Category: Family and Friends

California/Campaigns/compassion and choices/Death and Dying/Dying Unafraid/End-of-Life/Healthcare/Law/Lifestyle/physicians/Politics & Causes/Religion/seniors
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Arguing With the Doctor – A plea for end-of-life choice

by Fran Johns

Dandelion

Does the doctor always know best? And in the case of one’s own precious life and death, is it wise to argue the point?

“No One Here Gets Out Alive” – a quote from Jim Morrison – led the title of a lively (pun intended) debate about aid in dying held recently at San Francisco’s Exploratorium. Part of a series on the intersection of science and politics, the event’s full title was “No One Here Gets Out Alive”: The Science, Politics and Law of Death and Dying. The program sought to address a few issues not easily covered in two hours – but still – including (reprinted verbatim):

Is there a constitutional right to “physician-assisted suicide”? What about a “dignified death” – and what is a dignified death? Should terminally ill patients facing mental incapacitation or unbearable pain have access to fatal ingestion – also known as physician aid in dying? Or would that jeopardize our society’s progress toward more compassionate, comfort-based care?

Participants included John M. Luce, Emeritus Professor of Clinical Medicine and Anesthesia at the University of California San Francisco; Laura Petrillo, MD, a Hospice and Palliative Medicine fellow at UCSF; and program host David L. Faigman, Professor of Law at UC Hastings College of the Law and Director of the UCSF/UC Hastings Consortium on Law, Science and Health Policy.

The program kicked off with a discussion of the science of death itself – defining death being more and more problematic these days. Think Nancy Cruzan, kept alive through a feeding tube in a “Persistent Vegetative State” for nearly a decade until her family managed to convince the State of Missouri that she would never have wanted to be “kept alive.” Or Terri Schiavo, whose PVS ordeal lasted even longer. More recent is the tragic story of 13-year-old Jahi McMath, declared brain-dead by multiple physicians more than a year ago but whose body is still existing somewhere, connected to machines that keep her heart beating.

Those cases are just a few of the markers on the path toward today’s critically important death with dignity movement. This writer’s involvement in the cause began with work as a hospice volunteer in the 1980s, a member of an HIV support group in the ’90s and a volunteer with Compassion & Choices (and its predecessor organization Compassion in Dying) since the late 1990s. C&C is currently leading the fight to make aid in dying legal throughout the U.S., having won significant battles – five states now protect that right for terminally ill, mentally competent adults – with others underway in many areas.

And that issue – should medical aid in dying be legalized in California (and elsewhere) – was the heart of the two-hour program. Of the two physicians, Luce was eloquently in favor, and Petrillo was adamantly opposed. In this writer’s admittedly biased view, Luce’s lifetime of experience as a distinguished physician and professor rather embarrassingly outweighed Petrillo’s credentials, but it is possible to see her emerging-palliative-care-physician status as basis for her absolute certainty that everyone on the planet can experience graceful, pain-free death if only he or she has access to palliative care.

I am less certain. Thus my argument.

In the Q&A period, I posed this question to Petrillo: “If you were my doctor, which is unlikely, and I were dying, which is increasingly likely (I’m 81, for heaven’s sake,) and I have expressly, repeatedly made clear that I do not wish to linger – why should you have the right to insist that I linger?”

Petrillo dodged the question. “I would ask what is causing your pain,” she said. “I would try to determine if you are depressed, and talk about how we can alleviate your pain and possible depression…”

After several abortive attempts to get a response to my question, and figuring the audience had not paid good money to listen to me rant, I gave up. But here are the arguments I had for Dr. Petrillo, questions I wish the minority of physicians who do still oppose aid in dying would answer:

Why should you have the right to insist that I linger, when I am dying?

How can you presume to understand my pain better than I? And why should I have to describe it if I don’t choose to do so?

When I have watched dying people with the very best care and pain control suffer in ways I would not choose to suffer, how can you insist on my going that route?

Why should your conviction about the efficacy of your medical field trump my autonomy?

Dr. Petrillo said she is not religious, so this question would be addressed to others: Why should your religion overrule my religion? Or dictate to me?

It’s my only precious life, after all. Why should I be denied control of its precious end?

 

 

 

California/General interest/Lifestyle/San Francisco/seniors/Sports
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When Fences Come Down

by Fran Johns

Fence.Mtn Lake

“Something there is that doesn’t love a wall,” wrote Robert Frost, and I think he was onto a larger truth. Of course, Frost – in his “Mending Wall” – was talking about rocks and neighbors, and the poem leaves us with ambivalence about the goodness of fences.

Fences and walls may, at times, make good neighbors – but the big ones tend to be symbols of enmity (think Berlin, Israel, Arizona…) and we just want them down.

A few months ago a high, dark fence went up around lovely Mountain Lake, in the San Francisco park that is one of my favorite spots on the planet. It’s a city park, but the lake (fortunately for us all) is part of the Presidio National Park and has been undergoing an extraordinary restoration for the past few years. It may not yet be back to the purity that made its water just fine for Spanish settlers (and probably the Ohlone and Coast Miwok indigenous people before them) to drink, but years of accumulated glunk, trash and sludge have been hauled away and the lake’s return to life has been a rare joy to watch.

The problem? Although the waters began to clear and native greenery emerged, a proliferation of non-native fish were quashing any hope of bringing back the fish who once belonged. We’re not talking just a couple of ordinary intruders. It was possible to stand on the beach near the murky water’s edge and watch goldfish the size of ahi tuna swimming casually back and forth. With native fish and turtles long displaced by casually dumped household pets, the lake was overrun with carp, bullfrogs – somebody reported a sturgeon – and who knows what else. This writer remembers the brief residence of an alligator, who famously evaded a gator hunter imported from Florida but was eventually removed to the local zoo.

Presidio Trust personnel tried snagging, netting and every known removal method before conceding that the only solution would be to poison the lake. They chose plant-based Rotenone, which kills everything with gills (and happily not much without) and disappears within three days. Thus the fence went up – presumably it was still not a good idea for gill-free people to be wandering near the water. Almost the moment the solution was poured into the four-acre lake, the alien fish died. They were scooped up by the thousands to be studied by ecologists (who reluctantly went along with the project) to determine their origin and soon composted as a final act of goodness. But the fence, for assorted reasons, did not come down.

Sign.Mtn Lake

And over the long weeks that followed it was as if the park itself was inhabited by an alien being. Children still played on the adjacent swings and slides, dog walkers still tossed tennis balls, this writer still exercised on the bars of the fitness trail – but the now-sparkling lake was hidden behind its foreboding shield. Even when the gulls could be heard returning beyond the black screen, and actually seen if you peered through the mesh, the park felt bifurcated and somehow forlorn. Thanksgiving came and went, Christmas was less merry, the New Year not yet happy.

A few days ago, the fence came down. Mountain Lake, the shimmering heart of Mountain Lake Park reappeared, putting on a show of new life. A few familiar ducks may never have left; now they have been joined by coots and grebes and a spiffy ruddy duck who is apparently courting two slightly less flashy lady ruddy ducks. Western pond turtles, chorus frogs and native fish will begin to return in the spring.

Lake.Mtn Lake

The metaphors are abundant: fences come down, sunlight spreads from reflected waters, varied creatures happily coexist, romance blooms.

 

Where is Robert Frost when we need him?

 

 

 

 

Abortion/compassion and choices/Death and Dying/End-of-Life/friendships/Holidays/Lifestyle/Religion/Reproductive rights/Women
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Saying Goodbye, and Hello to 2015

by Fran Johns

sunrise

My friend M has died, just shy of the old year’s end and significantly decreasing the joy of the new. But her dying was full of life lessons about saying goodbye, being grateful and trying to ring in a better planet for the days ahead. And thus she leaves a gracious greeting for 2015.

M was a believer in good causes, and she put her substantial time and energies to work for them all. We became friends over our mutual love of writing but we bonded over our mutual commitment to end-of-life choice. Once you concede that you won’t live forever, a reality most prefer to ignore, it is possible to live both gently and joyfully even in tough times. Both of us spent long years encouraging anyone who would listen to confront mortality, make choices, and make personal decisions known to all. It’s called living fully, even into dying.

So M, after conceding her own days on the planet were dwindling, sat down over a cup of soup I’d brought her not long ago and we went about the business of saying goodbye. I told her why I thought she was such a wonder, and she told me all the things I’d be happy to have said for my own eulogy. OK, we had an extravagant mutual admiration society. But the life lesson is that telling others about their own gifts and good qualities (however hard it might occasionally be to uncover them) is something anyone can do, any time; the planet would be immeasurably better if more of us did it more often.

M was supportive of my activism for reproductive justice, having done more than a little of that herself in years past, but once she expressed reservations about how much time I was investing in that cause. “It’s time for young people, young women, to take that on,” she said. Well, yes. Another 2015 greeting for that demographic: reproductive rights are disappearing at an alarming rate. Unless more of us of whatever gender or age pitch in, women – particularly women without money or power – will soon be back in the pre-Roe dark ages, with no control over their own bodies. Which could make for a very unhappy new year for uncounted thousands of women.

The daughter of a rabbi, M was aggressively non-religious. We didn’t waste a lot of time on the subject, though she applauded the idea of my Presbyterian church working to break cycles of poverty. But once, after some sort of “What Would Jesus Do?”-type remark I made she said, “Oh, you and Anne Lamott.” I am personally fine with being lumped in with my funny, gifted friend Lamott, but this was not meant as a compliment. It did lead to a brief, lively discussion about faith and practice. And wouldn’t 2015 be a happy new year if fewer wars were fought in the name of Allah (or Whomever) and more focus were put on the peace, justice and love for fellow creatures that is the basic message of every religion around.

Rest in peace Maya Angelou, Robin Williams, James Brady, Pete Seeger – and all those other good souls we lost in 2014. Most especially, M.

And Happy New Year to us all.

California/Family and Friends/Health/Healthcare/Medicine/physicians/Politics & Causes/San Francisco
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Immigration Then and Now: Three families, three stories

by Fran Johns

PRELUDE: A contemporary story –

Maluki had what she thought was a minor infection in her chest. She took a couple of pain relief tablets. She is undocumented and uninsured. She had no access to a community clinic where she might have seen a doctor with no questions asked; no one in her suburban family had heard that such things exist. Within a few weeks Maluki was doubled over with pain and was rushed by a neighbor to an emergency room at a major public hospital two hours away.

Two surgeries later the 38-year-old mother of three will be out of work for a very long time. Her husband, partly disabled, works irregular hours when he can, leaving the family dependent on what money the teenaged children – all U.S. citizens – can bring in. The children still hope somehow to finish high school and attend college.

What’s wrong with this picture?

Almost everything, if you asked the five California experts on a recent Commonwealth Club panel in San Francisco. “Undocumented and Uninsured” brought together two heads of clinics where treatment is available to all and two others with unique insight and perspectives. Moderated by Daniel Weintraub, Editor in Chief and Project Director, California Health Report, the panel included John Gressman, President and CEO, San Francisco Community Clinic Consortium and Scott Hauge, President of CAL Insurance & Associates Inc and Co-Founder and Vice Chairman, Clinic by the Bay; Laurel Lucia, Associate Policy Specialist, UC Berkeley Center for Labor Research and Education; and Jirayut New Latthivongskorn, Co-Founder of Pre-Health Dreamers. They were looking at how the Affordable Care Act will impact immigrants unable to get health insurance, and what the healthcare future might hold for them.

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There are, by one estimate, 11.7 million undocumented immigrants in the U.S. Some have health coverage through their jobs, and a few have private coverage; but the vast majority of these are uninsured. The resulting costs, in human terms such as the case above, are inestimable; the costs in dollars are also significant. “If we get the patient into basic care for colds and flu,” said Gressman, “we save thousands in hospital care.” In California, care is widely available through publicly funded community clinics as well as nonprofits – the problem is in getting the word out and building trust. “We look at how to get the patient to care,” Hauge said, “not at anyone’s immigration status.”

While Gressman, Hauge and Lucia each brought extensive understanding of both the policy and the real-world details affecting healthcare needs of undocumented immigrants, it is the personal stories of Lucia and Latthivongskorn that illuminate the remarkable richness of our immigrant nation.

Nearly a century before she was invited to bring her expert knowledge to a Commonwealth Club panel, Laurel Lucia’s great-grandfather was a frequent speaker at the Commonwealth Club himself. Felipe N. Puente was memorialized in the Club’s Journal upon his death in January, 1951. He was, his obituary reads, “by far the most important personal tie between Northern Californians and the Republic of Mexico for nearly a quarter of a century.

“Commencing as a colorful revolutionary Mexican leader in 1917 (as Jefe de Transportacion for the late Revolutionary General Francisco Villa), he had for 25 years been a resident of San Francisco, with five children in our public schools, and the long-time Manager of the Mexican National Railways, San Francisco division, in the Monadnock Building.

“Although a railroadman by profession, his expert and sagacious advice was freely at the service of American travelers by sea, highway or air, and a letter from ‘el Puente de San Francisco’ (the San Francisco Bridge) as he was affectionately known clear down to the border of Guatemala, opened all doors in Mexico.” Great-grandfather Puente’s expertise reached beyond transportation to government affairs. In a Commonwealth Club speech broadcast over KYA Radio in 1942 he spoke of the importance of Mexican-American cooperation in the war efforts, citing cargo lanes and Mexican ores that were critical to the U.S. and quoting President Avila Camacho as saying, “Mexican soldiers are willing to shed their blood anywhere in the world where they may be needed.” His Journal obituary began and ended, “Adios, Amigo Felipe N.Puente!”

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Lucia missed out on knowing her notable ancestor, “but I was quite close to his daughter, my grandmother.” She had not, she says, ever made any connection between his immigrant status and her current work – as a Policy Analyst for the UC Berkeley Labor Center – which partly seeks to strengthen the safety net for those more recently arriving on our shores.

 

Laurel Lucia with Moderator Weintraub

As for the other young person on the “Undocumented and Uninsured” panel, Jiryat New Latthivongskorn (hereafter identified by his familiar name, New) confesses to having been a little startled to hear himself constantly referred to during the evening as “the first undocumented student to be admitted to UCSF (the University of California San Francisco) Medical School.” But that is, in fact, part of his current resume, and a not insignificant achievement.

There were 7,453 applicants to UCSF Medical School for New’s class, out of which pool 490 were interviewed and 149 were accepted. The overall grade point average was 3.77.

New Latthivongskorn came to this country with his parents when he was 9 years old. His parents worked in Thai restaurants every night until 11:00. But whenever he tried to help, he said in an interview on KQED Radio last May, “the answer never changed. ‘Don’t worry, and do your job.’ My job was to get an education.” So far, he appears to have done his job quite well. New never considered the idea of being a doctor until one scary incident during his junior year in high school when his mother fell gravely ill and had to be taken to the emergency room. The family had, until that time, relied on a medicine cabinet full of remedies for colds and pain and a few old antibiotics from Thailand. But in the ER, when his mother couldn’t understand the doctors and they couldn’t understand her, New realized his job might be more than just a translator.

There are those, including a few who commented on the KQED program, who argue that anyone who is in this country illegally should simply be sent back to wherever he or she came from and until then should receive no benefits – and certainly no healthcare. That may, however, be an overly simplistic – not to mention cruel and unusual – answer to a very complex issue.

“Immigrants don’t come here,” New told the Commonwealth Club audience, “for free healthcare. They come here to escape danger or terrible conditions; they come here to work.” In short, to create a better life for themselves and their families, and ultimately to give back to the communities of their new world. That was definitely true for immigrant Puente a century ago, and is demonstrated by the hard-working parents of doctor-to-be New.

Other than the Native Americans who pre-date most of us, it would be hard to find many U.S. citizens whose ancestors didn’t have similar stories.

 

 

Death and Dying/Dying Unafraid/End-of-Life/geriatrics/seniors
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Danger Zone in End-of-Life Talk

by Fran Johns

carved ice dove

A suicide pill for everyone over 85? Not the wisest plan to suggest right now. But it is, in fact, a possibility put forth by Joyce Appleby, Professor Emerita of History at the University of California, Los Angeles.

In a letter published in the New York Times on November 13, Appleby notes a recent anti-longevity article by Ezekiel Emmanuel and a new book on end-of-life care by Atul Gawande (both physicians,) and says,

“Perhaps the moment is right for broaching the idea of what we might call prophylactic suicide: the decision of an elderly person to pre-empt the grim reaper and avoid the disabilities of extended life.”

Appleby goes on to note that organizations such as Compassion & Choices, with which this writer has worked closely for well over a decade, “are campaigning for dignified terminations of life for those with incurable diseases” but writes, “What I propose goes a step further, extending the right to people before they face terminal or debilitating illnesses.”

Not surprisingly, Appleby’s letter – one of The Times’ regular “Invitations to Dialog” – drew more than 300 responses. Nine were selected to appear either in print or online; this writer’s is among those online and is as follows:

“I strongly support the right of a terminally ill, mentally competent adult to choose aid-in-dying, now legal in five states, but Ms. Appleby does a disservice to the cause by suggesting “a step further” — prophylactic suicide. The latter bears no relation to the former.

“We would be far better served to fight unwanted medical treatment, so often futile and excruciatingly painful at the end of life, and to enforce individual advance directives. My own directives (I’m 81) stipulate that no medication other than pain relief be given should I become unable to speak for myself, and stress that I do not wish to be fed if unable to feed myself. More important, all of my children and close friends understand these wishes because we’ve had the conversation.

“Let’s work toward those sane measures, and leave “suicide” out of it.”

Because the Death With Dignity movement is so important, and informed dialog about it so critical, it is both tragic and dangerous to have misinformation and misperception spread. There’s been enough of both over the decade+ in which the movement has slowly gained strength. To set the record straight:

Death With Dignity – the right of a terminally ill, mentally competent adult to ask a physician for aid in dying – is now legal in five states (Appleby left out New Mexico) and the movement is fast gaining ground in half a dozen others. This is partly because people increasingly understand that Death With Dignity is not suicide – and is certainly no kin to “euthanasia,” as Emmanuel would have us believe. Under Death With Dignity laws, death comes because of a disease. Every death certificate for those who have considered or used DWD laws lists the cause of death as the disease; it is not caused by suicide. Euthanasia would never be allowed under DWD laws.

But the movement is also gaining strength because it has been carefully thought out and tested. Because it is rational and safe. DWD laws are designed to promote individual autonomy, and incorporate safeguards against abuse.

Much of the opposition (as evidenced in several of the letters in The Times) comes from misunderstandings which are advanced by Emmanuel’s and others’ misuse of the word “suicide” and by fears that the elderly will be encouraged to get out of the way as Appleby’s notion suggests. Both writers muddy the waters and undermine an important cause.

Death With Dignity is a safety zone. Irresponsible words throw it into a danger zone.

 

Environment/Family and Friends/Health/Politics & Causes/World Affairs
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Bold Hope for the World’s Poor

by Fran Johns

Map_of_the_world_1998

A Solution to Poverty?

If governments can’t solve world poverty, and nonprofits can’t make serious dents in it… can the private sector be the answer? With the help of you and me and major investors?

Mal Warwick thinks so. Warwick, co-author, with Paul Polak, of The Business Solution to Poverty, spoke recently at the Commonwealth Club in San Francisco about their conviction that the long-term solution to the ongoing tragedy of global poverty lies in coming up with answers that will pay off. Not just to suffering individuals, by helping lift them out of poverty, but to investors by turning a profit.

Warwick’s audience included a variety of interested individuals familiar with much of the work already being doing by nonprofits whose funders tend to seek reward through humanitarian success rather than financial return. But major infusions of capital, Warwick maintains, will be needed to continue building the ladders people everywhere will need to climb out of poverty’s depths, and that will require – business solutions.

As a shining example, Warwick cited the treadle pump. It is a human-powered device, inexpensive to manufacture and simple to use, which enables farmers to multiply the yield of their land and thus, in many cases, raise themselves and their families out of poverty. It works as a business solution on a number of levels. Factories needed to manufacture the pump were set up in villages, providing employment for people there, village shops distributed them, workers were employed to drill the wells and financial institutions made loans for purchases.

The problem, Warwick says, was with marketing – radio, TV, newspapers and traditional advertising methods weren’t available. The solution? Roaming troubadors and a Bollywood movie.

Among the facts Warwick brought to light were: One billion people lack access to electricity. One billion people lack access to safe water. One billion farms are without irrigation. The 20 million people lifted out of poverty between 1981 and 2006 by international aid programs, Warwick says, are only a drop in the bucket to the numbers who continue to suffer.

“It’s possible,” Warwick says, “to create brave new companies” with the lure of “reaching at least 100 million $2/day customers.” Some of those companies already at work include Australia’s SunWater which is developing a variety of safe-water solutions, several businesses working toward turning organic waste into affordable charcoal briquettes, and SpringHealth, which is addressing the problem of contaminated drinking water.

If governments and nonprofits can’t solve global poverty, can businesses? It might take all of the above – plus you and me, ordinary citizens.

Feminist Collection/Health/Lifestyle/seniors/Women
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WHI: Strengthening Women’s Health

by Fran Johns

WHICould the health and wellbeing of a few million women be improved, and a few billion dollars saved in the process? A very big dream.

When the Women’s Health Initiative was established more than 20 years ago, no one was talking in grandiose terms and few would have anticipated the wide-ranging health benefits (and huge cost savings) that would result in the decades ahead. Many of us were simply saying, “Imagine this. At last we’re studying women to find answers about women’s health issues.”

This writer was proud and happy to enlist in the first WHI study. I joined more than 100,000 other postmenopausal women volunteering to fill out forms, have blood drawn and answer questions over the next 15 years. That initial focus was on tracking the effects of hormone therapy, dietary patterns and/or calcium/vitamin D supplements on prevention of heart disease, cancer and osteoporotic fractures. I had not yet had breast cancer – that would come about 10 years into the study; a family history of osteoporosis added to my personal interest in WHI. Over the years I volunteered to participate in some of the wide-ranging ancillary studies looking at other health-related things like physical activities, lifestyle, tobacco and dozens of peripheral issues. (My personal favorite question appeared on one of the multi-page annual update forms. It read – Yes or No – “When you enter a room full of other people, do you have the feeling they are talking about you?” There may someday be a report on women and paranoia.)

Mysterious questions aside, WHI is serious business. Here, excerpted from the latest Extension Study newsletter are a few facts about what has been learned from the historic initiative, and a little of what is still ahead.

Those hormones millions of postmenopausal women were taking, widely thought to be miracle answers? Studies showed the risks far outweighed the benefits, and millions stopped taking them. Hormones in different combinations had been commonly taken to minimize chances of cardiovascular disease, cancers, fractures, diabetes, gall bladder disease and a variety of quality-of-life measures; quitting the hormones proved a better choice. Health benefits can’t be precisely measured, but the reduction in hormone use has led to a decrease in rates of breast cancer and cardiovascular disease.

And in dollars and cents? Some $37.1 billion, (in 2012 when all costs and quality-adjusted years of life are considered, has been the total economic return of the WHI trial.

By June, 2014, over 1000 papers based on WHI data had been published in scientific journals. What’s ahead? Researchers are looking at pet ownership and risk of cardiovascular disease; physical activity during childhood and risk of Alzheimer’s disease; breast cancer distribution by rural/urban areas and geographic differences in cognitive decline/dementia.

Every year on their birthday, WHI study participants receive a card – some of us call it the “Hooray, you’re still alive” card. For women everywhere, it represents something worth more than gold.

Abortion/Family and Friends/Feminist Collection/Reproductive rights/Women
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Abortion, Four centuries later…

by Fran Johns

Suffragette-that-knew-jiujitsu

Was the abortion debate really going on four hundred+ years ago? Indeed. And who knew?

As it turns out, Donald Foster knew. Foster, Jean Webster Chair Professor of English at Vassar College, knows a lot about an astonishing range of things – Jon Benet Ramsey’s possible murderer, the “Anonymous” author of Primary Colors (Joe Klein), Unabomber Ted Kacynzki, Shakespeare – and women’s medicine in the sixteenth century. The first three of those instances of Foster’s endeavors – he provided expert help on all three cases – explain his sometime ID as a “forensic linguist;” the fourth relates to his day job. His day job also covers almost all things literary.

This writer’s esteem for the distinguished professor is of course unrelated to the email he sent which began, and I quote, “Let’s hear three cheers and see three billion readers for Perilous Times.” Well, maybe just a teeny bit. But an opportunity to reinforce the argument for women’s reproductive rights with the scholarly writings of a Vassar professor is not to be ignored.

This essay, henceforth, is shamelessly lifted from an attachment to the above email, excerpted from Volume 2 (pp.355-360) of Foster’s four-volume Women’s Works, a study of the issue covering the years from 900 to 1650.

Abortion, which was decidedly a part of women’s works, was also part of the debate all those centuries ago, beginning (if not earlier) with the “herb-wives – women who supplied the herbs and spices used for health care.” Women not only nursed those who were ill, we learn from Foster’s extensively documented studies, “they supplied much of the medicine, or physic.” They passed along their knowledge and skills from generation to generation, and were appreciated more by some than by others. Foster quotes Robert Green’s Quip for an Upstart Courtier in which a poor man mocks a wealthy lord: “I make my wife my doctor, and my garden, my apot’ecary shop – whereas Master Velvet-Breeches cannot have a fart awry, but he must have his purgations, pills and clysters, or evacuate by electuaries…” (It gets worse, but you’ll have to read the book.)

Getting to the specifics, Foster tells us “It will come as a surprise to some modern readers that there was enormous demand, throughout the medieval, Tudor and Stuart periods, for abortifacient herbs, with many effective recipes and a plentiful supply.” As reported in John Gerard’s Herbal (1597), a handful of herbs seemed to have taken care of the conception needs of barren women, whereas there were “more than sixty herbs used to induce menstruation after one or two missed periods. Not all of the treatments that he names were reliably effective, and some were dangerous, bringing a risk of hemorrhage and death if taken in too strong a dosage.”

Does this sound familiar? If not, we respectfully refer you to the stories in Perilous Times: an inside look at abortion before – and after – Roe v Wade, of women in 20th — and 21st – century America who, denied access to safe procedures, wind up dying in back alleys or emergency rooms. The abortifacients have, sometimes, fancier names in the case of contemporary drugs, but taken without proper advice or supervision can leave women with unwanted pregnancies today just as dead as their sisters in Tudor England.

In the same Volume 2 of Women’s Works, Foster offers an historical perspective of the root of the abortion debate, which seems unchanged over the centuries: do rights of the fetus prevail over those of the woman, and whose theology says what? “For the first seventeen centuries of Christianity,” he writes, “no authority of record, either Catholic or Protestant, taught or suggested that the fetus during the first two or three months after insemination was a human being. Ensoulment or quickening was an act of God: in His own good time – typically, in the third or fourth month – God infused the dormant seed with a human soul, created ex nihilo.” About the ensoulment business, Foster adds, “it was deemed an essential point of Christian ontology that the individual life was created by an act of the Almighty in Heaven and not by a horizontal act of the parents.”

God, in other words, probably wouldn’t back the 20-week ban. This writer is disinclined to get into theological argument (despite wishing today’s politics could be dictated by medical science rather than conservative religion.) But you are again referred to the “What’s God Got To Do With It?” chapter of Perilous Times. Or to pages 357 – 360 Vol. 2 of Women’s Works, for a fascinating overview of how assorted popes and Anglicans (“About the sixth month the immortal soul is infused,” wrote Rev. Christopher Carlile in the 16th century) changed the rules and differed in opinions. Which also sounds familiar.

In 1856, Foster tells us, “Dr. Horatio Storer organized a national drive by the American Medical Association to end legal abortion altogether.” His efforts resulted in actions by the various states and territories to strengthen laws against abortion, and by 1880 there were restrictive laws and practices virtually everywhere mandating that a woman, once impregnated, had no safe or legal means to alter the course of what was going on with her body.

Leaping ahead to 2014, has any progress been made in the name of women’s reproductive justice?

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