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When we talk about barriers to the entrance of women in the American workforce in the 20th century, the story we tell is largely cultural and economic. Married women with career aspirations had to contend with wage discrimination, marriage bars, and the perception that a working woman was ipso facto a degenerate wife and mother. A neat new working paper from the National Bureau of Economic Research suggests that we often understate the role of basic medical advances when talking about that sudden, collective jump from home to workplace. It's easy to forget how dangerous childbirth used to be; complications associated with sepsis, toxaemia and obstructed labor could ravage a body well into middle age. "Many maternal conditions had very long lasting or chronic effects on health," the researchers report, "hindering women's ability to work beyond their childbearing years."
Using historical data to quantify the effects of various maternal conditions, economists Stefania Albanesi and Claudia Olivetti find that medical advances like the introduction of antibiotics, the standardization of obstetric practice, and the hospitalization of childbirth were absolutely critical to the rise of married women's participation in the labor market over the last century. They also find a very large effect for the introduction of formula as a mainstream alternative to breastfeeding in the 1930s. A typical woman in 1920 between the ages of 23 and 33 would be nursing for something like 40 percent of her potential working time. As Hanna has so forcefully illustrated, our cost/benefit calculations change when we start to consider the possibility that a mother's time might have some kind of value.
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At what age can a child refuse medical treatment—and do his reasons for doing so matter? Daniel Hauser, a 13-year-old Minnesota boy suffering from Hodgkin's lymphoma, went through one course of chemo before he and his parents decided to reject standard cancer treatment in favor of alternative medicine. They've said that their practices reflect their religious beliefs as followers of the Nemenhah Band, a group led by Phillip "Cloudpiler" Landis that encourages natural remedies. (They also attend a Catholic church.) Last week, a judge ruled that Daniel's parents were "medically neglecting" him by refusing to continue to treat him using conventional medicine. The family was supposed to appear in court today to discuss the results of a chest X-ray and determine a course of treatment, but Daniel and his mother didn't appear. (It sounds all too close to Miriam's Well by Lois Ruby, a YA novel I cherished as a young teen, but I doubt it'll have the same happy ending.) Now an arrest warrant has been issued for Colleen Hauser. His father says that he hasn't seen them since last night and doesn't know where they are—convenient. He's gravely ill and recently told a doctor that he had pain that was "10 out of 10" in his chest, but that pain apparently hasn't convinced him to submit to an oncologist's will. He even threatened to punch and kick any doctors who tried to treat him.
It sounds as though Daniel is simply trying to adhere to his faith, but he might just be scared to undergo treatment. The blogger at Respectful Insolence, a scientist/surgeon, asked last week whether the Hausers are just using religion as an excuse. Daniel underwent one course of chemo—the first of a recommended six—in February, and he and his family were alarmed by the complications; he is also reportedly haunted by the fact that an aunt died while undergoing chemo when he was 5.
If this is a case of rejecting the side effects rather than the idea of medical treatment, it's tough to tell who led whom down this path—did Daniel himself balk first, or did his parents? Thirteen seems far too young to be able to decide to treat or not to treat, and Daniel himself reportedly can't read and has demonstrated poor understanding of his illness. That makes it a pretty open-and-shut case, as far as I can tell—find the kid, if child protective services can find him before it's too late, and make him undergo if his cancer is still treatable. (Do the legal eagles among us think differently?)
I can't help but wonder, though, how this would play out if it were a highly mature 17-year-old who rejected faith healing, alternative medicine, and conventional treatment. If he wanted to forgo treatment in favor of dying just because he hated chemo, would we force him?
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New research published today sheds light on an old scientific puzzle: Why is cancer so rare in people with Down Syndrome? It turns out that a gene on chromosome 21, which Down syndrome patients have an extra copy of, may help to suppress tumors by blocking the development of blood vessels they need to grow. (The nitty gritty appears online in Nature.)
The finding builds on work by the venerable cancer researcher (and one of my scientific heroes), Judah Folkman, who died in 2008. It was Folkman who pioneered the idea of treating cancer by suppressing the growth of blood vessels that tumors need to develop. For years, Folkman was a lonely advocate of this approach. And early efforts to commercialize it in the U.S. largely fizzled. But the strategy of choking cancer's blood supply hit it big in 2004 when the biotech company Genentech introduced its (wildly expensive) blockbuster Avastin. Other drugs that work on similar principles are now available or in the pipeline. Folkman also argued that a related mechanism might explain why people with Down Syndrome are less likely to get cancer. Today's finding, by a member of his lab at Children's Hospital Boston, validates that view and serves as a posthumous tribute to his career. As for breakthroughs in cutting off cancer's blood supply: Expect more to come.
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If you're interested in adding another woman-authored blog to your list, I recommend Sarah Scott's Mayday Productions. A former Martha Stewart Omnimedia employee, Scott ended up "tits-up in a ditch," as she put it to me once in a line borrowed from the title of an Annie Proulx short story, when she was in a cycling race accident in 2005. "I don't remember if the EMT woke me up, or I just came to on my own, but I remember looking down at my thighs and thinking about dead meat. Big hunks of dead meat." On her blog, she candidly chronicles the physical and psychological challenges of life post-spinal cord injury with blistering honesty.
The new me is paralyzed from the bottom of my sternum down, 100% reliant on a wheelchair for mobility. I'm no longer a size four with marilyn curves etched on taut muscles. I no longer wear heels, and I've had to give away most of my clothes from my old life. Some I'm still holding onto, but slowly and surely they continue to be discarded as I keep loosening my grip on the past.
Her bio adds: "My life is decidedly not tragic, despite my good looks." And, on a parallel blog, she covers her work training service dogs in words and photographs. If your interests include autonomic dysreflexia, apotemnophilism, and armoured women, Scott's blog is a must-read.
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Faltering country clubs are finding that they have to get a little less exclusive in order to make ends meet. (Washington Post)
Doctors are reporting more canceled appointments and fewer preventive-care visits than before the recession began. (Kansas City Star)
Americans are not moving en masse because of the Great Recession, unlike the exodus from the Dust Bowl during the Great Depression. Instead, they are staying put more than they did before the downturn. (Slate)
European surveys found the recession easing in May, reinforcing hopes that growth may emerge possibly by the end of the year. (Associated Press)
Neal Templin writes about losing a major chunk of his nest egg over the past year, and how that is affecting his investment plans for the future. (Wall Street Journal)
“The recent optimism that ‘green shoots’ of recovery will lead to the recession to bottom out by the middle of this year … appears grossly misplaced,” writes Nouriel Roubini. (Forbes)
A deepening confidence from financial markets is lifting the economy, but unemployment is likely to remain elevated until at least 2011. (Washington Post)
Young artists talk about how the recession is affecting their lives — and their art. (New York Times)
With fewer people plunking down big bucks for expensive wines, rare vintages are now much easier for collectors to find. (Chicago Sun-Times)
The recession has presumably added value to two domain names which are going on the auction block this week: Wealth.com and Resumes.com. (Boston Herald)
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Newsweek has an article out debunking much of the health advice shilled by celebrities on the Oprah Winfrey Show. Most famously, Jenny McCarthy has been on Oprah several times claiming that vaccines caused her son's autism (the vaccine/autism link has been scientifically disproven). But, more entertaining is the anti-aging regime that Suzanne Somers promoted in January:
Each morning, the 62-year-old actress and self-help author rubs a potent estrogen cream into the skin on her arm. She smears progesterone on her other arm two weeks a month. And once a day, she uses a syringe to inject estrogen directly into her vagina ... Next come the pills. She swallows 60 vitamins and other preparations every day. 'I take about 40 supplements in the morning,' she told Oprah, "and then, before I go to bed, I try to remember ... to start taking the last 20.' She didn't go into it on the show, but in her books she says that she also starts each day by giving herself injections of human growth hormone, vitamin B12 and vitamin B complex. In addition, she wears 'nanotechnology patches' to help her sleep, lose weight and promote 'overall detoxification.'
The authors of the Newsweek article argue that by allowing Suzanne Somers on her show to spout off about "nanotechnology patches" unchallenged by medical professionals, Oprah is tacitly condoning Somers' wackadoo advice. Though Oprah is arguably the most powerful woman in America, I find it hard to believe that more than one or two of her millions of audience members would run out and buy syringes to start injecting their hoo-has with estrogen just because someone on the Oprah show recommended it.
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Newsweek has an article out debunking much of the health advice shilled by celebrities on the Oprah Winfrey Show. Most famously, Jenny McCarthy has been on Oprah several times claiming that vaccines caused her son's autism (the vaccine/autism link has been scientifically disproven). But, more entertaining is the anti-aging regime that Suzanne Somers promoted in January:
Each morning, the 62-year-old actress and self-help author rubs a potent estrogen cream into the skin on her arm. She smears progesterone on her other arm two weeks a month. And once a day, she uses a syringe to inject estrogen directly into her vagina ... Next come the pills. She swallows 60 vitamins and other preparations every day. 'I take about 40 supplements in the morning,' she told Oprah, "and then, before I go to bed, I try to remember ... to start taking the last 20.' She didn't go into it on the show, but in her books she says that she also starts each day by giving herself injections of human growth hormone, vitamin B12 and vitamin B complex. In addition, she wears 'nanotechnology patches' to help her sleep, lose weight and promote 'overall detoxification.'
The authors of the Newsweek article argue that by allowing Suzanne Somers on her show to spout off about "nanotechnology patches" unchallenged by medical professionals, Oprah is tacitly condoning Somers' wackadoo advice. Though Oprah is arguably the most powerful woman in America, I find it hard to believe that more than one or two of her millions of audience members would run out and buy syringes to start injecting their hoo-has with estrogen just because someone on the Oprah show recommended it.
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Generally, I try to avoid advertiser-created viral videos like the plague. Created by corporations, they tend to make me feel duped into watching them, whether they're any good or not. But I found a new series of viral videos by Tampax to be unusually amusing and surprisingly endearing.
At Zack16.com, 16-year-old Zack Johnson wakes up to find his penis has disappeared and been replaced by a vagina. Quelle horror! I'm sure some PhD candidate would have a fine time unpacking the constellation of Freudian issues therein—oh, the anxieties of being a man in the 21st century!—but as entertainment, it's amusing, even adorable to watch Zack struggle with the mysteries of his new genitalia, find out how boys act through his new eyes as a sort-of-girl, and struggle through the surprise of getting his period for the first time.
Some of the gender issues Zack encounters reminded me of a documentary I once saw on women who were transitioning into men. They inhabited this unique double-consciousness: Am I man? Or a woman? Or something in between? Sometimes, puberty is like that, too.
Sure, I guess this makes me one more sucker for Tampax's latest stealth campaign, but watching a teen boy do the oh-my-god-I-got-my-period-in-class shuffle made me laugh.
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A guest post from Robin Marantz Henig, a contributor for the New York Times Magazine (and Sam's mom!):
The death two weeks ago of Summer Stiers, a young woman I met last year and wrote about at length for the New York Times Magazine, made me think about how hard it was for her to get anyone to take her perplexing illness seriously. Whatever ailed Summer seemed to cause a wide range of symptoms, which is why nobody could quite figure out what was wrong with her. She bled from her intestines; her kidneys failed; she had chronic pain in her legs and back; she developed severe toxemia while pregnant and lost her baby; her bones were damaged; she had frequent mental blackouts attributed to seizures; she had lost one eye, and the retina in the other was damaged; she was profoundly fatigued; her hair was completely gray, even though she was only 31.
When Summer first made the rounds of physicians, beginning in her teens, she was often thought to be exaggerating. Some doctors thought she might have a relatively common but vague condition, the kind that is diagnosed in many young women, like chronic fatigue syndrome, fibromyalgia, or irritable bowel syndrome.
It took one astute physician from her home town of Bend, Ore., to realize that all of Summer's complaints might be linked, and to put her in touch with the National Institutes of Health, which had recently created a program to study people with mysterious, undiagnosed diseases. The NIH scientists took Summer seriously, but even now, seven months after they first met her and took samples of her blood and skin to probe her DNA, they have no real idea what she had or why she died. They're getting close, but it will probably take a long time still, and it will obviously be too late to help Summer.
Summer’s case is a reminder that lumping together too many disparate conditions into the same diagnostic grab-bag can be a serious mistake. Maybe a lot of the people (mostly women) who are diagnosed with chronic fatigue syndrome have completely idiosyncratic causes for their symptoms—Summer certainly did—and it's wrong for scientists to insist on looking for the single unifying problem. If we're to get anywhere in the age of genomic medicine, we have to get past the tendency toward glib diagnostic categories. It might turn out that most people with weird, often subjective (and therefore easy to dismiss) symptoms, like poor Summer Stiers, have unique problems that we have to dig deep into the genome to really understand.
Photograph by Getty Images.
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How sad that Summer Stiers, the young woman suffering from an as-yet uncategorized illness who was profiled so heart-breakingly by Robin Marantz Henig in the New York Times Magazine, has died. At least she ended up at the National Institutes of Health where the doctors tried—unsuccessfully—to puzzle out the reason for her many medical maladies.
One of my daughter's favorite shows is Mystery Diagnosis, which presents the story of someone with strange symptoms who goes for years without being able to get a diagnosis. Inevitably, during the course of their search, a doctor, or doctors, tells these patients that their symptoms, from nightly vomiting to loss of consciousness, are all in their heads.
This, too, happened to Summer Stiers, as Robin writes, even though she ended up with kidney failure and loss of eyesight. These difficult patients are told they should just see a psychiatrist, pop some anti-depressants, and leave their busy internists alone. Both the Washington Post and the New York Times have regular features that describe the quests of people with anomalous symptoms to get help. These accounts are full of dismissive doctors who tell the patients there's nothing wrong with them. I have great respect for the medical profession and understand that doctors are under constant pressure from all sides. I'm sure there are patients who are physically fine and suck up busy doctors' time. But over and over I've wondered why it is that doctors, when they don't know what to do, can't say to suffering people, "I'm sorry you're going through this. There is something wrong with you, and right now I don't know what that is. But I will do my best to find out."
Photograph by Getty Images.
