Friday, October 21, 2011

Mutation, Misinformation and the Marvelous Mütter Museum: Not a Children’s book by Emmi

It is one of my absolute favorite times of year. I love the (stipulation: rare) stunningly clear and distinctly scented autumn days, I love the sweaters, I love the flavors of fall – the pumpkin, the sage, the maple syrup, the late blackberries. I love the way, even in the miserable, soggy, grim expanse of the pacific northwest, that subtle blush of color spreads over the leaves until all the trees blaze out in a defiance of crimson.
And I love the fall fashions. I get excited every year to see what new trends emerge. This year, there doesn’t seem to be much novelty in vogue, which has been really, really disappointing. Much like last year, we are still seeing a preponderant focus on ADD, ADHD, Asperger's, and bitching about the flu shot.
Oh heavens, I’m sorry. Did you think I was about to talk about clothing? If you want my sartorial critiques you are just going to have to wait until spring, when I’m good and donked up on vino verde and someone gives the Olsen twins another slab of stock in Walmart. Until then, I’m going to stick to sarcasm directed towards issues more directly in my wheelhouse, though admittedly those issues are pretty much confined to “bottles of wine that cost less than 10$.” But it’s my favorite season, google keeps sending maniacs to this blog, some people just had shoulder surgery, and anyway I’m hoping to post a little more frequently this term, as It has become far more imperative that I avoid any actual work. There’s also the small matter of needing to step up my game after I accidently promised to marry everyone I meet on the internet.  I’m inspired!
So God damn, could we just move on to something innovative in our disease crazes? For years, we have been over-diagnosing and carping about the same old shit. Remember when suddenly everyone had depression? And now everyone has ADD? For god’s sake, everyone had Attention Deficit Disorder when I was a kid, and it’s been completely played out for years. For awhile, I really thought that the grand obsession with the Autism spectrum was going to help guide our focus in a new and truly avant-garde direction. But, no. Alas. I don’t exactly know who decides these things, but please just get a grip. It is way past time to move on. These guys are sticking like denim when they should have been jeggings. Let’s be real.
Every year holds the promise of a new arena of pathology, and every year I’m held back by a redundant deluge of the several million examples of why we should probably declare Jenny McCarthy’s asinine twitter feed a public health emergency. This year, I was so sure that things were going to be different. Firstly, we sequenced the BLACK PLAGUE. THE BLACK FUCKING PLAGUE, Y’ALL. And then we found out that the black plague AINT SHIT! How Badass is that?! Like, if the black plague were to come back, our immune systems wouldn’t even give a fuck! Our immune systems would give the black plague the kind of scornful once over that gets directed towards a fat girl who wore the same dress as you to a party. “Oh,” our immune systems would say. “I didn’t know you were coming.” As an aside, our immune systems would turn to our nervous system and whisper something about how they just let anyone in, these days. Daaaaaaaamn.
Secondly, popular culture has given a big boost to those of us in the health services by making epidemiology really, really sexy.

Remember how lame Dustin Hoffman was in Outbreak? 2011 won’t stand for that! The bathrooms in movie theaters after Contagion lets out are filled with people washing their hands more thoroughly and self consciously than ever before.
I realize that it’s really difficult to establish a cultural trend of conditions that are at baseline binary – I mean, you either have tuberculosis or you don’t. But there are so, so, so many disorders that fall somewhere on a diagnostic spectrum; couldn’t we just give one or two of those a chance to get crammed all the hell the way down the throats of people until we’re so goddamn sick of them we could just die? Like Trichotillomania, or Histrionic personality disorder, or Anemia? Obsessive Compulsive Disorder looked to be making a comeback, but much like overalls, that movement fizzled out in a hiss of Jack Nicholson.  I think we’re doing a massive disservice to a huge component of the population by failing to acknowledge that pestilence, plague, and the vast and colorful spectrum of viral and bacterial infections are relevant and often integral parts of many lives. Maybe we could start a movement encouraging increased sensitivity? Who exactly decided that whole populations are suffering from a disadvantage as opposed to an alternative lifestyle? I’ll be the first to acknowledge that I don’t always remember to refer to some individuals as “differently-eased.”
I know that some of you will be skeptical. “What’s next?” You’ll ask. I’ll probably ignore you. Considering that the slippery slope argument inevitably ends in the mass extinction of a vulnerable population or sex with dogs, I try to use it sparingly if at all. I can only take so much.
On that note, Let’s talk about pathology as a pastime.
The Mütter museum in Philadelphia is a warped wonderland of deformity and bizarre affliction.
A monument to morbidity, the museum is in fact beautiful, gleaming mahogany and burnished wood cases housing row upon row of grinning, alarmingly imperfect skulls behind spotless glass.
In a concession to modern sensibilities, there is a half assed exhibit at the very beginning of the museum dedicated to medical forensics, civil war wounds, and forensic anthropology.
one of these was a lady.
It doesn’t take long to get to the good stuff, though; Some broad that turned into soap and an entire case of surprising things that grew out of various sites generally considered unpopular or insalubrious for things to grow!
like a forehead.
The museum itself is a part of the Philadelphia College of Physicians, which, founded in 1787 boasts the oldest doctors in America. (Some details fuzzy.) The museum metastasized from a collection of curiosities donated by Dr. Thomas Mütter in 1858, and quickly became a repository for all the screwed up things people secretly want to look at but need some thinly veiled educational veneer as an excuse. 

the sign reads: “I have been digging this shit out of urethras for 35 FUCKING YEARS and putting it in jars. You can judge but please remember you paid to look at this.”

  That sign says, “I kept this monster hand in a jar so that next century, all you little bitches who can buy hand sanitizer in the express line at Old Navy and know how to defecate remotely can wrap your sterile little minds around what Gangrene looked like.”

One of my favorite exhibits was this exquisitely articulated skeleton. The bones are twisted and feathery, the joints eroded by strain and friction. As a piece of art, it’s breathtaking. As a monument to the freakish potential for human suffering, it’s heartbreaking.
This exhibit below was way more fun, because it is the direct result of the fascinating and limitless extent of human imbecility.
There are 32 drawers in this cabinet, and each one of them is filled completely with the staggering array of fatuous things that people have somehow choked to death on.  All the usual suspects, like buttons, small bones, marbles, sanctimony and excessive cologne are all represented, but some of this shit is insane. Why would you put fishing lures in your mouth? Why? WHY????! I can only conclude that there are numerous people who have just got the concept of fishing completely ass backwards in the most pathetic and tragic way possible.
One of the specialties of the museum is abnormal births, and there is an entire wall dedicated to portraits and biographies of Siamese twins, jars of conjoined fetuses, and in one central isolated case, the embalmed body of conjoined brothers who lived into old age, acquiring separate farms, and wives, and lives that they took turns living weekly.
The museum may seem grotesque, exploitative, morbid, deranged. But the subjects are preserved lovingly, displayed with respect and deference, and painstakingly cared for.
While it’s true that I was fascinated by some, and repelled by others, and while it’s clear that the point of the museum is to cater to that slightly unhinged, gruesome obsession we have cultivated with the alien and the dead, there’s something to be said for how humbling it feels to stand in front of the skeleton of a ten foot tall woman, and wonder what your life would be like if you were defined by an aberration so extreme you could never hope for an interaction that was not somehow colored by it.
And there’s something to be said for the kind of miraculous transformation that can bring us face to face with the freaks and the feared, the sideshow mutants and the tragic remains of lives lived in pain, and somehow endow the encounter with dignity and intimacy, and leave us with the suspicion that just beyond some numinous boundary, the things we deny are reverently illuminated and monstrously sacred with the strangest beauty.

Thursday, October 6, 2011

Chinese Medicine

It’s been a long few months. As much as I am enjoying graduate school, I have to admit that being obliged to prioritize all my activities has really forced me to acknowledge just how much I enjoy drinking. Boy oh Boy. Then again, people talk a lot about the benefits of recognizing and being mindful of your coping mechanisms, and since I don’t have health insurance I’m pretty positive that even if I really stepped it up and starting drinking at ten in the morning it would still be cheaper than therapy. Probably. Even assuming I only have about ten or fifteen therapy sessions a week, I would still come out on top. And this way, I can have therapy any time. WHO COULD JUDGE ME FOR THAT?!
I currently require more medicinal alcohol than usual, given the time of year and the uproarious run of luck I’ve been having lately. Some people get really excited for sweater weather. I get really apprehensive about spider weather. The Pacific Northwest is home to some incredible fauna, such as conifers, seasonal depression, and arachnids. Given the concatenation of various factors of my life, such as the fact that my house is a moribund wreck on par with Miss Havisham, the fact that there is obviously a curse on me, and the clemency of breeding conditions for ghastly pestiferous eight legged fiends, this has been a banner year for horrifying shit occupying my house. Even allowing that every year yields a prodigious crop of things that I completely fucking hate, this year has been particularly fruitful thanks to the nest of bragilions of what appear to be actual BLACK WIDOW SPIDERS LIVING IN MY DRYER. Although this is statistically unlikely, it is also not improbable given that my life is generally punctuated by the type of bad luck that is both contingently remote and generally inexplicable.
The consequences of this pyrrhic discovery are diverse. I live in fear, I am applying for a permit to carry a bazooka, and laundry is hella old school.  Until an exterminator comes, our house is covered in layers of undergarments I washed in the bathroom sink. As usual, the environment around me is undergoing the inexorable transformation into that of a whorehouse.
As a more relevant repercussion, however, I have become excruciatingly aware of the inadequacy of my health insurance. Granted, a perfect plan for me would cover burns, inadvertent poisonings, spider bites, ethanol IVs, ancient curses, things I accidentally swallowed, motorcycle crashes and dysentery, which I hear from my HR representative is unlikely. But health care, and what constitutes adequate insurance for health care, are hot topics in the current landscape of U.S. legislation.
The general underlying premise of health insurance in various nations is predicated on what, in terms of U.S. constitutional law, is considered a right. Certain nations consider health insurance to be an unalienable right, whereas some philosophies regard it as a privilege. Regardless of your own personal opinions on the subject, it’s pretty clear that these diverse ideologies give rise to equally diverse systems of care.
Chinese medicine is more of a holistic process than the mostly reactive, specialized event type of care common in the US. Some aspects of Chinese medicine are completely accessible, intelligible, and evidently effective. Some are alarming, confusing, and inexplicable. And some processes are simply ineffable. A lot of the obstacles Western individuals encounter when attempting to parse Chinese medicine are direct results of ideological conflicts between Eastern and Western philosophies.
Health care in the United States is primarily evidence based, responsive, sterile, and specific. We manifest a constellation of symptoms, we remark those symptoms, we submit them to an accredited expert, and that expert in turn analyzes those symptoms and pronounces a diagnosis, which then informs a prescribed course of treatment predominantly contingent on the disease rather than the individual. Western medicine applies a highly specified and specialized approach to illness; conditions belong to specific parts of the individual’s body, and have distinct definitions and parameters.
The Chinese approach to medicine is entirely different; the individual is viewed as a system, each aspect is interrelated and dependent on the others.  We as westerners have some difficulty envisioning the concept of a life force, a motive, fluid, dynamic and animate power within the body and the mind that flows both perceptibly and inexorably.
Also, putting a snake in a bottle and covering it with booze is not necessarily consonant with my idea of tylenol.
My field being medical ethics, and having a personal investment in the scientific method, there was pretty much no way I could visit a country with such a markedly different epistemology without participating in some hands on research. The following  activities are things we engaged in in the interest of exploring alternative ideologies.
(Note: As the Principle Investigator, I was able to outsource some of the more tedious data collection, and focus on diligently documenting the procedures and adhering to the protocol. Being a PI means that you don’t have to do any boring shit like math or work. You get a graduate student to do that kind of BS.)
This treatment requires that fire is used to suck the air out of a glass globe, which is then immediately affixed to your skin by way of advanced super heated vacuum technology. Ever cleaning the globe is unacceptable.
EEEEEEEEEK. Tedious Data Collection like being IMMOLATED.
Bamboo cups are added to make you look less like a pokemon. The difference between the two vessels, and the rationale for the disparate application, was not explained to me in a way that I could comprehend. This could be because it doesn’t make any sense, or because my Chinese is so overwhelmingly Bu Hao.
The final product, is, however, inspiring.
It’s a miracle! He’s cured!
It is, of course, possible to visit modern hospitals in China. The Matilda hospital in Hong Kong is considered one of the most superlative and progressive research and treatment facilities in the world. However, in addition to massage, cupping and liquor distilled from the types of organisms generally associated with nightmares (perhaps they would like a tour of my basement?), ancient Chinese medicine is a discipline practiced widely and successfully.
My experience with Chinese medicine had heretofore been exposure to repellent substances that are alleged to improve virility. There is traboccant evidence to prove that the worse a thing is, the better it will be for your manhood. Rat juice? Horse Anus? Essence of Cloaca? These are not Ozzy Osbourne solo projects. These are treatments.  It might also be germane to note here that every other experience I have had with Chinese medicine has been the procedure where a person repeatedly strikes your wrist with their eyes closed and then tells you that you’re fat. This should be experienced annually.
So imagine my excitement when our friend Shao Shao offered us the opportunity to consult with a traditional Chinese Medical Doctor in his home clinic. I don’t know what you picture when you hear the term “home clinic” (For me, it’s reminiscent of the bathroom cut scenes in Silent Hill, but you may have had a better childhood), but the reality in this case comprehended a single room with a corroded floor, flyblown mirror, and a  peeling decal of a long washed up Chinese pop star on the wall. At least it wasn’t a home surgical suite.
The room was about 20 square feet, and was crowded and damp. In addition to myself, my brother, Shao Shao and the doctor, the room contained a camp bed in déshabillé, a rusted rotary fan, two ancient computers, and several posters of the human body of the type usually seen on the wall at budget massage parlors. (as an aside, unlike Vietnam, massage parlors in China are not generally used as euphemistic fronts for whorehouses. Those are hair salons, as Chinese humor is geared towards the growing body of 12 year olds that think a double entendre involving the word “head” is hilarious.) Drying lines of faded clothes and greying underwear were roped across the ceiling.
The doctor himself was wearing an outfit that presumably conformed to the standard professional uniform. A hastily donned frayed white shirt, paired with worn professional grade underpants. “BAD BOY!” proclaim the ragged boxers. “USA!” 
After the introductions, the exam began. Fred admitted to feeling tired and stressed out. The doctor asked about his diet, his exercise, his love life. He prodded Fred in various places, and listened to his chest.

Towards the end of the exam, the doctor repeatedly tapped Fred’s wrist and then informed him that he was fat. Thank God, because I was beginning to feel a little self conscious and uncomfortable. “Should I say something?” I thought. “I’m certain this man is really breaching the standard of care by omitting this procedure.” We were looking at a serious malpractice suit here. What a relief!
Ultimately, the doctor gave Fred a plastic pouch of his personal formula of all purpose panacea, which he kept in a grungy plastic bag underneath his camp bed.
The storage instructions in Chinese translate roughly to: “Keep in a gross dark place. Film with grime. Refrigerate after opening.”
He also wrote Fred a prescription for another demulcent, which could be filled at any pharmacy.
The efficacy of this treatment is currently under evaluation.
In many ways, I enjoyed my experiences with Medical treatment in China far more than I have in the states. I find a lot of comfort in massage. I feel like western medicine has a lot to learn from acupuncturists. I firmly believe that the US could benefit from the Chinese practice of providing pedicures with 90 minute foot rubs for less than twenty dollars. But more than anything, I really enjoyed the novelty of being treated as more than the sum of my parts.
Although my experiences with the Gynecologist were really unsettling.