clarence thomas wants you to know that you should hide your drugs in your underwear, because there’s no way that the school will have the balls to look for them there!

(in an amazing twist of logic, thomas wrote,

“Redding would not have been the first person to conceal pills in her undergarments,” he said. “Nor will she be the last after today’s decision, which announces the safest place to secrete contraband in school.”

which might make some sense if redding actually had concealed anything in her underwear… but she hadn’t. thomas thinks it’s okay to abuse children because of what they might do. nice.)

the fourth circuit court of appeals has upheld virginia’s (previously overturned) “Partial Birth Infanticide Act,” which apparently criminalized a specific abortion method.

although it isn’t clear to the layperson (read: me) which procedure was banned, the wp describes this:

Although the Virginia law permits women to choose various abortion procedures, it specifically makes it a crime for doctors to perform a rare midterm abortion that involves partially delivering the fetus before crushing its skull to ease removal.

i haven’t yet had a chance to read the opinion myself, but the post’s coverage indicates that the majority’s opinion essentially reasoned that doctors’ criminal liability for performing this type of procedure is so unlikely that the fact of the criminal liability isn’t enough to invalidate the law.

the entire purpose of the law is to criminalize that abortion procedure. if it’s exceedingly unlikely to fulfill its purpose, the law is unnecessary legal accretion and has no reason to be cluttering up the books. taking the majority’s assertion (as interpreted by the post; as i mentioned, i haven’t yet read the opinion) at face value, if doctors are unlikely to actually face criminal prosecution for performing the procedure, and yet there’s substantial pressure to retain the law, there must be some other reason driving the decision.

hmmm. i wonder what it could be.

abortion opponents are apparently very willing to criminalize doctors’ therapeutic decisions. they seem to ignore the fact that if the doctor is committing a crime, then the woman is an accessory to the crime, and guilty of conspiracy as well. abortion opponents should be honest about their intent, and attempt to hold the woman criminally responsible as well. let’s see how far legislative efforts would go then.

on my way into work on this morning’s second-to-last 3Y metrobus. (i originally wrote “penultimate,” but that just sounded pretentious even though it’s correct.) on E street, a woman in a black coupe pulls into the bus stop as we’re approaching, and opens the driver’s side door… right into the front of our bus. my quick view of the scene suggested no major damage to either her car or the bus. IMO, however, she was at fault.

i was so engrossed in my current reading (straub’s if you could see me now) i barely noticed the lurch as the bus driver slammed on the brakes to avoid a collision, and when i did look up from my last-row seat, the bus was echoingly empty. we all transferred to a 16Y that was right behind us. i don’t envy what the 3Y driver’s day is going to be like.

and i’m still glad i don’t drive in the district.

everyone probably already knows about the horrific red line accident yesterday afternoon. i have nothing to add to the coverage of the incident; i haven’t regularly ridden that stretch of the red line since i moved out of silver spring in 1995. i don’t ride the metro rail much anymore at all, but many of my loved ones do, and the knowledge that this could happen to them is sobering. until we learn more, there’s no reason to think that this type of accident couldn’t occur anywhere along metro’s 103 miles of track or at any time of day. (however, i’d like to see a beltway vs. metro comparison of fatalities-per-passenger-mile-traveled. my hunch is the beltway’s considerably more dangerous.)

lacking a direct connection to the accident (although several work colleagues called me to make sure i wasn’t on the metro), i immediately started thinking about the administrative details that would need to be handled. the investigation. the impact on metro ridership. and whether metro will provide psychological counseling to the survivors of the accident. even if this is handled as well as humanly possible, i don’t see how it won’t generate at least a few lawsuits.

it’s the lower lip. and the eyes. or maybe… the morning suit?

(what is a morning suit, anyway? my first husband wore one at our wedding, as did the various and sundry groomsmen and ushers. i still don’t know what it is, though.)

update: james informs me that wikipedia is a font of knowledge on the morning suit. and so it is. well, “morning dress,” anyway. hint: it has to do with ascot, apparently.

hey, judy, wherever you are – the president signed the FDA tobacco bill. i think you’d be pleased with most of it.

miss you.

the alarm woke me
just as i was running up ancient
stone stairs and into
the waiting arms
of Neil Patrick Harris.
damnit.

i always feel some embarrassment when former professors or other people i’m familiar with are publicly called out for wrongdoing, justifiably or not. such is the case with tee guidotti, former department chair at GWU SPHHS. a review panel found that “inattention to detail,” rather than interference from DC’s water utility, led him to the central conclusion in a published article that

there had been no identifiable health impact from the unprecedented concentrations of lead in [DC's] water from 2001 to 2004

subverting research for money, i can understand (but abhor). sloppy research? from a professor? inexcusable.

###

the draft of kennedy’s HELP bill currently circulating (his answer to health care reform) prohibits health insurers from excluding pre-existing conditions from coverage. it also limits what characteristics insurers may consider when setting premiums, to “family structure” (although i wonder if that means they could charge higher rates for same-sex couples), community rating area (minimum size set by HHS), actuarial value of the benefit, and age (with limitations).

because insurers are also prohibited from excluding potential enrollees or placing annual or lifetime limits on benefits, (“each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual in the State that applies for such coverage”) this could force a greater pooling of risk – causing some premiums to rise, and others to fall – although i suspect the actual outcome would be that insurers would simply offer a wider variety of clinical coverage options, and charge more for more comprehensive plans.

the bill does set out minimum coverage requirements for all plans, which must include preventive services rated “A” or “B” by the US preventative services task force (such as regular mammograms for women age 40 or over, cervical cancer screening for sexually active women, cholesterol & blood pressure screening, and certain disease screening for pregnant women. all other OB-GYN screening guidelines are interestingly currently under revision.), immunizations, and non-adult preventive care and screenings in guidelines promulgated by HRSA.

(at page 40 of 615 they started talking about health insurance gateways, and lost me completely.)

and of course, it goes on and on, and is currently being marked up in committee. best quote so far, by barbara mikulski (paraphrased): “some call this bill a combination of rube goldberg and karl marx. well, the current system is a combination of adam smith, darth vader, and invasion of the body snatchers.”

###

update OH! and i totally forgot – my favorite public health news story of the week – yesterday’s news that a smoking ban is being rolled out in virginia’s prisons. in unsurprising republican fashion,

“I don’t have any problem with prisoners being denied the right to smoke,” said House Majority Leader H. Morgan Griffith (R-Salem). “The only question I have is what effect it would have on control.”

go figure.

earlier this month, maryland authorities issued a warning against consuming rockfish and bluefish caught in coastal atlantic waters (according to their chart, this doesn’t extend to rockfish caught in the chesapeake, but the chart hasn’t been updated since may ‘07).

the warning says that

pregnant women, women of childbearing age, nursing women and children under 6 should not eat rockfish or bluefish caught in the Atlantic by amateur fishermen. People not in those groups may eat one meal of rockfish, also called striped bass, from the Atlantic every month, and one meal of bluefish every other month.

note that it only applies to fish caught by amateur fishermen. not to commercially-caught rockfish or blues from the same area. why? well, it’s not because commercially-caught fish are safer. it’s because commercially-caught fish fall under federal jurisdiction.

when i have a spare moment, i’m going to check the feds to see if they’re also warning against eating those fish. it’s not like PCBs discriminate by type of fisherman.

update: a quick search on the fish & wildlife service website yields nothing; the FDA is equally useless. USDA?

i was browsing through the google analytics, curious about what search parameters bring people to this blog, and i came across this question buried in the list. it struck me that i’ve never really thought about it.

first, there are the definitional questions. what did the searcher mean by “worth it”? and – don’t laugh – what did he or she mean by “be”? is this a cost-benefit analysis? a worldview question? is my existence defined by my advanced academic degrees? (the short answer to that one is a resounding “no,” by the way.)

i grew up in a public health household, and the most fulfilling work i’ve ever done has been in that field. i decided to earn an mph for entirely economic reasons, though – the added income from the degree. there was very little offered in the coursework that i either hadn’t already studied, or hadn’t learned at the dinner table or in the field. (obviously this wouldn’t be the case for most people, but i remember looking at maps of central american countries with my father when i was in 7th grade, as he determined the catchment areas of rural health posts. the broad street pump was practically a bedtime story. in fifth grade, i made a presentation to my class on contraceptive methods, much to my language arts teacher’s dismay. imagine explaining vaginal suppositories to your teacher when you’re ten years old…)

the mph was “worth it” in the sense that i completed my coursework while working full time, and saw a satisfying bump in my income. but it didn’t do much to change the way i looked at the world, or analyzed problems. it was really just academic and professional recognition of something i already knew.

the jd on the other hand – now that is a completely different story.

i went to law school – several years after earning my mph – simply because i could. i scored well on the LSATs; international trade law and health law issues were directly pertinent to my work, and unlike public health, it was not something i could learn from my parents or on the job. i never had any interest in practicing law in the courtroom or for a firm. i just wanted the additional analytical tools. and from that perspective, earning the jd was definitely “worth it.” i loved law school. i didn’t have much exposure to the socratic method, but it was thrilling in the classes where the professor used it. hypos were essentially big puzzles to which case law, statutes, and regulations could be applied – fitting the pieces together to determine possible answers. i learned more about the u.s. government than i had before (growing up overseas and having a narrow academic interest in college can stunt one’s civics education), and my appreciation and respect for the rights and responsibilities of individuals grew enormously, challenging my generally-unquestioned collectivist public health mindset. my public health positions have been somewhat altered by my legal education, both reinforcing some beliefs and leading me to question and reject others. i think these are all good things.

i “am” an mph jd in the sense that those letters come after my name on my business cards. i currently work for an organization whose primary focus is the law, and in an issue area that happens to be health (but not public health as its usually construed). when i read the newspaper, i naturally gravitate toward health and law reporting in areas that interest me, and i think i’m more likely to question assumptions i come across than i was before my degrees. but the mph/jd doesn’t define all of me. a quick search through this blog gives a much better picture of who i “am” than five letters on cardstock, or the diplomas gathering dust at the back of my closet.

i’ve found many benefits to having an mph/jd, and given the opportunity, i would likely do it again. one drawback, though, is that i’ve educated myself out of the type of jobs (and beyond the expected income level) that i like – at least for the moment. i’m an analyst at heart. show me a forest, and i’ll start cataloguing the trees and wildlife, and developing theories about pretty much anything i’m asked about. the big picture – the policy decisions, the strategic planning, the long-term outlook – these are things in which i have no particular interest. if i agree with them, i’ll happily work to support them, but i’d rather leave the development to someone else.

so there you go. a more introspective post than i’ve written in some time. and it probably won’t help the person who originally posed the question one bit. because what “worth it” and “be” mean to me may be entirely different than what they mean to him or her.