16 December 2014

Fear of Side Effects / Call Me Superwoman

Theorists of disability have very rightly criticized the "medical model" suggesting individuals should be rehabilitated, normalized, fixed, in favor of a social model calling for modifications to the built environment that avoid putting, as Leviticus forbids, a stumbling block before the blind, or, for instance, stairs when a ramp or a sidewalk-level entrance would allow more equal access.

My experience of disability, however, involves interactions with the world that are hindered by exacerbations of chronic illness, typically asthma attacks triggered by upper-respiratory infections that for most of the people who catch them are at worst an annoyance, as well as by life-threatening allergies to things that other people aren't in the least bit bothered by. Or that they love, like mushrooms and cats.

Building streets with curb cuts and buildings with ramps as a matter of course is an obvious act of inclusion. Eliminating smoking in public areas to help everyone avoid upper airway disease is a no-brainer. But object when Edinburgh University gives a cat a library card or a cafe owner opens the premises to cats, and you might get death threats.

Actually, I'm not interested in challenging anyone's right to consort with cats, though if a friend has a cat, I can't visit, ever, and The Mate hasn't eaten mushrooms at home in years. I am trying to make the point that the idea that disability is a socially constructed phenomenon, rather than an individual problem subject to remediation, is problematic in my experience.

Chronic illness seems to depend upon a medical model. The wheelchair icon and the understanding of disability as constructed by exclusionary social practices both suggest that disability in individuals is stable. But chronic illness seems to be characterized by flux, whether progressive decline or alternating periods of illness and remission. Medical help, usually in the form of pharmaceuticals, can delay decline and treat attacks and exacerbations. Sometimes medicine is needed to keep a person alive long enough to recover and return to remission.

If there were a pill that made my allergy to cats go away? I'd take it in a minute.

Actually, there is such a pill: prednisone.

The problem with prednisone, as with many other medications people take for epilepsy, asthma, depression, crohn's disease, rheumatoid arthritis, and multiple sclerosis, to name just a few, is side effects.

Maybe a medication is extremely effective in treating a symptom, and the side effects are so minor, that it's not worth worrying about.

Maybe a medication works like that for most of the people who take it, but for a small minority, it turns out to have life-threatening effects.

Maybe it wasn't anticipated during trials that a lot of real-life people taking the drug under investigation would also be taking another medication at the same time, and the interaction between those two medications would turn out to be potentially lethal.

Maybe the test population didn't include any women, because women's hormonal cycles were long thought to screw up the results, and the drug turns out to be more effective in women. Or less effective.

Drug development and testing is done by people in lab coats, with careful measurements of doses, conditions, and outcomes. It sounds like science, it smells like science, it must be science. But real live people turn out to be so different in their responses to medications, including reduction of symptoms as well as side effects, that treating individuals turns out to be more art than science.

With some medications the line between effectiveness and toxicity is narrow. Or non-existent. If I took enough prednisone to eliminate my cat allergy I'd probably have a few great years. Manic years, since prednisone also is known to affect moods; it makes some people depressed and suicidal, but it makes me fly high as a kite. Kind of fun, and I tend to get a lot of work done, but not necessarily what I want when my body needs rest to recover from the infection that triggered the attack.

But then the side effects would almost certainly take over: weight gain, suppressed immunity, diabetes, hypertension, osteoporosis, psychosis, dementia.

Last week, I did a six-mile run and I lifted some weights, as well as other exercise. Monday morning, I woke up so sick I got winded brushing my teeth. I am the stumbling block, or in any rate my lungs are; there's no social reorganization that will change the fact that I need to breathe, or I'll be dead.

Even Harry Potter needed the occasional hit of oxygen during that underwater scene.

So I take just enough prednisone to control the symptoms. I watch as my cholesterol and A1C levels creep up, despite a vegan diet and lots of exercise. I need the medicine; I fear the side effects. As for the mania? I finished a book chapter, outlined another, and wrote two blog posts today.

Call me superwoman.

15 December 2014

What I Can't Live Without: Clean Water

What can you not live without?  A cousin asked me that excellent question after I wrote my last post about minimalism in the kitchen.

I'm on sabbatical at the moment, living in a furnished apartment in the UK, with a tiny kitchen containing far fewer pots and pans and gadgets and appliances than my kitchen, or rather storage locker, in New York.

And even my New York kitchen is fairly small by white upper-middle-class American suburban standards.

I've been mulling over that question for the last several days, because I've also spent a fair amount of time cooking in even more minimal conditions on camping trips.

What I can't live without includes a knife, a cutting board, a pot. But it also turns out to include fresh fruits and vegetables, whole grains, legumes, and some variety of gluten-free flour. Home-made jam and applesauce and thai curries and Indian utthapams and bhajis and vegan soups and stews. Enormous salads. Bowls of cooked greens.

And lettuce and other greens, as I discovered during the lower Manhattan blackout after Hurricane Sandy, require large quantities of running water for cleaning. You can scrub root vegetables in a small amount of water, then rinse with another small amount. Most fruit can do with just a quick rinse, and legumes don't require too much more than cooking water.

But greens -- kale, collards, chard, spinach, bok choy, and lettuce -- I wouldn't want to have to live without those, not for the long term.

We take clean running water casually, so terribly casually, for granted, in North America and Western Europe.  Even as we buy vast quantities of bottled water, we forget that in large parts of the world -- and even in parts of the US -- the water isn't safe to drink or take a shower in.

I am very glad not to have to live without clean running water.

10 December 2014

Fighting for Minimalism

I've lived in apartments in New York City for the past 25 years, and that means keeping possessions to a relative minimum unless I want to pay for storage for stuff that I then won't be able to use ... because, well, it's across town in storage.

Today, I ran across the Haters Guide to the Williams Sonoma Catalogue, which includes this gem:
The Williams-Sonoma catalog will not rest until you need a separate pot for every single goddamn thing you make.
For a while, I owned a crock pot that I'd found in my building's recycling area, with a note promising, "it works!" Since I'm either home all day or out for fifteen hours, I never left the thing unattended, and eventually I came to the conclusion that I could cook more efficiently in -- gasp -- a normal pot on the stove.

By that time I'd moved, twice, paying movers to schlep that crock pot down five flights, up four, back down the same four, and up three. In the last move, I finally after nearly 25 years in New York City moved to an elevator building, but still.

In the end, the crock pot ended up at the Salvation Army. Maybe now some other poor soul is using it based on the promise of better meals than you can make with a normal pot on a normal stove.

But the thing about Black Friday and Cyber Monday and our consumer-driven society in general is that, with the exception of kids moving out on their own, people pretty much already own all the pots they need. And so Williams Sonoma, and for that matter Walmart, need to persuade you that you need MORE pots in your kitchen.

If they can find a way to sell you DISPOSABLE kitchenware, for instance single-use roasting pans or pie pans, then they've hit the jackpot.

It takes WORK to avoid advertising. I regularly make phone calls to get people to stop sending catalogues, but one on-line purchase can mean another whole pile of them. I've installed ad-blocker on my PC, but I still see advertising on my iPad. And internet advertising is a special horror:it takes extra discipline not to click through to the next web site, and the next.

Everyone wants me, or rather my limited amount of disposable income. Another pot, a better cleaning product, another sweater, a new pair of socks, a better health plan. I'm constantly fighting the capitalist barrage of advertising trying to persuade me that I need another item.

And budget considerations aside, it's an environmental issue. How do you fight the good fight?

17 November 2014

Green Christmas

It seems early, but then I want to get this post up before Black Friday. Christmas has become, for many people, a holiday of massively commercial proportions. Hannukah isn't far behind. With the commercialism comes a massive environmental impact. So here are some ideas about how to minimize the impact.

Presents

Consider making gifts, if you can, or buying from a craft market featuring the creations of local artisans, rather than buying on Amazon (with all that shipping and packaging) or Walmart (of the dismal labor record). Think about gifts that the recipient can use and enjoy -- food? -- rather than things that will need to be stored indefinitely.

Food

Food waste is a major contributor to over-consumption, with estimates for how much of our food we throw away ranging from 30 to 50 percent. As you plan your holiday meal, or meals, think about food waste. We all cook extra to make sure everyone will have enough to eat. Can you make plans to freeze leftovers for future use? Make the turkey bones into soup, maybe even with leftover vegetable side dishes?

Packaging

There's the packaging that stuff comes in. Would you consider choosing purchases based on the amount of packaging? Amazon comes to mind again. But making stuff by hand or buying locally also has good potential to reduce packaging. Then there's wrapping paper. We keep a box of used wrapping paper; other families use cloth wrapping bags and reuse them every year; others use the comics section of the newspaper for wrapping.

Travel

With family in Europe and across the US, I travel a lot, and I often end up flying instead of using ground transport, and I often travel by car rather than on trains or buses. So I feel a bit hypocritical including this category. But the point is for everyone to think about areas where they can cut back, and different things will work for all of us. Think about carpooling or, if possible, taking a train or a bus to your destination. Shopping locally can also limit driving time.

Chocolate

The Hershey corporation has made a commitment to ending the use of child labor in its source chains... by 2020. You can end child labor in your own chocolate today by purchasing fair trade chocolate.

Happy holidays, y'all.

03 November 2014

Joseph of the Colorful Coat as Climatologist

A guest post by Bill Menke, October 9, 2014

I would like to use the story of Joseph to illustrate the problems that we scientists experience in talking about Global Warming.  The Joseph that I am referring to is the Biblical character who you might have encountered, either from having read the Book of Genesis, or by having seen the musical, Joseph and the Amazing Technicolor Dreamcoat. Joseph’s story is long and complicated – a fine story to tell around a bonfire in a Middle Eastern desert – but here I am focused on only a small part of it, the part that concerns Joseph’s prediction of an Egyptian famine. The short of it is that circumstances allowed Joseph to guide Pharaoh‘s response to that famine better than any of us scientists have been able to influence our own society’s response to Global Warming. I want to tell you why.

Here’s an abridged version of Joseph’s story …

Pharaoh had a dream  He was standing by the Nile, when out of the river there came up seven cows, sleek and fat … After them, seven other cows, ugly and gaunt, came up out of the Nile  And the cows that were ugly and gaunt ate up the seven sleek, fat cows. Then Pharaoh woke up. He fell asleep again and had a second dream: Seven heads of grain, healthy and good, were growing on a single stalk. After them, seven other heads of grain sprouted--thin and scorched by the east wind.The thin heads of grain swallowed up the seven healthy, full heads. Then Pharaoh woke up; it had been a dream. In the morning his mind was troubled, so he sent for all the  wise men of Egypt. Pharaoh told them his dreams, but no one could interpret them for him. Then the chief cupbearer said to Pharaoh, "Today I am reminded of my shortcomings.Pharaoh was once angry  and he imprisoned me and the chief baker in the house of the captain of the guard. Each of us had a dream the same night, and each dream had a meaning of its own. Now a young Hebrewwas there with us ... We told him our dreams, and he interpreted them for us, giving each man the interpretation of his dream. And things turned out exactly as he interpreted them to us …So Pharaoh sent for Joseph Pharaoh said to Joseph, "I had a dream, and no one can interpret it. … I cannot do it," Joseph replied to Pharaoh, "but God will give Pharaoh the answer he desires." Then Pharaoh said to Joseph, "In my dream Then Joseph said to Pharaoh, "The dreams of Pharaoh are one and the same. God has revealed to Pharaoh what he is about to do. The seven good cows are seven years, and the seven good heads of grain are seven years; it is one and the same dream. The seven lean, ugly cows that came up afterward are seven years, and so are the seven worthless heads of grain scorched by the east wind: They are seven years of famine. Seven years of great abundance are coming throughout the land of Egypt, but seven years of famine will follow them. Then all the abundance in Egypt will be forgotten, and the famine will ravage the land. The abundance in the land will not be remembered, because the famine that follows it will be so severe. … And now let Pharaoh look for a discerning and wise man and put him in charge of the land of Egypt.Let Pharaoh appoint commissioners over the land to take a fifth of the harvest of Egypt during the seven years of abundance.  This food should be held in reserve for the country, to be used during the seven years of famine that will come upon Egypt, so that the country may not be ruined by the famine." The plan seemed good to Pharaoh  So Pharaoh said to Joseph, "I hereby put you in charge of the whole land of Egypt."
Book of Genesis, New International Version1

A really key part of this story is that Pharaoh, the political leader of Egypt, realized that something was wrong.  Now, I don’t want you to get distracted by this realization coming in the form of dreams. Today, we don’t take the content of dreams seriously.  I’d rather you think of Pharaoh as an astute leader with an intuitive feel for the rhythms of his society.  He begins to suspect that something is amiss and that suspicion manifests as dreams, either as a literal expression of the Pharaoh’s subconscious mind, or a metaphorical device of the Biblical storyteller.  The point is that the initiative to investigate comes from Pharaoh, himself.

Folks, issues involving climate are just not on the radar screen of the great majority of our leaders.  This is not to say that the more committedamong them don’t sense problems and take the initiative to understand them and to solve them, but they are focused on different problems – economic problems, foreign relations problems, and so forth.  I think this points both the subtlety of the climate problem - we can’t smell rising CO2after all - and to the degree to which we of the Industrial Era are sundered from Nature.

I’m not sure who in today’s White House might play the role of Pharaoh’s chief cupbearer.  He seems to have had more influence than the White House’s chief chef but to have been well outside of the inner circle of advisors and Cabinet Secretaries.  But in any case, not only didhe bring Joseph to Pharaoh’s attention, but he gave him a strong recommendation based on his own eyewitness account of Joseph’s abilities.

I don’t know what kind of testimonial would make a compelling case forus scientists.  Both the public and the political leadership confer us a fair degree of respect, in a distant sort of way, but the same time portray our opinions as esoteric and politically naïve.  But more importantly, although we are recognized as having achieved some practical successes - building the Bomb, curing polioinventing the Smart Phone and so forth  our ability to forecast the future is seldom acclaimed.  And, in fact, climate change is a new arena in which no long history of scientific predictions is available.

We scientists portray ourselves as being guided by the transcendent lawsof physics and chemistry with much the same spirit that Joseph portrays himself as merely the conduit through which God’s words are spoken. We do not invent Global Warming; we simply report an inevitable consequence of rising CO2 levels that changthe heat balance of the atmosphere.  Pharaoh accepts Joseph’s ability to speak for God to a far greater degree than, say, the Congress of the Unites States accepts the ability of climate physicists to speak for the First Law of Thermodynamics. In the modern world every authority is suspect.

Joseph was in the very enviable position of speaking to the leader of what was, for all intents and purposes, the only political power in the affected region. Pharaoh could unilaterally decide to adopt Joseph’s program and know that its success would not depend upon the actions or inactions of his neighbors.  As a subsequent part of the story reveals, Pharaoh did have to deal with an influx of starving refugees (among who were Joseph’s brothers). But no invading armies arrived, intent upon carrying away Egypt’s stockpiles of grain.

The region that is both responsible for, and affected by, Global Warming is the whole world.  The United States is only of several major emitters of CO2 and only one of the many nations to be affected by its consequences.  No CO2 reduction unilaterally made by any nation is likely to have anything but symbolic value, for other nations can easily take up the slack.  Any lasting solution will require an international agreement whose negotiation will be a slow and tedious process.

The scenario that Joseph presents, of seven years of plenty followed by seven of hardship, is one which resonates with Pharaoh.  It connects with his experience in the same way that yet-another water shortage resonates with the mayor of Los Angeles. The Pharaoh had experienced famines before, had witnessed their horrors and the land’s slow recovery from them.  Unfortunately, none of us alive today have prior experience with Global Warming.

We scientists have not done well articulating what Global Warming is all about.  Nor have we done well explaining why it is a concern and especially why its effects are to be feared.  Few of my fellow scientists would ascribe to the apocalyptic scenarios put forward by the more extreme environmental activists – a group composed mostly of non-scientists.  Nevertheless, most of us agree that the world will change and many of the changes will cause great human hardship.  But here I think that our knowledge of history – I mean geological history – jades us. Anyone who has studied the earth knows that our planet has experienced great changes and that every change has engendered both winners and losers.  Scientists, committed to the power of the mind, are inherent optimists. Perhaps we can adapt in such a way to be among the winners. Global Warming is not nearly as simple as famine. And complexity leaves rooms for ambiguity.

Joseph’s solution to the problem of the forthcoming famine is simple: spend the next seven years of plenty stockpiling enough food to get through those seven lean years.  And the fraction – a fifth – of each year’s harvest that must be put aside is manageable. Pharaoh agrees that it can be done and orders the program to start.

Scientists have not put forward a plan for stopping Global Warming that is anywhere near as workable as Joseph’s.  We know at the very least that we must stabilize atmospheric CO2 at its current level and preferably reduce its level back to what it was in 1980. To stabilize it, we must either stop burning all fossil fuels or, alternatively, capture and store all the CO2 that their combustion produces.  To go further and actually lower CO2 levels would require the capture and storage of three decades-worth of burning.  Both scenarios are possible. Alternative sources like wind and solar can replace fossil fuels and sequestration technology can scrub CO2 from the atmosphere.  But both are massive undertakings of daunting scale.  Saying that the United States needs to install one million wind turbines, for that is the number it will take, is not the same as building them. Congress is not going to fast-track myproposal to expedite construction.

I envy the clarity of Joseph’s message to Pharaoh.  But as a scientist trained in the rigorous estimation of error, I shudder at the certainty with which it is presented, for it goes against scientific culture in which everything is subject to probability.  Hour before its landfall, the chances are ninety percent, not a hundred, that the hurricane will hit New York. We scientists cannot calculate precisely how severe the effects of current CO2 levels will be and so rightly state large bounds on our predictions.  Sea level will rise somewhere between one foot and threeby the year 21002Our perspective is laudable, yet we are focusing on the wrong question.  There is no reason to think that CO2 will stay at its current level and every reason to think that their rise will be steady, or even that it will accelerate.  The two-thirds of the world’s peoples who are at the bottom of the economic ladder are rushing climb up – a process fueled by fossil fuels.  The probability of hugely painful climatic impacts is one hundred percent in a burning as usual world. Somehow, we scientists need to get that across.

1Gensis 41:1 – 41:41, www.biblestudytools.com/genesis/41.html
2http://www.climatechange2013.org/images/report/WG1AR5_SPM_FINAL.pdf

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William Menke is a Professor of Earth Sciences at Columbia University.  He researches earthquakes and volcanoes and has won several kayaking awards. He also spends a lot of time hiking and taking photographs.

19 September 2014

Cultivating Memories

The whole bucket list thing has bothered me for a long time, but I couldn't put my finger on why -- and Rebecca Mead has just nailed it in the New Yorker:
Dropping by Stonehenge for ten minutes and then announcing you’ve crossed it off your bucket list suggests that seeing Stonehenge—or beholding the Taj Mahal, or visiting the Louvre, or observing a pride of lions slumbering under a tree in the Maasai Mara—is something that, having been done, can be considered done with.
Mead suggests, instead, a list of "touchstones to be sought out over and over."

I've been wanting for years to go to Wales. I finally got there a few weeks ago, and spent two days exploring along the route of Offa's Dyke, and three nights camped at the foot of Mt. Snowdon, climbing in rain on our last day in Wales.


But we got lucky: by the time we reached the summit, the weather had cleared, and we had stunning views off into the distance in all directions.

During the trip, I realized there's a good chance I'll never go there again: life is getting shorter at the front end. But Mead points out that we can still revisit such things in memory. I will enjoy the recollection for the rest of my life.

Some other memories I cherish:
  • climbing Mt. Washington as a teenager with my family, including my Guatemalan brother
  • biking across the Peloponnesian peninsula in Greece, stumbling across 3000-year-old bridges and other ancient sites along the way
  • camping at the foot of Snæfellsjökull in Iceland
  • bicycling around Lake Constance with the Alps in the distance
  • crossing the Berner Oberland on foot with The Mate
  • hiking in the Dolomites with the Mate and The Offspring
  • biking in the Outer Hebrides with the Mate, on our honeymoon
  • looking the Beowulf manuscript in the British Library
  • living as an exchange student in the Valais with my Swiss family
  • climbing Mt. Washington in New Hampshire with several of my cousins, just last summer
  • sightseeing in Rome with The Mate and The Offspring
I love the idea that, even if I never hike those trails again, never again see the Parthenon or the Colosseum or look down from the summit of Mt. Snowdon, I can always summon the memories of places I've been and people I've spent time with.

And that appeals to me a lot more than making a list of 100 or 1000 things to do or see and crossing them off as "done."

18 September 2014

Do Plastic Bag Bans Do Any Good?

The short answer: YES.

Mother Jones reports that California has just banned plastic bags, but says "hold the rejoicing."

The article contains a lot of good information: you have to use a paper bag three times to reap an environmental benefit over plastic, when production costs are taken into account, and you have to use a cotton bag a whopping 131 times.

But if you shop twice a week, you'll get through those 131 uses in just over a year.

I can't speak for suburban folks with big cars to bring home huge loads of groceries, and big pantries and closets and freezers to store weeks of groceries at a time, but as a long-time city dweller, I can tell you I shop at least twice a week.

Some cloth bags might not last a year, particularly once they've gone through the wash a time or two, but I've had many cloth bags for a decade or more.

But here's what I think is the key statistic from the article: in studies in Ireland and California, 40 percent of shoppers didn't use a bag at all after bans or fees were imposed.

That blows all the re-use statistics out of the water.

Think about it: how many times have you left a convenience store with two items in a plastic bag, only to take one item out immediately? or both? Even if your community doesn't ban bags, think about just saying "no" to the bag next time. Or pick up the phone and call your local elected official and tell her or him to add a bag ban to the legislative agenda.