I have tokophobia and two kids. My mother and both grandmothers were ripped apart during childbirth. They all had lifelong incontinence and sexual dysfunction after countless surgeries. It destroyed one of my grandmother’s marriages. My father just resorted to affairs but stayed with my mother despite her complete inability to orgasm and having to wear basically adult diapers most of her life. (She still does.)
When I became pregnant, I thought I could rationalize through my fears of ending up the same way, but I was terrified. My OB ended up performing an elective cesarean at 40 weeks. I had a healthy baby and excellent recovery. I did it again two years later with the birth of my second daughter. Both times I was walking around the halls with my new baby within 12 hours.
So far I’m the ONLY woman in my family to give birth without incontinence and sexual dysfunction. I’ll advise my daughters to also have surgical births. Sometimes tokophobia is valid.
But this next reader, Diane, thinks that term is being tossed around too loosely:
It’s not a PHOBIA! I’m sure I’m not the first person to point this out. It’s a legitimate and rational fear. Walk through an older cemetery sometime and check out the dates of death for the women vs. the men.
The doctor did not make it on time to ANY of my deliveries. Not one. And the practice at the time was to force me to wait for the doctor to show up, even though the baby’s head was showing. My last baby was delivered by the nurse because the baby wasn’t waiting any longer, and it was the best delivery I had.
Here’s the book I read before my second childbirth: Immaculate Deception by Suzanne Arms. [The New York Times in 1975 named it Book of the Year.] It helped me be able to argue with the medical professionals that I did NOT need pain medication. (And it helped me prepare my husband to back me up and not side with them, because they tended at the time to use a tactic of turning to the husband, while you were in labor, and saying something like, “You don’t want your wife to suffer, do you?”)
But I still wound up having an IV inserted that I did not need, “just in case,” and after the birth I still wound up getting pitocin [a synthetic hormone used to induce labor] to “shrink my uterus,” which caused worse contractions than childbirth.
[Suzanne Arms’s] groundbreaking exposé reported how women in childbirth were routinely separated from their partners, physically restrained at the wrists and ankles, lowered into the stirruped lithotomy position, administered drugs without their consent, given episiotomies without their consent, discouraged from breastfeeding, and denied their babies following delivery. At the time of that publication, most obstetric practices hadn’t been studied rigorously, if at all.
The most shocking part of Block’s description of that era: “60% to 90% of women giving birth got episiotomies”—an episiotomy being an incision down the perineum, or the area between the vagina and the anus, to allow for quicker and ostensibly safer delivery and the prevention of tearing. At least 60 percent. Nowadays that figure is much, much lower, thank god:
Since then, the use of this surgical incision has dropped significantly — from 21 percent of all vaginal births in California in 2005, for example, to fewer than 12 percent in 2014. National trends have been similar.
This last reader, Marina, says she isn’t sure if her aversion to getting pregnant qualifies as tokophobia:
I’m a 31 and have been with my spouse for seven years (and married for three). I can remember in first grade knowing I never wanted to be pregnant or give birth. I figured there are enough kids who need parents that I didn’t need to create my own. (I probably had a vague idea of pregnancy and birth from National Geographic animal documentaries at the time.) When I would tell adults that I wanted to adopt, I was always told that I would change my mind when I got older.
A few years down the road, the addition of learning the biological process (and viewing the infamous video) and my feelings towards childbirth were only strengthened. I also started to strongly dislike the thought of the pregnancy and dealing with a newborn. When puberty hit, my feelings didn’t waver. In fact, the drive to never get pregnant caused me to delay having sex until quite a few years into my twenties. But I also started taking birth control in my teens just in case. (I grew up in a pro-choice family, so this was driven by going overkill on pregnancy prevention.)
Even in my mid twenties, as all my friends became baby crazy, I still wanted nothing to do with having a baby. When I reached my late twenties, I was diagnosed with Ehlers-Danlos Syndrome [a connective tissue disorder]. If I were to get pregnant, I would likely have a difficult pregnancy, the pregnancy would cause a permanent decline in my health (the opposite of what pregnancy often does to those with autoimmune disorders), and there would be a 50 percent chance that the baby would also have Ehlers-Danlos.
In the past year or so, I have been feeling a stronger desire to be a parent. However, I would still avoid pregnancy and childbirth at all costs. My spouse and I recently got a puppy and it is has reminded me that I would be happy to be a parent if my body is able to handle it … but my ideal scenario is probably adopting a potty-trained toddler.
I am not sure if my situation is tokophobia (I normally lack phobia and anxiety; I am way too comfortable with heights, snakes, taking tests, etc.). Or maybe I was innately aware of how faulty my genes are. Regardless of why, I have always, and assume will always be, opposed to personally being pregnant or giving birth.
I am a childfree woman in her late 20s. I find the idea of pregnancy abhorrent and frightening in almost every way. Everything about it makes me cringe, most intensely if I imagine myself giving birth. I occasionally have nightmares about being pregnant and giving birth.
Ten years ago I used hormonal birth control for a short time and had several unpleasant side effects, including morning sickness, weight gain, and mood swings. Since pregnancy hormones are orders of magnitude stronger than birth control hormones, I am terrified of the changes my body would experience if I were pregnant. I’m afraid I would have hyperemesis gravidarum [severe nausea and vomiting] or some other horrible complication.
Going off the hormonal birth control was ten times worse.
I had depression, insomnia, amenorrhea [no menstruation], gained more weight, and I developed an eating disorder in effort to lose the weight. I believe these issues would repeat themselves—probably in fuller force—after a pregnancy, and that scares me more than anything.
It took a lot of time for me to regain my health, and I wouldn’t like to have to go through that process again. I always feel that my hormones are in a perpetual state of delicate balance. If anything, such as pregnancy, disrupts that balance, I will never regain it. I know it’s irrational.
I have always had extremely painful periods, and without strong painkillers I am unable even to get out of bed. I know that the pain of childbirth would be much worse, and that is not something I ever want to experience.
Several years ago I had exploratory surgery to see if endometriosis was causing my painful periods. It wasn’t the cause, but at that time, something deep inside me had been hoping that it was and that it would render me infertile, just so that I would have no risk of ever becoming pregnant. I still hope I’m infertile and have thought about getting tested, just so I can know for sure.
I’m glad that neither I nor my husband want children. I track my monthly cycle religiously so that I can make sure we have sex at the times that I am least likely to be fertile. I also record and pay close attention to the small changes my body undergoes throughout my cycle, such as PMS symptoms, mood changes, etc. This way, I’ll notice new or intensified symptoms that may indicate pregnancy, if it ever occurs.
I, like Ashley Lauretta, struggle with generalized anxiety, which probably has affected my experiences and predisposes me to tokophobia. Tracking my cycle helps me deal with it by giving me a sense of control and comfort.
From the article that started this whole discussion:
There are not many women who openly discuss having tokophobia, though some have spoken out in media or online in recent years to share their stories or seek help. One woman on Reddit, in a channel devoted to people who don’t want children, notes that her tokophobia was so severe she was afraid of having sex with her significant other for fear of becoming pregnant, even when protection was used. “I know it’s silly that I’m this afraid,” she writes, “but I can’t help it.”
That recent college grad, Eileen Jones, emailed hello@ to elaborate on her experience. In her long and compelling note below, she recalls several events in her life that triggered her tokophobia and how those deep-seated fears derailed her first career goal. Her phobia is so overwhelming that she’s “only had vaginal sex two times.” And her thoughts on self-sterilization raises some interesting questions. Here’s Eileen:
I turned to reddit for advice because for years I had felt like such a freak of nature because not only do I not want children, but I am also terrified of pregnancy. It was such a relief to find an online community that understood how I felt.
I can’t exactly pinpoint what caused my tokophobia. I have always thought that tokophobia/not wanting children might be some sort of evolutionary response to overpopulation. I knew when I was about 4 years old that I did not want children. I think I was maybe around 13 when I realized that I actually had a fear of pregnancy. I remember doing sex education stuff around that age and abstinence was really pushed at my school. I can remember the nurse explaining some of the symptoms of pregnancy and being pretty repulsed.
When I was in high school, I had my heart set on being a doctor.
I attended a National Youth Leadership forum on medicine. During this program, I shadowed a radiologist. She showed me an x-ray of a pregnant woman and you could see the fetus inside of her. Although I did not mean to show any sort of negative reaction, the doctor could tell that I was physically repulsed. She asked if something was wrong, and admitting to her that I didn’t really like “pregnancy stuff” was kind of embarrassing for me. I felt like I was being really rude.
Also, during this medicine program, I remember medical students talking to us about rotational programs where you would intern for a set amount of weeks as an ER doctor, then you would switch for a certain amount of weeks and intern as a pediatrician, etc. I remember thinking that there was no way I would ever become a doctor just because I knew I wouldn’t make it through interning as an OB/GYN. Gastroenterology? Fine. Proctology? Great! But something about working in the OB/GYN field was gross to me. Honestly, gynecology doesn’t bother me one bit, but there is no way I could handle obstetrics.
I really related to the part in Ms. Lauretta’s article when she describes how Helen Mirren felt when she watched a film about childbirth. When I was a senior in high school, my anatomy teacher showed us a film on childbirth. I remember staring down at my desk the entire time. My best friend, who sat in front of me, was turning around periodically to check on me. I remember her asking, “Are you okay? No, really … are you okay… ? Are you sure?”
I’ve recently stumbled upon the MTV series 16 and Pregnant. Although I do think it’s a great series, when they show the girls in labor, I can’t watch. I’m seriously like your average person watching a horror movie and shielding their eyes from the screen. I’ve even had to mute it.
Another thing I’ve had to deal with is the repulsion of seeing pregnant stomachs. A friend of mine who is currently pregnant recently posted a video of her stomach on Snapchat. In the video, you can see her baby moving around inside of her. I was so freaked out that I had to exit the video; I couldn’t even watch it.
As far as my sex life goes, I don’t really have much of one. I’ve only had vaginal sex two times. Both times, the guy used a condom, but I still panicked. The last time I engaged in vaginal sex, I sat in my car and cried for a few minutes after. I drove myself to the nearest Walmart and bought some Plan B. I was basically an anxious mess until I had my period. I even took a pregnancy test AFTER I got my period just to make sure I wasn’t pregnant.
I feel that the only way I will ever have a normal sex life is if I get sterilized. Unfortunately, most doctors are not keen on this because they are concerned you will change your mind. However, as I stated earlier, I’ve known since I was about 4 years old that I didn’t want kids and I have only become more sure with age.
I really wish there wasn’t such a negative stigma around women who do not want children. [CB: Readers discussed the contentious subject last year.] I don’t consider myself to be generally selfish. I’m not a child-hating monster. In fact, although I’m not too keen on babies and toddlers, I do enjoy interacting and working with older children, especially teenagers. In college, I volunteered with at the Science Olympiad where I worked with middle and high school kids and really enjoyed it!
One thing I wish people knew about tokophobia, or at least in my case, is that I don’t think less of someone for being pregnant. I don’t hate pregnant people. In fact, I am excited for my friends and family members who are pregnant because I know they’re happy and excited. I will definitely attend their baby showers and get them gifts.
I really wish that I wasn’t mortified by things related to pregnancy, but it’s something that has definitely improved a little in recent years. I can actually look at sonogram images now without being disturbed!
I was so happy when someone told me about Ms. Lauretta’s article. It’s always comforting to me to read about people who feel the same way I do. Thank you so much for taking time to read this. If you have any questions, I would be happy to answer them.
Incredible and timely piece, thank you so much. I actually am writing to ask a question. The article says over and over to get some help if you believe you have this phobia and want to have a baby. That's me, and I want to know how to get help. What are the concrete suggestions from Brian Salmon [a doula and lactation consultant] and his colleagues with regards to getting over this?
My story: I’m a 40-year-old woman, and I’ve only just come to decide that it’s time to be a mom. I don’t have the money to adopt, but I absolutely would if I could. I’m disgusted by being pregnant and terrified of giving birth. I’ve been pregnant before, more than once, and it felt like being invaded by a destructive alien force.
I would say that my phobia comes from the following experiences:
1. I’m a control freak. I’m a lawyer, alpha, eldest child, feminist, political activist, and conservator over my only sibling, who has DD. I fill with anxiety over mere annuals because I cannot STAND the idea of a stranger in my vagina unwantingly, without my guidance and oversight. I avoid them like the plague.
2. Those pregnancies and the subsequent abortions, ONLY with regards to the physical pain, and again, having all these people prod my privates.
3. My parents were open lefties who perhaps shared too much, including horrifying birthing stories that my mother identified (my birth especially) as “the most traumatic experience of her life.” She also showed me videos and books too early, like Our Bodies Ourselves, which depict women screaming in agony with their vaginas gaping in a room full of old white men.
To be fair, my mother’s OB/GYN was an Indian woman, and I have a dear friend who grew up on The Farm with the doulas and midwives who wrote the manuals. And I saw The Business of Being Born, so I know that, rationally, I have options outside the nasty hospitals and their profit-driven approach. And I know that there are oils and exercises to avoid tearing. But this fear isn’t rational, right?
So here I am, ready to do this, and paralyzed with fear. And your article just gave it a name, and the hope of fixing it. Please point me in some direction for fixing it.
When speaking with sources for my piece, I learned a lot about the options available to women who have tokophobia yet wish to have children someday (me being one of them). They recommend finding both a therapist and a midwife, both of whom specialize in tokophobia or have at least worked with it previously. They can not only help you discover the root cause of your phobia but also break it down into smaller related fears and work through each one specifically. They can educate you on the birthing process and your options for it—hospital vs. home, for example, or Cesarean vs. natural—and then advocate for you.
I followed up with Kirsten Brunner, MA, LPC to find out if there are any specific questions or concerns you should broach in therapy.
“Voicing your fears and reaching out for help is half the battle in overcoming tokophobia,” notes Brunner. “So many women sit in silence and shame with their fears, and that only causes the anxiety to grow.”
“Finding a professional who is familiar with tokophobia and/or reproductive mental health issues is essential.” Brunner suggests that you find a therapist comfortable working with couples, as it may be helpful for your partner to be in the sessions from time to time to better understand your tokophobia and help work through it with you.
When you start looking for a therapist, don’t feel like you need to choose the first one you visit. Brunner notes that having a connection with your therapist is shown by research to be the strongest predictor of a positive outcome. Should you encounter anyone in your search who responds to your fears with judgement or with shaming, they are not the therapist for you.
If you don’t know where to start in your search, Brunner suggests asking your ObGyn for referrals. “Make sure that your therapist, doula, or midwife feels confident that they can help you get to the root of your fears and overcome your phobia,” stresses Brunner. “You want to surround yourself with positive, optimistic energy, as Brian Salmon correctly stated in the original article. Pregnancy and childbirth can be a beautiful and relatively comfortable experience, and aligning yourself with professionals and friends who ascribe to these empowering beliefs is essential.”
Should you not be ready to reach out to a therapist, Herrera recommends having a lifeguard in place. “Have somebody who loves you pay attention to what is happening; if they see that you are having increased tokophobia or symptoms of postpartum depression or anxiety, then they get help,” stresses Herrera. “Have everything lined up, have a therapist lined up with your insurance whom your lifeguard can call.”
I hope this gives Kelly and other readers struggling with tokophobia a sense of where to start as you begin your journey to parenthood. Many of you, like Sacha Zimmerman, had the fear but didn’t know there was a name for it, and I want to remind you that you aren’t alone. You aren’t irrational or broken—you have a legitimate phobia—and asking for help is the best thing you can do to work through your fears.
I always thought I was missing some important maternal chip in my system, some crucial feminine widget in my consciousness that was supposed to look at childbirth as simply beautiful—as the most natural thing in the world. Instead, long into adulthood, my overwhelming feeling toward the act of giving birth was something along the lines of: You want me to push what out of where?!
Ashley Lauretta’s wonderful piece for us this week, “Too Afraid to Have a Baby,” mentions that Helen Mirren was scarred by a childhood viewing of an educational film on the topic. I feared childbirth from the moment I heard how it was done; I don’t remember ever not thinking it sounded ghastly. But I too had my own filmstrip moment that pushed me further over the edge.
In my mid-20s, I saw an episode of Susan “Stop the Insanity” Powter’s short-lived talk show (please do not feel obliged to remember Susan Powter) about nightmare-childbirth scenarios. One guest on the show suffered something so completely horrific, I dare not write it. Suffice it to say, she had to go through several corrective surgeries and receive hundreds of stitches—down there.
Do I sound immature? I felt immature. I also felt rational. That maternal chip I was missing was really a blind spot. Other women could not see the obvious flaws of natural childbirth, but I was cursed with perfect vision.
When I became pregnant at 37, I could feel my due date hurtling toward me like a runaway train. Maybe I could have an elective C-section. I read up on the procedure—too many people have it, hospitals and doctors are too quick to turn to it, it’s driving up health-care costs, it’s selfish, the baby will be bathed in drugs …
As I read, I was not chastened. Instead, I thought, So it’s do-able.
The other women in my mommy pace group would smile at me serenely, beatified by their holy cargo. I’d be fine, they’d assure me. It wouldn’t be bad at all, they promised. I didn’t have the heart to tell them about their childbearing blind spots.
I screwed up my courage and confessed my fears to my doctor. “I’m not sure I can do it,” I cried. “OK, let’s schedule a C-section,” she replied without missing a beat. Yes! She was one of those doctors I’d read about who handed out surgery like candy. She told me that at my age, the chance of ending up with a C-section was already increased because more things go wrong the older the mother is. Given that, she said, she always prefers to schedule procedures than to end up with emergency C-sections—which, obviously, no one plans for. She also said that being in a fevered panic about childbirth was no way to, well, experience childbirth—not to mention it was a pretty poor way to be pregnant; after all, my stress was probably being transmitted to the child inside me.
So as far as my doctor was concerned, it was a no-brainer. Science!
But I still dared not tell a soul. I knew what the world saw: I wasn’t doing it the right way, the best way. I was a selfish, scared, immature crazy person.
Then, as I neared the end of my pregnancy, my baby didn’t turn around; he was breech—a common reason to need a C-section. My doctor and I laughed. “So I’m legit?” I said. Since then, if my C-section ever comes up in conversation (which is far less often the more distance from the event I get), I say, “He was breech”—as though I had no choice in the matter. But I did have a choice. And I actively chose.
Now I don’t look back on the day I gave birth as one in which I was tearful and totally terrified, thinking only of the cruel physics of what was about to happen. Now I remember every detail of that happy spectacular day with joy. Because it was all about my son.
The senator from New York is a battle-tested campaigner who thrives as the underdog. But 2020 is proving to be a much tougher challenge than she thought.
DES MOINES—Isaac Rosenberg is stumped. What is it about Kirsten Gillibrand that makes people love to hate her, the rush of coverage eager to point out how her presidential campaign has underperformed?
Maybe, Rosenberg says, “it’s because America isn’t used to such an opinionated and strong woman.”
Rosenberg doesn’t get it. They hit it off. Rosenberg likes her style—in politics, and in fashion. They’d just done their makeup together upstairs. “I like a full, pink lip; she likes a red lip,” Rosenberg tells me.
We were standing in Blazing Saddle, a gay bar in the East Village neighborhood here. Rosenberg had on a white top exposing a bare midriff, and a flowing white skirt that people in the crowd had to be careful not to step on. Rosenberg is better known as the drag queen Vana, and is one of the senator’s biggest fans in Iowa.
The Democratic Party’s gerontocracy is holding back the political causes it claims to want to advance.
Why have national Democrats and not national Republicans fallen under the tyranny of the 70-somethings? It seems so contrary to common expectation. Democrats are, as they often remind us, the party of progress and the future. The question seems to rival those enduring, unanswerable mysteries such as “What happens when you die?” and “Why did Mick Taylor quit the Rolling Stones?”
People in their mid-to-late 70s are thick on the ground nowadays, while in an earlier era, of course, you’d have been more likely to find them under it. This is especially true in the urban centers of the Northeast and mid-Atlantic, according to a recent survey of census data by the Associated Press–NORC Center for Public Affairs Research. In particular, the Washington, D.C., area is a leader in “senior labor force participation,” by which the researchers mean the region is loaded with people who have passed the age of retirement yet somehow neglected to retire.
A faction of the religious right has concluded that if liberal democracy does not guarantee victory, then it must be abandoned.
By the tail end of the Obama administration, the culture war seemed lost. The religious right sued for détente, having been swept up in one of the most rapid cultural shifts in generations. Gone were the decades of being able to count on attacking its traditional targets for political advantage. In 2013, Chuck Cooper, the attorney defending California’s ban on same-sex marriage, begged the justices to allow same-sex-marriage opponents to lose at the ballot box rather than in court. Conservatives such as George Will and Rod Dreher griped that LGBTQ activists were “sore winners,” intent on imposing their beliefs on prostrate Christians, who, after all, had already been defeated.
The rapidity of that cultural shift, though, should not obscure the contours of the society that the religious right still aspires to preserve: a world where women have no control over whether to carry a pregnancy to term, same-sex marriage is illegal, and gays and lesbians can be arrested and incarcerated for having sex in their own homes and be barred from raising children. The religious right showed no mercy and no charity toward these groups when it had the power to impose its will, but when it lost that power, it turned to invoking the importance of religious tolerance and pluralism in a democratic society.
No novel of the past century has had more influence than George Orwell’s 1984. The title, the adjectival form of the author’s last name, the vocabulary of the all-powerful Party that rules the superstate Oceania with the ideology of Ingsoc—doublethink, memory hole, unperson, thoughtcrime, Newspeak, Thought Police, Room 101, Big Brother—they’ve all entered the English language as instantly recognizable signs of a nightmare future. It’s almost impossible to talk about propaganda, surveillance, authoritarian politics, or perversions of truth without dropping a reference to 1984. Throughout the Cold War, the novel found avid underground readers behind the Iron Curtain who wondered, How did he know?
Mama was in her 70s before she discovered the true story of her conception.
Late on the eve of my mother’s wedding day, in August of 1965, in Springfield, Illinois, a hoot owl on a tree outside her bedroom window called out “Who? Who?” The call echoed in the darkness of her high-ceiled room. It was a loaded question.
Earlier that day, my grandmother (Granny, we kids called her) had taken my mother (whom we call Mama) aside for a private talk. “Now Beth,” she said. “You know that Daddy and I had trouble having you.” In spite of Granny’s midwestern Methodist reserve and impermeable feminine decorum, Mama did know a little about this. When, as an unusually intense and imaginative little girl, she had begged Granny for brothers and sisters, Granny had finally explained that siblings were impossible. She and Grandpa had tried to conceive Mama for five years and sought the assistance of doctors at a Chicago hospital; it was a miracle she had been born at all. Mama would have to content herself with her cousins in Moweaqua—the children of Granny’s little sister. Effusive and highly sociable, Mama bonded with her cousins as if they were her own sisters and brother, and made near-siblings of the kids on her block, herding them to perform dog circuses and theatricals on their quiet street.
Fifty years after Jazzercise was founded, it is still shaping how Americans workout—for better or for worse.
“You’re not in Jazzercise, ladies,” a trim, tattooed, fitness instructor chided me and the roomful of women who were attempting to work up a sweat one morning a few months ago. I’d never done Jazzercise, but I knew what she meant. The caustic cue conjured grainy VHS tapes—the kind that circulate on social media for their Totally ’80s aesthetic—featuring a gyrating blonde who’s all limbs, leotard, and embarrassing exclamations like “find that boogie body.” My instructor was calling us uncool.
Tempting as it may be to dismiss Jazzercise to the dustbin of fitness history, the dance-cardio program—which turns 50 this month—is more than a punchline. The format founded in a dance-studio basement by Judi Sheppard Missett, the frontwoman in the videos, established the style and substance of “boutique fitness,” the fastest-growing segment of today’s $26 billion industry. Jazzercise set the standard not only for contemporary choreographed offerings, but also for the franchise model exemplified by the likes of Curves, PureBarre, and Barry’s Bootcamp.
At its annual meeting, the evangelical denomination initially declined to consider a statement of its opposition to the alt-right.
Updated at 6:10 p.m. EST on June 14
The Southern Baptist Convention’s annual meeting turned chaotic in Phoenix this week over a resolution that condemned white supremacy and the alt-right. On Tuesday, leaders initially declined to consider the proposal submitted by a prominent black pastor in Texas, Dwight McKissic, and only changed course after a significant backlash. On Wednesday afternoon, the body passed a revised statement against the alt-right. But the drama over the resolution revealed deep tension lines within a denomination that was explicitly founded to support slavery.
A few weeks before the meeting was slated to start, McKissic published his draft resolution on a popular Southern Baptist blog called SBC Voices. The language was strong and pointed.
Americans are hypochondriacs, yet we skip our checkups. We demand drugs we don’t need, and fail to take the ones we do. No wonder the U.S. leads the world in health spending.
I was standing two feet away when my 74-year-old father slugged an emergency-room doctor who was trying to get a blood-pressure cuff around his arm. I wasn’t totally surprised: An accomplished scientist who was sharp as a tack right to the end, my father had nothing but disdain for the entire U.S. health-care system, which he believed piled on tests and treatments intended to benefit its bottom line rather than his health. He typically limited himself to berating or rolling his eyes at the unlucky clinicians tasked with ministering to him, but more than once I could tell he was itching to escalate.
My father was what the medical literature traditionally labeled a “hateful patient,” a term since softened to “difficult patient.” Such patients are a small minority, but they consume a grossly disproportionate share of clinician attention. Nevertheless, most doctors and nurses learn to put up with them. The doctor my dad struck later apologized to me for not having shown more sensitivity in his cuff placement.
Like many rich Americans, I used to think educational investment could heal the country’s ills—but I was wrong. Fighting inequality must come first.
Long ago, I was captivated by a seductively intuitive idea, one many of my wealthy friends still subscribe to: that both poverty and rising inequality are largely consequences of America’s failing education system. Fix that, I believed, and we could cure much of what ails America.
This belief system, which I have come to think of as “educationism,” is grounded in a familiar story about cause and effect: Once upon a time, America created a public-education system that was the envy of the modern world. No nation produced more or better-educated high-school and college graduates, and thus the great American middle class was built. But then, sometime around the 1970s, America lost its way. We allowed our schools to crumble, and our test scores and graduation rates to fall. School systems that once churned out well-paid factory workers failed to keep pace with the rising educational demands of the new knowledge economy. As America’s public-school systems foundered, so did the earning power of the American middle class. And as inequality increased, so did political polarization, cynicism, and anger, threatening to undermine American democracy itself.
A growing pattern of attacks across Europe is as much about electoral opportunity as a conflict of ideas.
When Federico Batini, an Italian academic, wanted to research classroom bullying, he distributed a questionnaire to 54 schools in central Italy. The survey was carried out in partnership with local education authorities and sought to explore the extent to which young people faced racial, homophobic, or gender-based discrimination from their peers.
But instead of learning more about students’ experiences, Batini found his name smeared in the national media and his research abruptly discontinued. A senator from the far-right League party condemned Batini’s questionnaire as “gender indoctrination.” A national conservative daily, La Verità, berated the survey as “crazy gender ideology.” Then the Italian education minister, Marco Bussetti, a member of the League, blocked the questionnaire altogether.