Search Results for: Medicine

If You Were a Sack of Cumin

Two people walking down a destroyed Aleppo street, on August 28, 2014. Karam Almasri / NurPhoto / Getty

Khaled Khalifa | translated by Leri Price | an excerpt from the novel Death Is Hard Work | Farrar, Straus and Giroux | February 2019 | 18 minutes (4,899 words)

 

Hussein soon suggested that they toss the body out on the roadside, asking his brother and sister how confident they were that they would pass other checkpoints without trouble. They would be right back where they started if the next checkpoint agents discovered that their father was a wanted man. He added that the dogs were eating plenty of bodies nowadays, so what difference did it make? Why didn’t they just leave it or bury it anywhere and go back to Damascus?

Bolbol could tell that Hussein wasn’t joking this time; he wanted an answer, wanted his brother and sister to make a decision. Bolbol wanted to ignore him, but suddenly a great strength welled up inside him, and he declared he wouldn’t abandon his father’s body before his last wish was carried out. Fatima agreed and asked Hussein to speed up, even though it would be impossible for them to arrive at Anabiya that night in any case. The highway came to an end a few kilometers before Homs, and they would have to use the side roads, which were dangerous at night; no rational being would even consider traveling them in the company of a dead man. Read more…

Behind the Writing: On Research

Type by Katie Kosma

Sarah Menkedick | Longreads | February 2019 | 29 minutes (7,983 words)

In December, I turned in the first draft of my second book. I assumed that when I finished it, I would stand up and scream. Actually scream “YES!” followed by a stream of sundry obscenities, then collapse on the floor and make my husband take a picture for Instagram.

Instead, I was in a quiet back room of Hillman Library, on the University of Pittsburgh campus, drinking a 99¢ mug of coffee, googling Erich Fromm quotes, when I suddenly realized I was done, and I just sat there mildly stupefied, then caught the bus and went home. It was an appropriate end to a writing process that felt a lot less like glorious creation and a lot more like survival and persistence: just getting through one day, one page to the next, trying to keep the pyramid of information, ideas, and sentences from collapsing into a wet heap. It sucked, but in the way most serious creative endeavors suck, with a lining of deep gratification that afterward allows one to pretend that it was all in the service of a mystical something and not really, at base, insane.

It was an appropriate end to a writing process that felt a lot less like glorious creation and a lot more like survival and persistence: just getting through one day, one page to the next, trying to keep the pyramid of information, ideas, and sentences from collapsing into a wet heap.

What made this second book so difficult was research: not the process of doing it, not compiling and organizing it, but the quandary of how to make it creative. How to write a book that felt like it spoke to huge questions — the meaning of life, what matters and why, all the things one gets misty-eyed about around a bonfire — via gobs of information.

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Into the Mouth of Madness and Out Again, Alive

A still from video released via the Thai NavySEAL Facebook Page on Wednesday, July 11, 2018, shows rescuers with an evacuated boy at the Tham Luang Nang Non cave, Thailand. (Thai NavySEAL Facebook Page via AP)

In the summer of 2018, 12 members of a Thai junior football team and their coach were successfully rescued from a cave in which they’d become trapped when heavy rains caused sudden flooding. The rescue options ranged from unrealistic to torturous to deadly to mad. At Maclean’s, Shannon Gormley tells the story of the rescue divers who chose “mad” — and succeeded.

Dr. Harry believes the risks of sedating the children beat the risks of not sedating the children. The lead divers believe the same, and the Thais believe the experts know best. The children cannot dive; the children will panic; the children will drown their rescuers and themselves. That is why Dr. Harry is going to do this: inject 12 kids with a sedative so powerful it will knock them out cold.

Ketamine: a horse tranquilizer, an operating-room drug, a soon-to-be cave-rescue pharmaceutical product in its early testing stages on rock-entombed human minors.

If only it were so simple. The children’s drugs will need to be topped up with half-doses along the way. Dr. Harry cannot dive every child out himself, but the divers are not medical doctors. Dr. Harry must give a dozen cave hobbyists and small-business owners a crash course in do-it-yourself anaesthesiology.

If anyone dies—and many divers think they will be lucky to save two or three of the kids—Dr. Harry will bear much of the burden. He is not licensed to practice medicine in Thailand, let alone teach other foreigners to practice. Though Thailand and Australia have offered some assurance that he won’t suffer legal consequences for his young patients’ probable deaths, a conscience and a name are not so easily protected.

Cave divers are solitary creatures, Dr. Harry will later say to the cameras he normally avoids. And as he instructs laymen how to sedate a bunch of boys in the dark before dragging them through a flooded, stalactite-strewn tunnel, Dr. Harry is very alone.

He thinks the drugs might help some children survive. He’s going to try, anyway. That’s the plan. But you never know.

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How Diderot’s Encyclopedia Challenged the King

The encyclopedists meet at Diderot's home. Hulton Archive / Getty

Andrew Curran | an excerpt adapted from Diderot: The Art of Thinking Freely | Other Press | January 2019 | 19 minutes (5,105 words)

Denis Diderot’s incarceration at Vincennes took place exactly halfway through his seventy years on earth. Prison became the dramatic pause that gave shape and meaning to both sides of his life. Before prison, Diderot had been a journeyman translator, the editor of an unpublished encyclopedia, and a relatively unknown author of clandestine works of heterodoxy; on the day that he walked out of Vincennes, he was forever branded as one of the most dangerous evangelists of freethinking and atheism in the country.

During Diderot’s three-month imprisonment, his jailer the Count d’Argenson and the count’s brother the marquis had looked on with amusement while this “insolent” philosophe had bowed and scraped before the authority of the state. In a diary entry from October 1749, the marquis related with glee how his brother the count had supposedly broken Diderot’s will. Solitary confinement and the prospect of a cold winter had succeeded where the police’s warnings had failed; in the end, the once-cheeky writer had not only begged for forgiveness, but his “weak mind,” “damaged imagination,” and “senseless brilliance” had been subdued. Diderot’s days as a writer of “entertaining but amoral books,” it seemed, were over. Read more…

Labor Pains: A Reading List

A doctor examines a pregnant woman in Allahabad, India, 2011. (AP Photo/Rajesh Kumar Singh, File)

Sara Benincasa is a quadruple threat: she writes, she acts, she’s funny, and she has truly exceptional hair. She also reads, a lot, and joins us to share some of her favorite stories. 

Prior to researching this column, I felt no significant babymaking desire tugging at my uterus. This is not to say I have not thought of being a mother or a stepmother. Adoption and foster-to-adopt programs have always held a special fascination for me, even when I was a little kid. But the biological mechanics of what happens at the end of the human assembly line — you know, the manner in which the finished product exits the factory door? That always freaked me out.

According to my mother, Child Me reacted to the discussion of labor and delivery with disinterest at best and revulsion at worst. Mom worried that she’d somehow made me afraid of it. In fact, she had not; she’d always spoken of pregnancy as the happiest time of her young life, and had two relatively swift and uncomplicated deliveries with healthy babies. When she was 24, I woke her up at 1:00 a.m. one October morning and was out in the world by a quarter past four, taking the traditional route. When she was 27, my brother took maybe six or seven hours on a Sunday in early December. She said he “shot out like a football.” I never knew how to react to that, and I still don’t.

As a child, I asked her how painful it was. She said, “Kind of like… having to do number two in a really big way.” She has since admitted this was an understatement, though one often does go number two when one does a vaginal delivery, but says “it wasn’t that bad” and “at the end you get a beautiful baby!”

My mother accepted long ago that making babies was not high on my priority list. She always encouraged my career and creative aspirations. I give her a lot of credit for not pressuring me about it like some women’s mothers do. I’ve told her that I just don’t have baby fever.

But then I researched this column.

And now…

Well, aside from abstinence from sexual intercourse, there is no greater method of birth control than reading birth stories. Add articles about labor and delivery as managed by the medical industry in the United States, and you’ve got a cocktail that should be nearly as effective as the common oral contraceptive.

My hat is off to women who go through with having a baby — and especially those who choose to do it again. That’s wild, lady! But as you’ll see from the stories I’ve collected below, some labor and delivery experiences are less than ideal, to say the very least. I’m glad real women share what really happens to them rather than glossing it over with some fairy tale bullshit. More real stories from real women who don’t pretend everything is easy, please. And more reporting on the way Black women and poor immigrant women are consistently offered a lower standard of maternal healthcare.

1. “I Think, Therefore I Am Getting The Goddamned Epidural” (Rebecca Schuman, Longreads, November 2017)

I despise every hippie braggart Schuman cites from Ina May Gaskin’s creepy-sounding books Spiritual Midwifery and Ina May’s Guide to Childbirth. At one point I also wanted to lightly smack her husband and kick the shit out of her anesthesiologist, though probably not as much as she did.

Dads make mistakes. It is a fact that my dad is awesome and also that while I was being born, he walked into the wrong labor and delivery room, misreading the name on the door. He did not recognize the gaping vagina before him and swiftly made his exit. During my mother’s second delivery experience, with my younger brother, he pissed her the fuck off by a.) complaining about the room temperature and opening the window when she was fucking cold and b.) bringing in a TV so he and the doctor and any orderlies could watch the game. But he turned out to be a splendid dad.

(As for a similar redemption for Schuman’s shitty, bored, Instagram-scrolling anesthesiologist, I have less hope. I’ve always regarded anesthesiologists as the groovy magicians of surgery — they show up, make your life better — or worse, if they want! — and then disappear. This gal seems to have gone to the wrong wizarding school.)

Schuman, who is one smart cookie, talks about Descartes in an accessible way and connects him quite easily to birthing:

“But what then am I?” he asked. “A thing which thinks. What is a thing which thinks? It is a thing which doubts, understands, [conceives], affirms, denies, wills, refuses, which also imagines and feels.” These might not seem to be questions (or answers) that one naturally associates with the act of giving birth, but perhaps they should be. The midwives in my books were asking versions of these questions, after all, and they shouldn’t be the only ones who got to. Indeed, what makes all that mother-Goddess-yoni-orgasm stuff disquieting is not actually its medical dubiousness. It’s the decidedly un-philosophical certainty of the operation.

If I still drank, I would toss back some bourbon with Schuman (though not if either of us were pregnant, obviously). Regardless, I would like to buy her a beverage or a large carbohydrate-based baked substance one day.

2. “The Lavender Room” (Cheryl Strayed, Slate, April 2014)

Cheryl Strayed had an ideal situation: the desire for a baby, good health, access to excellent care. Then she labored for 43 hours and pushed an 11-pound kid out of her undercarriage. I have no words other than “holy shit, what a warrior.” She is very encouraging of other women having their baby the way they want, which makes this a very sweet and loving story. When she mentions laboring while asking her deceased mother to help her, I got teary-eyed.

It also reminded me of how long labor can take. My sister-in-law and younger brother texted me a few hours after her water broke on a Sunday afternoon. I felt sure the baby would be there by the time I arrived to New Jersey on a flight from Los Angeles the next afternoon. Nope! I visited the hospital room, drank margaritas at the Stuff Yer Face in New Brunswick, New Jersey with the other aunties and an uncle and got a full night’s sleep before I finally woke up to the news that a child was born unto us. Now we are all obsessed with him and his favorite song is “Psycho Killer” by the Talking Heads. He is 17 months old and looks like Wallace Shawn.

3. “I’ve Given Birth 4 Very Different Ways – Here’s What I’ve Learned” (Laurie Batzel, PopSugar, June 2018)

I think I love this woman. She curses way less than I do but she does not pull punches.

I’m a former ballet dancer and have performed in blood-soaked pointe shoes through severe sprains and other sundry injuries. My pain tolerance is not insignificant. But there is no pain on earth like having a baby. When the nurse told me it was too late for an epidural, I would have sobbed if I’d had the strength. I had marched around the labor and delivery unit for three hours straight to avoid Dr. Jerk, I hadn’t slept in over 36 hours, and, as badly as I wanted the “traditional” birthing experience, I would have performed my own C-section right then and there to make the pain stop. Seriously, it’s a good thing there were no spare scalpels, letter openers, or jagged shoelace tips lying around, because I would have gone rogue in a heartbeat.

She had two C-sections followed by two VBACs (vaginal birth after Caeseran). She also says that if a guy tries to convince you that passing a kidney stone is as painful as giving birth with no drugs, you can punch him “in the biscuits.” Starry eyes over here! She concludes with the very kind sentiment “there’s no wrong way to become a mother.” What a refreshing antidote to some of the “you must have a vaginal birth with no drugs so that you can be a true woman” bullshit I read while looking through articles.

4. “Lost Mothers” (ProPublica, 2017-2018)

In publishing, any subject can become a trend, a flash in the pan, a momentary topic of national chatter. Sparked in no small part by Serena Williams talking to Vogue about nearly dying after the birth of her daughter, 2018 saw more mainstream publications begin to cover the topic of maternal mortality among Black women. But organizations like ProPublica, NPR, and smaller independent publications had addressed the issue previously, and Black women themselves had been speaking up about it for years.

It is incumbent upon reporters at mainstream publications to continue to report on this humiliating and devastating national health crisis. In the meantime, ProPublica did the legwork with a series of articles about the many, many Black women who experience a ghastly standard of maternal healthcare in the United States.

5. “I Was Pregnant and in Crisis. All the Doctors and Nurses Saw Was an Incompetent Black Woman” (Dr. Tressie McMillan Cottom, Time, January 2019)

This story is vivid and it is horrifying and it is heartbreaking. Read every word of it. Here are a few: “When the medical profession systematically denies the existence of Black women’s pain, underdiagnoses our pain, refuses to alleviate or treat our pain, healthcare marks us as incompetent bureaucratic subjects. Then it serves us accordingly.”

6. “Why does it cost $32,093 just to give birth in America?” (Jessica Glenza, The Guardian, January 2018)

These statistics are stark. Writes Glenza:

Despite these high costs, the US consistently ranks poorly in health outcomes for mothers and infants. The US rate of infant mortality is 6.1 for every 1,000 live births, higher than Slovakia and Hungary, and nearly three times the rate of Japan and Finland. The US also has the worst rate of maternal mortality in the developed world. That means America is simultaneously the most expensive and one of the riskiest industrialized nations in which to have children.

So we’re paying the most in the developed world for the shittiest treatment in the developed world? Okay, makes sense. No wonder so many women reject the conventional medical approach to birth and buy into comforting “orgasmic birth is possible, babies just slip right out, pain is all in your mind and was put there by The Man, also buy my book and taint moisturizer” pseudoscience, rocketing from one extreme to the other.

As with anything else, it seems, a complementary medical approach is best, blending conventional medicine with alternative or “traditional” healing techniques. But while my complementary medical idea sounds delightful if you can afford to pay out of pocket, how may health insurance plans will pay for your midwife, doula, obstetrician, nurses and 1+ nights stay at some swanky, soothingly lit spa retreat? Oy vey, what a mess.

* * *

The other ways to obtain a beautiful baby without almost certainly going number two in the process have always seemed the more palatable options to me. Of course, the headaches and heartbreaks possible with adoption and foster-to-adopt are innumerable. Taking on the huge responsibility of parenting does not seem simple — nor should it, I suppose.  Plenty of abusive, nasty jerks have kids, and I rather wish they’d give up for fear of poop on the delivery table or too many forms at the agency.

I may yet become a mother. I don’t know. At present, I am glad to be an aunt; I am glad to entertain my friends when they have kids, or to entertain the kids so that my friends can use the toilet in peace or take a nap. I feel enormous gratitude that generations of American women have fought to ensure that women of childbearing age have rights and protections that were unthinkable years ago — as well as the right to prevent or terminate a pregnancy.

I feel energized to work harder to ensure better access to healthcare for all women, and to help make certain motherhood remains a choice. I should say “biological reproduction” because, as Batzel wrote, “There’s no wrong way to become a mother.”  And of course I know — and you now know I know – it is fine to choose to go without children. You’ll sleep more and save money, much of which you can spend spoiling other people’s kids. I can’t recommend that enough.

* * *

Sara Benincasa is a stand-up comedian, actress, college speaker on mental health awareness, and the author of Real Artists Have Day JobsDC TripGreat, and Agorafabulous!: Dispatches From My Bedroom. She also wrote a very silly joke book called Tim Kaine Is Your Nice Dad. Recent roles include “Corporate” on Comedy Central, “Bill Nye Saves The World” on Netflix, “The Jim Gaffigan Show” on TVLand and critically-acclaimed short film “The Focus Group,” which she also wrote. She also hosts the podcast “Where Ya From?”

Editor: Michelle Weber

Chimayó

Robert Alexander / Getty

Esmé Weijun Wang | an excerpt from The Collected Schizophrenias | Graywolf | January 2019 | 17 minutes (4,971 words)

When I walked into the neurologist’s office in 2013 with C., it should have been apparent that something was very wrong with me. I struggled to keep open my eyes, not because of exhaustion but because of the weakness of my muscles. If you lifted my arm, it would immediately flop back down again as though boneless. My body frequently broke out into inexplicable sweats and chills. On top of all that, I had been experiencing delusions for approximately ten months that year. My psychiatrist suspected anti-NMDA receptor encephalitis, made famous by Susannah Cahalan’s memoir, Brain on Fire: My Months of Madness, but that did not explain everything that was wrong with me, including the peripheral neuropathy that attacked my hands and feet, my “idiopathic fainting,” or the extreme weight loss that caused suspicions of cancer—and so I was referred to this neurologist, who was described by my psychiatrist as “smart” and “good in her field.”

“I don’t think you have anti-NMDA receptor encephalitis, based on your chart,” she said brusquely while C. and I sat in matching chairs that faced her examination table. “I’m doing this as a favor to your psychiatrist.” And then she added, “Someday, we’ll be able to trace all mental illnesses to autoimmune disorders. But we’re not there yet.”

In Santa Fe, New Mexico, where I had never been prior to 2017, my friend and fellow writer Porochista insisted that we visit the pilgrimage site of Chimayó. “You’ll be able to write something amazing about it,” she said. We were in the IV room of an integrative healthcare clinic when she said this, facing each other in enormous leather chairs with oxygen tubes in our noses and IV needles taped to our veins.

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Our Understanding of Sun Exposure and Health Keeps Evolving

Myung Jung Kim/PA Wire

Controversial new research is upending the narrative about sun exposure and vitamin D: that the most reliable way to avoid skin cancer is to avoid excess sunlight, always wear sunscreen, and to offset these measures by taking vitamin D supplements. As Rowan Jacobsen reports in Outside, D supplements are not very effective, and a group of scientists have discovered that the relationship between sun exposure and skin cancer is far more complex than we thought. One Journal of Internal Medicine article phrased it this way: “Avoidance of sun exposure is a risk factor of a similar magnitude as smoking, in terms of life expectancy.” But don’t call this all counterintuitive.

When I spoke with Weller, I made the mistake of characterizing this notion as counterintuitive. “It’s entirely intuitive,” he responded. “Homo sapiens have been around for 200,000 years. Until the industrial revolution, we lived outside. How did we get through the Neolithic Era without sunscreen? Actually, perfectly well. What’s counterintuitive is that dermatologists run around saying, ‘Don’t go outside, you might die.’”

When you spend much of your day treating patients with terrible melanomas, it’s natural to focus on preventing them, but you need to keep the big picture in mind. Orthopedic surgeons, after all, don’t advise their patients to avoid exercise in order to reduce the risk of knee injuries.

Meanwhile, that big picture just keeps getting more interesting. Vitamin D now looks like the tip of the solar iceberg. Sunlight triggers the release of a number of other important compounds in the body, not only nitric oxide but also serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms. It reduces inflammation and dampens autoimmune responses. It improves virtually every mental condition you can think of. And it’s free.

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The Silence of Women

A scold's bridle. From The Strand Magazine:, July to December, 1894. (Hulton Archive/Getty Images)

Jane Brox| an excerpt adapted from Silence: A Social History of One of the Least Understood Elements of Our Lives| Houghton Mifflin Harcourt | Januray 2019 | 15 minutes (4,034 words)



What becometh a woman best, and first of all? Silence. What second? Silence. What third? Silence. What fourth? Silence. Yea, if a man should aske me till Domes daie I would still crie silence, silence.

Thomas Wilson, The Arte of Rhetorique, 1560


For women, silence within the world of judicial punishment has its own complex history. It’s less recorded than that of men, and fragmented. Details must be teased out of obscurity and can be distorted by what is absent. Often, there are more questions than answers for punishment that amounts to silencing on top of silence, since women have long been expected to govern their tongue.

In colonial America this presumption of silence was reinforced by women’s subordinate place in society, and bolstered by centuries of English common law. No woman had the right to vote and once she married — in an age when most women married — she became subject to the law of coverture, which meant that she not only became dependent on her husband but, as William Blackstone in his eighteenth-century work, Commentaries on the Laws of England, explains: “By marriage, the husband and wife are one person in law: that is, the very being or legal existence of the woman is suspended during the marriage, or at least is incorporated and consolidated into that of the husband; under whose wing, protection, and cover, she performs every thing, and is therefore called in our law — French, a femme covert… under the protection and influence of her husband, her baron, or lord; and her condition during her marriage is called her coverture.” Read more…

‘In a Marriage, You Grow Around Each Other’: An Interview with Tessa Hadley

Corbis Historical, HarperCollins

Sarah Boon | Longreads | January 2019 | 16 minutes (4,272 words)

 

Tessa Hadley is a late-bloomer in UK fiction, despite having wanted to be a writer since she was a child. “It chose me rather than me choosing it,” she says about writing. Hadley published her first novel at the age of 46. Since then, she’s been an unstoppable force, publishing five additional novels, two short story collections, and contributing regularly to The New Yorker. Her new novel, Late in the Day, delves into the institution of marriage, particularly long marriages. She explores how couples grow around each other, like trees, and how the sudden death of a partner can send life into a tailspin. Read more…

A Woman’s Work: The Outside Story

All artwork by Carolita Johnson

Carolita Johnson | Longreads | January 2019 | 23 minutes (5,775 words)

When I freelanced as a “fit model” in the early aughts (the unglamorous kind of modeling that helps patternmakers adjust their patterns to fit humans correctly) I signed a contract with my agency that legally bound me to “maintain” my “appearance” while they represented me. My skin, all my visible hair (on my head, my eyebrows, my legs, armpits, and face), as well as my weight and several key body measurements all fell under this rubric.

There is nothing unreasonable about this: the main part of the job, besides the obvious — trying clothing on for patternmakers to see if there’s anything in an item that needs correcting, to avoid producing thousands of flawed garments — is to make sure your body is always the same so that a designer can produce clothing that is a consistent fit. The unspoken truth is that even though it’s technically only about measurements, it wouldn’t do to show up without a minimum of good hair and makeup, looking as attractive as you possibly can with whatever looks you pulled in the Lotto of good looks. This goes for all size categories, from junior to plus size.

Accordingly, my accountant and I came up with a deductible category we called “maintenance” — well, I came up with it and she translated it into the IRS-accepted language — and under this category I placed gym membership expenses, haircuts (and eventual hair color as I aged, because my gray hairs upset some designers even if their clothes still fit me perfectly), mani-pedis, and occasional waxing for lingerie and swimwear jobs. I might even have been able to get Botox deducted if I’d kept doing the job long enough. I left it to my accountant to decide what I could legally include.

For context, just because most people are curious about the job description, the ideal fit model has a body that isn’t extraordinary in any way. I was a size 6/junior medium, a size for which there’s a relatively small market, so I didn’t work 9 to 5 like a size 10 or a size 18W would have. This was what made the job perfect for a cartoonist/writer like me.

It was extremely enjoyable to be able to deduct these expenses for that relatively brief period of my life as a woman. It never escaped my ironic notice that with few exceptions, most women feel contractually bound to maintain their appearance in all the same ways I had to as a pro, while paying for it all on a sliding scale from “religiously” to “happily” to “begrudgingly,” usually depending on the amount of social and financial power they are born into or acquire through hard work or marriage.


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