Life as an Extreme Sport

Category: …and everything else

Mostly everything else in a brain-academic way.

Outsourcing Health Care

...and everything else, Bioethics

I used to joke that going into medicine was a safe bet for just about anyone, because it’s the one thing you’re not going to find outsourced. Well, it appears I was wrong. What worries me about this, though, is not issues like safety and standards – those do seem to be addressed, at least somewhat. What worries me is that this is an ‘out’ to the current state of medicine/health coverage in the United States, creating a system where there is no issue for those insured, or those who have the money to travel abroad not just for heart surgery but heart replacement, but a system where the gulf between “have” and “have-not” continues to grow. This doesn’t begin to address the under or un-insured, and furthers the rift between those who, even if they are not well off, are well enough off to afford these things, and those for whom $9,000 is an impossible amount of money.

In the growing divide between with money and poor in our country, we seem to focus on the services available (or not) to those on the with money side, and ignore those who don’t have it. It’s an almost Calvinist approach, assuming there is something morally wrong with those who can’t afford what we’ve deemed the basic necessities of life.

While it’s certainly not a bad thing that people without access to health plans or the finances to bankroll $50,000+ surgery, it’s not good that this is being seized as a possible option to ease American health insurance problems, because it doesn’t address a huge problem that exists: those with the dual problem of low income and no insurance.

What I Did With My Saturday night

...and everything else, life and living

My Saturday night, in pictures:

A ticket to see Colin Mochrie and Brad Sherwood!


Why, what’s that piece of paper?


That looks kind of notecard shaped…


What does that say? Adulterous whore?

Yes, my front row, first chair seat got me several interesting experiences this evening. First, I was next to a very nice, very chatty young boy… who, when Brad asked for a third child of about the age he was, I very sneakily pointed to and got the kid on stage – to his parents delight (and gratitude), and the kids near-ecstacy. He got to be one of the three kids playing a version of “Change Line” – they honked the horn every time they wanted them to say something new. Brad nearly killed them – it was most fabulous.

Other awesome things were the game If Ya Know What I Mean, which is well-played when teaching someone how to play poker. Just imagine all the innuendo with Queens, hands, lows, beating men with hands,… they barely kept it together, and at one point, Brad just… went, breaking everyone up.

Sound Effects was also just incredible, with the girl doing the sound effects for Brad doing the sound effect for the megaphone… and saying something like “I need to remove this object from my anus.” Til then, she’d been doing fabulous sound effects – and then this. And it broke Brad. Hard. Colin was right behind, but managed to keep it together much more, and goad the girl to say more, and worse things. (They were chasing a sheep. Take your imagination where it wants to go – she did worse, I guarantee.)

I verified, for Brad, that indeed I could not see through the blindfold being used for mousetrap. He said something like I wouldn’t tell them if he could see, anyhow, and I asked why he said that – after all, it wouldn’t be nearly so funny if he could see what he was doing. He blinked, agreed, and then we watched them play The Most Dangerous Game in the World – barefoot, across the stage strewn with 100 mousetraps. But that’s not hard enough, so they also played the Alphabet Game, singing it opera-style, about nanotechnology.

I laughed so hard I needed my inhaler.

After the break, they collected our suggestions for the game Whose Line (“yes, Whose Line is it Anyway has a game called Whose Line – go figure!” ahem), and proceeded to run through them. The scenario was mountainclimbing in the Himalayas, searching for the rare Himalayan giraffe.

The above card was my suggestion. I cannot explain the smiley. I don’t know why I drew it, I just did. And oh, was I mocked. Brad drew my card, read it (attributing it to advice from his father), folded it into his pocket, pulled it back out, and noted how happy and optimistic his father was, showing everyone the smiley. And I folded over in laughter, and he stood over me: “Oh, I wonder who wrote this!” Since I was folded over laughing, I missed him handing the card down to me, but the kid next to me grabbed it and gave it back to me.

The rest of the show, they’d come back occasionally to make fun of me… including singing it in the show finale. Which was taped. They mentioned my being embarassed about being teased, standing over me and pointing grandly. It was awesome.

The last game played was Crime, in which Brad had to guess that he did the following:
while dressed in toe socks, velvet bellbottom overalls, and a cast iron jock strap, sold comic books illegally while giving a chicken steroids, in Chictawhaga (I’m spelling it phoenetically, and yes, Brad GUESSED this), where he left behind a raisin and a sticky bun.

I can’t believe the seat I had – I was maybe a foot from the stage. Colin walked out and stood right in front of me, making direct eye contact, winked, smiled, and was simply charming. Brad, once he’d centered in on me, made a lot of eye contact and faces my way the rest of the night. And since I kept reacting to his left field philosophy-esque jokes, he kept making them, and looking to me after each one to watch me crack up.

It was glorious. I had an amazing time. I’m so, so glad I went. I’m going to be chuckling quietly to myself for weeks.

Cats

...and everything else

It’s been a while since I’ve uploaded any photos of my boys, as evidenced by the fact that my camera was full of pictures. So, a new album of kitty pictures, and a couple of my favourite posted here.


My big baby, Toledo.


Both my boys have been burying themselves under blankets, lately. I think it’s their way of saying that they’re cold.


I walked in to this a couple of weeks ago. My guess is that they were playing rough…and it didn’t affect Lunar’s ability to sit there, so why not?


He’s flexible.


Easier to stay warm in pairs.

The Gardasil Controversy

...and everything else, Academics, Bioethics

This post on the Modestly Yours site, where I was directed by a friend (cuz y’all know I sure don’t qualify), perpetuates many of the myths and beliefs about Gardasil, the HPV vaccine. I did reply to the post in their comments, but since they are moderated and I was blunt in my disagreement, I don’t necessary expect the comment to make it to air (as it were). So, in the interests of preserving what I wrote, because damnit, I actually bothered to fact-check,…

Sorry, but I strongly disagree.

First, to clear up some misunderstandings in your post. Gardasil actually protects against four of the main variants of HPV, types 6, 11, 16 and 18. To break it down, HPV 16 and 18 cause 70% of cervical cancer and adenocarcinomas, and 50% of the precancerous histologic lesions, CIN. The four variants together cause 90% of genital warts, which can be infectious and invisible for both men and women, and are not protected against from common prophylactic means (they can be, but as they can grow in areas not covered by condoms, they can be transmitted when you believe you’re having safe sex). Since warts can be flat, smooth, internal, or simply invisible, it’s extremely hard to get an accurate number of how many cases of HPV/genital warts there are – 200,000 per year is the tallied number, but it’s expected to be significantly higher. Unfortunately, the highly cancerous versions of HPV tend to be the ones that are invisible to detection.

It’s also worth remembering that HPV is indicated in other forms of genital cancer, as well as soft palate cancers.

Secondly, the vaccine age approval is nothing more than a reflection of the ages that Merck tested the vaccine in. This has practical reasons: most people, by age 26, are infected with HPV. Women who test clean of any of the variants being covered by Gardasil are encouraged to have the vaccine, regardless of their age. While their is not proof it will work, the body really doesn’t have an internal clock going “oh, you’re 28, so Gardasil won’t work in you.”

While the majority of HPV cases do clear up on their own, those are the low cancer risk variants that can be unsightly, but cause no real harm. (There are, after all, over 40 variants.) But the vaccine is not targetting these low cancer risk variants, it’s targetting the ones that kill.

Gardasil is also one of those vaccines that has been developed not just by the Big Pharma, but in conjunction with the National Cancer Institute, whose interest is in protecting the public, not in benefiting the stockholders. While it’s certainly more than sane to be suspicious of Big Pharma’s, and to carefully read the FDA decisions, the CDC isn’t implicated in or even involved in vaccines on the level you imply. Beyond that, the true test of science is empirical study and peer review – this is where the issues with Vioxx came out, after all. In the case of Gardasil, empirical evidence from around the world backs up the claims of the NCI and Merck. There is nothing in the vaccine suspension that brings any cause for concern, and is in fact the standard suspension for any number of vaccines we give children and ourselves daily.

Finally, though, your argument about “social engineering” and “childhood” are the most spurious. You’re suggesting that by vaccinating a 9 year old against HPV, the 9 year old is going to run out and become sexually active. This is hogwash, plain and simple. There is absolutely zero data that would even give this the merest credence – tell me, when you received your tetanus vaccine, did you go out and step on a rusty nail, just because you could? I mean, it might have been painful, but it wouldn’t run the risk of hurting you.

This is the exact same logic you’re using to argue that Gardasil is going to confer some sense of irresponsible behaviour on girls. But when you take the emotional “omg my baby is going to have sex eventually” aspect out of it, and transfer the example to something as benign as tetanus, the fallacy of the argument becomes clear.

But beyond that? Children receive numerous vaccinations through-out their childhood, and well into adulthood. If you think kids pay any attention to what’s being injected into them, you’re giving way too much credit to your kids. For them, it’s a doctor visit, it’s a needle, and that’s all. Go up to any 12 year old and ask them what vaccinations they’ve had – they might be able to list tetanus, especially if it was under a painful circumstance, and MMR, but that’s it.

Yes, there are recommendations for avoiding HPV infection, and they’re the same for avoiding any STI. But all it takes is sex with one person, and you cannot judge infection visually – there’s no way to know. (And this doesn’t even address things like date and stranger rape, and the vaccine is not effective after exposure.)

Thinking beyond the self for the moment, there are also future children – fetuses can be infected by HPV upon birth. Many women with precancerous and suspicious HPV are recommended and counceled to have their pregnancies time with a “clean” cervix in an effort to downgrade the risk to fetus.

Yes, it can be uncomfortable to realize that children are going to behave in ways that you don’t approve of… but as a parent, your job is to protect your child as best as possible. That means protecting them from danger, and cervical cancer is really, really dangerous. Yes, the short term means acknowledging the sexual potential of your child, but it is, in the long run, the better thing for your child.