Guest post by Skylanda: Fat - The new sin tax?

The idea of a "fat tax" - putting a tariff on high-calorie/low-nutritional value foods - is nothing new. Since the 1980s, self-appointed armchair health advocates and budget-wary politicians alike have suggest that forcing the price on fattening foods upward would help stem the rising tide of obesity. Basic economic theory suggests that if you put a higher price on undesirable items, people will tend to consume less of them; whether this approach actually leads to the secondary aim of reducing the average body weight remains to be seen.

Recently though, this reasonably well-intentioned idea has morphed into a push not for a tax on fattening foods, but a tariff on fat people themselves. After all - goes some twisted reasoning - if all these fat people are costing the health care system so much cash, they should have to take on their fair share of the financial burden. Once you hit a certain threshold, you gotta kick down the cash to cover the increased cost of your health care and other sundry services that you will surely suck out of society like a vampire bat at a bloody feast. Say, once you hit the 400-pound mark, you gotta dump an extra 10% of your earnings into the government pot. Sounds fair, right?

Not so fast. And definitely not so fair.

A simple calculation might tell you that more money from those who are draining the most out of the system would solve the problem - it would give incentive to lose weight, and it would add to the pool of public money we have to cover people's health care costs (especially Medicare, which kicks in around the age that obesity-related diseases take their greatest toll). But this simplistic model falls prey to a logical twist, a little something that public health wonks like to call the "prevention paradox." The prevention paradox posits that interventions that widely benefit society as a whole rarely offer profound benefit any one individual, who gets only a fractional improvement which, when added up over millions of people, has a profound impact. In other words, if everyone who falls into the arbitrary "obese" category lost ten pounds, that would have a profound impact on the national state of health - but that would not profoundly change the look of any one American, including the morbidly (or "malignantly") obese. As an offshoot of this, epidemiologists have noted that those whose risk factors are highest - in this case, the most obese, with the most co-morbid conditions - do not often comprise the demographic group who suck the most services out of a system. That is because there are usually very few people who belong to the extremely high risk group (say, in this case, those who weigh over 500 pounds), while millions and millions of people hover around the more middling weights (say, 200-250 on a five-eight frame), where risks for health complications from excessive weight are lower but not negligible. In other words, it matters very little what the few people people who weigh 500+ pounds use up in resources per capita; but it matters very much what the millions of us carrying just enough extra weight around use up in a knee surgery here and a couple decades of blood pressure medications there. And once you start talking in those numbers, you'll quickly find that the pool of people willing to cough up extra bucks for their own extra ten pounds drops through the floor, even though this is the group most likely to bust the health-care budget over the years.

But there's a more personal, individualized story too. Recently, after fifteen years of uncontrolled pain, a merciful neurologist evaluated my case and handed me a prescription. Within a few weeks, I went from a condition very aptly described as "chronic daily headache/mixed migraine type" to a couple of bad headaches a month with many pain-free days in between. I stopped buying ibuprofen in bulk orders and started going out of the house without double-checking my emergency drug supply to combat the headaches that barreled at me like an oncoming train wreck with no rhyme or reason. But the drug has some less than pleasant side effects, things like dry mouth, excessive sweating, and weight gain. Within a couple months, I regained the ten pounds I recently lost and put on another fifteen to boot; for the first time in my life, my weight started to push that arbitrary but ever-so-important border between "overweight" and "obese." (Please note that I'm far from an unusual case; just ask anyone who's been on the steroid drug prednisone, or any number of psychiatric drugs, for any length of time.)

So I have a choice. I can quit the medication and lose extra pounds. And if I do that, I will go back to having debilitating headaches that threaten my ability to finish graduate school. Or I can stay on the drug, finish graduate school, get my overeducated self into the productive workforce, and be content with that ever-progressing nudge over the BMI limit into the world of obesity. So do I "deserve" to be labelled obese, a burden on society, a drain on our precious public resources? After all, it's not my unchanged eating habits or my exercise regime, which had previously kept me in the lower ranges of the BMI; it's the drug, one might proclaim.

That remains to be an arguable question, but what does emerge from it is that this word "deserve" is a tricky one. It brings to mind connotations of old English Poor Laws - and that implicit (and often explicit) division between the "deserving poor" (women widowed with children, disabled war veterans) and "undeserving poor" (women with children out of wedlock, alcoholics, and the like). And that point so clearly underlines the crassly moralistic yardstick we descendants of the Puritans like to inflict on our fellow Americans, which is so apparent in this proposed "fat tax": if you are the deserving fat, you get some consideration of mercy; if you are the undeserving fat, you're not just on your own, you should be forced to pay for the wages of your gluttonous sins. Or maybe we should just throw all us fatties, from a BMI of 24.9 to a scale-busting 500+ pounds in the same category: we are all bad, bad, bad, undisciplined, lazy, gluttonous sloths (have I missed any relevant cardinal sins here?) who all deserve to be charged financially for gross negligence of our personal health.

The problem with this puritanical elitism (aside from the fact that there's no talk of charging wealthy people for high-risk recreational activities like downhill skiing and white-water kayaking) is that it solves none of the problems that push the trend toward sedentary lifestyles and the health problems that go along with them. It punishes without offering alternatives; it takes from those who are most likely to be experiencing weight-related disabilities and all it does in return is lend an air of self-righteousness to those who happen to have been born with the right genes, or blessed to have the pocket cash to pay for a gym membership, or lucky enough not to depend on a whole host of obesity-inducing medications. It does no service to tax the few extremes, unless satisfying a sanctimonious sort of fat lust could be considered in the best interests of the public's health.

Posted by Skylanda.

Moral Aphorisms As The Bombs Fall and The War Spreads

or Deep Thought

In the latest Israeli-Lebanese war a lot of revolting things have been said. The most disgusting have been the refusals by the Bush administration and others to try to stop the killing from the lofty heights of principle.

Ah, principle. Ideals. So like their deceptive and slippery academic cousin, theory, but so much more deadly in the hands of someone who wants to use them for gain. I come by my suspicion of theory quite honestly, having spent untold hours in sterile labor bringing forth useless harmonizations of figured base lines from Piston’s Harmony - on paper*. The best that can be said is that no one had to hear them.

Unfortunately the same can’t be said of the principles and ideals of the politicians, the only ones who have it in their hands to act to get a cease-fire agreement. The various pitch lines that Condoleeza Rice and her titular boss use to prevent peace so that principle might live on are a good opportunity to look at what happens when abstraction is placed over the blood and lives of real people. We haven’t had such a good current events illustration of the problem since Kissinger used the shape of the “peace” table to prolong the war in Vietnam for political advantage. That was the first nail in the coffin of principle, for me.

The principle at stake in a cease-fire in Lebanon is that of endurance. Only a lasting peace that is guaranteed to endure through the ages is worth Condi’s time. Having, with only spotty success, pointed out for the past four years that Condoleeza must have been using quite a lot of that time practicing piano, I’ll let that pass for now. That such an eternal peace has eluded all but the dead in the Middle East for the past sixty years, doesn’t deter our Secretary of State from mouthing the empty words.

Why does anyone accept such a lame excuse to allow killing to go on in a clear attempt to cover up the disaster in Iraq? Why is anyone listening to their prissy statements of principle when it is growing ever clearer that these criminals are trying to expand the war into Syria and Iran? These people are criminally insane. You might as well get your ethics from a freelance knee-capper you meet in your local dive. He’ll have less blood on his hands.

Why is it when a politician or their hired hacks use the word “principle” that a curtain falls on reality? Not that our media has been focused on reality since Bush took office. His selection really did have an effect on American morality, bringing a massive revival of this kind of principle. Seldom have we been more principled. To death, even.

There might be principles and ideals that are worth dying for, I am less confident that there is a single one that is worth killing for. Theories, principles, ideals, these are all abstractions, they aren’t a substitute for life. Professional thinkers and those who are supposed to be thinkers are in the habit of talking and acting as if their ideas were superior to real life, the Platonic ideal. Unfortunately no tally of their accuracy is kept, you are more likely to find yourself out of a job for getting it inconveniently right than profitably wrong. In the distant future a lot of these catch phrases will look exactly like what they are, self-serving fantasies and even more self-serving lies.

Our media, ever star struck by those with a reputation for being smart, are impressed. Such deep thinking has largely replaced mere reporting in our “news”. In one of the supreme ironies of the age, deep thought is the daily bread of the cabloids, a fact alone that should impeach its worth. You would think that the pictures of peoples’ bodies and the screams of the wounded and surviving would break through the lyin’ curtain but they don’t very often. Not often enough to make much of a difference.

* If any of you are aspiring musicians, I beg you, spend your time studying harmony at the keyboard or your guitar. If you can’t hear it, you won’t learn from it. It’s just a penmanship exercise without the sound.
For scientists who might object. I’m not using the word “theory” as real science uses it but as non-scientific disciplines use the term. In my field, music, almost all theory is a waste of time better spent on dealing with and producing actual music. “Theory is slovenly,” Roger Sessions said. And in music, it is.

The Eternal Boy

In the carefully promoted backlash against feminism more than progress in equal rights has been lost. Before Hoff Sommers leaves another gooey scribble blaming it all on feminists, let me point out that adult men aren’t just endangered, they’re almost extinct.

Today’s idealized male image mostly comes from fascist-chic movies of the Reagan years and those of Clint Eastwood, at least those from before old age came on him with all it many qualms. What doesn't, comes from Porkey’s or other frat fantasies. None of the boys in these guy flicks are what you'd call grownup and the role play provided by video games is infinitely worse. Our popular entertainment doesn't much do grown up men anymore. There might be a few shows or movies that depict a decent, intelligent man but they’re often not what they seem. You see nice guys in movies, you're just waiting for them to be revealed to have secret lives as cannibals or worse.

The roles for males encouraged in pop culture are brainless studs, rapists, sadistic killers, enthusiastic tools of fascism. You know this. It isn't asked often enough why this trend started or grew. I think the oligarchy wanted cannon fodder for its wars of conquest and operators for its computerized machine, the sex is just the draw. Most of all they want males who either won’t vote or who vote reflexively for the “masculine” option of Republican. Grown ups tend towards unprofitable attachment to reality and reality doesn’t favor conservatives.

What else is behind this? As anyone who attended jr. high knows, hyper-masculinity has always been a too-much protesting demonstration that a male wasn’t gay. That is the first and most violent manifestation of it in most cultures*. Straight, male gender anxiety is the basis of it and that fact has been put to most effective use by the political right. Violence and a willful refusal to face reality fits into their economic plans. The only real strength required of most of these tools is to follow orders and to resist reflection.

Least you think that I’m saying they are entirely without discipline let me reassure you. Most conservative men have proven to be rocks of self denial in one respect, depriving themselves the ultimate "male" experience of putting their own sweet fat on the line in combat. But these boys of the ruling class have been provided with a form of cultural consolation. The absurdly mythic image of entrepreneurs has been so calculatedly conflated with sexual potency and the assertion of The Will that business attire has attained the unlikely status of a sexual fetish. No accounting, huh? And if you've seen accountants ..... please, don't tell me.

On the Ursatz level, the role requires, in accordance with the needs of an imperial capitalist system, that the real man treats people as property. Children, women, weaker men are objects that are his to own, his to exploit or there to be trashed, especially if not in his possession. The real man sees all things in terms of his own utilization like a pre-socialized toddler, mitigated only by what he can't get away with. Respect for the rights of other people or for sympathetic understanding are a compromise of the masculine imperative, a willful and shameful relinquishing of the male identity. Even the biosphere he, himself, requires to live is to be used up if he so wills it, And a real man will will it. Real men laugh at giga-death, sustainability is for sissies. It can't be a coincidence that it was the refusal of a zoning permit that motivated Clint Eastwood’s political career.

The detailed implications of cartoon masculinity for gay men, such as myself, are probably for another time. But I will tell you that the stridently defensive reaction on various blogs to my condemnation of the homicidal, objectifying hatred expressed in Tom of Finland’s gay S&M smut proves that fascistic machismo isn’t the cootie shot against being gay that the straight boys think it is.

Adults being sales resistant, the things that define an adult, reasoning, forebearing, self-sacrifice, basic decency and fairness are not encouraged in our commercial culture. When coupled with the traditional male persona their absence is deadly. Their opposites show up in violence directed against girls, women and other people, in our voting patterns and in our politics. They define our foreign policy, where unimpeded exploitation used to be quarantined, but we should anticipate its further expansion into domestic life. **

The "endangered boys" hucksters won't consider why boys are really endangered, the toxic male role models that oligarchic culture presents to them. Neither will they reflect on why so few boys seem to be in any danger of growing up no matter how old they get. But I rather like decent adults and believe every child should aspire to become one. “I won’t grow up,” is an option that should disappear at the age of 14. Yes, for boys too.

* Look at the stream of word play in which Mercutio taunts Tybalt in Romeo and Juliet. More double entendre in one scene than in Mae West's entire filmography. I don't think anyone but a gay man could have depicted someone so obviously obsessed with gay sex during that period.

* *In case you think I'm exaggerating, John Podhoretz is afraid that we're getting too nice to have an effective imperial policy. Makes you realize that the body count can't get too high to discourage them from their piracy.

Blue lily: Terrorism, airport security and the disabled

I haven't flown anywhere since before 9/11 and I've never flown internationally, but I suspect air travel for the disabled using power chairs (and ventilators) is much more complicated now than it ever was before. Especially today with the security crackdown due to information in the UK of a terror plot.

Currently, no carry-on luggage is being allowed except a single clear plastic bag per passenger. According to the BBC, this is what's allowed in that plastic bag:

Pocket-size wallets and pocket-size purses plus contents (for example money, credit cards, identity cards etc (not handbags

Travel documents essential for the journey (for example passports and travel tickets)

Prescription medicines and medical items sufficient and essential for the flight (eg, diabetic kit), except in liquid form unless verified as authentic

Spectacles and sunglasses, without cases

Contact lens holders, without bottles of solution

For those travelling with an infant: baby food, milk (the contents of each bottle must be tasted by the accompanying passenger) and sanitary items sufficient and essential for the flight (nappies, wipes, creams and nappy disposal bags)

Female sanitary items sufficient and essential for the flight, if unboxed (eg tampons, pads, towels and wipes)

Tissues (unboxed) and/or handkerchiefs

Keys (but no electrical key fobs). All passengers must be hand searched, and their footwear and all the items they are carrying must be X-ray screened.

Pushchairs and walking aids must be X-ray screened, and only airport-provided wheelchairs may pass through the screening point.

In addition to the above, all passengers boarding flights to the USA and all the items they are carrying, including those acquired after the central screening point, must be subjected to secondary search at the boarding gate.

Did you catch the likely problems for various disabled folks? Liquid medications must be "verified as authentic." "Walking aids must be screened." "Only airport-provided wheelchairs may pass through the screening point."

It's always smart to travel with prescriptions as evidence for medication and other medical concerns, but if mothers are being asked to taste their babies' bottled milk at screening points what are diabetics being asked to do with their insulin vials? How does this authentication take place and how consistently are the least... invasive procedures being used?

Since prosthetic legs are walking aids and have been subject to security search since 9/11, it's likely amputees are required to remove them today as well. Are other limbs searched too? Are travelers given a little privacy for this or does it occur in the hallway right at the checkpoint with a line of people staring? Are airport-provided wheelchairs x-rayed too? Are those using them given an adequate and safe place to sit while the equipment is taken and checked? Can an x-ray machine even distinguish the aluminum and steel of canes, walkers and chairs from anything suspicious? My understanding was that they could not, and this was why I was always directed around the walk-through devices at checkpoints and searched with a pat-down, a mirror-on-a-stick, and a handheld scanner.

What happens to the travelers who must surrender their power wheelchairs and scooters? They might have been fully capable of traveling alone without these surprise restrictions, so are they provided with appropriate assistance for whatever they need between the checkpoint and the plane seat? Like a last chance to use the restroom? I can't imagine the airlines have the staff for this, so likely these folks are simply unable to pee until they reach their destination (How many hours for a flight from Britain to the U.S.?) Pee on the plane? Surely you jest. You've been in those little closet-like restrooms, right? Accessibility of airplane bathrooms is largely a joke -- a big bladder-filled knee-slapper. Luckily carry-on liquids are banned too, though any knowledgeable gimp traveler is on a self-imposed liquid fast already.

Never in my many pre-9/11 airport experiences did I see an airport-provided wheelchair with a headrest. (And the newer aisle chairs lack them too.) If these don't exist now, there are folks like me who literally may not be able to sit in these loaner chairs without serious risk of injury. How is this handled? Are these people given a pass to keep their power chairs until the gate? (Unlikely.) And are power chair users really surrendering their $5,000 - $10,000 machines at checkpoints with a prayer they show up at their destination unharmed and useable? (As it is, it's incredibly common to get off a plane and find equipment so damaged it's unusable with hundreds of dollars of repair needed -- and never any reimbursement, btw.)

What about gel-cell batteries that power these machines? The list of banned materials includes wet-cell batteries and all explosives, but laws for disabled access have always allowed gel-cell batteries that will not spill. Since today's restrictions specifically ban "liquids and gels" from carry-on, I expect there's some confusion about gel-cell batteries today. There was confusion throughout the 1990s when I flew, so why should this new stressful situation bring clarity to that? I was constantly defending my batteries, arguing to keep them, keep them with my chair, label them as mine before they disappeared forever from me.

None of these concerns trumps the security of not being blown to bits while over the Atlantic, I know. Disabled folks want to make it to their destinations in one piece just like everyone else. But they do want to make it to their destinations. And they want to get there without humiliation or harm. If heightened security is the price we pay for living in today's world, which of these safety measures will only be temporary? Is education on treating the disabled with respect when working airport checkpoints part of security training?

What level of discomfort or humiliation is the proper price for safety on airplanes? That question isn't any easier to answer than the question of how much freedom of speech or privacy we should relinquish for national security, but it does impact disabled folks more. And it's worth everyone's consideration.

Posted by Blue Lily and crossposted at The Gimp Parade

Coturnix on Sex, part II - The Hooters Conundrum

Purposefully written to provoke.

Abel PharmBoy of Terra Sigillata asked:

Can Hooters support the fight against breast cancer all without being perceived as capitalistic, misogynistic, or otherwise demeaning to women?

You need to read his whole post to see the context, i.e., exactly what kind of sponsorhip for exactly what kind of breast-cancer research. Definitely something that could be, if done carefully, be done in good taste, with the cancer folks dictating, for instance, exactly how the sponsorship would be done, the slogans, images, etc.

PZ Myers is, essentially endorsing any means of getting more money into research, with some caveats:

I'm of the opinion that we ought to get every penny we can from them, but stop short of giving any hint that we actually endorse their business…although I'd wonder if even asking them for their assistance is granting them respectability, or if acknowledging the assistance of Hooters would turn a serious event into a joke.

On the other hand, Shelley Batts is firmly against:

I'm of the opinion there is no way to turn Hooters into a charity bastion. I completely expect them to turn breast cancer awareness into a "Save the Whales" level fiasco, prompting wealthy men to save the endangered Great Tit. I can envision the t-shirt campaign now: a tight white middrift with the word "Save Me" in a thought bubble eminating from the bosoms. Hellz no.

There's more. This was just the most colorful paragraph.

All three bloggers received quite a lot of comments, quite interesting in their own right, leading to many interpersonal misunderstandings. After musing about this for a couple of days, I think I figured out the source of such misunderstandings: different people were talking about different aspects of Hooters.

Some were talking about the corporation, some about a particular franchise, some about management, some about employees, some about customers, and some, importantly, about the symbolism of the word "Hooters" in today's landscape of cultural discourse, i.e., the "code word", what Hooters is supposed to represent even if it is not spelled out in detail in a conversation.

Let's look at each of those separately, before putting them all back together again.

The Hooters corporation

This is a big chain of restaurants. It operates just like any other business. They found a niche, they have a product to sell to that niche, and they use every corporate trick on (and off) the books to minimize expense and maximize profits. They peddle food, beer and the allure of sex. They are quite open about it. Once in a lawsuit, they used the "hooters refers to an owl" defense, not because they thought anyone would believe it, but because the law is often based on literal reading (you all remember the definition of 'is') so they tried to get off on technicality. It's just a lawyers' game, not in any way an attempt to hide that they sell sex - they are ah-so-open about it.

Halliburton sells death.

Also, the Hooters-style sale of sex occupies a very specific niche. They do not want to compete against strip clubs, or pornography, or prostitutes. They are not keeping their waitresses dressed because they are afraid to make them take the tops off. The type of sex they are selling is exactly the type of sex they want to sell - that is their niche and they have cornered the market there - the "cheerleader" allure. Not all sex is hardcore.

Phillip Morris sells death.

The individual Hooters franchises

Every franchise owner is different. Every town is different. The surrounding culture is different. It is to be expected that every Hooters franchise is different - some much more raunchy than others. The menu, the beer, the music, the "look" of the waitresses, the strictness to which they adhere to the famous handbook ...all that will be different between a Hooters in rural Alabama, a Hooters in Portland, OR, and a Hooters in Japan. Which one have YOU been to? How does that color your perceptions of the establishment?

The management and the employees

As with the franchises, they will reflect the local situation.

The customers

Again, it will vary, but not everyone coming in is a lecher, or a frat-boy, drooling at the sight of a female form.

The Symbol

This is what many commenters - especially those who attacked Hooters and were against its sponsorship of cancer research - were refering to. In many ways, "Hooters" has become a symbol of the patriarchy, of a particular way of demeaning women. The symbolism is in many ways deserved. That is exactly what they are selling. Quite openly. But, as it often happens, the complete story is not so black and white.

It appears to me that none of the commenters who attacked the Symbol ever set a foot inside a Hooters restaurant to see for themselves. They attacked a Symbol ferociously. One commenter (who was actually all for taking their money for research) even thought that the waitresses there were topless! No, they are not.

Let me backtrack a little and put in a few cents of personal experience. For a couple of years, a Hooters restaurant was the only food establishment within miles of where I was teaching. On some days, after four hours of talking energetically (and, being a perfectionist, not being able to eat before class out of apprehension), I was just too hungry to make it home to eat. So, not being able to stomach Taco Bell food (the only other food in the vicinity), I went to Hooters. Trust me, the first time around I was quite nervous about it, not knowing what to expect and fearing the worst, mainly because all I knew about Hooters was the Symbol.

Anyway, for a couple of years, I'd make it there perhaps twice a month or so, sometimes more often, sometimes not going in for months - but often enough to be recognized as a "regular". It was usually at an odd time (like 3pm) on an odd day (e.g., Monday or weekend), so it was never very crowded, which means that I perhaps never saw how rowdy the place may get at night.

I thought I'd use the opportunity to learn more and to do a little informal study of the culture of the place. I asked the same set of questions of every waitress that ever served me a meal. And I observed the people around me. What did I find?

A couple of times I walked around the parking lot and counted bumper stickers, always getting roughly the equal number of Bush and Kerry sticker-counts.

The restaurant was mostly populated with families with children, couples, and small groups of soldiers. There were a couple of sleazy-looking guys (usually quite old) sitting at the bar as well, but I never saw one do anything bad. In other words, it looked just like any other restaurant-bar. And the same kind of music.

And the same kind of food - not better not worse, not more or less expensive. The wings are far too greasy for my taste, but philly, burger, grouper and quasedilla are quite OK. When I actively seek a place to eat well instead of being stranded in the middle of nowhere, I am not going to start looking for Hooters, of course, but it is not as bad as some people say (again, I believe they never ate there, they just heard the gossip that the food there is bad) and in a pinch, it will do quite fine.

Only very few of the waitresses conformed to the Hooters stereotype - the thin, athletic build with big boobs. Some were fat, some were super-skinny, most just normal. Many were flat-chested. All too young to be seriously attractive to me.

Most of the waitresses were students, majoring in everything form nursing to zoology, and one even double-majoring in chemistry and biochemistry. They are smart women.

A few are young (married, unmarried or single) mothers, who, after wild teenage years decided to take control of their lives and work their way through community college.

As far as I could figure out, not a single one of them was an ex-stripper (I know a much nicer restaurant in town which employed several ex-strippers) - another stereotype held by people without first-hand knowledge.

About a third of the waitresses were Democrats, a third Republicans, and a third did not care about politics at all. About half are religious, about half do not care about religion at all.

I asked them about the atmosphere there and the potential problems. They work there because they get twice as big tips as anywhere else. After a day or two on the job, they completely forget to be aware of eyes trained on their asses. They say that most customers are really totally normal and cool. They feel as part of a team, working together to feed the customers and earn their tips, and at the same time conspiring to milk the occasional pervert out of his money and laugh afterwards.

If a customer gets too offensive, the waitresses may switch tables amongs themselves - a younger, more timid waitress gets replaced by a more experienced one who knows how to put the guy in his place with a smile and still part him from his money. Sometimes they work in pairs and put the guy through the machine. And they fully enjoy their power. If nothing else works, they tell the manager who gives the guy a spiel and, if neccessary, escorts him out of the establishment. Again, a scene that can happen at any bar.

What did I do while there? Watch tits and asses? I usually read the newspaper, ate and left.

Of course, this may be a relatively nice and tame franchise. I heard that the other Hooters across town has events, like bikini carwashes, beauty contests and mud wrestling. Perhaps that other one is much more rowdier. Perhaps that owner picks girls that do look like a stereotypical Hooters waitress. I don't know.

Certainly this frenchise owner in Alabama is a scumbag (and the manager and the waitress he fired are NOT). So, your experience may differ.

In any case, as a whole, as much as Hooters brand is about selling sex, from what I could see first-hand, neither managers, nor waitresses, nor most of the customers really bought into it - they treated is as any other family restaurant. A place in a good spot where there is no other food around. I feel more comfortable there than in some more hyped establishments in town (I mean restaurants - I have not visited a strip club and do not intend to ever, so I can retain my own biases and stereotypes about strip clubs and can yell in blog comments against them).

So, yes, the corporate idea is to sell sex. Like Maxim. It may work in some places, but in others, it is just another restaurant. It makes money for the company, so the bosses do not care how it does so. It is in a way a spoof and a put-down of misogyny - "we get money out of suckers" - and the waitresses are in on that plan, not the slaves of it.

So, I'd say - get their money for cancer research. They have given for it before.

Now let me hear the feminists in the comments....

(Cross-posted on A Blog Around The Clock - go check the comments)

Coturnix on Sex, part I - Blogging in the nude

I did not know that Dr.B is just a little bit younger than me. Her wisdom makes me feel like a child.

Usually when I see that a post already has 170 comments I don't even start reading them, but the comments on this recent post of hers are worth your while (as well as people who commented on their own blogs and spawned their own comment threads, e.g., . Aunt B, Brooklynite and Steinn).

While the post is primarily about bringing a young son into the female locker-room to change, it is really about several topics, and commenters sensed it and responded accordingly. It is about nudity in the locker-room, at the pool, at the beach and in public, it is about shyness about our own bodies, and it is about societal attitudes towards the naked body. It was also a challenge to male bloggers to write about sex.

Attitude Towards Nudity

The commenters brought out in sharp relief two interesting phenomena - the differences in attitudes towards nudity in space and in time. First, in space, there are apparently differences between acceptance of nudity - public or locker-room - between East Coast and West Coast, as well as between both coasts and the middle of the country. Even greater is the difference between the States and the rest of the world (excluding the Middle East). For instance, Sister_luck wrote (and read the comments there as well):

There seems to be a big difference between Europe and the United States in how the naked body is perceived and how much of it is permitted to be shown. I couldn't understand the fuss about Janet Jackson's wardrobe malfunction - you didn't even get to see a nipple! Then there was the brouhaha in the livejournal community about banning default userpics showing breastfeeding. Generally speaking, in Germany and other parts of Europe, we tend to see more completely naked people on tv or in magazines and full-frontal male nudity is shown, too.

Part of this might have to do with the fact that we don't automatically connect the nude body with sexuality and see it more as a 'natural state' of the human being. Even if the nudity is shown in a sexual context there is less censorship involved - it's quite interesting to compare the age restrictions of movies - in Germany, violence is more often the reason for restricting the audience of a film and films that feature full frontal nudity here can be seen by a twelve-year-old or even by a six-year-old if there is no strong sexual content.

I've also noticed how for some Americans being in your underwear already equals being naked which I think goes a bit far! But there are also women who'd say that they feel naked without their make-up on.

I grew up in a pseudo-hippy family, so running around naked at home isn't a big deal for me. Going to the nudist beach with my family was okay, but puberty made me slightly more ashamed (though I must say that swimming in the nude is much nicer than in a bathing suit) and I stopped going with them. Today, I'm still quite comfortable in my skin, but have started worrying about silly stuff like showing bodyhair etc.

That is certainly my experience. Growing up in Belgrade, I certainly saw a lot of nudity on TV, in magazines and elsewhere. Two large rivers pass through Belgrade and there is a large island on one of them. On one side of the island, the river was dammed to form a lake (in which the water is cleaner than in the river itself). The beach of that lake is a couple of miles long and is a favourite place for Belgraders to go on a hot summer day (on some days literally half of Belgrade - that is half of 2,000.000 people - showed up there!).

The nearest end of the beach, perhaps the first couple of hundreds of yards, is informally designated as "family" or "textile". The last couple of hundred yards are a nudist beach (there is no fence in between - the actual length of this portion depends on the number of people on it on any given day). Everything in between is "top-optional" where perhaps half of the women (of all ages) wear the top and the other half do not. Some people swim, some people play sports, some hide in one of the restaurants to eat and drink, while some go into the woods and have sex. Big deal! Nobody ever cared.

Spending summers on the Adriatic sea every summer also made me aware that there are nudist beaches there everywhere! Skinny-dipping is fun! You should try it one day if you have not already. And nobody cares, nobody is "titillated" by all that naked flesh around them.

We had swimming classes in Kindergarten, boys and girls together, all naked. It was just the way the world was. And as for locker-rooms, both in school and in my karate practices, walking around nude was no big deal. It was almost like a primate colony, baboons walking around with hard-ons to assert social dominance, and others joking with them to put them back into the equality of the group - we were all on the same team.

Apart from differences in attitides across space, there were also a couple of comments on Dr.B's thread indicating the differences across class lines - the upper classes being more comfortable with nudity, as long as the proles are not around to watch.

But, what was really interesting was an oft-repeated observation that the attitudes have changed over time - not in the expected direction towards more freedom, but the opposite, becoming more and more repressed and self-consciouss. I am wondering if that is a part and parcel of the society (in the States, at least) going through its conservative phase.

I have no idea if Europe has gone back any. I do not even know if it is happening in Serbia, after a decade of grief, economic woes, bombing and losing at least half a million of its best and brightest (the liberal, educated people who could pursue careers abroad) and replacing them with some of the poorest and least educated people who arrived as refugees from Bosnia, Croatia and Kosovo. I am assuming that general zeitgeist there is much more conservative now than it was when I left in 1991, but I do not know if such conservatism also brought back the ideas of puritan shame and the need to cover up again, or is that an element only of the American-brand conservatism.

So, is this a part of a see-saw of attitudes over time? If conservatism is now in shambles politically, does it immediately reflect itself in the societal norms, as in norms of public nudity? Lance Mannion thinks so:

An odd, and probably too self-revealing an aside: the bikini seems to have made a big comeback. I don't remember seeing so many the past few vacations.

Then Lance points out another thing that changes over time - the age of people, i.e., the age-cohorts present at the beach:

My first thought was that a sizeable cohort of teenagers made the jump from little girls to young women over the winter and so there were just more bikini wearers everywhere I looked. This was unsettling, because I try very hard not to ogle anyone who is not old enough to serve in the United States Senate. Not because I'm so mature or such a gentleman. It's just too embarrassing to be caught looking at a 16 year old even if she does have the body of a centerfold and is not dressing to disguise the fact.

But there were plenty of their mothers in bikinis to distract me. Now another odd fact. I am ambivalent about the idea of women in their 30s and 40s and up wearing bikinis, no matter how good they look in them. I can't get over the idea that for older women wearing a bikini is as appropriate as wearing a pinafore and patent leather shoes.

I think that's cultural conditioning on my part. Too many Beach Boys tunes in my youth plus the fact that one piece bathing suits were the fashion for the last twenty odd years and I learned to appreciate the middle aged female form in a tank suit.

Yup, it is cultural conditioning. One-pieces, in my European eyes are for swimming competitions only. Lance continues:

I'm against men wearing bikinis too. No man of any age, no matter in how good a shape he's in, should wear a Speedo unless he's on his high school, college, or Olympic swim team and actually competing at the moment.

I had to buy a non-Speedo when I first arrived in the USA. Back home, boxers were worn only by Gypsies (some kind of ethnic identification symbol?). But then, there's not that many fat people there.... Again, obviously a cultural difference across space, but I am really interested in the changes over time (as well as between classes) as a possible indicator of ideological/political shifts in the society at large.

Body self-perception

People have worn clothes for thousands of years now and shyness is a normal part of every pesrons emotinal make-up. But where does it come from? Certainly not from our naked ancestors, so it must be a culturally induced emotion. If it is a culturally induced emotion, then it is to be expected that it takes different forms and different intensities in different cultures, as well as that it changes over time as other social norm change over time.

One can think of it this way, perhaps: The form and intensity of shyness in any goven society is a result of that society's social norms and, as such, is the best adapted form and intensity for life and survival in that society. In a society of prudes, it is advantageous to be prudish yourself, and in a society in which nudity is no big deal, it may be counter-adaptive to be too shy about one's body.

So, in that perspective, whatever the social norm of shyness is at any given place and time is the best. But is it? Here's Lance again:

Much has been written and said about how the Media's constant exploitation of a certain standard of female beauty to sell stuff creates anxiety and self-loathing in young women in respect to their bodies. Presented with an impossible ideal, they learn to hate their own looks and long for an alternative self-image that of course they can't achieve, leading to more anxiety and self-loathing, but which they spend inordinate amounts of time and money on trying to attain anyway.

But I think that there's another, equally damaging effect.

The constant fetishization and eroticization of female beauty in magazines and on TV teaches many young women to eroticize and fetishize their own bodies.

I don't think it's too much to say that they fall in love with their own reflections.

I wouldn't go as far as blaming the whole Girls Gone Wild phenomenon on a generation of narcissists falling in love with their own reflections. But I do think there are probably more women, young and middle-aged, who learned to admire themselves as objects of desire and who need to have eyes upon them to know they exist. They need the camera's gaze, not simply the male gaze.

They need to see themselves reflected in order to see their own reflections.

The problem, of course, with falling in love with a body, your own or anyone else's, that's 15, 16, 17 years old is that you won't have it to admire for long. A teenage body, even a 20 year old body, is an unfinished body in the process of finishing itself in a hurry.

Bones keep growing into your thirties, which means that no matter how hard they resist it, through dieting, excercise, and surgery, young women get bigger as they advance towards middle-age.

The result of this for a lot of them is that they get ugly in their own eyes.

I think this explains why so many of the professionally narcissistic---young actressess---have taken to starving themselves. They are trying to maintain the adolescent body shape they fell in love with in the mirror (the mirrors in their bedrooms and the mirrors in magazines and on TV), a body shape they only approximate through an excessive thinness that very few straight men respond to.

So, both Dr.B and Lance are noticing, and certainly not lamenting, that bodies change over time. Lance prefers a more mature form. Dr.B, on the other hand, feels comfortable in her own skin today, but still thinks that her younger self was hotter. An important point of Dr.B's post is that aging bodies are not as hot as they used to be and that we need to learn to live with that.

Of course, some commenters immediatelly jumped in (on both blogs), pointing out that many young women are not happy with their bodies even when they are young, way before age takes an additional toll. Some may hate themselves for that reason, but many cope differently - by joining Goth, athletic, nerd or art cliques in their schools, for instance, and despising the pretty girls from there. Surrounded by like-minded people, they are now judged not by how hot they are but by how cool they are (or how good at something). While this limits the options, i.e., narrows the potential breeding pool, it is limited in a good way - those who show interest are those who are seeing beyond T&A, thus they deserve reciprocating. The shallow, body-focused guys selected themselves out. It almost makes dating game easier.

It worked for me. I was always extremely skinny as well as geeky (though riding horses, which outside the USA is not considered gay, as well as having a black belt in karate, added some athleticism to my image). Thus, I could never do what my loudmoth, muscular friends did - walk into a bar and find a girl for the night. But I never wanted a girl for the night. So, although I could not date a lot of girls, I dated the good ones - those who knew me well and saw something in me they liked. They were smart girls. The smartest of them all, in the end, got my ring.

And, some of those girls I dated were not 'hot' in a conventional sense. Yet, I loved their bodies because they were theirs, not because of some waste-hip ratio or cup-size. An ass attached to an interesting, intelligent woman is a hot ass.

If her opening gambit is "I bet you are a Libra", the date is, for all purposes, over. It happened to me once. Two most boring hours of my life! In the beginning, being young and horny and hoping to get some of that smoking hot body, I smiled and nodded, but as the day wore on, a diatrabe on fine points of astrology (yes, that is all she talked about for two hours and there was no way I could, no matter how much I tried, to change the topic) gradually changed my perception of her body - thos tits and ass were not so hot any more because they were attached to a silly head. In the end I told her that I did not believe in any of that and that, I am really sorry, but I did not think there was any future in our relationship. She was pissed - she was very openly and aggressively pursuing me for six month prior to that and then she blew it on that one date I agreed to in the end....

So, the beauty is in the eye of the beholder. If you are interested in the mind, the body looks hot. If you are interested in the body, who cares what she is thinking as long as she is keeping her mouth shut! I have posited several times (e.g., here), that the distinction between the two is, roughly, the distinction between - the conservative ideology based on the hierarchical moral order, and liberal ideology based on interactions between equal players (at least one post on this topic is forthcoming this week to clear all this up).

Thus, the angst by a woman about her body is a response to the conservative social norms. She is trying to be pretty in order to attract the conservative guys who are attracted to T&A, not understanding that, once she gets one of them, she is supposed to sit still, be quiet, look pretty for his friends to see, and raise her legs on command - in short, be abused.

And if she, then, bumps into a guy who wants to actually talk to her and is interested in her as a person, she is confused and weirded out. That is not the game she was trained to play. What's wrong with him, after all? Can't he pay attention to her cleavage and not ask her to exert herself with all that mental stuff and reveal her general confusion about the world, life and everything else? What did she work so hard on her body for if he is not paying attention and wants to probe her untrained mind instead? That must be initially flattering but ultimately scary!

Lance wrote:

A middle-aged man has only to pick up a hammer and start banging to fool himself into thinking he's young, virile, and sexy. A middle-aged woman is still required to stand still and pose.

Yes, she is required to stand still and pose because voicing her opinion is a threat to his masculinity and her beauty is, after all, meant not for him but for his friends in order to raise him in the male social hierarchy. That is what psychiatrists call "placing on a pedestal".

The top guy is the one who managed to snag the hottest girl. The top girl (and yes, they have hierarchies, too - have you been in high school lately?) is the one who manages to snag the top guy. So, if the "topness" in the hierarchy is defined by the standing in the hierarchy of your partner, who decides who is hot?

Well, the broader societal stereotypes - thin girls with big tits and muscular, rich guys (and the media and business realized that, are using that for profit, and are perpetuating it for future profit).

So, they each try to attain that ideal. Girls get diet pills although they are ineffective and harmful, and pay big money for boob-jobs (and nose-jobs and other stuff needed for absolute perfection). Guys lift weights and wear/drive obvious signs of wealth (Rolex/Ferrarri) even if they have to sell their grandmothers to get them. It's all about rising in the hierarchy and has nothing to do with aesthetics.

The only way to succeed is to climb up the ladder and the only way to climb the ladder is if you push someone else down. This cruel competitiveness is the essence of conservative ideology, one on which they base everything, from economic ideas, to foreign policy, to environmental policy. Everyone is a competitor and a potential enemy. In order to survive, you have to throw the other guy down. Do it fast. Do it ferociously so others don't dare challenge you in the future. Be a man if you want to be respected by other men!

It sounds quaint, but that is how they operate. That is why they are all fucked up about gender relationships and about sex. They would not know how to deal with a woman who has an opinion and speaks her mind and refuses to be put down. That is why gays scare them - people who are happy despite opting out of macho competition. Thus, they should be made miserable again.

And they get that way through upbringing, both by their parents and the broader community (read that link for more).

Is that also changing as the society as a whole is slowly loosening the medieval shackles of conservatism? Lance, again, thinks so:

I think that's changing. As women become more active, not simply in their professional lives, but as they play more sports and exercise more and take on more formerly male-only tasks, like picking up hammers and wrenches, they are beginning to redefine female beauty as an active ideal too.

The female ideal of beauty will become like the male ideal a body in motion.

Dr B probably didn't intend this response on my part, but I'm sorry, I can't help myself, and I hope, if she reads this, she won't mind. The most atttractive aspect of her nude self-portrait is that she describes herself always as a body in motion.

Do you agree? How's the dating game in liberal areas these days?

Sex Blogging By Men

In response to Dr.Bs call for men to blog about sex more, PZ Myers wrote an excellent response (you will have to find the comment yourself, it is in the first 20-30 or so on Dr.B's post). After all these years, I am still waiting for the day when I vehemently disagree with anything PZ writes.

But Figleaf goes further:

To be honest I'm not sure why more men don't blog about sex. Or, more accurately, why more don't blog non-pornographically about sex.

------------------snip-------------------

[click on the link for some steamy prose here]

I *love* writing about that!

But while those sorts of things are probably the most *fun* part of sexuality, it's not always the most *important* part. Sometimes it's just as important to talk about the obstacles to sexuality -- our conflations of virginity and commodity; our false dichotomy of reproductive penis and imperial phallus which overlooks the cock as the only human organ evolved expressly to caress; and extensive catalogings of good vs. immoral sex acts while stinting again and again the taxonomies of consent, alienation, and commitment.

And while those are the fun parts and the important parts of sexuality it's *also* important to talk about the *realities* of sexuality. The times -- days, sometimes months, weeks, sometimes years -- we spend grinding under deadline, under class schedules, under childrearing, under threat of war or poverty or illness or age, where sexuality is honored (if it's remembered at all) in the breach rather than the commission.

So, for the reasons PZ stated, I do not and will not write erotica on my blog (not even start an anonymous one on another platform). But, many of those other aspects of sex - from science and medicine, to culture and politics - are covered by male bloggers. Off the top of my head - Chris Clarke and Hugo Schwyzer and many more men occasionally. Or Bill, from a completely different angle.

Or me, for that matter (even more accumulated on my old blog).

Or this post which, I think, is now finally finished.

(Cross-posted on A Blog Around The Clock, go check my commenters...)

Coturnix: Introduction and a chance to shamelessly blogwhore...

Hi, just a quick hit-and-run introduction. It is nice to use Blogger WYSYWIG again, though scheduling posts in advance is a nice thing about MovableType which I am missing right now - it means I'll have to actually get up in the morning to post here!

Some of you may know me from my old, mostly political blog Science And Politics. I also used to run a purely science blog Circadiana about circadian rhythms and the biology and medicine of sleep. I also wrote an education blog - The Magic School Bus. You can check out my best old political and science posts from those three blogs if you want.

Those three are shut down now, as I am one of 45 or so bloggers now happily hosted by Seed Magazine's ScienceBlogs. My new blog there, A Blog Around The Clock is a fusion of the old three blogs. There, I write about science much more than I used to before. Again, mostly about my own area of expertise - the science of chronobiology, i.e., about circadian rhythms, both in humans and in other organisms, as well as the science and medicine of sleep.

I also write about other areas of science, including evolution, ecology, physiology, neuroscience and ecology. And of course, bitching about the sad state of science reporting. And there are still posts about education, especially science education, the life in academia, posts about blogging, personal and fun posts.

But I have not entirely stopped writing about my favourite topics - ideology, religion, politics and sex (both in humans and in other critters) and the way those four things interact.

So, I hope you come and visit me one of these days. And also see my 44 SciBlings over there - it's not just Pharyngula, there are a lot of other good bloggers there.

I am scheduled to guest-blog here on Thursday, Saturday and Sunday mornings and I will try to write a few posts about sex, science and politics and how they relate to each other. I may also come by on Friday afternoon if olvlzl does not manage to get on to Blogger to post at that time.

While I keep my science writing, and even my science blogging, to the highest standards of accuracy, my posts about other topics, e.g., politics, ideology and sex, are more likely to be speculations, stuff from my own experience, or just a way to vent frustration. Often, they are a way to state, on purpose, something controversial. This is a great way to get a lot of comments. I love nothing better than to be put in my place by a smart, informed commenter who provides links to information that proves me wrong. That is how I learn something new every day. I hope you do not go on vacation and wait for Echidne to come back but enjoy yourselves in the comments this week as well.

Guest Post by Skylanda: Profit, Ethics, Big Pharm, and One Little Girl

Cassie* was just six years old last January when she started to turn pale and feel an unfamiliar ache in her bones. The change was so gradual that months passed before her parents became worried enough to take her to the pediatrician. But before the appointment was scheduled, she was rushed to the emergency room, so weak she could barely stand; by the end of the evening Cassie was diagnosed with ALL: acute lymphocytic leukemia. The white cells that are supposed to defend her body from microbial invasion had instead grown like a parasite in her marrow, strangling out the vital tissues that produce red blood cells and platelets. (*not her real name)

Childhood leukemia is now a treatable disease. Thirty years ago, she probably would have died after a few months of cutting-edge yet still clumsy treatment. A hundred years ago, before people learned to type and transfuse blood, she would have died within weeks, so anemic that she was. Today, about 85% of childhood ALL cases in kids achieve permanent remission with chemotherapy - a minor miracle of modern pharmaco-chemistry that highlights how the laboratory bench is just as important in medicine as compassion and caring.

But Cassie’s rosy outlook shattered when her cancer was genotyped a week later to discover exactly what had caused the wildfire growth of malignant cells. She turned out to have a rare subtype of ALL – one that placed her squarely in the 15% that don’t beat cancer in the first round. In fact, most kids with her genetic twist don’t beat cancer at all. Cassie had the Philadelphia chromosome.

In 1960 researchers in Pennsylvania began to describe a cancerous white cell in which a piece of the ninth chromosome had switched places with a piece of the twenty-second chromosome. No one understands why this happens, but the protein that is read off one of these abnormal strands is named – in the peculiar parlance of molecular biology – bcr-abl. Bcr-abl belongs to a family of enzymes called tyrosine kinases, which are involved in signalling cells to reproduce. Normally, tyrosine kinases are turned off and on by other enzymes, but the mutant bcr-abl protein locks the cell’s reproductive cycle into the on position, spiralling that cell into self-perpetuating expansion which takes over the marrow with ever-multiplying clones. This so-called 9:22 translocation – the “Philadelphia chromosome”– is the basis for most cases of chronic myelogenous leukemia (CML), which mainly affects older adults, and also for a small percentage of ALL cases like Cassie’s.

This arcane bit of biochemical mechanistics sat on the shelf for several decades without much clinical importance, but it held out a tantalizing implication: if a cancer is caused by a well-described signalling error, could a drug be invented that inhibits the mutant enzyme alone, gumming up the machinery that causes the malignant transformation without poisoning the body’s normal cells?

This was the burning question Dr. Brian Druker asked in the early 1990s when he began a cooperative project with the Swiss pharmaceutical giant now known as Novartis to test compounds that showed promise in blocking the bcr-abl protein. Modern cancer chemotherapy broadly targets rapidly dividing cells – including both cancerous and normal cells – which is in part why chemo patients lose their hair and battle intractable gastrointestinal problems. Some clinicians quietly mutter that this treatment will one day be regarded the way we now look at bloodletting: as a barbaric and primitive strategy which too often causes more harm to the long-suffering patient for too little gain.

Druker and other visionaries sought to change all that. Using the specific molecular biology of an individual type of cancer cell, narrow-spectrum drugs could be invented that circumvent the scorched-earth tactics of standard chemotherapy. These hypothetical drugs would not be a “magic bullet” for cancer at large; they would be a magic bullet for a particular type or even subtype of cancer. By 2001, a particularly promising tyrosine kinase inhibitor known as imatinib – branded by Novartis under the name Gleevec – set the record for the fastest drug approval ever by the FDA, effectively transforming CML from a fatal disease into a chronic disorder, and giving new hope for patients with Philadelphia-positive ALL.

But this radical advance came at an immense cost, a gamble that pharmaceutical companies make with every compound they consider: the price of developing a drug like Gleevec from start to finish is estimated at up to $800 million. With only about 4500 CML cases (and a handful of Philadelphia-positive ALL cases) annually in America, those R&D costs must be recovered from a small pool of patients, whose insurance – if they have insurance – is billed over $25,000 a year for a patented drug that many patients will take for the rest of their lives. Invoking cash numbers of this scale inevitably raises debate about access and equity in the distribution of vital medicines, and Novartis has hardly escaped this fray. In fact, Novartis has inadvertently positioned itself at the vortex of an economic and ethical storm.

The controversy started when Novartis made the grandiose promise that no patient on the planet who could benefit from Gleevec would go without. Besides several unresolved logistical complications (including the fact that Gleevec was not yet approved in many nations), this promise came with some hefty strings attached. Novartis warned India – one of the world’s largest emerging markets for pharmaceuticals – that the charity would end if the nation allowed any generic knock-offs of Gleevec. In Korea, the government set the prices for Gleevec far below the open market value, and supplies of the drug dwindled while the Novartis and the Korean government bickered over the issue. All over the developing world, Novartis has been accused of using its charitable donations as a strategy to enter a market and then leverage patients into lobbying for governments and private insurers to reimburse for this medication, whose cost far outweighs the average per capita health care spending in many developing nations – sometimes by a factor of ten or even one hundred-fold.

It is tempting to unilaterally condemn Novartis for their exploitation of a vulnerable population, holding leukemia patients hostage to a life-saving drug and demanding a monetary tribute neither they nor their cash-strapped nations can reasonably afford. But without the pharm company’s investment, Gleevec never would have come off the shelf and into patients’ mouths – in fact, it is said that Druker had to gently strong-arm Novartis into investing in the compound at all, because the revenue on such a drug was not projected to bring in sufficient profit. Now Novartis has only a few short years until the patent runs out to recover the initial investment – a chunk of money they put down without a guarantee of any return at all (indeed, most compounds examined by biotech companies never make it out of the test tube, and biotech firms routinely swallow those unrecoverable funds as a cost of doing business). Critics counter that Gleevec would never have existed without the initial research that identified the Philadelphia chromosome - research that Novartis certainly did not fund or compensate anyone for – and that Druker’s work was carried out in a lab supported largely by Oregon Health & Science University, a public medical school in Portland. The fact that Novartis regularly nets over a billion dollars annually on its aggregate drug sales does not lend the company much sympathy from activists either.

In any case, Novartis’ heavy-handed tactics may have already backfired. In January of 2006, the agency that controls patent rights in India ruled that Gleevec is not protected, and half a dozen Indian pharmaceutical makers are now racing into the market to undercut Novartis’ price by up to 90% and effectively end the monopolistic practices allowed by patent rights. This is good news for Indian patients who have sold house and home – even bankrupting themselves – to purchase Gleevec when the promised charitable donations did not come through smoothly. But it may be bad news for sufferers of other diseases that have potential drugs in the pipeline; with patent rights threatened under this precedent, research and development may be hindered by this sharp downward adjustment in projected revenues in the large Indian market.

There is yet a far more fundamental question in the provision of expensive drugs to developing nations: do poor countries really need a fancy new cancer drug? This question addresses what economists call the “opportunity cost” – the list of things you cannot do because you put your money into another activity. One might question what other health assets or advances could be purchased with the $25,000 per patient per year that nations outside India might still have to pay for access to Gleevec. Blowing such a large chunk of public cash on one cancer patient may seem crassly unjust in nations where such money could treat hundreds of tuberculosis, AIDS, or malaria patients – yet that policy is exactly what Novartis is pedalling by exerting pressure on patients to lobby their governments for full reimbursement for Gleevec. On a grander scale, one might ask why a company is spending $800 million on drugs for diseases that affect about 5000 Americans per year when the world is struggling to treat millions of TB patients with drugs that are increasingly inadequate against resistant strains. These questions become even more pressing in light of the fact that novel drugs are now in the pipeline to combat resistance to Gleevec that emerges in many patients on chronic therapy – in effect throwing even more resources into a rare disease that has already merited one miracle drug.

The conflict engendered by pricey drugs is by no means limited to developing nations. In the US, a similar controversy is likely to brew in the coming months over Avastin, which inhibits certain tumors from building the blood vessels needed to feed their growth – at a cost of $100,000 per patient per year, a number which causes patients and insurers alike to balk. Herceptin (a synthethic antibody that marks certain types of breast cancer cells for destruction by the immune system) made headlines in Britain last year when the National Health Service refused to pay the equivalent of $35,000 a year for women in the early stage of the disease to receive the drug. The NHS grounded their decision in the evidence, which had yet to prove any positive effect for women with early cancer, since the drug was largely developed for difficult-to-treat metastatic disease. Moreover, the NHS must control expenditures so that all British citizens can get basic and advanced care without bankrupting the system. The women who challenged the decision argued that with their lives are at stake, any chance of benefit would be worth the cost – and the NHS eventually backed down and agreed to pay for the treatment. The decision was hailed as a landmark advance for patient rights, but by further straining and already-stressed national health system, this victory may help a vocal minority of patients at the expense of other beneficiaries who are less empowered to demand their rights.

It may seem as if these opposing groups – the NHS versus breast cancer patients, pharmaceutical companies versus impoverished leukemia patients – are speaking different languages: one of hard numerical reality and the other of the unquantifiable value of their own lives, with an added subtext of controversy regarding patient autonomy over treatment decisions that are historically left only to doctors (and more recently placed in the hands of private and public insurers – a fact of modern life that neither patients nor doctors are particularly happy about). In fact, both of these are languages we all speak. Every lay person knows that gut-wrenching feeling of being faced with a sudden, unexpected expense that throws even the best budgeting projections into a tailspin. Contrarily, no insurance executive, health economist, or NHS official is immune to cataclysmic illness in the family.

And it is within that common ground that a more effective dialogue needs to be opened between the stakeholders: patients, physicians, pharmaceutical companies, insurers, and the general public whose funds are allocated for these treatments. In a world of limited resources, tough decisions have to be made between pursuing expensive novel treatments for rare diseases and providing routine care for the world’s top killers. The open market has not been particularly apt at doling out these resources to the satisfaction of the masses – as evidenced by the breast cancer patients in Britain and the leukemia patients in India. Creative new solutions are in demand – perhaps giving pharm companies tax breaks for keeping drug prices in the reasonable range, or increasing federal funding for basic research while capping prices on drugs that are produced with such public funds. Whatever the proposed solution, it is imperative that patient advocates take their place at the negotiating table, but equally vital that decisions are made with the limits of real-life economics in mind – economics of production, economics of purchasing, and economics of the relative value of health in rich and poor nations.

In the end, Gleevec is good medicine – even great medicine – though its existence implies some problematic economics. Dr. Druker has become a folk hero among patients whose lives have been given new promise by Gleevec; websites have sprung up dedicated to posting letters of thanks to the man who reinvented hope for a terminal disease. Meanwhile, with the help of Gleevec, Cassie’s stubborn leukemia was forced into remission this spring, but because long-term data on remission in Philadelphia-positive ALL is still lacking, in May she underwent a bone marrow transplant to eradicate any possible remaining pockets of hidden cancer. In June she was declared cancer-free for the first time, but after enduring all the pre-transplant radiation and chemotherapy, she suffered a profound lung injury and has been on life support for endless weeks now, struggling to stay alive while her lungs slowly heal over. The grave consequences of such invasive procedures like bone marrow transplant point to the importance of developing effective and well-tolerated drugs – drugs like Gleevec, Avastin, and Herceptin – that treat the disease while circumventing the heroic but costly interventions that modern medicine employs so commonly. Despite the ongoing struggle for Cassie’s life, for her mommy and daddy and the mesh of family and friends who love their young daughter, any price was worth the cost of Gleevec.

Posted by skylanda.

Farewell.....

...to Bush's Connecticut lapdog.

Three-term Sen.Joe Lieberman fell to anti-war challenger Ned Lamont in Connecticut's Democratic primary Tuesday, the first major election-year test of sentiment over the conflict that has claimed the lives of more than 2,500 U.S. troops in Iraq.

"Tonight we voted for big change," a jubilant Lamont told supporters. Unbowed, Lieberman vowed to fight on, announcing plans to run as an independent this fall.

"Of course I am disappointed by the results, but I am not discouraged," Lieberman said. "For the sake of our state, our country and my party, I cannot and will not let that result stand."

Lamont won with 52 percent of the vote, or 146,061, to 48 percent for Lieberman, with 136,042, with 99 percent of precincts reporting. Turnout was projected at twice the norm for a primary.[...]

The Connecticut Senate race dominated the political landscape, and its outcome promises to echo through the fall. The race was watched closely by the liberal, Internet-savvy Democrats who lead the party's emerging "netroots" movement, groups such as Moveon.org that played a big role in pushing Lamont's candidacy.

Critics targeted Lieberman for his strong support for the Iraq war and for his close ties to President Bush. They played and replayed video of the kiss President Bush planted on Lieberman's cheek after the 2005 State of the Union address.[...]

Yeah, those were some good times.

[...]Jubilant Lamont supporters predicted victory in November.

"People are going to look back and say the Bush years started to end in Connecticut," said Avi Green, a volunteer from Boston. "The Republicans are going to look at tonight and realize there's blood in the water."[...]

In Mckinney and other primary news...

In Georgia, McKinney, her state's first black congresswoman, lost to Hank Johnson, the black former commissioner of DeKalb County, 58 percent to 41 percent.

In the heavily Democratic district, the runoff winner is likely to win in the fall.

McKinney has long been controversial, once suggesting the Bush administration had advance knowledge of the Sept. 11, 2001, terror attacks. Her comments helped galvanize opposition and she lost her seat in 2002, but won it again two years ago.

In her latest brouhaha in March, she struck a Capitol Police officer who did not recognize her and tried to stop her from entering a House office building.

A grand jury in Washington declined to indict her, but she was forced to apologize before the House. She drew less than 50 percent of the vote in last month's primary.

In other primaries Tuesday:

• In Michigan, Republican Rep. Joe Schwarz, a moderate who supports abortion rights, lost to conservative Tim Walberg, a former state lawmaker. The race drew more than $1 million from outside groups; Schwarz has received support from President Bush and Arizona Sen. John McCain.

• In Colorado, two open congressional seats have drawn crowds of candidates.

• Missouri Republican Sen. Jim Talent and Democratic challenger Claire McCaskill, the state auditor, won their party's primaries.

So what does all of this mean for the Democratic Party and the November elections? Who knows? One can certainly speculate. I sure hope that Lieberman's defeat will send the Democrats a clear message that it's time to grow a back-bone, start seriously opposing Bush and the Republican wingnuts in Congress, and quit selling out their voting base in a pathetic attempt to woo the fundie-social-conservatives, who would probably never vote for them anyway.

(***Graphic via Pandagon and originally BushSpeaks.com)

--Posted by Pseudo-Adrienne

My Summer Vacation

Takes place from tomorrow morning and lasts exactly one week. So you will be free of me for glorious seven days. But have no fear, this blog will not be there like a silent reminder of a once-lovely relationship. No. I have some wonderful guest bloggers all lined up for you. Well, more or less lined up, except for a few stragglers.

Let me introduce them to you. Tarampampam! (that's the sound of trumpets):
Blue lily, coturnix, pseudoadrienne and skylanda. And if I can sort out the paperwork in time, also hybrid0 and olvlzl.

My heartfelt thanks to all the guest bloggers.

For Your Information

I wrote a longish post of advice on how mainstream journalists might cover the liberal and progressive blogs. It's on Eschaton.

IOKIYAR

It's OK if you are a Republican, especially if you are called Ann Coulter. What is OK? Well, misusing sources in a book might be. Using information from the 1970s to argue about liberal evil-doings today. Or implying that liberal experts are advocating teaching kindergarteners about fisting based on a source which discussed the sex education of Dartmouth college students twenty years ago:

. On Page 175, Coulter attacked "liberals" who would "foist" sex education topics such as "[a]nal sex, oral sex, fisting, dental dams, [and] 'birthing games'" on kindergarteners. Citing a November 8, 1987, New York Times article, Coulter wrote:

But in contrast to liberal preachiness about IQ, there would be no moralizing when it came to sex. Anal sex, oral sex, fisting, dental dams, "birthing games" -- all that would be foisted on unsuspecting children in order to protect kindergarteners from the scourge of AIDS. As one heroine of the sex education movement told an approving New York Times reporter, "My job is not to teach one right value system. Parents and churches teach moral values. My job is to say, 'These are the facts,' and to help the students, as adults, decide what is right for them."9

To those who find it odd that Coulter would support her claim about "fisting" being taught to kindergarteners by quoting "one heroine of the sex education movement" and referring to students as "adults," there is a very good reason for that. The woman Coulter quoted was Dr. Beverlie Conant Sloane, then-director of health education at Dartmouth College. The Times article cited by Coulter, titled "At Dartmouth, A Helping Candor," (subscription required) was about the sex education programs available to adult students at Dartmouth -- not children in kindergarten. Not only is the article about adult students, but it is from November 1987, close to 20 years old -- hardly what would be considered to be relevant information on current sex education policies.

Does talking about this matter? Am I just giving Coulter more attention than she deserves? You decide, as the Fox News might say. But the fact of the matter is (see how I'm falling into a wingnutty way of writing here?) that I have read many comments from people who believe that Coulter makes sense, under all that cruelty and ridicule that she wields so masterfully/mistressfully, and this means that it's worthwhile to point out when she doesn't make any sense at all.

Then there is the old, pathetic reason about trying to write without distorting everything, and we really shouldn't let it be ok to distort if you are a Republican.

Landlords and Sexual Harassment

A diary on Kos discusses this issue:

I am an ex-fair housing lawyer who prosecuted several civil sexual harassment cases for the Department of Justice's Civil Rights Division, on behalf of aggrieved women. (I also co-wrote the article that Cyrus cited at the beginning of this diary.)

I want everyone to know that sexual harassment in housing happens a LOT. There aren't any good statistics out there, but I know from my experience on these cases that we were barely scratching the surface. Some observations, again just from my own experience and that of my colleagues: Housing harassment is not usually an isolated phenomenon...

[snip]

but rather a situation where the landlord makes it his standard operating procedure to rent to and harass vulnerable women.

Most of the time, there are multiple victims in each case. (The smallest number of victims I ever had was 7, the most was 21. I think one of my colleagues had a case with 24.)

While I have read about cases of landlords who harass middle-class tenants, the usual targets are low-income women with children. All but one of my cases involved women who qualified for public or subsidized housing. (The exception, horribly enough, was a trailer park outside of a military base, where wives of men who were in Iraq were being harassed by their landlord. A few of the women couldn't move because there was not enough base housing for families, and the other trailer parks in the area were full.) In fact, some of the women in my cases were IN Section 8 housing when they were harassed. That's right -- their landlord was receiving taxpayer dollars for the pleasure of harassing them.

...

One poster was correct in making a point about criminal liability. A lot of the conduct we would see was clearly criminal -- sexual battery, home invasion, forcible rape. The problem is that few tenants were willing to report this sort of thing to police, because they feared (probably accurately) that the police would take no action. Again, from my experience, and that of my colleagues: The landlord is invariably of a higher social status. He owns property (by definition), he is usually white, is usually in his 50s, 60s, or 70s (my office had more than one harasser try to use the "Viagra defense"). The victim is often black, very poor, and under 30. Some of the victims in my cases have had criminal records, substance abuse problems, or mental health issues, making them even more vulnerable. The very vulnerability that makes them fair game for the landlord also makes it less likely that they will feel like they can call the police, and that the police will believe them. (One woman in a case I had called the police to report that her landlord was threatening to evict her unless she had oral sex with him. The police arrested HER when they discovered she had an outstanding traffic warrant. The landlord, meanwhile, persuaded the cops that she was just a bad tenant who was trying to get even with him for attempting to evict her. Guess what happened? He evicted her.)

This is a problem that has probably been underreported, at least compared to the sexual harassment at work, but it has similar roots: One participant has more power than the other and thinks that this power can be used to extort sexual services of some kind, while the other participant is at least partially locked into the bad situation; partially locked, because finding a new job or apartment is hard, time-consuming and involves real costs and losses. In the examples the Kos diary quoted the power imbalance is even greater as the tenants don't have the money to rent an open market apartment.

We need more study and discussion of this.

Meanwhile, in Ohio

All U.S. politics wonks are right now focused on the Connecticut Democratic primary where Ned Lamont is challenging Joe Lieberman for his Senate seat. But politics is happening everywhere, and in Ohio some recent events are worrisome:

For Tony Minor, the pastor of the Community of Faith Assembly in a run-down section of East Cleveland, Ohio's new voter registration rules have meant spending two extra hours a day collecting half as many registration cards from new voters as he did in past years.

Republicans say the new rules are needed to prevent fraud, but Democrats say they are making it much harder to register the poor.

In the last year, six states have passed such restrictions, and in three states, including Ohio, civic groups have filed lawsuits, arguing that the rules disproportionately affect poor neighborhoods.

But nowhere have the rules been as fiercely debated as here, partly because they are being administered by J. Kenneth Blackwell, the secretary of state and the Republican candidate in one of the most closely watched governor's races in the country, a contest that will be affected by the voter registration rules. Mr. Blackwell did not write the law, but he has been accused of imposing regulations that are more restrictive than was intended.

Under the law, passed by the Republican-led state legislature in January 2006, paid voter registration workers must personally submit the voter registration cards to the state, rather than allow the organizations overseeing the drives to vet and submit them in bulk.

By requiring paid canvassers to sign and put their addresses on the voter registration cards they collect, and by making them criminally liable for any irregularities on the cards, the rules have made it more difficult to use such workers, who most often work in lower-income and Democratic-leaning neighborhoods, where volunteers are scarce.

So if a canvasser is paid he or she must personally take all the registration cards in and must also sign for them, and she or he becomes criminally liable, too. As far as I can tell the same regulations do not apply to volunteer canvassers:

"Quit whining," said the Rev. Russell Johnson, the pastor of Fairfield Christian Church, who chuckled while shaking his head. "We work with the same challenges that everyone else does and we're not having trouble."

Surrounded by cornfields and middle-income homes, Mr. Johnson's 4,000-member evangelical church in Lancaster, Ohio, is part of a coalition of conservative groups that aims to sign up 200,000 new voters by November, he said.

In the past several elections, Republicans have been effective in registering voters and getting them to the polls. Mr. Johnson said conservatives were better able to depend on voter registration volunteers because the conservatives had a message that attracted people who were willing to work free.

This whole thing reminds me of the favorite strategy of the pro-life state governments, which is to saddle all reproductive health care clinics with so many legal requirements that they can't possibly satisfy them all and then will be closed down.

Housekeeping News

I'm guest blogging on Eschaton until Wednesday night. And then I'm going to go on vacation for one week. A later post will introduce the guest bloggers who kindly agreed to take care of this blog while I'm gone.

All those musical chairs. And no money is changing hands! Isn't the blogosphere wonderful?

Now I'm going to write something proper for this blog.

Framing Issues

Froomkin's latest column quotes Bush and some others from his administration on the proposed Israel-Hezbullah resolution:

Responding to specific questions about the resolution and the conflict, Bush tirelessly dipped into his small store of stock answers, repeatedly extolling the universal appeal of liberty and asserting the importance of addressing the "root cause" of the violence -- terrorists in general, Hezbollah in particular -- as part of "the great challenge of the 21st century."
A Trap?

In their press briefings yesterday, Rice and national security adviser Stephen Hadley not coincidentally used the exact same phrase to describe what they expect will happen after the resolution is approved: "We'll see who is for peace and who isn't."

Of course, if you believe Lebanese officials, that's because the resolution is a trap.

Note all the framing issues in that short quote? Talking about "root cause" without actually saying anything about it, mentioning "the great challenge", without actually telling how we are going to face it. He's punching emotional buttons without adding any new information at all.

But the "We'll see who is for peace and who isn't" piece is new and very clever. The framing reduces the available options to two: Either you accept the U.S. view and are for peace, or you are not for peace. No other options exist.

This is how issues are framed by the Bush administration, and in a short while we are all talking about people "being for peace or not", as if the verity of the framing was in no doubt at all.

Susan Butcher, RIP

The great musher succumbed to leukemia on Saturday.

Sunday Night Dog Blogging

Thanks to saoba, in my comments, who saved the weekend from being dogless.

The New Gender Divide at the New York Times

This is a series which is advertised as follows:

Articles in this series are examining what has happened to men and women several decades after the women's movement began.

That is a wishy-washy way of explaining these events as a consequence of the women's movement, I'd wager. And so far the following articles have appeared in the series:

Previous Articles in the Series:
Men Not Working, and Not Wanting Just Any Job (July 31, 2006)
Small Colleges, Short of Men, Embrace Football (July 10, 2006)
At Colleges, Women Are Leaving Men in the Dust (July 9, 2006)

David Brooks and John Tierney couldn't be any happier! See what feminism has wrought! Men in the dust!

It's always possible that the series first looks at all the horrible things that have happened to men (whether they actually have happened in any sense of trends is another thing altogether), and that the later articles talk about all the good things that feminism has done, for both women and men, mind you. But if so, this part of series hasn't started yet. Today's piece is entitled:"Facing Middle Age With No Degree, and No Wife".

This is another of those trend-manufacturing stories that the Times seems to specialize in.

Week in Pictures

From Jesus' General. I found the funeral pictures immensely moving. We should make a law that those who send people to die in wars must go to their funerals.