Choice in Health Care

This is a really big topic, and the center of a lot of debate at the moment.

When I was pregnant with my son, we spent a lot of time looking over all of the information about the different tests and things that were available to us. We decided not to do any tests that we could not do anything about. What that means is that if the result of a test would tell us something, but we could not do anything to change the outcome then there is no point. One of these tests would tell us that our child would likely have down syndrome. Because there would be no way to lessen the probability following the test, we decided not to do it. Additionally the risks associated with the test were far more likely to cause problems than the likelihood that it would find anything. I have worked with down syndrome kids and we knew that if anything were to happen we would deal with it.

That said I was seeing many different doctors within the practice so that I would have met any of the ones who might end up delivering the baby. One of these doctors (luckily they were no longer employed there by the time I went into labor) was very indignant that we opted not to do this test. I understand that doctors have their own personal beliefs, and that they are supposed to do no harm. We were very upset that she refused to respect our choice, especially since that choice, according to the statistics, the science, was the less damaging. The doctor agreed that there was nothing that could be done about the results, and understood our risk/benefit analysis. Unfortunately the doctor’s personal preference to know took precedence and made us very uncomfortable.

This is something that is the patient’s choice. It has no effect on anyone else’s life. Us knowing in advance would change nothing except potentially adding problems because of the test.

Some people choose to have the test because if the child is more than likely going to have down syndrome, they would terminate the pregnancy. This would be considered a medical reason and is subject to different rules than if the parents chose abortion for a healthy child. I respect that choice. Having children is a huge responsibility, children with special needs more than doubly so. Although I do believe that every person has worth I know that many people would not be able to handle the care that these children require.

Abortion is a choice that does affect other’s lives, mostly the parents and the child’s. That choice should be about what is best for those people. If the parents, specifically the mother, know that the child would not be well off growing up in that household or situation, they have the options of adoption or abortion. It is the responsibility of those involved to make the decision about what is best. Just being alive is not always the better option. I used to say that having a child would end my life, not in a literal sense, but in a figurative one. When I was younger I would not be able to devote the time to improving my situation if I were to care for a child. The child would come first, and unfortunately would not be able to be brought up in the way I would like if I did not have a job and an education.

So what about the other big debate right now? Vaccines. I believe in free choice. I do not like it when the government imposes things we have to do. As far as I am concerned wearing a seat belt should be a personal choice. The statistics are out there, it is undoubtedly safer with a seat belt, but the only life lost would be your own, yes other lives are affected by this as well. In a perfect society I would say that people need to take that into consideration as they weigh the risks and benefits (?) of not wearing a seat-belt. I know however that people tend to be self-centered and not consider that others would be affected by their passing.

What does this have to with vaccines? I believe that people should be allowed to make their own choices. However people are not very good at weighing the data, or considering others. I really feel silly for repeating some of this, but the original study used to back the argument that vaccines cause autism has been retracted, and the author discredited. The other risks that are often cited are concerns about the inefficacy or side effects of the vaccines themselves. If the vaccine is ineffective, you are no worse off than if you did not have it, so I believe there is no more to be said about that. As far as side effects, these are usually minimal, a little soreness, but come on, you stuck a needle there, why wouldn’t it be sore? Yes, some people are allergic to certain elements of the vaccines. The chances of this are extremely remote. Those who are too young, do have a bad reaction, or find that the vaccine is ineffective are those who have to count on herd immunity. As a culture we have had this type of immunity for long enough that some people forget what the risks really are, which makes a real risk/reward analysis skewed. It can also allow people to forget that their decisions can affect others.

This is an article about a child who was exposed to measles. And this is the response from an anti-vaccine advocate. One of the points made in the response is that the man who carried the infection had been vaccinated. This means that he is just as much of a victim of the shrinking herd immunity as the child. Yes, I have problems with the pharmaceutical industry, but that is about them charging too much for things. They have something of value and a monopoly on it. They are taking advantage, and not realizing who that might hurt, but I do not believe they are evil. If you look at some of her links you can see that the evidence does not all fit. The risks associated with the vaccine are stated, but it is clearly stated that those risks apply to the people who should be counting on herd immunity. Her link about the court case has a headline reading “Merck Whistleblower Suit A Boon to Vaccine Foes Even As It Stresses Importance of Vaccines”.

I do believe in free choice, but I am an idealist and think that people should have the ability to make informed decisions when they are given the information. I have a problem when what I believe should be the case is not the case. In the case of vaccines, I am tempted to say that the government should take away people’s right to choose, for other’s protection. But if I do that, am I any different than those who want to take away women’s right to make decisions about abortion? Am I any different than those who advocate taking guns away because some might be used to kill? Am I any different than those who are trying to take away our right to choose our leaders? If I choose to limit people’s right to spread misinformation I am not different than anyone who tries to limit my speech against corporations or governments. These are rights I believe in, and I refuse to participate in setting a precedent that would assist taking away these rights, and others. I can only hope that giving people the information and teaching them how to use it (including reforming our current school system) is the best way. I am not willing to risk the future of our democracy in order to combat one ill-informed decision. A functional democracy depends on having an informed populace. That is what we need.

 

Intelligence

What is intelligence? I know I have touched on this before. Traditionally we define intelligence as IQ, or Intelligence Quotient. This is something inherent to us that does not change within our lifetime, or at least that is how it is thought of. IQ is a way that we are all assigned a number that puts us on a line from less intelligent to more intelligent. There is no second dimension to it. More or Less, that is all.

But I believe that there is more than that. Think of it as the difference between plotting a point on a one dimensional number line and plotting a point in three dimensional space, except that I want more planes than even that and adding time (as a fourth dimension) would allow. There are so many different ways that people (and animals) can be intelligent. This is how we generally think of animal intelligence.

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But not only do they probably think the same of us, but what if they are the smart ones? All it takes is a small perspective shift. They have figured out a way to let us do the work while they reap the rewards. Pretty smart.

In my opinion, intelligence is made up of many things, including some that cannot be tested for. I don’t really see the point of testing for it anyway. As I see it the point of testing is to see who is superior, and I would argue that no-one is. Everyone has their own strengths, and beyond finding a way to discover those, testing is superfluous.

Children are a perfect example of this. People often laugh at children because they believe the things they say are stupid. When I was young I put together the fact that I saw the world as flat and the fact that I knew there was another side of it and imagined that the world was a cube. Obviously my conclusion was incorrect, but you cannot fault the logic. I had used the information available to me to come to a more accurate representation of the world than man had for centuries. Intelligence, in this case, is about taking pieces of information and putting them together.

My son still has a very limited vocabulary, but he is figuring out ways to tell a story. Sometimes he will say ‘hot’ and ‘mom’ while pointing to the kitchen. It is pretty clear at that point that he wants a meal. He is communicating not only that he is hungry, but he wants hot food, or a meal. One time I came home and he said ‘eye’ and ‘ear’ and pointed at a wall. I was a bit confused, until my husband told me that they had been pointing out the eyes and ears of the girl in a picture on the wall. My 18 month old was telling me what they did while I was at work.

I know that may not sound like much, but one of the smartest things about kids, and this applies double to babies, is that they soak up information all the time. Learning itself is a part of what intelligence is. And, as many parents have discovered, they don’t only learn what you try to teach them. Many parents find to their dismay that the kid has picked up curse words. This is for the same reason that many babies first word is ‘no’. Kids say what they hear.

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These type of images are all over the internet, and people laugh at the dumb little kids. Really though that is a very smart kid. He knows that he is hungry, and food comes from boobs. He is just missing some information that led him to a false conclusion.

All the time kids fall down because they are still learning physics. If a kid learns to walk in a room with a perfectly flat floor and nothing on it, they will stumble when he gets on a ramp or a hill. But the younger they are, the quicker they are able to learn to compensate.

Another group that is often mocked for low intelligence is older people. When someone with Parkinson’s shakes and drops something they are called ‘retarded’. (We will address that in a minute.) The person’s mind can be as sharp as ever, but if the motor function starts to drop off, the labels fly off the shelf. In many cultures, and I am sad that mine is not one, older people are respected for their wisdom.

I completely understand that it can be very frustrating to try to teach someone who did not grow up using a computer how to do something that my generation regards as basic. But all it means is that the person’s mind is less malleable. They have more information stored in their brains than we do. Their intelligence is generally called ‘wisdom’ and it comes from the build up of all of the information that they have accrued in life.

Even people with what most people would consider ‘diminished mental capacity’ are intelligent in their own way. Today Einstein would probably be diagnosed with half a dozen learning disabilities. The reason that we think in terms of higher and lower intelligence is because we are giving the fish and the birds the same test as the monkeys and the elephants.

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This image has been used as a mockery of our current educational system, and it is. But the problem goes deeper than that. While many kids can excel at reading, teaching a dyslexic student in the same way can be disheartening, and make them wary of not only books, but the information contained in them. While trying to teach an autistic child to read can be completely futile. (And yes, under No Child Left Behind they are held to the same standards of ‘proficiency’ as anyone else in their grade).

That same autistic child might be a savant at something else. For some it might be advanced mathematics, another might be just obsessed with trains. While some teachers might try to use that obsession to motivate the child, (nothing wrong with that) I would suggest going even further and trying to figure out what it is about trains that they love so much. It might be that she is interested in creating the path for them because in their mind they can instantly see the most efficient route, or maybe it is the idea of multiple things following in the exact same path.

Sensory Processing Disorder is diagnosed when people’s sensory perception is abnormal. It is often described in terms related to ‘broken’ but what if some of them feel the need to re-confirm the solidity of objects because they somehow subconsciously know that atoms are mostly empty space? When Earnest Rutherford first discovered that fact, he is reported to have been afraid to get out of bed in the morning because he did not want to fall through the floor.

I am not presenting any of these ideas as fact, but as a thought exercise, a reminder that things are not always how we perceive them. Something that we see as stupid can, in fact, be signs of intelligence. It just means that we not see something in the same way as someone else. Rather than judging in the moment, we should give some time to consider how they came to that conclusion. It might just be that our own understanding of the situation is missing some information, or that they understand something better than we do.

Renewable Energy

Hey America! Fossil Fuel is not the answer. Even Nuclear Power is unnecessary. Let’s set aside the debate over whether or not global climate change is happening or if it caused by man. It does not matter. There are enough reasons to stop using fossil fuels without that.

The argument about the technology not being ready has been made since the 1970s. The technology is there now. We have the ability. Yes, batteries are still the weak point, but there are very promising possibilities there too (Tesla) (Hydrogen). The potential energy that is out there is astonishing. The power from the sun alone provides more than we need.

Many countries are making great headway towards completely eliminating the use of fossil fuels (Germany) (Austria) (China). If this is possible so quickly after starting down this road, why is America vowing only to reduce our output by a small percentage over the next several decades? Those in power are making this seem like it is an incredibly difficult goal to attain and is going to make a huge difference.

The only reason that this is challenging is because of the power that the existing structure has to prevent any change. Our current model is to the benefit of a few who will pay a lot of money to keep it the way it is.

What about the other objections people raise? One of the strangest to me is that the technology is not nice to look at. For one thing, what is more important? The future of the planet or the color of your roof? Another thing, the methods of getting fossil fuels are a lot less pretty. solar_vs_fossil_fuels

Ok, so you don’t want solar panels or wind turbines in your backyard and you are willing to pay for the line loss. There are other possibilities too.

Or you could just use your clear windows! There are many projects out there, big and small.

In fact keeping energy production closer to home can solve lots of problems. As far as I can tell the main reason that we are currently using large wind and solar farms rather than investing more in at-home systems is because the power companies still get their cut this way.

Ok, what about those job losses we hear so much about? Renewables create more jobs than it replaces.

A few more arguments that are worth discussing.

Ok, so this is more like a list of outside info than a real post, but seriously, the information is out there. I don’t need to repeat it.

Education in Finland

Much has been said of late about the amazing success of Finnish schools. In many ways they are the antithesis of U.S. schools. Everything that we have done in an effort to improve our educational system, Finland has done the opposite. To many Americans the system would seem to be counter-intuitive, but the results are a proof of concept.

Recess – In Finland students spend around one third of the day at recess. This may sound like a lot, but when you consider that this is broken up into many small breaks, it can sound more manageable. These frequent breaks make the day less monotonous for students. After each 45 minute lesson, students go outside for a 15 minute recess. This success of this routine is backed up by the science. When the human body sits for too long, the brain begins to shut down. Obviously students need their brains working at their best in order to make the time in class as effective as possible. Allowing students time to move and play gives them a chance for their brain to stay engaged in the class work.

This has also allowed the school day to be shorter. Students spend only around 4 1/2 hours in school a day. They also start school later; while publicly funded day cares are available at younger ages, mandatory school does not begin until age 7. Despite what many people might think, less class time has not had an adverse effect on education, but may be contributing to its success.

One surprise however, is that even with so much outside time, Finnish students are not getting that much more physical activity. While free play is of more value to getting students less distracted in the classroom than teacher directed play, it may be necessary to integrate some structure to prevent kids from spending this time in sedentary activities.

Testing – In Finland, student assessment is left up to individual teachers until graduation, when a single, comprehensive test is administered. This saves class time for instruction. Testing would also conflict with the intention of getting students more active. Formal testing is a stressful activity. Students free of this stress are able to get more enjoyment out of school. When you enjoy something, you are more likely to prize it, remember it, and value it.

Teaching – In Finland, being a teacher is such a lucrative career that only 1 in 10 graduate applicants are accepted for the required master’s degree program. Incomes for teachers are on par with other professionals. Teachers are a highly valued resource, and given far more respect. Teachers also have more freedom to make their own decisions for their classroom. While they are given a generalized curriculum, they are free to tailor the lessons to their students. Teachers are trusted to keep their students on track and find ways to give them the assistance and attention that they need. Students are not held back for poor performance, but are instead given special attention. This way they are not stigmatized by their peers. They are able to avoid repeating the same information, which would make anyone bored.

Administrators – Those who are in charge of making decisions about school policy are recruited from within the educational system, instead of from the outside. This means that they are largely former teachers. They understand the struggles, and they understand the students. This means that they are better equipped to make decisions that will be beneficial.

Public Funding – Rather than having funds drained into private schools, and allowing vast disparities between the education of the haves and the have-nots, Finland had only publicly funded schools. This means that anyone who has an idea has only one place to enact it, so that everyone receives the benefits. Schools do not have to compete with one another, but are encouraged to work together, as are teachers. This team mentality allows everyone to succeed, rather than only those on the winning side.

Finland has a lot that they can teach the world. The experiments that they have undertaken prove that more is not necessarily better. Having a balance is the best way to achieve success.

 

Freedom of Expression; Gender Identity

My son is about 18 months old now, and I want it to be his choice when he gets his first haircut, because I believe that it is about self-expression. His hair is getting long enough to be in his eyes, and I sometimes manage to pull it back for awhile before he takes out the hair tie. Because of the long hair people always assume he is a girl, but especially when it is up. I don’t really care, at that age gender doesn’t mean anything. To me the only thing gender means is how you have sex, and some limited biological brain functions. Most of what we consider gender identity is created by our culture.

Today my son was wearing a red flannel shirt and jeans while his hair was pulled up in a pink hair tie because that is what I happened to have with me. A gentleman stopped by to say hi and asked “who is this sweet girl?” I introduced him as my son. I thought it was rather amusing that it was more believable to the man that a little girl would wear a full boy’s outfit than that a boy would have long hair in a ponytail. In our culture girls have more freedom in this regard than boys do. We have fought for it. A century ago a girl wearing pants was even more taboo than a boy wearing a skirt is today.

Not only do women have a box they are expected to fit into, so do men. For women it is about fingernails, hair, and makeup. It is about shopping for shoes and clothes that allow her to be the woman she is supposed to be. For all of the fighting that women have done to be equal to men, there is still a box. The fight is not over.

The problem is that some men feel like by women gaining ground they are losing it. That is not the point. I am not sure what about the feminist movement gives that impression, but some people’s notion that women are trying to take over might have something to do with it. Men are confined in a box too. They have always been, and have not put together a fight the way that women have. Men and boys are pressured to be macho. “Be a man”, “Grow some balls”, those types of statements are endemic of the battle that they face. The equivalent “Act like a lady” is reserved for specific situations, but for the most part women have permission to be more manly than men have to be womanly. Not only is the behavioral box more confining for men, they are also more confined in dress. Women are expected to wear makeup, but the choice not to is not as taboo as the choice of men to wear it. Women can wear all sorts of tops, dresses, or skirts or pants. Men get shirts and pants. The variety even within that is very limited. As a costume designer I find designing for men from the 19th century on rather boring. And to top it off, men are expected to support the women in life in a way that they can do the shopping they are supposed to do.

I believe that the crisis that some people have with gender identity would not be nearly as bad if they did not feel pressured into a mold they did not fit. When a boy is forced to be a boy they feel the need to push back just because they like some things that are considered ‘girly’. Rather than sending this child on a whirlwind of identity, how about we just let him play with the dolls if that is what he wants. Later he may turn out to be straight, or he may turn out to be gay. He may even turn out to identify as a girl. That is okay.

To me it seems that the dichotomy between male and female has created a very damaging society. I understand that for some people who identify as their non-biological gender they only feel complete once they have completed their gender re-assignment surgery. I have no problem with the surgery, if it is that important to you, go for it. I support you 100%. My concern is that some people feel that in order to fit they have to completely identify as one or the other. I would rather live in a society where a man is allowed to wear a dress and makeup when he feels like it, but is still allowed to go hunting with the guys. Rather than having distinct gender identities, and spending so much time categorizing people (including adding new distinctions) we should just let people be themselves and skip the labels. For some people just being allowed to be themselves is enough, they would not need to go through all of the physical changes. For others the body they were given is not themselves, and they should have the right to change it.

 

Freedom of Expression; Costumes and Dress Codes

A few days ago I was reading a blog by a teacher about the day after Halloween. I did not save the link, and I should have. One of the students wore a cape to school that day. The teacher kept considering telling the child to take it off, but she noticed that a child who is normally awkward and clumsy was far more confident. The article seemed to be written in order to pride herself on doing a great thing for this kid, as it seemed to help him in the future as well. No students even mentioned the cape, although teachers did do a double take. I think that all of this is great. But in the end, the teacher, while she did compliment the cape, told him not to wear it again. I cannot figure out why.

I wore costumes to school every day. I got a lot of flak for it from my peers, but it allowed me to be who I am. In high school, people who did not know me by name knew me as Little Red Riding Hood because I always wore a red cape that I had made. Today there is a lot of discussion about school dress codes. They are being attacked for being sexist, and even for creating the very over-sexualized environment they were created to fight. I agree with all of those points. The rules are often stated in ways that target girls more than boys. They are nearly always more strictly enforced with girls than with boys. By making such a big deal of it, we are teaching young kids to look at one another’s clothing and bodies and question “Is that enough clothing”, “Shouldn’t they cover up more?”, and “Why, what is wrong with this outfit that I have to change?” We are saying that what they wear is more important that who they are, and more important than why they are at school.

Some of the rules are unfair to certain body types. In my district short and skirt lengths were determined by arm length. A silly rule since some girls were completely within regulations and still showed ass when they sat down, while I broke that without ever being questioned since my skirt was plenty long because my arms are long.

This is not the message we should be sending kids. We need to be encouraging them to look beyond the clothes, and beyond the body to what a person is really made of. When we focus on the clothes, the person gets lost. This encourages people in our society to dehumanize one another. This allows people to do things to people without feeling regret. Whether that action is teasing in school, or physically assaulting someone. We live in a society where we do not have the luxury to personally meet everyone that we interact with. This means that we cannot afford to make any of the interactions we practice with those we do know contribute to that dehumanizing effect.

The point of many dress codes is to avoid ‘distractions’. This is ridiculous. The fact that a girl’s skirt is a little short, or that a boy’s pants are too baggy (showing my age a bit) should not be allowed to be a distraction in the first place. A teacher notices that someone is leering, call them out. If they persist, they should be sent to the office. Not the person they were looking at. We should not be teaching children that others, girls especially, should cover up so that people looking at them can feel more comfortable. We need to be teaching children that people have different tastes and make different decisions. We need to be teaching children that they are responsible for their own actions.

I went to a middle school with a more extreme dress code, called a Uniform Code of Dress. It was not quite a uniform, but very close. We had 2 colors of pants or skirts we were permitted to wear, in one style, and 5 colors of polo shirts. This was initially instituted to prevent students from wearing gang colors. My friends and I were so out of touch with that world that we could not even tell you the names of the gangs active in our area, let alone what their colors or signs were. I would probably have worn gang colors a lot without realizing it, as many people do.

This system ended up in a lot more time tied up in determining if students were within regulations or not. Not only were we measuring if the girl’s skirts were actually longer than their finger tips to also trying to determine if someone’s pants were the right color. My first dying project was adding coffee to the washing machine while washing a slightly lighter skirt that had been called white too many times to make it more khaki. After I left the school, it was decided to keep the style restrictions, but lift the color rules. So the entire reason for the Uniform Code of Dress was thrown out the window.

During this period I was very frustrated with the rules because I could not express myself. I took to wearing what I call “happy socks”, or the ones with bright colors, pictures, or separate toes. I took a lot of time braiding my hair on the car ride in so that it was as weird as possible. In trying to find ways to express myself I tested the limits that no-one had thought to make. But I also lost something. The goal was not about me being me, but rather about being strange or drawing attention to myself. I still wear the happy socks, but the hair took too much work, and did not really mean anything to me. Later I turned to doing elaborate masks in makeup, which worked when I had an hour and a half bus ride each morning, not so much once I started driving. I kind of miss the masks.

There is another issue that is gaining attention these days. Gender identity. I think that this ties in perfectly with this topic. In high school I had a gay friend choose to wear a skirt one day. I honestly did not even notice it until he mentioned at lunch how much shit he was getting. He had chosen to do it in part to find out what the reaction was. He committed to going a full week. Of course when he stopped, the people around him may have felt like they won, but there is no point in continuing something on the principle of proving someone wrong.

I do believe that clothing is a key way to express who you are. I look back on that as inspiration to be myself no matter what since I cannot wear costumes to work every day. These days wearing a full costume is rare because I am lazy and getting all dressed up to go shopping doesn’t really feel worth it. Childhood is a special time, you do not have to worry about what bosses or clients think. If we allow children to express themselves when they are young, they will be more accepting when they are older, and they will have a better concept of who they are. I do not think that expression should be restricted unnecessarily, to me it is a part of Freedom of Speech. It is a human right.