Silence Is The Enemy

I've never been raped, never been sexually assaulted, never been inappropriately touched even. In all honesty, I have never been nervous walking to my car at night, in a deserted parking lot or on an empty street. I've never been concerned about a man or women staring at me in a restaurant or the coffee shop - honestly, I'm pretty oblivious to that sort of thing.

I have however, been the object of wary, nervous glances from women who happened to be walking on the same deserted street I was. I have been an object of fear, because I am a guy and in certain circumstances women should be assuming that I am a potential attacker. Actually they shouldn't, because reality shouldn't require it - but it does and as long as it does they should. I hate being thought of that way - being the type of person that I am, that is the last thing that any women should fear from me. But that's the reality in which we live.

Rape happens here in this corner of the western world. It happens all too often and while we as a society don't approve and indeed consider rape repugnant and vile, women still need to be wary of strangers on the street. Because whether the assault was instigated by a stranger or, more often, by someone the victim knows or is related to, I doubt anyone reading this doesn't know a women who was sexually assaulted - most of us probably know men who have been as well. Even in our western society, with western mores, there are a lot of sick fucking people who do sick fucked up things to other people.

But at least in our society, this behavior is considered vile and repugnant, the perpetrators pathological.

In many other cultures, in other parts of the world this is not the case. Nicholas Kristof of the New York Times writes of post-civil war Liberia, where rape has fallen off from 75% of Liberian women being raped during the war. Now the figure is around 12% of "women" seventeen years old and younger being raped - with 33% of those being inflicted on children twelve years old and younger. And this story is echoed all over the globe, in cultures that just accept it as a matter of course.

From Congo, to Darfur, all the way into Latin America, there are places where one can assume that any women you meet over the age of twenty has probably been raped - violently. Those who have not are the exception. And unlike the U.S., the UK, Germany or any other western nation, these women don't have the support of counselors, law enforcement or anyone else outside of their own families and sometimes not even there. It's life and that's that.

Sheril Kirshenbaum and Dr. Isis have teamed up with Scicurious, Tara Smith and Jessica Palmer, in donating their blog income for the next month to Doctors Without Borders. Sheril Writes:

The goal is two-fold: Raising funds and–arguably more importantly–awareness. Since blogging revenue increases with traffic, we hope to get people to keep coming back for more information about what’s going on and thinking about how to make a difference. Do not feel obligated to donate, but it’s one idea. There are many ways to contribute: Write and email Members of Congress (Congressional Directory here), speak at community meetings, encourage others to get involved, or donate to our chosen charity (Doctors Without Borders). Help us maximize our donations by visiting Isis, Jessica, Tara, Neurotopia, and returning here often because every click will help raise money. Spread the word. We want to make sure elected officials at multiple levels realize this is a global issue that matters to a large voting constituency!

There is always something we can do, even those of us who haven't money to help with. If you have a blog, write about this. Whether you do or not, write to the people on your email list - send them to Sheril's blog post, or that of anyone else who's written about this. Hell, copy and paste this whole entry and send it to them. Write your local and federal politicos and pretend they're actually good for something. Talk to the student affairs office, or it's equivalent at your local educational institutions and see about having someone in to speak about it - or even do some research and ask if you can speak. Public libraries are also a good place to try to have a speaking engagement of this sort. Be creative - if you have other ideas, leave them in comments or email me with them.

And if you do choose to write about this at your own blog, email Sheril at srkirshenbaum@yahoo.com and let her know. For that matter, let me know too and I will do my best to put up links as well.

I discovered Sheril's post via Greg Laden's post on this - well worth reading.
And here is a list of bloggers stepping up...Soon to be in Sheril's sidebar.

CAM, Anti-Vax loons and the Morons at Merck

I am more than a little pissed after reading this post, which I found through Greg Laden. I am pissed because I have become increasingly involved with fighting non-evidence based medicine, mostly with people around me. I don't really write about it much, though I have begun thinking that I should. I haven't really felt the need to, because there are a lot of great medical bloggers out there who do such a fantastic job of it - several of whom are linked in my sidebar. In particular, Orac, PalMD, Mark Hoofnagle and the great people at Science Based Medicine do one hell of a job tearing down the veneer of crap and exposing it for what it is.

Here's the issue I have. I'm a reasonably intelligent person, a bit above average even. Yet I am also what I like to call, pathologically credulous. I have fallen into remarkable amounts of magical thinking over the years and not because I'm dumb. In fact part of it is because I tend not to assume that something is true, just because everyone else says it is. And my relationship with non-evidence based "medicine" was largely grounded in the idea that evidence based medicine is largely profit based and therefore largely corrupt. What wasn't so apparent to me at the time, was that a lot of the bullshit that I was falling into was just as profit based and much of it was even more corrupt - though much of the corruption was a very different sort. I also fell into a lot of the bullshit because many of the claims were made by people who also made claims that were easily verifiable - they fostered my trust and I believed what they had to say about things that weren't so easily verifiable.

And that is the key to sucking people into so called alternative medicine. Efficacy by association. Throwing plant medicines that actually have some degree of efficacy (largely because many pharmaceuticals are derived from plant sources) into the mix, even though this can actually be quite dangerous in some cases (a whole post of its own sometime). Throwing legitimate medical treatments in, but using them for things they simply aren't called for - such as chelation therapy. It makes it easier to sell people on flat out bullshit. Things like osteopathy, homeopathy and energy medicine - things that are not only not supported by evidence, but which are flat out absurd on their face. Things that are based on nothing more than magical thinking.

It's bad enough that some of these "medicines" can be dangerous in and of themselves - either because the actual treatment is harmful, or more often, because the treatment is used in place of evidence based medicine. But it doesn't stop there. There is a very dark side to this, with insane and deadly notions like HIV/AIDS denialism, denial of the germ theory of disease, the anti-vaccine movement and anti-chemotherapy proponents. People actually die because of this complete and utter bullshit.

Another reason it is easy for some people to fall into magical thinking in regards to medicine, is because of the perception that evidence based medicine is mostly based on therapies developed by corrupt pharmaceutical companies. Most people don't start out believing that, but I think that most people do recognize that pharmaceutical companies and for that matter, medical science in general, is not immune to corruption. And I think that most people recognize that sometimes that corruption includes maliciously covering evidence that companies wish to avoid becoming public. This makes it rather easy for some people to buy the CAM line that critics of CAM and even fringe CAM ideas, are simply shills for Big Pharma - an evil bogyman that's out to addict people to their medicines and cast them aside when they've been poisoned by them. From there it isn't much of a trek to believing that all evidence based medicine is evile and that doctors are merely merchants of death, the death manufactured by Big Pharma.

This is why I am so very angry at Merck and the doctors that contributed to their advertising rag, disguised as a legitimate science journal*. The doctor involved should should face sanctions. And Merck should be fined heavily by the FDA. Things that would happen, if we lived in a reasonable world, in a reasonable country with reasonable oversight. There is something very wrong with a system where this can happen and the people involved don't even understand that they did something wrong. This is absolutely and categorically disgusting and unconscionable.

But the idea that this somehow validates the proponents of woo, the peddlers of magical thinking in the guise of medicine, is a logical fallacy and a rather obvious one - if not also one that is easy to accept. Just because another pharmaceutical company and some doctors were really damned stupid and highly unethical, does not mean that all of science based medicine is. And there are several doctors and scientists out there who would like to make sure you know that this is not the mainstream of science based medicine. Some of them have even written about this....


Respectful Insolence

Adventures in Ethics and Science


Dr. Isis

Stranger Fruit

Greg Laden

*I would also note that I am more disappointed in Elsevier for publishing this bullshit, than I am with Merck and the people involved from their end. That they would choose to put out this kind of garbage reflects poorly on them and while it may be a while yet before I am publishing papers, this will certainly reflect on my decisions about where to publish.

Drugs and Children, the Conversation that Never Ends

Abel Pharmboy has a great post up, about the dangers of prescription and even some over the counter medications, that kids use to get high.

Related to the DrugMonkey post, PharmGirl just tipped me off to this Benadryl nightmare at the Sweet Hill (OR) High School. Students have turned up in local emergency rooms after having taken 20 to 30 of the tablets, each containing 25 mg of diphenhydramine.

At high doses, diphenhydramine's central antimuscarinic effects become apparent as hallucinations but this is a terribly risky approach. Suppression of parasympathetic drive to the heart can cause tachycardia and lead to fatal cardiac arrhythmias. The story is deeply concerning...

He then goes on to describe the problems with a couple other commonly abused medications, well worth reading the entire post and comments. Towards the end of the post, he poses a very important question;

But it's stepping over the line to tell them if they're going to choose any illicit behavior, there are far safer alternatives.

How do other parents ethically approach this conundrum?

First I would like to comment on the very notion that it's stepping over the line, to tell children there are far safer alternatives.

One of our very important responsibilities as a parent, is to do everything that we can, to ensure they survive childhood. The point that we decide that something this important is off the table, is the point where we really start to gamble with the lives of our children. Kids are all individual, different beasts. They each have unique needs, what works for one child, won't work for another. Thus it is important to recognize that one needs to tailor this discussion, to the needs of their child – also realizing that the approach you take with one of your kids, may not work for the next one that comes along.

This is much akin to the discussion of sex. It's a hotbutton issue, with no easy answer. But just as we gamble with the life and well being of our children, if we refuse to teach them about making sex safer, we also gamble with their lives, if we just say no. It is not telling your child it's ok, to make them aware of ways to keep themselves safer. But we owe it to our children, to give them information that can and probably will, keep them alive and safe.

While every kid is different, there are some very standard, near universal steps one should take, when making their child aware of the dangers of drugs. Most of this also applies to every single hotbutton issue we should discuss with our kids.

Honesty – Always

This cannot be emphasized enough. There is nothing more important, than always being honest, when talking to our kids about sex, drugs, dangerous activities or any hotbutton issue. Never, ever lie about anything. Never even exaggerate anything with them. Always be honest with your child. If they ask a question your not comfortable answering, at the very least tell them your not comfortable talking about that. The best policy is to be open with them, occasionally telling them you will be happy to discuss it when they are a little older, if it really isn't age appropriate. But if you just can't bring yourself to respond, then have the courage to tell them that.

The point that we start to lie or overstate the case for something, is the point that we lose all credibility about that issue. Do it enough and we lose credibility all together. For a good many kids, the credibility we are talking about, is a lot easier to lose, than it is to ever regain it, should it be lost. If the goal is to have a child that is confident and comfortable with bringing up any and every topic they wish, then this credibility is essential. We throw that away at our own peril. More importantly, we throw that away at our child's peril.

Get Your Facts Straight

Do not approach the topic of drugs, without doing your homework. If, like me, you have personal experience to draw from, by all means use it. Even if your experience is limited to only small aspects of the discussion, they are far more valuable than anything else you will bring to the table. First, this is establishing credibility. They know you're being honest, when you discuss your own failings, or even less dire experiences, with licit or illicit drugs. Too, they place a lot more value on your actual experiences in life, than they usually let on.

For those with less experience, or even those with a lot of them, read and question people who've been there. Don't depend on sites the government provides. Read a wide range of information, from different perspectives. Call organizations such as narcotics anonymous and even alcoholics anon. Tell them you are interested in finding someone who can talk to you and your kids about substance abuse. I can virtually guarantee that they can and will be very keen on helping you. The perspectives of people who have lived the worse of drug use, are extremely valuable.

But the most important aspect of this, is to never overplay the very worse of consequences. Talk to your kids realistically. Taking alcohol as an example; Focus the majority of your attention, on the potential consequences to their bodies development, especially the brain. Make it clear that in their early to mid twenties, the consequences of having a drink, are far less dire. The brain is pretty well developed, having a drink or smoking a little pot, is going to do far less damage. While the brain is still developing, THC or alcohol (not to mention a whole lot of different drugs) will inhibit proper neurological development. It may not translate to significant loss, but there is no getting around it, they will impair neurological development.

Use Realistic Risk Assessments

Yes, you are right in sensing a theme here. But it is critical that we make sure we use the best possible information. Risk assessment, is where a lot of drug campaigns really falter. They want to scare kids out of using drugs, so the focus is on the very worse potential consequences, consequences that are the least likely to be observed by the child. Meanwhile, the milder, but far more common consequences are virtually ignored.

The thing is, most kids, unless they are sheltered to an extremely unhealthy degree, are going to observe the milder, more common consequences of various sorts of drug use. The more dire consequences are less likely to ever be observed. Focusing more on the realistic, provides another source for the credibility that is so important.

To take an honest risk assessment approach, means that you will be telling your children that there are safer, albeit still dangerous alternatives out there. Such as, you will be telling them that smoking pot isn't nearly so dangerous as huffing canned air or gasoline. You will be telling them that freebasing cocaine (crack) is more addictive and dangerous than snorting a line of cocaine. You will be saying that it is far safer to only drink where it is safe and stay there, if they decide to drink, instead of following their parent's advice. Because always, above all else, we have to focus on safety first.

Do Not be Afraid to Tell Kids How to be Safe

We can be clear that something is a bad idea, while maintaining that there are things that can make certain activities far more dangerous than they inherently are. To tell a kid to use a condom if they are going to have sex, does not have to mean we condone them having sex. Likewise, telling a child the difference between smoking crack and smoking a joint, is not telling them they should go smoke pot. What we are doing, is refusing to gamble with our children's lives.

The consequences of having unsafe sex, can be as bad as death, or at least a horrible, ravaging disease. The consequences of using various substances to get high, can also be as bad as death. There are all sorts of potentially dire consequences, to all sorts of activities. There are also ways of reducing the potential for the very worse consequences, for any number of activities. Some people, in the name of ideological or dogmatic purity, feel the need to take an abstinence only approach to all of these topics. They want to make it as simply black and white. Then they trust that there kids will just do as they are told and abstain.

This is nothing less than gambling with your child's life. You are doing nothing less than throwing your child to the wolves, without the least bit of protection. You make them vulnerable to perfectly natural impulses they may be unable to control. If they are going to break down and have the sex, they're going to do it. Statistically, it is far more likely they're going to than they're not – no matter what try to teach them. Likewise, it is entirely likely that they are going to use some sort of inebriant, some time in their youth. The only question becomes; What sort of risk assessment are they going to use? Because if one's just as “bad” as the rest, one of the easiest ways to get high, is using highly toxic, very dangerous inhalants. They are bar none, the easiest to get their hands on.

Build Confidence

The more confident the kids, the less likely they will fall prey to peer pressure. Peer pressure is a huge part of using various substances. Most dangerous, it takes the control out of the hands of our kids, and gives it to their compatriots. By themselves, our kids are probably in pretty good shape for staying safe and listening to us parents. It's when they feel it's more important to fit in, than to be safe (or safer), that they really can get into the worse trouble.

Start Early

It is never too early to talk about the hard stuff. Make it a habit from the git go. We first discussed drugs with our son, when he was three. He saw a friend of ours rather drunk and the conversation began. A few months later, we saw someone smoking crack in the streets. When he was five, he actually had quite the q&a with a guy he saw hitting a crack pipe. He has also talked with a friend of mine, who has been dealing with some serious substance abuse issues for much of his life. We started with very general, very basic ideas and haven't progressed far beyond them. But we have begun the habit of talking about drugs and inebriation. Likewise, we have done the same with topics such as sex, bigotry, hatred, environmental issues, social issues. It doesn't take much, but with even the tiniest foundation, you pave the way for talking about it when these issues become very relevant to your child.

Showing them you have the courage to talk about difficult issues, also makes it more likely they will want to involve you in their decision making process. As much as I would love to see my children retain their virginity until they are secure, mature adults, I would settle for them being comfortable asking my advice, when they decide they are going to do it anyways. Likewise, I would love to see my boys forgo smoking pot or drinking, until they are much older, if ever. But I will settle for them talking to me about it, before they decide to do those sorts of activities. Remember, if they don't feel they can trust you, they aren't going to talk about it. They will however, likely make decisions you aren't going to like anyways – you just won't know what it is.

This means biting your tongue. It also means standing your ground and making it clear what the consequences are likely to be. It means knowing your child well enough to know when they are likely to do something dangerous and when you just have to bite it and do what you can to keep them safe while they do it. Because it may be the difference that prevents them from transmitting HIV, or means they have a beer instead of dying with a can of air freshener in their mouth. Most importantly, it means making sure that they never have to question your love for them, no matter what they choose to do. Let them know when you are disappointed, but never let them question your love. Like your credibility, if they question the love, you've lost important and hard to restore ground.

There is plenty more involved with this topic. I would love to go on about it far more than I have here and may well do so, but these are what I consider the most important keys to keeping one's children safe. For certain, they are pretty universal.

I am also going to just have to admit that it is unlikely I will get to a lot of things any time soon. We just have a lot on our plates and things aren't slowing down anytime soon. I will keep up posting as much as I can, but please bare with me, it will be slow.

Sorry about the silence

Complete and utter chaos, would be an understatement. Life is absolutely insane these days. But I do have several issues that have been grinding at me, that I hope to hit on soonish. Not sure what the priorities will come out as, but here are the topics;

The abolition of marriage as a civil institution, beyond marriage equality for GLTs. More and more, I am finding that I am far from alone on this. I have a lot to say on this issue, but in short, even allowing gay marriage, would still restrict marriage rights to those who are in, or are willing to claim to be in a romantic relationship. I for one, find this ridiculous.

The absurdity of simplistic dichotomies (to steal a phrase from my brother). As the primaries are getting into full steam, the stench of partisan politics is enough to make the strongest of iron stomachs retch. From republicrats, to the conservative/liberal dichotomy, where do I fit in? Where do you? When you really think about it, do the labels we are pegged with really fit, even if they are self imposed? I am prochoice, progayrights, for ending the drug war and believe in a comprehensive, if a not so comfy welfare state. I am also progun, fiscally conservative and dead against affirmative action.

Private security contractors in America. Another topic my bro has written a lot about lately, I would like to hit on it from a different angle. Though this article does a particularly great job of expressing what the America with PSC's might look like, I think it's important to look at where they already are. Do you have PSC's operating in your towns business district? Portland does and it is a problem.

The War on Vice. Because gods know, the guy down the street smoking a joint is causing irreparable damage to your lifestyle. Especially if he has a hooker once in a while. And that friendly poker game in his basement once a week, how dare he skirt the state and native monopoly on gambling. So lets spend billions upon billions annually, persecuting these folks. Lets continue to incarcerate a larger percentage of our population than any other country* in the world. Yeah! We're number one!

*Keeping in mind that China tends to execute, rather than incarcerate. And they're not alone.

There are these and more. Including more on ADHD, bipolar and neurodiversity. More discussions of rights in the abstract. More thoughts on euthanasia. More about denialism. And a discussion about about CAM "medicine" and a (hopefully) soon to be published print article, by your's truly. Indeed, if all goes well, I will have a print article out, about the HIV/AIDS denial (and denialism in general) as well as the CAM article.

So what do you think I should focus on first?

By and by, my baby has discovered the things that flop around him are hands and he controls them. He has also started smiling and giggling, though the giggles are rather a disturbing sound. Unfortunately, he seems to have some distaste for the camera, so the smiles are yet unrecorded.
Homeschooling is definitely starting to come together, though it is slow and unweildy as of yet. But we have found even more resources and are starting to get a stride.