Month: March 2018

No, Kids Cannot Treat Each Others’ Gunshot Wounds, Either

Miri, , , , , , , , , , , , ,
A person taking a CPR class practices on a mannequin.
You really don’t have to be a healthcare professional to know that this won’t treat a gunshot wound. Photo credit

[Content note: descriptions of injuries and gun violence]

Yesterday[1] I discussed the phenomenon of adults expecting children to become impromptu school counselors for kids who are socially excluded and possibly planning a school shooting. Today I will talk about another job title that some actual people who are old enough to vote and drink alcohol expect children to take on: field medic.

Erstwhile Republican presidential candidate and professional stack-of-rats-in-a-suit Rick Santorum had some comments[2] about the young people organizing against gun violence, which I recommend reading out loud to yourself because that’s the only way I’ve found of making sense of this word salad:

How about kids instead of looking to someone else to solve their problem, do something about maybe taking CPR classes or trying to deal with situations that when there is a violent shooter that you can actually respond to that….They took action to ask someone to pass a law. They didn’t take action to say, ‘How do I, as an individual, deal with this problem? How am I going to do something about stopping bullying within my own community? What am I going to do to actually help respond to a shooter?’… Those are the kind of things where you can take it internally, and say, ‘Here’s how I’m going to deal with this. Here’s how I’m going to help the situation,’ instead of going and protesting and saying, ‘Oh, someone else needs to pass a law to protect me.’ …I’m proud of them, but I think everyone should be responsible and deal with the problems that we have to confront in our lives. And ignoring those problems and saying they’re not going to come to me and saying some phony gun law is gonna solve it. Phony gun laws don’t solve these problems.

(You might need to read it a few times, slowly, before it makes any sense. Actually, it may never make sense at all.)

The salient points here are:

  • Children should stop complaining to adults about their petty little problems like being shot with assault weapons in schools, and instead “take action” to “do something” about it.
  • Taking a CPR class is a good response to the problem of school shootings.
  • Laws cannot protect children from violence.
  • Demanding that adults pass laws doesn’t count as “doing something” about a problem.

Although I’m still convinced that Santorum is a stack of rats in a suit–surely no human being could blame children for being insufficiently proactive about surviving gun violence–I’m going to respond to his arguments as if he is a human being. I’ll grant him that, even if he wouldn’t grant it to me, or to my teenage siblings.

To state the very, very obvious, CPR is not an appropriate response to a gunshot wound. I am certified in CPR and first aid. CPR, or cardiopulmonary resuscitation, is an emergency procedure (my god, I can’t believe I’m even having to write these words, what the fucking hell) that is useful in exactly one situation: when someone’s heart has stopped. Applying manual compressions to a person’s chest in this particular way can help blood continue to circulate through their body and reach their brain, increasing the chances that they’ll survive once they get prompt medical attention and reducing the chances of brain damage.

I will never forget the words of the fire department chief who facilitated my most recent CPR refresher training: “You can’t hurt someone by giving them CPR, because if their heart has stopped, they are already dead. You’re not gonna make them more dead.” CPR, while taught along with first aid in many cases, is different from many other first aid techniques in that if someone needs CPR, they are already minutes (or even seconds) away from death. CPR can ultimately fail even if administered perfectly because the body needs oxygen and it’s pretty rare for CPR to actually restart a stopped heart. It’s just a way to keep the person from really dying until the paramedics get there.

So, if you get trained in CPR, you will need to be prepared for the very real possibility that you will watch another human being die with your hands on them. That’s…you know, kind of a big deal.

But all of that is mostly irrelevant here because CPR will not keep someone from bleeding out from a gunshot wound. What will, if they’re lucky enough to have been shot in an arm or a leg, is a tourniquet, a first-aid technique that blocks blood flow to the injured part of the body to limit blood loss before the person can get emergency treatment. It’s not for the faint-hearted, whether you’re making or receiving one.

Getting trained and certified in CPR and first aid[3] is a great idea, including for young people. When I was a teenager, many of my friends worked as pool lifeguards during the summers and it definitely made me feel a bit safer to know that they were all trained in, well, guarding lives.

However, when I think about teenagers learning first aid, I imagine situations like, your friend stepped on a sharp object, or you got into a minor car crash, or someone forgot their EpiPen at marching band practice. I don’t think about mass shootings.

So let’s think about them now. If you found yourself sympathetic to Santorum’s comments, I want you to imagine yourself as a teenager, crouching beneath a tiny classroom desk with your best friend, who is bleeding profusely from a gunshot wound. More gunshots and screams are echoing in the halls. Your best friend is trembling, tears streaming down their face. Their blood is on your hands and clothing. You can’t risk getting up and finding a first aid kit, because then you might get shot too. You have a few minutes to save your best friend’s life with a tourniquet you made with a broken-off chair leg and someone’s belt.

Imagine surviving this. Imagine surviving it, but your best friend dies anyway, underneath that desk with you. Imagine that your best friend survives, but with permanent physical damage (to say nothing of the psychological impact). Imagine that your best friend survives, but the other classmate next to you dies, because you helped your best friend first. Imagine finding out later that you spent five valuable minutes performing CPR on someone who was never going to wake up anyway, while someone else bled out across the room from you.

Imagine that this is our lawmakers’ best answer to the fears of children who tell them they don’t want to die in their schools.

Kids and teens are capable of incredible acts of bravery and selflessness, including saving lives. But even after all this–by which I mean, our general political trajectory of the past decade or so–I can’t quite wrap my mind around how it is that a man with children (young children) could so blithely suggest inflicting such trauma on them rather than reckoning with the $116,000 he has received from pro-gun lobbyists since 1990.

See, this is why I’m pretty sure Santorum is a stack of rats in a suit.

But if you’re not buying that theory, I have another one, and it’s more depressing.

What do you think Santorum would’ve said if the Parkland students had, instead of advocating for greater restrictions on gun ownership, marched to their statehouse and to Washington, DC to demand fewer restrictions on gun ownership? What if they’d asked for laws that would provide guns and weapons training for teachers? Laws that would provide grant funding to the NRA so that it can do more of its valuable work? Laws that would increase, in theory, the likelihood that a “good guy with a gun” could take down a school shooter?

Somehow, I don’t think he’d be rebuking them for “asking someone to pass a law.” Those kids would be invited to speak at every GOP rally and fundraising event from Florida to Alaska. We wouldn’t be hearing a peep from conservatives about “coaching” and “taking political advice from kids.”

In other words, it’s just more of the same tribalist bullshit we’ve been pointing out since the election[4] and before, and it doesn’t smell any different.

When traumatized children demand political changes that are associated with Democrats and progressivism, it suddenly becomes okay for Santorum and others to bully them, ridicule their physical appearance, and casually suggest further traumatizing them by forcing them to literally take the problem of gun violence into their own hands. [5]

Memo to Santorum, or the rats which comprise his physical form, or whatever: “asking someone to pass a law” is taking action, especially when that someone is a fucking lawmaker tasked with keeping our schools and communities safe and when the person doing the asking is a fucking child who’s supposed to be able to rely on adults to keep them alive long enough to vote those adults the fuck out of public office.

[1] https://the-orbit.net/brutereason/2018/03/25/please-do-not-walk-up-to-people-you-think-might-murder-you/

[2] https://www.cnn.com/2018/03/25/politics/rick-santorum-guns-cnntv/index.html

[3] https://www.redcross.org/take-a-class

[4] https://the-orbit.net/brutereason/2016/12/27/hypocrisy-often-just-tribalism/

[5] Unfortunately, this is often the only option available to children of color living in areas marked by frequent gun violence. For example, in Chicago, a grassroots group called Ujimaa Medics teaches kids and teens to give first aid to gunshot victims. Remember that if we’re saying the Parkland students don’t deserve this kind of trauma, neither do the children of color all over the country who live it every day.

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No, Kids Cannot Treat Each Others’ Gunshot Wounds, Either
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Please Do Not “Walk Up” to People You Think Might Murder You

Miri, , , , , , , , , , , , , , 1 Comment

I had a double mastectomy a week ago, which for the context of this article means two things: 1) I was unable to participate in the March For Our Lives yesterday, although I really wanted to; and 2) I’m not in a particularly charitable mood. You might even say, in fact, that I’m feeling extra protective of this fragile corporeal vessel I’m forced to inhabit.

Right before the mastectomy, during the National School Walkout on March 14, most of us were seeing nonsense on social media about “walk up, not out,”[1] meaning: instead of walking out of school to protest the fact that it’s not a safe place for kids and teens, why don’t you walk up to classmates you think might be the next Nikolas Cruz and talk to them in order to…this is where things get fuzzy. But presumably in order to keep them from becoming the next Nikolas Cruz.

I am no longer a child and I do not have children, but what I do have is two teenage siblings, and I will be absolutely, thoroughly god-damned before I instruct them, or allow anyone else to instruct them, to do something so equal-parts patronizing and dangerous.

Since I don’t have much to do these days besides read and monitor my surgical wounds, let me break this down.

Adults are historically terrible at dealing with social exclusion in schools

I’m not surprised that at the heart of this infuriatingly condescending meme lies a fundamental misunderstanding of social dynamics among children and teens, because adults (at least, the ones who don’t study this academically) seem to have always had difficulty grasping what most kids (yes, even the “socially awkward” ones) know intuitively.

When I was little, this manifested itself in ways such as classroom rules (formal or informal) about having to give a Valentine’s Day card to each student in the class, or invite each student in the class to your birthday party, so that nobody feels excluded. Never mind what a creepy message this ultimately sends, or how humiliating and uncomfortable it would be (and was, for me at times) to receive cards and party invitations from kids that you know hate you.

I don’t know if kids still give out Valentines, but I do still see headlines now and then about elementary and middle school students being forced to say “yes” to anyone who asks them to a school dance [2], or being banned from having “best friends” so that nobody feels excluded [3]. To these things I can only say: yikes, you guys. Yikes. Are the adults okay? Who hurt you? (Apparently, the kid in your 6th grade class who said no when you asked them to the dance.)

What kids know, and what many adults apparently quickly forget, is twofold: 1) Social exclusion will be a part of our lives in some way no matter what; and 2) if people want to exclude you, there is nothing—no rule, no requirement, no sugar coating—that will hide that fact from you, or make it sting any less. In fact, one of the most hurtful and memorable forms of bullying a child can experience is having their classmates pretend to like them, care about them, or include them (to the praise of parents and teachers, probably) only to yank that positive regard away. This isn’t a new thing. Hasn’t anyone seen Carrie?

Social exclusion isn’t a childhood phenomenon; it’s a human phenomenon that many adults also experience in their social groups, workplaces, and communities. There’s no simple answer to it, and any effective intervention would probably have to address the prejudices that people use to decide whom to exclude, rather than the exclusionary behavior itself. But that’s for another article, or rather, for another book.

All social exclusion is not made equal

Another mistake adults make when trying to mitigate social exclusion in schools is assuming that it’s all cut from the same cloth. Sure, on the surface, the behaviors can look the same—ignoring or avoiding certain students, laughing at them, refusing to sit with them at lunch. But the motivations behind these behaviors can vary a lot.

That means that on the surface, you can’t really tell if a group of kids is avoiding another kid because they think his hand-me-down clothes are ugly, or because he’s a pompous asshole who makes them feel small and dumb whenever they try to talk to him, or because something about him is just…off in a way they can’t articulate but that reminds them of when their parents told them to avoid that creepy old dude down the block because “we’ve heard stories.”

Kids, especially younger ones, don’t always know how to make sense of their feelings in that last case. So they sometimes act out those feelings by passing mean notes about that classmate or making fun of his dark baggy clothes or the music he listens to. It’s mean. But it’s covering up for something else that they haven’t been taught to name yet.

(I do wonder, though, how true that even is in today’s landscape. I do know that ten years ago when I was a high school student, I could never have even contemplated mounting the sort of campaign the Parkland students have, as have the many young people of color protesting gun violence during the past few years. I just didn’t have the schemas to understand it. Today’s teens are different.)

In any case, in situations where a school shooter was bullied or excluded prior to his acts of violence, it’s possible that the social ostracism was less a cause and more a warning sign. Maybe his classmates knew something was up, but they didn’t know what, and they didn’t know how serious it might turn out to be.

This means that when you encourage students to “walk up, not out,” you’re not just asking them to walk up to the new kid, or the disabled student, the girl who’s been made fun of ever since she got her period in gym class, or the gender-nonconforming young person. You’re also asking them to walk up to the young white man with violent lyrics plastered all over his locker, who nobody ever wants to talk to because all he wants to talk about are his guns and the need to keep the white race pure or whatever.

Imagine, too, being the new kid or the disabled student who suddenly has a bunch of kids “walk up” to you right after the National School Walkout, only to realize that they’re doing it because they’re afraid you’ll shoot them.

Bullying does not cause school shootings

The idea that the prototypical school shooter is necessarily a “troubled” young person who is cruelly bullied and excluded by their peers is not necessarily based on reality. Even in the case of Columbine, the typical example, it’s straight-up false. [4]

It is often very difficult to put all the puzzle pieces together after the fact and figure out whether a shooter was mistreated by their peers or not, especially if that shooter has committed suicide and isn’t around to answer questions.

Part of what makes it difficult is that social dynamics among kids and teens are extremely fluid and can change by the day. Very few kids are always the victims, always the bullies, or always the bystanders. If you examine random slices of my K-12 life, you will find times when I was mistreated and left out, times when I had a healthy, supportive group of friends, times when I stood by while my friends bullied others, and probably even times when I was the bully. If you read my teenage diaries, you might find some wildly conflicting evidence in there.

Here are some characteristics that many (possibly even most?) school shooters have in common, that aren’t being bullied or excluded: being white, being male, having a record of violence or harassment against women, having an interest or a record of participation in white supremacist/neo-Nazi/ethno-centrist groups. (Another item that doesn’t belong on this list? Mental illness.)

Really, if you wanted to prevent school shootings without having kids walk out of schools and march to demand action on gun control, it almost seems like the most effective strategy wouldn’t be making sure all the loners feel included, but that we intervene when we see young people developing strong sexist and racist beliefs. Almost.

There’s some value in encouraging kids to include each other

That’s not to say that the underlying message of “walk up, not out” is entirely bad. From a totally basic, uncomplicated point of view, sure, it’s nice to encourage children and teens to consider who might feel left out at their school and try including those people. I would endorse that statement in about the same way that I would endorse statements like “it’s good to eat vegetables” and “we should try to drive within the speed limit whenever possible.” That is, I agree, but I’m not about to put it on a bumper sticker or tattoo it on my body.

The generally uncontradictory nature of that statement is probably why many kids already do that. Most kids who are rejected and excluded by some classmates are accepted and included by other classmates. Most “unpopular” kids do have friends—friends who are often also unpopular and can relate to their experience. When I was getting bullied the most—seventh grade—I had a small group of loyal friends who liked me and hung out with me. They just weren’t necessarily in the same gym class.

Being concerned with including other students and walking out to protest gun violence are not contradictory. In fact, they go together. Our schools should be places where all students feel that they belong—if not in every single social group or with their entire class, then in a club or group of friends where they feel wanted and welcome. However, before our schools can be those places, they need to become places where children do not fear being murdered with a gun. Remember Maslow’s Hierarchy of Needs. [5] Which of these do you really think we should start with?

An illustration of Maslow's Hierarchy of Needs, with comments by me to show how it would apply to a school setting.
Here’s a handy visual aid, even.

.Kids and teens can be as biased and prejudiced as their parents, but they also often have very well-developed gut instincts when it comes to unsafe people—unless we shame them into suppressing those instincts. We should challenge the young people in our lives to approach uncomfortable conversations with other young people who are different from them, while drawing a very clear line between that and disregarding one’s own personal safety. We should read The Gift of Fear by Gavin de Becker [6], discuss it with young people, and then stop demanding that they ignore all the good advice in it.

We should ask ourselves, too, which images pop into our minds when we think about asking kids to “walk up” to someone they’ve excluded. Do we imagine the Mexican immigrant kids, the Black kids, the gender-nonconforming kids, the girls who got labeled “fat” or “slutty,” the boys who wear nail polish, the kids who need IEPs? Or do we imagine the white boys who give Nazi salutes and submit essays about why slavery is morally justifiable?

What labor are we asking young people to perform, here? Which problems are we asking them to solve that we ought to be solving for them? Whose voices are missing from this conversation?

And why are we having this conversation, exactly? Is it because we’re so very worried about social exclusion, or is it because this is easier to talk about than guns?

[1] https://www.cnn.com/2018/03/14/us/ryan-petty-walk-up-walk-out-stoneman-douglas-shooting-trnd/index.html

(Sidenote: I feel quite bad about trashing an idea that seems to have originated from the father of one of the Parkland victims, but unfortunately, losing someone to this type of violence doesn’t necessarily give you the psychological, sociological, or legal expertise to determine how to prevent it.)

[2] https://www.washingtonpost.com/news/education/wp/2018/02/13/a-school-made-children-say-yes-to-any-classmate-who-asked-for-a-dance-then-a-parent-spoke-up/?utm_term=.06576c7f05b5

[3] http://www.chicagotribune.com/news/columnists/kass/ct-met-best-friends-ban-kass-0119-story.html

[4] https://www.facebook.com/rebeccawald/posts/10156114680017429

[5] https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs

[6] https://www.amazon.com/Gift-Fear-Survival-Signals-Violence/dp/0440226198

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Please Do Not “Walk Up” to People You Think Might Murder You

The Freedom of Infertility

Miri, , , , , , , , ,

Before cancer, I wasn’t sure if I wanted to have kids. I knew that I had plenty of time to decide, and that I might start to feel strongly about having them at some point. But I was committed to not having them until I felt very strongly about having them, and I was also quite certain that I have no desire to experience pregnancy and childbirth. I find the mere thought of it revolting and horrifying.

Because of that, my thoughts about becoming a parent were always murky and difficult to bring into focus. I was obviously aware that adoption is a legitimate option even for people who are able to conceive and bring a pregnancy to term. But everyone I knew–and knew of–who had adopted children had done so because they couldn’t become pregnant or get someone pregnant, or because they couldn’t do so with the specific person they wanted to have the baby with.

I couldn’t imagine having to explain to dozens of nosy people why I had chosen to adopt, and face the disapproval of all the women who believe that pregnancy and childbirth is The Most Rewarding Thing You Can Do As A Woman and would look down on me for wanting to spare my body from it. When I’d shared my feelings about pregnancy and childbirth, I was usually told that if I wanted a baby badly enough, I’d be willing to do anything, even put myself through labor.

I understand now that a lot of that is post-hoc rationalization on their part. I have no doubt that if I actually had a child, I would do anything to preserve that child’s life, even go through pain and suffering like that. But since no child yet exists–the child is theoretical at this point–I’m not willing to sacrifice very much at all. Some people really do feel that way, but I can’t love someone who doesn’t exist yet.

For a long time, these were things I thought about pretty rarely, because they weren’t really relevant. I wasn’t in a place in my life to have a baby, and I had years to get to that place if I wanted to. None of my partners have wanted to have children while we’ve been together, so the conversation didn’t come up that way either.

Then, in an instant, everything changed, and I was sitting in an exam room in a gown and my oncologist was telling me that if I want to be able to conceive later, it would be a very good idea to freeze my eggs before starting chemo.

“Would it delay treatment?” I asked.

“Yes, by at least a few weeks.”

“Does that increase my risk of metastasis?”

“Any delay in treatment potentially increases your risk, though in this case it’s a small risk and many women choose to–”

“Then no.”

You know that scene in Doctor Strange when the Ancient One strands Stephen on top of Mount Everest to force him to learn how to use his nascent magical powers? That was me in that moment. The prospect of death can catalyze all kinds of learning and insight. In that moment, stranded on the mountain, I learned that I value “natural” childbearing so little that I was unwilling to accept even a very small, oncologist-sanctioned risk for it.

The doctor continued: “You seem like you know what’s right for you, but I am obligated to warn you that you might regret that decision later.”

I said: “I may feel sad about it later, yes. But I will never regret being alive to be sad about it.”

A few weeks later, I learned that even if I’m still able to conceive after my treatment, I shouldn’t. I have the BRCA mutation, which raises my lifetime risk of developing breast cancer to about 70% compared to 12% in the general population. For ovarian cancer, it’s 44% versus about 1%. Any child I conceive has a 50% chance of inheriting this shit.

When I brought this up with my doctor, he immediately told me that they can use IVF to select eggs that don’t have that gene and selectively implant those or whatever, but that sounds like 1) a massive fucking headache and 2) something that I definitely don’t get paid enough to be able to afford. In any case, I do know that that’s not how I want to have a child whatsoever. In fact, I don’t want any needles or other medical instruments to be involved at all.

So that makes two reasons so far why I can’t/shouldn’t get pregnant: the chemo may have destroyed that capability, and I don’t want to pass my genes on. Even if I circumvent these two problems, there’s a third: in order to prevent recurrence, I will be on endocrine therapy for a decade. That means that my ovarian function is suppressed and the estrogen receptors in my cells are blocked.

Theoretically, then, I could have a child when I’m 37, after that part of my treatment is over. But at 35, I become eligible to have my ovaries removed to prevent ovarian cancer. So you can bet that within weeks of my birthday I’ll be back in the hospital for that. There won’t be a window for a pregnancy to happen.

Of course, there could be if I asked to delay that surgery, which they would. 35 is just the earliest age when they’ll agree to do it. But to me that’s just like my decision about delaying chemo to freeze my eggs: in a word, nope.

So, in a matter of weeks I understood that becoming pregnant would be impossible, inadvisable, unethical, or at least more risky than I’m willing to accept. That option summarily slid off the table. I started to consider seriously the fact that adoption would be my only practical way to start a family.

At first I highly disliked this option too. There’s a lot to criticize about how adoption works in the United States. I hated to think that I might end up adopting a baby that some mother–probably young, probably poor, probably non-white–had been pressured to give up. International adoption felt out of the question to me, for similar reasons plus white saviorism. And if we’re being honest, I’m also appalled at the idea of paying such frankly ludicrous sums of money to adopt a child who needs a home anyway. It’s not like the adoption agency is doing me some sort of favor.

And I worry, too, about having a child with an unknown genetic legacy. At least in my family we know what the dangers are. With an adopted child, how would I be able to guide them to take care of their health in adulthood if we have no idea what their vulnerabilities are?

Then again, my parents didn’t know I had the BRCA gene, either.

But in any case, these are mostly solvable problems. I can do my research to ensure that my adoption is as likely as possible to be ethical and non-exploitative. I can make sure my child’s birth parents are as present in their life as they want to be. I can, somehow, save up $30,000. I can accept that we can never fully plan for medical crises.

Once I realized this, my thoughts about becoming a parent started to lose that murky quality that they used to have. I’m still not sure if or when I want to start a family, but I’m no longer distracted by my overwhelming fear of pregnancy and childbirth. Now I can imagine what it might be like to have a baby without all of those visions being clouded by phobia.

As you can imagine, things seem a lot more positive when they aren’t preceded by nine months of suffering. I imagine welcoming a baby into my home without already being wrecked with pain and fatigue. I imagine greeting my baby for the first time with my mind clear and my body strong. I imagine weathering the sleep deprivation of caring for a newborn without already being so depleted by pregnancy and childbirth. I imagine feeding my baby without pain or discomfort. (Obviously, no breastfeeding after a double mastectomy, even if I give birth.) I imagine being able to maintain a sexual connection with my partner even as a new mother. I imagine the months and weeks before I bring my baby home to be full of celebration and activity, not exhaustion, pain, and panic.

I like the idea of meeting my child standing up and wearing clothes, not lying in a hospital bed, covered in bodily fluids with tubes coming out of my body.

Weirdly, that’s what feels natural to me. Pregnancy and childbirth is what feels deeply unnatural, grotesque, and wrong.

And now I’ll never have to go through it.

Of course, that’s ridiculous to even say, because I never had to go through it. I could’ve always chosen adoption if I wanted kids. I know that. But it would’ve been a much more complicated choice, and I would’ve been expected to continue to defend it, or at least say something about it.

Now pregnancy and childbirth are off the table, and although they were never the only things on the table, they took up more than their fair share of space on it. Now there’s plenty of space for other possibilities, possibilities that I might actually enjoy considering.

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The Freedom of Infertility