Category: Health

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Abortion foes are winning, folks

by Fran Johns
WASHINGTON - JANUARY 22: A pro-choice advocat...
Image by Getty Images via @daylife

Will women in the U.S. soon be unable to have a safe, legal abortion? That scary possibility becomes more likely every day. Does anyone really understand the pre-Roe v Wade horrors which abortion foes want to see returned? Not really. That’s because huge numbers of women who could have told the horror stories died at the hands of back-alley abortionists, and those of us who did survive are dying off fast, unheard.

This space welcomes writer John Leland’s front page article in today’s New York Times to the voices crying in the wilderness — just in case someone other than Nancy Keenan might care to listen.

At least 11 states have passed laws this year regulating or restricting abortion, giving opponents of abortion what partisans on both sides of the issue say is an unusually high number of victories. In four additional states, bills have passed at least one house of the legislature.

In a flurry of activity last week, Gov. Haley Barbour of Mississippi signed a bill barring insurers from covering abortion in the new insurance exchanges called for under the federal health care overhaul, and the Oklahoma Legislature overrode a veto by Gov. Brad Henry of a bill requiring doctors who perform abortions to answer 38 questions about each procedure, including the women’s reasons for ending their pregnancies.

It was the third abortion measure this session on which the Legislature overrode a veto by Mr. Henry.

At least 13 other states have introduced or passed similar legislation this year. The new laws range from an Arizona ban on coverage of abortion in the state employees’ health plan to a ban in Nebraska on all abortions after 20 weeks, on the grounds that the fetus at that stage can feel pain.

Fetal pain is a subject of debate in the medical community, and the United States Supreme Court has recognized the government’s right to ban abortions only after a fetus becomes viable, which is more than a month later.

“Fetal pain” is just one ploy; its determination can easily go from 20 weeks backward to ban the morning-after pill. Other ploys? Forcing a pregnant woman to look at ultrasound pictures, prohibiting a physician from discussing fetal abnormalities with his/her patient, and “in Utah, after a pregnant 17-year-old paid a man $150 to beat her in an effort to induce a miscarriage, legislators passed a law that would allow a woman in such circumstances to be charged with homicide.”

Unwanted pregnancies happen. When they do, the man involved can simply walk away, as countless millions have done and will continue to do. Why, then, should so many men purporting to have such omnipotent wisdom be empowered to eliminate a woman’s right to choose what happens to her body?

It’s going to get worse. Unless people — and that includes males of the species who still have brains and some concern for the future of womankind — start paying attention, and standing up to the fundamentalists of all stripes, the U.S. Conference of Catholic Bishops and the religious factions who claim authority over all women, it’s going to get worse than many people in today’s society can even begin to imagine.

Opponents of Abortion Advance Cause at State Level – NYTimes.com.

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A once-a-month alcoholism shot? An anti-cigarette pill? Could happen

by Fran Johns
addiction
Image by alancleaver_2000 via Flickr

For those of us who got off addictions the old-fashioned way, reports from the recent American Psychiatric Association‘s annual meeting sound like good news, even if it’s a little late in coming. AP Medical writer Lauran Neergaard summed up the latest:

“This is the next frontier in substance abuse: Better understanding of how addiction overlaps with other brain diseases is sparking a hunt to see if a treatment for one might also help another.

We’re not talking about attempts just to temporarily block an addict’s high. Today’s goal is to change the underlying brain circuitry that leaves substance abusers prone to relapse.

It’s “a different way of looking at mental illnesses, including substance abuse disorders,” says National Institute on Drug Abuse Director Dr. Nora Volkow, who on Monday urged researchers at the American Psychiatric Association’s annual meeting to get more creative in the quest for brain-changing therapies for addiction.

Rather than a problem in a single brain region, scientists increasingly believe that psychiatric diseases are a result of dysfunctioning circuits spread over multiple regions, leaving them unable to properly communicate and work together. That disrupts, for example, the balance between impulsivity and self-control that plays a crucial role in addiction.

Addiction is a strange phenomenon, and we who know a lot about it (this writer kicked cigarettes in the 60s, alcohol in the 80s, crunching ice — you haven’t ever met an ice-crunching addict? Believe it. — five or six years ago) say it’s about time we got our own dysfunctional circuitry studies.

Think of it as if the brain were an orchestra, its circuits the violins and the piano and the brass section, all smoothly starting and stopping their parts on cue, Volkow told The Associated Press.

“That orchestration is disrupted in psychiatric illness,” she explains. “There’s not a psychiatric disease that owns one particular circuit.”

So NIDA, part of the National Institutes of Health, is calling for more research into treatments that could target circuits involved with cognitive control, better decision-making and resistance to impulses.

Addictive behavior has drawn attention from researchers and writers for years. A 1983 study done for the National Academy of Sciences by Alan R. Lang, Professor of Psychology at Florida State University reported that “some mental health experts find it useful to view addiction as including all self-destructive, compulsive behaviors”  and cited references to addictions as wide-ranging as caffeine (guilty), chocolate (definitely) and gambling (not on your life.)

Changing behaviors to conquer addictions, with a little help from therapies and therapists of all sorts, has been plugging along as a solution for decades. Takes a lot of work. Wouldn’t a magic pill be lovely?

Targeting brain circuits for addiction, relapse.

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Guns, drugs & sit/lie laws: who's got the real rights?

by Fran Johns

Discussions stirred up by the comments in this space a few days ago (see below) concerning gun rights v public safety rights ranged from the specifically pro-gun and pro-open carry (“citizens use firearms for self-defense between 150,000 and 3,052,717 times a year. The lowest estimate comes to about 410 times a day, and the highest estimate is 8,363 times a day,” says willbill; “How many times has an open carry proponent shot someone? If you use statistics rather than “from the hip” anti gun rhetoric, you will find legal gun owners are not the problem. Illegal gun owners are the problem,” says airtechjr) to the pointedly anti-gun (“Besides looking really stupid, having a gun visible – even if unloaded – is scary! Do you know how fast you can jam a clip into a Glock Automatic? 3 seconds,” says Tom Medlicott.) Emeryville, CA Police Chief Ken James says it’s 1.3 seconds.

In the long run, though, the argument is not about gun rights v public safety rights, says carlfromchicago, because I have no constitutional right to feel safe in public. And this all started because I admittedly did not feel safe while attending a panel discussion on the proposed California Open Carry ban (AB #1934 now in the state legislature) and learning that I was the only unarmed citizen within three solid rows of citizens carrying (presumably legal) concealed weapons. According to Carl,

Whether people are comfortable around guns is a very interesting and relevant social discussion. But this is not a question of two rights pitted against one another. As much as we all want to feel safe, it’s simply a frame of mind. The right you have is to think what you wish, and feel what you wish … but that compels no one, or the government, to ensure what you think or what you wish becomes reality for everyone.

This brings us to San Francisco’s currently proposed sit/lie ordinance. It says (more or less) you may not sit or lie on the sidewalk. It means, please get the drug pushers and increasingly obnoxious defecators-on-front-steppers out of the ‘hood. It arose out of frustrations in San Francisco’s famously tolerant Haight Ashbury (remember the 60s?) neighborhood where things recently have gotten somewhat out of hand.

This space is a strong supporter of humane treatment and expanded rights for homeless. Countless local and national programs, some good, some better, are in place and worth everyone’s attention; I try to make regular, teeny contributions of time and resources. But should I have the right to walk along Haight Street in broad daylight without tripping on a soiled, zoned-out kid whose dog is only loosely tied next to him? That’s the question. And should we now have a law enabling law enforcement officials to wake him up (if possible), move him along or toss him in the paddy wagon to be deposited in a jail cell? That may not be the answer. Either way, it is generating great heat and not a lot of light in my beloved hometown.

San Francisco is not alone in this dilemma. City Watchdog blogger Melissa Griffin, on her Sweet Melissa blog, reports having dug up a report (“Big pdf here,” she warns) on “Homes Not Handcuffs: The Criminalization of Homelessness in U.S. Cities.”

The report surveyed laws in 235 cities (including San Francisco) and made some interesting findings:

  • 30 percent prohibit sitting or lying in certain public places.
  • 47 percent prohibit loitering in certain public places and 19 percent prohibit it citywide.
  • 47 percent prohibit begging in certain public places; 49 percent prohibit aggressive panhandling; and 23 percent have citywide prohibitions on begging.

At almost 200 pages, the report provides an exhaustive discussion of the legal landscape in 90 cities. Some have definitely used creative methods:

  • In Billings, Mont., it’s illegal to “aggressively solicit” and/or lie about being “from out of town, a veteran, disabled or homeless” while asking for money.
  • In Boerne, Texas, all panhandlers have to buy a license to solicit (like other solicitors and vendors) at a cost of $115. Durham, N.C., charges $20 for a panhandling permit.
  • Las Vegas, briefly had a law that prohibited sleeping “within 500 feet of a deposit of urine or feces.”

I am getting right back on the fence. Public safety does seem to me both an appropriate issue for discussion and an individual right. How far it can be legislated (there are over 20,000 gun laws already on the books across the country, uncertain wrote in) is debatable. I still wish guns would just go away. I don’t know what to do about obnoxious sitters/liers upon the sidewalks. Both seem obstacles to the peaceful communities some of us have in our memories and all of us have in our imaginations.

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Abortion wars: pro-choice forces question accuracy of new poll

by Fran Johns

However the “pro-life” tag for all those anti-women’s-rights people came to be co-opted, it was a stroke of genius. It is, of course, more devious than truthful. Anti-abortion forces, as this space has raged about from time to time, piously support the life of a fertilized egg, while ignoring the lives of mature women. But the loaded label is firmly set.

Most recently, a Gallup poll has brought it to the forefront once more. That poll, released early this month, showed that slightly more Americans call themselves “pro-life” (47%) than “pro-choice” (45%.) The figures are about the same as shown in a similar poll last July, though the pro-life leanings are actually weaker than the percentages a year ago (51% to 42%.) Writer Amanda Marcotte, blogging at RH Reality Check, argues that the poll numbers don’t reflect the political strength of pro-choice Americans. Rather, she says,

the term “pro-life” is more of a tribal identifier or a feel-good term than it is a political stance.  This becomes only clear when you consider that pro-life activists tend to follow the lead of the Vatican (even if they’re Protestant) and object to all forms of fertility control that offer women a reasonable amount of control over their own bodies.

Marcotte interviewed Jessica Grose, whose article on Slate.com about the poll also questioned whether the pro-life numbers reflect a trend against women’s choice, or might be attributable to other factors. Republicans not wanting to be counted as pro-choice because it might align them with Democrats, or Obama; the general movement of Gen Y away from pro-choice. Grose does not, in the long run, see the poll numbers as a voice of doom.

The notion that more and more Americans are embracing the pro-life label is pretty terrifying for pro-choicers. But what does it really mean to call yourself pro-life or pro-choice? Do the labels actually track people’s views about the legality of abortion? The answer may be yes, but not in a simple or neat way. Though more people are calling themselves pro-life, the percentage of Americans who say abortion is morally wrong is down six points from last year. But at the same time, a Pew poll from last August showed that slightly more people are also saying that abortion should be illegal in all circumstances, though the gain is only 1 percent from the previous September.

The upcoming Supreme Court nomination process could potentially shift things back to the pro-choice label. It’s not about Elena Kagan per se, but Gallup senior editor Lydia Saad says that when the abortion issue is raised in relation to the Supreme Court, the issue tends to help the pro-choice side—because, in the end, most people don’t want to overturn Roe v. Wade. Recent data back up the second part—according to a CBS News/New York Times poll from April says that 58 percent of Americans still believe that Roe v. Wade was a good thing.

A hopeless optimist to the core, I wish I could join these wise observers in finding any glimmer of hope in the whole scene. From where I sit and what I know — and I am among the steadily dwindling few who know first hand the horrors that women faced pre-Roe v Wade — the hard core anti-abortionists are pulling every trick in the book to gain ground, and it’s working. If they ultimately do win, women will suffer an unfathomable loss.

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Nobel Laureate Muhammad Yunus speaks on micro-lending — and world hope

by Fran Johns
Muhammad Yunus, Managing Director, Grameen Ban...
Image via Wikipedia

Recently, someone remarked to Muhammad Yunus, the Bangladeshi banker/ economist/ crusader against poverty, that he must be a very rich man.

“I said, why would I be a rich man?” he tells an attentive audience. “Well, you have all those companies; you must be rich to have all those companies.”  Yunus scratches his chin and smiles the beguiling smile that makes you want to be a believer. “Oh. I start these companies, but I would never own them.” You are now a believer.

Yunus was in San Francisco Monday, at a social entrepreneurship program sponsored by the Commonwealth Club. He is winding up a U.S. tour promoting his new book, Building Social Business: The New Kind of Capitalism That Serves Humanity’s Most Pressing Needs. In the process, he is promoting a theory that social business — business operated for the benefit of society (such as the poor who are commonly the beneficiaries and owners of Yunus’ companies) — can and should be a viable segment of the global economy.

Grameen Bank, which was begun in 1976 with $27 out of Yunus’ pocket and now provides loans to more than 8,100,000 borrowers — no collateral, just good faith and trust — would seem to prove his point. Defaults on Grameen micro loans are so few as to make Fannie Mae weep.

From micro loans, Yunus expanded into business ventures on the same basic principle: to achieve one or more social objectives through the operation of the company. The investors/owners can gradually recoup the money invested, but cannot take any dividend beyond that point.

There are now Grameen (the word refers to a rural village) companies in banking, agriculture, healthcare, telecommunications and other areas.  Yunus gave one as an example of why he believes the principle works:

Grameen and Group Danone went into a joint venture to create a yogurt fortified with micro-nutrients to decrease malnutrition for the children of Bangladesh. The yogurt is produced with solar and bio gas energy and is served in environmentally friendly packaging. The first plant started production in Late 2006. The 10-year plan is to establish 50+ plants, create several hundred distribution jobs and self-degradable packaging.

The environment is protected, children get healthy, grow up to create businesses. Yunus spoke of one skeptic saying, “where will I get a job?” and said he explained, “You don’t look for a job, you create a job.”

Grameen Bank has more than 2500 branches — now including three in New York (where Yunus would like to see payday loan and check-cashing operations go out of business), one in Omaha, and in the near future: one in San Francisco. If Yunus is enjoying the proving out of his theories and the lifting of vast numbers of people out of poverty, he may be enjoying most of all the reminiscences about those who scoffed at his notions in the 1970s.

“They said the poor were not credit worthy,” he smiles. “I was told, about non-collateralized loans, ‘You can’t do that!’ After 2008, I wanted to ask, ‘Who is credit-worthy?'”

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Grief: A mind/body conundrum

by Fran Johns
Physician treating a patient. Red-figure Attic...
Image via Wikipedia

This is a cautionary tale.

The main character, a woman of a certain age, became concerned about suddenly being short of breath. Nine months earlier she had defended her title in a 5k community road race, so it didn’t seem to make sense that she would be huffing and puffing after one block on a slight incline. She worried more and more, and finally went to see her primary care physician.

“No,” said the doctor, “this should not be. We’ll start with a stress test to check out the heart, and then go with a pulmonary function test. Recent x-rays haven’t shown anything wrong with your lungs, but we’ll want to make sure.”

The patient aced the stress test, which relieved everyone. Subsequently, at the end of the pulmonary function tests she did the six-minute walk, as instructed, regular pace, and the nurse who had been following along in case she conked out said, “Well, you’ve got no shortness of breath, and I’m exhausted.”

In between, an interesting thing had happened. During a visit with her niece, who is a family practice physician in another state, the medical dilemma happened to come up. “Well,” said the niece, rather gently, “you’re doing all the right things: seeing your doctor, having a stress test first, checking pulmonary function. But when all is said and done you did just lose a sister to respiratory failure, while you were still grieving the loss of another sister almost within the same year…   It could be that your body is just trying to tell you something.”

Almost immediately I felt better. Went ahead with the pulmonary function test just to err on the side of caution, but by then I was feeling so much better that just walking around that hospital corridor at what felt a leisurely pace was still enough to wear out a nurse who is 10 years younger. She hadn’t told me she was required to follow. And of course, at the start of it all, I hadn’t thought to mention anything about sibling loss to my primary care doctor. Communication is good.

Soon afterwards, I attended a meeting at which the keynote speaker was Lyn Prashant, founder of an organization called Degriefing. Among the handouts was a page headed “Common Grief Reactions,” featuring lists of physical, emotional and mental responses to grief. Number 5 under Physical? You guessed it: shortness of breath.

Who knew? Certainly not this writer, who has only spent the past three decades intensely involved with end-of-life issues. Hospice volunteer, part of an AIDS support group throughout the 1990s, currently a chapter board member and client volunteer for Compassion and Choices, author of dozens of articles and one book about end-of-life issues. Never heard of any of those physical manifestations of grief — or if I had, they were too abstract to register.

That was then, this is now: Loss, sorrow, grief — is it all in your head? Maybe not.

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Illness, loss and words of comfort

by Fran Johns

New York Times Personal Health writer Jane Brody last week noted another chapter in the wrenching drama she has shared with readers, first with the cancer diagnosis of her husband, lyricist Richard Engquist, and later following his death on March 18. In the new essay Brody tells of condolences received from friends and strangers. The writing, she says, has been therapeutic.

But one piece of therapy I never expected was the feedback from readers, friends and acquaintances: many hundreds of condolence letters, e-mail messages and comments on The New York Times’s Well blog.

Whether in a card, note, letter, phone message, hug or pat on the shoulder, some people seem to know instinctively how to show they care and will remember the deceased. What stands out most in these messages is their deeply personal quality. People who knew my husband in various walks of life (especially his advocacy for his beloved Prospect Park and his career as a writer for the musical theater) saw him in ways that had escaped me, because I was too close to have their perspective. By sharing these details, they have rounded out my memories of a life shared and separate from his — memories I will cherish for the rest of my life.

Brody gives examples of the many messages about her husband that brought comfort, and offers thanks for the fact that those unwanted messages — “Surely you’ll meet someone else;” “I know how you feel, my dog died last year” — had not arrived.

There’s one thing often of great comfort to someone who’s suffered a loss that Brody doesn’t include and that doesn’t occur to everyone. It’s the reminder of what the survivor meant to the now-deceased, one of the easiest ways to write a quick, meaningful condolence note. I learned it many years ago from someone I never met. Her Army officer brother, to whom I’d been pinned (an emblem of commitment in those olden days; I’ve no idea if such customs still exist) was killed in Korea. I could not travel across the country for the funeral, all of the sympathy and support was rightfully going to his family, but I felt bereft and unconsoled. Then I got a two-line note. “Dave said you could always make him smile,” she wrote; “and that will always make us smile.”

Thoughtful people have reinforced the knowledge of how much such a thought can mean. “Your mother was so proud of you because —.” Happily, in this fast-moving world the snail-mail sympathy note seems to survive. And I suppose even the e-mail condolence is better than nothing. If you’re stumped for a note you could be writing, try it this way.

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Sitting with Marina Abramović: MoMA event invites art study and self-study

by Fran Johns

You have one more week to run over to the Museum of Modern Art — this will necessitate a quick trip to Manhattan if you’re not already there — to sit with Marina.

That would be performance artist Marina Abramovic, who has been hanging out in the atrium at a bare table in the middle of a huge, white space with itinerant visitors every day since late March.

She doesn’t move, she doesn’t speak. You can do the same, seated across the table, for as long as you like, if you’re willing to wait in line. One sitter sat for more than a day, incurring the wrath of the sitters-in-waiting, but a large, soft-spoken guard and the general tradition of gentility at MoMA keep the lid on things.

When I visited the site recently — I would happily have sat for a few moments, but the sitters-in-waiting told me they’d been sitting in line for close to three hours — the scene raised a whole bunch of questions. Being more Mom than art critic, I couldn’t help wonder about the toll this has to be taking on Abramovic. She spoke about it with James Westcott of guardian.co.uk at the beginning of this saga:

“I have to be like a mountain,” the artist told me a couple of days before going into her “big silence” for the performance. She will go home every evening when the museum closes, but, in order to sustain her meditative state, she will not speak until 31 May. “The atrium is such a restless place, full of people passing through. The acoustics are terrible – it’s too big, too noisy. It’s like a tornado. I try to play the stillness in the middle.”

While I was talking to her, Abramović was anything but still. Her habitual anxiety and jovial hyperactivity – so different to the formidable power and placidity she has demonstrated in 40 years of extreme acts of endurance – were in overdrive. “People don’t realise it is pure hell sitting so long,” she said in her thick Serbian accent, while fidgeting. Cramps will set in after an hour or so. Her bum will begin to hurt. But she will ride out the pain. “The concept of failure never enters my mind,” she insists. To insure against it, a masseuse, a nutritionist and a personal trainer will visit her apartment before and after each day’s work.

She will undoubtedly need all of the above, and possibly a long soak in a hot tub. Visitors, though, get off easy and certainly are never bored. For the rest of the show, a retrospective of her work including some fifty pieces from four decades, visitors are invited to galleries upstairs. Entrance to those galleries involves squeezing in between naked people standing in the doorway (Abramovic trained others to replicate her original creation of the standing-in-the-doorway piece, when she and her partner were the standers-in), but the squeamish can go through an alternative entryway.

It is the contemplative aspect of the seated Abramovic that most strikes this viewer. Sitting motionless, speechless, for extended periods of time suits some of us better than others. My gentle therapist friend Sue, for example, leaves this weekend for a vision quest. Part of it, she explained, will involve four days in the wilderness, alone. “No books?!,” I said? She gave me one of those patient, indulgent laughs. I think that means you just sit with yourself, possibly speechless, motionless.

I’m not so sure about myself, but Marina Abramovic could handle it.

Performance artist Marina Abramović – ‘I have to be like a mountain’ | Art and design | guardian.co.uk.

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