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.
Freddie Gray's death on April 19 leaves many unanswered questions. But it is clear that when Gray was arrested in West Baltimore on the morning of April 12, he was struggling to walk. By the time he arrived at the police station a half hour later, he was unable to breathe or talk, suffering from wounds that would kill him.*
Gray died Sunday from spinal injuries. Baltimore authorities say they're investigating how the 25-year-old was hurt—a somewhat perverse notion, given that it was while he was in police custody, and hidden from public view, that he apparently suffered injury. How it happened remains unknown. It's even difficult to understand why officers arrested Gray in the first place. But with protestors taking to the streets of Baltimore since Gray's death on Sunday, the incident falls into a line of highly publicized, fatal encounters between black men and the police. Meanwhile, on Tuesday, a reserve sheriff's deputy in Tulsa, Oklahoma, pleaded not guilty to a second-degree manslaughter charge in the death of a man he shot. The deputy says the shooting happened while he was trying to tase the man. Black men dying at the hands of the police is of course nothing new, but the nation is now paying attention and getting outraged.
Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.
A magnitude 7.8 earthquake struck Nepal early on Saturday, centered 10 miles below the surface, less than 50 miles from the capital of Kathmandu. At least 1,100 are already reported to have been killed by the quake and subsequent avalanches triggered in the Himalayas. Historic buildings and temples were destroyed, leaving massive piles of debris in streets as rescue workers and neighbors work to find and help those still trapped beneath rubble. Below are images from the region of the immediate aftermath of one of the most powerful earthquakes to strike Nepal in decades. (Editor's note, some of the images are graphic in nature.)
In her new book No One Understands You and What To Do About It, Heidi Grant Halvorson tells readers a story about her friend, Tim. When Tim started a new job as a manager, one of his top priorities was communicating to his team that he valued each member’s input. So at team meetings, as each member spoke up about whatever project they were working on, Tim made sure he put on his “active-listening face” to signal that he cared about what each person was saying.
But after meeting with him a few times, Tim’s team got a very different message from the one he intended to send. “After a few weeks of meetings,” Halvorson explains, “one team member finally summoned up the courage to ask him the question that had been on everyone’s mind.” That question was: “Tim, are you angry with us right now?” When Tim explained that he wasn’t at all angry—that he was just putting on his “active-listening face”—his colleague gently explained that his active-listening face looked a lot like his angry face.
Four hours after learning about Saturday's devastating earthquake in Nepal, I received a Facebook notification I had never seen before: Sonia, a journalist friend based in northern India, was "marked safe." An hour later, the same notification about a different friend popped up. Then another. Soon, several of my friends wrote that they, too, had learned via this strange new notification that their friends in Nepal were okay.
A few hours later, the mystery was solved. On Saturday afternoon, Facebook CEO Mark Zuckerberg announced on his timeline that the notifications came from Safety Check, a service the company launched last fall. "When disasters happen, people need to know their loved ones are safe," he wrote, "It's moments like this that being able to connect really matters."
Today was the latest installment of the never-ending Clinton scandal saga, but it won’t be the last. Yet in some ways, the specifics are a distraction. The sale of access was designed into the post-2001 Clinton family finances from the start. Probably nobody will ever prove that this quid led to that quo … but there’s about a quarter-billion-dollar of quid heaped in plain sight and an equally impressive pile of quo, and it’s all been visible for years to anyone who cared to notice. As Jonathan Chait, who is no right-wing noise-machine operator, complained: “The Clintons have been disorganized and greedy.”
“All of this amounts to diddly-squat,” pronounced long-time Clinton associate James Carville when news broke that Hillary Clinton had erased huge numbers of emails. That may not be true: If any of the conduct in question proves illegal, destroying relevant records may also have run afoul of the law.
“People skills” are almost always assumed to be a good thing. Search employment ads and you will find them listed as a qualification for a startling array of jobs, including Applebee’s host, weight-loss specialist, CEO, shoe salesperson, and (no joke) animal-care coordinator. The notion that people smarts might help you succeed got a boost a quarter century ago, when the phrase emotional intelligence, or EI, entered the mainstream. Coined in a 1990 study, the term was popularized by Daniel Goleman’s 1995 book . Since then, scores of researchers have shown how being in touch with feelings—both your own and other people’s—gives you an edge: compared with people who have average EI, those with high EI do better at work, have fewer health problems,and report greater life satisfaction.
After more than a year of rumors and speculation, Bruce Jenner publicly came out as transgender with four simple words: “I am a woman.”
“My brain is much more female than male,” he explained to Diane Sawyer, who conducted a prime-time interview with Jenner on ABC Friday night. (Jenner indicated he prefers to be addressed with male pronouns at this time.) During the two-hour program, Jenner discussed his personal struggle with gender dysphoria and personal identity, how they shaped his past and current relationships and marriages, and how he finally told his family about his gender identity.
During the interview, Sawyer made a conspicuous point of discussing broadly unfamiliar ideas about gender and sexuality to its audience. It didn't always go smoothly; her questions occasionally came off as awkward and tone-deaf. But she showed no lack of empathy.
Lots of conservatives talk a good game about how citizens should resist federal control and devolve power to local governments. Few of them are willing to put their convictions into action in quite the same way that Sheriff Joe Arpaio is.
The man who calls himself "America's toughest sheriff" was already in trouble with Uncle Sam, on trial for contempt of court in a U.S. district court. It was only once that was under way that Arpaio and his lawyer apparently had the idea to sic a private investigator on the wife of the federal judge hearing his case. That shows toughness. It shows a willingness to use unorthodox tactics to resist federal interference. It's also not especially bright.
Reporters in the courtroom describe a somewhat shocking scene. Lawyers had completed their questioning when Judge Murray Snow announced he had some questions for Arpaio. After a series of queries, Snow asked: "Are you aware that I've been investigated by anyone?"
CHELSEA, Ma.—The woman Barry Berman saw sitting in the dining room of the nursing home was not his mother.
Or, at least, she was his mother, but didn’t look anything like her. His mother was vivacious, or she had been until she was felled by a massive stroke and then pneumonia, so he’d moved her into a nursing home so she could recuperate. He knew he could trust the nursing home, since he ran it, and knew it was lauded for the efficiency with which it served residents. But when he went to look for his mother a day or two after he moved her in, he barely recognized her.
“I’ll never forget the feeling as long as I live,” he told me. “I said, ‘Oh my God, there’s my mother, this old woman, in a wheelchair, lifeless. Look what my own nursing home did to my own mother in a matter of days.”