Tuesday, April 27, 2010

I won't go quietly

For over twenty years my parents have lived in Southern Arizona. That's right, in the part of the country that is in the news now because of the new state legislation aimed at pruning immigrants from its midst.

A frequent day trip from my parents' retirement community is to an artsy enclave called Tubac which is about 20 miles away and smack between their home and the Mexican border. Artists have started bemoaning the fact that their business is way down in no small part because of the border patrol posts that create traffic backups as uniformed Homeland Security agents with very dark glasses lean over the drivers' side and check out the passengers.

When they see two tamish white chicks like my Mom and myself, they never ask for any sort of papers and wave us on. I always rail to my mom as she pulls away, threatening to speak Spanish and see what they would do. "How," I always ask, "would they know I'm not Mexican? Since when does my driver's license say anything about my nationality even if they asked for it? They are the worst kind of racial profilers." And on and on. She responds: "Oh, I don't know. Can't we just have a nice outing together?" They make me angry; they could ruin our day.

Now, I am tempted to boycott the road blocks. There are back dusty roads around their posts, I am sure of it. Rattle snakes be damned. Actually, it makes me want to boycott the whole damn state whose Governor Brewer is pandering to the reactionary forces of the state and taking immigration law into its own hands. Of course, they already have a pretty good track record on this in Arizona with sheriffs who proudly display their hatred, racism and fear-mongering on television.

Speaking of reality television and Arizona, a frontpage story today in the New York Times, entitled "Boozy, Bawdy Reality TV, With a Few Wrinkles", tells us about the middle aged "sassy" retirees of Phoenix Arizona who share their meaningless antics, drinking and even their hernia repair operations with the world. All in all, it's not a pretty picture for the state.

In today's New York Times, Linda Greenhouse has an idea. She writes:
Everyone remembers the wartime Danish king who drove through Copenhagen wearing a Star of David in support of his Jewish subjects. It’s an apocryphal story, actually, but an inspiring one. Let the good people of Arizona — and anyone passing through — walk the streets of Tucson and Phoenix wearing buttons that say: I Could Be Illegal.
I'd love one of those buttons. And maybe I will just go down to Tubac, buy some cowboy art and return speaking Spanish. "Ola, que tal, senor?" That's my kind of sass.

Monday, April 26, 2010

The Pill Turns Fifty

June 2010 marks the fiftieth anniversary of the birth control pill. At the time of my own adolescence, I had no idea that it had just come on the scene. Like women's lib, drinking at age 18 and conscientious objection, we took this for granted as part of growing up. As a practitioner I prescribe it every day; as often as not it's for a problem that is not directly related to contraception. Many people are still surprised at the multi-tasking the Pill can do in a woman's body.

In reviewing the history of the pill I ran across a 2000 New Yorker article by Malcolm Gladwell about the first days of the pill and in particular the story of Dr John Rock's attempts to make the new birth control pill as acceptable as possible to the leaders of his own Catholic church. Rock worked hard to present the Pill as a "natural" method of birth control to rival the more acceptable "rhythm" method (meaning timing intercourse with the menstrual cycle to try to avoid the days surrounding ovulation). Not only did he try to sell the idea that birth control pills promote the "natural" safe times of the month, but the classic 28 day cycle was created with the pills to mimic what they thought were the "natural" cycles of most women. Another remarkable aspect of the pill was the packaging:it was first marketed in the now familiar plastic round compact in order to pass as a makeup container in a woman's pocketbook, a natural for most women.

Since this time, a great deal of anthropological and endocrine research has shown that the 400 or so menstrual periods that a modern woman gets between her first one and her menopause are mostly a result of modern lifestyle. Before the twentieth century it would be more likely for a woman to have only about one hundred periods with the difference being accounted for by more period-free pregnancies and lactation. Experts wonder what the effects of so much exposure to female hormones, albeit "natural" ones, might be.

In the meantime, we celebrate the gains that oral contraceptives have afforded women and the way in which many of the modern hormone-related afflictions of modern life (acne, heavy or irregular periods, menstrual cramps, polycystic ovaries, and endometriosis) can be managed with this little middle-aged pill.

We have learned a lot about the Pill in the past few decades.

Wednesday, April 14, 2010

Thank you, Michelle Obama (and Oprah, too)

First Lady Michelle Obama's bilateral High Five on the front page of the New York Times this morning will draw you into the picture of pig-tailed Haitian children greeting her during a surprise visit to Port au Prince yesterday. But take a look at her furrowed brow, and you can only imagine what is going through her mind. I think it might be a mix of sorrow and admiration and a desperate wish to help in some way.

My first response when I heard she had decided to visit Haiti was "it's about time." I have wanted to see Barack's face on the front page of the paper walking in boots among the rubble. Ever since my visit in January I have wanted him to go there to lend support to the Haitian people. I have wondered why he has not gone personally to this amazing country where slaves overthrew their French oppressors only to go on to oppress their own for generations that have followed. Maybe the security concerns extend to a fear that the man would be swamped and exalted as a new savior for the Haitian people.

In any case, if there is one thing Michelle (and Jill Biden, too, by the way) can do it is to provide a photo op, even without stylish clothes, to remind us all that the plight of Haitians is still very much alive. With time, the needs are evolving and the call is more sophisticated and sometimes harder to negotiate as described yesterday in the New York Times article about the dancer/amputee who is a pawn in an international struggle over goodwill.

One more person has been keeping Haiti on the front burner. That is Oprah who is sponsoring a Mother's Day walk in New York City to help a number of charities, including Partners in Health, my Haitian favorite. I plan to be there.

Thanks, Ladies!

Thursday, April 8, 2010

The Eyes Have It!

While preparing to move my office in the last few days with all the stresses that such disruption entails, my right eye has gone crazy on me. I have wondered if it is "conjunctivitis" --also known as Pink Eye (love that name!), a spider bite, an allergy, or just a good old fashioned sty (hate that word!).

So this morning when my online Journal Watch came up with "Pink Eye-to Treat or not to Treat" of course it caught my you know what. It turns out there are four simple criteria that help determine whether a pink eye needs antibiotic treatment or not. This is important because all kinds of institutions require a certain amount of antibiotic treatment (and usually a doctors' visit) before allowing a student back to school or an adult into the workplace. So we can save lots of time and money if we can avoid this. In addition, we must concern ourselves with the development of resistance to antibiotics among bacteria in our midst. Over-treating, as we know, will lead to increased resistance through natural selection of hardier bugs.

The four criteria about a patient that seem to indicate at least 90% of the time that an infection is not bacterial and does not require antibiotic drops or ointment are:
  • older than six years of age
  • infection presenting between April and November
  • watery or minimal eye discharge
  • "no glued eye in the morning" (love that description)
So next time you can't reach your doctor, the co-pay is too high on the visit or the meds, or you are out of town, think through these criteria before letting panic set in. The good old ice pack to the eye and frequent wiping with a damp cotton ball followed by scrupulous hand washing ought to do it. Guess it's back to packing my boxes.