Twenty years ago today, the Berlin Wall was breached. Günter Schabowski, an East German Politburo member, announced that East Germans were free to travel. Now an old man, Schabowski claimed on the BBC this morning that he didn’t make a basic mistake, that he just jumped the gun by a few hours, but the record is more ambiguous on that. Anyway, the people of East Berlin seized the moment, drove their cute but stinky Trabants into West Berlin, and shredded the Iron Curtain forevermore. As a young grad student in German history, I watched the Wall fall on my 13-inch TV in my little apartment in Ithaca, New York,

Ten years ago today, I was living in Berlin. Fireworks were exploding. Mikhail Gorbachev and George H.W. Bush were speechifying. I was begging my midwife to top off my epidural, which was only working on one side, and running through my little arsenal of breathing techniques. Shortly after three in the afternoon, my first child, the Bear, was born. I was dimly aware that the rest of the city was celebrating. My own world had radically contracted, both literally and figuratively. The small part of me that was still sentient thought it was cool that my child arrived on an auspicious day. I liked to think the fireworks were exploding for him. The rest of me, the greatest part of me, was only animal. I’d lost a lot of blood. I could hardly walk. Truth told, by the end of the day the Bear was far more alert than I.

Hardly anyone predicted that the end of the Cold War would usher in a new era of terror, instability, and fundamentalist hatred. On November 9, 1989, people danced on the Wall. A decade later, the fissures in the new, united Germany were apparent: high unemployment in the East, increased xenophobia throughout Germany, and mutual resentments and recriminations. Two years later, the Twin Towers fell. Those of us who’d comfortably embraced that creature called the “New World Order” realized it had fangs. Nothing in history is as simple as it initially seems.

So, too, in our personal histories, in our transitions to parenting, we can’t imagine what will come next. I think much of this is true for involved fathers, too; I’d love to hear from some of you, since I can only speak for myself as a mother. In all the propaganda about the joys of motherhood, no one ever mentions how sleep deprivation can render a person virtually psychotic. No one explains that you may feel, for awhile, as if your former self is not so much transformed as dead. Hardly anyone offers a road map for finding your way back to full personhood. Pundits expound on “work-life balance,” but the process of redefining one’s self runs immeasurably deeper than questions of career and time management. Nothing in mothering is as simple as it initially seems.

Then again, no one would have predicted that the Bear would grow into the deeply empathetic, intelligent, charming person that he is today. Well, okay, my mother saw it coming, even when he was throwing hour-long tantrums as a preschooler. (He never did stop being intense and alert.) He still has lots of moments where he’s bossy and ornery. But our Bear is a pretty wonderful kid.

I still don’t know what will come next, but this I do know. Freedom is better than oppression. Loving is better than refusing to risk one’s heart. Commitments to principles and people trump opportunism any day. And if we don’t embrace change and vulnerability, we might as well give ourselves up for dead. We might just as well erect our own, personal Walls.

A couple of months ago, I wasted a half-hour of my life listening in on a town hall conference call with my congresscritter, Charlie Wilson. Amid all of his reassurances to reactionary constituents that he wouldn’t sign off on death panels, he kept repeating: “I am a Blue Dog Democrat. I am pro-life.” This weekend, he delivered on that promise by becoming one of the 64 Democrats who sold out women’s health by voting for the Stupak amendment to the House healthcare bill.

In case you didn’t hear, the Stupak amendment will prevent all private insurers who participate in the new insurance exchanges from covering abortion as part of their basic benefits package. As a result, millions of women who currently have abortion coverage will lose it, unless the Stupak amendment is removed during the process of reconciling the House and Senate bills.

I thought about posting on this yesterday but I wasn’t up for writing anything because I was dealing with pain. I have suffered from this particular pain since I delivered my first baby. For the first couple of years, it was my constant companion. After I had a second baby, it receded to a day or two every month. It is not the normal pain that women get with their period. It is the direct result of structural damage done by childbirth.

So instead of blogging yesterday, I took half a Vicodin, cranked up my heating pad, and waited for the day to end.

I am lucky in that I don’t suffer from stress incontinence. You know all those boxes of Poise and Depends in the supermarket? That market is much, much larger than the elderly. Plenty of young women use them, too, thanks to damage incurred during pregnancy and childbirth. Incontinence is a serious risk factor in elderly women for landing in a nursing home. Just over 11 percent of all women will have surgery to repair damage to their pelvic floor at some time during their lives. About 12 percent of these women will undergo repeat surgeries after the first one fails.

These days, American women count on surviving pregnancy. But that doesn’t mean childbirth has become risk-free. Just in my acquaintance, I have one friend who acquired a serious postpartum infection, another who suffered a stroke after giving birth, and a college classmate who died of eclampsia.

It’s one thing to undergo the health risks of pregnancy when you deeply want a child. It’s quite another to be forced to bear a child – and the attendant risks -against your will.

This is why any healthcare package that reduces women’s access to safe, legal, and affordable abortion isn’t reform. It’s a blow to women’s health. It should not be negotiable – especially by congresscritters like my own who will never, ever have to put their health on the line in an unwanted pregnancy.

From ICHC?

Via Effect Measure, I learned that it’s possible for cats to catch swine flu from humans – something scientists didn’t know, either, until just this week. Tara Parker-Pope wrote in the New York Times about a 13-year-old cat in Ames, Iowa, who caught the virus:

The cat, a 16-pound orange tabby, began acting lethargic and lost his appetite on Oct. 27. He is the only pet in the house and never goes outside. The cat, described as “large framed but not chubby,” stopped eating and drinking and stopped cleaning himself. He also rested by hunching on all four feet, rather than sprawling out on his side as usual, a sign of respiratory discomfort. A few days earlier, two out of three family members in the home had developed flu-like symptoms, with fever and body aches. …

The next day, the cat arrived at the veterinary school, where he was seen by Dr. Jergens, a small animal specialist and immunologist. Upon examination, it appeared the cat had a respiratory condition, so Dr. Jergens performed a bronchial lavage, injecting fluid in and out of the lungs to collect cells to determine what was making the animal sick.

“It didn’t reveal anything that was consistent with what we typically see with pneumonia in a cat,” Dr. Sponseller said.

Although cats can contract flu from birds, this cat never left the house and was never exposed to any other pet. At that point, it occurred to the veterinarians that since the family members had been recently ill, they might be seeing a case of flu transmitted from human to cat. The school is the site of a major diagnostic lab, so the veterinarians were able to test the cat and quickly confirm he had H1N1, a finding that was later confirmed by additional testing by the U.S. Department of Agriculture. …

Dr. Sponseller says the cat is about 85 percent recovered. He was given fluids for dehydration and put on antibiotics to prevent a secondary bacterial infection. “He’s eating well, moving around well, and he’s back in his window watching the squirrels outside,” he said. …

It’s not clear how the cat contracted the virus, but given how easily flu is transmitted between family members, it’s not particularly surprising that a friendly cat would come into contact with the virus as well.

“He’s a very social cat,” Dr. Sponseller said. “He would visit with them in their laps when they were watching television or reading. He was known to climb up on the bed. He’s a very charming cat with a lot of personality.”

(The whole article is here.)

Just to be clear: No one is saying the cat gave the virus to his people. Cats tend not to sneeze much, plus the cat only had contact with humans. I’m glad that this furry fellow – who sounds adorable – is going to be fine.

On the phone, during a short break from comforting her daughter who was suffering from swine flu, my sister tells me: “I am so angry at our government!” Now, this is not a woman who routinely turns to the government for help. She votes Republican, largely on fiscal grounds. But my sis has been trying for weeks to track down some vaccine, to no avail. She’s pissed. And like me, she sees that the government promised far more vaccine than it’s been able to deliver.

We here in Athens, Ohio, may yet get ours. My husband “got shotted,” as the Tiger says, last weekend, but only after passing through a strict triage protocol. Both the Tiger and the Bear are slated to get the intranasal spray on Monday at school. Originally I’d promised to accompany them – they’re both scared of needles – but they know how to “sniffle it up,” for which I’m grateful, since their immunization clinic overlaps with teaching times for both my husband and me.

And yes, since both kids are still slated for immunization, this means that we “have swine,” in the terms of my worried post two days ago, and we do not actually have swine flu. (Did I just bury the lede?) The Tiger spiked a vigorous fever at the start of a very mild cold. He stayed home yesterday out of an excess of caution. Today he went back to school his usual energetic, ornery self.

Judging from the hurried exchanges I had with other parents at tonight’s school carnival, many of us have been worried, and most of us are grateful that our kids are in line for the vaccine.

But my sister is right. These delays are unconscionable. Worse, they’re not even necessary. In Alternet, Barbara Ehrenreich writes:

In July, the federal government promised to have 160 million doses of H1N1 vaccine ready for distribution by the end of October. Instead, only 28 million doses are now ready to go, and optimism is the obvious culprit.

“Road to Flu Vaccine Shortfall, Paved With Undue Optimism,” was the headline of a front page article in the October 26th New York Times. In the conventional spin, the vaccine shortage is now “threatening to undermine public confidence in government.” If the federal government couldn’t get this right, the pundits are already asking, how can we trust it with health reform?

But let’s stop a minute and also ask: Who really screwed up here — the government or private pharmaceutical companies, including GlaxoSmithKline, Novartis, and three others that had agreed to manufacture and deliver the vaccine by late fall? Last spring and summer, those companies gleefully gobbled up $2 billion worth of government contracts for vaccine production, promising to have every American, or at least every American child and pregnant woman, supplied with vaccine before trick-or-treating season began.

According to Health and Human Services Secretary Kathleen Sebelius, the government was misled by these companies, which failed to report manufacturing delays as they arose. Her department, she says, was “relying on the manufacturers to give us their numbers, and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy.”

If, in fact, there’s a political parable here, it’s about Big Government’s sweetly trusting reliance on Big Business to safeguard the public health: Let the private insurance companies manage health financing; let profit-making hospital chains deliver health care; let Big Pharma provide safe and affordable medications. As it happens, though, all these entities have a priority that regularly overrides the public’s health, and that is, of course, profit — which has led insurance companies to function as “death panels,” excluding those who might ever need care, and for-profit hospitals to turn away the indigent, the pregnant, and the uninsured.

(Read the rest here. She takes a couple of cheap swipes at drugs for ED and restless legs, but the rest is worthwhile.)

Exactly! We cannot expect a for-profit system to maintain massive facilities for producing vaccines that are needed only irregularly. So much of our economy relies on just-in-time deliveries. The pharmaceutical industry is no different – except that its “just-in-time” model for vaccines assumes several months’ lead time while moving from one seasonal flu virus into the next most likely mutation. The current system has no capacity for faster responses when a pandemic strikes.

You don’t have to adopt Ehrenreich’s basically socialist convictions to see that when vaccines mix with free enterprise, the results are bound to be deadly. On the one hand, delays are inevitable because profit-making enterprises cannot justify to their shareholder the massive “excess” capacity required to produce vaccines in a fast-moving and potentially highly virulent pandemic. This is capacity that must otherwise lie idle. On the other hand, as long as vaccine production is privatized, the pharma companies will beg for immunity from lawsuits in cases where rare side effects may have caused lasting harm. Even if these companies are fully indemnified, they’ll still have a strong disincentive to publicize such adverse effects, which can only bring bad PR.

Imagine, now, that instead of this swinish H1N1 we were instead facing a highly communicable mutation of the already horribly virulent H5N1 (bird flu). Even assuming the virus lost some virulence in exchange for better transmissibility, millions and tens of millions would be dead before any vaccine were available. And suddenly, the same pharma companies who’ve found vaccines to be unprofitable would be able to demand, essentially, menace money. They could charge whatever the market would bear. And the market could bear a hell of a lot. Seriously, how much would you be willing to spend on a vaccine that gave you any hope of escaping the near-lethal consequences of bird flu? How do you value the preservation of an individual loved ones’ life? What price would you put on your own life?

In short, a free market is bound to fail every whichway when it comes to vaccine production. The government needs to get involved, either by establishing strict regulatory standards, or – more likely, since regulation will push manufacturers to withdraw from an already risky market with low profits – by taking over production itself.

Infuriatingly, the technology for producing more vaccine faster already exists – just not in this country on the grand scale we’d need. Ehrenreich links to ex-Senator Bob Graham on this point, who notes that speedier technologies already exist; the U.S.  just hasn’t pursued them aggressively enough:

Part of the slowness is due to the fact that all six US manufacturers of flu vaccine use chicken eggs. A modern and faster method to make a safe flu vaccine uses a process called “cell culture.” Cell culture does not require eggs. Vaccines for polio and the modern smallpox vaccine have been produced for decades using this technology.

Abandoning chicken eggs for cell culture has several advantages:

• Rapid scale-up in production would be possible.
• Egg-specific steps in the production process would be removed, saving time.
• Vaccine can be given to people who are allergic to eggs.
• Chickens are susceptible to avian influenza infections, which could disrupt the supply chain of eggs and cripple vaccine production.

The U.S. has invested in cell culture technologies, but none are yet available.

(More here.)

We could also be taking advantage of adjuvants, which are essentially biochemical accelerators for vaccines. Revere at Effect Measure has been advocating for exactly this. He writes:

Europe’s adjuvanted flu vaccines don’t appear to be any less safe than non-adjuvanted ones and are far more effective and efficient in the use of the scarce active ingredient, the viral antigen. It is availability of viral antigen that is limiting vaccine production. Unadjuvanted vaccines require much more viral antigen than those with adjuvants.

(Do read the rest! I promise it’s highly accessible to non-specialists.)

Adjuvants aren’t new or untested. They’ve been used for years in Europe. Their safety profile is good. They could help us stretch our supply of vaccine not only in the U.S. but also in poor countries that will otherwise likely be last in line.

All of this wisdom comes too late for the current pandemic – though it’s worth noting that voices in the wilderness, like Revere’s, have been calling for adjuvants and more efficient vaccine production for years.

If we’re smart, we’ll learn from this pandemic and be sufficiently prepared for the next one, which could be a helluva lot worse. (But are we that smart?) We need more than just vaccines, anyway; we need more critical care beds, more capacity to ramp up ERs, and additional public education on the usefulness of social distancing. We further need research on drugs that disrupt viral replication more efficiently than Tamiflu and its cousins, and on statin drugs (such as Lipitor) that might damp down the out-of-control immune reactions (aka cytokine storm) implicated in the deaths of vigorous young people when the pandemic virus is especially virulent. Revere suggested back in 2005 that the threat of highly virulent bird flu ought to spur research on statins. We’re still waiting for that research.

Just as we’re waiting for the proverbial other shoe to drop. My niece’s father out in California is now down with a fever and probable swine flu. (We worried about him once before, but this time he’s the daddy of a known “vector,” also known as my sweet niece.)

And as for me? Well, I’m the only person in my little family who’s not clearly in a risk group. I’m uneasy, because I don’t know if my Mystery Disease would put me at risk. I know I’ve got some wacky autoimmune stuff going on, along with some obvious neurological and metabolic misfiring – not to mention a long rap sheet for broichitis. But you can’t really march into a high-risk immunization clinic and announce, “Hey! I’ve got Mystery Disease! And my students all cough and sneeze on me! My young children wipe snot on me!” Um, no. That won’t get me very far. But it also won’t quell my qualms.

Wish me luck. I’ll be wishing the same for you, dear readers.

Apparently it’s poetry week here at Kittywampus. Following up on Rumsfeldian penis-spam poetry, we’ve now got the next literary contender from Wasilla. If you didn’t hear William Shatner’s dramatic reading of Sarh Palin’s tweets, you’ve got some catching up to do.

All caught up? Then you’re ready for Shatner performing Levi Johnston’s twitterpoems – if indeed you can ever truly be prepared. Just be sure you’ve swallowed that mouthful of coffee before you hit play. (Shatner comes onstage at about the midpoint of the clip.)

(click here if you can’t see the clip from your blog reader)

I guess we now know why Palin tried to ban a bunch of books from the Wasilla library. She was just making space on the shelves for the local literary output.

German has this wacky way of expressing good luck: “Schwein haben,” or having swine/pig. It’s clashing with the nomenclature of swine flu, which ain’t such great luck if you get it.

My sister tells me my niece is coming along well – she’s stopped puking, at least – but 19 out of 24 kids were absent from my niece’s first-grade class on Monday. Apparently one child went to school with a fever (we’ll reserve judgment on those parents – maybe they didn’t notice) and one case flowered into 19.

Today, I was that parent, and the Tiger was that child. The phone rang at 11:50, just as I finished reading an email from the school nurse, announcing further delays in obtaining swine flu vaccine. I was still home, about to swing on my bike for my 12:10 class. (Yes, my commute is the awesomest.) It was the principal. He said, “I’ve got good news and bad news. I’ve got [the Tiger]  here in my office. He’s got a fever. Just measured it at 100.8.”

I said: “Oh damn shit fuck fuck fuck!” Well, actually I didn’t, because if my kids ever got busted for cussing on the playground, I’d be on the hook. So instead, I hung up the phone and emitted a short primal scream. In a total panic, I momentarily considered taking the Tiger to class with me, but realized my students would hate me forever, after I’d inflicted first Judith Butler and now H1N1 on them. I got back on the phone, and Dr. Hydraargyrum and his dear wife, Dr. Hydraargyra, kindly agreed to move their romantic lunch date to the germ-infested petri dish that I call home. Then I ran to the Tiger’s school. Those who know me in real life know how rare a sight it is to see me run, and how very ridiculous.

I got to my class ten minutes late. My students were waiting patiently (the math department secretary had posted a note that I’d be late). They performed brilliantly, and the two hours flew past. My husband had taken over for our friends at 1 p.m., missing a critical meeting on our bloody budget cuts. I relieved him at 2. Somehow, it worked.

I’m still bemused by the “good news” that our principal promised but didn’t deliver. Was it simply that the Tiger wasn’t puking? Was it just that I’m lucky to be his mother? (Well, I am – most days!) Was it insider knowledge that the Tiger is often at his sweetest when sick?

The principle’s mysterious message remains, well, a mystery – as does the Tiger’s condition. His fever stayed lower for the rest of the day. He has a history of unexplained fevers from his toddler years, and even now he’ll run a higher temp than other kids with just a cold. He also isn’t really coughing and has no evident GI symptoms.

So do we have swine flu? Or do we just “have swine”? Worst case, the entire family gets sick but we don’t get diagnosed, and then the kids have to “get shotted” with the vaccine anyway.

I surely “had swine” today when it came to support. Most of my time is pretty flexible, but those two-hour teaching blocks are sacrosanct. As instructor, you’re allowed to stay home if your current residence is a casket; otherwise, you’re probably slacking. My husband and I usually stagger our teaching so one parent will always be available for emergencies, but we couldn’t quite swing it this quarter. I felt lucky to have friends (and probable survivors, already, of H1N1 2009) who were willing to drop everything and cover me.

Before this pandemic burns itself out, a lot of parents will face choices much more harrowing than mine today. Unlike me, they may have no flexibility. Unlike me, they may lose their job for any unscheduled absence. It’s workplaces that need to respond to this dilemma with greater flexibility; families can’t resolve it by having a Plan A, B, and C for childcare. It’s virtually impossible to find childcare when a child is sick, unless you’ve got close family nearby. It’s well-nigh unethical to inflict your sick child on someone else when the disease can be quite serious in some individuals – and we don’t know who those individuals are. And yet, millions of parents in America cannot count on a single hour off to cope with a sick child. (See Joan Williams’ excellent report, “One Sick Child away from Being Fired” – note: this is a pdf file).

Meanwhile, I noticed a scratchy throat this afternoon, then a sensation like a baby elephant sitting on my chest. I’m feeling somewhat better again by now – enough so to hope that the Tiger and all of us will “have swine” in the German sense.

The one semi-redeeming quality in Donald Rumsfeld was his poetic streak. Who can forget this classic?

The Unknown
As we know,
There are known knowns.
There are things we know we know.
We also know
There are known unknowns.
That is to say
We know there are some things
We do not know.
But there are also unknown unknowns,
The ones we don’t know
We don’t know.

(From Hart Seely’s collection at Slate, “The Poetry of D.H. Rumsfeld”)

We’ve heard a lot from Dick Cheney since he crawled out of his bunker and left office, but what has Rumsfeld been doing with himself? Well, based on the deluge of penis email that is swamping me lately, I think he’s found a second career – as a spamwriter.

Consider these little gems, which are taken verbatim from the emails except for deleting the link in the middle of each one; I’ve only arranged them as I think an editor might do for Rumsfeld:

blithe spirit behind ocean
(link)
clodhoppers somewhat

overwhelmingly haunch inside pork chop
(link)
ruffians

around cough syrup
(link)
starlets often

shadows lazily
(link)
tenor toward photon

and hypnotic
(link)
abstraction inside related to host

stalactites inexorably
(link)
waif behind globule

because brides
(link)
assimilate for dust bunny

guardian angel inside philosopher
(link)
necromancers slyly

operate a small fruit stand with
(link)
beyond abstraction goes to sleep

The fruit stand is a recurring motif, by the way. I suppose it’s significant that it’s a small one.

Some of the subject lines have also been outstanding, if a bit less poetic:

• SexualAndEroticAnaesthetizeForMirths
• BelieveInViagraSlangDopeForFortitude
• ProfessionalDownerForGladnesssWillCareAboutSex
• StandardTestedViagraSuperActiveOpiateForMerriments

Here’s watching y’all lots of mirths and merriments without too much erotic anesthesia.

And on this Election Day, may we all be spared the poetry of Rumsfeld in our new officeholders.

I don’t typically endorse candidates here, because I like to be an equal-opportunity critic, and because honestly Kittywampus is hardly the New York Times or even the Athens News. However, we’ve got a contested election in my ward, and a friend of mine is ably defending her seat on city council. For once, I’ve got only praise.

Chris Fahl has stood for wise development, sustainability, and foresightful planning. She is working to improve traffic safety in the neighborhoods and was the key council member in winning a grant for this purpose. She has a background in both environmental science and planning, so she brings real skills to the table. As she has demonstrated in her first term in office, she plays well with others and has won over a lot of folks who were initially skeptical.

Chris has been at the center of the grassroots movement to have Athens city government reflect the progressive ideals of its citizens. If I may go mildly negative for a moment, her Republican opponent has yet to put forth a real platform beyond beefing up the city police with money that would have to be siphoned away from other vital services. A vote for him is essentially a vote for the old regime in which the landlords call the shots and to heck with the future or keeping Athens a lovely place to live.

Chris is honest, politically savvy, and principled. She’s also a good friend; she has saved my ass innumerable times when I needed help picking up my kids from school, and she went with me to that awful doctor appointment last winter where I was given a diagnosis of possible MS. That’s the kind of person she is. (She’s also a friend of this blog, but don’t let that stop you!)

So if you’re eligible to vote in Athens’ Fourth Ward (much of the East side of town) and you care about the quality of life in our town, please be sure to cast your ballot for Chris Fahl. Since it’s a contested seat, every vote will count.

No, I’m not sick, nor are my kids – and my husband got the swine flu shot this morning, as one of those “lucky” people who are likely more vulnerable than average. But as I was stirring the dinner pots this evening, my sister called to tell me that her daughter (my six-year-old niece) has got swine flu. It struck with the GI symptoms are a hallmark of swine flu. By now, though, my sister suspects that Tamiflu may be making things worse, as my niece puked just once before taking the first dose and six times since. (She also has the other classic symptoms: a cough, high fever just short of 103, chills.)

I’m assuming – hoping – that my niece will recover quickly, as most kids have. But even “mild” flu is pretty wretched. I suspect there’s a lot of misconceptions afloat about what “true” flu is like. People think it’s just a little tougher than a cold, or they confuse it with “tummy flu,” which is not flu at all. By now, a couple of my local friends have nursed kids and spouses through what must have been swine flu, even though they didn’t go to the doctor. None of them suffered serious consequences. Even so, the flu hit them hard.

And that’s why I really don’t understand the suspicion people harbor about being vaccinated. Two-thirds of Ohioans say they don’t plan on getting the shot. That number may be inflated due to fatalism as vaccine deliveries take even longer than expected; people figure they will have been exposed anyway before they can even get the shot. Way back in June, Knitting Clio commented here that parents’ unfounded fears of autism might deter them from vaccinating their kids. I’m sure that’s part of the picture, too. Lots of folks seem to believe that the vaccine is “new and untested.” In fact, it’s produced in the same, depressingly slow process used for regular flu vaccine. (If you’re a fence-sitter, yourself, and you need data on the safety and efficacy of the vaccine, go on over to Effect Measure and read their recent archives.)

More disturbingly, health care workers – including those serving the high-risk group of pregnant women! – are highly skeptical about the vaccine. Consider this abstract for a study just published by D.E. Broughton et al. in the November 2009 issue of Obstetrics and Gynecology:

OBJECTIVE: To explore obstetric health care workers’ attitudes and beliefs regarding influenza vaccination in pregnancy.

METHODS: A survey consisting of 16 multiple-choice questions was administered to nurses, medical and nursing assistants, receptionists, and clinical administrators in obstetric settings. Survey questions addressed general knowledge of influenza and recommendations for vaccination during pregnancy, as well as personal beliefs about the acceptability of the vaccine in the pregnant population. The study was conducted at two sites, Women & Infants Hospital in Providence, RI, and Magee-Women’s Hospital in Pittsburgh, PA. Variables were compared by Fisher exact test.

RESULTS: Two hundred sixty-seven completed surveys were available for analysis, with a completion rate of 85%. Almost one third of health care workers surveyed do not believe that vaccines are a safe and effective way to decrease infections (31%) and a minority believe that vaccines are safe in pregnancy (36%). Just over half of health care workers know that pregnant women are at increased risk of complications from the flu (56.6%). Only 46% were able to correctly identify influenza symptoms, and only 65% would recommend influenza vaccination to a pregnant woman if indicated. A small percentage would be willing to give an avian influenza vaccine to pregnant women during a pandemic if it had not been tested in pregnancy (12.3%).

CONCLUSION: Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy. Misinformed or inadequately informed health care workers may represent a barrier to influenza vaccine coverage of pregnant women. This lack of knowledge among the health care workforce takes on added importance in the setting of the H1N1 2009 swine-origin influenza pandemic.

(Source: Abstract for D.E. Broughton et al., “Obstetric Health Care Worker’s Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy,” Obstetrics & Gynecology: November 2009, Volume 114, Issue 5, pp. 981-987; my emphasis)

Got that? Precisely the people who are gatekeepers in caring for a vulnerable group, pregnant women, are appallingly ignorant about the risks of flu in pregnancy and the safety of any vaccines in pregnancy, not just the one for swine flu. And yet less than half of them can even correctly identify flu symptoms. (Please note that the study did not look at doctors.)

It’s not alarmist to say that as a result of people’s ignorance, hundreds or thousands will die unnecessarily. A three-year-old in my town died in late October after testing positive for inluenza A. While definitive testing will take weeks, virtually all of the flu currently in circulation is swine flu. It’s reasonable to assume that swine flu is what killed this little person. It’s also reasonable to assume that many of us will know someone, sooner or later, who suffers the loss of a family member.

As usual, Jon Stewart got it right: It’s only us wimpy pasteurized milk drinkers who are sure we want to be vaccinated. Otherwise, we’d know the shot was only a government plot! Glenn Beck said it, so it must be so!

If you can’t view the video, please click here. Via Effect Measure, which is such an awesome blog I’d probably read it even if I weren’t worried about the flu.

Note: I intentionally refer to this illness as “swine flu” and not H1N1 because H1N1 is a broader subtype of flu, and because I don’t mind keeping the spotlight on reckless agribusiness practices that may foster the genetic reshuffling of the virus.

One of my former students, who’s now graduated and out in the world, wrote a letter to the campus paper that just made me so proud of her. A rape case that I wrote about last spring was first tried in the local media, and now the defendant’s lawyers are pulling the same shenanigans in the courtroom. Here’s how my former student analyzed it:

It doesn’t matter if you’ve had sex with someone once, twice or 1,000 times – a sexual past does not make a sexual future mandatory. The current rape trial that has been reported in The Post (“Rape trial commences for former OU student” in the Tuesday issue; “Rape trial defense prompts questions” in the Wednesday issue; and”Victim details relationship with accused rapist” in the Thursday issue) highlights the misconception that if someone consents to sex once, it is etched in stone that consent is guaranteed at all times in the future, regardless of the circumstances.

I am not criticizing this case specifically, nor am I claiming to know the specific details of the case. Rather, I think this case follows the format of many sexual assault cases in perpetuating an attitude and obstacle that sexual assault survivors often face – that women can’t say both “yes” and “no” to sex with the same person. …

Lawyers often use someone’s sexual history against her, and it’s appalling. Constantly in court – and in society – people candidly tell women that, basically, they asked to get raped because on a completely different occasion they consented to sex. This notion is disgusting, and it is shameful to see women – who publicly take criticism in rape cases and get stereotyped as “promiscuous” or “asking for it” – get torn down, after already dealing with emotional and physical trauma and still having the strength to face their attacker (and possibly friend, boyfriend or husband) in court.

I don’t want other survivors of sexual assault and rape to read articles like this, see the tactics that go on in the courtroom and refrain from taking legal action because the decisions they made before they were aware their friend, boyfriend or husband was capable of sexual violence are going to be used against them after the fact.

(The whole letter is here.)

I can’t claim credit for forming her political consciousness as a student; she came to me as a senior, already clued in and extremely smart. Nonetheless, I feel really proud of her! I also know she’s not my only former student who’s doing wonderful things; she’s just left a public record of it. (For instance, a week ago I heard from another former student who’s working for Senator Sherrod Brown. She says he’s as cool as he seems.)

I only wish there were no cause for anyone to have written such a letter in the first place. The accuser in this case has lots of physical evidence and corroborating statements on her side. The defendant claims “rough sex.” I obviously haven’t been privy to all of the testimony, but I hope the jury will understand that when someone says “yes” it’s not a free pass in perpetuity.