Breast Cancer? Ask questions!

In honor of International Women’s Day (even if I didn’t quite get it finished in time,) this brief message is about a book recently re-issued by Dr. William H. Goodson III that should be in the hands of every woman with breast cancer, wanting to understand breast cancer or helping someone who is going through breast cancer.

Pink flower

It’s Your Body . . . ASK is a guidebook for talking with your doctor about breast cancer. I would’ve given anything to have had it when I had breast cancer, and a mastectomy, a dozen years ago. Maybe I would’ve made different decisions, maybe not. But the reality is this: most women, unless they have had medical training, would never think to ask a question like “What are the side effects of removing axillary nodes?” Personally, I didn’t think to ask about nodes at all. Other than considering the size of my cancer, in fact, questions I might have asked about its rate of growth, alternative treatments, follow-up therapies – – were mostly not discussed because I didn’t know to ask them.

This is a book that gives not just answers (it offers many answers about families, about hormone-based therapies and other issues) but more importantly: questions. If you, a breast cancer patient, know the questions, your doctor needs to give you the answers. What’s that lump about? What about these other pains and symptoms I have? What are all of my treatment options?

(I would say, here, Full disclosure: Dr, Goodson is a friend of mine. But it would be more braggadocio than disclosure. Bill Goodson and I shared a few discussion program podiums It's Your Bodyseveral years ago when his gripping novel about sexual violence against women, The Blue-Eyed Girl and my Perilous Times: An inside look at abortion before – and after – Roe v Wade were both newly released. I’m a writer. He’s a Senior Scientist at California Pacific Medical Center Research Institute; a recognized leader in breast cancer care who has been (among other things) a Professor of Surgery at the University of California San Francisco and President of the San Francisco Medical Society, and is listed in The Best Doctors in America.)

Credentials aside, It’s Your Body . . . ASK is worth a look. It offers a pathway through turbulent times, which can be far less turbulent if you have some help in steering your own ship.

Check it out.

There’s Hope for Reproductive Justice

Art by Megan Smith

Art by Megan Smith

Let’s hear it – one more time – for the Millennials. Especially the youngest Millennials, just now reaching or approaching voting age. A generation unto themselves.

Invited to speak at a recent “Awareness into Action” day at Drew School, a private college preparatory day school in San Francisco, this writer went with some trepidation into a classroom set up for about ten high school students. Who – when she hasn’t been a high schooler in more than a half century – knows high school students today?

My workshop was on Reproductive Justice. Other choices the students could make included workshops on Mindfulness, Parks Conservancy, Anti-Racist Dialogue, LGBTQ issues and Immigration Law (to name a few.) I figured if 5 or 6 girls showed up it would be fine. By the time we were ready to start there were 14 girls and two brave (and handsome) guys around the table and sitting on chairs and tables in the back corner, plus one teacher keeping an eye on it all.

For openers, I’d written several facts on the whiteboard:

A woman dies of cervical cancer almost once every two hours. HPV vaccine prevents most cases of cervical cancer.

17 states mandate that women be given counseling before an abortion that includes information on at least one of the following: the purported link between abortion and breast cancer (5 states); the ability of a fetus to feel pain (12 states); long-term mental health consequences of abortion for the woman (7 states.) None of the above are true.

Then I told my own story. The story of a 22-year-old who had never had sex – after all, nice girls did not have sex before marriage in 1956. A victim of what would today clearly be workplace rape, I did all the dangerous things that women desperate to end an unwanted pregnancy are increasingly doing today. When nothing else worked, I had a back alley abortion by an untrained man who probably had not even washed his hands.

“I think,” I said to the roomful of attentive faces, “we’re going straight back to the dark ages.”

Not if these young people have anything to say about it.

Aware that they are among the lucky ones, they are concerned about the unlucky. They seemed a little taken aback by statistics like this one:

In 2006, 49% of pregnancies were unintended. The proportion of unintended pregnancies was highest (98%) among teens younger than 15.

. . . and by other data about how widespread is the denial of access to reproductive healthcare for poor women and girls (and men and boys) in more than half of the U.S. “It’s just wrong,” said one student.

So what do you think you can do to change things, I asked.

“Vote,” came the first answer, before I even finished the question.

“We have to learn to listen to people we disagree with,” said another student, who had been rather vocal in her description of political villains. “You may have to bite your tongue,” I said. “Yeah, I know,” she replied. “Because we have to learn how to have dialogue.”

“We just have to know the laws,” said another, “and work to change them.”

“We need to support these organizations, too,” commented another student, tapping the table with some of the materials I had distributed from groups like Advocates for Youth, Planned Parenthood and Sea Change.

For this writer, who lived through the worst of times, the workshop brought hope for the future of reproductive justice in the U.S. Returning to the worst of times is not on the agenda for these Millennials.

 

 

The Shame of Abortion?

scarlet A“Help us protect the unborn, and save women from the shame of abortion” read the invitation.

It was an invitation to a fundraising event – this writer is on a strange variety of mailing lists – for a pregnancy crisis clinic. A friend who works at the clinic, and whom I respect although our opinions about abortion are poles apart, told me they never pressure or deceive women who come to the clinic. “We just explain that we don’t counsel on abortion,” she says. The fundraiser invitation sounds decidedly less compassionate.

The Shame word tears at my soul.

Thirteen-year-old Natasha, brutalized by more than one relative, is given another chance at childhood through an early abortion at a Planned Parenthood clinic. On top of all the trauma she has borne, she is supposed to feel shame?

Or the couple with a developing fetus they desperately wanted and loved, who decide to terminate the pregnancy later in its term to spare their baby a brief life of terrible suffering. In addition to their deep sorrow, anguish and grief, they should be ashamed?

Or the countless young women in circumstances similar to my own: after choosing to end an unwanted pregnancy for widely varying, compelling, always unique, deeply personal reasons because we are rational women in control of our own bodies – we need a shameful scarlet ‘A’ tattooed on our foreheads?

Words matter.

LIES 5 (2)

The banners proclaiming “Abortion Hurts Women” – posted by groups that seek to end legal abortion – testify to this fact: The posters work, but the words lie. Abortion is in truth far safer than childbirth. It does not hurt women, it protects women. The words are not true. But they work in exactly the same way that the shame word works.

Some words, even when they lie, go straight to the emotions. Emotional appeals become tools to generate support for political positions which hurt women. They should shame those who seek to deprive women of dignity, health and autonomy.

‘Shame’, ‘hurt’ – the emotional trigger words are being used to turn the clock back to the dark ages when women had no voice, no power, no control of their own lives.

As one who has been hurt, not by abortion but by powerlessness, and who strenuously objects to shaming, I declined the invitation.

Women deserve better.

 

Abortion, Four centuries later…

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?

The Art of Listening

The Art of Listening

AS I WAS SAYING……..

listening

“Can we talk?” – that phrase so famously and often asked by the late great Joan Rivers – actually had an implied second clause: “Will you listen?”

And thereby hangs the problem. Talk is cheap; listening is rare.

Want confirmation? Spend a few minutes at a bar, restaurant, night club or any other social gathering venue. The noise level is almost guaranteed to be too high for meaningful conversation. One partygoer (okay, a 34-year-old, several generations younger than this writer/partygoer) said, “it just doesn’t feel like fun until the music and vibes are loud.” Restaurants say the noise level is needed for “buzz,” even while admitting to repeated complaints about diners’ inability to carry on conversations. It’s more just talk and talking back.

Politicians, who tend to like to talk, go on a lot of “listening tours,” the word first becoming commonplace with Hillary Clinton’s notorious preparation for her New York senatorial bid. The theory seems to be that if potential voters feel heard they’ll vote for you. But the reality is that the politician is generally listening more carefully for what potential there is for his or her upcoming campaign/proposed legislation/planned left or right direction than for the pleas of the constituency. Not that some pleas aren’t heard – More jobs! Healthcare! Housing! – but is any serious listening going on, on the part of either politician or voter? Not often. Generalized messages get through – shouts on camera do count – but these tours are for selective listening.

Serious listening is not selective, and involves a degree of compassion. Even the Buddha knew that. In a recent article published in The Buddhadharma, Zenkei Blanche Hartman responds to a question from someone whose friend is considering an abortion. Among other comments, she says, “Have you listened carefully to your friend…” and “What is the most compassionate response in this situation?”

Imagine, if carefulness and compassion could happen in the listening process.

One of the most treasured conversations I had when just beginning work on Perilous Times: An inside look at abortion before – and after – Roe v Wade was with a beloved adult niece who is a lifelong conservative Christian. I suggested that she might have to pretend she didn’t know me when my book came out, but asked if she would listen to my own story that had motivated it. She did listen, quietly and thoughtfully, not once interrupting or showing negative reaction through her body language. When I finished, she had this to say:

“Well, you know, Frannie, I believe that life begins at conception and that abortion is murder. But I do feel that someone in your situation should have had better options.” We left it at that. I did not in any way change her mind about abortion – she still believes life begins at conception and abortion is murder – but she acknowledged that my story is unique, just as all of us in the reproductive rights movement believe that every woman’s story is unique. And most importantly, I felt heard.

Of the many deeply divided and overly politicized issues roiling the U.S. today, probably none is more desperately in need of civil dialog – reasoned talk and compassionate listening – than that of reproductive justice. Abortion foes term the issue “rights of the unborn.” Clearly you can’t give rights to an unborn fetus without creating injustice for the woman involved; the first, obvious obstacle to listening is in the fact that we can’t even hear each other’s subject line.

This writer recently talked about the listening business with Heather Buchheim, a Senior Manager with Exhale Pro-Voice. Buchheim is a very good listener. This may have something to do with the fact that Exhale is all about listening. Not lecturing or advising, not judging or admonishing – listening. They are also about talking, with their Storysharing and their National Pro-Voice Tour, but it is talking with attention to the listener. They hope for a culture change through much the same nonviolent ways the Buddha suggested, a change many progressive activists today still dream of: “sharing our stories and listening respectfully (because) feeling heard is crucial to our emotional wellbeing.”

Perhaps, if the decibel level were turned down a little, wellbeing might increase.

 

 

Should Abortion Be ‘Rare’?

This first appeared on Huffington Post

Beware the Rare-word.

Many of us — fiercely pro-women, fiercely pro-choice — bought into the “keep abortion safe, legal and rare” mantra of several decades back. It was, in fact, a useful mantra — until it was sunk by the potential anti-women interpretation of the word “rare.” The endless focus on the ‘rare’ word at times approaches the “it-depends-on-what-the-meaning-of-the-word-‘is’-is” hubbub.

In defense of both sides:

Make abortion rare! By supporting universal contraceptive coverage. By supporting Planned Parenthood. By expanding education. By reducing unplanned pregnancies in all ways that empower women and reduce violence against women.

But get rid of the ‘rare’ word. It is, apparently, sending the wrong message. Jessica Valenti covered the issue well in a recent piece in The Guardian, citing two leaders in the area of women’s reproductive justice. One is Dr Tracy Weitz, co-founder and former Director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. In a paper published in 2010, Weitz wrote that “rare suggests that abortion is happening more than it should, and that there are some conditions for which abortions should and should not occur. It separates ‘good’ abortions from ‘bad’ abortions.”

None of this — ‘good’ abortions, ‘bad’ abortions, whether or when there should be abortions — is anybody’s business but the woman involved. Only she and her physician can know the circumstances, and the circumstances of no two women are the same. So if the ‘rare’ word is clouding the issue, let’s dump the rare word.

Valenti also quotes Steph Herold, Deputy Director of the Sea Change program, who says abortion needing to be rare “implies that abortion is somehow different than other parts of healthcare. We don’t say that any other medical procedure should be rare.” Sea Change is working to remove the stigma attached to abortion and other reproductive issues, a laudable, and monumental task. More than a few of the women who share their stories in Perilous Times: An inside look at abortion before – and after – Roe v Wade speak of suffering almost as much from the stigma attached to this most personal of women’s issues as from any physical harm, real or feared. While breast implants, sex-change details and erectile implantation (among other personal decisions) are fair game for cocktail party conversations, when is the last time you heard anyone volunteer information about her abortion? One in three women have an abortion; we Do Not Talk About It.

But here is the fact: There are bad abortions. They happened before 1973; they are happening today.

A mother of two physically challenged toddlers, pregnant with a third in 2014, unable to get to the nearest clinic — which is hundreds of miles away and impossible to access (despite the famous comment made by Texas Judge Edith Jones that it’s easy to go 75 mph on those flat roads) — punctures an interior organ trying to self-abort the old-fashioned way. She lives, but this is a bad abortion.

A desperate teenager in the rural midwest manages to get what she hopes is the right abortifacient through an internet site. Wrong drug, wrong instructions, wrong outcome. She gets to an ER before she bleeds to death. She lives, but this is a bad abortion.

This writer, pregnant from a workplace rape, overcome with shame and sheer terror, managed to find a kitchen-table abortionist in 1956. It was a bad abortion. We thought those stories were ended in 1973 when abortion was made legal and safe. But they are being repeated daily in this country, the land of the free; every one of them speaks of a bad abortion.

Women are suffering and dying again today from bad abortions, or because they are being denied access to safe, legal care. Whatever it takes, whatever words we use, the lives of those women are worth fighting for.

 

Vessel: New documentary, powerful voice

Working with Women on Waves – the organization determined to make safe abortion available around the globe – is not for the faint of heart.

Vessel, a new documentary currently being shown around the U.S., traces the progress of Women on Waves from its beginning more than a decade ago and through its now sister organization Women on the Web. That progress winds through angry protest mobs pushing, shoving, shouting “Murderer!” “Go Away!” and worse, and throwing eggs (and worse.) The women of WoW, mild-mannered though they may appear, retaliate by cutting the ropes of police boats attempting to tow them away, going nose-to-nose with burly guys on protest lines and breaking the seals of locks placed on their supply cabinets.

Meanwhile, the movement steadily grows.

Women on Waves was founded in 1999 by Rebecca Gomperts, MD, MPP, who was trained in both medicine and visual arts in her native Amsterdam, the Netherlands. (It doesn’t hurt, for the film, that Gomperts is also attractive, articulate in several languages and highly photogenic.) As a young Ob/Gyn Gomperts traveled – one might say trained – with the Greenpeace ship Rainbow Warrior as its doctor and an environmental activist. While sailing in South America she was struck by the numbers of women suffering from lack of access to reproductive health services and safe, legal abortions – and inspired by their stories to start Women on Waves.

The group built a clinic-in-a-box, loaded it onto a ship and sailed into such unwelcoming ports as Morocco, Portugal, Spain, Poland and eventually scattered cities around Africa, Central and South America. The strategy was to anchor 12 miles offshore in international waters, where local authorities had no jurisdiction. Local authorities were seldom pleased. Gomperts was often on land, hanging banners announcing the phone number for pregnant women to call, drumming up press – usually unfriendly press – agitating the authorities and spreading the word, smiling pleasantly in the face of incredibly hostile opposition.

Once the medical abortion procedure using misoprostol became widely available and safe, if used as directed, Women on the Web began its own ambitious program of making the procedure available through the internet. And safe abortion slowly gained through changing laws.

The movement has one simple goal: to reduce the number of deaths from unsafe abortion. It is the same goal that motivates every other reproductive justice organization, from the Center for Reproductive Rights to ACCESS: Women’s Health Justice to NARAL Pro-Choice America.

But the film ends with a litany of places where poor women (if you’ve got money, you can manage to find a safe abortion somewhere) remain at risk for lack of access to safe abortion, notably including much of the U.S. Watching it in the U.S., where abortion has been legal since 1973, and being reminded again that women here are suffering and dying today, is sobering, and indescribably sad.

The sadness comes from hearing the same, tragic stories that first inspired Rebecca Gompers, and some years ago inspired this writer to create the book you see at the right. They come through the voices in the film:

“I’m scared to death.”

“I tried hitting myself in the stomach…”

“My family would disown me if they found out.”

“Can you help me?”

How can we be ignoring these voices in the United States today?