Author: Richard

I am a retired obstetrician-gynecologist who has been fortunate to live and work in the wonderful community of Durango, Colorado for 40 years.

Categories
Hope Medical Women's Issues

Feminize Medical Care

Feminize Medical Care—4-2010

© Richard Grossman MD, 2010

May God bless you with discomfort at easy answers, half truths, and superficial relationships, so that you may live deep within your heart;

May God bless you with anger at injustice, oppression, and exploitation of people, so that you may work for justice, freedom and peace;

May God bless you with tears to shed for those who suffer pain, rejection, starvation, war and loss, so that you may reach out your hand to comfort them and turn their pain into joy;

May God bless you with enough foolishness to believe that you can make a difference in this world, so that you can do what others claim cannot be done;

May God bless you with God’s comforting presence now and in your journeys through each day.

Franciscan blessing

Read by Reverend Ginny Brown at Dr. Leanne Jordan’s memorial service

My first year medical school class had 125 students in it; only six were women. Now half of medical students are women.

I did my specialty training at the University of New Mexico and was surprised that several other residents in obstetrics and gynecology came from medical school in Denver. The former chair of the OB-GYN department excluded women from his program. Imagine not letting women learn to care for women! Fortunately that has changed; now only two of thirty-six OB-GYN residents at the University of Colorado are male.

A friend studied the culture of operating rooms for his doctorate in sociology. He noted a huge change from the 1960s to the present. Men initially dominated—both figuratively and literally—and many OR nurses lived in terror of the behavior of surgeons. As more women became surgeons the ethos improved. The OR became a kinder, gentler place, and patients benefited as well as the staff. Worldwide, empowerment of women is one of the most important steps we can take to slow population growth.

Women in medicine often take off time to have children and to raise their family, so female doctors may take longer to finish their training. I am proud of our daughter-in-law, Dr. Stephanie Shrago, for excelling in med school and family practice residency and having two wonderful daughters. Of course, I also have to thank our son Dave who does a lot of our granddaughters’ care.

Another remarkable physician with whom I practiced for almost twelve years just died. Dr. Leanne Jordan’s memorial service was held earlier this month with an overflow crowd of admirers. Speakers at the service recalled Leanne’s talents: an amazing athlete, empathetic friend and an outstanding doctor. When we worked together in the operating room I felt as though I were energized with a second cup of coffee, because she was always so quick—but careful—during surgery.

One friend said that Leanne’s smile would light up a whole room. I knew about many of her accomplishments and numerous athletic skills that were mentioned during the service. I will never forget the story of her skinny-dipping with a friend after rowing practice when some guys moved their clothes away from the river’s bank.

Leanne died of the breast cancer that she fought valiantly for years. I admire her for being the “poster child” for cancer treatment. She did not hide the fact that she was battling the disease. This openness was a source of solace for others with serious illnesses, and an encouragement to get screened for cancer.

Early detection of breast cancer is key to its cure, as with many other diseases. Breast self exam is good, but mammograms can detect disease long before it can be felt.

Mercy has just opened its state-of-the-art Breast Care Center. It has the latest equipment for the diagnosis of breast problems. In addition, it is beautiful. Stunning art, a fireplace and the dragonfly motif help to soften the usual medical atmosphere.

In the past I heard complaints about pain caused by mammograms, but I don’t any more. That may be because the new digital machines are faster. They are safer, too, since they use less radiation.

Regrettably, not all women have health insurance to cover mammography. There are programs to help women older than 40, so finances shouldn’t be a reason to avoid this important test. The criteria are confusing for the different programs, so it is best to call B.J. Boucher at the American Cancer Society local office, 259-3527.

We have benefitted from more women participating in medical care. It is sad that we recently lost one of the finest, Dr. Leanne Jordan.

This article may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at: richard@population-matters.org.

Categories
Population

Welcome Back Family Planning–12-2009

Welcome Back Family Planning—12-2009
© Richard Grossman MD, 2009

The International Conference on Population and Development helped propel me toward being a more dynamic population activist. Bryan (our younger son) and I attended the conference in 1994 with press credentials from The Durango Herald.
You may remember that the ICPD in Cairo, Egypt, strongly supported reproductive health. Unfortunately it was soft on population. Reproductive health includes family planning, but is much broader, and therefore more expensive. Abuses, especially in India and China, were cited as the reason to turn away from goals in reducing population growth rates.
Certainly reproductive health is important; I have spent my professional life working for this goal. It is unfortunate that the ICPD turned attention away from population growth, however.
It is true that setting goals and offering incentives for meeting those goals caused some abuses. In the past family planning workers were given bonuses depending on how many people they convinced to limit their family size. Now there is careful policing of programs to avoid that sort of coercion, so family planning programs are purely voluntary. Incentives are unnecessary since people are happy to accept contraception of their free will; they want to limit their fertility.
The first major international family planning conference in fifteen years was held last month in Kampala, Uganda. It was a lot smaller than the Cairo conference, and was sponsored by nongovernmental agencies rather than by the United Nations. Sub-Saharan Africa was very well represented, showing great interest in family planning in that part of the world.
Human population has been out of the limelight for fifteen years now; indeed, the Kampala conference received scant attention in the US press. The consequences of the burgeoning population have received attention, however. Global climate change, extinction of species, pollution and depletion of fisheries all make the headlines. In the intervening fifteen years the number of people in the world has increased by 1.2 billion with nary a mention of this basic cause of these problems.
The recent International Conference on Family Planning in Kampala focused on several important issues. People reported on the importance of family planning in decreasing transmission of HIV to newborn babies, lowering infant and maternal mortality, and reducing unsafe abortions—largely by preventing unwanted pregnancies. Research also demonstrated the importance of involving men. For instance, a study in Nigeria found that women were much more likely to use contraception postpartum if their husbands were with them and witnessed their giving birth.
Researchers are stressing the importance of linking family planning with HIV prevention. There is a call for methods, such as a vaginal gel, that will achieve both these goals.
Another point from the conference is that women are relying more on long acting contraceptive methods. This is just as true here in Durango as it is worldwide. In much of the world IUDs and implants are favored over short acting methods (such as pills and condoms) because their supply is more reliable. In Durango, with excellent pharmacies, women like the long acting methods because they don’t have to worry about taking a pill every night.
In much of the world vasectomy is becoming more popular. Unfortunately, tubal ligations still outnumber vasectomies. For many providers it will require a new mindset to include men.
Dr. Cates, a US family planning expert, mentioned another change in mindset when he summarized the conference. He pointed out that the cost to provide reproductive health care and family planning worldwide would be less than just ten days of worldwide military action.
The Kampala conference was an important step in the correct direction. Remember that the least expensive way to reduce carbon emissions is by reducing the number of unplanned pregnancies—and thereby reducing the number of people causing emissions. As I write this, the Copenhagen conference on climate change is underway. It is much bigger than the Kampala one, and is receiving much more press coverage—partially because President Obama will attend. Please remember, however, that if more attention had been paid to family planning over the past fifteen years, the climate crisis would be much less severe. We can slow carbon emissions if the 200 million women who wish to limit their fertility (but lack the wherewithal) had access to modern contraceptive methods.
“Reproductive health is a human right” was the mantra at ICPD. Although RH is an important goal, it may be too inclusive at this point in time. We need to move quickly to help people limit their fertility when they wish to do so.

This article may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at: richard@population-matters.org.