The Bicameral Mind

Time to unwrap the Jeremiad again, I’m afraid; I’m getting tired of this. Really tired. I know it’s an American thing, but stop it will you? Or can you? Every time there’s a bicameral shift it tears the fabric a little more and unravels what I want to believe about your country. Yes, I’m Canadian and watching with unvetted eyes I guess, and yet sometimes it is good to hear from the other side of the mirror. To listen to the indrawn breath and pause to look around. Sometimes acumen travels in disguise: the dusty traveller leaning on the fence, the unwashed face of Vishnu. Wisdom does not always wear a flag.

One of the things I’m referring to, of course, is the perpetually probationary status in the United States of both family planning and pregnancy termination. Women’s rights seem contingent upon the prevailing ideology, their status as stable as the government in power -guaranteed only conditionally, and as changeable as the pen that underwrites them.

As a non-combatant, I suppose I should only listen with firmly closed lips; perhaps the border should be a closed curtain so I cannot see through. And maybe I should apologize for being so critical, but when is this vacillation going to stop? I accept that there are valid differences of opinion, and that any decision is inevitably temporally adjudicated. Times change, and so do populations and their ethnic and cultural compositions. It’s happening to us all. But surely the answer isn’t to retreat behind the doors and barricade the walls.

And defunding organizations that seek to address the issues of involuntary overpopulation would seem unduly parochial and even internationally misunderstood. It is the special duty of an enlightened nation to accept that there are many roads and many destinations. It has, it seems to me, the burden of reasonable neutrality, grounded observation, and judicious guidance.

The issue, I think, should be one of choice not fiat. Conscience, not doctrine. To offer alternatives is not to coerce, nor to prejudice the selection; it is surely to achieve the goal for which the options were offered in the first place. Not all things are equally acceptable; not all choices are politically or culturally permissible, to be sure. So a variety of solutions might have a greater likelihood of admissibility. A greater possibility of success.

Several years ago, I travelled to the States to attend a gynaecological convention and discovered that not only was pregnancy termination still an inflammable topic for many delegates, but even the provision of Family Planning counselling for whoever requested it. I found this hard to understand, especially at a meeting of specialists in the field.

I remember questioning one of the doctors I met there and she rolled her eyes at my Canadian naïveté. “Do you remember that fable of Aesop called ‘the Belly and the Members’?” Now I felt really naïve because I had to shake my head.

She seemed surprised. “Well,” she said, after interrogating my face for a moment to make sure I wasn’t kidding her. “The version my daddy told me when I was young went something like this. One day, after carrying the body through a long day of heavy work, the feet complained that they seemed to be the only ones in the body who had to work. Of course the hands argued with them that they were the ones who should complain -the feet may have carried the body, but they had to carry and even balance the load. The only thing they could agree on, after a long argument, was that although the four of them worked all day, in the end it was the stomach who got all the food.

“So, they devised a plan. The feet refused to walk to the stove, and the hands refused to pick up any food.”  The doctor smiled at this point and pierced me with her eyes. “And you can guess what happened after a while… They all got weak and finally had to agree to work together. Only the stomach could give them the strength they needed.”

She giggled at the end and touched my arm playfully. “I can’t believe you didn’t know that one, doctor.”

I hate it when a colleague calls me ‘doctor’, but I let it pass. “And I take it the fable is telling us that we all have to work together, no matter that we’re different? And that we can all have different opinions?”

Her expression changed and a puzzled look crept onto her face. “Never thought of that, actually… My daddy said it meant that we all have our jobs, but need someone –something- watching over us to give us strength and direction… Reminding us of what we should do. He said the Stomach was our Conscience… But I think he really meant the President… Or maybe the Lord…” She shook her head in apparent disbelief at my interpretation. I blinked, because it didn’t make sense to me. I wondered if she’d remembered it wrong.

“You must have similar fables even up there in Canada…” I could tell she was trying to understand my confusion. Transcend boundaries.

“Well,” I started, just like she had, “I do remember one about chopsticks…” She smiled at my multiracial example –so Canadian. “It was something one of my Chinese patients told me after giving me a little gift for delivering her baby. She said her father had told her this when she was a child.

“’There was an old man,’ she said, ‘who was close to death, and worried about what would happen after he died. He decided to ask the wise village elder if he knew what it would be like in Hell. The elder smiled and told him to imagine a large room filled with people. ‘They are all thin and hungry,’ he said ‘even though there is food everywhere.’

“’Then why are they so thin,’ the old man asked?

“’Because their chopsticks are each ten feet long,’ was the answer.

“The old man thought about it for a minute. ‘And Heaven,’ he asked, ‘What’s it like in Heaven, then?’

“The elder laughed. ‘Imagine another large room. There is food everywhere, but the people are fat and happy in spite of their ten foot long chopsticks…’

“The old man was puzzled. ‘But… I don’t understand.’

“The elder smiled and put his arm around the old man. ‘In Heaven, they feed each other…’”

Perhaps, I thought, after watching my colleague’s reaction, perhaps there is something more profoundly different about our two countries than simply the colour of our mailboxes…

The Night of the Undead -Condom, that is… (female condom, I mean)

They’re back! Well, sort of… My somewhat sketchy memories of them -professional, you understand- are that they resembled the plastic bags you get at a supermarket… not female condoms (FC1s). They didn’t look at all like condoms! In fact, I still remember the jokes about needing Walmart greeters on entry and theft alarms on exit -this from the women themselves. No one seemed particularly enamoured of the concept: they were apparently made of polyurethane and quite apart from the distracting noise they made during use, they were ungainly not to mention unsightly. To use one at all required unprecedented devotion to the product and a fair amount of lead time…

Ahh, but they’re back; this time with fresh clothes: the new and apparently improved FC2 is made of non-rustling synthetic latex (as reported in the BBC News magazine : http://www.bbc.co.uk/news/magazine-25348410 ). I mean, the concept is a good one: empower the person who would suffer most from a pregnancy -the woman. And the article cites other advantages of the device as well: ‘They can be inserted hours before sex, meaning that there is no distraction at the crucial moment, and they don’t need to be removed immediately afterwards. For women, there is better protection from sexually transmitted infections, since the vulva is partially covered by an outer ring that keeps the device in place.’ All well and good; hard to argue with that… I guess.

Perhaps I am being overly critical, but I begin to sense a car salesman approach to a more professional selection in an article recently published in Lancet Global Health about three new models of the female condom: ‘The Cupid is available in India, South Africa and Brazil. It is vanilla scented and comes in pink or natural colours. It is currently the only model besides the FC2 to have been qualified by the World Health Organization (WHO) for public-sector purchase. A smaller version aimed at the Asian market is in trial.’ I suppose anything you can do to spruce up a classic is worthwhile if it makes it more desirable…

Innovation is what drives industry and no doubt adding variations to something I hadn’t even thought about for years, will appeal to a new and younger audience. A different audience. Several models -or at least their names- tweaked my interest. One, called the Air Condom -apparently available in Columbia- has a little pocket of air somewhere in it to make it easier to insert. And then there’s the Panty Condom (gotta love the name) that ‘is packaged with a special pair of knickers’ to keep it in place. Wow. That’s gotta appeal, eh?

But is merely sprucing up an old idea enough? I can’t help but wonder why the female condom never achieved much success in the first place. Is making a re-usable product -as some have suggested for poor countries- the answer? Or even an answer? I mean, would you hang it on the line to dry..? There must be something vaguely anathema about it -something subtle, perhaps embarrassing: something unsettling in the background. Or maybe it comes from the male partner and his unwillingness to countenance it. Who knows..? It might be as simple and intuitive as the idea that it’s better to Saran-wrap the outside of a stick than the inside of a glass. Anybody’s guess, I suppose.

And yet, whether the female condom ever takes off (no pun intended) I think that all is fair in family planning. Anything that adds a little spice to it, or makes people realize they have options is good. There’s an article in the Huffington Post with an interesting variation on this theme: ‘To Promote Family Planning, Let’s Have More Controversy’ ( http://www.huffingtonpost.com/christopher-purdy/to-promote-family-planning_b_4174943.html ) In other words, if people are talking about it -whether positively or critically- they’re thinking about it. Discussing it …and publically! Even condemnation provokes worthwhile response.

A good example of this is another mention in the Huffington Post of the Gates Foundation awarding grants for ‘Condoms of the Future’: http://www.huffingtonpost.com/2013/11/20/gates-foundation-condom_n_4312699.html Make male condoms interesting; make them exciting; make them up front and used above all. So if men aren’t happy with female condoms, make them happy with the testosterone version. Let men think they’re the ones leading the fashion parade. Let them think they’re in control… As long as family planning is out there and -dare I say- sexy in the community at large, everybody wins. Maybe even a souped up multicoloured twenty-first century retro model like the female condom. Personally, I’d change the name…