Monday, May 23, 2011

Dr. Demented (revisited)

Recently while out bowling with my wonderful children at the every bit as wonderful Dormont Lanes I slipped while trying to perfect my hook-- ok not perfect more like actually complete a hook that knocks down more than two pins-- and managed to crush my pinkie with a bowling ball. It was a wonderful little injury with pieces of fat and other gore oozing out and bright red blood. I had no intentions to visit the ER; it was my son's birthday for goodness sake and in no way did I want the day to revolve around me and one or two stitches. I wrapped my injury with paper towels and watched the kids bowl. Unfortunately later on, back at my home, my son managed to slip and fall while he was bowling with his home bowling set and ended up splitting his chin; not as much blood, but enough of a wound that the wife thought, Daddy's doctor aversion aside, we ought to have him looked at.

Thankfully we were seen by a P.A. instead of an MD. However I was surprised when she told me it was my mother's fault that I had smashed my finger.
"Really?" I asked, shocked.
"Well yes, the AAP is now recommending routine infant pinkie removals to prevent just this type of injury. If your mother had been more forward thinking this would have never happened to you."
"I'm surprised since, you know, it was kind of a bizarre accident. Doesn't seem worth removing a baby's pinkie to prevent something that probably won't happen when he gets older."
"You do have a point. Actually I'm not supposed to tell people this but penile cancer is even more rare than serious bowling accidents statistically speaking and we tell people that one of the reasons circumcision is so great is because it prevents penile cancer."
"Hmmmm," I mused. "Do you ever think people are just trying to come up with bogus reasons for an awful thing that they do to because it fulfills their own psychic needs?"
"No, doctors are too wise for that. They're so wise in fact they don't even bother sewing people up anymore if they can help it. Hold still now..."

(OK I didn't really get to have that conversation with her, but isn't it interesting that the foreskin is the only part of the human body that docs advocate removing to prevent cancer? They don't remove colons or ovaries or breasts at birth even though millions of people die of cancer related to those parts of the body. Seems a little fishy if you ask me.)

She glued my son's cut chin together and then stitched me up while he watched. Then they charged my insurance company an exorbitant amount of money and sent us on our way. It was very straightforward. Nothing "preventative" about this care. We came in bloody, we left less bloody. Hard to give that kind of care a bad evaluation. Now I'm not against a routine visit to your dentist once in a while or your eye doctor-- especially if you wear contacts like I used to and have to worry about getting one of those weird eye diseases if you don't keep them clean, ugh-- however, I think this whole idea of preventative care is a big part of the circumcision problem, outside of the previously explored all important need to preserve ego. Most doctors are pretty good at fixing things if you indeed have a genuine need for care, best evidenced by loss of huge amounts of blood, a cavity that feels like it's boring a drill into your gum, etc. It's when we take healthy adults and children to doctors that they become dangerous.

Think about it this way: You've got a brand new Caddy. 6 miles on it from the lot and that's it. You take it in to your trusted mechanic and say,
"Can you do something to be sure my car continues to run good."
"Well sure I can!!!" he says.
$300 later he assures you he's extended the life of your new car and you have little evidence to disprove his claim. It is, after all, a new car.

Babies don't need doctors to keep them well. If they did the human race would never have evolved past the middle links of the food chain. Heck we probably wouldn't be here at all. But somewhere along the road to current medical practice "First do no harm" got replaced with "There's always something you can do to make this body better." Once the medical profession sold us on the idea of preventative care we as healthcare consumers were basically cooked. We would buy whatever modification they said our car needed and hey if Dr. Demented says we can prevent future rust problems by hacking the entire tailpipe off our new Audi then we should probably do it. He ought to know about these things. He wouldn't let us sign up for anything that did HARM to our car, I mean child, would he?

It's sad because I think there are a lot of well-meaning people in various medical professions who themselves have bought into the all-important nature of preventative care. Case in point:
My oldest daughter brought home a coloring book from a recent trip to the veterinarian's office. One of the pictures had the following caption:
"Veterinarians help keep our pets healthy and happy."
Shouldn't the caption read,
"Veterinarians help sick and injured pets get better?"
Unfortunately veterinary medicine needs preventative care to stay afloat, just like your doctor, and, of course, your mechanic. The coloring book was interesting because it made me think this is probably how some vets conceptualize themselves: keeping healthy pets from keeling over and dying for no reason, making sure everything goes according to plan health-wise. Again, how did dogs survive for 2,000 years without veterinary care? Somehow sometime in the last 50 or so years human and animal medicine decided bodies were inherently flawed just because these bodies tend to eventually expire, that the doctor's job was not to fix what was broken but to set out on a relentless and at times ethically questionable quest to make the body and everything about it Perfect.

My finger is not perfect. It's ten days post injury and my digit is still sporting bright blue stitches and a jagged red mark a little too wide to consider completely healed. It's condition will improve with time and, eventually, the scar will probably fade. However it looks I'll be happy with the outcome since it was without a doubt damaged and in need of medical fixing. Unfortunately, like all circumcised males, I still bear the scar from that injury. It will never heal. I will see it every time I have to pee and almost every time I dawn a device to help with restoration I will experience an emotion at varying places along the continuum between peeved and devastated. Please keep in mind part of the reason my foreskin was removed was because a doctor told my parents there were health benefits. Harm was done to me with the claim it would prevent future harm.
"I know I'm not supposed to but let me do a teensy bit of harm now," Dr. Demented says, "I PROMISE it will mean less harm later."

I for one am not signing my kids up for any kind of harm. Even if JAMA or some other medical journal publishes a double blind study proving that circumcision will make people live 20 years longer and prevent Alzheimer's disease I still would not do it to my child; I would still advocate against circumcision until the day I die. I will never trample any child's rights for some nebulous future benefit no matter how much "cutting-edge" research has supposedly been done. After all do you think it's a coincidence that all those researchers are they themselves circed or else they're women from circed families or even women who have circed their own children and want/need to justify this thing that every fiber of their motherly instincts tells them is WRONG?

Interesting final digression: I once met a girl on the bus who was reading a text from nursing school. I asked to see it and tried to find an entry on circumcision and could not find one. I found this odd and broached the subject with her. She eventually informed me she had "observed" a few being done and went on to make a feeble attempt to tout the health benefits of this procedure. I did my best to make her see how the real crux of the issue was the fact that it was unethical to remove body parts of children without their consent. But she already had her walls up. I could see she didn't want to let the information in. Why? Because she had witnessed circumcisions being done and had not intervened. If this procedure was indeed ethically wrong she would have to bear some ethical responsibility for standing there and doing nothing. She was kind of like the guy who delivered lunches to the guards at Auschwitz. She was kind of like the guy who gassed up the plane that dropped the A bomb on Hiroshima. She played a role, albeit a small one, in the genital mutilation of those children. She stood by and did nothing while that baby screamed. Millions of doctors and nurses have had this same kind of training. I suppose trying to find reasons to justify circumcision is the best way to distract them from the blood on their hands.

PS: final final digression. RD left comment touching on circumcision practices during the Korean war. I worked with an African-American woman whose father served in Africa in World War II. She informed me he was forcibly circumcised by the military upon entering the service, the excuse being that he might contract some kind of dreaded disease. She assured me this was done against his will, basically do it or be court-martialed. I found this quite frightening and couldn't help wondering if this happened to more black soldiers than white ones or if the military was just cutting everyone they could get their hands on back then. If anyone has links or additional info about the military's approach to circumcision past or present please share!

Sunday, May 15, 2011

Dr. Demented

Anybody who knows me knows I don’t trust doctors. Sure, if I ever manage to acquire a gunshot wound or if I’m ever in a horrific car accident and need my arm to be reattached I will happily entrust my future wellbeing to an MD. I think very highly of emergency room doctors. Most of the time I imagine their job as being fairly straightforward: person comes in broken, they need to fix the person enough so they don’t die and then refer on to a specialist from there. However, that’s about the only doctors I trust. I haven’t gotten a physical in years and have no intentions of doing so unless I actually feel seriously ill for a long time—- wild concept huh? Why not, Jeff? Don’t you want to prevent cancer, don’t you want to live to be a 103? Well, here’s the problem, I don’t think US medicine can entirely be trusted. Now here’s one caveat to this entire post: I work in the behavioral health industry. While the job I do is focused mostly on improving the lives of people labeled for whatever reasons as having “mental illness” I do work with psychiatrists and these are, in my opinion, some of the worst doctors there are out there. (chiefly because none of them can actually fix anything. Too squeamish to mend bones or stitch flesh, they join an industry that serves the interests of, primarily, the pharmaceutical industry.) This has a great deal to do with why I don’t trust doctors, I suppose. However, I have a sneaking suspicion it may also have something to do with the fact that almost 34 years ago a doctor rubbed my penis until it became semi-erect, clamped some sort of metal device to it, and sliced off my foreskin with a scalpel.

Let’s really consider this for a moment. Throw out all the arguments that doctors give for why circumcision can be a good thing—- we’ll return to that parade of snake oil salesmen later. Let’s look at it from me, as a little baby, my point of view: “Oh god, that really hurts. I have no idea why this is happening. You are hurting me. Where the hell is my Mom?” I did not give consent for this to happen. No one talked to me about risks vs. benefits of this operation much less the permanence of it. I was not consulted. Hmmmmmm.

I like to carry things through to their logical, or in this case illogical, extension. So I have three kids. Let’s say I decide that my son, little Sullivan’s nose is too big, it’s quickly growing into that enormous Sanger nose I’ve been sporting my entire life. After much involved discussion with my wife we decide it would be better to give Sully a nose job NOW. If we do it now he won’t remember it hurting and then when he grows up he won’t have to face the challenges of having a big nose. Now I realize plastic surgeons care about money perhaps even MORE than the average doctor does but do you think I could find any doctor in the US who would be willing to perform such an operation? Maybe, but it would be difficult. Why? Perhaps they would cite the fact that it’s not a good idea to perform cosmetic surgery on a child, or perhaps they might even point out that I ought to wait until little Sully can give his consent. At what age does a child’s consent start to matter I wonder? At what point do they stop being property and become little citizens. Here’s a strange thought: regardless of how you feel about abortion, isn’t it kind of funny that pro-lifers want the state to protect unborn children but not their foreskins after they’re born?!?!?!?! Yes, I believe in consent, even for people who can’t speak. If they’re not equipped to give it as infants perhaps we should wait until they are able to. Now I’ll admit I may be a bit of a fanatic in this regard: I refuse to even cut my kids' hair unless they want it to be done. To date none of them has had a haircut. But perhaps I’m so conscious of the sacredness of their right to control their own bodies because I never had this control over my own body.

Back to Dr. Demented. Do I think Mom and Dad made a mistake signing off on part of my body being cut off? Yes. However, they’re from that generation that believes doctors can do no wrong, that they can’t be influenced by money or powerful corporations, or politics, or their own cultural biases. I know better. More and more people these days know better. But for Mom and Dad they read the APA statement of the day which said circumcision was not really necessary but did, honest to god we promise, prevent a bunch of horrible, dirty, health problems. Well, Dad’s cut, they thought to themselves, it must have been because of the health benefits. We should do it to Jeff too.

That’s what all of this goes back to: all of us circumcised guys have this moment shortly after we realize we are “cut,”-- and I have heard of people who didn’t even know what the word meant until their 20s-- sometime after this moment we ask ourselves, “Why was my foreskin cut off?” And that question leads to some pretty difficult feelings you've got to start repressing ASAP.

Let’s pretend you woke up this morning to find your right ear was hacked off. All that was left was a bloody hole like that poor cop in “Reservoir Dogs.” You come down to breakfast screaming and your mother informs you she cut it off because your doctor told her it was the most hygienic thing to do, especially considering the fact you’ve got two of the damn things and all they do is fill up with wax anyway. You’ve got two choices at this point:

Choice #1 You believe the doctor. This is oddly comforting because now you can look down on all the people that have two ears: “Yes, they have two ears but they’ve got that extra wax to deal with and besides, I’ll have the last laugh if they develop that rare but horrific ear cancer the doctor told mom about.” This also absolves your mom of responsibility so you don’t have to admit there’s any kind of issues in that relationship. Mom cut off the ear because she was looking out for you. End of story.

Choice #2 Your mother has done something horrible to you which she refuses to acknowledge as horrible. This is obviously the more difficult choice: not only must you admit that the person who is hardwired to protect you from harm has instead volunteered you up for it, you must stand up and assert that Dr. Demented who has lots of important letters after his name and who, after all, was REALLY good at chemistry and biology does not know what the F*&# he is talking about.

Therein lies the explanation for why circumcision is a vicious cycle. Ironically I think the docs themselves go through this same process. A lot of these guys are cut too and they engage in the same thought process that the rest of us do. After deciding on choice one, they go on to be doctors, to help people. "If removing ears helps people then by God we’ve got to do it. These people are just not smart enough to know what’s good for them." Suddenly they’re wielding the scalpel themselves and instead of acknowledging the true, deeply buried subconscious sentiment of satisfaction at having ensured someone else will not have the opportunity to have any additional equipment they themselves were deprived of, they can instead tell themselves they are helping this little baby, sparing him from a life of potentially unhygienic choices. My favorite part is even as they lower the scalpel and blood gives from the crease in the skin and baby screams and writhes against the circumstraint, doc tells himself, “Hey even if I’m wrong, which I never am, and this is all bullshit I’m still ethically clean because it’s mom and dad’s choice and it’s ok to let them pay me to cut off part of their child’s body if it’s important to them. Really!?!?!?!?!? It’s kind of like the guy at Auschwitz saying, “Hey sorry I burned all those kids but talk to Hitler man, I was just following orders.” We all have to face the choices we make. Believe me I’ve made some dumb ones myself. But the thing about doctors is they still maintain this air of authority. Enough so that millions of mothers let their pedes or OBs “convince” them that circumcision is the right thing to do. "Why would Dr. Demented lie? He wants what's best for my baby." Well, here’s the problem, it’s kind of like getting advice on choosing shoes at a double amputee convention. If Dr. Demented is cut, he's probably not hip to the benefits of being intact. He can’t help but tune out information about the benefits of being intact, it is likely psychologically painful to him. He's got to hold his penis in his hands to pee and stare at his poor exposed, toughened, centurion helmet-top the same as I do. He really doesn't want to spend continuing education hours on learning about why it stinks to be circumcised. It’s much more palatable to find reasons why it’s great since he's got to live with it.

That’s my beef with docs in a nutshell. They have perpetuated the cycle of circumcision to protect their own egos. They’ve claimed circumcision cures seizures, masturbation, laziness, bad behavior, etc, the list goes on. HIV is just the latest addition. Once it’s proven circ doesn’t really prevent that either they’ll find something else it prevents. Um thanks, but until you’ve got some hard, ha ha get it?, evidence I think I’ll let my son make his own choices. If he hates wearing a condom he can always sign up for a circumcision later in life I suppose. As for masturbation, well, I haven’t met too many adolescent boys who want to cure themselves of that!

So Dr. Demented, first do no harm. If you’re cut I think you should recuse yourself from supporting circumcision. You have a conflict of interest, unless of course you circed yourself. Regardless of whether mom and dad are behind it you should not be removing body parts without the person’s consent. Face it: your profession did some very sick, very bad stuff back in the day. You said smoking was good for us for God’s sake! Could you please just admit you blew this one and stop making excuses to protect all the penis cutters out there? It’s wrong. Even if you can fabricate oops I mean produce a study that shows circumcision extends lifespan by 50 years it’s still just wrong to alter/mutilate people’s sex organs without their express consent. I’m sorry it was done to you, Dr. Demented, but no matter how many baby penises you mutilate it’s not going to make you feel better about your own. No matter how hard you try to make the whole world look like you, you can’t escape the fact that every new baby boy is born exactly the way he should be and you’ll never, ever, be able to cut them all.