Henrietta

I just finished reading The Immortal Life of Henrietta Lacks by Rebecca Skloot. It was an excellent read and beautifully edited. (Before this I read in rapid succession all but two of Jasper Fforde's comedic novels, such as The Eyre Affair and The Fourth Bear, all of which contain at least one glaring typo for every five pages, so I felt this was noteworthy.) While heart-wrenching and painful to read (particularly when Skloot and Henrietta's daughter Deborah find Elsie's mildewing autopsy report) occasionally disgusting (watching Zakariyya eat over a pint of ice cream off a paper plate), and reminiscent of all of the time I spent in high school learning to hate myself for just how much white people have abused black people for centuries in the USA, I nevertheless had room in my brain left over to consider the more pragmatic issues surrounding Mrs. Lacks's cancerous tissue.

The big question that dominates the end of the book regards the ownership of components of the self once they have been voluntarily removed from the body. No one argues that if someone hacks off someone else's arm for the fun of it, they should put it back, or at the very least compensate their victim for the harm they've caused. But if a surgeon removes a damaged or damaging component of a willing patient, should the patient still have some claim to it? I'm referring to tumours, gangrenous appendages, iffy-looking moles, ruptured appendices--all things that A. people are better off without, and B. won't survive on their own once they're cut off.

If biopsies, blood samples, and other bits and pieces are useless to patients, and will more than likely rot or be discarded if given back after testing, then it makes sense that people who not only have a use for the samples, but know how to keep them useful should keep them. Figuring they're doing all the work to keep the cells alive, preserved, or indexed, and spending all the money on formaldehyde and electricity to run deep freezers, it's only fair that, given the opportunity, they should be allowed to earn the money back from any commercially viable discoveries they make using said samples.

But.

Patients did put in all the effort of growing those tumours from the outset. Whether or not the friendly doctor saved his life by removing it, and whether or not he wanted said tumour, the patient did do all of the primary work. Not only that, why shouldn't the patient be compensated for all the time he spent in pain, nauseated, bedridden, coughing up blood, and generally having a lousy time of it? We have this concept in our world that people should pay to get better, not be paid for being sick. But being sick is work--indeed, for some people it's the most difficult work they've ever undertaken. It may not always be work that supports a profitable enterprise, but if a patient is undergoing some course of treatment it has the potential to. The fact that some people volunteer to make theatre doesn't mean that practitioners shouldn't be paid if the show makes a profit. Surely if a researcher wishes to be paid for his medicine, he should compensate everyone who worked to achieve it.

Now, Henrietta may have waived her eligibility for compensation--not because of something she signed in life, but because her cancer cells went out of their way to sabotage years and billions of dollars' worth of research all around the world. I mean, I'm sure there's a breach of contract violation in that somewhere. If nothing else, it made a lot of people unhappy when they thought they'd made breakthroughs, only to realize that no, they'd just made another freezer-ful of Baltimore Black Lady. Maybe that's what happens when you harvest malignancies without informed consent. Henrietta let science make great advances and save millions of lives, but she got some pretty good jabs in for her trouble.

Anyway, a very well-written, touching, and pragmatic book that approaches the reader like you're an interested adult--at no point did I feel patronized, but the style likewise never dropped into unintelligible medical jargon. I'm very glad Skloot took the time to do it properly (the project took her ten years), and to communicate with Henrietta's family as people--to not only get their story, but to help them understand what happened to their mother, and how she changed the world. I'm grateful to Henrietta Lacks.

And Georgios Papanikolaou.

Poked, Prodded, and Tea'd

So, I just got back from the colposcopy clinic. A very nice (man) gynaecologist did exactly what the procedure says on the tin, with a bonus prize: the colposcope has a camera built in, which was hooked up to a monitor, so I got to watch. The nurse (woman) kept me distracted and talking and I didn't really feel any discomfort, but I was absolutely fascinated by the whole thing. My cervix is exactly the same colour as my gums! There was a little spot, about the size of a pencil eraser, that turned white and looked odd, but the doctor didn't think it was a big deal. He took a cylindrical biopsy of it with this long skinny contraption, and got me to cough when he did it and somehow I didn't feel a thing. (I also didn't watch the monitor for that bit.) Well done there, I think.

Meanwhile the nurse was asking me about where I came from, oh isn't it warm there? You said you came here as a student, what did you study?

"I...erm.. What Did I study?" I was entirely too fascinated by my own personalized NOVA show to remember anything about myself. "My mom's a nurse too, but she works labour and delivery. This is so odd--I'm having a hard time believing it's me I can see." "Do you want to have kids?" "No, that's not really the plan." "Well, if you decide to have babies, they'll grow just behind that." "I'm well aware of that, I just mean I feel rather detached, more like I'm watching a science programme. Is that the string from my IUD?"

Afterwards I asked to see the biopsy, and found it fascinating, which made the nurse laugh like a drain. And there was a condom on the handle of the colposcope. And instead of foot stirrups they had these sort of curved leg pad things, far more comfortable. And everything smelled of vinegar. (The naughty cells react to vinegar, so fair enough). The lighting in the hospital is terrible, but the place was clean and well-appointed.

No one but me in the waiting room spoke English, but there was another waiting room just around the corner full of pregnant teenagers and their boyfriends, all of them white and dumb-looking. I wandered in there on accident and was briefly confused because they all had numbers, but the receptionist hadn't given me one. I was also the only person in there who had come alone, which got me some pitying looks until I realised I was in the room with pictures of babies all over the walls when I should have been in the room plastered with posters for cancer support groups. Way to make a lady feel comfortable.

So now I get to wait three weeks for the biopsy to...do its thing, I suppose. Are they going to try and grow it? Or make a slide of it and examine the cell pattern? I suppose I could look it up. I'll go do that.

col-PAHS-co-py

So. A letter just came through the door inviting me down to the girls room for a poke-n-prod.

Erm. To rephrase. I've received correspondence from my local NHS trust informing me that I have an appointment for a colposcopy. Apparently my most recent Pap smear turned up a HSIL, or High Grade Squamous Intraepithelial Lesion, or Severe Cervical Intraepithelial Neoplasia, which I've had a fun hour or so of reading about. At my appointment in 2 weeks I'll get the fun experience of having a 3% acetic acid solution spread on my cervix to see if it turns white in areas where there's a high concentration of cellular nuclei. I'll probably be biopsied and may even get to experience the sublime joy of the LEEP (looped electric excision procedure, which sounds a lot like the slice-n-toast knife in The Hitchiker's Guide to the Galaxy film) And then, joy of joys, I'll get two more Paps over the next year, and annual pappage over the next 10. Whee, who doesn't love the sound of that?

Interestingly, in my last hour of low-grade-panic-driven research, I've learned that the plastic broom I've always associated with Pap tests is not very good at collecting cells, which might help to explain why my 2009 Pap came up completely normal but all of a sudden in 2011 it's come up hellafuckedup (technical term).

I've also learned that the person who detected my abnormality is called a Cytoscreener, which is awesome. Thanks, Cytoscreener, for helping me stay healthy.

I've known for a while that most everyone has at least one, and probably several strains of HPV. I know I have had at least 2, now--I also got a verruca from lifeguarding at a summer camp in 2004. Kids are gross. I had to have the verruca frozen off with liquid nitrogen which was astonishingly painful. Like, it felt kinda funny for a sec while the doctor was applying the goop, then he got up and left the room just as a bolt of lightning shot from my heel to my hip, causing me to clench up and jerk around like a rabbit in a snare while emergency lights flashed red in my head alerting me to the fact that my foot had been cut off. If the same thing has to happen to my cervix, be prepared for a killing spree. Getting an IUD was bad enough.

I like the way the letter was phrased. To paraphrase: "you're probably fine, this is all fine, don't worry, you're great, we love you, cancer, you're a good person, you're better than healthy, it's probably nothing, do not miss your appointment for any reason, this happens all the time, it's downright routine, hugs and kisses, NHS." Kinda like that time I was grabbed by a London transit police officer to have my Oyster card checked after a fault caused me to get smushed in the gate--ID badge, big smile, mind if I check your card? big smile. I'm sure it's fine, you look like a good person who wouldn't try and get away with not paying, criminal, big smile, there we go--the person ahead of you must have not touched the reader properly, big smile.

Oof. What is it, when people tell you not to worry, it just makes you even more anxious? Like when people tell you it's not going to hurt, you totally know it's going to be a gore-splosion, or when someone in a bad movie says "nothing could possibly go wrong." I'm sure I'm fine, I'll be fine, and even if it has the potential to be not fine, it is still in a it's-fine stage of not fine. But nevertheless...AAAARRGGGHHH.

As for silver-lining thinking: At least I'm not in the USA without health insurance right now. I have a valid NHS number and a valid work visa.

As for appropriate responses to that line of thinking: FUCK YOU, REPUBLICANS. I'm safer in the UK than at home, despite massive blows to the NHS under a Tory-led initiative to try and privatise and profit-drive healthcare because they're mass-murdering wankfucktards who have no concept of I can't afford it EVEN IF MY LIFE DEPENDS ON IT and therefore assume that poor people just don't care enough...even with those EVIL IDIOTS in charge, I'm BETTER OFF than with YOU.

Without tax-funded women's health centres like Planned Parenthood, many women will not receive Pap smears. They won't be able to afford them, or at least won't see an appreciable cost/benefit ratio to paying to have them as often as they should. They will not detect problems early. They will not have the fucking chance that I think I have...fuck. Fuck fuck fuck. Fucking republicrats. Fucking religious aristocracy trying to punish all us naughty heathens for our normal, human behaviour. Fuck you, yes you--judging me for bringing all this on myself with my youthful indiscriminate actions. If you hadn't told me not to, I probably wouldn't have. I pay my fucking taxes... (descends into incomprehensible mewling)

And Guess what I started reading on Monday?

The Immortal Life of Henrietta Lacks, by Rebecca Skloot.

Faaaaaaaack.

developmental biology for beginners, or Mother Nature is Amoral

If by some bizarre set of circumstances Asshat McGee in Georgia manages to shove through his "miscarriage punishable by death" legislation, the logical next step is actually the prohibition of any non-barrier form of contraception up to and including the rhythm method.

See, he wants to define personhood as beginning the moment a sperm bites into an egg. Wham, two cells combine, it's Joe. Unfortunately, the fact that cells have combined in no way guarantees a live birth, or even that the active zygote won't be passed in the woman's next menstruation. Indeed, it is a matter of general consensus among reproductive healthcare providers that after day 13 of the menstrual cycle one or more eggs is released into the uterus and will survive about 24 hours. If the egg is not fertilized in this time it is flushed out of the body about two weeks later. If the egg is fertilized in this time but for whatever reason doesn't adhere to the blood-rich uterine lining it too is flushed out of the body about two weeks later. Joe, meet tampon.

Women's bodies do this on their own all the time, as is doubtless being discussed throughout the internet at this moment. Billions of uteri over the years have rejected or simply failed to accept viable zygotes because the zygote simply never made it over there, for no particular reason. This is not a tragedy, this is not a miscarriage, this is not a baby, this is not a person. It is a microscopic cluster of cells that oozed out of a woman along with a whole bunch of blood and mucus.

Inter-uterine devices (IUDs (or Coils, in the UK)) work (we think) by inhibiting a zygote's ability to attach to the lining of the uterus. If you look at it like a Fundie, that would mean that an IUD works by starving the poor helplessly-flailing fertilized cell to death. Progesterone-infused IUDS are even worse--they don't usually inhibit egg release, but they do prevent the body from building up a uterine lining And physically inhibit zygote implantation. Oh, what a hostile environment!

Hormonal birth control methods generally do inhibit ovum release, so I guess they should be Fundie-fine, but they're absolutely horrible in every other way. They screw around with women's physiology so much that they cause neurological disorders, emotional disturbances, weight problems, digestive problems, dermatological problems, fibroid problems, bleeding disorders, and a host of other unpleasant changes. Barrier methods likewise prevent fertilization...when they work, but they're notoriously movable, breakable, by-passable, and faulty. The most reliable, least-unpleasant form of contraception is in fact the IUD, which, to the Fundie, could be considered forced miscarriage, i.e. muuuuurrrrder.

Obviously, non-implantation happens on its own constantly--the Mayo clinic has stated that non-implantation and even implanted miscarriage within the first 3 weeks of pregnancy occurs all the damn time, far more than the 1/4 of detected pregnancies that end in spontaneous miscarriage. Evidence exists to suggest the likelihood of Most pregnancies failing at this time, but it is utterly impossible to tell how many unacknowledged fertilized ova have been absorbed by sanitary products, even in women who were hoping to not have a period this month.

All IUDs do is bump up this number a bit, but if you believe, as many morons do, that personhood begins at fertilization, they could be seen as aiding and abetting the natural inhospitable nature of the uterus toward God's chosen innocent helpless blastocysts. It would follow, then, that the miscarriage police would feel comfortable in banning implantation-inhibitors, and should enforce that all sexually active women take human chorionic gonadotrophin supplements to prevent evil progesterone cycles triggering the uterine lining to shed before implantation occurs. If personhood begins at fertilization, we must do everything in our power to ensure that zygotes survive, including suppressing normal biology and causing heinous damage to women's bodies and minds in the process.

----

The trouble is, religion and law don't really fit with the truth of how bodies and societies actually work. They exist in this idealized, inhuman sphere that cannot cope with the truth that the body is amoral. It does its own thing no matter what you tell it. Whenever life begins is irrelevant to the uterus. The menstrual cycle is only a pattern of chemical releases, one that pregnancy may or may not interrupt. So too is a woman's decision-making process entirely comprised of electrochemical impulses. Whether the uterus or the brain decides to not see a pregnancy through, it is all part of the functionality of the female. If a fertilization results in a non-viable foetus, if a woman is on drugs, what have you--the inside of a woman must be off-limits to the prying, judging, moralizing, arbitrary eyes of the law and the church.

In conclusion: It may be Joe, but that really doesn't matter.

Notes from a discussion; A letter I sent to my senator

I can honestly say I've never had a worshipful attitude toward science. I recognize science for what it is--the process of trying to figure out how things work. That's it. Its not fickle--it grows and changes as researchers continue to think they've figured things out. There's no central hierarchy, it's just an ever-growing body of knowledge. Some published papers are bullshit, some may lead to helpful technologies. Conceptual science rarely sticks its nose into my daily life, though if I'm seeking medicine for a gastric ailment I will seek the advice of a qualified pharmacist.

I don't think I understand your sentiment regarding love's enslavement. I certainly don't allow my behaviour, wants, needs, or opinions to be dominated by the people I love. If we differ, we discuss. Frequently we agree to disagree and leave it alone. We may try to persuade one another to conform to our thinking, but we are free to refuse. If we come across an insurmountable, relationship-ending difference, we're free to leave. That's one of the great things about being an adult--you're not bound to places and people that make you unhappy, and you're not required to do things that make you unhappy to please others. If you choose to...well, that makes me sad, but it's your choice.

Religions are not like this, however. According to many sects and theocratic governments, if your wants and needs do not conform to established teachings, you must change. Even if they are not harmful to yourself or others, your views and behaviours are not to be tolerated. And according to their beliefs, you can't get away--if you reject your religion to pursue that which makes you happy, you'll be punished--either after death or by your state. There is no room for the self in religion. If that makes me selfish. . . good. It's not anybody else's job to give a hoot about my distinct individuality.

The thing that is so different between mortal love and holy love, though, is that if you stop believing that an omnipotent supreme being loves you--not because you've done something wrong, but because you can't believe it exists--it disappears as though it never was. This is not so for another human being. I can't decide that Ben doesn't love me. Even if I try and convince myself he doesn't, my disbelief in it won't change it. Likewise if he stops loving me but I continue to believe that he does, that won't make him start again. But as soon as I realized I didn't believe in holy love, it went away and I felt fine. No grieving, no sense of loss. Quite the opposite--for the first time, things made sense and I felt whole.

I didn't have a gaping hole in my psyche or emotional needs that I had to turn around and fill with something else--physics or what have you. The desire to worship is not inherent. That's where a lot of people get lost, and where a lot of people try to interject their own Ism-bound interpretation of simple atheism. Atheism is not a belief. It is a concise declaration that you have an absence thereof, because "sansbeliefitude" sounds funny and custom decrees that you can't get away with saying nothing. Many people, particularly in the UK, are able to, one morning, state calmly, "I have no need of faith-based belief" and never think about it again. They go on with their lives completely unperturbed by it, without a need to justify it, mull over it, or even occasionally sit down and wonder why they're here at all. If someone asks them what the meaning of life is without belief, they can easily say, "it doesn't matter, and I'm happy with that."

I don't believe people are endowed with certain inalienable rights. I recognize that established societies tend to adopt a responsibility for the base-line well being of most of their populace. The fact that most Britons aren't huddled starving in the streets attests to England's general success in that pursuit. But it is a pursuit, not an inherent responsibility. No geographical region Has to have defensible borders, nor does it have to establish a system of governance that looks out for the well-being of its inhabitants. And a lot don't.

But spiritual rights and privileges are immaterial. Yes, every believer has equal access to their god, but that does not fulfil their physical needs. Among those who believe, they will always believe that their deity is on their side, regardless if they are in direct conflict with another believer. Right and wrong, good and bad, are still just as contentious within the religious world, and the winner is not always the most good. Because being convinced that something is god's way doesn't make it right, or good, or useful. And being convinced something is evil doesn't make it bad. That's why institutions schism so frequently. Then of course one is invited to align with a belief structure that suits their principles, but where does that land them? If enough people don't agree with it they can change it? That means mortals are calling the shots. The fact that religions disagree, in my mind, undermines the entire concept. And as everyone believes that their sect is the most right, the Real One, the one everyone else should drop what they're doing and join...impasse, again. It's funny, really--or would be if it didn't make people so angry.

But I think that's my trouble with it, in a nutshell--it doesn't make people happy. It does not placate, it does not comfort, it is not an opiate. I broke through religion because I found it was an undue burden. I didn't like the way it told me to view myself, others, the church, or the functionality of the world. Indeed, the fundamentals of nature had nothing to do with it--it was me. There it was, in black and white, submit to, get down, obey men--I couldn't. I wouldn't. I knew it was wrong. I realized then and there, age 12, that this set of moral absolutes was a construct of mankind intended to suppress the individual from within. No matter what it says, even if I got to write the rules of my own religion according to what makes me happy it wouldn't work. I can't accept that any set of absolutes or free-standing instructions on how to live are anything more than one person's way of controlling the minds of others.

----

I realize that Fort Mill and the surrounding area are full of fundamentalist Christians, and you'll of course make plenty of them happy by trampling on the rights of women and severing our access to birth control and cancer screening, but believe it or not, it is not your job to protect evangelical Christians from being offended by the existence of Planned Parenthood. Planned Parenthood does not proselytize, it is not out to get you, and it is not staffed with baby-haters or rampaging atheists bent on world domination. They're there for the poor, the helpless, the scared, and the overwhelmed. They're there for women--a group it IS your job to protect. Your job is to ensure that people who are not causing harm do not come to harm. Not to ensure that the will of the mob is enforced on the maligned minority (or in the case of women, the traditionally abused majority).

You want to help prevent abortions? Ensure we have free, no-strings-attached access to contraception. Planned Parenthood provides this to women who can otherwise not afford it. Planned Parenthood gave me my IUD for free when I was broke, and it is to Planned Parenthood that I owe my freedom, my safety, and the fact that I've never needed an abortion. No one else in South Carolina offered me this. Nowhere else, aside from USC's student health center, could I find contraception I could afford.

You have to give us something. I don't care if contraception goes against your moral code--if you're not going to help poor women to have abortions, at least allow us to prevent unwanted babies. You will not make a woman want a child by taking away her ability to get rid of it. No woman seeks one out for fun. No woman thinks of abortion as a form of birth control. It's a last resort before your life is ruined. Before your Fundie parents begin beating you or throw you out of the house. Before you starve. Before you lose your job, your home, and your future.

You cannot force women who don't want children to abstain from sex. Sex is normal, natural, and important. Regular, satisfying sex is a vital component of mental health. Women enjoy it and should be proud of the fact that they do. Any religion that tells you otherwise is dangerous. Abstinence is not the solution. Psychological research has beaten this archaic notion down again and again. People don't, they never have, they're not supposed to. Give it a rest.

I've been in a monogamous relationship with the man I love for six years. I have always used protection, and I count on the IUD Planned Parenthood gave me. I've donated what I could to them every year since because I appreciate what they did. My friends' lives have been saved by the early detection Planned Parenthood cancer screening provided, both of the breast and the cervix. A PP practitioner even patched me up when I was injured.

By offering Prevention, Early Detection, and Termination Planned Parenthood has saved the USA millions, possibly billions of dollars on cancer treatments, complications of pregnancy, and legal fees. Planned Parenthood has made your job easier, and empowered women to live their lives without fear. If you kill Planned Parenthood, you know good and well that fear, abuse, and poverty will take its place.

Face it. The only reason to de-fund Planned Parenthood is misogyny. Do you hate women, sir?

Come on, BBC

UPDATE 9/01/11: Thank you, Ben Goldacre, for your ability to talk to the right people and find the right numbers. The real story: 584 failures out of 1.355 Million users.

Almost exactly TRIPLE the number in 2005, which I cited as a conservative estimate in any case.

----

I just read THIS shock-and-alarm article.

Part 1. Understanding Statistics.

Yeah, did you read the whole thing? 584 unintended pregnancies...out of the entire user base...in 11 years.

Eleven years.

Implanon contraceptive devices have demonstrated a failure rate of .05% in clinical trials. 1 in 2000 users may become pregnant. 14 women involved in a lawsuit cited in the above article hadn't even been wearing one--their doctors missed, and nobody noticed. Human error happens--when I got an IUD it took 3 tries--3 IUDs--to get one to fit because I stupidly consented to letting a supervised trainee insert it. (Oh the unimaginable agony. Seriously. Still makes me flinch, and that was three years ago. I don't know how any woman would consent to giving birth, let alone more than once.) So of the 584 failures, probably about 5% had nothing to do with the device at all. It was human error compounded with negligence, exhaustion, or poor eyesight.

The article does not mention the whole number of implant users over the past 11 years, just mentions that it is popular. So I've been looking it up. The NHS National Institute for Health and Clinical Excellence (NICE) reported that, as of 2005, 3% of women age 16-49 were using an implant, and the only one licensed for use in the UK is Implanon. (helpful) So. I asked the department of statistics what those deets were--14 million women were aged between 16 and 49 as of the 2001 census. I'd imagine that number has grown considerably, but that's the most recent official data. The CIA world factbook bets the UK has 20 million women between 15 and 64, or probably closer to 17 million women of childbearing age.

So. As of 2005, 3% of, let's be reasonable and say 15 million used an implant. 450,000 women that year.

This is not the same as the number of implantations, as the implant is intended to be replaced every 3 years.

This is also not the total number of women who have used it since it was introduced in 1999, which IS the non-existent data set the "oh the humanity!" articles are citing.

I am certain hundreds of thousands more users have existed or currently exist. Merck does not seem to have any sales figures or total-usage-per-country statistics available, and NICE suggests that they don't really know how many women have gotten them, how many times.

The usage rate cited was accurate for the device being available for 5 years. It has now been available--and gaining in popularity--for over 10. Usage may have doubled. Anyone with better data please let me know.

But this is the data I have. okay. .05% failure rate. 250 pregnancies allowable per 450,000 users. we're out by 350. This is clearly an epidemic and the drug should be taken off the shelves.

Except.

The failure rate is for perfect use, when neither doctor nor patient is a moron. If you read the relevant trial data you'll find that about half the failures associated with the implant were in fact pregnancies that were already under way. Implanon is not a day-after pill and is not marketed as such. Patient didn't know she was pregnant, urine test came up with a false negative, implant went ahead, statistical fail. Okay, do blood and urine tests before implantation. Zing. Other failures were pregnancies that appeared to have started within a week of insertion. Apparently the patient was so excited to go try it out she didn't hear when the doctor said "give it two weeks to get into your system. If you've already ovulated, this will not retroactively prevent egg release. Hold your horses until you've had your next period." Not an indication of the drug failing to work as it says on the tin.

Still others cited well-known drug interactions (many of which were not mentioned until after the discovery of a pregnancy), poorly-inserted implants, and morbid obesity as reasons for failure (and undetected pregnancy, both for visual and chemical reasons). The device is intended as a one-size-fits-most, and if your body needs more, your doctor should notice that when you show up. These are still not faults of the drug or even its distribution method, but failures in staff training.

It is a common medicine, but that doesn't mean it shouldn't be taken seriously--it should only be administered by trained, informed medical practitioners who understand how it will work for each individual patient. I'm sorry, but "the doctor prescribed it to me even though I'm too fat for it to work" is not a fault of the product, it is a fault of the doctor. There are other things that will work for the obese, such as IUDs and local-absorption products such as the Ring.

Most of the complaints, of the 584 cited by the BBC, were apparently device-expulsion related. Yes, bodies do that. They don't like foreign objects embedded in them. It's why piercings sometimes disappear (my sister had an eyebrow piercing suddenly and painlessly vanish. The ring just fell off in her hand. True!) and how splinters quietly slip away. If the device is properly implanted subcutaneously this is less likely to happen. Again, Human Error. If the damn thing falls out, and you run off and get knocked up anyway, don't blame the device. Blame your stupid self for not calling your doctor immediately and saying "look bitch, the damn thing fell out" and using condoms until you can get it re-inserted properly.

There may have been a few people for whom the drug just didn't work. I'm sure there are. And people have gone off it for reasons such as weight gain, headache, mood changes, and desire to have children. Some people have expressed anger about scars the IMPLANTED BIG PIECE OF PLASTIC GOD DAMN DO YOU LISTEN TO YOURSELF WHEN YOU SPEAK? left after removal. These are all well-documented risks that you should discuss with your doctor in a pre-insert session so you can determine if this is the right birth prevention method for you.

The 584 pregnancies are not statistically relevant. They should not deter women who wish to prevent pregnancy from using this product.



Part 2. Why I'm Angry.

I'm not surprised to see the BBC's health team cite piss-poor statistics again. Every time an issue regarding medicine or public health comes up they manage to completely blow it out of proportion, be completely wrong, or simply not understand the scientific relevance of the data they're citing, pro or con. Their statistical analysis team is pathetic, probably because it's one high school-aged intern in a windowless room with an unrestricted internet connection (for medical research, after all) and an HD monitor for better porn viewing. They're usually wrong, and if they're not wrong, they're exaggerating, and if they're not exaggerating, it's not relevant.

Nevertheless, they have a responsibility to uphold when it comes to issues of public health, particularly family planning issues. (don't you hate that term? 'family planning--of course everyone plans to have a family someday, just not right now!' what about 'family prevention' issues? That's my kind of term.) The BBC is the most respected news provider in the world. What they write gets read and trusted.

Most people do not read news articles' statistics with an air of complete unbelief. Most people do not have the time or patience to check their facts and figure out where their numbers are coming from, or are composed of. Most people just read "600 pregnancies! This stuff is useless! I'll never waste my money on it, no way. I'll trust my good sense." Not realizing that it's 600 out of hundreds and hundreds of thousands, not realizing that most of the failures are in fact unrelated to the medicine entirely, not realizing that this news is not newsworthy. It's the 5th most popular story on their site today. The BBC is affecting people's judgement with their pure, unadulterated idiocy. Some dumb teenage girls who were considering an implant may now decide to try their luck without, ('cos hey, you know what's smart? teenagers.) because Doofus in the office wanted to make a sensational headline. Or they'll go with the Estrogen/Progesterone combi pill, which has over 60 years worth of reported side effects and time-sensitive dosage related failures to its name.

This insert is one of dozens of medicines which have emerged in response to the regular failures of the original pill. We know it sucks. It works, but at such a cost as to make it not worthwhile to many people. The daily pills at exactly the same time; the weight-gain, the bloating, the depression, the nausea, the acne, the drug interactions, the fibroids, the migraines...it's all well-reported. Is Implanon the be-all fix? Of course not. We can always strive to improve it, and there's plenty of other options that work well for plenty of women. I'm happy with a non-hormonal IUD. In 10 years I'll have to get another one, but hopefully by then the fear will have passed. But the point is, it is hugely irresponsible for the BBC to wag its ass around bad-mouthing what are, even where they aren't perfect, clear improvements on the old medicine. It is stupid to try and shock the public into mistrusting a drug which is far more trustworthy than most alternatives, including Old Reliable.

The new drugs have developed because people figured out how to do things better, even if the primary improvement needed was in the patient herself. Implants and IUDs don't have different numbers in the 'perfect use' and 'typical use' columns. Because they don't rely on a normal human brain with a normal memory and normal habits to keep them working. If you miss one Pill, even by a few hours, your entire month is wasted. That's not reliable, even if the chemical in them technically is.

Implanted hormonal birth control is the best option for teenagers--it's low-dose so it doesn't screw with their brains or bodies too much, it steadily delivers, they don't have to think about it, it may slightly lower libido which could help them focus in school, and as IUDs may slightly increase your likelihood of contracting an STI if you sleep around they're a better bet for kids with poor impulse control or who get pressured by stupid boys out of using condoms.

Throwing teen girls directly into daily pill regimens does not teach responsibility. It relies on a responsibility that is usually absent--a dearth which is likely to have devastating consequences. Our state and culture should encourage usage of thought-free birth control for girls. The Pill has gone the way of the Studebaker--the clunky, awkward old technology without anti-lock brakes, crumple zones, or airbags. Birth control needs to keep you safe from yourself as well as others, which pills cannot be relied upon to do--particularly when you're in situations (lake house weekends) where sexual activity is likely (the whole reason you're there.)

----

I also believe our state and culture should encourage teenage through college-age boys and girls to think that buying condoms is coooool. It's just not right that it's so awkward to go to the student health centre and see the big fishbowl full of brightly-coloured prophylactics on the desk next to the kind-eyed elderly receptionist. "I..I want them, I know they're there for us, there's even a heart-shaped sign on the front that says 'Take what you need!' but...but...what if she's a widow? What if she hasn't had any in like, half a century? What if she's judging me, or jealous? How am I going to get any good use out of these if all I can think about is the old condom lady?" I remember gingerly taking a couple on my way out one day after having my arse x-rayed, just because I can't resist free stuff, and she looked at me, smiled, and said "Always the girls taking those. I don't think the boys can face me for them, but I've always insisted on having them out for you kids. Be safe!" I smiled as I left the building--my bruised but not broken coccyx still aching--then shuddered at the idea of ever using Sweet Old Lady Condoms.

NHS musings

I've been going to the NHS for several months now to seek assistance with my skin. My face, chest, and back have until recently been constantly coated with antibiotic-resistant, regularly refreshing acne, and it's taken its toll on my self-esteem. For about 5 years I have felt ugly, ashamed, and sad, which has inhibited my motivation to take care of myself, exercise, wear pretty clothes, or give a damn about anything aside from my fury-inciting reflection.

I started seeing a GP in September, who, after hearing my carefully documented treatment history over the past 5 years in the USA, began me on the exact same treatment I started on 5 years ago in the USA. I came to understand that if you move country, your health records aren't recognized as legitimate. Fun.

So I spent an entire academic year on a trip down memory lane--the same old treatments, the same old failures. Benzoyl Peroxide/clindamycin cream, BP/CY plus lymecycline tablets (topical plus internal antibiotics), Retin-A plus lymecycline tablets, more Retin-A, and finally "I can no longer treat you. I'll refer you to a dermatologist."

Great. 3 months of Retin-A later, my dermatology appointment arrived. I waited over an hour and got a ten-minute appointment in which I was told, "the next step is isotretinoin, but I can't prescribe that here. We'll have to re-evaluate you at the hospital and decide if it is best for you there."

Between starting treatment and reaching this point, I moved. Not a huge distance, but I moved from Greenwich's NHS trust to Lewisham's NHS trust, and continuing to see the same GP was becoming a hassle. After the move I asked if I could transfer my records and progress to Lewisham and was told no. "You'd have to start over from scratch."

I moved 4 miles, in the same country, within what I thought was the same health service (that whole "National" thing kinda threw me) but my records would not follow me. That makes no sense.

Nevertheless, I persevered, and six weeks later I was seen by no less than 5 doctors who all agreed, after I passed a pregnancy test (I suppose? Passing is being not pregnant, failing is being pregnant? Is pregnancy a failure? I mean with some medications it is, but what about at fertility clinics?) liver function test, cholesterol test, blood count test, platelet test, and additional pregnancy test, that I was a good candidate for Accutane. I signed the NO BABY forms, promised I would not remove my IUD, received my first month's supply of medicine, and got a little cold.

What's that about the little cold, you ask? How is that relevant?

See, in order to receive this treatment, for which I am very grateful, I have to go to one of the giant hospitals in Greenwich council. To get my blood tests, I have to wait about 2 hours in a vast, crammed-full lobby with hundreds of other outpatients, all stiff-upper-lipping through their godawful diseases. When my eyes get tired of reading I tend to quietly play "find the sickness" with my fellow patients. With many, it's dreadful diseases of the elderly--painful-looking skin and joint conditions that are both causes and symptoms of a sedentary lifestyle. Others snarf back slime while trying to entertain screaming and oozing children. Still other afflictions aren't apparent until you see the back-pain dance when their numbers are called. (And then there's the otherwise-fine folks like me, feeling apologetically out of place but staunch in our assertions that we deserve treatment too, and dammit, we pay our taxes and we've waited long enough.)

But as with all overcrowded hospitals, feeling fine on arrival is no indicator that you'll leave in good or better health. These people, coughing and even just breathing in your vicinity, are certain to share something during your afternoon in this poorly-ventilated, windowless sick-tank. At least half of them have been there an hour or longer, silently spreading their sickness to surfaces and staff alike. (hopefully not staff, but I couldn't leave the alliteration chain hanging.) The sniffles and subsequent nausea from knowing where that bacterium just floated over from leave me wanting a scour-shower when I get home--something I shouldn't do now that my skin has been made delicate and sensitive by my medication.

The thing is, none of this is necessary. I recognize that medicines such as Accutane are controlled substances, and reasonably so, and as such it may not be a good idea to dispense them at Boots. But there's no reason why they can't be dispensed at offsite dermatology clinics. With the right distribution controls it makes far more sense to provide medications at purposed pharmacies--if you run a general practice, the NHS pharmacy nearby offers a well-rounded supply of frequently requested drugs. If you run a neurology practice, next door you sell brain-related pharmaceuticals. You offer phlebotomy services at GPs, even if you occasionally have to send samples to larger labs for more obscure tests, and you do not make thousands of patients spend entire days waiting in stuffy, pathogen-rich disease transfer centres for testing and medication. That's a huge health risk--indeed, probably the biggest health risk in the entire system. F'ing Ellis Island was cleaner than this.

But no, those tight-fisted money grubbers at stage 2 of funding are fighting tooth and nail to keep that from happening. See, the big cheques come from the government to the hospital trusts, and they like to keep all their money to themselves. They distribute a little bit of it to community GPs and clinics, but the bulk of the cash never leaves the hospital. They account for this by offering all the services that would otherwise be distributed throughout the neighbourhood on-site, but crippled to near uselessness by three-month waits, overcrowding, under-staffing, and poor site management. Worse, referrals into the hospital are complicated by hundreds of different forms used by the hundreds of different GPs who haven't had the money to upgrade to something compatible with the centralized data system, or the last 10 upgrades to the hospital data system. So you walk up with your handwritten phlebotomy form and the receptionist spends ten minutes digging through her notebook of phone numbers to find a contact for the doctor's office who produced it so she can ask them what this form number refers to in the new system. Gaah.

Centralization has never worked. Big hospitals are the biggest culprits when it comes to accidental disease transmission and stress-related malpractice. You just can't cram all those different conditions into one place and expect things to be okay. Even with a huge full-time well-trained custodial staff shit goes wrong, sometimes literally.

Take Outpatients Out of the Hospital. Separate maternity centres from skin disease wards. Let people avoid six month queues by allowing more doctors to practice in more places, and let qualified pharmacists make informed decisions no matter where they are.

If you're curious (and have a strong stomach--otherwise please skip this paragraph), my skin is looking a million times better than it did this time last month. Thanks to it being that lovely time of the month my face is bumpy and my pores are enlarged, but I'm not seeing any of the typical redness, gross inflammation, pain, oil sheen, or pustules. The doctor says the bumpiness and pore enlargement should go away over the course of treatment. I've been getting some red patches on my arms but I moisturise constantly. My cholesterol and liver function are still fine. My hair stays clean for days on end, so I'm saving water, and interestingly--mom, get this--you know all that weirdness in my ears? That's been wet and inexplicable for more than a decade? I still hear the crackling noise whenever I swallow, but I've not had any active dripping all month. Indeed, my earwax is actual wax, not a fluid. Wow. (grossness ends)

Anyway. While I appreciate the NHS, there's a lot that can be done to improve it without increasing costs or reducing safety. If the conservatives can pull off what they claim they'll do in that regard, I'll applaud them. If, however, they let their grand scheme get buried in business-as-usual, I will not be surprised.

knees

Bona-Fide question--I would like to know, of my readers, who finds ladies' thighs that don't touch when her knees are pressed together attractive. As in, ankles and knees touching, but one and a half to two inches of breezeway between the legs when they meet her groin. I am genuinely curious here.

Because I don't. I think it looks wrong, at the Id level. The animal in my brain is frightened and repelled by ultra-thin frames. This is not my aesthetic speaking--I appreciate all shapes of people for their artistic value--but the hungry, violent, sex-craving, and linguistically impaired chunk of my functionality makes my heart race and my feet want to run away when I see stick-legs. While the impulses these people elicit in me rarely reach the analytic area of my mind, or even form themselves into words, when I see these breathing Jack Skellingtons folded into chairs I find myself very hungry, very anxious, and very aware of my exits. My self-preservation instinct, which will never understand the intricacies of society, is scared that I'll become trapped in here and made to starve with these people.

Yes, I spent my past two weeks working in fashion. (Buh? You? Fashion?) I was dressing models and tending wardrobe for a high-end New York design firm for a sales event of some persuasion. It was actually pretty fun, and half of it was work I do anyway in my closet, just on a larger scale. Each garment, of which there were about 400, had a place in a very specific order, which was listed in a book. All I had to do on the showroom floor, aside from serve occasional coffees and clear up tables, was make sure that each garment was put into, and put back into, its exact spot in the rack--which lined all of the walls of the large space--between buyer appointments. Backstage, as rackfuls of clothes were brought in for the models to, well, model, I loosened, unbuttoned, and untied garments, put them on the models, tucked, tightened, zipped, and buttoned dresses, buckled shoes, sent the girls out, collected the garments when they returned and, after putting the girls in the next look, re-hung, re-buttoned, tied, fastened, straightened, and snapped all closures and hung them on the buyers' racks in the showroom. We were forbidden from allowing garments to touch the floor--the cheapest of which would have taken me a month to save up for, the most expensive would have wiped out my savings and put me into serious debt--and probably would have been flatly executed if we'd soiled or damaged anything. As it was, the sample clothes started falling apart by day 5--hastily sewn collars parted, unfinished seams began to unravel, snaps fell off, zippers snagged, and the floor was literally littered with sequins and beads. One particularly ugly zipper snag, which everyone agreed was not preventable, had to be taken up to the designer's desk so she personally could snip it out. and by "taken" I mean "walked"--the model was trapped in the dress. It was kinda funny.

Most of the buyers were lovely people, though some were jerks--the kind of people who want to see this dress in all five colors it comes in, as quickly as possible, only to say, "no, I hate all of them." Occasionally a model would ask, "Didn't I just have this on?" and the seller would reply, "oh yes, you showed these dresses a few minutes ago, but the buyer wasn't paying attention so if you'd please walk them again? thanks." through tightly clenched teeth. But, even in haute fashion--or perhaps especially so--the customer is always right. And the sellers were always smiling. As much as it may have hurt.

I liked the people at this fashion firm--they seemed genuine, for the most part, and if the pants size in the building was an eighth of the city's average so what? Skinny people need jobs too.

I spent most of my time, however, sitting and doing crossword puzzles in the dressing room with the girls. Most buyers would block two hours for their visit but the modeling component only took a third of that time, so we would chat about current events and our own lives. One of the girls had just bought a condo with her husband. The other is working on her PhD. They both party on the weekends and come in with blinding hangovers when they overdo it. They read the paper, they file taxes, they love their families, and if it weren't for the fact that they were both 5'10," flawless of complexion, comfortable naked, and frighteningly rail-thin they'd be just like you and me. They are aware of the anger their careers incite. They're aware of the pain that their glorification generates. They suffer for their bodies, and they suffer when they fail anyway, just like us.

"I'm downright obese for a model." said the emaciated girl as she stepped out of a pair of trousers she deemed ill-fitting. "These were made on the other girl, who is shaped right. I'm a fatty. I mean, I know I'm still terrifyingly underweight for a real person, but in this field...pass me that skirt. I can wear that."

"You are a bit of a big one," the other twig replied as she took the aforementioned trousers and pulled them on. "I mean, I'm really proud of this company for hiring you. Not every designer feels comfortable hiring a plus-sized girl like you, but I think this company is responding to current social pressure to stop making chubby little girls feel bad about themselves by contrast. And they started with you! What an honor."

"I know, I'm doing my part. But it's true. He thinks my hips are too wide."

"Yeah, he thinks my boobs are too big."

(she has hips? She has boobs? Where?)

The girls ribbed on each other like this all the time. The one may have weighed about three pounds more than the other, and while this was not noticeable to the naked eye, for some garments it meant the difference between a dress squeezing on and not. Because yes, even though these girls were underweight to the point of infertility, even though they couldn't maintain their own body temperature, even though their cheeks were hollowed out with melon-ballers, they were too big for the clothes. And it wasn't the clothes' fault.

Even runway models are expected to modify their bodies to fit the clothes. It's not just "real" women who are made to feel imperfect by a French seam. It's not just "real" women who are made to believe that their woman-shaped butts are too big because they cupcake over the waistline of their trousers. Even the people for whom the garments are made are told they fail to fulfill the designer's vision.

Because the garments are not made for these models. Nope, not even these women who work hard and starve daily, these delicate, shivering towers--they don't do the dresses justice. Because who they would really look best on is twenty year old drag queens.

I am tired of being told how to look by gay men. I have boobs. I have an ass. I have thighs and a belly and my hips are a force to be reckoned with. I'm shaped like a girl and I should like that. I do like that. Gay male fashion designers need to be designing for the little cross dressers they love. Their ideal woman is not a woman. And if they weren't in a position of global influence that would be absolutely fine. But it's not just that women around the world are frustrated with themselves for not being tall and thin. We feel frustrated with ourselves because we're not teenage boys.

I AM NOT A TEENAGE BOY.

I may have the acne of one, but I'd never pass for a gangly gay youth. I have curves that designers flatly ignore. The reason the size 12 version of that dress will still look horrible on me is because you've just made it a foot larger all around--I go out and in and then out again in what some people would assert is a rather pleasing manner. But That dress in my size will be two feet too long, too big in the waist, too small in the bust and hips, and wouldn't even begin to accommodate for my arms. And if I got it altered--well, actually it would still look stupid, because if it is reshaped for a person with a shape, it's no longer the same dress. No matter what, the top designs will not look good on me, because they're not intended for me. They're not intended for women.

I know my proportions are not media-beautiful, and my weight is downright alarming, but even when I kept my hair cropped to a uniform 1" all around I was rarely mistaken for a man. But even when models have full Farrah Fawcett heads of hair a part of me wonders if any boys have been slipped in--I'm sure it's the next logical step for most designers. When your best model fails to conform to the ideal, it's time to change the model, not the ideal.

"This next look coming out on 15-year-old Hans is our playful take on the classic bikini. Note how the beading moves the eye away from the bustline, encouraging a slimming effect and smoothing out any roundness. Available in lime, tangerine, and cerulean, sizes 00 through 2. $11,300."

sniffle

I enjoy the Wombats. particularly the backing vocals. I think everyone should.

I recently bought my first set of Grundens foul weather gear. they are mighty.

I have a bad head cold. the first thing that goes when I get stuffy is my balance. then everything gets funny. then starts the coughing. now i've hit the slap-happy-headache stage. I think its Grayhounditis. When in doubt, blame public transit.

Since I moved to Baltimore, New York City has become less of a hated, feared, nasty place and more of a haven for fun drunken weekends and culture. NYC, I don't hate you anymore!

I still panic in crowds though.

The Heat Index or When A Gallon Just Isn't Enough

So it's pretty dern hot and humid out. This weekend saw the first day of hazardously hot weather for the greater Baltimore area so the computer voice on the weather station had helpful tips and reminders for how to stay safe. In addition to the temperature, wind, and waves, the weather voices occasionally are programmed to offer little quips such as "turn around--don't drown!" and "on frosty days, cover your delicate seedlings and bring potted plants indoors." While the voices are a bit more sophisticated than the typical "Alvin" speech replicator, they nevertheless sound pretty funny when called upon to say anything more than "at Thomas Point Light House, Fog was Re-ported. The TEMperature was Nine-ty Four deg-rees. Now for some Ob-Ser-Va-tions from the surrounding A-rea."

In any case, I realized I drank 5 liters of water today and still felt a little dehydrated. We've reached a point at which it's just too damn hot to eat, but if you don't eat you get even woozier with nothing to hold your water. Bleh. Interestingly, this hot weather has brought with it the smell of salt and a number of breathtaking lightning storms, pretty much overnight. I'm glad I got my hair cut when I did--curls plastered to the back of my neck would be intolerable right about now.

clunk

today I whacked my head a good one down in the fo'c'sl, whereby I earned a fun little goose-egg right on my hairline. It already hatched into a throbbing headache and died down, but man, i hadn't clocked myself like that in a while--literally knocked myself down.

This was after waking up this morning without the ability to speak. My voice came out as a pinched, scratchy, bubbly whine that rarely peaked above a whisper and was a source of some amusement for my crew and students. I am currently enjoying a lovely throaty-coaty tea, donated to the cause by my friendly co-worker (who's been battling the same microscopic invader for some time now.) Mmm. Tea.

In short, today was a bit rough on the ol' upper body, but the kids were excellent and our helpful intern did my speaking for me, so things worked out okay. And though I have had "Nice Weather For Ducks" running through my head since i whacked it, I don't think I'm concussed.

Now please excuse me while I give this pink elephant directions to Candyland.

ill again

I think my mom kinda likes it when i'm sick--my semi-annual battles to the death with microscopic assailants really make her feel appreciated. The last time i felt this lousy i had a 3-day hangover, but even that didn't include a sore throat. I feel like whining.

I Heart Hospitals

Somehow, every time a virus makes its rounds about this household, it seems to be brought in by the healthcare professional.

sticky

I'm back in South Carolina and damn, i forgot what 100°F, 100% humidity felt like. and what it looks like when bugs kamikaze-dive into your windshield. and how Loud nature is. did you know bugs make noise in their spare time? I'd gotten so used to the high-altitude cool dryness and quietude i completely forgot that the south is absolutely not at all anything like that.
I got out of the car and my eyes immediately started watering and my sinuses stopped up like they were desperately trying to close the blast doors against invasion. There's all this...flora here.

On an interesting note, all of the sealed bottles in my luggage crunched and squished on the drive down from 9,000 feet to sea level. the altitude change did a similar number on my ears. I wonder, if you dropped a lightbulb out of an airplane at cruising height, how long would it fall before it popped?

drugs

The other day i saw a television advertisement for a new medication targeted at people with "Restless Leg Syndrome"--folks who wiggle so much in bed that they have a hard time sleeping.

Um. Wow. Screw searching for treatments for legitimate diseases, lets patent and sell a drug for folks who don't get enough exercise during the day so they have pent-up energy at night. I have a funny feeling pharmaceutical companies have taken to inventing medical conditions so they can invent treatments for them. Restless legs? Take a walk. Go out, buy a dog, buy a leash, and walk it.

Now I recognize that profits are falling for one of the bigger drug companies after a cholesterol-lowering medication, made available to the public, turned out to have some nasty side effects that got it recalled. It came as a biting hit as they were really counting on the patent revenue from this drug (i think its called Lipitor?) to keep them afloat for the next few years. So i can only assume, now that this product has generated a loss, that they're going to be promoting their less-interesting drugs a bit more vehemently to make up for it. Unfortunately, an unwanted side-effect of this marketing campaign is that they make themselves look like dorks.

And i can only hope that this RLS drug occurred completely by accident. I envision a tired chemist mixing, pouring, looking cross-eyed at a sheet of ingredients, filling an eye dropper with a cloudy pink solution and feeding it to one of his twitchier lab rats through the grating on a sterile aluminium cage. After a few minutes the rodent falls asleep and he checks his vitals, takes some blood, pokes and/or prods the animal and records "day 312: Mopsy's tumor is no smaller, but interestingly, though his resting vitals are all normal, he's less wiggly in his sleep."

If anyone actually funded a project to develop a drug to reduce nighttime twitchy-ness...i think the entire medical community should hang its collective head in shame. That's a waste of money, time, resources, and above all, intellect. I would be so embarrassed to go through twenty years of schooling and get four PhDs, only to get a job heading that product team.

games and recreation

When I was a kid I hated gym class. From first through twelfth grades, I was the Anti-PE. And in retrospect, its no wonder.

The thing is, when it comes to physical exertion, there are several activities I dread: running, hauling, and team sports. Running and hauling hurt, and as any archive-reader will know, I'm of the opinion that pain is your body's way of saying No. I carried a 4'x8' (1.2m x 2.4m) sheet of half-inch MDF about a city block today. These sheets generally weigh about 80 lbs (36kg) and catch the wind like a sail (which, naturally, pushed me backwards). By the time I put the damn thing down my hands were blistered and raw and my arm was tingling. Hauling just isn't fun. I don't understand the appeal of the "world's strongest man" competitions because frankly, all they're doing is heavy labor that nobody in their right mind would do for fun--and only the winner gets paid!

Anyway. Team sports. I despise team sports. I just do not have the enthusiasm for any activity that involves running after or hitting or trying to gain possession of...a ball. Maybe if it involved swords or oranges or something, but certainly nothing so pointless as a ball. What always made it worse in school was the teachers' constant attempts to get you "into the game"--to get you to look like you gave a damn. Yes, i was one of those girls in softball--standing in the outfield, chatting with the other apathetic outfielders about how cute the batter looked in his little gym shorts, and occasionally glancing up as a ball sailed three inches over my head and over the fence. They always told us we were graded on participation, but as there were about 80 students in each class, we figured out pretty early on that "participation" meant "attendance."

Thing is, though, I enjoy a lot of physical activities, but I always hated gym class because they never offered us the option of doing any of them. We always had to line up with tennis rackets and whack a ball over a net or line up with basketballs and try to make a lay-up shot or simply run around in circles for an hour and a half every day. When I was in school, I was a dancer. I have the knees to prove it. I also spent about four hours a day, five days a week practicing (okay, i was in the school color guard. I didn't go to Julliard or anything.) It always struck me as funny when my gym coach would accuse me of being lazy because i couldn't be arsed to chase other children around the football field until i was winded. I always wished they would offer you the option of taking ballet or gymnastics or yoga or something. We got the choice of jock- PE or Marine Corps ROTC, and i figured the former was slightly less likely to get me shot.

When I was really little, PE frequently involved group games that involved a lot of squealing and giggling. Back in the day we played Red Rover (i've heard it was recently banned in schools as too many children were getting broken arms and concussions from it), London Bridge is Falling Down, and one i never quite got on with, Mother May I. For anyone who's never heard of it, Mother May I is played by a medium-sized group of children who all know each other's names. One caller (the "Mother") is at the front, and the other children face him or her from a line a specific distance away. One by one, the Mother orders each child to take a specific number of steps toward or away from him/herself, frequently in a forceful or threatening voice. At which point the called-upon child must remember to ask, "Mother, may I?" and wait for a response before proceeding. The Mother may then choose to respond by saying "Yes you may" or "No you may not" and the child must behave accordingly. If the child fails to ask if he may move, or if he moves too few or many steps, he is thrown out of the game. The first child to reach the Mother wins, and becomes the Mother for the next round.
As an adult, it occurred to me that this game is based upon the notion that all mothers are, in fact, senile. Did your mother ever holler at you to clean your room, even threaten you with punishment if you didn't, then show up in your partly-cleaned room ten minutes later and ask why you weren't downstairs doing your homework? That's kinda the premise of this game. You are given a direct order, made to ask if you are permitted, and then are frequently told you may not do as you were told. Huh?! Its like the conversation, "Go do your laundry." "Do I have to?" "Not a bit. You stay right there and play your video game." I just don't get it. Is the game intended to encourage obedience or sass? If a kid ever responded to an instruction with "mother may i?" to her own mother, she'd be smacked for givin' her attitude. Yet this game has been around for probably centuries in one form or another. It resembles Simon Says in that you're supposed to wait for a specific word or phrase before complying, but i never liked that one either on account of the fact that the teacher usually played Simon or Mother and they barked orders at you like a friggin' drill sergeant. After a while I really wanted to miss a command and wait for them to say "You didn't ask 'mother may i', you're out!" just so i could look incredulous and say "So, what, you're encouraging me to question authority now? Well I'll be damned. And in public school."

ooh me back

General inquiry directed toward any and all who may casually read this blog--my back is killing me. every morning i wake up kinked all to hell and it lingers all day. I've tried putting a sheet of plywood under the mattress to give it some back support, i've tried it with egg crates and memory foam and without, i've changed out pillows, i've even tried sleeping on the floor. i still hurt!
i exercise regularly and sleep just about 8 hours a night. i'm a theatre carpenter and spend my working hours lifting, hauling, and using high-torque power tools, but i've been doing this for years without adverse effects and i'm still young. So--question time: does anyone know a way to improve a shitty bed (note: the bed provided in my temporary housing is sized to comfortably fit a ten-year-old pygmy...but my bedroom is also appropriately sized for such a being) without caving and buying a new bed that i'll only use for the next three months?

in other news, i think i have found the evil "left wing liberal media" that the white house made such a stink about a few years ago. its called MAD magazine. they've completely given up on subtly criticizing the president and are even today warping our nation's youth with blatant statements of dissent concerning our nation's foreign and domestic policy. And to think, i was about to let my 12-year subscription lapse.

Open A Window

I am the anti-smell. Scented candles make me nauseated. Bathroom fresheners cause my temples to throb. Odor-eliminating sprays are my #1 migraine trigger. It Baffles me that people spray nasty chemicals into the air in their stuffy houses to "freshen" them, and then they proceed to stay in the room and Breathe that shit. Ever read the side of a bottle of Febreze? "odor eliminator" is considered an ingredient. I consider that a massive unpronounceable compound that someone figured they'd simplify. Some sort of noxious, plastic, cinnamon-inspired completely-artificial vein-inflaming horror has been reduced to "odor eliminator" on a brightly decorated spray container. Frequently these have warning labels that say "may be harmful to children or pets." but not harmful to you, you grown-up purchaser of pressurized stench. It may kill Fido but you'll come out with little more than a nagging head cold and a depleted immune system. Because This stuff is good for the air and your brain cells. That's why Corporate America encourages you to spray it directly into your nose--so you'll unlearn the dangers of huffing vaporized industrial particles and BUY MORE.

...someone put one of those stink-cones in my house. Two hours after I removed it my head still hurts and I'm dizzy.

on sports and sugar

I gotta say, I am so proud of myself for not dating a sports fan. I don't know how golf widows do it. So frequently I hear my friends' young men babbling excitedly about whatever sport is in season--how the player slammed the puck straight out of the court with the bases loaded with ten seconds left to score the winning touchdown. I see them running around, using furniture and pillows to re-enact the momentous scene, even going so far as to mimic the player's particular end-zone dance, to prove to their dearest loves that this is only the awesomest thing to happen in the history of the universe. I see my friends' eyes glaze over as soon as the word "basketball" is uttered, and I watch their default game-faces set in like a dose of Botox. You know the ones--the smile that doesn't quite reach the eyes, the frequent nod of understanding, the occasional "ooh, wow!", and the gradual development of a twitch in the right side of the face that worsens as time draws closer to the Superbowl. I listen as these patient ladies comfort their distraught mates when their teams lose in spite of everything--blame the refs, blame the weather, blame anything to keep the boy from crying. They hum the school's fight song like some grim travesty of a lullaby and stroke their greasy heads that reek of so much cheap beer.
I do not envy these women. I have no patience for sports and even less for the people who enjoy them. I do not understand people who's evenings are made or ruined according to the behaviors of people they do not know who get paid whether or not they win. I don't understand the joy or the grief of game watching. The last time I watched a football game the only thing I recall feeling was my ass going numb on the aluminium bleachers. It was not a joyous experience.

In other news, since I moved to California I've decided to eliminate corn syrup from my diet. It has gone well and i feel that i am eating more healthily than ever before. Moreover, it is very easy to avoid chemical foods out here--in fact, there are chains of grocery stores here that exist on the very premise that food should be healthful and inexpensive. What a concept. Unfortunately, when i went to the east coast this winter I was reminded that this is not the case for everyone. Entire areas of the country know nothing about the contents of their food, and have no other option for sustenance than the preservative-riddled, corn-sweetened, petroleum-based offal sold by Wal-Mart. WHEN DID AMERICA DECIDE PLASTIC COULD BE SOLD AS FOOD?

You wanna know why American children are overweight? Even the ones who don't have playstation threes? You're feeding them bright pink corn-syrupy garbage. Just because the advertisers can get away with calling Lucky Charms "part of a complete breakfast" doesn't mean its okay to feed to toddlers.

What's that? You say you don't feed your toddlers bright pink food but they're still fat, ADD, lethargic morons? READ THE INGREDIENTS. Most "whole wheat yes this is good for you" bread is full of high fructose corn syrup, maltodextrin, hard-to-pronounce sweeteners and bizarre chemical combinations that are not good for you. They sell it as "healthy" because its brown and the first ingredient is unbleached wheat flour. But read the rest of them. Yeah, all the rest of them. Get out your periodic table and figure out which lab-developed molecule you're eating today because Post or General Mills wanted to cut corners on raw ingredients.

General rule of thumb: If it ain't found in nature, its not food. That's not to say rocks and arsenic Are food, but let's be reasonable. Scientists invented trans fats because they thought they'd be better for you. Now they're killing people. Oops. Chances are, 20,000 years of species development has figured out a lot more about what's edible than 50 years of molecular science. I'm waiting to hear that Omega 3 fatty acids are a carcinogen or the inevitable "okay, we lied, there's no such thing as good or bad cholesterol." The country only started having pandemic obesity and obesity-related disease problems since we moved our jobs inside and started eating silicone. Somebody please pass a law. We must make healthy, chemical-free food readily available to the general masses if we don't want to watch our national IQ plummet even lower.

on the subject of taboo

all right you Freuds out there, whip out your pencils, 'cos i've been thinking about sex lately. unfortunately...not really in a fun way, but with the self-righteous disdain i usually reserve for politics and ex-boyfriends.

To state the obvious, many Americans want young people to be taught that sex before marriage is a really, really bad idea. Many laws have been passed to make sure that not only are children and teens taught the government-edited version of human reproduction, but that they understand it is wrong, dangerous, and frightfully uncool until a judge and a preacher permit it between you and only one other person of the opposite gender. Parents, educators, clergy members, and police officers alike are unified in their desire to see young people remain face-twitchingly horny until they've jumped through the appropriate hoops and signed the dotted line indicating that they're now permitted to fulfil a need their entire physiology has required for a decade or more.

I have touched on this topic before, but it never really occured to me to consider the history of what is now called "abstinence-only sex education." I remember all too well shuffling uneasily into the gym bleachers and observing fuzzy line drawings of my reproductive anatomy while a coach droned on about the dangers of STDs. I recall feeling horror and revulsion when a dry, flaccid condom was passed to me by the twelve year old to my left and hearing sob-stories about infections and childhood pregnancies. But until this week i never really thought to wonder Why all this emphasis was placed on deterring the young and unwed from getting jiggy. Is it to curb the spread of infection? No--in this country little tax money is spent on medicine so its not really hitting people in the pocketbook. Most people don't care if others have disesases, so long as they don't, and anyway the government doesn't give a rat's ass about young people's health or well-being. (They recruit young people to go get shot at, for chrissakes.) Is it to prevent unwanted pregnancy? Again no--the fact that someone is married is not an indicator that they want children, and thanks to hormone technology babies can be prevented until they're wanted regardless of marital status. Okay, then, it must be because Jesus said so. ...Still no. Though the Bible does speak out against adultery, it says nothing about premarital or unmarital sex.

What is it, then, that makes Americans so insistent that their children not only endure sexual frustrations to the point that they torture small animals, but actually pretend to not have these impulses? Today's parents like to imagine that their teens are asexual and only date with the mindset of finding someone who's nice to talk to. Though I'd be hard-pressed to find a rational adult who actually believes in this fancy, people nevertheless hope that their children aren't out using their reproductive organs, even after taking reasonable precautions.

I can only assume that they think in this way because they've been conditioned to by their parents and preachers, and those before them--even back to people who didn't know about sexually transmittable infections and didn't care if poor people got knocked up.

Nothing that is taught in schools legitimately adds up to a longstanding will among humans to prevent extramarital relations. The church states only that sex is an act to be enjoyed only by married couples, as though its a reward for putting up with the rest of their BS.

And then it hit me. The most logical reason why anyone would want their partner to not have experienced sex before they tied the knot is because they don't want them to know how it's supposed to feel.

Kristen's Axiom #1: Men are insecure about their penises.

Everything comes clear! Men want to marry virgins because virgins have never been pleased or displeased in bed before. They have no idea if their husband is doing a good job because they have no basis of comparison. They're terrified that they're lousy at pleasing their parter, but as long as the wife has never had better she's not likely to leave him on account of it. she's just less likely to want it much, or maybe she'll even believe that sex is supposed to feel that bad. Thus their marriage is not dependent upon their wife's appraisal of their ability.

which, of course, sucks for the woman. Many women go through life thinking that they don't have the ability to orgasm, or that sex is simply something to be endured as infrequently as possible in order to keep the family name going. They don't have a clue that there are men out there who are not only good at it, but enjoy going out of their way to make their partners happy. It is on account of the average man's fear of failure, paired with his unwillingness to put effort toward pleasing his wife, that for centuries humans have tried to keep sex from being an orgasm contest.

I believe that sexual failure is reasonable grounds for divorce.

Moreover, i believe unwed people should be encouraged to engage in protected, disease-tested sexual behavior. Girls and boys alike should go on dates with a stern warning to do it as safely as possible. Not just a reluctant "well i know you're going to do it anyway" but a serious encouragement to get out there and learn. So that if the young person decides to get hitched, they're more likely to have a good, low-stress adult life with someone they love. 'Cos face it, if you know what you're doing, you're very unlikely to glue yourself to someone who's incompatable with you in bed. That's masochism.

Human behavior is regulated by the body to serve its needs through a fairly simple system of rewards and punishments. Whenever you do things that your body likes, different glands secrete happy hormones into your bloodstream. One of these hormones is Oxytocin. It is released when people hug, when mothers breastfeed, and in significant amounts during orgasm. Oxytocin is also instrumental in the development of trust and friendship in the brain, as it associates the positive feelings induced by Oxytocin with the hugger, baby, or partner in question. Your brain, as smart as it is, very easily becomes addicted to things that make it feel good. Oxytocin is generated by the body and is not carcinogenic so its okay to be addicted to it, and more to the point its release rewards healthy behavior. The "mother-baby bonding" that happens during breastfeeding is not just a sweet idea--its actually chemically conditioning the mother to want to nurture the baby and the baby to trust its mother. Similarly, the happy stupid feeling people have after a good round in the bed is chemically induced and imprinted on the brain in the file marked "partner." Couples who have good orgasms are much more likely to start loving each other, and stay in love thanks to the brain's will to do anything to get more Oxytocin. If your brain was a junkie, and you were its dealer, this stuff would be your crack.

The key to a successful relationship is happiness, and the key to happiness is positive hormone reinforcement. And that means good relationships and good sex. The fact that we're uncomfortable saying this aloud and keep it behind closed doors indicates that a lot of people aren't having good sex, and may not be very happy. I believe it is time we encouraged the unwed to begin to practice and learn with their friends how to make each other feel good. It is about damn time we as a society grew up and had a healthy, mature attitude toward sex.