"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....

the first day -- again...

i'm amazed that one year after writing this post, i've just relived the first day of medical school again. today was like one gigantic deja-vue dream. the slides were the same. the lecturers were the same. the message was the same (aka: they own my ass. still.). the only difference? this time, they decided to begin anatomy on day one. so in addition to hours of talks on policies and procedures, we had two hours of anatomy lecture. that shocked most of the incoming students, i could tell. it's one thing to hear described how much information will be thrown at us; it's an entirely different thing to experience it. by the end of the day, it seemed like the class was rather sobered.

i feel like being a brat and saying 'i told you so,' particularly to my roommate, who was eyeing me suspiciously all weekend as i studied anatomy. "classes haven't even started yet!" she exclaimed. my response? "it doesn't matter." i kept studying.

when i mention to my new set of peers that i'm a returning student, i get some pretty odd looks. many people prickle a bit, on the assumption that i've got some kind of academic advantage. sure, i've heard these anatomy lectures before--but i'm not certain that makes up for the loss of confidence that comes from having done poorly in the course the first time around.

the days leading up to today were riddled with anxiety for me. can i do this? am i well enough? should i do this? am i making the right decision? is it worth it? what if i fail? <--these were just a few of the questions rattling around in my head. i still don't have answers to the questions. but i did come up with one crazy idea: to find one thing, each day, that i learned that interested me. i'm sure on many days there will be more than one thing that piques my curiosity--but it's not always easy to remember to be curious in the midst of such a pressured environment. since i'm here because i love to learn, though, i need to remind myself why i'm doing this. and i need to remind myself as often as possible. so...i'm off to a new start again. here's to hoping the road will be less bumpy this time around....

....

interesting factoid of the day:

"during early embryonic development cilia containing a 9 + 0 pattern of microtubules establish the left-right asymmetry of internal organs"*

this quotation refers to the fact that there are these itty bitty hairlike processes (cilia) that extend from cells that help cells to move (think of high school biology class and seeing weird critters move around under the microscope via what look like little caterpillar legs.). apparently, recent research studies have shown that the location of the internal organs in the body (i.e. that our heart is on the left & the liver on the right, etc.) comes from the movement of these little cilia found on cells really early in embryonic development. the significance? people who lack these little cilia end up with situs inversus, a condition in which the internal organs are reversed in their position, such that what is usually on the right ends up on the left and vice versa.

sketch of the apperance of situs inversus in the thorax

pretty cool, no? ;-)

....

daily mileage:
orientation lectures: 6.5 hours
anatomy lectures: 2 hours
time spent trying to get the class schedule to print properly: 1 hour
individual study time: 0 hours

....

* Ross, M et al. "Histology: A Text and Atlas." 5th ed. New York: Lippincott, 2006. Pp. 105