5.28.2010

Gestures toward victory

I happened to catch the end of last night's debate between the various GOP candidates vying for the party's nomination in the Maine gubernatorial race. It offered some interesting insights, one of which was that a distressing number would advocate for the teaching of creationism in schools.

What was really interesting to me, however, was the answer to the question about same-sex marriage. Most of the candidates were opposed to legalizing same-sex marriage, which comes as no surprise. But only one or two (and there are, I think, eight in the running) explicitly disavowed legal recognition for same-sex couples. Almost all said that same-sex couples deserve some (or equal) protection under the law, even without calling it marriage. One advocated for equal legal status for all couples, and having marriage be an exclusively religious designation, which suits me just fine. And we'll get to Peter Mills in a second.

I found this remarkable. Admittedly, this is leftist Maine we're talking about, but these are the GOP candidates for governor. And almost all advocated for legal recognition of same-sex couples. While we're obviously a long way from full equality, and I think it'll be a while before the state gets anywhere near another attempt at marriage equality, I can't help but be encouraged.

And on that note, I'd like to specifically call out Peter Mills. He was, if I recall correctly, the only Republican in the state Senate to vote in favor of marriage equality, a stance he reiterated without hesitation last night. (He also unequivocally repudiated teaching creationism in schools.) If he gets the GOP nomination (which I think is a long shot, at best), I will have a hard time deciding who to vote for (particular if certain Democrats end up running against him). I kind of enjoy the hilarious hubris of endorsing a candidate, so here is the First Official Bleakonomy Political Endorsement of All Time -- Peter Mills for the Maine GOP nomination.

Someone alert Mark Halperin.

In which I contribute 0.4% to his readership

For those of you who might be interested in reading unparalleled, in-depth scientific analysis of the current oil crisis in the Gulf of Mexico, I'd just like to put in a little plug for a really great blog, whose author may or may not be related to me. He's been getting quite a bit of exposure recently, from across the ideological spectrum, and is providing information of a kind that's both high quality and hard to come by.

People who may or may not be related to the author are quite proud.

5.24.2010

Guys, I don't mean to alarm you

But it seems that Cthulhu has eaten Milla Jovovich.

Dithering about the closet

Andrew Sullivan has been all in a swivet about Elena Kagan. Generally when he gets in said swivets, I find him a little hard to take. But on the subject of Kagan and closets, I find myself agreeing with him.

Elena Kagan may or may not be a lesbian. I have no idea. If she's not, then it is beyond obvious that denying it is the only appropriate response. If she is, on the other hand, then I think she has a moral obligation to say so. I certainly understand why she might be inclined to keep her private life private, but there are implications and obligations beyond her desire not to have her love life scrutinized.

Let me be clear. I am sincerely sympathetic when it comes to why she would be deeply, indescribably reluctant to have the likes of, say, Jeff Sessions casting aspersions about how she lives her life. I am, luckily, able to tell the likes of Jeff Sessions (were he to ask) to cram his inquiries about my private life into [redacted] without fear of losing my job. Kagan is not so lucky at the moment, and so she has to face the monumentally unpalatable task of hearing the opinions of Sessions et al about her love life and her fitness to be appointed to the Supreme Court. I get it.

She should still answer the question in a straight-forward manner, should it (almost certainly) come up. The time for lesbianism to be considered a shameful secret is well past, and good riddance. The people who would oppose her nomination on those grounds would (bet your bottom dollar) oppose her nomination regardless. It will be a convenient excuse for them, to be sure, but I would just as soon have them expose themselves (once again) for the flagrant anti-gay bigots we already know them to be as have them bloviate about something else.

Social change requires courage, and I would honestly hope that anyone worthy of serving on our nation's highest court, in a branch co-equal with the presidency, would have that kind of courage. I know doing so is politically inconvenient. She should do it anyway.

Don't all roll your eyes at once

So, did you miss me?

(If I had the ability to insert a visual of a tumbleweed rolling across the screen, I would do so here.)

OK, so perhaps my exile from blogging didn't leave the Internet sobbing and begging for my return. It's not like I was expecting that people would miss me. Well... maybe a little.

The new office is very busy, so I doubt I'll get a chance to post with anything like my previous frequency. But I'll try to get something up a few times a week, for those of you who have been pining desperately for my return.

5.20.2010

On the need for feminist heroines

I will begin by saying this. I can't stand when a film or novel by a certain kind of man depicts females as cardboard-flat male fantasy figures. Currently I am watching the Tudors, and after every episode I think how much better the show would be if it concentrating on understanding the female characters, instead of figuring out more and more contrived ways to unlace their bodices.

What I am interested in is a well-drawn female character. One that shows understanding of what it's actually like to be a female. One that shows psychological insight. What I don't want is a political prop.

I come across questions and arguments like this all the time. The question is roughly: is X a feminist heroine? is Y a strong woman? If not, then the artwork is suspect.

There are a few problems with this question.

First, look who is doing the asking. Usually, it is someone with already-feminist leanings, who already has a notion of what it means to be a strong woman (which really is a nebulous concept). So why do they need a strong female heroine? Because they have such paucity of imagination that they cannot watch a fiction who depicts someone different from they? I assume why they are demanding feminist heroines is so that other people, a fortiori less informed than they are, might have a guide on how to behave. On the day the entire goal of fiction is actually to teach the less informed how to live, I will give up books and movies and take up mahjong. There's nothing wrong in noting that people learn from literature. They do. But there is something seriously condescending in the plea for a yet more feminist heroine from people who are already feminist.

Second, even supposing that one goal of fiction is to teach people how to reset their gender notions, one should not underestimate the power of the negative example. One learns what to be not only seeing what is admirable, but also by seeing less-than-admirable behavior.

Third, there exist less strong-willed women in the world. Should we not depict them? Sometimes, they have other sterling qualities that some strong-willed woman lack. Is a female admirable only insofar as she is a rootin' tootin' badass?

Here's a more nuanced take from Meryl Streep. She discusses how she judges men based on which character of hers they find appealing (seems reasonable), but also notes the value of portraying a more beaten-down female character. A psychologically real female will and should elicit a variety of responses, but is more truly valuable than a piece of propaganda.

Is it okay to ask if someone is gay?

Andrew Sullivan has been driving this point home: if you really think there's nothing wrong with being gay, why is not okay to ask about it? Why shouldn't we ask Elena Kagan if she is gay?

I think he's right to a certain extent. Certainly the Obama administration was acting like there was something wrong with it when they smacked the press for asking the question.

But I don't think that it's true that if an action or property of a person is value-neutral, then it cannot be private. One might think being gay is value-neutral and still want to keep it private. Shame is not the only reason why one does not share all the details of one's personal life. There are plenty of things that are value-neutral and private. How often someone goes to the bathroom. How frequently someone has sex with his or her spouse. Whether someone has ever doubted her faith in God. Whether someone is no longer in love with his spouse. Whether someone resents her parents. Etc.Some of these might actually influence how someone votes on the Supreme Court.

If I were gay, I'd doubt I'd keep it quiet. But Kagan has chosen to. It is certainly reasonable that one might not want to divulge to whom one is attracted. It's a plausible candidate for privacy. Given that she seems to want to keep it private, I see no reason to ask her about it. And that is not because I think there is anything wrong with being gay.

Boycott BP?

Dan has (for reasons that only he and god know) given me the ability to guest-blog in his absence. And what better temp could there be for Dan than a heterosexual, libertarian-ish, atheist… Might I add that I’m not a doctor... that I merely diddle around in the ivory tower?

Our local BP station is a nice shop. The mechanics seem really to know their stuff and it has the warm feel of a “mom and pop” shop (as much as any automotive garage can). It’s a small business run by real people from “Main Street.” Ultimately, though, the masterminds of the current catastrophe in the gulf are behind it, collecting revenue, enjoying profits. In a recent fit of anger directed, not at my local shop, but at BP the corporation (or at least some fuzzy idea of the gargantuan entity responsible for the current catastrophe) I was tempted to “boycott” BP, i.e., stop filling my tank and getting my cars repaired there. But I wondered, what did the local owner do to deserve that, or the hard workers in the garage barely eking out a living? Assuming that BP acted negligently, weren’t these workers participating in the BP franchise mislead too? Didn’t they trust BP to conduct their practices safely and responsibly? If so, should they be punished for the misdeeds of their ultimate owners?

On the one hand, we certainly don’t want to punish these folks. They’ve done nothing wrong but might well suffer from a boycott, or at least a boycott with any significant impact (whether or not boycotts actually wind up effecting any change in the first place is a different issue -- it’s a matter of “principle”). On the other hand, those responsible need to be held accountable, and perhaps we shouldn’t continue to support the BP Corporation, even if it means that some innocent folks would suffer by losing jobs.

In that regard, I don’t think a boycott of BP is as insensitive to the worker as it might seem at first glance. Consider: if you work for an employer who, unbeknownst to you, engages in criminal activity, would you really want people to continue to support the employer just so you can retain your employment (think Enron or Bernard Madoff)? Even if BP’s actions aren’t accurately characterized as criminal, BP erred royally. And erring royally even with with the best of intentions shouldn't allow you to keep your job, especially when public safety is at stake on a large, perhaps even global, scale. It might be difficult for the innocent workers who participate in the BP franchise to restructure their lives, however, that does not seem like an adequate excuse for not taking action against the BP corporation.

5.14.2010

Would David Cameron Lead the Republicans?

Another difference between Tories and Republicans, besides gay rights and climate change. I can't imagine the leader of the Republican party admitting publicly that he sometimes wondered if it would be better if his severely disabled son (whome he clearly adored) were to die, and then leading his party. Nuance plays better to Tories than Republicans.

What Obama has Failed To Do

I sometimes feel as I am the lone remaining true fan of Obama, who thinks he ranks among our best presidents. He is the intelligent pragmatist compromiser I have been waiting for!

One thing he has been especially bad at, however, is letting his image get tarnished with falsehoods. Very few Republicans realize just how moderate he is, just how much he has let down the Left, just how concerned he actually is about the deficit, just what the stimulus did avert, how we helped in Haiti, how his health care bill actually has most of the features people say they want. Fox News is setting the terms of the public debate. To the degree that he has not forced people to recognize, and thus puts his own reelection in jeopardy, he has been a failure.

Tiger Woods's Dad as Parenting Model

Since it has become apparent that Tiger Woods has voluptuous tastes (of which the mother of his children failed to approve), there has been a strain of sadness - how that would disappoint his father! His wonderful, legendary father!

The Earl Woods love-a-thon is baffling to me. The fact that he could publish books on his parenting technique is also mysterious. Here is a guy who left his kids that he had with his first wife, and concentrating on programming Tiger from infancy to be a great golfer. To the degree that it worked, I suppose his parenting is interesting. But he hardly left Tiger the choice what to do with his own life. In focusing on success in the sports arena, failed to cultivate his whole person. Not to mention, he programmed him to be a golfer. John Stuart Mill's father did a similar Frankenstein move on Mill ("I will create the man I wish I could be!"), and his method also worked: he created the great utilitarian philosopher that he wanted. And I would argue that the works of John Stuart Mill are more valuable the entertainment of Tiger Woods's golf. But Mill's nervous breakdown at 19 showed that his father's move had serious costs, and, on any moral view besides utilitarianism, is seriously wrong-headed.

How is Earl Woods any different than a pushy stage mother or JonBenet Ramsey's parents (on the assumption that they didn't kill her)? Both push their kids to be professional at a young age, both force them into adult-pleasing roles, both develop the ability to entertain over being a good person. Yet everyone hats stage mothers and pageant moms. Is there some sexism here? Is golf that much inherently better an activity than acting? Shouldn't we all recognize that to try to create a person focused only on one activity, we fail to respect the autonomous person are child will become, limiting severely her options?

5.13.2010

The Ashley Treatment

I had never heard about this case, but apparently it got some press. Ashley X was born with severe brain damage as an infant, and while alert and attentive to her environment, cannot talk, sit up, hold up her head, hold an object, or eat on her own. Her parents and doctors attenuated her growth and development by, among other remedies, a hysterectomy and removal of breast buds. An ethical uproar apparently ensued, which I missed until I came across this yesterday. It is an argument against Ashley and her parents.

The degree of disability is not important nor is the type of disability. We people with a perceived disability are simply the other. Given this, I do not consider myself one iota different from Ashley in spite of the great difference in our cognitive ability. In coining the term the Ashley Treatment doctors have not only over reached the bounds of ethics in medicine but sent a shot across the bow of every disabled person in American society. The message is very clear: disabled people are not human—they are profoundly flawed beings and extreme measures will be taken to transform their bodies. Consent is not necessary as the mere presence of people with a disability, particularly those like Ashley with a profound cognitive disability, is inherently unacceptable. Modern science however has come to the rescue and doctors have the technology to save us. The problem with this line of thinking is that it is inherently dehumanizing. Ashley need not be saved, surgically altered any more than me or the people listening in the audience.


It is on issues like these that I part ways with many activists for the disabled, whom I largely support for their advocacy and success in changing the treatment of cognitively disabled individuals.

First of all, the disability does indeed matter. The notion of autonomy presupposes rational abilities. It is in virtue of rational abilities that we grant people autonomy - which simply is the right to exercise their rational abilities. Cognitively disabled people cannot exercise rationality (at least, many of them cannot). Neither can children. So while one is a child, one's parents must act in their interest. Parents must choose what children eat, with whom they socialize, how they are educated, when they shower. All of these are decisions it is entirely inappropriate to make for another adult, because it violates their autonomy. Children do not have autonomy, and neither do the severely intellecutally disabled.

Which brings me to consent. Consent is only useful if it is a) informed consent, and b) arrived at through rational processes. Consent cannot be granted by people who lack adequate information and and the cognitive processes necessary to make decisions. A child cannot give consent for a vaccination, because he cannot understand fully what is at stake. Ashley cannot give meaningful consent.

Given that she cannot give consent, a decision not to operate is just as much a decision made for Ashley as a decision to operate. In cases like these, paternalism is unavoidable.

Just because Ashley lacks rights to autonomy or bodily integrity does not mean that she has no rights. I think this is what makes many disability activists, such as the one quoted above, nervous. They are also remembering the callous treatment of the intellectually disabled of the past. But recognizing that she cannot make decisions does not mean she is not to be valued. She has a right to beneficence. She has a right that someone care for her and make her world as comfortable and happy as possible. These are by no means insignificant rights.

The other thing that seems curious to me is the insistence on looking only at Ashley's interests. Ashley's interests matter morally, and I do think her interests should be weighed the same as a typical person. But her family also has interests. Don't they matter morally?

I am a bit sensitive on this issue. Just a few months ago, it was a live possibility that my son would be in Ashley's condition. Now he can hold objects, and sometimes hold his head up. He seems headed in a better direction than Ashley is. But he is still entirely tube-fed. It is a live possibility that he will never walk or be toilet-trained (although thankfully it is looking increasingly less likely). He is also 95th percentile for height and weight. Our ability to care for him will be seriously circumscribed by size alone. The future is bleak for parents in such situations, as it is for siblings. If their lives can be made easier, that is morally important, too. Not to mention it allows intellectually disabled people to remain at home cared for by loved ones longer.

In short, we can't be talking about bodily integrity, autonomy, and consent when it comes to the intellectually disabled. We must be talking about beneficence. And a treatment impacts not only the recipient, but the entire family. Ashley's family was justified in looking at the entire situation and choosing for their daughter what she could not choose for herself.

5.12.2010

Radical Idea: Don't be stupid about nuclear power



Given the reality of climate change (for which the science is as clear as say, vaccines), the possibility of a return to nuclear power is pretty strong. It's not a terrible idea -- I grew up near the Cook County nuclear power plant, and still have a coffee mug from their gift shop. The fact that both my parents died of cancer is coincidental, I'm sure. I hope.

So a recent study of mutations around nuclear power plants was a bit sobering:
Conventional wisdom holds that nuclear power stations don't leak enough radiation to create malformed organisms. But in some locations, Hesse-Honegger discovered mutations — curtailed feelers, misshapen legs, asymmetrical wings — in as many as 30 percent of the bugs she gathered. That's 10 times the overall rate of about 3 percent for insects found in the wild.
As pressure mounts to build new nuclear power plants, perhaps we can all agree not to be stupid (or incredibly stupid) about how we build them. Apparently what we're doing now simply isn't good enough.

It wasn't long ago that we detonated nuclear explosions in the upper atmosphere -- just to see what happens. Giant (and thankfully temporary) belts of radioactive energy encircling the entire planet...

The kind of responsibility that nuclear power demands is massive. Finland has a 100,000-year plan for storing nuclear waste. It's going to take 20 years and several billion dollars to build. A country that can't get it's act together on the most basic legislation seems unlikely to be able to come up with a realistic plan for building nuclear plants and storing waste. We seem more interested in pork, regardless of, well, basic geology.

Hesse-Honegger is also a incredibly talented botanical illustrator, by the way; that's her painting at the top of this morning's post.

5.11.2010

In the news today

David Cameron is the new Prime Minister of the United Kingdom, though he doesn't yet have a majority coalition. Because the now-former Prime Minister graciously resigned -- something I have a hard time imagining in American politics. Or is it just that politicians on the left (see: Al Gore) are more willing to concede for the 'good of the country' ?

Meanwhile, back on this side of the pond (provided you can get past the new cloud of Icelandic ash), Halliburton, favorite punching bag of progressives (count me among them), may be at least partially responsible for the horrendous oil spill in the Gulf of Mexico. Halliburton's defense was that they had left 20 hours before the blow-out. So it couldn't have been their fault? I mean, if the plumber comes to my house to work on the toilet, and after they leave the first time I flush the toilet explodes -- that couldn't be the plumbers fault, right?

Looking forward to watching BP, Halliburton, and Transoil tear each other apart like a trio of 9-year olds shouting "He did it!" Except in this case, a trio of nine year olds who've managed to create a catastrophic toxic spill covering several states...

I mean, it's not like they should have had, I don't know a plan in place in case something went wrong. I mean, how often do blow-outs happen? Well, actually, fairly regularly.

And BP did such a good job cleaning up from the Exxon Valdez spill, right? Oh, oops, they screwed that up too. That's right, kiddos. BP was the contractor for the clean-up of the Valdez spill, and they didn't have enough booms then either. Charming.

But if the polite waltz of British politics is too boring for you, or the ongoing oil spill too depressing, you can join us in watching the GOP paint Kagan as a Maoist man-hating Nazi queen of abortions. Or you could just do your own vetting. I wonder if anyone will go to town with the fact that she was once the defense attorney for the National Enquirer? "Obama Nominates Bat-Boy to Supreme Court!"

And to think its only Tuesday.

Dan, finishing unpacking soon! Not only is the news depressing, there wasn't one decent joke in this whole post!

5.09.2010

Sometimes a thought reveals itself

This confused AP article seems to reveal some attitudes on the part of the author and/or headline writer.

First, it's poorly written. At one point it says, "America's suburbs are now more likely to be home to minorities, the poor and a rapidly growing older population as many younger, educated whites move to cities for jobs and shorter commutes" which implies that suburbs are now primarily minorities. Then it says, "Suburbs still tilt white. But, for the first time, a majority of all racial and ethnic groups in large metro areas live outside the city."

Then the head line was pretty striking. It's "Suburbs lose whites to cities." Not "Suburbs gain cultural and racial diversity." A sub-hed calls it "Bright flight," and the article does not seek to stress that brights does not equal whites. Quite the opposite. Ouch.

5.06.2010

The definition of "slave"

So I was listening to the Diane Rehm show yesterday, and Isabel Allende was on. Apparently, Allende's most recent book has something to do with slaves.

A caller called in, full of dignified outrage, and said something along the lines of, "Please don't use the term slave anymore. It's offensive. Use 'enslaved.' These people were unwillingly held." Allende murmured her agreement with the new nomenclature and said "That's right. I hadn't thought of that." Diane Rehm said approvingly, "That's an excellent point. The enslaved were held against their will."

Huh? I'm pretty sure most definitions of "slave" already include the concept that slaves are held against their will (or at least, despite their will). I mean, it is actually necessary to the concept. Otherwise, that person would be considered an employee or someone working pro bono. What, exactly, does "enslaved" add? It's kind of shocking to see how people just jump aboard when someone suggests, no matter how ludicrous the grounds, that a given word is offensive.

"The time has come," the Walrus said...

And so, we must speak of many things.

We here at the Bleakonomy Northern Office are moving southward. After five years in the greater Augusta area, Yours Truly has accepted a new position at a practice in Massachusetts. It's an exciting opportunity, of the kind that probably come very rarely. I'm too superstitious to kvell about it, as there are still a few administrative Is to dot and Ts to cross, but the new job means I'll get to work at a couple of nifty hospitals and have a minor academic appointment to a medical school of good reputation.

Anyhow, I mention this because the move will probably mean a big change in my ability to post here. While our Wee Little Blog hasn't quite taken the Internet by storm, we do have a steady stream of regular readers, for which I am genuinely grateful. I've had a lot of fun, and have enjoyed the ongoing conversation that has sprung up here. I hope I'll be able to continue to post with some frequency, but over the next couple of weeks it will probably get pretty spotty. Once I'm at the new office, we'll see if there are gaps in my day that afford time to write for the blog.

Thanks for reading, and for your comments. Thanks to my other authors, who I hope will continue to post. And for now, wish me luck.

How's the view from under the bus, George?

Wow. That's a mighty big petard you got there, Family Research Council co-founder George Rekers!

When George Alan Rekers, a cofounder along with James Dobson of the Family Research Council and a leader in the ex-gay movement, was caught walking off a plane from Europe with a young male prostitute, he first insisted that he didn't know the young man was an escort until halfway through their 10-day vacation.

"I had surgery," Rekers told the Miami New Times, which broke the story yesterday, "and I can't lift luggage. That's why I hired him."

Rekers had hired the escort, dubbed "Lucien" by the New Times, through the website RentBoy.com (NSFW), a popular site that hosts ads for gay male escorts. There's little mistaking what the site is for. [Ed: Link to RentBoy.com disabled. It is very, VERY NSFW.]


For those of you unfamiliar with the Family Research Council, it's pretty much one-stop shopping for all of your frothing, anti-gay needs. I think we can all be glad that Tony Perkins has a platform.

Rekers, a leader in the "ex-gay" movement, appears to be having some trouble with the "ex" part. Normally I have a lot of sympathy for tortured, self-hating closet types. (It sucks in there, guys. Step outside and take some deep breaths. You'll feel so much better.) But normal tortured, self-hating types don't co-found reactionary theocratic political organizations bent on crushing my civil rights. So George, you get no sympathy from me.

Of course, you can bet that the FRC is standing by the man who helped bring it into being, right? (Those who agree should see me about some exciting real estate deals along the Gulf coast.)
The full statement from Perkins:

In the past 24 hours FRC has received calls regarding Dr. George Rekers and his connection with the Family Research Council. After reviewing the historical records we did verify that Dr. Rekers was a member of the original Family Research Council board prior to its merger with Focus on the Family in 1987.

Reports have been circulating regarding Dr. Rekers relationship with a male prostitute. FRC has had no contact with Dr. Rekers or knowledge of his activities in over a decade so FRC can provide no further insight into these allegations.

While we are extremely disappointed when any Christian leader engages in the very activities that they "preach" against, it is not surprising. The Scriptures clearly teach the fallen nature of all people. We each have a choice to act upon that nature or accept the forgiveness offered by grace through faith in Jesus Christ and do our best to ensure our actions, both public and private match our professed positions.

"After reviewing the historical records." I love the idea of some cantankerous old coot, down in the dusty bowels of the FRC vault, blowing cobwebs off the box of archives that contains the one record of George Rekers. Kind of like Raiders of the Lost Ark, except in this case all the snakes are merely metaphorical.

I also love the nonchalant, offhand way they describe their reaction to the news. "It is not surprising." Really? I would have thought the news that one of your co-founders was found in the company of a male prostitute would be very, very surprising. (I would be surprised.) I get the impression that the FRC is packed to the gills with guys who are thisclose to going nuts, flying to some distant location and paying for sex.

Anyhow, I typically prefer that people be left to their own personal moral failings in peace. But in the case of people who bent their career toward demonizing people like me (and, it turns out, themselves) I'm willing to make an exception. Enjoy the love of your old pals, George. It's no fun to be on this side of the firing line, is it?

5.04.2010

Reassuring news, paranoid parents!

One of the deeply humbling things about having the Critter around is realizing how incredibly ignorant I have been when it comes to the actual business of parenting. You'd think with all the fancy book-larnin' and Board certification and such, I'd stride through the experience of child-rearing with the wind in my hair and a smile on my lips.

No.

When Critter was brand spanking new, he made (in the manner of all newborns) a variety of horrible strangulating, squeaking or gurgling noises while he slept. Even worse was when I couldn't hear him breathing, and would stand over his bassinet fighting the urge to poke him to make sure his lungs were working. While I had attempted to be reassuring during nights on call when panicked parents would call with similar worries, it was an entirely different experience to live through when it's your own kid.

In that vein, friends with young children (you know who you are) have done far more for my sanity than any pediatric text ever could. More recently, Critter has been a little bit slow to crawl. While I was deeply proud of his early development when it came to certain skills (he was transferring objects from hand to hand like a champ a couple of months early, and currently delights in his new-found page-turning skill to confound my attempts to read to him), I was convinced that his lack of crawling by nine months meant something dire about his long-term cognitive prospects. He would reach toward objects, get annoyed, and commence self-soothing thumb sucking. (Now that he is crawling tentatively, I can move on to other areas of paranoid craziness.)

But at least all of this monitoring is useful, right? It gives me a glimpse of his general intelligence and overall developmental potention, yes?

No. So says Nicholas Day in Slate:
[B]ut when parents today worry about their child not meeting developmental norms, especially for motor skills, they're too often worrying needlessly. The typical child, it turns out, is a myth. But someone forgot to tell the parents.

Arnold Gesell, a pioneering developmental scientist at Yale, came up with the theory of developmental norms—the idea that there is a normal way for humans to develop—a little less than a century ago. Gesell believed that motor development was a question of neuromuscular maturation: Motor skills developed as the brain matured. It followed that all infants had to pass through the same series of developmental steps, in the same order, at the same times. Gesell just had to map what those steps were and when exactly they occurred.

He did so in astonishing, migraine-inducing detail. Using cameras to record the tiniest details of infant behavior, Gesell described the appearance of 40 different motor skills and the developmental stages of each of those skills: 23 stages of crawling, 58 stages of grasping, 53 stages of rattling. His work was rigorous, seemingly authoritative, and the basis for the first charts depicting how infants should develop. These showed babies as they moved in a strict, perfectly timed procession from lying to rolling over to sitting to crawling, and so on. Gesell's work was hugely influential: It cemented the concept of developmental norms, and the separation of normal and abnormal, into the popular consciousness. Gesell's books and the movies of infants produced by his laboratory made him famous, an early child-rearing expert. This video offers a sense of his patient, painstaking style and the quiet grandeur of his pursuit.

Yet Gesell himself knew that his norms weren't set in stone. As Ann Hulbert writes in Raising America, her magisterial history of modern American childrearing advice, he warned that norms " 'are readily misued if too much absolutist status is ascribed to them,' as he knew from having arrived at them by observing countless deviations."


The article goes on to describe how pervasive the idea of developmental milestones has become in pediatric training and care. The certification exam of the American Board of Pediatrics is full of questions about subtle differences in milestones between, say, month 3 and month 4. You're expected to know them backward and forward. Delays of any kind are meant to be monitored closely, and intervening early is frequently recommended to shore up skills that seem to be lagging.

I think Day overstates things when he dismisses developmental monitoring out of hand. Keeping track of general progression is useful, and patients who show delays in numerous domains really do warrant further investigation. However, the attention we pay to every single milestone is excessive, and only leads to anxiety and frustration.

The funny thing is that this is my philosophy as a pediatrician. As often as seems prudent, I reassure worried parents that their kid who isn't babbling quite on time or who still hasn't taken that first step is almost certainly normal. (I take as non-alarmist an approach as I can, generally speaking.) Unless something is clearly wrong, I tend to avoid over-investigating and take a "wait and see" stance. So far, this has worked out quite well.

But when it's my own kid? OHMYGOD HE'S NOT CRAWLING YET??!?! It's depressing how human a parent I remain. But, in the long run, I know he's going to be just fine.

Sue Lowden really needs better health care advisors

Hoo, boy. First chickens, now this:

The good news for Sue Lowden's Republican Senate campaign in Nevada is that it's no longer talking about bartering, bargaining, and chickens. The bad news is, Lowden's campaign is still struggling with health care policy.

This week, the candidate's campaign manager, Robert Uithoven, was asked a straightforward question: does the campaign believe all Americans should have access to health care. He replied:

"They do. If I have a bullet hole in my chest, I can go down to UMC and I'm gonna get health care."

You know what you'll get after you "get health care"? A bill.

As the Political Animal link at the top of this post makes clear, this whole GOP "we have universal health care, it's called the emergency room" meme is as forehead-slappingly idiotic as it is common.

First of all, care delivered in the emergency department is not free. Somebody has to pay for it. Doctors and nurses don't work there gratis, and all the tests and treatments still cost something. Patching that bullet hole will involve a trip to the operating room, with a whole other set of nurses and doctors and medications and stitches and bandages and anesthesia, not to mention the care Lowden's moronic campaign manager would need as he recovered.

Further, not only does someone have to pay for all that "universal health care" people supposedly can access through the ED, but you can only get acute care there. What if, during the course of his bullet wound treatment, a chest x-ray discovers a suspicious mass that turns out to be lymphoma? Will Uithoven go to the ED for chemo or radiation? What about vaccines for his kids? EDs don't stock them.

It astounds me that so many prominent members of one of our two major parties seem to think EDs are a catch-all solution to health care problems. Quibble with the health care reform bill all you want, but don't suggest galactically stupid alternatives.

5.03.2010

Proof that I am no longer young at heart

As God is my witness, when I saw this picture, which accompanied an article about the White House Correspondents Dinner,



my first thought was "that kid looks just like Tatum O'Neal."

2666 : thank God that's over

"An oasis of horror in a desert of boredom."

-- Baudelaire

"You said it, buddy."

-- Dan

I will say this for Roberto Bolaño -- he has helped me accomplish what I once thought impossible. I have now found an author I enjoy less than Thomas Pynchon. I would rather read V. ten more times than 2666 even once more. (That's not much by way of praise, nor is it exactly fair. I rather liked V. [Gravity's Rainbow and Against the Day? Not so much.] And if given a choice between the phone book and 2666 to take to a desert island, at this point I think I'd opt for the former.)

What a wearying, wearying book that was.

Many (most?) of the people who participated in this group read (and one could see the attrition in the precipitous drop in posts and comments) came to it on the heels of the Infinite Summer project. While I didn't participate in that group read other than to follow along and comment on occasion, I am very familiar with Infinite Jest. It has seemed that readers occasionally cropped up to compare 2666 (negatively) with Infinite Jest, despite the very different tone of the two books. Using IJ as a counter is as good a method as I can think of to discuss why I simply did not like 2666, and am so very glad to be done with it forever. (I agree with commenter Joan at Infinite Zombies that I will probably never pick it up again.)

First of all, and perhaps most damning for me, the characters in 2666 were exactly that. They were plainly, unmistakably characters in a literary novel, whose behaviors and motivations resembled those of actual human beings only in so far that the same verbs could be used to describe both. At no point did I pause in my reading and say "yes, real people really are like that. I understand why [character] did [action] for [reason]." They remained oddly stitled, unnatural and removed at all times and in all situations.

Contrast that with any of the characters in Infinite Jest. Both Wallace and Bolaño seem to have a passion for telling every single character's story, no matter how closely related to the action of the novel itself. The difference is that Wallace cared about his characters, to the point that they are as real as a fictional person can possibly be. Hell, even though he patently loathed them, Jonathan Franzen at least cared about the various protagonists in The Corrections. I've read short stories about ants with more relatable characters than anyone in 2666.

Further, I haven't the faintest foggiest clue why Bolaño wrote a word of this book. It seems an extended meditation on the phrase "shit happens." Given that the characters are neither sympathetic nor unsympathetic but merely there, and the action of the various Parts fit together in no discernable way, by the time we find ourselves confronted by grisly murder after grisly murder, what possible reason do we have to continue? Bolaño apparently expects us to invest in further reading for its own sake, despite no hope for any possible understanding of why he has chosen to exhume and thinly fictionalize these real-life murders.

Infinite Jest leaves many questions unanswered, and ends in a similarly abrupt manner. But it's obvious that Wallace had something to say that mattered. He honestly cared (probably [tragically] too much) what you, the reader, would experience and take away from his book. If Bolaño cared a whit for the reader's experience, he leaves no evidence that I can perceive. Perhaps I, a Mere Reader, should be grateful to have experienced the ineffable brilliance of the Great Author, but this Mere Reader is inexpressibly hostile to that particular attitude.

Finally, I simply reject the worldview that seems to pervade 2666. Infinite Jest is, in many ways, a heartbreakingly, achingly sad book. For all its humor and humanity, it is very, very sad. But Wallace admits the possibility that, hard as it may be, a person can still be happy. I can think of at least four characters that are either described as happy, or at least have a decent shot at redemption. (Some of them minor and surprising, but there nonetheless.) There was not one moment of genuine joy in the entire span of 2666, this arid, godforsaken book. (Please, tell me if I missed it.) Apparently Bolaño's world is either boring (and worthy of scorn) or horrible (and worthy of cold fascination). And that's an attitude I find loathsome.

So, call me pedestrian or small-minded. I really don't think that the faintest whisper of an actual narrative (dare I say "story"?) is too much to ask. I don't think that believable characters are an unreasonable expectation. And I certainly don't think any author can write a book without either that is also largely fixated on unmitigated brutality. The critics all seemed to love 2666. They can keep it.

Anyone desperate for a dose of loveliness (an oasis, if you will) after this blighted expanse of a book, written in the most beautiful way about people so real they could walk off the page, might I suggest the exquisite novels of Marilynne Robinson? Or maybe the phone book. Anything besides more of the same.

The value of a New Yorker

Matt Yglesias wonders why the bomb in Times Square is inciting less freaking out than did the Christmas underpants bomber (what an odd epithet to have attached to oneself!). I suspect three things:

1) The Times Square bombing is in New York. People kind of expect New York to get bombed, and it doesn't make them feel uncomfortable in Tupelo.

2) Americans, in general, lack a kinship with New Yorkers. All those jibes about Real America speak to a real disconnect between many Americans and New Yorkers. I think part of the reason why everyone went on and on about the firefighters after 9/11 was not only because their actions were heroic, but because people across the country found firefighters relatable, far more so than a worker for Cantor Fitzgerald.

3) The guy who did it seems to have been white. Therefore, while less relatable than even a New Yorker, he is more relatable than a Muslim Arab. It will be interesting to see how people react if it's a Tea Party type who did it.

5.01.2010

Who knew?

I am, it seems, a conservative left-wing progressive. (Hat tip Ordinary Gents.)