You have to have fun with your staff, because it is so rough out there.

It was a real honor to be part of the opening plenary at ASAM this morning. What a rough three months, but seeing thousands of providers working hard to help people with substance use challenges…I am so proud to know you are all here. We can do great things together.

I did that this week!

I’ve been on hormone therapy for twenty one years this month. Happy Trans Day of Visibility. Remember, trans people are not your problem, fascism is.

Thank you to Senator Cantwell for getting the word out about why we need to save Medicaid! 24% of all Washington State residents are Medicaid members, disproportionately children. For my agency’s patients, 95% are on Medicaid. There is nothing about cutting Medicaid that helps people. Call your rep!

Teaching students at Whitman College about the utility of drug checking for reducing opioid overdose, with our amazing technician, Malia. Science is fun!

If young queer and trans people ask me to show up for them when their rights are being quashed, I do my best to show up for them. Like today.

Oopsie poopsie, they left a mention of LGBTQ up!!

The choices at my local drive thru baristas earlier today:

This is my dog. His name is Puddles. He is the very best boy.

Taking down SSA’s guidance on how to make a gender marker change but letting AI qualify as a prescribing physician under FDA makes me want to feed the AI docs false information so that they prescribe gender marker changes to everybody.

Today and always.

My youngest often forgets his lunch box at school, so I put his lunch in a paper bag. Here are the bags from the last two weeks.

Our tree of life, in our back yard. It’s pretty much the whole yard.

Forgive me, I transposed the numbers. It’s 75.