I mean, this is my research, so most of my ranting takes place in a confined academic setting where I can't actually 'rant' more like humbly share my opinion in 10 to 15 second intervals. I'm finding this all overlapping with my freakishly fucked up life and I'm just in the need to write a rant that covers the gamut of what I do each fucking day.
This morning, I woke up to this article:
http://www.time.com/time/health/article/0,8599,1823096,00.html?cnn=yes
Now, Cochrane reviews are the BOMB. And I know women who have had many benign biopsies that are fucking painful.
So, as a society, we're all obsessively individualistic. In the health world? Yep, it's all on US (me and you), ladies and gents. So as a public health person, there is nothing that pisses me off more than this individualistic view on health aimed at changing our individual behaviors and SHIFTING responsibility, guilt, blame, and shame on us.
What does this relate to, oh let me think . . . KICK COUNTS . Yes, you know, that magical solution to stillbirth. For the record, fuck kick counts. Yep. That's right. I would never tell anyone to do them, I didn't do them, and they wouldn't have done shit for me. So I'm not carrying that baggage for the public health community any fucking more. What else does this relate to, BED REST, CERCLAGES, FETAL MONITORING on low-risk pregnancies, pap smears (which are only really needed every three years if that!).
You know what else? Fuck self breast exams, I don't fucking do them, I NEVER have, and I HAVE FELT GUILTY. NOT ANY MORE!!!!
Fuck it all, because at this point, I don't think there is anything in women's health that is EVIDENCE BASED, it's all a bunch of fucking bullshit. And I'm tired of carrying this individualistic bucket of water around for the public health community and for the peace of mind of doctors who don't miss a wink of sleep over recommending stupid spoonfed BULLSHIT about CHOICES.
So, here is my message to the public health community, and this is my goal as a reasearcher, as a woman, as a mother to a daughter; get the fuck off our backs and start working on the motherfucking institutional and socioeconomic causes OF BREAST CANCER, CERVICAL CANCER, and STILLBIRTH and PREMATURE LABOR. Because there are studies, a fucking ton of them if you ever wanted to pick up a Soc of health journal or gender and health book written by sociologists that indicate this shit is societal. We are organizing our society in a way that HURTS WOMEN'S HEALTH. And, because we live longer, but have more disabilities (yes, took a comprehensive exam on this issue), it's in our societies economic interests to FUCKING DO IT.
Thank you. Had to get that off my chest this morning before I go talk about this bullshit all day at work with a big grin on my face being a yes girl to all the psychologists and MALE MD's who think they know what the fuck they're doing.
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3 comments:
I don't do self-exams, and have never felt guilty about it. I do, however, disagree about kick counts. They didn't do anything for me, because of the particular issue my son had, but there are situations where they would be helpful. I am doing them again this time. Though I do think there is an opportunity for a nice large-scale research project there (can talk more if you want).
I am also not sure what you mean about cerclages. Maybe I am missing something, but I have never heard of one being performed in a low-risk pregnancy. All the ones I have ever heard about have been done after a previous loss or as an emergency.
I agree that there is a long road before much of medicine, and women's health issues in particular become truly evidence-based, but I am not sure I agree with all the particular examples you cite in this post. Issues with pregnancy, in particular. It is possible that some women, having known or been related to someone who has lost a child, would have an increased anxiety level through pregnancy, even if they are themselves not necessarily classified as high risk. For these women I would argue that maternal anxiety may be reason enough for increased non-invasive monitoring. Why not? Mental health is not an insignificant aspect of health in general, and pregnancy in particular. Yes, number needed to treat may be objectively high among these women, but I think taking anxiety into account is important. I don't think extra monitoring should be pushed onto low-risk mothers, but I do think anxiety needs to be taken into account and accommodated.
julia, I just love your comments and posts and just being able to talk about these issues.
I'm not meaning to say that some of these things aren't beneficial in some cases, I'm saying that doctors use them based on values, or beliefs that are not based on studies. Now, why these studies aren't being conducted could be debated all day. As a feminist, there are major breeches of human ethics in the past, but i think it's used as an excuse today, and people are afraid of, don't care about pg women. The best study, one I hope to use in my career (all of it) is the national children's health study. Google it. Oh yeah, and I'd like to think with Obama, more money will be coming into NIH NICHD to solve these issues. I can dream can't I?
:) Thanks again, Julia, what do yout think?
The page for that study is on "scheduled maintenance" for the last two days. Most annoying. I will check it out again later.
One would hope that with Obama NIH in general would get more money, since a lot of these (and other) issues still could use a lot more basic research as well.
Also, I think it depends greatly on who your doctor is. I discuss primary literature with mine. (And then we complain about what passes for education research these days. It's great.)
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