Search Results for: Medicine

A British Seaweed Scientist Is Revered in Japan as ‘The Mother of the Sea’

Pahala Basuki / Unsplash, Algonquin Books

Susan Hand Shetterly | Excerpt adapted from Seaweed Chronicles: A World at the Water’s Edge | Algonquin Books | August 2017 | 16 minutes (4,260 words)

Occasionally you can still find them out on islands, crumbling near the water’s edge, the old eighteenth- and nineteenth-century kilns built out of stones gathered from the shore. People on the Irish and Scottish coasts and in Brittany cut and burned seaweeds in the pits of those kilns to make potash and pearl ash, valuable potassium salts. The wet seaweeds — AscophyllumFucus, and the kelps — had to be lugged up from the shore, carefully turned and dried, and then burned at a temperature that would render them into products that were sold to make glass and soap, to bleach linens, to encourage bread to rise, and to use as fertilizer to sweeten fields. In the boom time, around 1809, Ireland was exporting about 5,410 tons of potash a year. It was backbreaking work that whole neighborhoods engaged in, and at its height, the many kiln fires created smoke so thick it endangered the lives of nearby pasturing cows. It wasn’t long before the seaweeds in some places were overcut, the shores laid bare.

Then, as suddenly as it had appeared, the market vanished when potassium salt deposits were discovered underground in Germany and in Chile, and mines were opened.

The burning of seaweed resurfaced with the discovery that the ash residue could be used to extract iodine. But that, too, disappeared when deposits of iodine were found belowground. Left alone, seaweeds regrew, with farmers coming to the shore to harvest them for their gardens, and gatherers cutting favorite species to eat and to feed to their domestic animals. Over time, the old kilns were disassembled by wind and rain and snow. Read more…

She’ll Be Everything He Isn’t

Photo by Andryusha Romanov via Wikimedia Commons (CC BY 4.0)

Larry Nassar molested hundreds of young athletes as the doctor for the U.S. gymnastics national team. One of those young athletes was Selena Brennan, who started seeing him for back pain at age 12 and saw him not just as a healer, but as a career role model.

Finally, here was a doctor with whom she shared a vocabulary, someone who did not need to be taught what a front walkover was. Here was a doctor who understood what was expected of her in the gym and who could treat her injury in a way that catered to that. It was through that lens that she started to see a future in sports medicine for herself.

“Just being able to be with a doctor who understood the sport made it a lot easier. It was like I could take a deep breath, and I didn’t have to explain how [I do] what I do. Sometimes primary care doctors give you some type of way to cope with the pain. But when you’re practicing that much in a gym, you’re constantly putting pressure on your back,” Selena said. “Those things don’t necessarily work, because there’s a ton more pressure on your body than the average person. It was nice to have reasonable tools be given and be like, ‘OK, this is something I can actually do, this might actually make a difference.’ After my [first] visit I was like, ‘I’m doing this.’ I ended up telling him, ‘I want to do what you do.’”

Alexanrdria Neason tells Brennan’s story at Bleacher Report — the abuse, the aftermath for Selena and her family, the shadow it cast over her dreams, and how she’s reclaiming her ambition.

Amid the campus activism—marches and protests, teal ribbons tied around trees, therapeutic fitness classes exclusive to survivors—Selena worked hard to untangle her love of sports medicine from Nassar. He was at once an example of what she wanted to be and exactly the type of person whom she did not want to become. She questioned her ambitions and worried she had been misled.

What if he was leading me down the wrong path, career-wise? She thought. What if he wasn’t giving me real advice, or what if he was setting me up to fail in my education because I was listening to what he was saying? I’ve based years off of this, so what am I going to do now?

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Earth to Gwyneth Paltrow

MIAMI, FL - DECEMBER 15: Gwyneth Paltrow at her book signing at Goop Pop Up at Miami Design District on December 15, 2017 in Miami, Florida. (AP Images) People: Gwyneth Paltrow/IPX

At the New York Times Magazine, Taffy Brodesser-Akner reports on Goop, Gwyneth Paltrow’s health and wellness empire, which started off as a newsletter where G.P. (as she’s known) simply recommended things she liked. Fast forward a few years. Now Goop is a huge brand: a clothing-and-beauty-company-slash-publishing house with a magazine, a website, and a newsletter, all estimated to be worth $250 million from flogging new-age products for eliminating wrinkles and flab while improving your sex life. But the truth is catching up to Goop; it’s been investigated by the Council of Better Business Bureaus and TruthInAdvertising.org for deceptive marketing claims, forcing Goop to attempt to embrace science and facts across the empire as a “growing pain.”

By the time she stood in that Harvard classroom, Goop was a clothing manufacturer, a beauty company, an advertising hub, a publishing house, a podcast producer and a portal of health-and-healing information, and soon it would become a TV-show producer. It was a clearinghouse of alternative health claims, sex-and-intimacy advice and probes into the mind, body and soul. There was no part of the self that Goop didn’t aim to serve.

G.P. didn’t want to go broad. She wanted you to have what she had: the $795 G. Label trench coat and the $1,505 Betony Vernon S&M chain set. Why mass-market a lifestyle that lives in definitional opposition to the mass market? Goop’s ethic was this: that having beautiful things sometimes costs money; finding beautiful things was sometimes a result of an immense privilege; but a lack of that privilege didn’t mean you shouldn’t have those things. Besides, just because some people cannot afford it doesn’t mean that no one can and that no one should want it. If this bothered anyone, well, the newsletter content was free, and so were the recipes for turkey ragù and banana-nut muffins.

The newsletter was at first kind of mainstream New Age-forward. It had some kooky stuff in it, but nothing totally outrageous. It was concerned with basic wellness causes, like detoxes and cleanses and meditation. It wasn’t until 2014 that it began to resemble the thing it is now, a wellspring of both totally legitimate wellness tips and completely bonkers magical thinking: advice from psychotherapists and advice from doctors about how much Vitamin D to take (answer: a lot! Too much!) and vitamins for sale and body brushing and dieting and the afterlife and crystals and I swear to God something called Psychic Vampire Repellent, which is a “sprayable elixir” that uses “gem healing” to something something “bad vibes.”

The weirder Goop went, the more its readers rejoiced. And then, of course, the more Goop was criticized: by mainstream doctors with accusations of pseudoscience, by websites like Slate and Jezebel saying it was no longer ludicrous — no, now it was dangerous. And elsewhere people would wonder how Gwyneth Paltrow could try to solve our problems when her life seemed almost comically problem-free. But every time there was a negative story about her or her company, all that did was bring more people to the site — among them those who had similar kinds of questions and couldn’t find help in mainstream medicine.

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Making Peace with the Site of a Suicide

Photo by Liz Arnold

Liz Arnold | The Common | Spring 2018 | 19 minutes (5,189 words)

Sixteen years ago, my mother found my father behind the shed on a Saturday morning in June. “Get up off the ground in your good shirt,” she told him, before she understood he was dead. “He looked like he was sleeping,” she told us. “The gun glinted in the grass.”

Seven years after my father’s suicide, I opened the envelope containing police photographs of the scene. He did not look like he was sleeping. Limbs: a swastika. Angles inhuman. Violence and velocity rendered in two hundred pounds of a six-foot man. The gun glinted in the grass — she was right about that.

Initially, I was upset she got it wrong. Did she get it wrong? Or she lied to protect her children, three grown adults. (I was 25 at the time.) Or shock wrote its own version. She says that shock drove her back into the house to start a load of whites. She watched her hand grasp the silver knob on the washing machine.

Maybe we’re trying to protect each other. I haven’t told her that I’ve read the autopsy report, or that I viewed photographs of the scene.

I remember how, on the night of his death, when I’d flown home to Michigan from Los Angeles, she tapped her temple twice, quickly. “Not a lot of blood,” she said. That was true, though I wouldn’t know until years later that the temple wasn’t the site of the entrance wound. “Intra-oral,” it said on the report. Of course. He was a dentist who collected guns, and his expertise in those two fields converged at the palate, the most vulnerable place in the skull. Bypassing bone, the impact destroys the control center for vital organs.

I’ve since revised my account to believe he was standing. He was standing behind the shed, and then—I can’t piece it together anymore. Read more…

You’re Not Clean Until You’re 110% Clean

A 35mg liquid dose of methadone (AP Photo/Kevin D. Liles, File).

Medication-assisted therapy (MAT) for drug addiction — that is, methadone or Suboxone — is a proven way to help addicts stay clean. Narcotics Anonymous programs offer community support that helps addicts stay clean, but turns away people who are using medication to aid their recovery. Why, if their goals are the same?

The misconception stems from the fact that most medications for treating addiction, like Suboxone and methadone, are opioid-based. With the correct prescription, an addict’s compulsive behavior, loss of control, constant cravings, and other hallmarks of addiction will usually vanish. But if you take too much, you will get high. The idea that MAT is just a replacement drug has been debunked countless times by medical organizations, including the U.S. Department of Health and Human Services (HHS).

Nonetheless, Michael has been told that he is still a junkie, not only by people in the 12 Step meetings he used to go to, but also by friends: “They look at you like you are still using, that you are not sober, that you are basically still living the life of a drug addict, when you are not.” Michael has come to terms with the fact that he will probably have to take methadone for the rest of his life. He hates the stigma associated with his medicine, but he knows that he needs it to function.

Narcotics Anonymous requires complete detox, from all substances, before a person can enter the program. In The New Republic, Katrine Jo Anderson and Cecile Maria Kallestrup look at whether this stance actually exacerbates the opioid crisis — it not only keeps people apart from a potentially critical source of community support, but can be physically dangerous.

But what is accepted with grim resignation at the detox ward is a source of deep dismay for medical experts. “Detox without MAT is potentially dangerous,” said Bachaar Arnaout, an assistant professor of psychiatry at Yale School of Medicine. “An overwhelmingly majority of people end up relapsing after detox. It’s a gamble with lives.”

When patients go through detox, their tolerance decreases drastically. If they fall off the wagon and take the dose of opioids they were used to, or even a lower dose, this can be enough to shut down vital body functions. This is especially the case today, Arnaout said, because the opioid epidemic is largely driven by fentanyl—an opioid up to 50 times more potent than heroin.

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The Wheel, the Woman, and the Human Body

CTK via AP Images

Margaret Guroff | The Mechanical Horse | University of Texas Press | April 2016 | 35 minutes (4,915 words)

Angeline Allen must have been pleased. On October 28, 1893, the 20-something divorcée, an aspiring model, made the cover of the country’s most popular men’s magazine, a titillating journal of crime, sport, and cheesecake called the National Police Gazette. Granted, the reason wasn’t Allen’s “wealth of golden hair” or “strikingly pretty face,” though the magazine mentioned both. Rather, the cover story was about Allen’s attire during a recent bicycle ride near her Newark, New Jersey, home. The “eccentric” young woman had ridden through town in “a costume that caused hundreds to turn and gaze in astonishment,” the Gazette reported.

The story’s headline summed up the cause of fascination: “She Wore Trousers” — dark blue corduroy bloomers, to be exact, snug around the calves and puffy above the knees. “She rode her wheel through the principal streets in a leisurely manner and appeared to be utterly oblivious of the sensation she was causing,” according to the reporter.

It is unlikely Allen was truly oblivious, having already shown an exhibitionistic streak over the summer when she appeared on an Asbury Park, New Jersey, beach in a bathing skirt that “did not reach within many inches of her knees,” according to a disapproving newspaper report. (“Her stockings or tights were of light blue silk,” the report added.) Allen didn’t mind people noticing her revealing outfits — “that’s what I wear them for,” she told one reporter — and she kept cycling around Newark in pants despite the journalistic scolding. As another paper reported that November, “The natives watch for her with bated breath, and her appearance is the signal for a rush to all the front windows along the street.”

For a grown woman to reveal so much leg in public was a staggeringly brazen act. What was noticeably unnoteworthy by then was Allen’s choice of vehicle. Ten years earlier, all bicycles had been high-wheelers, and riding one had been largely the province of daring, athletic men. The women who had attempted it were seen as acrobats, hussies, or freaks; one female performer who rode a high-wheeler in the early 1880s was perceived as “a sort of semi-monster,” another woman reported. But by the early 1890s, the bike had undergone a transformation. Allen’s machine — a so-called safety bicycle — had two thigh-high wheels; air-filled rubber tires; and rear-wheel drive, with a chain to transmit power from the pedals. In fact, it looked a lot like a 21st-century commuter bike, and it had become nearly as acceptable as one. Even the fashion police who scorned Allen’s riding outfit didn’t object to her riding.

What had happened to the bicycle in the interim? Market expansion. In the 1880s, when bicycle makers had begun to saturate the limited market for high-wheelers, they sought products to entice other would-be riders, particularly men who had aged out of the strenuous high-wheel lifestyle. In the United States, where bad roads made tricycle ridership impractical, the sales potential for an easy-to-ride bicycle looked stronger than in Europe. In response, manufacturers on both sides of the Atlantic created a profusion of high-tech two-wheelers, including models with foot levers instead of pedals; “geared up” bikes with chains and sprockets that spun the driving wheel more than once for each rotation of the cycle’s cranks; and a supposedly header-proof version with the small wheel in the front and the big wheel in the rear. Riders and makers started calling the standard high-wheeler an “Ordinary” to distinguish it from experimental models.

Several of the new bikes used geared-up rear-wheel drive as a way to bring the rider closer to the ground. The most influential of these was the English Rover, with a rear driving wheel only thirty inches tall that had as much force as a 50-inch Ordinary wheel. (Even today, American bicycle gears are measured in “gear inches,” which indicate how tall an Ordinary wheel of equivalent force would be.) At 36 inches, the Rover’s front wheel was slightly bigger than its rear one, but apart from that, the machine looked as streamlined as some models of fifty or a hundred years later.

Introduced in England in 1885, the Rover Safety Bicycle delivered the speed of an Ordinary, but with a greatly diminished risk of skull fracture from flying over the handlebars. The Rover’s manufacturer made some quick refinements, and a model with same-sized wheels caught on in Britain and inspired a fleet of imitators: low-mount, rear-wheel-drive bikes also called “safeties.”

The major US manufacturers weren’t impressed by this new low profile, though; they dismissed the safety style as a mistake. In 1886, after a two-month tour of England’s bicycle factories, the US industry titan Albert Pope expressed confidence in his high-wheeler: “I looked at nearly all the principal [English] makes and I could not find a point that was in any way an improvement over our own.” Echoed his lieutenant, George H. Day, who also made the trip, “Every innovation is regarded as a trap.”

But when imported safeties hit the US market in the spring of 1887, the machines found eager buyers; Pope and other American cycle makers scrambled to put out their own versions of the header-resistant contraptions. By November, the safety bicycle was established in the United States as the modern option for men, even though its low wheels evoked the comically old-timey velocipede of 20 years prior, as one bard made clear in the accented voice of an immigrant child:

In days of old, full many a time
You’ve heard it told, in prose and rhyme,
How down the street a wheelman came,
And chanced to meet his beauteous flame
Just where a pup in ambush lay,
To tip him up upon the way,
And make him wish that he was dead,
While gyrating upon his head.
In days of old
You’ve heard it told.
But nowadays, it’s otherwise.
The safety craze new joy supplies;
The boulders lose their terrors grim,
Stray cans and shoes are naught to him;
He laughs at rocks, he kicks the pup,
But, in the end, things even up;
For, as his maid he gayly greets,
Some unwashed urchin always bleats —
“Hi, look at der big man on der melosipetes!”

For a short time, Ordinaries and safeties coexisted like Neanderthals and Homo sapiens, with the bigger, older species continuing to inhabit its traditional niche while the smaller, nimbler creature carved out a new one. “I do not think that [the safety] will hurt the sale of the Ordinary bicycle,” predicted one US industry watcher in late 1887. “It will open the pleasures of cycling to a great many who have been afraid to venture upon a high machine.” The writer was thinking of physicians and other “professional men” for whom an Ordinary was too dangerous, but some enthusiasts suspected that the safety would also appeal to female riders. Offering women “a clumsy wheelbarrow of a tricycle” to ride while men zip around on slender bikes, wrote one sympathetic man, “is offering a woman a stone to eat while men have soft biscuit.”

And the safety bicycle’s low profile did intrigue many American women, especially after the spring of 1888, when makers offered a drop-frame version, in which the bike’s top bar scooped downward to make room for a lady rider’s long skirts. As one woman reported that year, “A sudden desire began to awake in the feminine mind to ascertain for itself by personal experience, what were those joys of the two-wheeler which they had so often heard boastfully vaunted as superior, a thousand times, to the more sober delights of the staid tricycle.”

With the safety’s smaller wheels, its ride was bumpier than the Ordinary’s at first. But then came the pneumatic tire. Devised in Ireland in 1888 by a veterinarian named John Boyd Dunlop, who was seeking a faster ride for his son’s trike, the air-filled rubber tube cushioned the road’s ruts and bulges in a way that springs and other early shock-absorbing devices never could. This marvel arrived in the United States by 1890 and became standard equipment on American safeties within a few years. “It permitted travel on streets and roads previously thought unrideable,” recalled an American journalist of the time, “and added to cycling a degree of ease and comfort never dreamed of.”

In the 1890s, bikes got lighter as well as more comfortable. The average weight of a bicycle dropped by more than half during the decade’s first five years, falling from 50 pounds to 23. And since new gearings were able to mimic wheels larger than those of the largest Ordinary, speed records fell too. In 1894, while riding a pneumatic-tired safety around a track in Buffalo, New York, the racer John S. Johnson went a mile in just over one minute and thirty-five seconds, a rate of nearly thirty-eight miles an hour. He beat the previous mile record for a safety by fourteen seconds, and the record for an Ordinary by nearly a minute–and the record for a running horse by one-tenth of a second.

The Ordinary — which had by then acquired the derisive nickname of “penny-farthing,” after the old British penny and much smaller farthing (quarter-penny) coins ─ became obsolete. High-wheelers that had sold for $150 to $300 just a year or two earlier were going for as little as $10.

The first safeties, meanwhile, cost an average of $150 during a time when the average worker earned something like $12 a week. At such prices, the new bikes targeted the same upscale demographic as the tricycle. But a strong market for safeties among well-to-do women goosed production, and competition among manufacturers reduced prices, making the bikes affordable to more would-be riders — and further fueling demand. In 1895, America’s 300 bicycle companies produced 500,000 safeties at an average price of $75, according to one encyclopedia’s yearbook. Even manufacturers were surprised at the demand among women, who thrilled to the new machine’s exhilarating ride. As one female journalist wrote, “If a pitying Providence should suddenly fit light, strong wings to the back of a toiling tortoise, that patient cumberer of the ground could hardly feel a more astonishing sense of exhilaration than a woman experiences when first she becomes a mistress of her wheel.”

It wasn’t just that women enjoyed the physical sensation of riding — the rush of balancing and cruising. What made the bicycle truly liberating was its fundamental incompatibility with many of the limits placed on women. Take clothing, for example. Starting at puberty, women were expected to wear heavy floor-length skirts, rigid corsets, and tight, pointy-toed shoes. These garments made any sort of physical exertion difficult, as young girls sadly discovered. “I ‘ran wild’ until my 16th birthday, when the hampering long skirts were brought, with their accompanying corset and high heels,” recalled the temperance activist Frances Willard in an 1895 memoir. “I remember writing in my journal, in the first heartbreak of a young human colt taken from its pleasant pasture, ‘Altogether, I recognize that my occupation is gone.’” Reformers had been calling for more sensible clothing for women since the 1850s, when the newspaper editor Amelia Bloomer wore the baggy trousers that critics named after her, but rational arguments hadn’t made much headway.

Where reason failed, though, recreation succeeded. The drop-frame safety did allow women to ride in dresses, but not in the swagged, voluminous frocks of the Victorian parlor. Female cyclists had to don simple, “short” (that is, ankle-length) skirts in order to avoid getting them caught under the bicycle’s rear wheel. And to keep them from flying up, some women had tailors put weights in their hems or line their skirt fronts with leather. Other women, like Angeline Allen, shucked their dresses altogether and wore bloomers. The display that reporters had deemed shocking in 1893 became commonplace just a few years later as more and more women started riding. “The eye of the spectator has long since become accustomed to costumes once conspicuous,” wrote an American journalist in 1895. “Bloomer and tailor-made alike ride on unchallenged.” (For her part, Allen may well have given up riding, but not scandal; she progressed to posing onstage in scanty attire for re-creations of famous paintings, a risqué popular amusement.)

Bicyclists’ corsets changed too, though less publicly. The corset of the 1880s was an armpit-to-hip garment stiffened with whalebone stays, which helped the hips support heavy skirts that hung from the waist. But while corsets braced women’s torsos, they also weakened their wearers, squeezing women’s lungs and displacing other internal organs, making deep breaths impossible. Out of necessity, female cyclists looked for alternatives, and many chose another garment that had been advocated by dress reformers decades earlier: a sturdy, waist-length cotton camisole with shoulder straps. When introduced in the 1870s, this garment was called an “emancipation waist,” and it featured a horizontal band of buttons at the hem, to which drawers or a skirt could be attached. Later versions were named “health waist” or, finally, “bicycle waist.” One 1896 model included elastic insets; its maker promised the wearer “perfect comfort — a sound pair of lungs — a graceful figure and rosy cheeks.” All for $1, postpaid.

If women’s clothing constrained them, so did their role in society. More Americans than ever worked outside the home; by 1880, farmers made up a little less than half of the country’s labor force. But even among the urban working class, married women typically stayed home during the day to cook, clean, tend to children, and often manufacture homemade goods for sale. Meanwhile, their husbands, sons, and unmarried daughters toiled in factories, shops, offices, and other people’s houses. Many Americans came to believe that men and women naturally inhabited two separate spheres: men held sway in business, politics, and other public arenas, and women took charge of the home. For most middle-class women, respectability meant appearing in public only under certain circumstances ─ such as while shopping ─ and making as small an impression as possible. “A true lady walks the streets unostentatiously and with becoming reserve,” instructed an 1889 etiquette manual. “She appears unconscious of all sights and sounds which a lady ought not to perceive.”

In addition, an unmarried young woman didn’t go out without a chaperone, usually an older female relative. Being seen on an unchaperoned date, even at a restaurant or other public place, could be cause for social ruin. An 1887 etiquette guide warned against sailing excursions, for example, lest the boat be becalmed overnight: “A single careless act of this sort may be remembered spitefully against a girl for many years.”

The bicycle challenged all that. Wives who had stayed close to home — venturing out only on foot, by trolley, or, if wealthy, with a driver and horse-drawn carriage — were suddenly able to travel miles on their own. Being so mobile, and so visible, was a revelation to many. “The world is a new and another sphere under the bicyclist’s observation,” wrote one female journalist. “Here is a process of locomotion that is absolutely at her command.” If a woman’s sphere begins to feel too small, wrote another, “the sufferer can do no better than to flatten her sphere to a circle, mount it, and take to the road.”

As for unmarried women, manners mavens urged them to cycle only with chaperones, but the rule didn’t take. “New social laws have been enacted to meet the requirements of the new order,” reported one newspaper editor in 1896. “Parents who will not allow their daughters to accompany young men to the theatre without chaperonage allow them to go bicycle-riding alone with young men. This is considered perfectly proper.” According to the editor, the reason for this difference was the “good comradeship” of the bicycling set. Fellow enthusiasts looked out for one another on the road, he wrote ─ so in a way, every ride was supervised. The historian Ellen Gruber Garvey suggests a second possible reason: propriety already allowed unmarried women to ride horses unchaperoned. Bicycles, as a less costly equivalent, may simply have extended this freedom down the economic scale.

But the same things that made the bicycle liberating also made it threatening. Moralists warned that skimpy costumes and unsupervised travel would lead to wanton behavior. “Immodest bicycling by young women is to be deplored,” declared Charlotte Smith, founder of the Women’s Rescue League, a group that lobbied Congress on behalf of “fallen women.” “Bicycling by young women has helped to swell the ranks of reckless girls, who finally drift into the standing army of outcast women.” Smith reported that her tours of brothels and interviews with prostitutes confirmed this.

Physicians — who at the time shouldered responsibility for patients’ moral as well as physical well-being — had their own concerns. One visited New York’s Coney Island and saw a 16-year-old cyclist get drunk on wine provided by a beautiful but nefarious older woman. “She looked like an innocent child, but was away from home influence,” the doctor reported. Many physicians fretted that pressure from the bicycle seat would teach girls how to masturbate, a practice thought to lead to spiritual and psychological decline. Climbing hills on a bike could excite “feelings hitherto unknown to, and unrealized by, the young girl,” wrote one doctor in 1898. (Boys faced the same danger: pressure on the perineum would call their attention to the area, warned one doctor, “and so lead to a great increase in masturbation in the timid [and] to early sexual indulgence in the more venturous.”)

The bicycle’s peril was medical as well as moral. In the late nineteenth century, many saw physical energy as a finite resource that had to be carefully parceled out, not a power that could be renewed through exercise. The fashionable malaise of neurasthenia was only one of the disorders thought to be caused by a depletion of energies. Overexertion could also cause tuberculosis, scoliosis, hernias, heart disease, and other maladies, doctors believed. Safely sedentary middle-class women, who frequently suffered from varicose veins and other consequences of annual pregnancies, were prone to fatigue; one Boston writer called them “a sex which is born tired,” adding that “society sometimes seems little better than a hospital for invalid women.” Particularly for women in heavy dresses and constricting corsets, any activity that raised the heart rate could seem more likely to be the cause of fainting and listlessness than their remedy. Opponents of the bicycle latched onto this perception, arguing that riding would cost women more effort than they could afford. “The exertion necessary to riding with speed … is productive of an excitation of nervous and physical energy that is anything but beneficial,” Charlotte Smith warned. “If a halt is not called soon, 75 percent of the cyclists will be an army of invalids within the next ten years.”

But even as Smith made her dire predictions, Americans’ fear of cardiovascular exercise was beginning to lift. For decades, health reformers had trumpeted the benefits of fitness, and during the 1880s, the United States saw a spike in organized physical activity. Citizens of America’s growing cities tried new sports such as baseball and football, and exercise advocates built the first public playgrounds and pushed for physical education for both boys and girls. Doctors continued to caution against overexertion, but they acknowledged that, in moderation, fresh air and exercise tended to improve patients’ health. The high-wheel bicycle of the 1880s proved the benefits of regular exercise to those who could ride it; proponents made extravagant claims for the risky machine’s ability to restore well-being. “For constipation, sleeplessness, dyspepsia, and many other ills which flesh is heir to, not to speak of melancholy,─all are curable, or certainly to be improved, by the new remedy, ‘Bicycle,'” wrote a Texas physician in 1883. “It is always an excellent prescription for the convalescents, and nearly always for chronic invalids.”

Not everyone could take the prescription, though. High-wheeled cycling and rigorous team sports were acceptable only for young men. The new games deemed suitable for mixed company, such as lawn tennis and golf, were far less taxing — and therefore far less likely to lead to noticeable improvements in fitness. As for working out on your own, the recommended options were either too costly (horseback riding) or too boring (indoor calisthenics) to gain much popularity. As a result, many more Americans of the 1880s thought they ought to exercise than actually did it. So when the safety bicycle appeared at the end of the decade and Americans began riding in large numbers — an estimated two million by 1896, out of a population of about seventy million — few were certain how such vigorous physical activity would affect them.

Doctors were wary. Most US physicians believed that each patient’s condition was based largely on his or her habits and experiences, the weather, and other environmental factors. Good health was a reflection of proper balance among bodily systems and energies. “A distracted mind could curdle the stomach, a dyspeptic stomach could agitate the mind,” writes the medical historian Charles Rosenberg. It was a doctor’s job to know each patient well enough to restore balance when something was out of whack, using laxatives, diuretics, and other purging drugs to reboot the system. Even contagious diseases could not be treated in a cookie-cutter fashion, argued an 1883 medical journal editorial: “No two instances of typhoid fever, or of any other disease, are precisely alike … No ‘rule of thumb,’ no recourse to a formula-book, will avail for proper treatment even of the typical diseases.” To many doctors, advocating a specific drug to cure a specific disease seemed the height of quackery.

And just as there were no one-size-fits-all medical treatments, many physicians believed there were no one-size-fits-all exercise routines. While cycling enthusiasts rhapsodized about the safety bicycle’s benefits for riders of both sexes and all ages, doctors fretted that many of their patients would be harmed by the new machines. Even seeming success stories were suspect. In an 1895 paper on heart disease, one doctor reported that a patient who had panted for breath after climbing one flight of stairs was now able to cycle up hills with ease. “It would be wrong to conclude from this that cycling is not injurious,” the doctor wrote: there hadn’t yet been time to observe the bicycle’s long-term effects. Moreover, as an unfamiliar activity, cycling tended to catch the blame for pretty much anything bad that happened to a new rider afterward, up to and including death.

Logically, acute injuries were a concern. Though the safety bicycle did greatly reduce the risk of head wounds, it didn’t obliterate that risk, particularly among “scorchers” — thrill-seeking youngsters who hunched over their handlebars and pedaled as fast as they could. “It might seem almost impossible to fracture a skull thick enough to permit indulgence in such practices,” reported the Boston Medical and Surgical Journal, “but the bicycle fool at full speed has been able to accomplish it.” Medical journals also noted the danger of road rash and broken bones.

More insidious than crash injuries, though, were new chronic complaints attributed to cycling. The bent-over posture of the scorcher was thought to cause a permanent hunch called “kyphosis bicyclistarum,” or, familiarly, “cyclist’s stoop.” Repeated stress to the cardiovascular system — that is, regular workouts — could lead to the irregular heartbeats and poor circulation of “bicycle heart.” Gripping the handlebars too tightly might cause finger numbness, or “bicycle hand,” and a dusty ride could trigger “cyclist’s sore throat.” Practically every body part seemed to have its own cycle-related malady; at least one New York doctor devoted his entire practice to treating such ailments.

Of all the physical woes attributed to the bike, the one that most strained credulity was the “bicycle face.” Characterized by wide, wild eyes; a grim set to the mouth; and a migration of facial features toward the center, the disorder was said to result from the stress of incessant balancing. A German philosopher claimed that the condition drained “every vestige of intelligence” from the sufferer’s appearance and rendered children unrecognizable to their own mothers. The bicycle face hung on, too, warned a journalist: “Once fixed upon the countenance, it can never be removed.”

The doctors raising these alarms were careful to state that many of the new diseases affected only cyclists predisposed to them — which would explain why so few of their fellow physicians might have encountered the disorders. “Whilst thousands ride immune, a small percentage will suffer,” wrote one doctor. Another, who blamed cases of appendicitis, inflammatory bowel disease, and the thyroid condition Graves’ disease on excessive riding, said it didn’t matter how many people believed that cycling had improved their health: “It would not affect my argument in the least if swarms of them had been rescued from the grave.”

Nevertheless, the more Americans took to bicycling, the more tenuous these claims of danger came to seem. The machine made physical activity both practical and fun. “The bicycle is inducing multitudes of people to take regular exercise who have long been in need of such exercise, but who could never be induced to take it by any means hitherto devised,” one doctor wrote in Harper’s Weekly in 1896. And all that activity had an effect. Riders quickly noticed improved muscle tone, increased strength, better sleep, and brighter moods. Women, especially, transformed themselves, wrote the novelist Maurice Thompson in 1897: “We have already become accustomed to seeing sunbrowned faces, once sallow and languid, whisk past us at every turn of the street. The magnetism of vivid health has overcome conservative barriers that were impregnable to every other force.”

The empirical evidence of cycling’s health value began to overtake conservative doctors’ concerns, as the rhetoric scholar Sarah Overbaugh Hallenbeck argues. Though many physicians continued to raise objections to the sport, their voices were increasingly drowned out by those of more observant — and pragmatic–practitioners. “The bicycle face, elbow, back, shoulders, neck, eroticism,” wrote one military doctor in 1896, “I pass as not worthy of serious consideration.” Rather than discourage bicycle use, most physicians came to cautiously endorse it. “So long as the cyclist can breathe with the mouth shut,” wrote one such doctor in 1895, “he is certainly perfectly safe.” Some went further, citing evidence of the bike’s benefits for heart patients, migraine sufferers, diabetics, and others with chronic conditions. In Chicago, the demand for injectable morphine dropped as patients with anxiety or insomnia “discovered that a long spin in the fresh air on a cycle induces sweet sleep better than their favorite drug,” the Bulletin of Pharmacy reported.

This shift paralleled a transformation in medical thinking during the 1890s, when American physicians increasingly embraced the scientific method. Some clinics in Continental Europe had adopted this evidence-based approach early in the nineteenth century, using statistics to determine the efficacy of treatments and evaluating patients’ conditions according to universal norms, rather than trying to divine what was normal for each individual patient. In the United States, however, doctors arguing for this approach were long in the minority. According to Rosenberg, the rift between medical traditionalists and empiricists “provided an emotional fault line which marked the profession throughout the last two-thirds of the century.” Only at the very end of the nineteenth century did a research-based, objective philosophy take hold at US medical schools.

It would be folly to suggest that the bicycle alone caused this transformation. Many other factors were at play, such as improved trans-Atlantic communication; an influx of European immigrants, including scientists; and a snowballing of evidence for new medical concepts such as the germ theory of disease. For centuries, Western healers had believed that contagion could erupt spontaneously, but between 1870 and 1900, researchers disproved this theory by isolating the microscopic causes of illnesses including typhoid, tuberculosis, cholera, diphtheria, meningococcal meningitis, plague, and malaria.

But even if the bike did not independently modernize American medicine, its unprecedented impact on fitness — and the clash this revealed between what doctors said and what experience showed — may well have accelerated the shift. Much as the bicycle triggered changes in women’s dress that high-minded advocacy could not, it bolstered scientists’ then-radical argument that what is good for one human body tends to be just as good for another.

To the bicycle faithful of the 1890s, this seemed to be just the beginning of the changes that the machine would bring about. The gulf between social classes would recede under the influence of this “great leveler,” one enthusiast wrote in the Century Magazine: “It puts the poor man on a level with the rich, enabling him to ‘sing the song of the open road’ as freely as the millionaire, and to widen his knowledge by visiting the regions near to or far from his home, observing how other men live.”

And while women may not yet have had full access to higher education ─ or even the right to vote — the unchaperoned, self-propelled bloomer girl seemed to be pedaling in that direction. “In possession of her bicycle, the daughter of the 19th century feels that the declaration of her independence has been proclaimed,” wrote one female journalist, “and, in the fulness of time, all things will be added to complete her happiness and prosperity.”

The first-wave feminist Susan B. Anthony was born in 1820, the year after Charles Willson Peale built his iron draisine. By the time of the safety bicycle boom of the 1890s, she was a snowy-haired eminence, too old to risk riding, but she had an opinion of the sport. “I’ll tell you what I think of bicycling,” she said in an 1896 newspaper interview as she leaned forward to lay a hand on the reporter’s arm. “I think it has done more to emancipate woman than any one thing in the world.”

***

From The Mechanical Horse: How the Bicycle Reshaped American Life. Copyright © 2016 by Margaret Guroff. All rights reserved, with permission of the University of Texas Press.

The Road to Asylum

As dawn arrives, Marfil Estrella looks out the window of the bus that will take her from San Salvador, El Salvador to Guatemala City, Guatemala. Photos by Danielle Villasana.

Alice Driver | Longreads | June 2018 | 21 minutes (5,300 words)

DISPONIBLE EN ESPAÑOL

“I want to finish elementary school.” — Karla Avelar, 40, founder of the Comcavis Trans Association, which advocates for LGBTI rights in El Salvador

* * *

“Women, don’t be deceived,” boomed the weary, yellow-eyed preacher, his sombrero tipped forward with a drama fitting for his bus-ride sermon, one that would last all the way from San Salvador, the capital of El Salvador, to Guatemala City. As he made his way down the aisle of the bus, he stopped to touch women and girls on the head or the arm. “Don’t let men trick you,” he shouted, holding his bible up so high its well-worn pages brushed the roof of the bus. He didn’t touch Marfil Estrella Pérez Méndoza, 26, whose chosen name translates to Ivory Star. As she rested her round, hopeful face on the bus window, dark eyes peering out into the rainy grayness of early morning, the preacher passed by without laying a hand. “How do you say asylum in English?” she whispered.

Marfil Estrella was born in Cuscatlán, El Salvador, in a body that never felt like her own. She was assigned male at birth, and at 15, she came out as gay to her family. Their response was to disown her. “They told me that I brought shame on the family, that I should forget about them, and that I needed to leave,” explained Marfil Estrella. Like many members of the LGBTI community in El Salvador, her family forced her onto the street, and her schooling ended abruptly at ninth grade because she had no money to continue. She fled to San Salvador and slept in a park where she met other gay boys. “I saw a transsexual, and I said, ‘I want to be like her! I want to be like her!’” she recalled. She lived on the street, grew out her hair, and began to dress in women’s clothes, but she had no way to earn a living and consequently became very thin. Eventually she started to do sex work, one of the only options available to trans women in El Salvador to earn money. Read more…

Making Peace with Selective Reduction

Getty / Photo illustration by Katie Kosma

Amber Leventry | Longreads | June 2018 | 11 minutes (2,805 words)

 

December, 2012. I shifted my gaze to my partner and away from the snow hitting the windshield of our SUV, coming at us fast and dizzying like those moving star screen savers we used on our desktops in college.

My partner was asleep in the passenger’s seat. Hours earlier, her pregnant belly had been home to three living fetuses. It now held two beating hearts and one that had stopped after being pierced with a needle full of potassium chloride.

My knuckles were white from gripping the steering wheel. I took a sip of my Diet Coke and ate a cheddar-filled pretzel Combo. Even with a snowstorm hitting the East Coast, we left right after the procedure. We didn’t want to stay another night in Boston, three hours from home and too far away from our 20-month-old daughter, who was in the care of friends. We knew we were driving right into the heart of the storm, but our journey had never been easy, and it seemed fitting to be pursuing comfort in difficult conditions.

***

November, 2012. “Are you religious?” the doctor asked as we stared at the flat-screen television mounted to the wall.

Two weeks after undergoing intrauterine insemination (IUI), Amy took a home pregnancy test and it was positive. At seven weeks we went back to the fertility clinic to have our first ultrasound.

The black-and-white picture on the screen was a projected image of my partner’s uterus. Joined by two nurses, the OB-GYN checked that there wasn’t a fourth fetus in my partner’s belly. He maneuvered the ultrasound wand with one hand and labeled the image with the other. I watched him manipulate the machine, looking for life as if he were playing hide-and-seek. He found three. My partner was pregnant with triplets.

I grew up in a Christian church, under the eyes of God and in a congregation full of hypocrites. My partner went to Hebrew school and was raised on Jewish traditions and family poker games.

“No,” we both answered. He seemed strangely relieved.

Before I could ask why he cared, he wanted to know if we knew the term selective reduction. We didn’t. He suggested we make an appointment to return and talk with him about our options. Unless religious reasons prohibited us from considering it, he wanted to provide the pros and cons of aborting one or two of the healthy fetuses.

While we don’t practice religion, it has hugely impacted our life together. Religion was the reason my mother chose not to come to our 2001 civil union ceremony in Vermont. When we were still just girlfriends, college students living together illegally in an off-campus condo, my partner and I used to tell each other, “I’m going to marry you someday.”

In 1999, we were still in college and knew the post-graduation ceremony we wanted to have would only be valid in the eyes of friends and some family. We knew the only ones who would consider our love sacred would be us. Homosexuality was against my mother’s beliefs. She loved me but wouldn’t support my “mockery” of marriage.

Religion was what slowed the momentum behind states beginning to recognize gay unions, and religion was why marriage still hadn’t been recognized by the federal government.

Religion was something used to limit us and our ability to be respected and considered equal as queer individuals and as a same-sex couple. Religion was not a sounding board my partner and I used to make decisions.

When the doctor seemed happy that faith did not prevent us from thinking about the next steps, religion was no longer a limiting factor in our lives. Our lack of religion was suddenly opening up our options as a couple.

Read more…

Nurses, Unite!

Getty, Illustration by Katie Kosma

Livia Gershon | Longreads | June 2018 | 9 minutes (2,201 words)

Kate Phillips, a nurse who works in the intensive care unit at The Johns Hopkins Hospital, in Baltimore, is part of a group trying to form a union. “Every nurse here has talked about times where he or she felt unsafe because there was not enough staffing, not enough equipment, or medicines came late because there were not enough pharmacy techs,” she told The Sun. The administration, she went on, “can basically make all the decisions and they don’t look at things from the perspective of patient care like we do.” This past January in Virginia, Patty Nelson, a psychiatric nurse who is the chapter chair of her local union, called on the state’s general assembly to expand Medicaid as soon as possible, citing clients with mental illness and addiction who can’t get the treatment they need. And the California Nurses Association (CNA), the largest union of nurses in that state, has emerged as a champion of a single-payer health care system, fighting their way to their capitol. “We understand that these legislators are not going to do this on their own,” Bonnie Castillo, a registered nurse and executive director of the union, told California Healthline, a health care news site. “It’s going to take a movement of their constituents, nurses and other health care professionals. Legislators are going to need an intense amount of pressure, and that’s what we’re doing: We’re knocking on every door, we’re meeting and organizing.”

Nursing work, like most other health care jobs, is growing fast: the Bureau of Labor Statistics projects that the United States will add 438,100 jobs in registered nursing by 2026. Their strength in numbers has also brought organizing power: while most of the labor movement has declined in the face of pressure from unfavorable laws and moneyed opposition, in the past decade, nurses’ unionization rates have been gaining momentum, with tens of thousands more members.

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The Power in Knowing: Black Women, HIV, and the Realities of Safe Sex

Illustration by Janna Morton

Minda Honey | Longreads | June 2018 | 11 minutes (2,763 words)

 

In December, when a creative agency asked me to participate in a regional Volunteers of America public service announcement encouraging my fellow community members to “know your status,” I said yes. A hesitant yes, but a yes. At least once a year, I make it a point to enlighten myself by asking my gynecologist for a full screening for sexually transmitted infections, including an HIV test. But I’m more of a safe sex bronze medalist than an all-star. My 17-year track record of requiring men to wear condoms during intercourse is only nearly flawless, my trysts with unsafe sex more recent than I’d like to admit.

A retrospective on my vagina’s contact with bare penis: When I lost my virginity — It was over and done with before I could utter any questions about using protection. There was time the condom slipped off — it happens. Or at least it did that one time. In an encounter with that same man, who I’d casually been sleeping with for a long stretch, he sweet-talked me into letting him take the condom off mid-act. I want to feel you, he’d said — I’d felt terrible afterward. I knew better than to trust these hoes with my sexual health. There was the spontaneous Halloween makeup sex in the back of a minivan with a guy I was kinda in a relationship with. Immediately after, he accused me of trying to get knocked up because I’d always been so vigilant about condom use, nevermind that a jobless, carless rapper living with his brother’s girlfriend’s parents isn’t my ideal baby daddy material. There was the man I was seeing who made a fuss about it every single time, whining he couldn’t come with one on, so half-asleep, I finally just let it happen sans condom. Shortly after, I learned he’d been cheating on me. And, I assume, he’d been doing the same sort of whining in the other woman’s bed, being sexually reckless with us both.

And, more recently, when after a 12-hour stretch of drinking, I fell into bed with a man and nodded when he asked if it was OK, even though I knew I wasn’t OK with going without a condom. Every time we hooked up after that first time, I felt weird about insisting he wear one, so I didn’t ask him to. Even though changing your mind is totally allowed and asking can be so simple and I’m sure he would have complied, it just felt complicated in ways that feel dumb now. This lapse in judgement happened to overlap with my period deciding to be six weeks late and my new gyno calling to tell me my IUD might have shifted and might not be effective. After two intravaginal ultrasounds (and a negative pregnancy test) it was determined that, LOL, my IUD was actually where it was supposed to be all along.

I worried that doing the PSA would make me a hypocrite. Who was I to encourage others to engage in safe sex when there were times I hadn’t? I reasoned with myself that I’d read enough inspirational quotes on Instagram to know my humanity wasn’t a byproduct of my perfection but rather of my mistakes. So I decided to do the shoot anyway, because I was someone who knew what it was like to be so distracted worrying about the possible long-term consequences of my split-second decision not to require a condom that I couldn’t even enjoy the act itself. I was someone who’d felt bashful about asking to be tested because heaven forbid the medical professional I pay to look after my reproductive health, and who I was required to see once a year to re-up on my birth control pill prescription, know that I, an adult woman, was having sex outside of a monogamous marriage for purposes other than conceiving a child. I was someone who was tired of always being the enforcer in the bedroom. It made me feel like a finger-wagging mom-type: “Eat your Wheaties, do your homework, wrap it up!”

Read more…