The Holy Gift of Killing Time

lgfak01“And tell me, do you play with your children? Do you waste time with your children? The free gift of a parent’s time is so important.”
~ Pope Francis

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Of Autism, Prenatal Testing, and the Seventh Extinction

People say, ‘The price of genetic diseases is high. If these individuals could be eliminated early on, the savings would be enormous.’ It cannot be denied that the price of these diseases is high…, [b]ut we can assign a value to that price: It is precisely what society must pay to be fully human.
~ Jérôme Lejeune, French pediatrician, geneticist, and Down syndrome research pioneer

brain3_0ac27ea9c169f18cd259c0d38219c6cdCulture of life, culture of death – how big is the divide? Here’s one measure.

The other day I caught a story on NPR about researchers identifying genetic signals in utero of future mental illness. The following is a quotation from the transcript. Read it, and then jot down the first word that pops in your head:

Having a map like this is important because many psychiatric and behavioral problems appear to begin before birth, “even though they may not manifest until teenage years or even the early 20s,” says Dr. Thomas Insel, director of the National Institute of Mental Health.

OK, what was your word? “Provocative,” perhaps? “Fascinating,” or “Wow!” even?

How about “Abortion?” That was my first thought, and my wife reacted similarly when I I brought the story to her attention. If you’re committed to building a culture of life, I imagine that was your reaction as well.

But could it be that we pro-lifers just tend to be a bit paranoid? Could it be that my wife and I simply overreact to stories like this, discerning nefarious anti-life implications where none are warranted?

I don’t think so.

To begin with, it’s no surprise that the story itself is unabashedly rooted in abortion. The researchers obtained the brains they studied from four aborted fetuses, “a practice,” the NPR story notes, “that the Obama administration has authorized over the objections of abortion opponents” – you know, paranoid pro-lifers like you and me. So, even if the research does in fact lead to life-affirming therapies, it will be forever and inexorably tainted by it’s life-destroying origins.

And what of those potential life-affirming therapies? The NPR report is curiously silent on this point. Perhaps that is not unusual since this is ground-breaking research in its earliest stages. Nevertheless, there are telling gaps in the story where at least some speculation regarding future clinical applications would’ve been appropriate – maybe even expected. Take, for instance, this observation regarding autism, including a comment from Ed Lein of Seattle’s Allen Institute for Brain Science:

[T]he map shows that genes associated with autism appear to be acting on a specific type of brain cell in a part of the brain called the neocortex. That suggests “we should be looking at this particular type of cell in the neocortex, and furthermore that we should probably be looking very early in the prenatal stages for the origin of autism,” Lein says.

_65307055_autistic_boy-spl-1We all know that autism advocacy is very prominent these days, so shouldn’t a report on these exciting brain mapping developments include some kind of comment regarding the possibility of a prenatal cure? Instead, what follows in the NPR story is a discussion of how human brains differ from mouse brains, and how fetal brains differ from adult brains. The autism question is sidelined.

In a separate NBC News story, Lein held out a little more in the way of hope:

The findings are also in line with other research suggesting that early intervention can make a big difference for children with autism. “There’s converging evidence on a place in space and time where we should be putting our focus,” Lein said.

More hope for autistic children already born, yes, but still very vague with regards to prenatal implications – at least from the researchers’ vantage point. But those of us who follow such stories closely, the prenatal implications are all too clear: Once the genetic markers for mental illnesses like autism are identified and confirmed, and a test is developed that is cost effective from the heath insurers’ perspective, parents will be encouraged to screen their pregnancies accordingly, and babies destined for autism will be eliminated just as Down syndrome children are.

Does that sound crazy? Maybe, but it’s really just Margaret Sanger’s eugenicist dream come true. Sanger, the founder of what has become the international Planned Parenthood organization, was known to rail against those she labeled “morons,” “imbeciles,” and “mental defectives,” and she especially advocated for expanded birth control access for the lower strata of society in order to be rid of such persons. Sanger declared that “the greatest crime of modern civilization” was “permitting motherhood to be left to blind chance, and to be mainly a function of the most abysmally ignorant and irresponsible classes of the community.” And what Sanger wasn’t able to accomplish with birth control alone, her heirs are certainly accomplishing with prenatal testing and selective abortion.

And it’s not just mental illness and Down syndrome in the eugenicist cross hairs. Consider these sobering words from Nick Cohen writing in The Observer:

Suppose researchers claim to identify gay genes. Their discovery would be pseudo-science. A Gordian knot of environmental, cultural and hormonal influences would be as important in determining sexual preference. But there they would be on the web and in the text books: gay genes. Parents, who hated the idea of a gay child, could demand screenings and abortions. Why not? Parents who hate the idea of a daughter have unleashed a “gendercide” across China and northern India, where there are now 120 boys being born for every 100 girls.

age-dinosaur-bones-1The new research on fetal brain development is hot off the press, but we’d have to be naive to think that there aren’t people already thinking about how they can cash in on this new research – and I’m not talking about prenatal curative therapies. Let’s face it: Getting rid of a problem (in this case, human beings with a problem) is always easier (and sometimes more lucrative) than solving the problem itself.

Which calls to mind another story I heard on NPR – this time, about Elizabeth Kolbert’s recent book, The Sixth Extinction, in which she argues that, following on the heels of five massive natural extinctions, mankind is currently responsible for another ongoing global extinction of species that is as big as its predecessors, and could prove to be one of our most significant legacies on the planet.

Serious as Kolbert’s claims are, they pale in comparison to what some are calling a Seventh Extinction, in which man is projected to, in essence, wipe himself out.

Projection? It’s already happening. First, it was Down’s and girls; next it could be autism and other brain disorders; perhaps later, gays and lesbians; and then, who knows?

In any case, given the current penchant for cleansing the gene pool, it’s not a bad idea to be on guard, especially when your obstetrician starts talking to you about prenatal testing. And as far as the new fetal brain mapping is concerned, I like this comment from Brussels researcher Pierre Vanderhaeghen: “It’s always difficult to know what will come out of it.”

No argument there.

Empty Stadiums, Empty Promises

J8255969ohn Dillinger robbed his last bank here in South Bend – the Merchant’s National Bank, at 229 South Michigan Avenue. On June 30, 1934, Dillinger and his gang entered the bank, shot up the ceiling, and got away with $29,000. A South Bend traffic cop, Officer Howard Wagner, lost his life trying to intervene, which prompted J. Edgar Hoover to put a $10,000 bounty on Dillinger’s head. About a month later, Dillinger was gunned down by Chicago police outside the Biograph Theater.

The building at 229 South Michigan Avenue still stands, and you can visit it today. But it’s no longer a bank. In fact, it looks like the Cambodian restaurant that’s housed there now was always there – like it belongs there. It doesn’t even look like the building was ever a bank.

Down the street a piece from the Cambodian restaurant stands another old bank, but this one definitely retains it’s bank-y allure. The building at 911 South Michigan is an imposing edifice with big marble-looking pillars, and it’s frieze still2769984996_d9aae32fa5 bears the name, “South Bend State Bank.” It definitely looks like someplace you’d want to store your cash, maybe even today. I’m not sure what’s there now, but what you can see from the street gives an unmistakeable message of safety and security.

It seems like most banks used to be built that way – big, sturdy, stone, impregnable. It was a marketing ploy even after it became obsolete in terms of actual security – after, that is, money was not kept piled up in safes any more, but was relegated to digital blips on computers and fiber optic filaments.

Today, long after banks transmuted into storefronts in strip malls and mere counter space in grocery stores, colleges and universities have gotten into the act of building big to impress and sell.

Last fall, Colorado State University was in the news for the pricey football stadium they were building, despite the poor performance of the CSU Rams on the field. Even now, after cutting back the plans by $20 million, CSU’s president Tony Frank still insists the $226.5 million they’ll still end up spending is in the University’s “best long-term interest.”131008085725_new-csu-stadium-01

The CSU story is unfolding at a time when stories abound about the sinking relative value of a four-year college degree – and at a time when CSU itself wants to raise tuition by 5%. It seems the more colleges and universities spend on stadiums and amenities, the less cost effective it is for most Americans to obtain a college degree, especially when it involves crushing debt. And even when they do manage to get through college, many graduates struggle to find gainful employment in the fields in which they trained, not to mention the struggle to pay back loans.

So, what’s the alternative? Skip college and become, what, a plumber or something?

Well, maybe. For some – why not?

Better that than, say…, getting robbed.

 

I Will Accept No Bull From Your House

bullThrough such an admission man looks squarely at the sins he is guilty of, takes responsibility for them, and thereby opens himself again to God” (CCC 1455).

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Salt of the Earth

salt_1364790c“That simple crowd — that followed Jesus because what He said did their hearts good, warmed their hearts — this people wasn’t wrong. They…listened and sought to be a little bit better.”

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Here We Are Again

In praying, do not babble like the pagans,you-cant-take-it-with-you-dinner2
who think that they will be heard
because of their many words.
Do not be like them.
Your Father knows what you need
before you ask him.
~ Jesus

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Love Lessons in Uptown

jimmyChrist plays in ten thousand places,
Lovely in limbs, and lovely in eyes not his
To the Father through the features of men’s faces.
~ Gerard Manley Hopkins

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Of Honest Labels and Down Syndrome

Can a mother forget her infant,
be without tenderness for the child of her womb?
~ Isaiah

Driving home from the hospital after late clinicals recently, I stopped at a 7-Eleven for a snack. I wasn’t particularly hungry, but I wanted something to munch on to help me stay awake. Cheddar flavored Chex Mix looked tasty, so I made my purchase and hit the road again. The open bag sat next to me on the passenger seat, and I grabbed handfuls from time to time as I listened to late night radio chatter and finished my journey.

CCChexmix06By the time I’d gotten home, about 3/4 of the bag was gone – I guess I was hungrier than I thought – but, hey, Chex Mix has “60% less fat than regular potato chips” according to the bag, so I was probably breaking even, nutritionally speaking.

Anyway, I didn’t think about it much until the next morning when I heard Allison Aubrey’s NPR story about the FDA’s new, more realistic food labeling regulations. She used ice cream for an example, pointing out that the nutritional data on current labeling can be based on a half cup serving size – a half cup! I know, right? Who eats a half cup of ice cream? Allison comments:

I mean it wouldn’t even fill half of this mug here and it’d be up to a half cup, so most of us eat a lot more than a half cup. The new label will set a standard for the ice cream serving: one serving equals one cup, which is a lot closer to what we eat.

The story made me chuckle until I remembered my snack for the road the previous evening. I dug the empty package out of the trash and examined the label. That “60% less fat” claim? It’s based on a serving size of – you guessed it – a half cup. Then I did the math. According to the old FDA guidelines, my late night nosh was closer to being a meal calorie-wise. In fact, the FDA would’ve had me sharing that single little bag of Chex Mix with an additional two and a half people! Am I a pig or what?

So, three cheers for the FDA! Under their new rules, my Chex Mix bag would’ve provided me with significantly more candid insight with regards to what (and how much) I was jamlabel-reading-girl-HP-610x300ming down my pie hole. No doubt, it wouldn’t have made a whit of difference in terms of the outcome (that is, I probably would’ve consumed about 3/4 of the bag anyway), but it might have, and that’s the point. Sure, sure, caveat emptor – “let the buyer beware” and all that. Yet basic trust is at the heart of our economy’s compact between consumers and producers, and misleading product information is no better than information that is blatantly false. In fact, misleading information is worse: It’s harder to detect and account for.

All of this reminded me of another NPR story that had just aired the day before the one about FDA labeling. This one was by Rob Stein, and it was about a new prenatal blood test that is proving to be highly accurate – and much less risky – than the standard procedures for diagnosing birth defects.

Until now, checking for fetal abnormalities involved a hit-or-miss hormonal blood test that regularly produced false positive results. Consequently, additional testing was required, including ultrasounds, but usually a more invasive test as well – either chorionic villus sampling (CVS) or amniocentesis. Both of these exams involve obtaining a intrauterine sample, and then scrutinizing it for subtle signs that something is genetically amiss with the baby.

Amniocentesis and CVS are highly accurate when it comes to diagnosing chromosomal fetal abnormalities, but both tests are risky. They require inserting an instrument into the uterus – either a needle through the abdomen or a tube through the cervix – and that means potential harm to the baby, and possibly even a miscarriage.

The new procedure – dubbed “verifi” (sic) by the manufacturer – changes all that. It’s still a maternal blood test, but instead of checking hormone levels, it isolates bits of fetal DNA that circulate in the mom’s bloodstream and correlates them with estimated gestational age. Too much DNA? A chromosomal anomaly like Down’s is suspected. A recent study published in the New England Journal of Medicine (NEJM) confirms that Verifi is a highly accurate test – about ten times more accurate than the old blood tests.

pregnancy blood test 300Verifi is not infallible, however, and a positive result would still require CVS or amniocentesis to get any kind of certainty. Still, the Verifi prenatal blood test greatly reduces the chance of false positives, and so it has the potential for slashing the number of women who feel compelled to get the more dangerous invasive procedures.

Sounds good, right? Prolife even, in a way.

In keeping with the FDA’s renewed vigilance with regards to candid product information, let’s dig a little deeper and check the label – or, rather, its equivalent on the Verifi website:

Shed much needed light on the chromosomal health of a developing fetus with the reassurance of reliable answers only the verifi® prenatal test provides. [T]he verifi® test delivers accurate genetic information safely, non-invasively,… [a]nd all of this vital knowledge can be yours in as little as 1 week’s time. Now that’s reassuring, enlightening and empowering (emphasis added).

Reassuring, enlightening, empowering. It’s right there in the Verifi ad copy. Let’s consider what meaning those words convey.

To begin with, Reassuring. That can only refer to negative Verifi test results. Based on the manufacturer’s claims and the NEJM study, expectant moms who get those negative results can be pretty confident that their babies are developing normally, and no further tests – invasive or otherwise – will be required.

Enlightening? That must be in reference to the quick test result turnaround and it’s accuracy. Obviously, the women getting these tests are hoping for a negative result, but even if it’s positive, it’s reliable information that was previously unattainable, and it’s provided quickly.

Which brings us to the third descriptor: Empowering. For insight as to what Verifi means by empowerment, we can look further on the website “label” – like this question from the website’s FAQs page: “I don’t have an increased risk for Down syndrome, but I am really worried about it. Can I have this test?”

That’s a clue to the real agenda of Verifi, although it’s otherwise barely discernible on it’s online label. The brutal truth is that Verifi is intended to refine the targeting of Down syndrome for elimination. It’s generally acknowledged that about 90% of babies diagnosed prenatally with Down syndrome are aborted, although that figure is somewhat controversial. Still, does it matter if it’s 80% or 50%? Even 1%? The fact is that our culture and our healthcare system have decided to eradicate Down syndrome as if it were a virus, and tests like Verifi provide an elegant (and profitable) means of furthering that end.

Down syndrome is still commonly referred to as a “birth defect,” and organizations like the March of Dimes still pay lip service to the idea that identifying 253140_10151294010543973_1933169162_nDown syndrome prenatally can allow the parents time to “prepare medically, emotionally and financially for the birth of a child with special needs, such as arranging for delivery in a medically appropriate setting.” But who are we kidding? Even the March of Dimes know that most families, when faced with hard news, will “consider the diagnosis and their options” – and when they say “options,” is there really any doubt that they mean “termination” in most cases?

Here’s the deal when it comes to Down syndrome and prenatal testing, especially since positive results so often lead to abortion: We’re not fixing a problem, but rather getting rid of the people who have the problem; we’re not reducing the incidence of a disorder, but rather reducing the sample size; we’re not curing a syndrome, but rather killing those who have the syndrome. And is this really going to make the world a better place? Is it just? Is it civilized? Isn’t it really a kind of genocide?

In the end, it does come back to inaccurate labeling, but not just the labeling on prenatal tests. More importantly, it’s the grossly inappropriate “defect” label that we insist on attaching to children with Down’s and similar conditions. No wonder our society is inclined to get rid of them!

In contrast, consider these words of Dr. Brain Skotko, a Harvard geneticist, who offered an alternative vision in the NPR story:

People with Down syndrome are artists. They’re poets. They’re athletes. Their lives are happy ones and fulfilling ones. I have a sister with Down syndrome who certainly is a life coach, for not only myself, but for my entire family. If the new tests become a routine offering, then we have to start to ask: Will babies with Down syndrome slowly start to disappear?

Pray for those with Down’s – they are not defective. Pray for their parents, their families, their friends. The world needs these witnesses to the truth that all human life is sacred and intrinsically precious – from the moment of conception, and regardless of chromosomal variation.

And with regards to Verifi and prenatal testing? Caveat emptor.

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A version of this story appeared on Crisis.

The Failure of St. Dominic

st-dominic-praying“Although Dominic had hoped to journey to barbarous lands to preach and eventually to achieve martyrdom, this was denied him.”
~ from The Lives of the Saints, Father Joseph Vann, ed. (1954)

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The Health Benefits of Not Getting Pregnant

babies I guess you can’t argue with science.

In case you haven’t heard, various studies claim that not having a baby is considerably safer than having a baby. Epidemiologically and statistically, they argue, the risks of pregnancy and childbirth are greater than the risks of contraception, or even abortion. But people keep having babies, so what’s the deal? Obviously, family planning advocates have done a lousy job getting the word out.

From a public health perspective, I suppose, it’s a simple “do the math” thing: Too many kids already strain the resources of our healthcare system, our government, and the environment, and now we have scientific proof that not having babies is actually healthier and safer than having them. So just stop already! It’s for your own good!

That got me thinking.

There must be plenty of other common human activities that are fraught with statistical risk which aren’t receiving the attention they deserve. I’m musing about all this while munching on a bagel, with a cup of coffee at the ready, and then it dawns on me: Eating! Now there’s a risky activity!

Think of all the choking hazards involved in swallowing, or the possibility of inhaling your latte as you laugh at a Vine on your tablet. What’s more, think of all those folks scalded by their hot beverages, probably daily. AND IT DOESN’T MATTER HOW BIG YOU MAKE THE WARNING ON THE CUP, ordinary folks, caught up in the rush of daily existence, will still disregard how hot their coffee is and spill it in their laps.hot

Plus, there’s our obesity epidemic – people just eat too damn much! We’re reminded of this by the First Lady and a host of celebrities all the time via PSAs on every conceivable platform. And we don’t even need their reminders – the magazine covers in the grocery store checkout lines do a pretty good job already, with their svelte models and headlines about the latest celebrity diets.

So, with apologies to Jonathan Swift, I’d like to modestly propose a new public health campaign. I’m calling it: EATNOT!

It’s simple, catchy, and very green –  think of all the plant life that will be spared if we simply halted harvesting. I’m counting on environmentalists – and PETA activists, of course – to be among the first to take up the EATNOT! cause.

And consider the public health advantages! No more aspiration pneumonia, no more choking – the Heimlich Maneuver will go the way of the rotary phone. And, like last summer’s tan, obesity will simply fade away, along with the associated higher risks of cardiac problems and diabetes. This a no-brainer – why haven’t we thought of it before?!

“Ah,” you say. “You’re forgetting that our bodies require nutrients and fluids to function. How will the EATNOT! campaign address that significant drawback?”cop_content_386883

I’ve got three words for you: Total Parenteral Nutritionor TPN as we call it in the healthcare biz. It’s a fairly common treatment in which all the nutrients and fluids you need are administered directly into your veins. Eating and digestion are bypassed completely, and the doc (with help from the pharmacist) steps in to totally take over your metabolic equilibrium needs.

Usually, TPN is reserved for the very sick – those enduring cancer or other ailments which prevent them from taking in oral nutrients at all, or simply not enough. The risks are low – mainly the possibility of infection to the catheter inserted in the blood vessels – and occasional lab work allows tweaking of the TPN formula to optimize nutrition and health.

So, obesity issues? No prob! Just reduce the calories in the next few bags, and watch the weight fall away. And how about other medical advantages – like diabetes management, for example. Blood sugars all over the map? Simply adjust the carb and insulin components in the formula, and you’ll have smooth sailing, endocrinologically speaking.

As you can imagine, TPN is pretty expensive, but once you factor in the cost savings – no more obesity alone means considerably less spent on heart disease, stroke, hip and knee surgery, etc. – then I think you’d agree that this is a campaign that deserves serious consideration.

Scrooges_third_visitor-John_Leech,1843On the other hand, getting a bag full of nutrients run into my vein isn’t quite the same as enjoying a bagel and a cup of joe – especially if I’m fortunate enough to be sharing them with a friend. True, it would be so much more efficient to have the intravenous treatment, but not nearly as pleasant, nor as conducive to conversation. Could it be that meals are more than the delivery of nutrients, and nutrients themselves are more than simply nourishment? Darwin would tell us that we have taste buds and appetite primarily for survival, yet can it be simultaneously acknowledged that those human features have a purely sensual value as well, not to mention a communal one?

I’m envisioning a big family dinner. As everyone enjoys the food, they talk. They laugh, they cry; they celebrate and mourn; they nourish themselves while they nourish relationships. Perhaps God gave us hunger and taste not just to get us to eat, but also to enable us to feast, and to feast is to join with others in eating extravagantly – something hard to accomplish via an IV drip.

G.K. Chesterton asserted something along these lines when he wrote about Omar Khayyam’s practical approach to drinking wine:

It is bad, and very bad, because it is medical wine-bibbing. It is the drinking of a man who drinks because he is not happy. His is the wine that shuts out the universe, not the wine that reveals it. It is not poetical drinking, which is joyous and instinctive; it is rational drinking, which is as prosaic as an investment, as unsavoury as a dose of camomile.

Are there risks involved with actual eating? Dangers and downsides? Temptations even? Yes, but I’m thinking that focusing on the risks misses the point – i.e., that feasts are more about the feasters than the food, and more about the stuff of living than the stuff of health. Maybe my EATNOT! campaign isn’t such a good idea after all.

The same goes for avoiding babies for health reasons. “All birth control methods are safer than childbirth,” Planned Parenthood informs us. I’m no statistician, so I won’t try to rebut that. Even so, like the image of someone choosing TPN over eating to avoid risk, there’s something downright silly – even ridiculous – about contrasting the risks of childbirth with the benefits of having another baby.

And for those not convinced, I offer this as supporting evidence in favor of risking childbirth: A Coke commercial from Argentina that went viral late last year. It’s hawking cola, I know, but it also tells a beautiful story of real family life in a mere 60 seconds.

Those of us with children know these emotions very well. Sure, having a baby can be a challenge. Sure, parenting is hard, and life with kids is bumpy. And, sure, there are plenty of risks involved with all of this, even dangers. But is it worth it? Should we take the risk?

I say: Feast!

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A version of this story appeared on Crisis.

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