medical side effects

Archive for October, 2010

Misguided Idealism

Wednesday, October 27th, 2010

I have an idea.  We should stop giving the measles vaccine.  Obviously the measles is a serious medical condition, and yes, there is a proven and effective vaccine for it.  But I think we should stop giving it to kids.  They need to learn to take control of their health and I think we should stop the spread of measles by encouraging personal responsibility among children.  We should teach kids not to interact with other children who might have the measles.  We should tell them not to trade lunchbox items with kids who could be infected.  And we should teach them that they’ll have to deal with the consequences if they end up catching the measles.  Okay?

Not okay.

I hope you know I’m kidding.  That entire paragraph was dripping in satire and sarcasm.  I want to be clear about this: I do not believe we should get rid of the measles vaccine. Obviously, in this case the measles vaccine is an analogy.  But for what?  So glad you asked: Sex education.  (In case the big picture of a condom tip you off…) 

Last week I read this article about teen birth rates which was written in response to a new report from the CDC.  I learned that in Connecticut, New Hampshire, Massachusetts, and Vermont – where comprehensive sex education programs are in place – teen birth rates were less than 25 per 1,000.  In Oklahoma, Arkansas, New Mexico, Mississippi, and Texas – states which emphasize abstinence – teen births numbered more than 65 per 1,000. 

I both was and was not surprised by these numbers.  That teen birth rates would be higher in the South?  Not so shocking.  That teen birth rates are up to three times higher in the South?  I didn’t see that one coming.  But really, what surprised me the most about the article were not the statistics themselves, but my own response to them.

For the first time I thought about teen pregnancy as a health issue.  Why I’d never cast it in this light before baffles me.  I had thought about it as a social problem or a cultural problem, but not a health problem.  And yet, its ranking as a health problem is much more significant than anything else.  Teens are far less likely to have planned their pregnancies.  As such, they are also far less likely to be educated about prenatal care, to understand how to maintain a healthy lifestyle during pregnancy, or to have regular OB visits.  And those are just the physical issues.  Teen moms also face a whole host of psychological issues such as embarrassment, shame, and fear just to name a few.  And then, of course, are the risks to the baby.  According to the CDC report babies born to teen mothers “are at higher risk of being born prematurely, having low birth weight and dying during infancy.”  This is clearly more than just an issue of who’s loose between the sheets. 

So, if teen pregnancy is a health issue, and if significant statistical evidence tells us that teen birth rates are up to three times higher in states that do not offer evidence-based sex education than in states that do, then why is it not being treated like one?  Most of the media coverage of teen pregnancy speaks in terms of moral values and social stigmas.  But this isn’t a function of conservative versus liberal or religious versus agnostic.  It’s a function of healthy versus not healthy

Do I believe that teenagers should be having sex?  No.  Do I believe that they would be better off choosing abstinence?  Yes.  But the evidence tells me that abstinence-only education does not work and I cannot ignore that.  I believe that those people who advocate for abstinence-only education have their hearts in the right place.  But their idealism is totally misguided in its application.  If we really care about preventing teen pregnancy (and STDs!) then we need to educate our teens about safe sex.  Kids are clearly going to have sex either way*, so we need to do what we can to ensure that they’re protected.  Anything else feels a lot like getting rid of the measles vaccine to me.

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*To clarify that point: This isn’t to say that I think we should just give up on teaching abstinence as well as contraception.  We should teach kids that having sex is a big decision; that it carries physical and emotional repurcussions for which most teens are not prepared; and that there are risks of pregnancy and disease that can change their lives forver.  Abstinence is certainly the only sure-fire way to avoid this minefield of issues.  Nevertheless, we can’t afford to stop there in our educational efforts.   

Drawing the Lines

Monday, October 25th, 2010

At some point, in the early stages of a marriage (or other cohabitant relationship), we draw lines.  We answer questions like:  Who pays the bills?  Who does the grocery shopping?  Who cooks dinner?  Who does the dishes?  Who cleans the house?  Who does the yard work?  Who gets the oil in the cars changed? 

Over time we add to the list.  Who cares for the kids, or handles the childcare logistics?  Who walks the dogs?  Who gives them their monthly flea and heartworm preventative?  Who bathes the dogs?  Who brushes them?  Who sweeps and vacuums the house because the dogs shed so constantly it’s a wonder they’re not bald?  (Sorry.  The dogs are in the midst of one of their biannual shed-fests.  I’m going a little crazy.  But I digress…)  Who figures out whether or not to refinance the mortgage again?  And so forth and so on. 

I got to thinking about all these things because of a comment I left on one of Big Little Wolf’s posts over at Daily Plate of Crazy last week.  She wrote a post about cash versus credit and posed the question: How do you pay for your groceries?  In my not-at-all-rambling comment I mentioned that I am a bit debt averse, but we pay for everything (everything!) on credit because we have a killer rewards program and because GAP is very financially savvy and does a top-notch job of keeping track of balances, making sure everything is paid off each month, and knowing when longer term balances are due. 

The follow-up thought to that comment is one that I’ve addressed in my head many times before.  GAP and I maintain very traditional gender roles.  He handles nearly all the finances, the yard work, and the dinner dishes.  I do the cooking, the grocery shopping, the coordination of nanny, housekeeper, and dog walker, and most of the other dog stuff.  Except for the fact that I have a job, we could be Ozzie and Harriet.  How on earth did this come to be? 

Sometimes I’m self-conscious about where we’ve drawn the lines.  Sometimes it seems like GAP should be responsible for a dinner or two and I should edge the lawn from time to time.  But in spite of my self-consciousness, I never wish we’d actually drawn the lines differently.  You see, I like cooking.  I enjoy my relationship with our nanny.  GAP loves tinkering with our investments and (I think) gets some sick sense of satisfaction out of balancing our many checking and credit accounts each month.  And I don’t really like the idea of being pushed around by some misguided application of feminism.  This is what works for us.

I have girlfriends who handle all of the finances and whose husbands whip up dinner every night.  I have friends who’ve drawn the line straight down the middle in all departments.  And we’re lucky to live in a culture where we can each choose differently.  We should all find the path that works for us and stick to it until it doesn’t anymore.    

Nevertheless, there’s something that feels strange about choosing the role that many women were forced into for so many generations.  However, if feminism is about anything it’s about options.  It’s about choice.  And if it means that we can’t still choose for me to cook dinner and for my husband to pay the bills then it failed, plain and simple.

A Living Legend

Friday, October 22nd, 2010

It’s not often that I have the privilege of watching someone do the thing they were clearly born to do. While we all have our strengths and weaknesses, and I always advocate for trying new things and stretching our boundaries, there is something about watching a person so plainly in his element that just brings you joy. This happened to me on Wednesday night when I got to watch Chuck Berry play rock ‘n roll.

He is, by nearly all estimations, the inventor of rock ‘n roll. He was the first to cross elements of country music with the blues and refine them into what became rock ‘n roll. And, fittingly, he was the first inductee into the Rock ‘N Roll Hall of Fame. Berry still plays one night a month at a bar a few miles from my house. GAP and I have been saying to each other for six or seven years: We really need to go see him while we still can. So this week, we did.

He is old now, having turned 84 on Monday. Given this, I expected to see a relic of a man seated in the center of the stage resting comfortably on his well-earned laurels, which would have been just fine. Before he came on a friend and I wondered aloud whether at 84 years old he would still get fired up to perform, or if these appearances are merely another in an interminably long string of days at the office. He answered our foolish question immediately.

He wore a red sequined shirt and a jaunty white cap. He stood the entire time. He danced a bit. He did the duck walk, for crying out loud! And he sang, and sang, and sang. The man has still got it! His eyes smiled the entire time. He beamed with pride as his son and daughter joined him onstage. (Talent did not skip a generation in this family.) And he wore that shirt, that hat, and several guitars as only a true rock star could.

Some people are blessed with a singular purpose in life. And sometimes we get to watch those people do that thing they were meant to do. I’ve watched Tiger Woods save par. I’ve watched Christopher Parkening play the guitar. I’ve watched Albert Pujols hit a home run. And now I’ve watched Chuck Berry play rock ‘n roll. These moments, when they come, crystallize in my mind and I know I’ll be able to recall them for the rest of my life. Talent like this has a way of packaging itself with a bow on top, so that you never lose sight of what a gift it truly is.

When Less Is More

Wednesday, October 20th, 2010

Lots of people who are knowledgeable about such things have been saying for a long time that the current American model of suburban sprawl is unsustainable.  It is inefficient and heavily reliant on fossil fuels.  It is predicated on the existence cheap and easy capital.  And it collapses under even moderate economic pressures.  However, throughout the world time has tested and proven a couple of other models – the big city and the small town.  What do these formats of civilization bear in common?  Ironically, size. 

Sure, big cities look nothing like small towns on the face of it.  But if you dig a bit deeper you’ll find some keen similarities.  City dwellers might get to know their doorman just as rural folks might know their mailman.  Both are accustomed to shopping from independently owned shops (the corner bodega and the general store are not such a far cry from each other).  And neither one probably lives in a 7,000 square foot McMansion with 15 bathrooms and vaulted ceilings. 

The modern-day suburban scenario seems so normal to us now, but I wonder if history will see it as the outlier.  I wonder if we will return to lives that are smaller in scale than the existence many of us live today.  Conveniently, I’m not the only person with this query.  Boyce Thompson, the editorial director of Builder magazine, shares my curiosity.  So he commissioned the design of a new concept home - Home for the New Economy - which was debuted at this year’s International Builders Show.  

As explained in this article, at just 1,700 square feet this concept home is smaller than the American average by 800 square feet, and smaller than most suburban McMansions by a factor of two or three.  The virtual tour available on the website reveals a home that is cozy in an electronic rendering, but which could feel cramped when filled to the brim with the typical family’s full array of accoutrement.  Nevertheless, a commitment to ridding one’s life of unnecessary excess could render this type of space quite livable.  The description of the master bedroom indicates it is designed to be “a place of rest and privacy, not a palatial retreat or mini-theatre…”  Something about the scale and scope of such a room really appeals to me.

But there is always a “but.”  And the “but” in this case is what we ask of our houses.  In addition to shelter, electricity, and safety, we ask our homes to say something about us.  We ask them to identify us in some way.  Successful.  Minimalist.  Showy.  Modest.  Modern.  Traditional.   And so on.  We see our homes as an extension of ourselves and all that we have accomplished in life thus far.  It’s a tall order.  And as our homes have become proxies for ourselves they have ballooned in size such that many are about to burst.  (Or be shuttered by foreclosure, as the case may be.)

I am no expert.  Nor am I wholly innocent in this game.  (We expect to outgrown our current home in the next four or five years.)  And yet I wonder what it will take for Americans to change our paradigm.  What crisis of faith (or net worth) must we endure before we will divorce our egos from our addresses?  At what point will we reassemble ourselves into an existence that is sustainable.  At what point will 1,700 square feet feel adequate for a typical family?  I don’t pretend to know.  But I do intend to watch and find out.

Let Us Break Bread Together

Monday, October 18th, 2010

Throughout my childhood my family ate two meals together every day.  We sat down to breakfast as a family and reconvened for supper at the end of the day.  There were exceptions here and there – sleepovers, evening sports games when Anne and I were a bit older, and so on – but by and large we ate together every day.  I’m fairly certain that I didn’t recognize the value and importance of this at the time.  I’m completely certain I didn’t recognize the amount of effort put forth by my mother to pull this feat off day after day.  And as I look into the future of my own family I wonder how I will manage to bring my family together every evening.

It’s fairly common knowledge that there is a distinct positive correlation between the absence of family meals and the presence of a myriad of behavioral problems in kids.  This article by Kari Henley cites a 10-year study done by Columbia University which found that kids whose families eat dinner together fewer than three times per week had significantly increased likelihood of tobacco and marijuana use, eating disorders, and depression.  I don’t take these statistics lightly.*  And I want to be sure that our weeknight routine is one that facilitates awareness and conversation and involvement in each other’s lives.

So where does that put my family?  IEP is nearly two years old.  He eats his supper earlier than GAP and I do, and we eat together after he’s asleep.  Our days are fairly regimented.  We have a nanny schedule, a dog-walking schedule, a workout schedule, etc.  We’ve found a routine that works for us, but I wonder at what point it will cease to work for us.  Or more importantly, when will it cease to work for IEP?  Before too long we will need to eat dinner as a family, which will, in turn, up-end our existing weeknight routine.  I certainly value my evening workouts (regular exercise keeps me sane), but if my kids need me at the dinner table each night, I may have to sacrifice some of my gym time.  (Yet I also care about setting an example of physical health and fitness, and so where does this figure back in?)

The other thing that scares me a bit about the family dinner is my role as a working mom.  My own mother quit her job when she was pregnant with me and never looked back.  I’ve taken a different path and the wonderful example that was set for me as a child may not work for me as an adult.  I will need to find ways to make sure that we all sit down to a home-cooked meal each evening, even on days when I’m in the office until 5:30 or later.  I’m sure this will involve conscientious menu planning and Sunday afternoon prep work.  And knowing myself I’m relatively confident that I’ll pull it off most of the time.  But that doesn’t mean that the whole premise doesn’t still overwhelm me. 

As I write this I remind myself that parenting isn’t for the faint hearted.  I made it through the first six months of overnight feedings.  I made it through teething.  I’m currently surviving increasing two-year-old tantrums.  I suspect I will also survive all of the unknown challenges that await me.  I just hope that I manage to get dinner on the table in the process.     

*I do think it is important to point out that one misnomer regarding these types of studies is correlation versus causality.  Family dinners are correlated with more stable and well-behaved kids and teens.  They do not cause that improved behavior.  Rather, families who eat dinner together regularly are more likely to experience fewer behavioral problems because family dinners are symptomatic of parents who are actively involved in their kids’ lives.

Party Pooper

Friday, October 15th, 2010

Queen Elizabeth is not feeling festive.

It was reported this week that her biannual staff Christmas party (which entertains more than 1,200 staff members from a handful of palaces, estates, and private residences) has been called off.  It was confirmed by a palace muckety-muck spokesperson that the cancelation is the result of the shaky economy.

I wonder about this.  Specifically, I wonder about the example it sets.  Is it a good example or a bad one?  Let’s explore this.

Position A: It sets a good example.  She is aware that much of the rest of the world is facing uncertainty of some kind.  People are preparing for a modest holiday season.  They are adjusting their expectations (some for the second or third year in a row…) according to their budgets.  For the queen to host an extravagant party during such a time would be callous and insensitive. 

Position B: It sets a bad example.  While many people are scrimping to get by these days (especially in the servant set) there are fewer treats and perks to go around.  As the figurehead of the nation and a person whose own financial circumstances are not tenuous she comes across as miser-y to cancel the event when she could treat her minions to something special.

I think the ultimate lesson of this conundrum is that when it comes to money (which is really what this is all about) rarely is there an easy choice that makes everyone comfortable.  There is no “normal” when it comes to money.  There is no “right.”  And this means that most people are easily made uncomfortable by discussions and decisions surrounding it.  We are each left to choose the path that we think is right, and hope to step on as few toes as possible in the process. 

I hope that QE2 (the woman, not the ship) made her decision with Position A in mind, but I’ll never know (we’re not close…).  I’ll also never know how this decision will strike the staff themselves.  Hopefully they too will believe it sets the right tone and was made with the best of intentions.  At the very least, the people who would have been staffing this massive gala will have the night off.

Game On?

Wednesday, October 13th, 2010

Say you are a video game junkie.  Say you love to play Grand Theft Auto or Mortal Kombat.  Say you spend hours upon hours lost in this virtual space taking on avatar personas and doing untold damage on the digital world you inhabit.  What does that mean for your real life when your mom/girlfriend/wife calls you up to dinner?  (I have to assume that if this description fits you that you are also male and in a basement.  Some stereotypes are just too hard to pass up…  I kid.  Sort of.)

I ask these questions because of a story I heard on NPR on Monday.

The popular video game Medal of Honor is getting a lot of press for its latest version of the game.  All of the hoopla has to do with the fact that the new release originally allowed users to select the Taliban as their gaming avatar.  (The final version of the new release changed the name of this avatar option to “Opposition Forces.”)  Now, I am not a gaming junkie.  Far from it.  (I haven’t played anything since the original Super Mario Brothers.)  And I think this may be why I found this piece by Heather Chaplin so fascinating. 

The story begins by explaining the Taliban/Opposition Forces controversy above, but then delves into a discussion of the psychology of play versus other forms of entertainment.  Take movies as an example.  We watch (and acclaim) movies about sensitive and violent subject matters all the time.  You need look no further than Saving Private Ryan or Bowling for Columbine or The Hurt Locker to know that.  Chaplin comments, “Games are held to a different standard. … This double standard between movies and games stems from a fundamental misunderstanding of the psychology of play.”

There is a common argument among gaming critics that by making a game out of these subjects they are inherently trivialized.  But somehow this critique is not leveled against books, movies, or television shows.  When I watched the movie Jarhead I could sense in every scene the seriousness with which the filmmakers took their subject.  I felt intimately acquainted with the plight of the characters by the end of the film.  The idea of turning this premise into a game is off-putting to me.  My inner monologue says, “… but this isn’t a game.  This actually happened!” 

The NPR story then goes on to explain that video games are actually more intense for people watching them, than they are for the players.  The players must maintain a sense of detachment from the game in order to interact with it.  That is, in order to run, jump, shoot or strategize you must always maintain the understanding that you are causing the action which continuously reiterates to the player that it isn’t real. 

I suppose that’s what clinches it for me.  These things – things like war – are real.  We should not come to these topics in a way that allows us to deny that reality.  It’s not that I think gamers will run out into the streets killing people because they can’t understand the difference between true and digital realities.  It’s the fact that the gamers can (and do) make that distinction that I find most troubling.  The act of gaming allows them to take something that is an unendurable hell for many people, and turn it into an afternoon pastime. 

In this follow-up opinion piece former Marine Corps officer Benjamin Busch comments that, “For those who truly want to play for a Medal of Honor, recruiters are standing by. Only eight have been awarded since we invaded Afghanistan. All but one have been posthumous.”

Taking Our Temperature

Monday, October 11th, 2010

According to the brief description following his byline, Thomas Moore (not the poet or the saint), “has been a monk, a musician, a professor, a psychotherapist, an author, and a lecturer.”  My initial response to that mini-bio is to think, “Wow, someone couldn’t make up his mind, could he?”  But that is tacky and judgmental and wholly irrelevant in this case because in this article he makes some very interesting points.

How many new electronic gadgets have you purchased in the past five years?  How many pieces of artwork have you acquired during that same time?  I realize the second question feels like a non sequitur to the first.  But Moore poses this question because he believes that the latter in some way counterbalances the first; like a cultural carbon offset.  He likens technological additions to our lives to coolness – with every Kindle, iPad, or Droid we become cooler.  The problem with this, he asserts, is that we should also add things to our lives that make us warmer.  The things that Moore proposes make us warmer?  Non-technological things: artwork, music, books, and the like.    

There’s something appealing about this idea to me; the idea that as things in life make us cooler (metaphorically speaking, of course) that we should take steps to make ourselves warmer.  We should not be allowed to evolve into mechanized versions of ourselves, engaging with the world and with each other only through objects with on/off switches.  Moore writes, ”There’s nothing wrong with cool… But if cool gets in the way of warm, we individuals and the culture at large lose important values: connection, empathy, nostalgia, a strong sense of home and civility.” 

This was where I really got on board.  Connection, empathy, nostalgia, home, and civility are words that resonate with me.  If those words are a part of my life then I’m probably doing something right.  Right?  At the end of a day, or even moreso at the end of a life, these are the components of our lives that matter the most.  These are the barometers of a life well lived.

The other aspect of Moore’s cooler/warmer premise that I like is that as he explains it our coolness and warmth are not mutually exclusive.  He does not ask us to eradicate our coolness; to recycle our iPhones or Tivos and return to the existence of a pre-Alexander Graham Bell time.  He allows us our gadgets, but merely asks that as we accumulate them we even ourselves with other additions to our lives that balance them out. 

I’m not a huge gadget junkie.  And I think I probably rank higher on the warm scale than the cool scale most days.  But Moore’s ideas ring true to me, and as I add new technological gear to my life I should work to make sure that the warmer things in my life are not subsumed by the cool.

The Truth

Friday, October 8th, 2010

The blogosphere is supposed to be a place where we can say the things we’re otherwise afraid to say.  I’ve been blogging for nine months now, and this is what I’ve been afraid to say.

For the most part I love blogging.  I love the way it makes me think, and process, and choose words, and explore ideas.  But there are moments when this online world reminds me of myself as an insecure teenager.  I read what you write.  And I compare myself to you. 

There has been some rough stuff in the blogosphere this week.  There has been talk of loss, unrelenting sadness, depression, and stigma.  These topics accompany other frequent and similar topics – refrains of estrangement, dysfunction, financial strain, and general struggle to keep up with life’s curve balls.  This makes it sound like our virtual community is a downer of a place to hang out.  The amazing thing about it, though, is that nothing could be further from the truth.  We bare our souls only to find them uplifted by our friends and counterparts, which isn’t depressing at all.  But – especially in my less confident moments – it has gotten me thinking about some things.

Many of you walk through your real-world lives carrying incredible weight.  You feel obligated to obfuscate these burdens with smiles and cheery discourse.  And it is only here in this virtual space that you finally feel at liberty to unburden yourself through honesty and confrontation and confession.  I am grateful that the online world offers us this freedom.  And I am honored and privileged to respond to your posts and attempt to alleviate your pains in some feeble way.  But when it comes to my own interactions I find myself in quite the opposite position. 

I am a fundamentally happy person with a fundamentally happy life.  This is a good thing, but not stylish or dramatic, and sometimes, here in this place, I feel that I should leave it conveniently unwritten.  Rather than masking my sadness to the real world I find myself masking my happiness in the virtual one.  (Perhaps this is why I most frequently write about my responses to other topics, rather than my own life.  Privacy is certainly an issue, but for the most part a happy life is not interesting fodder for reflection.  Tolstoy got that one right.)

But blogging is supposed to be the venue to bring our authentic selves forth.  We are to drop our veils and state the unfettered truth about who we are.  And if this is the case then today is the day I will do just that:  I am happy.  I am perky.  I am outgoing.  I laugh a lot.  I have never lost a parent, sibling, spouse, or child.  My family and I are all in good health.  My marriage is strong.  My faith is sturdy, but not unquestioned.  I have been fortunate.  I am not without grey days, but they are few in number and short in duration.

I do not mean to be arrogant or proud.  And I do not – ever for one moment – take these things for granted.  I say them because they are true.  And if this is the place to say the things that are true then I want to do that.  I just hope that you’ll accept me as I am even when it doesn’t blend into the blogging scenery.

Choosing

Wednesday, October 6th, 2010

I was walking to my company’s IT help desk on Monday and as I made my way through a sea of cubicles something popped out at me.  A printed version of the poster below was taped to someone’s file cabinet, and it made me smile. 

I love the idea of a bird with a French fry.  I love the idea that upon finding such deep fried goodness a little robin or sparrow thinks he has struck gold.  He is not stuck with acorns or pinecones or even birdseed.  He has a French fry, and that is a happy occasion for a bird, to be sure. 

I also love the implicit concept of choice in this funky little mantra.  This kind of happiness is not reserved for birds with French fries.  It can be mine too, but only if I choose it.

I am surrounded by first-world problems: I have a BlackBerry and I want an iPhone.  I’m not sure I love the hair color that my stylist and I picked out last weekend.  I haven’t had the time to make dinner reservations for our vacation to Washington, DC later this fall.  And so on.  Woe is me, right?

Sayings like this one about the bird and the French fry cut straight to the heart of the matter for me.  Somehow the silliness of it casts a bright light on the lunacy of my discontent.  I am healthy and I have a job.  I have a solid marriage and good relationships with my family.  I have a lovely home and the means to travel.  I have satisfying friendships, hobbies, and interests.  And I have a son more perfect than I ever could have imagined.  Truly, I want for nothing.

And yet I (we all) find things to lament.  Little things.  Meaningless things.  I have problems that millions of other people would kill to have. 

I’m not a big complainer.  And I don’t believe that I should stifle my every frustration just because someone else in this world is in worse shape than I.  But I have a choice.  Every day that I wake up I can choose to be as happy as a bird with a French fry.  And I think that frame of mind sounds like a delightful way to spend a day.

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This poster was created by Etsy artisan “dazeychic” and is available for purchase here.