The controversy reveals that we wrongly assume, with dangerous implications for public health, that women who get breast implants must be rich.
A Venezuelan woman sits next to the two PIP breast implants that she had removed. The yellow implant at left, made by Poly Implant Prothese, had broken. / AP
the past few months, the leak-prone breast
implants of French company Poly Implant Prothese has turned into an international furor. At issue
is the company's use of non-medical-grade silicone, which has an
increased risk of rupture. The gel inside the implant, once released,
can inflame the surrounding tissue. Though there's limited evidence for this, fears
persist about the irritation leading to an increased risk for
cancer. The scope of the potential impact is tremendous. As of last
week, the estimate cited by
the BBC was that "up to 400,000 women in 65 countries are believed to
have been given implants" from the company. PIP founder Jean-Claude Mas is now facing
charges of involuntary injury, while policy professionals, journalists,
and the public are asking how the implants could have made it past
safety inspectors to have reached so many women.
there were ever a time to move beyond our dangerously facile debate about
cosmetic surgery, it's now. European media have been hammering the point that it's time to take implant safety as seriously as
drug safety, and take cosmetic procedures as seriously as any other operations, which is what they
To answer the question of how the
implants could have made it to so many women, though, one has to ask how
and it is that so many women are getting breast implants at all. Paris-based plastic surgery and dermatologist
organization IMCAS recently released some new numbers that help explain. Cosmetic surgeries not only rose by 10.1 percent in 2011 but are expected to
rise by another 11.12 percent in 2012, despite the scare.
A significant portion of the debate touches on a longstanding theme of how people think about cosmetic surgery: who, if anyone, should help cover the costs for removing and replacing defective implants? Though insurance policies and national
governments have already declared themselves willing to foot the bill for the
faulty implants' removal, that doesn't come without caveats. The implicit moral question the responsible officials seem to be asking themselves is, Should governments compensate for losses in botched vanity
projects? And herein lies the need
for a more careful look at the phenomenon of plastic surgery.
France, the government will only pay for new implants if the originals
were for reconstructive surgery. Politicians in Germany have been urging
similar policies. Elizabeth Niejahr neatly summarized this thinking in Die Zeit as "one
shouldn't make cosmetic surgeries even more popular. ... Those who, out
of vanity, decide to undergo the knife, should be aware of the
consequences." SPD Carola Reimann, Niejahr pointed out, has also argued
that "It's about the beauty ideal and the pressure to conform."
These politicians have a point, namely about moral hazard. But behind these sentiments lies a deep confusion about plastic surgery that's worth
surfacing. The idea that implants are for "vanity" seems to imply selfishness and, with it, an exercise
of will. But the charge that implants are about a "pressure to conform" implies the opposite. Which is driving
the trend towards plastic surgery? A projected growth in surgeries,
despite the dire stories of the past year, begins to look like a
pathology not just in individual women and men, but in society itself;
if that's the case, how helpful is it to blame individuals for
succumbing to what appears to be a mass psychosis?
criticizing the French and potential German positions, makes an
important related point: many politicians are assuming that the women
paying for non-reconstructive implants must be rich, and are adjusting
their rhetoric accordingly. But a glance merely at "trash talk shows,"
Niejahr notes, suggests this is "a false picture." How? "There may be many
women who save for new breasts or with what little credit they have
choose a larger chest over a new car."
just an inaccurate image: the suggestion that women who get breast
implants must be rich is a dangerous misconception with real implications. The enormous black market in cosmetic surgery, as
well as the apparently flourishing cosmetic surgery tourism trade -- with
terrifying stories of incompetently executed, dangerous procedures -- should be
evidence enough, even without Niejahr's trashy TV.
This isn't to say that governments should pay
for implant replacements (though Niejahr does make that argument): it's
questionable fiscal policy to pay for implant replacements in the
current European economic climate, even before you get to the possible
moral hazard argument. But in the debate over the appropriate policy
position, European politicians do need to be careful about the
assumptions they convey in their rhetoric.
these few critics in the current Continental debate show, this may be the
perfect time to probe the dark undercurrents of plastic surgery trends.
Tighter regulations may reduce dangers within the European Union, but they don't
change the fact that these surgeries still carry risks -- and they're
definitely not going to help the women who head to Mexico. Double-D
millionaires aren't a public health problem -- but they are a disturbingly convenient fiction.
Should you drink more coffee? Should you take melatonin? Can you train yourself to need less sleep? A physician’s guide to sleep in a stressful age.
During residency, Iworked hospital shifts that could last 36 hours, without sleep, often without breaks of more than a few minutes. Even writing this now, it sounds to me like I’m bragging or laying claim to some fortitude of character. I can’t think of another type of self-injury that might be similarly lauded, except maybe binge drinking. Technically the shifts were 30 hours, the mandatory limit imposed by the Accreditation Council for Graduate Medical Education, but we stayed longer because people kept getting sick. Being a doctor is supposed to be about putting other people’s needs before your own. Our job was to power through.
The shifts usually felt shorter than they were, because they were so hectic. There was always a new patient in the emergency room who needed to be admitted, or a staff member on the eighth floor (which was full of late-stage terminally ill people) who needed me to fill out a death certificate. Sleep deprivation manifested as bouts of anger and despair mixed in with some euphoria, along with other sensations I’ve not had before or since. I remember once sitting with the family of a patient in critical condition, discussing an advance directive—the terms defining what the patient would want done were his heart to stop, which seemed likely to happen at any minute. Would he want to have chest compressions, electrical shocks, a breathing tube? In the middle of this, I had to look straight down at the chart in my lap, because I was laughing. This was the least funny scenario possible. I was experiencing a physical reaction unrelated to anything I knew to be happening in my mind. There is a type of seizure, called a gelastic seizure, during which the seizing person appears to be laughing—but I don’t think that was it. I think it was plain old delirium. It was mortifying, though no one seemed to notice.
Why the ingrained expectation that women should desire to become parents is unhealthy
In 2008, Nebraska decriminalized child abandonment. The move was part of a "safe haven" law designed to address increased rates of infanticide in the state. Like other safe-haven laws, parents in Nebraska who felt unprepared to care for their babies could drop them off in a designated location without fear of arrest and prosecution. But legislators made a major logistical error: They failed to implement an age limitation for dropped-off children.
Within just weeks of the law passing, parents started dropping off their kids. But here's the rub: None of them were infants. A couple of months in, 36 children had been left in state hospitals and police stations. Twenty-two of the children were over 13 years old. A 51-year-old grandmother dropped off a 12-year-old boy. One father dropped off his entire family -- nine children from ages one to 17. Others drove from neighboring states to drop off their children once they heard that they could abandon them without repercussion.
How Vladimir Putin is making the world safe for autocracy
Since the end of World War II, the most crucial underpinning of freedom in the world has been the vigor of the advanced liberal democracies and the alliances that bound them together. Through the Cold War, the key multilateral anchors were NATO, the expanding European Union, and the U.S.-Japan security alliance. With the end of the Cold War and the expansion of NATO and the EU to virtually all of Central and Eastern Europe, liberal democracy seemed ascendant and secure as never before in history.
Under the shrewd and relentless assault of a resurgent Russian authoritarian state, all of this has come under strain with a speed and scope that few in the West have fully comprehended, and that puts the future of liberal democracy in the world squarely where Vladimir Putin wants it: in doubt and on the defensive.
Civic participation offers a way out of the 2016 doldrums.
For anyone still in a post-election stupor, unsure what to do or how to repair our ailing democracy, here are three words of advice:
Start a club.
I don’t mean that sarcastically, as in, “Oh, you got a beef with Trump or the rest of them in Washington? Well, join the club!” I mean it literally. Make a group. Invite people. Create rules and rituals. Establish goals. Meet regularly. In short: Start a club.
This is the great democratic self-cure sitting right before our eyes. I was reminded of this immediately after the election, when so many people I knew were in states of shock or despondence. At Citizen University, the nonprofit I run, my colleagues and I decided that doing something was better than doing nothing. We accelerated plans for a project called Civic Saturday, which we’d been intending to launch in the new year but instead launched four days after Donald Trump was elected president.
His paranoid style paved the road for Trumpism. Now he fears what’s been unleashed.
Glenn Beck looks like the dad in a Disney movie. He’s earnest, geeky, pink, and slightly bulbous. His idea of salty language is bullcrap.
The atmosphere at Beck’s Mercury Studios, outside Dallas, is similarly soothing, provided you ignore the references to genocide and civilizational collapse. In October, when most commentators considered a Donald Trump presidency a remote possibility, I followed audience members onto the set of The Glenn Beck Program, which airs on Beck’s website, theblaze.com. On the way, we passed through a life-size replica of the Oval Office as it might look if inhabited by a President Beck, complete with a portrait of Ronald Reagan and a large Norman Rockwell print of a Boy Scout.
The same part of the brain that allows us to step into the shoes of others also helps us restrain ourselves.
You’ve likely seen the video before: a stream of kids, confronted with a single, alluring marshmallow. If they can resist eating it for 15 minutes, they’ll get two. Some do. Others cave almost immediately.
This “Marshmallow Test,” first conducted in the 1960s, perfectly illustrates the ongoing war between impulsivity and self-control. The kids have to tamp down their immediate desires and focus on long-term goals—an ability that correlates with their later health, wealth, and academic success, and that is supposedly controlled by the front part of the brain. But a new study by Alexander Soutschek at the University of Zurich suggests that self-control is also influenced by another brain region—and one that casts this ability in a different light.
A chain helmed by the nominee for labor secretary has unseated Chick-Fil-A as the perfect encapsulation of this cultural moment.
Despite his predilections for KFC or taco bowls, or his appearances in ads for Pizza Hut and McDonald’s, the president-elect is really a Carl’s Jr. kind of guy. The California-based chain is best known for its oversized burgers, hypersexualized ads, and confusing affiliation with Hardee’s—the fast-food chain it acquired back in 1997. Like Trump, Carl’s Jr. aspires to flashiness and brashly appeals to men. It’s slogan? Eat Like You Mean It. Trump made this unspoken kinship official on Thursday, when he announced Andy Puzder, the longtime CEO of Carl’s Jr and Hardee’s, as his choice for labor secretary.
To many white Trump voters, the problem wasn’t her economic stance, but the larger vision—a multi-ethnic social democracy—that it was a part of.
Perhaps the clearest takeaway from the November election for many liberals is that Hillary Clinton lost because she ignored the working class.
In the days after her shocking loss, Democrats complained that Clinton had no jobs agenda. A widely shared essay in The Nationblamed Clinton's "neoliberalism" for abandoning the voters who swung the election. “I come from the white working class,” Bernie Sanders said on CBS This Morning, “and I am deeply humiliated that the Democratic Party cannot talk to where I came from.”
But here is the troubling reality for civically minded liberals looking to justify their preferred strategies: Hillary Clinton talked about the working class, middle class jobs, and the dignity of work constantly. And she still lost.
A professor of cognitive science argues that the world is nothing like the one we experience through our senses.
As we go about our daily lives, we tend to assume that our perceptions—sights, sounds, textures, tastes—are an accurate portrayal of the real world. Sure, when we stop and think about it—or when we find ourselves fooled by a perceptual illusion—we realize with a jolt that what we perceive is never the world directly, but rather our brain’s best guess at what that world is like, a kind of internal simulation of an external reality. Still, we bank on the fact that our simulation is a reasonably decent one. If it wasn’t, wouldn’t evolution have weeded us out by now? The true reality might be forever beyond our reach, but surely our senses give us at least an inkling of what it’s really like.
“Well, you’re just special. You’re American,” remarked my colleague, smirking from across the coffee table. My other Finnish coworkers, from the school in Helsinki where I teach, nodded in agreement. They had just finished critiquing one of my habits, and they could see that I was on the defensive.
I threw my hands up and snapped, “You’re accusing me of being too friendly? Is that really such a bad thing?”
“Well, when I greet a colleague, I keep track,” she retorted, “so I don’t greet them again during the day!” Another chimed in, “That’s the same for me, too!”
Unbelievable, I thought. According to them, I’m too generous with my hellos.
When I told them I would do my best to greet them just once every day, they told me not to change my ways. They said they understood me. But the thing is, now that I’ve viewed myself from their perspective, I’m not sure I want to remain the same. Change isn’t a bad thing. And since moving to Finland two years ago, I’ve kicked a few bad American habits.