Monday, January 26, 2015

Sexual Liberation And Sexual Inequality

Whatever, by Michel Houellebecq. I love that The Independent called the book "funny, terrifying, and nauseating."

I was reading MathBabe the other day and she linked to this piece by a professional dominatrix who was arguing that greater sexual liberty would make the world a better place. Especially, she said, if men felt free to be themselves instead of being laced into some absurd masculinity, then they might relate to women in a better way.

Here's a passage I find appealing:

" the majority of my sessions, I am creating a space for men to explore areas of their sexual lives that society feels are unmanly; they come to me to be penetrated, to be used, to serve, to submit, to worship, to be taken. A client might have any or all of a bewildering array of fetishes, but they mostly come to me to experience something well outside the very narrow confines of what society says that it means to be a man."

As she goes along, she develops an idea that feminism, if it rejects a certain kind of sexual moralism and narrower views about sexuality, might contribute to men's well-being in wide-ranging ways, including sexual liberation of a kind that would allow men to be themselves and perhaps be less caught up in problematic kinds of masculinity and aggression.

Basically, I agree with this idea. Years ago I on TKIN I wrote a post that said, "You know how they say, 'If you want peace, work for justice?' Well, if you want sex, work for feminism."

Really, nobody is more for sexual liberation than I am. One of my philosophical research projects is devoted to developing theoretical concepts of sexual freedom and autonomy that go beyond the crude kind of "you can't tell me what to do" -- concepts that can articulate a sense of positive sexual freedom, the freedom to be yourself sexually, which surely goes beyond the right to be left alone and not told what to do. So, yeah.

And yet. I think it's important to acknowledge that there are certain problems that sexual liberation will not solve, and could plausibly exacerbate. And I think that some of those -- contra to the spirit of the essay -- are linked to anger and aggression.

First, as one of the MathBabe commenters said: "Unfortunately there is tension between liberty and equality, and complete sexual license would probably increase sexual inequality rather than diminish it."

Here is an elaboration of that idea, expressed in what I take to be the canonical text on the matter: the novel "Whatever" by the French novelist Michel Houellebecq:

"It's a fact, I mused to myself, that in societies like ours sex truly represents a second system of differentiation, completely independent of money; and as a system of differentiation it functions just as mercilessly. The effects of these two systems are, furthermore, strictly equivalent. Just like unrestrained economic liberalism, and for similar reasons, sexual liberalism produces phenomena of absolute pauperization. Some men make love every day; others five or six times in their life, or never. Some make love with dozens of women; others with none. It's what's known as 'the law of the market.' In an economic system where unfair dismissal is prohibited, every person more or less manages to find their place. In a sexual system where adultery is prohibited, every person more or less manages to find their bed mate. In a total liberal economic system certain people accumulate considerable fortunes; others stagnate in unemployment and misery. In a totally liberal sexual system certain people have a varied and exciting erotic life; others are reduced to masturbation and solitude."

If that's too wall-of-texty for you, here's the Cliffs Notes. Basically, if sexuality is constrained by commitment and monogamy, then roughly speaking each person gets one -- or maybe a few -- sex partners. That is, it's something like "each person gets one person," with a little wiggle room around the edges.

If you're at the top of the sexual hierarchy -- the most attractive, rich, accomplished, fit, sexy -- commitment and monogamy mean you might attach yourself to one person and have a few affairs or see a few prostitutes. At most.

If you're at the bottom of the sexual hierarchy, commitment and monogamy mean there will be other people of your preferred sex/gender for partners who will also be at the bottom of the sexual hierarchy, and you can form commitments and marriages with them and then have sex with them.

So with commitment and monogamy, the people at the top and the bottom would be having some sex with not too many people. Once things open up and those constraints go away, you get immediately into a more sexual "haves" and "have-nots" situation. And what's more of a trigger for male aggression than being a sexual have-not?

Gendered attitudes about sex are obviously complicated, but even leaving all of that aside, I guess I'd want to say that sexual inequality could be, in itself, a bad thing, and that the fact that some people never get to have sex at all would be, in itself, a very bad thing, and that even just the concept of "hierarchy" in sex is a bad thing. Bad, that is, for women and men alike.

I don't think any return to the constraints of commitment and monogamy are what we should be aiming for. But I wish we could talk about sexual inequality in a constructive way that wasn't all caught up in anger, aggression, indignation, and blame.

Monday, January 19, 2015

My Eroding Love Of Luxe

Jan Steen (1625/1626–1679), In Luxury, Look Out. Via Wikimedia Commons.

I used to be kind of in love with luxury. I loved beautiful clothes and I figured when I had enough money I would buy some. I daydreamed about owning a Ferrari or some other absurdly expensive car. I grumbled, silently, about the ugly buildings in the big public universities I've long been affiliated with, vaguely imagining that someday maybe I'd be walking some beautiful ivy covered halls and feeling a rightful place in the world.

I don't want to overstate anything. I've never thought luxury was unproblematic, and I've always been very aware of both the practical problems of luxury, e. g., fancy stuff made in horrible working conditions, and the abstract problems of luxury, e. g., the fancier your stuff is the worse everyone else feels. Luxury is often non-sustainable, elitist, whatever. I've always known that. So it's not like I had some plan to get rich and surround myself with luxe. I just had a certain kind of love. Probably unrequitable, but love nonetheless.

As I get older, though, that love of luxe is rotting away.

I think the first sour note was introduced between me and luxe when I started to have enough money to buy an actual purse. As a young person I just carried a backpack, and when I got to grad school I found a Coach bag in a thrift store for thirty dollars which I used for years. After a few years of having a real job, I thought: I could get a proper bag, something nice.

I don't know if you've ever shopped for a woman's purse, but the situation out there is pretty out of control. Coach, it turns out, is actually seen as the poor-woman's-nice-bag, even though the purses are a few hundred dollars apiece. A proper "nice" bag, like from Prada, you're talking a few thousand. Something luxe, like a Birkin bag, you're talking many thousands of dollars. (In case you need help, Forbes has an article for you: "How To Buy Your First Hermès Birkin.") 

I don't know if this is just me or whether you have it too, but seeing all those bags, it makes the "nice" but reasonably priced bag seem a little ridiculous. Like, am I really going to spend serious money and get something way inferior and not even something considered proper luxe?

I wrote about this problem before, where I called it the "hedonic stairmaster." Once you're in consumer goods mode, how do you settle for 3, or even 7, on the ten-point luxe scale? You just keep climbing. I can't stop.

So our my relationship with luxe was already strained. And then we had the economic crisis and sudden focus on inequality and poverty and things started to be tough on everyone. Then things that were too luxe started to feel weird to me. Not just in the cognitive way I'd understood before, but in a more visceral level. I started to emotionally connect those beautiful Birkin bags with something that felt bad, something I didn't want to be a part of.

Weirdly, the financial crisis doesn't seem to have had this effect on many people. Everyone's all about the luxe now. High end malls are doing better than ever, while J. C. Penney can't catch a break.

Anyway, lately I've come to appreciate even the ugly buildings I work in. It feels like they form a suitable and appropriate venue for the discussion of ideas. Honestly, at a time that feels like a financial struggle for a lot of people, it starts to feel like there's something odd about the whole sitting-around-in-beautiful-buildings-talking-about-stuff thing. What are we, priests?

In some ways the intellectual thing works best when the status aspects are ratcheted down as much as possible. And there's nothing like utilitarian architecture and crappy lighting to quietly ratchet down the status aspects of what you're doing.

Just a couple of months ago I taught Rawls in my Introduction to Philosophy class, and we were talking about inequality. As I walked back from class, I passed through the quite elegant new addition to our building which is part of the Accountancy program, through the double doors, and into the dim and grim hallway that my office is in. Don't get me wrong: my office is book-lined and has a window and I've got zero complaints about it, but drabness-wise, our building is up there.

And suddenly I found myself so happy to be leaving the luxe Accountancy space, with its huge windows and fancy staircase, to pass back into the drab. I remembered how much harder it is to shake things up and be a rabble-rouser if you're spending a lot of money -- especially money that came from someone else. I remembered how the ivy halls of my daydream connect the physical space to a history in which some pretty unsavory elements, like racism and sexism and classism and all kinds of other things -- were even worse than they are now. I remembered how the drab physical space could help put me and my students on a more equal footing, could be welcoming and non-intimidating to them -- with both of us having to acknowledge that even a Starbucks has a more luxe interior than the space we're in.

Bag-wise, I never did buy anything nice. I've gone back to wearing a backpack. For fancy occasions, I bought one of those standard nylon Longchamp bags. And, of course, I've still got my thrift-store Coach.

Monday, January 12, 2015

Universalizing The Female Niceness Tax

Woman on a Striped Sofa with a Dog, by Mary Cassatt, via Wikimedia Commons

Frequently I find myself dealing with what I think of as the female-niceness-tax. If you're a woman you probably know what I'm talking about. It's the way some men, men we don't know, talk to us in a way that asks for care, concern, a listening ear, some moments of our time, a bit of sympathy. Not all men. But enough men that it's a thing.

Sometimes it's men you're attempting to deal with in a consumer or economic transaction, like you're taking a taxi ride and the driver won't stop talking to you, and other times it's just people you run into when you're trying to do something. Like the other day, I was getting the snow scraper out of the car of someone I know and someone else was kindly wiping snow off their car, and it turned into this whole like let-me-tell-you-some-things "guy confidential."

Often it's a tale of woe, like when someone wants to tell you about how they had some illness, or got screwed by some other person, or got fired unfairly, or got rejected from school, or whatever. Sometimes it includes Q + A, which in this context means Questions and Advice, like where you say you live in X place and the guy says "You live where? Why do live there when you could live in this other place? You should live in this other place, it'd be much better for you."

Snow scraper guy talked to me for about ten minutes, and hit most of the big categories, including details about how he, too, was going to do a PhD but there was X problem and the police got involved (we'll just leave that story there for now). It was about 15F, and it was still snowing, but I was clearly expected to be nice and stay and chat and listen and make appropriate sympathetic sounds.

The nature of this "expectation" is interesting, because obviously nobody is forcing you. But usually, at least in my experience, the implicit trade-off is pretty clear: you can stay and listen and be nice, or you will be thought to be a bitch, or called a bitch to your face, or worse.

It can be annoying. You're there hoping to get back to your thoughts or your book or your project or your music and instead you are thrust into this dilemma: stop what you are doing and do a little niceness work, or deal with some angry fall-out. Either way, it's like a niceness tax: pay up or else.

The reason I think of this as a female-niceness-tax is that for some reason I'm not clear on, the men who talk to female strangers this way don't seem to talk to male strangers this way. These men, when they encounter other men, seem to have a different game going on altogether. Either they say nothing, or they want to impress, or they want to exchange opinions, or show off some knowledge. But silence among men often seems acceptable. One of the advantages of being out in the world with a guy instead of alone is getting to dodge the female-niceness-tax.

In the modern world, the payment of the tax feels unfair to me, a constant drag on my ability to do the things I need to do or the things that gain modern would currency like accomplishing things or making money or getting tasks done so I can move on to something else.

Here's where it gets complicated, though. Because it's easy to be indignant about the tax and it's easy to express that indignation by saying the tax should be abolished, that women must be left alone to go about their business, that this constant interfering in their mental lives is bad, a wrong, a problematic way that people relate to one another.

But do you really want to say that a small attempt at human connection is an essentially problematic way to relate to others? I don't. I actually wish people could be a bit nicer and warmer to one another all the time, not a bit colder and harsher. So someone needs a pat on the back, an attentive listener for a few minutes, someone to say "wow, that sucks that that happened to you."

In my view, the problem with the tax isn't that it's there, it's that we're the only ones paying it. I wish it didn't have the particular gendered component that it has. Even the negatives of the gendered component really count as negatives only because our society has become so peculiar in making the pursuit of exchangeable commodities like money status and prestige so essential to an OK life.

So rather than abolish the female-niceness-tax, can't we just make everybody pay it?

Monday, January 5, 2015

A Crisis Of Epistemic Overconfidence

Alchmemy illustration in the Italian book Della tramutatione metallica sogni tre (1572?) by Gio. Battista Nazari], via Wikimedia Commons

The world is complicated, so sometimes we don't know what's up. When you don't know what is going on, you can still have opinions about the best thing to do. But what you can't do is present those opinions with confidence, like Oh that, we have that all sorted out. And yet -- it seems like that's exactly what people do. It's infuriating.

Often I feel like when you look into why people told you to believe something, it was like some version of "sounds reasonable," "makes sense to me," "sounds legit."

For example, the more we learn about nutrition, the more it seems that whole idea of eat-less-fat be-less-fat doesn't really add up. Just like the whole eating-cholesterol causes high cholesterol didn't add up. Just like the whole massive doses of vitamin C or E or whatever didn't add up.

And then you find out that the reason people believed them had to do with things like "fat has more calories per unit weight than carbohydrates," or "some vitamins are good so more is probably great" combined with some vaguely suggestive empirical studies.

Sounds reasonable. Also sounds absurdly oversimplified. And turns out, it was. Yet things like this are often presented as well established and they've had huge effects on our lives.

There are so many things like this in medicine. When I was a kid, everyone said that even a low fever should be treated with aspirin, since it seemed reasonable that a fever would be bad for you. Everyone also said to treat swelling with ice, since it seemed reasonable that swelling was bad and you should try to counteract that. But now we know: fevers and swelling are both ways the body helps fight whatever is wrong with it. Which, once you think about it, also seems reasonable.

Of course, the same thing happens in economics. In this Times op-ed defense of economics being a science, Raj Chetty says the fact that there are constant disagreements, epistemic uncertainty, and extremely limited opportunities for controlled studies doesn't mean economics isn't a science, since "big picture" medicine has the same problem, and it is certainly a science.

It seems to me maybe if you have enough big picture problems it'd be more accurate to say "could be a science" than "is a science," but leaving that aside: the reason the science issue seems important to people is mostly because of the truth, objectivity, and certainty aspects that come in its wake. People want to know: does this activity present results that tell us what is going on?

And the answer there seems to be mixed at best.

It's fine that economics and big picture medicine are difficult, and that answers there "remain elusive," as Chetty puts it. But if you don't know, act like you don't know. Don't go throwing your weight around, shaming the butter-loving, the aspirin-reluctant, the anti-capitalist. 

They might not know what is going on, but face it, you don't know what is going on either.

Monday, December 29, 2014

Three Micro-Moments In 2014 Literature

Woman Reading, By Mary Cassatt, via Wikimedia Commons
Maybe you don't remember the interview from the mid-nineties where David Foster Wallace talks about the magic of fiction. I do, because I think about it all the time. He said:

"There's a kind of Ah-ha! ... It doesn’t happen all the time. It’s these brief flashes or flames, but I get that sometimes. I feel unalone -- intellectually, emotionally, spiritually. I feel human and unalone and that I'm in a deep, significant conversation with another consciousness in fiction and poetry in a way that I don’t with other art."

I get this feeling from literature as well. This explains why, while I can't bear to see sad movies because they just make me sad, I can and do read sad books. Because there's something about the internality of reading that for me that I can share the sadness, or put it into context, or feel it as a way of being human rather than as a crushing pointlessness.

So, here at the end of 2014, a pretty bad year for humanity overall, I thought I'd mention just a few things I read this year that I can't stop thinking about.

1. I just finished reading Akhil Sharma's new book, Family Life: A Novel, which is about a boy whose older brother becomes severely brain damaged when he hits his head on the bottom of a pool, shortly after the family has immigrated to the US from India.

Over time, their father develops a terrible drinking habit. Later he tells his family how awful it is to be hungover all the time:

"He said that in the morning he would be in his car driving to the train station and, when he heard people on the radio, it was as if they were broadcasting from another country, that he was in a country where there was a war going on and these people were broadcasting from a nation that was a peace."

I love that so much.

2. In the middle of the year I read Roz Chast's amazing graphic novel Can't We Talk About Something More Pleasant. It's about her experience with her parents aging and dying. At one point her mother has been so seriously in decline that Chast has mentally prepared herself for her mother's continued weakening followed by death.

You can tell she wants it to be painless. You get the impression that after months and months of the process, she's looking forward to that process winding down and finally coming to an end somehow.

But then she comes by for a visit, and there's a new nurse, and Chast's mother is up and dressed and sitting on the sofa eating lunch. And she's a little shocked, and she says,

"Where in the five Stages of Death, is EAT TUNA SANDWICH?!?!?"


3. This year I also read Miriam Towes's recent book All My Puny Sorrows. It's about a woman dealing with her suicidal sister. Her sister is a perfectionist, and at one point the narrator explodes with frustration over her sister's whole world view.

And she says,

"Stop being perfect! That doesn't mean you have to die, you moron. Can't you just be like the rest of us, normal and sad and fucked up and alive and remorseful? Get fat and start smoking and play the piano badly. Whatever!"

When I feel down on myself for not meeting some stupid life goal or whatever this passage occasionally pops unbidden into my mind. It's a good reminder that a lot of what people need from one another has very little to do with being brilliant and accomplished, and much more to do with just being around, sharing a meal, cracking an occasional joke, you know.

Monday, December 22, 2014

When Did We Become A World Of Debate Team Lunatics?

To me one of the weirdest things about the modern world is the way social media has brought out the debate team nerd in everyone.

Wasn't it not that long ago that if you talked to people about having an "argument" for their claims, or having an "objection," or a "rebuttal," that people would look at you like you were from Mars?

Maybe I'm sensitized to this because as a philosophy professor it's long been part of my job  to encourage people to engage in just these activities. For a long time, like in the 90s, that encouragement used to meet generally with just blank stares. Like, you want us to do what, exactly?

Some of those blank stares I understood as arising from the idea that communication was, for most people, not generally about convincing people of things. Communication, people seemed to generally feel, was about expressing feelings, or sharing something, or making a joke, or coordinating plans.

Sure, if you were protesting, or canvassing for a cause, or involved in a political campaign, you might get involved in the "making arguments" and "having rebuttals" business. But for most people, most of the time, that was not the main thing we were doing with words.

But now, with social media, it feels like that is all anyone ever does with words. "Having an opinion" is like the main currency of online communication. People are constantly challenging one another's epistemological credentials, standpoint biases, and unstated assumptions.

You click on the "comments" of almost anything and it's like you stumbled into some parallel universe where everyone signed up for lifelong membership in some focus-group-debate-team-mashup where it's really important to state an opinion and challenge those who don't agree with you.

Some of the constant comment arises because people with horrible offensive views now feel empowered to express those views and disagreement with those views is essential, and I get that. But it also feels like there's been a huge uptick in the expression of views about every conceivable thing under the sun: the relative merits of this or that thing; the right way to prepare this or that food; the hidden ethical and social implications of seemingly trivial and innocuous choices.

And if the thing you're sharing is SO innocuous and nice that it's impossible to generate some debate about it, you can rely on someone to start a discussion of whether sharing that innocuous and nice thing is OK and how and why and when.

You can't debate baby pictures, but you sure as hell can debate whether, how, why, and when it's appropriate to share them. I'm often astonished by how passionate people's opinions are on which cute or fun things it is and isn't OK to share.

Why is this happening?

Are people naturally full of opinions and the need to convince other people and social media just finally gave them an outlet for pent up demand?

Did social media just happen to evolve that way so that it's a culture of the thing and now when we get into it that's how it is?

Are we living in an age of indignation and OMG it's so unfair for other reasons so that in an act of psychological transference we are putting all that "I WAS DISSED" energy into pointless arguments that have nothing to do with the true source of indignation?

Maybe it's a perfect storm of all three. Anyway, thinking about all this always reminds me of the Paul Krugman quote from 1988:

"The growth of the Internet will slow dramatically [as it] becomes apparent that most people have nothing to say to each other."

Boy, was that ever wrong or what.

Monday, December 15, 2014

Guest Post: A Dry Rob Roy

This guest post is by my former co-blogger at Commonwealth and Commonwealth, Captain Colossal

My father’s mother died Thursday night. She was 97 years old, which I find easy to remember because she was born in 1917 and I was born in 1977. She died in her sleep after about two years of mostly waiting to die.

My father and his partner happened to be visiting me at the time. We decided to honor her memory by making dry Rob Roys and cooking beans and greens. The beans and greens were a more straightforward tribute than the Rob Roys. I lived with my grandmother for about three months after college. It was a time when I had no idea what I wanted to do with myself and I took over the cooking because my grandmother’s idea of dinner was a single hot dog on a little plate without a bun.
After the first night I cooked, she said, “Do you think you could make beans and greens?”

I had never heard of beans and greens. This was a number of years ago, so instead of going on the internet I went to the library and checked out the cookbook section. I found a recipe and made beans and greens. When I went to visit her this spring, she told her caretaker that she had taught me to cook, which is true, in a certain sense. My husband reminded me, when we were talking about the beans and greens, that beans and greens were the first thing I ever cooked for him. My grandmother loved being cooked for; she loved being taken care of.

My grandmother also enjoyed drinking. She was not, at least to my knowledge, a rowdy drinker -- she was a quiet drinker. She drank beer in summer, but in winter she said she needed something to warm her up. When I was a child she became very concerned about the American trade imbalance and so she switched from drinking Scotch to drinking rum.

The story with the dry Rob Roys is that there was a time when she was on a long-distance car trip with my father and his partner and they stopped for lunch at some kind of diner-type place. The three of them were on their way to an event and they were running late. They had hours of social engagement ahead of them. The teenage waiter came over to take their order, and my grandmother pursed her lips thoughtfully. I wasn’t there, you understand. This is an imaginative re-creation. “I’d like,” she said, “a dry Rob Roy.”

Do you even know what a Rob Roy is? The teenage waiter didn’t, in any case. In any case, it was a strange time to order a cocktail and a strange place to order a cocktail. Several years later I read a Lydia Davis story in which the narrator’s elderly father requests a Rob Roy under similarly inappropriate circumstances. It gave me a funny feeling about the world, a feeling that the world, rather than being a place of infinite possibility, is more of a Tetris-type situation, where certain pieces will always have to be combined with certain other pieces.

A dry Rob Roy is Scotch, dry vermouth, and Angostura bitters. At least, that’s what the internet and the Joy of Cooking tell me. It is one form of alcohol combined with two other forms of alcohol. I don’t usually drink cocktails, and so I was surprised that all three of the ingredients were alcoholic. The grocery store nearest my house sold all three forms of alcohol, which surprised and pleased me. I didn’t have a single cocktail shaker, although at one time I had two. I got rid of them because I never used them. When I do drink a mixed drink it usually means that I have added some significant quantity of non-alcoholic mixer to the alcohol in my glass. You don’t need a cocktail shaker for that.

We mixed the ingredients in a pint glass. We used crushed ice, which was a mistake, because it started melting almost immediately. When we poured out the dry Rob Roys my father’s partner used a coaster to keep the ice in the pint glass. The recipe said to use two dashes of vermouth and one dash of Angostura bitters per cocktail. I wasn’t sure what a dash multiplied by three looked like.

The dry Rob Roys were very pretty looking, all golden in the glass. We raised our glasses and took a sip. My father made a face. “It’s so sweet,” he said. I didn’t think it was sweet. It burned. My father drank about a third of his. My father’s partner drank hers. “It makes me feel weird,” she said. I drank mine very slowly. Because I drank it so slowly it got warm, which did not make it taste better. It made me feel drunk, not in a fun way, but in a way where the room seemed a little askew. I couldn’t get past the idea that the taste was made by combining different varieties of alcohol.

I could tell you endless stories about my grandmother -- how she kept her belongings beautifully clean and took care of them for decades, how she declined to get a new cat when her last cat died almost fifteen years ago because she thought the cat might outlive her, and that would be unfair to the cat, how she loved being kidded -- she loved it when I or my father, telling her goodbye, would tell her to behave, to stay out of trouble. “I try,” she would say, and she would shake her head a little bit with the difficulty of the task. There are a lot of things I know about her, a lot of things I could tell you, and even more that I couldn’t. I knew her better than I know most people and she remains mostly mysterious to me. The desire for a dry Rob Roy at midday in a roadside diner, with a long day ahead, is only one of those mysteries.

From The Archives: Let's Make War On Christmas A Reality

Due to circumstances beyond our control, TKIN is going to be delayed today. If you're bored, why not check out this timely classic from the archives, Let's Make War On Christmas A Reality?

Monday, December 8, 2014

News Flash: People Have Priorities Other Than Just Living Longer

Dispensing of medical electricity. Oil painting by Edmund Bristow, 1824. Via Wikimedia Commons
A little while ago the doctor and medical culture commentator Atul Gawande wrote this very touching piece in the New York Times about a woman who was told she didn't have long to live, and how neither "extraordinary measures" nor "just dying" seemed like the right thing, and how her hospice team was able to arrange things so that she could have a few good days toward the end doing what she really wanted most to do, which turned out to be spending some time with the students she'd taught piano lessons to for years and teach them a few more things.

Dr. Gawande's own kid is one of those piano students, so he happened to see the whole thing unfold in a personal way. It prompted him to engage in conversations about dying, with end-of-life care specialists, patients and other people. Summarizing what he's learned he writes,
"First, in medicine and society, we have failed to recognize that people have priorities that they need us to serve besides just living longer. Second, the best way to learn those priorities is to ask about them."
From the context, you can tell he's talking specifically about people near the end of their lives. These people want to do certain things or live a certain way and doing that is more important to them than just having more time.

But to me the truth is much more radical, and it is that everyone, at every age, has priorities beyond just living longer.

You'd never know this from the way medicine is practiced, though. Basically if you ask your doctor anything you just get told what to do. Medical advice in the media is basically just do this don't do that. There's no acknowledgement that most medical decisions these days actually involve trade-offs.

There are trade-offs between medications and sex. There are tradeoffs between medications and other medications. Virtually all birth control entails trade-offs. And, of course, there are relentless constant trade-offs between things that "will make you live longer" and things that you enjoy doing that make you feel good.

 If a medication makes you feel like crap but will make you live longer, how is it not a reasonable decision to just not take it? Of course it's a reasonable decision.

But there's no space for these discussions. Instead you have the concepts of "compliance" and "non-compliance," where you're supposed to do what you're told without any consideration of what things matter to you and why.

It's always kind of mystified me that the principle of informed consent can co-exist beside the concept of non-compliance. I mean, who's in charge here?

There was this great moment on "Wait Wait Don't Tell Me" a while ago where the guest was Michael Pollan and he was talking about eating real food and how you tell if something is real food instead of a food-like substance and the great Paula Poundstone said "Okay, but let me ask you something. One of the things that has made my life worth living is Ring Dings. And I feel that it is food. Are you going to tell me that's not food?"

And Pollan mumbled something about Ring Dings and a "special occasion" and Paula basically shouted at him, "What do you mean, special occasion? I said it's what makes my life worth living."

So. Cancer or not, old or young, healthy or not: People have priorities besides just living longer. The best way to learn those priorities is to ask about them.

Why is this such a difficult concept for people to get their heads around?

Monday, December 1, 2014

My Problems With People And Doors

William Henry Margetson, At the Cottage Door, via Wikimedia Commons

What could be simpler than going through a door? And yet: doors are a site of contestation in my inner life.

Problem 1: The perverse and pointless door crunch tango

My first problem with people and doors arises in the context of a bank of glass doors. You know: you're entering or exiting a large space, like a mall, or a subway station, or (cough cough) a university building, and there are three or four or six doors all in a row.

I try to stay to the right -- and you could do a whole blogpost about this, I think, is staying on the right in pedestrian contexts a thing? but passons... -- but mostly I try to go through doors that other people are not attempting to go through. That is, if I'm about to go through door X, and I see someone coming toward me through the glass from the other side like they're about to come through door X, I shift to go through door Y.

So far so good. But then some non-trivial percentage of the time, the perverse opposite happens, by which I mean that a person seeing me trying to go through door X decides this is a great moment to go through door X themselves. So that we have to pass through a single door going in opposite directions at the same time For No Reason. Even more infuriatingly, sometimes if I shift to go through door Y, as above, the person on the other side will themselves shift to go through door Y. What causes this utter perversity in door-related behavior?

I can only come up with one theory. And that is that by going through the same door I'm going through, instead of a different door, the other person is hoping to avoid the strain and hassle of opening a door for themselves.

If this is even close to right, it's mind-boggling. And it's made more so by the fact that I often have this experience when I'm on campus surrounded by university students. What, are they so weakened and worn down from being on social media and avoiding their work that they can no longer opens doors on their own?

The door crunch tango conclusion: Not my fault. Everyone else's fault.

Problem 2: the ambiguous holder/blocker

My second problem with people and doors is when there isn't a bank of doors, there isn't even a pair of doors, there's just the one door, and someone is coming through it toward you as you're getting ready to pass through it the other way, and that person tries to hold the door by standing in the doorway holding the door open behind them.

I don't get this. So now I'm standing there, and the door is open, but you are in it. WTF?

I usually try to smile and gesture like "oh go ahead" hoping the person will take the hint and move along and I can, you know, go through the door all by myself, which is something I know how to do. Sometimes it works. But sometimes it's a stalemate, and the other person stands there goggling at me, like "but I'm holding the door for you."

This problem has the obvious gendered component, that sometimes it's a guy you don't know standing in the door, and you're a woman hoping to go through the door, and the way he's holding it open, you'd have to smush yourself all up against him to get through. And you have to wonder: is this guy just hoping for a casual, unwanted smush? Gross.

The holder/blocker conclusion: these people are probably just trying to be nice, but I don't have to like it.

Problem 3: the person you're not walking with who just holds a door

You'd think if someone is walking ten feet or so ahead of me and we're going in the same direction and we're going through the same door and that person pauses in the door to just hold it back for me so I can catch it as I go through before passing through myself that at least that would be the kind of reasonable, nice, normal door-related interaction a person like me should be able to get behind, but for some reason even having the door held for me can annoy the hell out of me.

Usually it happens when I'm 1) lost in thought 2) not in a rush and 3) tired of interacting with people all day long. I'm in my own headspace. If the person is right ahead of me, it's fine, but often they're a bit ahead, and they pause there, and I have to decide whether I'm going to rush to the door so they don't have to stand there holding it longer than necessary or whether I'm going to mosey in my own sweet slow way even though they're standing there. Either way is annoying. And if I've been talking to people all day, even that little "Oh, thanks" "Oh, my pleasure" or whatever feels like too much interaction. Just let me me listen to my headphones and pass through the door alone.

The door holder conclusion: I'd be a better person if I could just chill and smile and say thanks without treating every situation like a goddamn federal case. But sorry: no can do.