Monthly Archives: May 2009

Wow, that’s offensive

I joined Facebook because my medical school class had a webpage with announcements before class started two years ago, and it was the main way we were distributing information. I am generally a fan of Facebook, believe it or not. One complaint I have is that there are plenty of time wasters on there, and even if I don’t choose to participate in them, my “news feed” is full of the goings on of my “friends”. I try to ignore the thousands of applications and quizzes, which are usually more annoying than offensive.

Well, some of my “friends”, including one from medical school, are taking the “What mental disorder do you suffer from?” quiz. One fellow medical student, who is by all my observations very neurotypical, got the result “autistic”. Here is the summary that is visible on my main page, which is all I can read without joining the stupid application:

“Austism (sic) is a pervasive development disorder. You will suffer from poor communication, a lack of relationships and joy, and repetitive motor mannerisms that will generally piss people off, such as tapping your pencil or flapping your arms…”

Not only is this a very negative, not necessarily accurate description of autism, but it is being used by a neurotypical to joke around about how ironic it is to compare him, a successful medical student who was the president of a major student organization and has a girlfriend to some caricature of a mockable arm flapping joyless person who will never have a good relationship with others.

To make it worse, he is a medical student. I was annoyed when my first “friend” who took it, a former high school classmate, was diagnosed with virtual sorta obsessive compulsive disorder. How amusing! *snort* She must be tidy. How easy to compare that to someone with a possibly disabling mental disorder!

But, I hold future medical professionals to a higher standard than the average shmo on Facebook. I was disappointed by the snickering in our behavioral science / psychiatry system when some of the mental disorders were described. I was disappointed when one of my classmates sent out a ranting email with derogatory comments towards classmates with “lazy eyes” (huh?) and ADHD.

Medical professionals should not use medical diagnoses as insults or jokes. Medical students should not add to the stigma of mental illness. Medical students should not perpetuate incorrect stereotypes of mental illness or developmental disorders.

That is all. I am done with my rant, and I need to study for &^%$#@ boards.

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Reply turned post, breastfeeding nazis and formula is poison style

PhD in Parenting has a hopping post about the term “breastfeeding nazi”. I also have a problem with that term, which I have written about.

After we dispensed with some devil’s advocate apologist nonsense in the comments, the conversation devolved into familiar territory. People telling horror stories about the two extremes: the most judgmental breastfeeding supporters (you know, certain message boards *roll eyes* have people tell people formula is poison), and the other alternative, (women who don’t want to breastfeed shouldn’t have children), and that breastfeeding should never be discussed in public. See Mommy Wars Bingo if you want to fill in some squares.

Anyway, this is my reply turned post. If you want to read more than a hundred comments, you can get all the nuance of this particular comment thread, but this is my most recent reply:

Wow, none of my breastfeeding posts got this many replies!

Breastfeeding, like every other health issue, must be discussed with nuance. It does not have to be avoided in the public sphere, and treated like a secret between the mother and her pediatrician.

KC, I am sorry about your grief about not being able to breastfeed. My closest friend, whose birth I was a doula for, had a similar situation. There are options, like the SNS (supplemental nursing system), available to provide nourishment (either in the form of pumped breastmilk, the mother’s or donated, or formula) while still supporting the breastfeeding relationship. For my friend, this worked for a while, but she ended up giving formula from a bottle after trying for months. With a hospital grade pump, and several consultations with lactation consultants.

What I am trying to say is that there are interventions that will nourish the baby if the baby is losing weight inappropriately when the breastfeeding relationship is not working adequately, for whatever reason. Supporting breastfeeding and lactation consultation are definitely not at odds with making sure babies survive optimally. If a baby is not getting enough nutrition, then obviously the health outcome is not ideal, and there should be a different health option, which would be to use an intervention like formula.

No responsible breastfeeding advocate would tell a mother that she is feeding her baby poison if her baby is not getting adequate nutrition over a physiologically significant period of time. (Or if there are any other medical reasons why she cannot or should not breastfeed).

This is the equivalent, but opposite, of the breastfeeding nazi remark. It is ridiculously out of proportion and meant to be hurtful. Do both extremes happen? Yes. Do they need to dominate every breastfeeding conversation? No.

But, remember, I have heard nurses, family members, doctors, and women in my own family say a baby is “starving” after one failed latch or during a crying spell on the first day, even if there has been other successful feedings. I have heard people say a baby is “starving” because the mother’s milk isn’t in yet, just the colostrum.

There is no reason why this can’t be handled with accurate information and sensitivity.

As for the sexual abuse and breastfeeding argument, this article in the journal Lactation says that women with a sexual abuse history report wanting to breastfeed more than those without. This article stresses the wise tenet from the article linked to above: never underestimate or overestimate a woman’s desire to breastfeed. Again, each situation must be dealt with with sensitivity, appropriate health treatment and accurate information. We cannot speak for other’s sexual abuse experiences, just as we cannot speak for other’s lactation experiences.

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Dream internship

OMM (Oh My Maude), the Reproductive Freedom Project of the American Civil Liberties Union Foundation is offering an internship to a medical student who wants to do research and writing about reproductive rights.

EEEEP!!

I am so interested, yet I am afraid to even look into it. I think it is in New York City.

I am writing to find out how long it is, if I can telecommute for any of it, if there is a stipend. My friend just told me her dad keeps a usually empty furnished apartment in Long Island that I could use. My older bro and SIL live in NJ, and my bro commutes every day into the city, but I think they would make me sleep out on the lawn if I was interning at the ACLU.

I am hoping it is a short internship, maybe a month or two. (I see ACLU “spring internships” for legal students listed on websites, but can’t find this specific one. I was just sent a small info sheet about it from medical students for choice with no details). I am hoping they would consider letting me fly up for a work week in the beginning, attend a “staff meeting” (described in duties). and then do the rest, which involves reading and disseminating current medical research, (one of my favorite things!) from here at home.

I am pretty sure the school would be fine with me using some of my research fellowship year doing this internship, since it is a research position.

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Cesareans done in most Miami-Dade mothers

Long time no see!

I came back from ACM pretty excited and exhausted. I had to play catch up all week.

I visited with some dream programs at the residency fair. I would love, love, love to go to OHSU, whose website has a strong positive position on resident work / life balance. They have a family planning fellowship and pro-choice, opt-out training. And, it’s in PORTLAND, the most fabulous city ever.

Instead, this is the obstetrical climate in Miami, the city of my geographically-limited scope. We have a higher than 50% cesarean rate, officially, in Miami-Dade county (the county I was born in, and that houses the residency program I will probably be ranking very highly). The county I live in, Broward, home to Ft. Lauderdale, is not far behind with a cesarean rate in the 40th percentile.

Considering our medicolegal situation here is also one of if not the worst in the country, I don’t think the strategy of sectioning to avoid lawsuits has been working.

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Off to the ACM

Sorry I have been neglecting the blog, but things have been really busy lately. Funny, because classes are officially over. I had my last graded event of my preclinical years of medical school Tuesday night, a standardized clinical experience (we call it an OSCE at our school). I saw five actor patients, read 3 EKGs, read 2 X rays, and analyzed some blood gases of a poor soul who was in diabetic ketoacidosis.

Wednesday I finished my final project and presentation for my research methods class, and helped S conduct his science experiment in the same afternoon. Thanks for the 24 hour notice, kid. (My Facebook status said there was methods in my madness that day.) I would post my final paper here, but it was nine pages long, so I guess it would make a crazy long post. Maybe I can find a way to post it and link to it if I get the time and the savvy.

I am on my way to the Annual Clinical Meeting of the American College of Obstetricians and Gynecologists at an ungodly hour tomorrow morning. I doubt I will be posting from there, but I get insomnia when I travel (I almost typed amnesia there, that would make it an interesting trip) so I may end up babbling int he wee hours.

Miss me. *Mwah*

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