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.

Marketing: Sometimes It is the Messenger

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As I have mentioned a bunch of times already, I am following a Coursera/Wharton Intro to Marketing course on the Coursera website. I was taking a peek at some of the discussion boards and found that for once I felt like contributing. I tend to be pretty passive in those kinds of things, but somehow I just wanted to ramble in pretty much the same way I do here.

Someone posed the question as to whether there is value in celebrity endorsements, which got the community engaged in a good discussion on how celebrity endorsements have changed in the ever-shifting, digital landscape. The question went a step further, asking whether consumers would be more likely to trust celeb endorsements OR crowdsourced reviews and information (such as information from Yelp, Trustpilot or even customer reviews on Amazon or something similar).

I have given a lot of thought to celebrity endorsements, and more specifically, celebrity activism and causes. We’ve seen celebs like Angelina Jolie as a humanitarian activist and UNHCR goodwill ambassador and pompous mouthpiece Bono of U2 appoint himself a kind of expert on developing-world debt and debt forgiveness (he is possibly the most visible – even if his fellow countryman Bob Geldof got the ball rolling with his Band Aid and Live Aid initiatives back in the early-to-mid 1980s and continues to work with debt forgiveness today). While undertaking my MA in communications for development, there was a segment focused on celebrity activism and cause marketing – as well as “brand aid”, where brands become actively entwined and aligned with a well-known cause or charity, and market their products in a way that makes the consumer feel good about him/herself for buying it, i.e. “One dollar of every purchase goes toward –insert cause here”. A lot of what we studied and discussed had to do with how much of this successful marketing actually contributed to the efforts of the cause – in many cases, just contributing directly to whatever cause would be considerably more advantageous for the cause, so the benefit in the end was debatable.

Point being – are people influenced by celebrity (or brand) involvement? And has this changed? Does it make a difference if it is cause-related? Does the messenger make that big a difference?

During my exploration of the discussion on the Coursera site, I thought about it and concluded that celebrity endorsements may take different forms than they have in the past. That is, giant ad campaigns for Pepsi, for example, featuring mass market stars might not hit the way they would have in 1983 or 1993. But with the granular-level of user data available to begin segmenting and targeting audiences, “smaller-scale” celeb endorsements that target specific groups become possible. Similarly, with social media, a “minor” or “niche” celebrity can have untold numbers of followers that they influence – and this can have a significant effect (and can be a cheaper, easier reach alternative for companies who still want celebrity connections but in a scaled-back way). The channels being used today (not the traditional ad campaigns, etc.) also allow for less overt “endorsement” and more subtle influence.

A few other students made very valid, important points – the nature of the product is key. A celeb endorsement for something like fashion or cosmetic items allows the consumer to project him/herself into that celeb’s lifestyle (“buying a dream”, even if it’s something simple like a new shirt or a bottle of perfume), so they might buy it based on that projection alone, even on a whim. Almost the same could be said for buying a car. A celeb might endorse/advertise a car brand – which might influence the consumer’s positive or negative perception of that brand – but would not ultimately make most consumers buy a big-ticket item like a car based on the endorsement alone. They will do their homework – research and look at actual product reviews from real consumers. Celeb endorsements in those cases create buzz and the “all eyes on me” syndrome.

A good set of examples, actually, comes from Volvo. They built enormous buzz with their “Epic Split” video featuring Jean-Claude Van Damme – and consumers talked a lot about it when the video of the ad went viral – but consumers were not the target of these ads for Volvo (commercial trucks).

But did it pique their interest in Volvo as a whole? Probably. Similarly, targeting consumers, Volvo tapped footballer Zlatan Ibrahimovic for another ad campaign – obviously appealing to an entirely different target group. Would anyone buy a Volvo because Zlatan gives his stamp of approval? Probably not – but his endorsement raises the profile and opens the door to research and crowdsourced reviews. Then with the reach of social media, ad campaigns and consumer reviews get a much extended reach – so even if an ad campaign was intended for only the Swedish market, for example, it would not be long before that campaign is seen worldwide if it has that big an impact.

With all of this in mind – having written mostly that “take” on it, I walked away with the ideas still stirring in my mind. I watched a few episodes of the series Years of Living Dangerously, a Showtime documentary series that follows actors/celebs into various places and stories that paint an alarming picture of climate change/global warming. Interesting enough but what struck me was how the show is a kind of “cause marketing” that employs both celebrities and a kind of “crowdsourced expertise”. A lot of documentaries take this tack, of course, asking experts to qualify and confirm the statements someone is making. But in this case it was a less than subtle move to target a specific group of people. Maybe someone would watch this and take Harrison Ford’s word for it that Indonesia has been deforested at a shocking rate. But someone else – particularly someone with disdain for “liberal celebrities and media” would not be inclined to believe a famous actor’s take on climate change no matter how much science or information s/he cited. This came into play when actor Don Cheadle traveled to Texas to assess drought conditions there that have put people out of work, put farms out of business and devastated industry, landscape and economy. The population/target audience, as Cheadle’s narration explains, cites Biblical causes and “solutions” – the people he meets do not believe in science or in the whole concept of global warming. Then Cheadle meets a scientist who also happens to be an evangelical Christian – she is also a loud voice for the truth and science of climate change. Because of who she is – both a scientist and a devout Christian – she is able to talk to and reach this particular audience and get past their doubts and convince them not only that climate change is real but that scientific belief is not at odds with their religious faith. She is not saying anything different from what Al Gore ran around preaching but the audience would not listen to him.

Cheadle made the point that actually gets to my bottom line: Sometimes it is not the content of the message but who delivers it – and this is why both celebrity endorsements and crowdsourcing have their place.

Why I Can Never Make Up My Mind: John Edwards

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Today, under George W. Bush, there are two Americas, not one: One America that does the work, another that reaps the reward. One America that pays the taxes, another America that gets the tax breaks. One America – middle-class America – whose needs Washington has long forgotten, another America – narrow-interest America – whose every wish is Washington’s command. One America that is struggling to get by, another America that can buy anything it wants, even a Congress and a president.” – John Edwards, 2004

Poverty – particularly among the working poor – has really only started to become a headline-worthy issue in the last four or five years when a significant number of people who had perhaps been just on the edge of poverty fell into it thanks to the economic collapse of 2008. At various points in history, of course, poverty and welfare have appeared on the mass media radar, and occasionally escaped from the lips of politicians. Mostly it has been all talk or has been negative, “shaming” talk (much like the 1980s rhetoric of Ronald Reagan demonizing the mythical “welfare queen”).

John Edwards, in focusing on poverty and inequality in America, may have been well ahead of the curve by focusing with laser-like intensity and precision – at the risk of his own political rise. Of course his penis and lies about what he was doing with it unzipped and undid him faster than his dedication to poverty-related issues, which is a shame when you look back on his rhetoric and ideas about America. He has been, as this article in The Atlantic described, been whitewashed from the Democratic Party, despite the fact that the platform the party stands on today is one he essentially built himself. I acknowledge that. It’s easy to gloss over the good Edwards did and would have tried to do given the mess he made of his personal life.

Who among us does not make a mess of our personal life? Most of us screw up – sometimes on a grand scale – but most of us are not in the public eye and won’t suffer serious consequences – like becoming a national joke, destroying whatever is left of our very public marriage, sacrificing any and all chance of holding political office. Unfortunately, Edwards’s fight against economic inequality will always be overshadowed by his personal choices and lies.

Edwards championed those who can rarely speak for themselves and highlighted hard truths about class and economic divisions in America (that many Americans, struggling or not, do not like to admit about America. But it is still hard to make my mind about him – I suppose my approach can be as complex as who Edwards actually is. It is not as though by making very poor decisions and very public mistakes (more than once) negates his role as a thought leader, activist or intelligent man. I suppose it just means that he was perhaps not that well-suited to become president.