ABSTRACT This article considers how five single mothers, who used adoption or donor conception to bring children into their lives, negotiate a persistent and pervasive discourse of ‘problematic single motherhood’ in their interview talk. Tactics of intersubjectivity (Bucholtz & Hall [2005]. Identity and interaction: A sociocultural linguistic approach. Discourse Studies, 7(4–5), 585–614.), especially the overlapping strategies of distinction, authorisation and illegitimation, are shown to be particularly salient for these parents, as they work to legitimise their routes to motherhood by distancing (...) themselves from widely stigmatised positions such as young motherhood, working-class motherhood and unplanned motherhood. I argue that these single women’s intersubjective positioning serves to protect them against stigma and discrimination, but often relies on the reproduction of other polarising and discriminatory discourses, which feed into idealised constructions of mothers as responsible, middle-class, and appropriately aged citizens. Overall, the analysis suggests that it is difficult for these single mothers to challenge the multiple and intersecting discriminatory discourses, ideals and stereotypes that converge in exclusionary and limiting constructions of single motherhood, whilst maintaining a recognisably legitimate social position for themselves. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Let Me Pay Taxes!Alessia MinicozziThe first memory I have of knowing that I was different was when I was five years old and a caseworker entered my house to verify that I existed.At the age of one and a half, I was diagnosed with a chronic disease called Spinal Muscular Atrophy, Type II (SMA). This left me in need of constant care and, at times, hospitalizations. My whole life, (...) I’ve been confined to a wheelchair, and the disease has always affected me profoundly, on a physical and mental level. I have limited range of motion and strength in my arms, muscle weakness affects my speech and breathing, and, like a monkey on my back, SMA has been a constant reminder of my fragility and mortality.In order to comply with Pennsylvania’s disability requirements, a state–appointed caseworker had to make regular home visits to make sure my needs were being met under my parents’ care and that my parents were not lying about my medical needs. These visits would leave me confused and annoyed. I still remember the events that took place the first time a caseworker entered my house and the emotional impact it had on me.The time read 8:09 a.m. on my white clock radio. I wore my favorite pink satin nightgown. My mother came to lift me out of bed and enclose me in my robe. She whispered in my ear that a gentleman was here to meet me—he’d arrived early—and he wanted to ask me some questions. As my mother carried me down the flight of stairs and sat me in my wheelchair, I felt the man’s eyes on our every move. This strange man sat with a scrutinizing look and asked me if I live in this house and do I normally wake up so late? I quickly turned to my [End Page 210] mother and gave her a perplexed stare. Why was this person here at all, and what right did he have to inquire about me like this?Later, my mother would explain that the man was there to make sure that she was not lying when she asked the government for money to care for me. I endured countless visits from that caseworker over many years. Finally, I asked my mother, “When is this man going to stop visiting me and asking me the same questions?” She looked at me and tenderly replied that when my father finished his residency program, then we would have enough money to pay for all my care. I accepted this response and continued playing with my Barbie. Two years later, my father completed his residency program and the visits from the caseworker stopped.In eighth grade, I left an all disabled school and enrolled in a mainstream public school, which seemed odd to me. I asked my parents why the change in schools? My parents explained that they will not live forever and in order for me to live outside an institution, I will need a salary that is above average to pay for personal care. They went on to explain that the only way to accomplish this goal is to succeed in school and to perform better than everyone else. They informed me that because I use a wheelchair, prospective employers will view me as daunting and they may be less likely to hire me. They stressed that the only way to stand out above other non–disabled candidates is to excel in an academic environment. Mom and Dad have always ended the conversation by reassuring me that as long as they are alive, they will make sure I accomplish everything I set out to achieve and that I never feel alone.Since that conversation over twenty years ago, I had only one goal in mind: employment. The possibility of being institutionalized has always been my motivation for persevering through late nights of writing papers and studying for exams. As promised, my parents were the ones who proofread my papers and stayed up with me in order to help me to bed once I was done. When I graduated from the University of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Secret Inside MeDiana GarciaGrowing up, our Chicano household was loud and boisterous. There were eight of us in one small house with one small bathroom. All five of us girls shared one bedroom so there was not much privacy, if any. Watching my sisters go through their puberty was isolating—I was never on the receiving end of the secret whispers and knowing looks I saw my mother exchange (...) with my sisters when they started menstruating. It made me feel “different” and excluded from that mother–daughter connection. My only comfort was that my sister, who was one year younger, had not started her period either, and we shared our fears that we were different from our other sisters.In 1979, when I was a senior in high school, I approached my mother and assertively told her that I had made the decision to seek out a doctor as soon as I turned eighteen years old because I felt I needed to get answers for myself and my sister. I was positive that something was not right. From the time I was about twelve years old, I would question my mom about why I hadn’t started my period. She always shooed me away saying that I was a late bloomer and that every girl starts at different ages, some at nine, some at fourteen years old. However, I always knew something was not right. I just knew.My mother was annoyed, but she said, “Alright mija, I’ve just been worried because you are a virgin and I don’t think I want anyone probing you down there.”I remember telling her something like, “Mom, at this point, if that is what needs to happen for me to find out, then so be it. But can you come with me to the doctor? Please?” [End Page 92]She said, “I know; I’m worried, too and yes, I’ll go with you.” My mom and I hugged, and I could feel the worry and tension in our hug. I was not sure if it was coming from me or her.The day of my gynecology appointment finally came. I had been looking forward to it for so long. This was my first experience as an adult other than having that grownup feeling the day I graduated from high school. The nurse told me to undress and to put on the paper gown and then left the room. I told my mother to stay sitting in her chair, that I did not want her to leave me for a second. The young doctor entered the room and introduced himself to us and asked me to sit on the examining table as he asked, “So, what is the reason for this visit?” I told him, “I want to know why I haven’t started my period. I feel like something is very wrong with me.”He had me lay back and put my feet in the stirrups, instructing me to relax. I reached my hand out to my mother and she stood and came by my side and held my hand tightly.He squeezed some gel on his gloved hand and again asked me to relax and to just let my knees drop back. His fingers with the cold gel probed and after a few seconds of probing he looked up and said,“What the heck?! There’s no cervix?”My mother and I looked at each other in confusion and then he said, “There’s nothing!”He then stood up and said, “Please get dressed and the nurse will show you to my office.” He exited the room, leaving us to look at each other with tears in our eyes, stunned at his outbursts.I will never forget his reaction or his words.A sympathetic nurse led us into the doctor’s office and we sat down.He looked at me and said, “You need to have surgery immediately or you will die of cancer.”I turned to look at my mother and we both started tearing up. I asked, “Why? What do you mean? I have cancer?”He said, “No you don’t. Not right now... (shrink)

When I was first invited by Prof. Kim Yong -pyo, editor of the IJBTC, to review this book, I declined, due to the fact that Prof. Park was my teacher and mentor at SUNY Stony Brook, not only as a graduate student, but as an undergraduate as well. For this reason I was afraid that I would not be able to bring the requisite critical distance to the task. After having had the opportunity to read the book, however, I changed (...) my mind, for two main reasons: I realized that it might be personally satisfying to take the opportunity to re-engage myself in the kind of Buddhist soteriological discourse that originally attracted me to Buddhist Studies to begin with, and the potential for lapses in proper critical distance notwithstanding, I felt that there is some sense in which I could bring some insights into the appraisal of this book probably only accessible to myself, given my long relationship with Sung Bae Park and my deep personal interest in his project. So I hope readers of this review will accept it with these factors in mind. There is one question that we may want to ask before dealing with a book like this: Is there a place in our Buddhist Studies academia for the discussion of personal religious experience, or for the investigation of the phenomenon of religiosity? I know of more than a few who would answer such a question with an outright "no." Others might say, "It depends upon how one goes about it." And still others may be very excited by such a prospect. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Normalizing” Intersex Didn’t Feel Normal or Honest to Me.Karen A. WalshI am an intersex woman with Complete Androgen Insensitivity Syndrome (CAIS). My 57–year history with this has its own trajectory—mostly driven by medical events, and how I and my parents reacted. Most of my treatment by physicians has not been positive. It didn’t make me “normal” at all. I was born normal and didn’t require medical interventions. And by (...) the way, I’ve never been confused about who or what I am.Truthful disclosure didn’t come to me about my biology and what was done to me as an infant until I was 33, when I forced the issue by removing my medical records from my endocrinologist’s office. I learned that there was never full disclosure to my [End Page 119] parents either, and therefore there was no informed consent for the “corrective” surgeries performed on me as an infant. My parents were only told that their little girl would get cancer and would not have a normal development as a girl unless her “deformed ovaries” were removed, and that they should never discuss these problems with me. Thus, after having presented with an inguinal hernia and having exploratory surgery at age 16 months, my intra–abdominal testes were removed in a second surgery two months later. I was pronounced a “male pseudohermaphrodite,” a diagnosis that was shared neither with my parents nor with me.Years later, I discovered an article my surgeon published in 1960 in the Delaware Medical Journal about me and another intersex person he operated on (whom he labeled a “true hermaphrodite”). The article gives a very detailed pathology report of my gonads, but only two sentences regarding my welfare and the rationale for performing those surgeries. Dr. J. F. Kustrup wrote in this article, “These [two cases] emphasize the need for early diagnosis and treatment in order to avoid the possibility of malignant change and to permit these individuals to follow a normal psychosexual pattern.” And: “Hermaphroditism and pseudohermaphroditism are conditions in which early diagnosis and treatment are essential to avoid malignant degeneration and to allow the child some chance toward normal pyschic [sic] development.” I was grateful to find this article because it revealed the unfounded assumptions underpinning the recommendations for treatment, much of which continues today. Worse even than the sort of social prejudice that shapes treatment is the absence of evidence for what doctors treat as “necessary” interventions. For my syndrome, CAIS, there never was—and still is not—data to support the cancer scare, or the opinion that I’d be confused and not have a normal life.From about the age of four, I can remember being different and being stonewalled by my doctor and prevented by my parents from talking about it. The feelings and fears I tried to express were shushed away, and I could tell that my questions were upsetting everyone. Even if I had wanted to be complicit with their lame diversions and nonsensical explanations, the massive abdominal scars were there as a daily reminder and hinted at a very different story.The Road to Hell is Paved with Good IntentionsGrowing up, I was treated like a fascinoma and a lab rat at a major teaching hospital on the East Coast. All I learned from those doctors as a young kid was what it feels like to be ogled, photographed and probed by a roomful of white–coated male doctors. Dissociation made itself my friend, and helped me to cope through the annual genital and anal exams and probing. I thought I was a freak and I felt completely powerless to protect myself from them and their “care”.At my annual appointment at age 12, with my mom present, three doctors told me I was infertile. Learning that I couldn’t have kids really saddened and shocked me, but there was no opportunity to talk about my feelings—either that day, or any time afterward. I was told to stop crying. I remember them telling me that there was no one else like me and that this was a random genetic anomaly, thereby reinforcing the freakishness... (shrink)

The validity of the prayer which is accepted as the most basic worship of Islam has been tied to a set of rules. These rules which must be followed before and during the prayer are called conditions and pillars in the fiqh language. The recitation performed while standing during the prayer is one of the most significant of these rules and is accepted one of the pillars of the prayer. Therefore, in order for the prayer to be valid, it is (...) required to make enough recitations. If it is not done, the prayer is considered invalid. For this reason, the topic of recitation in prayer has been discussed in detail by the jurists, and different opinions have been submitted what, when and how much to recite. The jurists have suggested three basic views on this issue. Ḥanafīs have stated that a person who follows the imām in prayer should not recite, and they have accepted the recitation of ma’mūm as makruh regardless of whether the recitation is loud or silent. The Shāfiʿīs who uphold the opposite view of the Ḥanafīs have said that the ma’mūm have to recite in all the prayers in which the qirā'āt is loud and silent, and that it is obligatory for the ma’mūm to recite. According to Shāfiʿīs the prayer of a ma’mūm without recitation is not valid. Malikīs and Ḥanbalīs who have explained their opinions by taking into account that the recitation is loud and silent have stated that the ma’mūm should recite during prayers in which the recitation is silent. In the prayers where the recitation is loud the Ḥanbalīs have said that the ma’mūm should recite when the imām takes a break from recitation, while the Malikīs have said that the recitation is not required for the ma’mūm. However the jurists of both sects have not considered that the recitation is obligatory to ma’mūm. And they have acknowledged that the prayer of the ma’mūm was valid even if he has not recite. There is intra-sectarian disagreement in all of these three basic views which are presented as the general opinion of the sects. Although we are talking about the intra-sectarian disagreement, it is understood that the jurists except the Ḥanafīs have determined their views on the recitation of the ma’mūm within the context of whether the ma’mūm hear or do not hear the recitation of the imām. It can be said that this understanding is at the basis of the views put forward by the Shāfiʿīs who take into account that the recitation is loud and silent about the ma’mūm’s recitation of the sūrat after the Fātiḥa. Likewise it is possible to say that this understanding is at the basis of the perceptives brought forward by the Malikī and Ḥanbalī jurists about the prayers in which the recitation is sound. The jurists who expressed different opinions about the recitation of the ma’mūm similarly brought evidence from the Qurʾān, the Sunnah, opinions of the Companions and qiyās to justify their views. Although the jurists have grounded their views on similar evidence, they have reached different conclusions. The reason for this difference it can be shown that the direction of the verse (āyat) to be taken as evidence, their different approaches when evaluating the narrations transmitted from the Prophet (pbuh) and the fact that the arguments of qiyās are different. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Courage To LiveAntonella ColaceI am not the patient. I have not received an organ. I am her mother; I am a shadow patient. My responsibility was to make decisions about a gift for my one-year-old daughter in the summer of 2007. A liver.Elisa had a hepatoblastoma. After chemotherapy, the tumor might have been removed, but in the final stages of the work-up a portal vein malformation necessitated a (...) transplant. The medical team at a hospital in northern Italy informed us of the intervention.So many words! Trying to understand what they were saying seemed like a lost cause to me, but I quickly realized that these were people I should trust blindly.These medical team members, by the end of the experience, would all become part of my family. They embraced us in their capacity as professionals and as human beings. I never felt alone or excluded.How many times late in the evening I heard a soft knock at the door of Elisa’s hospital room and behind that delicate touch, I found her doctor ready to leave for home, but not before one last [End Page 131] recommendation for his little patient and a wish of peaceful sleep.The relationship between health workers and the family has developed into an effective relationship of communion and understanding, which has often translated into affectionate terms in communicating with each other. They asked me: “Mom, how is Elisa?”..... Yes—mom!These highly trained medical experts have understood that a parent can sometimes somehow discern the danger behind the otherwise asymptomatic daughter’s subdued attitude; or a surreptitiously high fever, of little concern because Elisa was playing and laughing.I was made to feel an active part of every initiative and decision. My observation point on Elisa, who could not speak for herself, was fundamental for them.I never experienced the hospital as a hostile environment—quite the contrary!It comforted me to have people around us, ready to intervene, reason, and solve the physiological difficulties of my little girl. The hospital was a room in my house, a room whose door was always ajar and in need, I crossed its threshold full of trust, hope, and courage.Today some of those doctors and nurses are my friends. I have a lot of respect for them, gratitude, and admiration.Elisa being placed on the transplant list and waiting for a donor were the first obstacles to overcome.The “warrior” fought against two monsters, time and the tumor. The timing was everything because Elisa had to be in the period of non-toxicity after chemotherapy but could not wait too many weeks without active therapy in favor of a cancer that, lurking like a vulture, was only waiting for the ideal moment to start growing again.The most dramatic thing to overcome and accept was hoping for someone’s death. For Elisa to live, someone else had to die. I felt like an executioner. I didn’t think of anything else; I didn’t sleep at night.In the end, choosing to visualize death as a gift, I had to accept it.It was summer, on August 20th, and another hot and boring night in hospital awaited us. The nurse came into the room to tell me that our lottery ticket had won that night. There was a compatible liver for Elisa. The organ would come from a young woman who had died while swimming in the Sicilian Sea.If they had stabbed me at that moment, maybe not a drop of blood would have left my body. I was paralyzed, incredulous, terrified.My daughter had already been operated on, but it would be different this time. This time they would open her abdomen to remove her diseased liver and replace it with that of a dead young woman, by now sealed in a body bag in a Sicilian morgue. A cold body, deaf now, silent!A young woman for whom, while I was rejoicing, some other shadow patient was despairing, caught up in an unstoppable whirlwind of pain.I felt like throwing up while I cried tears of joyful hope. Guilt grew in my... (shrink)

Advances in reproductive medicine have opened up new scenarios, changing our experience and our understanding of what it means to be a parent. Literature and cinema have quickly turned their attention to new forms of reproduction, and often do what doctors in centres for assisted reproduction advise against: they reveal secrets, re-unite the various different protagonists, who make the new life possible, and explore the dramatic and sometimes tragic entanglement of birth stories. Significantly, literary and filmic stories also give voice (...) to those whose voice is seldom heard: the children. In my contribution, after providing a brief summary of the history of assisted reproductive technologies, I discuss some contemporary novels and films, in English and Italian, that deal with these new scenarios. Examples include The Kids Are All Right (2010) by American director Lisa Cholodenko, Google Baby (2009) by Israeli director Zippi Brand Frank, Venuto al mondo [Brought into the world] (2012) by Italian director Sergio Castellitto, Carissimi [Dearest] by Italian writer Letizia Muratori, Non mi vendere, mamma! [Do not sell me, mom!] (2016) by Italian writer Barbara Alberti, and Katherine Carlyle (2015) by British novelist Rupert Thomson. I argue that each birth has a story and that we cannot struggle free from the stories that make us any more than we can ignore the fact that we were brought into the world. (shrink)

Mnoge biološke funkcije dopuštaju stupnjevanje. Na primjer, lučenje određenog hormona u organizmu može biti na višoj ili nižoj razini, u usporedbi s istim organizmom drugom prilikom ili u usporedbi s drugim organizmima. Koje razine funkcioniranja predstavljaju slučajeve disfunkcije; gdje da povučemo crtu? To je kvantitativni problem za teorije disfunkcije i bolesti. Cilj mi je braniti verziju bioloških teorija disfunkcije kako bih se uhvatio u koštac s ovim problemom. Međutim, također ću dopustiti da evaluativna razmatranja uđu u teoriju bolesti. Moj argument (...) se temelji na razlikovanju između biološke i kliničke perspektive. Prema mom mišljenju, bolest je ograničena na slučajeve koji spadaju u granice bioloških disfunkcija. Odgovor na kvantitativni problem ne zahtijeva proizvoljne odluke ili društveno vrijednosne sudove. Stoga se zalažem za nearbitrarnu metodu koja se temelji na činjenicama kako bi se riješio kvantitativni problem. Ipak, nisu sve biološke disfunkcije instance bolesti. Dodavanje kliničke perspektive omogućuje nam da spriječimo potencijalnu preveliku uključenost biološke perspektive, zato što postavlja dodatna ograničenja za određivanje granica bolesti. (shrink)

Effective doctor patient relationships are predicated on doctors' relational engagement and affective/holistic communication with the patients. On the contrary, the contemporary healthcare and patient-clinician communication are at odds with the desirable professional goals, often resulting in dehumanization and demoralization of patients. Besides denigrating the moral agency of a patient such apathetic interactions and unprofessional approach also affect the treatment and well-being of the sufferer. Foregrounding multifaceted doctor-patient relationships, graphic pathographies are a significant cultural resource which recreate the embodied moment of (...) clinical encounters as they also lay bare qualitative tensions between patient' illness experience with doctor's professional understanding of the same. Taking these cues, the present article drawing theoretical postulates of Rita Charon, Deborah Lupton, and Havi Carel close reads Peter Dunlap-Shohl's My Degeneration: A Journey Through Parkinson's, Brian Fies' Mom's Cancer, and Stan Mack's Janet & Me: An Illustrated Story of Love and Loss to investigate the nature of doctor-patient relationship vis-à-vis communication and the implications of bad doctoring/communicative practices on patient identity and emotions. Furthermore, the article also examines the aesthetic and functional role of comics in bringing into relief the graphically mediated doctor-patient relationship. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:100 Feminist Studies 45, no. 1. © 2019 by Feminist Studies, Inc. Carla Pascoe Leahy From the Little Wife to the Supermom? Maternographies of Feminism and Mothering in Australia since 1945 Men didn’t do anything.... The mother did for the child. The father went out to work.... I was a very determined, modern woman, but I didn’t mind being the little wife. —Marjorie, 1950s mother1 There were competing narratives. (...) One was a woman’s place is full time mothering in the home.... And then there was the feminist movement which said women can do it all.... There was level of unreality about both of them. I did feel really conflicted. —Sally, 1970s mother I read a headline today that said I send my kids to childcare and I refuse to feel guilty.... I feel the guilt a little bit but not enough to stop me from sending them, and I still know that in the long run... it’s far better for me to work and... I don’t want to be a stay at home mum for the rest of my life. —Ariana, 2010s mother 1. All interviewees are referred to by pseudonyms. Where permission is granted by the interviewee, interview material is preserved at Museums Victoria in Melbourne, Australia. All interviews are in the possession of the author. “Marjorie” was interviewed by the author on June 27, 2014; “Sally” was interviewed by the author on March 8, 2014; “Ariana” was interviewed by the author on April 5, 2017. Carla Pascoe Leahy 101 The daily lives and long-term aspirations of Australian mothers have undergone significant changes over the past seventy years, alongside shifting cultural and personal concepts of mothering, employment, and female identity. At face value, these quotes from three generations of Australian mothers imply a trajectory of shifting understandings of care, work, gender, and subjectivity, with women’s self-identity increasingly associated with paid work outside the home. Each of these women positions herself in relation to the dominant gender culture at the time she experienced matrescence.2 Marjorie, who had her children in the 1950s, characterizes herself as “the little wife” and recalls being contented with her role as a stay-at-home mother. Sally, who became a mother in the late 1970s, remembers wanting to believe that “women can do it all” without sacrificing family or career, but she experienced this radical ideal as conflicted at both a cultural and personal level. Ariana, a twenty-first-century mother, feels ambivalent about sending her children to childcare, but had always assumed that she would combine paid work with mothering. Despite this seemingly linear progression from a female identity centered on mothering to one focused on paid work, I argue that closer attention to these maternal narratives reveals that changing gender discourses were experienced as riven with internal contradictions by individual mothers. Drawing on a new collection of fifty-six oral history interviews co-created with Australian women about their experiences of becoming mothers, I will analyze the ways in which changing cultural understandings of selfhood, work, care, and gender have played out in the lives of mothers from 1945 to the present. When I started this project, I envisaged it partially as a history of my grandmother’s, my mother’s, and my own maternal generations. In this sense, it is a record of the living memory of Australian mothering; an archive of the maternal memories still circulating in contemporary Australia. But it is also a history of Australian mothering before, during, and after the women’s liberation movement of the 1970s. The women’s movement initiated fundamental shifts in the ways Australians thought about women’s role in society, 2. Matrescence is a term coined by Dana Raphael to describe the experience of becoming a mother for the first time. See Dana Raphael, “Matrescence, Becoming a Mother, a ‘New/Old’ Rite de Passage,” in Being Female: Reproduction, Power, and Change, ed. Dana Raphael (Berlin: De Gruyter, 1975). 102 Carla Pascoe Leahy their relationships to men and children, and their capabilities in relation to paid and unpaid work. My contention is that the women’s liberation movement unsettled and complicated Australian women’s relationships to... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Standing at the Intersections: Navigating Life as a Black Intersex ManSean Saifa WallAs I sit down to write this narrative, my mind is reflecting on the past year. This year has seen numerous protests against state–sanctioned violence with the declaration that “Black Lives Matter”. As a Black intersex man, I have witnessed the impact of state–sanctioned violence on my family and my community, both from the police state and (...) medical community. I charge the police state and the medical community with state– sanctioned violence: Each targets non–normative bodies—the former through incarceration and execution, and the latter by means of surgical and hormonal intervention. As a Black intersex man, I stand at the intersection bearing witness to how this violence has incarcerated my friends and loved ones as well as being subjected to medically unnecessary surgical intervention. Although this is where I stand now, both socially and politically, I have not always existed here.I was born in the winter of 1978 at Columbia–Presbyterian Hospital in New York City. I was the youngest of five children and one of three children in my family who were born with an intersex trait now known as androgen insensitivity syndrome (AIS). At the time, AIS was referred to as “testicular [End Page 117] feminization syndrome.” Upon receiving my medical records years later at the age of twenty–five, I noticed scribbling and a barrage of notes indicating the process by which the doctors assigned my gender as female. Although I had ambiguous genitalia, which caused some initial confusion among the doctors, XY chromosomes were not enough for me to be raised as male. My mother was told I would be raised as a girl and, according to the medical records, “function as such.”Unlike my sisters who were also born with AIS, my mom was not swayed by the surgical recommendations doctors made about my body. As a matter of protocol, my sisters’ gonads were removed in infancy, however, my mom made the decision that my testes would remain with me until they had to be removed.Because of intense pain in my groin area, my testicles were removed when I was thirteen years old. The pain that I felt following the surgery was perhaps the worst pain that I have experienced in my entire life. After surgery, my pediatrician prescribed estrogen and Provera as a hormonal replacement regimen. Fatty deposits changed the shape and contours of my face. Once robust and chiseled thighs now harbored cellulite. The beginnings of facial hair and prominent body hair became wispy and nonexistent. What was hard and defined became soft.At no point did anyone ask me what I wanted to do with my body.I actually missed the effects of my natural testosterone such as a deepening voice, increased hair and muscle mass; when I asked if I could take both testosterone and estrogen after surgery, my mother remarked, “You would look too weird.”The hormone therapy was coupled with intense social conditioning. I feel as if the social conditioning for young women raised with AIS is suffocating. When doctors prescribed hormones for me to take, my mother constantly reminded me how “beautiful” the little yellow pills would make me. As a means of reassurance, my pediatrician told my mom that “a lot of fashion models” have AIS and that I would most certainly be beautiful. In our dominant US culture, gender norms can already be oppressive, but for women with AIS, there is the impact of gender norms and the underlying fear that women with AIS are not really women since they have XY chromosomes. I did not succumb to the pressure to be more feminine, but actually gravitated toward masculinity. Before transitioning to live as a man, I considered myself a butch woman. When I came out of the closet at fourteen years old and presented as a masculine young woman, I never felt safe. Because I dated women who were more feminine than I, my relationship with these women seemed threatening to men who repeatedly reminded me through harassment and threats that “I was not a man.” Of course, I wasn’t trying to be a... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Living with Blindness and Fibromyalgia while Occupying AgingKatherine SchneiderI’m blind from birth and in middle age developed fibromyalgia. I’ve retired from a thirty year career as a clinical psychologist and am working on my third book tentatively titled “Occupying Aging: Delights, Disabilities and Daily Life.” My relationship with medical professionals includes gratitude (without good care I would not be alive) and also frustration for assumptions often made about my (...) abilities. I write from the perspectives of an impatient patient, woman living in the United States, former provider of mental health services, person with both invisible and visible disabilities, and boomer moving into the world of the aged. My stories are mine of course, but when I swap medical stories with blind friends, similar happenings abound.When my mom fell down the stairs at a friend’s house, five months pregnant with me, she was told to go to bed for the next four months to save the pregnancy. Thus began the impact of health care professionals on me. I was born a month premature and spent my first month in an incubator. In 1949 it wasn’t known that the enriched oxygen atmosphere in an incubator would cause blindness. At least one lawsuit was filed against physicians and a hospital by a person blinded in this way. A large out–of–court settlement was received. The way I look at it, the health care community did the best they knew and without enough oxygen, I would have died.Early in my life, my parents took me to several ophthalmologists to see what could be done for my vision. Family folklore has it that I could smell a hospital as we entered and would begin howling. These early traumatic experiences may have led to my current healthy lifestyle so I don’t have to go to doctors much now. By about age five, it was clear that nothing could be done about my vision. For the next twenty years my forays into the health care system were for tonsillitis, sprains, and the usual childhood ills.In my early twenties, I developed acute glaucoma in one eye—caused, I’m convinced, by birth control pills. In seeking treatment for this condition, I encountered the first truly insensitive physician I’d met, who said, “Your eyes aren’t doing you any good; let’s take them out.” I was horrified! They were my eyes. I was attached to them, psychologically as well as physically. It turned out that a simple operation relieved the pressure and allowed me to keep my eyes. True, they are not the best looking big brown eyes around, but they did come with the package.Life with blindness seemed quite straightforward until my early forties, when I developed extreme fatigue and pain all over. I was worried. I knew a blind woman who had developed multiple sclerosis and I admired her, but I did not want to walk in her brave footsteps. Then a college student came to see me with the same symptoms and said that she had recently been diagnosed with fibromyalgia. I am often very empathetic with people’s concerns, but this time she complimented me by saying, “You’re great! You seem to know just how I feel.” I sagely counseled her about portioning out her energy carefully, prioritizing, using short cuts, and taking elevators when possible. Being an adult [End Page 216] student used to overachieving, she did not like what I was saying, but said she’d try to follow my advice because she could no longer do it all.What finally broke through my own denial was the day coiling up a hose and dragging it to the basement for the winter took me an hour. It left me totally exhausted and I figured that even being middle aged couldn’t account for feeling that awful.After a thorough physical and plenty of blood work to rule out Lyme disease and multiple sclerosis, I was diagnosed with fibromyalgia and placed on low doses of antidepressants to help me sleep through the night. The medication worked and I began to feel like myself again. My battle to accept that... (shrink)

The subtitle to the conference upon which this journal issue is based invited us to ‘follow Crowter’. This paper does so primarily by following the person and only thereby attends to the legal judgment. In particular, it will attend to her comment that When mum told me about the discrimination against babies like me in the womb, I felt like a knife had been put into my heart. It made me feel less valued than other people. The argument is that (...) (I) there are strong reasons for such an approach from the field of theological ethics and that this is valuable for pastoral theology and for bioethics. With this case made, the argument proceeds (II) by following and building on three elements of Heidi Crowter’s words concerning (a) the knife (b) the heart and (c) the person. The argument concludes (III) with theological reflection and deliberation regarding institutions, practices and actions which will make for ‘ethical society’, principally focussed on ecclesial life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:116 Feminist Studies 41, no. 1. © 2015 by Olumide Popoola Olumide Popoola Fishing for Naija To choose. To find a way in which one can tell everything. Not just the he and she. But much more of it, all. Gestures. Opening and closing. To do both is saying quite loudly: no not now, not here, not you. John opened the door and stepped out of the car. Uncle (...) T was shifting from one of his loafers to the other, white handkerchief in hand, wiping his shiny forehead. He pulled on the other door so Karl could come out too. Karl didn’t. The bungalow door opened. Ó could hear the excitement in John’s voice. It was all relief and shit. Greetings were exchanged. Words passed back and forth. Uncle T laughed. Happy, it seemed. John laughed too. A joke. Apparently. Karl remained in the taxi. “I think you will need some privacy. We will be back in one hour.” John hugged è. Karl finally stood in the cemented driveway. “I believe we have some catching up to do.” Stepping away from the entrance the father entered the room, leaving the door wide open, turned his head, scrutinized è, two deep lines furrowing the forehead, eyes a good stare in them. They were the opposite to Karl’s, no deflection whatsoever, no putting things at bay, first, Note In this excerpt from a novel, the gender neutral Yoruba pronouns “o” and “e” have been used to replaced the English ones. Please note that the correct Yoruba character for the pronoun “e” has a grave accent and a dot underneath. Because that character is not available, it has been represented by the character è instead. Olumide Popoola 117 then processing in small bits, nothing at all, no fucking warmth as far as Karl was concerned, but all getting into you, straight away. “Carla.” The odds we bet on, the strands we hold, the time we spare, and all falls, or betrays that itch, that place we want to find where belonging meets the now, the here, the us. It was musty inside. No one had bothered to open the windows when the electricity cut off in the morning. “Sit down. What do you want? Water, soft drink?” “I’m fine,” Karl replied. The thank you was stuck in è throat. The eyes. Like whoa, all over the top. Demanding. “This is not what I’ve been expecting.” It was funny like that. This is not when I was expecting you, Karl thought. “What do you think of our country so far?” “I love it. Really.” Ó could see è father’s legs, ashy feet in leather sandals with a large flap covering the top of the foot, a small ring for the big toe. They were obviously different. Very different. Uncle T and him. No moisturisation on this front. At all. The father didn’t seem to believe in Uncle T’s shea butter products. At least not for the feet. The seat cushion shifted. The father leaned back, arms crossed over his head, touching the wall, eyes looking straight ahead. Very delaying tactic. For emphasis. For drama. As if rehearsed. But then again he’d had two weeks since Karl’s arrival in Nigeria. Two weeks of leaving everyone in limbo, just so he could now come with effing heavy artillery. “I was expecting a daughter.” And the manner of closing is always more defined, more punctuated than the question opened. It hangs on the hinges, only for effect. body ['badi] n pl bodies the entire physical structure of a human being adjective versatile 118 Olumide Popoola A mosquito was buzzing around, making the silence between their words like a spotlight. You couldn’t not look. Karl followed it with è eyes. “I always knew. As long as I can think. Mum always lets me be myself. As long as I do nothing wrong. Nothing real bad, I mean. Be polite. I want her to be proud of me. When puberty started I just said I wouldn’t pretend to be a girl no more. She understood. She knew. I had never been one.” It was hot, no fan or air-conditioning to separate the time from the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Just ImagineAlisse Waterston (bio)The united states is a flower of harm.—Tongo Eisen-Martin, “Taking a Common Name (after Claudia Rankine’s Just Us)”I never have to go far for evidence of the truth of this line from Tongo Eisen-Martin’s response to Claudia Rankine’s Just Us.On a Friday, Kyoo Lee, coeditor of philoSOPHIA, invited me to offer my own response to Eisen-Martin’s and Fanny Howe’s essays in what she said would be (...) “like a game of exquisite corpse,” a productive way, I think, to build up rather than tear down, the latter of which is too often the case in academia. I had to think about it, to think about Just Us, Claudia Rankine’s powerful, generous, sharp, and profound book. In it, she makes an urgent request for “an American conversation” on whiteness. Rankine teaches us: “Universalized whiteness, that racial imaginary, lives in every moment” (2020, 329).I pace around the house, make some tea, and pick up the New York Times, scanning the headlines. There it is, front-page news this very day: “Sights Set on School Districts as G.O.P. Targets Race Theory” (Saul 2021, A1). Scarlett Johnson, profiled in the article, is a dirty-blond “just a mom” from Mequon-Thiensville, a school district in Wisconsin. Johnson has made it her mission to refuse the conversation; she is buttressed by a set of powerful and wealthy behind-the-scenes interest groups. Rankine writes, “I have only lived as me, a person who regularly has to negotiate dismissal, erasure, disrespect, and abuse” (2020, 23).The news article goes on: “Republicans say critical race theory has invaded classrooms.” Then, Wisconsin senator Ron Johnson implores, “take back our school boards, our county boards, our city councils” (Saul 2021, A12; emphases [End Page 141] mine). Rankine observes, “Among white people, black people... are not allowed to implicate the present company in [their] precariousness. They are not allowed to point out its causes” (2020, 155). She explains “the narrative of white privilege that secures white spaces,” then quotes legal scholar Cheryl Harris on “the set of assumptions, privileges, and benefits that accompany the status of being white... a valuable asset that whites sought [and seek] to protect” (Rankine 2020, 25). Only connect.§§§The spiraling back, the turn of the screw to take it out, to look at what happened, to break apart the cover, to disclose in reverse, recalibrate and recapitulate, to find points of composure and recognition—to view the news as what happened already but left the stain of reportage and evidence of fraud and failure.... The time we live in and the way we make use of our “screws” to construct a new stage to play on.—Fanny Howe, “After Reading Just Us”Here, Fanny Howe offers a beautiful metaphor for Rankine’s gift to the world, if it will take it. Many people, not enough, have joined in turning the screw. Those who have are engaging the process of thinking, without which the catastrophe of universalized whiteness and its human toll will endure. Howe writes of a new stage to play on, which I interpret as an exciting challenge to re-create. Claudia Rankine writes: “what if ” (2020, 3).What if we imagine. The Oxford English Dictionary defines imagine as the process of forming an image of something in the mind, something akin to dreaming, visualizing, thinking, supposing. To imagine is to form a mental image of something, perhaps a goal, an end to which one yearns to arrive, an achievement not yet actualized. On the last pages of Upside Down: A Primer for the Looking-Glass World, the Uruguayan writer Eduardo Galeano dares readers to exercise the right to dream. “Suppose we rave a bit?” he asks, and he offers a long list of possibilities for an alternative world (Galeano 2000, 333–36; see figure 1).In a classroom exercise designed by my former student James Williams, I ask my undergraduates at a public university in New York City to rave a bit, writing out on a slip of paper one thing they would change to make for an alternative world. The world they... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Over the YearsKimberly RockerMy daughter was diagnosed with an Ependymoma brain tumor in 1986 at the age of 19 months. Our journey began when we realized that we had become concerned about her falling. For example, we were staying at a lodge with a large stone fi replace and both my husband and myself were careful to cover the area with pillows from the couch. Then there were the (...) sporadic “jokes” from strangers who would say, “what has she been drinking?” as she walked past with a slight stagger in her gait. We took her to the pediatrician who listened to my concerns and then watched her walk in a narrow hallway. Surprisingly, she didn’t seem to stagger and she walked very “toddler–like” down the hall. We learned later that this tighter area would help compensate for my daughter’s lack of balance. We were told that she simply needed to develop her gross motor skill more and that she would outgrow it and I was simply an over–concerned first time mom. Unfortunately, the pediatrician failed to recall that my daughter had been walking since she was 11 ½ months old and the current lack of coordination and balance was actually a regression in her motor skills. This negative change in her abilities should have been seen as a red flag.I still couldn’t shake the nagging feeling that something was wrong. Since our doctor had been unresponsive to my concerns, I made an appointment with another doctor. I told my husband that if the new doctor is just as unconcerned about our daughter’s gross motor skills, then I would let it go. The new doctor refrained from making judgments about my parenting skills and concerns. She listened carefully as I described the situation. She examined my daughter and watched her walk in the large hospital hallway. Her next step, one that our regular doctor failed to do, was to measure her head circumference. The measurement exceeded the 100–percentile mark. They were immediately concerned and ordered a CT scan right away. The diagnosis was a brain tumor and due to the size and location, they didn’t expect her to live. We called family and said our beautiful little girl was very sick and was going to die.As a parent, we often know our children well. This can be both a help and a hindrance. Since the changes in our daughters walking skills declined gradually over several months, it was difficult for us to see just how far she had declined. We have a [End Page 25] video of our daughter taken just a few weeks before her diagnosis. I have only watched it a couple of times because it is difficult to see. It is painfully obvious that there is something terribly wrong. It does make me question our parenting and ability to know what is best for our child’s well being. Add to that a doctor that made you feel very inadequate as a parent, it was hard to have the confidence to question the doctor. But, that small quiet voice kept getting louder, demanding to be heard.My daughter will be 29 years old this August. One thing I remember very clearly during that first year is that I just wanted to know that somewhere there was another child who survived to live a happy, healthy life. At that time, it was difficult to find. During those first few months after our diagnosis, we met three other families who had daughters with brain tumors, Nina, Larissa and Wendy. My daughter is the only one still alive. We thank God for the gift of life He gave to our daughter but are full of sorrow for the families that suffered such a difficult loss. There were many miracles and many challenges along the way regarding her recovery. I believe our story can give hope to families as they struggle with this terrible diagnosis.One of our first miracles was the fact that the neurosurgeons were able to remove all visible evidence of the tumor. This is rarely the case since removing the tumor can also damage healthy areas of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Difficult Road to Deciding on CircumcisionAnonymous TwoAnonymous TwoWhen I got my results back from my noninvasive prenatal testing, NIPT and found out I was going to have a little boy, one of my first thoughts was, "I don't want to circumcise him," which sounds silly because I just found out the gender of my baby and my first thought is about his genitalia. The idea of growing and (...) carrying this perfect little baby for nine months and then hurting him was unthinkable to me. I simply did not want to hurt him. The idea of it made me feel sick. Anytime the subject came up, I would protectively put my hand over my belly. And I do admit there were a lot of times I wished I was having a girl so I didn't have to deal with the circumcision debate.There was a lot of conversation between myself and my husband about it. My husband was adamant about getting it done. He referred to uncircumcised penises as "snake penises" and said our son will be made fun of for being different. He said it would be easier for him to clean and when he's old, he won't have to worry about infection. I would counter with, "well what if he falls in love with a girl from a culture that doesn't circumcise? She will think his penis is weird." The more we talked about it, the more ridiculous it felt thinking that far in advance and all these hypothetical situations he might get in over his penis. My parents wanted it done for religious reasons, but that wasn't a factor for me. My mom kept saying it's in the Bible and it needs to be done. My boss is Jewish and she joked that I could just convert to Judaism and the choice would be taken away from me so I didn't have to stress over it. Everything I read on my mommy groups and sites like Reddit called male circumcision child abuse and stated how barbaric it was. Terms like "genital mutilation" were thrown around a lot, and I didn't want to be part of a group that was seemingly looked down upon by so many.I spent my whole pregnancy saying how much I did not want to circumcise my baby. About a week after he was born and we were starting to get settled, my husband started to call around trying to get him an appointment for circumcision. It was unusual to do it this way, as typically it's done when babies are still in the hospital. But the hospital wasn't doing circumcisions because it was elective, and they weren't doing elective procedures because of COVID. At his first doctor's appointment, I talked to our pediatrician about it. She is Indian and told me she didn't circumcise her boys and said that it was very normal in many parts of the world to not do it. I would watch her pull back the skin to check it for fibers and think, "Is it really that bad to keep it? It's just skin." Our pediatrician didn't do it, as she doesn't perform procedures in the office, and she gave us some names of doctors that were supposed to be doing it. My husband called them all and none of them were doing circumcisions either. Finally, my husband found a doctor, but he was booked out for almost a month and a half. With no other option, we made the appointment. I was not thrilled about it, and made my husband do all the calls and arrange it because I did not agree with it.What made me change my mind about circumcising him was I didn't want him to be different. My husband assured me this was the best choice and he was very concerned our son would be bullied for being different. I have a good friend that is a nurse in a long term care facility currently. I called her and asked if it was really that bad for old men to care... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eleven brothers and sisters followed me in quick succession and the old farm house was bursting at the seams. So Mom and Dad put on a new dining room. Somehow it didn’t fit. It was built differently than the rest of the house. It was out of place, like a new patch on an old shirt. Some parts of the Later Rule of Saint Francis just don’t fit either. (...) They are “patches,” sewed on afterwards. Those little “patches” on the Later Rule stand out and they tell an important story.In 1221 Saint Francis re-edited the legislation of the Order. At the end of the twenty-four chapters of the new edition of the Rule, he commanded that “on behalf of Almighty God and of the Lord Pope, and by obedience ... that no one delete or add to what has been written in this life” . He would do everything possible to avoid changes, but just a couple of years later there was yet a newer edition of the Rule, which we know as the Later Rule. In his Testament, Francis does not distinguish between these two or, in fact, any of the different stages of the development of the Rule. In spite of the changes, even changes that were not to be expected, it seems that for Francis the Rule is one and the same at whatever stage.The Later Rule consists of twelve chapters. The chapters are not enumerated in the two original manuscripts, but rather are simply distinguished by headings set off from the rest of the text by bold lettering.2 The titles give us the theme of each chapter. It will become obvious to us that the number twelve was intentional and limiting, when we examine the Rule’s “patches” and see that they bring extraneous materials into the twelve chapters of the Rule. By “extraneous” I mean that the materials of the “patches” neither pertain to the principal theme of the chapter of the Later Rule into which they are inserted nor are they drawn from the corresponding chapter of the Earlier Rule. The “patches” do not make a good fit with the chapters in which we find them, but they do have two consistent characteristics: each of them comes at the end of its chapter in the Later Rule and, except for the last of the four patches, each of them includes materials from different chapters of the Earlier Rule. The “patches” we will examine are Chapter III, 10–13; Chapter VI, 7–9; Chapter X, 7–10, and Chapter XII, 3–4. The “patches” shed light on claims that Francis was forced to omit from the Rule ideas that were important to him, and even the myth that the whole original copy of the Rule was intentionally lost. They bring us to the conclusion that nothing important was lost in the transition from the Earlier Rule to the Later Rule.Chapter III, 10–13Chapter three of the Later Rule carries the heading, “The Divine Office, Fasting, and how the Brothers should go about in the World.” Chapter three of the Earlier Rule had also dealt with the divine office and fasting. The earlier text had begun with the saying of the Gospel that some evil spirits could only be driven out “through prayer and fasting” . This Gospel phrase explains why the Later Rule, following the Earlier Rule, deals with prayer and fasting in the same chapter. With respect to the Earlier Rule, Francis has included new content in the corresponding chapter of Later Rule. It is material that goes beyond the themes of prayer and fasting, and it doesn’t mesh neatly with these two themes.Chapter three of the Earlier Rule ends saying, “However, at other times, according to this life, let them not be.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The TripletsManeesh BatraI am a neonatologist and for the majority of my clinical time I care for babies and their families at a large University-based referral neonatal intensive care unit (NICU) in the United States. In 2003, I first visited this rural Ugandan hospital shortly after the opening of a special care baby nursery there, and have been involved with development of that program ever since.Uganda is a beautiful, (...) land-locked country in East Africa with a sordid political history. It is a developing country that is poor, mostly rural with a high fertility rate and a life expectancy of 42 years. The government spends $5 per capita per year on healthcare. The district with the hospital has a population of 500,000, the majority of which is rural. Access to health services is poor, even by Ugandan standards, and child mortality is in the higher band in the country.Most people in the region live in extended family clans. A common home is made of earth, with a grass roof, and a jerry can out front for collecting water from the well. It is an exquisitely lush landscape with fecund soil. At the hospital, there is limited electricity, lab support, medications, blood supplies, and health care workers. For the 200 bed hospital (that accommodates upwards of 400 inpatients when necessary, no one is turned away) there are four to seven Ugandan doctors, who do everything from C-sections, to colostomies, to HIV care to resuscitate babies in the NICU. For a ward of 20-80 patients there are one to two nurses, and maybe a nursing aide. Families do the majority of the care in the hospital, even in the NICU. Mum's express breast milk, perform tube feeds, wash the linens, notify staff when an IV infiltrates, and keep babies warm.Day OneAnother beautiful morning, with fresh instant coffee in hand, birds chirping and kids playing outside. It is good to be back. Over the last eight years, I've [End Page 78] made some close friends here and its good to be among them again. Every time I visit and return home, I leave a piece of me here, and bring back something new with me. This morning that feeling is overwhelming me, an incredible inspiration swells. I am not tired and I want to be busy. It is no wonder that this is where I was inspired to pursue caring for babies as my career. Over these years, it has been amazing to see the staff care for the community's babies and mums here. As an outsider, an opinioned one at that, I feel burdened at the thought of these babies dying somewhat needlessly. Is it really no-one's fault? How should one act in the face of scarcity, knowing there is a better standard to be had if only circumstances were different?I walked into the NICU to find triplets had arrived! Born at about 33 weeks they were two months early. Since they weighed around 1.5kg (about 3 lbs) each, they were at very high risk of dying —however, it was absolutely incredible to see the way they were tucked in by the skilled team. Within an hour of delivery—they were in incubators with IVs, having their hypoglycemia corrected, and two out of three were on oxygen (all of them had their O2 saturations checked). The three babies were tucked in so calmly, with the finest skill and expertise neonatal care anywhere has to offer. In stark contrast to the first admissions I witnessed years ago, the nurses now knew exactly what to do and how to do it. As a result, they had saved many lives and restored hope among the mums of the region that there was somewhere to go to get help. This success resulted in a healthy swagger among the staff because they could intervene successfully.These were spontaneous triplets to this young mum, who already had three other children. She looked tired when she walked into the NICU one hour (yes one hour) after delivering the trio, but if I hadn't known prior, there was no way to know... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How was Haiti?Sadath Sayeed"She smelled of milk and urine. Chacko marveled at how someone so small and undefined, so vague in her resemblances, could so completely command the attention, the love, the sanity of a grown man."—Arundhati Roy from The God of Small ThingsFather and SonTwenty minutes before I was to be taxied to the airport in Port-au-Prince, the baby boy handed to me did not breathe continuously. He (...) didn't breathe at all. Born a few hours earlier at home—probably in one of the hundreds of make-shift tent cities. I did ask if the baby cried after he came out of mom. Yes. He didn't suckle well and stopped crying. Dad decided to get help. Climbed onto a moped with his baby wrapped in a blanket. Must have tucked him under one arm and rode between piles of rubble to the closest health care facility.People at this other place tried to help his baby boy breathe. They pushed air into his mouth like you are doing. After a few minutes, they said that they couldn't help anymore."Go to the University hospital."From a shirt sleeve pocket, he pulled a crumpled white piece of paper with some writing scribbled on it. I gathered it documented this last visit. They took the time to hand him a note before they sent him on his way.What did Dad think? Thanks for the note. Okay, now what? Swaddle my baby. Tuck him under one arm. Hop on my moped.Strained ResourcesL'Université d'État d'Haïti has been the main teaching hospital for all of the country for decades. Many, if not most, formally trained Haitian health care providers have spent some time in Port-au-Prince at this institution. As important as it is, it has suffered from neglect over many, many years. The earthquake made matters exponentially worse. [End Page 98]Dad must have been directed to the pediatric service when he arrived. There, a few Haitian pediatric residents and nurses were doing what they did every morning. Tending to an overcrowded patient population of babies, children, and parents. The pediatrics building was left uninhabitable. All inpatient and outpatient care took place on a street where the tents had been erected.In the ICU, tent twenty beds filled a space probably meant for ten military style cots. Metal cribs and full adult hospital beds were jammed next to one another to fill every possible nook. Parents slept on the adult beds with their sick children or underneath the cribs. Siblings too. Outside, hundreds of parents would line up starting at six a.m. and stand in line for hours so that they could get their children seen in a couple of smaller tents that were used to run the outpatient clinics. Moms would fan their kids under the shade of trees on the side of the road. Feed them some milk or juice while they waited. Smile at us passers-by. They seemed to possess a bottomless well of patience.Power cords with extension wires littered the street-hospital floor under the canopy.When it rained, we were only modestly concerned about electrocution. A single 1950's style metal desk with two worn out chairs greeted visitors to the entry way and was usually occupied by some of the medical staff. A single, large metal fan that had collected enough dust and soot in its circular cage to look bearded hummed a breeze toward the desk.A bottomless well of patience and resiliency. In the popular media, this last word has been thrown around a lot to describe the character of the Haitian people. It is insufficient. Their adversity is truly absurd. Sense cannot be made of the scene in the pediatrics tents months after the earthquake struck, nor elsewhere on that campus, let alone outside its walls.The local medical staff hadn't been paid a dime in many months even prior to the earthquake. They suffered unimaginable losses during the earthquake. They still came to work."We love our children. They love us too."What so many of us think of as charity... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Obesity Treatment:One Size Does Not Fit AllKarin KwambaiI am obese. That phrase is actually very hard for me to say out loud. Saying it feels as if I am standing at an “obesity anonymous” meeting, except there is nothing anonymous about being fat. Everyone knows it. I often feel that it is the first and only thing people notice about me. I’ve been overweight, chubby, fat my entire life. (...) My mom enrolled me in Weight Watchers when I was 12 years old; I learned to use Molly McButter in front of her and sneak oatmeal cream pies when she wasn’t looking. I’ve learned a lot of maladjusted behaviors around food over a lifetime of trying to lose weight. I’ve tried meal replacement shakes, pills, souping, juicing, and the “Master Cleanse”—a diet of lemonade with cayenne pepper and maple syrup. All of these tactics only messed up my mind and body even more. The summer before my freshman year of college, I literally ate only an apple a day because I was so worried about not making new friends because of my weight. It was not about being healthy; it was about being accepted.Twenty years of blame and shame later, and despite mixed reviews on its success, Weight Watchers is still the first recommendation for weight loss from my doctor, along with Medifast, a 1000 calorie a day diet, or bariatric surgery. My naturopath told me to make my smoothies and spinach salads smaller, and my therapist told me I think too much about exercise and should “just do it.” I have gone many rounds with Weight Watchers and had some success. I have also had success losing weight by tracking food intake and exercise on apps like My Fitness Pal. But like all attempts at losing weight, following medical advice works until it stops working, and the weight comes back—plus some.Obesity as a DiseaseI recently sought treatment with an Obesity Specialist, but after an inspiring complimentary consult where she explained her holistic approach, I found out that my health insurance won’t cover the cost because the diagnostic code for obesity is excluded from my coverage. I have heard that the Affordable Care Act is supposed to impact insurance plans covering the cost of obesity treatment, but that has not been the case for me. In fact, I’ve been forced to pay out of pocket several times for labs that doctors feel the need to run, despite my urging that I am not diabetic. Trust me, I say; I know what diabetes looks like. I have watched family die and seen clients suffer, and I am earning my Masters in Public Health. I had been hopeful that the recent classification of obesity as a disease by the American Medical Association would open treatment doors, but it has not. In fact, I’m concerned that it will close doors for treatment opportunities because of how insurance [End Page 104] companies decide what medical costs they will cover. Obesity seems to be a four–letter word for health insurance companies. My insurance plan will cover prescription medications for high blood pressure, high blood sugar, and high cholesterol, but it won’t cover weight loss medications. Where is the incentive to address weight loss before potentially developing a life–threatening disease? I believe that obesity is a disease; I just don’t trust how the healthcare system will handle the responsibility of addressing it as such.In fact, the debate on whether obesity is a disease or a lifestyle is a frustrating one for me. If we claim lifestyle is the cause of obesity, it means that there is only one factor causing obesity. If that were true, then the commonly prescribed solution of “eat less, move more” would be more effective. The reality is, there is no single cause or cure for obesity; there is no one–size–fits–all treatment approach. It is a complex problem that deserves a complex response in the forms of primary, secondary and tertiary public health interventions. I am hopeful that classifying obesity as a disease will lead to more disease model research... (shrink)

Who doesn't wish they hopped out of bed each feeling energized and ready to tackle whatever challenges lie ahead? In Morning Rituals, author Leslie Koren is here to help, with practices that will have readers kicking their day off right! This tidy volume offers dozens of invigorating, empowering exercises for the body and spirit: Set an intention for the day. Drink a glass of lemon water. Write morning pages. Do a set of push-ups, or a series of energizing yoga poses. (...) Pull a tarot card. Take a moment to be still, over a cup of tea or a book of poetry. Whatever rituals speak to you, do them with intention and do them regularly, and you'll find that your morning sets the tone for a brighter, calmer, more productive day. Each prompt includes straightforward instructions as well as ways to personalize and improvise the idea. This beautifully photographed book will make for a thoughtful, loving gift-perfect for Mom, a recent graduate, or someone in need of a pick-me-up, or as a way to treat yourself. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE UNITY OF THE VICES JONATHAN JACOBS Oolgate University, Hamilton, New York JOHN ZEIS Oanisius Ooilege, Buffalo, New York W:E SOMETIMES describe someone 1rus "just plain,, ' ' • • 0 " ' ' • • mean, or Just plam d1shonesit, orr JUSt pJam unw." Or we say" thaJt wrus ·a just plain ·stupid thing rto do.," G~a:liizing from tlhese and lik!e descriiptions, we can ask, are there any (...) "just plain" vices? By this I mean, are :amy vices pure, 1e.g., can rthere he Cl'lllelty hut nort injustice or in!t:Jempertance, intemperance hut no!t a £ailill'e orf pmctical wisdom, cowardice but not intemperance or injustice, and so on? Is therie perhaps a unity of the vices? Is each ;a col'l'IU!ption thrat involves the coITUpiting ctontriburtion of the othe'l'IS? If there is,a, run:iity of the vicies, then 1be:inig ra vicious individual is Il!Ort siinply 1a ma!bter o:f failing :across the dimensioill of one or rrunothe.r 1 Cihaa:iae1becisltic. ]t ms tan extensi,ve diaiilure, 1a unified (:if l[JIOrt toit.al) failure, even if it is most evident 1and preVialent in one or another •specific respecit. 'f1his iis not to isay thrut.theiie is just one vice,.any moil'!e 1than '!Jo.endorse the unity of it.he virtues is to reduce tth:em to Ollle. There.are many woes OOlld many virrbues, eaiCh respeotively h!ruving to do with dillemnt 1and variously!l'le1aibed crupacirties, motives, emotions, and tiiaiits. Yet, rut least with respect to the virtues a good caise can be mrude :that they.are unified, aind thrut ·AnisbotLe was oorrreot in concluding that practical wisdom :and viWtues of cha;riacter mum occur st quite 1 s1tably, even if '1llolt happily. In any case, we ail"e in 1 to:tal ag.rteemelllt with Geach when he 1sayis 1that ithaJt "If 1a man's ha1bit of sound moml judgme1J11t is virtiiafod anyiwhere, then :it is at risk eVierywhere; but not all dangel"s issue in disa1sit1e'f!s." 3 But 1thes1e dis1as!ters arie aV1eTted r.not because of,any moml str1ength of characil:er 1 th:ait the agent 1truly ihas bUJt heca:us1 e of a me11e inc1ilJJaition tues. 'Ilhe former may he very :firm ox srtable. Mo11eover the n:aituil'ally vi11tuous rindividual may giener1a1ly no1t he oornfused or.impeded maction by "b.ar:d easies" or nnvelty. Alt times he rmay, 1and lthien me may find his re1sourroes iinoompe1be!I1t O'I.' unoel 'l:Ja1in in 1bhreir direetives. Hut the main rpo:inlt of co111iCT'last is thait mo11al virtues 11eflieot 1a 1evel of 1agency wh1oh involves undersitanding 1and self-determin1ation engiaged 1 to t:hat undersltanding, 1a 1leviel tihJait tis 1ruhsen1t foom iinc1ination-grounded action. Na,tu11a1l vri:r1tues 1a1rie ll101t to he despised, 1 and 1aclts :thait fLorw 1f110m 1tJhem 1are not w:iithout moml Wiortlh. But, using the fangiuiage of Fr1a:nk£u:rt, mom1l virtues are oha1racter]s,tios thait refiecrt second order volitions.5 The aiotis: thait flow fil1om them •are not H11e reis:ult of ways one just hrupens to be. And the undeil'-,starnding involvred in moml vrntues makes mo'ral misdireotion 1 1es;s li1"ely. Again, mnswder suoh t.lrings rus mis1applied oomprussfon, or paiti:errce, whioh can involve u1mairness 1and imprudence. P1 errharpis it.is heoausie rbhe mo:rial V1mtueis rare unified that it is 1so hard to rbe 1good. They invo1vie a complex reperrto:We of judgmenits, d1sposi!tiorrs, and moti¥es. No one of them can he oomp1ete on its own, and wie c1an't oome to have 1 tJhem simply 1hy decis1on. One oan til.'y rbo he move coumgeous bU1t caill't ibring it rubout meriely hy init1emal eommanid. Self-imposrutiion in5 In " Freedom of the Will and 'The Concept of a Person," H. Frankfurt writes, "Someone has a desire of the second order when he wants simply to have a certain desire or when he wants a certain desire to be his will. In situations of the latter kind, I shall call his second-order desires "secondorder volitions" or " volitions of the second order." Now it is having... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Psychopathy, Other-Regarding Moral Beliefs, and Responsibility”Jennifer Radden (bio)Fields’s line of reasoning may be summarized, though to do so is to lose much that is nice, and important, in the details. He begins by distinguishing the kind of disorder we are dealing with. Psychopathy is a personality disorder: an unchanging, trait-based condition, not a mental disease or illness. Then he asks why we might judge the presence of (...) psychopathy to vitiate moral and legal responsibility, and answers that psychopathy must reflect some kind of disability. It has been hypothesized (by Duff) that this disability concerns moral understanding, but Fields offers an alternative account. Rather than lacking moral understanding, he argues, the psychopath is disabled in that he cannot form other-regarding moral beliefs. A very convincing argument is then made to persuade us that such a disability would—or should—constitute an excuse.Much of this reasoning is unassailable, and Fields’s careful and systematic approach is impressive. Yet I am left with a lingering concern. He has not convinced me that the psychopath is incapable of forming instead of merely disinclined to form the required sort of moral beliefs. And rather than furthering or supporting his incapacity explanation, Cleckley’s example of Milt undermines it.Maybe the example of Milt’s callousness is the place to start, although whether this is as strong an example as Fields and Cleckley seem to think of psychopathy, is questionable. It is a rather underdescribed example, certainly. We are told that this is the unvarying pattern of Milt’s behavior. Indeed, it has to be to fit the clinical definition of psychopathy as a trait-based character disorder rather than a short-lived “out of character” response. And yet Milt has reached driving age and his mother is still naive enough to expect he’ll pick her up! We need to know more. If mother hasn’t grasped Milt’s dispositional traits yet, why not? Perhaps these traits are not so unvarying and entrenched after all. Or mother is colluding, or denying? Perhaps the understanding between mother and son contained meanings not apparent in the bald clinical description provided by Cleckley. There may be more to this story than meets the eye.So I’m not sure that the example successfully illustrates the clinical definition of psychopathy. But let’s say it does. If we accept the story as we are told it, there remains a gap in the reasoning. That Milt lacks the capacity to form such (other regarding) beliefs, and to harbor guilt feelings as Fields asserts, would explain his irresponsible [End Page 287] behavior—why he “so easily gives way to whims, even though he knows that to do so is to leave his mother... stranded”(p. 33).An incapacity to form other-regarding beliefs may explain this behavior, true. But so equally might being someone given to whims. After all Milt might just have the personality trait, also long established and unchanging, that he gives in to whims more often than most. This is what people sometimes mean when they attribute impulsiveness. And impulsiveness is not only a rather common trait; as it happens it is also one associated with this particular disorder (among others).Fields recognizes the type of explanation which refers to the presence of an unthought out impulse to act, a whim explanation. But he fails to give this kind of explanation its due, using it only selectively and arbitrarily. If, as Field establishes, it is more coherent to think that Milt’s initial offer to his mother was a matter of whim—rather than evidence of the other-regarding belief that one ought to concern oneself with the welfare of one’s parents—then there is no reason to suppose that his failure to follow through and pick her up was not also a whim. This second whim represents an equally satisfactory (simple, plausible, explanatory, not ad hoc ) explanation: Milt might have come to pick up his mum but he whimfully chose not to.And this is a separate and distinct explanation from the one Fields proposes in terms of incapacity. A whim is not (immediate) evidence of incapacity... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 21.1 (2001) 151-154 [Access article in PDF] Book Review The Happiness Project: Transforming the Three Poisons that Cause the Suffering We Inflict on Ourselves and Others The Happiness Project: Transforming the Three Poisons that Cause the Suffering We Inflict on Ourselves and Others. By Ron Leifer, M.D. Ithaca, New York: Snow Lion, 1997.313 pp. This book focuses mostly on Buddhism and psychotherapy, but it ranges widely and (...) includes many reflections on Christianity. Today there are many good books that compare Buddhism with Western psychology, but this one is not to be missed by anyone interested in the topic. Leifer (a former colleague and friend of Ernest Becker, who wrote TheDenial ofDeath) is obviously a very experienced psychiatrist, with deep knowledge of psychoanalytic theory to supplement his many years of practice [End Page 151] as a therapist. This book is many things: a primer on demythologized Buddhism; a superior "self-help" book; a history of psychotherapy, including a critique of its modern medicalization; a speculative account of the evolution of human consciousness; and, not least, the most insightful interpretations of the Job, Oedipus, and Eden myths that I have encountered. The prose style is lucid, and only space limitations keep me from quoting it at length.The title turns out to be ironic, since our Happiness Projects are the main source of our unhappiness. Our selfish strivings for happiness are, paradoxically, the main cause of the suffering we inflict on ourselves and others.What we "fail to see" (avidya)is not some great mysterious wisdom. "The core of the esoteric knowledge we seek consists of secrets we hide from ourselves. We hide from them because they are not what we want them to be. The world is not what we want it to be. Life is not what we want it to be. Others are not what we want them to be. We are not ourselves what we want to be. We hide from these truths because they mystify and terrify us" (12). The basic "secret" of happiness is that the three poisons--greed, ill will, and ignorance--are the source of our pain and suffering, by creating rebounding karmic ripples. The ego is a trickster who is continually the victim of his own trickery. True happiness can only be the product of an inner transformation that changes our habitual patterns of thought and action, enabling us to "relax into existence." Leifer's psychologized Buddhism is a therapeutic path cleansed of the mystical and paranormal; there is no place here for psychic powers or any transcendental salvation (nirvana is not discussed). The focus throughout is on how we are bedeviled by our own desires.The book is organized into four main parts. The first offers Leifer's understanding of the first two Buddhist truths. The second part, "Western Views of Suffering," includes profound interpretations of Job and Oedipus Rex. Job's suffering illustrates the first truth, that life is suffering, and his patience is virtuous, even heroic, in its refusal to demand that life be different than it is--an endurance that allows him to avoid making life worse: "Patience is the willingness to suffer without aggression" (131).The key to the Oedipus story is in his answer to the Sphinx's riddle: humans are the creatures who walk on four legs as infants, on two legs as mature adults, and then on three legs (with a cane) in old age. The riddle is a metaphor for the truths of our impermanence, old age and death. But Oedipus cannot accept it. "From a Buddhist point of view, the story of Oedipus is a metaphor for neurotic mind. Oedipus was the victim of his own grasping ego--of his desires and aggressions. His fate was sealed by his own efforts to escape it. The source of Oedipus' pain and tragedy were his own ignorance, passion, and aggression: the three poisons" (135). His desire for Mom is better understood as a symbol of human desire generally: our refusal to grow up... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Little Body Hidden WithinTara ChapmanBeing “fat” was not a choice. It was my life and it slowly happened over time. Being obese is a disease that I have struggled with my entire life. I am 36 years old, nearing 37.I might not have eaten the right foods, but I didn’t overeat. I grew up eating typical American food and continued to cook that way into my adult life. I (...) ate eggs and toast for breakfast, sandwiches, chips and a few cookies for lunch, or leftovers, and some kind of meat and potatoes or pasta for dinner, with a canned vegetable. I very seldom ate fresh vegetables, but I did like summer fruits. However, those are filled with natural sugar and are only in season for a few months out of the year. I didn’t eat out, other than having my daily Starbucks Mocha Frappuccino on the way to work five days a week. I didn’t load my plate up with food. I ate less than my brother, sister and parents who are smaller than me. I took exercise and fitness classes all through college and knew what I was supposed to do. I exercised over the years, only to quit because I never lost weight and got discouraged. I would feel [End Page 93] better physically; however, I just kept packing on the pounds, which took a toll emotionally.By November 2012, I topped the scale at 291 pounds and could barely fit into my size 22 jeans and 3xl tops. I would sweat uncontrollably because of all the extra weight I was carrying around and could barely make it up the ramp at work or a flight of stairs without huffing and puffing. Because I would sweat profusely, my wardrobe consisted of white or black shirts. I had to hide the sweat stains. I had high blood pressure and cholesterol. I was on medication for both. My insulin levels were all over the boards. I knew that when I was shaky and my levels were high, it was time to eat. I would control my type II diabetes by eating a small piece of candy, which would instantly control my shakes. I would follow the candy up with a meal. My diet and exercise habits were causing me to have terrible headaches. In my early 20’s, I was diagnosed with Polycystic Ovarian Syndrome (PCOS). Besides having ovarian cysts and unbalanced hormones, the major issue with PSOC is unexplained weight gain and not being able to lose it. My health was spinning out of control and I secretly knew it. I just didn’t know how to fix it or what to do.I had to do something and I needed help. I didn’t want to die by the time I was 40; and the path that I was on was leading me to an early grave. I could hear it in my mom’s voice every time I talked to her. She knew something was wrong; she would try to talk to me about it and tell me I was going to have a heart attack. She would tell me how worried my dad was. I wouldn’t listen. I began to sleep more and more every day after work and on weekends. I had to take naps almost daily because I was so exhausted and had no energy. I didn’t know what to do. I was depressed and felt like I was alone. Nobody in my family understood and my friends couldn’t relate to what I was going through. I was fat and they weren’t.I heard about a special clinic that focused on women’s health issues from a co–worker. Under the close watch of the clinic’s doctor and her medical staff, I began a therapeutic lifestyle change on February 27, 2013. I had no expectations because I had always been obese. I had never lost weight, so why would this be any different? This lifestyle change includes committing to a healthy diet of high protein, vitamins and supplements, balancing hormones for PCOS and exercising. However, before I could begin changing my eating habits... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Vertical Transmission:The Patient, the Student, the TeacherMiguel PaniaguaHe did not ask for this fate, nor did he deserve it, particularly considering the tragic circumstances. Lì presented to the campus health provider one month prior with fatigue, abdominal pain, and jaundice. He and his parents immigrated to the United States from China when he was a child. He was well aware that he had hepatitis B from what is termed (...) "vertical transmission." His mom unknowingly passed on this virus to him during her pregnancy. In most countries with a high prevalence of the virus, prenatal screening is routinely undertaken, and prophylaxis administered. I am not certain this occurred in Lì's case and at this point it did not matter. Lì knew he would live with this for the duration of his life. In fact, he told me he had gone his whole life to this point without any symptoms whatsoever. What is known about chronic hepatitis B infection is that in most people affected, it can be considered a chronic disease where most live a long full life. The risk of advancing to liver cirrhosis or cancer in general is low. This unfortunately was not the case with Lì.What transpired was what they most feared. As he was studying for his final exams, Lì endured days of worsening fatigue, malaise, and nausea. He noticed his skin was a tinge of yellow and he was having some itching that was unusual. He noticed his clothes fitting more loosely and found he had unintentionally lost twenty pounds. He visited the campus health center and after a series of tests and imaging studies, Lì was diagnosed with advanced hepatocellular carcinoma, an unfortunate sequela of this chronic infection. It was then that he put school on hold and returned home to get further care.I first met Lì in the hospital as a consultant for the palliative medicine service. "He won't listen." "He is so difficult." "He is in denial." These were examples of some of the care team's exasperated assessments of his demeanor as a patient. What I did not realize prior to visiting him the first time was that Lì was a pre-clinical medical student. When I first met him, he did not want to talk very much; he was preoccupied and distant. In retrospect, I can see that he was suffering on so many levels. His appearance was gaunt and cachectic. The lights in the room cast shadows in the concave areas of his temples and his collarbones were the most prominent feature of his torso through his hospital gown. He glowed yellow from jaundice. When I examined him on this first visit, I noticed that his liver, a now grossly enlarged hard and nodular structure, occupied most of his abdomen. I found that speaking to him as a colleague, even calling him "doctor," helped him feel respected and enabled me to build rapport with him. At one point, I described to him the findings I felt in his abdomen. "I can palpate the edge of your liver here, what seems to be eight centimeters below your costal margin. There are many palpable nodularities on the ventral surface." It was at this point I invited him to palpate what I was feeling. I gently guided his own hand over his abdomen and noticed him studying the features as if they were not his own, like a skilled diagnostician.Over the course of three weeks, I visited with Lì when I was on service. The last time I saw him, he had declined rapidly, his disease progressing [End Page 17] cruelly, and he was very short of breath and becoming more somnolent. I noticed his mother in the room, standing by his bed, and crying inconsolably as he lay suffering. I felt deep anguish and remorse, wondering if she said these words to herself "It is all my fault," considering the source of his initial illness. I cannot even imagine.As I assisted the team in titrating his comfort medications, I sat with him. He shook my hand with all the strength left that he could muster and said, "you are a good doctor." I... (shrink)

continent. 1.4 (2011): 279—285. Concerning its Transitive Nature, the Conversion of Native Americans of Spanish Colonial California, Indoctrinated Catholicism, & the Creation There’s no direct archaeological evidence that Jesus ever existed. 1 I memorized the Act of Contrition. I don’t remember it now, except the beginning: Forgive me Father for I have sinned . . . This was in preparation for the Sacrament of Holy Reconciliation, where in a confessional I confessed my sins to Father Scott, who looked like Jesus, (...) at least in Western cultural representations of Jesus since the middle ages, and if Jesus put on a few pounds. Father Scott was long-haired, redheaded, bearded, chubby, and tall. When he left church with the procession of altar servers and Eucharistic ministers, yelling, “Sing a Good Song Unto the Lord,” he smiled, hands folded, and he gazed over his parishioners, and bounced along. For four months every year he lived among the Crow Nation in Montana, where towards the end of his tenure at Our Lady of Refuge, they adopted him as an honorary member of their tribe. * This is the prayer we chanted, holding hands, every night before dinner: Bless us oh Lord, for these our gifts, which we are about to receive, our bounty through Christ, our Lord, Amen. Then we all said, God bless the cook! When we were with my grandparents, Grandpa said, God bless Chicky, and Holly, and Harvey, and Boots—all the dead dogs. * My sister tells me that she sits next to a handsome man on a flight across the country. After chitchat, she withdraws her book. She’s reading Kevin Sampsell’s A Common Pornography . After a few moments, the handsome man also reads from his book—his leather-bound Bible. Sister thinks, Oh, Jesus—too bad. She falls asleep. Later, settled in Nashville, she opens her volume and out falls a Jesus-covered card that reads, You can still find God and Salvation! Because that handsome God-fearing young man saw that word— pornography . * I suppose Father Jim’s dark hair, beard, and glasses made me think doctoral-ly of him. He called while I was in the midst of a breakup, after I’d twice attempted suicide, and my mother was desperate for help. She somehow found and phoned him. And Jim, now years out of Our Lady of Refuge’s parish, twenty years since my baptism, years even since he’d left the priesthood and the Catholic faith, still made the effort to bring me back into the fold. He said, “Have you seen a priest?” I did not respond, as I was more shocked to hear his voice than anything, so I said, “How are you, Father Jim? Sorry, I guess I shouldn’t call you ‘Father.’” And I said, “Why did you leave the priesthood? Do you have a girlfriend?” He said that I should call him just “Jim.” He said, “Do you need someone to talk to?” I said, “Not really.” He said, “Call your mother; she’s worried about you.” That was the last time I talked to Father Jim. * Mother let me know just how disappointed Jesus was. I cried and cried, and said I was sorry. Into my hands she placed my missal, ordered forty Rosaries. She said next Saturday I would go to confession. I hated confession. Who wouldn’t? * I realize, of course, that this page is a kind of confessional. * The Kumeyaay, Ipai, Tipai, Chumash, Esselen, Rumsen—all Native Americans of Alta California—shared similarities in their religions. Southern Californian tribes made use of Datura, or jimpson weed, a hallucinogen, for religious rituals. In the creation, God made brother sky and sister earth. Brother and sister mated, and sister gave birth to all things on Earth, including people, but it was difficult to distinguish people from all other aspects of Earth because everything was alive: granite and obsidian, the Pacific and its waves, the San Diego and Los Angeles Rivers. Wiyot—a hero—was very powerful, born from lightning, the son of the Creator and a virgin. When Wiyot thought that human women’s legs were more beautiful than Frog’s, Frog became jealous and poisoned Wiyot. The dying Wiyot went to all the people’s villages, and he distributed his power among them. He said, “When I die, I should be cremated.” The people built the fire and funeral pyre. When the fire was ready, and the people about to place Wiyot’s body upon it, Coyote came and snatched away Wiyot’s heart. * My friend Nick told me once how he ate some jimpson weed and that he hallucinated for three days. His family took a road trip and, while driving over the Sierra Nevada mountains, he kept seeing dinosaurs roaming the open meadows and charging down snowy slopes. So it’s no wonder that Native Americans who ingested this plant would have developed religion. * Walking Castroville’s streets after school I got into fights but mostly watched other boys scrabbling on the asphalt. I went to Burger King for Whoppers. Me and my friends cussed. Antonio admonished me when I said, “damn,” while strutting a sidewalk alongside the church. He said, “Jaime”—pronounced Hi-May, which was what all the Mexicans called me—“you’re crazy, eh. Don’t cuss at the church.” He meant while at church, as in, within its vicinity. I said, “We’re not in church.” Once we’d crossed the street, Tony said, “Damn dude, you’re fuckin crazy!” * Blessed Father Fray Junípero Serra raised the Eucharistic goblet to his lips, and candlelight danced on the blood’s tiny waves. Incense clouded the church so completely that some of the Pame natives grew nauseous. So, too, felt Blessed Father Fray Junípero Serra later that night, as he bent over a ceramic bowl and vomited blood, not only the Lord’s, but his own, for poison had laced the sacred vessel into which he poured the sacrament. The physician tending to the sick prelate urged him to take the remedy he’d prepared. But Blessed Father Fray Junípero Serra refused, said that he would pray, for he had never taken any medicine in his life, and he never would. * The Chumash of El Valle de Los Osos called themselves the Stishni, separating themselves from Chumash of other regions, those varying tribes of the central California coast that spoke mutually unintelligible dialects of their Hokan language. This made learning their languages impossible for the Spanish friars, to say nothing of translating the Doctrina. Thus the priests baptized few natives, despite the help that the tribes offered the fledgling settlements in the form of meat and acorn meal, which the Spaniards found repugnant. Some from these cultures, feeling threatened by the newcomers, shot flaming arrows into the thatched roofs of the mission structures. And why wouldn’t they feel threatened when priests chastised them for performing, for example, their Coyote Dance, wherein a man donning a coyote-skin-and-skull costume dances while a singer sings his tale, which laments the human feces strewn imaginatively about the Earth? Coyote, meantime, tries to get an onlooker to lick his genitals, and finally engages in public sexual intercourse with a female tribe member or two, then ends the dance by defecating. Though the Franciscans called such forbidden acts devilry , the Chumash maintained their Datura cult religion, along with the enforced Christianity. For the Chumash, the Earth was made of two enormous snakes that caused earthquakes when they slithered past one another—a vast reptilian tectonics. In the 20th century, long after Blessed Father Fray Junípero Serra and his cohorts had died, when asked by an anthropologist about religious contradictions, conflating the Datura and Christian cults, a Chumash man replied, incredulous: “But these are two different religions.” * When Portolá ordered that if by March 19th, the feast day of St. Joseph, the San Antonio had not arrived in San Diego Bay to relieve them, the Sacred Expedition to Nueva California would be abandoned, Blessed Father Fray Junípero Serra prayed a novena for San José’s intercession. And lo, a lookout sighted the San Antonio ’s sails—what seemed to the priest a miracle—that very Saint’s feast day. Europeans would stay in California, and Blessed Father Fray Junípero Serra would continue to reap a great harvest of souls for the Lord. By the end of mission secularization in 1836—sixty-six years after the San Antonio rescued the Spaniards—Native American populations in California had declined by seventy-three percent. * When Peter the Aleut would not renounce his Eastern Orthodox faith the padre of San Francisco had a toe severed from each foot with each refusal, totaling ten. The native Ohlones employed in this gruesome task—their obsidian chiseled knives tearing through skin and grinding bone—continued as per their orders, and cut off also each of Peter’s fingers (equals a total of twenty refusals). They quartered the martyr, spilled his bowels, as if from bear attack, attack by a bear in the shape of a Catholic. * Blessed Father Fray Junípero Serra absolutely believed that the slow rate of conversion for the native people was due to the influence of the Devil, who had been outraged by the coming of the Catholics to California, this region that he had long held in his dominion. * In his reception speech for the Nobel Prize for Literature, John Steinbeck said, “Man himself has become our greatest hazard and our only hope. So that today, St. John the Apostle may well be paraphrased: In the end is the Word, and the Word is Man—and the Word is with Men.” * In 1602, when Sebastián Vizcaíno and his friars sang mass on Catalina Island, as many as a hundred Pimungans witnessed the rite, asking by signs what it was about. According to Vizcaíno’s records, the Californians marveled not a little at the idea of Heaven and at the image of Jesus crucified. * Vizcaíno was brought to a prairie on Santa Catalina Island where the Pimungans worshipped their sun god. Upon the prairie they had placed an icon, a headless figure with horns protruding from the body, a figure that Vizcaíno predictably described as a demon. The Pimungans urged Vizcaíno not to approach the image of their deity, but he ignored them. He placed his crucifix against the wooden figurine and prayed the Our Father. Vizcaíno told the natives that his prayer was from Heaven, and that their god was the Devil. Vizcaíno held out his crucifix, encouraging the Pimungans to touch it and receive Jesus. He pointed at the sky and indicated Heaven. The Pimungans worshipped a sun deity, so they were impressed with this white man and his description of his god, for their gods seemed to be one and the same. It’s no wonder then that Vizcaíno’s diary reports the natives being pleased with this exchange. “Surely,” the diary says, “they will be converted to our Holy Faith.” * The Miwok women wailed and scratched at their faces when their men consorted with Sir Francis Drake and the other Englishmen who had landed on California’s coast in the summer of 1579. “The blood streaming downe along their brests, besides despoiling the upper parts of their bodies of those single coverings . . .they would with furie cast themselves upon the ground . . . on hard stones, knobby hillocks, stocks of wood, and pricking bushes.” Drake and his men fell themselves to their knees in prayer, their eyes Heavenward, so that the natives might see they prayed to God and they too might worship God then their eyes that had been so blinded by the deceiver might be opened. * Father Fray Antonio de la Ascención—Carmelite friar in Vizcaíno’s party—writes that the Indians of California can “easily and with very little labor be taught our Holy Catholic faith, and that they would receive it well and lovingly.” He calls for two hundred older and honorable soldiers to ensure brotherhood during the conquest, so that peace and love—the best tools to pacify pagans—should reign. The religious, the friar says, should likewise be wise and loving to easily quell animosities between Spaniards and the heathen, and therefore avoid war. The Spaniards should bring with them trinkets—beads, mirrors, knives—to distribute amongst the gentiles, so that they might come to love the Christians, and see “that they are coming to their lands to give them that of which they bring, and not to take away the Indians’ possessions, and may understand that they are seeking the good of their souls.” No women are to accompany the conquest, says Father Fray Antonio, “to avoid offenses to God.” * In 1955 Wallace Stevens admitted himself to St. Francis Hospital in Hartford, Connecticut. There, it’s rumored he converted to Catholicism before dying of stomach cancer, exclaiming to his priest after the baptism, “Now I am in the fold.” Stevens’s late-career poems seem less cynical, more in awe of being and death (read “Metaphor as Degeneration” from The Auroras of Autumn ). He could have chosen from at least three secular hospitals in Hartford at the time. * I was reading Stevens’s Collected Poems when I joined eHarmony and listed that as my “currently reading” book among the “more than twelve” books a year that I would read. I fell in love with my wife when she said, “Are you sending your work out to literary journals?” Prior to this, the first girl I talked to on the phone, when I explained my doctoral exams, said, “So, you’re like, reading Stephen King and stuff?” When I said not exactly she responded defensively: “He must be doing something right, since he makes all that money.” * Mom walked me, my brother, and sister, through the Stations of the Cross. We did this on Ash Wednesdays, or whenever she thought we needed extra God after church. It might’ve happened before church, though that’s unlikely because we were always late. Anyway, it’s easiest to walk the Stations of the Cross when there’s no one else around. To walk the actual Stations means one goes to Jerusalem and walks the Via Dolorosa to the Church of the Holy Sepulchre. So the Stations elsewhere—usually paintings, or low-relief sculptures upon church walls—serve as a kind of virtual Dolorosa. Mom held our hands and started from the rear of Our Lady of Refuge: the First Station. Mom said we should say a prayer at each Station and to think of all the pain Jesus went through so that we could go to Heaven. It was hard to keep thinking about that one thing for so long. My mind went to that Saturday’s little league game, to the donut and chocolate milk (our after-church reward from Castroville Bakery), and as I grew older I thought about girls. When you’re thirteen you can’t not think about the girl’s butt in the pew in front of yours as she kneels and stands to pray throughout mass. * It grew increasingly juvenile to lie awake at night daring myself to utter a simple sentence. Even if I said I didn’t believe in God, wouldn’t He know the truth? He was omniscient, like a narrator. Even the idea of Him as a him ceased making sense. Not only did this come with a budding realization of my paternalistic culture, but due to the simple question of why? If God was everything, everywhere, all knowing, then why would he be a man? There’s that question: If God is a man then God must have a penis, and if so, what for? * The Catholic Church incorporates some modern scientific research into its dogma concerning the formation of the Universe, Solar System, and Earth, as well as evolution. According to Catholic doctrine, in approximately the fifth millennia BCE, humans began to worship the one true God. Those humans were Adam and Eve, though the Church says humans had been around for thousands of years prior to Adam and Eve. The Church claims to be infallible. Every time the Church changes its doctrine it remains infallible. * One Catholic writer, Tom Meagher, writes that “Modernism[—]the idea that we come to our beliefs individually through emotional or personal experiences[—]has crept into our Catholic schools.” * Catholics believe that evil spirits, given power through Original Sin, can imbue ordinary inanimate objects of everyday use. Thus, such objects should be blessed in order to induce in them the desire to serve the good. Such objects are not limited to, but include, “new ships and boats, railways and trains, bridges, fountains, wells, cornmills, limekilns, smelting furnaces, telegrams, steam engines, and machines for providing electricity.” * In The Sound of Music Julie Andrews and Christopher Plummer sing together: “Nothing comes from nothing, nothing ever could...” * To explain competing theories on the very early universe, and pre-verse would be another book. What was the inflaton? Did (mem)branes collide, initiating the Big Bang, as opposed to Lemaître’s primordial atom, a singularity? Without a unified theory there’s gravity hanging out there, fucking everything up. We cannot make sense of the mechanics of the Planck Epoch—0-10-34 seconds into the Universe’s creation—named for Max Planck, who stumbled into the discovery of quantum mechanics in the early twentieth century. * My students often ask if I believe in God, since I espouse evolution, the Big Bang, Science, reject a strictly biblical or creationist theory of the Universe. I tell them that yes, I believe in God, though not the God that they imagine one must believe in. * When questioned regarding the rumor that, before his death, founder of quantum mechanics Max Planck had converted to Catholicism, he replied that he did not believe “in a personal God, let alone a Christian God.” * Physicist and Catholic priest George Lemaître, who formulated the theory and wrote the 1946 book The Primeval Atom Hypothesis , was made a household name by then-detractor Fred Hoyle, who pejoratively referred to the idea as a “Big Bang.” * Suicide is a mortal sin. To end one’s own life one must have despair, which is to lose hope, which is to lose faith, and to disbelieve in God. * Archaeology has uncovered graffiti in all of California’s missions—Indian pictographs inscribed into the adobe, covered with layers of whitewash. Native deities and depictions of cultural practices show that tribespeople never fully gave up their native traditions even after baptism and coming to the missions. There was something inside Native Californians that would never die. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How We Keep Caring While Walking Through Our PainOla Ziara and Rachel CoghlanAuthor Dedication. To my dear brother Omar Ziara, a bright doctor, entrepreneur, and community advocate who was killed in an Israeli bombing in November 2023.May your soul rest in peace and may your memory remain alive in our hearts. May your unborn child grow up to become the wonderful man that you were. Forever loved by all.Palestinian-American (...) poet, Suheir Hammad, writes:Occupation means that every day you die, and the world watches in silence. As if your death was nothing, as if you were a stone falling in the earth, water falling over water.And if you face all of this death and indifference and keep your humanity, and your love and your dignity and you refuse to surrender to their terror, then you know something of the courage that is Palestine.I am a doctor from the Gaza Strip in Palestine. I live through acute war and protracted occupation. I work under missiles and through scant resources. I experience risks and dangers and face abominable choices made from nightmares. I know heartbreaking death.As doctors here, we fear, suffer, cry, and grieve alongside our patients and their families. This is my story of how we continue to care.Summer 2014 A Fifty-Two-Day War: How To Stay And How To Keep Them SafeThe huge bombardment strikes close to the hospital, scattering glass and rubble. It brings an abrupt end to my rare, quiet pause for coffee. Are the babies hit? We sprint to the Neonatal Intensive Care Unit, our full attention only on those infants, hastily checking every crib. My thoughts are frenzied. What if the next missile strikes us? Will I be able to rescue them? Will I have time to carry their tiny bodies outside through wreckage and fire? How will I choose who to save, and who to leave behind? Could I choose? Will I even be able to think lucidly, act logically for those babies if the fire consumes us? We stay.Somewhere, a house razed to the ground, a mother and her children dead. This time, our babies are safe.Summer 2014 A Fifty-Two-Day War: How To Cast Off Danger And How To Find ConsolationA missile shatters our neighbour’s roof. I am about to leave home for my evening shift. I check on my shaking mum; she is okay, not hurt at least. I ring the senior doctor. I am sorry. I am coming. I will be a little late. Two further missiles hit, wiping out the next-door building completely. No, do not send an ambulance for me. It is too dangerous. I will come [End Page 153] alone. Trembling through the dust and darkness, I leave on foot to reach those babies. I must compose myself. We are needed there to bring calm, to keep caring.And we gamble our lives to seek distraction and comfort for ourselves. We find solace through unbearable pain in our caring.Winter, Spring, Autumn, Summer, Any Day: How To Question Purpose And How To Feel HelplessIt is an ordinary night shift in ‘quiet’ times. Tonight, all the beds are occupied. All the ventilators are taken, forcing life into small, sick faces. At dawn, the phone call comes. A new baby struggling to breathe is on his way. I call around. No more beds to take him here or anywhere. No more ventilators—here or anywhere. Bring him here. We will care for him.He is in a very bad way. He needs immediate life-saving care. We take turns manually ventilating him, working to the hissing rhythm of the Ambu Bag1—inflating, deflating, inflating. Our arms ache. We keep pumping the bag. Do not stop. The moment when the morning shift arrives is our moment of salvage. We can go home. We have made it through the night without medicines, machines, disposables, or enough manpower, our arms throbbing. We have kept him alive.But he is so fragile, the system is fragile, we are fragile. Dare I even ask—is it worth it? Is it worth a baby surviving the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Game ChangeMaximo CortezOn November 17, 1983, I was born with a condition called mixed gonadal dysgenesis, and ambiguous genitalia. My gender was not of a big concern at that time. The more urgent matter was that I had a heart murmur, which was repaired when I was twelve months old. [End Page E5]It was not until I turned five, and by issue of the Texas Children’s Protective Services (CPS), (...) that my mother was forced to authorize providers to perform normalization surgeries on me. An anonymous caller tipped the CPS that my mother was raising a boy as a girl. The state intervened and explained to my mother that she would have to consent to these surgeries or else she would lose custody of me. This included a gonadectomy and a clitorectomy. Without any consent, these surgeries were performed “in my best interests.” My mother was an epileptic, Hispanic, Mormon, single parent.I was raised to be a socially acceptable female, though as early as five, I played with “boy” toys and enjoyed TV programs aimed at male youth, like Teenage Mutant Ninja Turtles. It was not until I had those normalization surgeries performed on me that I felt different. I knew that something major had happened to me. I woke up in a hospital bed in a gown. I raised the covers and noticed that I had an “X” carved in my groin area. Doctors mutilated my clitoris by reducing its size, which made me feel alienated and angry that something was wrong with my body.I had a surgery performed on me that was to be kept secret and never talked about. This sense of fear and shame was instilled in me shortly after the surgery. I do not recall any psychological evaluations or counseling to help me cope with such surgeries. Seeing everyone else my age going through puberty during my teenage years, I felt behind. I wasn’t becoming a boy with a deep voice or facial hair. Instead, I visited the doctor’s office with my mom and was told that I would be taking oral estrogen to become a woman. I wasn’t until that moment that I understood I was seeing a doctor to foster the development of female secondary characteristics. I felt betrayed by the medical community and by my own mother.Just a few years later, I saw a urologist to find out whether I was ready for a vaginal construction surgery (vaginoplasty). Thankfully the urologist suggested that I was not ready to move forward with an invasive and irreversible vaginal construction surgery. I never pursued it as an adult, as I have always felt male gendered.Social sexual relationships have always been difficult for me but more so with my attraction to women. I first realized my attraction to women in early middle school. Being raised Mexican and a Mormon and knowing that I was homosexual created a lot of conflict for me. I felt that I was a male–gendered person forced into a castrated, mutilated, and medically created female body. I suffered through depression from an early age and it continues today. My conservative Mormon upbringing brought me much shame. The Mormon religion, as most people understand it, expresses a great intolerance to homosexuals and transgender people. I felt like I was a heterosexual male in a female’s body, but the Mormons would never accept me.My later teenage years and mid–twenties were a dark time in my life. I even attempted suicide in my early twenties. My depression was treated with antidepressants and talk therapy. Once I began testosterone, I gradually stopped taking antidepressants. When I was only on estrogen, I felt very moody, angry, and in an emotional funk. I would cry easily and would become very irritable and emotional without cause. With testosterone therapy, I began to think more clearly, had balanced emotions, and began to think more logically.I began to research intersex online and found a women’s androgen insensitivity (AIS) support group. At one of their national conferences, I met another intersex individual who was raised as a female and who had transitioned to male. Like me... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Am I the Bad Guy?Tavishi ChopraWhat do you do when the 6-year-old patient you have vowed to protect suddenly deems you the bad guy?The afternoon started out like any typical afternoon during my inpatient pediatric rotation. We had finished rounding, grabbed lunch, and began to see our new admits. My residents told me to go see a 6-year-old, Ela, in the ED. All I knew was that she had (...) a burn injury. As I walked to her ED room, my heart sank.Burns from cigarette stumps covered her torso and back. She was holding her shirt off her chest to prevent the excruciating pain caused by her t-shirt rubbing against her skin. As soon as Ela made eye contact with me, she immediately started crying and exclaiming, "Mommy didn't mean to!" confirming exactly what I thought. These burns were inflicted from someone she loved.Ela was eventually admitted into the hospital, and the Department of Child Services was contacted. Little did I know that I would be so conflicted by this decision.DCS launched an investigation on Ela's mom, but during the investigation, Ela's mom was permitted at her bedside. It was very clear that Ela felt protected and loved by her mom. Often it was only her mom who could get her to stop crying during the painful dressing changes. I felt torn allowing Ela's mom to have such a strong presence in Ela's hospital stay. To me, nothing in the world can justify hurting a child so cruelly, and inflicting that pain so many times. However, my job was to help Ela heal. That meant that because Ela turned to her mom for support, I also needed to include Ela's mom in our medical decisions. I buried away any negative feelings I had, and I proceeded to interact with Ela's mom in a professional manner.It was this that allowed me to get to understand Ela's mom a little bit more. She was a single mom [End Page E8] working multiple jobs to help keep her family afloat. She often lived her day on three to four hours of sleep, so she was very tired. The sleep deprivation made her frustrated more easily, and she didn't have a healthy outlet to release her emotions. Unfortunately, Ela was on the receiving end of that frustration.Hearing her story made me even more angry, confused, and upset that a child suffered. I strongly believed that as adults, we should have better control of our emotions, and sleep deprivation and frustration weren't an excuse. I couldn't find it in me to respect Ela's mom, who I shamefully began to avoid.I still wanted to bond with Ela and show her unconditional love. When Ela's mom was at work, I would use that opportunity to go and spend time with her. We would play "princesses," blow bubbles together, and turn dressing changes into a game. We formed a special bond, and I always made it a goal to go and spend some time with her every day.DCS, meanwhile, was actively conducting an investigation. They interviewed Ela's mom, Ela's siblings, and Ela. The findings of their investigation revealed that Ela's mom often would lose her temper, and the kids feared their mom. Hearing this further proved to me that I did not need to interact with Ela's mom. Embarrassingly, it was just as much a priority for me to avoid Ela's mom as it was to spend time with Ela.DCS eventually concluded that Ela's mom would lose custody of Ela for the time being. Because of the connection that Ela and I had, I took it upon myself to deliver the news to her. Our bond was shattered right then and there. She immediately began to cry, told me she hated me, and asked me to leave the room. Anytime I would go into her room after that, she would start screaming and refused to talk to me. In a span of five minutes, Ela's mom made a decision that destroyed their family... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Note on Being Ability–different, Atypically–bodied... Criptastic?Emily HutcheonIn being prompted to write about my experiences with disability [alternatively written: (dis)ability, dis/ability, “disability,” disAbility], I am confronted with more questions than I have answers. Am I to reflect on that small window of time, one so small that I don’t actually remember it, when I did not know that I was different? My mom [End Page 196] has recounted vivid (...) moments where I seem to come to this realization—for example, at the age of three, when I see my twin sister and friends scrambling on a playground and I process that I am unable to join them. Realization of my differentness (my different body, my different way of moving, my different abilities) continued into my youth and adulthood (Can’t skate—check. Can’t ride a two–wheeled bike—check. Usually walk behind others, destined to be the last in a group—check. Was the smart kid in class, aka smartass–in–training—check).Eventually, I realized that my differentness was not contained to my body or my abilities. Were my mind, my self, and my relationships different as well? I seemed to empathize when others didn’t or couldn’t. I saw that certain things were just wrong, and was confused when others didn’t share my concern. I seemed to see, feel, and experience things that others did not. For instance, I had two invasive operations before the age of eleven, a handful of minor procedures and countless physiotherapy sessions. Some memories of these times are horrific. Some I cherish, including the genuine care of the health care staff. Some are hilarious, like being doped–up before invasive surgery at the age of ten and calling my favorite surgeon “So cute!!” But always, there was physical pain, pain, pain. At times, I was completely dependent on others to help me to the bathroom, the shower, to move around, and to recover. I received such tender and exquisite care from my mom during these times. The dependency, which I had no choice but to experience, the dependency that is feared by almost everyone I know (“If I am ever a burden to my family, shoot me”) is something that my mom and I constantly joke about (“Em, I will take care of you now, only if you change my diapers when I’m old, kay?”). I have come to learn that this dependency, along with those other shades of vulnerability, are an inevitable consequence of being human, and to deny this is to relinquish our capacity to connect with others.I had, and continue to have, relationships with strangers, friends and family, which are, in my best estimation, atypical. I am the recipient of staring, laughing, pointing, sympathy, disgust, empathy, tender care, curiosity, hostility, resentment, and ambivalence. While in the gym, complete strangers approach me to say, with all the kindness, enthusiasm, and obliviousness in the world: “Glad to see you out and about. Good for you!” For some, I am to be protected; for others, I am to be tiptoed around; and for others, I am to be congratulated for “overcoming my circumstance” and for being oh–so–valuable to society because of my smarts and productivity.It is a rare few who accept what Cerebral Palsy and epilepsy offer to my life and to their own, with all of their accompanying complexities, possibilities, and contradictions.It is ironic that the excellent health care and services I have received, which have probably changed my life for the better, are only made possible because of the “disability” label, which I have come to heartily dislike. I have always felt ill–at–ease with this word and concept. In my mind, it just does not describe me or others around me. Perhaps more accurately, the definitions and associations that stubbornly accompany the term (e.g., the disabled person as asexual, passive and in need of protection, the disabled person as the conquering hero) would never accurately describe me. Undoubtedly, the term is negative in its connotations. And, of course, the concept of disability relies on certain notions of “normal.” By most accounts in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Yet Life Keeps ComingPatricia Romanowski BasheWhile the guidance offered to authors of commentary articles suggests they not write about their personal experiences, the fact is, I would not be here were it not for my personal experience as the mother of a young man with autism spectrum disorder and other diagnoses. Though I left a successful writing career to become a special education teacher and then a Board Certified (...) Behavior Analyst (BCBA), it was not, strictly speaking, a career decision. It was a mom decision. When asked how I came to where I am today, I say, “Well, one day, I looked across the table at an individualized education program (IEP) meeting and asked myself, ‘Could I do as good a job as the people sitting across from me?’ And the answer was, yes.” Some people believe I am joking. I am not.To parent a child with autism is to be confronted daily with a dream of his future and the realization that you probably cannot achieve that alone. Instead, you will rely on a world of professionals, institutions, and systems to make it happen. How well that works out for you depends on a number of factors that should not matter but ultimately do: where you live, how well funded and law abiding your local school district is, how much access you have to qualified professionals, and how well your state agencies charged to care for individuals with disabilities after they leave school does its job. Though essential, love, dedication, and hope may not be enough to hoist your child over the hurdles, whether they are set by immovable bureaucracy or mercurial brain chemistry. We each strive to clear the track, to level the road, and I chose to do that by “going pro” and becoming a small part of the system that will serve my son and countless others with ASDs throughout their lives. Even so, I find myself as daunted by the transition to adulthood and the prospect of preparing him for a life without me as anyone writing here. Anonymous Three, who recounts her son’s struggle for independence, captures the questions that most of us might never get to answer but can’t stop asking: “What happens when we can no longer care for him?”When a pediatric psychiatrist diagnosed my own son with Asperger disorder in 1997, I wished to be one day free of the obligation to explain his diagnosis to people who had never heard of it. Today, thanks to major campaigns to promote autism awareness and the public recognition of a handful of celebrities with autism, there is less explaining required. It seems that everyone knows someone who has a child with autism, and everyone knows Temple Grandin’s story. Contrast this to the world of 1993, shortly after my friend and coauthor Barbara L. Kirby (Romanowski Bashe and Kirby 2001, 2005) turned to the internet to make sense of her son’s Asperger diagnosis. There was no Google, no Bing. It would be months before the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), which included Asperger’s for the first time, was published. Local doctors and teachers had never heard of it; parents and professionals were still gathering facts, trying to put the pieces together to form a coherent picture of what it meant to have autism. [End Page 183]Some things are different now, nearly twenty years later. Professionals, parents, and individuals with autism have developed a culture of autism, complete with opposing views on everything from applied behavior analysis and classroom inclusion to medication and guardianship. As a number of narratives illustrate, parents often find themselves making tough choices around these issues, and the best option in the abstract is not always the best option or even a possibility in the real world, on the ground. These narratives depict how the parents of individuals with ASDs struggle, sometimes mightily, to bridge the gap between what should be in terms of reliability of diagnosis and prognosis, access to effective, affordable, evidence–based education, treatment, and intervention, and—perhaps most important—meaningful, practical, realistic planning and programming for successful transition to adulthood. And... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Trial of PatienceChristopher LewisIt seemed like after two weeks, my “flu” symptoms should have resolved. I was not eating, could not hold anything down, and had no energy. It was easy enough for my pediatrician at the time to attribute this to a common virus. This was not sitting well with my parents, however. My mother decided to take me to the emergency room and get me evaluated (...) there. The doctors there assessed me and sent me back home with a medication to help with the nausea. Later that evening, my mom gave me that medication, and it caused a seizure. She called 911, and I was brought by ambulance to the hospital. After an extensive workup, it was determined I was in liver failure related to an aneurysm in my hepatic artery. I was going to require a liver transplant if I were to live. I had to be transferred to another hospital in New York from the hospital near our home in Connecticut. I do not remember any of the details leading up to this after the seizure. I do not remember being told I needed a liver transplant and I do not remember going into surgery.My memories of these events start after the surgery. What I remember is being in the pediatric ICU and being told my mother was able to donate part of her liver to me. I had quite a lengthy recovery after this point. I spent about two months in the hospital and then went to a rehab facility where I would have to learn how to walk again and regain my strength.By the time I was discharged from the rehab facility, I had missed the last half of my 5th-grade year. By the time I was able to return to school, it was already several months into 6th grade. Slowly but surely, life was returning to normal. I was able to get back to doing the things an eleven-year-old should be doing. For twelve years after this initial transplant, I was in great health, my transplant team was happy with how I was doing, and I just required annual checkups after a while. Unfortunately, I saw as a child how fast things can change. This was once again the case. [End Page 126]I was in my last week of college classes, just about to finish my Bachelor’s degree in nursing and looking forward to starting my career as a nurse in the neuro ICU. However, I once again became acutely ill with seemingly flu-like symptoms. After a few days of dealing with these symptoms, my mother brought me to the emergency room. When we got to the emergency room, they did some initial testing and told me I would need to be admitted for antibiotic therapy. The first thought that came to my mind was, “Would I be able to be discharged in time to take my final exams next week?”Once I arrived in my hospital room, I met with my transplant team. They delivered the grave news. The imaging they had done showed that the graft artery from my original liver transplant as a child had failed. The graft had thrombosed and I had infected bilomas in my liver. Now, twelve years later, I would need to be re-listed for another transplant. I was devastated and in disbelief. I recall telling my mother, who was with me at the time, that we should hold off on telling my dad, thinking this could not be possible, and we shouldn’t worry him over something that was not necessarily true. Unfortunately, however, this was my reality. I would go on to wait a little over two years for the perfect liver from a deceased donor.The road to being listed and ultimately having a repeat transplant was not without its challenges and bumps in the road. About three months into my two-year wait for a liver transplant, I received my first offer for a liver. I went through all of the pre-op preparation and the next morning went into the OR and underwent anesthesia. However, I... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:My Gratifying Testimonial of My Extended Warranties of LifeDanette RaginMy name is Danette Ragin. I am a 2-time kidney recipient who has been diagnosed with ESRD (End Stage Renal Disease). Both transplants were performed in Baltimore, Maryland. I am also a 3-time Donor Family Member and the proud Mom of a living donor.I received the first kidney from a deceased donor on June 22, 2008. The donor was traveling (...) thru Maryland with her family on vacation and experienced heart complications. My second kidney was donated to me by my youngest daughter Angel on December 20. 2016. I am thankful to God for both of my extended warranties. I’d like to share a little about my journey with you.Around the year 2002, I started seeing my PCP (Primary Care Physician) for terrible migraine headaches, which on occasions lasted for weeks. After several tests, she expressed her concerns. I had been spilling protein in my urine and my kidney function was showing some abnormalities. My PCP sent me to see a neurologist after several failed attempts to gain some type of reprieve from the nerve-racking headaches. My nephrologist confirmed my PCP’s diagnosis, and I had visits with the nephrologist every 6 months until they noticed a substantial change.“Ah, Mrs. Ragin, you’re in the beginning stage of End Stage Renal Disease”. Boom! (That hit me like a ton of bricks.) “Umm, you mean I have kidney failure! No! Not me. I’ve worked in dialysis. That can’t happen to me!”Of course, I was in complete denial. Both my PCP and nephrologist were very supportive mentally, physically, emotionally, and even spiritually. This information was so devastatingly painful that I started working harder and longer. I turned into a Superwoman with my family, work, and church. I was trying to drown out the fact that my health was being compromised, refusing to believe this could happen to me. I started to slow down in my daily functions, my appetite decreased, and I lost weight as a result. I thought that my weight loss was bringing my “Sexy Back,” only to realize that I am not exempt from sickness. My nephrologist assured me of a possible solution. He advised me to have my name placed on the waitlist of one of the transplant centers in Maryland.In October 2006, I had surgery to have an A/V fistula placed in my left arm to prepare for possible dialysis treatments in the future. In January 2007, I went to be evaluated for a kidney transplant. I was given 6 weeks to complete all required tests to secure a place on the transplant waiting list. Determination allowed me to complete all tests within 2 weeks.In April 2007, I was approved to be placed on the transplant list. In October, I had a PDC (Peritoneal Dialysis Catheter) placed in my abdomen so that I could dialyze myself at home. I loved it but it didn’t love me. It was removed in January 2008. Right afterward, I received my first unsuccessful call to be transplanted. (The kidneys were cystic and could not be used.) “Bummer.” I also received another call in April 2008 (Easter Sunday). Those kidneys were [End Page 134] at another hospital in Maryland, so if the waiting patient at their facility refused the kidney, I would be next in line. The patient accepted the donation. It wasn’t my turn yet.In the meantime, I had already started hemo-dialysis in mid-March 2008. On Saturday, June 21, 2008, while enjoying the weekend with my family, I received a call around 2:30 p.m. My youngest daughter and I were out shopping. We were in a crowded store that was going out of business, and I felt my phone vibrate. I noticed a slightly familiar number. I stepped out of the store to retrieve the call.“Mrs Ragin...Me: Yes.“Danette Ragin...Me: Yes.“We are calling from the University with an organ offer for you!”I told them they had me at the sight of the first few digits of the phone number they were calling from!In June... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Overtones:A CollagePaul Youngquist (bio)Mom leans against the keyboard of the old upright piano in the den. She puckers her lips and gently fingers the valves. A couple of times a month, she frees her trumpet from the purple velveteen lining its case—out of love or frustration I can never tell. She stares hard at the bell, pointed somewhere near my feet. She inhales deeply, pressing the silver mouthpiece to (...) her crumpled lips. A silent moment passes—torn by a noise pitched past the sun, a shrieking flare sound. Another follows and another, bright glissandos blinking out somewhere below middle C. They shatter everything I know about her. Everything I thought I knew. What sound was that, what cry? What aspiration to be free? After those initial stabs, she falls into familiar melodies: "Bugler's Holiday" by Leroy Anderson, maybe, or "When the Saints Go Marching In." I'm unsettled for the rest of the day.Trumpeter Don Cherry's sound unsettled me too. I was much older when I first encountered it on Ornette Coleman's The Shape of Jazz to Come. It took me back to Mom's cries. I heard her sound in his: bright, high, and transient: less pitch than smudge, transmitting unknowable overtones. On "Lonely Woman," for instance. Cherry states the plaintive melody in hazy unison with Coleman, blurs the third note, wavers and plays his peculiar temper, untimely and free to move beyond the platitudes of harmony until, after Coleman's baffled cry, he parts company to play a sixth above (if such language matters, and it doesn't), descending in half steps to resolve (not happily) on a minor third, Cherry now pitched below. Their unison breaks apart to reconverge, and the brief bridge feels like a heaving between sobs. This isn't music. It's too raw for the repartee of bebop or the sociability of swing. But everybody can feel it, which explains the scandal of Coleman and company's extended appearance in late 1959 at the Five Spot in New York's East Village. Writing in the New York Times Magazine years later, Joseph Hooper likened it to the furor erupting after Stravinsky's Paris premier of "The Rite of Spring" in 1913. In an interview with Terry Gross, Cherry remembers everyone who was musically anyone being there—from Leonard Bernstein to Thelonious Monk—to witness the sacrilege. The implacable trickster Charles Mingus appeared one [End Page 133] night with Phineas Newborn, a keyboard virtuoso famous for his perfect pitch. Newborn sat and stared at his cufflinks. He never played a note. After the set, Mingus barreled onto the stage and, with his long arms and big hands, crashed all the keys. "That's where it is," he bellowed. "It's all there." Everywhere and nowhere. Cherry and Ornette decentered intonation. They distempered tradition's scales. Afflicted with perfect pitch, Newborn couldn't follow their cries and whispers. They flew free from the comforting staff. Still you feel them, hear their immeasurable sound.Don Cherry: "I've always been on the outside, and that's a good quality for the music to have, like the wind in your face."Cherry's mother Daisy gave him his first horn when he was fourteen. It breathed life into him, offering a way to express sounds his body harbored. Born in Oklahoma City in 1936 to "Negro-Choctaw Indian parents" (his words—his mother's mother was half native), Cherry heard gospel, blues, and Indian songs from the start. The family's move to the Watts neighborhood of Los Angeles in 1940 only multiplied the sounds of diverse ethnicities mixed with the rumble of jazz from the Cherry Blossom, his father's club, where Don and his sister sometimes danced for dimes. His horn funneled all this sound—all the music he'd ever make—through a peculiarly powerful feeling: "that feeling to me, through as much music as I've learned, I still remember just that feeling when I first got that horn." What feeling exactly? "Infant happiness" (in-fant, not speaking). The feeling of life before language: "infant happiness, infant happiness, beautiful! That's what music is really... (shrink)

This chapter contains sections titled: The Maternal Condition: Freedom in Situation Beyond the “Ideal Mother”: Creating Our Own Identities Mommy and Me Notes.

This paper criticizes an empirical reading of On Perpetual Peace. It is also equally critical of the approach taken by philosophically minded scholars to give preference to Kant's philosophical outlook. Instead, it focuses on the peculiar oscillation between the philosophical and political aspects of the essay. Contrary to current concerns to update the conceptual framework of On Perpetual Peace—to rescue it from becoming obsolete—its salient irony, which mediates between both aspects, is singled out as a clue to an interpretation which (...) seeks to account for both of them. Thus, the essay can still be a source of inspiration for peace research. (shrink)

Festschrift for Maḍiniyavela Śrī Mēdhaṅkara, Sri Lankan Buddhist monk; contributed articles chiefly on economic and ethical aspects of Buddhism.

Si l'art n'est pas d'abord considéré en tant que production d'objets mais comme manière d'être au monde, intéressant tout homme et toute société, si la foi n'est pas considérée en tant qu'adhésion intellectuelle aux vérités de la foi, mais comme acte capable d'illuminer et transformer le monde, alors, loin d'être uniquement en rapport d'interaction, d'interdépendance, ou de ressemblance, l'art, la foi et le politique sont une unique réalité vivante. En ce sens, chacune des trois entités sera d'autant mieux comprise et (...) pensée qu'elle sera vue comme l'une des modalités de la même dynamique. Cette thèse se développe en trois étapes éclairant successivement les présupposés de sa démonstration, son effectivité dans la personne individuelle comme dans la société, enfin sa portée programmatique : le monde n'aura d'avenir qu'en assumant le ressort poétique qui le constitue et l'anime depuis le commencement. (shrink)

[1] Ḥeleḳ ha-moʻadim -- [2] Ḥeleḳ parashiyot ha-Torah -- ḥeleḳ 3. Be-ʻinyene midot.

The development of modern evolutionary ethics began shortly after the publication of Charles Darwin's On the Origin of Species by Natural Selection. Early discussions were plagued by several problems. First, evolutionary ethical explanations were dependent on group‐selection accounts of social behavior (especially the explanation of altruism). Second, they seem to violate the philosophical principle that “ought” statements cannot be derived from “is” statements alone (values cannot be derivedfrom facts alone). Third, evolutionary ethics appeared to be biologically deterministic, deemed incompatible with (...) the free will required for ethics to be possible. Fourth, social policies based on evolutionary theory (for example, eugenics in the early part of this century) seemed patently unethical. Sociobiology (which coalesced as a field of study with Edward O. Wilson's Sociobiology: The New Synthesis, 1975) addressed several of these problems and provided a rich framework and a new impetus for evolutionary ethics. The lingering problems were the philosophical is‐ought barrier and biological determinism. After tracing the early and more recent development of evolutionary ethics, I argue that the remaining problems can be surmounted and an incipient evolutionary ethics can be defended. Thoroughgoing evolutionaryethics must await theoretical developments in neurobiology and cognitive science. (shrink)