this ain't livin'

On Organs | 29Feb08

I’ve been following the story of a surgeon accused of basically killing a patient to harvest his organs with some interest. If you haven’t heard anything about the case, the New York Times has a decent article on it. Basically, the surgeon made some…interesting medical decisions which appear to have been designed to hasten the death of a disabled patient, after discussion about harvesting his organs for a cardiac death transplant (most transplants in the United States are performed after brain death, but cardiac death transplants are possible). It was clear that the patient was going to die anyway, so his ventilator was removed, with consent from his mother, and when he didn’t die immediately, drugs were prescribed. Depending on how you view the case, the drugs were given for comfort, or to try to speed the patient’s death. Either way, he still didn’t die immediately, and his organs turned out to be useless for donation.

This case intrigues me on a number of levels. For one thing, the surgeon hasn’t been convicted yet, so information may come out in the trial to justify his actions. Given that I’m not a medical professional, I am obviously not qualified to comment on the patient’s treatment. But it does raise the specter which organ transplant advocacy organizations have been fighting for years: the idea that people could be killed for their organs. Or simply that surgeons could be a bit, er, hasty.

I’m not surprised that this case is getting a lot of press, since it’s such an easy thing to write a story about. It’s kind of unfortunate, though, because I think it may scare some people off, making them decide they don’t want to donate their organs for fear of a case just like this. And that’s unfortunate, because I think that the bulk of organ harvests in the United States are perfectly legal and well within ethical guidelines. And organizations which promote organ donation here are probably incredibly frustrated that this case has become so high-profile.

The “donated” organs coming from China which have been linked with executed prisoners are far more sketchy, and should be a cause for serious concern, rather than an isolated and as-yet unproved accusation here in the US. And maybe people wouldn’t be turning to a very shady source for organs if we had a more organized donation system in the United States, say an “opt-out” system like they have in many countries. In an opt-out system, it is assumed that everyone consents to organ donation, and people must specifically request that they not be considered for donation if they are opposed to it.

I’m a fan of opt-out systems because I think that a lot of people would be perfectly ok with having their organs donated, but they haven’t explicitly stated that, and as a result their organs go to waste when they die. And these systems greatly increase the supply of organs, making it possible for more people to get them, and I happen to think that this is a good thing. For people who don’t want to donate, it’s generally easy to opt-out.
We aren’t allowed to sell our organs here in the United States, which I think is probably a good thing. We are allowed to freely give them to each other, bypassing transplant queues, which I think is also a good thing. But I think we could avoid awful cases like this one if we made organ donation a mainstream, assumed thing, like vaccinations. And maybe transplant surgeons wouldn’t be faced with situations like this if they knew that the organs their patients need were readily available.

I am curious to see how this case impacts the rate of organ donation in the United States; maybe there will be a decrease, maybe not. If we don’t notice a decline in confidence about organ donation, it will be a testimony to years of patient education on the part of donation advocates.

Reader Poll For Science | 19Feb08

(This photo was taken by Julie, who kindly uploaded it to her Flickr set and licensed it with Creative Commons. I like sharing! And here’s her blog.)

Readers, I have a pressing and urgent question for you.

I was reading recently that some people do not generate stinky pee when they eat asparagus, or perhaps they are lacking the receptors in their noses to realize that they are generating stinky pee. So I’m putting the question to you: what happens when you eat asparagus and you pee?

I have no idea if my nifty poll will show up in RSS or not, but I guess I’ll find out. Feel free to add comments, especially if you are in the medical community and you can bring your knowledge to bear on this pressing issue. If you “don’t eat asparagus,” start, because it’s one of the most perfect and wonderful vegetables on the Earth.

Office | 15Jan08

“You don’t look like you’ve had a lot of dental attention,” he said, tapping one of my molars.

“Yrrch,” I agreed, drooling slightly and wondering if anyone had ever bitten him by accident.

“I’m going to need a peri probe over here,” he muttered.

“Ergh?”

After a bit of poking and prodding which included being gouged in the gums with what felt like a toothpick, he pulled his hands out of my mouth. I’m not really sure what the etiquette is here, I mean do I leave my eyes open and gaze blankly at the ceiling, or do I close them demurely while the dentist plunges around in my mouth? And why do dentists talk to you when you can’t respond?

“Well, I don’t see any problems.”

That’s right, kids, apparently when you don’t go to the dentist for a decade…nothing happens. But seriously. I still think regular dental care is a good idea, and I’m really pleased that nothing is going on in my mouth that shouldn’t be. I also appreciated the fact that the dentist didn’t harass me at all for not going for over a decade. The dentist recommended a cleaning, and he seemed slightly astounded that I didn’t have suppurating ulcers in my mouth or something, but apparently my teeth are a-ok. My father, of course, pointed out that his teeth didn’t bother him until he was 40 when I smugly called him with the news, implying that the best is yet to come.

Not so pleased with the state of dental x-ray technology, however. I feel like x-rays weren’t very pleasant when I was a kid, but perhaps the dentistry industry might have developed, you know, a better system. Apparently that is not the case. The dental assistant took 18 films of my teeth, and I gagged and drooled through pretty much the entire process. Apparently I’m the worst patient she’s ever had; I heard her say it in the hall. I think she might have said that because she thought I was going to vomit during film 17, though. Which I would like to argue was not my fault, since my tongue was trapped under an incredibly sharp piece of x-ray film and I had snot pouring down the back of my throat and I was drooling, and I defy you to not at least gag when that happens.

I would recommend that the American Dental Association consider investing in some research and development to create smaller, padded x-ray films. My mouth feels like it’s been sliced apart by a rabid sushi chef.

Break On Through | 08Jan08

Yesterday afternoon, I picked up the phone to make a great personal sacrifice. It’s something that I have been battling for quite some time, and it took immense introspection to finally break down and do it. These kinds of things are such personal decisions that I greatly appreciate the fact that no one pressured me into this sacrifice, or even harassed me. I simply woke up and decided that it needed to happen. Well, actually I woke up last Friday and decided it needed to happen, but there was no power, so that kind of screwed the pooch.

“Hello,” said the chipper receptionist on the other end of the phone. “This is Dr. Carney’s office, how may I help you?”

“Er, yes,” I said. “I, uhm, need to make an appointment? For a dental checkup?”

“Ok, I’d be happy to do that for you,” she said. “Are you a regular patient?”

“Uhm, no, I’m a…new patient?”

“Ok, great,” she said. “We love new patients! Are you having a particular problem you wanted to talk to the doctor about?”

“No, I just haven’t been to the dentist in over a decade, so I thought it was probably time. I know it’s silly, but I really am terrified of dentists. But I know I should forestall any problems before they start.”

This was the point where I expected a long and awkward silence. Followed by being berated for not going to the dentist.

“No problem,” she said cheerfully, without missing a beat. “I’m got an appointment on the 15th, does that sound ok for you?”

I can’t really explain why I haven’t been to the dentist in over 10 years. I understand intellectually that going to the dentist is very important. That dental problems, in addition to being painful, can also cause other health problems. And I also know that the earlier you catch them, the less expensive they are. I can’t even really use lack of insurance as an excuse at this point, because I can well afford the exam fee (and if I couldn’t, I’ll bet my father would pay for it).

I really am just afraid of dentists. I don’t trust them, and I don’t like them. I think all of this stems from a dental experience which went very, very wrong when I was a child. It ultimately required the services of another dentist, who was perfectly nice and gentle but by then it was too late. I kind of feel bad for dentists, because they really do have an undeserved bad rep.

I’m sure that Dr. Carney will be perfectly nice (he’s my father’s dentist, which is why I chose him), and I doubt that he will give me too much grief about allowing over 10 years to elapse between dental appointments, because he’ll be happy I’m getting dental services now. Although he will probably have a comment about my oral piercing, which raises a brief period of debate for me; so I take it out, so that it’s not the first thing he sees? Or do I leave it in? It’s not the kind of thing I would lie about; if I took it out, I would tell him about it, since I think it’s relevant to my dental care, but I also don’t want to get into an ideological argument about whether or not piercings are harmful to the teeth. If I have any skulking dentists reading this, I would appreciate input.

I did draw the line at a tooth cleaning, though; the receptionist gently suggested it and I said I’d stick with a checkup, and again to her credit, she didn’t push it at all. In fact, she was very sweet and totally cool, and that was greatly appreciated. I imagine receptionists for dental offices are carefully chosen because of the intense burden of stigma which dentists bear.

I’m not sure what’s going to happen at my dental appointment. To my knowledge, I don’t have any dental problems, so I’m going to be a bit skeptical if the need for fillings and so forth is pronounced. I imagine that those of us who profess a knuckle-whitening fear of dentists get little notes on our files to encourage the doctor to go gently, in which case perhaps he will ease into things rather than pronouncing my mouth a total mess. My father (who does have a total mess going on in his mouth) says that he’s a good dentist who is generally helpful and informative; I guess I’ll find out.

I view my decision to finally go to the dentist as being akin to kicking a major habit. (Although obviously the psychological agony of, say, quitting smoking is far worse than the tension I experienced when I picked up the phone to call the dentist’s office.) It really is the kind of thing that someone needs to come to on their own; I am well aware of the consequences of lackadaisical dental care, so I have no excuse for not going beyond my own fear and mental block, and I finally overcame that.

Now I have a whole week to fret about what’s going to happen. Rest assured, gentle readers, I will report back on the grisly details of my dental experience, complete with x-rays if there’s anything really awesome going on inside my mouth.

Stigma | 19Dec07

“It’s a junky’s disease,” they say carelessly. “People only get it from sharing dirty needles and being degenerate low-lifes.”

It’s funny to hear the people things say out of ignorance, and out of misconception. It’s not so funny when these thoughtless comments are stupid, wrong, and hurtful, and you feel an uneasy need to speak up but you don’t want to be the one to do it. Ignorance may be bliss, but it can also be amazingly, horrifyingly cruel, and even after the ignorant have been educated, the hurt still lingers.

Nowhere is this more true, for me, than in the realm of bloodborne diseases. Did you know that you can only get AIDS if you are gay? That Hepatitis C only strikes junkies? That if you’re sexually promiscuous, you could get Lassa fever? If you get a tattoo, you’re just asking for Marburg? Because I didn’t, but according to popular opinion, all of these things are true. According to popular opinion, none of the following is a potential vector for bloodborne disease transmission: needlestick incidents at hospitals, being bitten by a drunk while on duty as a police officer, tainted blood donations, giving CPR to a bleeding accident victim without protection, being born to a mother infected with a bloodborne disease, working on an ambulance and having a patient vomit blood on you, being exposed to infectious materials in the course of your work, or a malicious and willful effort by an infected individual.

The thing is, to get a bloodborne disease, apparently, you need to be asking for it. Because people who don’t ask for it obviously don’t get bloodborne diseases. Bad things never happen to good people, and this, therefore, gives you carte blanche to make blanket statements about things you don’t know anything about. And Pete forbid that people should educate you about risk factors so that you can make informed decisions (and statements). It’s far better to keep people in a state of utter confusion and fear, rather than being up-front about things.

Do some choices increase your risk of getting a blood-borne disease? Sure thing. Being a nurse is a great risk factor. So is being a doctor, a police officer, or a paramedic. Oh, and unprotected sex is a great way to get some bloodborne pathogens, especially AIDS. Sharing dirty needles probably isn’t such a good call, and neither is getting a tattoo at a dirty shop. But there are risk factors for everything, and bloodborne pathogens have multiple vectors for transmission, which means that you can’t make sweeping statements about the lifestyles of people who have them. And when you do, you sound stupid. And given that people you know are probably infected with the diseases you’re spouting off about, it’s fair to say that you’re also hurting someone with your stupidity.

We live in a society where people with bloodborne illnesses have been taught to conceal it, to live underground, to not say anything about it because they will be met with social stigma. When every disclosure of your disease status is met with horror and disgust, except among those who share it, you tend to be closemouthed about it. 200 million people worldwide have Hepatitis C; around 2% of Americans do, according to the CDC. 30 million people have AIDS. Are the people who make dismissive comments about these viruses really so sure that they know everything about the people who have them? Do people seriously still believe that only gay men get AIDS? That junkies are the only ones who get Hep C?

Periodically this issue just inflames me with irritation; you can see the post Ostracism for more on this subject, for example. I note that I wrote that last December, so maybe it’s something about the end of the year that gets me seething when it comes to bloodborne pathogens. But I’m tired of listening to people make uninformed statements. I’m tired of people who make sweeping claims about things without a shred of evidence. I’m tired of people who tell me that they vote the way they do because someone else tells them to. I’m tired of people who mindlessly parrot the things they are told, rather than questing for verification. I’m tired of the complete lack of initiative and imagination in this country.

I’ve been told before that I am an intellectual elitist, and maybe I am. I don’t have much of a tolerance for stupidity, that’s for sure, and I don’t have much sympathy for people who can’t take the time to educate themselves. But I also think that idiocy isn’t always the fault of the idiot, especially when so many sources of information are so very wrong. Is it an idiot’s fault when he or she only gets information from people who are not allowed to disclose the whole story, as is the case with sexual education in the United States? Is it the fault of an idiot that he or she is scared into thinking something by an authority figure? Maybe it’s the intellectual elitist’s fault for complaining about the idiot, but not offering up some new sources of information.

For me, symptoms of irritation tend to emerge as a result of exposure to idiots. Alas, an idiot allergy is a difficult thing to manage; like those who are allergic to nuts, I could just avoid idiots, I suppose, but it’s harder than you think. You never know when idiots might be baked into the crust of a seemingly innocuous pie, or when idiot oil is used to fry your food. Fortunately, one exposure won’t kill me, but sometimes it feels that way.

Maybe it’s time to get more aggressive about idiot education. I’m tempted to do a series here on bloodborne diseases, except that I hope that all of you, gentle readers, are not idiots. But maybe I’ll do it anyway: what do you think?

Recognition | 13Dec07

I was at the post office the other day, in line to pick up a package, and I saw someone who looked vaguely familiar, but whom I couldn’t identify. This happens a lot; it’s a small town, you see people around, you read stories about them in the paper, and so forth. But this person…it was nagging at me. She saw me, nodded, and smiled, and I smiled back and said “hello,” while I tried to parse who she was.

Just then, my clerk came back with my package, and I thanked her and left, still trying to figure out who it was that I had talked to in line. As I departed, I noticed that she looked kind of puzzled…

…and later I realized it was my landlord’s partner, who had actually dropped by the night before to address the Great Heater Situation of 2007*.

I’ve noticed that this has been happening to me a lot recently, even with my relatively new glasses. I was going to write a witty entry today about my apparent inability to recognize faces, and the brilliant scheme my friend A and I came up with, of putting facial recognition software in my glasses so that I could identify people, and then I did a bit of research and learned about prosopagnosia.

As in, face blindness. This is not to say that I have face blindness; a lot of the articles I was reading were talking about parents who couldn’t recognize their children after they changed clothes, or people who had difficulty recognizing siblings. I don’t think that my facial recognition skills are quite that bad.

I do have a lot of trouble recognizing faces, though, even faces that I see on a regular basis, and when I took some of the screening tests which are primarily meant to stimulate thought about the issue, rather than diagnose it, I was surprised to learn that I am actually really, really bad at recognizing faces. My scores weren’t dismal, but they were pretty darn low, and it was kind of interesting. The face recognition tests I took are pretty neat; if you have 15 minutes or so, you should take them, just for kicks.

I noticed several interesting things when I took the tests, other than my obvious difficulty with learning faces. The first was that in a test which asked me to memorize names, I scored 100%, which I think really illustrates how verbal I am. In a test where I was asked to name celebrities, I got most of the people wrong…unless they were politicians. (Although I did confuse Margaret Thatcher with Camilla, Duchess of Wales. I don’t want to talk about it.) So apparently if you are a politician or I see your name written down, I will remember you.

Prosopagnosia isn’t an inability to see faces, it’s just an inability to parse them. It’s kind of hard to explain, I think, because everyone assumes that they “see” faces the same way, when this is not, in fact, true. People with this condition tend to use other cues to recognize people, and when I started thinking about it, so do I. I recognize a friend of mine by the distinctive hat that he wears; he could probably pass right in front of me without wearing it and I might not parse who he was unless I recognized one of his unique ties. I tend to catalog people by gait, common accessories, car, hair cut, favorite shirt. I am often teased, in fact, for my inability to recognize people, and I’ve also been called cold, rude, or bitchy on occasion as well for failing to acknowledge someone.

It’s also a bitch for me to follow movies, because I have trouble identifying the characters, which I had assumed was relatively common for everyone, but apparently its not. I often confuse characters, which can lead to a state of extreme perplexity and questions like “wait, didn’t she just die?”

Apparently, prosopagnosia is often caused by brain damage, although there is also a genetic component. Since I haven’t been dropped on my head at any point and my father doesn’t have trouble recognizing people, I still don’t think I have it, or if I do, I have a mild case. But it would explain a lot of my social awkwardness, and it explains why people often think I’m being rude; it’s not that I intend to ignore someone or snub them, I just have no idea who they are. Just out of curiosity, I filled out their contact information form; we’ll see if I hear back or not.

It’s interesting that I can start out doing research for what I think is going to be a humorous post, and I end up suspecting that I may have an obscure neurological condition. Or maybe not so obscure; it is believed that around 2% of Americans have face blindness. Given that there’s no real treatment for it, it’s not as though there would be meaningful changes in my life if I found out that I do have it (although I might call my landlord’s partner and excuse my apparent rudeness with a neurological complaint. In fact, I might do that anyway. I don’t think they read my website, so I’m safe. Maybe I should say I have a tumor. I wonder if I’d get a break on the rent if I had a tumor? But what if tumors are a self-fulfilling prophecy, and because I said I had one, I got one? Then I’d be screwed.)

Or maybe I’m just a hypochondriac who needs new glasses. Again. That’s the thing about glasses, you know.

*In brief summation: when they installed gas this summer, my landlord asked if I wanted a heater. I wanted to be all tough-guy, so I said I didn’t think I needed one. Then it started getting cold, and I started whining to Tristan about how cold it is. Tristan, reasonably, said that I should stop whining to him and ask my landlord for a damn heater. I continued whining, until finally it got insanely cold, and I asked for a heater. End of story. Bet you wish you hadn’t followed that footnote now, sucker!

World AIDS Day | 01Dec07

33 million people around the world have AIDS, according to a United Nations estimate.

Needless to say, that’s a lot of people, and it’s depressing to think that most AIDS medications are very expensive. Most people in the West view AIDS as an irritating chronic illness now, since it can often be managed with drug cocktails. But in developing countries, AIDS is a death sentence, and despite the best efforts of health organizations, the infection rate is on the rise. Not just in places like Africa and Asia, but here in the West. We’ve come a long way from the scared early ’90s now, and maybe that’s not a good thing.

In the West, it’s on the rise because people view it as a manageable condition. Because people don’t view it as the bogeyman anymore, and because of certain subcultures which sadly cultivate a lack of responsibility about STIs and disclosure of disease status. I am not usually one to pass judgment on subcultures, but I do take exception to the idea that it’s ok to infect other people with AIDS, or to the concept that people who cheat on their partners are magically immune to STIs.

In other parts of the world, AIDS infection rates rise because there is not enough education, because women are afraid to protect themselves, because of cultural values which reject transparency and basic steps to prevent STI infection, like the use of condoms. Because governments deny the fact that AIDS exists and that it needs to be dealt with.

At least many Westerners have access to expensive drugs and state of the art treatment. Victims of AIDS in Africa aren’t that lucky, and many of them leave orphans behind. In places like China where the truth of AIDS is ignored, AIDS patients can be lucky to get any sort of treatment.

The crushing reality of this disease can seem insurmountable. As individuals, it may seem like there’s not much we can do. But we can get tested on a regular basis, and we can encourage disclosure of infection status with AIDS and other STIs. If we are open about things, shame and stigma tend to be less problematic. The response to “I have an STI” shouldn’t be shock or horror, it should be “ah.” Perhaps if people weren’t afraid to be frank, transmission in illicit subcultures wouldn’t be such a problem.

We can also be smart about protecting ourselves, and encouraging others to do the same.

I don’t know what to do for the developing world. There are a lot of events and conferences going on today worldwide to talk about this very issue, and I just don’t know enough about medicine and about other cultures and their governments to come up with a solution to a problem which other people obviously haven’t been about to solve. I would hate to think that there is no solution, and maybe that’s why I keep trying.

One Shot | 17Sep07

Health care appears to be entering the focus this week, with several candidates announcing various versions of plans while others tear them apart almost as quickly. I’m glad to see candidates waking up to the fact that health care is a major issue in this country, but I am very, very, disappointed by all of the plans so far. None of these plans seem to accept the fact that this is our one shot at health care reform; if it goes wrong, we don’t get a second try.

What we need, and what people are asking for, is a “socialist European style” system, as a Republican candidate put it earlier today. What we do not need is a plan which still relies on a system of private insurers to provide care. I don’t quite understand why no candidate seems capable to recognize this. Private insurance should not be part of the solution to American health care. Period. The Democrats are going on about “health care for all,” but they are not providing the framework to make that a realistic possibility, they’re providing the framework to completely fuck up the health care system.

Socialized healthcare works because of the lack of private insurance. This is because a set of standardized prices and plans can be created by the government, with doctors being rewarded for good work and health care being paid for entirely through public funds. It is a cost effective system, focusing on preventative and holistic care; a national health system will cost us much less than any of the hybrid systems being proposed. If you want care which is not covered in a national system, you can pay for it, or purchase supplemental insurance, but insurance is not the hinge of the plan; it’s a fringe option. This a big difference, because the government has a vested interest in keeping costs low and quality high, while private insurance does not. A national health system is what we need, and anyone who says otherwise is foolish.

I really loathe these plans talking about “requiring” health care like most states require car insurance. This is insane. I look at my budget, for example; I cannot afford the additional expense of carrying a health care policy, even with government help, and I wouldn’t qualify for free health care under these plans, because I make too much money. I’ll bet that a lot of people are in the same position I’m in, actually. Now, if the massive amount of funds I was sending to the IRS every year were going into healthcare, I’d be set. But they’re not. I pay thousands of dollars in taxes to fund the war, and that ensures that every spare penny I make goes directly into a savings account for the IRS to feast on in April. Under a national health system, my tax money could be used efficiently to provide me with health care.

I do not want to see a halfhearted attempt at a socialist healthcare system, since it will be doomed to fail. And that means that any future attempts will be roundly rejected, with people saying “well, look what happened last time.” This is it, my friends. This is our chance to totally reform the American health care system, which is entirely broken. It’s not about “fixing the broken bits,” it’s about tearing it apart and completely rethinking the way in which we operate.

The Democrats really need to stop being such whiny little pussies.

Into the Future | 15Sep07

The Times today has an article about women who are choosing preventative mastectomies out of fear of breast cancer. The article is a bit of manipulative, somewhat clumsy journalism, rife with pathos, but it did get me thinking about genetics and genetic testing, which are beginning to be more accessible in the United States. Many people seem to feel like genetic testing is an important weapon in the war against cancer, and maybe they’re right. But I found the article rather difficult to read seriously, because the contents were so far abstracted from my reality.

Ultimately, this article was about a dilemma for the rich, or at least the middle class; I, for example, could never afford genetic testing. If I somehow scraped together the funds, I wouldn’t be able to afford to take any action on it, let alone an extremely expensive surgical procedure like a mastectomy. In fact, like many American women, if I was diagnosed with breast cancer, my best hope would be to die quickly, because I could not afford even the most basic of treatment. For all of you who oppose universal healthcare: scroll down for a picture of untreated breast cancer.

The paper makes a reference to the “DNA age,” but I think it’s just another example of the growing gap between rich and poor. Wealthy people can afford extensive genetic testing, and when gene therapy and high tech solutions become available, these will be within reach as well. But the vast majority of us don’t need to agonize over whether or not to get genetic testing, because it’s not even an option.

In a way, genetic testing feels like fortunetelling, to me. A form of looking into an uncertain future; does looking into the future influence the outcome?

Genetic testing seems to have become pretty standard for expecting mothers, as well, which I think is very interesting and somewhat terrifying. Surely, such testing is only prudent, ensuring that the baby is healthy and making note of any conditions which may complicate the pregnancy, right? But what happens when the baby isn’t healthy? Are we unwittingly entering an age of eugenics? I am beginning to fear that we are, when I see “termination” recommended for abnormal prenatal tests. Are there cases when this may be a more humane and sensible solution? Most assuredly, I think, when it is clear that the infant would have lived a brief and tormented life. But should we encourage abortion for children with Trisomy 21? Trisomy 13? Many people with these conditions go on to live healthy, happy lives despite their disabilities; should we really be denying them that chance?

On the one hand, people with genetic defects may incur substantial medical bills over the course of their lives, or require serious intensive care. That’s a huge commitment to ask for, even from people who are already willing to be parents. A severely disabled kid can really change your life, I know; but isn’t that a risk you take every time you decide to have unprotected sex? Are people only interested in parenting perfect, whole children? I’ve really been struggling with this lately.

It feels odd to be arguing against abortion, since I am an ardent supporter of the right to choose, but I think that aborting because your baby could be abnormal is a bad reason, and I’m not sure I support it. I realize that this sets me up for attack from some members of the feminist community, who seem to think that there is never a gray area or a middle ground, we need to be all for one or fail. One person’s abnormality may be another person’s normality, and I feel like it sets us up for a truly eugenic society, where people abort children for more trivial reasons. Hell, they already do, when multiple embryos are implanted and then “culled” once they take. This is done, of course, to ensure that at least one embryo does take, and I understand the rationale, although I am extremely opposed to fertility treatment for a variety of reasons which I may discuss at some other point. Will blonde hair someday become a genetic defect? Will parents abort embryos which won’t develop into smart people? Infants who are predisposed to obesity? Will we find ourselves engineering the future? And, if we do, where will it lead us?

On Accessibility | 13Sep07

The New York Times had an interesting article yesterday talking about the issue of accessibility for disabled diners. Accessibility issues have always been a topic of interest for me, so I was intrigued to see an article on restaurant access featured in the Times. One of the things they talked about was that many restaurants obey with the letter of the law, but not the spirit; setting up a wheelchair lift which opens out onto a dark corner of the kitchen, for example. With more and more disabled people in the American community, I think this is going to be a growing issue.

So, what’s with all the disabled folks anyway?

Well, I think that a couple of things are going on. The first is that we have a large and rapidly aging generation which is enjoying huge developments in health research, and therefore living longer. Some of these people, however, are finding themselves using wheelchairs, walkers and other mobility devices. This problem is only going to get bigger, not smaller; the glut of babies born around the Second World War is starting to get old. Fast. And some of these people have an attitude of entitlement which is going to make them challenging to deal with when their needs are not met. It’s only going to get worse when self important yuppies from the 1990s and 2000s get old.

In addition, general advances in medical science are allowing people to recover from formerly fatal accidents and incidents, like, oh, having your Humvee blown up by an IED. And, of course, people born with serious disabilities are being saved, rather than discarded like chaff. People who might have otherwise died find themselves living, often experiencing fruitful, excellent lives despite the fact that numerous businesses don’t comply with the Americans With Disabilities Act.

I know that for some businesses, it’s a tough call, especially for small companies which can’t afford to make major retrofits. However, small steps can make your business more welcoming, and as one of my sometimes wheelchair bound friends says: handicapped people vote with their pocketbooks, just like everyone else. They will take their business elsewhere if you don’t serve them, and as their ranks grow, they’re going to get more vocal about it. It’s going to be good business to make your establishment wheelchair friendly; not just to install ramps and elevators and ADA compliant doors, but to be genuinely welcoming to people with unique needs.

Imagine how frustrating it would be to know that you can’t visit half of the businesses in your home town. How irritating it is to call ahead every time you make restaurant reservations, to check and see whether or not you can even get into the dining room. To get to the restaurant and find out that the elevator is broken, or that the person who took the reservation flat out lied, or didn’t bother to check for you. When every expedition requires extensive planning because you know you can’t cross the street at a certain point. And how very humiliating it is to be turned away from an establishment, to have your companions get angry on your behalf.

Different people in the disabled community have different takes on how issues like accessibility should be dealt with. Some, for example, are vehemently against legislation, because they believe that the free market would ultimately sort the problem out. This is certainly a valid point, and it may to some extent be true, but I am supportive of legislation. I am also supportive of common decency and kindness, of going out of your way to please clients and customers to keep them coming back again. And of treating disabled people equally; a restaurant wouldn’t pile mops at the top of a public staircase, now would it?