All the privileges, all the plumbing

 

In honor of turning 50, I got a colonoscopy.

I know -- everyone’s got that one friend who wants to tell them about their medical procedures.  Don’t worry, I’m not actually that friend*. What I do want to tell you about is social injustice.  

Yeah, everyone’s got that one friend, too.  But I’m the quirky friend, so I’m going to relate it to toilets. 

We don’t have one. 

In case the connection to commodes isn’t glaringly obvious: in dutifully reading the six-page preparation guide provided to me by The Medical Establishment, I found that it assumed that all patients have access to a bathroom that they can commandeer comfortably and without interruption for at least half a day.

I repeat, we don’t have one.  We have an outhouse. 

Okay, that’s super-weird.  But at the same time, it’s not weird.  About 7% of Fairbanks North Star Borough residences are in this category – a small but not insubstantial minority.  Shouldn’t the literature at least recognize this? 

Shouldn’t the literature at least recognize this? 

Right.  In registering my own mild affront, I started thinking about everything else that is, so to speak, not recognized in the literature -- not in the particular literature I was dealing with, not in the literature for mammogram I also had and the shingles vaccine I need to get because I’m now officially Sort of Oldish, and not in the broader and more metaphorical Literature of Medical Assumptions.

It’s amazing how a tiny lack of privilege can highlight what a boatload of privilege I DO have.  In contemplating my outhouse, I started counting my advantages within a rigged system.  There are a lot of them.

First, I have health insurance.  This is huge. 

Second, my employer nags me about getting checkups, and provides me with incentives to do so. This is annoying as hell, but even with all that nagging, I still managed to procrastinate for six months, so… yeah.

Third, I am well educated.  Like, way over-educated.  I have a PhD in biology, so I at least know how a colon works, assuming that I can remember even 10% of what got me through the GREs. 

Fourth, I have connectivity and information access.  I have Google, and I also have 24-7 EBSCO access to articles with improbably long titles.  If I’m in the right mood, I even read them.  A primer: colonoscopies are not only useful for screening and catching cancer early when it’s still treatable and survivable; they also prevent cancer.  Colon cancer starts as precancerous polyps.  Polyps are routinely removed during colonoscopies.  Boom, no cancer ten years later. Nice.

Fifth, I have transportation and time: a working automobile and a driver’s license, and a spouse with the same.  We both have vacation time, flexible hours, and the ability to work partially remotely. 

Sixth, I have enough income and savings to not have to worry about minor out-of-pocket expenses, deductables, fancy fluffy toilet paper, whatever.

Many of these privileges were already on my mental radar, but I’d never really added them up until I read through the multi-page prep instructions.  The assumptions are all there: you can get to a pharmacy or a grocery store whenever you want, buy all the necessary items, and get them home with you.  You understand exactly why going through all this hassle is totally save-your-life worth it.  You do not fear it, even though the document offers no FAQs to assuage potential worries. You can take two whole days off work, during which you apparently do nothing at all -- no childcare, no remote work, no chores. You can get to the hospital or clinic, and you also have someone who can be there to pick you up, because the paperwork insists upon no walking, no taxis, and no Ubers due to the after-effects of sedation -- although it fails to mention that the sedation itself is NOT mandatory. 

This is a lot – financially, logistically, structurally, educationally, emotionally, and socially.  This is not a given, for a lot of Americans. 

Even a very brief session of #4 (All the Scientific Articles) uncovers some harsh truths. People are dying, and they are doing so in a manner that disproportionately affects racial minorities and anyone who is poor.  They’re dying because they are not getting screened. Colonoscopy reduces the risk of death from colorectal cancer by as much as 88%. The strongest correlations with lack of screening are lack of high school diploma, income below the poverty line, and lack of health insurance.  Gee, what a surprise.

There are quite a few academic papers that attempt to unravel why this is the case.  Most of them seem to conclude “it’s a lot of things”.  Yeah.  See the list above.  It’s a lot of things.  A lot of privileges that a lot of people don’t have.  A lot of reasons why people might avoid doing something that not only sounds totally gross, embarrassing, scary, and mystifying, but is also a massive financial and logistical hurdle.

And now, back to the toilets.

Toilets are obviously not the biggest factor, but I’m going for Toilet Symbolism here – whereby toilets represent all the unanswered questions and all the unacknowledged privilege, not just the assumption that you can hog a bathroom for hour upon hour, presumably in your suburban home with its 2.5 baths. Toilets underscore privilege.  Go take a moment to admire your privilege.  Aaaaah. 

Back now?  Good. 

So, as you might guess, outhouses in November in Fairbanks, Alaska are not a reality that meshes very well with colonoscopies.  But I’m living this weird cabin-in-the-woods lifestyle because I want to, not because I’ve been economically forced into it.  As such, I got myself a hotel room for one night.  It was luxurious. 

“Luxurious” is probably not a word most people would use to summarize their colonoscopy.  But there you have it.  Not everyone can afford bathroom-related luxury -- or any of the aforementioned logistical, social, and informational luxuries.  So, weird as it seems, our society is set up such that colonoscopies are a luxury. 

Wait.  There’s one more luxury that I almost overlooked: Advantage #7.  Due to the fact that so many of you, my friends, are socioeconomically A-OK, we have the advantage of Social Support Via Demystification.  In other words, I lied; for your own good, I am going to tell you about my colonoscopy.

It was… fine.  Non-stressful.  The prep was a bit tiresome and somewhat hungry, but not as much so as I expected.  Mostly I was lolling on a comfy bed, typing on my laptop as usual, and eating non-red lollipops.  This felt decadent, in a goofy little-kid way. 

The procedure?  Slightly humorous, and kinda fascinating, because I chose not to be anaesthetized (you knew that was an option, right?), and there was a big viewing screen.  Cool! Cecum!  I’m a biologist, I have the sensibilities of a twelve-year-old, and I enjoy Ms Frizzle and her Magic School Bus.

The results?  The doctor found, removed, and biopsied two sesame-seed-sized polyps. Serrated sessile adenomas.  Definitely not cancer – yet.  Those two tiny lurkers are gone now, no longer a potential threat to my ten-years-from-now self. 

The future? Because of those pink dots, I get to do this all again in five years, rather than the usual decade.  And… that’s a privilege.

There you have it.  If you’re part of my 1972 cohort or some even more archaic gang, be sure to take advantage of the luxury available to you.  Appreciate it.  And, of course, in the true spirit of Advantage #7, be sure to tell all and sundry about it.

 

 

*Yes I am. Obviously.

 

 

 

 

 

Replenish the earth

Female dust mite, Wikipedia

 

There are mites in your eyebrows!

Every so often I run across a meme, an ad, or a click-baity headline that reminds me – dramatically, hyperbolically, photographically – that I live in a world that is utterly saturated in creepy-crawlies.  My couch is inhabited by hordes of pale, eyeless critters happily munching on my dead skin cells!  My countertops are reproductively active!  My water is wiggling!

I’m supposed to be horrified.  Instead, I find myself comforted.

I’m a biologist.  Most of the time, I work in the field of climate change adaptation research, but I also get a chance to teach.  As the professor for “Natural Resource Measurement and Inventory”. I torture students with data analysis, statistics, and experimental design.  Type one and type two error?  Correlations that mislead? Graphs that lie?  I like teaching that stuff; it brings out the scientific hardass in me.  But I love it when we get to take a step back.  Way back.  I love it when we get to look at the Earth as a great big ball of green, growing, oozing, pulsating, sticky, messy, many-legged life.

Having spent much of my adult life as one kind of environmentalist or another (after having spent much of my childhood rescuing ants and climbing trees), it’s easy to become depressed about just how much of Earth’s life we humans are destroying.  The numbers are staggering.  The losses are irreplaceable.  Measuring by sheer mass alone, we’ve already wiped out 85% of the planet’s wild mammals and birds, and replaced them with ourselves and our livestock. 

Eighty-five percent.

According to UN estimates, the human population of the earth will reach eight billion people this week – on November 15^th, 2022, to be weirdly over-precise about it.  We’re an infestation.  In the face of this horror, I find it immensely relieving to know that at least we’re still vastly outweighed by insects. 

We’re even more out-hefted by bacteria and fungi, including our own microbiome.  The person in the mirror is a big sack of microbes; most of our own cells are not actually our own cells.  But those little beasts are cooperating with humans, a shady alliance, so perhaps they are not entirely to be trusted.

Plants outweigh us even more dramatically, but those guys – from lowly single-celled algae to towering redwoods – are the producers, not the consumers.  We’re not in their league; even if we humbly take a few steps down from the pinnacle of the food chain to enjoy a nice vegan stir-fry, we’re not going to be any good at photosynthesizing.  I take immeasurable solace in the green things, but it’s our hardy little competitors over here in the animal kingdom that offer a different and more perverse cheer whenever they remind me that we don’t really hold dominion over all the animals, regardless of whatever it is the bible says we are supposed to do with arks and whatnot.   

“Holding dominion” is clearly not in humans’ skillset.  We are, seriously, sooooo bad at it.  The insects will do a better job.

No one really knows how many insects, arachnids, and other crunchy-leggy little contenders there are in the world.  We don’t even have a clear sense of how many species there might be, let alone how many individuals.  But rough estimates suggest that for each human, there are about forty metric tonnes of arthropods. 

Forty tonnes. 

They’re in your couch.  They’re on your countertop.  They’re in your eyebrows!

Thank goodness.

 

Totally Winning!

 

Photo by Sarah Manriquez, Paris Photographics

I won a medal. 

It’s an award for being oldish. And fast-ish. female-ish.

It says so right on the back: “1^st Place 50-54 women”.  On the front it notes that the event in which I was fastish, oldish, and female-ish was the 2022 Equinox Marathon (adding, for an added dose of accurate-yet-arbitrariness, that a marathon is 26 miles, 385 yards).

Totally winning!

For all that humans are clearly way into “winning”, we’re terrible at defining what it means, what is doesn’t mean – and whether it’s okay to care.

As a little kid, I got used to losing.  And losing again.  And again.  This wasn’t because I’m a total loser – although, yeah – but because I was the younger kid in a family that like to play challenging games such as bridge, Facts in Five, and no-holds-barred croquet, and didn’t pull punches for lame excuses such as “being six years old”. 

So I lost. In my impressionable little mind, the significance of winning was rife with ambiguity.  Based on my primary role models, success was something to be loudly celebrated, and also something to be downplayed to the point of secrecy.

I can still picture the grinning flourish with which my dad would play a 50-point-bonus bingo in Scrabble – ha, take that, third grade opponent!  Every time his preferred baseball team scored a run, he’d leap off the couch or out of his stadium seat in a spontaneously dorky happy dance.  At the bowling alley, he’d hop and lean as his ball rolled, as if kinetically controlling it from afar, brow furrowing deeply if it spun awry.

Conversely, my mom stressed that competitiveness was gauche.  When I received my first standardized test results at the age of eight, she allowed me to see them only after I made a reticently British promise: “You mustn’t tell any of the other children your scores.” This proved awkward, given that other kids had been given no such instructions; I ended up feeling weird and ashamed. 

Outside my own family, the social rules were equally confusing.  Kids cared about winning to wildly varied degrees. I found that I usually won at games like Rack-o and Mastermind, and lost badly at games that were clearly way cooler, like dodgeball – where other kids’ competitiveness tended to leave me covered in welts.  Plus, other families had very different rules from my own.  I was mystified when I realized little kids were often allowed to win.  To me, this was cheating, and thus Not Fair.  Being Not Fair was bad. 

But… what is fairness?  This confused me as a child, which is not surprising, given that it still confuses me – and possibly everyone else.

A pause from facetiousness: there’s a much bigger question buried in here about societal fairness in all its forms, built from multi-generational evil, greed, oppression, and arrogance. We humans theoretically want to create fairness, but at the same time it’s clear that we don’t; history demonstrates just how badly we’ve done. I can’t pretend that I’m doing justice to such a big topic in a brief and flippant blog post, but at the same time, it lurks beneath everything, and to ignore it is to perpetuate it.

In an effort to create fairness, children’s sports and academic challenges are usually divided by age or grade level. Most adult sports are divided by gender, and some also have age categories – although in the Iditarod, for example, the genders and ages of the musher and the canine athletes are considered immaterial. Boxing and wrestling have weight classes.  Adult cerebral competitions such as crossword championships are not divided by age, gender, height, or weight, and there is no Jeopardy category for people like me who seem kinda smart but are irretrievably terrible at Jeopardy. 

Everyone would agree that a chess tournament in which kindergarteners had to go head-to-head with Grandmasters would be… uncomfortable.  But things get weird when someone has to decide where the cutoffs should be, because all the pertinent variables exist on a continuum -- youth, old age, weight, height, and (yes, newsflash) gender.  Plus, the expected “handicaps” associated with youth, age, weight, height, gender, and other factors varies widely. The basketball player with the greatest physical advantage doesn’t look much like the ideal gymnast or jockey.

When one of my kids turned 13 and suddenly found that she had to compete in the “adult” category at rock climbing competitions, the boundary was abrupt and artificial.  Being small for her age, she couldn’t reach many of the holds intended for people over five feet tall.  It wasn’t “fair”.  But, as she and I discussed, it also wouldn’t have been “fair” if adult-sized 13-year-olds competed as children. There was no perfectly “fair” solution.  There never is. 

Life is not fair.  Has everyone had this conversation with every kid, everywhere?  

Some parent-child discussions of unfairness -- spawned by racism, sexism, violence, and fear -- should never, ever have to occur.  This is not the kind of unfairness that’s inevitable; it’s the kind that’s insidious.

As for the inevitable kind – I now realize that both my parents taught me that life is not fair, but in different ways.  My mom’s perspective was that life wasn’t fair, so I should chalk up any victories to that unfairness, and take no credit for them.  In fact, I should be vaguely embarrassed by them.  My dad’s perspective was that life wasn’t fair, and thus I shouldn’t whine about the bowling ball being too heavy when he beat me, his 45-pound opponent. “It’s a poor workman who blames his tools,” he told me.  Really, he did. 

As a teen, I continued to excel at academics but lose at sports – unless you count garnering the third-place points in unpopular high school track meet events (3000 meters, shot-put) in which only three girls participated. The scattering of other times I’ve “placed” in sporting events have all been equally suspect.  A triathlon in which there were only three female participants?  A dawn to dusk winter solstice run at forty below zero in which I was the only woman to keep trotting for all three hours and forty-one minutes?  Yeah.

These “wins” felt like participation trophies – those “thanks for showing up” prizes that didn’t become common until I was an adult.  Curmudgeons waxed pompous about how such awards would make an entire generation – the millennials – weak, lazy, and coddled.  Every generation of old farts says this about “young people today” and (I remind myself as I age into old-fart-ness) each generation is wrong.  Participation trophies were born out of a noble effort to remove emphasis from crushing the opponent. They stemmed, albeit indirectly, from a growing societal discomfort with the much larger win/lose unfairness that has poisoned us across centuries.  As such, I applaud them.  But they didn’t work out.  Even six-year-olds knew that participation trophies didn’t convey pride of accomplishment – not because winning was everything, but because some other metric was necessary to replace it, and “merely existing” was not sufficient.

This shiny new marathon medal can easily be downgraded to “participation trophy”.  There were only twelve people in my narrow age/gender group.  There were nine women in the older 55-59 group, and two of them beat my time – one by a whopping 26 minutes. And the fastest women in the race, taking 8^th and 12^th places overall, against all ages and genders, were two 42-year-old women. In other words, someone named Meg, only eight years younger than me, beat me by more than an hour and half.  When Meg crossed the finish line, I was eight miles back, bumbling off Ester Dome while eating a lint-covered cookie from my pocket.

This is where my brain goes, when there is some hint that I might have won something – I automatically figure out why the win is meaningless.  Is it a victory if other people got sick?  Got hurt?  Went home?  Never showed up in the first place?  

I learned this tactic from my mother, but this outlook is by no means unique to her; .Jay holds even more firmly to this perspective than I do.  He managed to be embarrassed and in denial when he won the Iditarod Trail Invitational, a thousand-mile human-powered race across the wintery wilderness of Alaska.

It's easier for me to argue against this mindset when it’s put forth by others.  I mean, come on, Jay!  Celebrate a little!  I want my family and friends to feel joy, pride, inspiration, thrill, and adventure when they succeed.  I especially want this for my kids.

What I don’t want, though, is for them to fall into the trap that limited my dad’s joy: wanting someone else to lose.  When I was about twelve, Dad forbade me to read the dictionary because he didn’t want me to improve my Scrabble game “unfairly”.  Um… Dad?  Being so dead-set on winning at a board game that you want your own child not to learn, and to do badly is… not a good look for a middle-aged man. 

Nor do I want anyone to fall into the trap that limited my mom’s joy: being so socially averse to the pitfalls of the win-lose dynamic that success can never be celebrated, or even noted. 

As a child, I managed to extract the worst aspects of each parent’s viewpoint.  I concluded that neither parent was proud of me, and that I should not be proud of myself. 

Totally winning! 

As an adult – and particularly as a parent – I’m realizing (a bit late) that I need to flip this upside down. I can reject my mom’s restraint while embracing her fierce sense of equality and social justice. I can reject my dad’s pettiness while embracing his joy. 

I want this for my kids.  I want them to see their own privilege and advantages with absolute clarity.  I want them to try to create fairness wherever it’s possible to do so.  I want them to understand that “winning” doesn’t mean someone else is a “loser”.  Success is not pie – or if it is, it’s the kind of pie that you can bake more of, and share.  If we’re all competing, we’re ultimately doing so not against one another, but against our past and present selves, and our past and present aspirations.  Everyone can increase their Scrabble score, reduce their marathon time, or learn to bake a more delicious pie. I want my kids to seek out and celebrate other people’s successes.  But I also want to them to celebrate their own successes – to grin the way my dad used to grin, and leap off the couch to do a happy dance.

I want this for myself, too – because why not?  My “victory” over other individuals who happen to be my age and gender is silly and misleading, but my time in the crazy-hilly Equinox Marathon was the fastest I’ve ever run, in my fourteen attempts over the past twenty-one years.  I was faster because I trained just a bit more, and tried just a bit harder, and sometimes even remembered to stretch.  I challenged myself, and I felt good about that -- and maybe it’s okay to admit it. 

Totally winning!

I won a medal.  It means something, and I appreciate that.  It also means absolutely nothing – and I like that about it, too.