Playing God
On the Media
For the first time, the Pulitzer Prize for investigative reporting went to an online news outlet – the not-for-profit ProPublica.org – for its story about the decision doctors made to euthanize patients at Memorial Medical Center in the aftermath of Hurricane Katrina. ProPublica reporter Sheri Fink talks about her piece.
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Pro Publica's Continuing Feature on Memorial Medical Center in the aftermath of Hurricane Katrina
Showing posts with label Doctors. Show all posts
Showing posts with label Doctors. Show all posts
Friday, May 28, 2010
Thursday, March 11, 2010
Mark Benjamin: Waterboarding for Dummies
Waterboarding for dummies: Internal CIA documents reveal a meticulous protocol that was far more brutal than Dick Cheney's "dunk in the water"
By Mark Benjamin
Salon
Self-proclaimed waterboarding fan Dick Cheney called it a no-brainer in a 2006 radio interview: Terror suspects should get a "a dunk in the water." But recently released internal documents reveal the controversial "enhanced interrogation" practice was far more brutal on detainees than Cheney's description sounds, and was administered with meticulous cruelty.
Interrogators pumped detainees full of so much water that the CIA turned to a special saline solution to minimize the risk of death, the documents show. The agency used a gurney "specially designed" to tilt backwards at a perfect angle to maximize the water entering the prisoner's nose and mouth, intensifying the sense of choking – and to be lifted upright quickly in the event that a prisoner stopped breathing.
The documents also lay out, in chilling detail, exactly what should occur in each two-hour waterboarding "session." Interrogators were instructed to start pouring water right after a detainee exhaled, to ensure he inhaled water, not air, in his next breath. They could use their hands to "dam the runoff" and prevent water from spilling out of a detainee's mouth. They were allowed six separate 40-second "applications" of liquid in each two-hour session – and could dump water over a detainee's nose and mouth for a total of 12 minutes a day. Finally, to keep detainees alive even if they inhaled their own vomit during a session – a not-uncommon side effect of waterboarding – the prisoners were kept on a liquid diet. The agency recommended Ensure Plus.
"This is revolting and it is deeply disturbing," said Dr. Scott Allen, co-director of the Center for Prisoner Health and Human Rights at Brown University who has reviewed all of the documents for Physicians for Human Rights. "The so-called science here is a total departure from any ethics or any legitimate purpose. They are saying, ‘This is how risky and harmful the procedure is, but we are still going to do it.' It just sounds like lunacy," he said. "This fine-tuning of torture is unethical, incompetent and a disgrace to medicine."
To Read the Rest of the Article
By Mark Benjamin
Salon
Self-proclaimed waterboarding fan Dick Cheney called it a no-brainer in a 2006 radio interview: Terror suspects should get a "a dunk in the water." But recently released internal documents reveal the controversial "enhanced interrogation" practice was far more brutal on detainees than Cheney's description sounds, and was administered with meticulous cruelty.
Interrogators pumped detainees full of so much water that the CIA turned to a special saline solution to minimize the risk of death, the documents show. The agency used a gurney "specially designed" to tilt backwards at a perfect angle to maximize the water entering the prisoner's nose and mouth, intensifying the sense of choking – and to be lifted upright quickly in the event that a prisoner stopped breathing.
The documents also lay out, in chilling detail, exactly what should occur in each two-hour waterboarding "session." Interrogators were instructed to start pouring water right after a detainee exhaled, to ensure he inhaled water, not air, in his next breath. They could use their hands to "dam the runoff" and prevent water from spilling out of a detainee's mouth. They were allowed six separate 40-second "applications" of liquid in each two-hour session – and could dump water over a detainee's nose and mouth for a total of 12 minutes a day. Finally, to keep detainees alive even if they inhaled their own vomit during a session – a not-uncommon side effect of waterboarding – the prisoners were kept on a liquid diet. The agency recommended Ensure Plus.
"This is revolting and it is deeply disturbing," said Dr. Scott Allen, co-director of the Center for Prisoner Health and Human Rights at Brown University who has reviewed all of the documents for Physicians for Human Rights. "The so-called science here is a total departure from any ethics or any legitimate purpose. They are saying, ‘This is how risky and harmful the procedure is, but we are still going to do it.' It just sounds like lunacy," he said. "This fine-tuning of torture is unethical, incompetent and a disgrace to medicine."
To Read the Rest of the Article
Saturday, February 06, 2010
Bill Moyers Journal: Dr. Margaret Flowers on Medicare for All
Dr. Margaret Flowers on Medicare for All
Bill Moyers Journal
While many in Congress, the press and the public have given up on the idea of even a limited public option in health care reform, Flowers and her group, Physicians for a National Health Program, are standing firm for a single-payer plan. Specifically, they want to extend the Medicare program, which they see as a functioning single-player plan, to the nation as a whole. Flowers has testified before Congress and penned Op-Eds and she has been arrested three times in her attempts to get Congress and the White House to pay attention to single-payer.
Single-Payer
The term "single-payer" generally means a system in which rather than having private, for-profit insurance companies, the government runs one large non-profit insurance organization. That organization pays all the doctor, drug and hospital bills — it is the "single-payer" of all medical bills. In most single-payer plans, every American would be enrolled and would pay into the fund through taxes.
Advocates argue that a single-payer system would pay for itself, saving huge amounts of money in administrative costs. The U.S. currently pays a higher percentage of health dollars for administration than any other nation.
Critics of single-payer plans like the American Enterprise Institute say that other nation's single-payer plans are less than perfect in part because they aren't forced to compete in the marketplace. "Single-payer systems do not guarantee universal access and do not necessarily result in high-quality health care. State-run systems have trouble keeping up with changes in consumer demands and new medical technology." Other critics contend that a government-controlled health care system constitutes too much government in private matters.
The U.S. also ranks highest in total cost of care, but according to a recent report by the Commonwealth Fund, ranks last among industrialized countries "in preventing deaths through use of timely and effective medical care." In a recent FRONTLINE report comparing the health care systems of five other capitalist democracies, "Sick Around the World," WASHINGTON POST reporter T.R. Reid notes that, "The World Health Organization says the U.S. health care system rates 37th in the world in terms of quality and fairness. All the other rich countries do better than we do, and yet they spend a heck of a lot less."
Biography
Dr. Margaret Flowers is a Maryland pediatrician with experience as a hospitalist at a rural hospital and in private practice. She is currently the Congressional Fellow of Physicians for a National Health Program, working on single-payer health care reform full time. In addition to her activity with PNHP, an organization of 17,000 doctors who support single-payer national health insurance, she is a member of Healthcare-Now! of Maryland and a co-founder of the Conversation Coalition for Health Care Reform. Dr. Flowers obtained her medical degree from the University of Maryland School of Medicine and did her residency at Johns Hopkins Hospital in Baltimore.
To Listen to the Interview and to Access More Resources
Bill Moyers Journal
While many in Congress, the press and the public have given up on the idea of even a limited public option in health care reform, Flowers and her group, Physicians for a National Health Program, are standing firm for a single-payer plan. Specifically, they want to extend the Medicare program, which they see as a functioning single-player plan, to the nation as a whole. Flowers has testified before Congress and penned Op-Eds and she has been arrested three times in her attempts to get Congress and the White House to pay attention to single-payer.
Single-Payer
The term "single-payer" generally means a system in which rather than having private, for-profit insurance companies, the government runs one large non-profit insurance organization. That organization pays all the doctor, drug and hospital bills — it is the "single-payer" of all medical bills. In most single-payer plans, every American would be enrolled and would pay into the fund through taxes.
Advocates argue that a single-payer system would pay for itself, saving huge amounts of money in administrative costs. The U.S. currently pays a higher percentage of health dollars for administration than any other nation.
Critics of single-payer plans like the American Enterprise Institute say that other nation's single-payer plans are less than perfect in part because they aren't forced to compete in the marketplace. "Single-payer systems do not guarantee universal access and do not necessarily result in high-quality health care. State-run systems have trouble keeping up with changes in consumer demands and new medical technology." Other critics contend that a government-controlled health care system constitutes too much government in private matters.
The U.S. also ranks highest in total cost of care, but according to a recent report by the Commonwealth Fund, ranks last among industrialized countries "in preventing deaths through use of timely and effective medical care." In a recent FRONTLINE report comparing the health care systems of five other capitalist democracies, "Sick Around the World," WASHINGTON POST reporter T.R. Reid notes that, "The World Health Organization says the U.S. health care system rates 37th in the world in terms of quality and fairness. All the other rich countries do better than we do, and yet they spend a heck of a lot less."
Biography
Dr. Margaret Flowers is a Maryland pediatrician with experience as a hospitalist at a rural hospital and in private practice. She is currently the Congressional Fellow of Physicians for a National Health Program, working on single-payer health care reform full time. In addition to her activity with PNHP, an organization of 17,000 doctors who support single-payer national health insurance, she is a member of Healthcare-Now! of Maryland and a co-founder of the Conversation Coalition for Health Care Reform. Dr. Flowers obtained her medical degree from the University of Maryland School of Medicine and did her residency at Johns Hopkins Hospital in Baltimore.
To Listen to the Interview and to Access More Resources
Tuesday, February 02, 2010
Martha Coventry: Making the Cut
Making the Cut: It's a Girl! ... Or is it? When There's Doubt, Why are Surgeons Calling the Shots.
by Martha Coventry
Ms. Magazine
On New Year's Eve, I sit with an acquaintance and talk. We are nearing the end of a long, pleasant evening. My friend, also a writer, leans toward me into the little circle of privacy we've created. "So you mean what happens to African girls?" she asks, after I tell her what I am working on. "No," I say. "I mean what happens to children in the United States." And as I explain the details of the story, she earnestly watches my face, then sits back, stunned. "I am astonished," she says, and I have to agree with her. It is an astonishing story.
The tale begins in England. It is 1858, and the Victorian Age is in full swing. A respected gynecologist named Isaac Baker Brown, who later served as president of the Medical Society of London, has an interesting theory about women: most of their diseases, he believes, can be attributed to over-excitement of the nervous system, and the pudic nerve, which runs into the clitoris, is particularly powerful. When aggravated by habitual stimulation, this nerve puts undue stress on the health of women. He lists what he calls the eight stages of progressive disease triggered by masturbation: first comes hysteria, followed by spinal irritation, hysterical epilepsy, cataleptic fits, epileptic fits, idiocy, mania, and finally, death.
Baker Brown wasn't alone in his focus on "excessive venereal indulgence." A cultural obsession with masturbation had been building since the end of the eighteenth century and would reach its zenith in Britain and the U.S. in the early 1900s. Various methods had been tried for decades to curb the habit in girls and women, including applying caustic substances to the clitoris and vulva to produce a chronic sore, but masturbation continued unabated. Its consequences, believed to be chiefly hysteria and epilepsy, were becoming nearly epidemic in some people's opinion. The cure Baker Brown offered was complete excision of the clitoris with scissors, packing the wound with lint, administering opium via the rectum, and strictly observing the patient. Within a month, the wound usually healed, and according to Baker Brown, intractable women became happy wives; rebellious teenage girls settled back into the bosom of their families; and married women formerly averse to sexual duties became pregnant.
Physicians had been recommending clitoridectomy for masturbation since the writings of ibn Sina, the tenth-century Persian scholar, but it never became a regular procedure. And they had been removing clitorises that were diseased or so large they interfered with intercourse for at least a century before Baker Brown. But what made Baker Brown the "inventor" of the medical clitoridectomy was his sterling reputation, the scale on which he carried out his surgeries, and the fact that he popularized his method in a book called On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females.
Eventually Baker Brown fell out of favor with a medical establishment that would have preferred more discretion about women's genitals. But before his fall from grace, Baker Brown influenced U.S. doctors, who were discussing his procedure in medical journals by 1866. It was used off and on for decades to stop masturbation, nymphomania, and hysteria. In 1894, a surgeon reported in the New Orleans Medical and Surgical Journal that he had excised the clitoris of a 2 1/2-year-old to stop her from masturbating and slipping into insanity. He noted that after the operation, she had "grown stouter, more playful, and (had) ceased masturbating entirely." As late as 1937, Holt's Diseases of Infancy and Childhood, a respected medical-school text, stated that the author was "not averse to circumcision in girls or cauterization of the clitoris." A couple of years ago, I spoke with a 66-year-old woman in Michigan who had a secret to tell me: as a 12-year-old in 1944, her parents took her on a car ride that ended at a doctor's office. There, as she sat on the exam table, an attendant clamped an ether-soaked rag over her mouth from behind. When she woke up, her clitoris was gone. "They tried to keep me from masturbating," she said. Then, after a pause, added, "Didn't work."
Toward the middle of the 1950s, just as U.S. medicine seemed to be awakening to the brutality and ineffectiveness of clitoridectomies as a means to control behavior, it found another use for the procedure. This time the rationale was that the operation could be used to make a child whose clitoris appeared bigger than other girls' look "normal," thus helping the child, and everyone around her, feel more comfortable. In 1966, a full century after Baker Brown's clitoridectomies were first discussed in this country, this recommendation appeared in the Journal of Surgery: "Some persons have been reluctant to advocate excision of even the most grotesquely enlarged clitoris. . . . half-way measures are much less satisfactory than complete clitoridectomy." Given this attitude, in 1966, was any girl in the U.S. whose clitoris protruded noticeably beyond her labia at risk of getting it amputated? Yes. Would a girl in the year 2000 still be at risk of losing at least part of her clitoris? Yes.
The rationale for clitoridectomy in Baker Brown's time was straightforwardly terrible, and ridiculously unscientific. By contrast, modern theories seem slightly more humane, but when you get down to it, the same question of gender links the Victorian Age's clitoridectomy to its Dot-Com Age cousin. We have been altering the healthy genitals of our children-—boys as well as girls-—for 135 years so that a girl will look and act like a girl, and a boy will look and act like a boy, according to social norms. The strict division between female and male bodies and behavior is our most cherished and comforting truth. Mess with that bedrock belief, and the ground beneath our feet starts to tremble.
To begin with, we rely on the notion that the bodies of females and males are distinctly different. We imagine a dividing line with penis, scrotum, testicles, testosterone, and XY chromosomes on one side, and clitoris, vagina, uterus, ovaries, estrogen, and XX chromosomes on the other. But were we to look between the legs and into the chemical and chromosomal makeup of real people, we would see that nature often refuses to abide by that tidy division.
Over the past 50 years, medicine has established standards for female and male bodies. Girls, if they want to perceive themselves, or be perceived, as fully "feminine," should have clitorises no longer than about 3/8 inch at birth. Boys, if they hope to grow up "masculine," should have penises that are about one inch in stretched length at birth. (Variation in phallus length can be a sign of an underlying medical problem, but it is also used for nonmedical judgments about "normality.") Girls should have vaginas fit for future intercourse, and boys should have urethral openings at the tip of the penis.
By eight weeks gestation, all external fetal genitals have the potential to develop into what we think of as female or male genitals. The genitals will become female if testosterone, or a hormone that mimics testosterone, does not interfere. If it does, then the clitoris extends to make a penis and the inner labia wrap around the underside of the penis and fuse to form the penile urethra. The outer labia come together to create the scrotum. The process for the internal sexual organs is similar. All fetuses start out with precursors of female and male sex organs. By the third fetal month, if the rudimentary male ducts have not been triggered to mature into testes and vas deferens, they will disappear. The female ducts will then grow and develop into ovaries and a uterus.
To Read the Rest of the Essay
by Martha Coventry
Ms. Magazine
On New Year's Eve, I sit with an acquaintance and talk. We are nearing the end of a long, pleasant evening. My friend, also a writer, leans toward me into the little circle of privacy we've created. "So you mean what happens to African girls?" she asks, after I tell her what I am working on. "No," I say. "I mean what happens to children in the United States." And as I explain the details of the story, she earnestly watches my face, then sits back, stunned. "I am astonished," she says, and I have to agree with her. It is an astonishing story.
The tale begins in England. It is 1858, and the Victorian Age is in full swing. A respected gynecologist named Isaac Baker Brown, who later served as president of the Medical Society of London, has an interesting theory about women: most of their diseases, he believes, can be attributed to over-excitement of the nervous system, and the pudic nerve, which runs into the clitoris, is particularly powerful. When aggravated by habitual stimulation, this nerve puts undue stress on the health of women. He lists what he calls the eight stages of progressive disease triggered by masturbation: first comes hysteria, followed by spinal irritation, hysterical epilepsy, cataleptic fits, epileptic fits, idiocy, mania, and finally, death.
Baker Brown wasn't alone in his focus on "excessive venereal indulgence." A cultural obsession with masturbation had been building since the end of the eighteenth century and would reach its zenith in Britain and the U.S. in the early 1900s. Various methods had been tried for decades to curb the habit in girls and women, including applying caustic substances to the clitoris and vulva to produce a chronic sore, but masturbation continued unabated. Its consequences, believed to be chiefly hysteria and epilepsy, were becoming nearly epidemic in some people's opinion. The cure Baker Brown offered was complete excision of the clitoris with scissors, packing the wound with lint, administering opium via the rectum, and strictly observing the patient. Within a month, the wound usually healed, and according to Baker Brown, intractable women became happy wives; rebellious teenage girls settled back into the bosom of their families; and married women formerly averse to sexual duties became pregnant.
Physicians had been recommending clitoridectomy for masturbation since the writings of ibn Sina, the tenth-century Persian scholar, but it never became a regular procedure. And they had been removing clitorises that were diseased or so large they interfered with intercourse for at least a century before Baker Brown. But what made Baker Brown the "inventor" of the medical clitoridectomy was his sterling reputation, the scale on which he carried out his surgeries, and the fact that he popularized his method in a book called On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females.
Eventually Baker Brown fell out of favor with a medical establishment that would have preferred more discretion about women's genitals. But before his fall from grace, Baker Brown influenced U.S. doctors, who were discussing his procedure in medical journals by 1866. It was used off and on for decades to stop masturbation, nymphomania, and hysteria. In 1894, a surgeon reported in the New Orleans Medical and Surgical Journal that he had excised the clitoris of a 2 1/2-year-old to stop her from masturbating and slipping into insanity. He noted that after the operation, she had "grown stouter, more playful, and (had) ceased masturbating entirely." As late as 1937, Holt's Diseases of Infancy and Childhood, a respected medical-school text, stated that the author was "not averse to circumcision in girls or cauterization of the clitoris." A couple of years ago, I spoke with a 66-year-old woman in Michigan who had a secret to tell me: as a 12-year-old in 1944, her parents took her on a car ride that ended at a doctor's office. There, as she sat on the exam table, an attendant clamped an ether-soaked rag over her mouth from behind. When she woke up, her clitoris was gone. "They tried to keep me from masturbating," she said. Then, after a pause, added, "Didn't work."
Toward the middle of the 1950s, just as U.S. medicine seemed to be awakening to the brutality and ineffectiveness of clitoridectomies as a means to control behavior, it found another use for the procedure. This time the rationale was that the operation could be used to make a child whose clitoris appeared bigger than other girls' look "normal," thus helping the child, and everyone around her, feel more comfortable. In 1966, a full century after Baker Brown's clitoridectomies were first discussed in this country, this recommendation appeared in the Journal of Surgery: "Some persons have been reluctant to advocate excision of even the most grotesquely enlarged clitoris. . . . half-way measures are much less satisfactory than complete clitoridectomy." Given this attitude, in 1966, was any girl in the U.S. whose clitoris protruded noticeably beyond her labia at risk of getting it amputated? Yes. Would a girl in the year 2000 still be at risk of losing at least part of her clitoris? Yes.
The rationale for clitoridectomy in Baker Brown's time was straightforwardly terrible, and ridiculously unscientific. By contrast, modern theories seem slightly more humane, but when you get down to it, the same question of gender links the Victorian Age's clitoridectomy to its Dot-Com Age cousin. We have been altering the healthy genitals of our children-—boys as well as girls-—for 135 years so that a girl will look and act like a girl, and a boy will look and act like a boy, according to social norms. The strict division between female and male bodies and behavior is our most cherished and comforting truth. Mess with that bedrock belief, and the ground beneath our feet starts to tremble.
To begin with, we rely on the notion that the bodies of females and males are distinctly different. We imagine a dividing line with penis, scrotum, testicles, testosterone, and XY chromosomes on one side, and clitoris, vagina, uterus, ovaries, estrogen, and XX chromosomes on the other. But were we to look between the legs and into the chemical and chromosomal makeup of real people, we would see that nature often refuses to abide by that tidy division.
Over the past 50 years, medicine has established standards for female and male bodies. Girls, if they want to perceive themselves, or be perceived, as fully "feminine," should have clitorises no longer than about 3/8 inch at birth. Boys, if they hope to grow up "masculine," should have penises that are about one inch in stretched length at birth. (Variation in phallus length can be a sign of an underlying medical problem, but it is also used for nonmedical judgments about "normality.") Girls should have vaginas fit for future intercourse, and boys should have urethral openings at the tip of the penis.
By eight weeks gestation, all external fetal genitals have the potential to develop into what we think of as female or male genitals. The genitals will become female if testosterone, or a hormone that mimics testosterone, does not interfere. If it does, then the clitoris extends to make a penis and the inner labia wrap around the underside of the penis and fuse to form the penile urethra. The outer labia come together to create the scrotum. The process for the internal sexual organs is similar. All fetuses start out with precursors of female and male sex organs. By the third fetal month, if the rudimentary male ducts have not been triggered to mature into testes and vas deferens, they will disappear. The female ducts will then grow and develop into ovaries and a uterus.
To Read the Rest of the Essay
Wednesday, January 27, 2010
JoAnn Wypijewski: Sexual Healing
Sexual Healing: Carnal Knowledge
By JoAnn Wypijewski
The Nation
...
As Rachel Maines demonstrates in her delightfully illuminating history The Technology of Orgasm, making patients out of sexually unsatisfied women was good business. The afflicted would neither die nor be cured but required regular massage treatments, weekly, sometimes daily, for an hour or even three. By one 1863 estimate, such therapies accounted for three-quarters of physicians' business, but doctors seem to have got no pleasure out of diddling women. It was, Maines says, "the job nobody wanted." And bringing women off was work, abstracted from sex (i.e., the robust progression from male hard-on to vaginal penetration to male orgasm) and requiring time and skill. With the vibrator, doctors' productivity exploded, as sixty-minute visits shrank to ten, raising more revenue from more patients per day, until the device became so popular and multipurpose (Sears marketed a home vibrator with attachments for beating eggs, churning butter, operating a fan) that the medical profession had worked itself out of a job. Miraculously, the sick were healed as soon as the first vibrator popped up in porno in the 1920s.
Leap across the decades, and this quaint history appears positively progressive in that, willy-nilly, medicalization marched toward putting sexuality into women's hands, into their heads in terms of body knowledge, and into the mix of culture, personal relations and a polymorphous physicality more true to life than biological function alone. The white coats came out again with Masters and Johnson but bumped into a counterculture and an emancipation movement that pushed against their categorizations of normal or not. Every 1970s woman might not have gone to one of Betty Dodson's masturbation workshops; every man certainly was not reborn as an attentive, exploring lover. But nor was everyone straight, in all senses of the word, and the fluidity of sexuality as part of the great mishmash of human experience was in the air-conditioning system of the culture. It was sexual but political, too. Today the cultural air is thick with sex, but the rhetoric of freedom and rights largely serves a commodified notion of sexual satisfaction. The politics has dropped out, and without politics we're all just patients, or potential patients.
How else to explain that a reality as old as god--that the vast majority of women do not climax simply through intercourse--has re-emerged as dysfunction? Or that another grab bag of indicators of dissatisfaction and low desire are renamed as symptoms of hypoactive sexual desire disorder, for which a female Viagra or a testosterone patch or cream or nasal spray must be developed? How to explain that middle-aged women go under the knife for vaginal rejuvenation, basically pussy tightening, and that young women go under the knife for laser labiaplasty, basically genital mutilation, saying they only want to feel pretty, normal, and raise their chances of orgasm through intercourse? How to explain that a doctor like Stuart Meloy of North Carolina, a throwback to charlatans who tried to shock hysterics into health with electric charges, has even one patient to test his Orgasmatron, an electrode threaded up a woman's spinal cord and controlled by a hand-held button that the patient can push (assuming the procedure doesn't paralyze her) to make her clit throb with excitement during intercourse and reach the grail of mutually assured orgasm?
A terrific new documentary, Orgasm Inc., by Liz Canner, addresses those questions in terms of corporate medicine and the creation of need via pseudofeminist incitements to full sexual mastery by Dr. Laura Berman and other shills for the drug industry. Female sexual dysfunction, it turns out, was wholly created by drug companies hoping to make even bigger money off women than they have off men with the comparatively smaller market for erectile dysfunction drugs. That's capitalism; that's its nature. The more obstinate question is why so many people are willing to be its slaves, and whether a resistant politics can grow up to say not just "We want in" to healthcare but "We want out" of the profit system and, on the sex front, out of a medical model that elevates a doctor over "playing doctor" or a more sensual ease with oneself and others.
"So many times I don't think sex is a matter of health," Dr. Leonore Tiefer, a sex therapist and founder of the New View Campaign to challenge the medicalization of sex, told me the other day. "I think it's more like dancing or cooking. Yes, you do it with your body. You dance with your body, too. That doesn't mean there's a department of dance in the medical school. You don't go to the doctor to learn to dance. And in dancing school the waltz class is no more normal than the samba class." You might not be a good dancer by some scale of values. You might not get the steps right, or do steps at all, but even in wheelchairs people learn to move to the music.
To Read the Rest of the Editorial
By JoAnn Wypijewski
The Nation
...
As Rachel Maines demonstrates in her delightfully illuminating history The Technology of Orgasm, making patients out of sexually unsatisfied women was good business. The afflicted would neither die nor be cured but required regular massage treatments, weekly, sometimes daily, for an hour or even three. By one 1863 estimate, such therapies accounted for three-quarters of physicians' business, but doctors seem to have got no pleasure out of diddling women. It was, Maines says, "the job nobody wanted." And bringing women off was work, abstracted from sex (i.e., the robust progression from male hard-on to vaginal penetration to male orgasm) and requiring time and skill. With the vibrator, doctors' productivity exploded, as sixty-minute visits shrank to ten, raising more revenue from more patients per day, until the device became so popular and multipurpose (Sears marketed a home vibrator with attachments for beating eggs, churning butter, operating a fan) that the medical profession had worked itself out of a job. Miraculously, the sick were healed as soon as the first vibrator popped up in porno in the 1920s.
Leap across the decades, and this quaint history appears positively progressive in that, willy-nilly, medicalization marched toward putting sexuality into women's hands, into their heads in terms of body knowledge, and into the mix of culture, personal relations and a polymorphous physicality more true to life than biological function alone. The white coats came out again with Masters and Johnson but bumped into a counterculture and an emancipation movement that pushed against their categorizations of normal or not. Every 1970s woman might not have gone to one of Betty Dodson's masturbation workshops; every man certainly was not reborn as an attentive, exploring lover. But nor was everyone straight, in all senses of the word, and the fluidity of sexuality as part of the great mishmash of human experience was in the air-conditioning system of the culture. It was sexual but political, too. Today the cultural air is thick with sex, but the rhetoric of freedom and rights largely serves a commodified notion of sexual satisfaction. The politics has dropped out, and without politics we're all just patients, or potential patients.
How else to explain that a reality as old as god--that the vast majority of women do not climax simply through intercourse--has re-emerged as dysfunction? Or that another grab bag of indicators of dissatisfaction and low desire are renamed as symptoms of hypoactive sexual desire disorder, for which a female Viagra or a testosterone patch or cream or nasal spray must be developed? How to explain that middle-aged women go under the knife for vaginal rejuvenation, basically pussy tightening, and that young women go under the knife for laser labiaplasty, basically genital mutilation, saying they only want to feel pretty, normal, and raise their chances of orgasm through intercourse? How to explain that a doctor like Stuart Meloy of North Carolina, a throwback to charlatans who tried to shock hysterics into health with electric charges, has even one patient to test his Orgasmatron, an electrode threaded up a woman's spinal cord and controlled by a hand-held button that the patient can push (assuming the procedure doesn't paralyze her) to make her clit throb with excitement during intercourse and reach the grail of mutually assured orgasm?
A terrific new documentary, Orgasm Inc., by Liz Canner, addresses those questions in terms of corporate medicine and the creation of need via pseudofeminist incitements to full sexual mastery by Dr. Laura Berman and other shills for the drug industry. Female sexual dysfunction, it turns out, was wholly created by drug companies hoping to make even bigger money off women than they have off men with the comparatively smaller market for erectile dysfunction drugs. That's capitalism; that's its nature. The more obstinate question is why so many people are willing to be its slaves, and whether a resistant politics can grow up to say not just "We want in" to healthcare but "We want out" of the profit system and, on the sex front, out of a medical model that elevates a doctor over "playing doctor" or a more sensual ease with oneself and others.
"So many times I don't think sex is a matter of health," Dr. Leonore Tiefer, a sex therapist and founder of the New View Campaign to challenge the medicalization of sex, told me the other day. "I think it's more like dancing or cooking. Yes, you do it with your body. You dance with your body, too. That doesn't mean there's a department of dance in the medical school. You don't go to the doctor to learn to dance. And in dancing school the waltz class is no more normal than the samba class." You might not be a good dancer by some scale of values. You might not get the steps right, or do steps at all, but even in wheelchairs people learn to move to the music.
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