healthcare

(im)balance

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I don’t want to rain on anyone’s parade (oh, who am I kidding?), but what is going on in the minds of people who can’t hack their own careers or lives and decide to be life coaches?

I am all for self-improvement and can even support the very Scandinavian/European concept of admitting you’ve “hit the wall” (i.e. succumbed to a kind of existential stress that means you aren’t going to be working for a few months or even a year). I have met so many people who have experienced this, who have felt the overwhelming exhaustion of this stress and its more sinister physical manifestations. I feel for them; I am in fact pleased for them that they live in – and possibly have grown up in – a system that lets them feel comfortable with this and supports them until they get back to full (mental/emotional) health. I did not grow up in such a system, so it’s next to impossible for me to square myself with the idea that this kind of “break” (either the breakdown or the taking a break) is possible. I don’t think it is possible in my conscience, and I would need to be catatonic/unconscious to be forced into this kind of break.

I am not saying my approach is good or right. Having a stress breakdown and taking time off as a result feels wrong for me. We all handle stress differently. What I call stress is not what someone else calls or experiences as stress. As part of my trying to live my life in understanding and compassion, I applaud people for being in touch with what they need, with recognizing debilitating and damaging stress and doing what they need to for themselves, hopefully learning to cope.

But what gets me (and isn’t there always a ‘but’?) is when these same individuals who were so stressed out (sometimes more than once in their career) that they had to take extended sick leave and sometimes retrain for a less stressful career become ‘work-life balance’ coaches.

Yes, seriously.

Seriously. I have seen no fewer than three former colleagues take this exact path.

I won’t argue that they didn’t get some coping mechanisms from their time off. But I will argue that someone who found him/herself in that situation in the first place is not qualified to teach me anything about finding a balance between work and life. Ending up as a life coach in the first place somehow screams, “I couldn’t manage anything myself; I kind of failed at all my other goals, so now I am going to tell you how to manage your life”. Maybe I am extraordinarily closed-minded; maybe through the experience of ‘failure’ (I recognize the harshness of this word) these people have found a calling (helping others), but I am not signing up for seminars in rock-bottom reinvention.

Photo by dylan nolte on Unsplash

The operating system of women

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Several months ago, Mr Firewall asked me if I had ever seen the ads for Bodyform feminine hygiene products that he remembers from his youth. I guess they were only in the UK (possibly Europe) because, as far as I know, Bodyform products don’t even exist in the US. As he always does, he charitably decided to belt out the ‘theme song’ of these ads. I thought surely his rendition was exaggerated and over-the-top… but for once, as I sought out the actual ads from the 80s, his version was almost toned down. I was a bit… stunned. What the hell kind of song was this?

 

Don’t say I didn’t warn you…

Firewall remembered the first ad, but my first exposure was this second one… I can’t really tell what the people are doing. First it looks like a water tank, then an oil rig-like thing and then like they are welding or something. (Okay, I admit I am not really watching closely.)

In the months since my introduction to Bodyform advertising, Firewall has continued to regale me with his renditions of this song, sometimes spontaneously and sometimes in response to my statements, such as “I must have PMS” or “I must be ovulating”.

We recently had a discussion, though, about how so many men have no clue about menstruation. (Firewall has a bunch of older sisters, so he well knows.) But I read a handful of things online recently that echoed the same kinds of things I have heard boys, and even men, say… in all their ignorance. For example, they imagine that women can control their periods in the same way people control their bladders. Just WILL THE BLEEDING TO STOP – hold it in! Beyond that, the lifetime cost of having periods will apparently add up to almost USD 20,000.

I don’t really know why I am writing about this except that it makes me mad. We must deal with – as women – for almost our entire lives – something out of our control, uncomfortable and often painful. And then deal with the total misunderstanding and ignorance surrounding this within society. And then get to pay for the privilege… to the tune of the cost of a car. But even that isn’t as infuriating as it could be. At least I have access to choices and resources. And as ignorant as people can be about something like periods, I don’t live in a deeply shame-based culture that demonizes menstruation.

I was talking to someone else last night, mentioning these menstrual misconceptions and issues, and he said that he, too, had spent the evening talking about menstruation… although slightly more targeted than my kvetching aimlessly. No, he was discussing how he and a group with whom he will travel will get feminine hygiene products in bulk to girls in Sierra Leone. He himself will travel with 60kgs of tampons. (I am wondering about the efficacy, probability and feasibility of supplying menstrual cups, which seem easier to manage, transport, distribute sustainably… but not sure how well that would work.)

And this issue makes me infuriated at my own helplessness – not just the fact that young women in Sierra Leone, West Africa, many parts of Africa and all over the world don’t have these kinds of basic tools at their disposal – but the fact that resources in general are so scarce that it is always like anything one does ‘to help’ is a futile ‘drop in the bucket’, yet at the same makes a tremendous difference (in the way it never does in a well-resourced part of the world). I recognize that I am unfocused and grazing the surface in this venting.

Photo by Jake Hills on Unsplash

you never know

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We never really know what knowledge is going to come in handy. I might never need to know that molluscs have teeth, or what kind of teeth they have, but knowing doesn’t hurt anything. But, other than the joy of knowing for the sake of knowing, can it actually help?

Well, one never knows. I think it might have been in Imre Kertész‘s Fatelessness, or possibly in Ta-Nehisi Coates‘s Between the World and Me, or maybe even neither (although each contains some aspect of this theme): you go through life and start to realize, possibly even lament, all those things you could have learned but didn’t because you didn’t see their applicability or value.

In my last job I had to learn a great deal about laparoscopic surgery and specific lap procedures. Being the “all-in” type (as well as the one responsible for drumming up themes, ideas and topics – as well as often ghost-writing the posts – for a blog that internal folks rarely understood the purpose of) I dove into research and studies about laparoscopy and its uses, technologies and tools … and blah blah blah. Sure, this made it easier for me to do my job, much easier to talk to the former clinicians within the company who were responsible for marketing lap-specific products and also to talk to clinicians externally (to whom we were selling). But beyond that, I saw no real scope for applying this knowledge elsewhere. Did that stop me from going wild like a pig at the research trough? No.

And wouldn’t you know that after I spent significant time and effort inhaling laparoscopy, a friend would require a hysterectomy and had been told by surgeons in her country that, because she had never had a child, she would have to have the full open surgery? I’m no surgeon; heck, I am not even a healthcare professional. But I was reasonably sure, given the evidence and research I had just spent months combing through, that it was absolutely possible for her to have a laparoscopic hysterectomy. I gathered the evidence I could find, sent it her way and told her to push back and ask more questions.

This is perhaps the other important note: We don’t know, we are not experts, so we fear pushing back. We tend to trust the specialists in whom we place our care and well-being, and we doubt that their advice is given because they are trying to fool us… but there are other institutional matters a healthcare professional weighs in diagnosing and offering treatment. In this case, the friend’s surgeon perhaps did not have the most up-to-date information or was not capable of performing the laparoscopic procedure himself. Or, as is often the case, the healthcare system and its practitioners will try to push the cheaper option, even if it is riskier and involves longer healing times. We are often at our most vulnerable and afraid in these situations, so less likely than ever to push back: who are we, untrained mortals, to push back against the education, expertise and experience of these medical professionals? But who else is going to advocate on our behalf?

Still, I am happy to say that she did push back, armed with a bit of evidence. (Ironically, one of the world’s leading experts on laparoscopic hysterectomy procedures comes from her tiny country but practices in the US….) And she was referred to a surgeon with the appropriate expertise and had the procedure laparoscopically, with a much shorter recovery and healing time.

And here I go back to the point: I never imagined that the knowledge I gained in my last job, which was so far outside the boundaries of anything I imagined doing in my career, would have a real-life pay off. And yet, that knowledge I gained might well have been the most important thing I ever learned in a workplace in terms of how great a difference it made in someone else’s life and well-being.

Photo (c) 2006 Amanda Graham used under Creative Commons license.

May for the M word

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May is National Masturbation Month. In fact it’s International Masturbation Month! I will stick with poetry, which had its month in the sun during April, but masturbation is still an interesting and compelling topic.

“Ordinary people who do it think there’s something wrong with them, and it’s painted as a pathetic third choice if you can’t get someone to have sex with you. In fact, if you can shake off this bad rap, masturbation is amazing. It can provide extraordinary pleasure, or just help you get to sleep, teach you about your body and sexual responses, and help keep the blood flowing in the nethers, as they might say on Firefly. It’s good for you, unless you do it so much that you forget to eat or run afoul of the laws of physics — here I’m really talking about friction.”

Every article about the existence of masturbation month reminds us of Bill Clinton’s no-nonsense US Surgeon General, Joycelyn Elders, who wanted to normalize masturbation as healthy. And, hell’s bells, people – it is. We all do it. But this was back in 1994 and her approach was most certainly not accepted in the spirit in which it was meant. Contextually, Elders delivered this as a part of World AIDS Day message – total abstinence from all sexuality is unrealistic, but if we were to destigmatize masturbation, which seems like a pretty innocuous message to me, perhaps we’d not only open up dialogue about sexuality and sexual health in general but might stave off premature (and uninformed) sexual activity. Her message – no surprise – was taken to its extreme and false interpretation:

“She meant that we should teach kids that it’s okay to masturbate. Spin media decided that her message was: “let’s bring some dildos to class and teach these kindergartners to have some fun!” Not the situation Elders was suggesting. She later went on to explain that masturbation could prevent the spread of AIDS; unfortunately, her bold statements led to a forced resignation.”

And you know – sometimes masturbation might have been a better option for a lot of people. Case in point: woman hires male prostitute (referred to in the article as a “professional priapist”) in Germany and becomes pregnant. She tries to track down this unwitting sperm donor/once-owner to claim child support. But Germany’s rigid data privacy laws prevailed on the side of protecting the man’s anonymity.

Meanwhile, here’s a fun masturbation infographic. With wanking stats, not an infographic of masturbation itself.

And of course there’s a poem even for this. Many, in fact, but today’s is from Israel.

MASTURBATION
–Yona Wallach
You slept again with Mr. No Man
loved his empty glance
and hugged his absent body.

The eyes of your lover look toward a foreign point
not exactly at you not on you,
he’s young and already so bitter.

The love that penetrated your flesh for an instant
fills your body and soul with heat
from the tips of your hair to your inner organs,

leaving you again with Mr. No Man
stroking with no hand your body
that responds with no emotion no expression
no heat on each stroke –

You showed the poem to your young lover
he responds with rage and says that it’s bad
and no poem at all and turns his back,
perhaps he thinks that he’s no man,

does he think that he’s no man?
doesn’t understand poetry, with feeling
demands too much, hours,
when five minutes of love would suffice
to fill an entire day with the heat required,

no man chills your emotions freezes
your body, the chill spreads through your limbs
freezing your cheeks and sending a nervous shudder
from the curve of a cheek to the opposite eye and extinguishing
the bud of emotion and sending the taste of pain
to the gullet to different parts of the neck and to the back.

You explain to your lover the meaning of the time of
love, five minutes are like hours
five hours even, there are all kinds, it’s worth it
to use all possible times whenever
for it’s impossible before work in the morning
to love three hours you have to warm up and that’s it
he catches on fast and tries but is disappointed
it doesn’t seem nice to him so fast
he wants it more plentiful than it is,
but he’s smart and there’s a chance an opportunity
like this might not return in his short lifetime
you have to change your ideas a little and adjust to the situation,
but again he’s alone with himself and with you
and demands the strength of a night in a brief morning.

You send a cold look to no man
and promise to meet him again in the evening
for sure he’ll  return, he is spiritual death
he gives the coldest look
and stands by you waiting to catch each feeling
through the air, to turn it into complete emptiness into nothingness.

You studied your lover’s look
his dark eyes two berries
that threaten to send a glance as soft
as the memory of the taste of grapes, looking in terror
and more than this blind nerves
that endanger
the soft shoots of feeling and love.

Will he go crazy you ask, will he lose,
the wind’s movement over his face marks
tracks that you expertly decipher,
you give voice to cheerful sounds
of stretching, he cooperates for a moment sends a smile
and you turn him inward with self-love
bring him out and stare at him as at a jewel,
he emerges from the old songs and he
is one of their heroes, also his beauty
is such, he is one of the wondrous names
so lost in the frightened anxious
being in the womb of society,
he will be born out of there even more monstrous
be born anew and will love you
each morning  as it should be as he is able,

he will get used to your prostitution whose source is internal
and logical otherwise it wouldn’t emerge
and its decency according to each honorable homely understanding
that distinguishes between what and how when and where,
and his love will wear less dead forms,
and you will surrender again to Mr. No Man
in the difficult moments he will freeze your fingers
stroking yourself with different desires,

but poems are just a technicality
acquired during years of living
the hero will live in every poetic form
as third person or first or second,

he will understand this also
will live as first person, second or third
the impression he makes is mainly that he
lives as third person with himself
speaks about himself as about he as about someone you’ve tired of,
speaks separates between himself and his sex
speaks about himself as about he and not about these his emotions
that’s someone else altogether the other
of whom he is jealous of whom he will be afraid,
sex that’s him, he gives it to him
you are his mother bring him up
give him back his confidence his faith in himself
you meet with Mr. No Man and learn about
other people about the other he
even though the he could be all kinds of natures
you join his separated sex to himself
it I feel it I sense it,
I my body my soul myself and flesh myself,
he will be cultivated will love operas and emotions,
will generalize with more ease about others of his kind,
because the fruit of love is short lived
even more than the fruits of a poem like this.

Your pain is nothing to me: Teeth

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“The teeth and back reject…” -Marge Piercy

For much of my life I’ve struggled with the teeth – and these last days have been hobbling along like an 85-year-old lady with a back ‘disturbance’, so the quotation feels apt. This is what happens when you push too hard.

Nerding out, as I do, as soon as I read a review of the book Teeth: The Story of Beauty, Inequality and the Struggle for Oral Health in America,  I knew I had to read it immediately. God knows why. Weird things fascinate me, and maybe it’s not true to say that I “nerd out” sometimes. I am, let’s face it, a full-time nerd.

“The dividing line between the classes might be starkest between those who spend thousands of dollars on a gleaming smile and those who suffer and even die from preventable tooth decay.”

I get fired up about reading the most random of things – this time about teeth and the history of dental care and dentistry: everything from the obsession with the cosmetic aspects of teeth (which is treated at length in the book, but about which I choose not to focus here) to the pain, suffering and real, life-threatening medical emergencies that can occur when teeth are not cared for (and a system that isn’t designed to care for the majority of people and their teeth).

“In the way that they disfigure the face, bad teeth depersonalize the sufferer. They confer the stigma of economic and even moral failure. People are held personally accountable for the state of their teeth in ways that they are not held accountable for many other health conditions.“

“The teeth are made from stern stuff. They can withstand floods, fires, even centuries in the grave. But the teeth are no match for the slow-motion catastrophe that is a life of poverty: its burdens, distractions, diseases, privations, low expectations, transience, the addictive antidotes that offer temporary relief at usurious rates.“

What does it say that this book actually made me cry? That a child’s dental health (or any person’s really) is able to reach such a state of total breakdown that it is his final frontier. Once teeth are beyond all help, the body itself slips toward mortality – that’s too much for my emotional parts to process. The story of 12-year-old Deamonte Driver, a Maryland boy who died of a systemic infection caused by one decaying tooth was heartbreaking and not at all unique.

Not to add that America, with its fragmented health or dental care systems, which are – as the book explores – completely separate, the idea of preventive care, while trotted out in marketing and ad efforts for toothpaste, isn’t taken very seriously. (“Parents need to teach their children: “Your teeth are pearls. You should keep them,” she said.“) And analyses of the total cost involved (not even looking at the tragic loss of life) balance an 80 USD tooth extraction against the estimated 250,000 USD that Driver’s emergent medical condition, surgical procedures and hospitalizations ended up costing. Driver might have been saved had the labyrinthine system, leading his mother around in circles but going nowhere but an unnecessary and excruciating death, had more transparency or advocates in it.

“The rate of dental suffering is a grim kind of economic indicator.”

It’s complex. How did the human body and its (medical) treatment become completely disconnected from the treatment of the mouth and teeth, moving further away from any notion of “holistic treatment”? The book highlights, for example, the squeamishness that even seasoned combat and trauma physicians feel when it comes to extracting a rotten tooth from a patient who comes to the ER in the absence of some other form of treatment or pain relief. The theory behind this is that perhaps working with teeth is just too personal.

None of it is new. The teeth tell a story, both an evolutionary and individual history. And can erupt in the pressure of the kind of pain and suffering that can scarcely be put into words.

“The teeth flame out when they die. That is a very old kind of pain. The human fossil record bears mute testimony.“

“At some moments, he said the pain was so deep it became like a partner. “Really the pain almost feels good after a while*. The medulla takes over and you waltz through it.” At other times, he said he was its slave. “I’m in a lot of pain but I can’t do anything about it,” he said. “I don’t beg, borrow, or steal. Shoot me in the head, please. It would be a lot easier if you put me out of my misery.””

*As I always say, there is a poem or song for everything. PK Page writes in her poem “Suffering”:

“But
suffering is sweeter yet.
That dark embrace – that birthmark,
birthright, even.
Yours forever
ready to be conjured up –
tongue in the sore tooth, fingertip
pressed to the bandaged cut
and mind returning to it over and over.

Best friend, bestower of feeling
Status-giver.
Something to suck at like a stone.
One’s own. One’s owner.
…One’s almost lover.”

“”SHOW ME YOUR TEETH,” THE GREAT NATURALIST GEORGES CUVIER, is credited with saying, “and I will tell you who you are.” That a tooth could tell a life story, he was certain.“

Eight weeks

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How different eight little weeks, and the speed with which they pass, can feel depending on the place you find yourself in life.

For a man struggling every day, every minute, with sobriety, eight weeks is an eternity – but almost an unbelievable one (to the degree that he has been fearful to even count or keep track consciously). And each little milestone (being able to claim two months!) feels like a major triumph, but also comes with a possible downside. Like all lifelong ‘afflictions’, it’s forever. It’s something he lives with that must be maintained and nurtured with great care and consideration. He may be sober but never free of the label, the disease, the temptation.

Eight weeks feels like a very long time: each of the days passing not hour by hour but minute by minute. Each day packed with AA meetings, work and gym-going (or whatever fills those minutes) and the slowing evening more difficult, staring at the clock while the minutes pass until the stores that sell alcohol finally close. (All these themes appear at length in David Foster Wallace‘s Infinite Jest, which I’ve been slogging my way through for days; the addiction parts are by far the most interesting.) It’s a safety net, knowing he can’t get anything if he suddenly fell into despair. Eight weeks, eight days, eight hours, eight minutes. Everything broken down to the smallest parts, anything to make the time go faster.

Meanwhile, for a newly pregnant woman, if she is even 100% sure she is pregnant at eight weeks, time is almost accelerated. At eight weeks, she has barely accepted the reality but is in a race with time if she, for example, intends to terminate the pregnancy. Many places have a 12-week cutoff point (at which point she could still terminate but needs special permission from her doctor or a panel of doctors), and while one would imagine that the four weeks in between eight and twelve weeks is a whole month, it’s never quite that simple.

She has a massive, life-changing decision to make. She may be in denial. She may even attempt to schedule an appointment to terminate, but even that can take time. Again it depends on where in the world she is. (It could be that depending on the stage of the pregnancy, the abortion will cost more; in the US many states don’t have abortion facilities at all, making the whole ordeal that much more challenging.) Eight weeks into a pregnancy, it’s already so well underway – like two months have already slipped away sneakily, almost without her conscious knowledge. And she wishes for anything that could make the time go slower.

It’s not what we thought…

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Everything turns out, in time, not to be what we thought it was.

Women’s fertility, thought to hit a precipitous slide downward from the age of 27 – or 35 – or some other number conjured up by dubious science, may decline in general/on average. But then it turns out fertility is not quite that simple.

“But it’s no wonder we’re so easily panicked. The fearful narrative around women’s fertility fits with a broader theme that’s become all too common as women have gained economic independence over the last several decades: we’re going to pay for our equality. Mothers going to work in the 1980’s were told they were subjecting their kids to an epidemic of sexual abuse at daycare centers. In 1986, Newsweek reported that 40-year-old single women were “more likely to be killed by a terrorist” than find a husband. These stories and many more like them, of course, are completely false. Perhaps the best way to fight the panic is to question those who’ve made a business of selling it.”

Pregnancy after 40 is becoming quite common. In fact, in the UK at least, the number of over-40 pregnancies outnumbers the under-30 pregnancies for the first time in 70 years.

I lived for years in Iceland, where it is quite common to have children (many, in fact) when you’re quite young (late teens/early 20s). This is seen as the norm. When a non-Icelandic friend lived in Iceland, everyone around her hounded her about having a baby before she was an “old hag” (meaning mid-20s, I guess???). She did not have a child until she moved to Denmark, and by then she was in her late 20s. The Danes, though, insisted that she was “so young” to be having a child, and all the other women in her maternity ward had at least ten years on her.

And this very pressing issue – fertility – reminds me not only that life goes on but also that, as it does, there are so many other things we don’t know shit about but pretend to (or to trust experts about them): Addiction, aging, the brain, radiation, education, the powerhouse Japan was supposed to be… or even pasta. Nothing is definitive – it keeps changing as the environment around it changes. We really don’t know anything – even what consciousness means.

The same can be said of people, but that’s another and different challenge.

The tentative language of healthcare marketing

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We are taught over and over throughout our educations that “helping” verbs (auxiliaries) and other crutches weaken and dilute our writing and our message. But then, because of invasive regulatory and legal constraints on making claims about healthcare or medical devices, writing (in marketing) about solutions in these areas becomes virtually meaningless.

“Device X can contribute to helping reduce infections.”

Not a single definitive statement in there, and that’s how it is. Definitively.

Innovation v Invention – Not knowing how to change things when you work from a template

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As long as something is deemed sufficient, even if imperfect, no one will change it. Most people who work in technology or in any field that relies on innovation know that “innovation” is rarely, if ever, borne of someone expressing a specific need and someone else finding a way to meet that need. Sometimes innovation comes from hidden needs – the solving of a problem. Those who express their problem but don’t have ideas for or even an expectation of finding a solution are eventually met by those who have framed their problems with a solution in mind, developed solutions and introduced these solutions (or sometimes introduce solutions for problems that were somewhat hidden).

There are, of course, other innovations that are so novel, so innovative, that they create whole new things, new paradigms, new ways of seeing, perceiving, gathering information, organizing the world and living in that world. These tend to be things that are widely perceived as “crazy”, such as statements like “every home will have a personal computer by whatever year”. This seemed so outlandish, unnecessary and beyond the realm of possibility at the time. But there were visionaries who could see the potential for personal computing. We have seen the same with the smartphone, spearheaded by Apple, and other connected devices. We used to have crazy long-distance phone charges just to speak to someone who lived in the next county – and even though we all hated it, it is not like the majority of us tried to devise innovations to liberate ourselves. True innovation is often vision and a means to liberation (not just a run-of-the-mill solution to a problem). It anticipates a solution for many problems or features that we want to use long before we have the problem or want the features. Steve Jobs and Bill Gates are written about ad nauseam as the forefathers of this sort of thing – mostly because they have been the front-men and are identifiable figures. We don’t often hear about the thinkers, geniuses, programmers who have come up with a lot of the inventions (tech oriented or not). But real innovation usually changes the world.

This is where I have a lot of problems with normal corporate life. Most companies have adopted “innovation” as a buzzword and concept – have tried to weave the idea into the corporate behaviors, running workshops on how to think about and teach approaches to “innovation”. But this is just not how it works.

In a somewhat related area, I recently read an article about why we don’t have better condoms. The most “revolutionary” development in the condom-making arena in the last 40 years has been synthetic latex condoms (since latex allergies are serious, and one wouldn’t want a latex allergy to prevent someone from having safer sex…). (Durex apparently used the word “revolutionary” in its marketing of a polyisoprene condom.) This is not innovation, at least not by its modern, accepted definition. Perhaps if we think of the literal definition of “innovation” – it is a bit like “to make new again/improve”, in which case, making small, incremental changes and improvements IS innovative. And polyisoprene is a variation of an existing product and existing material. True innovation, as the word is used, should be called “invention” – meaning that you will end up discovering something completely new and different from what anyone could have imagined. Some completely new material that totally changes the game.

Condoms have never been the most interesting topic for anyone – and because, until the onset of the AIDS crisis in the 1980s, condoms were seen primarily as a non-invasive birth control method (not something gay men were particularly into), they were not something anyone really needed to talk about. It was also not high atop anyone’s “let’s revolutionize this design/material” agenda, going back to the point that if something is sufficient, there is no real reason to fast-track change or seek to think about it in a new way. Indeed, at the height of the AIDS crisis, real innovation had to go into something more urgent – seeking viable, life-saving treatments for the disease itself. (It was not entirely clear early on, before the virus and its spread was fully understood, that condoms could act preventively.)

“If you believe Danny Resnic, hard at work on his Origami condom, polyisoprene is a symptom of Americans’ failure of imagination when it comes to condoms. “When I first told people I was developing a new condom, they went, ‘Well, what could be different about a condom?’ ” he said. “They couldn’t imagine anything different, because there’s never been anything different.” Resnic thinks men have become desensitized by latex condoms. “They’ve come to accept that level of sensation as the maximum.” If they use condoms at all.”

I would argue that lack of invention in many areas comes down to this same lack of imagination. There seems to be no shortage of imagination in technology. And while changes occur frequently in areas like healthcare and pharmaceutical/medical device development, the regulatory and legal requirements, costs, lack of “sexy factor” and human factors considerations make this field much more difficult to operate in. Real change seems to occur only when there is a loud enough public outcry or public health emergency (the response to HIV/AIDS in the 80s – only because the gay community and its few supporters were vocal, organized and demanding enough or to some extent in response to Ebola, which some argue came belatedly). Some “imagination” is not as possible to implement – and certainly not as swiftly as one would desire – in healthcare and medtech.

When looking at something as “boring” to most as condoms, we have a working template, and very few people have the interest or imagination to change or improve it.

“Everyone has AIDS!” – When Did AIDS Become a Punchline?

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I watch an undue amount of television and films and have begun to wonder: when did it become okay to joke about AIDS? And when is a joke a joke too far?

When did AIDS stop being a histrionic soapbox issue in one isolated, “very special” TV episode (à la Designing Women) or a story arc for a regular character (à la Life Goes On and its Chad Lowe character “Jesse” – which actually handled it pretty well – but didn’t that show have enough going on with an economically strapped middle-class family rearing a Down Syndrome kid, an overachieving nerd kid and a late-in-life, unplanned pregnancy, among other things?).

Back in the early days of the crisis, which rightfully terrified every person conscious and alive at that time, we did not see a lot of gay stories on TV (we know of course that all AIDS stories were not gay stories, but the dearth and lateness of mainstream stories can be placed squarely on the fact that network television was not the semi-gay-friendly place it has now become), but there were some exceptions – Designing Women had a particularly poignant episode guest starring a very young Tony Goldwyn (yes, yes – President “Fitz” Grant from Scandal).

AIDS showed up in pop culture now and then… but when did it become okay to joke about it?

When you think about treatment for HIV and AIDS – and the awareness of it – it has advanced further and faster than advances in almost any other disease or illness. I’d attribute it to the persistent, loud demands of won’t-take-no-for-an-answer activism from an hitherto marginalized community of gay men who were disproportionately affected by this epidemic. We can all thank them – even if, as one characterization of the crisis puts it, we have ended up in a “complacent” or “indifferent” place in society with regard to what is now a treatable illness.

But does this advancement mean that all of societal perception has shifted? Does the tempering or perceived neutralization of the threat and the almost-distant memory of the devastation AIDS once caused in the western world mean that we have reached a stage where we can laugh at it? Young people today (I know I sound elderly starting a sentence that way) did not live through the fear and terror of those early years and thus don’t feel the same limitation or deference to the topic’s seriousness. It’s seen as a “developing-world issue” if it is thought of at all. Taking that into account, is it possible for some of the humor to be intelligent analysis or satire of the place we are with the disease – or with other things in society when held up to it? And where is that line? What happens when someone crosses it?

A woman named Justine Sacco found out the hard way, as she completely failed to walk the tightrope when she tweeted something that went viral and was widely seen as completely inappropriate and in horrible taste. (Her Tweet read: “she tweeted: “Going to Africa. Hope I don’t get AIDS. Just kidding. I’m white!”)

“Despite Ms Sacco only having around 200 followers, the message quickly spread to online news organisations, with social media users around the world expressing their disgust.

The irony of a supposed public relations expert tweeting such an insensitive comment, and the fact it could not be corrected during a 12-hour flight without an internet connection, meant the hashtag #HasJustineLandedYet was soon trending on the social media site.”

Apart from being a perfect example of displaying very bad judgment, it is also a perfect illustration of the viral nature of social media and why we have to be careful.

But pop culture is… well, popping with all kinds of increasingly frequent joking references to AIDS. From the parody of the popular musical Rent in Team America: World Police with its “Everyone Has AIDS!” song

to the South Park play on the different meanings of the homophones “AIDS” and “aides” (which reminds me of my days observing TESOL/ESL courses; one afternoon one of the teachers discussed acronyms and had used AIDS as an example – later in the lesson, although on a different topic, she introduced the word “aides” and asked the perplexed class, “Do you think Bill Clinton has aides?”).

What prompted this entire train of thought on the subject, apart from watching the heartwrenching HBO treatment of The Normal Heart last week, was my marathon-viewing of Comedy Central’s Inside Amy Schumer, and an episode in which Amy’s boyfriend announces he has AIDS (humorously summarized here). Seeing it almost shocked me because I was not sure whether to find it funny or not. I think Schumer stayed on the right side of the humor because she was not actually laughing at AIDS but was shining a light on a lot of different issues, ranging from hypocrisy to the awkwardness of conversations in which you feel a certain pressure to accept or agree to things that you need time to process, regardless of what they are (but when put on the spot, it is not like you know what to say, so when the boyfriend asks if his having AIDS is a dealbreaker, she nervously, awkwardly chimes, “No, it’s great!”).

The question, though, cannot really be answered universally – where is the line?