Monday, August 30, 2004

So Where Have I Been?

Originally, I wasn't sure that I would post about this, but Moe Lane says that I'd be a jerk not to. And besides, it's the first day of the Republican National Convention, and I'd like to post something life-affirming. So:

It turns out that there actually is something in this world that's more obsessively all-consuming than politics - gestation. Baby otter formation has been taking up most of the time that I used to spend reading blogs, writing posts, and generally fulminating about the Bush Administration. I don't expect it to be a permanent, or even nine-months-long, condition - eventually, I am told, I'll stop wanting to sleep 22 hours a day and being nauseated by scrolling text during the other two hours. But in the meantime, I'm a little preoccupied.

Because I can't turn my political mind off completely, I've been piecing together the ways in which the the pregnancy industry lays the groundwork for a lifetime of double-bind guilt for women. Pregnant women are assigned infinite responsibility for the protection of their fetuses - without, I can't help noticing, actually having much real control.

"The first trimester is the most important part of your pregnancy, because all your baby's major body parts and organs are formed during this time." So begins the endless list of all the things you aren't supposed to do during pregnancy, from taking a hot bath to eating a ham sandwich. (There's an equally extensive and detailed list of things you are required to do. Very few things are optional.) Your responsibilities seem clear. And yet, 20-30% of pregnancies miscarry during that "most important" first trimester - and 99% of those miscarriages have nothing to do with the list of required or forbidden activities. You can, quite literally, spend every waking moment chasing after an ideal of perfect pregnancy behavior, but it won't make a damned bit of difference to whether your baby dies before you've even heard a heartbeat. Responsibility without control.

"Every time you pick up your fork, ask yourself, 'is this the best bite I could possibly give my baby?' " directs the most popular American pregnancy guidebook. White sugar is sternly forbidden for the duration of pregnancy, with dire consequences threatened for the health of your baby. And yet the same book approaches prenatal exposure to environmental toxins from a reasoned perspective that considers dose and duration of exposure, timing, proximity, et cetera. You're left with the vague impression that a Krispy Kreme doughnut will do more damage to your baby than the paint factory up the road. Why? Probably because, from the perspective of the pregnancy industry, the only important risk factors are the ones that are the pregnant woman's sole responsibility.

Bypassing the traditional medical model for the crunchy-granola model of childbirth merely trades one set of rigid behavioral expectations for another, I find as I guiltily grab a packaged yogurt smoothie from the fridge instead of spending twenty minutes making a homemade organic one in my blender. Plus, in the crunchy-granola model you get assigned a new enemy: the obstetrician, who is out to Ruin Your Birth Experience unless you prevent him via constant hawklike vigilance. I've seen women wracked with ongoing guilt and anger because their baby was briefly removed for medical treatment in the moments after birth, an experience thought to be emotionally scarring. Once again, the crushing weight of responsibility without, in fact, very much control at all.

You'd almost think it was a plot to keep women scared and guilty and focused on their own imperfections, instead of angry and political. But of course it's more likely to be the same old story: fear sells.

Can I recognize the ridiculousness of all these expectations? Mostly. It's harder than you'd think to throw them off completely, with a constant onslaught of pregnancy hormones predisposing me to heightened emotionality. But yes, for the most part I am blissfully happy. It's just that falling back into otter mode gets the suspicious, analytical part of my mind working at top speed. (That's probably a good thing, at least in moderation.)

Thursday, August 19, 2004

Tuesday, August 17, 2004

Bush On The Campaign Trail

Dan Froomkin reports on the campaign style of the most managed President in history:
Instead of taking questions from reporters, President Bush has become increasingly partial to playing talk-show host to an audience of sycophantic fans.

There were four "Ask President Bush" events last week and in each case, after a long speech and staged interviews with prepped guests, Bush opened the floor to some incredible softballs.

The format allows the president to come off as very smooth.
...which, of course, is quite the accomplishment. But, as Froomkin makes clear, the audience "questions" go well beyond softball level to outright character assassination of John Kerry - without the Bush campaign having to get their own fingers dirty:
"Q On behalf of Vietnam veterans -- and I served six tours over there -- we do support the President. I only have one concern, and that's on the Purple Heart, and that is, is that there are over 200,000 Vietnam vets that died from Agent Orange and were never -- no Purple Heart has ever been awarded to a Vietnam veteran because of Agent Orange because it's never been changed in the regulations. Yet, we've got a candidate for President out here with two self-inflicted scratches, and I take that as an insult. (Applause.)

"THE PRESIDENT: Well, I appreciate that. Thank you. Thank you for your service. Six tours? Whew. That's a lot of tours.

"Let's see, who've we got here? You got a question?"
Froomkin's thesis is that the press corps is getting tired of this kind of theater, but I'm less optimistic. Fox News will always have an endless appetite for pro-Bush quasi-news clips, and in the echo chamber of right-wing punditry, admiration of Bush's natural touch with the voters - and voters' overwhelming distaste for Kerry - will flourish undisturbed. Even in the mainstream news, the propaganda events seem to be working well enough. Froomkin himself links to this Valentine of a Washington Post article by John F. Harris, which speaks admiringly about Bush's smooth speaking style and demeanor:
In loosening his style, Bush tightened his message. Fielding friendly questions at "Ask President Bush" forums, or lathering up the crowds at pep rallies like the one here on Saturday afternoon, he presented his case for reelection with a force and fluency that sometimes eluded him at important moments over the past year.
Harris also writes that, despite polling data suggesting that the Bush campaign is embattled, in fact he is "drawing appreciative crowds" - without bothering to mention just why the crowds attending Bush rallies are so uniformly enthusiastic. Even the Froomkin piece notes that Bush events have been successful in eliminating "hecklers," instead of making it clear that Bush events have barred everyone but true believers.

Saturday, August 14, 2004

CDC HIV Prevention Regulations: Reprise

Recently, Doug Ireland's April scare piece about new CDC regulations for HIV prevention activity has been given new life in the blogosphere. In the last couple weeks, I've seen the article quoted all over LiveJournal, as well as in favorite blogs of mine, such as Echidne of the Snakes. People have also started e-mailing it to me again with requests for comment.

I don't normally reprint my own stuff, but given the increased circulation of the Ireland piece, I'd like to repost a link to my analysis of the proposed new CDC regulations. In summary: I think that Ireland's piece is an alarmist and misleading distortion of what the regulations actually say, and I don't think that the proposed changes will have a negative impact on HIV prevention activities. The new regulations certainly do not restrict future HIV prevention efforts to "abstinence only" models. If you're still concerned, follow the link for my detailed analysis.

Friday, August 13, 2004

What God Hath Joined Together

Marriage is a term with legal meaning, but that's not all that it is.

Marriage is the binding of persons by sacred oaths.

Marriage shelters parents and children together in stable families.

Marriage is the means by which communities recognize relationships as legitimate, and pledge to support them.

Marriage is a declaration that two people strive for permanency of their relationship, for better or for worse, for richer or for poorer, in sickness and in health.

As I said last February: come what may, these people are married. Look at them, look at their faces. The California Supreme Court may have annulled their legal certificates, but their marriages abide. The long fight is still before them, still before us, but their marriages abide.

What God hath joined together, let no man put asunder. Some things can't be taken away.

Thursday, August 12, 2004

At Last I Have Arrived

Every little girl growing up in America dreams of this moment.

Compassionate Conservatism In The ER

Via Body and Soul, I discover that the Bush Administration's conservatism just keeps getting more and more compassionate.

Hospitals are required to treat anyone who shows up in the Emergency Room with a bona fide medical emergency, regardless of that person's ability to pay. If the person can't afford to pay anything, or can't be billed because they have no legal address, the hospital is required to absorb the cost. For hospitals in border states, a disproportionate number of these indigent ER patients are illegal immigrants. These hospitals have been arguing for years that illegal immigration is the government's problem, and that the government should reimburse them for the costs of emergency care given to undocumented patients.

Last year, they managed to convince Congress to set aside some money for it, and all seemed well. But now the Bush Administration has declared that, in order to be reimbursed, hospitals must ask all uninsured emergency patients about their immigration status, including placing photocopies of immigration documents in the medical record. They won't be required to turn the records over to the government unless they are audited, but the INS and local law enforcement officials will presumably be able to access them - as they can access the rest of the medical record - via subpoena.

This policy will obviously have the effect of keeping illegal immigrants out of the ER - and probably many legal immigrants, as well. Parents who are undocumented will hesitate to bring their U.S.-citizen children to the ER, for fear that the parents' immigration status will be questioned. Legal immigrants whose papers aren't at hand, or aren't perfectly in order, will be afraid of being misidentified as illegal. No one will trust that the hospital won't notify the INS.

People won't get the emergency health care they need.

Hospitals want to use common-sense methods of identifying cases eligible for reimbursement - for example, counting all indigent patients who give invalid Social Security numbers. The Bush Administration argues that "hospitals could ask the questions in 'an unobtrusive way' that would not discourage immigrants from seeking care." As if there's an unobtrusive, casual way to ask questions like:
Are you a United States citizen?

Are you a lawful permanent resident, an alien with a valid current employment authorization card or other qualified alien?

Are you in the United States on a nonimmigrant visa of the type issued to students, tourists and business travelers?

Are you a foreign citizen who has been admitted to the United States with a 72-hour border crossing card?
One of two things will happen under this new policy. Hospitals with a serious dedication to making emergency care accessible will refuse to ask immigration questions, foregoing reimbursement. Hospitals too financially strapped to forego reimbursement, or too focused on the bottom line to care, will be avoided by anyone whose immigration status is undocumented or ambiguous. More of those people will wind up seeking medical attention from unlicensed traditional healers, or going without care altogether. But here's what won't happen: large numbers of illegal immigrants declaring their status at the ER and receiving treatment for which the hospital is reimbursed.

Once again, the Bush Administration will have it both ways: they'll get a PR boost from a policy which seems humane and compassionate, and yet they won't actually have to pay for the provision of costly services.

Why should we care? If "human kindness" isn't a sufficient answer, then we should care for reasons of public health. You don't want someone with untreated Hepatitis A in the restaurant kitchen, making your salad. You don't want a child with ringworm or an untreated infection playing with your child on the playground. You don't want there to be a population in your city which is undervaccinated, living under poor sanitary conditions, and without prompt access to health care. That's how epidemics start.

Monday, August 02, 2004

Terror In The Skies!!! Australian Style

Lots of people defended Annie Jacobsen's bizarre episode of anti-Arab paranoia by pointing out that the plane's crew was apparently concerned as well. Jacobsen has cited support from multiple airline employees who have written in to tell her that Arab terrorists are constantly probing airline security and conducting "dry runs" of attacks. Surely these reports are trustworthy. Surely air travel professionals would have calm and reasoned responses to innocuous, terror-free in-flight events.

Surely not.
Ninety minutes after taking off from Sydney Airport, a flight attendant on a United Airlines flight bound for Los Angeles found an airsickness bag - presumably unused - in a lavatory with the letters "BOB" written on it.

The flight attendant decided that the letters stood for "Bomb On Board" and immediately alerted the captain, who decided the risk was serious enough to turn the plane around and land back in Sydney. [...]

Why in the world would someone decide that out of all the possible meanings that "BOB" scribbled on an airsickness bag could have, its presence on this particular airsickness bag on this particular flight must mean "Bomb On Board"?