boobs. again.

This post makes me want to go out shirtless, just to see what would happen. Would I get arrested in this country (i.e. the U.S.) if I went out without a shirt? How come women in Europe and other parts of the world don't have to cover their breasts in public, but we do? Why is a breast, in any form, perceived as obscene? Does "the public" not realize that the difference between a man's breasts and a woman's amounts to some adipose (i.e. fat) tissue and developed ducts and glands? Or that breast milk is technically classified as a kind of mucus secretion?

It's just a breast people! Yes, i said it: breast. Maybe I should shout it: B-R-E-A-S-T.

And now for the point: to all those who have issues with seeing breasts, whether on a billboard, a magazine cover, a nursing mom, or on the street, or wherever, I say: GET OVER IT!

Seriously!

But I'm guessing that the people who have a problem with it are probably not reading my blog. *sigh* So what are we to do? How do we educate/liberate people? How do we get the advertisements and messages portraying women as mere sex objects to stop? Why do we buy products that are advertised like this? How come the conservative rhetoric seems to overpower the liberal voice these days?

????

I think I need to move to a blue state. Then again, here's some food for thought: none of the states seem to be doing well when it comes to women's health, in particular. Did you know that the majority of the states are not meeting the minimum basic requirements for women's health? The picture is bleak. Why aren't more people outraged?

"family planning"

my mom forwarded an email to me about the recent appointment of Susan Orr, PhD, to head the Federal Family Planning programs at the Department of Health and Human Services. the message was rather tantalizingly incendiary, and while my personal beliefs meshed with their assertions, i was curious to know whether the piece was slanted. so, thanks to Google, i did a little research.

the liberal slant on this appointment is that it's yet another huge step backwards for women's reproductive rights because Dr. Orr proposed elimination of contraception coverage for federal workers' insurance plans. the conservative slant is that it's a positive movement toward affording a greater amount of choice to individuals, particularly in the form of what components of health insurance coverage they choose to elect.

but what does this office of Federal Family Planning do, exactly? i wondered. so i looked them up. after a bit of digging, i discovered that title x is the main "to do" of this governmental unit. given this, theoretically, their mission is the following:

Program Priorities

1. Assuring ongoing high quality family planning and related preventive health services that will improve the overall health of individuals;

2. Assuring access to a broad range of acceptable and effective family planning methods and related preventive health services that include natural family planning methods, infertility services, and services for adolescents; highly effective contraceptive methods; breast and cervical cancer screening and prevention that corresponds with nationally recognized standards of care; STD and HIV prevention education, counseling, and testing; extramarital abstinence education and counseling; and other preventive health services. The broad range of services does not include abortion as a method of family planning;

3. Encouraging participation of families, parents, and/or other adults acting in the role of parents in the decision of minors to seek family planning services, including activities that promote positive family relationships;

4. Improving the health of individuals and communities by partnering with community-based organizations (CBOs), faith-based organizations (FBOs), and other public health providers that work with vulnerable or at-risk populations;

5. Promoting individual and community health by emphasizing family planning andrelated preventive health services for hard-to-reach populations, such as uninsured or under-insured individuals, males, persons with limited English proficiency, adolescents, and other vulnerable or at-risk populations.

Sounds okay, right? I mean, I don't personally like the notion that they exclude institutions that do not provide abortion services while including faith-based institutions (seems to me that in order to be "neutral," they shouldn't allow either or should allow both), but I'm all for educating people about reproduction and providing health services, particularly in under served areas. I looked up their allocation of grant funds for FY 2006, and while some of the studies seem a bit unrealistic, others did seem like they'd result in some helpful information.

Here's the kicker, though. Any organization that applies for/receives a grant from the government under title X must agree to the following:

None of the funds appropriated in this Act may be made available to any entity under title X of the Public Health Service Act unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities

Um, is it just me, or does that sound like any applicable program has to teach abstinence and take away the rights of minors in order to be funded? *sigh*

I get that people are concerned about the appointment of Dr. Orr to this organization, but based upon what I've read, it seems like most of the funding has already been restricted and directed toward the conservative abstinence-only, family-centered approach. If she continues to support the current administration's conservative views, i suspect we're in for more of the same--a decrease in funding and support for any program that advocates something other than abstinence.

This isn't quite what bugs me most about the appointment, though. What I want to know is why someone with degrees in politics is running a branch of government that should, at the very least, be run by someone with training and expertise in public health, if not medicine? How will she be able to make educated decisions about policy if she can only rely on her own opinions to guide her? I dare say, it would be like putting me--a pacifist--in charge of the Army! ;-)

At any rate, it all makes for interesting debate. What do you think?

As for me, well, I don't know yet. I've got to go read a good five chapters of embryology before I can even begin to form a foundational knowledge of what, exactly, "family planning" means....

Breast Cancer Walk 2007

i'm happy to report that, thanks in no small part to many of you, the mwms group raised over $1400 for breast cancer today! :-) the photos tell all....

the multitude of walkers

mwms students making strides!

the group pose

rant: Breaking News - Cleavage on Display

Have we reverted to the Victorian Age? Based upon the following email I received from NOW, one would think so.

Breaking News: Cleavage on Display

"There was cleavage on display Wednesday afternoon on C-SPAN2. It belonged to Sen. Hillary Clinton... There wasn't an unseemly amount of cleavage showing, but there it was. Undeniable," the Washington Post reported.

NEWSFLASH: Hillary Clinton has breasts.

And apparently that "news" merits coverage in the Washington Post.

In a Style section cover story on Friday, fashion "reporter" Robin Givhan notes that Hillary Clinton has taken a brazen step for a woman politician by wearing a low neckline. "Showing cleavage," says Givhan, "is a request to be engaged in a particular way. It doesn't necessarily mean that a woman is asking to be objectified, but it does suggest a certain confidence and physical ease."

Shock! Horror! A prominent woman showing confidence and physical ease!

Givhan goes on with her psychobabble: "It means that a woman is content being perceived as a sexual person in addition to being seen as someone who is intelligent, authoritative, witty and whatever else might define her personality. It also means that she feels that all those other characteristics are so apparent and undeniable, that they will not be overshadowed."

This article about the frontrunning candidate for U.S. president caused quite a stir in the NOW office this morning, eliciting reactions ranging from "You've got to be kidding!" to "What century is this?" The piece is definitely outrageous, but it's also hilarious. Absurdly hilarious. And it's an indictment of our society's lingering archaic notions of femininity, assumptions about breasts and sexuality, and fears about powerful women.

What do you think? Share with us your take on this story -- whether analysis or satire. We'll post the best ones on the web site. Send your submissions to cleavage@now.org.

Read more on media treatment of politicians including Hillary Clinton. Sign our petition to major media outlets. Send this story to your friends.

my reaction to all of this?

*headdesk*

Basically, the Washington Post is saying that in order to be taken seriously in this world, I have to have a sex change operation. I mean, that can be the only conclusion, given that I am a woman who has breasts and that, no matter what I do, they're evident. As a future female physician, will I always be second-guessed because of them? What a horror, to think that a physician might *gasp* have breasts!

Come on, Victoria's Secret, where's your new line of cinch bands for women who want to have successful careers?

clearly, you've missed the market....

rant ii: the government versus a woman's body

the supreme court released its decision re: partial birth abortion today. i wish i could provide a direct link to the court document, but it's a rather large pdf file, and i have nowhere on the web to store it myself. so if you're interested in the nitty gritty of what i'm about to say, you may want to go read that document first. now has a link to it in their news section, as do several other news pages and organizations.

if you've been reading my blog, you know by now that i consider myself a feminist. i tend to agree with liberal politics, primarily because i'm an academic at heart and i'm always questioning everything. (my favorite question growing up: why?) i believe that conventions are made to be questioned and analyzed, not reflexively followed. i also am an exceptionally sensitive person, one who holds life dearly enough that she's been known to run into traffic to save a turtle about to meet its demise by attempting to cross the street. i cried when someone killed the wasps outside my house recently, even though i was afraid of them (i don't like pain and therefore avoid critters that sting/bite/want to eat me). basically, i'm a big mush--my heart is always on my sleeve and, no matter how hard i try, i cannot conceal this fact.

that having been said, i struggle with the issue of abortion. i feel that life is sacred. i've always been fascinated by childbirth and i know i'll likely end up focusing my career on women's health. *and* i have a strong respect for women's bodies and their choices about what happens to their bodies. so although i don't think i could ever have an abortion myself (<--i'm a little biased because i have fertility problems and it would be pretty darn hard for me to get pregnant without medical intervention), i think every woman has a right to choose. i also acknowledge the fact that, given my interest in women's health care, i may be trained and/or asked to perform this procedure. this fact scares me, but i acknowledge the reality, nonetheless. i cannot imagine the suffering that an unwanted child must endure throughout his or her life. i also don't think any woman should be forced into poverty or put her life in jeopardy for a fetus. it's my opinion, plain and simple.

when i first heard about partial birth abortion, i was incredibly disgusted. the description of the procedure seemed absolutely horrific to me and i couldn't understand why anyone would ever want to have that kind of an abortion. then i read the supreme court ruling.

if i'm understanding it correctly, a partial birth abortion involves delivering the fetus to a certain point and then killing it. in contrast, other types of late-term abortion involve dis-membering the fetus in utero and then delivering it. knowing what i know about science (remember, i just studied embryology and neuroanatomy, among other things), if i had to choose between someone whacking me on the head to kill me versus tearing me to shreds, i'd choose to be whacked. it's not even in the realm of being contestable--one act causes immediate death, the other is pure torture. but what did the courts just do? they just prevented physicians from performing the "humane" form of abortion while permitting them to torture fetuses via the alternate method. they say they're trying to preserve the sanctity of life--how on earth does this decision uphold that sanctity? seriously! can anyone follow the logic here? or did they simply make the decision so ambiguous as to prevent providers from performing any late-term abortions? hmm....

i really don't understand how the same government that has allowed us to invade other countries where we are killing innocent children and that allows our children to access guns so that they can kill each other can take a stand against killing a fetus that cannot survive outside of its mother. i also don't understand how our government can refuse to allow sex education to be taught in schools. if they don't want women to have abortions, then why aren't they teaching pregnancy prevention? if they're professing abstinence as a "cure" to prevent pregnancy, then why is the government (in some states) requiring young girls to be vaccinated against sti's? if they truly believed in their abstinence programs, there would be no need for the vaccinations. oh, wait--that's right--boys can have all the sex they want and spread around the sti's while girls have to remain abstinent until marriage wherein they get exposed to sti's because the guys were sleeping around--that's why we're mandating the vaccines, right?

i swear, if it weren't for the right to free speech, i think i'd be on the next plane out of this country. until the government takes away my right to rant, though, they'll just have to deal with me screaming from my blogspot.

little known facts about women & aging

this semester, in addition to being inundated with work for PBL, OMM, & CE, we first year medical students also have the privilege of taking on 4 additional 5-week classes: ethics, geriatrics, public health, & healthcare management. for geriatrics, one of our assignments is to write a review of an article. the particular one i chose, "comprehensive evaluation of the older woman," (H Amin MD et al. Symposium on Geriatrics: "Comprehensive Evaluation of the Older Woman." Mayo Clin Proc. 2003;78:1175-1185.) offered some surprising information. Here are some of the little-known facts I learned:

• in general, the aging woman accounts for nearly 70% of the caregivers of older persons and a woman is more likely to live alone, experience more years of dependency, and, in her later years, experience more financial difficulty and/or poverty than a man
  
• dementia, defined as an acquired persistent and progressive impairment in intellectual function with compromise in multiple cognitive domains is the fourth leading cause of death in older women, with a prevalence of 25% to 47% in patients over 85
• delirium, defined as an acute, fluctuating disturbance of consciousness, associated with a change in cognition or the development of perceptual disturbances, and has two causes: an underlying medical condition or medication. the most common cause? polypharmacy (i.e. 5+ medications--including vitamins & herbal supplements--taken on a daily basis)
• the prevalence of major and subclinical depression in older women is 15% and women aged 65+ are 2x as likely to have depression as men of the same age (so much for the theory that hormones cause our mood swings, eh?)
• women are twice as likely as men to suffer urinary incontinence
• falls are the 6th leading cause of death in elderly persons and contribute to 40% of nursing home admissions; there's a 20% mortality in the first year after sustaining a hip fracture
• the lifetime mortality risk of coronary heart disease (CHD) among postmenopausal women is 31% compared with 2.8% for hip fracture, 2.8% for breast cancer, & 0.7% for endometrial cancer; of women 65+, 55% experience functional limitations, morbidity, & impairment of quality of life due to CHD (and yet we hear more about cancer than we ever do about CHD)
  
• more than 1/3rd of women (ages 20-70 years) in the united states have hypertension, 25% have hyperlipidemia, 25% are smokers, 25% are obese, & nearly 60% are sedentary (i.e. all this mortality is relatively preventable)
• nearly 70% of sudden deaths in women are from unrecognized CHD; in women, 40% of all coronary (i.e. heart) events are fatal, but women with CHD are not treated as aggressively as men (traditionally, anyway--let's hope that's changing!)
• women who smoke present with their first MI (i.e. heart attack) 19 years earlier than female nonsmokers
• the onset of type 2 diabetes can be reduced by 58% in women who exercise moderately 2.5 hours per week; improvement in cardiovascular risk has been shown even in women who walked only 1 hour per week
• the lifetime risk of developing hypertension (i.e. high blood pressure) in people who never had it before who are 55+ is 90%; in persons over 50, the risk of cerebrovascular disease DOUBLES for each 20/10-mmHg increment of blood pressure level
• more than 80% of patients with diabetes die of cardiovascular disease; the risk of CHD in women with diabetes is 3 to 7 times higher than in women without diabetes
• after age 65, the risk of developing uterine cancer increases by 2x and the risk of ovarian cancer by 3x; and yet...15% of women aged 65 to 74 and 38% of women over 75 have never had a PAP smear
• endometrial cancer is the most common invasive gynecologic malignancy (but we're not even close to having developed a reliable test for it)
• age is the most predominant risk for breast cancer; 1/3rd of breast cancer cases are in women over 70; an increased risk of breast cancer was found in people who drink alcohol (but alcohol lowered the risk of CHD...pick your poison?)
  
• decreased sexual activity is influenced by the fact that by age 80+, there are 39 men for every 100 women; the geriatric population has the second highest rate of HIV infection after teenagers (proving that viagra should be packaged with condoms)
• in women aged 65+, 31% did not graduate from high school
  

time for change!

first, i decided it was time to change my blog template. the dots were starting to drive me crazy. alas, my attempts to find some really neat artistic template failed when i realized that i was spending too much time tweaking and not enough time studying. so, for now, my html alterations on font, plus a different blogger template, will have to suffice.

but, when i titled this post "time for change," i wasn't thinking primarily about the template, or the impending daylight savings time debacle (does anyone know *why* we still do this? does it stem from hubris? i need my hour, dagnabit!). no, my thoughts were of a more radical sort: thoughts that call for alteration of our conventions.

my problem, at present, has to do with the conventions of being a woman in medical school. more specifically, my problem has to do with american definitions of "modesty," particularly in clinical settings. it's been insulting enough to be a female patient, one who gets asked to don a paper gown for every examination. does anybody really think that wrapping myself in paper preserves my modesty or my dignity? the darn things are practically translucent! not to mention they slide off with the slightest movement, rendering one nearly or totally naked in spite of the paper. but i digress. this week's problem isn't about being a patient, it's about the insult of being a female medical student.

****disclaimer: if you're the sort of person who cannot cope with precise anatomical descriptions of the human body, you might want to skip this post.****

that said, medical students, as i may have mentioned previously, learn the art of physical examination by practicing on one another. we do this in a large room, with a handful of physician instructors who wander around and monitor/amend our progress. it should, for all intents and purposes, be a very professional learning environment...right? wrong. first off, let me mention that the school chased off the only female physician instructor for our clinical exam class. (don't even get me started on how i feel about that--she was, after all, our best lecturer and really the only female role model here within an age range to which we could relate--i could vent for hours about my anger over her absence.) so, now, our clinical examination class (we call it ce for short) is led entirely by a staff of male physicians, most of whom are retired from clinical practice and/or getting there. don't get me wrong--some of these guys are brilliant and it's a privilege to get to learn from people who have been in practice for a number of years (i.e. 30+). since it's one of the anatomists/deans that refers to me (and every other woman in the class) as "honey," i can even say i have comparatively good rapport with these men.

however, on tuesday, our ce lab covered the cardiac exam. the night before, we got an email from one of the primary instructors, reminding us to wear our omm (osteopathic manipulative medicine) attire. this consists of shorts or sweatpants and a t-shirt. for the women, it also means we have to wear a sports bra. (the professor's email blithely mentioned that this piece of the attire was optional for the men.) supposedly, we have to wear sports bras to "preserve modesty" when doing the exam. whatever....

the cardiac exam requires that we remove our shirts, which is no big deal since we do it every week for our omm class anyway. however, in order to properly perform a cardiac exam (at least in the thorough manner in which we're taught to do it--i've never actually seen a physician perform each and every one of the components of the entire physical exam in a real clinical setting), we have to palpate the chest for the pmi (the pmi is the point of maximum impulse; it's about a 1cm spot on the chest where you can feel the heart beat up against the sternum/breastbone). when the physician instructor demonstrated this technique to the class, he (of course) chose some young chiseled man as his specimen. in order to find the pmi, the professor noted, we should find the level of the nipple line and move slightly inferior (below) that. any of you who are female readers should already begin to see the problem here. but did the professor mention it? no.

so, he instructs us to begin practicing on each other. several of the female students and i began working on each other. we quickly noticed a big problem: breasts. first off, when breasts are bound up in a tight-fitting sports bra, they don't move a whole lot. you can't really separate them, lift them, or otherwise get them out of the way without getting bound up and/or stuck in the elastic of the fabric. so, we tried to feel for the pmi around them. no luck. we tried to find the pmi on ourselves (so as not to have to molest our lab partners); again, no luck. at the 4th and 5th intercostal spaces (the areas between the fourth and fifth ribs), there is, in many of us, simply too much tissue to get anywhere near the breastbone. we were stumped. so, we did what any normal group of students would do: we called over one of our professors to ask for help.

the professor, upon hearing our question, turned bright red. by this point in the day (we'd had 5 hours of lecture already), i was too tired to censor myself, so i said, "haven't you seen like a million breasts in clinical practice? what's the big deal?" he stammered a bit and then said that it's different when it comes to students. what's different? i thought, my breasts? but fortunately, i bit my tongue before the questions came out of my mouth. essentially, we got no answer from him as to how to perform the exam properly. we were only given the impression that, in a room full of 80 students and a dozen faculty, the men were still afraid that someone would claim inappropriate behavior if they demonstrated on us.

after class, a bunch of us gathered and began talking about the experience. now i, having been a women's college graduate, really have no problem with breasts. (they're breasts, people! i wanted to shout. parts are parts!) in fact, as a medical student, after having seen cadavers and the like, i really don't have a problem with any body parts. but i also recognize that i am not everyone. some of my closest friends here are muslim. as such, they cannot remove their t-shirts in lab because we're in a co-ed lab. i asked one of them why the school did not offer her a separate lab session; apparently, one of the other medical schools kicked a muslim student out of school because she requested this. (can they do that?!?!? isn't that against our civil rights or something?!?!?)

is it 1950 again?

needless to say, i am angry. part of me wants to go to the next lab braless, but i have a feeling that'd give half the old guys heart attacks, and then i'd actually have to *use* the new cpr skills i just learned and...well...i'm not ready for that. i did end up emailing one of the professors and asking him to address the issue at the next session, but he hasn't replied to my message. am i surprised? no.

so, what is a girl to do? you might ask. for starters, never call a female over the age of 18 a girl. or honey for that matter. as for my solution? i scraped up my pennies and joined now.