Tuesday, August 28, 2007
Sunday, August 26, 2007
For those who haven't stayed up all night checking to see if mom's ready to push, a VBAC is a Vaginal Birth After a C-section. During a Caesarian, besides cutting through mommy's belly, mommy's uterus gets cut as well. When a woman has another child, the worry is that since the uterus has already been cut before, the spot of healing isn't as structurally sound as the original uterine wall, thus the pressure placed on the uterine wall during subsequent pregnancies would then result in uterine rupture, and the need for emergent surgery. Emergent surgeries carry a multitude of greater risks than elective procedures.
But then some studies cited in this NPR story mention that the actual rate of uterine rupture in VBACs isn't that large, but when a uterine rupture DOES occur during a VBAC, outcomes are comparably terrible. This lead ACOG to recommend that adequate surgical faculty be available when a woman was attempting a VBAC. The problem arises when smaller hospitals simply don't have the resources to ensure those adequate surgical backups are at hand, and hospitals then ban VBACs because they simply can't afford to keep a full back up team on call.
Which creates the interesting public health versus personal autonomy dilemma we've all come to know and love. Women absolutely have a right to attempt a VBAC (and yes, "attempt" is the correct terminology) with a fairly low threshold for proceeding to a repeat caesarian should complications arise. And hospitals have a right to not offer services they simply can't afford to offer when medically acceptable alternatives exist. "Medically acceptable" and "personally acceptable" are, of course, not always in agreement.
Where I've trained, the VBAC was always an option, mostly because the hospital is equipped with the staff to handle any complication that could arise because patient volume and the high-risk patient population justify their use. On a population level, the risk is astronomical. On a personal level, the risk is miniscule.
Of course, the naturalist spin is that obstetricians are evil bastards who want to cut so they can go home and get some sleep so they'll have time to wake up early enough to spend their hefty salaries. Actually, obstetricians, like other physicians, don't like the idea of folks dying during an emergency from a partially preventable incident.
The woman in the NPR story gives the most revealing quote, however. She is rightfully upset that she is being forced to have a VBAC. When presented with the rationale for why this is so, she replies:
"That's what they hospital is there for, to handle emergencies. And so, in that respect, the policy never made sense to me."No, emergency rooms are there to handle emergencies, as long as by "handle," you mean do the best that anyone can to stabilize an unstable situation, recognizing that some unstable situations simply cannot be stabilized, and should be avoided if possible.
Hospitals exist to provide inpatient medical care following complicated medical algorithms in which physicians and patients take action to minimize the risks associated with illness and treatment. If a particular hospital can't handle a particular risk, it shouldn't try to do so. It should refer to a tertiary care center, and it should be blatantly honest with its patients about local limitations.
We don't send burn victims or trauma victims to any old hospital and expect that hospital to be staffed to handle those emergencies. We have regional burn centers and a tiered-trauma centers so that patients can receive quality care, and our society can afford to provide that quality care.
A woman has every right to demand an attempt at a vaginal delivery after a caesarian section for a prior pregnancy. Heck, I imagine if I were a woman on my second pregnancy after having a C-section the first time, I would almost certainly demand a VBAC. However, no hospital can be expected to offer a service it simply can't afford to offer. If I want the VBAC, I have to go find a facility that does offer that service, since I'm probably unwilling to spend the extra zillion dollars required to keep sufficient surgical staff available during my delivery. And my current providers have an obligation to help me find that facility.
For the most part, Starbucks has an obligation to give you precisely what you want, because coffee isn't dangerous, and they can charge you whatever that coffee is worth to them.
For the most part, your medical provider has an obligation to give you precisely what you want, as long as what you want is reasonably safe, economically viable, and consistent with what can comfortably be called standard of care. For example, elective abortions and emergency contraception meet each of those criteria, and thus each woman has a right to receive them. In some contexts, a VBAC doesn't meet those criteria (according to ACOG... that's certainly up for further debate). Thus, the provider's obligation is limited to directing the patient to a context in which the patient's preferences do meet those criteria.
Update: The Onion offers the proper supplement to this story:
Friday, August 24, 2007
Recently, congress passed an expansion of the State Children's Health Insurance Program (SCHIP) to allow more children to enroll. Yay, for the kids. The Bush Administration threatened a veto claiming fears of socialized medicine. But going beyond this, the Bush Administration has issued a set of "rules" that would prevent any state from increasing their enrollment unless a slew of requirements are met:
Under the requirements, children must be without insurance for a year before they can be enrolled, and families of children in the program must pay fees for care similar to those paid by families with private insurance. In addition, the state must show that it has enrolled at least 95 percent of children below 200 percent of poverty and that the number of children insured through private companies has not dropped more than 2 percentage points over five years. The latter requirement is supposed to ensure that employers aren't dropping family coverage.This is outrageous on a number of points. Firstly, it requires children to be without health insurance for a year in order to qualify. A lot can happen in a year (vaccinations, checkups, broken bones). Why would this Administration claim that the best way to insure children is to require them to be uninsured. Additionally, the 95% requirement is ridiculous, since most states simply can't achieve that level of enrollment. And finally, the whole point of these rules is to subvert a law passed by the legislative branch. The constitutional role of the executive is to enforce the law, not subvert it. If Bush wants to threaten a veto, then he's just a jerk who doesn't care about children, but when he continues to trample on the federal constitution then he's a criminal.
Posted by Matz at 11:10 AM
Tuesday, August 21, 2007
Under the Blacklight looked like a possible bright spot in a really boring music summer (I kinda grooved the new DadRock version of Wilco, and the new Rufus sounded very promising and tightly written, even if I can never make myself care enough to listen to more than three tracks. It's like, dude, I get it. You're really really gay.).
The reviews I can find online fall into two categories: a) Rilo Kiley without crunch guitar sucks, and b) hahaha omg watch the indie kidz squirm lol stfu!!1!
I can understand how pop critics would mess their pants anytime an indie band sells out whatever sound put them on the map. If you like pop music, this album is probably a really great pop album. But if you've bought a Rilo Kiley album before, it's probably because pop music bores you to tears. Call us pretentious, and we'll call you just plain bland.
I'd say there's a 35% chance this album will grow on me. But on first listen, this thing is 90% Sucks Ass. Even tracks I want to like figure out a way to push me away.
Jenny Lewis is Bob Dylan with good fashion sense. And even Bob Dylan shat out some incredibly terrible albums in the spirit of "experimentation." Rilo Kiley will probably sell more albums than ever before, but that's only because you can't take back an opened CD.
Update: EW's review is fair, if a bit forgiving. I just have to deal with the fact that this might be a good album, but a terrible Rilo Kiley album.
Sunday, August 19, 2007
Friday, August 17, 2007
I've recently run across two words that have instantly found a home in my "that's just a cool word" mental bin. So I must share.
Second, and much better for a general audience, crank bug. (4th paragraph)
To be clear, I claim the latter for the totally awesome indie grass band I will someday assemble.
Wednesday, August 15, 2007
You OWE IT TO YOURSELF to go watch the video. By the way, the hospital in the 15-second commercial prior the clip is the one in which I was born. And I graduated high school with the liquor store employee.
So apparently this was on the Today Show this morning. I saw it on Fark as well, so it must be a big deal, right? And Yahoo! news. Problem was, I heard it the night before from my mother, since this occurred about two miles away from my parent's house.
Without further ado, the Duct Tape Bandit!
This guy is obviously in need of a good forensic psychiatrist.
Tuesday, August 14, 2007
Steve Levitt, of Freakonomics fame, hits one out of the park:
If the problem is that not enough young people are volunteering to fight in Iraq, there are two reasonable solutions: 1) take the troops out of Iraq; or 2) compensate soldiers well enough that they are willing to enlist.
The idea that a draft presents a reasonable solution is completely backwards. First, it puts the “wrong” people in the military — people who are either uninterested in a military life, not well equipped for one, or who put a very high value on doing something else. From an economic perspective, those are all decent reasons for not wanting to be in the military. (I understand that there are other perspectives — for example, a sense of debt or duty to one’s country — but if a person feels that way, it will be factored into his or her interest in military life.)
One thing markets are good at is allocating people to tasks. They accomplish this through wages. As such, we should pay U.S. soldiers a fair wage to compensate them for the risks they take! A draft is essentially a large, very concentrated tax on those who are drafted. Economic theory tells us that is an extremely inefficient way to accomplish our goal.
Critics might argue that sending less economically-advantaged kids to die in Iraq is inherently unfair. While I wouldn’t disagree that it’s unfair that some people are born rich and others poor, given that income disparity exists in this country, you’d have to possess a low opinion of the decision-making ability of military enlistees to say that a draft makes more sense than a volunteer army. Given the options they face, the men and women joining the military are choosing that option over the others available to them. A draft may make sense as an attempt to reduce inequality; but in a world filled with inequality, letting people choose their own paths is better than dictating one for them.
Monday, August 13, 2007
Sunday, August 12, 2007
So I tried to earn my "not worst husband ever" stripes by making Courtney breakfast this morning before she drudges off to work. While the Food network (since my cooking was obviously not enough to hold our attention), this uber-strange ad pops on the screen:
Courtney: Wtf? Why is the bee Hispanic? It sounded like Antonio Banderas or something.
Garrett: (grumpily) He's not Hispanic, I think the bee is Spanish.
Courtney: (knowingly) That's where you are wrong, pitiful derelict intellect!
And she's right, on so many accounts. First: (thank you, Dictionary.com)
Usage Note: Though often used interchangeably in American English, Hispanic and Latino are not identical terms, and in certain contexts the choice between them can be significant. Hispanic, from the Latin word for "Spain," has the broader reference, potentially encompassing all Spanish-speaking peoples in both hemispheres and emphasizing the common denominator of language among communities that sometimes have little else in common. Latino—which in Spanish means "Latin" but which as an English word is probably a shortening of the Spanish word latinoamericano—refers more exclusively to persons or communities of Latin American origin. Of the two, only Hispanic can be used in referring to Spain and its history and culture; a native of Spain residing in the United States is a Hispanic, not a Latino, and one cannot substitute Latino in the phrase the Hispanic influence on native Mexican cultures without garbling the meaning. In practice, however, this distinction is of little significance when referring to residents of the United States, most of whom are of Latin American origin and can theoretically be called by either word. · A more important distinction concerns the sociopolitical rift that has opened between Latino and Hispanic in American usage. For a certain segment of the Spanish-speaking population, Latino is a term of ethnic pride and Hispanic a label that borders on the offensive. According to this view, Hispanic lacks the authenticity and cultural resonance of Latino, with its Spanish sound and its ability to show the feminine form Latina when used of women. Furthermore, Hispanic—the term used by the U.S. Census Bureau and other government agencies—is said to bear the stamp of an Anglo establishment far removed from the concerns of the Spanish-speaking community. While these views are strongly held by some, they are by no means universal, and the division in usage seems as related to geography as it is to politics, with Latino widely preferred in California and Hispanic the more usual term in Florida and Texas. Even in these regions, however, usage is often mixed, and it is not uncommon to find both terms used by the same writer or speaker. See Usage Note at Chicano.To add insult to injury, the bee really was Antonio Banderas!
So there you go. Don't a) question your wife, b) muddle the distinction between Hispanic and Latino, which the standard OMB demographic form seems to do, and c) mistake Antonio Banderas for a common Hispanic bee voice.
Which doesn't answer the greatest existential crisis evoked by the commercial. Why the hell is Antonio Banderas the voice of the Nasonex Bee? Only celebrity willing to humiliate himself as a bee besides Jerry Seinfeld? A well-meaning (but totally failing) attempt to be more inclusive, the way that every picture in every textbook or academic brochure that has three people must include two women and two African American, Hispanic, and/or Asian folk, despite the fact that the random probability of those three people actually hanging out is like 1 in 3 trillion? Or does Antonio Banderas only voice Puss-n-Boots after spiking some Nasonex?
Saturday, August 11, 2007
The blood drive will coincide with the Halloween premiere of the latest title in Lionsgate and Twisted Pictures' "Saw" franchise, Saw IV, which opens nationwide on October 26, 2007.The Saw films are dropping off in quality exponentially, and I found Saw III mostly unwatchable. But this certainly demonstrates that marketing schemes can have a little social conscience.
The Saw "Give Til It Hurts" blood drive has become a key element of the "Saw" franchise, as much a part of the horror hit's annual rituals as its Halloween premiere date. Since the first SAW blood drive in 2004, "Saw" filmgoers have donated nearly 38,000 pints of blood to help save as many as 112,500 lives.
Friday, August 10, 2007
Hopefully this post will evolve. I think it might just be best to start posting crap as I find what I want to post, and then commentate later if I ever get a chance. I have high faith in my taste in postable articles.
Remember when cheating at video games was fun? Ah, the sentimentality of the Contra code. The most interesting additional piece of information here relates to Asian WoW players who apparently spend lots of time doing nothing but mining gold, and then selling that gold (like really selling, as in legal currency, not fake WoW money) to lazy Americans who want to, well, act like globalizing Americans, and outsource their own video game playing efforts. Libertarian economists may find this as clever as they find ticket scalping. But apparently there are vigilante WoW players who just go around killing these gold-whores to preserve the integrity of the online community. How much integrity an online community can really have is up to you.
And more Seth Rogen! An EW Superbad Roundtable discussion. Too many notable quotes, so I'll just pull my favorite:
MICHAEL CERA: Same thing with Arrested Development. One of the writers, Jim Vallely, said if we got picked up on Showtime, the first shot he would want of season 4 of Arrested Development would be a shot of Will Arnett having a sex with a girl from behind. Just to kick it off.
Posted by Garrett at 1:24 PM
Thursday, August 9, 2007
So there's this headline:
The two had shared the symbol amicably for more than 100 years — Johnson & Johnson on its commercial products and the American Red Cross as a symbol of its relief efforts on foreign battlefields and in disasters like floods and tornadoes.Sorry, J&J. And more:
From time to time, the American Red Cross sold products bearing the symbol as fund-raising efforts. Jeffrey J. Leebaw, a spokesman for Johnson & Johnson, said the company had no objection to that.
But in 2004, the American Red Cross began licensing the symbol to commercial partners selling products at retail establishments. According to the lawsuit, those products include humidifiers, medical examination gloves, nail clippers, combs and toothbrushes.
Mr. Crisan said it was not clear how far the American Red Cross wanted to go in licensing the symbol for commercial purposes, noting that the red cross was a trademark of Johnson & Johnson before the American Red Cross was officially chartered. Mr. Crisan said that some of the items being sold under licensing agreements by the American Red Cross seemed to compete directly with products sold by J.& J.What planet does the Red Cross live on that it thinks this is a legitimate practice? And Mark Emerson, president of the ARC says:
“The Red Cross products that J.& J. wants to take away from consumers and have destroyed are those that help Americans get prepared for life’s emergencies,” Mr. Everson said. “I hope that the courts and Congress will not allow Johnson & Johnson to bully the American Red Cross.”Yes, Mr. Emerson. Nobody else makes disaster kits except for the companies to which you license J&J's commercial logo. Americans are gonna die because they can't buy products with your license. Right.
h/t to the Pot. Feel free to mock my mancrushes, but I guess it's okay if my wife is directing me to the links. Actor Seth Rogen is in awe of British funnyman Simon Pegg - because he can't believe how good his movie Shaun Of The Dead is. The Knocked Up comedian had a similar movie idea to Pegg's 2004 zombie comedy, but was pleasantly surprised when he found out he had been beaten to the big screen by the Hot Fuzz star. He says, "When I first saw Shaun Of The Dead, I thought, 'F**k! F**k those guys!' I'd been thinking of writing a zombie movie about two dudes, and then that came along. I couldn't believe it! Not only are these guys quicker, they're better than me, too!"Hot Fuzz would come off the LONG WAIT list on my Netflix queue.
Wednesday, August 8, 2007
Fellow Southern expatriate Jeff Klineman's celebration of true Southern Sweet Tea deserves your anthropological attention. I've always gravely lamented my own lack of Sweet Tea experience, and I'm actually working on developing a taste for iced tea. The problem, of course, isn't with the beverage, but my unwillingness to knowingly put that much sugar in a glass and drink it. Thank you, Splenda, for letting me re-explore my heritage without further increasing my chance of diabetes. Courtney assures me that it's my grandmother's fault, since her grandmother always had a pitcher of the prototypical Pitcher of Sugar Flavored with a Pinch of Tea ready in the refrigerator. I was too busy drinking chocolate milk and my grandfather's special recipe root beer floats, I guess.
Saturday, August 4, 2007
Kurt understood the significance of the asterisk after whatever number of home runs Bonds steals away from the forces of good:
Picture stolen from this website, a collection of author self-portraits. Copyright somebody who's not me.
Friday, August 3, 2007
Courtney and I turned off our DVR-ed Jeopardy episode last night, only to see this ridiculously painful crash on the X-games. 720 into a 540 turns into a 720 into SPLAT! I thought the dude was dead, since I don't think I could personally survive a fall down a flight of stair, but you can't kill people stupid enough to ride skateboards 50 feet into the air. So it's worth the watch, if only to hear the stoner announcer's reaction: "Ah, man, that was... that was the heaviest slam we've ever seen... Oh, my God. Wow, I can't believe he nailed that 720."
Wednesday, August 1, 2007
Fomy: What did you feel when you finally wrote the kiss, awaited so much by the fans, of Ron and HermioneAnd lots more. h/t to Yale physics ninja, Jack Challis.
J.K. Rowling: I loved writing it, and I loved the fact that Hermione took the initiative! Ron had finally got SPEW and earned himself a snog!
since I'm more comfortable with John Roberts now that he carries a diagnosis of epilepsy? Am I becoming a psychiatrist because I'm somehow naturally more comfortable with folks who have Tegretol or Lamictal in their blood stream?
Stranger things have happened.
All-white church may hire black pastorThe Good: My hometown has just modernized itself out of the 19th century!
ASHLAND — First Baptist Church in Ashland may soon lay claim to a first: The all-white church is on track to hire a black minister full time.
The Bad: The newspaper has to run an article with such a headline. Why would the race of the pastoral candidate be worth more than a passing mention if the expectation wasn't that such outdated racism still would figure prominently in the church's decision making.
Towler said race wasn’t an issue in the church’s relationship with Moore, either in a positive or a negative way.Note to all: the church representative just used the "I'm not racist, I have black friends" argument.
“It wasn’t an issue at all,” he said. “Although we don’t have black members now, we have had black members in the past. ...I can honestly tell you (race) was never an issue in any form or fashion. We think Harold is filled with the spirit and preaches the Bible and that’s what we’re looking for.”
The Ugly: The article ends on an uncomfortable Uncle Tom note: