Legalized Intimidation & Harrassment of Ordinary People

I had recent dealings with the US Immigration and Customs Enforcement Department. One of these encounters was at Dublin airport on the 14th of February, 2007. It is a surreal experience to see American officials in their cubicles interrogating/ approving each passenger in a foreign airport. Another innovative development in the quest to control American borders. So there I was lined up waiting to get questioned, have my documents examined and to (oh please god!) be determined worthy to board the plane to the States.

One particular official among the half a dozen stood out for his loud, lecturing tone, and a gaze that assured us that he was clued into our unfitness to enter his presence. I thought to myself, what are the chances that I get this obnoxious denizen of the USICE to grill me. I am a legal, permanent resident of the USA whose paperwork is in order, so I am safe right? I get to the head of the line & he calls out "next!"

He says where are you coming from? The UK sez I. When were you last in the US? December 2006. Why were you in the UK? For a fellowship which just ended. He then proceeds to inform me that technically I have lost my green card status!! My heart is in my mouth and I am thinking WHATTHE....!!!!! Immigration officials have known about my work status from the start since I was granted my green card while I was a fellow in England. Have you ever lived in the US, demands he. Since 1993 to 2005, say I. By this point I was alarmed and probably looked and sounded it. I was also aware that his voice was loud and mine had suddenly gone squeaky and I felt everyone was looking at me. He lectures on about how I am supposed to reside in the country a minimum of 180 days every year. (Hmm... obviously this is in some top-secret document not given out to us ordinary permanent residents, because the document I read said that I could not be out of the country for 365 days consecutively.) He informs me that in the absence of the special paperwork I should have completed, he is within his rights to cancel my green card then and there. I ask him that if it was a simple case of some form, does he really think a reasonable person would not fill one out when so informed. He continues to talk all over me, stamps my passport and says, this is not for you to have vacations in the USA and you had better appreciate it.

I was shaking by the time I took a seat in the waiting lounge for boarding but then my blood started boiling and even now the bitterness of the experience galls. I was as clean a case as one could get. A person who has followed all the rules and kept anyone who needed to be informed in the loop. And I get this treatment. What for? Makes you wonder how they would treat someone whose paperwork might not be in order for whatever reason.

The USICE has new posters promising new standards of service. Even the department name is new, and it leaves one thinking that perhaps there is a genuine effort here to redress their recent heavy-handedness in treating anyone who wants to enter the USA and is not a citizen with suspicion. But oh no, they set me right. Nothing has changed. If anything, things are worse. Across the world, the US consulates are known for humiliating people by making them queue in weather, grilling them, making silly demands (my ears were not appropriately positioned on my head for photos- go figure!) and worse.

This country has been my home for years now and in a few years I can apply to be a citizen of this country. There is so much this country, which has been my home for over a decade, has going for it. There are so many good people I know. And yet, I can't escape the feeling that government policies concerning immigration have created America's own class system. This administration has dehumanised migrants and the rest of the world more than any other recently. Now that is a shame for a country that is built on the back of migrant sweat and blood. We need to stand up and say Enough.

The Minimality of the Wage

When I first moved to the States from India and I came across the concept of the minimum wage, I remember thinking how civilized a concept it was. A hallmark of good public policy. I think it used to be around $4.80 or so then (1993). Then I went to the UK in 2005 to work as a fellow. Casual labor in the UK gets paid about the same as workers here in the States if you consider $1=£1 (of course, this is not really the case for those of you who are econ-heads but the buying power of the currencies are roughly equal in their respective nations). Minimum wage in the UK went up to £5.35 per hour in 2006 from £5.05.

However, I would argue that the UK worker is getting a much better wage than her American counterpart despite getting a max 10% tip (in service industries) if you get any tip at all.

The UK minimum wage is a much more humane living wage because health care for all its citizens is already taken into account. The minimum wage in the USA is a sick joke on the poor. The poor are expected to work and not be a drain on the system. In the land of opportunity, it must surely be the lazy who are poor.

Can someone on minimum wage afford to buy health insurance? Can they afford to take care of their children or even themselves? Can they eat nutritiously and focus on the positive things in life? I would answer in the negative. The American minimum wage is a farce played to keep policy wonks happy for doing something and the industry happy for getting such cheap labor.

The number of working poor in this country is not insignificant though it is not something that gets talked about openly, not being a sexy topic for conversation or even for news reportage. A significant proportion of the working poor are mothers. There is a tragedy unfolding here. This is not the America that this country should grow into. We need change. We need compassionate and realistic public policy.

This government is By the media, Of the lobbyists (elected and otherwise), For the rich (industrialists and otherwise).

Welcome, 2007!

Happy New Year, all!

I thought I’d try to beat Radhika to the punch and blast out our first blog of 2007.

She’s pointed out that it’s a lot easier to blog when you are angry about something. I agree. I am a lot more eloquent when I have something to rage against. But I am feeling pretty blessed.

And it’s not that I don’t have the opportunity to find something that would enrage me. Turned on NPR earlier and heard the former President Bush proclaiming that dead President Ford could have stepped out of a Norman Rockwell painting. Huh? Isn’t that a completely bizarre thing to say at the man’s funeral?

The 3000th American serviceperson died in Iraq this weekend, along with Saddam Hussein. Am I the only one that is utterly horrified by both events? What I see as more blood on our hands is, to American leadership, only more insignificant blood under the bridge, I guess.

But the local still wins out. A dear friend called last week to say that she is recently married and newly pregnant. She’s one of those friends who drifts in and out of my life periodically, always leaving deep memories and warmth. She asked for advice and I’m sending her some of my favorite books on home birthing and compassionate child raising. She’s going to be an amazing mother.

I am part of an ecovillage project in upstate New York. This amazing group of people gathered a few weeks before Christmas and decided, and not without great debate, that we would govern ourselves by consensus. For those who would roll their eyes at this, I submit that ecovillages, and all other culture changing, world saving things, cannot possibly be governed by any other style of decision making.

This year I’ll be finishing up a PhD, in the Decision Sciences. I already consider myself a researcher, and a fairly good one at that, but we need to save up enough box tops, endure the requisite hazing, before we are permitted to stand among our peers, so I trudge forward. And luckily, I have a terrific sponsor, and fantastic friends, who are helping me garner the strength.

In February, my beautiful, deeply passionate, and endlessly enduring daughter will turn 4 years old. Followed in June by the one year birthday of her brother. As she debates evening television choice with her father in the adjoining room, and her brother sleeps, I am simply struck by how lucky I am.

It doesn’t make good blogging, I’m afraid, but I am living a charmed life.

But stay tuned anyway.

Loving Science but Hating Academia

You know what- we don't really learn what science is unless we get lucky and end up learning from a teacher who loves it. I had one such teacher the first year of my Ph.D. and another who guided me through my Ph.D. The early teacher was Ronald Red Owl Hoskins. Had us delving into the philosophy of science, Popper, Kuhn, examining what we knew about "Truth" and whether it existed. His teaching excited me and made me into a "true believer."

The man who guided me through the Ph.D. is Tom Stewart, a scientist and human being par excellence. He speaks little but boy, he personifies the scientific ideal. A keen mind and a no-frills scientist. His integrity truly sets him apart. When I was down about my dissertation research not resulting in a "stop-the-presses" type finding, he was the one who pointed out the true value of any finding, its role in progressing scientific thinking.

But most of academia does not work for the benefit of science. It works to support itself as an institution and a profession. It is not uncommon to see acts of self-glorification in academia. What is worse, it is not hard to find cases of academics trying to undermine and undercut the work of their colleagues. And worst of all, falsification of research.

"Publish or perish!" It is the mantra given to all young researchers. Scientific findings do need to be proclaimed far and wide in order to further science and knowledge. But "publish or perish" also sets up perverse incentives to the detriment of science. For example, the public now believes that you can always find evidence to favor whichever position you prefer- you only have to look!

Science is not meant to work like that. Scientific research depends on the impartiality and integrity of researchers and their tools. Scientific publishing on the other hand does not reward all scientific findings alike. Add in the factor of the variously vested interests of funders (many from the private sector) and we do indeed have a mix that is not the most conducive to true scientific progress in academia.

A recent heart-warming example is that of Grigori (Grisha) Perelman. Here is a guy who has turned down offers to be an institutionalized academic. This man has recently turned down the Fields Medal which is the foremost award in the field of Mathematics. He was chosen for the award for solving an unsolved 100+ year old mathematical problem, the Poincaré conjecture. (You can read more about this by googling it).

Grisha does not work to a schedule. He works on something that interests him, continues working on it till he thinks he is done and then as often as not publishes the result; and then not always in academic journals. No fan-fare, nothing. Can you see this happening in an academic department at a university? Nope, they would want to get maximum mileage out of it - if that is they allowed such a slow person to stay on as long as they have. Of course, I could be dead wrong about all of this, but I doubt it.

Meantime, there is another academic who sees a chance to further himself here because a) Perelman's derivations are hard to follow, b) are not published in an academic journal and c) Perelman is not beating his chest saying he done it. Dr. Yau, a former Fields medalist, gets two of his students (Zhu & Cao) to work double-time on a paper presenting this same result and publishes it in his own journal (conflict of interest anyone?!) after giving the editorial board three days notice by email to comment on the paper. Oh did I mention that neither the paper, its abstract nor any reviews were attached to the email. When one member asked to see the paper, they were told it was not available. Oh the wonders of the modern peer-review process- the paper gets published! Even the title is not the same one as proposed in the earlier e-mail notice.

I will close here with some words from Perelman.
On ethics in academia:
It is not people who break ethical standards who are regarded as aliens. It is people like me who are isolated.

On the Zhu-Cao paper:
It is not clear to me what new contribution did they make. Apparently, Zhu did not quite understand the argument and reworked it.

On Yau:
I can’t say I’m outraged. Other people do worse. Of course, there are many mathematicians who are more or less honest. But almost all of them are conformists. They are more or less honest, but they tolerate those who are not honest.

On his decision to refuse the Fields Medal and leave academia:
As long as I was not conspicuous, I had a choice, Either to make some ugly thing [an issue about academic integrity] or, if I didn’t do this kind of thing, to be treated as a pet. Now, when I become a very conspicuous person, I cannot stay a pet and say nothing. That is why I had to quit... I am not a politician!

[The quotes here come from a Nassar & Gruber article in the New Yorker.]

Uterine Fibroids and Treatment Options

We know that many women get fibroids growing in and around their uterus at some point in their lives and that some of us become very uncomfortable because of the symptoms the fibroids produce (these range from urinary frequency to painful and heavy bleeding). Research still has not shown why this happens and what predisposes us to it. I have a previous post in this blog about some of my experience so far and I will be writing more about it as I undergo treatment.

Considering that uterine fibriods have been a problem that has existed long before modern medicine came into being and given that they are the second most common reason for major surgery in women after child-birth (specifically c-section), it is a bit puzzling why we still don't know what causes fibroids. Not only this, what is even harder to understand is the lack of information women are given about the various options available for treatment. I am going to go over the options here in case someone who wants to know stumbles on them on this little outpost of the web.

Do nothing: Most women who have fibroids are aymptomatic and needn't take any course of action. These benign growths do not interfere with their lives. Other women turn symptomatic and still may choose to do nothing if the symptoms do not affect their quality of life. Even if the fibroids do affect the quality of their life, a woman may choose it as the lesser of two burdens given the treatment options. In addition, a woman who has not had children may, depending on location and the affects of the fibroid(s), choose to put off treatment till after childbirth in order to ensure that her fertility is not negatively affected.

Gonadotrophin therapy: Some women are given gonadotrophin drug (Lupron in USA or Prostap in UK) injections to chemically induce menopause. As the levels of estrogen and progesterone drop, reproductive organs (and the fibroids growing in and around them) shrivel. This therapy is associated with all the other wonderful symptoms of menopause such as hot flashes, bone loss (over time), vaginal dryness, etc. Soon as therapy is stopped, the reproductive organs AND the fibroids spring right back. This therapy is used pre-surgery (typically for 3 months) in women who are heavy bleeders and anemic to shore up their blood and help with recovery post-op. It is also supposed to reduce bleeding during surgery. However, this treatment is not indicated pre-surgery for non-anemic women. Surgery is easier on a non-shrunken uterus and fibroids. However, incision size may be larger if the fibroid is extremely large.

Hysterectomy: This has previously been the option of choice for many surgeons (and by extension their patients) as it was often the only option available. It remains a frequently used option and many women are expressing discomfort and displeasure with doctors who seem to present it as the only viable option. On the other hand, for many women who have severe symptoms, recurring fibroids and who are past child birth, this remains an acceptable option. Of course, a hysterectomy entails permanent menopause with its own issues. For women who are younger and who still want to keep their options for reproduction open, this is not an ideal option.

Myomectomy: This comes in two forms. Abdominal myomectomy and laparoscopic abdominal myomectomy. The first is when they manually make an abdominal incision and surgically remove the myoma(s) or fibroids. The second is when they use laparoscopes to do the surgery making small holes in the abdomen to thread in the laparoscope. Healing times and rates of infection differ. Typically the larger the fibroid or the more delicate its position, an abdominal myomectomy would be preferred over a laparoscopic myomectomy. The advantage of a myomectomy is that it is a more uterus conserving surgery and a woman may hope to maintain her reproductive abilities. Even if reproduction is not an important consideration, the avoidance of abrupt menopause alone would make this desirable in my opinion. [Menopaused women are not troubled with fibroids as the reproductive tissue has or is shrivelling.] However, myomectomies do not prevent the fibroids growing back.

Uterine Arterial (or Fibroid) Embolization: UAE involves threading catheters into the two uterine arteries. The catheters are used to deliver silting agents into the blood supply of the targeted fibroids. This results in the fibroid starving and shrivelling away and this relieves most symptoms. There are a couple of issues with this treatment beyond its indication for certain types of fibroids. Firstly, UAE is performed by radiological experts rather than gynecological surgeons. This may create a conflict of interest in that many gynys may not refer their patients away to another specialist for treatment even if they remain the doctor of record. Secondly, UAE is still doubtful for women looking to conceive as the blood supply to the uterus and ovaries should be as little compromised as possible.

Holistic options: There aint no herbs out there that I know of which can target a fibroid specifically and not affect anything else. I can imagine there are herbs that help relieve some symptoms (such as heavy bleeding). However, if a drug claims to shrink fibroids, it is probably functioning as a gonadotrophin. Now we know that menopausal women are outta the fibroid game, which leaves only those of us lucky enough to need these herbs to worry about the consequences of a potentially gonadotrophin herb. And if you are still considering giving birth at some point, you need to make the decision while weighing in your reproductive health and that of any baby that you will carry. In terms of other holistic options such as meditation and exercise, the way I see it, these can't harm us and if they help us- then great. Good food, healthy eating habits, relaxation and exercise are never wrong.

Toxic Wastes in Abidjan- Progress Report

So far Trafigura maintains that the wastes were not toxic and that it tried to dispose of them but due to its unfortunate selection of an Ivory Coast company called Tommy, many people were poisoned and about 10 lost their lives. Investigation has however revealed that Tommy is a shell company created while the Probo Koala was on its way to the Ivory Coast - talk about custom made. A report out this week suggests a chain of incompetence and negligence was to blame for the tragedy. So far those jailed include the manager of Tommy, two European Trafigura officials and a few Ivorian businessmen. Trafigura meantime has retained a high-flying British lawyer and is sticking by its story of compliance with national and international laws.

This is how globalism and international capitalism works. The tiny people get ground up and spat out by the cogs of big MNCs. All this delaying, legal mumbo-jumbo and obfuscation puts such heart-rending injustice out of mind over time. We feel less and less outraged as our lives are not affected and we can still get cheap oil. Hey, a few hundred unhealthy and 10 dead Ivorians versus the $300,000 to be paid for safe clean up. I mean, if Trafigura paid that sum, they would have to pass it on to their customer and we all know that cheap fuel keeps our world going around, right?

[Same picture, NYT- thanks.]

The Elusive Surgeon

Yuck! Well, I've been diagnosed with a uterine myoma and that has screwed with my head somewhat. Going from totally healthy and fit to being a patient is not easy because you are not mentally geared for it. I have also always taken good care of my health- good clean food, no bad habits, exercise... so of course, a small voice in your head goes- how'd this happen to me? Turns out, too many of us women suffer from this problem. It is the second most common reason for surgery in women after childbirth (why childbirth even needs surgery is another blog being written by April one of these days).

Depending on where you get your info from, fibroids occur in 40 to 70% of all women. A post-mortem study showed it in 70% (or was it 80%) of women autopsied. Most women, it seems, are asymptomatic and either never know they have fibroids or don't need to have them removed. Some of us turn symptomatic. I am one of them. Urinary frequency (my bladder is now reduced to the carrying capacity of peanut - ok not really, but close enough), a belly that is beginning to protrude (doc describes it as 16 weeks) are some of my symptoms.

I want to talk about how difficult it has been as a patient, specially when faced with a physician- oh wait! I have not been faced with him yet and am not likely to before I am rolled into surgery! I have had 2 appointments with my consultant (known as specialists in the US) in the UK under the NHS. And both times I met a fantastic research fellow working under him. She was thoroughly lovely, easy to talk with and extremely helpful but she ain't a surgeon (so she won't be cutting me open) and she is not the expert when it comes to answering my questions on treatment options. What information I have been gaining about what I have and what to do about it has come less from my consultant than from other sources due to active efforts on my part. The one letter I have from him addressing an issue I raised suggests that the guy is probably competent and means well, but boy oh boy, the fact that I will never even get to be more than a paper patient and then a sedated uterus to this guy bothers me no end.

Oh btw, the consent form I had to sign to get on the waiting list for surgery lists the "serious or frequently occuring risks" as:
1. Excessive bleeding during blood transfusion.
2. Excessive bleeding requiring hysterectomy (removal of the womb).
3. Incisional complications including hernia.
4. Infection which may require antibiotics.
5. Injury to adjacent organs requiring further surgery.
6. Venous thrombosis which may or may not result in pulmonary embolus.
7. Failure to achieve desired result.
8. Pain.

Would have been nice to observe a slightly greater investment or even interest in my care from the surgeon.