without weekly pickup. (When we move, for this reason and others, it will be to a place with a yard.) Without weekly pickup, virtually every home in the US could serve as a case study of hoarders.

The things people throw away can be counter-intuitive. In the face of food shortages, people waste more food, presumably because people stock up more of scarce foods than they can really use (Rubbish!). People who eat repetitive diets waste less food. People throw away empty candy wrappers after Halloween and uneaten candy (still in the wrappers) after Valentine’s Day.  Everyone grossly underestimates how much food they throw away, while simultaneously under-reporting their consumption of processed foods and over-reporting their consumption of produce. Hazardous waste, in the form of personal care products (nail polish), auto care products (oil) and lawn care products (weed killer) makes up a startling large share of ordinary household waste despite efforts to separate it. And very little degrades in a landfill; 50-year-old guacamole will not brown and newspapers remain legible after decades. Waste placed in a landfill is forever.

When I think about what bothers me about waste I realize it is two things: finality and a lack of respect. It takes time, effort and raw materials to create the things we purchase and use. Bringing something home and then throwing it away is disrespectful of the resources used to create it. I find this increasingly distressing when thinking about disposable packaging, which has only one purpose—to carry something from one place to another—and which lasts forever, particularly plastic packaging. Even worse, reusable packaging can easily replace its disposable counterpart. Food waste is even more disturbing; there are hungry people everywhere, and there is no reason to buy more food than we can or should consume.

The lack of respect we show to the things we throw away is equaled by the lack of respect shown to sanitation workers. Despite their enormous contributions to public health, they are often invisible. People prefer not to see them or speak to them. (One exception to that general rule is parents with young children; ever since our son was six months old we have been on a first-name basis with the people who pick up our bins thanks to his fascination with trucks.)

The more I learn about garbage the clearer it becomes that nothing really disappears. Things are stored in landfills instead of being stored in our homes but they are still there. It is difficult for me to look at a full garbage can the same way after realizing that everything in it will be around virtually forever, even if I can no longer see it. And given the quantity of things we throw away, by volume, waste is probably the greatest product of our society.

Waste is rarely something that we’re charged for directly, but it is not costless. There are still places where stores provide “free” bags although San Francisco is no longer one of them. Once I started shopping with reusable bags, the costs of packaging became evident: I could buy a pound of salad greens in bulk for $6 or a quarter-pound of salad greens in a plastic clamshell for $5. The first time I bought soap in bulk I realized that I’d been rooked for years: 20 ounces of organic dish soap in an old repurposed vinegar bottle cost me $1.52, while a new plastic bottle of the same soap cost $5 for 12 ounces. Our zero waste efforts reduced our costs because there was less to buy (goodbye, processed food) and because the things we could buy were closer to their original state (and thus cheaper) and because we weren’t paying the invisible costs of packaging. If we were responsible for our own garbage pickup costs (it is illegal for San Francisco landlords to pass garbage costs on to renters) we could save even more by switching to the smallest possible garbage can. Packaging costs invisible money at purchase and visible money in weekly garbage pickup costs. Avoiding packaging saves not only those costs, but the costs of buying things spontaneously that we have no need for and would ultimately throw away.

More important than the financial savings for me, however, is the greater sense of peace with how we are living. Although I can’t necessarily pinpoint why, throwing things away feels uncomfortable and somehow wrong. Now we rarely fill up the small garbage can under the kitchen sink in a week, even with our recent reliance on takeout. Some weeks we’re equally unlikely to fill the even smaller recycling bin.  Those are good weeks. Now that I understand that away is not gone, generating less waste feels important. The things we have left in our wake have historically been things I would not want to be remembered by—crumpled plastic bags are an ugly legacy. Nevertheless, in the long term, both people and societies are known primarily by what they place in landfills. When I think about that, I want what we leave behind to have both meaning and purpose.

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How to protect against disaster

The last few weeks have been trying. My leg did not break simply, but dramatically. Both my tibia and fibula snapped in two, and above the breaks, the bones shattered into fragments. I was admitted to the hospital from the emergency room and went into surgery the next morning, where surgeons drilled into the unbroken ends of the bones and my femur to attach an external fixator. Because I was unable to move my leg with the weight of the fixator, I stayed in the hospital until the swelling went down enough that it could be replaced with internal fixation in a second surgery, specifically, a metal plate along the side of my tibia holding the bone fragments in place with a dozen screws. For much of this time I was given doses of narcotics so strong that I could barely string words into sentences. They did not really control the pain. This level of injury is apparently not unusual for people who get hit by cars, whether they are on foot, on a bike, or in another car.

When I was released from the hospital I was told that I could get full function in my leg back if I followed instructions. The most important one is no weight bearing for 12 weeks, with extensive home physical therapy. I initially had hopes that I would be able to work from home. But between the narcotics, which induce narcolepsy every time I try to read anything more detailed than my discharge instructions, and 6+ hours of physical therapy each day, this hasn’t happened and isn’t likely to happen for some time. I was told to stay at home except for medical appointments because the fracture is so fragile still that even being bumped on the sidewalk would be a significant risk. I’ve gone to the grocery store twice after my appointments—I was out anyway, and grocery stores have cool electric carts to ride that keep me off the leg—and passed out after each trip. I can’t work, I can’t take the kids to school, I have difficulty moving around the house, I’m constantly sleepy, and for at least four hours each day I’m stuck in a continuous passive motion machine, lying flat on my back. It’s been 3 weeks and I have 9 to go.

As frustrating as this is, it’s not a complete disaster. That’s because I have good insurance.

I work for a medical center and had a choice of several health insurance plans. Because I work in a medical center, I know how much a serious condition can ring up in expenses. I only considered the two plans that had no lifetime coverage limit. As a result, no matter how much my care costs, the insurance company will not cut me off. And I’m sure it will cost a lot. We haven’t seen many bills yet, but just the ambulance ride to the ER that I took with my son cost $5000. Add two surgeries, two weeks in the hospital, several weeks of home physical therapy, all the assistive technology, and an expected 18 months of follow-up and the numbers become staggering. There will be a financial reckoning for us at the end of this, of course, but there’s no point at which everything becomes solely my personal responsibility.

Because I am a professor, I also had the chance to buy affordable disability insurance. It’s cheap because it takes a lot to get professors to stop working. I like my job and it makes me crazy that I can’t do it. I will get back to work as soon as I’m allowed to drag myself into the office. Disability insurance doesn’t cover my whole salary, but it will ensure that twelve weeks off the job don’t topple us into bankruptcy. Being disabled is expensive. Matt has had to take time off work, we have had to line up sitters to take the kids to and from school, and there has been a lot of takeout. There was a co-pay for our son’s ER visit, I’m taking a dozen new medications, and Matt has had to arrange extra car rentals and rides that ferry me to various medical appointments. It adds up. I never thought I’d need disability insurance. Now I know better.

In a perfect world, the drivers who cause messes like these would be responsible for all of the associated costs. Unfortunately, not everyone is hit in front of dozens of witnesses as I was. Many drivers hit and run. Even drivers who don’t can be laughably underinsured. Most states require low levels of liability insurance, maybe enough to cover the cost of an ambulance ride to the hospital. And the kind of irresponsible driver who rams into a pedestrian or cyclist is probably not the kind of person who chooses anything more than minimum coverage required by law.

So I am very lucky: this situation is awful, but whatever happens with the driver’s insurance, I have coverage for my medical costs and part of my income is replaced when I can’t work. Not everyone is so fortunate. While everyone should have access to affordable health insurance, not everyone does. And disability insurance is even harder to come by: self-employed people often find they can’t buy it for any price. People who have the option to buy either or both kinds of policies would be crazy not to, especially if they have dependents. But what about people who can’t?

There is another way to get insurance for these kinds of worst-case scenarios, although it is more complicated. If you are hit by an uninsured or underinsured driver and have auto insurance of your own, any costs incurred for treatment can be covered through your uninsured motorist coverage, even if you were on foot or on a bike. Even people who don’t own a car can buy a named non-owner auto insurance policy—these policies are cheap, and also cover car rentals. For further insurance, especially for the self-employed who can’t buy disability coverage, an umbrella liability insurance policy will provide up to a million dollars that can be used for expenses that go beyond what any auto insurance policy will pay. These policies pay out after the fact, and that can take a while. But they will protect against bankruptcy and keep your kids off the street. And like named non-owner auto insurance policies, umbrella liability coverage is typically inexpensive.

I didn’t know much about any of this until I got injured. I never thought it would matter: I’m healthy and active and rarely sick. Why would I need disability insurance? I was lucky that my employer more or less defaults everyone into decent coverage. In hindsight, knowing what I know now, I realize that I could have made better choices.

I am bitter about losing time off work and the vacation time I had planned to spend with my children this summer. I am frustrated that I am stuck at home in bed every day and useless, and that there are many more weeks of this to come. I am angry when I’m in pain, which is a lot of the time, and that I haven’t even been able to take a shower for a month. I am depressed that while I can expect full range of motion to return in my right leg, I will probably never get my full strength back—I may not be able to ride an unassisted bike again. But I’m not afraid that we’ll go broke. And because of that, I can usually remind myself that this is temporary, and things will get better eventually. Despite my ignorance, it turns out that we were prepared for disaster. And we’re all still alive. It could have been much worse.

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Home again

After two weeks in the hospital, I have returned to our place. Despite the fact that I wasn’t allowed to leave until I showed I was able to hobble up and down stairs on crutches, doing this at home, where we have many, many stairs,  has left me exhausted. It will be months yet before life is back to normal. I will not be allowed to put any weight on my right leg until August. At that point the real physical therapy will begin. The good news is that my surgeon (also a bike commuter!) expects I’ll regain full function.

Aside from the injury itself, we feel very fortunate. Our families have cleared their schedules to spend time helping us, friends have been ferrying our kids to school and back, and my coworkers made sure my hospital stay was as comfortable as it could have been. I am grateful, too, that we know so many people who have broken their ankles, knees, and hips, and who have loaned us crutches, a bath chair, and other bits of assistive technology that I never imagined needing before.

I really appreciate all the well wishes. I had no idea so many people were reading the blog and found it valuable. It was a very welcome thing to learn during a difficult time. Thanks so much.

I’m not sure what, if anything, I could write about for quite a while. Although I’m likely to have lots of spare time in the next few months, I won’t be able to spend any of it riding a bike. And it’s a bit embarrassing to think about zero waste after spending so much time in the hospital, a place where a single bandage change filled a large garbage can. Moreover, I’m mostly bed-bound for the next two weeks (coming soon: a synopsis of ceiling cracks!) I’m open to suggestions.

In the meantime, locals can still catch Matt and the kids out on the Bullitt. Be sure to tell him he’s awesome if you do. Thanks for hanging in.

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