Friday, January 10, 2014

On Some Liberals' Distrust of Doctors

Baby Gaga is in for a checkup.
I make no secret of the fact that I'd be thrilled if one of my kids grew up to be a medical doctor. Doctors have job security and respectable status in society, which would please any parent concerned about our kids' futures. But another part of the appeal to me is the ethics. A doctor's job is to use knowledge obtained through science to try to heal people. What could be a more noble profession from the secular humanist perspective? 

The medical field isn't for everyone. Not only does it require a strong ability to study difficult subjects such as organic chemistry. There is also the gross factor: blood, guts, tissues, fluids, horrible smells, and basically being able to look at human bodies just as a mechanic looks at a car. I couldn't even handle dissecting a frog in high school (I got light headed and ended up being excused to the library. Oddly enough, I'm okay cooking a chicken.) 

Monkeys need doctors too!
Given the rigorous training and noble objectives, it surprises me that not everyone shares my deep respect for the medical profession. 

Some of my friends are dismayed that I would encourage my kids to be doctors. It's sort of the bizarro version of adults who discourage kids from taking an interest in the arts for fear they'll grow up to be impoverished, drug-addled bohemians. In this case, the fear is that as doctors the kids will grow up to be arrogant automatons, brainwashed by scientism and serving the corporate greed which supposedly drives the medical establishment. 

These are the sort of liberals - mostly highly educated, middle class, and white - who drive today's Anti-VaccinationNatural Childbirth, and other Alternative Medicine movements. 

I was reminded of this sort of contempt toward doctors while reading/viewing New Mom's Uncensored Photos Reveal the Beautiful, Messy Reality of Homebirth. It includes an interview with writer Ruth Fowler followed by the live documentation she and her photographer husband did of her son's birth on Twitter and facebook. 

Right off in the video, the interviewer refers to the "intrusive" nature of modern "technology", and it is clear that this story is framed as a human interest story about the beauty of a natural childbirth in contrast to the sterility of a conventional hospital birth. 

Ruth Fowler describes herself as not the extreme. She says to the interviewer, 
I'm not the kind of crunchy, granola mama who's like "Women who go to hospitals are bad mothers" I'm somewhere in the middle. My birth experience kind of reflects that. I'm somebody who had a natural, un-medicated home birth, but then I had to go to the hospital afterwards to get treatment that probably saved my life. And so I'm not an anti-hospital person. I just wanted to birth at home with my husband, with the people I care about, in the environment I care about. 

Doctor Lysi and Nurse Bebe get to work.
I found this statement puzzling. First of all, her birth experience doesn't reflect a moderate position. She had to be transferred to the hospital because she had a postpartum hemorrhage and would have certainly died otherwise. So according to Fowler, she isn't extreme because her distaste for the medical setting isn't so severe that she's willing to die to avoid it. That's a pretty low bar for extremism. 

She makes a point of saying she chose an "un-medicated" birth, but then used a whisky sour to help ease the pain. So in her view drugs designed to ease the pain of contractions and dispensed by medical professionals are undesirable, but hard liquor is just great? I'm not faulting her for the whisky sour (I've been in labor without pain meds for 24 hours, I know what that feels like), only the hypocrisy. 

Even though the headline of the Huffington Post article includes the word "messy", nothing messy is actually shown. The series of photographs show a beautiful, pregnant woman enduring great pain with dignity and ending up in a naked embrace with her newborn son. Then, suddenly, there is a jump to a couple of photos of mom and baby (hauntingly gorgeous) in the hospital, and the statement: 

… Nye was occidental [sic] posterior. He flipped to come out but shoulder dystocia ripped me apart. Then the placenta wouldn’t come out – some medical termI don’t know – which basically mean, it tried to detach and ripped more of me out! So I lost over half my blood and got transferred by great emt’s [sic] after the birth.
Felt awful but now recovering in UCLA Santa Monica on a TON of fentany1 (it kicks ass!) and blood transfusions and will be back home with Jared and Nye Soledad Iorio tomorrow. This mad experience Just reiterated how goddamn crazy birth is…
I don’t want to be an ass but this experience has taught me birth is beautiful and primal and mysterious and painful as ****. Thanks to my amazing midwife Racha Tahani Lawler for getting me through that, and her assistant Tanya and my brilliant doula Allegra Hill.

At this point my mind is screaming, what the fuck!? Does Huffington Post not realize that the messiest (and also terrifying) part of this birth experience has gone completely undocumented and downplayed? On her blog The Skeptical OB, Amy Tuteur lists crucial elements of this experience that have been omitted from any photographic or written documentation, including: 

Where is the photo of the postpartum hemorrhage with the blood pouring from between your legs?
Where is the photo of your husband’s face, horrified and frightened, as it dawns on him that you may bleed to death and leave him as a widower with a new baby?
Where is the photo of the EMTs hustling you out the door, racing against time to save your life?
What I find also concerning (and is noted, too, by Amy Tuteur) is how Fowler makes a point of thanking all the people who made her feel warm and fuzzy, but then neglects to thank the doctor/s and other medical staff who literally saved her life. Just as she wanted to give birth at home because that environment was one she "cared about", the midwife, her assistant, and doula are people she cares about, and the medical staff are to be treated as cogs in a machine. 

Little sis tries on big sis's lab coat.
A lot of people complain about the poor bedside manners of doctors as if the rift of contempt and distrust that often exists between doctors and patients were all the fault of one side. And as if things like a jolly bedside manner are worth a damn when one is lying on a table bleeding to death. 

This really gets me on a personal level since I am someone who attempted a totally natural childbirth with my first kid and vaginal birth with a CNM. (Neither were homebirths. I view homebirth as a reckless choice.) With both labors I experienced complications which ended with necessary surgeries. In the case of my second child I had a uterine rupture that threatened the lives of myself and my child. 

And I'll tell you what, while I appreciate the care I received from the very professional CNMs who did my prenatal care and were there with emotional support while I was in labor, I damn well feel immense gratitude toward the skilled obstetricians - both stern, serious-looking women - who opened me up and got my babies out safe! 

Sure, Fowler's not saying other people should do things the way she has chosen to do them. But she is romanticizing her experiences and then allowing that prettied-up narrative to be presented as reality. For a writer using documentation supposedly to better understand her own experiences, she seems utterly oblivious to the irrational prejudice she has against the medical establishment. 

My daughters may grow up to enter any number of careers. Right now my four-year-old wants to be a ballet dancer and painter, either of which would be amazing paths to follow. I certainly don't discourage those interests. But if either of them happen to grow up to be a stern, serious-looking obstetrician who saves the lives of women and babies, I'd be as proud as if they were Martha Graham or Louise Bourgeois

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