Health Care and my Fondness for Fingers and Toes

As a Canadian who has been spoiled with free health care my entire life, I have often been given to wonder whether the constant availability of doctors has made us into a nation of hypochondriacs. But when I compare my predilection to err on the side of caution with a system that allows a 12-year-old boy to die of a toothache (Washington Post Article) I start to think that we’re doing okay.

There have definitely been times when I’ve wasted the government’s money. For example, I probably could have stayed home that time when I *ahem* lost my tampon. Also, I’ve had more than a few panic induced calls to 9-1-1 when I was sure I was dying of nut allergy. There are other times, though, now that I think about it, that me dragging myself out to emerg was the right choice, even when I wasn’t even sure of it at the time.

I worked in a kitchen for two summers, and since I’m a perpetual klutz, I ended up slicing my hands up on more than one occasion. One time in particular sticks out in my mind – I had been using a paring knife in an entirely inappropriate way and ended up cutting a line between the second and third joints of my ring finger. It didn’t look so bad, just like a surface wound running diagonally along the top of my finger. It wouldn’t stop bleeding though, and soaked through bandage after bandage to the point that my Chef asked me to go home.
Heading home, I kept my finger elevated and by the time I drove past my house there was blood down my arm. I slowed down at my side street, but decided I may as well get it looked at. I had some medical tape at home, so I seriously contemplated just driving home and taping it up.

The wait at the clinic was joyfully short, but the receptionist was a little skeptical that I needed to see the doc for a cut finger. She was finally convinced by the amount of blood and a nurse put me into a room pretty quickly. When the doctor came in, he took one look and told me that I was going to need lots of stitches. I actually still disagreed that my finger even needed the work, after all, it didn’t hurt all that much and even though it was bleeding a lot, it just looked like a cut on the top of my finger.

It only took him about ten minutes to sew me up, and I didn’t bother going back to get the stitches out (tweezers and some scissors worked fine), when I saw the scar I realised what a good call it had been for me to go to the clinic – the scar actually started underneath my finger, and the slice had gone right through my finger, nicking the bone.

If I had lived in the States, it’s entirely likely that this would have been covered by some sort of worker’s insurance. My sister lives in the US though, and not getting going to the doctor’s office is more a state of mind. She doesn’t have insurance and even when she’s in Canada and fully covered, we can’t get her to go to the doctor’s for anything.

In a similarly digit-related incident, I had an interesting experience with faulty bandaging and a hematoma after some surgery on my leg went wrong. My toes started to go numb, and since they’d wrapped my leg so thoroughly and so tightly, there was no way I was going to be able to get through the bandages and plaster to check on my foot. By the next night I had lost all the feeling in my toes. It didn’t hurt or anything, just numb.

My mom took me to the emergency room at the nearby hospital, and though it was the grubbiest hospital I’d been at since I nearly died in British Columbia, the doctor was really nice, and he told me about his time working as a doctor in rural China while he cut the wrap off my leg. He ended up having to pry the hardened gauze off of my foot – my surgical incision had bled so much that the blood had fully saturated the gauze and it had gotten steadily stiffer to the point that it had cut off all the blood to my toes.

After all the great adventures-in-China stories, during which he cleaned the area and redressed my leg using a less-likely-to-harden gauze and some plaster to protect the damaged bone, he let me know that if I hadn’t dropped by, even if I’d waited until morning, I probably would have lost my toes. Scary thought. I like my toes.

Nothing life threatening, but I do think I would have been less than pleased to be living my life with nine fingers and five toes. My skiing would have suffered. Also, getting married without a ring finger may have been awkward. There are lots of times when people don’t realise the full extent of their injuries, or don’t know enough to guess the implications of their symptoms. Especially with the swine flu going around, when a fever and diarrhea could spell death, I’m much more comfortable living in a country where I don’t have to worry about draining my bank account for a false alarm. Instead, Canadians can go to the hospital, don a free hospital mask and have their health verified on the government’s tab.

I mean, taxes suck, but I think it's probably worth it.

Marion Bethel and the Art-Life Conundrum

The last time I went to a literature reading was years ago, when the brilliant J. K. Rowling blessed Toronto with her presence. It was a record-breaking event, securing my (though anonymous) immortality in the Guinness Book of World Records. This was a decidedly different experience.

This was an intimate occasion, with no more than thirty of us packed into the tiny New College Women's Lounge. She stood on the same level as us, with a small podium to hold her work and a chair for her to sit in after the reading. Dr. Christian Campbell, a professor at the University of Toronto in the English Department, gave the standard introduction ("Marion Bethel is a Bahamian poet, fiction writer and feminist activist...") before delving into his personal history with the artist.

When Bethel was given the stand, she was just so shockingly humble; she spoke some more about Dr. Campbell, and then proceeded to personally thank nearly every member of the audience. It soon became clear that this was a reunion for her.

Bethel immigrated to Canada at the age of ten, sent to boarding school in Toronto by a father who wanted a better life for her. Many of the people at the reading last night were people who had helped her to become accomidated to Toronto: the family that took her in as one of their own, the teachers who fostered her talent. She was also joined by her contemporaries -- other Caribbean writers, artists and teachers. The atmosphere in the room was comfortable and familiar, and those of us who were not formally acquainted with Bethel soon settled into the feeling of intimacy between audience and performer.

She then proceeded with the dedications, during which she was very emotionally moved. She spoke about her mother, Jane Bethel, who is afflicted with Alzheimer’s. Bethel revealed that her mother's spirit anchors much of what she does and fuels her poetic journey. She dedicated the reading as well to the memory of her father, and she noted that his legacy continues to unfold in her life. She also spoke about the aforementioned foster family, who gave her refuge when she first came to Canada and introduced her to the culture that her new home had to offer.

Her readings were done from her newest manuscript, Bougainvillea Ringplay, and it was such a privilege to be given a glance at the brilliance of this work. Since her first book, Guanahani My Love, she has adopted a more jazzy tone, leaving the more formal structure of sonnets and quatrains. Her newer poems took more risks and certainly had more erotic undertones. I'm not sure when the book will be released, but I'm hoping it's soon!

One of my favourites was the first poem she read, called "Tobacco Dove". She introduced it by explaining that a tobacco dove is a species of dove found in the Bahamas; it is brown with a black ring around its neck. Bethel described a memory of the dove that had stuck in her mind -- of when she was taking a walk and saw a woman cradling such a dove, stroking it and trying to coax it to fly again. The poem was told from the first person from the dove's perspective, and was an ode to the desperation that comes attached to being no longer able to do what your body is built to. It had a thread of loss throughout it, and also a sense of defiance.

The next poem that really connected with me was called "Sweet Chariot". As an introduction, Bethel described a young man she had met while she was working as a lawyer in the Bahamas. She was attempting, on appeal, to get this man off death row. He was in his early twenties, and had been in jail since he was 18, but asked her to give up the appeal -- he had made his peace and was ready to die.

This poem was an emotional performance, painting a picture of a man dying by hanging. It was peppered with onomatopoeia and the sense of rapidity, "quick quick", "high high" and then finally "snap". Bethel combined the descriptions of death with shocking erotic images which forcefully conveyed the sense of disparity, the paradox of the situation. His life, she explained, brief and violent though it had been, was far less terrifying than his death.

The poem which, I personally felt, best conveyed her own personal history was the poem "In the Marketplace". It reaches deep into Bethel's memory, to the time when she was sent away to Canada by her father. It reveals how the purpose of her move was to "buy her a new tongue" and shows the regret and sorrow she felt when she lost her accent and characteristic hip-swinging walk. The poem moves through her crisis of personal identity by evoking the image of a marketplace and shows how she felt commodified by the decisions her father made for her. She was being sent for a new tongue. The question inevitably raised is, what was wrong with her old one?

The interview after the reading revealed a lot about her motives in writing poetry, about the class distinctions which shaped her life and the aesthetics of her poetry and how her writing continues to evolve. She spoke about the other artists who influenced her throughout her life and the activists who inspired her. It was truly an illuminating performance; it was honest and felt raw, unstaged. The way in which she was able to find her literature through her career as an attorney really came through to me; so many of us have to fight so hard to find time for our art. For those people who are truly gifted, such are Marion Bethel, no matter where circumstance and politics place them they will always find themselves guided back on the path towards their art. Bethel is taking a hiatus from law now to focus exclusively on her poetry, and I, for one, am thankful for it.

Event: Marion Bethel at the Women and Gender Studies Lounge, 2nd floor, New College, 20 Willcocks Street at the University of Toronto. Thursday October 15, 2009 from 6pm - 8pm

The Nobel Peace Prize and the Highly Confused Masses

The Nobel Prize Laureates have been a pretty exciting bunch this year. From Herta Muller, one of less than a dozen females to ever win the Nobel Prize for literature to the winners of the Prize in Physiology or Medicine, the first time two woman have ever received the prize. But I think that the choice for the Nobel Peace Prize is going to make the most noise: newly elected President of America Barak Obama.

At first I was shocked at the news, but I was kind of okay with it. Then I started thinking about other people who might have deserved it more -- Zimbabwe's Morgan Tsvangirai for example. Here's someone's who's been an activist in his country since the age of 20, who had to deal with (maybe) rigged elections and extreme violence towards his supporters before he was finally able to come into power in February 2009. He brought democracy to Zimbabwe after generations of violence and dictatorship with little support from surrounding countries.

Obama has only been in power for 9 months, which is a full month longer than Tsvangirai. He had a whirlwind campaign in which he made promises (as politicians do) and people believed him (as people do) enough to elect him. Nothing against the guy, but he hasn't managed to get the American troops out of the Middle East, and his big-deal health bill hasn't even been voted on yet. He hasn't passed any foreign policies which were successful either. So what's he winning for, anyway?

"his extraordinary efforts to strengthen international diplomacy and cooperation between peoples."

Fair enough.

Now, this might be a bit conspiracy theory of me, but I think this might be a bit of an insurance policy on the part of the Norwegian Nobel Committee. It is one thing to make promises and wave your arms around and talk about nuclear disarmament, but it is another to be given the equivalent of $1.4 million dollars for it. It's not a lot of money in American government terms, and I have a feeling that Zimbabwe could have used it more, but it means something.

The Nobel Prize is one of the highest honours that a person can win. There's a long history of the Nobel Committee choosing people who have already made a difference to the world: Marie Curie and the discovery of radium, Fire and Mello for RNA interference, Ernest Hemingway...

But this time, they made an anticipatory selection. By giving him this prize, especially for his ideas of global nuclear disarmament, they are putting their support behind an idea of a unified and nuclear-free world. And if his Nobel Bio one day reads, "won the Prize for his amazing vision for the future... which unfortunately did not exactly turn out how he told us it would." It would really suck.

Source:
Reuters. "U.S. President Obama wins Nobel Peace Prize." National Post. 9 Oct. 2009. Web. 9 Oct. 2009. .

HIV Vaccine and the Kind of Happy Scientists

In a tentatively optimistic article, researchers report that in Thailand a study has just finished testing a vaccine that lowers the rate of HIV infection by 31.2%¹. They modestly point out that the vaccine is safe and that it shows some effectiveness. I, on the other hand, find 31.2% an extremely exciting number – it’s not 100%, nor even close to 100%, but when you look at the big picture, even a sort-of-successful trial such as this one should be reason for celebration.

First of all, this isn’t an AIDS vaccine. They’re working on those, too; in Science they just published an article last week about a “surprising” AIDs vaccine which is currently being “pondered” (if only I could gain access to that article! I’ll hack you yet!). An AIDs vaccine is something that the 7,397 people who contract HIV each day are hoping for². And I really hope they find it, but an HIV vaccine offers something more.

If we ignore the social issues which accompany the idea of mass dissemination of an HIV vaccine (such as monetary shortages, etc., etc.), then a vaccine, such as this one, which is currently only 31.2% effective still has staggering implications. Instead of 7,397 people being infected every day with HIV, that number would be closer to 5089.That means that each year, 842,420 people would be saved from contracting HIV.

So maybe it is not 100%. And, despite the vaccine’s promise, it doesn’t actually reduce the viral load in those who do contract it¹. This means that for the 51 people in the study who actually did contract the virus while on the vaccine, there was absolutely no benefit for having been on the medication. It’s an all-or-nothing situation it would seem, though their proof-of-concept study 6 years ago demonstrated its ability to lower the HIV virus count of those infected.

But it’s the positive results that count. Based on the scale of the HIV/AIDS pandemic, numbers really are important. Had this vaccine been distributed throughout the world a generation ago, then 10,296,000 people (31.2% of the 33,000,000 million² people currently living with HIV/AIDS) would not be infected. This vaccine doesn’t stop, or even slow, the process of HIV to AIDS to death, but instead halts this process at its very beginning – contraction. 31.2%? Well, with more research that number is only going to get better.

The science side of things is well on its way. Now we only have to figure out how to make it affordable. How to make sure that people take it properly. How to convince those religious folk that preventing STIs isn’t going to make our little girls promiscuous (I’ll see your condom and raise you a Gardasil!). How to distribute it to people without health insurance. How to get it to Africa, where an estimated 75% of world AIDS deaths occurred in 2007².

Oh silly social issues. What are we going to do with you?


EDIT: was able to nab that Science article. It's reporting on the same study: the "surprising" result was that though clinical trials showed it was likely to reduce viral load *(mentioned above) and therefore protect against AIDS, instead it protected against HIV. Hmm. That is something worth pondering.
(HIV/AIDS Research. Jon Cohen (2 October 2009) Science 326 (5949), 26. [DOI: 10.1126/science.326_26]))


Sources

1.  "HIV Vaccine Study First to Show Some Effectiveness in Preventing HIV." AIDS Vaccine Week (Oct 5, 2009): 11. General OneFile. Gale. UNIVERSITY OF TORONTO. 8 Oct. 2009.

2.  UNAIDS, Report on the Global AIDS Epidemic, July 2008 .