Archive for the 'social justice' Category

Written by “An Anonymous Doctor” and originally published as this post on Whatever.

Reprinted with permission.


Where Is The Physician Outrage?

Right. Here.

I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.

I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.

I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.

In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.

After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.

Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.

It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.

It’s time for a little old-fashioned civil disobedience.

Here are a few steps we can take as physicians to protect our patients from legislation such as this.

1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.

2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.

Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.

3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.

4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)

5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.

In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.

It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.

Because we are their last line of defense.


Reframing the conversation

You may have heard of Alexandra Wallace, the UCLA student who recently posted on YouTube a rant called “Asians in the Library” about how Asians were “taking over” her school. (If you haven’t, just Google her name.) The video went viral within hours and created a shitstorm that she never expected. She quickly removed the video and offered a fauxpology, but the cat was out of the bag. Lots of people responded with thoughtful rebuttals to her arguments. And, unfortunately, lots of people responded with their own racist or sexist (or both) rants against her.

A slam poet named Beau Sia created this video, which is one of the best responses I’ve seen. He doesn’t insult Wallace by commenting on her sex or ethnicity; rather, he presents his comments in her “voice,” and ends up with a very sharp critique of racism and white privilege:


(Via the awesome folks at Sociological Images.)

…it does.Remember my post the other day about Rush Limbaugh’s attempts to speak “Chinese”? Here’s the follow-up:

“California Lawmaker Receives Racist Death Threat Warning ‘Rush Limbaugh Will Kick Your Ch-nk Ass’”

Last week, California State Sen. Leland Yee (D) called on right-wing hate radio host Rush Limbaugh to apologize for mocking Chinese President Hu Jintao and the Chinese language by speaking gibberish “ching chong chang” Chinese on his radio program. Yee, who is Chinese-American and chairs the state Senate Select Committee on Asian and Pacific Islander Affairs, said Limbaugh owes the Chinese-American community an apology for his “pointless and ugly offense.” Naturally, Limbaugh did not apologize, and instead railed against Yee the following day on his radio, calling him out repeatedly by name.

Yee’s call for civility did not sit well with one Limbaugh fan, who responded by sending several racist death threats to Yee’s office this week.

What are the odds that Limbaugh won’t refudiate repudiate his fan’s actions? Pretty good, I think.


Water, water everywhere…

…and, for about a billion people in the world, not a drop to drink–that is, not a clean, healthy drop.


Today is Blog Action Day 2010. Every year on October 15, bloggers throughout the world participate in this event by posting about that year’s topic. This year, the topic is water.


Think about this:

  • Every week, nearly 38,000 children under the age of 5 die from unsafe drinking water and unhygienic living conditions.
  • African women walk over 40 billion hours each year carrying cisterns weighing up to 18 kilograms to gather water, which is usually still not safe to drink.
  • Many scholars attribute the conflict in Darfur at least in part to lack of access to water. A report commissioned by the UN found that in the 21st century, water scarcity will become one of the leading causes of conflict in Africa. (And it’s already causing problems in the Middle East.)
  • While the developing world faces a water crisis, those in industrialized countries consume far more than their fair share. (Twenty-four liters of water to produce a hamburger. Half a liter of water to charge an iPhone. The production of a cotton t-shirt takes 1,514 liters of water.)
  • People in the USA drinking an average of 200 bottles of water per person each year. (And over 17 million barrels of oil are needed to manufacture those water bottles, 86 percent of which will never be recycled.)
  • Every day, two million tons of human waste are disposed of in water sources
  • Death and disease caused by polluted coastal waters cost the global economy $12.8 billion a year.
  • Today, 40% of America’s rivers and 46% of America’s lakes are too polluted for fishing, swimming, or aquatic life.

In July 2010 the United Nations declared access to clean water and sanitation a universal human right. A declaration without action is meaningless, and obviously there’s a long way to go before everyone has clean water. Getting to that point is going to take a lot of work, but there are things you can do to help:

  • Stop contributing to pollution runoff to help keep our rivers and streams clean.
  • Calculate your own water footprint.
  • Take a look at how much water is needed to produce some of your favorite foods and products…and maybe reexamine your consumption patterns.
  • Support organizations such as and Charity:Water in their efforts to bring fresh water to communities in the developing world.
  • Stop using bottled water. Most of the water sold in bottles is municipal water repackaged for dupes; the few products that are truly “mineral” water are transported long distances, at great cost to the environment. The manufacture of bottles (most of which aren’t recycled) uses a lot of resources, and of course the money people spend on this stuff could be much better used elsewhere. Get a reusable SIGG/Kleen Kanteen/whatever (seriously–there are a gazillion inexpensive choices out there for BPA-free reusable bottles) and fill it up with water from your tap. (Don’t like the taste of your tap water? Filter it! But for goodness sakes stop killing the planet with bottled water!)

Most importantly, SPREAD THE WORD. Most people with reliable access to clean water take it for granted. Reminders about its scarcity can make us all more mindful about how we use it–and how to help others get it.



Tune in tomorrow…

…for my post for Blog Action Day 2010! (And it’s not too late to sign up and contribute your own post tomorrow, too!)

Why, get them to help you raise funds for the Jewish and gay groups they hate, of course! This is absolutely brilliant.



Honestly, I can’t imagine how anyone can say this is a bad thing. Seriously–what arguments can possibly be made against this ideal?

I’ve signed the charter. I hope you do, too.


Blog Action Day: Poverty

Today is Blog Action Day. Today, bloggers throughout the world are writing about the same topic: poverty. Usually I never find out about this global blogging events until they’re over, but I actually came across this one a few months ago. Ever since I signed up for it, I’ve been wondering about what to write.

Mulling over the meaning of poverty, I feel so incredibly lucky to be living in this time and place. I’m by no means wealthy. But I have a home, I have clothes, I have access to decent medical care, I drink clean water, and I never go to bed hungry. The same can’t be said of a good chunk of the rest of the world.

If you’re reading this, it’s a safe bet that your basic needs are met, too. And more: you and I have access to technology, access to the vast information on the Internet, and enough leisure time to permit us to use both. Compared to more of the world, we are filthy stinking rich.

It may seem impossible for one person to have an effect on global poverty, but there are many effective actions that individuals can take. As you move through this day, think about what you have. And what lots of people throughout the world don’t have.