F-Words

A false-positive is as false as a false-negative.

2009-11-18T10:21:00.000-08:00

The horrified reaction to the new guidelines for less-frequent mammograms in women over 50 has been driving me nuts. The way it's being sold is just terrible (as in they just don't want people to worry over nothing), but that doesn't mean that it's a bad recommendation. If we're going to complain so much about doctors overtesting and practicing "defensive medicine," I'd expect this kind of thing to get a better reception. The last straw for me was when I saw a Newsweek article saying that the real problem with mammograms is that they tell us too much stuff that we don't understand, and that hey, it's just a matter of figuring that stuff out, so irradiate away for the sake of the few that actually benefit from yearly mammograms starting at 40, regardless of the risks that everyone else are taking on. It's really misleading to say that mammograms give us a lot of info we're not using. If we don't know what it means, it's not information. I have a hard time understanding how the method made it into everyday practice, for its rather pathetic track record.

The article says:

Many cancer groups opposed the decision, and it's easy to see why: their job is to ensure that no one, no matter how slim the odds, dies of cancer that could have been prevented. Proponents of evidence-based medicine say that mammograms lead to too many unnecessary tests and the detection of too many tumors that may not really need treatment. But as it turns out, mammograms themselves aren’t the problem.

I can understand the impulse to dismiss the harm of a false-positive, but everyone assumes that the mammogram isn't susceptible to false-negatives. Everyone brings up their friend who was the exception to a rule as evidence that the rule is useless, but weird stuff confounds even very accurate tests (which the mammogram is not). It took me a long time to recognize that I am a vanishingly rare exception, so my experience with medical misadventures isn't really relevant to basically anyone.

I think I have emotional standing to assert that exceptions aren't what we should base standard practices around, so I don't want to hear about your grandmother who caught her breast cancer early with a mammogram before the age of 50. It is pretty nice when people luck out and get useful information from a mammogram in their 40s, but most of the time, all you get from a mammogram is a confirmation of what you knew to begin with. Plus, a patient undergoing mammography is exposed to radiation, and that's best avoided.

On a barely-related and sort of silly note, I always think of how the children in A Series of Unfortunate Events were subjected to unnecessary surgery, which has caused me to associate unnecessary medical procedures with melodrama more strongly than I should. Plus, I should admit that I have probably had an unnecessary MRI or two over the past few years, but I'm not about to argue with my neurologist as he tries to feel his way around the unlit area where my health hangs in the balance. If anyone has a good chance as guessing right, it's him. My somewhat-educated feeling is that I'll probably be okay, and if I go four or five years like I have been, I'm probably out of the woods.

Why not abortion insurance?

2009-11-09T09:43:00.000-08:00

I'm as peeved about the Stupak amendment as anyone else, but with the paranoid political climate out there, I expected nothing else. It makes me wonder why I've never seen supplementary coverage for abortion available for sale. There is the self-selection thing, where people philosophically opposed to abortion wouldn't buy a policy, but the procedure itself usually isn't very expensive, so I imagine a pool of pro-choice policy-holders who may never find themselves needing to access their abortion coverage would be able to support the cost of the procedures undertaken.

I'm at a stage in my life where if a pregnancy comes, I'll go with it, but a D&C is something even some planned pregnancies end with, so I couldn't honestly skip buying a cheapish policy out of self-interest. Then again, the cost of a simple abortion is probably the kind of cash I could scare up at a time when I needed it, so I would be a lot better off just donating to an abortion fund, rather than building a policy where some of my money would have to be skimmed off the top of the pool to line the pockets of some insurance broker.

Maintaining access to abortion is something that a not-explicitly-feminist organization can't really do at the moment, so as always, it's up to the explicitly feminist organizations to make it happen.

Everyone loves a tomboy

2009-11-01T18:47:00.000-08:00

I was never big on girl-culture as a child (that is, I don't remember much interest in dolls or makeup or family-type games), but I didn't fit any description of a tomboy (I am a total weakling and uninterested in sports), so I didn't really feel that I had a gender-mold to fit into, but I found that I tended to identify a lot with tomboy characters in books, and loved the idea of a girl having a boy's name. My name is most definitely a girl's name. I was so disappointed when I found out that it had such a lamely-patriarchal meaning (it's often just defined as "Abraham's wife," but "princess" comes up a lot.) I thought about this when I came across this article about androgynous names trending toward girls, and how parents who prefer androgynous names usually go for more-masculine ones, regardless of their child's gender. The author uses the example of the name Leslie as one that began as a boy's name, and once it became popular for girls, boys' parents dropped it like a hot rock. Hello, ambient misogyny. Girls who act like boys are cool, but boys who act like girls are fags.

Compounding the disappointment

2009-10-30T14:21:00.000-07:00

The ~~BMJ (British Medical Journal)~~ British Journal of Criminology has declared the widespead use of date-rape drugs to be an urban myth. This depresses Tressugar, but I am GLAD to see it said so clearly. It drives me batty when people get so earnestly grave and serious with their roofie-warnings for young women. When people use oversimplifications/exaggerations like this to pretend to confront a problem as complicated* and serious as rape, it creates a sense of complacency.

Tressugar says:

It's troubling that some experts and the media cannot find a way to remind people about the dangers associated with binge drinking without discrediting women who have been victims of sexual abuse.

I think it's conceding too much to say that this is a discredit to victims of rape. I imagine that blackout-drunk women pushed into sex haven't played out in their minds exactly what all the possible consequences of extreme drunkenness could entail. I don't think that acknowledging that a victim's actions contributed to the situation in which they were vulnerable is a discredit; it's a simple acknowledgement of cause-and-effect. To me, it's like the math that you do when you decide whether or not to buy health insurance. You can do a bunch of things to lessen the likelihood that you will become very very sick, but you can't eliminate the possibility. Shit happens, and blame isn't really the point, especially because the one who actually pays is the victim. I ignored/didn't really notice a constant headache for a couple of months, and if I'd noticed it sooner, I just might have been able to prevent the devastating illness I ended up with. But maybe I couldn't have; I don't know. I'm not in charge of these things. I'm also not in charge of how people around me act, and neither is any other drunk woman of the people she's with. Glossing over the contributing factors to anything works against the possibility of preventing it.

So the roofie lie is dangerous in two ways: it leaves people more vulnerable to rape AND it discredits the anti-rape cause, which its detractors would say collapses without an overcautious but shamelessly deceived victim. There's nothing just-so about the story. The last thing I expect out of the godless, random universe in which I live is fairness. It's up to people to enforce that.

Of course, the number one contributing factor among the things that make rape happen is the action of the rapist. It's really not possible to control all the influences upstream from there; most people who get drunk don't get raped or commit rape. But a lot of people who are raped or commit rape did get drunk beforehand. I mean, how many hundreds of times have you heard the story about the marathon-running only-organic-vegan who died of a heart attack at 55?

Justice is not natural, so we have to consciously choose it. We can and should BLAME THE RAPIST FOR RAPING. It's not a crime (or even really impolite or unwise) to get drunk; It is a crime to rape. You don't just increase the chances that someone will be raped when you rape them - you decide that you will rape. You may get away with smoking cigarettes for a couple of decades without related health problems, but you will definitely have created a problem if you fill your kid's sippy cup with bleach.

It seems pretty simple to me, but a rape culture's self-enforcement doesn't get it, (link via Amanda from Pandagon) and refuses to, so if I'm going to really face facts here I'm not going to hold my breath until our sick culture can acknowledge what the facts mean.

Someone got raped? Let's think of anyone we could blame who is not the rapist! Maybe...the victim! Yeah, she's a total slut!

It's pretty nice when the stars align so that your drunken escapades don't end up with some guy raping you, but that doesn't make you better than the people whose did. I know I've never drunk so much as to black out again for a couple of reasons: a) I don't want that to happen to me again and b) it's just not fun to be falling-down drunk, or to have the falling-down drunk hangover.

*I know that people claim it isn't complicated, but I'm not convinced, and I find it seriously counterproductive to gloss over the complications of the subject. There are a lot of debates about what is and is not rape, and to use some pop-cultural examples, I think it's pretty damn clear that Joan was raped by her fiance, but Pete did not rape the babysitter that lived down the hall. He used some deception and unfair coercion, but he "convinced" her to sleep with him, and in the face of her disadvantage, she relented. That transactional view of sex is icky, sure, but it seems to be an actual way people carry out their sex lives. I'm not willing to define rape down to where it is the primary mode of sexual interaction between two people who are getting a raw deal out of their sex lives, but basically comfortable with it.

A stereotypical woman who "gives" sex to her partner in exchange for love/security/material support may in fact be satisfied with her sex life. It's obviously not a great way to negotiate a sexual relationship - to me it's downright creepy - but if it helps some limp through patriarchal control of their lives, I say let them keep it as long as they want it.

Acceptable Rebellion

2009-10-09T15:04:00.000-07:00

I am a fan of Lady Gaga. Lame provocateurs rely on cliches to upset people - The 90s saw Marilyn Manson "pushing" the same boundaries metal trashed in the 80s. She pushes some of the go-to boundaries like nakedness and gender - to good effect. I was really impressed with Gaga's red lace dress that covered her face. It really helped me understand why I don't buy it when people talk about fashion being artistic. Fashion's completely and voluntarily restricted by the paramaters of prettiness. No one experiments with outfits that make them look fat or like they have a pretty bad case of scoliosis.

I can only imagine that the intersex rumor was started by her, as a part of the attempt to really push boundaries of what people find attractive or interesting. Of course, she still follows a lot of rules: she's thin, she's white, she's American, she's rich, she usually complies straightforwardly to gender norms, and she makes vanilla pop music. It's an unfortunatev truism of boundary pushing that there are always some holds barred.

Another thing I love about her is that it's hard for someone who grew up after the sexual revolution to have any comprehension of what it must have been like to be actually shocked by something a media figure does. My age cohort hasn't had a single cultural shock. I do wonder what it is with the kids these days, though. Nothing seems subversive. Self-deprecating humor is basically the only kind out there, but I think that Liz Lemon is really a subversive character because she embodies Impostor Syndrome. Self-critical people use really melodramatic terms (I'm so STUPID, how could I have done that?) and Liz is what that melodrama describes. She's bad at everything (skills/looks/relatioships) except work. And her mom thinks she's cool.

stepping out of the corner Republican sensationalism has painted us into

2009-10-09T11:54:00.000-07:00

The first thing I heard this morning when my alarm went off was NPR saying that Obama won the Nobel Peace Prize. It was kind of a lolwut moment for me. Obama hasn't even been in office for a year, and even for that little amount of time, hasn't done very much. He ran a very emotional campaign, and I think it's resulted in a little confusion. Hope and change are pretty neat things, and it must have been a conscious decision to make him the fun candidate. Like a lot of opinion regarding Barack Obama, I think that hading this prize to him is more about projection than what he's actually done. The rest of the world seems pretty taken with him, and relieved that the US hasn't been permanently poisoned by Bush-brand haterade.

For all the talk about Bush's everyman appeal, I find Barack Obama's no-drama approach to Presidenting to embody common sense in a way I'd never expect out of a national leader. The low-key response to rooting out some potential terrorists has been very impressive, and I just loved how he brushed off the media for the national day of prayer. I don't think he can really fake enthusiasm, or have press-conference tantrums. Also, a little while ago, the DHS came up with an SOP for deciding when to raise or lower the terror-rainbow alert system. Bush didn't have a way to lower it - literally.

I'm not thrilled with Obama, but I think he's engineering his media presence to be as unexciting as possible. If he can succeed in toning the media down, he'll have done something that this country has needed very badly.

But here I am projecting and speculating, almost as badly as a talking head.

Well no kidding

2009-10-08T08:28:00.001-07:00

It turns out that shackling prisoners during childbirth is unconstitutional. Idaho is one of the states where this is practiced, and the ruling came from the 8th circuit, so I don't know how/when this might reach us, but it's sure nice to have a conservative court ruling in favor of women's reproductive freedom. From RHReality Check:

Last week, in Nelson v. Norris, a federal Court of Appeals held for the first time that the U.S. Constitution protects pregnant women in prison from the unnecessary and unsafe practice of shackling during labor and childbirth. Notably, although the American Civil Liberties Union argued the case more than a year ago, the court’s decision comes on the heels of three states (TX, NY, and NM) passing legislation in 2009 to restrict the use of shackles on pregnant inmates. These three join IL, VT, and CA in restricting the practice. Both the outcome and the history of the Nelson case and the recent legislation demonstrate the dramatic shift that has taken place around this issue.

Being a good sick person

2009-10-04T12:13:00.000-07:00

I still am totally fascinated with my brain thing. It's been nearly a year and a half since I had surgery, and most people I meet have no idea what happened to me. I don't have a shaved head or black eye I need to explain away anymore. For a while, I tried to be more vague when it came up that I had ongoing medical issues, but I only ever came up with a more spooky and ominous impression that way. I had a major medical incident which I'm pretty much better from now, even though it completely turned my life upside down - but let's move on to something more interesting. When I saw Rachel Getting Married, I was completely mortified when I recognized Kym's self-absorption in myself. I think it's probably a stage everyone with a huge illness goes through. When your entire world is what medications to take and when, you don't have a lot else to talk about. I have a couple of factors contributing to me being a broken record about my issues - there's the almost died, life changed thing, plus, the technical issues behind it are exactly the kind of thing that tickles my intellectual curiosities.

Both of my younger sisters got engaged to their long-time boyfriends over the past few months, and one of the first things I thought (besides "yay!") was, "Oh thank god -- something exciting is happening to someone in my family and it's not me having a stupid medical problem." I've been grateful to have such a supporting family and set of friends, but being brain surgery lady gets kind of old. Getting a new job where no one knew what happened to me was pretty thrilling - they aren't handicapping my performance with my condition in the backs of their minds. The crowd at Disability Support Services probably has a handle on the etiquitte necessary to have a working relationship knowing about a person's particular difficulties, but I've decided not to really disclose my issues, since it gives me a place not to be Brain Surgery Lady. The mood at DSS is kind of one of don't ask don't tell, where we work hard to let clients keep their privacy in general. I haven't met most of my clients (not that I have a lot), even now that I'm in the classroom providing services.

Rachel at Women's Health News wrote a post about the reception Penelope Trunk has gotten after tweeting something related to her miscarriage: Trunk got a lot of grief about oversharing, and she wrote a great rebuttal about how we do our best to ignore major ~~medical~~ issues women have because they make us uncomfortable. It's even more uncomfortable to have shame heaped upon you for even mentioning your ongoing miscarriage than it is to hear about it. Right on, sister. Miscarriage is often a Big Deal in a woman's life, and everyone tries to ignore it as much as possible. I'm sorry if it's awkward for you to hear about my bizarre medical condition (and I promise you, whatever it was that happened to me really was bizarre). If you had the patience and empathy to deal with other peoples' problems, you would realize that it's not all that bizarre for miscarriage or neurological problems to occur.

Rachel mentions that she has always found Trunk's blog to be off-puttingly self-promoting and sensationalistic. And then once something interesting happens to Trunk, she mentions it, and all of the sensationalism backfires on her. I spent most of my life kind of cultivating an eccentric personality, and all of a sudden it backfires when my neuro-immunity goes bonkers one day. I was weird before, and I'm still strange now. Very soon after I had surgery, one supposed supporter of mine decided to explain away my support for gay rights as a delusional side-effect of my condition. So if I'm going to have a different outlook on things, I have to conform in every other possible way to get anyone to take me seriously.

Terrorism is apparently a poor tool for communicating

2009-09-11T09:09:00.000-07:00

If someone murders an anti-choice activist, it's just not necessary to believe that there's a pro-choice terrorist on a rampage. It's an awful possibility, especially because the victim, Jim Pouillo, was murdered while engaging in a protest against abortion, but I think it's a remote one, especially since he was not the only victim of murder in his town today, and there's really no pattern of this kind of thing happening before. Police have connected a suspect with both Pouillon's murder and the second victim's.

I extend my condolences to the victims and their families. Should there have been a political motive to the killings, it's the responsibility of the pro-choice movement to decisively and immediately stamp that kind of thinking out. Everyone is still shocked and horrified about the murder of Dr. George Tiller, but fighting terrorism with terrorism is not only bad tactics, it's evil.

Jezebel found the response of

Fr. Pavone of Priests for Life told LifeSiteNews.com that he hoped to see "a strong expression of indignation from the pro-abortion community, just like there was a strong expression of indignation form the pro-life community at the killing of Dr. Tiller."

I don't know about Fr. Pavone, but I recall a pretty anemic expression of indignation from anti-choice activists after the assassination of Dr. Tiller.

Ashley Todd set back the cause of Republican martyrs by decades - she had us going for a good 12 hours, but her mistake was unnecessary melodrama and, of course, that backwards B. Also, it's tough to fabricate your own murder, and really a bad idea. I simply don't think that anti-choice manipulation goes that far.

Something smells fishy about this, especially how media reports immediately seized on the victim's history of activism as an implied motive for murder. I don't need to remind anyone about the tendency of media to take the first sensational idea connected with a story and run with it. A second man was killed in the same city on the same day, and there's no word on who he was or what kind of political enemies he had.

To Hell with Skepticism

2009-09-09T16:20:00.000-07:00

When I got sick, I first tried to tell myself that I should just deal, and I may have felt pretty bad, but that happens from time to time, so whatever. The ironic thing is that I was really getting into what hypochondriacs dream of - a life-stopping, sympathy-garnering, ambiguous medical condition. If I was going to go on living, I had to be a little flexible, and to stop going along with the luddite guilt trips about "overmedicated" Americans. I take at least six medications on any given day, and who knows if they're doing exactly what they're proven to do?

What I have just isn't on a label. I was diagnosed with an advanced case of WTF. There are lots of symptoms that I address variously, and I feel pretty good most of the time. The classics like eating healthy food and exercising tend to do what they're supposed to, but sometimes I'm exhausted and I have to choose if I'm going to go for a walk or do the dishes. Or to just eat the damn burger and stop my tummy from growling. I don't always make the right choice, and I try to learn from it when I do the wrong thing. I was holding out against particular drugs because I didn't really think they were necessary (IANAD), but soon enough I was completely nonfunctional and miserable. I had to do something.

Empirical purity be damned, I'm not going to circle down the drain for the sake of principle. There were possibilities I hadn't fully explored, and things were getting ridiculous. I dropped the wishful thinking and coyness about symptoms and laid it all out for the various doctors I see, and we got down to some brainstorming. When insurance balked a little, I laid out the cash in good faith* until they relented. I'd held out as much as my health could afford. I'm young and have a whole life ahead of me where I'd rather avoid disability and pain. Mistakes I make in recovery could be irreversible if we don't get astounding new medical technology within my lifetime. I'd like to say that I can prove that I need to take all these meds, but I don't think I can. Precision is great and all, but I'm happy if I feel better. My life completely destabilized, and I can't afford to pare down on these drugs until I have more stability. In the meantime, I'm trying to cultivate an environment in which I can thrive, and keep things as simple as possible.

My unified theory of what to do when there isn't anything to do is that you need to know when to break your own rules.

This can also be stated as, "All things in moderation." But that's boring.

Sometimes I become obsessed with the temptation of a guilty pleasure, and it's a lot more of a problem for me than eating a Twinkie will be in the long run. So, whatever. Screw purity. I rarely act out of hedonism, and when I do it's usually pretty harmless.

*Do you have any idea how expensive speech therapy is? I didn't, but I went in for an appointment before insurance would approve it, and they ended up retroactively covering the consultation.

Blue Dog Betrayal

2009-09-03T10:46:00.000-07:00

It seemed like a miracle to elect a Democratic representative in the first district of Idaho. The guy who previously held the seat was a disgrace, and his failures were Walt Minnick's success. An Idaho blogger by the blogonym of Mountain Goat has a bone to pick with Minnick's manipulative and dishonest campaign that stood in support of sCHIP on principle. But health care for everyone else? No way! His constituents don't want that kind of socialized craziness! Take it away, MountainGoat!

On Halloween day last year, in an interview with University of Idaho's KUOI radio in Moscow, you scolded your opponent for voting against expanding the State Children's Health Insurance Program, saying, incredulously, "Who could be opposed to providing health care to single moms who don't have jobs?"

Bill Sali said we couldn't afford it and voted against it—four times.

You said, "There are some places this country has to invest," and called the votes shortsighted.

Read the whole thing n weep, folks.

Hard-working Idahoans like Tom and Karen sent you to Washington because you gave them hope. Hope that you could and would convince their country to see them as an investment. People of the 1st District had enough of the rigid ideology that told them they weren't worth the price and sent you to represent them instead. They didn't expect to get a more finely honed rigid ideologist. They didn't expect, nor did they deserve to get their lives turned into political footballs—least of all by you.

Yet that is exactly what you've done. You joined the chorus of townhall crazies and fear mongering ideologues who turned Tom and Karen and every other Idahoan who can't afford medical care into political footballs.

Instead of coming home and working to convince Idahoans that they had nothing to fear and much to gain from health care reform (something many of us were prepared to help you do), you and your advisors (with their legendarily acute grasp of messaging) sent out misinformation-laden press-releases playing up the fears of Idahoans using triggers like "socialized medicine," "big government" and "raising taxes."

Naively, I thought that getting an Idahoan into the Democratic majority could give the progressive agenda some kick to it. But those damn dirty blue dogs rolled right over when they saw blood in the water and donations to their re-election funds. I'm disappointed by Obama in a lot of ways, but I may in fact regret my vote for Walk Minnick.

I just wanted to highlight this fantastic post and give it a push, plus add my own frustrated feelings. WTF, Walt? You're not as silly as Sali, but you're about as useful.

Hey, didja hear she was faking?

2009-08-26T17:01:00.000-07:00

I posted about a report of an assault on the WSU campus, and since then there have been two more reports. I not only got two e-mails about how the third report was later recanted, but I also got a text message on my phone. Has some unsafe campus got a guilty conscience?

The cankle default

2009-08-24T17:57:00.001-07:00

It pains me to use the term "cankle," but I had the poor judgement to click on a link to a news article about the triviality of the size of one's ankle. I noticed something interesting in the wording of one paragraph:

According to podiatrists, the average ankle size is about 10 to 11 inches around; men's ankles may be a little larger. The American Podiatric Medical Association does not recognize cankles as a medical problem, but according to Dr. Kathya Zinszer, a physician at Temple University's School of Podiatric Medicine, cankles can be caused by all types of medical issues.

If we're going to keep to a simple gender binary, the "average" ankle being written about is a woman's, and it's the size of a man's ankle that's the tacked-on side note. Well, bare minority of human beings, look who's "average" now.

Amazing, brilliant magazine editor lets up on body-fascism for one photo, is lionized

2009-08-20T15:31:00.000-07:00

Fair warning: every link I'm using in this post has pictures of naked ladies on it.

Via Jezebel, Glamour magazine is making waves with a photo of a naked lady with a tummy. (Maybe NSFW) It's really a lovely photo, and I've never seen anything like it in a women's/fashion mag. The editor's blog entry about all of the glowing praise she's gotten for including the photo is overly-self-congratulatory. Include one photo of a happy naked lady, and we'll forget all about the decades of body-image-assassination that your industry thrives on. She asks rhetorically:

With all the six-packs out there, do you even know what a normal belly looks like anymore—other than the one you see in the mirror?

I'd like to answer that question. I never really knew what a fat woman's body looks like until I had one, which made it a continual disappointment until I wised up. Plus-sized models are carefully arranged so as not to create the rolls of fat that everyone acts like are so unsightly. Sure I've been in locker rooms and stuff, but there's almost no media representation of what actual fat(esque) female bodies look like. The diversity of female bodies is completely steamrolled in media; Things like this really don't need to be a revelation.

Photography projects like Shape of a Mother, Adipositivity, the "normal breasts gallery" were a real shock to me in my early twenties. I really didn't know what stretch marks were. I vividly remember my horror as a teenager when I actually tried out a few yoga poses in the nude, and decided it was thoroughly unerotic.

To conclude: this all pisses me off quite a lot, like when feminists are supposed to fall all over themselves thanking men for understanding that women are people. Stopping active harm is good, but it's not exactly charity.

Public Service Announcement

2009-08-20T10:28:00.000-07:00

I got an email about a reported assault on a woman on WSU's Glen Terrell Mall, and wanted to reproduce some useful information (in a manner I am stealing directly from one Penny Dreadful, via Shakesville):

[WSU Police] remind potential perpetrators of assault to be vigilant [and polite] at all times; don't walk alone; stay in well-lighted areas and to use safe transportation whenever possible.

Anyone with information about the assailant is urged to call WSU Police at 335-8548 or 9-1-1 in an emergency.

This information is released as a service to the WSU Community and in compliance with Clery Act requirements.

The original sign that Penny found is a lot more amusing and to-the-point. The release WSU sent out wasn't all that malleable, but I think it would be perfectly appropriate to hang up copies of it at wazzu.

'Regrettably, due to a number of recent incidents, it is necessary to remind men walking alone through the park not to rob, rape, threaten or assault anyone. Thank you in advance for behaving like decent human beings. Signed, single women who refuse to live in fear'.

You have to admit it's getting better

2009-08-17T09:04:00.000-07:00

When Obama backs off, he really backs off, but I think I need to recognize that I should take what I can get for now. No public option!? This will do the opposite of reducing health care costs in this country, and just get more premium-payers contributing to Aetna (or whoever)'s massive bloat. I wish I knew more about nonprofit health insurance companies/co-ops, but as someone who's paying a massive premium to stay on Group Health's rolls, I know remarkably little. I will say this, though: the people praising Group Health are basically on the money. It doesn't come cheap, but this is American medicine here. I've run into only a few people who complain about GH, but most docs I've been to have been delighted when they found out the entity with which I am insured. I have a lot of half-baked theories as to why I've had such a good experience with them, but it can't hurt that they approve almost anything a doctor orders. When they reject it, they reject it, so I have spent almost no time fighting with them. I've had to show some rather expensive good-faith, but they've been pretty go-along get-along.

Talking about health care is getting extremely old, but it's kind of like looking at a car crash (or, really, the bills from the ER after a car crash).

The major failing in the "dialog" has been almost no serious proposals for reducing costs. And those that I've seen, like a general policy to skip ineffective treatments, have caused Republicans to scream bloody murder.

In other news, I've started working a part-time job at the U of Idaho - I'm training to caption classes for students who are Deaf or hard-of-hearing, and even the training is kind of fun. I recently got serious about a job hunt again, and scored two interviews. One was for this job and the other for one at a local biotech, basically doing the exact things I disliked about my previous job; I don't think I was really in the running for that one, though, and I think I'd have really hated it. This is a completely new direction for me, and takes better advantage of my natural talents.

As it is, I'm working just less than half-time, and I am a gajillion times more productive regarding things like housework when I am working outside the home at least a little. This is a new thing for me - I don't think I've had a part-time job while not doing anything else since I was 19 - and I'm going to take advantage of the fact that I can pretty much afford it. (I think the new "We'll live on love" is "We'll live on loans.").

Satire begins to Resemble Stenography

2009-08-15T13:55:00.000-07:00

I went to see District 9 last night and went in with kind of a bad attitude, but came out having seen a movie I liked. I was prepared for the worst after the first twenty minutes of dull, earnest satire. There was no way I could sit through two hours of that with the volume set at 11. Somehow, Daniel Engber of Slate was disappointed that the political agenda of the movie never went anywhere, but even after reading his entire article, and especially after seeing the movie, I have no idea why. After the overly-political setup, the movie completely veers off into a narrative about a dude stuck behind enemy lines. Every review's comparison of Wikus Van der Merwe to Michael Scott is perfect.

Wikus is ambitious, desperate for everyone to love him, and basically a pretty nice guy. But he's incompetent. There's a really strong George W. vibe with Wikus. He seems to think he should go ahead and try to do this humanitarian intervention thing, since he really wants things to work out and to be a part of that, and maybe he'll make a few friends along the way. As he bungles his way through evicting the residents of the District 9 slum, he accidentally steals a key piece of alien technology that infects him and begins a process that begins metamorphosizing his biology into that of the "prawn." The process is revolting, painful, and scary.

Between prawn and man Wikus loses some of his illusions about his mission at MNU, and allies with an alien named Christopher Johnson that may be able to a) get the prawns off of this godawful planet and b) reverse Wikus' prawnification process.

This isn't because Wikus is a good person. He's basically acting out of self-interest, and giving a hand up to the prawns in the process is a lucky coincidence. If his life didn't depend on working with Christopher, there's no indication that he'd be able to pull off the crazy moves it took to further the cause of the prawn. Essentially, The Man is what's keeping the prawn down, and people and prawn alike needed this coincidence to save them all. If the prawn technology had been completely lost, MNU would have gone merrily on its way to genocide, and the prawns would have missed their chance at fixing this whole disaster.

If you go, be aware that it's incredibly gory and long. Plus, the prawn language sounds to me a lot like burping or vomiting.

You got a better idea?

2009-07-29T15:31:00.000-07:00

Woo! Progress on health reform! How much of a difference it will make remains to be seen, but unlike those of us whose insurance denied to fund the use of our iron lungs, I'm not holding my breath until I find out.

I got a press release from Walt Minnick today that included the following remarks:

Like most Americans and like the President, I believe that health care reform must reduce costs, rely on the private sector, prevent restrictions based on age or employment status or preconditions, and must ensure coverage for all Americans. However, this bill simply will not get us there.

Mr. Minnick, you're the congressman here - you have some kind of power to change things, and just saying "nope, not good enough" is a little half-assed in my mind. I thought the Democratic majority was supposed to do away with the "party of no" nonsense. But I was naive.

In my estimation, just about anything would be a step up from what we've got. As an uninsurable Idahoan, I'll take what I can get. The above list of things Minnick wants out of a health plan aren't necessarily feasible or desirable. I don't care what happens with "the private sector," since we've been relying on that to get the same level of care as anyone else at twice the cost. We don't owe them anything (except our huge medical debts).

Making an exception

2009-07-15T18:00:00.000-07:00

At the feministing community blog, an author "rmanning" has an infuriating post about her difficulty obtaining a hysterectomy as a woman under the age of 21, even though she's got UTERINE CANCER. It just goes to show that regulating reproductive health decisions tends to be a "one-size-fits-many" thing that leaves some people totally screwed.

I thought it was kind of precious when Andrew Sullivan was astounded that people have late-term abortions for REASONS. He seemed to think he was the only person to ever figure this out. And he's thinking of compiling stories into a book! Never mind how exploitative it is for an outspoken anti-choice pundit to use other people's tragedies to publicly congratulte himself for being able to change his mind. Also, the book has been written many times.

I used to be a little apathetic about reproductive health regulations, but the bizarre and horrible things that can happen to people continually amaze me and have made it clear that such regulation can't be enacted humanely. rmanning mentions text in state law that explicitly says that doctors shouldn't perform hysterectomies on women younger than 21 so they won't make decisions they will later regret. She prudently doesn't mention which state she's contending with, but I suspect that working through the specifics would reveal that the reluctant doctors are being hypersensitive about things that are really more guidelines than laws. And anyway, how could an effort to preserve fertility apply to her killer uterus? I'm no doctor, but it's kind of hard to conceive when you've died of an operable and treatable cancer.

I'm sure that if she was 9, she could get this operation. But it's squickier to the doctors she's run into to yank reproductive organs out of a woman who is nearing what would otherwise be her childbearing years.

I was pretty well convinced that I wouldn't ever have kids when I was 18, 19 and 20, but it turns out I've changed my mind in the interim.

I only say this to illustrate the fact that an 18-year-old can make decisions about her reproductive capacities that she will later regret. But that takes living to "later," which is the primary purpose of her medical care.

Convenience food triage

2009-07-07T16:24:00.000-07:00

I like fancy-schmancy food, but I also like junk food. I really like it. Day-glo cheese powder still feels like a fun treat no matter how much I eat it. Both Jezebel and Amanda Marcotte have addressed the issue of how people eat when they're alone, and I think it's a fun topic, but seems incredibly obvious to me. I've never developed a good cooking/cleaning habit, and have frequently opted to go grab some fast food instead of digging out my kitchen. Being hungry tends to make me panic: "I'll never get dinner done before I starve to death!" Knowing that I have this tendency, I've taken a triage approach to feeding myself. If I would otherwise eat a Big Mac for lunch, I figure it's cheaper and probably better for me/the environment to make some convenience food at home, regardless of how junk-foody and excessivley-packaged it is. When I was trying to shake a bad going out for lunch habit, I turned to frozen dinners to bring to work for lunch, and got hooked on the Ethnic Gourmet palak paneer. I load up whenever it's on sale at the co-op. It's all wrapped in plastic, but it's less packaging than you get at a drive-through window. It's also significantly less expensive. It may be yuppier than Lean Cuisine, but I eat it and I like it. Plus, who can argue with brown rice and spinach? My other lazy-food crutch is the avocado. Smoosh it up with some salsa, eat on chips, and there's lunch! It's also just good with salt and a spoon (but it doesn't quite add up to a whole meal). People always warn you about the high fat content and calorie-density in avocados, but they usually aren't taking two drugs that suppress appetite.

I know in my heart of cheap hearts that making the palak paneer myself would be healthier and less expensive and tastier (and more fun), but that's when I have to go back to the triage concept. Letting the perfect be the enemy of the good has filled my belly with a lot of cheeseburgers over the years. Oddly, this has become a much more-functional operating principle since I've lost a lot of appetite and not had to contend with the hunger panic. I usually have to remind myself that I need to eat three meals a day, and I don't have my animal instincts to tell me to put that thing in my mouth NOW. If I am not likely to eat anything of substance during the day, I might as well put on some mac and cheese and knock down a few hundred calories so when I do get hungry in the evening I don't turn to quick, yummy things like popcorn and cookies.

Don't worry that I'm dying of a vitamin deficiency: I'm overstating the severity of my food-stupidity to make a point/joke.

YOUR body - be afraid of it!

2009-06-17T19:09:00.000-07:00

If all media were like women's magazines, it would be as confusing as these two headlines caught on CNN's homepage today:

If Kermie doesn't think I'm cool, I'll kill myself

2009-06-11T10:09:00.000-07:00

I've got a post brewing on the subject of moral panics, and figured this terrible early-90s anti-drug film would be a good lead-in.

The Pill Thrills

2009-06-06T12:04:00.000-07:00

Today is "The Pill Kills Women" Day, which is so absurd I can't even believe it, and I wanted to add one of my favorite one-liners I've ever come up with to the chorus of "WTF?" I've always said that the birth control pill is my favorite recreational drug. The very small risk of dangerous complications really outweighs the extremely high risk of unwanted pregnancy, to me (as a non-smoker). I have effused to everyone I know about how much I love the particular pill I take, so if you're looking for that perfect pill, I'd be happy to pass along my advice/experience. I have taken a couple different kinds over the years, and stuck with this one for nearly a decade now.

Regret

2009-06-05T08:20:00.000-07:00

A lot of pro-life rhetoric is spent on warning women that they may regret abortion for their entire lives. I'm sure this is at least sometimes true, but it is not always true. The scare-tactics about abortion decreasing fertility don't have anything to do with killing a particular embryo - just that it might be harder to raise another one in the future. This might seem like an easy argument that avoids a few abortions, but it only works on principles that affect the would-be mother (and father). I think you can regret an abortion for entirely selfish reasons. For that matter, when you have to make a decision between only bad options, I think you're proably going to regret it no matter what you do. I don't think "regret" is necessarily tied to guilt.

My malpractice is your problem

2009-06-03T20:11:00.000-07:00

I ran across a strange comment thread at Kevin, MD's blog about whether a plaintiff in a medical malpractice case deserves any right to privacy regarding the particular complaint. The comments very aggressively argue that they do not. One comment really jumped out at me:

I also agree that once you file that malpractice lawsuit you are saying two (maybe three) things.

1) I think I was wronged
2) I think I deserve some cash
3) I will fight PUBLICLY for my rights

You can guarantee that the lawsuit will be registered as a complaint against the physician and freely searchable for all to see that it occurred. It should NEVER be allowed for a plaintiff in a malpractice lawsuit to be anonymous for this reason. They have to assume a “profile risk” that is commensurate with the physician’s, in my opinion.

If the patient actually was wronged, he or she still deserves their medical privacy. Probably even if they weren't. Patients seek doctors (who sometimes make mistakes) because they are human beings and therefore need medical care. Just because some doctor botched your procedure/care, you shouldn't have to publicly disclose information that is usually protected. The post above assumes that a malpractice suit is generally filed in bad faith. Also, the poster is clearly more worried about the black mark on a physician's record than the possibility that the plaintiff was wronged and the court will rightly decide the case. Most people aren't equipped to make a better decision about a malpractice case than the original judge and jury, or even the quack who got himself charged with malpractice.

I understand that cases are sometimes wrongly decided and people not at fault are punished, but I don't think that a chain of events caused by being alive should be grounds for a patient to lose privacy rights (such rights are something people agree to afford each other - it's not like we can blame fate for a policy of disclosing medical information. People make policies, but they don't get to decide whether they'll ever get sick.). In any case, who the patient is really isn't important to the question of whether they were harmed. Malpractice is malpractice even when it's visited upon someone who has a personal beef with their physician. The commenter's reasoning only applies to those who harass physicians for no good goddamn reason. It's not outside the realm of possibility that Joe Q. Patient hates a doctor's guts and will stop at nothing to see the doctor's career ruined, If a significant number of people had the inclination AND wealth to harass a physician with lawsuits such that it runs their career into the ground, I would be extremely surprised. It's rare that anyone, mean or not, has that kind of wealth, or a Punisher-like desire to ruin someone who also happens to be a doctor. The number of contingencies adds up to make a pretty small population. The reason that all medical facts need to be connected with a person's name in a malpractice suit is some number of people who A) have lots and lots of money and B) hate someone enough that they are willing to sacrifice that money and their time, plus C) the hated person is a doctor.

It also creates a disincentive for victims of malpractice regarding embarassing conditions to seek redress. So, specialize in the treatment of sexually-transmitted diseases and you don't have to worry about lawsuits.

I can't see it adding up to a good effect.