FAIRLAWN — When Richard Warden walked into the hospital room and saw his wife, he said he knew instantly it was over. It was March 4.
“This time it was just different, and it stayed different,” Richard said. “She was smiling. After having major surgery, she was happy. It was a miracle.”
The years of suffering, the dimming vision and memory loss, the nine previous surgeries that failed to give relief and the big, frightening 10th procedure Lauren Warden had just survived — it had all led to this moment.
“There was no pain in my brain,” Lauren said. “When you live with pain, 24/7 for as long as you can remember, and then going from there [the operating room] and waking up six hours later, and it’s not there, you know that it’s over.”
In that time, Dr. Rashid Janjua of Novant Health in Winston-Salem, North Carolina, had removed much of the skull on the left side of Warden’s head and reformed it, adding material to create a bigger space for her brain.
The procedure relieved constant pressure that little by little was taking Lauren’s hearing, her sight, her memory and the person she’d always been.
A rare disorder
Idiopathic intracranial hypertension — also known as pseudotumor cerebri — is rare. In the Western world, fewer than one in 100,000 people are diagnosed annually, according to a study published in 2014 in the International Journal of Ophthalmology and Clinical Research.
Sufferers experience severe, sometimes unremitting headaches, nausea and vomiting, altered vision and pulsating sounds in the head. And it can cause other problems, such as stiff neck, eye pain, memory and hearing loss and in severe cases, blindness.
Scientists don’t know exactly what causes it. But women between the ages of 15 and 44 bear the brunt of the mysterious disorder. Yearly, about 4 out of 100,000 women are diagnosed. And three years ago, Lauren was one of them.
“When I was first diagnosed, I was told it was very uncommon,” Warden said. “I had joined all these [support] groups. Well, it wasn’t uncommon. There are people I know that have it – people that live in Fairlawn or Draper, and Christiansburg and Radford.
“And a lot of doctors don’t understand pseudotumor, so to find one that does is amazing,” she said.
Janjua is one of those physicians. A neurosurgeon who takes regional referrals, he has many female IIH sufferers in his care.
“In my experience, these women have young kids, they have jobs. They are wives; they are mothers; they are daughters. And they keep on doing this, and by the time they come and see me, they are at wits’ end,” he said.
That was Lauren’s story, too.
The 31-year-old mother of three young boys thought it was just stress at first. After one of her three sons became gravely ill in 2017 and had to spend nearly two months in and out of hospitals, her head began to ache.
Her son recovered, but Lauren did not.
Still, she went on taking the boys to sports, taking care of the house and working as a long-term substitute elementary school teacher in Pulaski County. Slowly, the pain became more and more debilitating.
“When the pressure would get up, she would have to spend a lot of time in bed – not because she wanted to, but because she had no choice,” Richard said. “Every time she would try to attempt to do things. She would do more than she should have done just because she’s a good mom. But always it would end up taking control.”
Despite his long hours traveling as a DIRECTV installer, Richard would pick up the pieces she couldn’t handle, Lauren said. And so did Lauren’s mom, retired Pulaski County school administrator Elaine Woolwine.
Woolwine babysat the boys while Lauren and Richard went through surgery after surgery over the years. She loaned them money to help with deductibles and copays they struggled to meet.
“I’m just so thankful for her,” Lauren said of her mother.
But Lauren said there was never any choice but to keep going.
“There was no point that I was going to stop my life because I was sick. That wasn’t an option,” Lauren said. “I had kids, and I was responsible for my children.”
The three boys – Alex, 13; Stanley, 12; and Tanner, 10 – were also her inspiration.
“I needed them more than they needed me, and that’s what kept me so positive and closer to God,” Lauren said. “They never stopped praying, even when I did. They were my strength. I tell them all the time, you’ll never know how much you got me through this.”
A rare treatment
Many IIH patients get relief from less invasive treatments, from shunts to fluid drains to weight loss to medications, all of which can relieve pressure on the brain. But none of that worked for Lauren.
Her last option was a cranial expansion. It’s a rare treatment for a rare disorder. Janjua has done about one a year over the past three years, according to Novant Health spokesman Josh Jarman.
Janjua describes the procedure as akin to taking a tightly pinched hand out of a too-small glove and putting it into a bigger one.
Lasting several hours, the operation required him to remove about 80 percent of the left side of Lauren’s skull and reform it into a larger container for the brain.
It’s a big surgery, and requires many small procedures and tests leading up to it. In one of those procedures, a plastic surgeon places a tissue expander under her scalp to stretch the skin in readiness for a larger skull.
“I think Lauren is one of the bravest women I’ve seen,” Janjua said. “And we did all this, not just for Lauren but for Lauren’s husband and Lauren’s sons, too. They’re now at an age where they want their mom to be very active with them, and I wanted to give Lauren her life back.
“And I was very lucky to be able to work with her,” he said. “She’s absolutely fantastic.”
The morning after the surgery, Lauren took several laps around the intensive care unit and was sitting up in bed when Richard arrived. Despite the 65 sutures in her head and the black and blue circles around her swollen eyes, Lauren was ready to go home.
“I looked like death, but I felt great,” she said.
The couple left at mid-day and drove home to Pulaski County.
Since then, Lauren has regained her energy. She’s done a zipline and gone to the beach and plans to go deer hunting this fall – things she hadn’t done for years.
She’s also struggling with medical bills for both her son’s illness and her own. The family’s high deductible health plan has paid some of the cost, but the Wardens owe hundreds of thousands of dollars out of pocket, Lauren said.
“I’m sure we’ll have to claim medical bankruptcy after this,” she said. “As you know, the insurance companies are horrible, and I’m sure we’re not the only family going through this. And we’ll just do what we need to do, and God will be with us.”
Still, Lauren said, she is grateful to Novant Health and Janjua.
She’s gone on television news in North Carolina and given other media interviews to talk about her surgery and the relief it brought her.
Speaking out about her disease and her struggles is not something she ever expected to do. In fact, she said it freaks her out a little bit. But she wants other women who suffer from IIH to get the help they need.
“I didn’t do this for the attention, but just to help somebody,” Lauren said. “I want them to be fully aware that they have control of their health, and to fight and to never give up hope.”
NEW YORK — Angela Wynn had just launched her own project management business, hitting a career stride after years of struggle that began with earning an undergraduate degree as a single mother.
Then the coronavirus pandemic hit, forcing many schools to shift online. The now-married mother of five saw little choice but to give up her newly minted business to help three of her children cope with remote learning while her husband, the primary breadwinner, kept his job at a senior living center.
“To see all that come to fruition, I did it, but now it’s gone,” said Wynn, who has always been the main caretaker for her children, ages 1, 5, 11, 12 and 18. “But my priority is my kids, and their education is everything.”
Wynn’s story is becoming distressingly common. Research is increasingly pointing to a retreat of working mothers from the U.S. labor force as the pandemic leaves parents with few child care options and the added burden of navigating distance learning.
The trend threatens the financial stability of families in the near-term. In the long-term, the crisis could stall — if not reverse — decades of hard-fought gains by working women who are still far from achieving labor force parity with men.
Thousands of school districts are starting the school year with remote instruction, including most of the largest ones.
At least half the country’s child care providers are closed and may not survive the crisis without financial help to cope with implementing safety standards and reduced enrollment.
Negotiations for a bailout of the industry have stalled in Congress.
In August, federal jobs reports showed that women in their prime-earning years — 25 to 54 — were dropping out of the work force more than other age groups.
About 77% of women in that age group were working or looking for work in February, compared to 74.9% in August.
The decline is most pronounced among Black women of that age range, whose participation rate is down 5 percentage points since February, compared to 4 percentage points for Hispanic women and 2 percentage points for white women.
Overall, the drop translates into 1.3 million women exiting the labor force since February.
“We think this reflects the growing child care crisis,” BNP Paribas economists Daniel Ahn and Steven Weinberg wrote in recent report. “It is hard to see this abating soon, and if anything could become worse as we move into fall.”
Few families can afford for mothers not to work indefinitely: Mothers are now are the equal, primary, or sole earners in 40% of U.S. families, up from 11% in 1960, according to federal labor figures.
Women also comprise nearly half the U.S. labor force, making their inability to work a significant drag on the economy and hindering any recovery from the pandemic’s ravages.
In Wynn’s case, she is working a part-time job to help pay the bills. Even so, the family is taking a financial hit, refinancing their home outside Nashville and starting a garden in their back yard to cut down on grocery bills.
Despite the leaps over the past decades, working women still entered the pandemic at a disadvantage. They are typically paid 82 cents for every dollar men earn, according to research by the National Women’s Law Center.
Among working mothers and fathers, the wage gap is even higher at 70 cents. The median household earnings for mothers in the U.S. is $42,000, compared to $60,000 for fathers.
When left with no choice but to give up one income as child care options collapse, that wage gap incentivizes fathers to stay in the workforce and mothers to leave, or at least scale back.
“There is already a motherhood wage gap. In times of uncertainty and recession, you protect the primary earner,” said Liana Christin Landivar, a sociologist at the Maryland Population Research Center and author of the book, “Mothers at Work: Who Opts Out?”
More mothers than fathers have left jobs since the pandemic began, according to research published in August by Sage Journals, which analyzed data from the Current Population Survey.
Between February and April, labor force participation fell 3.2% among mothers with children younger than 6, and 4.3% for those with children 6 to 12.
Fathers of children under 12 also left the workforce, but at lower rates, said Landivar, who co-authored the report.
In a separate study, the same researchers found mothers are cutting back on working hours more than fathers.
Mothers of children under 12 were working more than six fewer hours a week than fathers in April, compared to less than five fewer hours in February, according to the study, which looked at sub-sample of heterosexual married men and women from the CPS, a monthly survey of 60,000 households sponsored by the U.S. Census Bureau and the Bureau of Labor Statistics.
“We already knew there was a large gender inequality in the labor force, and the pandemic just makes this worse,” Landivar said.
For Anna Hamilton and her husband, juggling two careers while raising two children was always a bit of a house of cards. The pandemic knocked it down, at least for now.
Hamilton, who lives in the Atlanta area, is taking indefinite leave from her job at a small investment firm, a job she stuck with for 12 years in part because it allowed her family to move twice so her husband could pursue his career as a cancer surgeon.
She has mixed feelings, but one thing she knows is that working full-time while handling remote schooling was unbearable.
“There was a lot yelling. I thought, ‘Let’s just admit what’s happening and maybe everyone will be happier,’ ” said Hamilton, 43, whose sons are 6 and 7. “I hope it’s not a career-ender.”
Concerned about attrition and loss of productivity, some companies are now rolling out generous benefits to help working parents cope with school and day care closures because of the pandemic.
Microsoft is offering an extra 12 weeks of paid family leave for employees struggling with child care issues. Google added 14 more weeks.
Duolingo, the foreign language-learning app, is allowing parents to request reduced work hours with full pay and benefits.
“Our CEO has talked to other tech CEOs who said they’re starting to see attrition tick up, especially with female employees. They thought it had to do with the parenting load,” said Christine Rogers-Raetsch, vice president of people at Duolingo.
“We set a directional goal for ourselves: Let’s not lose any parents during this.”
But most women don’t work for tech companies, and instead make up a majority of the country’s teachers, nurses, child care workers, social workers, librarians, bookkeepers, waitresses, cashiers and housekeepers, according to federal labor figures.
Mothers in particular are the majority of the country’s teachers, nurses and child care workers.
Additionally, despite the progress over the past two years, 80% of U.S. private sector workers have no access to paid family leave, which is not mandated by federal law.
“When we leave it to employers, the vast majority of higher income workers get more coverage and low-income workers just don’t. This disproportionately affects women,” Landivar said.
The pandemic has particularly affected women who put their careers on the back burner with the expectation of ramping back up once their children reached school age.
With the youngest of her three children now 6 years old, Kate Albrecht Fidler had begun studying for certification as a human resources professional, hoping to jump-start a career she had largely put on hold.
But in April, the 49-year-old was furloughed from her part-time job at a hospital and now she’s once again looking for any flexible job she can get because she’ll have to shepherd her children through remote schooling in her rural town of Adams, New York.
“For women in their prime earning years, this is a complete disaster,” Albrecht Fidler said. “There’s no way to catch up.”
David Bowers started his mayoral campaign on a dreary February day, going door to door and talking to voters. He planned to knock on as many as 3,000 doors before the Nov. 3 election.
“I got to 180 and then the curtain came down with the pandemic,” Bowers said earlier this week.
Roanoke Mayor Sherman Lea, who is running for reelection, likewise had to curtail face-to-face campaigning during the COVID-19 pandemic. Instead, his campaign plans to rely heavily on direct mailings to homes, yard signs and other methods to reach voters.
“I used to like to get out and walk and meet people,” Lea said. But COVID-19 “has changed things up dramatically.”
Labor Day is typically the traditional kickoff for fall political campaigns. But in Roanoke — where Lea and Bowers face off for mayor, and eight people are running for three open city council seats — this campaign will be as nontraditional as they come.
The COVID-19 pandemic that has led to more than 1,200 confirmed cases and 15 confirmed deaths in Roanoke, according to the Virginia Department of Health, is forcing candidates to find new ways to get their messages out to voters.
And with absentee voting slated to start Sept. 18, time is of the essence.
City elections will be held Nov. 3, the same day as the presidential and congressional elections, a first for Roanoke. Last year, in a controversial move, the Roanoke City Council moved the date from May to November as a way to increase turnout. Opponents of the move believed the change was made to favor Democrats in a presidential year and have vowed to make the switch a campaign issue.
The consequence of that change, which was unforeseen when it was approved last year, is that candidates are now trying to reach voters during a time when social distancing is encouraged. Instead of pressing the flesh, people are asked to stay 6 feet apart. Instead of kissing babies or smiling for photos with voters, candidates are wearing masks.
From videos to Zoom news conferences to livestreamed speeches, Lea and Bowers are using a variety of old and new technology to be seen and heard.
“It’s a different campaign season,” Lea said. “You can’t just jump out there.”
Lea, a Democrat, acknowledges that incumbency has helped him stay in the public eye during the pandemic. The mayor, running for a second term after being elected in 2016, ran city council meetings that dealt with an abundance of significant city issues in the spring and summer.
Between April and early August, the council dealt with topics that included passing a city budget gored with pandemic-related cuts, doling out millions of dollars of federal relief money to agencies and nonprofit groups, approving the removal of the Robert E. Lee memorial from downtown Roanoke and tackling racial issues in the wake of a downtown protest on May 30.
Lea also led a weekly news conference streamed over Facebook Live that dealt with pandemic-related announcements. The mayor has spoken at a few public events, and he gave the annual State of the City address via Facebook and YouTube on Aug. 26.
“I have had exposure,” Lea said. “I would never use anything concerning council to my political advantage, but when you’re mayor, you have to get out in front of people. I get to talk about city issues and show leadership. Strong leadership.”
For Bowers, a former Democratic mayor now running as an independent, the campaign has forced him to use the internet to earn media and public attention.
Bowers served two terms as a city council member and four terms as Roanoke mayor for a total of 24 years in office. He did not seek reelection in 2015. He also received national notoriety and criticism that year for a memo in which he compared the threat of refugees from Syria to the long-regretted internment of Japanese-Americans during World War II. Bowers apologized for the statement.
On July 1, Bowers made news with a campaign video in which he criticized Lea and the current council for extending their terms by moving the election six months from May to November. In that video, Bowers called Lea and a majority of council “unelected” because their terms would have expired that day had the election been held in May.
In August, Bowers hosted two news conferences with reporters over the Zoom videoconferencing platform, which has become familiar to people forced to work at home and attend live meetings online. In one news conference, Bowers talked about race relations in Roanoke and he rejected calls to defund police departments, while supporting law enforcement and other city workers.
In another video news conference, Bowers said that he would support development of the Evans Spring property across Interstate 581 from Valley View Mall. Charlotte, North Carolina-based Pavilion Development Co. had proposed a major project that could have included a Costco and a golf facility on a 93-acre site.
Those plans never reached the city council, however, because the developer withdrew the project after pushback from the city’s planning commission and a nearby neighborhood group. Bowers has said that the city should not turn down economic projects, especially investment that he called “Charlotte money.” He would work with developers and city staff to reboot that project, he said.
He also appeared at a “Back the Blue” event to support local law enforcement in Roanoke on Aug. 18, a rally that included Republican council candidates Peg McGuire and Maynard Keller, as well as Republican Rep. Ben Cline, R-Botetourt, and Daniel Gade, a GOP nominee for the U.S. Senate running against Sen. Mark Warner.
Right now, no candidates’ forums have been scheduled as the pandemic persists and large in-person crowds are still discouraged in the city. Both Lea and Bowers said they will still explore other ways to reach the public.
Getting campaign messages out quickly is perhaps more important this year than in past years because Virginians can start voting Sept. 18. Roanoke voters can vote early in person at the City Registrar’s Office at 317 Kimball Ave. N.E. by presenting identification. Voters can also request vote-by-mail ballots online from the Department of Elections at https://bit.ly/2QPtHEU.
Roanoke registrar Andrew Cochran said that by early last week the city had received approximately 8,500 vote-by-mail applications. By this point in 2016, Cochran estimates that his office had received about 500 applications.
Because so many votes might be cast before Nov. 3, candidates must make their cases to voters soon.
Current council member Trish White-Boyd is the only incumbent for reelection, which means there will be at least two new members next year, and possibly as many as four depending on the Nov. 3 result.
Lea wants voters to look at his record before the pandemic blunted Roanoke’s economic growth.
“Prior to the pandemic, people were saying the last four years were the best Roanoke has ever had,” Lea said. “Now is not the time to change leadership. The mayor’s position is very important. I have been engaged and have made the tough decisions. People can trust my leadership. They may not agree with every decision, but I will make tough decisions, even in the pandemic.”
Bowers said that council needs an overhaul and Roanoke needs new leadership.
“My concern about this council is that they seem to have an agenda,” Bowers said. “They work behind the scenes, announce how they’re going to vote to the newspaper and then say, ‘By the way, let’s have a public hearing.’ That’s not the way [longtime mayor] Noel Taylor conducted business in the city, and it’s not the way I conducted business when I was mayor.”
In 12 days, voters can start making their choices.
NEW YORK — Ahead of Labor Day, unions representing millions across several working-class sectors are threatening to authorize work stoppages in support of the Black Lives Matter movement amid calls for concrete measures that address racial injustice.
In a statement first shared with The Associated Press, labor leaders who represent teachers, autoworkers, truck drivers and clerical staff, among others, signaled a willingness Friday to escalate protest tactics to force local and federal lawmakers to take action on policing reform and systemic racism. They said the walkouts, if they were to move forward with them, would last for as long as needed.
“The status quo — of police killing Black people, of armed white nationalists killing demonstrators, of millions sick and increasingly desperate — is clearly unjust, and it cannot continue,” the statement says. It was signed by several branches of the American Federation of State, County and Municipal Employees, the Service Employees International Union, and affiliates of the National Education Association.
The broader labor movement has been vocal since the May 25 killing of George Floyd, a handcuffed Black man who died after a white police officer pressed his knee into Floyd’s neck for nearly eight minutes during an arrest over counterfeit money. The death of Floyd in Minneapolis set off an unprecedented surge of protests and unrest from coast to coast this summer. In July, organized labor staged a daylong strike with workers from the service industry, fast-food chains and the gig economy to call out the lack of coronavirus pandemic protections for essential workers, who are disproportionately Black and Hispanic.
Now, in the wake of the August shooting of Jacob Blake, who was critically wounded by a white police officer in Kenosha, Wisconsin, the union leaders say they are following the lead of professional athletes who last week staged walkouts over the shooting. Basketball, baseball and tennis league games had to be postponed. Some athletes resumed game play only after having talks with league officials over ways to support the push for policing reforms and to honor victims of police and vigilante violence.
“They remind us that when we strike to withhold our labor, we have the power to bring an unjust status quo to a grinding halt,” the union leaders said in the statement.
“We echo the call to local and federal government to divest from the police, to redistribute the stolen wealth of the billionaire class, and to invest in what our people need to live in peace, dignity, and abundance: universal health care and housing, public jobs programs and cash assistance, and safe working conditions,” the statement reads.
Among the supportive unions are ones representing Wisconsin public school teachers who, ahead of the mid-September start of the regular school year, urged state legislators to take on policing reforms and systemic racism.
“We stand in solidarity with Jacob Blake and his family, and all communities fighting to defend Black lives from police and vigilante violence,” Milwaukee Teacher’s Association president Amy Mizialko told the AP.
“Are we striking tomorrow? No,” said Racine Educator United president Angelina Cruz, who represents teachers in a community that abuts Kenosha. “Are we in conversation with our members and the national labor movement about how we escalate our tactics to stop fascism and win justice? Yes.”
The Nonprofit Professional Employees Union, which represents several hundreds of professionals working at more than 25 civil rights groups and think tank organizations, told the AP it signed onto the union statement because “the fights for workers’ rights, civil rights, and racial justice are inextricably linked.”
At the federal level, the Democrat-controlled House of Representatives has already passed the George Floyd Justice In Policing Act, which would ban police use of stranglehold maneuvers and end qualified immunity for officers, among other reforms. The measure awaits action in the Senate.
A Republican-authored police reform bill, introduced in June by South Carolina Sen. Tim Scott, failed a procedural vote in the Senate because Democrats felt the measure didn’t go far enough to address officer accountability.
Meanwhile, officials who serve on governing bodies in more than a dozen major U.S. cities, including Seattle, San Francisco, New York City and Austin, Texas, have voted to defund their police departments and reallocate the money to mental health, homelessness and education services.
Although some unions have a history of excluding workers on the basis of gender and race, the marriage between the racial justice and labor movements goes back decades. That alliance was most prominently on display during the 1963 March on Washington for Jobs and Freedom, which featured the visions of the Rev. Martin Luther King Jr. and Rep. John Lewis and was organized by A. Philip Randolph, a Black icon of the labor movement.
Today, Black workers are more likely to be unionized than any other segment of the workforce as a result of decades of collaboration between labor and civil rights activists, said New York University professor and civil rights historian Thomas Sugrue.
“That connection has only intensified because of the importance of workers of color, particularly African Americans, in the labor movement,” Sugrue said.
Public and private employers are faced with a “Which side are you on?” moment due to growing support for the BLM movement, said Maurice Mitchell, national director of the Working Families Party and a leading organizer in the Movement for Black Lives, a national coalition of 150 Black-led organizations.
“If I was a decision-maker that was considering whether or not to meet the demands of the unions, I would be scared,” Mitchell said. “This movement is spreading. We’ve been on the streets consistently, we’re building on the electoral front, and now we’re seeing this conversation at the highest levels of labor.”