She blinked, and demurred every so slightly, but continued on, "Well, I just want to make sure--"
I interrupted. "Are you really asking me if that your IUD, in your uterus, can cause pain in your throat?" I asked as incredulously as I could, never breaking eye contact.
This was no fourteen year old girl. This was a thirty-two year old woman who'd had three children, vaginally, (not nasally, as you might expect from her inquiry) and thought that her uterus was connected, I don't know how, to her throat. I couldn't get the anatomical image out of my mind: where is God's name was the stomach, the liver, the heart and lungs? Was it all just flesh, some amorphous congealed mass of stuff? And then I thought of her daughters, and realized that if a grown woman carries around ideas like this, they don't have a chance.
My husband and I watch a lot of old sitcoms on television. Some are mildly entertaining, some more funny than others. My husband seemed to really like Becker, starring Ted Danson as a New York City doctor who hates people and loves to complain. I asked him one night what appealed to him, and he said, "Don't take this the wrong way, but he sort of reminds me of you." I burst out laughing, and he continued. "No, really, he does. He's really compassionate, he takes good care of people, but you'd never know it because he complains about everything so much." Later we came to the conclusion that really, I was a deadly combination of John Becker and Red Forman, the cranky dad on That 70s Show, who constantly threatens to stick his foot in your ass. They are both completely unsentimental and not very charming misanthropes, and I am their love child. Unfortunately, like John Becker, I work in health care, and this is my tale of woe.
Another thirty-something woman asked me if a noticeable difference in her vaginal discharge was caused by ovulation. She was using hormonal contraception at the time. "You're not ovulating; you're using the Ring. How do you think you haven't been getting pregnant? By magic?"
It's hard not to bark like Red Forman every time I hear something like this. I know it's completely unprofessional, but it drives me crazy. Ignorance is one thing: it's okay to be ignorant, especially if you're fifteen (or nineteen if you have evangelical parents). But to parade your ignorance as scholarship: that's another thing. Patients will often comment that they've done 'research' when asking me questions about contraception. Research? I want to say. Are you a Ph. D. candidate? Because that's research. What you're doing, I believe, is known as surfing the net.
Another bee in my bonnet is the 'natural' argument. "It's just not natural," a patient will whine when reviewing her hormonal birth control options. "I just don't think hormones are natural."
My tongue should be hemorrhaging from all the biting it suffers. "Nothing's natural," I want to scream. "There's nothing natural about wireless service, SUVs or lattes, either."
It's as if they want to avoid pregnancy, but don't want to have to actually do anything to avoid it. Everything is such an inconvenience: I can't remember to take a pill everyday, the patch fell off, the ring is weird, I don't like shots, etc. Women in the sixties couldn't believe their good fortune: if they just took this little pill every day, which was smaller than an aspirin, they wouldn't get pregnant. It must have seemed like a miracle, especially when abortion wasn't even an option. Today, I hear patients tell me how every single method has a problem. That's probably true: there's nothing perfect in this world. But the inability to tolerate even short-lived side effects is significant. We all think we are so unique, that we're tender lilies and the smallest chemical disturbance will destroy us: but somehow smoking (as a teenager) and drinking (ditto) are pristine in comparison to hormonal contraception. A patient wasn't concerned about her marijuana use because, you guessed it, "Pot is natural."
Obviously, those who are against birth control have waged a very effective and pervasive campaign of misinformation. It finally dawned on me that girls, and even most women, had no idea how hormonal contraception worked. Now I explain that to every patient with a new prescription, because I know better. These girls (and women) don't know things because it was their parents who wanted sex education out of the schools and in the home. I'd be hard pressed to name a more brilliant failure. Maybe sex education doesn't include information on contraception: okay, fine. But to have it encompass nothing more than "Don't have sex" is a crime. I won't even begin my lecture about the number of girls and women who don't have orgasms: that's another story for another day.
Around the world it is known that the more educated a woman is, the fewer children she bears. With a planet bursting at the seams, what is wrong with that? According to figures from 2006, there are an estimated 245 births each minute, roughly 4 births each second of every day. Less than half of that number die: 110 people per minute, or a bit less than 2 per second. The highest birth rates remain in the developing world, specifically Africa, which has corresponding low education levels for women. Hormonal birth control is responsible for decreasing birth rates, to an extent, in the developed world. Our sisters in the developing world, when they can get it, choose the non-hormonal intrauterine device. In fact, this is the most commonly used form of birth control in the world.
Why is it seen as more 'moral' to bear rather than abort an unplanned pregnancy? I think Howard Stern is a pig, but he once dubbed abortion "crime stoppers." Crude and insensitive, perhaps, but Freakonomics authors Levitt and Dubner came to a similar conclusion regarding the availability of legalized abortion and the decrease in the crime rates. We here in the United States are lucky, privileged and some would say spoiled: we have incredible access to contraceptives in this twenty-first century. Let's start using them, why don't we, and let's start telling our daughters and sons that it's okay for them to use them, too.
It's true that John Becker and Red Forman would, sadly, still be very proud of me as their ill-begotten spawn. But I must confess I am another sort of love child, closer to the real thing. I was conceived on my parents' honeymoon, and in a twist that could only be stranger than fiction, born on Valentine's Day. But that's not all: my father's middle name is (wait for it) Valentine. Inside, deep inside, I care. In a country that claims children as its most important and valuable asset with a skewed world view that puts fetuses on the highest pedestal, isn't it time to put our money where our mouths are and make each child a true love child?
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