"Stigma" with PA State Representive Bridget Kosierowski

September 21, 2022 Joe Van Wie / State Rep Bridget M. Kosierowski Season 2 Episode 31
"Stigma" with PA State Representive Bridget Kosierowski
Show Notes Transcript Chapter Markers

State Representative Bridget M. Kosierowski was elected to serve the people of the 114th Legislative District in the Pennsylvania House of Representatives following a special election in March 2019, becoming the first woman to represent Lackawanna County in the General Assembly in more than 50 years.

Kosierowski has spent her professional life in the health care sector working as a registered nurse. For more than 25 years, she helped patients live long and healthy lives, while also witnessing families struggle to afford quality health care. As a mother who has raised a survivor of a devastating leukemia diagnosis, she knows firsthand the hardship that too many families face. Through these experiences, she understands the impact compassionate leadership can have.

As state representative, Kosierowski's legislative priorities include preserving and enhancing health care services for all. She will work to preserve the state's Children Health Insurance Program, expand Medicaid access and protect those with pre-existing conditions from higher insurance premiums. She also plans to take steps to address the burden of school property taxes, as well as support efforts to impose a tax on natural-gas extractions and to close legal loopholes that allow multi-state corporations to pay lower income taxes.

Kosierowski is committed to focusing on the needs of her constituents through assistance provided by her office and through community outreach. She will work with members of both parties to find common ground that benefits the local area and communities across Pennsylvania.

Kosierowski is honored to serve the residents in the 114th District. She is guided by a deep desire to improve the lives of every man and woman to make communities a better place to live, to work and to raise a family.

Kosierowski is a lifelong Pennsylvanian, and graduate of Scranton Preparatory School and Villanova University. She resides with her husband Joe and their four children in Waverly Township, raising her family in the same neighborhood where she and her 5 siblings were raised.

To access any Healthcare Access Concerns & Recovery needs you can contact Her office below,

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Joe Van Wie  0:04  
Hello and thanks again for listening to another episode of all better. I'm your host, Joe van wie G. Today's guest is state representative Bridget Kazaa Roski Bridget's on the show today to speak and only a matter of public service but as a family member, a person recovering from substance use disorder. Bridget was elected to serve people with 114 Legislative District and the Pennsylvania House of Representatives. Following a special election in March 2019. The tragic loss of our state representative said Michaels after that election, she became the first woman to represent Lackawanna County in the General Assembly. More than 50 years as a Roski has spent her professional life in the healthcare sector. Working as a registered nurse for more than 25 years, she's helped patients with long, healthy lives, while also witnessing families struggle to afford quality health care. As a mother who had raised the survivor of a devastating leukemia diagnosis, she knows firsthand the hardship that too many families face. For these experiences. She understands the impact Compassionate Leadership as a state representative kaza Russkies legislative priorities include preserving and enhancing health care services for all. She will work to preserve the state's Children's Health Insurance Program, expand Medicaid access and protect those with pre existing conditions from higher insurance premiums. She also plans to take steps to address the burden of school property taxes, as well as supports efforts to impose a tax on natural gas distractions, and to close legal loopholes that allow multi state corporations to pay lower income taxes. Because the Roski has committed to focusing on the needs of her constituents. Through assistance provided by her office and through community community outreach. She will work with members of both parties to find common ground that benefits the local area and communities across Pennsylvania. Gaza Roski is honored to serve the residents of the 114 district. She is guided by a deep desire to improve the lives of every man and woman to make communities a better place to live, work and raise a family as a Roski as a lifelong Pennsylvania and graduated from Scranton Preparatory School and Villanova University. She resides with her husband Joe, and their four children in Waverly Township, raising her family in the same neighborhood where she and her five siblings were raised. Well, let's meet Bridget.

We're here with State Representative Bridgette Kaiser Roski. Thanks for coming in. Of course. This is recovery podcast and thinking what what are we going to talk about? But I thought we would start with how you grew up? And how did you first become familiar with the idea of addiction back then more termed alcoholism, substance use disorder? How did you become familiar that this was more than indulgence? If you could summarize the

State Rep Bridget M. Kosierowski  3:50  
big question? So I grew up in Clarks Summit. You know, my mom, Rosie and my dad, Edie. I'm the oldest of six. There's five girls, one boy. So being the oldest brings just automatic responsibilities, just your birth order, I guess. And my mom and dad are wonderful people. I really had a, I had a wonderful childhood. But being the oldest of a family who had a dad who has had an addiction to alcohol, but a high performing surgeon, sure, I'm busy and, you know, loving and had I, you know, had five siblings and my mom was able to stay at home with all of us and take care of all of us. And you know, we had a great household and we walked to school, we walked earlier peace school, but I was acutely aware of my dad's struggles. My mother is an amazing person in the sense that she did not want us to know the kids. She always protected us. We never, we never knew my dad. You know? When I say struggles, I think my father now knowing, you know, my dad just turned 80 years old, had an addiction to alcohol, and had gone to treatment. Now, you know this, I'm talking now as a 50 year old, his 50 year old daughter, knowing all this history. I think I had an awareness that there was a stressor or that, you know, he wasn't, he wasn't himself after a couple of drinks, you know. And, you know, it's funny, because honestly, my five siblings didn't, they had no idea because I, because I watched my mother protect us, I protected them. I was the one that you know, here's an example. We grew up in this neighborhood, right? And, you know, sidewalks friends in the neighborhood, and my mom would say to me, where's your father? Was your father across the street? Go see if your father's across the street. Because if I went over and got my dad and said, Oh, Dad, mom's looking for you. He would be more willing to decline? You wouldn't? Yeah. And he was me. I was 10. You know, I was looking for him. If my mother came over, he probably would have said, you know, beat it or get out of here. I'm hanging out with it. You know what I mean? So, like those little things, a little examples of, you know, how I knew that. I had to go over and get him. And then he would if he was coming back over to the house walking over to the house, he would not walk so straight or, you know, start singing or something that was for me as a 10 year old. I thought that's weird. Why is he you know, but he was, but he had some booze on board. So he, you know,

Joe Van Wie  6:43  
was there light side to that? Was he more approachable to my dad

State Rep Bridget M. Kosierowski  6:47  
has an unbelievable personality. I mean, he's wicked smart. But he also has an unbelievable sense of humor, self deprecating humor. He's a humble guy. He makes everybody feel good about themselves. He takes care of people, but he's a great storyteller. He makes people laugh, people love to be with my dad. And sometimes alcohol, he just, he just the all of that got better, you know, it got better. But then, like, then you don't feel good the next day or you don't feel good that you know, and then there's there's that level of stop, there was no stop. You know how there's some people that can have a glass of wine? Sure, or two, or three, and they're okay. And they're done. And they know their limits. But sometimes there's people that just like my dad, just, there was no limit, you know, and he would just keep going. So and then he would need it the next day or the next day. So and then I think when you're you're aware of it, and your family's aware of it, then you start to hide, you know, yeah, he my dad would he knew he wasn't supposed to. So he would, you know, hide it. And that's when you like, you know, we got a problem here.

Joe Van Wie  7:54  
So that's when you you have to split realities, and Medicaid. It's not even drinking at that time. In the terror, if you fully gave it up, if sobriety was the solution,

State Rep Bridget M. Kosierowski  8:06  
that is the solution. That is the solution. It's it's the entrance

Joe Van Wie  8:10  
in this, like, when you're a drunk, and you think not drinking, I'll have to do this, but like, you don't consider any texture to it. Like it's just not drinking. It's terrifying. Yeah, like, what am I gonna feel like the rest of my life, it's gonna be a nightmare. So it definitely

State Rep Bridget M. Kosierowski  8:24  
did something for him in the sense that it made him happier or better, or it made him more comfortable to be in an environment where there was people and he, his storytelling got better. He was having a great time. Everyone's got a great time. And, you know, I think so it was a good it was a good medicine for him. Yeah, you know, but but it didn't make him feel good. I mean, he didn't he didn't. He, it took him a while to rally the next day, you know, and you got to go to work. And you got it, you know, and he had an unbeliever, he still has an unbelievable work ethic. So that was a I think, a problem too, because he he never stopped him. Yeah, you know, he never not he never not woke up the next day, he never skipped a day at work. So for him to be able to do that. And then still go to work and work all day long. And never skip a beat was a bad thing because

Joe Van Wie  9:15  
it could last longer. That long. Yeah, it's hard to justify like a confrontation. You see, you're challenging them as a family. It's hard to let them go. What do you mean?

State Rep Bridget M. Kosierowski  9:23  
Yeah. Is that a stressful job, too? It's a stressful job. It was a stressful job for sure. So you can understand. I mean, you there are people that are in those fields of you know, medicine airline, the pilots, that was a group of a profession that struggled very much with addiction and alcoholism. You know, probably guys on I mean, I was more aware of my dad's own personal profession and how many physicians struggle with addiction to either booze or narcotic narcotics because they had accessibility to it. So I think that that that was a perfect One that had a high rate of addiction.

Joe Van Wie  10:03  
So Bridgette, you were aware of this even at 10. Like you're seeing in your the oldest kind of mother hanging your siblings away from the idea of what's happening. Yeah. How does it? How does this end? How is it resolved like, that you come to understand? Well,

State Rep Bridget M. Kosierowski  10:19  
I think it kind of hit you and you look at me now look back now I was just said mother hen. I think I became, you know, I went to become a nurse. I mean, that's what our nurses take care of people. I think that field, I mean, yeah, we watch your father in the medical profession. But I think that formulated the kind of profession I chose, and that was, you know, taking care of people. And I think it probably made me something that isn't the greatest personality, you know, character have as being a people pleaser, because, you know, I was always trying to take care of everybody and make everybody happy and smooth everything over. Because, okay, my dad is, you know, he's not doing well, or he's not feeling good or so, alright, I'll make my mom happy, I'll make him happy. You know, my kids, the siblings, or I'll take care of this, or I'll take care of my dad, because I think my diagnosis when I aged up a little bit, and my dad didn't go to treatment, I was I was the I was the textbook of an enabler. I was the textbook, you know, because I took care of everything. That's what an enabler does. So was my mother.

Joe Van Wie  11:24  
Was that a revelation to you that yes,

State Rep Bridget M. Kosierowski  11:26  
this was, you know, this was probably 1980. I think my dad went away to rehab in 1985. Wow. And those were, you know, that was allanon. Yeah. And, again, very, we chuckle about it now. But my mother now think of this. My dad goes away to a rehabilitation center. And I think he was in Florida, Virginia, I don't know where he went. And I was in high school. My siblings thought my dad went to a hand surgery clinic to learn. Hansard like to be a fellowship enhancer or something away, because my mother, we didn't talk about alcohol. We didn't say, you don't say those things. You know, it was very private, very image, you know, you wanted to it was, well, that's the statement we

Joe Van Wie  12:07  
talked about, rightfully so at the time there be consequences if you're to

State Rep Bridget M. Kosierowski  12:11  
absolutely I mean, absolutely. So, you know, his his partners, and we were he was gone away to rehab, and they were, you know, supportive and proud of him to do it. But my mother was very, very, very protective of us. And so was I. So I was the only one that went to the Al Anon meeting with her. And they're like, don't you have other moments? No, they're fine. They're at home like we drink. We don't talk about this where we don't we do not discuss. I mean, you have to keep in mind, we grew up in a house with five. You know, there's five girls My mother never spoke about. The change anything that went on in your body, a pregnancy of tampons, none of that stuff was no we didn't she did not. It's just funny. Like, I just think that's so but there was that

Joe Van Wie  12:56  
White House was that we don't talk about the sisters. I've never talked to my sisters about anything. We don't talk in my house. We don't We didn't talk much during dinner.

State Rep Bridget M. Kosierowski  13:05  
No, I remember one day, there was the Phil Donahue show was on. And I remember my mom, we had just gotten a television in the kitchen or something. And I remember he had a guest on and the guest said something about pregnant and my mother leaped across the kitchen counter and turn the television off. Because the person said the word pregnant. And that was like don't like you know, because we didn't, we didn't talk about so certainly that level of protection. I admire her for what she did because she was one strong cookie. I mean, you gotta you gotta you know husband, that's gone away. No income six kids. Boom, like, you gotta you gotta hustle, make things work. Yeah, but you also have to keep yourself together, keep your, you know, family together and make sure that everything's just hunky dory. That never happened. We're gonna move on. Like, that's how, you know. So I think it's such a you know, and you can relate, you know, yeah, you

Joe Van Wie  13:56  
gotta keep watch over how CD Phil Donahue was becoming a TV pregnant at the Vatican channel. I don't know, your mom and my mom got and they grew up at Southside Irish Catholic that creates that only a culture that's a group personality of how you approach life and what you talked about, we avoided all conflict. We were very funny. We could laugh at tragedy. And I know you can relate to that. But we didn't talk about those other things because I don't there's some kind of socio economics of Irish people to to leave Southside with such ambition that you couldn't show weakness because it was like almost Victorian some weird rule.

State Rep Bridget M. Kosierowski  14:40  
We have that what you're saying I'm nodding my head here and now I'm a podcast. You can't see that but for sure that Irish Catholic just the pride and you know, privacy your is definitely something that's very familiar with both of us.

Joe Van Wie  14:57  
Yeah. You know, I get it.

State Rep Bridget M. Kosierowski  15:01  
And humor, humor, but humor was such a met. It was a medicine for us, we were able to

Joe Van Wie  15:07  
see when you could afford it. And

State Rep Bridget M. Kosierowski  15:09  
we were all good at it. I was Catholic after a couple of drinks. We were fantastic. We were great storytellers and everything, you know. And also, like you said, tragedy and, you know, sometimes even you know, we I look at our family, and something really tragic or sad is happening, but, you know, to laugh or to smile about something, just, you know, helps helps. And we have that

Joe Van Wie  15:34  
it's my religion. I get out of bed because of irony. I really do. I don't want to lose that experience of life being so ironic. It's it's the best part of it. I don't know how to make sense of some things until I laugh about it. I don't know what they met in my life until

State Rep Bridget M. Kosierowski  15:52  
we can. Yeah, and for many situations. So with

Joe Van Wie  15:56  
that, that personality, was it hard to get involved? Did you find yourself getting involved at a young age with Allah? Was it allanon Altoona? Oh,

State Rep Bridget M. Kosierowski  16:04  
my goodness, no, no, no, no, no, no, no, we did not get no, we did not like we went to the meetings. And that was my we didn't talk about no. And I mean, when I talk about enabler, that was the only thing I understood, I didn't understand what you know, the disease process is that it is a disease, that it is something that is okay to talk about, that is something that we should address that we should as a family and understand and support and what triggers and what, you know, genetics play all that kind of stuff? Nope, we did. We, you my dad came home, he went back to work. I was cruising along well, and then you know, he had to go to school. Again, he didn't do so well. You know, because it is an unbelievable disease. And it's really hard to control. And some people are able to control it with certain treatments that are there and the traditional, you know, treatments in the alcohol anonymous, going to meetings, that was not my dad's,

Joe Van Wie  17:02  
it's, and let's I'm going to painting an elite or exceptional rule. With that profession. It was just sensible. You don't want to ruin a reputation of something that may or may not be affecting your work and, you know, in someone's mind, and the same with police officers. My brother's a police officer. And he's open about recovery. But he goes to police meetings, right.

State Rep Bridget M. Kosierowski  17:28  
There were a special meeting. I mean, there were meetings that were physicians only, you know, I think I guess Yeah, I think I think there were although I always thought my is my my I remember my dad would come home from an Alcoholics Anonymous meeting my mother God who was there, and my first became Alcoholics Anonymous, we

Joe Van Wie  17:48  
wear masks.

State Rep Bridget M. Kosierowski  17:51  
We're not gonna really, but he, you know, he never got the pro he never bought the program, I guess. You know, he just never worked the work the program is

Joe Van Wie  18:00  
not the only path to recovery.

State Rep Bridget M. Kosierowski  18:02  
It's not but for him, he knew he needed the support in any community. I just think that he just 30 days, nothing from he, he was he he was and he didn't have the coping skills, mechanisms or anything. I mean, we're talking about a really smart guy. But he that that was a bad thing. Cuz he was he knew how to Doctor manipulate, right? Yeah, yeah, he knew manipulate and I think that was in then, you know, sometimes the, it's easier to hide a pill than it is a drink. Yeah, you know, so if you can take a pill, that's easier than taking a couple having drinks that they're harder to hide harder to, it's

Joe Van Wie  18:43  
less of an investment. I, when I would drink especially at the end of this last bout it would take out I have to commit days to where I want. Where I want to be

State Rep Bridget M. Kosierowski  18:55  
your pro at this. Yeah, exactly. This tolerance,

Joe Van Wie  18:58  
you got to do some research what exotic drugs have been made in the last one since I've been in high school that are gonna help my mind, get where I want to be. But that's, that's an alternative. But you were saying earlier it takes a year especially if someone ends up in their 40s professional or not. It takes a year for your brain to heal itself without will without cognition with post especially with alcohol post alcohol withdrawal syndrome has serious effects in judgment, brain lock, emotional processing, visual cortex, panic anxiety,

State Rep Bridget M. Kosierowski  19:36  
it's well those are the reasons you sometimes you drink

Joe Van Wie  19:39  
it is you This is what life is in sobriety. So you don't even see past at least the long term withdrawals that can be 90 Days to a year. And what you come to find out you're not there yet to find out. It's not the drinking so much as the way I think

State Rep Bridget M. Kosierowski  19:56  
that's the support system that I think we we didn't have For the earlier times of when we started to do you know, treatment, I don't think there was that. aftercare. Yeah, they call it aftercare. Right? So, aftercare, there was no aftercare, you went home, right back to here, access to bars, prescription pads, your friends. There was that wasn't there? I don't know the statistics. And I, you know, but but those people that really went to those programs for 30 days, and worked it and just did it, I don't know who they are. I commend them. I don't know if they were truly alcoholics were they truly alcoholics that were able to come out of those?

Joe Van Wie  20:36  
There's a good study Harvard did for about 20 years with the help of a general services. What, you know, perceivably it looks dismal the results for one year and five years and they're all these cross tab breakdowns. But it's also had this scenario what is alcoholism like this is what's not defined in the tabs of who's who's got just maybe clinical depression has been abusing alcohol versus having a serious substance. So it gets complex and it's hard to point at metrics because it's, it's, it's a population, you can't really get to sit down and get,

State Rep Bridget M. Kosierowski  21:16  
and you know, you think like, you know, you've got colon cancer in breast, well, what kind? What kind do you have? Yeah, what what is the source? Is it? Is it a metastasized part, like there's so many different it's it's not colon cancer, and I think that's alcoholism. Okay, you okay, you're diagnosed alcohol? Why? Is it this? Is it this? Is it this? And how do we treat that part? It's just, it's the same as a disease process that we treat in in, you know, your concrete cancer, you see it on a on a cell. It's something that we could trip it, there's all different kinds. And that's what I think we have with addiction, and why you have addiction and what what what your choice of addiction was, and how do we treat it?

Joe Van Wie  21:55  
I think you're absolutely right. I, with the DSM five from for, just for reference, a lot of the more complex autism or even bipolar disorder. And mood disorders went on to a spectrum that you can pick from of degrees, because of, you know, just as broad symptoms of some scenario, that one person just doesn't fit into one box. But it's, it's the best way to describe it, I think addiction, I wonder if you'll see that trend of it going because we know that we call it stages of addiction, I think clinicians would, but they're not all the same, or have the same comorbidity somehow involved trauma, some might be an addiction might have rose up from Generalized Anxiety Disorder,

State Rep Bridget M. Kosierowski  22:42  
or, you know, you look at all these addictions to narcotics that lead to, you know, I remember when I was a nurse, and I worked a lot of orthopedics, right? Yeah. And a lot of people would come out, and they would give them a, you know, 60 vikins, to go home. And these people, you know, some of them would take one or two and be good one, some people would take one or two, get sick from them, never take it again, they would go to town out, but sometimes, I saw too many patients that would take it, and then they'd need more. And they'd get them, oh, we'll give them the bike in an extended strength and they won't need it. It just, it just started this whole entire generation of, you know, to no fault of either physicians or, you know, some physicians, yes, but yeah, or the patient themselves, and then they would, and then they would just need more or something different or something different. And then now, the, the new, you know, way to treat was to stop prescribing well, that set their hair on fire, now they're looking for something, you know, I need this, I want more, and then they'd go get something street level and that it was,

Joe Van Wie  23:43  
you know, the total broad stroke description of the opioid crisis from Oxycontin. But, you know, they had malice and bad intent, the Sacklers the way these drugs were advertised, but in itself, I don't know if you're familiar with Johann Hari did a great TED Talk About eight years ago. And he he sets the case for drugs are just not these magical hooks in them. Like, why didn't your grandmother come out from our hip surgery all strung out? Exactly. Or even the case of Vietnam soldiers coming home, you know, save 40% 20 30,000 We're using heroin actively in Vietnam come home, only 10% remain in the distress of addiction when they become come back home. So I look at that scenario, what you're describing is our culture. So you know, muted or deaf to the emotional problems we're carrying because of our how we're structured just as from work, what our debts are, that when that person first got there, got the first chance to use a narcotic now stronger than any of them in history. Did that meet an emotional need rather than the pain? It's not the drug Like I just hate thinking people think that this you accidentally became an addict. I think it's meeting a need really differently.

State Rep Bridget M. Kosierowski  25:06  
And you just said it was emotional. Yeah, the pain will go away from a from a surgical repair, it'll go away. But when they took that medics that medicine, whatever it may have been prescribed to them, a benzo or a narcotic, something happened to them that made them feel better. And they were able to, you know, function and or get through their day or activities of daily living and then they needed it again, and they needed it again. And that's where

Joe Van Wie  25:32  
bonding Yeah, that's where the addiction large made a bond.

State Rep Bridget M. Kosierowski  25:36  
Yeah, it's interesting. I've never heard it said that way, but it is that, you know, monta

Joe Van Wie  25:40  
describes it as a bonding like if say, you know, in the general description you you call addiction, disconnection. Well, what does that mean? You have not bonded with anyone, or even if you were the caregiver and the protector of the family, it does sometimes it doesn't give you a chance to be something outside of that role. Like, what is the intimacy coming back to?

State Rep Bridget M. Kosierowski  26:00  
Because I was always worried. Yeah, that being the care like what, you know, even going away to school or when I went away to college, I was always worried about is my dad, okay, is my mom okay? Like, you know, you're always I was out that that played a big, big role in my, in my just mental daily life.

Joe Van Wie  26:19  
It should worry. You chose nursing. Yeah, I

State Rep Bridget M. Kosierowski  26:21  
chose nursing.

Joe Van Wie  26:22  
What kind of I don't know. What kind of nurse were you? Like?

State Rep Bridget M. Kosierowski  26:27  
i When I graduated from nursing school in Villanova, I went to work at University of Pennsylvania Hospital and I worked bedside in a med surg floor, which I think every single nurse graduating from a nursing school should be mandated. I hate that word. But I do to do bedside nursing. I think that we are losing that.

Joe Van Wie  26:49  
What do you define as bedside nursing?

State Rep Bridget M. Kosierowski  26:52  
Those nurses that really work alongside a patient population in a hospital setting, and they have an assignment of eight to 10 patients, a lot of a lot of our nurses go into different fields now that go right to become nurse practitioners. They go on to become a nurse anesthesia, or specialization, specialization. Yeah. Education, which we need, we need all of them. But I think we're I just the art of bedside nursing, talking to your patients, being with them understanding and I get it, we our medical world has changed so much in time in terms of financial and time restraints. So a lot of times these nurses are just burned out, they are overwhelmed. The patients are so sick now that are in the hospital. I mean, I got to take care of patients. And I think I was a little bit spoiled. Because when I worked at University of Pennsylvania Hospital when you came to have surgery, you came the night before. So we got you set up for surgery, no, nothing to eat, we put your IV and we gave you some instructions, sent you off to the O R the next day. Then he came back and you know, you got more instructions you had a night overnight. Now we're sending patients home, you know, and it's all insurance driven, you know, send a patient you come in the day of you have your procedure you go home and that's a whole other podcast we can talk about. I do think that that that kind of nursing i So I worked in hospitals, I have worked in the hospital setting or to recovery rooms like operating you know, after Paki they pack US Post Anesthesia Care you all the acronyms. Yeah. And so that was I and then I worked in a surgery center, like an outpatient surgery center for 17 years. I love I loved I loved being a nurse, I love my job. I love talking, I love talking to people and meeting people and taking care of people. So

Joe Van Wie  28:35  
it's recovery i in the sense that the nurses I was lucky to have when I've been bedside. I really credit them with my recovery or turn around. Because it's just a humiliating experience to be in a bed, especially if you're young or sick or something and to not feel human or that you're the product or someone's having a bad day. It's hard to tolerate each other's burnout but that's where they're at stress. Yeah. With that idea, did you have any human services kind of lens when you would be looking at their a lot of the medical problems? Did you notice when something was a health issue, because of a complication with an addiction, or a human service problem?

State Rep Bridget M. Kosierowski  29:21  
When I started at the end of my career when I started working with physiatrist that were doing pain management? Yeah. Trying to help people you know, combat their pain, chronic pain with other alternative methods, whether it be like an injection, a steroid injection, or managing their medicine without narcotics, you know, yoga, physical therapy. I would look at these patients med list and think Oh, Holy Mother of God, this guy's on he's on 15 Different like us, you know everything from blood pressure, to depression, to pain, manage. I mean, these people were taken 15 meds a day, and they'd come in with notebooks of doctor's appointments that they had seen. And I have my god this is consuming their entire lives this pain, but the pain, you know? So, yes, so that addiction I saw stressful, yeah. But then I would see generation I would see, you know, either their kid or their parent, and I'd be able to see the whole picture and I think, oh my goodness, I, we need to educate. We need to help it. This is not this, they're not going to get better. And they were young, they were young, and they were, you know, there was obesity, certainly depression, some mental mental strategies that they, you know, we're gonna have to come back. They weren't working. Yeah, I mean, it's just, I, it's overwhelming. It's overwhelming. And I don't know why, you know, you didn't know where to

Joe Van Wie  30:51  
start. Well, that's, that's the hard thing that like, as I get older, I look at recovery as individual. I grew up around a being the number one solution, you get a wider lens as you get older, and you see kind of just the genesis of addiction is culture. It's the response to reality of some painful reality or a disconnection with relationships with primary caregiver arises out how do you how do you bring that into a more short discussion, instead of just saying individual problems with drugs? It's hard to it's too overwhelming.

State Rep Bridget M. Kosierowski  31:28  
It is. Yeah, it is overwhelming. And that's why we want instant gratification, right? We want immediate fix results. You and I both know, like if you've got back pain or, you know, go into physical therapy three times a week, taking that time for yourself, we as a society, do not do that anymore, because we are all completely on speed. 100 million miles an hour all the time. You know, you and I both talked about, like I got to I was really, really blessed that I got to grow up in a home that I have my mom at home, I work, I work, and I have four kids, but I've always worked and I do not want to make dinner. So I you know, I just take out and my mother is horrified by the amount of takeout that we'll use but sometimes

Joe Van Wie  32:14  
I'm like cycled through either DoorDash or Uber Eats.

State Rep Bridget M. Kosierowski  32:18  
I didn't do that. No, I haven't I well, I did hit a parenting low the other day I said to my husband, oh my goodness. I just ordered McDonald's from DoorDash from Harrisburg to Noah who's in Clarks summit because he was up in my house Joe has his office of in Pike County. So he's in Pike County. I was in Harrisburg. Did I like this is this is I just ordered like just like one of those bundle boxes or something because he and his two friends were at the house. And we're looking for food. I'm like, oh my god, this is terrible. Did DoorDash from it? Yeah. So,

Joe Van Wie  32:49  
you know, there's crisis in this house when I'm parked in McDonald's in a dark corner over in Wyoming. You know, I got a fight with my wife. I'm just making the Hato Second Quarter Pounder out into the abyss.

State Rep Bridget M. Kosierowski  33:05  
I don't know that kind of. It's just, it just helps. Okay, Joe at worst, and I was like, I saw that I was a problem solver. I did it. I felt good about myself. But then I really felt bad. I'm like,

Joe Van Wie  33:16  
That was bad. Like that's it's convenient. So convenience.

State Rep Bridget M. Kosierowski  33:19  
And getting back to what I just said about instant gratification. I think we are not patient anymore. We are not people that I mean, look at look at all this member. I mean, I was talking to my friends the other day when I'm 50. So I was talking to my friends about like waiting for the neck. Remember when we were little and you would wait for Friday night and it was like the next series whether it be you know, the love, I was loved Dallas or Dallas, Dukes of Hazzard The Love Boat, all those silly fun shows, but they were you had to wait till the next Friday or Saturday morning cartoons. You had to wait till Saturday morning. Our kids can just boom, Google anything, look at anything, see anything they want at any time immediately.

Joe Van Wie  33:57  
Even status, like member slam books, like the notebook, you'd have to wait to lick up back to you until you understood what was written about you. That's immediate dopamine release now in your pocket. It's it's a constant visual and visceral reminder of who you are, where you are in your pack. What you what you've with the optics of your life is it's

State Rep Bridget M. Kosierowski  34:21  
it has exploded these kids with all like we talked about spectrum. Yeah. And you and I am a tad older, but you and I when that was you're just you're just in one box. You know, you were you know whatever the word they would use if you had needed something if you had anxiety or depression I don't even DD we don't have any we didn't have those diagnosis is did not exist now. And I think we have just done such a disservice. All of us in this with these instant this this media and the cell phones and the I mean, it's really It's intense.

Joe Van Wie  34:57  
It's an intense way to grow up. So So structure would rely on an event, place geotargeted you use the phone app to have a quarter your clothes were kind of your Facebook profile of what you could put on that could be cool or creativity there. Your yearbook was the first time you would have your Facebook page. Right now we all construct who we are like a persona, and how we're going to present ourselves not only family, but to actively do it as an act of cognition all the time through that phone. It's I do it.

State Rep Bridget M. Kosierowski  35:35  
I've done I do, my kids that I let them do I bought them the phones, like they have, there's no I'm not shaming, blaming. And I mean, that just it's a lot different. And it's just like you said, there's we we had to have an event, right, you had to have, you know, something that would bring you together. And it allows

Joe Van Wie  35:56  
a different form of communication. I think that we evolved for its inflection, it's 90% of what's happening in the physical level. That's not the content of words. That is relating to the spectrum that is growing with, you know, Asperger's or autism. I don't know if it does, but it's like almost kids can't see that inflection of a word.

State Rep Bridget M. Kosierowski  36:21  
I know where my, you know, say I had 15 girls in my eighth grade class. Well, I didn't know if one of them was having a sleepover, because I didn't see pictures on Instagram. These kids now are home and they're thinking, oh, you know, Joanne is having a birthday party. And I see these pictures. And I wasn't invited. And it just messes with these little Did you watch

Joe Van Wie  36:39  
social dilemma I did not. It's depressing. The rise of suicide rates in adolescence. And the only direct correlation is the way they relate to their social media in their pack. It's live, it's ostracism, it's in group out group, it's every day it's on escapable. It's on the phone, the effect of filters, and beauty, your own self esteem.

State Rep Bridget M. Kosierowski  37:07  
That pack is keeping you know, that's where do you fit in the pack? And then you struggle, terrible anxiety. And then you know, compare it comparing yourself and it's not real. It is not real. We didn't I didn't we didn't have to see, you know, a

Joe Van Wie  37:19  
solution to that when I was 13. I was smoking ungodly amount. Go stare at a stream.

State Rep Bridget M. Kosierowski  37:27  
I filter myself, I would just completely filter myself on the eye. I believe me and I am.

Joe Van Wie  37:32  
Why isn't everyone whacked out in their mind? Smoking. That's what I would think. The challenge is to care and to care. The way I see you do it transition here, like I listened some a great podcast that was talking about the distinctions of empathy and sympathy and their difference. And the way you put a saddle on empathy is sympathy. It's to feel and care and have compassion for another person with agency though what a plant empathy, raw empathy, in context of what we're talking about, is really destructive. If there's no filter or plan because I can get overwhelmed not only by your joy, your grief, or I can't really have a plan to help because now I have to feel exactly the torment. Sympathy allows you to dip in and say, Well, I can't stay here with you, but I can help. Yeah. Taking that attitude from the way you approached nursing, when did you fully commit like what was that process like to public life? Like you knew you could I can make a change here.

State Rep Bridget M. Kosierowski  38:38  
So I would like to have this all nailed down that question, but it kind of just kind of just evolved, you know, it evolved the public life thing. I knew I wanted to kind of segue out of nursing and I was thinking about doing a a career and kind of a, what's the word? I'm thinking here? I'm blank on my people that are admitted to the hospitals now. Yeah, they don't have an an advocate. Sometimes. You know, we have a very high population here in Pennsylvania of geriatrics. A lot of people that are in that sandwich generation, like I call myself, I have my own children. My mom and dad are here. I work so a lot and a lot of our generate left town to go to work, parents still live here. And there was no kind of an advocate for them to communicate with their family and what's happening in hospitals. And I was hoping to start some kind of a service because some kind of a nursing service that we would be the liaison. Thank you. The liaison Thank you, bingo. The liaison for that family members. Sure. I just saw I saw people coming out of hospitals out of the surgery center, why worked going home to a place that they really couldn't care for themselves and in backup in a hospital. Either they fell or they had an infection and then you know the trajectory of their care. error and their cost was high. Right? So I thought we had wanted to fix this somehow. And then there was a situation where this state representative seat opened up. Our our old representative his name was Mrs. Coolidge, our guy from the 114 first race Did you Yeah, he was just driving by good soul. Oh, he was everybody knew said because it was I mean, we love I don't know if you know this in Lackawanna County. We love high school sports. Yeah. So he was he was a sports guy. So everybody knew his name. And he was just easy to be around and so likable and he did an amazing job and unfortunately had a complication and a surgical procedure and had an unexpected, you know, death and very sad, just tragic. Believe me, I know that when I went to work in Harrisburg, everybody, he just had so much as much as people loved him here. They loved him in Harrisburg, too. So, having said pass away, that seat opened up, and it was a special election. I think, looking back, that was great, because it was baptism by fire. I didn't have time to think about it. That's great kind of just, it happened.

Joe Van Wie  41:11  
And we don't need anyone that knows like,

State Rep Bridget M. Kosierowski  41:13  
this was we need it, oh, you need to go there. And really, so when I say I was a rookie, I had no political experience, none and very little government or political. You know, that wasn't in my wheelhouse. I had four kids, I was a nurse. You know, I hardly had time to read the newspaper. Sometimes, you know, I just you know, we discussions are taught listen to the news on television, but, you know, you're busy and you're working and your life is in there and, and then I went to Harrisburg, and I got elected and I went to Harrisburg and again baptism by fire. I was surrounded by amazing people. That really helped me because I needed it. I need it. So my colleagues

Joe Van Wie  41:51  
with that it was there was a rise of women of women in the last 10 years at the local level. And we grew up known a total different paradigm. Like like you think of Nancy Reagan, Tipper Gore like you thinking of these ideas, you are now running for office. The state rep you walk in Harrisburg is not opulent but it's overwhelming. There's a lot of

State Rep Bridget M. Kosierowski  42:17  
history. It's a good word because our state house and I I'm hoping that I get to bring more students. Yeah, it is. It is opulent. Our statehouse in Pennsylvania is one of the most impressive pieces of architectural structure I have ever. I get it every time I go into the House floor. I'm like, gosh, yeah, this is a lot nicer than the colonoscopy suite. I used to work in every Monday morning for 17 years with my good friend, Dr. Jay Bannon.

Joe Van Wie  42:40  
Yeah, so like, it's 1000 years. Building. So what do you feel? Would you I want to stop that would like, I always wanted this with people because I walk in some people can be motivated, what they're seeing a legacy, maybe leave behind other people I think could be overwhelmed by their own mortality. When you walk into a building like that, especially where Catholic churches are trying to look like a capitol. What do you feel when you're in that room? Because I think optics and visuals that can't be ignored? Architecture is just so consuming, what control what room you walk in what you're seeing, what do you feel what motivates you,

State Rep Bridget M. Kosierowski  43:20  
I have a sense of responsibility. I mean, honestly, this I have 63,000 people that I represent Pennsylvania's very diverse. And I bring a certain skill set to the House of Representatives. I am the only nurse in the House of Representatives 20 203 of us. Certainly, having been there a couple months and then COVID hit, and I was the only, you know, real medical, you know, professional in the whole house. And there was lots of medical questions. I mean, people, you know, some people don't even know how to pronounce, you know, what is it what the hell is an epidemiology epidemiologist? What, what the hell what it was cool, you know, there was a lot of, so I felt this, or this sense of responsibility, this sense of, I have to get this right. I mean, there's a healthy dose of of a fear in this in this healthy dose when I say that, I mean, I, I think I owe there's a tremendous amount to learn. Yeah. And I, I want to get it right. I want it

Joe Van Wie  44:18  
Yeah. It's hard to not call it fear because it's curiosity academically. There's a liberty to curiosity. You can get scammed by someone but you're in the public light and you're, you know, the responsibility. But, you know, screw fear. It's curiosity. How do you how do you do that? Take that humility. Do you feel an obligation as a woman and a woman leader? Is there any ego games that are still left you think you're like old boys kind of shit in Harrisburg? I don't know.

State Rep Bridget M. Kosierowski  44:52  
Yeah, I guess they're, I guess, yeah, of course, but you

Joe Van Wie  44:54  
combat it. What do you do?

State Rep Bridget M. Kosierowski  44:56  
I don't really, I work with really intelligent Smart men that are great at what they're doing. They are doing it for the reasons they want to have good change in Pennsylvania and our Commonwealth. But yeah, I mean, I think, you know, keep in mind this this seat that I hold. It has been 5055 years since a woman took this, but the woman that we had before me was Marian Munley. Marian Manley's husband got married in my life and Mundelein law firm that big family she, her the grandmother, she took over the seat for her husband who passed away. Wow. And while he was in office, and there was no interstate 81 At the time, Marian got herself back and forth. I mean, she says this woman is like, I think about her and I get to think about her when I get to Harrisburg because she her portrait is in the back of house floor and there's no other portraits on the back of the house. Just Marian Minh Lee's portrait is hanging on the back of the house floor. And it's kind of a reminder when I look at her like, you know, she looks at me and she's you got this? Yeah, yeah, yeah. Lackawanna? Yeah, exactly. I know, but there's little pods of you know, there's the Philadelphia caucus. There's the Pittsburgh caucus, there's the SE delegation, there's, you know, I'm the we're the Northeast here, obviously. So yeah, I do feel a sense of responsibility. I want to I want to make people proud. I want to do I want to enact good change back here. And I'm in my district.

Joe Van Wie  46:21  
And so you have the medical lens, you got you were very big help, especially on social media with the with the stuff you were putting out there during the pandemic. Thanks, Max, bipartisan stuff. I don't get, you know, political background and get too into the weeds politically on sides. But are there certain issues, especially with you having the lens of medical, compassion care? Kind of, you know, a middle finger to stigma to any of this stuff as you because we just talked about, Is there stuff that rises still in Harrisburg above that partisanship, that when there's a road back from this, how polarized we are locally, statewide federally, that there's a road to forgiveness that we can we can get back to maybe a faster bureaucracy? I'm not against bureaucracy, I think it saves it. But do you? Are you starting to see any paths to keeping things bipartisan when it's like when it comes to recovery? Specifically?

State Rep Bridget M. Kosierowski  47:27  
I do think that there's, there's certainly I have friends on both sides of the aisles on the aisle, certainly, and I get I get to work with people that knew it back then, you know, 20 years ago, this wouldn't happen. 20 years, no one would were say that no one would go up to, you know, there are constant reminders of that kind of, but when it comes to addiction, health care, and pediatric mental health, I think COVID And I say this, you know, if anything, kind of opened our eyes to the broken health care system that we have, and the need to really focus on preventative care, education, mental health. It's the Gateway sometimes I think, if we don't take care of that, in the in that pediatric level, I think it can be the gateway to addiction, and a lot of in a lot of ways that we you know, this is my, you know, my, my did not do a thesis or a study or, but you know, I do think that we that is something that bipartisan support, I have seen it, I sit on the health committee. So I you know, I'm hoping we can get a little bit more legislation and attention and, you know, at all we need money, we need support you need you need to have financial support for these programs, because they don't support them. We don't have we don't, we don't have enough professionals working in this field. Because a we don't pay them enough. B They come out with school loans. And it's hard, we need more I mean, I statistically have just the professionals and they in schools, we the ratio is like two to three 300 kids or something. It's you know,

Joe Van Wie  49:08  
it's crazy crisis here. This is a first wave mental health, right? Human Services crisis, and it's going to be here.

State Rep Bridget M. Kosierowski  49:16  
In the preventative part, we

Joe Van Wie  49:18  
that's where

State Rep Bridget M. Kosierowski  49:20  
we get like, we're just talking about money, but you save so much down the road, you save so much to everything from all kinds of health challenges, whether it be addiction, or obesity or depression, all these things that are going to really take life lifelong diabetes, type two diabetes, but

Joe Van Wie  49:38  
you want to make a better nation. Yeah, that's it a

State Rep Bridget M. Kosierowski  49:41  
preventative care. Gotta we gotta invest in our preventative care, pediatric level mental health in schools.

Joe Van Wie  49:51  
What you said is the outline to every expert that is taken seriously makes me feel that I'm

State Rep Bridget M. Kosierowski  49:57  
an expert without speaking

Joe Van Wie  49:59  
specifically about addiction. Yep. All expertise points to identifying first trauma. This is the first flag for pediatrics. Can you identify that in a screening? Can a school counselor do that? So even if it's less subtle than, say, an event of trauma, little tea, or would be, you know, was this a stressful pregnancy? Did you have too much cortisol, this can mute well, how people self soothe you

State Rep Bridget M. Kosierowski  50:26  
speaker lots of stuff. I, you know, your eyesight, your hearing your teeth, your body height and weight, we got to get better at screening and preventing and identifying those triggers. Yeah.

Joe Van Wie  50:39  
Yeah. And before your eight, your, your form kind of a, a feedback loop of a personality? I mean, on average, most people do. Can we find this before five or six? Because that's where you, you can make big changes. And, you know, I'm not saying they decrease onwards after that. But

State Rep Bridget M. Kosierowski  50:58  
they do though, it may mean preschool, we should have preschool, and then it helps with child care. Yeah, all these working parents, I mean, both parents are working, how glorious would it be to know that you've got preschool, you know, that these kids can go to that they are getting, you know, resources, and that that will help them down down the road?

Joe Van Wie  51:21  
Well, you know, the struggles I see targeted for addiction in the state, and we have a DD app does a pretty good job in the sense they have a new regulation, I mentioned to recovery houses that bring a standard and to housing of, of alcoholics or people with substance use disorder. But the strong statement I'm hearing now from professionals is a great, great phrase. I don't know if housing is medicine, specially in addiction, and just seeing that I will always advocate for longer treatment, 90 days levels of care that step down program to up to a year and some kind of solution to make Medicaid. More competitive, no private, the good companies, you know, it's sad enough, but I don't see a lot of business models being designed to service that. And there's a huge need.

State Rep Bridget M. Kosierowski  52:19  
Yeah, absolutely. We do it for you know, if you need chemotherapy outpatient, if you need long term care for a disease process, we make it happen. We have to make it happen for 30, you can't do it you can't unique, you still need a level of care to be able to be successful and your recovery after afterwards, and these at home at home, say to get home as medicine,

Joe Van Wie  52:42  
housing as medicine. How's medicine? Yeah. And so the trend, I'm seeing detox like in other progressive states like California 28 day, we have that classic 30 day, but some of it insurance companies are seeing well, okay, we're paying this much for what would be the next level of care right now. You go detox, 28 day residential treatment, then PHP, you're seeing this trend, where it's detox straight to BHP, and that's fine. But but it's for 90 days, right

State Rep Bridget M. Kosierowski  53:14  
as well, you know,

Joe Van Wie  53:15  
maybe is because you're getting 15 hours of clinical, they're seeing the same criteria being met. But now you have a little more liberty. You know, I don't know what those you know, the catch all of all that is good or bad. But you're seeing a longer form of treatment, they're seeing a better return, and then an aftercare program up to a year this increases the chance if the metric sobriety up to a year that person's individual goal of sobriety, it goes up exponentially, which is,

State Rep Bridget M. Kosierowski  53:45  
yeah, that's what we want. Right? Yeah. We you just said California, I think we and the one thing I do realize in Pennsylvania is we're, we're like allergic to change, we have a hard time. We have a hard time moving moving along, you know, like getting, and we have really, you know, wonderful resources of information. And this is how it's going to work. And this is what we should do. It's just like, let's come on. Like, I think that's the other thing working in Harrisburg. It's a very different. I mean, when you nurses, I punched a clock at 6am and punched at 230. I was you know, but I was there was no downtime there. You just You just moved all the time. So I think that was an adjustment for me just the, you know, meetings and then okay, well, what I don't understand what just happened in this, like, what do we what are we doing? Like I need to, you know, I don't like just and a lot of people do say that we can have all these meetings, and we can discuss all this stuff. And we can share all these statistics, and we can have these unbelievable experts that we have here in Pennsylvania tell us, hey, this is what you got to do. Well, then, let's Okay, let's do it. And that's where it's sometimes it's frustrating.

Joe Van Wie  54:53  
It's hiring a maverick. One of the Mavericks, like if you hire one from the inside, it's like, Was it hot? Didn't, Harry Hopkins was SDRs built the human story. He was a maniac. He said, You we need a maniac, then you work this job like you're gonna get fired. I'm not gonna be here next week. So So what get get it done the right way. Yeah. expect not to be there long. And now what do you do you do it the right way do it the right way. You'd be a maverick.

State Rep Bridget M. Kosierowski  55:19  
And there's lots of people that I work with that that's their that's how they want to do it. Yeah, it's just not enough of them, I guess.

Joe Van Wie  55:25  
Yeah. Any more support? So if so, our flourishing recovery community here, which could be up to 5000 people in this county, any they ever need resources, they could always reach out to your office? The

State Rep Bridget M. Kosierowski  55:38  
right 100%? You know, clearly, that's as great as we have here. And although we still have a pretty healthy epidemic, yeah, yeah, we do, we really do. And we got to fix it, we got to fix it. Because that one addict is affecting so many other people in their world. And for many different ways, whether it be a child in that child's completely stressed out all the time, because mom or dad is an addict, and they're trying to always, you know, fix things and save things. And you know, so that's just one little example, or, you know, their job, whatever it may be that one addict always has a ripple of people that they affect in their life

Joe Van Wie  56:17  
before I kind of wrap up. The one thing I forgot to mention harm reduction, I mean, for the triage of what you're seeing numbers from not only our own area, your district, but like the super crisis of say, even south of us, Kensington. All of the good data says harm reduction. This is triage sense and harm reduction being in the form of safe needle exchanges, safe sites. Ma T's Nioxin not having to have a script for which we're doing in our county.

State Rep Bridget M. Kosierowski  56:52  
Yep. But that's all stigma stuff to show. Yeah, like, needle exchange as people like, Oh, my You know, what?

Joe Van Wie  57:00  
You sober? Yeah, I tell them.

State Rep Bridget M. Kosierowski  57:03  
Good. You know, that's how clean Yeah, I mean, that's where we have to get better at the education, stop the stigma. This is a disease process, you would not you if somebody has diabetes, cancer, you know, we are compassionate. And we have empathy. We take care of it. There's nothing but we don't do it yet. For addiction problems. There's

Joe Van Wie  57:24  
a long history of pain associated with addiction of the pain addicts that we love, good cause each other or we cause ourselves that there has to be this objective attitude. We got to step outside of ourselves and say, We're all in pain. Let's make it all dignified for each other. Yeah, yeah. Some people are more pain, harm reduction. Reduction. Yeah. Yeah.

State Rep Bridget M. Kosierowski  57:46  
You got to come to Harrisburg. And I'll just take you down on the House floor and throw you on the putting just have at it. Go for it. I'd love you to do a

Joe Van Wie  57:53  
dance interpretation. I'll open up my addiction. Yeah, bring my own cardboard. Wonderful.

State Rep Bridget M. Kosierowski  57:57  
I, you and I would be a hit. I think we would be ahead of bringing on to the health committee. But no, seriously, listening when I say that I'm privileged to be able to sit on these committees, but I get to listen to health experts talk about and everybody's well intended, but we just kind of, we got to make it happen. We have to do do something. So that's kind of a goal, I guess. You know, it's

Joe Van Wie  58:18  
it's happening in this area. I see a lot of Smarter approaches in care. You can't be you can't dial in sincerity. And we have we have generations of sober people that have been active in our community. And that helps you can replace that. Yeah,

State Rep Bridget M. Kosierowski  58:35  
I'm very proud of them. I have some family members that are wonderful. Just, they're they're they're rock stars in my eyes because they they just they take care of others that took care of themselves. And now they're taking care of others and that's we need more. Yeah, that's it. Yeah. Well, alright. So we're going to Harrisburg, you're going to fix everything we're going to I got to Okay, we have a plan. Here we have a plan. Alright, let's

Joe Van Wie  58:56  
get started. Okay. Hey, thanks for listening. And thank you again for coming. Anytime.

I'd like to thank you for listening to another episode of all better to find us on all or listen to us on Apple podcasts. Spotify, Google, podcasts, Stitcher, I Heart Radio, and Alexa. Special thanks to our producer John Edwards, an engineering company 570. Drone. Please like or subscribe to us on YouTube, Facebook, Instagram or Twitter. And if you're not on social media, you're awesome. Looking forward to seeing you again. And remember, just because you're sober doesn't mean you're right.

Transcribed by

Birth Order
Protecting the Problem
Vacation ?
Year of Healing
Bonding Agents
Culture & Mind
Constant Contact
Issues beyond Party Lines...
Level of Cares
Housing is Medicine