“Since Dustin Hoffman heard that memorable ‘just one word,’ plastic has re-made American society. In a stroke of brilliance, Laurie Essig brings together plastic credit cards, bodies, and gender identities by telling the story of how economic insecurity has intersected with the celebrity culture and the neo-liberal ideology of choice. Essig's well-researched and original analysis deserves our serious attention.” —Juliet Schor, author of Plenitude: The New Economics of True Wealth
As the new year begins, many people's thoughts turn to "improving" their bodies, and, in our age of quick solutions, plastic surgery often is looked at as a shortcut to perfection. Over the last decade there has been a 465 percent increase in cosmetic work, and we now spend over $12 billion annually on procedures like liposuction, face-lifts, tummy tucks, and boob jobs. In American Plastic: Boob Jobs, Credit Cards, and Our Quest for Perfection, sociologist Laurie Essig argues that this transformation is the result of massive shifts in both our culture and our economy—a perfect storm of greed, desire, and technology.
Plastic is crucial to who we are as Americans, Essig observes. We not only pioneered plastic money but lead the world in our willingness to use it. It's estimated that 30 percent of plastic surgery patients earn less than $30,000 a year; another 41 percent earn less than $60,000. And since the average cost of cosmetic work is $8,000, a staggering 85 percent of patients assume debt to get work done. Using plastic surgery as a lens on better understanding our society, Essig shows how access to credit, medical advances, and the pressures from an image- and youth-obsessed culture have led to an unprecedented desire to "fix" ourselves.
This fall I had the privilege of releasing my second book Food Rebels, Guerrilla Gardeners, and Smart-Cookin' Mamas: Fighting Back in an Age of Industrial Agriculture. As it makes the rounds of book reviews, and I tour the interview and lecture circuit – casting myself as it were to the lions of the marketplace – I have found that the book's first responders are drawn to its main title and less so to the subtitle. This is as I expected. People naturally want to hear stories about doers, real-life action heroes, and pioneers who might lead us out of the wilderness of the industrial food system. They are eager to get their hands in the dirt and less patient with the intellectual gymnastics required to deconstruct the half-truths of Big Food and its kissing cousin, Big Agriculture. The philosophical framework, so to speak, that mountaintop above the din and the thrum of the real world where many writers, including this one, love to dwell, is too often by-passed by the harried reader earnestly searching for a shortcut to the answer.
So allow me to use this space to reacquaint you, diligent reader, with the Big Idea of Food Rebels and why, in my humble opinion, it matters. I opened the book with a few lines from from Fyodor Dostoevsky's parable The Grand Inquisitor: "Today, people are persuaded more than ever that they have perfect freedom, yet they have brought their freedom to us and laid it humbly at our feet…And we alone shall feed them…Oh, never, never can they feed themselves without us! In the end they will lay their freedom at our feet, and say to us, 'Make us your slaves, but feed us.'" I spare little subtlety in drawing a parallel between this iconic passage of Western literature and the industrial food system's quest to control the hearts and minds of us, the dependent food consumer. After all, we know, as the industrial food system loves to remind us, that we are staring down the twin barrels of too many people and too little food.
Interestingly, the same lead was used in a recent review of Food Rebels by "Food Safety News." After going on for nearly three pages with an accurate, blow-by-blow account of the book's main points, the reviewer concludes with "Although Winne delivers strong arguments for the alternative food system, his book too glibly disparages the benefits of the industrial food system—namely, an inexpensive food supply, a system that can meet the growing worldwide food demand…." So, in the spirit of Auld Lang Syne, let me offer a selective retrospective of the industrial food system's sins for 2010 'less them "be forgot, and never brought to mind."
Wednesday's New York Times ran my article on DVDs and group classes that introduce babies and toddlers to sports. A lot of reaction - pro and con - on the Times Web site. Last time I looked, 105 comments.
Each company cited in the article - and the entrepreneurs behind them - seems to be coming from a slightly different perspective. Doreen Bolhuis, who created the Gymtrix exercise videos, believes that babies truly can improve coordination by working out. She's quoted in the article on this point and during my interview with her spoke about it at length, telling me, “We sell babies short because they can’t speak yet. But they’re all about learning how their bodies work and about movement patterns. When we guide them they learn so much more quickly than if we leave it to chance and hope they’ll figure it out."
Other company executives quoted in the story cited different reasons for getting really, really young ones started in sports - fighting childhood obesity, getting them in the habit of being active and teaching the basics of games they may pick up later.
How many parents are buying videos and signing up for classes hoping to turn their babies and toddlers into superstars later on is impossible to say. Clearly some companies are appealing to that instinct, subtly or otherwise.
I had a small role in putting together this video which ran with the article on the Times site. It's worth a look.
In our first post, we featured Connecticut's Working Lands Alliance and the National Farm to School Network. Today we profile the Sustainable Food Center, headquartered in Austin, Texas, and the W. K. Kellogg Foundation's Food and Community Program.
The Sustainable Food Center's mission is to cultivate a healthy community in Austin, Texas, by strengthening the local food system and improving access to nutritious, affordable food. SFC envisions a food secure community where all children and adults grow, share and prepare healthy, local food. Through organic food gardening, relationships with area farmers, interactive cooking classes and nutrition education, children and adults have increased access to locally grown food and are empowered to improve the long-term health of Central Texans and our environment.
The SFC's major projects include the Grow Local program, which provides education to increase proficiency in food gardening, and aid in the establishment and long-term sustainability of community and school gardens; the Happy Kitchen, a cooking and nutrition education program; and Farm Direct, which runs the Austin Farmers Market and connects local growers with institutional consumers.
In December, the Happy Kitchen will hold a facilitator appreciation banquet at a local library. And SFC will benefit from a CharityBash fundraiser for young professionals on December 8th.
The W. K. Kellogg Foundation's Food and Community Program is focused on creating healthy places where all children thrive. The program includes efforts to improve school food, aid community-led initiatives to increase access to good food and opportunities for physical activity, and works to build movements to promote healthy eating and active living.
Among the many programs supported by the foundation is Double Up Food Bucks, a Detroit-based group which helps families receiving food assistance benefits purchase more fresh fruits and vegetables at farmers’ markets. This brings benefit to both the families and to the local farmers selling the fresh fruits and vegetables. Watch a video here or at YouTube to find out more about the program.
Over the past twenty-five years, the practice of medicine has been subverted by the business of medicine, sacrificing old-style doctoring to fit the values of consumer capitalism. InWhite Coat, Black Hat: Adventures on the Dark Side of Medicine, physician and moral philosopher Carl Elliott traces for the first time the evolutionary path of this new direction in health care, revealing the dangerous underbelly of the beast that has emerged. We're introduced to the often shifty characters who work the production line in Big Pharma: the professional guinea pigs who test-pilot new drugs; the ghostwriters who pen "scientific" articles for drug manufacturers; the PR specialists who manufacture "news" bulletins; the drug reps who will do practically anything to get their numbers up; the "thought leaders" who travel the world to enlighten the medical community about the wonders of the latest release; even, finally, the ethicists who oversee all this from their pharma-funded perches.
Check out Carl Elliott's recent clinical trial expose in Mother Jones, and his piece on Big Pharma's Thought Leaders in the Chronicle Review.
Sonia Sanchez "drenches her words in honey goodness so they sound like the sweetest thang you've ever heard," The Root gushes in this feature interview, where the poet discusses what she's reading and the future of African-American literature.
Chalk the union of one man and one woman up to the good influence of their gay friends: it took a lesbian wedding for Jeremy Adam Smith to understand the importance of marriage.
It costs a lot to lock people up (by some estimates $32 billion annually). You have to house them, feed them, give them basic medical care.
It costs a lot, even if you cut corners. Overpack a dorm or double-bunk (as dangerous as that practice is). Serve cheap food—unrecognizable, processed meats; overripe, almost rotted fruit; white bread that wads up to the touch. Save on health care by not giving any. In the county jail where I taught high school for ten years I'd seen young guys with cheeks ballooned out from abscessed molars told to wait two weeks for the next dentist visit; or students go without their essential medications because they supposedly filled out the wrong forms which would eventually get "lost" anyway in the great paper-shredder of jailhouse bureaucracy. One male warden on the women's unit even decided to save money by rationing toilet paper and tampons.
Today, some states such as Virginia, Utah, Missouri, Arizona, New York, New Jersey and Iowa have a new, more direct approach: charge locked up men and women fees for room and board.
Today's post is an excerpt from a new book by Pulitzer Prize-winning Newsday reporter Beth Whitehouse. Her five-part front-page series "The Match," which was the basis for this book, won numerous awards, including the American Association of Sunday and Feature Writers First Place for Narrative Writing, a National Association of Science Writers Award, and a Casey Medal for Meritorious Journalism in Service to Children. Whitehouse is an adjunct professor of journalism at Columbia University.
Stacy Trebing yanked off the yellow paper hospital gown that covered her shorts and T-shirt, unhooked the surgical mask from behind her ears, and stuffed both items into the garbage pail in the entryway of her daughter's hospital room. She'd been at her three year-old daughter's bedside practically every minute of the past ten days.
She needed a breather.
The next morning, Stacy's daughter would have a bone marrow transplant, a medical procedure that would either cure her or kill her. Every minute since Katie's birth had been leading to this day. Everything Stacy and her husband, Steve, had done, every decision they'd made, had propelled them here.
Including the most controversial of their choices: to create a new human being they had selected as an embryo because he genetically matched a critical portion of his sister's DNA.
That one-year-old baby would be brought into the hospital the following morning to donate the life-changing bone marrow that was the only chance to heal his sister. Christopher Trebing was born to be a member of the Trebing family, but he was also born with a job to do. He would be put under general anesthesia while a doctor inserted needles repeatedly into his hips and siphoned the tissue that could repair Katie's ailing body.
In To Uphold the World: A Call for a New Global Ethic from Ancient India, author Bruce Rich contemplates the rule of the Indian emperor Ashoka over 2,200 years ago, whose philosophy of tolerance, conservation, nonviolence, species protection, and human rights still have much to teach us today. One of the many programs established by Ashoka was a system of universal health care for people and animals which, once established, served the Indian empire for close to a millennium. Rich discusses Ashoka's health care system in this video.
Bruce Rich is a Washington DC based attorney who has served as senior counsel on international finance and development issues for major environmental organizations such as the Environmental Defense Fund and the Natural Resources Defense Council. Rich has published extensively in environmental and policy journals, as well as in newspapers and magazines such as The Financial Times, The Nation and The Ecologist. He is the author of Mortgaging the Earth, a widely acclaimed critique of the World Bank and reflection on the philosophical and historical evolution of the project of economic development in the West. He has been awarded the United Nations Environment Program 'Global 500 Award,' the highest environmental prize of the United Nations, in 1988, and also won the World Hunger Media Award in that year for the best periodical piece on development issues.
Today's post is from Maggie Kast, whose story "Joyful Noise," appears in the anthology Love You to Pieces: Creative Writers on Raising a Child with Special Needs, edited by Suzanne Kamata. Kast is also the author of and The Crack between the Worlds: a Dancer's Memoir of Loss, Faith and Family (Wipf and Stock, 2009). Her essay, "No Pity," appears in the anthology Gravity Pulls You In: Perspectives on Parenting Children on the Autism Spectrum, edited by Kyra Anderson and Vicki Forman (Woodbine House, 2010).
Browse this book
Rahm Emanuel's recent use of the "r" word to castigate conservative Democrats has created a flurry of comment about the word, both as slang for incompetent and as derogatory term for people with developmental disabilities. Sarah Palin demanded he be fired, and Rush Limbaugh called Rahm's meeting with advocates for the mentally handicapped a "retard summit at the White House." Questioned about Rush's rant, Palin called his use of the word, "crude and demeaning," although she later excused it as "satire."
This current publicity merely highlights a longstanding problem and efforts to solve it. In March, 2009, the Special Olympics held a youth summit, and this group of young people conceived and launched a campaign to "Spread the Word to End the Word," designed to eliminate "retard" both as epithet and descriptor. Several governors have endorsed this campaign and forty-eight states have replaced "mental retardation" with "developmental disability" or a related term in their laws and departmental designations. A bill known as "Rosa's law," currently before Congress, would change the term "mentally retarded" to "intellectual disability" in several federal statutes.
As the parent of a child who failed to sit up, walk or talk when expected, I faced the question of what to call his condition. Never fond of euphemisms, I still dreaded the harsh sound and still harsher meaning of the "r" word and yearned to call my son anything else. At the same time, I wanted to say the word before it was said to me. More than anything, I hoped my son would never hear it, would never know this cruel fact about himself. One night in the '70s, as I listened to reports of Nixon's wrongdoing on the radio, my son propped on his hands on the kitchen floor, and repeated to myself: "retarded, retarded," coming down lightly on the "r's" and the "e" and clipping the "t" and the "d's," trying to improve the sound of the word and get myself used to it. Accepting the term was part of my facing difficult facts, and my regret was matched by
Jonathan Metzl discusses schizophrenia, the DSM (The Diagnostic and Statistical Manual of Mental Disorders), and how the disease moved from being thought of as a ailment of housewives to a diagnosis of violent behavior among African-American men.
There is a veritable epidemic of doctor-writers out there. What is going on?
Are doctors suddenly in the kiss-and-tell mode? What about confidentiality? Professionalism? HIPAA?
one of the aforementioned doctor-writers, I look upon this trend with
both awe and trepidation. I suspect that that this flourishing
literary phenomenon relates to the public’s fascination and fear
about all things medical. It also relates to the falling away of
previous, pedestal-like images of doctors and doctoring. Lastly, it may
have occurred to the medical profession-- and this has taken a few
centuries, it seems-- that doctors have profound emotional reactions to
the work we do, and that exploring these reactions may offer benefit to
both patient and doctor.
Whatever the reason, this literary
genre appears to be here to stay, and it is worth considering the
ethical implications. Legally, there doesn't appear to be much beyond
protecting identity and avoiding libel.
Public hospitals have a bad rap. They're viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.
As a long-time physician in a public hospital, I'm sensitive to this reputation. I wouldn't work in my hospital if I didn't feel that it delivered excellent health care. I'm certainly aware that private hospitals have amenities that public hospitals can't afford, but many of these are cosmetic issues.
On the cosmetic side, though, public hospitals have come a long way. Bellevue Hospital, where I work, has built a gorgeous ambulatory care building, complete with a soaring atrium that floods the waiting areas with sun and space. The ICUs and emergency wards have been renovated to enviable standards.
But beyond cosmetics, there is an extremely dedicated staff who is committed to providing high-quality care, despite the many financial and logistic challenges that public hospitals face.
In March 2007, the nonprofit Disability Law Center sued the state of Massachusetts over its treatment of hundreds of mentally ill inmates. Prisoners with emotional problems who are unruly in some way are kept in 23 hour solitary confinement, which, according to a November 10 Boston Globe article, has "led to self-mutilations, swallowing of razor blades, and numerous suicides."
In response to these grave concerns the Patrick administration, in an out-of-court negotiation, proposed building special treatment units for mentally disturbed inmates. Now, that proposal is off the table; citing the budget crisis, those units will not be built. So it's back to court in an effort to force the state to give its incarcerated citizens their constitutional protection against "cruel and unusual punishment."
Massachusetts isn't alone in facing the problem of caring for mentally ill inmates. Every state has had to confront this growing trend which started in the 1960s and accelerated in the 1980s, when the system of large state psychiatric hospitals was shut down even though, as Oliver Sacks states in his bittersweet eulogy to these former mental hospitals ("The Lost Virtues of the Asylum" New York Review of Books, 9-24-2009), it was obvious that these closings created "as many problems as they solved." Communities weren't prepared, and still aren't prepared, to absorb and meet the needs of what he calls "sidewalk psychotics."
With these closings, along with the current "tough on crime" policies, it shouldn't surprise anyone, then, that these same people-- alone, unsupported, often self-medicated with drugs and alcohol-- increasingly end up behind bars, despite the fact that jails aren't set up to help people deal with emotional problems, problems that confuse their judgments and impel them to destructive actions
No doubt these are hard choices in hard economic times for any state. Yet, once again, as municipalities struggle to come up with innovative ways to deal with the money crunch, the one formula that never gets recalibrated is that the people with the greatest need and the least resources take the biggest hit.
I got a call from Kaiser Permanente several days ago informing me that I was due for my yearly mammogram. That call came the day before I saw the headline in the New York Times telling me that having a test every other year is now the recommendation from the U.S. Preventive Services Task Force for a woman my age. Besides, they say, nevermind the breast self-exam, or even the exam by my primary care physician. None of this is going to save my life. Statistically, anyway. And besides, more frequent exams may lead me to extreme anxiety when a lump is found that turns out to be benign (which has happened 2 or 3 times already), and I may be subjected to unnecessary treatment for an early-stage cancer which might have gone away on its own-- unnecessary treatment being more tests, and perhaps radiation and/or chemotherapy, and even surgery. Whoa! What should a woman do?
"Angelina Gomez," the medical assistant hollers out to the crowded waiting room. As always, I cringe when I hear this. It sounds so harsh, so cattle-like. I know that the assistant is actually a gentle and caring person, and I understand that he uses a loud voice so that he can be heard over the general din of a large waiting room.
Nevertheless it feels horrible to me, so demeaning, like we're in the DMV instead of a medical clinic. I want the environment to be more humane, more civilized, and so when I go out to call a patient, I use a much softer voice, with a tone that I hope conveys more respect.
Of course, no one can hear me. Heads turn, ears strain, faces contort as people try to figure out who I am calling. The medical assistant usually gets the right person on the first try. I, on the other hand, end up pacing up and down the waiting room repeating the name. Am I making the environment any better?
Next Friday, I'm meeting with my daughters' principal. The meeting isn't directly about my kids, though if not for them I wouldn't be going. This time, my daughters didn't do anything wrong, nor anything particularly wonderful, nor even cause trouble on the playground, but I'm nervous about the meeting, anyway. I've rallied the troops and called in reinforcements, making waves at school, in advocacy for the schoolyard weeds.
For the last several years, I have received notices from school, supposedly telling me when and where a pesticide would be applied to the school grounds. I've looked at them for all this time, and so far, have read and ignored them, because the pesticides have been aimed at mulched areas in front. Some ofthe herbicides bother me more than others, but since all have involved spaces that my children didn't directly contact, and which I didn't really want to hand-weed as a volunteer, I ignored the notices.
Last week's notice, which I got on a Wednesday afternoon, was different. On the space where it told "where," the answer in bold was "lawns," and that single answer made me look twice. Lawns are where my kids play. School yard lawns are supposed to have flowers and weeds, because those provide entertainment for children. Plantain, dandelion, clover: these are schoolyard weeds which every kid should know, even if no one at school knows the Latin for them.
I then looked up the EPA registration on the herbicide, MEC something or other -- herbicide trade names are always changing, with new combinations and ratios so variable that no one could expect to follow the market, any more than we expect to recognize companies on a 2-bit stock exchange. I looked at the active ingredient, just as anyone in a drug store knows to look for acetaminophen on the generic Tylenol. And I looked again, in shock: the ingredient was 2,4-D.
If asked what a doctor does, most people would probably come up with the standard description of diagnosing and treating disease, usually while wearing an ill-fitting white coat. Before I entered practice, even during my medical training that probably would have been my answer too.
But my years in the trenches of real medicine have altered that definition greatly. I do spend time doing the things I learned in medical school like diagnosing disease and writing prescriptions, but that turns out to be only a part of the job, often a very small part.
Much of the time I find myself acting as sounding board. Recently I saw one my regular patients, a woman whose main medical issue is hypertension. But for most of our visit she spoke, often tearfully, of the strain of raising grandchildren since her daughter died of HIV. We never really got to her hypertension, and I certainly didn't have any easy answers for her difficult life situation, but this seemed to be the only time and place that she could devote to her own issues.
A good portion of my time is spent being a teacher. So much of medicine involves education-- talking about what a disease means, which medication side effects are important to watch for, how to plan a healthy diet, which screening tests are important, what a particular diagnostic test entails, what the various lab results mean, and so on.
Today's post, in honor of National Midwifery Week, is from Patricia Harman, author of The Blue Cotton Gown: A Midwife's Memoir. Harman got her start as a lay-midwife on the rural communes where she lived in the '60s and '70s, going on to become a nurse-midwife on the faculty of Ohio State University, Case Western Reserve University, and West Virginia University. She lives and works near Morgantown, West Virginia, and has three sons.
As I travel around the country speaking and signing copies of The Blue Cotton Gown: A Midwife's Memoir, I spend more time talking about midwifery than I do about the book. This makes me smile; I didn’t set out to be an ambassador for the profession, but I couldn't be more pleased.
I am surprised that most people don’t know that, worldwide, roughly 70% of babies are born into the hands of midwives; they don’t know that in the US the numbers are growing, almost 10%, up from 3% ten years ago. I’m surprised when they don’t know that midwives are legal in all 50 states and that most practice in the hospital in collaboration with physicians. I'm surprised that they don't realize that there are two kinds of midwives: the nurse-midwife is an advanced practice provider, usually with a
Masters degree, who can do deliveries in the hospital, a birthing center or at home, prescribe medication, and is also trained to do gynecology. The direct entry midwife trains by apprenticeship and delivers, usually at home. I was both kinds.
Thanks to Nan Hunter for alerting me to the proposed regulations implementing my favorite family leave policy: the one that allows federal government employees to use their sick leave to care for "any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship." I've had numerous posts on this topic on my Beyond Straight and Gay Marriage blog . I love the current policy because it allows employees to define their own family members. Whenever advocates for marriage equality cite the unfairness of preventing one partner from caring for another who is ill, I always respond by arguing that the solution to that problem isn't marriage -- it's an employee leave policy like the federal government's! Such a policy encompasses same-sex couples but also ensures that unpartnered LGBT individuals, who may be estranged from or live far from their families of origin, can receive care from the people they consider members of their families of choice.
The proposed new regulations make clear that "domestic partners" are included. Appropriately, the definition of domestic partners requires commitment and some shared responsibility for each other's "common welfare and financial obligations," but it does not require living together. It also encompasses different sex couples. No couple must marry, or register with the state as domestic partners, or enter a civil union, to qualify for the leave. The proposed regs also make explicit that the child of a domestic partner is in the category of children one may use sick leave to care for, but, again, such children were always covered because the standard has always included (and continues to) all children to whom the employee stands "in loco parentis" (in other words, functions as a parent).