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    My Friend Is Refusing to Talk Politics With Me. Can She Do That?

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    A reader feels spurned by a friend’s “self-righteous” declaration that she would no longer engage with him about politics after he revealed he didn’t plan to vote.My wife and I are longtime friends with another couple whose political views differ from mine. I have disagreed with the wife occasionally on some issues, and she with me — but always respectfully. Before the presidential election, I told her that I didn’t plan to vote because I could not support either candidate. She had a negative reaction to this and told me that, going forward, we should avoid political discussions if we want to remain friends. I found her statement self-righteous — as if she can be friends only with people who agree with her, and I should be careful not to express a different political opinion. Is that an acceptable ground rule for friendship?FRIENDEvery day now — and often, every hour — I am confronted by some reminder of what a divisive time this is in American life. (It’s depressing — and exhausting.) And worse, I have begun to lose faith that we will talk our way out of this mess. Most people I know seem to be done with being persuaded. Surely you must have noticed something along these lines.So, I am largely sympathetic with your friend. Rather than engaging in prolonged and pointless arguments, or jeopardizing a longtime friendship, she has suggested a boundary to reduce her aggravation during her leisure time. It doesn’t sound as if she is foisting her opinions on you. In fact, it seems pretty evenhanded to me — not self-righteous at all.Now, if her proposal bothers you, you can make a pitch for continued political debate. But frankly, if you weren’t motivated to vote by the starkly different views espoused by the candidates last year, knowing one of them was bound to win, it seems disingenuous to claim that you can’t make it through a dinner party without sounding off on politics. Find another topic! Your friend is trying to preserve her tranquillity and your friendship. I respect her for that.Miguel PorlanFeeling Left Out of the PictureMy husband and I have been married for 15 years. We have a teenage daughter. Sadly, both of his parents died long before we met. His sister hangs a large family photograph from 30 years ago above her mantel: It includes my husband’s ex-wife and another sibling’s ex, and it doesn’t include me or our daughter. When I mentioned the enormous photo to my husband, he said that their parents are in it, which is why his sister hangs it there. But why can’t she find a different photo? Is it fair that I’m upset?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      A Guy I Know Had a Liver Transplant. Now He’s Boozing Again.

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      The magazine’s Ethicist columnist on how to support someone with an addiction problem.My significant other has a friend who is a longtime alcoholic, while also being intelligent, entertaining and conniving. For example, he used to tell his wife he was going to the gym and then head to the bar; before returning home, he’d dampen his clothes in the bathroom to make it seem as if he’d gotten a good sweat on. He was off the radar for a bit, and then we learned he had a liver transplant. After that, he had an episode of hepatic encephalopathy, a brain disorder caused by liver dysfunction. It seems the doctors knew he was still drinking but gave him the new liver anyway and counseled abstinence. A few parties later, he was sneaking vodka, gin and whatever else was around. He lies to everyone and has made his guy friends vow not to tell his wife about his drinking. They’ve made a meager attempt to confront him, only to be assured that he just fell off the wagon and would be good. Just don’t tell the wife!I’m appalled that they’re going along with this. There are a couple of ethical issues here. First, who should decide whether someone is entitled to a transplant? Some hospital systems deny a liver transplant to patients who continue to drink alcohol, and other hospitals don’t. Second, do the friends have an obligation to tell this man’s wife that he’s still drinking? She could insist he leave the house and go to rehab, in which case he might have a chance of living long enough to see his children get married. Some additional context: A friend of mine died waiting for a liver transplant. I am also the child of a lifelong alcoholic. — Name WithheldFrom the Ethicist:There’s more than one morally defensible way of allocating donor organs. In the United States, as in Western Europe, the system emphasizes equity and basically gives priority to patients with the greatest need. An approach that focused instead on efficiency — on getting the maximum use out of donated livers, as measured by ‘‘quality-adjusted life years’’ — might give an edge to people who were younger and otherwise healthier and might work against low-income and minority populations.Organ allocation in the United States is governed by the Organ Procurement and Transplantation Network (O.P.T.N.), whose policies determine the order in which deceased-donor organs are offered; they do not, however, dictate medical practice. So it’s up to a medical center to decide whether or not transplant candidates with alcohol-related liver disease are to abstain from alcohol for some period — six months having long been a typical sobriety window. Some studies indicate that carefully selected patients who aren’t subject to a sobriety window can do just as well as those who are (though the data is hard to interpret because of the ‘‘carefully selected’’ part). And if your drinking has caused a severe case of acute hepatitis that doesn’t respond to medical treatment, you probably won’t survive a six-month waiting period. So the trend seems to be away from requiring an extended interval of abstinence.The point is that the current system for allocating this scarce resource is morally legitimate, whatever trade-offs it may entail; its architects are perfectly aware that many liver recipients will not succeed in refraining from heavy drinking afterward. The fact that this longtime alcoholic has returned to his old habits is distressing. It doesn’t mean that the system isn’t functioning the way it’s meant to.One thing that transplant centers may try to determine is whether patients with an alcohol problem have social networks that could help them stay sober. This brings us to your second question. This fellow’s friends weren’t looking after him when they agreed to uphold this boozy bro code and keep mum. He doesn’t want to die, but he’s drinking himself to death, which means that, at least in this key area, he lacks the capacity for rational decision-making. In a situation like that, it’s more important to attend to his interests than to respect his autonomy. If there’s a chance that his life can be extended by successful management of his alcoholism, and if discussing the problem with his wife will help, thoughtful friends would do just that.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Quitting Drinking Was Easy. Learning How to Be Myself Around Friends Was Hard.

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      Quitting drinking was the easy part. Figuring out how to be myself was harder.About six months after I quit drinking, I sat at a corner table in a candlelit restaurant with one of my closest friends. It was the kind of place where we used to refill each other’s wine glasses all night, sharing appetizers and intimate details of our lives.That night, though, it felt more like we were catching up: surface-level conversation you might have with a work acquaintance or when seated next to a distant cousin at a wedding. By the time the entrees came, we’d reached the end of these “so what else is new” updates. I recognized that we were at a threshold — one I had been unable to cross so far without booze.There are studies that confirm what I — and anyone else who has ever made friends with another drunk woman in a bar bathroom — have always known: Drinking can help build social bonds. It lowers inhibitions and fosters feelings of connection. But what happens when you’ve come to rely on alcohol to establish and reinforce those connections?I started drinking when I was 13, skipping class to chug cheap vodka and 40s with friends. We’d sprawl out on park benches or huddle on stoops, laughing about everything and nothing. I liked the sloshy, blurry feeling; the warmth in my cheeks and heaviness in my body. But what I liked most about being drunk was that it made it OK to say how sad I was — or to just start crying, without saying anything at all.By my late teens, a drink in the evening (and then a second and third) to soften the edges of my life seemed normal — even more so once I became a bartender, tucked away in a nocturnal world that revolved around alcohol. I prided myself on being able to do shots with customers all night and still settle the register correctly at 5 a.m.On my nights off, my friends and I went out, often to the same bar where I worked. And though I didn’t loiter on stoops drinking vodka out of the bottle anymore, the end of a night out was ultimately the same: Once I’d had enough to drink, it felt safe to admit to being sad or lonely or unsure.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Friendship Challenge: The Health Benefits of Texting Your Friends

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      I’m Catherine Pearson, and I cover families and relationships for The New York Times. Today, I’m making the case for something many of us have a love-hate relationship with: texting.Recently, I was having a lousy day. My husband was out of town, and the kids were fighting nonstop. Just as I was about to threaten my 6- and 9-year-old boys with boarding school, a text popped up on my phone. It was from Miranda, a high-school friend whom I catch up with only a couple of times a year. She had texted simply to tell me she’d been thinking about me — it probably took her 30 seconds to write, and it took me even less time to read. But her message lifted me right out of my funk.Ample research shows that social connection is crucial to our physical and mental health and longevity. It is good for our brains and hearts, and helps protect us against stress. One oft-quoted 2010 study concluded that lacking social connection might be comparable to smoking up to 15 cigarettes a day.Friendship is a very specific and valuable form of social connection, said Julianne Holt-Lunstad, the lead author on the cigarette study and director of the Social Connection and Health Lab at Brigham Young University. “It’s difficult to be choosy about your neighbors or co-workers. You’re born into your family,” she explained. “Friendships are chosen and, because of that, we need to intentionally make time for them.”Putting in the effort to maintain friendships may feel like a heavy lift, and to a certain extent it is. Research suggests people need to spend around 200 hours hanging out together in order to forge a close friendship. Unfortunately, the amount of time Americans spend engaged with friends every day has declined over the past two decades.The good news? Research also shows that smaller efforts can help established friendships flourish. A 2022 study found that when you casually check in with a friend — the way Miranda did with that text — it’s more welcome than many of us realize. More

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      Quiz: What’s Your Friendship Style?

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      Welcome to Well’s 5-day Friendship Challenge! Step one is to discover your friendship style. Do you like to plumb the depths of a new acquaintance’s soul? Or are you surprisingly skilled at small talk? We all need social connection, but we thrive in different ways. So we partnered with Kasley Killam, a social scientist and […] More

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      Why Didn’t My Sister Include Me in Her ‘Family’ Birthday Party

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      A reader’s feelings are hurt after offering to fly to celebrate her sister’s 70th birthday only to be told not to bother, as “all her family” would be there.My sister and I live in different parts of the country. We’re not close, but we are cordial and visit each other every year or two. She is about to turn 70, so I offered to fly halfway across the country to help her celebrate. She declined, saying that “all her family” — her kids and grandkids — were coming for a party, so it wasn’t a good time for a visit. I stay in a hotel when I visit her, so it’s not a matter of putting me up, and there are no hard feelings between us. I am hurt not to be included. I thought I was family, too. I might have accepted a white lie (“I’m not doing anything special”), but telling me I’m not invited to her party seems hostile. Thoughts?SISTERI’m sorry your feelings are hurt. I’m also struck by how readily you placed yourself at the center of your sister’s birthday — in the same breath as reporting you aren’t close to her. (I get it, of course: We are all the starring players in our lives.) I agree that your sister chose her words poorly, but it doesn’t take a big leap to decipher what she really meant: She wants to focus on her children and grandchildren when they visit.Many siblings drift over time (and distance). And your “cordial” relationship with your sister is not uncommon: You may have been central to each other — formative, even — in early life but not so much today. That doesn’t take away from the warmth you feel for each other. She was simply being honest when she said she wanted to give her undivided attention to her children and grandchildren on her birthday. She may not get to see them as often as she would like.Your visit probably constitutes a different kind of special occasion: more nostalgic and rooted in the past. And a gentler reading of your sister’s response is that she didn’t want you to fly halfway across the country and feel neglected. So, I hope you can get past your hurt feelings and find another time for a sisterly celebration.Miguel PorlanNursing a Grudge to Honor a Friendship?In college, my best friend and I dated another pair of best friends. After we graduated, five years ago, the other couple broke up, but my partner and I are still together. My friend’s ex was unkind to her during their breakup, and she still resents him — even though they are both in other relationships now. The problem: The ex is moving to our city. My partner would like me to spend time with his friend and his girlfriend occasionally, but I think my friend would be hurt if I did. (And my partner will be hurt if I don’t!) Advice?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Insurance Companies and the Prior Authorization Maze

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      More from our inbox:Elect the U.S. Attorney GeneralFriendship MemoriesA Leadership GapInsurance companies have weaponized a seemingly benign process to protect their profits, and it’s putting patients at risk.To the Editor:Re “‘What’s My Life Worth?’ The Big Business of Denying Medical Care,” by Alexander Stockton (Opinion video, March 14), about prior authorization:Mr. Stockton’s video captures a current snapshot of an important truth about medical insurance in our country and in doing so does a service to all citizens by making them aware of this threat to themselves and their families.The immediate truth is that medical insurance companies are inadequately regulated, monitored and punished for their greed. In their current iteration they are bastions of greed, power and money. They need to be reined in.But there are other truths as well. Some physicians, just like some pharmaceutical companies, are unable to contain their greed and allow avarice to cloud their judgment, compromise their ethics and in some cases cross the line to Medicare fraud or other illegal activity.Medical care in our country is very big business involving billions of dollars. Without proper controls, regulation and monitoring, malfeasance follows. The challenge in such a complex and multifaceted context is how to implement such controls and monitoring without making things worse.Ross A. AbramsJerusalemThe writer, a retired radiation oncologist, is professor emeritus at Rush University Medical Center in Chicago.To the Editor:The Times’s video exploits tragic outcomes and does not mention basic important facts about the limited yet key role of prior authorization in ensuring that patients receive evidence-based, affordable care.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How to Check in on Your Emotional Well-Being

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      We know we should get a physical exam every year; we have annual reviews at work; some couples even do periodic relationship audits. And yet many of us don’t regularly check in with our emotional health — though it is arguably the most important contributor to overall well-being. The New York Times talked to experts […] More

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      My Oldest Friend Is Being Paroled From Prison. Can I Dump Her?

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      After supporting an old friend through years of incarceration with letters and shipments of books, a reader wants out, put off by the woman’s lies about her situation.My oldest friend — we met in nursery school and are now in our 60s — is about to be paroled from prison after six years. She pleaded guilty to manslaughter in the death of her sister and to charges of animal cruelty. (Two dogs were also killed.) When she is released, she will have to move in with her parents, not far from me. She still insists that the reports of the police investigation are “all lies.” But it’s clear to me that much of what was reported was true. While she was incarcerated, I wrote her letters and sent her books because I felt sorry for her situation. But now that she is being paroled, I can’t abide the pressure to accept her lies. Any advice on exiting this relationship without causing pain?FRIENDYou have no obligation to remain friends. One of the consequences of bad behavior is that others may choose to cut ties with us — even our oldest friends. Still, I find it hard to believe that the sympathy that fueled your letters and gifts while your friend was in prison has suddenly vanished now that her parole is imminent.If I am wrong, be straight with her. Tell her you no longer want to be in contact. If you are willing to go a bit farther, though, you may be well positioned to offer a great kindness: Explain that her failure to take responsibility for her actions — claiming the reports were “all lies,” for instance — has made your friendship untenable. Encourage her to be honest with herself and others. She may not change her story, but you will have offered a true path to redemption.Now, this approach may cause her pain — as any ending to your long friendship might. But it would seem more consistent with your loyalty during her incarceration than simply disappearing from her life. Still, it’s your decision. I urge you only to think about it.Miguel PorlanMay I Be Excused? I’m Having Trouble Breathing.On Thanksgiving, my family went to dinner at my sister-in-law’s house. As dinner began, our teenage daughter, who has asthma, became short of breath. I suspected it was triggered by house cats, so I took her outside and stayed with her to make sure she was OK. Eventually, I grabbed our plates from the table so we could eat outdoors. When we rejoined the party, our hostess was livid. So, I explained why we had eaten outdoors. She yelled at me and called me rude. I felt so uncomfortable that we left. She has since said she will never invite us to her home again. Was I rude?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More