Is This Happening in America????

John Kerry's talk on a Florida university campus drew an outspoken response from a student who believed there were certain things Kerry could and should have done about the election he lost, about voter suppression and about impeaching Bush for the war. Yes, the student was loud and his aim was to make some strong political statements and ask some tough questions of Kerry (ok, so he also threw in a question about the skulls and bones). As he correctly points out, Kerry spoke for a long enough time, his few minutes should not be begrudged him.

What completely amazes me is that his refusal to not give up the mike resulted in the police dragging him away bodily without response from Kerry or the other students present- other than to jeer and clap. There were enough people there so that if everyone or even a large proportion had stood up to the police, the police would have been helpless and would not have administered electric shock to the student Andrew Mayer. Even if the students could not have prevented it, I cannot imagine that except for the one female student you hear screaming "You can't do that," not one other person did anything to protest what unfolded on youtube as a horrific and extremely distressing event. Were these students somehow under the impression that this was all a game (a lot of laughter and general bedlam is heard in the background)? How is it that no one got up and overpowered the police when and after force and the taser were used upon Mayer? This is exactly what happens in oppressive states where people stand by when someone else is singled out and targeted by figures of authority.

What is even more disturbing is that John Kerry is on stage throughout this event making ineffectual noises and not preventing the travesty unfolding before his very own eyes. This harms American credibility to protest similar abuses of human rights and suppression of free speech in the world. How can America stand up and point its finger at the police brutality of citizens elsewhere when it condones such violence against its own? Kerry has sunk to a new, unrecoverable low in my opinion. This was not a violent student as one can see on the youtube clip. And Kerry's efforts at humor (he says "I'll answer his question. Unfortunately he is not available to come up here and swear me in as president..." leave one wondering whether he could hear and see what had to be unfolding in front of his eyes. Glasses and hearing aid, John? You were a counterpoint to the authority the police wielded and could really have lead by example.

On youtube and elsewhere, justifications are being provided by UF students for non-action, claiming that Mayer was a known prankster who came into the event sans ticket and cut into the line of questioners. It doesn't matter if he was rude, obnoxious and generally disruptive. None of these are crimes and deserving of the police treatment we are witness to. Not only was Mayer, forcibly removed, taken down and tasered, he was also jailed overnight. The police treatment itself was deserving of a lot more reaction than we see from anyone else present. Why are we turning into sheep that won't do anything when we see someone being tortured and taken down??

Physician Heal Thyself

Last year, I was faced with a myomectomy for a fast-growing fibroid on my uterus. I want to use my experience to present a comparative assessment of two different health care systems. The two systems are the nationalized health care plan of the UK (the NHS) and the privatized health care plan of the USA.

I was in the UK when I started developing symptoms that indicated that something might be going on in my reproductive system. I was registered with a GP in Birmingham city center but I had moved to a different address. I went to the GP and she carried out an external examination and determined that I might need some tests but when she found out that I had moved, she told me that I really had to register with a GP where I lived because otherwise there would be lapses in my care. So off I went to find a GP near my place. A new GP carried out an internal exam and he thought I had fibroids and needed to get an ultrasound and see a GYN specialist. Since the system uses electronic medical records, the new GP could easily access my previous records without undue delay. He made these referrals for me. This was in August 2006. He said I should hear from the specialist and the ultrasound clinic about an appointment. The appointment would likely be 6 weeks away.

I did hear from the clinic in six weeks but only to say that I should call them to set up an appointment. The earliest appointment I could get was in November 2006 for an ultrasound. In the UK you are triaged for specialist appointments based on urgency and it seems there were many other people requiring or already signed up for ultrasounds. My GYN appointment was scheduled for a week before the ultrasound. As it turns out, this was not ideal but the specialist's office was accommodating and saw me, not only at the original appointment but also, a week later in order to interpret the ultrasound and answer my questions about treatment options.

I have written, in an older post, about the fact that I never saw the specialist himself but rather a nice registrar he was training. Not seeing the specialist made me feel like he was not as invested in my care as he should be and this bothered me a bit. Another thing that bothered me was that my specialist was telling me to undergo gonadotropin therapy. I would be on Prostap (known as Lupron in the US) for 3 months and be menopausal so that during and after surgery, I would have less bleeding and not need transfusion.

To begin with, I hated to think about the kinds of severe hormonal changes the therapy would induce in my otherwise healthy body. So while I was still in the UK, I called a couple of physicians in the US to find out what they thought. I was still covered by my husband's health insurance. One of the doctors I called was a female doctor and the other was a male OB-GYN recommended by an acquaintance. Both asked me whether I was anemic. I wasn't. At which, they both said that in a healthy, non-anemic patient they would not recommend the gonadotropin therapy as unshrunken uterine tissues would be easier to operate on for the surgeon and should not unduly hamper the patient's post-op recovery.

Armed with this knowledge, I got back in touch with the UK specialist's registrar to find out what their rationale was for recommending this therapy and if I could avoid the 3 month treatment and get my surgery sooner. The registrar couldn't answer my question but she passed on my question to the surgeon who wrote me a letter explaining that the gonadotropin therapy was standard and not only prevented blood loss but also made the surgery incision smaller and less obtrusive. He also said that if I chose not to undergo Prostap therapy he would still operate on me but it wouldn't change the date of the surgery as he was fully booked for the next 3 months.

At no point, did we discuss costs. Everything would be covered and I would be in a nice university based research hospital which I had visited during my consultations. However, I felt like I wasn't getting personalized attention from the surgeon and also I felt like I shouldn't have to wait 3 months for surgery. The American doctor told me that he could fit me in sooner. I told my employers that I needed medical leave. That was all it took and I went off on paid leave.

In the States, I called both the female and the male doctor. The female doctor couldn't even see me for an initial consultation for a month (waiting periods vary from doctor to doctor in the US as we know) which made my choice easier and I chose the male surgeon. I went to see him and he scheduled me for surgery about 3 weeks from initial consultation. He thought everything would go off just fine, nothing to worry about and no complications. He seemed so magical after the elusive UK surgeon.

I went into surgery and when I came out a few hours later the surgeon told me that everything had gone off well and I should be recovering quite well. I was in good spirits and decided to start walking around as per the advice given me. However, within a few steps, I'd lose all energy and wilt. My blood pressure which was being monitored every few hours, started to creep lower. The next day the same thing kept happening. I would wake up in good spirits every few hours but any movement and I'd start to wilt without energy and my BP kept getting lower till I was about 70/40. It took the doctor till the next day, i.e., 2 days after surgery to hit upon the fact that I was losing blood internally and needed a transfusion. I was put in the position of signing documents when my mental capacities were not at their sharpest. I chose the transfusion as otherwise my recovery would have been even longer and since I was being discharged from the hospital (I was already slated to stay a day longer than the doctor originally planned because of my post-op complication) and going home to be alone (my husband was going to travel the day after I got out), I felt I could use all the boost of a transfusion.

Anyone with any inkling of human physiology and medicine, let alone a trained GYN specialist, should have thought of the eventuality of a complication and the surgeon had 3 weeks before my surgery to do so and think of having me donate my own blood to be held in case I needed it. It also took the doctor well over a day and a half to think of bleeding as the cause of my sinking diastolic pressure. It seemed like once the surgeon had me signed on as a patient, he divested himself of any more special interest in me as a patient. It did not occur to him to spend a little bit of time thinking through a procedure like this and saying to the patient, let's collect some of your blood just in case; let's think about what happens in case there are any complications needing your approval. No sirree, we were signed on for an expensive procedure that was going to put a substantial amount of money in the doctor's pocket but to him I was still one of his "routine" patients.

After the fact, I have thought long and hard about the differences in the system. There were many pressures on me in the American system which I had not expected. Once I had chosen a doctor I had assumed myself to be in good hands and absolved of the need to collect my own medical information. This is not true as not all doctors in the privatized system are invested in patient care as detractors of nationalized systems would have you believe. Further, my doctor not only did not think of the possible medical consequences and complications of abdominal surgery, he also did not bother to pick other specialists who were covered by my health plan. Post-surgery, I started receiving large bills from an out-of-plan anesthesiologist and surgical assistant.

Unlike the nationalized health system, hospital stay is really expensive in the States, and the pressure was on post-surgery to get me out of the hospital. I was given one extra day past my discharge date because of my blood-loss complication. The transfusion was my only option to not go home completely weakened and try to recover alone.

The quality of a health care system is not determined solely by how much money is invested in that system. By that measure, the US ranks number 1 as more is spent and yet more is reaped in the medical system here. And yet, we are not able to provide health care for all. But we tout very loudly that the health care we do provide is top-notch. Well, no, we don't provide top-notch care across the board. As more and more studies are showing, the record is quite spotty and inconsistent. There are some centers of health care which do provide cutting-edge health care better than anywhere else in the world. But overall care and coverage are worse than most developed nations of the world.

I have presented here an objective account of the service and care I received in 2 different systems. In both cases, the surgeons were men who were not showing due diligence and were not invested properly in my care. But in one system, I had to pay for the same level of shoddiness.

Corny Economix

I did not think I'd have to follow up my last blog about Ethanol quite as soon as this. I wrote that biofuels, as they were being manufactured and utilized currently, were ill-conceived and short-sighted. I had thought that in the near to medium future I would be writing once again about the effects of ethanol farming as they became more visible and undeniable. I am compelled to address this issue again in the face of unmistakable dynamics that are already manifesting themselves and affecting various aspects of the economy.

Corn is one of the five major crops for which American farmers receive huge subsidies. This creates perverse incentives all around and is as harmful to poor farmers around the world as to the American farming culture. The recent popularity of ethanol as a fuel has seen an upsurge in corn prices as well as land prices. Since the ethanol fever shows no signs of abating in the near future, more people want to grow corn for which they can receive subsidies from the government and sell it at the rising prices to the ethanol producing facilities (see adjacent picture). This has lead to land grabs in states such as Iowa and Nebraska where land prices are at an all-time high. More and more land is coming under corn production.

This creates multiple unhealthy dynamics. It discourages the small farmer who concentrates on other crops. They don't receive subsidies and have to labor to bring fresh vegetables, fruits and other crops to the market. And this at a time of a growing obesity crisis in this country. We are telling people to eat healthier by incorporating more diverse produce, fresh fruits, vegetables and whole grains in their diet. But we still continue subsidies to big farmers practicing corn mono-culture which is also the mainstay of the processed food industry with its reliance on fructose.

By subsidizing corn the government encourages farmers to produce a lot of it which used to get dumped on other countries at an artificially low price, thereby hurting indigenous farmers globally (this continues for the other subsidized crops). In corn's case, in addition to the creation of fructose, we now have a new internal outlet for all the excess farmers can produce- Ethanol! Subsidies make the big rich mono-culture farms richer. They do not, in general, open up the market to small farmers who are held out of the market because they cannot afford the escalating land prices or because the big farmers, who own most of the land, charge high rents for it.

On the one hand having an additional outlet within the country for all the excess corn, means it won't be dumped on the rest of the world at lower than cost. However, this may make corn everywhere more expensive as demand for corn to make ethanol continues to outstrip supply and may eventually make corn costs too much as food and feed.

A researcher at Berekely, Tom Patzek, has written a technical paper on the corn biofuel and all its implications. He quantifies the sustainability and the renewability of this resource and finds that it falls short.

I wonder if demand for corn as a biofuel source will forcibly change the processed food industry when fructose becomes scarcer. I hope at least one good thing comes of it but I fear even that one good thing won't balance out all the negative outcomes that will result if we continue down this path of converting food sources into fuel. We don't need more subsidized resource-intensive mono-culture farms. The focus should not be on creating alternative fuel sources. The focus should be on reducing consumption of fuel altogether and finding alternative, energy-efficient and cost-effective ways of accomplishing growth and progress with good health.
Copyrights associated with the pictures can be viewed by clicking on each image which will take you to the copyright page.

Fueling a Corny Debate

Americans are joining the green movement in droves nowadays. Some of them because various media sources have brought to their attention that global warming, disputed and ignored by the American administration for a long time, is very much occurring all over the world and the consequences are not remote to the United States. Others have been brought to this awareness through faith groups which have spawned environmental movements asserting that the bible makes them custodians of the earth and all in it. Yet others are following the example of opinion leaders (mostly located in Hollywood) and coming to the conclusion that going green might not only pay but also make them feel better and look good to others.

Of course, as happens with all such movements in a system as highly skewed towards a capitalist mode as this one is, the big industries do their best to cash in. So we have a "green" movement in more ways than one. Rather than curbing expenditure on a simpler greener life, the greening of America takes a uniquely American approach. You buy your way to being more energy conscious. You spend on specialized products (no one has yet addressed what happens to the old energy-non-efficient replaced products in a nation as given to throwing things away as we are). What is even more disturbing is that some of the green replacements are short-sighted and could come back to haunt us. For instance, the new super fuel ethanol.

Ethanol, which is basically alcohol, is a healthier fuel option than petroleum in important ways. It is a renewable resource since ethanol can be man-made unlike petroleum. It burns quite cleanly not releasing as many effluents and pollution as petroleum. Brazil has been at the forefront of developing and using this technology and at the moment almost 50% of all cars there are able to use 100% ethanol or flex-fuel (ethanol-petroleum) as fuel. Combination or hybrid fuels reduce consumption of petroleum and our reliance on petroleum resources.

However, ethanol is produced from organic food sources such as sugar cane, corn and other grains such as sorghum. Ethanol is produced more efficiently using sugar cane than using corn and other grains. Sugar cane doesn't grow everywhere so the source of choice in the US currently is corn. However, it takes a lot of resources that are not energy neutral to grow the quantities of corn required to produce ethanol. Large swathes of land, water, fertilizers (that are generally petroleum based) and pesticides. One may argue that the left over by-product of the process would make feed for cattle and in turn cattle manure could be used as fertilizer thereby reducing some of the energy consumption in producing ethanol. However, this still remains an energy-intensive process.

The problem is twofold. Firstly, as long as petroleum remains expensive and automobile manufacturers focus on short-term fixes that modify current technology only slightly, food grain based ethanol will look attractive in comparison (despite its own high associated costs which are being subsidized by the tax payer, but that's another story). The second problem, which should trouble us even more, is that diverting food crops to other uses and driving their price up when poverty and hunger are still a problem in much of the world is just morally wrong. This solution can come back to bite us.
Copyrights associated with the pictures can be viewed by clicking on each image which will take you to the copyright page.

Women bleed

Lybrel is finally here.

This new birth control drug is being heralded as several steps above the color-coded pills that I illicitly (at least in the eyes of my Roman Catholic mother) indulged in during college. Not only does it prevent pregnancy most of the time – women will finally be relieved of menstruating altogether.

Reading Karen Houppert’s editorial about Lybrel reminded me of a conversation I had with a friend’s husband recently. I was sharing with her (and he was, at first, an unfortunate bystander) the news that my Keeper had just arrived in the mail. I was about to be a menstrual cup virgin no longer. The Keeper is essentially a little rubber “cup” that fits inside your vagina and captures the menstrual fluid as it flows.

My friend’s husband was disgusted, apparently by the possibility that I would come in contact with blood.

I tried pointing out that it was, in fact, my own blood, and I was totally okay with it. He was horrified anew. I tried explaining that the Keeper is reusable, which attracted me. But there’s another reason, too.

I had my babies at home – there was a lot of blood, though less than you might think. I also had an unassisted miscarriage at home – even more blood. Blood, my blood, was in both cases a beautiful reminder of the brutal fact that I am human. Not only that, I am a healthy woman – my body is working just like it should be. The blood is proof.

I didn’t even come close to winning him over, though. And, really, I don’t think he’s alone. This is the reason why Lybrel’s existence is so completely unsurprising. Our culture is so thoroughly anti-woman that it predictably would want to do away with everything that reminds us that we are women. And it expects us to celebrate our sexlessness with verve and gratitude. Apparently, we can now get on with life.

For me, several years into my thirties, I am experiencing what I think a lot of women do at my age. I am feeling, to my core, how my body changes throughout the course of the month. And, without a hint of new-agey mysticism, I will tell you – I think it is incredibly cool.

My moods – the ones that Lybrel’s maker, Wyeth wants to anesthesize – shape who I am as a mother and wife, as an activist, and as a writer. As I bleed every month, I do feel the cleansing process of my body – I do feel renewed. (The folks from Wyeth are snickering now, no doubt.) As I cease to menstruate, the passion I feel for life is unequaled – this is the time of the month when my most impassioned emails get sent, when my work building an ecovillage bursts into full bloom, when that damn dissertation actually gets some attention. This is the time when I savor every inch of my amazing husband. It’s when I take my children blueberry picking and dig up every tillable inch of my backyard and plant morning glories and birdhouse gourds and lettuce and beans and beautiful flowers. Sometimes I feel life so deeply it hurts.

After I ovulate, blissfully dancing without calling any new babies, I begin to feel more introspective – the world starts spinning a bit slower. This is when it becomes harder to write – and my children and I spend countless hours at the lake, playing in the sand, marking the time with quiet conversations. It’s also when, sometimes, the darker side of me takes over a little – and I mourn what we are losing. It’s when the stories about Iraq bring me to tears, when I worry most about my friends, states, sometimes countries away. It’s when I need to find the reserves of compassion that I didn’t know I had, again.

So when I menstruate, it is honored, and welcomed. It is a subtle, beautiful reminder that I am human and I am woman. That our culture continues to create drugs that define human potential by the obscene standards of a patriarchal, dominator culture is a travesty; that we women would willingly erase that piece of ourselves that is most precious is a tragedy.

Bi-Pedalism

I love how versatile the bike is in terms, not only, of uses but also in the benefits one accrues from using it on a regular basis. Here's a little known fact- the car is a highly inefficient form of transportation: it is so heavy that 95% of the energy consumed by it is used to move itself and only 5% to move the person. Think about it and this should make sense to you. How heavy are you? How heavy is your car? How much energy would it take to move you? Makes you wonder which genius came up with the SUV.

The bike on the other hand is one of the most efficient forms of transportation. You pedal and it gets you to your destination. And you get there in a much better frame of mind than sitting in those rush-hour snarl-ups. You get to enjoy the wind in your hair more cheaply than buying a convertible. You save on gas and you help the environment stay green. You have the independence to go where you want to go; even to car-free zones. And you end up healthier every time you pedal. What's not to like?

Countries in Asia, like India and China, have traditionally had many bicyclists as it was the most practical and cheap form of transportation available to the common man. But it is seen as the poor person's means of conveyance at this point and everyone is hankering to get to a place where they can own a car or two now. Parts of north-western Europe on the other hand have been moving in the opposite direction. I loved seeing everyone going about their daily life on their bicycles on this trip to Europe. It did not matter if you were dressed special or had your big dog or all five of your kids with you. You could do whatever you needed to do with your bike. Oh, you need to get to work and its far away? Ok, get on the bike, get to the commuter train or tram or bus, load up your bike and go. Oh your work involves carrying heavy stuff? There are attachments for bikes which will allow you to move things around. I loved how much a part of their life the Europeans had made the bike - especially in the Netherlands.

The Netherlands and some of the other Northern European countries have made riding bikes very much easier for their citizens by providing specials lanes for bikers on all roads. These are clearly marked and do not just meander off into nowhere. Even alongside highways, special bike paths exist for those who want to go longer distances on their two-wheels. Children are taught bike-safety and road rules for traffic at school as part of their mandatory class-work. This leads not only to safer traffic all around but also to a lot more children who are independent and can bike to where they want to go.
Imagine how much we would gain in terms of cleaner environment, less expenditure and use of gas, the (mental and physical) health benefits of a physically active lifestyle if we chose to replace our car with the bike as our main mode of transportation.

[I have provided a link to a private website extolling the virtues and weirdness of biking in Amsterdam with some really cool and funny images. Enjoy]

The Power of One

A young woman in India, Pooja Chauhan, took the unusual step of stripping down to her underwear and marching to the police station to demand action and justice. She had previously registered complaints against her in-laws that they harassed and abused her for not bring dowry and for giving birth to a daughter. Her march resulted in a lot of gawkers and some slow traffic in the little town where she lived but it got her results. The police immediately arrested the in-laws and two neighbors (no explanations have been given for how the neighbors were complicit).

Police say a case may be registered against her for indecent behavior however, they will wait till an examination of her mental state has been conducted. One would like to ask that a case also be registered at the same time against the police for the dereliction of their duty that drove this young woman to the extreme measures she had to resort to in order to bring attention to her plight.

Time and again, the forty year old anti-dowry laws have been flouted in India. Every once in a while a particular young woman's courageous protest focuses attention on this social evil. Nisha Sharma was the last such lightning rod. She called the police on her bridegroom even as last minute demands for dowry were being made. The groundswell of admiration and protest she generated is a testament to how many Indians hate this part of Indian culture and yet, we must be a cowardly nation because we allow this heinous practice to continue, we turn a blind eye when others around us make demands and torture their daughter-in-laws and we also ask for dowry ourselves when we have sons. While the Pooja's and Nisha's are few and far between, we have been inured to the more common reports of young brides burnt and killed by in-laws and husbands.

Neither of these young women were from a particularly privileged or remarkable background. They were not surrounded by supporters or well-wishers who egged them on to rebel. They had nothing to gain and quite a bit to lose. And yet, others in their position have submitted to the violence and injustice perpetrated upon them without raising their voices. It takes a lot of courage to be a Pooja or a Nisha. Some may think it futile since social and cultural mores are slow to change. But each Pooja is a beacon of light, a call to arms in the fight for justice and against tyranny.

I am only one, but still I am one. I cannot do everything, but still I can do something; and because I cannot do everything I will not refuse to do the something I can do.
- Edward Everett Hale

[Photographs courtesy of the Times of India and the BBC. Thanks]