Notes and Comment Blog

The life of Inky

Sep 1st, 2015 9:44 am | By

Michiko Kakutani on Oliver Sacks:

Those case studies captured the emotional and metaphysical, as well as physiological, dimensions of his patients’ conditions. While they tracked the costs and isolation these individuals often endured, they also emphasized people’s resilience — their ability to adapt to their “deficits,” enabling them to hold onto a sense of identity and agency. Some even find that their conditions spur them to startling creative achievement.

I remember reading one of his books in a book group years ago and getting into an intense argument about that ability to adapt to “deficits”…arguing over Temple Grandin, and what she said about experiencing being Temple Grandin. I argued that from her perspective her autism wasn’t a deficit, it was just being Temple Grandin, and it gave her some skills that are particular to autism. The other party argued that what she was missing out on was a real deficit, and that it made her life less good than that of neurotypical people. I still don’t buy that.

In fact, Dr. Sacks wrote in “An Anthropologist on Mars,” that illnesses and disorders “can play a paradoxical role in bringing out latent powers, developments, evolutions, forms of life that might never be seen or even be imaginable in their absence.” A young woman with a low I.Q. learns to sing arias in more than 30 languages, and a Canadian physician with Tourette’s syndrome learns to perform long, complicated surgical procedures without a single tic or twitch. Some scholars believe, Dr. Sacks once wrote, that Dostoyevsky and van Gogh may have had temporal lobe epilepsy, that Bartok and Wittgenstein may have been autistic, and that Mozart and Samuel Johnson could have had Tourette’s syndrome.

See that’s why I don’t buy that you have to have all the usual “normal” skills and experiences to have a good life. I think an odd eccentric life can be a good life too, because different people want different things.

Animated by a self-deprecating sense of humor and set down in limber, pointillist prose, Dr. Sacks’s autobiographical accounts are as candid and searching as his writings about his patients, and they suggest just how rooted his compassion and intuitive understanding — as a doctor and a writer — were in his youthful feelings of fear and dislocation. He tells us about the lasting shock of being evacuated from London as a boy during the war, and being beaten and bullied at boarding school. The rest of his life, he writes, he would have trouble with the three B’s: “bonding, belonging, and believing.”

And yet he was Oliver Sacks. Who would wish he had been different?

Dr. Sacks once described himself as a man with an “extreme immoderation in all my passions,” and his books pulsate with his “violent enthusiasms” and endless curiosity: his fascination with ferns, cephalopods, jellyfish, volcanoes, the periodic table — for all the marvels of the natural world; as well as his passion for swimming, chemistry, photography and perhaps most of all, writing. Known as Inky as a child, he began keeping journals at the age of 14. For the shy boy, writing was a way to connect with the world, a way to order his thoughts; and he kept up the habit throughout his life, amassing nearly a thousand journals, while using his books and essays to communicate to readers the romance of science and the creative and creaturely blessings of being alive.

I identify as an Inky.

His patients have lost an erudite and compassionate doctor. The world has lost a writer of immense talent and heart, a writer who helped illuminate the wonders, losses and consolations of the human condition.

We still have his books though.

This confusion sucks up a lot of mental energy

Aug 31st, 2015 6:21 pm | By

Sometimes being a feminist is a strain, because there is reality and then there is feminism and there can be a quarrel between them.

Michelle Goldberg points out the trap this can lead to.

Because sexism is so interwoven with how we live our lives, it sometimes feels like the transformation of our personal lives is demanded by feminism. This is extremely exhausting, leading to a neurotic level of analysis and justification of our own preferences, motives and interpersonal relationships. Two kinds of personal essays, repeated with nearly infinite variations, manifest this neurosis. One is confessional: I’m a feminist, but I enjoy X, in which X is some traditionally female thing like not working, wearing makeup, being submissive in bed, or doing all the housework. The other is tautological: don’t judge me for doing this traditionally female thing, because it makes me, a feminist, feel good, and thus must be more feminist than it appears.

We live in the real world; sometimes doing the feminist thing is too damn much work, so we don’t. That’s life.

Often doing the conventional thing is the path of least resistance. (That’s why it’s the conventional thing.) It is not easy—it might be impossible — to live a productive life while bucking social expectations at every turn. It’s too bad that so many young women have gotten the idea that feminism expects them to.

Or even that feminism expects them to apologize for failing to. (I expect that, but that’s not feminism, it’s just me. I’m a shithead.)

This confusion sucks up a lot of mental energy, leading to guilt and defensiveness. It turns feminism—the demand that women be recognized as full, equal human beings, legally and socially—from something libratory into another thing for women to feel like they’re failing at. It becomes, ironically, a source of gender inequality, since men, by and large, don’t spend so much time second-guessing their romantic decisions and aesthetic preferences. Changing your name is not a feminist act. You have not betrayed feminism if you change your name. The same is true for staying home with your kids, wearing high heels, or getting Botox. Women live in a sexist system, and contort themselves to negotiate it, picking from a menu of mostly bad options and then hating themselves for choosing wrong. The problem is the system, not the women. That’s what the personal is political is supposed to mean.

I feel better about these pink socks I’m wearing now.

The girl that nobody wanted

Aug 31st, 2015 4:59 pm | By

This is a terrible story from two years ago.

A Belgian man has chosen to die by euthanasia, after his sex change operation turned him into “a monster”.

Nathan Verhelst, 44, was administered legal euthanasia on Monday afternoon, on the grounds of “unbearable psychological suffering”, by the same doctor who euthanized two deaf twins last year.

Shortly before he died, he told Belgium’s Het Laatse Nieuws: “I was ready to celebrate my new birth. But when I looked in the mirror, I was disgusted with myself.

“My new breasts did not match my expectations and my new penis had symptoms of rejection. I do not want to be a monster.”

Verhelst was born the only daughter in a family of three boys, and admitted that he had been “the girl that nobody wanted”.

That’s horrifying. I hope he didn’t get the sex change operation because he had been “the girl that nobody wanted” – I hope there was a lot more to it than that. But even assuming there was a lot more to it than that, it’s heart-breaking.

Not that I think that’s anything exclusive to people who want a sex change. There are lots of people whose unhappiness with their bodies basically ruins their lives. I shouldn’t be surprised that some of them choose suicide…but god it’s sad.


Participants had lost gray matter

Aug 31st, 2015 3:53 pm | By

There’s a new study of changes in the brain caused by hormones. I find it rather disturbing. Rachel Gross reports for Slate:

Research has shown that women have the advantage when it comes to memory and language, while men tend to have stronger spatial skills (though this too has been disputed). But due to ethical restrictions, no study had been able to track the direct effect that testosterone exposure has on the brain—until now. Using neuroimaging, Dutch and Austrian researchers found that an increase in this potent hormone led to shrinkage in key areas of the female (transitioning to male) brain associated with language. They presented their findings at last week’s annual meeting of the European College of Neuropsychopharmacology in Amsterdam.

Shrinkage. Just plain old shrinkage. It sounds very drastic. (And I can’t discuss it without thinking of that Seinfeld episode about swimming and shrinkage…)

For the study, researchers scanned the brains of 18 individuals receiving high doses of testosterone as part of female-to-male gender reassignment surgery before and after hormone treatment. After just four weeks of receiving testosterone, participants had lost gray matter (which mainly processes information) in the regions of the brain that are used for language processing. That change amounted to a “real, quantitative difference in brain structure,” said researcher Rupert Lanzenberger of the Medical University of Vienna.

Sobering, isn’t it.


He spent his final days doing what he loved

Aug 31st, 2015 2:41 pm | By

The Oliver Sacks Foundation on Facebook:

Oliver Sacks died early this morning at his home in Greenwich Village, surrounded by his close friends and family. He was 82. He spent his final days doing what he loved—playing the piano, writing to friends, swimming, enjoying smoked salmon, and completing several articles. His final thoughts were of gratitude for a life well lived and the privilege of working with his patients at various hospitals and residences including the Little Sisters of the Poor in the Bronx and in Queens, New York.

Dr. Sacks was writing to the last. On August 14, he published an essay, “Sabbath,” in the New York Times. Two more articles are to be published this week, one in the New York Review of Books and one in the New Yorker.

Sacks also left several nearly completed books and a vast archive of correspondence, manuscripts, and journals. Before his death, Sacks established the Oliver Sacks Foundation, a nonprofit organization devoted to increasing understanding of the human brain and mind through the power of narrative nonfiction and case histories.

The foundation’s goals include making Dr. Sacks’s published and yet-unpublished writings available to the broadest possible audience, preserving and digitizing materials related to his life and work and making them available for scholarly use, working to reduce the stigma of mental and neurological illness, and supporting a humane approach to neurology and psychiatry.

We at the Sacks office extend our love and sympathies to Dr. Sacks’s partner, Billy Hayes, and we are enormously grateful for the outpouring of love and support from Dr. Sacks’s readers and friends around the world.


Guest post: Being an AIDS patient in a Catholic building

Aug 31st, 2015 12:22 pm | By

Originally a comment by Kevin Hutchins the Bellinghamster on Left to the Church and its tribunals.

My HIV physician is continuing her private practise, but because so much of the work involves the hospital, she might be actually moving her practise INTO the hospital by the end of this year. She said it’s a trend in Infectious Disease specialists.

It’s a Catholic hospital which has already almost killed me before.

When I try to tell her i’m concerned about this, she says she doesn’t see anything improper happening, she assures me she’ll keep taking good care of me the same as always. I didn’t have a chance to press the issue with her because we were too busy talking about medical physiological issues for me to even have time to get into these more abstract things. I told her I’ve always trusted her because she’s helped keep me alive for years, but I have so much paranoia being an AIDS patient in a Catholic building with Catholic crucifixes in the alcoves and Catholic crucifixes on the desk staff and Catholic prayers over the intercom… and almost entirely Catholic employees… employees who are very likely to be looking less favorably on the fag with AIDS who comes into their hospital, than they might look towards some other kinds of patients, good Christian faithful patients.

The paranoia is unproductive, I try to stop myself from going overboard, I don’t want to be afraid of Catholic boogeymen, the way that some Christians get their panties in a bunch around queer boogeymen.

But they’ve already demonstrated poor decisions during my previous inpatient stays at that hospital and one time it almost killed me (but I survived, but it was incredibly torturously painful what they were doing wrong for a few days continuously) so I have shaky confidence at best. The only thing that keeps me from giving up on the situation entirely is knowing that my partner will stick by my side if I have to be at the hospital. If I had to do any more of this ALONE, I would just be too paranoid and scared and I would give up.

This is part of why i think Ophelia’s blog is so important. It helps remind the queer atheist feminist gender-nonconforming vegan pacifist that there are people who care and people who have overlapping problems, and we can all look at them and discuss them together. No matter what our gender or personal characteristcs are, no matter how weirdly different, this blog is good for making people feel like they have somewhere to voice concerns that would get them into serious trouble if uttered in most other places.

Siobhan is speaking her truth

Aug 31st, 2015 12:05 pm | By

Coming out as trans-everything.

Mostly it is women who pay the price

Aug 30th, 2015 4:36 pm | By

Another excellent post from Diana at Neopythia.

I want to talk about something I find offensive and morally repugnant.  It is the notion that trans women, who have arrived at a gender critical position, or simply accept certain realities are self hating.  I know this is a popular meme.  It’s an easy rationalization for those who hold certain political ideologies, or those too consumed by irrational fear to think.  It is completely without merit and harmful [to] women and trans women alike.

I think I know what political ideologies she means, and I think I know of several people who hold them.

Literally nobody identifies as a terf*. It is a term which has moved far beyond whatever usefulness it once had, if it ever had any.  It is a slur thrown about indiscriminately to silence those certain people disagree with.  I wish it was just a twitter thing, confined to largely meaningless internet squabbling, but increasingly there are real world consequences. Mostly it is women who pay the price, but isn’t that usually the case? Anyway, I don’t even label myself a feminist. I wouldn’t presume to, though I ally myself with women to the extent I am able.

*Going forward where others would use “terf,” I will use “women” to illustrate just how ridiculous this is.

That’s something I’ve been wondering about a lot, especially over the past few weeks – the fact that mostly it’s women who pay the price. Why is that? Why is it women, and specifically feminist women, who get trashed and shunned and demonized over this issue? Why is so much fire and brimstone called down on women while men are left alone? Why is feminism the enemy? Why do so many women join in with this pattern? Why do so many feminist women join in with it? Why don’t they notice the gender imbalance and the bad effects on feminism?

The self hatred meme goes something like this: a trans woman regrets her transition and is consumed by self hatred. Devious women, always preying on the weak and disillusioned, pounce, exploiting this self hatred to turn them into token women. The newly minted tokens parrot all of the hateful rhetoric and work from the inside to bring down transwomen.  What the token gets out of this, I don’t know.

Aside from sounding like something out of a horror story, I hate all of the implications of this. It is puerile, delusional thinking.  It removes any personal agency from any individual transwoman and lays the blame squarely at the feet of women.

And laying the blame squarely at the feet of women is just the same old shit – the same old misogynist patriarchal shit. Why would trans women want to perpetuate that? It’s sort of like wanting to join a club so desperately that you fight with every single member before you join.

Nobody lured me.  Nobody preyed upon my weakness or insecurity.  I made the decision on my own. I chose to listen to women, really listen.  I read their words and witnessed their testimonials.  I read books and blogs that challenged the way I think, not just those that reinforced it.  I read these with a critical, but not defensive mind. I started to look honestly at who I am, about my past, and how the world shaped me.  For the first time I talked honestly with others, and myself. It wasn’t easy. Sometimes the truth is painful to confront.  But the truth is this: I was born male. I transitioned to live as a woman. I am legally and socially accepted even if I am still learning what that means and still struggling to bury my male socialization.

It’s supposed to be the height of terrible to say that trans women have had some male socialization…and yet in all other contexts we agree that gender socialization is pervasive and unavoidable, even for people who reject it at a conscious level. If that’s true…how can it be anything but true that trans women have had some male socialization?

If you listen to transwomen, you’ll hear how dangerous and poisonous testosterone is.  What you won’t hear is how dangerous masculinity is, except in purely descriptive terms such as dress.  Gender is insidious.  It shapes us from birth in unseen ways.  It can be toxic to the way we think, especially in how we view women.  Socialization is very difficult to unlearn. We are unaware the extent to which it permeates us. To believe [that because] we have transitioned, started to transition, or “feel like a woman” we are immune to our male socialized thinking is dangerous and delusional. While not immutable, it will forever be part of our experience.

Right? How could that not be true? Nobody is immune to socialization (unless raised by wolves).

Trans women share a venn diagram of experience with women. Our experiences overlap, but are not universal.  To use a poor analogy: Even if you live in another country for decades, you will never experience it in the same way as someone who is from there. You can learn the customs and the language, even pass as a native, but there remains a level of experiential knowledge which is unobtainable, and that’s ok.

I know this. I’ve spent a lot of time in the UK, I’ve lived there for extended periods, I’ve learned a lot of customs and idioms, but that’s not at all the same as being born and growing up there.

The dirty secret is that, far from hating myself, I’m happier now than I’ve ever been.  By accepting certain basic, biological truths, and accepting how much about “being a woman” I don’t know, and can never know, I’ve found peace.  I cannot tell you how liberating this is.  I never realized how much energy I spent maintaing the delusion until it was gone. I look back and am able to reconcile the person I was with the person I am.  I don’t have to pretend. I haven’t always been a woman.  I’m a transwoman, and I’m fine with that.

I hope soon things can shake out so that that will be the usual and available way of thinking about it.

Enough money and fame to be insulated from everything

Aug 30th, 2015 10:28 am | By

A trans woman wrote a post about Caitlyn Jenner back at the beginning of June, when the Vanity Fair cover was all over the place.

The post says many things I thought at the time (and continue to think when I catch a few minutes of “Meet Cait” on cable tv) but didn’t dare say – things about how odd it is to treat a rich privileged self-absorbed conservative as an icon of both trans rights and feminism.

Friends sent me notes of congratulations as if I’d done something, as if I cared. An aging reality star spent more money than I will see in my lifetime to make himself into a pin-up queen and this is cause for celebration? I didn’t respond to any of them. I watched my progressive male friends police the words of others.  “It’s She not He!” “It’s Caitlyn not Bruce!” I suppose they think they’re helping, but I’ve never asked for it. All of them are more concerned about their progressive bona fides over my actual feelings.

I see that a lot – progressive male types policing words to demonstrate their progressive bona fides at the expense of…so many, many things.

I couldn’t get away. Every twitter refresh, every website, every television commercial, there she was. I sought refuge with my friends. Their words supported me even as the ground shook beneath me. I felt as if piece of me was torn out, stomped on, and left bleeding on the ground. I could not comprehend why, and then a friend, a friend who has taught me so much about what it means to be a transwoman, wrote this:

I want to be able to have my own story, to be who I am. To be a person, but what becomes more and more clear each day is that I will not have this small, small privilege. I cannot be a bird. I must be the kite on a string, defined by the wind…am I an object? Am I a human? I will forever after today be described to people as “Like Bruce Jenner.” I am no more.

I broke.

Tears streamed down my face as I read and re-read her words. I couldn’t read any longer.  I turned off the computer, picked up my headphones and crawled into bed.

This is part of what I was thinking about that cover all along. Why on earth set the bar there? Why make it look as if that’s what transition is supposed to be? Why make it a beauty contest?

Everything we are. Everything we were.  Everything we struggled for, fought for, and hurt for is gone. We are eclipsed by our own shadow. Whatever we were, we are no more. We are all reflections of an aged wealthy conservative living out his own personal gender passion play. Like a perfumed Pontius Pilate, he has condemned us all.

Did I misgender Caitlyn? Honestly, I don’t care anymore.  None of it matters. I have spent the last twenty years in transition. Jenner has enough money and fame as to be insulated from everything. Jenner will never experience what it is like to live as a woman in society, or even what it’s like for most to transition. Yet Caitlyn is now our queen; the standard all transwomen will be measured against henceforth. I feel as if my life and struggle has been ripped from beneath me, tarted up, and paraded about for the world to gawk at. It is the Real Housewives version of the transgender experience.

Brilliantly put. I loathe the whole “Real Housewives” whatever-that-is for the way it defines the female experience, so why should I think the trans version is any better? Both are insulting.

The whole spread is an exercise in wealth, privilege, styling, and photo shop. This is what every young transwoman now has to strive for. Only after you have visited the facial feminization doctor will you be complete. Assimilation? Who cares! it’s all about the photo shoot.  It is the transformation salon fantasy played out across our media, with a societal stamp of authenticity; Narcissistic indulgence as political act.

And yet there are many who feel the Vanity Fair cover is empowering, that it “increases awareness” of trans people. To that I say, Fuck you. Come to the city and we’ll visit young transwomen, mostly transwomen of color, homeless on the streets because their families cast them out for living their “true authentic selves.”  They did not wait to amass personal and financial security, nor have millions of dollars of plastic surgery. Such a thing is impossible and yet I’m supposed to view Caitlyn’s actions as brave? Here’s bravery for you: For the past fifteen years, Bruce Jenner has been the member of a male only golf club.  So brave. So feminist.


This is what I’ve been saying – trans activism is not the same thing as feminism, and not all trans women are feminists. I support trans rights, no question, but that does not mean I can’t disagree with particular trans women on particular subjects, including feminism.

Even those who once held him in high esteem

Aug 30th, 2015 8:33 am | By

More terrible news from the subcontinent:

The police suspect the involvement of Hindu extremists in the murder of Dr Malleshappa M Kalburgi, a prominent Kannada scholar and former Vice-Chancellor of Kannada University in Hampi.

Kalburgi was shot on his head by one of the two unidentified men on Sunday morning at his residence in Dharwad’s Kalyan Nagar locality. He was later taken to a district hospital where he was pronounced dead.

Even as the police suspect Hindutva extremists for Kalburgi’s murder, Bajrang Dal co-convener Bhuvith Shetty allegedly took to Twitter to say that that Indian critic and rationalist KS Bhagawan will be their next target for making fun of Hinduism.

Making fun of a religion is a reason for murder then?

“Then it was UR Anantamoorty and now it is MM Kalburgi. Mock Hinduism and die a dogs death. And dear K. S Bhagwan you are next,” Sheety tweeted at 10:41 am on 30 August. Shetty’s Twitter handle was, however, deleted shortly after.

Ananthamurthy, another Kannada writer, who died of cardiac arrest and renal failure in August last year in Bangalore (now Bengaluru), too had problems with Sangh Parivar outfits for his staunch criticism of their ideology and activities for over five decades.

Kalburgi was a renowed scholar and recipient of the National Sahitya Akademi award. However, he was condemned by Hindu extremists for his remarks against idol worshipping and questioning superstition.

And now he’s dead from a bullet through the brain.

Kalburgi once again incurred the wrath of some people for speaking against idol worship and the superstitions related to it.

In June 2014, while addressing a seminar on Anti-superstition Bill at Bangalore, Dr Kalburgi referred to the late litterateur UR Ananthamurthy and said “there was nothing wrong in urinating on idols”, according to a Dajiworld report.

Kalburgi had reportedly quoted an excerpt from Ananthamurthy’s book ‘Bettale Puje Yake Kadadu’ – ‘Why Not Nude Worship’.

His statement triggered immense criticism from Hindus who demanded his arrest. A case was also filed against Kalburgi and Ananthamurthy for allegedly hurting the religious sentiments of the community.

That’s an actual thing in India and Bangladesh and Pakistan – that idea that “hurting the religious sentiments of the community” is a criminal act.

Massive protests were held at the time by supporters of Bajrang Dal, Sri Rama Sene, Vishwa Hindu Parishad and other Hindutva activists in Karnataka.

Following his comments at the seminar, Kalburgi was criticised by even those who once held him in high esteem.

Of course he was.

This woman is dying before our eyes

Aug 29th, 2015 6:15 pm | By

The rest of that article on miscarriage management (or the lack thereof) in Catholic hospitals.

Some doctors have decided to take matters into their own hands. In the following case, the refusal of the hospital ethics committee to approve uterine evacuation not only caused significant harm to the patient but compelled a perinatologist, Dr S, now practicing in a nonsectarian academic medical center, to violate protocol and resign from his position in an urban northeastern Catholic-owned hospital.

I’ll never forget this; it was awful—I had one of my partners accept this patient at 19 weeks. The pregnancy was in the vagina. It was over… . And so he takes this patient and transferred her to [our] tertiary medical center, which I was just livid about, and, you know, “we’re going to save the pregnancy.” So of course, I’m on call when she gets septic, and she’s septic to the point that I’m pushing pressors on labor and delivery trying to keep her blood pressure up, and I have her on a cooling blanket because she’s 106 degrees. And I needed to get everything out. And so I put the ultrasound machine on and there was still a heartbeat, and [the ethics committee] wouldn’t let me because there was still a heartbeat. This woman is dying before our eyes. I went in to examine her, and I was able to find the umbilical cord through the membranes and just snapped the umbilical cord and so that I could put the ultrasound—“Oh look. No heartbeat. Let’s go.” She was so sick she was in the [intensive care unit] for about 10 days and very nearly died… . She was in DIC [disseminated intravascular coagulopathy]… . Her bleeding was so bad that the sclera, the white of her eyes, were red, filled with blood… . And I said, “I just can’t do this. I can’t put myself behind this. This is not worth it to me.” That’s why I left.

From Dr S’s perspective, the chances for fetal life were nonexistent given the septic maternal environment. For the ethics committee, however, the present yet waning fetal heart tones were evidence of fetal life that precluded intervention. Rather than struggle longer to convince his committee to make an exception and grant approval for termination of pregnancy, Dr S chose to covertly sever the patient’s umbilical cord so that the fetal heartbeat would cease and evacuation of the uterus could “legitimately” proceed.

How’s that for a horror story?

Dr G also circumvented the ethics committee in her southern Catholic-owned hospital. She opted not to check fetal heart tones or seek ethics committee approval when caring for a miscarrying woman for fear that documentation of fetal heart tones would have caused unnecessary delays. This led to conflict with the nurse assisting her.

She was 14 weeks and the membranes were literally out of the cervix and hanging in the vagina. And so with her I could just take care of it in the [emergency room] but her cervix wasn’t open enough … so we went to the operating room and the nurse kept asking me, “Was there heart tones, was there heart tones?” I said “I don’t know. I don’t know.” Which I kind of knew there would be. But she said, “Well, did you check?” … I said, “I don’t need an ultrasound to tell me that it’s inevitable … you can just put, ‘The heart tones weren’t documented,’ and then they can interpret that however they want to interpret that.” … I said, “Throw it back at me … I’m not going to order an ultrasound. It’s silly.” Because then that’s the thing; it would have muddied the water in this case.

The nurse probably could have gotten her fired for that.

Physicians working in Catholic-owned hospitals in all 4 US regions of our study disclosed experiences of being barred from completing emergency uterine evacuation while fetal heart tones were present, even when medically indicated. As a result, they had to delay care or transfer patients to non–Catholic-owned facilities. Some physicians violated the authority and protocol of the ethics committee to deliver what they considered safe medical care that reflected the standard of care learned in residency. The extent to which this might occur needs to be researched further but may be difficult to assess, because most physicians are not likely to discuss such behavior even in a confidential interview.

It’s one long horror story.

H/t ema.

Unless it looks as if she’s going to die

Aug 29th, 2015 5:45 pm | By

This should make your hair stand on end:

When There’s a Heartbeat: Miscarriage Management in Catholic-Owned Hospitals. Lori R. Freedman, PhD,corresponding author Uta Landy, PhD, and Jody Steinauer, MD, MAS:

The findings reported here were not the original focus of our research. In the process of conducting a qualitative study about abortion provision in the clinical practice of obstetrician–gynecologists, we interviewed 30 obstetrician–gynecologists around the United States. During the interviews, which were conducted in 2006, 6 physicians working with or within Catholic-owned hospitals revealed that they were constrained by hospital policies in their ability to undertake urgent uterine evacuation. They reported that Catholic doctrine, as interpreted by their hospital administrations, interfered with their medical judgment. For example, some of them were denied permission to perform an abortion when uterine evacuation was medically indicated and fetal heart tones were still present.

The Savita Halappanavar situation. It happens here too.

Catholic-owned institutions and their employees must adhere to medical practice guidelines contained in the “Ethical and Religious Directives for Catholic Health Care Services” (hereafter called “the directives”) written by the Committee on Doctrine of the National Conference of Catholic Bishops.8 The directives state that abortion is never permitted. However, regarding emergency care during miscarriage management, the manual used by Catholic-owned hospital ethics committees to interpret the directives states that abortion is acceptable if the purpose is to treat “a life-threatening pathology” in the pregnant woman when the treatment cannot be postponed until the fetus is viable.9 The experiences of physicians in our study indicate that uterine evacuation may not be approved during miscarriage by the hospital ethics committee if fetal heart tones are present and the pregnant woman is not yet ill, in effect delaying care until fetal heart tones cease, the pregnant woman becomes ill, or the patient is transported to a non–Catholic-owned facility for the procedure.

Risking the pregnant woman’s life, in other words.

Obstetrician–gynecologists working in Catholic-owned hospitals described cases in which abortion was medically indicated according to their medical judgment but, because of the ethics committee’s ruling, it was delayed until either fetal heartbeats ceased or the patient could be transported to another facility. Dr P, from a midwestern, mid-sized city, said that at her Catholic-owned hospital, approval for termination of pregnancy was rare if a fetal heartbeat was present (even in “people who are bleeding, they’re all the way dilated, and they’re only 17 weeks”) unless “it looks like she’s going to die if we don’t do it.”

In another case, Dr H, from the same Catholic-owned hospital in the Midwest, sent her patient by ambulance 90 miles to the nearest institution where the patient could have an abortion because the ethics committee refused to approve her case.

She was very early, 14 weeks. She came in … and there was a hand sticking out of the cervix. Clearly the membranes had ruptured and she was trying to deliver… . There was a heart rate, and [we called] the ethics committee, and they [said], “Nope, can’t do anything.” So we had to send her to [the university hospital]… . You know, these things don’t happen that often, but from what I understand it, it’s pretty clear. Even if mom is very sick, you know, potentially life threatening, can’t do anything.

That should be malpractice.

In residency, Dr P and Dr H had been taught to perform uterine evacuation or labor induction on patients during inevitable miscarriage whether fetal heart tones were present or not. In their new Catholic-owned hospital environment, such treatment was considered a prohibited abortion by the governing ethics committee because the fetus is still alive and the patient is not yet experiencing “a life-threatening pathology” such as sepsis.

You see what they’re saying there? A situation that will lead to sepsis is not enough, they have to wait until sepsis develops – by which time it may be too late, as it was for Savita Halappanavar.

This should be a crime. The hospitals should be not just sued but prosecuted.

Dr B, an obstetrician–gynecologist working in an academic medical center, described how a Catholic-owned hospital in her western urban area asked her to accept a patient who was already septic. When she received the request, she recommended that the physician from the Catholic-owned hospital perform a uterine aspiration there and not further risk the health of the woman by delaying her care with the transport.

Because the fetus was still alive, they wouldn’t intervene. And she was hemorrhaging, and they called me and wanted to transport her, and I said, “It sounds like she’s unstable, and it sounds like you need to take care of her there.” And I was on a recorded line, I reported them as an EMTALA [Emergency Medical Treatment and Active Labor Act] violation. And the physician [said], “This isn’t something that we can take care of.” And I [said], “Well, if I don’t accept her, what are you going to do with her?” [He answered], “We’ll put her on a floor [i.e., admit her to a bed in the hospital instead of keeping her in the emergency room]; we’ll transfuse her as much as we can, and we’ll just wait till the fetus dies.”

Ultimately, Dr B chose to accept the patient to spare her unnecessary suffering and harm, but she saw this case as a form of “patient dumping,” because the patient was denied treatment and transported while unstable.

And this is all because the hospital is Catholic.

More to come, because I don’t like to make posts too long.


A picture to say

Aug 29th, 2015 12:21 pm | By

Hmm. Tim Roberts isn’t such a good poster boy for freedom of Twitter after all.

Near the top of his Twitter timeline right now:

Tim-A-Roberts ‏@Tim_A_Roberts 1 hour ago
Oh – for the obsessed fans out there – a picture to say – I’m sorry

Embedded image permalink

But remember – in the UK, “cunt” is in no way a misogynist epithet.

She’s not going anywhere

Aug 29th, 2015 11:54 am | By

Jessica Valenti talks to Anita Sarkeesian.

Sarkeesian also points out that explicit abuse is just one way women are harassed online: some are targeted with conspiracy theories, or social media accounts that impersonate the victim. One person fabricated a tweet from Sarkeesian claiming she had spent her Kickstarter funds on designer shoes (with a picture of Gucci flats alongside a caption reading, “Buying 1,000-dollar shoes”).

Women are much more likely to be harassed in online spaces than men, and the harassment is much more likely to be sexually violent. A 2006 study by theUniversity of Maryland found that when the gender of a username appears to be female, the user is 25 times more likely to experience harassment. That same study found that those female-sounding usernames averaged 163 threatening or sexually explicit messages a day.

Because that’s what women are for – to be fucked or hated or both.

Sarkeesian is also fond of calling GamerGate a “sexist temper tantrum”, because “it does have that feeling of the kid screaming and you don’t know why”. When I point out that temper tantrums are generally thought of as harmless rages, and that the abuse she and other women have faced is much more serious, she agrees.

“That’s the reason I don’t like the words ‘troll’ and ‘bully’ – it feels too childish. This is harassment and abuse,” she says. But still, she says, GamerGate is a temper tantrum: “It’s just a scary, violent, abusive, temper tantrum. It’s an attack and an assault on women in the gaming industry. Its purpose is to silence women, and if they can’t, they attempt to discredit them.

“These dudes fling shit. They’re throwing things out there and trying to get something to stick.”

And of course something always does stick. Often everything sticks.

Valenti points out that a lot of the harassment comes from very young boys.

While Sarkeesian is careful to point out that the stereotype of teenagers in their parents’ basement is a dangerous one (much of the most dangerous harassment is perpetrated by grown men) she shares my concern that a younger generation is growing up with harassment of women not just as the norm, but as a way to impress your peers.

“There’s a boys’-locker-room feel to the internet, where men feel they can show off for one another,” she says. “A lot of the harassment is tied to this toxic masculine culture of ‘Look how cool I can be.’” Someone will send a woman a death threat and screencap it, posting it on a forum, which in turn inspires another man to do something even worse in a horrifying game of misogynist oneupmanship.

That’s the slime pit. That describes it exactly.

Sarkeesian’s strategy for dealing with her most persistent harassers is largely to block and ignore them. “There are men who make videos about me regularly. Some are just screaming; some hold guns while they talk about hating me. I don’t engage with them, as I don’t want to amplify their voices.”

Many of these men will insist it’s all for fun, or just a joke, but whether the intent is to harm, or simply to do some chest-puffing for friends, “it still perpetuates all of the harmful myths attached to that language and those words,” Sarkeesian says.

Perpetuates it, models it, rewards it…

Independent developers tell Sarkeesian her work makes them want to create better games. “People come up to me at events and tell me how much my work has meant to them and that it has helped them to speak up,” she says. At conferences, she can’t get from one end of the room to the other without people in the industry telling her how much they like what she’s doing.

That’s wonderful, Sarkeesian acknowledges, but she wants to know: “What are you doing? Because what is my work if you’re not going to do something about it, too?”

Sarkeesian is exhausted – she hasn’t taken a break since 2012 – but she’s not willing to give up. Even with the death threats, the obsessive abusers, the fear and the enormous personal cost, she asks a question asked by so many change-makers: “How can I give up now? I’m not going anywhere.”

Rock on.

Senior salutes

Aug 29th, 2015 10:58 am | By

Meet a clear example of rape culture.

Boys at an elite New Hampshire prep school, where a former senior is accused of raping a 15-year-old freshman girl, rubbed the carved name of a man from the class of 1947 on a campus wall for good luck during an annual spring game of sexual conquest, according to a prosecutor.

Defendant Owen Labrie, 19, and his friends would touch the name of a man they dubbed “The Slaymaker” as they plotted to “slay” female classmates during a long tradition at St Paul’s school known as “senior salutes,” deputy Merrimack County attorney Catherine J Ruffle said outside the courtroom.

“‘Slay’ was the term the defendant and his friends coined,” Ruffle told a jury in Concord on Tuesday at the start of Labrie’s trial.

“Slay” means fuck.

So that’s healthy – boys have a contest to do something to girls, and they recognize the aggressive nature of it enough to equate it with killing – but not enough to refrain from engaging in the contest.

Labrie was found guilty on some counts but not on rape.

The dean of students from the school, Chad Green, testified he was aware of the senior salute tradition at St Paul and knew it could contain a sexual component.

“I came to understand the senior salute as one element of a larger vernacular the kids at St Paul’s used to describe a wide range of relations between students,” Green said.

Crude social media exchanges between Labrie and his friends about the accuser were presented as evidence. He admitted he and a friend drew up a list of girls they wanted to “slay” during their waning months of high school but denied the term meant sexual intercourse. The girl’s name was in capital letters.

Oh well, it’s only girls.

After a seemingly harmless tweet

Aug 29th, 2015 10:38 am | By

Updating to add: The Independent reporting wasn’t very thorough. Tim Roberts seems to be pretty much on a level with the fans who trolled him.

Good grief.

The Independent reports:

A veteran stage technician, who worked in the West End for more than three decades, has quit his job after a social media row with fans of actor Benedict Cumberbatch.

Tim Roberts walked away from his position as a light technician for The Phantom of the Opera last week after a seemingly harmless tweet he posted on his own account escalated into a row with self-styled “Cumberbitches”.

His messages prompted Andrew Lloyd Webber’s Really Useful Theatres (RUT), which runs Her Majesty’s Theatre where Phantom is staged, to threaten him with disciplinary measures.

Mr Roberts criticised the company for “suppressing freedom of speech” among employees and he now fears he is unemployable in the West End.

He tweeted something critical about Cumberbatch’s Hamlet and the fan frenzy around it.

The tweet sparked a furious response from some fans who trolled his Twitter feed and even sent death threats.

Because that’s what you do.

Roberts responded rudely, and someone sent the whole thing to management at RUT, which opened an investigation.

The technician, who worked on Phantom for four years as well as Starlight Express and Bugsy Malone in the 1980s, was told disciplinary measures could be taken. “At that point I decided I would walk because I didn’t want to go through disciplinary,” he said.

So that’s his life ruined, because he said he didn’t admire Cumberbatch as Hamlet.

Eppur si muove

Aug 29th, 2015 9:54 am | By

Well color me surprised – a Catholic institution has budged. A Catholic institution has responded to public outrage, and thought again, and held a meeting, and budged. A Catholic institution has reversed itself on a homophobic policy. Stone the motherfucking crows.

The St. Mary’s Academy board voted Wednesday night to change the school’s policy on hiring gay employees after facing backlash over the administration’s decision to rescind a job offer to a gay counselor.

Students and high-profile donor Tim Boyle, CEO of Columbia Sportswear, had earlier condemned the choice not to employ 27-year-old Lauren Brown.

In response, administrators brought the board together and recommended members vote to expand the hiring policy.

No doubt they didn’t want to lose the donor, and other donors who might follow. I don’t care. They still budged.

In July, the Roman Catholic high school reversed its plans to make Brown an academic adviser after learning she was gay, the job applicant said. Friedhoff said the decision was made when Brown indicated she intends to get married.

Brown’s attorney said the 27-year-old had accepted the position in April and signed an employment contract. Friedhoff said the position was offered in April and a contract was sent to Brown, but administrators never received a signed copy.

Regardless of the precise reason or whether Brown had signed a contract, the decision not to hire her didn’t sit well with students. St. Mary’s families learned about the situation Tuesday night when the administration emailed parents.

Students aren’t always right, but sometimes they are. In this case they are.

About a dozen students showed up Wednesday morning to decorate a statue outside the school with rainbow heart glasses and a St. Mary’s hoodie with “FREE TO BE ME” taped on the front. The teens said the decision didn’t reflect the social justice values of St. Mary’s.

Good job, teens.

The original decision could have had financial implications for the school. Major donor Tim Boyle, CEO of Columbia Sportswear, said Wednesday afternoon in a statement that he and his wife had been “extremely disappointed” and believed the original decision should be reversed.

“Recently, one of us participated in a successful public forum hosted by St. Mary’s addressing how to prepare St. Mary’s students for the work force of the future,” Boyle said in a statement to The Oregonian/OregonLive. “The news this week is an example of how to not prepare students.  There is no place in the workplace of today, or of the future, for discriminating against an individual based on sexual orientation.”

Quite right. There’s no place for it because there’s no good reason for it. It was just a thought-free entrenched prejudice, a mindless oook-feeling, and nothing more.

I found out about this via the Facebook page I stand with Barb Webb. Remember Barb Webb? She taught chemistry at a Catholic school near Detroit for nine years, until they fired her after she told them she was pregnant.

Webb, 33, says she told the administration last month she was 14 weeks pregnant and offered to take a leave of absence until after her child was born. She says she was told she could resign or be fired. She chose the latter.

Webb said she does not believe her firing was strictly based on the fact that she is gay, but that it was because she became pregnant outside of a traditional marriage.

The school’s morality clause, which all teachers are expected to sign, is “quite vague”, Webb said, in that it only states that teachers and other employees must not publicly display or teach anything that contradicts Catholic doctrine. Legal experts say such clauses can often mask unlawful discrimination.

It would be pleasant to see that school change its policy, and re-hire Barb Webb.

Guest post: So used to living in boxes

Aug 28th, 2015 6:16 pm | By

Guest post by Tigger the Wing.

I would be very upset if people as intelligent, thoughtful and educated as Josh and Ophelia were to stop discussing this extremely important topic because a tiny minority of people are loudly bullying anyone who dares to broach it.

This is happening i
n meatspace, too, and it is the older people who are being silenced yet again. Just one person can ruin an entire organisation by making it just too uncomfortable for anyone else to say anything.

And they are ruining things for trans people.

Just as we had been making headway, getting laws changes so that we didn’t have to conform to the gender stereotypes of a particular psych gatekeeper in order to be allowed to transition, because wider society is slowly coming around to the idea that gender expressions and restrictions are largely societal constructs (whereas being drawn to a particular gender performance, or repelled by it, seems to be a matter of personality) they decide that we can’t be allowed to discuss the very gender norms that we are trying to subvert.

Honestly, if I look at a crowded street, the most common clothing is a variation of T-shirt-and-jeans. Make up is more likely to be seen on apparently female people than male, but over here it’s not particularly prevalent. Hair length doesn’t map very well to gender, nor does jewelry. Perhaps that is at least partly why Ireland passed the gender recognition bill shortly after the marriage equality referendum.

We don’t want to go back to the mindset of the late 1940s, when governments realised that telling women to leave the workforce and become housewives was likely to create less of a violence problem than not having jobs for millions of returning soldiers. That, to my mind, is how recent the gender barriers were erected. Up until then, women worked.

In the 1950s, my mother had to fight to stay in work when she married, but did indeed give up when she had me and didn’t do paid work again until we had all grown and left home. She’s probably the only one of my maternal ancestors who didn’t work while raising children. Fragile femininity seems to have been if not exactly invented then certainly raised to a ridiculous level during the 1950s and 60s.

Why can’t we discuss this? Is it because the people raised in an era when many of the equality battles seem to have been won can’t see how vulnerable those gains are? Are they so blinded by the recent pinkification of everything that they cannot see what is lying behind it?

Don’t they see that questioning the premise of gendering of presentation and performance is NOT rejecting the rights of people to perform and present however they like, rather the opposite?

People have apparently become so used to living in boxes that they cannot see that what is important is the place that the box occupies; remove the boxes, the walls, and we don’t remove the places; we make it so that people can freely wander into any place they desire.

A new editorial committee that includes a public relations staffer

Aug 28th, 2015 6:05 pm | By

Alice Dreger has resigned from Northwestern.

Dreger, a noted researcher and author, submitted a resignation letter to Northwestern Provost Daniel Linzer on Monday. She said she’s stepping down because the university censored faculty magazine Atrium, forcing editors to take the digital issue offline after they published an article last March about a consensual blowjob involving a nurse in 1978.

In the wake of intense criticism, the medical school allowed the magazine to resume publication and to repost its online digital issues 14 months later, but it also imposed a new editorial committee that includes a public relations staffer and would have say over future issues.

A public relations staffer! That doesn’t sound very academic, or legitimate.

Dreger is the second faculty member to call it quits at Northwestern over the Atrium dispute. She went public about the conflict in June, after receiving the backing of the Foundation for Individual Rights in Education, a free speech watchdog group.

The university’s lack of response to her concerns is partly why she decided to resign, Dreger said.

“It’s quite disappointing,” she told HuffPost. “Negative publicity around freedom of scholarship doesn’t matter to them as much as publicity about the hospital — I can only imagine that’s the calculation they’ve done.”

Greg Lukianoff, FIRE’s president and CEO, said he is “sad to see that Northwestern’s heavy-handedness led to them losing a champion of academic freedom.”

That’s how that works. Be too heavy-handed with a dissenter, and she just might walk out on you.

“The plain and simple fact is that Dean Neilson acted impulsively and wrongly in this situation,” Dreger wrote in her letter. “We all make mistakes, but this was a profound mistake that cut to the very heart of academic freedom. It should have been acknowledged and corrected immediately. That is most definitely not what happened. Instead, what happened was denial, avoidance, blame-shifting, and evasion. To this day, the university has not admitted its mistake, and it has not affirmed its commitment to academic freedom in a way that makes clear that similar incidents will not occur in the future. This failure should be embarrassing to an otherwise great university.”

Dreger conceded she was able to resign in protest because she’s lucky enough to have financial support from her book, scheduled appearances and other writing, but she said other faculty wouldn’t be so lucky.

It’s great to be able to resign.

71 people in the back of the truck

Aug 28th, 2015 5:46 pm | By

It’s been a bad week for refugees trying to get to Europe.

In Austria, 71 people — including four children, the youngest just a year old — suffocated after being locked in the back of a truck, authorities said Friday. It remained unclear why the migrants, at least some of whom were believed to have been fleeing the war in Syria, were left to die. Hungarian authorities arrested four suspected smugglers, but a police official in Austria acknowledged they were likely low-level operatives and said the ringleaders remained at large.

Meanwhile, some 2,000 miles away, at least 80 people drowned overnight Thursday when a boat, unprepared for the rigors of a trans-Mediterranean voyage, capsized soon after it departed from the Libyan coast.

The deaths added to a toll of at least 2,500 people who have lost their lives this year while seeking sanctuary in Europe.

Life is shit where the refugees live, and it’s less shit in Europe. You do the math.

Until now, much of the focus among European policymakers has been on halting the flows, either by destroying smugglers’ boats or building fences to keep would-be migrants out of Europe.

But the deadly incidents this week reflect the lengths to which people are willing to go to flee their home countries and arrive on a continent that is seen as an oasis of stability and prosperity.

You want to talk about privilege – never mind being born in the “right” body, what about being born in one of the right countries? That’s privilege for real. Syria is not the right country to have been born in right now, and neither is Libya.

Once in Libya, the migrants are desperate to leave. The country has been torn apart by civil war, with multiple factions controlling various patches of territory. Underlining the confused situation, there were conflicting reports Friday as to whether one boat had sank or two. The reported death toll ranged from 80 to 200.

The peril doesn’t end after migrants arrive in Europe, as the deaths of 71 people in the back of the truck abandoned on the main highway between Budapest and Vienna attest. The badly decomposed bodies were discovered Thursday, and police were uncertain until Friday exactly how many were inside.

What privilege we have, those of us who don’t have to risk journeys like that.