This week I’m reading Michelle Goldberg’s masterful The Means of Reproduction: Sex, Power, and the Future of the World with one of my classes. In it, Goldberg traces the history of foreign aid for women’s health – especially reproductive health – from its Cold War, Rockefeller/Ford/Guttmacher beginnings to the present era.
In 2011, well into the second decade after the UN International Conference on Population and Development in Cairo, you’d think we’d be well along the path blazed there: foregrounding women’s need for education and autonomy. Nuh-unh!! Instead, the proponents of women’s reproductive autonomy in developing nations and the Global South face constant friction and opposition from groups funded by the Radical Christian Right in the U.S. This trajectory toward radical rightwing interference is lucidly, chillingly described in Goldberg’s book. It’s as though women’s bodies became a proxy war for the tensions over reproductive rights and justice back here in the U.S.
And now, with the House of Representatives today voting to defund Title X funding, that proxy war has come home. For details, see excellent recaps by Lindsay Beyerstein and Jill Filipovic. The legislation wouldn’t affect abortions – except to inflate their numbers by making birth control less accessible to poor women and young women. No, the target here is broader. It’s a war against all women, but especially those who are poor.
When I was young and underinsured, I too turned to Planned Parenthood, and I’m forever grateful for their services. Some women are transiently poor, like I was. Many struggle with poverty throughout their childbearing years. All of us deserve affordable access to basic services like a Pap test.
I believe this even though – or especially because! – I had a few dodgy Pap test results in my early twenties. Those diagnoses of “cervical dysplasia” scared me. Cone biopsies were threatened. The cellular abnormalities resolved on their own, as HPV usually does. Had I progressed toward cervical cancer, Planned Parenthood might well have saved my life.
All women deserve preventive care, and that includes the prevention of pregnancy. This is sooo not rocket science.
Odds are good that the Senate won’t stand for the House’s crap. Still, I’m appalled that a majority in the House signed onto it. While some members may try to hide behind a figleaf of fiscal responsibility, that’s balderdash, as Amanda Marcotte argues:
Of course, rhetoric that attacks federal funding for contraception as a state-subsidy for promiscuity obscures the fact that continuing Title X is one of the more fiscally sound things the government can do: Research from the Guttmacher Institute demonstrates that every dollar spent on family planning saves the government four dollars down the road.
No, this is strictly culture war ammo, just as the Mexico City rule and all the other right-wing meddling into brown and black women’s bodies has to do with ideology and misogyny – not fiscal soundness.
This is merely the continuation of funding politics imposed on the “Third World” – now aimed at women that Chandra Mohanty once called the “Third World” in the United States. This is the redirection of contempt for brown and black women’s bodies to those women living within U.S. borders. Women like me – white, securely middle-class, employed, insured, and slouching toward the end of my reproductive years – will be just fine. It’s poor women of color who will suffer. College students who can’t tell their conservative parents that they’re on the pill. Appalachian women lacking any form of health insurance.
Senate? The ball’s in your court. Please show us that you consider women human beings whose health is as important as men’s – who should have a chance to participate fully in society – and who should not be written off if they lack racial or class privilege.
In the clip below, Michelle Goldberg suggests that the U.S. culture wars have affected women outside the U.S. more profoundly than women here at home. Up until now, she’s been right. As to the future? Well, that might just be up to the Senate.
Isn’t that nice? No guilt, only responsibility. I think the problem with this little speech is that from the moment that White people are born, they do take advantage of every single ounce of privilege that is bestowed upon them. They don’t have to feel guilty about slavery, or Jim Crow, but they should sure as hell feel guilty for the perpetuation of Whiteness. Tim may have gone to multicultural daycare, but his Whiteness made that an option, rather than a necessity. When he was streamed into university courses and the teachers worked hard to ensure that Blacks were not, he didn’t feel the need to question.
The discussion on Renee’s post made the important and valid point that white people shouldn’t dominate our conversations about race. Ultimately, a person who has grown up white needs to make the effort to read what people of color have written and listen to what they have to say. They can’t just listen to Time Wise and stop there.
But I would take issue with some of the other criticisms that Renee makes. First, Renee says that Wise should feel guilty about the unearned privileges he enjoys – about advantages he did not personally choose or seek. He should feel guilty about his daycare experiences? Really? How is he culpable for choices his parents made? Should he have foregone college, just because black and Latino boys are funneled away from it (and often into prison instead)?
Fighting privilege – or even “renouncing privilege” – shouldn’t mean voluntary abjection. Privilege comes in two basic forms. The first relies on power over others; it’s a zero-sum game. An example of this type of privilege would be the tendency of many audiences to take white middle-class male speakers more seriously than speakers from a marginalized group. (See, for instance, some conservative pundits’ dismissive comments on the Native American blessing given at the Tucson memorial service last week.) The second form of privilege need not entail the degradation of marginalized groups. Attending college falls into this category. These privileges shouldn’t be abolished but should be made so widely available that they cease to be privileges. (That doesn’t mean that every kid should attend college, or that colleges couldn’t be selective about admissions; instead, we would need to mitigate poverty, substandard K-12 school, dangerous neighborhoods, etc. until the racial makeup of colleges – including highly selective ones – looks very much like the demographics of the U.S. in general.)
More basically, I do not think guilt is a helpful emotion. Guilt paralyzes. It focuses attention right back on the feelings of the white person. It leads to inaction. It can even help perpetuate white privilege. As long as I wallow in guilt, I may have the illusion that I’m achieving solidarity with people of color. But that’s bullshit. Guilt is solipsistic. It’s a natural reaction, but if it’s more than transient, it’s toxic.
When I reject guilt, am I just shoring up my own privilege? After all, I’m a white woman who grew up in a practically all-white farm town in the overwhelmingly white state of North Dakota, dimly aware as a child that the civil rights and black power movements were taking place somewhere else.
So please consider, instead, the words of Audre Lorde:
Guilt and defensiveness are brick in a wall against which we all flounder; they serve none of our futures. … (124)
Guilt is not a response to anger; it is a response to one’s own actions or lack of action. If it leads to change then it can be useful, since it is then no longer guilt but the beginning of knowledge. Yet all too often, guilt is just another name for impotence, for defensiveness destructive of communication; it becomes a device to protect ignorance and the continuation of things the way they are, the ultimate protection for changelessness. …
I have no creative use for guilt, yours or my own. Guilt is only another way of avoiding informed action, of buying time out of the pressing need to make clear choices, out of the approaching storm that can feed the earth as well as bend the trees. (130)
(Audre Lorde, Sister Outsider, pp. 124, 130)
In fact, Lorde saw guilt as an obstacle to white women acknowledging difference, which in turn stopped them recognizing their own role in perpetuating racism.
In my teaching about racism, I’ve consistently tried to reframe the discussion as about responsibility rather than guilt. I try to show how racism is structural and systematic, rather than limited to outright bigotry. Most of my students are white, with backgrounds varying from rural poverty to suburban affluence, from highly integrated schools to all-white gated enclaves.
This past week I used the Tim Wise clip in my intro to Women’s and Gender Studies, and I thought it was very effective. More effective, in fact, than my teaching alone. Does it trouble me that may have Wise resonated with some of my white male students in part because he can draw on male privilege? A little. But I’m also pragmatic enough to see the value in male allies in anti-sexism. If Wise’s analogy of the manager who can’t ignore the debt side of the ledger makes some students more receptive to Patricia Hill Collins and bells hooks, then that’s a good starting place.
Many of the commenters on Renee’s post seemed to assume that Wise’s voice is crowding out the voices of people of color. I can understand why people of color would resent his earning an income as an anti-racist educator. I agree he has a responsibility to promote the voices of people of color, and I honestly don’t feel qualified to judge whether he does this adequately or not. From my perch here in Appalachia, I think Wise could do better in understanding the nuances of white poverty (in this otherwise useful piece, for example.) Overall, though, Tim Wise is helping to challenge young white people, especially, to see anti-racism as a cause that should matter to them.
Allies don’t have to be perfect. They/we need to be willing to listen. They/we need to be willing to speak up. They/we need to be willing to examine their own privilege. We’re all a work in progress. We all have opportunities to be allies. We’re all called to engage constructively with potential allies. Guilt doesn’t advance any of these processes. But a sense of responsibility sure does.
Despite having foolishly booked my return flight to Ohio through Chicago, I managed to avoid getting stuck there in last weekend’s blizzard – only to be snowbound with the kids all this week. We’ve had three full snow days and two mornings with two-hour delays. The high school kids didn’t get to take their final exams today; my fifth-grader and his friends have to postpone their geography fair until January; and neither of my kids had math even once this week, since that’s scheduled first thing every morning.
A walloping half-foot of snow has fallen over the course of the week, maybe a tad more.
We here in Athens, Ohio, are not like Seattle or Atlanta, where snow takes everyone by surprise. We get it every darn winter. Here in southeast Ohio, we actually get less snow than, say, Cleveland, but my students from Cleveland laugh at our inability to carry on with school once a snowflake sticks to the ground.
The problem, this year and every year, is that we don’t have the equipment to clear the snow quickly. We don’t have the manpower. The city does pretty well at clearing the main streets, but the county roads remain impassible. It’s all a function of money. You could just as well call many of our snow days “poverty days.”
It’s not even the first day of winter, and we’ve already blown through all our snow days. In fact, thanks to our “tornado day” back in September, we’re one in the hole. Our inestimably wise legislators reduced our allotment of calamity days from five to three, starting this fall. I guess they thought our kids would get more edumacated this way. Instead, we’re likely to have a few dozen more two-hour delays between now and March. To make up the snow days that we’re sure to have in the new year, we’ll lose every holiday except MLK and Memorial Day. The school year will extend into the summer, like it does every year. And our kids will miss a month or so of math.
So let’s say you’re seeing your doctor, whether for a checkup or an acute problem. She looks you over carefully. Just on the basis of your appearance, she decides you’re at risk for significant health problems.
Sure, most readers of this blog are aware that appearance counts for a lot (too much!) when it comes to work and dating. But in the doctor’s office? Did you know that one common measure of health is whether you look your age? For all the time I’ve spent studying medicine, this practice was new to me.
“Few people are aware that when physicians describe their patients to other physicians, they often include an assessment of whether the patient looks older than his or her actual age,” says Dr. Stephen Hwang, a research scientist at St. Michael’s Hospital and an associate professor at the University of Toronto. “This long standing medical practice assumes that people who look older than their actual age are likely to be in poor health, but our study shows this isn’t always true.”
For patients, it means looking a few years older than their age does not always indicate poor health status. The study found that when a physician rated an individual as looking up to five years older than their actual age, it had little value in predicting whether or not the person was in poor health. However, when a physician thought that a person looked 10 or more years older than their actual age, 99 per cent of these individuals had very poor physical or mental health.
Where I live – in an Appalachian county in Southeast Ohio – I suspect you actually do see lots of people who look a decade older than their chronological age. I’m basing this on anecdata gathered partly while in the waiting room at the ob/gyn’s office, where grandmothers-to-be often accompany their young pregnant daughters. I live in a pocket of endemic poverty. Poverty does beat people down. It ensures that they’ll grab cheap, satiating calories over a bunch of colorful veggies – just because it’s not pleasant to go to sleep at night with a gnawing sensation in one’s belly. We know that diabetes, for instance, is rampant in this region. So is extreme obesity.
But the pitfalls of using appearance as a proxy for health ought to be obvious, too. Take, for example, your faithful blogger Sungold, whose miraculously youthful complexion is due to … being born near the 49th latitude with her head in a book. I think I probably do look a few years younger than my age (especially compared to the local population) just because I didn’t get much sun as a youngster. But does that mean I’m healthy? Long-time readers know that I’ve got something undiagnosed, which is sort of like fibromyalgia and a bit like thyroid issues and a mimic of multiple sclerosis – but is apparently none of the above.
People who have a medical problem but look healthy are not well served by this rough-grained appearance test. Doctors will tend to dismiss their complaints because hey, they don’t look sick.
People who look much older than their actual age may also be poorly served. For example, too many doctors address problems like obesity on a radically individualized level, often with a dollop of shaming for letting oneself get too fat. The people in my region look old because they face multiple oppressions. Whatever wise or foolish decisions they’ve made in the past, they need a doctor to propose constructive solutions, not prejudge them based on appearance.
I hope doctors will take this study to heart and move toward evidence-based medicine when it comes to appearance. By all means, if someone looks extraordinarily aged, use that as a reason to inquire further. But do inquire. Please do ask. Appearance can only project a 2-D image. Patients’ words and embodied experiences can supply the essential third dimension.
I wrote this post quite a while ago, when an acquaintance’s experience in the Southeast Ohio Regional Jail gave me an inside peek at the American system of (in)justice. I didn’t publish it at the time because of privacy concerns. The case is now well in the past (and my friend is okay), but now one of my former students is facing serious charges, which I’m confident are either baseless or extremely trumped-up. I suspect his main offense is that he’s young, black, and poor. (I may write about his case if it becomes more public, as seems likely.)
Consider this a piece of fiction that is nonetheless entirely true.
* * * * * * *
You are arrested. It’s the middle of the night. Before you’re hauled off, you’re allowed to collect a few phone numbers from your cell phone. That’s it. You’re driven through the darkness to the jail in Nelsonville, the next town over, some miles from your home.
You are dumbstruck because you have no reason to believe you’ve broken any law.
Upon entering the jail, you are stripped of every thing you own. You’re not even allowed to have pen and paper.
The orange institutional clothing goes all the way down. You’re not even allowed to keep your own underwear. The standard-issue underwear are orange, too.
From inside the jail, you’re allowed more than the “one phone call” that TV cop shows. However, all calls must be placed collect. Cell phones can’t accept collect calls. You have a couple of phone number for lawyers who practice civil law. But it’s a weekend and answering machines aren’t so great at accepting collect calls either. You make an initial call in the wee hours just to alert a friend of your whereabouts.
You aren’t a hardened criminal, so you don’t know any attorneys who might represent you. Certainly you don’t have their phone numbers.
You wait, hoping for help.
Unbeknownst to you, your friends are trying to call you, cringing at the shame and, well, pollution they feel at dialing the jail. In fact, the jail isn’t even listed in the phone book, though there are numbers for the dog catcher and for the office that deals with numbering houses. They call the sheriff’s office, which has the jail’s number. They get through to the jail and are told that you’re not allowed to receive any messages. They ask if you can receive visitors, and they’re informed that visitations do occur on the weekend, but you’d have to make advance arrangements for that. They are left wondering if you were supposed to book visitors a day earlier, when you had no idea that you’d ever be arrested.
You call one of your friends. She’s uncertain and a little wooden on the phone, lacking even the vaguest idea of how to proceed or what to say. She says, Make sure you don’t say anything that could possibly incriminate yourself. You know she’s right, but her words widen the gulf between her comfortable world and the massive cell you share with 40 other prisoners. She says another friend wants to visit, and you should call him when you can. She makes reassuring noises about getting a lawyer, but you can hear that she really has no clue. You don’t break down, but nonetheless you sound defeated.
You pass a second night in the jail. With 40 men in the room, silence is a sweet fantasy. So is sleep. Maybe you think about the parallels between this 24-hour noise chamber and the intentional infliction of noise as an interrogation technique – or was that a torture technique? Maybe you don’t think about that, or anything coherent, because you’re scared and exhausted beyond words.
Next day, your friend visits. He tells you what he’s been able to learn about legal rights, based on his frantic googling. No, he’s not a lawyer, but he has excellent and dogged research skills. Not all of what he tells you is reassuring, because you seem to have fallen into a cleft in American law where the presumption of innocence is reversed and the normal rules of evidence don’t apply. You look ragged, worn, and demoralized, but he too looks visibly shocked at the jail’s surroundings: All these prisoners speaking through phones that crackle unto inaudibility. All these visitors who, like their locked-up men, look old far beyond their years. Every last visitor is female, apart from your friend. As for the prison personnel, they’re omnipresent through cameras (or so one must assume), but visible nowhere. This shabby regional jail is the ultimate faceless modern bureaucracy.
Meanwhile, your friends are trying to hunt down a lawyer. It’s surprisingly hard on a Sunday – surprisingly, because arrests don’t exactly plummet on weekends. A friend finally reaches a defense attorney who comes warmly recommended, and who thinks he doesn’t have a schedule conflict with the arraignment.
Again, this is all unbeknownst to you. A friend tries to call you Sunday evening and is first told that no messages can be conveyed to inmates. She shudders at thinking that you’re an inmate. But that is precisely what you are until the jail’s talons loosen their hold on your flesh and you’re dropped to earth like half-eaten roadkill. (At which point you’ll need a ride, because the law won’t transport you back to your hometown.) The line then goes briefly silent, and her heart leaps as she realizes she’s being put through to a supervisor. Oh, she’s good at reasoning with supervisors! So she mentions to the police officer who picks up that you really need to know that you can expect legal representation the next morning. After all, you’ve got a constitutional right to counsel. “That’s right, ma’am,” replies the officer. “He’s got a constitutional right to counsel. But he has no right to receive messages. That’s just policy.” He doesn’t say “sorry,” and his voice suggests he’s anything but.
Would you have felt better or worse, had you been able to overhear that conversation? It hardly matters, though, because you’re embarking on a third night of sleeplessness, and while your friends have heard from multiple sources that you’re likely to be released on your own recognizance, you’ve not heard that from anyone authoritative. All you can think of is the consequences of baseless charges for your family, career, and freedom. And without the distraction of a book or internet access, you’ve got infinite time to think and fret, for as long as you’re incarcerated.
* * * * *
What’s changed since I first wrote this? Only the phone system. Now it’s impossible to reach a real person, however unfriendly. There’s only a convoluted automated answering system.
Addressing a proposal in Australia to make baby formula a prescription-only product, Spilt Milk strikes the perfect balance between breastfeeding advocacy and respect for women’s individual situations, experiences, and autonomy.
As a lactivist I obviously have a problem with the marketing of infant formula and any implication that it is as good as, or better than, breast milk. But as a human being I also know that people are hurt, seriously hurt, when they feel judged and shamed and when they are exhaustedly holding a hungry, crying, baby at 2:30 am and it feels like no one can help them.
Removing systemic barriers to breastfeeding certainly may require improved measures to reduce the popularity of formula – popularity which can be attributed to decades of marketing not only to the public but to health professionals. A big part of that marketing is about convenience: huge displays in chemist shops and regular sales at the supermarket of products in familiar-looking tins add to the impression of ease of use and the normalisation of artificial feeding. But whether we like it or not, formula and its ready availability is important to many families. Removing that now feels like a stick where a carrot should be.
Give parents the tools to make sound decisions that benefit them and their babies. Give parents not only choices, but supported, realistic choices. Don’t tell a woman who has to go out of the home to work, or who has other children to look after and little support, that the choice to dedicate perhaps days to increasing her milk supply through frequent feeding and skin-skin contact to avoid supplementing with formula is an easy one: it clearly is not. Education and information are hugely important but they are only part of the picture when practical barriers still so often interfere with breastfeeding relationships.
Adding practical barriers to formula use, as I think this proposal would, isn’t a particularly kind way to help parents. Being caught between a rock and a hard place doesn’t make the rock seem any easier to budge: it just makes it hurt more to be stuck there.
I want to zero in on the problem of shaming. It’s illuminating to shift the focus away from infants and toward the choices that we adults make about our own bodies.
For instance: I had a super healthy dinner tonight: baked tofu, locally-grown Carola potatoes, locally-grown watermelon, and sliced golden tomatoes that I grew from seed. (I had been trying to grow these ‘maters, Aunt Gertie’s Gold, since I read rave reviews about them on Garden Web, but managed to kill them on the first attempt by mixing in too much organic fertilizer when I planted them out. Another year, they failed to germinate. This year – success!) I added a dab of butter to the potatoes and marinated the tofu in teriyaki sauce. I was in late-summer heaven.
But last night? Late after the kids were in bed? I ate a strawberry Pop-Tart. And damn, was that good too.
What if someone had decided to shame me about that Pop-Tart? Would that have caused me to ascertain that those potatoes were also organically grown, instead of just sustainably? Might I have foregone the butter? (Admittedly, if I’d been feeling well instead of ushering out a nasty GI infection, that pat of butter would have blossomed.)
Hell No!
I would have had a Pop-Tart for dessert.
Now, luckily people have not often shamed me for my Pop-Tart weakness. We don’t eat them regularly. My kids love them precisely because a Pop-Tart is a pink unicorn in their world, and a yummy one, at that. Most crucially, though: I am NOT FAT. And therefore I can only shamed along the “bad mommy” axis for keeping Pop-Tarts in stock; I’m pretty impervious to fat-shaming. (Fat-shaming would surely be worth a whole ‘nother post, and this post would be a whole lot different if not for my thin privilege.)
Of course, “bad mommy” shaming is the main tactic used against women who don’t conform to the loftiest ideals of breastfeeding practice. They’re told in no uncertain terms that their child’s survival depends on what they feed him or her. And they’d better feed mother’s milk, but then the true shaming begins. The new mother is eating all wrong! At least, this must be true, or the baby would settle better, sleep longer, give up his eight-hour crying jags. And so they’d better watch out for garlic! Peanuts! Soy! Cow’s milk! Eggs! That dejected bottle of prune juice, purchased solely in the hope of warding off postpartum constipation? Might as well dump it, dear; no one else in your family will go near it.
Through all this, the mother is trying to suss out her child’s new and changing needs. If she’s poor and/or not white, the “well-meant” advice may well come wrapped in a thick wrapping of paternalism. How’s she supposed to develop her sense of mastery and competency in this hullaboo of “Yer doin’ it rong!”
Really, what new mothers need is respect for the fact that they still are humans, and that their body remains their own. The baby has a moral claim on breastmilk, sure; the mother has a moral claim on being an autonomous person. In most cases, she also is willing to make very significant sacrifices for her baby – her sleep, bodily fluids, her illusion of invulnerability, the very minerals from her bones. Shame her, though, and you’ve shortcircuited her chance to figure out what combination of sacrifices (because there will be sacrifices) could help her child thrive without eviscerating her as a woman – as a person.
And darn it – sometimes every mother needs a Pop-Tart. Mine was strawberry. Toasted. And I haven’t breastfed since spring 2003, so how much more do new mothers need a Tart? I don’t believe food should have to be earned through moral machinations, but I do tend to think that I’ve got a lifetime entitlement to Pop-Tarts. I’m certain that there’s still one box of brown sugar/cinnamon in the basement. I will eat it with utter lack of shame. Next morning, with nothing but a Tart headache, I will help my kids get their reasonably healthy breakfasts and lunches. They are growing. I’m pretty sure we’re doing something right. Quite possibly something that deserves a Pop-Tart and champagne celebration.
I’d be interested in your metaphorical Pop-Tarts – and that goes for non-parents, too. What small self-indulgences keep you afloat? How do you gird yourself against scolds?
Almost all of these things enter into the story from Thursday night, through I don’t believe any wasps were involved. But honestly? I wouldn’t know; I was holed up with my kids. As I was cleaning up the dinner mess, I heard the scream of an emergency siren. I knew that the university was planning to test its emergency system – on Friday. So I flew out to my front porch, straining to hear the announcement through its bullhorn-distortions. All I picked up was “take shelter,” along with the oppressive air on my porch, and that was good enough for this North Dakotan-bred gal. I yelled upstairs, “Tornado warning!” The Tiger yelled, “Tornado warning!”
He and his brother, the Bear, tore down the stairs. I followed them into the basement, laptop and phone in hand. (Why, oh why, didn’t a flashlight even occur to me?) Minutes later, I chanced the upstairs again just long enough to rescue a few treasured stuffed animals and the cord for my laptop. I was alone with the kids. Mmy husband was at a meeting in the country, out of cell range, which was a blessing and a curse. A blessing, because he holds the theory that tornadoes never strike Athens, and that warning aren’t worth heeding. A curse, because I couldn’t be sure he was in safety.
For a good half hour, the biggest challenge was keeping the Tiger’s whine of “I’m bored!” from driving the rest of us around the bend. I let them watch a couple of silly YouTube clips (this one cracked them up again). I was hoping we could go back up once the warning expired at 7:15. The Bear would be about to go to his music practice, and we could try to track down their dad.
But then we heard the emergency siren again. And again. Soon sirens were wailing every minute or two. I still couldn’t catch the message, but I was certain it wasn’t “all clear.” I’d have guessed, oh, “prepare to die.” The next day, a friend said he’d heard “Tornadoes are surrounding Athens!” which I’m sure was close to the truth.
Here’s what it really said:
Looking around our basement hideaway, I started toting up the hazards. The small window. The bookshelves. My French horn (hey, that would be deadly if it went airborne.) I gave each kid an oversized pillow to shield their noggins and necks. At that, the Tiger’s boredom tipped over into terror. He would not be consoled by how silly it was to have a lumpy Winnie-the-Pooh chair over his head. I nixed YouTube so I could hear, and the LOLcats just weren’t cutting it as a distraction. Even the Bear was fighting tears. Heck, I was working hard to act brave. It didn’t help that the National Weather Service was starting to report multiple sightings of a twister touching down. Or that I was frantically hitting refresh on their page.
When we finally emerged from our secure underground location after an hour and a half (without ever sighting Cheney, I might add), we were all rattled. So were our neighbors and friends. We’d kept our power while most of the town and county had lost it. An acquaintance had actually seen the funnel cloud moving merrily down his road. Afterward, he had to take his chain saw to the large trees that had fallen across the road, trapping him and his family.
News filtered in only slowly. It seemed clear that Athens and its environs had been struck by at least one tornado. Rumors started to spread that the high school had been hit. One of the first reports noted that Pine-Aire Village had suffered damage and had to be evacuated due to a gas leak. The tornado had duked it out with the achingly poor mobile home park where I went canvassing in 2008. As usual, the tornado won. As usual, Pine-Aire Village lost. People who are trying their damnedest just to eke by now have new worries.
I haven’t taken a look at Pine-Aire because frankly, I’m still scared of the meth dealer and the vicious, unleashed dogs. But I did see how similar trailers were flipped and squished nearby in The Plains, the closest thing Athens has to a bedroom community. These mobile homes were located right next to Athens High School, which for bizarre reasons relating to government pork funds is located in the Plains.
This picture (and the next) was taken by my husband the next evening, as dusk was closing in. The woman next to the trailer is a Fox News local reporter. (They just lapped this up.)
Note how someone has scribbled “NOT SAFE” in big red letters. I’m not gonna argue.
The rumors about the high school turned out to be true. It was full with soccer and volleyball players and their families. The morning after the storm, a good friend of mine – the mother of the Bear’s best friend – responded to my worried email. She’d been working in the concession stand when some prescient soul yelled that a funnel cloud was approaching. She sprinted up the long steep hill to the high school and took shelter in the bunker-like locker rooms. Other adults, perhaps thinking they’d be safer sheltering in place (the hill is pretty daunting), remained in the concession stand. At least two of them were injured, though not seriously. One was taken to the hospital, the other treated on the scene.
That’s the inside of the concession stand.
That’s its exterior.
Meanwhile, the students on the field had sought shelter from the rain in the press box. Someone ushered them down to a locker room that’s located right on the edge of the field. Good thing. The press box blew clean off the top of the bleachers.
Cars were crushed as the press box collapsed behind the stands.
My friend had a bad half hour before she was reunited with her son. The fear of another strike hadn’t quite abated enough for everyone to be released. My friend was in cell contact with her son, but the wait was hard, especially as the smell of gas indicated leaks. When they were finally permitted to leave, they found a moonscape: mature trees snapped like sticks, debris everywhere, and a stadium that won’t host games anytime soon.
The scoreboard is whacked.
The football goals stand at jaunty new angles.
The wreckage in the foreground used to be a stadium light. (Those to the right and left remain standing, but their lamps have been turned 90 degrees.) The wreckage in the back – well, that was the visitors’ bleachers.
Structures to the right and left of the locker room were decimated. And yet, the kids sheltering there stayed safe.
School is called off until further notice. The high school suffered damage to some classrooms.
It also lost its two 1000-pound AC units, which blew off the roof.
It is a miracle that no one was killed. I heard one chopper take off Thursday night, and the next day a colleague confirmed that one person was injured badly enough to require transfer to Columbus. On the whole, though, injuries appear to be few and minor. Property damage is much more significant.
The tornado also touched down in Athens proper, leaving its main mark on Autotech, an automotive servicing and towing company at the edge of town. The only two buildings farther out along that road are the Super 8 Motel and the clinic where I had my colonoscopy. Those facilities survived with only minor damage (mostly missing shingles). Just a few yards away, Autotech was damaged beyond redemption.
The view from the highway.
Note the Coke machine encircled by corrugated metal. (I took this photo yesterday morning, and the machine was liberated by evening.) Note, too the wads of insulation. We saw them everywhere. All those years growing up in North Dakota, and I never imagined that the hallmark of a tornado could be oodles of rogue insulation.
Of course the impaired Coke dispenser adds credibility to the conspiracy theory …
… that this tornado was brought to us by Pepsi. (Photo from the high school.) Yes, I’m being flip. Black humor is one of the ways I deal with the world’s horrors.
I’m grateful that my family didn’t suffer any harm beyond the shock and fright. Today the Tiger has been playing with Lincoln Logs. Every once in a while a tornado comes and knocks them down. It’s spookily reminiscent of boys I knew who were 10 after the Twin Towers collapsed. They built mega-towers out of legos, which were level by terrorist flying planes. I shudder. Yet our kids seem to need these reenactments in order to come to grips with destruction that none of us can really fathom.
I’m grateful that all of the neighborhoods in Athens proper were spared, and that the elementary schools (except the Plains?) seem to be fine. (I still expect them to stay closed on Monday, given the track record of my boyfriend, the superintendent. We’ve now burned through a full third of our three calamity days.)
Ohio University got very lucky. It appears undamaged. Nor will the Darwin Award go to any of those students who went outdoors to watch the storm “cause I’ve never seen a tornado!”
Tonight, my thoughts are with the people of The Plains, the families of AHS students, and (further afield) the people who did succumb to the storm: a man in West Virginia as well as those killed in Queens in a separate, even freakier storm.
And I’m grateful for the rescuers, pictured here in an extraordinary photo by Spencer Heaps, taken the same evening as the storm:
Spencer Heaps has several other stunning photos at his blog. Please do pay him a visit.
There’s no really good footage of the tornado itself, thankfully. (I don’t want people putting themselves in harm’s way!) The next closest thing is this clip, taken by college students living on a hill on the south side of town, which to my knowledge was not damaged.
Americans who oppose “big government” usually oppose “handouts” to the poor. But here’s the thing: You may be comfortable. You may think you have all you need. And yet, if there’s poverty anywhere in your vicinity, you will not be immune to its pernicious effects.
Today’s instance of poverty splash-over: BOIL ORDER! Thanks to our weak tax base, the town’s infrastructure is crumbling. The water system is decrepit. Boil orders are issued as routinely as parking tickets. If you Google “boil order,” your second hit will be “City of Athens Boil Order Instructions.” Only the University of Missouri Extension Service outranks us. Sure, Boston had a boil order affecting 2 million people this spring, but Athens beats Boston on the Google! Boston! And its two million (2,000,000!!!!) water customers! If Boston can’t touch us, our title as the reigning champions of boil orders is virtually untouchable. (Yes, I realize most of the world should be under a boil order. Only my First-World privilege leads me to believe my family and I have a right to safe water from the tap. I’m not quite sure that Athens is located entirely in the First World.)
Today’s boil order alert went out via email at 3:30. (Email notification is still a novel service, implemented by our new-ish progressive city leadership.) I last checked my email at 3:25 before I picked up the kids. So I didn’t see it until 8:30, by which time we’d all swilled a glass or two of water and I’d washed our dinner veggies in it. Usually, boil orders affects other neighborhoods. Today, of all days, it hit my own.
So far no one is ill, and I think we’ll probably be fine. I suspect that the boil order is due to a hydrant that I saw spewing water this noon. (Hence the “splash-over” metaphor.) The likelihood of serious contamination is low. Still, I’m irked that we have to deal with the hassle until tomorrow evening. I’m uneasy as we wait and wonder if we’ll all come down with Athensitis indigestion.
Second case in point: the impact of poverty on local schools. I’ve written repeatedly about how often our kids miss school because there’s no money to clear the hilly county roads. (The city is rich in comparison to the county.) Now we’re seeing a decline in the elementary schools, which is having a ripple effect throughout the district.
At our back-to-school potluck, I learned that our little neighborhood school (let’s call it “International Elementary”) has 50% more kindergartners than in the past few years. At the last minute, they had to hire another teacher and carve out another classroom (which involved displacing disabled services to the poorest of our district’s five elementaries). There simply weren’t any open classrooms. Baby boom, you say? Unh-uh. They were all intradistrict transfers, most of them fleeing the second poorest elementary, whose test scores recently tanked. (You can see the data yourself at Greatschools.org under the listings for the “Athens, OH” district – and you can check out your own area schools as well.) I don’t know why their scores tumbled, though I’m loathe to blame the teachers. Much more likely, poor kids are suffering from hunger, which is rampant in our region, and can’t learn. Or their families are unable to be supportive because they received a crappy education, themselves. I’m guessing it’s the more affluent parents who are moving their kids, while the poorest children are staying put.
So the poverty in the county isn’t just hurting the two most vulnerable schools. It’s now spilling over into our excellent little school. I completely sympathize with the parents who are moving their sprouts; even it I didn’t, NCLB apparently gives them the legal right to switch out of a faltering school. In their place, I’d be attracted by International’s strong test scores and relatively diverse student body – which drew us to this neighborhood.
International Elementary will be fine for this year. But what about next year, when we’ll presumably need another first-grade room, too, and the years thereafter? What if we’ll permanently have three classrooms per grade instead of just two? The school is already in cramped quarters. The counselor and psychologist (who rotate through the district) share space with a skeleton in a closet. (Literally.) And you can’t extend the existing building. There’s just no space. I suppose you could just get rid of the playground … but even then, who’s going to fund the construction? The alternative – classes of 30 or more children – would just gut International’s strength, small classes with great teachers.
My point here isn’t just about “me me me,” though it sure feels good to vent. The larger point is that poverty can’t be contained. It spreads like a contagion – like a “miasma,” as nineteenth-century doctors would have said – and it ultimately affects us all.
So never mind altruism. It’s in everyone’s self-interest to ensure that the most vulnerable members of society have enough.
I’m glad Abby Sunderland has been found, adrift but safe in the Indian Ocean. As a parent and a sister, I empathized with her family and worried that they’d never see her again.
I will admit that I also had a moment or two of wondering: “What were they thinking? How could her parents let her sail around the world?”
Then again, just a few days ago I watched my little Tiger dangle from the monkey bars where he broke his humerus last winter. I felt my stomach clench and tumble. I checked my overprotectiveness. I cheered him as he swung from one end to the other. I imagine Abby’s parents went through something similar in deciding to let their beloved daughter try to become the youngest person to sail solo around the world – with, however, one difference. They had pretty good reason to assume Abby was up to the challenge. The Tiger, by contrast, has a very dicey record on the monkey bars.
That’s why I have to agree with Hugo Schwyzer’s thoughtful post on how not all 16-year-olds are equally mature, and how Abby’s parents likely made a reasonable decision based on her capabilities. I especially appreciate his point that 18 is not a magic age of reason, nor does it revolutionize the way parents see their babies:
On the one hand, I can’t imagine being comfortable sending my own child off around the world on a sailboat by herself. But if I’m honest, I know full well that protectiveness won’t vanish when my Heloise [Hugo's baby daughter] turns 18; I’d worry just as much if she were 18 as if she were a few months younger. Lines of demarcation don’t have much effect on the heart.
But here’s where I part ways with Hugo, and with the other commentary I’ve read: I don’t think parenting is the real issue here. Yes, American culture is riven with divides between parents like me who let our ten-year-olds bike to the local libarary, and those who think this is lunacy; parents who let their four-year-olds wander the neighborhood, and parents like me who worry that such small persons will be crushed under a car.
The issue in Abby Sunderland’s situation is, rather, this: Why does anyone feel compelled to set records at the cost of life and limb? Why do so many people still feel called to climb Everest, despite the fact that not only they but their local sherpas may well expire before they reach the peak? (This happened again just recently to a British climber, though he did get to the top first. Cold comfort, I say.)
I understand the impulse to explore and discover. In junior high, I dreamed of being an astronaut. That dream died forever in 1986 along with the passengers of the Challenger. But I can see why scientists still go to wild places. I have a friend who travels to Antarctica to research low-temperature life forms, and I completely understand why she does it, even though such expeditions always involve modest risk.
What I don’t understand is the desire to set records – to push one’s body beyond its healthy boundaries – to embrace risk just for its own sake. Sailing solo around the globe makes as much sense to me as playing chicken with a train, or drag racing on the freeway.
But drag racing and playing chicken are the desperate sports of poor kids. Setting records is the province of the privileged. The assumption is that no effort will be spared in trying to save you if your boat runs awry.
I’m not saying that Abby Sunderland should have been left to drift endlessly on the open seas. Of course not. I am truly glad and relieved she was found.
And yet. Every time an extreme athlete runs into trouble, massive resources are deployed to rescue him or her. Clueless skiers go into the Sierra backcountry and get stranded in a blizzard. Mountain climbers underestimate the danger of avalanche. Solo pilots fly into oblivion. The “resources” deployed aren’t just financial; human beings often risk their own necks in hopes of saving a life.
Just to underscore how much this is a function of privilege: In the last several days, tens of thousands of children have died of preventable disease: malnutrition, dysentery, malaria, typhus, etc. ad nauseam. How many could be saved with the money spent on rescuing people (children and adults) who – from a place of tremendous economic privilege – challenge themselves to break records, or simply assume that they will be “safe” in the wild because their lives have always been safe? Again, I’m not saying in any way that Abby should have been abandoned. Not at all. Only that we should question this cultural impulse to take risks and set records just because.
Once upon a time, parts of the globe were untouched by human exploration. Perhaps the urge to explore was extraordinarily adaptive a few million years ago – even a century ago. Today? We’d be wise to ask when exploration and adventure truly serve human knowledge, and when they’re only yoked to ego.
And I’m not saying this only because I’m so cautious, I only ever climbed one tree in my childhood. Perhaps that makes me an unreliable narrator – or just a chicken. Still, I think the larger point about risk and privilege is still valid.
As more wobbly Dem congresscritters commit to supporting the health care package, I’m guardedly hopeful that Bart Stupak is about to consign himself to the dustbin of history.
Nonetheless.
I’ve got two “pro-life” reasons why wafflers like my own congresscritter, Charlie Wilson, need to vote yes and put themselves on the right side of history.
The national health care reform legislation that was recentlypassed by the Senate has been modeled, in many respects, onthe Massachusetts reform law; both lack the “public option”that was included in the House bill, which was the focus ofthe Stupak–Pitts Amendment prohibiting federal subsidiesfor health plans that would pay for abortion. Therefore, I hypothesizedthat the early experience in Massachusetts might serve as agood model in which to examine whether a substantial expansionin health care coverage might result in an increased numberof abortions.
The relevant part of the Massachusetts program is CommonwealthCare, which provides subsidized insurance to the self-employed,small businesses, and unemployed individuals with incomes below300% of the federal poverty level. This quasi-public agencybegan coordinating care through five private participating healthplans effective January 1, 2007. I sought to determine whetherthis increased availability of care has led to an increase inthe number of abortions performed in Massachusetts.
The number of abortions in Massachusetts in 2006, the year beforethe new law was implemented, was 24,245, including 4024 amongteenagers. I obtained data from the Massachusetts Departmentof Public Health for each of the two subsequent years. Some158,000 people were enrolled in Commonwealth Care plans duringthe first year. The Urban Institute estimated that between thefall of 2006 and the fall of 2008, the proportion of adultswith incomes below 300% of the poverty line who were uninsuredfell from 24% to 8%; 63% of all newly insured adults were ineither Commonwealth Care or the state Medicaid program.
In 2007, the first year of Commonwealth Care, the number ofabortions fell to 24,128, and in 2008, it fell to 23,883 —a decline of 1.5% from the 2006 level (see graph). The numberof abortions among teenagers in 2008 fell to 3726, a 7.4% declinefrom 2006. These decreases occurred during a period of risingbirth rates, from 55.6 per 1000 women 15 to 44 years of ageto 56.9 per 1000 in 2006 and 57.2 per 1000 in 2007 (the latestyear for which data are available from the Massachusetts Departmentof Public Health), and an increase in overall population (in2008, the Massachusetts population surpassed 6.5 million forthe first time, and it was nearly 6.6 million in 2009, accordingto the Census Bureau). The abortion rate thus declined from3.8 per 1000 population in 2006 to 3.6 per 1000 in 2008. Overall,since 2000, the number of abortions in Massachusetts has droppedby 12% (from 27,180 to 23,883) and by nearly 36% since 1991.2 The Massachusetts abortion rate has similarly dropped by athird, from 30 per 1000 women 15 to 44 years of age in 1991to about 20 per 1000 in 2005, with most of the decrease occurringduring the late 1990s.3
Or, to put it briefly, abortions declined both in absolute numbers and on a per-capita basis. The drop was steeper for teenagers.
Now, it’s possible that Massachusetts is simply mirroring national trends, where abortions have slowly declined in reason years (with, however, an upward blip nationally in 2006). But at the very least, it seems reasonable to conclude that in the biggest, best real-life laboratory we’ve got, access to abortion – which was a covered service for Medicaid recipients and the next-lowest income tier covered by Commonwealth care – did nothing to increase the number of abortions performed.
Whelan doesn’t speculate what other factors might be depressing the abortion rate, but I can think of two. First, there may be fewer unplanned pregnancies if Commonwealth Care is delivering family planning services and contraception to the neediest residents. Second, a woman confronting an unplanned pregnancy may be more likely to keep it if she knows she can count on good medical care for her child and herself. I don’t know enough about the details of the Massachusetts system to know if it really does provide decent reproductive health care, but this seems like a reasonable conjecture.
What would happen if we expanded the Massachusetts experiment nationwide? Well, the likelihood of an upward trend in abortions might be even slighter in more conservative states, where cultural attitudes discourage abortion. Those women might also be less likely to avail themselves of contraceptive services, so they’d benefit less from access to it. On balance, my gut feeling is that red states would continue to have more unplanned babies and shotgun weddings than blue states like Massachusetts, but their abortion rates will remain about the same. That’s just my instinct, and I could be wrong, but if Massachusetts women didn’t start aborting by the millions, do we seriously think the gals in Utah will?
The second “pro-life” argument I’d like our congresscritters to hear relates to our shameful maternal and infant mortality rates. Our ostensibly pro-life politicians are utterly silent on those two interlinked scandals. They shouldn’t be.
It’s often asserted, including in this report, that infant and maternity mortality are key indicators in the health and social justice of a country.
I’d add that they ought to be key indicators for the seriousness of grandstanding “pro-life” politicians.
Take, for instance, the ranking of states according to maternal deaths. Maine comes out on top, with just 1.2 mothers dying per 100,000 live births. Vermont is second, at 2.6. You might object that these are small states with small populations, and that the number of women dying there is so small that figures may be deceptive. Could be. But then check out Massachusetts in third place with 2.7. Hmm, we’re starting to see a regional trend.
The District of Columbia rules the hall of shame with 34.9 maternal deaths per 100,000 live births, worse than Costa Rica. Georgia is second-worst with 20.5. (Figures are from pp. 104-5 of Amnesty’s report, Deadly Delivery: The Maternal Health Care Crisis in the USA.)
During 2004 and 2005, more than 68,000 women nearly died in childbirth in the USA. Each year, 1.7 million women suffer a complication that has an adverse effect on their health.
This is not just a public health emergency – it is a human rights crisis. Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.
So why should Stupak care? After all, these are just a bunch of women – disproportionately poor women of color – who should’ve kept their legs shut, right, according to Stupakian logic? In his view, aren’t these just throw-away mothers?
Well, when mothers die, babies sometimes die with them. Hemorrhage, eclampsia, embolism – all can endanger the infant as well as the mother.
While babies can’t yet talk, I don’t think it’s a big leap to say that most prefer not to be half-orphaned at birth.
Most significantly for Stupak and his allies, however, is that obstetric care benefits babies and mothers alike. Where mothers survive, infants are more likely to survive and thrive. That’s true here in the U.S. as well as globally. We do worse than Cuba when it comes to keeping newborns alive.
And guess what? Health care reform has the potential for helping mothers and (potential) babies get the care they need.
So I’ll be waiting to hear from Stupak and the bishops on how, exactly, killing health care reform will help preserve mothers and babies – and how, precisely, they can call the resulting deaths and complications “pro-life.”
German has this wacky way of expressing good luck: “Schwein haben,” or having swine/pig. It’s clashing with the nomenclature of swine flu, which ain’t such great luck if you get it.
My sister tells me my niece is coming along well – she’s stopped puking, at least – but 19 out of 24 kids were absent from my niece’s first-grade class on Monday. Apparently one child went to school with a fever (we’ll reserve judgment on those parents – maybe they didn’t notice) and one case flowered into 19.
Today, I was that parent, and the Tiger was that child. The phone rang at 11:50, just as I finished reading an email from the school nurse, announcing further delays in obtaining swine flu vaccine. I was still home, about to swing on my bike for my 12:10 class. (Yes, my commute is the awesomest.) It was the principal. He said, “I’ve got good news and bad news. I’ve got [the Tiger] here in my office. He’s got a fever. Just measured it at 100.8.”
I said: “Oh damn shit fuck fuck fuck!” Well, actually I didn’t, because if my kids ever got busted for cussing on the playground, I’d be on the hook. So instead, I hung up the phone and emitted a short primal scream. In a total panic, I momentarily considered taking the Tiger to class with me, but realized my students would hate me forever, after I’d inflicted first Judith Butler and now H1N1 on them. I got back on the phone, and Dr. Hydraargyrum and his dear wife, Dr. Hydraargyra, kindly agreed to move their romantic lunch date to the germ-infested petri dish that I call home. Then I ran to the Tiger’s school. Those who know me in real life know how rare a sight it is to see me run, and how very ridiculous.
I got to my class ten minutes late. My students were waiting patiently (the math department secretary had posted a note that I’d be late). They performed brilliantly, and the two hours flew past. My husband had taken over for our friends at 1 p.m., missing a critical meeting on our bloody budget cuts. I relieved him at 2. Somehow, it worked.
I’m still bemused by the “good news” that our principal promised but didn’t deliver. Was it simply that the Tiger wasn’t puking? Was it just that I’m lucky to be his mother? (Well, I am – most days!) Was it insider knowledge that the Tiger is often at his sweetest when sick?
The principle’s mysterious message remains, well, a mystery – as does the Tiger’s condition. His fever stayed lower for the rest of the day. He has a history of unexplained fevers from his toddler years, and even now he’ll run a higher temp than other kids with just a cold. He also isn’t really coughing and has no evident GI symptoms.
So do we have swine flu? Or do we just “have swine”? Worst case, the entire family gets sick but we don’t get diagnosed, and then the kids have to “get shotted” with the vaccine anyway.
I surely “had swine” today when it came to support. Most of my time is pretty flexible, but those two-hour teaching blocks are sacrosanct. As instructor, you’re allowed to stay home if your current residence is a casket; otherwise, you’re probably slacking. My husband and I usually stagger our teaching so one parent will always be available for emergencies, but we couldn’t quite swing it this quarter. I felt lucky to have friends (and probable survivors, already, of H1N1 2009) who were willing to drop everything and cover me.
Before this pandemic burns itself out, a lot of parents will face choices much more harrowing than mine today. Unlike me, they may have no flexibility. Unlike me, they may lose their job for any unscheduled absence. It’s workplaces that need to respond to this dilemma with greater flexibility; families can’t resolve it by having a Plan A, B, and C for childcare. It’s virtually impossible to find childcare when a child is sick, unless you’ve got close family nearby. It’s well-nigh unethical to inflict your sick child on someone else when the disease can be quite serious in some individuals – and we don’t know who those individuals are. And yet, millions of parents in America cannot count on a single hour off to cope with a sick child. (See Joan Williams’ excellent report, “One Sick Child away from Being Fired” – note: this is a pdf file).
Meanwhile, I noticed a scratchy throat this afternoon, then a sensation like a baby elephant sitting on my chest. I’m feeling somewhat better again by now – enough so to hope that the Tiger and all of us will “have swine” in the German sense.
After all, the typical woman spends five years of her life pregnant, or trying to become so, but a full 30 years avoiding pregnancy. Without good reproductive-health coverage and strong buy-in from women — who use more health care than men — it is difficult to see how a public plan would gain strength over time.
And there’s more: Women with private insurance may find their plans dropping reproductive care, whether due to market forces (as Ann implies) or conservative lawmakers’ meddling in insurance regulation (as Dana suggests).
Really, though, this whole debate rests on false premises. While the Hyde Amendment has prohibited Medicaid from covering abortions for over 30 years, abortions are already financed indirectly by taxpayer subsidies. Anyone with an employer-sponsored health plan gets their insurance tax-free. That’s a massive federal subsidy. Ann cites a NYT story that claims 50 percent of employers offer abortion services among their health benefits.
So taxpayers are already subsidizing abortion for women of the more prosperous classes. It’s just those poor women who’ve been excluded – ironically, the very same people whom anti-choicers demonize for having too many children. (I’m not advocating eugenic abortions for the poor, just noting the logical and fiscal inconsistency of many dogmatic foes of abortion.)
Up ’til now, even after a quarter-century of supporting abortion rights, I’ve tended to think, “Get reform passed, and then we’ll worry about specific services.” But Dana has convinced me that this isn’t just a distraction, though the ‘wingers will surely conflate public subsidies for reproductive health with their phantom death panels. This is a matter of reproductive justice for poor women, and a sustainable system for all Americans.
The truth is that statists – Liberals and Conservatives – do not believe in liberty at all. If they were honest about it, that would be fine, but they’re not. The Liberty to which I subscribe is this: That is is unethical for Person A (or a group) to aggress against the person or property of Person B, so long as Person B has not previously aggressed against others. More government in Health Care sounds like such a great plan and it is well-intentioned. But it won’t work, and even if it could would be unethical and against liberty.
Why? Because people living under a system of liberty are free to do what they want with their own property; coercion of any kind is wrong. To fund heath care the government must first tax, which is directly and undeniably antithetical to liberty. If I earn money by voluntarily working for another person (or firm), it is mine. It would be obviously wrong for a person on the street to pull out a gun and take the money from my pocket. While Liberals and Conservatives agree with that statement, they disagree that it is wrong for the government to do the exact same thing. Taxes are not voluntary; if you do not pay you will go to jail at the point of a gun, just ask Wesley Snipes. Of course, I have no problem with people who want to set up a VOLUNTARY system, to which you or anyone else could contribute as much money as you want. But to COERCE people to forfeit their rightful property is theft, plain and simple. I don’t think theft is an element of liberty.
Person’s argument, unless I misunderstood, is that *any* form of taxation is an infringement on liberty. Period. I agree that both liberals (in the present-day sense) and conservatives see an important role for government (though they practice different forms of redistribution) and therefore stand in opposition to Person’s position, which – if I’ve understood it correctly – is radical libertarianism. If I trace out the implications of Person’s position, federal and state funding for education would be equally illegitimate. That would hold true for K-12 as well as higher ed. And in fact, many, many Americans do object to paying higher taxes to finance the education system – as schoolkids in several central Ohio districts and, more locally, the Federal Hocking schools can attest. These districts are seeing school closures, cutbacks in basic classes, and the complete eliminations of “specials” such as music and art.
Myself, I see education, along with police and fire services, public libraries, and yes, health care, as crucial to positive liberty. If we are illiterate, in poor health ill, and/or terrified of crime, we can scarcely exercise the duties of citizenship, much less reap its benefits. We’ll be unable to perform work that contributes to our individual betterment, as well as the advancement of society. Elevating people above the level of ignorance, fear, and ill health contributes to the liberties of each individual, and to my mind this easily justifies the infringement on liberty that taxation necessarily represents. The same argument applies to the payroll taxes that finance Social Security and Medicare.
Seen from this angle, taxation isn’t aggression. It’s a trade-off of one liberty (freedom from seizure of property) for another (the freedom to be able to live one’s life without avoidable impairment of health). The latter is crucial if one is to work and earn money; taxation is irrelevant when disability results in long-term unemployment. In addition, lots of individual initiative is stifled because health insurance is prohibitively expensive or unavailable on the individual market.
Personally, I could afford to teach as an adjunct from 2002 up ’til fall of 2008 only because my husband’s insurance covered me. Had that not been the case, I would have been forced to seek out other work. Locally, that probably would have meant a secretarial job at the university. (I’m assuming Wal-Mart wouldn’t have me, and there aren’t many other games in town.) This would have seriously restricted my liberty to work in the field for which I’m trained. And while I was a darn good secretary back in the day, it would have prevented me from contributing to society in the area where I believe I have the most to give. It would also be a waste of many years’ training, much of which was subsidized by generous, privately-endowed grants.
My story repeats itself throughout our economy millions of times over. The present system creates perverse economic incentives for people to stay in jobs just for the insurance, and to avoid striking out and taking risks. This, too, stifles liberty. Entrepreneurship becomes well-nigh impossible when you literally risk your life by entering the individual insurance market.
Finally, the current system already does impose a de facto invisible tax on everyone who pays health insurance premiums. Emergency room doctors are ethically obligated to treat all comers, regardless of their ability to pay. Those who are insured subsidize ER patients without insurance. I’d much rather taxation be open and aboveboard, instead of smuggled in through the back door.
Update, wee hours of 9/23/09: Ballgame left this in comments, and oh my goodness you have to watch it if you won’t get in trouble for LOLing at work! Go Somalia! Go go go malaria!!
I’m sitting on my front porch, surrounded by nature’s goodness: blue sky with wisps of clouds, birdsong and the whirr of cicadas, mid-70s temperatures, leaves rustling in a soft breeze. It’s almost impossible to imagine the violence of Katrina that was visited upon the Gulf Coast four years ago today.
A friend and neighbor of mine, David Rae Morris, lived in New Orleans at the time. Since then, he has devoted much of his work as a photojournalist to documenting Katrina and its aftermath.
All of his photos are powerful, but these scenes from the Lower Ninth Ward remind me of not just the devastation but also the role of official indifference in amplifying the suffering. Katrina more than a natural catastrophe, it was a colossal human failure as well. David’s photos serve as remembrance of a disaster whose human costs remain huge. They also sound a warning, lest we ever again allow such incompetence and callousness.
(I’m just linking to his work instead of posting an image or here, because a single photo doesn’t do it justice and I don’t want to take the images out of the context he gives them.)
My family and I have “good” insurance. Oh, sure, I’ve spent dozens of hours fighting our insurer to reimburse us for life-saving cancer drugs that my husband had the temerity to need while he was in Germany, where those drugs cost somewhere between a tenth and half the price that they would have been in the U.S. They didn’t come with the exact same package size or dosage as is standard in the U.S., and so our insurer initially rejected some thousands of dollars in claims. Never mind that my husband saved them some tens of thousands by becoming critically ill while in Germany instead of Ohio. I contested those denials and won most of them. That’s what it means to have “good” insurance.
But yesterday, I just about blew my top on account of the latest hassle from our “good” insurance. On July 1, our employer switched to a new prescription mail plan, Express Scripts. That meant all of us employees needed to set up a login on this mail-order pharmacy’s website. I tried to enter my info, and the screen kept kicking out my email address. I tried setting up a login for my husband – easy peasy. But I couldn’t set up a login for myself.
After about an hour of wrestling with the website and talking with condescending phone reps “patient advocates” – I’ll spare you the tedious details – a supervisor finally informed me that their system wasn’t malfunctioning. Instead, the problem was that my employer hadn’t contracted for dependents to have access to their own prescription information. All my prescription management has to be done through my husband’s ID. All prescription reminders have to go to a single email address; it’s impossible for each partners to get a reminder sent to his or her individual email account.
How is this fucked up? Let me count the ways!
First, this has got to be in violation of HIPAA privacy rights. The Express Scripts supervisor told me that it’s HIPAA compliant. I don’t see how that can be squared with two basic premises of HIPAA: 1) no one but me has the right to access my medical records unless I waive that right, and 2) I have the right to access my own own medical records!
Second, this is just sucky customer service. “Express Scripts” is a wonderfully ironic name. I spend a good two hours dealing with this problem yesterday. (Add another hour for time spent calling physicians offices for old prescriptions that hadn’t transferred and complaining to HR that my kids weren’t on the plan at all).
Third, denying access to dependents decreases efficiency of service and drives up costs for Express Scripts, which will surely be passed along to subscribers. They supposedly want patients to use the website, judging from the message on autoloop played after you’ve dialed customer service and are put on endless hold. But in fact the only way I could access my information yesterday was through talking with a real (and rather snotty) person, who first implied that I must be doing something wrong if I couldn’t sign up for a login.
Fourth, given that the website is the only place where a patient can view her prescription records, lack of access could be medically dangerous. If you’re on multiple medications, they can be hard to keep track of. Plenty of illnesses, from HIV infection to mental health problems, can be exacerbated if you miss a dose.
Fifth, this system is absolutely infantilizing for the “dependent.” I’m 45 years old; I want to be able to manage my own health problems without always having to ask my spouse to do me the favor of forwarding emails, etc. Obviously I know his login and password – I set it up for him, after all, with his permission – but lacking access to one’s own record is structurally and symbolically infantilizing, nonetheless.
Sixth, this system is almost guaranteed to produce sexist effects. My employer’s policy says that when both partners work for the university, premiums for family coverage will be charged on the higher-paid employee. Since the university is the biggest dog in town, quite a few couples are in this position. I’d be very surprised indeed if women don’t make up a strong majority of “dependents” who are also employees in their own right.
And finally, for couples where one partner is controlling or abusive, denying the “dependent” partner access to their own records could subject her (or him) to further abuse. Obviously marriages where one partner tried to control the other through access to needed medications have much, much deeper problems. However, it’s because such marriages (unfortunately) exist that HIPAA privacy protections extend into the family.
Of course I called HR about this. Express Scripts told me that they do offer plans where dependents can access their information. Ohio University could have chosen to include this in their contract with Express Scripts. I asked HR why they didn’t do it. HR will “get back to” me. (Ha.) While I’m waiting for a response, I have plenty of time to ponder how this is just one of many, many ways in which our current system fails to deliver humane, rational, and efficient care and may be driving the need for blood-pressure meds and anxiolytics.
I don’t know if the now-endangered public option will be a panacea. It has the potential to fail, economically and politically, if private insurers are allowed to cherry-pick the lower-risk customers. But abandoning the public option would be even worse, for reasons Robert Reich outlines:
Without a public, Medicare-like option, health care reform is a bandaid for a system in critical condition. There’s no way to push private insurers to become more efficient and provide better value to Americans without being forced to compete with a public option. And there’s no way to get overall health-care costs down without a public option that has the authority and scale to negotiate lower costs with pharmaceutical companies, doctors, hospitals, and other providers — thereby opening the way for private insurers to do the same.
Yup. Isn’t it ironic that it’s now us liberals who are trying to introduce some real competition to outfits like Express Scripts? And that it’s the conservatives who are terrified of a little competition and cost control?
Update, 8/19/09, 12:30 p.m.: Late this morning I had a good conversation with the HIPAA privacy “team leader” for my region. He impressed me with his thoroughness and professionalism; it was worth waiting for a callback, and far preferable to speaking with an unknowledgeable phone rep. He had to be circumspect because he can’t prejudge a situation, but he basically agreed that there are two potential issues here: the dependent’s lack of access, and the primary policyholder’s access to an adult dependent’s information. The first is not a HIPAA issue if my employer’s notice of privacy practices specifies that we must ask for our personal health information in writing – which my employer indeed does – except that there may still be an issue of discrimination if dependents are treated differently than their insured spouse. On the second point, Ohio University’s privacy notice says: “Unless authorized by you in writing, your health information: (1) may not be disclosed by the Plan to any other University employee or department …” My husband is a university employee, so OU would seem to be violating its own policy on this score.
In short, if anyone is in violation of HIPAA privacy provisions, it’s Ohio University, not Express Scripts (which is guilty only of poor customer service). I’m still waiting to hear back from HR. If I don’t, or if I get an unsatisfactory, I have enough information to lodge a formal complaint. To those critics who complain that the government can’t do anything right and therefore can’t be entrusted with health care: My experience this morning shows that this needn’t be the case.
When I was 6 months pregnant with my first child, and on complete bedrest, I was laid off. I was unable to look for a new job, being so late into a very difficult pregnancy. My doctors that had worked with me on this high-risk pregnancy were not covered by my husband’s insurance company. We decided to use COBRA for me so I could continue to see my doctors of choice. My severance ran out the day my son was born prematurely, with complications from having the umbilical cord around his neck during birth.
The first bill for his expenses came as I was leaving the hospital without my son. When a claim was denied because they said my son had a preexisting condition, that was the final straw.
Oh, there’s that supposedly innocuous cure-all again: bedrest! Anyone still wondering about its social effects? But of course its social harms were vastly amplified here by the bad economy and a byzantine, irrational insurance system. This new mother had to spend the first weeks of her son’s life not just worrying about his health but fighting the insurance company. Her boy survived and thrived, but even with insurance “coverage,” her family was out $20K.
And then there’s the story that really resonated with me – that of a child who woke up with a fever one day when he was eight months old. His parents had no insurance, because adding him to their policy would have cost $236 per month with a $2300 deductible.
We kept him home from daycare and gave him children’s Tylenol. Over two days the fever continued to rise. When the fever hit 102.5 we called his doctor to find out how much a visit costs and if the fever was high enough to warrant the money we’d have to spend. We were broke, barely covering formula, daycare, diapers, etc. The doctor said that it was not considered an emergency and to call back if it went over 103. We were freaking out and scared. I remember crying to my son’s father that our baby was sick but we were too scared of the costs to get treatment.
My son’s fever ended up spiking so high that he had a seizure. We called 911 as he was convulsing and an ambulance rushed us to the hospital. He had an ear infection. The seizure was a febrile seizure brought on by the high fever. Had we brought him to the doctor that first day, this would easily have been discovered and treated prior to the ER trip. However, the doctor demands payment upfront and would have charged us over $100.00 to see him. We did not have the money. Not even close. That emergency trip ended up costing us nearly $3,000.00. We are still paying for it today with $20.00/month payments when we can manage.
Had this been my family, fevers would have driven us to bankruptcy. When the Tiger was not quite three, he ran a high fever for a few days. And I mean high: 104 F. We took him to the doctor. He got checked for strep, but I don’t remember if he was diagnosed with it our not. After about three days, he was suddenly fine.
The reason I don’t recall that initial diagnosis is that a month later, the Tiger had another high fever. And then another, and another. They always ran very high, peaking between 104 and 105. His neck glands would swell. Sometimes he’d complain of canker sores. (Mind you, he was not terribly verbal when all this began, since he talked late, so he was a fairly unreliable reporter.) His throat would look and smell streppy, so he got well acquainted with the dreaded popsicle stick. Sometimes he’d test postive for strep, sometimes negative. Sometimes the doc would prescribe antibiotics; sometimes we’d wait and see. We were lucky that he never had a febrile seizure.
Through it all the Tiger was in good spirits. He’d be floppy from the fever, but he was cheerful and very snuggly. My mother-in-law visited once and raved afterward about his good behavior. He had no choice about it, though – he was running a fever of 105 F! (This reveals something about her generation’s idea of proper childrearing that could be the basis of a whole ‘nother post.)
Finally, a young doctor asked if we’d ever mapped the fevers onto a calendar. I tried this, and they fell into a regular 28-day rhythm, with a couple of minor exceptions. The doctor tentatively diagnosed him with PFAPA: Periodic Fever with Aphthous stomatitis, Pharyngitis, and cervical Adenitis. In other words, fever with cancer sores, a streppy sore throat, and swollen neck glands. It’s a benign condition (though miserable for the kids) that they usually grow out of by school age. Some families have apparently cured ith with a tonsillectomy, but medical opinion is mixed on whether that’s the best course of action. (I found lots of info here – be sure to look in the files – as well as a great support group.)
As the Tiger approached his fourth birthday, we were all set to try out the limited treatments for PFAPA when his fever spiked again. Except this time, he complained of a nasty tummy ache. We took him to urgent care (of course it was Friday evening), which bounced us over to the ER. No one could rule out appendicitis, so our local ER sent us up to the Children’s Hospital in Columbus. There, the residents wanted to perform a CT, at which point my husband balked. Both of us were concerned about possible unnecessary radiation exposure. (The residents, of course, were worried about malpractice exposure.) What were the alternatives? Well, since we weren’t local, they didn’t want to discharge us. And so they admitted us. The Tiger and his dad shared a bed, while I slept in the chair. No one slept much. In the morning, the Tiger pooped, and his tummy ache was magically cured. He still prizes the purple Slinky he got as a prize upon discharge.
A few days later, once the Tiger’s fever was down, our pediatrician’s office called to inform us that lab work from the ER had picked up bacteria in his blood. The Tiger got a penicillin shot. And that was the last of his periodic fevers. Whether the bacteria in his blood had any relation to the fevers, we’ll never know. He still tends to run a higher fever than most kids with any random infection. Otherwise he seems to be just fine.
I shudder to think what that year of fevers might have cost us – with all the after-hours visits, ER adventures, and lab tests – if we’d been uninsured. Or even underinsured. We had the money for copays and medication. I realize how lucky we were. We only had to worry about our child’s health, not about our financial survival. This shouldn’t be a privilege. In a wealthy nation, it should be a basic human right.
So that’s the first area where intersectionality is useful: It reminds us that we aren’t the only people to face some sort of systematic disadvantage. I might not be on the front lines of other people’s struggles, but I can educate myself, try to be an ally, and at the very least try not to undermine them. I’ll surely fail, because we’re all caught in complicated webs of power/knowledge, we’re all shaped by our upbringing, and we often can’t see our own blind spots. But I’ll fail less egregiously than if I hadn’t tried.
Also, intersectionality points out how different oppressions don’t fit neatly into in separate little boxes. Apostate writes:
If and when my race and gender do “intersect” and I’m jointly oppressed under BOTH headers, I still look at them as separate offenses. He was both a racist AND a sexist to me. The two oppressions don’t somehow meld together to give a unique picture of oppression. There is simply more than one thing going on.
I’m sure this is true of her own experience, but I’m equally certain that it doesn’t describe everyone’s position. Often when two oppressions intersect, each changes the qualitative experience of the other. For example, a statement like “all women are harmed by rape” might seem unproblematic to a white woman. A black woman, however, might be leery of what the statement doesn’t mention – the racialized history of rape, which includes the lynchings of black men on threadbare suspicions of raping white women, and the myth of the black rapist – and how that history has harmed men she loves. Women of color have been directly victimized by rape, to be sure, but they’ve also been indirectly by the cynical use of “rape” as a pretext for harming the men of their community.
Apostate and the post she cites (by Suzie at Echidne of the Snakes) mention two substantitve reasons for doubting the usefulness of intersectionality. They are: the existence of individual circumstances, and the complexity of understanding multiple variables (or axes of oppression). These are legitimate and important concerns, but neither is fatal to intersectionality as concept or method.
First, Apostate and Suzie note that each individual experiences the intersection of oppressions in potentially unique ways. Patricia Hill Collins’ work on intersectionality actually addresses this point. Collins maps oppression onto three dimensions (which she borrows from Sandra Harding): 1) institutional (which includes government agencies, corporations, schools, churches, etc.), 2) symbolic (which is basically the realm of culture and language), and 3) individual (which asks how deeply each person internalizes oppressive ideas). Any of these dimensions can be sites of resistance as well as of oppression. At the individual level, a strong family member, teacher, or mentor can do a lot to mitigate the internalization of oppression.
But recognizing individual variation needn’t obscure the big patterns. Suzie worries that intersectionality, applied like a cookie cutter, can rob women of being seen as individuals living in very particular circumstances, with bad results for the delivery of essential services:
I agree that DV [domestic violence] counselors need to understand why some women don’t want to call the police. But if they assume all WOC [women of color] will be hesitant, they may deny them options or support. Also, some poor whites have little use for the police, and some poor white women don’t want to report abusers either. Ditto for some white immigrant women. Other variables include women of any race whose abusers work for, or have connections to, law enforcement, and WOC who live in areas where the police share their ethnicity. All in all, it seems like the best DV programs consider different options for different clients, without assuming one model works for white women and another for WOC.
However, it’s quite possible to be aware of a general pattern of mistrust – or several general patterns, as Suzie outlines – without assuming blindly that the pattern holds true in every individual case. There will always be individual variations as well as stark outliers. Any social worker (or theorist!) worth her salt will be sensitive to those variations. The broad patterns that intersectional analysis identifies are only a starting point for further analysis or action; they’re not meant to be the end of the line.
The second objection is that analysis becomes impossible when you try to include multiple variables. It’s absolutely true that analysis becomes substantially more complex with the addition of each variable. The trick is to try to identify which dimensions are most relevant in a given set of circumstances. For sexual assault, race is definitely important, as I just noted; social class and/or sexual orientation might also be relevant. For instance, when I teach the introduction to women’s and gender studies, I make sure that race was highlighted (we’ve got a largely white student body, so they won’t always come up with this on their own) and then I let them raise other concerns. How does a poor versus affluent neighborhood affect one’s fear of rape? Who is “one” in that scenario – a resident of a poor area, or a well-heeled person passing through? How do heterosexual assumptions affect rape myths? Usually, their questions eventually explore enough different axes that they add up to an intersectional analysis. It will be imperfect, but it’ll be better-rounded than if we’d only stuck to their own personal perspective of whether to walk home alone from the library after midnight. The process is also iterative for me, as a teacher; in the months ahead, I’m hoping to do a more thorough job of drawing out (dis)ability and the special vulnerabilities of transpeople to sexualized violence.
Intersectionality is also important in my research. In my dissertation, race wasn’t a very important axis, because Germany was racially (though not ethnically) homogeneous in the 1920s, and race didn’t affect women’s experiences of childbirth. Religion and migratory status (usually, from countryside to city) mattered very crucially. The category of religion captured differences between Jewish women and others, though in many ways Jewish and Protestant women had more in common with each other than with Catholics. Exploring these different axes wasn’t just an expression of my commitment to feminist methodology. It was also the only way to write a social and cultural history of pregnancy that didn’t grossly overgeneralize or erase the experience of the most disadvantaged women. (That prismatic view also resulted in the monstrosity that no advisor encourages: a two-volume thesis. Gulp.)
So while I think that the concerns Apostate and Suzie raised about intersectionality are reasonable, they don’t invalidate intersectionality as a useful way to look at the world. Intersectionality certainly doesn’t render feminism powerless and infinitely splintered. Rather, it gives us a way to forge real alliances with other women; bonds that don’t depend on effacing our differences.
Really, the need to grapple with differences goes back to Audre Lorde’s classic formulation:
The future of our earth may depend upon the ability of all people to identify and develop new definitions of power and new patterns of relating across difference. The old definitions have not served us, nor the earth that supports us. The old patterns, no matter how cleverly rearranged to imitate progress, still condemn us to cosmetically altered repetitions of the same old exchanges, the same old guilt, hatred, recrimination, lamentation and suspicion….these must be altered at the same time as we alter the living conditions which are a result of those structures. For the master’s tools will never dismantle the master’s house.
(Audre Lorde, “Age, Race, Class, and Sex: Women Redefining Difference” – no link, but if you google a phrase, you can find more in various Google Books.)
You might add: a single lens will never let you view the master’s house in its entirety. And so intersectionality offers a prism, which is dizzying and bewildering at times, but promises we can edge closer to truths, which will always be partial in all senses of the word.
** And Apostate, I absolutely don’t think you’re silly, but this is one time I disagreed with the more flippant part of your analysis, even while I appreciated your more considered points.
Dana Goldstein reports that women are twice as likely as men to depend on their partner for health insurance coverage. (Via figleaf.) That’s a big problem for women when a relationship ends, as she notes. Both widows and divorcees can find themselves suddenly uninsured.
From my own experience, I know it’s terrifying enough, worrying whether your spouse will survive a life-threatening illness. No one needs the added fear of becoming uninsured. And when women are uninsured, their dependent children often suffer the same fate. That’s exactly what would have befallen me and my kids, had my husband not survived.
Here’s another important point that Goldstein doesn’t cover: Being dependent on one’s partner for insurance creates a perverse incentive to stay in bad relationships. This does no favor to either partner. The insured person may feel an obligation, especially if his or her partner has had some health problems. The uninsured partner may feel trapped. I can understand staying together for the kids, if a relationship is otherwise dead. But for the insurance? Somehow this seems even more twisted and cruel than being stuck in a lousy job for the same reason.
Goldstein suggests expanding Medicaid coverage to the poor and letting partners who lose their insurance take part in health insurance exchanges, which should offer lower rates. But these are frustratingly incomplete solutions. They’re just a patchwork, even if they might be the best we can hope for, politically, at the moment. Lower-middle-class women, in particular, would be squeezed out, too rich for Medicaid but too poor to afford premiums without employer subsidies.
The simplest solution – which doesn’t require women to be either poor or well-paid – is a single-payer system. In a climate where the Democrats are waffling even on a “public option,” that may seem utopian. It’s the only route to full coverage and fairness, however. A public option may still be unaffordable for those with modest incomes, and adding a “mandate” to the system wouldn’t change that fact.
Ultimately, we have to decouple health care from employment status. We have to stop seeing it as a perq to be earned, and start regarding it as a human right.
Women are still more likely than men to interrupt paid work for family work, and that’s unlikely to change anytime soon. They’re also still clustered in lower-paying and part-time jobs, which are less likely to carry benefits. Separating insurance from employment is the only way to ensure full inclusion of women, as well as minorities, the very old, and the very young. For that matter, it’s the only way relatively privileged pale males won’t get left out in the cold when they become seriously ill. Right now, anyone who suffers serious illness is at risk of losing their jobs, and then losing their insurance. Even those who keep their coverage may find themselves woefully underinsured, resulting in bankruptcy or crippling debt. What’s more, the current recession has put more men out of work than women, and they don’t deserve to be uninsured or dependent on a partner anymore than women do.
Hmm. It turns out that the “feminist” argument for single-payer is good for everyone, not just women.
Daisy at Daisy’s Dead Air has put up a class privilege meme. It was originally intended to be a classroom exercise (full instructions are here), but Daisy’s discomfort in completing the exercise even anonymously online has convinced me: It’s as likely to shame the poor kids as the rich kids. That’s surely not its intent, but when you’re teaching, you’d better think of the consequences.
Good intentions alone are never enough. I once led a classroom discussion on gender and work in which a bunch of college gals vented about the piggish middle-age men who felt entitled to hit on them when they worked retail or restaurants. I thought we’d had a productive discussion. But at the end, after everyone else had left, a woman who’d been very quiet said: “Look. I don’t even know where to begin with these people. I know what it’s like to earn my money by literally shoveling shit.” It was a pedagogical FAIL for me. For her, it was an awkward and probably painful experience.
So, I’m not sure what I can glean from doing this meme, either, except that I think it’s important to talk about class, and maybe my experience shows how class privilege can come in different flavors. Here’s what I came up with. The italics indicate my editorializing – a bent that in itself might indicate a certain degree of privileged. (The most dispossessed people are unlikely to assume that anyone else cares what they have to say.) The bold statements are the ones that hold true for me:
If your father went to college before you started
If your father finished college before you started
If your mother went to college before you started
If your mother finished college before you started (college was taken for granted for all three of us kids)
If you have any relative who is an attorney, physician, or professor (my paternal grandfather was a country doctor; I had older cousins who were lawyers, doctors, and chemists, as well as farmers and teachers)
If your family was the same or higher class than your high school teachers(both my folks were teachers – though at annual salaries of less than $12,000 in the mid-1970s)
If you had a computer at home when you were growing up (no, but that would’ve required devoting a room to a mainframe! I’m just that old)
If you had your own computer at home when you were growing up (no, but my eight-year-younger sister did during high school)
If you had more than 50 books at home when you were growing up
If you had more than 500 books at home when you were growing up(pretty sure we did; most likely the majority were mine)
If you were read children’s books by a parent when you were growing up(every night – and practically every night my dad fell asleep – but hey, that was an incentive for me to learn to read so we could finally finish the stories)
If you ever had lessons of any kind as a child or a teen
If you had more than two kinds of lessons as a child or a teen(French horn for a year, plus six weeks of piano – lessons required a sixty-mile round trip to the next largest town, so mostly my mom taught me piano, then I taught myself)
If the people in the media who dress and talk like you were portrayed positively(well, at least until Fargo came out)
If you had a credit card with your name on it before college
If you had or will have less than $5000 in student loans when you graduate(just under – in mid-1980s dollars)
If you had or will have no student loans when you graduate
If you went to a private high school (there were none where I lived)
If you went to summer camp(music camp and Bible camp!)
If you had a private tutor (but if I’d needed it, my parents would’ve made it happen)
(US students only) If you have been to Europe more than once as a child or teen (I went once, with a touring band, when I was 16, and already thought that was massively privileged)
(International question) If you have been to the US more than once as a child or teen
If your family vacations involved staying at hotels rather than KOA or at relatives homes(we crashed pretty shamelessly with relatives, but where none were available, we stayed in motels because my dad suffered from Crohn’s disease and needed a nearby bathroom)
If all of your clothing has been new (heck no! that would be plain stupid)
If your parents gave you a car that was not a hand-me-down from them (I got a 1974 Maverick from them in 1985, and called myself lucky)
If there was original art in your house as a child or teen(by my grandma, who sometimes let me experiment with her paints)
If you had a phone in your room
If your parent owned their own house or apartment when you were a child or teen(nearly everyone did, in Medina, North Dakota, even if was just a trailer – but we had the biggest house in town, a wonderful old white elephant)
If you had your own room as a child or teen(always, until I went to college)
If you participated in an SAT/ACT prep course (they barely existed in 1980, and I didn’t even know that the SAT was coming up until friends clued me in; I missed the PSAT altogether and I’m still pissed I didn’t get a crack at National Merit Scholar!)
If you had your own cell phone in High School (not yet invented – is this also an old-fart meme??)
If you had your own TV as a child or teen
If you opened a mutual fund or IRA in High School or College (also not on the radar circa 1980, and WTF is up with capitalizing high school and college?)
If you have ever flown anywhere on a commercial airline
If you ever went on a cruise with your family
If your parents took you to museums and art galleries as a child or teen (there aren’t really any in North Dakota, unless you count various pioneer historical exhibits, and on our big trip to California the highlights were Disneyland and Johnny Carson)
If you were unaware of how much heating bills were for your family(but my folks also had to shovel coal in my early years)
Compared to Daisy and many others, I’ve enjoyed heaps of class privilege. But looking at the pattern that emerges from my answers, I notice it’s a little complicated. I’ve experienced tremendous educational privilege. I was born the child of two teachers, both of whose mothers were also schoolteachers. My mom owned a book entitled something like Games to Make Your Child Smarter. (You be the judge whether it worked!) My dad taught music, so he was happy to spring for lessons as long as I practiced.
On the other hand, my parents’ combined household income was less than $20,000 in the early 1970s. That’s just how teachers were paid in North Dakota. My dad had some family money as a cushion, but times were tight when his health forced him to retire from teaching in 1976, leaving my mom the sole wage-earner. My grandpa was a doctor, all right, but he served the sort of clientele where payment was often in some form of barter. He was still able to invest some money in Standard Oil around 1900, and that became the aforementioned cushion for our family.
When it came time for college, I was clueless about the process, and so was my family. But when my folks moved us out to California, they took care to find a decent (though not top-flight) school district. I was a high school (not High School) junior. My classmates (not my parents or counselor) nudged me to take the SAT on time, and to apply to one fancy-pants school – which admitted me and then coughed up generous financial aid when divorce decimated my mom’s finances and put my dad out of the picture for a while.
If there’s a more general point to be drawn from my answers, it’s that educational privilege is largely fungible for economic privilege. It won’t trump it, but it sure acts as a buffer. I may have had an English/social studies teacher in junior high who spelled subpoena as “supena,” but my mom made up for it at home, as did heaps of books. And educational privilege tends to beget more of the same; after surviving some piss-poor teachers in North Dakota as well as benefiting from a few great ones, I went to some of the best schools in the country for both undergrad and grad school. (They weren’t just prestigious; I really did get a great education.) I didn’t know the right etiquette and I was always dressed wrong, but I only came in contact with those “inadequacies” because I’d already been catapulted into the milieu of the very rich.
Don’t anyone tell me I earned these privileges (although I did have to bestir myself to finish my Ph.D.). If I’m smart, it’s due to genetic serendipity and my mom’s silly book. If I’d been born into a family that didn’t care about education, I would’ve done well to go to college at all. I was a lazy student until college and am still a horrible procrastinator. That’s the thing about privilege: It compensates for our failings and lets us do well despite our flaws. If you don’t have any of it, the world is a pretty unforgiving place.
And yes, my boys are growing up in a house full of books. But the count is probably closer to 5000 than to 500. So the pattern repeats itself, every generation accumulating a little more cultural capital.
If your father went to college before you started
If your father finished college before you started
If your mother went to college before you started
If your mother finished college before you started
If you have any relative who is an attorney, physician, or professor.
If your family was the same or higher class than your high school teachers
If you had a computer at home when you were growing up
If you had your own computer at home when you were growing up
If you had more than 50 books at home when you were growing up
If you had more than 500 books at home when you were growing up
If were read children’s books by a parent when you were growing up
If you ever had lessons of any kind as a child or a teen
If you had more than two kinds of lessons as a child or a teen
If the people in the media who dress and talk like you were portrayed positively
If you had a credit card with your name on it before college
If you had or will have less than $5000 in student loans when you graduate
If you had or will have no student loans when you graduate
If you went to a private high school
If you went to summer camp
If you had a private tutor
(US students only) If you have been to Europe more than once as a child or teen
(International question) If you have been to the US more than once as a child or teen
If your family vacations involved staying at hotels rather than KOA or at relatives homes
If all of your clothing has been new
If your parents gave you a car that was not a hand-me-down from them
If there was original art in your house as a child or teen
If you had a phone in your room
If your parent owned their own house or apartment when you were a child or teen
If you had your own room as a child or teen
If you participated in an SAT/ACT prep course
If you had your own cell phone in High School
If you had your own TV as a child or teen
If you opened a mutual fund or IRA in High School or College
If you have ever flown anywhere on a commercial airline
If you ever went on a cruise with your family
If your parents took you to museums and art galleries as a child or teen
If you were unaware of how much heating bills were for your family
A few days ago, Miriam at Feministing suggested we take another look at withdrawal as a contraceptive method. Up to a point, she’s right that “it might be a useful method in low-resource situations.” If, that is, we’re talking about the sort of grinding poverty where the partners can’t even afford condoms.
Overall, though, I’m really troubled by this idea. I think it’s setting women up for more unwanted pregnancies than they already experience. (I’m leaving aside the STI issue, not because it’s trivial, but because it’s self-evident that condoms are vastly superior.)
Now let’s compare the ideal conditions. Even with “perfect” use, the figures are 2% for condoms, 4% for withdrawal. (Both Guttmacher and PP agree on this.) So, for those of us who’re downright obsessive about avoiding pregnancy, that means withdrawal would be twice as risky! I don’t see that as trivial.
Secondly, if we’re talking about truly low resource conditions, it makes no sense to compare condoms and withdrawal. Instead, we should be asking how withdrawal stacks up against other free methods. The various rhythm methods – which Planned Parenthood calls “fertility-based awareness methods” – fail 12 to 25% of women per year. The proposal is to educate people on withdrawal, but honestly, how much needs to be said aside from “it only works if you do it on time, every time”? Where people are too poor to afford condoms, wouldn’t it make better sense to educate women to the point where they could use a fertility-based awareness method and approach that 12% figure? Where poverty is less absolute, condoms could be used on days when conception was more likely. Or scarce resources could be allocated toward fitting women for diaphragms, cervical caps, or IUDs, which don’t require major ongoing expenditures.
But the killer argument against withdrawal, to my mind, is how dependent it makes women on their partners. Much more than condoms, it puts a woman’s reproductive fate totally at the whim of her partner at a moment when he’s not clear-headed. This may not be a big deal in a long-term relationship devoid of abuse, where both partners trust each other, know their bodies, and wouldn’t experience a pregnancy as catastrophic. These, however, are mostly not the couples who need help and education on contraception.
Think about the fifteen-year-old with a twenty-year-old partner. Can she trust him with her future? What about the thirty-year-old mother of five in sub-Saharan Africa whose husband won’t wear a condom – can she hope he’ll more willingly commit to withdrawal? How about any hookup situation, never mind where or with whom?
Even for couples where the power differential is small and the trust is great, using withdrawal effectively requires much more than “good communication.” Miriam at Feministing writes:
But I think we can all agree that we want to promote communication around safer sex.
Yes, and the key word is “around.” By all means, talk about birth control before and after sex. Communicate your desires during sex.Negotiating contraceptive decisions or timing during sex is asking for trouble, however. I wouldn’t want to stake my reproductive future on complete and reliable communication at a moment when my partner (and maybe I) are both muddled with passion.
Can we even hold men wholly culpable when they promise to pull out but don’t? Is anyone fully compos mentis when they’re about ready to come? If you’re doing sex right, the guy shouldn’t exhibit Olympian detachment at the moment of climax. Myself, I wouldn’t want to be with a partner who was having to pull back erotically (and maybe emotionally too) in order to pull out. Condoms, at least, can be donned earlier, before arousal is at its peak, when both partners are still more sensible.
Any method that collides with people’s lived experience is bound to fail, over and again. Sex isn’t a game of Tiddlywinks in which you can change the rules and expect embodied experience – and thus behavior – to follow. Apart from those folks (men, mostly) who’ve internalized porn’s money shot fetish, doesn’t orgasm feel better for most men when they’re inside their partner? Don’t their female partners sometimes feel a loss, too, if detachment has to trump connection at a moment that should be about ecstasy, not calculation? Or if the lovely friction comes to a screeching halt right when she’s verging on orgasm, herself? Can the female partner really relax and enjoy if she’s wondering whether he’ll pull out soon enough? I’ve never relied on withdrawal, personally, but I’m certain I’d find it much, much more intrusive than using condoms.
Of course, withdrawal is a time-honored method. It was the method of choice for many couples in the early twentieth century, prior to the pill. It was quite effective when used with another time-honored backup method: abortion. In Germany during the 1920s, withdrawal was the primary method. Various dodgy douches held second place; all you really need to know about them is that whatever didn’t wash out got forced up into the cervix. So withdrawal was superior to douching. It was also clearly better than nothing. But the abortion rate was estimated at half a million per year – and this in a country of 60-odd million – despite abortion being illegal and often unsafe.
There’s a moment in the film The Abortion Diaries where one of the women telling her story says, “He said he’d pull out. And then he didn’t.” She’s retelling this because it’s the moment that led to her pregnancy. Her words are clipped and bitter. This, too, is a disadvantage to withdrawal: when it fails, someone is very clearly to blame. I have no idea how many other relationships have failed as a result, but the number can’t be trivial.
So I’ve got nothing against discussing withdrawal. And perhaps the Guttmacher authors are right in saying it has a place in providing extra insurance when used with other methods. (Even there, I can’t imagine compliance would be high: if you’re on the pill, will you really feel a need for you partner to pull out, too? If a guy is already putting up with the decreased sensation of a condom, will he be motivated to finish up outside his partner?) Still, there’s no reason to be “sanguine” about withdrawal. And there’s really no good basis for recommending it as a sole method, unless the alternative truly is no method at all.
Update, 5-21-09: This study continues to draw attention from the feminist blogs: Rachel at Feministe is skeptical, while Lynn Harris at Broadsheet gives it a more sympathetic reading. I’d like to repeat that this is just a single study and its findings differ from the existing literature. That doesn’t mean it’s wrong, but it means the discrepancy requires further explanation and can’t just be asserted as the new “truth.” According to the original study by Rachel Jones et al (.pdf), most of the couples using withdrawal were also using other methods (see Nat’s comments below, as she describes the kinds of strategies the researchers also found). It’s not clear to me that you can chart withdrawal on “safe” days against condom use on “less-safe” days and produce a meaningful comparison. These are apples and oranges! I’m having trouble linking the original study (it’s a .pdf) but you can get to it from the Guttmacher summary report. Its strong point, in my view, is its phenomenologically fascinating interview material, in which people talk frankly about how they use this method, how it feels, and how it fits into their lives.
I love critical but constructive feedback. I'm happy to entertain opposing arguments. I'm not willing to host mudslinging, ad hominem attacks, disrespect, unkindness, or hate - especially toward other commenters. Obvious trolls, jerks, and spammers will see their comments deleted and future comments blocked.
Patron cat of Kittywampus (1985-2001)
