citizen | too young

One of the amazing things about living in such a vibrant and international city is the exposure to cultures and issues from everywhere in the world.  I recently stumbled upon this amazing series of photographs by National Geographic, where they asked their photographers to come up with one photo that was especially meaningful to their journey and explain why.  The photos are beautiful and you should check them all out.  One in particular got me a bit choked up - and reading more. 

women | the hostess

I recently bought a copy of the magazine DARLING, which advertises itself as a magazine about "the art of being a woman".  I'd love if it said the "science and art of being a woman" but I'm a nerd.  It's one of those pretty expensive magazines on beautiful paper that I love to just hold in my hands - other versions being Kinfolk, and others.  This magazine was recommended by a good friend, Colette, and is just really fun.  This most recent addition is divided up into different roles that women play -

women | letters to a daughter

found this gem from the UK Times' caitlin moran in a letter to her 13 year old daughter.  It's not only very english, it's hilarious and profound:  it begins with first, be kind.  Last, never start smoking - it's like a baby dragon that will eventually burn your house down.   so good!

spring time // a first time

1. spring time
this is my first spring in DC and it is just STUNNING.  never mind the fact that I've been on nights for 7 weeks straight and that my family has had a grief-ridden first quarter of the year; I LOVE SPRING IN DC. The heat and humidity of the summer hasn't yet set in but the cold has gone for good (I think!) and being outside feels great, the perfect remedy for my exhausted body and soul. I can't believe I'm just a few short months from finishing intern year.

PS: that is an elephant jump suit you see right there. spring present to myself and probably my favorite clothing item I own.  I literally want to wear it ALL THE TIME.

2. a first time
sometime in the past few months I was called to the ED for a gyn consult for vaginal bleeding.  This is probably the most common consult that the ED calls us for, so I didn't think much of it. But  this patient experience reminded me why I became an ob-gyn.  She was a 20-something year old woman who had just had her first experience with sex and had a vaginal laceration.  We ended up packing the vagina - or creating a pressure dressing but in the vagina - and then we just had to wait to see if the bleeding stopped.

The waiting ended up being the best part, because she and I just talked.  It was clear while I was taking my history that she really did not have a lot of information - and even less accurate information - about sex.  So when I explained that normally when women have vaginal bleeding after their first intercourse, it's not this heavy because usually it's from tearing the hymenal ring - the ring of tissue that is at the opening of the vaginal introitus.  however, many if not most women have already "broken" this ring through movement or tampons so many women do not bleed at all after their first intercourse.  A laceration or deep cut in the vagina is never normal after intercourse.  Then I asked her if she had other questions.  She paused and then asked me about the different holes in a woman's bottom - she wanted to be sure he went in the "correct" one.  So I drew her a picture (and gave it to her to keep) and labeled the urethra, the vaginal opening, and the anus.  I asked if she had more questions.  She did.  We ended up talking for about 45 minutes - her asking questions, me answering them.  They ranged from what were normal emotions after a first sexual encounter (anything, I answered, can be normal), to whether or not she should talk to the guy and tell him what happened after she left (communication is probably the most important component of healthy sex, I answered, if you don't think you can talk with someone, it's a pretty good indication that it's not a great idea to have sex with them) to anatomy including the location of this elusive g-spot (I drew more for her).   Those 45 minutes were such a luxury in a time when my job emphasizes speed and efficiency, but I felt like even more than fixing her laceration, I was hopefully affecting her entire sexual life and hopefully for the better.  Moments like this, of helping women understand themselves and their bodies better, especially in vulnerable and potentially scary times, remind me why I do what I do.

Autumn Reading List

one of my dreams since moving to DC has been to join a book club.  it seems like everyone is in them here.  I want to be one of the people who meets up with brilliant, clever, funny people to discuss how a book made them think, feel, wonder differently about the world.  I'm in the process of scouting a few book club options, but in the meantime, here's my personal fall reading list:

1. When Everything Changed by Gail Collins
a nonfiction account about the truth, myths and mystery in the US women's revolution

2. The Fault in Our Stars by John Green
nonfiction account of a 16yo with terminal cancer who is just. so. freaking. hilarious and profound

3. A Suitable Boy by Vikram Seth
a full immersion story about relationships and life in India

4. Expecting Better by Emily Oster
a chicago economist takes on the data about pregnancy recommendations

5. Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande (a  re-read)
a book about how medicine is human

6. The Collected Work of Nikki Giovanni by Nikki Giovanni
a book of poetry by one of the most wonderful modern poets

7. A Spiritual Guide to Midwifery by Ida May Glass
a nonfiction account of Ida May's midwifery practice from beginning to present day

8. A Practical Wedding by Meg Keene
because, you know, I'm planning a wedding but don't want to be a crazy, silly bride

9. Let's Explore Diabetes with Owls by David Sedaris
my official book club book and one of the FUNNIEST authors ever. I'm so excited

10. The Guernesy Literary and Potato Peel Pie Society by Mary Ann Shaffer
recommended by several friends, entirely of letters during WW2

what's on your reading list?  what should I add to mine?
Also, I love the paintings of people's bookshelves in Jane Mount's book - I keep thinking about what would be on my idea bookshelf.  Maybe at some point I'll have to actually design one and draw it out.


photo credit: idealbookshelf by Jane Mount

on feminism

while my college did have an incredible women studies program, I somehow thought that I was learning enough about feminism outside of the classroom to not sign up for any actual classes on feminist theory and feminist history.  to tell you the truth, I'm still a little reluctant to get too involved in feminist theory, but I wish I had taken a history of women class (which I'm sure was offered).

but you know what matt damon says: "you wasted $150,000 on an education that you probably could have got for $1.50 in late fees at the public library..."

so instead of going back to college to take that class, I am going to do some reading.

Here's a book by Gail Collins recommended by a dear friend whose life mission is wonderfully intersecting with mine (yay collette!) and a website about the Reconstructionists (this is maybe where feminist theory would be helpful...) with beautiful drawings by Lisa Congden.

/////

"god may be in the details, but the goddess is in the questions. once we begin to ask them, there's no turning back."
- gloria steinem

flashback Thursday: May

And the return of FLASHBACK THURSDAY commences!  This feels so critical to me - like re-reading through my old journals - like a conversation with my past selves, asking their advice on if I'm living my life right and true now.  But because it's a lot, I think I may just do one entry at the first Thursday of every month (trying to make more realistic expectations of blogging for residency!).  Same thing as before - to read the full entry, click on the date (e.g. "May 2012").

What could you learn from your past MAY selves?  

What were you doing last May?

in May 2012, I was on my night float acting internship delivering babies and not sleeping very much.  It was a critical time for me because it solidified my decision to be an ob-gyn; even though I was constantly more exhausted than I had ever been before, I loved it.  Some of the guidelines for night float I wrote down then:

1. first thing you do when you get home is shower.  I don't care how tired you are, [other people's] amniotic fluid should not be on your sheets.
2. bring lots of healthy snacks - especially water-heavy snacks (fruits, veggies, just plain old water)
3. when you wake up (or if you feel alert before heading to sleep): work out.  even if it's short, ugly, traumatic - there's not a day when it will feel good so if you start using that as your measure if you should go work out, it'll never happen.

~~~~
in May 2011, I was on my family medicine clerkship and telling lots of stories about my amazing interactions with my patients.  My tribe also came to visit me in northern maine and we took a trip out to Acadia!  During that time, I came up with a list of "things I learned in family med" including:

1. Everyone is doing the best they can with what they have (even if sometimes what they have is a history of an alcoholic mother and bad coping mechanisms)

that one needs a pause for emphasis. okay, next:

2. Trust but verify. (Ronald Regan, about the Soviet Union)

3. Manage the unavoidable and avoid (or prevent) the unmanageable (-Friedman, about climate science)

4. Try not to work too much harder than your patients are working for themselves.

5. Results can be good or bad news, so deliver all results neutrally until you know how people feel

~~~~
in  May 2010, I was finishing up first year of medical school and trying to do a million things at once.  Also, the world cup was happening and I was maybe falling in love with the manfriend - slowly but surely!  (here's us at a US soccer game in CT where we drove through the night to get back for class the next day)




~~~~
in May 2009, I was preparing to move to Vermont and start medical school.  I only have one blog entry from that month and it is entitled "Loosening the Moorings on the Soul". For some reason this one feels the most fitting right now, perhaps because, four years later, I'm in yet another transition.  Here's an excerpt:

Question: How do we adjust our lives in a world that requires us to be in so many more places?

Answer inspired by a novel by Salman Rushdie, called the Enchantress of Florence:

"In a small wooden box concealed behind a sliding panel...[he] kept a collection of beloved 'objects of virtue', beautiful little pieces without which a man who traveled constantly might lose his bearings, for too much travel....too much strangeness and novelty, could loosen the moorings of the soul"
-Salman Rushdie, The Enchantress of Florence

~~~~
in May 2008, I was living in Boston, finally comfortable being single, still working at my very first job, and running along the Charles River pretty much daily.  Here's a passage from an entry reminding me to continue to interact with strangers:

So after I passed the Pretty Good-Looking Guy the second time, I'm smiling all happy-like. Ahead of me, walking the other direction listening to his old school Walkman is a slightly tattered Old Man. And because I'm feeling so happy, I smile briefly at the Old Man as I run by, thinking very little of it.

But a few strides later, I hear him yell back at me (yell in a kind, not aggressive, way) "thanks for the smile; that was very nice". I regret that I didn't turn, I just gave him a behind-my-head thumbs up and kept going the other way. 

Monday Giggles: Jennifer Lawrence

Because she's an advocate for mental health (sorta), super funny, totally adorable, 

and probably my new girl crush - 

Jennifer Lawrence's oscars press conference, 

Happy Monday!

Required Reading for Women 2012

HuffPo posted this article about the editorials of 2012 that should be required reading for women.

Check them all out for yourself! But some of my favorites - from that selection and the ones added in the comments - include:

At the Pinnacle of Hillary Clinton's Career
"Hating Hillary has jumped the shark"

The Mom Stays in the Picture
about how one mom realized that she had to be in pictures no matter how she felt about her body, and was rewarded by readers sending in tons of photos of them with their kids.

Why Millennial Women Do Not Want to Lead
by a 19 year old about why her (our?) generation is
"Ultimately, women equate leadership with perfection in a way that men don't.  Men are generally taught that perfection is not a necessary component of success, that, in fact, they can fail miserably - even commit felonies - and still bounce back to power."

Our Pregnant Week
a super well written story of finding out she is pregnant
"I zoomed home, called some feminists, cried more"

Opting Out of Parenthood
a NYT editorial about not wanting to have children - a follow-up to her blog about the cost of having a child

What else should we add to the list?

~~~~~~~~~

"life shrinks or expands in relation to one's courage"

- Ahais Nin

Pelosi Rocks

Nancy Pelosi articulately fields a question from NBC reporter Luke Russet about whether or not she felt like not stepping down to make room for "young leadership" was bad for her party. Congresswoman Pelosi correctly points out 2 things: that men in Congress are never asked to step aside based on their age and that she came to Congress later than she might have if she were a man because she only ran for Congress after her fifth child was about to go off to college.

As one of the most successful Speakers of the House - and the person we really need to thank for promise and hope given by the Affordable Care Act, among many other things - it seems perfectly reasonable for her to continue her incredible career.

~~~~~~

"Let's for the moment honor it as a legitimate question, 

although it's quite offensive but you don't realize it, I guess"

- Nancy Pelosi (D-CA, Minority Leader)

gender income equality by state

In a recent post on Slate, there is an interactive map of all the states, then also by county, how much income differs by gender.  It's astounding (and terrifying).  In the BEST states, women still only earn 75 cents to the dollar of men.

According to their data, the best cities for pay equality include DC and Dallas, followed by San Francisco, LA, Austin, Santa Fe, NYC, and Boston.  In most other major cities it's closer to 70 cents for every dollar men earn.



And for a look at data showing that more equal societies are healthier, a Tedtalk by Richard Wilkinson:

the turnaway study

*according to this new study, this woman is very wrong.

One of the hypotheticals that is always touched on in reproductive rights discussions is what would happen if we simply did not allow women to have abortions?  Well, the Turnaway study from San Francisco-based research group Advancing New Standards in Reproductive Health (ANSIRH), investigated that question and just presented their first results.  

There's a great overview on the Slate XX blog to check out.

In brief, the group followed over 1000 women across the country who went to have abortions.  Most were able to obtain abortions (97% had no regret), but almost 200 women were not able to have abortions, usually because they were farther along in their pregnancies than the places they went to have abortions would perform the procedure.  The researchers interviewed these women extensively and compared them with the group who was able to obtain abortions.  

A few (of the many) things worth mentioning:

1. women not able to have abortions were more likely to be financially struggling a year later.

Compared to the group who did have abortions, a year later (the study is ongoing) those who were "turned away" were more likely to be on government assistance, living beneath the poverty line, and less likely to be working full time.  

2. women not able to have abortions were more stressed.

They also reported more stress and were equally as likely to be depressed as the other group of women (as in, no happier).  

3. women not able to have abortions had more medical problems.

Including pregnancy complications and postpartum complications (abortion is almost always safer than pregnancy, as is birth control).  

4. women not able to have abortions were more likely to be victims of domestic abuse.

The researchers attribute this not to the "turn-aways" being more likely to enter into abusive relationships, but being less able to get out of them while pregnant/with a new baby.  But this didn't mean that men were more likely to stick around - they found that "men were no more likely to live with a turnaway who'd borne their children than they were to live with a woman who had an abortion".

This study is excellent data to add to the discussion of women's reproductive rights - showing that the consequences of our reproductive choices are far-reaching and longer lasting than just 9 months.

~~~~

"As women's access to abortion care...becomes increasingly restricted, it is extremely important to document the effect of unintended pregnancy on women and their families.  The Turnaway Study is an effort to capture women's stories, understand the role of abortion in women's lives, and contribute to the ongoing public policy debate on the mental health and life course consequences of abortion and unwanted childbearing for women."

- taken from the Turnaway study website, under Why this study is Important

(*I copied this image from the Slate XX blog review of the turnaway study, because it was just so good)

believing the whole concept

Back to Sarah* (*obviously not her real name) and our counseling session.  Sarah started the session by listing quickly - before we could even ask her any questions - all the reasons why terminating her pregnancy was the right thing.  Reasons that she - and many other woman- have cited included that her "life is a mess" and she could not responsibly bring a new life into it.  Sarah* was living with an on again/off again boyfriend who she loved, but struggled with uncontrolled and unpredictable bipolar disorder.  The two of them had been living in a van under a bridge for the past several months.  They were both having a hard time finding work.  Neither one of them had any support from or connection to family in the area, nor did they have any other resources to draw on.

She went on for several minutes listing these reasons and more.  We listened.  Then she stopped and paused, looking at us to see if we had anything to say, almost looking for our agreement with her reasoning.  But the very wise and experienced counselor said nothing, just waited.  I wasn't sure what to do, so I said nothing, and waited.  Then Sarah* said, "but the truth is, I want to be a mother more than anything else in the whole world.  Even though it doesn't make sense.  Even though it's not responsible.".

And that's when the counseling began, as the counselor started asking questions to help Sarah* work out what she thought and felt.  To help her see her situation in the truest light - without judgement, but without rose colored glasses either.

Sarah* said that she was concerned that if she terminated her pregnancy, that in several months - when the baby that would have been actually would have been - what if her life was better?  What if it was now responsible for her to bring a new life into it? What if she and her boyfriend had figured out jobs, had found an apartment, had organized their lives - would she then feel incredibly guilty and regretful that she had ended the pregnancy?

The wise counselor listened and finally said, "You know, Sarah*, no matter what you decide to do in this situation, your life will be different in several months.  And if you decide to end the pregnancy and your life is better in several months, how will you know that this decision didn't help you to make your life better? And if you decide not to end the pregnancy and your life is better in several months, how will you know that this decision didn't help you make your life better?  We just have no way of knowing how our lives would have turned out if we made other decisions, but I can tell you that this decision you are making now will absolutely affect your life over the next few months - because it will be very different if you are pregnant and expecting a baby than if you are not.  Only you can make this decision, but once you have made it, don't judge yourself for it, or think of all the other possibilities that could have been - because it will be different."

Later, after Sarah* left, without terminating her pregnancy, to think more about her decision, the wise counselor and I debriefed.  We talked about how even though her reasons for why she should not be a mother right now make logical sense to us - that if we really believe in a woman's right to choose, a woman's right to make decisions about her own body, then we cannot judge her decision, we cannot think to ourselves that she should make one decision over the other.  Our role is to help her make the best decision for her, in a non-judging, non-assuming way.

It's definitely hard, but feels incredibly important.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

"A woman's life can really be a succession of lives, each revolving around some emotionally compelling situation or challenge, and each marked off by some intense experience"

-Wallis Simpson, Duchess of Windsor (1896-1986)

Choosing What We Show

Recently, I interacted with a woman around my age who had come to the clinic where I was working with the intention of terminating her pregnancy.  It's been so long I can't remember how many weeks along she was, but not far.  Women enter these difficult and emotionally wrought visits with a clinician in all styles.  Some openly weep, some list all the reasons why this is the right decision - as if convincing themselves, some are silent and refuse to make eye contact, many are curious - about the pregnancy, about their options, about what they might see or not see, how their lives may be different depending on how they choose.

I feel so lucky to live in a country, in a time, when women get to make these decisions - though saddened that their decisions were not instead the less emotionally draining one of choosing effective birth control or choosing not to have sex in the first place.  I feel even more lucky to have worked in a clinic that allowed women the space to feel, think, and process whatever they needed.

This woman, let's call her Sarah* (*obviously not her real name), knew she was pregnant but was not sure how many weeks - so we did an abdominal (on the belly) ultrasound to take measurements to date her pregnancy.  There has been a good deal research on interactions with ultrasound technicians by women considering termination and the data is surprising.  But first, because ultrasound is a tricky subject these days, let me set the facts straight: everyone who is seeking or considering a termination usually has an ultrasound to date the pregnancy, because this determines many things about the possible procedures and counseling.  In the vast majority of cases, this ultrasound is done abdominally (on the belly) and is only done transvaginally (in the vagina) if the pregnancy is too early, and therefore the uterus too low in the pelvis and too small to see through the abdomen.  There are some people trying to pass laws about ultrasound and pregnancy termination that require very different things, including transvaginal ultrasounds, narration of ultrasounds, listening to heart beats, seeing moving images, etc.  This has not been my experience.  

In research investigating how to interact with a woman considering termination when conducting an abdominal (on the belly) ultrasound, the results are surprising in that many women are interested in seeing the image, many would even like an image printed to take home.  Even more fascinating is that there does not seem to be a pattern with the choices women make (in terms of keeping the pregnancy or terminating the pregnancy).  Additionally, when ultrasonographers (the people who do the ultrasounds) and clinicians are interviewed, they largely believe that women should not see the ultrasound if they are considering or have decided to terminate a pregnancy.  There are still many questions to be answered - including if the age of gestation matters (many of these papers were only involving women who were intending to have first trimester terminations), larger sample sizes, longer term effects, correlation with other factors such as parity and reasons for termination.

Planned Parenthood has a national policy where every woman is asked, before stepping into the ultrasound room, if she would like to know if she has more than one pregnancy (twins, triplets, etc), and if she would like to see any images.  Anecdotally, I have been told that most other clinics don't ask and do not offer unless the woman asks explicitly to see a picture.  

As I have had more experience with this, and after hearing an amazing presentation on some soon to be published data on women's experiences of ultrasound before a termination, I decided that I am going to ask women if there is anything they would like to see or not see, know or not know.  And I have been fascinated by the results.  

Which brings me back - finally - to Sarah*.  Sarah was very quiet when I brought her to the ultrsound room.  I had already asked Sarah the same question I ask everyone and she had said she would like to see an image.  Again, based on experience, the teaching I have received, and the data I have seen, whenever I show anyone an image, I zoom out so that there's slightly more realistic perspective of the size of the pregnancy, and I point out the abdominal wall, the uterus, and the pregnancy, as well as any other obvious structures.  When I did this for Sarah, she started crying.  In my desire to comfort her, I quickly turned the ultrasound away from her and sat in a chair next to her.  I asked her what was going on her in head at that moment, and if there was anything I could help with.  When she shook her head No, I put my hand on her back and reminded her that the next step at our clinic is to talk in depth with a counselor.  I asked her if she wanted to see any other images, and when she said No, I walked with her to the counselor's office, where the three of us sat and talked for a long time.

To be continued in the next post, as it takes this thought in a slightly different direction.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"I pointed out that she was, by definition, pro-choice.  In its simplest form all it means is that the woman gets to decide".

-Susan Wicklund, Physician and Author of This Common Secret

(click the link to see a NYT review of her book)

Mitt Romney's Personal Liberties

The Daily Show with Jon Stewart
Get More: Daily Show 'sFull Episodes

Having it All

As a future doctor (in T minus 9 months!) and as the daughter of two working professional parents who I can say without a doubt love me more than anything else in their lives (except for maybe my sister, and even then they assure us that we are equally what they love and value most), the recent article "Why Women Still Can't Have It All" by Anne-Marie Slaughter in the Atlantic was fascinating.  Though the article is quite long, it's completely worth it.  Instead of focusing on condemning our generation for not "striving for the top", or being falsely reassuring about the reality of having a high impact career and being highly impactful on your family, she brings the argument to how instead of continuing to give women horrible "choices" and judging what they choose, we should change the discussion.  Some examples include how technology can let us have more flexible work hours, how companies can encourage "family leave" acknowledging the importance not just of children, but of caring for a spouse or ill parent.  And this is probably one of my favorite paragraphs and is a great example of her shifting the discussion:

One final example: I have worked with many Orthodox Jewish men who observed the Sabbath from sundown on Friday until sundown on Saturday. Jack Lew, the two-time director of the Office of Management and Budget, former deputy secretary of state for management and resources, and now White House chief of staff, is a case in point. Jack’s wife lived in New York when he worked in the State Department, so he would leave the office early enough on Friday afternoon to take the shuttle to New York and a taxi to his apartment before sundown. He would not work on Friday after sundown or all day Saturday. Everyone who knew him, including me, admired his commitment to his faith and his ability to carve out the time for it, even with an enormously demanding job.

It is hard to imagine, however, that we would have the same response if a mother told us she was blocking out mid-Friday afternoon through the end of the day on Saturday, every week, to spend time with her children. I suspect this would be seen as unprofessional, an imposition of unnecessary costs on co-workers. In fact, of course, one of the great values of the Sabbath—whether Jewish or Christian—is precisely that it carves out a family oasis, with rituals and a mandatory setting-aside of work.

Without giving more away, and because I'm still processing it, I'll just tell you this: read it (click here). then let me know what you think. and then let's talk about the changes we can make.

that little number

I just got back from a quick jaunt in NYC where my sister and I got to do one of our most favorite activities - walk for hours and just catch up.   So many interesting ideas came up that I'm excited to write about soon, but one theme that struck me was an age old theme for women.  I am surrounded by so many beautiful women in my life.  And what's more - they're smart, funny, brave, clever, inspiring, strong, and kind.  And yet we all have this little number in the back of our heads that we think "If I saw that on the scale, I'd be happy".  This isn't news, I realize.  But what is, at least for us, is that most of the time when we, or the women in our lives, actually weigh that magic "happy" number - we aren't that happy.  I was at my lowest weight since the beginning of highschool this past year - but I was not sleeping, was moving around so much that I never felt settled, much less home, was more lonely than I've maybe ever been, and super stressed.  And that's how it works for most of us - that silly number is only achievable when we are too stressed or busy or out on our own to enjoy anything - including long dinners with family or walks along the beach with friends instead of a quick intense workout.  In some ways those 5 (or 10...) pounds signify that our lives are full of enough joy and love that we choose to spend time with friends and family instead of working out or choose to go out with friends for a beer a few times a week or to celebrate a friend's birthday with a whole lot of chocolate cake.  So the question occurred to us: what if those few pounds - that we stress and distress over - are really just your happy weight?  What if "filling out" a little bit, symbolizes our lives actually being more full?  If the answers are a resounding yes (which it is for us), then maybe we should try being a little more grateful, a little more tender towards the other, real, number.

And for fun, a little ode to the amazing and beautiful women in my life, otherwise known as a trip down memory lane:

                 

            

                                    

choice

All the battles over contraception coverage that have older men inappropriately talking about the reasons women use contraception, as well as the heated debates about new laws that humiliate and isolate women while they are making these very difficult decisions.

A recent study from the Guttmacher Institute showed that HALF of all reproductive age women now live in states that are hostile to abortion!  This map below shows the change over time in states hostility to policies related to contraception and terminations. 

It may also be a map of where I am applying to residencies next year.

and just in case you haven't been following along - Doonesbury is running a series on the new laws surrounding a woman's right to make reproductive decisions that is obviously now being censored.  Check out the censored strips on Slate blog.

Contraception

"It comes down to this: if the issue is contraception, Republicans lose. The polls are clear enough about that. But the numbers do move a bit depending on how you ask the question: if it’s framed in part as an issue of religious liberty, the picture looks better for opponents of the rule. There, Republicans have an opening—if they can shift the debate away from contraception, and instead make it about the President attacking religion and the religious (and throw in a few winking hints about his personal beliefs), then they have a chance to turn this into a winning issue come November."

Oh goodness, I hope note.
Read more of this New Yorker article here.

the president

amazing quote from a patient whose orientation I was assessing today - typically we ask all patients on the neurology service every day if they know who they are, where they are, what year it is, and something to orient them to the rest of the world, like who's the president.  It's a way of assessing sophisticated brain function.  So my patient (who has a chronic neurological disease and is never completely oriented) today says her name correctly, doesn't quite know where she is, states that the year is "definitely 2020" and when I ask her who the president is, she says, "Ohhh I totally forget her name.  Let me think. It's something like Joanne.  Yeah, Joanne.  I think it's Joanne."

Love it.