The ugliest period of the health reform wars was the summer of 2009, when Sen. Chuck Grassley and others held out the scary specter of “pulling the plug” on Grandma. Now the Republicans are trying to repeal “Obamacare,” and the Granny wars have reignited. Once again, Grandpa is nowhere to be seen.

“I can report that Granny is safe,” President Obama told a health care advocacy group recently. “She may not feel that way,“ retorted Karl Rove, in a Wall Street Journal op-ed headlined “The Politics of Saving Granny.”

What did happen to Grandpa?  Is anybody pulling the plug on him? Do we care?

Grandpas get old and sick, too. They get Medicare, and they run up bills, and they go in and out of hospitals, and they (and their families) face the same tough decisions about end-of life care. But Grandpa is not part of the never-ending rhetorical war on health reform.  I don’t think that’s an accident. I called a couple of experts on language, gender, and medicine. They don’t think it’s an accident, either.

The “granny” phraseology strikes a whole symphony full of chords about vulnerability and powerlessness in a way that “granny and grandpa” don’t.  “Granny evokes sympathy, nurturing, warmth. Granny Smith apples. Food. Cookies. All the association with warmth and family,” said Sylvia Chou, a sociolinguist who did doctoral research on how hospice patients, their families, and physicians discuss end of life.  (Chou now works at the National Cancer Institute on health communication, not on health reform policy.)

Grandpa doesn’t have such clear and universal imagery, Chou noted. Maybe we’ll think of an old man and a young boy and fishing poles. Maybe we’ll think “jolly.”  Some might think “grumpy.”  We don’t think apple pie. Then layer on “pulling the plug.“ That phrase connotes, and denotes, a loss of power, coupled with a dehumanizing image of a machine.

“That ‘pull the plug’ phrase. It’s very technological. You pull the plug ON someone,” Chou said.  Conversations between patients and doctors about end of life care are supposed to enhance autonomy.  Plug-pulling distorts that, turning the patient into a powerless (literally) victim who could be switched off.  Feminizing the language adds punch.  Women, more than men, become  “nonpeople” as they grow old, added linguist Deborah Tannen.  Decisions are made about them, not by them.

Marcelline Block, co-editor of a new anthology called Gender Scripts in Medicine and Narrative, recalled other subtle and not so subtle threads in health reform about women’s bodies—a lot more fighting about mammograms than  prostate tests. Abortion, too. But that’s not what shaped the public debate or fueled the town meetings that helped give rise to the Tea Party.  It was Granny, the death panels, the plug.  The end of life. The end of apple pie. But not, so far at least, the end of health reform.

Tags: health care debate, obamacare, pulling the plug on grandma

Marketers have long attempted to sell women empowerment by way of their products -- You’ve come a long way, baby and all that. Very often, there’s a not-so-subtle commingling of the notions of beauty and empowerment. Virginia Slims, after all, are eponymously slender (as are its models), with the implied promise of conferring the same on consumers. The Dove “Campaign for Real Beauty” of recent years does the same thing much more subtly, appearing to celebrate real women (God, I’m so sick of that ad word, celebrate) while still implying an imperfection that necessitates use of its products.

Diet Pepsi has now come out with a taller and thinner “Skinny Can” tied to New York’s Fall Fashion Week. “Our slim, attractive new can is the perfect complement to today's most stylish looks,” one of the company’s execs says in the stilted language of the press release. (Slate’s own Simon Doonan is doing a window installation featuring the cans in SoHo.) The copy calls the can’s design “sassier” (marketers, please put sassy to bed; it feels very ‘90s) and says the new design is a “celebration of beautiful, confident women.” Same old story – aspirational, looks-oriented advertising with a thin layer of faux-empowerment on top. If you’re confident on the inside, you’ll be skinny on the outside, or something. Huh?

This approach feels more tone-deaf than it used to. Consumers exposed to the Dove campaign and countless debates on model over-thinness want a more sophisticated argument these days. We expect to hear lip service paid to the world’s diversity of beauty, even if it’s only that. Though perhaps it won’t matter -- the Skinny Can may not be noticed much by consumers. Even as PepsiCo says it will be available nationwide in March, the company is keeping the old, fat can on the shelves. The Skinny Can appears to be positioned as a novelty. There’s no pretense that this tastes any different, after all.

Tags: Diet Pepsi, Dove campaign for real beauty, fashion week, skinny can, Virginia Slims

I love Mark Bittman. An entire NYT op-ed column devoted to the way we eat is genius. There's a thousand things to be said, and Bittman is the right guy to say them. His skewering of the new USDA Dietary Guidelines for Americans 2010 is dead on. Why won't we ever get food guidelines that make sense from our government food agency? Because it counts among its many missions the promotion of more consumption of the foods produced by American agriculture, and right now that means Big Ag and highly subsidized corn, rarely eaten in its natural form. "Eat food. Not too much. Mostly plants," will never fly as long as the subtext is "Eat corn. Lots of corn. Mostly processed."

But (of course there's a but) while Bittman is rocking his governmental critique, he's sounding a little tone-deaf on the subject of another big reason we eat the way we do. It's not all government promotion, or even powerful corporate advertising and lobbies. It's the way we live. It's two-working-parent families, single parents and people working two jobs. Convenience foods do something more than make us fat. They free up the labor that once went into all that eating of real food, and that labor was mostly female. As we encourage each other to get off the chips and back on the salads and rice and even steak, we can't forget that that "real food diet" demands real time in the making (or real money in the purchasing).

This is something Michelle Obama understands. As she ramps up her anti-childhood-obesity campaign in the coming year with a renewed focus on military families, she manages, in almost every speech, to make it clear that she understands that what she's asking of families is hard. Replacing chips with carrots isn't just a one-off switch, or even just a question of developing a taste for carrots. Carrots have to be washed and peeled, unless you spend the money to buy them that way. Carrots are tastier, or at least different, with dressing. Dressing takes a bowl, or, if it's in a lunchbox, a little container. At the end of the day said container must be removed from the lunch box and washed. Yes, that's a lot of whining about nothing. Multiply it by four kids and add in every orange that has to be peeled, every apple that needs slicing and two or three additional meals and you're looking at a lot of work. Are there tricks and ideas to make it easier? Sure. Should other family members help? Absolutely. But we have tried, in this family with helpful, independent kids (9, 6, 5 and 4), disposable income, and two involved parents, to give up all forms of packaged non-food for a week, and by the end of it, I would have crawled to the store on my knees in four feet of snow for a bag of chips. Eat real food means almost every single thing demands adult involvement. There are exceptions. There are not enough of them.

When Michelle Obama partners with Wal-Mart to make produce more affordable and packaged foods healthier, she's embracing the reality of the modern family. She's not asking the working single mother to do something that does indeed feel unthinkable—to do without the foods that help her get her kids out the house every morning without getting up to cook breakfast. She's saying, start here. This is better. And that's a fantastic thing to hear. And by involving Wal-Mart, she's recognizing that to get every family to eat better, someone out there is going to have to provide better, but still easier, alternatives to spending our busiest weekdays eating unsliced apples, nuts and berries. Wal-Mart's start with "healthier" packaged foods may feel laughable. Obama knows you have to start somewhere.

Bittman's "Eat Real Food" slogan gets, to use his words, "limited kudos." It's good advice, but in the form of a counsel of perfection that threatens to become the enemy of the good. Without a promise of more hours in the day, more patience, or more inexpensive but easy options, "Eat Real Food" is the kind of directive that can make a person throw up her hands and pass out the Twinkies. Like any quest for dietary perfection, it dooms its followers to at least some failure. What I would love to hear in a future Bittman column is "Eat MORE Real Food. Here's How."

Tags: Let's Move, mark bittman, Michelle Obama, Michelle Obama anti-obesity, USDA Dietary Guidelines, Wal-Mart

Matt Lauer's got company today on the political-mother shaming front: Rick Santorum.

Santorum is one of the possible GOP hopefuls for the '12 presidential nomination, along with Sarah Palin, of course. She decided at the last minute not to attend the conservative conference CPAC (she hasn't actually showed up the last few years, in fact—it's become a bit of a tradition for her to cancel). Santorum seized upon the no-show as an opportunity to criticize Palin, who's a hit among the same far-right base he'd be trying to appeal to in a run. First, in an interview with conservative S.E. Cupp, he hinted at her celebrity profiteering: "I have a feeling that she has some demands on her time, and a lot of them have financial benefit attached to them." This is not an unfair criticism—but his next one was. He pretended to offer a more understanding take on why Palin might be unable to come. "I don’t live in Alaska and I’m not the mother to all these kids and I don’t have other responsibilities that she has." (Itals mine.)

Santorum happens to be the father to seven children—one might assume no matter the parenting balance in the Santorum household, he does, in fact, have some responsibilities in addition to attending CPAC. But more interesting here is the criticism he's subtly rescuscitating. In '08, one of the few things many women on both sides of the aisle could agree on re: Palin was that she had steamrolled over the expectation that women could only go into politics in a big way once their kids were raised, and this was a good thing. Republican women and consultants told me this fall over and over again that seeing her up on the stage at the 2008 GOP convention with her young kids was a moment that everything suddenly looked different, more possible for them. It's how the whole Mama Grizzly movement began, this version of conservative feminism that we found vexing and powerful all at once. Maybe Santorum's comments were a one-off from a sui generis conservative, or maybe it's a sign that the good 'ol boys on the right (and perhaps the left, too) are no longer quite as entranced and stymied by the possibility of grizzly power.

Photograph of Sarah Palin by Robyn Beck/AFP/Getty Images.

Tags: mama grizzlies, rick santorum, rick santorum criticizes sarah palin

I spent a small chunk of a rather busy afternoon yesterday watching the latest Lila Rose video, filmed in a Bronx Planned Parenthood, and my emotional temperature during the entire thing was, in sum, bored.  The video, which Planned Parenthood claims was doctored (a substantive claim, as one of the videos from the latest string has been demonstrated to be doctored, and Rose and her comrades such as James O'Keefe have a long history of this) shows impatient Planned Parenthood employees trying to suffer fools for as long as it takes the get them out the front door.  The actors are unable to get past reception, and so they dodge the woman and grab a doctor, who is short with them.

The first video did show an employee acting unprofessionally (though admitting to them that most employees at Planned Parenthood do their jobs correctly), and further videos have shown literally nothing of interest.  In both videos, the employees are all about information, and they focus intently on getting rid of the person in front of them and insisting that any young women seeking medical care come in by themselves.  They emphasize their ability to educate the young women, explaining that they have translators.  Over and over again, the theme is that no one claiming to have control over minor a woman will be allowed to make decisions for her, and that minor women have to come in by themselves and work directly with doctors. When the actors did in fact mention illegal behavior that has to be reported, whoops, looks like that's exactly what Planned Parenthood did.

What I realized, watching this latest video, is that the intended audience is not me or anyone who lives outside of the sheltered enclaves of fundamentalist Christianity or white bread surburbia.  Rose claims that turning the actors into the police wasn't sufficient and implied that OB-GYN nurses should have somehow detained a man who they were supposedly led to believe is a violent pimp, presumably with the nursing-school-issued Tasers and handcuffs. These videos may be shocking---and most important for the intended Fox News audience, titillating---if you actually believe that anyone under 18 having sex is "evidence" of crime, and should be reacted to like you're Dirty Harry taking out a den of thieves.  (Certainly, one anti-choicer on Twitter pompously claimed to me that all STDs in young people are reason to call the police, while detaining apparently anyone and everyone in sight.)  I'd like to see that attitude taken up in the communities of those who are eating up these videos, instead of just pushed on the low-income and immigrant-heavy communities these videos were filmed in.  Who wouldn't want to see police raids of senior proms, with all the virginity losers cuffed and lined up on the curb.

I love especially how the actors use the word "confidential" frequently.  The only way the responses from the doctors and nurses would be shocking is if they said, "Nah, everything you tell a medial professional is immediately put on my blog with your picture and identifying information."  As much as Rose's audience may not like it, even young people, poor people, and immigrants have a right to medical confidentiality.  Yes, even women they consider dirty sluts have the right, though Rose has demanded a world where that right is terminated for some women and replaced with a system famously fictionalized by Hawthorne.

It's critical to separate the underage angle from the sex-trafficking angle. Put yourself in the shoes of the employees filmed.  An older man is asking about health care access---STD testing, contraception, possibly abortion---for some underage woman out of sight.  He implies that he's a pimp, though never says so directly.  First of all, this is a weird situation that doesn't happen in real life, and so you're caught off guard.  The proper response is to address the two issues separately---what he's doing and what the hypothetical young women need.  Tell the man that anyone seeking medical care has to do it on her own, and do everything in your power to make sure she's separated from him and informed of her options. Then, when he leaves, report suspicious activity to the police.  This is the only path that could possibly lead to the desired outcome, which is him in jail and her getting the medical attention she deserves.  And this just so happens to be what the employees try to do in what are very strange circumstances.

Despite some maudlin language at the top of one of the videos, the most striking aspect of these videos is how much Rose and her comrades don't see underage prostitutes as human beings who need care, but instead as titillating objects to be exploited.  At one point, the "pimp" even labels a woman he's asking about as Thai, and clearly the audience is supposed to be shocked that the doctor doesn't immediately yell, "Sex slavery!" and tackle him to the ground. But outside of conservative enclaves, I can safely say it's not assumed all Thai women are prostitutes, and in fact saying so is what you'd call racist.  The biggest demand Rose is ostensibly making is that Planned Parenthood approach the problem of sex trafficking in a way that makes absolutely sure the trafficked women don't seek medical care, are not counseled out of ear shot of their pimps, and are not given an opportunity to heal and perhaps get help to escape.  So, who's supposedly aiding and abetting sex slavery again?

Tags: James O'Keefe, lila rose, live action, planned parenthood

First Lady Michelle Obama went on the Today Show this morning, ostensibly to mark the one-year anniversary of her "Let's Move" campaign against childhood obesity. But before Matt Lauer would talk to Obama about school lunches and chicken wings at Super Bowl parties, he asked her a bunch of questions about Sasha and Malia. These questions implied that the girls were suffering in some way by growing up in the White House:

Matt Lauer: I was thinking, I was trying to do the math here a second ago—if your husband is fortunate enough to win reelection, that's six more years in the White House for your family. Sasha will be 15, Malia will be 18, she'll be ready not only to leave the White House, but to leave the house. This is their only childhood, and I know you've said to me in the past that you're making it as normal as possible, but you don't get a re-do. At the end of six years, you can't go to someone and say, now I want to re do this in a quieter and more private way. Does that concern you?

Michelle Obama: I think about it all the time. And that's why Barack and I really try to keep them out of this. And I think we've done a good job. If you talk to our kids, they're really very normal. We recognize them. I say this all the time, friends who come to visit, they say, these are the little girls we've known. So we're just going to stay vigilant. Knock on wood.

Lauer: But six long years is a long time to raise children in the White House, in the spotlight.

Obama: There are a lot of great kids who have come out of the White House, so the tradition is great. The Bush girls are magnificent, Chelsea Clinton, she's a solid young woman. We're all proud of them. Caroline Kennedy—we've got a pretty good track record. So the Obama girls, hopefully, will be among that group.

This is bonkers. Matt, it's the White House, not a crack house. The Obama girls have parents who clearly care about them and the opportunities they're being given as the President's children are tremendous and unparalleled. Apparently a mother can't win with the choices she makes, even when she's the First Lady.

Photograph of Michelle Obama by Jim Watson/AFP/Getty Images.

Tags: let's move childhood obesity, matt lauer, michelle obama matt lauer, michelle obama today show