Sunday, April 29, 2012

On jealousy


In my experience, there are four types of people in relationships: the jealous types, the ones in denial about being jealous types, those with a good sense of self-worth, and those who aren’t really in love. I’m of the jealous type. I quite openly admit that because I know myself and I know that I have never liked my partners paying too much attention, comfort, or affection towards others, especially if that attention, comfort, and affection tends to be focused on one or a few people. Why do I get jealous? Well, the immediate reason is I want all of my partner’s attention, comfort, and affection because I am in love with them! The non-immediate reason is I wonder if all that fond interaction between my partner and someone else could eventually lead to romantic feelings between them. And of course I’m in love with my partner and I don’t want that to happen. It’s not far-fetched, either; when we are courting someone what we do is start to pay them more attention, affection, etc… So, yes, of course, they could potentially fall in love.  Anyhow, that is the reasoning of us jealous types.

The people in denial about being jealous types are usually those at the absolute extreme of jealousy! Generally, these are the people who become jealous about you even interacting with completely platonic friends and family. The problem isn’t that they’re in love with you and want you not to fall in love with others; the problem is usually that they don’t trust that you love them. I used to think that jealousy happened because of this pathological sense of possessiveness, but really it’s more about having a poor sense of self-worth. If someone pays your partner some attention (even that may come about in the normal workings of a day), or if (god forbid) your partner pays someone other than you some attention, the exuberantly jealous partner’s thoughts run to “they’re going to leave me”. But the full statement they’re saying to themselves, often subconsciously, is “they’re going to leave me because I’m not good enough or as good as anyone else”. But before you go and feel sorry for the poor person with the low self-esteem, think for a second of the partner. As the partner of someone at the extremes of jealousy what you feel is this constant statement that your love for your partner isn’t convincing them enough, that you never quite do the right thing to convince them of your love, and that your own commitment isn’t valued and is being doubted each time. Unfortunately, the jealous partner can eventually start to leave out from conversations the “I love you”, the “I’ve missed you”, the “how was your day?”. Instead they greet you with an interrogation into who you’ve spoken to and spent time with, etc. Sadly, this is how jealousy erodes relationships.

Those with a good sense of self-worth are ideal partners, then, right? Yes, when they don’t doubt your love for them and their love for you… But it’s not all about self-worth. Paulo Coelho, in his novel The Zahir, speaks of a couple of two very self-assured people. They’ve been married many years and are far from what you’d describe as jealous. One day, suddenly, the woman leaves the man. He had no idea of there being any trouble in the relationship or the woman being unhappy or wanting to leave him. In fact, it turns out, he knew very little about his wife. There’s a thin line between trying not to come across as jealous and simply not caring. When you take no interest in your partner’s life, you risk not being a part of it.

Do I have a point with this discussion? I guess I’m just trying to make a point of being aware of the messages we put out in relationships, of being self-aware of our relationship style, and of reflecting on whether the way we interact is putting across the right message to our partners.

Sunday, April 22, 2012

On birthing - part 2


I once met an obstetrician who told me “a healthy baby lives, a sick baby dies”. That was his approach to that time around the birth of a child and also to prenatal care. At the time, I was quite shocked! I thought, then what is the point of medical advances in technology, of medical research, and basically of “medicine” in general? We have studied disease, pathophysiology, human anatomy, microbiology, biotechnology, and devised all sorts of theories and methods to try to keep people alive and healthy. What’s the point of medicine if not that? Well, the obstetrician’s theory was that we may have studied too much, devised too many new things, and medicalised too many things that would (and should, apparently) be just thought of as part of human life: things like childbirth and pregnancy.

I admit that it does concern me when you consider the massive amounts of money spent in neonatal intensive care wards and the number of chronic health problems suffered by those born prematurely. Over the past few decades, the gestational age at with a child could be born safely and with the best chance of survival has drastically lowered. At one point in history, a child born 6 weeks before its due date had little chance of survival. Then someone decided that this should not just be accepted as fact and the chance of survival could be increased by some or another medical intervention. Gradually, newer and newer methods have been devised to support the survival of increasingly more premature (younger) babies. However, the issues has become one not just about supporting a premature baby to survive its first few months of life, but these babies go on to become infants, adolescents, and even adults. The earlier than anticipated a child is born, the greater his chance of dying. The medical efforts needed to keep these babies alive costs a lot of money. Then after ensuring the baby will survive into infanthood, the fact is the younger that child was born, the greater the risk that he will suffer chronic, sometimes lifelong, health problems. The management of chronic health problems of children and adults again costs a fortune. The life of a person who is prematurely-born is, therefore, very draining of resources, economically speaking.

Would it be better if we made health care decisions based solely on economics? Or would it be better if we based them based solely on “nature”, and ‘let nature take its course’ when a woman goes into labour prematurely? Why do we find it so repulsive to accept that “a healthy baby lives, a sick baby dies”? The truth is that the majority of us human beings couldn’t sleep at night if we made decisions like this. If you ask the women who have given birth to premature babies, even extremely premature ones, if the life-saving efforts to keep their children alive into adulthood were worth it (even if that life went on to be marked by chronic illness), do you know what almost all of them would say? They’d say “Yes, of course it was worth it!” And that is because you are talking about a person to whom they have a profoundly close connection, and also because it is a small “innocent” child, apparently deserving of all our best intentions, efforts, love, money, protection, etc. etc. It is also another human being, a person. You could summarise it by saying that we are humane towards other human beings; we are human. That is why we act so many times against logic, against “nature”, against economic viability, and against the greater majority’s good.

For the majority of persons, our instinct is to promote the survival of ourselves and other people; but when it comes to fetuses, there has always been a discussion into whether or when they can be considered a “person”. Now, I’m not about to go into a philosophical, theological, or bioethical discussion about abortion because frankly I think that is a discussion an individual can only have with themselves and come to their own conclusions; I only care to discuss an interesting scenario that was recently raised. Some Australian philosophers made an argument that newborn children are no different to fetuses because they do not understand or yet know what life is, let alone appreciate it. They don’t know what it is to be human, they don’t identify themselves as persons, therefore, they are not persons with the usual “standard” human rights, including a right to be alive. In theory at least, then, you could extend the arguments raised about fetal abortion to “post-natal abortions”, i.e. a newborn child being considered no different to a fetus. If is right or wrong to carry out a procedure to procure the destruction of a fetus with no known congenital defect, so it should be right or wrong to destroy a full-term newly born healthy child... Before I digress, let me just ask if a child has rights? If so, when do those rights come into effect?

Now, I wanted to discuss birthing and not actually “abortion”. Ms. Janet Fraser, whom I spoke about earlier, claims to have incorporated into the coroner’s investigation into her daughter’s death, a stance to defend “women’s rights”. Specifically, she wants acknowledgement of a right of a woman to decide the birthing method of her unborn child, independent from any right owed to the child (or potential child). That’s ok, right? Legally, a cognitively competent person has a right to make decisions over her own body and any intervention to it, medically or otherwise. That legal right overrides the fact of whether an intervention is actually good for you or not. For example, I can refuse to have any surgery being performed upon me, even if that surgery can save my life and without it I will undoubtedly and precipitously die. But not just life-saving surgery, I have a legal right to refuse any medical intervention at all… What about epidural anesthesia at the time of birthing, is it ok to refuse that? What about antenatal care? I mean, pregnancy is not illness, so why should a person be forced to see a medical person, right?.. And what about fetal monitoring? No woman in labour particularly wants to be touched by anyone else. What about wanting to deliver a child traditionally at home and not in a modern hospital, particularly if you are scared of hospitals? And what about assisted delivery, I mean that is rarely to help the woman, is it? What about refusing a caesarian section, that’s a type of surgery so why should a person not have a right to refuse that?...

Why are these questions interesting? Because we accept that a person has a right to make decisions about their own body and their healthcare, but we are also aware that the decisions of this person affect another human being (even if we don’t consider them an independent person yet). Though we are unsure whether this “person” or “potential person” is owed any rights, we have this niggling little feeling that they deserve at least a chance or some consideration in the whole argument. What is the answer? Should a hierarchy be legally set up to nominate whose rights are or whose life is more important at the time of birthing? I don't claim to know what the right answer is, but unfortunately in the world we live in, people tend to be motivated more by laws and potential for punishment (or material reward) than the things that moved us in the past. I guess we can’t expect all people to reason that they will sacrifice something, anything, to ensure the safety and health of their child as a priority to their own personal preferences.

(I will not be donating any of my money to Ms. Fraser’s ‘fight for the rights of all women’, mostly because I appreciate and encourage more people [and not just women] to consider at least in some situations, that other fellow human’s lives are at least as worthy as their lifestyle preferences.)

Sunday, April 15, 2012

On birthing - part 1

I recently read a blog post by Janet Fraser where she asked for donations to help fund a legal battle she’s involved in. There is an ongoing coroner’s inquest into the death of her baby so it’s hard to comment on what still has a large number of unknown facts. Briefly, the allegations are that around late 2008, Janet Fraser became pregnant with her third child and decided that her child would be birthed at home without the involvement of any medical or nursing staff. There were apparently no medical antenatal checks during her pregnancy. In March 2009, she went into labour and as she and her partner had planned, they prepared for the birth of their child in their home. At the end of the labour, she delivered a full-term baby that was dead. Resuscitation attempts were made by the child’s father, and then an ambulance was called to take the child to hospital. The baby was not able to be resuscitated. Janet Fraser is not on trial for murder of a child; she is involved in a legal fight to establish her (and, as she claims, all “women’s”) rights to be able to opt to give birth at home, unassisted by medical staff.

Janet Fraser has delivered 3 children, the first of which was born in hospital. In 2003, Ms. Fraser was admitted to hospital for delivery of her first child. The whole interaction of this visit was experienced as a very negative, indeed “traumatic”, experience for her. The physical (aka vaginal) examination was unpleasant, the medical and nursing staff made medical and nursing decisions (apparently for and about her and not in conjunction with her), and her right to a vaginal delivery was denied. A caesarean section was performed for delivery of this child, as deemed medically necessary for either mother and/or child. Ms. Fraser felt that this “medical need” should have been no reason to overlook her right to make health care decisions (i.e. whether to have surgery or not), and a result of this she felt personally violated by the hospital system when the caesarean section was performed on her. This hospital birthing experience came to be interpreted by her as akin to rape. She never wanted to experience this ever again.

For delivery of her second child in 2006, Ms. Fraser wanted to avoid all possibility of having a caesarean section performed upon her (presumably against her will) and so decided to deliver this child at home. She eventually went into labour and this lasted 50 hours. After the birth of the child, she suffered a severe haemorrhage and was taken to hospital. Upon admission to hospital, she reported to hospital staff that she had only being in labour 3 hours so as to avoid potential reporting to policing authorities for child neglect or abuse (from willingly submitting the child to a prolonged labour). I wonder if she herself considered that this whole thing could be called child neglect or abuse had the possibility of prosecution not been raised…

Delivery of her third child in 2009 was attempted in the same way that of the second child was, at home. I guess Ms. Fraser considered that the risk of having another difficult birth after 2 previously difficult births did not warrant the greater medical care that may be offered in hospital. Everyone takes risks in life, right? There is always the chance that mum and/or baby could die during birth, regardless of where it takes place. There was always also the chance that Ms. Fraser could have delivered her third child healthily and so smoothly at her home that none of us would ever have heard of her. She must have weighed up those possibilities, the consequences of their potential outcomes, and then made the decision to deliver her child at home. The outcome was a dead baby; the consequence is that that outcome is final.

Sunday, April 1, 2012

On making "the unhappy" happy - Part 2/2

Of the war veterans I meet with post-traumatic stress disorder (PTSD) and depression, do you know what they value most in their lives? Not finding a “cure” for PTSD and depression, but just appreciating and being able to be with the people in their lives. They accept very courageously – not cowardly – the goals of treatment of these disorders: minimizing symptoms, moving forward from the last exacerbation, and decreasing the number of further exacerbations. They don’t seek a cure, though of course if it were feasible, they’d pay any price to have it. But why fight futile battles? So, I say again that they very courageously choose to expend their energies on the things that matter instead: love, productivity, enjoyment. But before you assume that I am making a claim such as “there is no cure for depression”, let me clarify that that is not the broad statement that I am making.

I used to think, naively, that once I fell in love, once someone loved me and I had someone to share my life with, I’d be happy. I wondered why the people I met who had the things that I thought would bring me happiness weren’t happy. How could they be depressed when they had a partner, children, a job they didn’t hate, generally good physical health, etc.? Why hadn’t the love they had in their loves not cured their depression? Because lack of love didn’t bring about the depression, nothing that was correctable did. Yes, they had love; but completely unrelatedly they also had a mental disorder. Finally I realized why people give flowers to sick relatives in hospital: the flower isn’t meant to “cure” the illness, just make it more tolerable by giving you that warm feeling inside that you’re not alone and reminding you that people care about you.

In persons who have become depressed or suffering PTSD as a result of some psychological social trauma, there is nothing in this world that can erase the memories and/or the cognitive processes that get programmed into your brain. Remarkably, though, a human being can go about their lives being perfectly functional and socially involved despite these demons we carry around in our head. When you have a chronic depression or PTSD of this kind, the best you can wish for is not being “cured”, but having people around you who understand you and stick with you on the journey. Not even “love” can erase the inner hell we experience with these mental disorders, but love can motivate the people around us to give us the all vital support and understanding. Conversely, if you find yourself in a relationship with a person who has depression or PTSD or a similar complaint, you will only hurt yourself by believing that your role is to bring about “cure”; it’s not. Your role is no different to that of anyone else who ever loved: to love, to give (including understanding), to receive, and to share life together.