Tag Archives: Health Care

Machismo and mortality

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My piece today at the Good Men Project: Men with ‘Macho’ Attitudes Die Early.

Excerpt:

In just a few months, I will have outlived my father’s father. That’s a haunting thought, especially as I have a very young daughter. Heloise is only 2; my wife and I took a long sweet time to become parents. If I am to see my little girl grow middle-aged, I am keenly aware I need to make different decisions than my father and grandfathers made before me. I can’t prevent every accident, of course, and even the most careful attention to diet, exercise, and doctor visits isn’t a perfect prophylaxis against untimely death. All any of us can do is improve our odds. And improving those odds means letting go of the foolish masculine ideal that demands we treat our bodies as if they were indestructible.

One of the defenses of the macho ethic is that it encourages men to be strong and tough to protect and defend their families and communities. Even if that were true, you can’t protect if you’re not present. The tragedy of traditional masculinity is that it shortens men’s lives; the scandal is that it does so in the name of making them better husbands, fathers, brothers, and sons.

We need to remind men that part of being a “real man” is being mentally, emotionally, and physically present for the people who love and rely upon us. Being present—and staying present—requires us to be better stewards of our bodies and our spirits. It doesn’t mean hypochondria or endless introspection. It means remembering that our value doesn’t lie only in our capacity to defend or to provide. It lies in our capacity to love, to connect, and to nurture.

We can do none of those things if we aren’t there.

The fragile male body

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Not much writing here, not least because I’m still fighting this bug that came home with me from Brazil. I’ve been sleeping in the guest room all week; Eira doesn’t need my hacking and my night sweats when she’s trying to get her rest. And it’s been painful not to have the energy for Heloise that I’d like to have, as I missed her so much during my eight days abroad.

It’s natural that one thinks about mortality when illness strikes. And I’m reminded of this post of mine from January 2, 2008, which I reprint here. I wrote this before I was a father, and I take it even more seriously now:

My father-in-law died early Sunday morning, and we have been busy with taking care of family and with funeral arrangements. (Remember, this is a reprint from three years ago.) Sunday afternoon, my wife and I spent several hours dealing with the cemetary, the mortuary, and all the minutiae that come with death. I’ve gotten too familiar lately with all the details that survivors cope with in the aftermath of a loved one’s passing.

My Dad died eighteen months ago, at 71. My father-in-law died three days ago at 63. Over and over again, the words “much too young” echo in my head. My father’s father died at only 44 (in a car accident); my mother’s father died at 62. Both of my wife’s grandfathers died relatively young as well. Though the causes were all different, we both come from families where there are plenty of older women — and too few older men. The statisticians tell me that men in America and Europe should live to see at least 72, but for my wife and for me, neither our fathers nor any one of our four grandfathers made it to that age. Meanwhile, all four of our grandmothers made it to at least 80, and most well beyond.

So in addition to the grief over losing a loved one, I’m feeling this week an acute sense of fragility. Some of that is just the reminder — of the sort we always get when we’re confronted with death — of our own mortality. But in my personal experience (and the experience of my family), dying “too young” is a largely male phenomenon. Though some of these deaths were due to poor lifestyle choices, the emotional impression I am left with is that men are somehow more vulnerable than women.

I opine frequently “against the myth of male weakness”. I am adamant that men can exercise the same degree of self-control as women can; I am convinced that men have the same capacity to nurture and love as women do. I see that proven by men all around me; I see it being proven — at last — by my own actions. What I don’t see, I’m afraid, is the same corporeal resiliency on the part of men that I do with women. “Premature” death has robbed me of my grandfathers (I never knew either); it has taken my father and my father-in-law and many other dear relatives. (My uncle Peter, a formative figure in my youth, died last year as well.) The impression all this leaves me with is that the strength of the male will is not matched by the endurance of the male body.

Yes, I know women outlive men for a variety of reasons. (I also know that thanks to death in childbirth, this has not always been true. Think of the ubiquitous “wicked stepmother” of the fairy tales, and ponder what happened to Cinderella’s biological mom.) I’m not writing this morning about medicine and masculinity, because my knowledge of the former is dim indeed. I’m writing from a place of grief, matched by an awareness that as a man who will not celebrate his fortieth birthday again, I have an obligation to be the best steward of my body that I possibly can. Accidents, alcohol abuse, over-eating, cigarettes: these were factors in the deaths of several of the men in the family. And though I could be — God forbid — struck by lightning tomorrow, I know that to at least some degree, my longevity is within my hands.

My wife’s grief is palpable. In a sense, it’s almost harder to bear than my own grief over losing my Daddy in 2006. Watching the person you love most in the world go through pain is harder than going through it yourself, particularly when your own experience tells you how sharp that hurt is. But her grief — and that of her family — is cautionary to me as well. The choices I make have an impact on others. Whether I buckle my seatbelt matters. How I eat and drink matters. How I take care of my body matters.

I’ve written about this before, particularly from an animal rights perspective. But not only is it important to me that my lifestyle choices be as “cruelty-free” as possible — hence my veganism — it is also my moral obligation to do everything I can to make decisions that will maximize my longevity. I have people in my life who love me and depend upon me. And while I do not expect to live forever, when I do things that might shorten my life I treat my loved ones with callous disregard. This will become doubly true when I become a father. I won’t be a young Dad by any means. Those of us over forty who contemplate parenthood for the first time surely have a special responsibility to do as much as we reasonably can to ensure that we will be around for as long as possible.

On Monday, we buried my father-in-law. Though all of his children and grandchildren were there, and all were in tears, the one who was perhaps most deeply affected was his youngest daughter. My “littlest” sister-in-law is just 22, still in college. Several times over the course of this difficult past week, through her tears, I’ve heard this sweet young woman say, “I wasn’t ready, I wasn’t ready.” No one is ever ready to lose a parent, of course, whatever the age of the child. But there’s little doubt that it’s harder to lose one when you yourself are still so very young.

As much as I honor the memory of my father-in-law, I acknowledge — as does his entire surviving family — that his own poor choices surely hastened his death. And what his passing reminds me of is that though men are not fragile, we are often foolish. Our greatest foolishness, perhaps, lies in our sense that our private daily habits do not impact everyone around us. I am inspired today to redouble my efforts to live fully, boldly, and, at the same time, with a sense that I am steward of my flesh. Though to die young is, of course, not a sin in itself, to continue to make decisions that are widely regarded as life-shortening perhaps is.

Give for Lila: one way to defend Planned Parenthood

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Lila Rose is at it again. She’s released another heavily edited and deeply misleading video designed to delegitimize the good and important work of Planned Parenthood. In the latest incident, Rose (a student here in Los Angeles and a pro-life activist since her early teens) attempted to catch PP employees turning a blind eye to an underage prostitution ring. Their plan failed when Planned Parenthood reported the ring to the FBI, doing exactly what Rose had hoped they wouldn’t do.

Lila Rose works often in conjunction with right-wing activist James O’Keefe, who was convicted of breaking into Democrat Mary Landrieu’s office in an attempt to uncover dirt on Louisiana’s senior senator. It’s worth noting that Rose attends UCLA, home of a famous film school where fantasies are nurtured and brought to life. (And where I got my Ph.D. Um, Go Bruins.)

As regular readers know, I’m a strong Planned Parenthood supporter. I’m giving this month in the name of Lila Rose, and asking others to join me. When you donate through the PP site, go to the section for “honorary giving” and add in the name “Lila Rose.” Send Lila a cordial email at lilarose@liveaction.org or let her know of your donation on her Facebook page. And yes, I do mean cordial: please, nothing threatening or demeaning. Though she’s created a high profile for herself through slick and dishonest means, she is — like so many whom Planned Parenthood serves — a young woman deserving of respect and dignity. No personal attacks, please: just remind her she’s raising money for a cause she abhors.

Let’s send Lila (and her backers) the message that her disinformation campaign only serves to increase our commitment to women’s health. Let’s do with civility towards our opponents, and with a relentless commitment to justice.

Join me. Give to Planned Parenthood in the name of Lila Rose.

Quixotic yes; obtuse, no: on marathons, health care, and re-registering as a Democrat

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I ran, if that’s the word for it, the Los Angeles Marathon again yesterday. I’m not trained the way I was in the past, so some friends and I jogged the course together, snapping photos and (at least in my case) providing live Facebook and Twitter updates as we moseyed from Dodger Stadium to the Santa Monica Pier. Slower than molasses, but lots of fun — and nice not to feel sore the next day, as I would have if I had actually put the proverbial pedal to the metal.

Last night, my wife was out and Heloise went down early. With my daughter asleep next to me, I sat on the couch and watched CNN and C-Span as the health care drama in the House of Representatives unfolded. During the race earlier in the day, I’d been keeping up to date on House negotiations via the iPhone, and knew about Bart Stupak’s decision to back reform before I finished the marathon. And I watched, fingers crossed and at times breath held, as the bill passed. When the number “216″ flashed on the screen, I pumped my fist and mouthed “Yes!”, carefully avoiding disturbing the slumbering little one at my side.

I don’t blog a great deal about politics and health care, but do want to make it clear that I strongly support health care reform. Indeed, count me in the army of those who would like to see a single-payer system in place! I’ve lived abroad, and have personally known excellent care with the NHS — as have many members of my family. I bristle at the misrepresentations of European-style socialized medicine by those who haven’t ever experienced it. Totalitarianism it most certainly isn’t.

Since I’d spent the day connected on Facebook and Twitter, I kept at it during the health care vote. I have lots of friends on the former who represent the political spectrum from pole to pole, and I follow a fair number of folks on Twitter. My conservative acquaintances were as aghast as my liberal friends were ebullient; reading their posts and tweets there were very few reactions anywhere between the extremes of jubilation and despair. Either America had fulfilled a long lost dream or abandoned it; either the country was headed for increased prosperity or desperation and malaise. The rigidly dichotomized reactions were perhaps emblematic of our polarized political climate, and perhaps they were also warranted, given that for once, the hype about the significance of a piece of legislation wasn’t oversold. This did matter, and both sides knew it.

Several years ago, I re-registered as a Republican. I posted about my quixotic hope to participate in a revival of progressive influence within the GOP. But I’ve watched as the few Republican moderates (with the loss of Lincoln Chaffee in Rhode Island, we have no GOP liberals in elected office left in the USA) were either demonized or forced to toe the party line. There’s idealistic — and then there’s silly. And I think that staying a Republican in the hopes that the few dollars I threw at Republicans for Environmental Protection or the Republican Majority for Choice would make a difference is absurd. Last night’s debate, in which the GOP seemed monolithic not merely in its opposition to sensible reform but also hate-filled in its rhetoric, demonstrated to me that it’s time to give up the silliness. I’m re-registering as a Democrat this week.

HPV and boys: new concerns

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My sources tell me that today, the immunization committee at the CDC (Centers for Disease Control) is debating whether to recommend the use of Gardasil, a vaccine against HPV, for use with male patients. HPV, or the human papillomavirus, is the most common of sexually-transmitted infections; the CDC estimates that 50% of sexually active adults will acquire HPV at one point over the course of their lives. Some suggest that the percentage is higher still.

HPV has been conclusively linked to cervical cancer. Since 2006, Gardasil has been approved by the FDA for use in inoculating women against HPV. Because the best form of protection is prevention, many health experts recommend vaccinating girls before they become sexually active. Given the grim reality that HPV can be easily transmitted through non-consensual sex, and given the ease with which the virus is spread through oral sex, vaccinating girls before the onset of puberty is encouraged. (This has led, of course, to predictable howls from the religious right, who are less concerned with protecting young women’s health and more concerned that a vaccine against HPV might encourage pre-marital sexual exploration.)

But as an article in the brand-new issue of Ms. Magazine makes clear, HPV poses a greater threat to men and boys than was previously known. The Adina Nack piece is not available online, but here’s a quote from what’s available on your newsstand:

While it is fears of cervical cancer that
have motivated young women to get HPV vaccines,
that’s not the only cancer caused by this virus: It can lead
to oral, anal and penile cancers as well. In fact, the combined
U.S. death rates for these cancers are at least twice
that of cervical cancers… Some researchers, in fact, believe that
HPV may soon cause more oral cancers in the U.S. than
alcohol or tobacco combined.

As a result of this research, the CDC may well soon recommend that boys and young men also be inoculated with Gardasil, as the connection between HPV and oral/anal cancer becomes as apparent as it already is with cervical cancer.

Nack emphasizes that men’s health is a feminist issue:

Women’s health—especially reproductive health—is usually
the focus of sexual-health discussions but men’s health
also deserves women’s attention—and not just because
women care about their sons, male partners and male
friends. It almost goes without saying that women can also
be infected by their intimate partners, and since the great
majority of women primarily have heterosexual relations,
that usually means by men.

In fact, men’s health is an even larger feminist issue.
“Feminists have a vested interest in advocating for policies
and circumstances around the world that shape men’s ability
to develop healthy sex lives, which, by definition, has
to include respect for the rights of those with whom they
partner, regardless of gender,” says Patricia Rieker, Ph.D.,
a sociologist at Boston University and Harvard Medical
School and coauthor of Gender and Health (Cambridge
University Press, 2008).

The truth is, if women don’t prioritize men’s health,
we’re not just losing a chance to foster the overall health
of our communities, we’re actually putting ourselves and
future generations at risk

It is axiomatic that women of all ages are more willing to seek medical treatment than are men. The “sturdy oak” myth of robust masculinity makes it difficult for boys and men to acknowledge vulnerability. Our cultural narrative about heterosexuality tends to suggest that women are emotionally and physiologically more fragile — and more likely to “suffer” from sex. That “expectation of female suffering” (associated with everything from first penetration to pregnancy to increased vulnerability to STIs to the guarantee of heartbreak after a break-up or abortion) is matched with a narrative of male imperviousness to harm. We like to pretend that boys are dense, violent, and comparatively shallow. But boys do cry, and boys do get hurt, and as the latest research shows, boys do get HPV-related cancers too.

Feminists have done much to dispatch the myth of female frailty. They have also been on the frontlines of fighting against this myth of the invulnerable male. It is no surprise then that we find this important clarion call for male sexual health in the pages of Ms. Magazine.

Men killing women: maternal mortality, heterosexual desire, and the work of male transformation

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Back to school with much work to be done.

After Friday’s post (immediately below) about male sexuality and its perceived dangers, I got an interesting email from blogger Erin Solaro. She wrote:

The reason male sexuality has been viewed as dangerous and yet at the same time men are supposed to push women has a great deal to do with biology, and no, I don’t mean that men have a higher sex drive than women…

…I mean that 1940 was the first time in America that the mythical average woman’s chance of dying in childbirth dipped below 1 in 100. (For black women, it was higher, about 3 times as high.) In modern Afghanistan, it’s about 1 in 7, which may be pretty close to the historic norm.

Until we understand that, we aren’t really going to understand why we think about men, women and sexuality the way we do.

It’s an interesting point. Any women’s history class must take into account the history of birth-related maternal and infant mortality. While it’s difficult to get accurate historic statistics, the 1 in 7 figure that Solaro cites for contemporary Afghanistan is probably lower than it was in many other time periods. It is generally assumed that until the 20th century, childbirth was the leading cause of death for all women of childbearing years; in some societies that maternal mortality rate may have reached 40%, while other medical historians prefer a lower figure of 1 in 4 or 1 in 5. Given that many women in the developing world still have half a dozen children or more, as they did in previous centuries, the overall risk is compounded by the sheer number of pregnancies carried to term.

Our cultural memory of this devastating toll is limited. We have a Mother’s Day, of course, but we have no public rituals to honor our countless female ancestors who died — quite literally — so that we could live. There is no Tomb of the Unknown Mother in Arlington, though more American women died from childbirth than male soldiers did in war for the first century and a half of our republic’s history. This legacy lives on best in fairy tales, replete with stories of single fathers (Beauty and the Beast) or wicked step-mothers (take your pick). When I ask my students what happened to Cinderella’s birth mother, it drives the point about maternal mortality home.

Whatever the exact figures, childbirth has probably killed more women than any other single cause in human history. Until very recently (a miracle two millenia ago in Palestine notwithstanding), the only possible cause for pregnancy was heterosexual intercourse. So if childbirth kills women, and sex causes pregnancy, then by the logical transitive property, heterosexual intercourse has been, not so indirectly, the most lethal of all human activities for one-half of the population. To put it even more bluntly, men have killed far more women by ejaculating inside of them than they have by any other method. Semen has killed more people than any other body fluid (and yet it is menstrual blood that is considered far more “unclean” in many Western traditions.) (This, by the way, is a good moment to note how absurd the argument is about AIDS being “God’s punishment for homosexuality.” Even if we were to assume that AIDS was primarily transmitted through same-sex sexual activity, the number of deaths globally from AIDS has not yet risen to the historic levels of those from childbirth. If God punishes by death those who engage in forbidden sexual activity, how then to explain that the leading cause of death for women for centuries was having intercourse with their own husbands?)

Very few, if any, men ever presumably sought to kill their wives or lovers through intercourse. But men did devise patriarchal power structures that forbade women from using contraception or from refusing sex to their husbands. From both a moral and a statistical standpoint, cultures that don’t allow women access to contraception — as well as the right to say “no” after marriage as well as before — are complicit in the death of countless millions of women. Of course, many women surely enjoyed sex despite the risks; many women surely longed for children even in the face of the grave dangers that attended pregnancy, labor, and delivery. All the more reason to honor the bravery and the sacrifice of those who fought for life against death on a battlefield far more lethal than those on which their husbands, fathers, and brothers struggled. Continue reading →

Best place to be sick and rich? Here. Best place to be sick and not rich? Not here.

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I have precious little that is original or interesting to share about the health care debate. Let me say that I strongly favor a “public option”, and honor the work done by the representative in whose district I now reside, Congressman Henry Waxman. I was inspired by President Obama’s speech last night, and look forward to an aggressive push by the White House for the most progressive bill possible.

I will note, too, that I’ve been infuriated (as have many members of my family) by the misleading and absurd attacks this summer on the British National Health Service from conservatives in this country. As a dual citizen, I’ve used the NHS on my visits to Britain; my nephew was born “on the NHS”; the service paid for a home birth, midwives, and doulas. My brother and his wife paid nothing out of pocket. I’ve seen the kind of pediatric care my nephews and niece get. I’ve been in emergency rooms in London, and I’ve been in emergency rooms in Los Angeles, and I know where I’ve been seen faster. And it ain’t here.

My wife and I are fortunate. We have excellent health care provided through my employer, the college. We also, out of our own pockets, use what’s called “concierge medicine” for our daughter; it’s a worthy but pretty penny. I’ve got my pediatrician’s cell phone number, and he actually answers when I call, which I’ve done more than once (nervous first-time father that I am.) But you know, I’d trade that concierge service and the “Cadillac Plan” I get from the college for a single-payer plan that embraced everyone. Failing that, I want the most comprehensive plan possible, one that leaves the fewest people behind.

I’ve been fortunate enough to travel a great deal, and live abroad from time to time. I’ve been unfortunate enough to be accident-prone and inclined to very serious cases of food poisoning. (I’ve puked on all seven continents, if you count a cruise ship just off the Antarctic coast!) I’ve experienced medical care in many places. My bottom line conclusion: with unlimited funds, America is the best country in which to be sick. But if you’re without money or first-rate insurance, America ranks well behind many other countries whose publicly-funded facilities I’ve had the privilege — and, in a sense, bad luck — to use.