Category: Population

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Population

Remember Red (and why population matters to me)-6-2011

“Speak Truth to Power”

Saying of the Religious Society of Friends

 

Leonard “Red” Bird was one of the first people we met after moving to Durango in 1976; he sold us an old Scout. Earlier this month our community said good-bye to him in a stirring memorial service.

For years I held Red up as a role model. He got a rough start in life, but became one of Fort Lewis College’s most revered professors. After auditing his class on Shakespeare, a doctor friend said that Red was the best professor he had ever had.

On a clear Saturday morning a couple hundred people gathered at the College’s amphitheater for a beautifully orchestrated series of remembrances of Red’s life. My cool concrete bench was never uncomfortable as each speaker illustrated new facets of Red’s complex life. Fortunately there was much laughter to help dry our inevitable tears.

Here are some highlights. Red and his half-sister, Jan Marini, grew up in a single bedroom house in southern California. The boys slept on cots in a garage with a dirt floor next to the house. Red’s father disappeared when he was young. The day before Red’s uncle left for the military, he took Red aside and told him that now he was the man of the family; Red was only eight years old.

Describing their reasons for joining the Marines, he wrote about his tent mate Washington (a black man from Alabama) and himself. “Eighteen-year-old high school dropouts who had been in trouble with the police, Washington and I had not joined the Marines in quest of world peace; neither of us had ever given the subject a moment’s thought. Our motives were other. I had joined because I had been expelled from the eleventh grade less than halfway through the year; … because I was lost and didn’t know what to do….”

Red found himself along with other Marines in the Nevada desert before daybreak too close to a nuclear test explosion. His haunting description of a mourning dove caught by the blast was read from Red’s 2005 book “Folding Paper Cranes: an atomic memoir”. “…the torn dove flops and twitches. We smell the stink of charred flesh. Melted eyes ooze gray pus, and from the throat of this scorched, twitching dove bubbles nothing but a faint ‘sqwick sqwick sqwick’.”

That detonation made Red sterile. That was not the worst of what he would suffer from that brief atomic experience, however. In his sixties he contracted a deadly form of cancer, multiple myeloma, likely due to radiation exposure.

Red’s life took an abrupt change when he shared a tent in Japan. His tent mate suggested that he should finish high school with a GED, and then inspired him to start taking college classes. He earned his doctorate on the GI Bill.

“Folding Paper Cranes” also describes the devastation we caused in Hiroshima. I had not thought of him in this way, but someone at the memorial service described Red as a peace activist. What a change—from Marine to pacifist!

Dr. Bird was an independent thinker and activist. He looked at our society, detected inconsistencies with his beliefs, and spoke up. In order for his voice to be heard, Red made a major sacrifice. He decided to have painful and risky treatment of his cancer in order to warn us about the destructive power of the atom. More than any other reason, he wanted to finish writing “Folding Paper Cranes”.

Sometimes we need reminders of who we are, what we believe and why we do what we do. Red’s memorial service served that purpose for me. Listening to a summary of his life, accompanied by gentle flute music and followed by a beautiful dance performance, I remembered how my interest in human population started.

Fifty years ago, as a senior in high school, I vowed to dedicate my life working for peace. The obvious path was as a politician, but I realized that I lack political aptitude. Science was more to my liking, and Albert Schweitzer one of my heroes. Knowing that high population density can lead to war, I headed toward medicine to work on family planning.

Red probably didn’t plan on being a college professor when he was in high school. His sister told us that, at one time, his goal was to be a second-hand car salesman. I am glad that our first encounter helped him realize this goal—and started a friendship of more than three decades.

© Richard Grossman MD, 2011

Categories
Population Public Health Women's Issues

Honor Girls–4-2011

I noted that Mrs. Lee was early in her third pregnancy when I was getting ready to see her in the office.

“How are you today?” I asked

“Very well, thank you. The morning sickness is getting better,” was her accented reply.

My examination showed that the size of her uterus was compatible with her 14 week gestational age and the fetal heart rate was average at 140 beats per minute. Then she had a question that I did not expect.

“How do I arrange an amniocentesis?” she asked.

Usually this procedure is done only if there is an increased risk of a genetic abnormality. It involves inserting a thin needle into the woman’s uterus to remove a tablespoon or so of the amniotic fluid that cushions the fetus. An amnio hurts a little bit and carries a small amount of risk of miscarriage.

“I don’t know why you should have an amnio. The blood test that could be done next week—the quad screen—is cheaper and without risk.”

“We already have two daughters and I want to see if this is a boy.”

Something clicked in my head. The Lees, being recent immigrants, wanted a son. “What would you do if you are carrying another daughter?” I asked.

“Well, we would have to think about it,” she answered evasively.

Many cultures favor males over females. In Hindu India, only a son is able to release a dead parent’s soul to go on its journey of reincarnation. Without a son to perform the ritual, the parent’s soul will be trapped forever in the corpse. Furthermore, since child mortality rates are very high in much of the developing world, it is safest to have two or three boys. Dowry is another motive. For a poor family a dowry can require a large proportion of the family’s wealth, making a girl child more of a liability than an asset.

When we traveled in China some fifteen years ago I photographed a beautiful tile picture, permanently imbedded in a wall at the railroad workers’ housing compound in Guangzhou. It showed a proud couple with the smiling father holding a baby up in the air. The child was obviously a girl, and no writing was needed to know the picture’s message. Although China hasn’t been very successful in convincing people to value girls as much as boys, South Korea has. Once females were treated inferiorly there, but now women have almost equal status with men. It is possible to change a society’s attitudes.

In some parts of the world one can pay for an ultrasound just to determine fetal gender. If female, it is likely that the mother will seek an abortion. Both India and China have outlawed these practices, but sex selection sonograms are still readily available.

Worse is what happens if a girl is born where female infanticide is still practiced. When a newborn is an undesired girl, she may be left outside to die. Even where femicide is not practiced, girls may be given short shrift. They may not be fed as well as their brothers, they are less likely to be taken for medical care when sick, and they are less likely than boys to go to school.

Without sex selection, more boys are born, but male infants are more likely to die than female. Overall, women live longer than men. Thus there should be more females alive than males, but sex selection has changed this. Males now exceed females worldwide by one percent.

In China there are 117 boys under age fifteen for every 100 girls. The ratio in India is slightly better at 113 to 100. Lots of young men will have difficulty finding wives!

The Chinese deal with their strong desire for a son in another way. Because of the limitations on most parents in China to raise only one child, many girls are abandoned to orphanages. They are usually well cared for there, but not all are able to go to school. Lucky American parents adopt a few of these Chinese children, who are almost all girls.

Back to my patient: should I do as Mrs. Lee asked?

“I will not do an amnio just to find out the fetus’s gender, without a medical reason,” I told her emphatically.

For many reasons we need to honor and empower girls, not select against them. One is that who girls are educated and have control over their lives will have smaller families when they grow up.

© Richard Grossman MD, 2011