The Man in the Mirror

I've never been a huge Michael Jackson fan. Sure, I've enjoyed his music, but I never bought one of his albums, never went to a concert of his. And yet, like so many, I was stunned and shocked by his untimely passing at the age of 50.

As a child of the 80s, his music was a part of the soundtrack of my childhood. I remember watching MTV at my friends' houses and marveling at his music videos. I'm sure I recorded a song or two of his off the radio for my mix tape collection. I danced around in my room to his songs. And, like every one else, I was increasingly disturbed by his transformation from a handsome young black man to an ethnically ambiguous caricature of a human figure. The lightened skin, the continued plastic surgery - it was all so bizarre. And as a child and then as a teenager, it made no sense. As an adult, however, it became clear that what we, the public, were seeing on the outside was a representation of the pain and disfigurement on the inside. Stories emerged from interviews with Michael himself, as well as family members and those who knew him, about physical and emotional abuse at the hands of his father, Joe. His immense talent - the very key to his fame and fortune - seemed to be the trigger for his father's driving him like slave to rehearse and perform. Rather than statements of love and approval, young Michael heard insults about his nose and the darkness of his skin. His talent, which brought him the love and admiration of a worldwide audience, only caused his father to push him more, to isolate him more, to abuse him more. And no one stood up to protect Michael. Is it any surprise that he became a man who could not survive as an adult? Is it any surprise that he became a man who could not see the beauty in himself and instead subjected himself to countless cosmetic procedures in order to achieve "perfection?" That little boy who had seemed to have everything, in truth, didn't even have the basic thing most children have: the love, acceptance, and protection of a parent.

That is the tragedy of Michael Jackson's life. His greatest gift was the reason for his downfall. And what is so tragic is that every day, we see that others are not heeding the moral of Michael Jackson's story, that there are still parents who treat their children not as a special gift to protect and nurture, but as a meal ticket to exploit and sell. There are still parents who see their children as a means to an end, and not a joy to cherish for its own rewards.

My favorite Michael Jackson song is "Man in the Mirror." In it, he talks about the need for change to start with each person looking at himself or herself and making a commitment "to make that change" starting with that "man in the mirror." It is so sad that when Michael Jackson looked at the man in the mirror, he saw the distorted image painted for him by his father, and not the one the rest of the world saw. Rest in peace, Michael. I sincerely wish you had found that peace while here on Earth.

Bad Medicine

Oh this ticks me off! The American Medical Association has come out against healthcare reform, primarily because of opposition to a public health care plan. One of the major reasons for that opposition is the contention that "the corresponding surge in public plan participation would likely lead to an explosion in costs that would need to be absorbed by taxpayers."

Right. Because our current system, in which there are 40 million Americans without health insurance, leading to a focus on emergency medicine rather than preventative medicine, is really cost effective.

Or is it that the AMA is worried about the effect of having someone who calls for evidence-based medicine holding the purse strings for medicine? What would happen to billing for the "machines that go ping" if the guys writing the check said they wouldn't pay for them because they do not improve outcome?

Whose health is the AMA more concerned with: the health of the average American, or the health of their members' bank accounts?

RIP Dr. Tiller

It has been several days since the Wichita doctor, George Tiller, was murdered while in his church. And I am still sad over his death. I have debated whether I wanted to blog about him and about abortion, about whether I wanted to enter the fray. And I have come to the decision that one of the best ways to honor Dr. Tiller's memory is to be open about the reasons women went to see him.

Back in February, my husband and I, accompanied by our toddler, went to the ob/gyn's office for what I expected would be our last visit before I transferred care to my homebirth midwife. I was approximately 18.5 weeks pregnant and was going to have the now-routine anatomy scan done. Technically, the scan is done to make sure the fetus is growing correctly, that the pregnancy is proceeding normally. But I would say most women see it as the chance to find out whether they are having a boy or a girl. My husband and I were hoping to learn that we would be having a little girl, though we would also be happy to find out we were having a healthy little boy as well.

The ultrasound technician was cheerful and made jokes with us as she began the scan. She remembered my son from our previous two ultrasounds and was joking with him as she went through the scanning process. My husband and I waited anxiously to find out whether we were having a boy or girl, and the technician quickly told us we were, in fact, having another boy. Lying on the table, I gave my husband a wry grin - another boy. We were in for another exhausting couple of years.

As the scan continued, I noticed that the technician became quiet. She stopped talking to my husband and I. She stopped joking with my son. I remember looking at my husband quizzically several times and noting from his expression that he, too, had noticed the change in her demeanor. After over half an hour, the ultrasound technician told us that a nurse would be in to take us to another room to speak with the doctor, and the technician left without looking at us. Both my husband and I knew something was not right. As we sat in the next room, waiting for the doctor to talk to us, I could hear the technician in the hallway, speaking with the doctor. I heard her say to the doctor, "I've never seen a cyst that big before." I was becoming extremely worried.

The doctor came in soon after and told us what the scan had found: the fetus had what appeared to be two large cysts, known as choroid plexus cysts, on his brain. He also had what appeared to be an enlarged stomach. Individually, these would not be cause for alarm, but since our baby had both, there was concern that the fetus might have a chromosomal abnormality. We would need to see a high-risk obstetrician with a more powerful ultrasound machine in order to determine whether there were more soft signs of abnormality and, based on that, we would need to decide whether to have further testing, such as an amniocentesis. I asked what chromosomal abnormality the fetus might have; the doctor said that choroid plexus cysts tend to be seen in fetuses with Trisomy 18, a condition that is generally not compatible with life. The doctor said that she would call the women's center downtown and make an appointment for us; since we were the last appointment on a Friday afternoon, we would have to wait until Monday to find out when our appointment would be.

I know I held it together until we left the doctor's office. I was sent to the lab to have some blood drawn, and the phlebotomist asked about the pregnancy and whether I knew what I was having. I remember thinking, "I don't know that I'm really having a baby" but actually telling her, in a daze, that it was a boy. Once we left the building and got in the car, I broke down crying. My husband and I sat there, with our son in his carseat, holding each other as I cried. I remember thinking this couldn't be happening. This couldn't be possible.

As soon as we got home, I looked up Trisomy 18. What I read was not heartening. If our baby had Trisomy 18, the chances of him making it to term were slim; 95% die in utero. Those babies with Trisomy 18 who do survive to delivery die within days, if not hours. The median lifespan for Trisomy 18 babies who make it to term is 5 to 15 days. I was heartbroken. Instead of sending out a happy email to friends telling them we were expecting another boy, my husband and I were facing the prospect of losing our child. It was at this point that we began to seriously talk about what we would do if the tests showed the worst case scenario was reality. We talked about abortion.

I spent the weekend reading more about Trisomy 18 and about abortion, between bouts of crying. My husband and I found that neither of us wanted to talk about the baby, it was just too painful to consider what might be, but we both wanted to comfort each other. But both my husband and I were honest with each other: if our baby turned out to have Trisomy 18, we would not carry to term. It was that weekend that I learned about Dr. Tiller and his practice in Kansas. I read the stories his patients had posted on different websites. I read about his compassion for women, for couples, having been dealt a cruel hand by Mother Nature and having to make a difficult decision. Above all, I spent the weekend hoping that I and my husband would not have to make that decision, that everything would be ok, that it was just a false alarm.

For nearly 4 days, I and my husband wrestled with the what-ifs, wrestled with the possibility that we would have to make the difficult decision to end the pregnancy. It was with great relief that I laid in a different ultrasound room on the following Tuesday and learned that the baby showed no other signs of Trisomy 18 or, for that matter, any other chromosomal abnormality. A follow-up ultrasound four weeks later showed the two cysts on the brain had disappeared and the stomach, while still somewhat large, was normal in size. It was going to be ok. The high-risk obstetrician discussed with us the very low likelihood of there being a chromosomal abnormality, given the level-II ultrasound results and the results of my bloodwork; based on that information, we opted not to have an amniocentesis. It was going to be ok.

I am grateful that we did not have to make the decision to terminate the pregnancy - to abort the fetus. But I know that there are other women, other couples, who do not receive happy news at their follow-up appointments, who do not get the sense of relief when their testing results come back. And it is for them that I also mourn. For while the service Dr. Tiller provided, late-term abortion, is not one that all people would like to have exist, it is one that needs to exist. And the health of women in the United States, the options of couples and families facing the realities of a pregnancy gone horribly, horribly wrong, is threatened by the loss of Dr. Tiller.

Rest in Peace Dr. Tiller.