Let’s talk about sexual harassment in academia

[Content note: In addition to the potentially triggering nature of the topic at hand, I’m probably going to curse a lot.]

It’s been in my news feed again.  Two cases of sexual harassment by professors—one recently at Caltech, another a decade ago in Arizona—came out in the same week.  Both were in the same field—astronomy—that was shaken last fall by the news that a prominent professor at UC Berkeley had been harassing women for years.  All of this, of course, spawned a flurry of pieces about “the sexual harassment problem in astronomy,” as though it’s something that’s contained to one distasteful little community that hasn’t caught up with the 21st century.

So let’s get one thing out of the way before we go any further:

Sexual harassment isn’t limited to any one field.  It isn’t just astronomy.  It’s anthropology.  It’s physics.  It’s philosophy.  It’s everywhere.  This happens all the time, people.  All the time.

It happens outside the academic world too, of course, because people suck and society isn’t nearly as enlightened as it likes to think.  But the way careers are structured in academia makes those lower on the hierarchy particularly susceptible: students and postdocs are typically supervised by a single advisor, and their careers depend on that advisor’s good word and networking connections.  While it may be hard to quit a regular job and find a new one when your boss is an asshole, it’s nigh on impossible to do so in academia.

One more preliminary note:

People of any gender can harass people of any gender.  However, I’m going to use pronouns that assume the harasser is male and the harassed is female.  Why?  Because that’s what all the recent examples have been.  And because loads and loads and loads of studies have shown that that’s the most common scenario.  And because the societal response to sexual harassment stories tends to be very gender-biased.

That response is one of the things I want to talk about, actually.  This next point is addressed to men in general, and particularly to men who want to not be assholes:

Dudes, you have to stop getting defensive.  (Or, as Hope Jahren puts it, calm the fuck down.)  When a story comes out about a male professor sexually harassing a bunch of students, that’s not an attack on you.  If you take it like it’s an attack on you, what you’re actually saying is that you would prefer to continue telling sexist jokes and hitting on your underlings and generally not having your power threatened in any way.  When you say, “Enough of talking about this, let’s get back to research,” what you’re really saying is that you’re an asshole.

“But I’m not an asshole!” you might say.  “I’m just worried that I’m going to say something that gets taken the wrong way!”

No.

Are you sticking your hand up grad students’ skirts?

Are you holding meetings at strip clubs?

Do you tell your underlings they would teach better without underwear?

(All of the above are real examples from the three recent cases in astronomy.)

It’s not about innocent actions being misinterpreted.

We all know that there are a fair number of people in academia who are socially awkward, and that people sometimes unintentionally say things that can be taken the wrong way.  New flash: women can be awkward and nerdy too!  We get it!  When we talk about ending sexual harassment, we don’t mean kicking you out because you complimented us on our shirt that one time.  If you read the cases linked above, these are all people who persisted in creepy, manipulative, intentional behavior for years.  They were all told—often multiple times—that their behavior was inappropriate.  They were also all found, after full investigations by their universities, to have violated campus policies.  They got due process.  They’re already swimming in the benefit of the doubt.  Nobody owes them any more.

Another thing that seems to get men all up in arms is the belief that anti-harassment policies will cramp their dating style.  Here’s a hint, dudes: if your dating strategy constitutes sexual harassment, you are doing it wrong.  I can speak from experience on this—I managed to date and marry someone in my field without anyone being creepy or anyone getting harassed.  I know quite a few grad students who’ve dated other grad students, in their own departments and elsewhere.  And heck, I think half the faculty in my department are married to each other.  So go ahead, have relationships, fall in love.  Just don’t be a fucking jerk about it.  Don’t feel like you’re entitled to women’s attention, or that you have a right to keep making flirty comments if someone asks you to stop.  And definitely don’t try to date your students.

Whew.  OK.  Moving on.

A lot of the narratives about sexual harassment in the news of late proclaim that we are making progress.  That we are going to Stop The Harassment from here on out.  “Astronomers are finally doing something about sexual harassment,” proclaimed The Atlantic in a piece that came out, rather ironically, a week before the latest two cases were revealed.  I suppose the academic world has made some progress—we’re actually talking about this stuff.  There exist offices at universities to whom one can report issues.  But…

Departments aren’t doing anywhere near enough.  In the sexual harassment cases at Berkeley and Caltech, there were great big shining fat red flags that were ignored.  Over the course of seven years at Caltech, the professor in question had graduated just two PhD students.  Which is maybe not that odd, given how long PhDs take to complete, except for the fact that nine students had started working in his group and then left.  Some report that they left because he was a jerk; others were “fired” (which isn’t a normal thing at the PhD level).  Even without any of the sexual harassment, the man was clearly a terrible advisor.  And yet he got tenure.

At Berkeley, the situation was even worse.  Students reported multiple instances of harassment to the department chair back in 2005 and were waved off; a year later, they tried complaining at the university level and were ignored.  Even when the university finally did get its act together and do an investigation, the results of that investigation were kept under wraps.  It wasn’t until BuzzFeed broke the story months later that the man was actually asked to resign.

I know of many more cases like this, some because they’ve been shared publicly, some because they’ve been spoken by people I know.  For all the hype about how prestigious it is to be a university professor, departments do an awfully shitty job of getting rid of people who don’t deserve to be there.  It often seems like the powers that be don’t give a damn about junior people.  They certainly don’t listen to us.

(Why yes, I am bitter about this.  I have thankfully not had any personal experience with sexual harassment, but I have had the lovely experience of working for an advisor who was absolute crap at their job and yet got promoted anyway.  Meritocracy, my foot.)

To wrap this up, I’d like to make a point about how this fits into the bigger picture of women in science.  Which is to say, it’s only one part of the story.

Sexual harassment isn’t the only thing driving women out of science. (And math, and tech, and various other traditionally male fields.)  Not that it isn’t a big problem.  If you think of the “leaky pipeline” metaphor for women in STEM, sexual harassment is like someone chopped off a fire hydrant and now water is just spraying everywhere into the street.  You’ve got to cap that off or all of your other efforts to fix leaks are useless.

But all the other leaks are still there.  Regular ol’ sexism is still there.  The whole structure of an academic career, which expects you to be unattached and willing to work 80 hours a week, or else have a stay-at-home spouse who doesn’t mind your long hours and is willing to move around the country (or world) with you every few years, is still there.  Imposter syndrome is still there.  If you write an article talking about how sexual harassment is The Thing keeping women out of science, then you are wrong.

Referring PhD students to counseling is treating the symptoms, not the disease

I went off on a bit of rant on Twitter yesterday, starting with the sentence above.  Around about the 7th or 8th tweet, I realized that I needed to work this up into a full-fledged blog post.  So here we go.

Two things set off this rant.  The first was reading the latest in a long line of articles about the mental health problem in grad school.  Don’t get me wrong, it’s a fine article, and the more people talk about this, the better.  However, like many of its predecessors, it focuses on access to counseling and other mental health care as the solution.  That’s absolutely important, and so is emphasizing the message that it’s OK to seek treatment.

But offering counseling and antidepressants is just treating the symptoms.  If my toddler woke up with a dangerously high fever, I would give him Tylenol to bring it down, but I’d also take him to the doctor, where the cause of his fever would be evaluated and treated.  If all the kids at his daycare came down with the same serious illness, the staff would give us all information about how to get them treatment, but they’d also clean the heck out of everything and assess whether their hygiene policies needed changing.

Along those same lines, we need to talk about why anxiety and depression are so prevalent among PhD students.  As the links above describe, graduate school causes mental health issues in many students, and exacerbates existing issues in others.  We need to make sure that those students who are suffering feel comfortable asking for help, but we also need to fix the system that’s causing this psychological epidemic in the first place.

I’m sure there are people out there who think that this is just how a PhD has to be, and sure, pushing yourself to your intellectual limits is always going to be hard.  But don’t you think people would do better—be more productive, produce better work—if the system didn’t function in a way that made them miserable?

The second trigger to my rant was a discussion that took place at a gathering of female postdocs and PhD students in my department.  It was a meeting to chat with last week’s (female) colloquium speaker.  Based on who organized this particular meeting, I suspected that any advice might tend toward the useless kind, but I went anyway.  (There were donuts, what can I say?)

The organizer and the guest of honor were both the kind of postdoc that the department likes to bring in to tell all us PhD students “how to succeed:” people who’ve won an especially prestigious postdoctoral fellowship, the kind that will get their resumes placed at the top of the pile in faculty searches.  These people tend to be extroverted, assertive, even cocky; in grad school, they did “groundbreaking research” and somehow managed to publish a half-dozen first-author papers.  Be like these people, goes the message, and you too can be successful and awesome.

This is the mold.  This is the person the system says you have to be.  There’s an underlying assumption that it’s possible, if you just work hard enough, for everyone to become this person—and that if you don’t, it’s because you didn’t try hard enough.

Which brings me back to why I’m not OK with “make counseling more available and less stigmatized” being presented as the full solution for poor mental health among PhD students.  It relieves the system of the burden of change and puts it on the individual students.  There is something wrong with you, says the system.  Go get that taken care of, and when you’re all fixed up, come back and fit yourself into our mold.  

Let me end with a personal example, in hopes of further clarifying my point.  One of the pieces of advice we always get is to talk to lots of faculty who aren’t your research advisor.  Make yourself seem more awesome.  Cultivate people who can write letters of reference for you in the future.

The problem with this advice isn’t its content.  Networking is an important skill that will serve you well in just about any occupation, and fundamentally, people won’t learn about your research unless you tell them about it.  No, the problem with this advice is that it’s universally delivered from the perspective of a confident, gregarious extrovert: “Just go talk to professors!”

I’m a shy introvert with major social anxiety—it’s incredibly difficult for me to “just go talk” to anyone, much less someone who’s presented as an evaluator and an important part of my career.  Talking to someone—taking up their time—makes me feel like I’m being a huge imposition.  These are my issues to overcome, and they do require real mental health care.

But you know what else would really help?  A system that acknowledges that this is hard for me.  A system that is just the tiniest little bit more encouraging of these kinds of interactions.  That reassured me that I’m not doing something dramatically wrong and weird and awkward when I knock on a professor’s door and ask to chat.  That doesn’t treat every discussion about research as an evaluation of me, designed to make the questioner look good.  And above all, a system that doesn’t assume that I’m a bad researcher just because I don’t fit the mold.

Don’t be like this obnoxious breastfeeding advocate

On Friday, I came across science journalist Tara Haelle’s latest piece in Forbes, titled “How Toxic Is Your Breastmilk?”  The headline is pure clickbait, but the article itself is a well-written discussion of a recent medical study.  Breastfeeding mothers need not worry: the “toxin” in question has no known major effects on humans, and the study was conducted on a small, isolated population and may not be widely applicable.

Besides the well-researched reporting, what I really liked about this piece was its overall attitude toward breastfeeding, namely, that it’s good and has known healthy benefits, but it won’t make your child into Superman or Wonder Woman.  The article starts with this:

Contrary to popular belief in some circles, breastmilk is not the pure and magical serum of the Earth goddess which ensures an eternal life of prosperity and good health to all who partake. That’s unicorn milk — it doesn’t exist.

And ends by affirming:

The real take-away, it would seem, is that there is no perfect, “right” way to feed a baby. […] But breastfed and formula-fed children all across the world are all leading happy, productive lives. So carry on. Feed your baby.

Absolutely.  Ab-so-fricking-lutely.  I want to write this on a sign and shout it from the rooftops.

I’ve written before about how the media and zealous breastfeeding advocates tend to over-exaggerate the benefits of breast milk.  It was so nice to see a balanced, positive take on this frequently guilt-inducing issue that I shared the article, first on Twitter (where I am pseudonymous), and then on Facebook (where I am not).

“Don’t panic, your breast milk is probably fine,” my Facebook post began, followed by a brief note about the way the advantages of breastfeeding tend to be over-hyped.  The first few comments I received were normal conversational stuff.  Some friends and I commiserated about how the study referenced in the article was woefully limited, yet the article itself described it well.

Then stuff got weird.

Specifically, a trio of my husband’s relatives started commenting, led by a woman I’ll call J.  All three of them work in health care.  J is the mother of a toddler, whom she breastfed throughout his infancy.  Like many women, she struggled with latch and other issues early on.

J et al. COULD NOT DEAL with the idea that breast milk might be anything less than 100% perfect baby food for 100% of children.  Over the course of a number of comments, they took it upon themselves to inform me that:

Breast milk contains hundreds of compounds that we don’t know how to synthesize and so aren’t in formula.

Yeah, I know, that was the third slide in breastfeeding class.

Breast milk transfers mom’s antibodies to baby, so baby is less likely to get sick.

Uh-huh, that was mentioned in the article, and, you know, everywhere else.

Breast milk has evolved to be the perfect nutrition for babies. 

OK, but you realize this article was about man-made contaminants, right?

The article and specifically my “Don’t panic, your breast milk is probably fine” comment are “scaremongering.”

I see where you’re coming from on the article title, but are we working off of different definitions of “don’t panic”?

Breastfeeding reduces postpartum depression because it promotes “connection and bonding.”

Wait, are you trying to imply that mothers who bottle-feed have trouble bonding with their babies?  The research is also more complicated than that: if you try to breastfeed but fail, your risk for postpartum depression is much higher than if you formula-feed from birth.

The man-made chemicals in formula and the potentially-contaminated water it’s mixed with are way more risky.

I’m not sure the best response to “don’t freak out about chemicals” is “freak out way more about these OTHER chemicals.”  Also, everyone involved in this conversation lives in developed countries with safe water supplies…

Also, opened cans of formula can be contaminated with bacteria.

Uh, guys, you’re turning this into a hate-on-formula party and I’m not OK with that.

And parents mess up formula mixing all the time.

I’m starting to really not be OK with this conversation.

They are offended by the last paragraph of the article.

Uh, you mean the paragraph that says formula-fed children are leading happy and productive lives and feeding your baby is the most important thing? Um…

This article and/or study might’ve been funded by formula companies.

(Actually, they wouldn’t come right out and accuse the study of this, but just kept trying to passive-aggressively imply it.)

Mothers who “can but won’t” breastfeed are “selfish.”

Oh.  No.  You.  Didn’t.  You did NOT just say that.

Did I mention that J not only works in health care, she cares for newborn babies in the hospital?  That’s right, she’s looking after infants while judging the snot out of how their mothers choose to feed them.

Needless to say, the rest of the conversation did not go well.  I did learn what had set J off so intensely, though.  In the course of an increasingly angry back-and-forth, she brought up her own struggles with breastfeeding, telling me that she found it “very insulting” to be told that she “could have saved all that trouble and just formula fed him and he would be just as well off.”

Way to insult everyone who’s ever given their baby formula, J.  Good on you for persevering, but you do not get to make yourself a martyr and decide that everyone who makes different choices is “selfish.”  Because you know what?  Formula-fed babies ARE perfectly fine.  Sibling studies show that pretty clearly.

So yeah, it’s been an emotionally exhausting weekend.

Referee report ridiculousness

Research has been a huge, tedious drag this week—even more than usual, I mean.  At least I still feel like I’m inching ever-so-slowly forward.  I’m responding to the referee’s report on the Paper From Hell.

For my non-academic readers, when you submit a paper to a scholarly journal, your paper gets sent out to one or more reviewers.  These reviewers, or referees, decide whether the paper is worth publishing.  This system is called peer review, although grad students don’t typically do the reviewing, so the referee isn’t really my “peer” right now.  Anyway, if the referee thinks your paper is OK-ish, he or she writes a bunch of comments on how to make it better.

The good news is that the Paper From Hell was not rejected.  It’s likely to be published with maybe one more round of edits after this.  The really good news is that the referee (there’s only one in my case) made almost zero comments on my interpretation and conclusions, which I frankly think are the shakiest sections of the paper.  Nearly all of her/his feedback has to do with the technical stuff.  That stuff is solid; apparently I just have to make sure I explain it re-e-e-e-e-e-ally clearly.

The bad news is that my referee clearly doesn’t work in my (fairly broad) subfield, and has asked a bunch of rather dumb questions as a result.  There’s always a fair point to be made that if your reviewer didn’t understand something, other readers might also not understand it, and therefore you should make it clearer even if it already seems obvious.  And so I do, but not without rolling my eyes.

One part of the Paper From Hell, roughly two paragraphs long, says (and I’m paraphrasing here, obviously), “To accomplish Z, we did X, and then we did Y.”  The referee asks:

1) “To accomplish Z, did you do Y?”

2) “When you did Y, did you do Extremely Common Technique, or did you do Thing That Doesn’t Actually Work For Y?”

3) “Where you say that you did X, you should say that you did Y instead.”

These really are three separate comments in a 23-point list.

Item #15 was easy.  “You should show some figures of Q.  See item #21.”  Item #21 turned out to be a repetition of this request, along with more specific suggestions on what she/he wanted to see in these figures.  It remains unclear to me why it was necessary to list these as two distinct points.

The general cluelessness of the comments has left us debating whether our referee is a young, inexperienced person or a cranky old guy.  I’m leaning toward the latter.  The phrasing of the comments gives off a subtle vibe—it could just be in my head, but it’s persistent—of implying that we didn’t have a clue what we were doing.  Let this be a warning: beware of adopting that tone, lest it turn out that it is in fact you who are the ignorant one in the situation.

Still, in the end, it could be a lot worse.  I’ve tidied up some paragraphs, added a couple of new figures, and written some stuff about how “we thank the referee for a constructive report.”  I’ve tracked down some fiddly details from my co-authors (which involved some truly absurd conversations, but that’s a story for another day).  The referee will hopefully be happy with our response, and I in turn will be happy that I never have to work on this paper again.

Stop acting like C-sections are always terrible

The concept of “gentle” C-sections has been making the news lately.  (Well, actually, I think it was making the news rounds back in March, but a friend recently brought it to my attention again.  They’ve been available in some hospitals for several years.)  In a nutshell, a gentle cesarean means allowing the mom to watch her child’s emergence, then laying the baby immediately on the mother’s chest.  The newborn thus gets immediate skin-to-skin contact, just as is recommended after a vaginal birth.

I think this is a great idea.  It wasn’t offered to us as an option for Little Boy’s birth, but we didn’t ask, either.  As it turned out, I was in no condition during my C-section to appreciate such a thing.  All my energy was focused on surviving the pain (don’t worry, that’s not normal).  Instead, Little Boy received nearly an hour of skin-to-skin time with his father before being brought to me for his first attempt at nursing.  It was wonderful.

However, I am seriously annoyed with the conversation in the media.  Take this NPR article, for instance, titled “The Gentle Cesarean: More Like A Birth Than An Operation.”  Wait, what?  More like a birth?  Excuse me, but I think that when a baby is born, it is a birth, regardless of whether surgery is involved.

Or take this paragraph from the start of an NBC Today article on gentle C-sections:

Friends and family who had gone through it told her it was more like having surgery than giving birth. A C-section is just happening to you, it’s not an experience, they complained.

Yes, a C-section does involve a lot of laying on an operating table thinking wow, this is crazy.  But it is sure as heck an experience!

Both articles describe cesarean sections with words like cold and sterile, and feature stories of women describing “vague memories,” “failure,” and “feeling empty.”  Why is this the dominant story we tell about C-sections?

Birth, no matter the method, can be traumatic both physically and mentally, and it can be made better or worse by the environment and demeanor of the medical professionals involved.  Because C-sections come into the picture when there are complications with pregnancy or labor, it stands to reason that there are more terrifying and traumatic birth stories associated with C-section deliveries—they are, after all, the option that saves lives when things go very, very wrong.

But treating C-sections as inherently negative, traumatic situations is a self-fulfilling prophecy.  If women are made to fear cesareans, if they are told that the operation will hinder bonding and breastfeeding, if the resources they read imply that a C-section represents a failure of womanhood—then of course they will feel scared, awful, and disappointed if one becomes necessary.

One of the women interviewed in the NBC Today article, the one who described feeling empty after her C-section, explains her hopes for her next birth:

Now pregnant with her third child, [she] is hoping to be cleared for a vaginal birth, but is comforted by having access to a family-centered cesarean if not, she said.

That’s all well and good, but what if there’s an emergency?  Will she feel the same sense of mourning and failure for something completely out of her control?

There is a hesitation, it seems, to talk about positive cesarean experiences, as though to do so would encourage women to ask for them and doctors to perform them unnecessarily.  But the “ideal” C-section rate—the rate below which mothers and babies start to die in childbirth in increasing numbers—is 10–15%, according to the World Health Organization.  That means that 1 in every 7–10 moms should be having a cesarean.

We shouldn’t be telling those women to expect to feel like a failure.  We shouldn’t be making those women afraid.

The pocket problem

Yesterday, I came across “How to Use a Simple Pocket Notebook to Change Your Life.”  Click-attracting title hyperbole aside, it’s a very appealing idea.  My life is built on paper notes, partially because I don’t have a smartphone and partially because of my innate attraction to physical handwriting.  I also have a very visual memory, such that I can picture the page of a research notebook that contains a desired piece of information, and even remember approximately where that page is in the book.

However, I don’t always keep a notebook on me.  My research notebooks and my day planner live mostly in my backpack, my “miscellaneous” school notebook stays in my office, and my doodle sketchbook and my random-household-stuff-but-mostly-packing-lists notebook migrate around the house.  Plus there are all the sticky notes with lists of songs I want to buy, and a collection of electronic notes on my laptop, iPad, and iPod from the times when I wanted to make sure I didn’t lose an idea.

A little pocket notebook — especially one with very few rules for use, so that the perfectionist in me wouldn’t get caught up in worrying what to put in there — would be nice.  There’s just one little problem…

Pockets.

Or rather, the lack thereof.

Women’s clothing sucks when it comes to pockets.  On a good day, my pants have enough pocket space for some lip balm and my office keys (because I’m not going to take my purse with me every time I leave my office).  On a bad day, I’m wearing a pocket-less dress or a skirt or stupid jeans with fake pockets and end up awkwardly carrying my keys around in my hand and hoping I don’t forget them in the bathroom again.

I was somewhat irritated that the original article didn’t mention this issue at all, and that the one attempt to raise it in the comments received only joking responses.  I don’t have a ready-made solution, either.  Someday I might actually buy a smartphone and want to carry that with me, but it’s not clear how.

Readers who wear women’s clothing, how do you circumvent the lack of pockets?

Mental health care access is a joke

We’ve been trying to find my husband a psychiatrist.  It hasn’t been going very well.

The first place we tried was a local community health center with several psychiatric nurse practitioners.  A referral and some phone calls later, he was told to come in at 8 a.m. on a specific day for a walk-in appointment.  It turns out “walk-in appointment” is an oxymoron, because, when he arrived, he was told that the earliest available time slot that day was 10 a.m., and that wasn’t with any of the people he’d been told he would see.  For one of them, he’d have to wait until at least 3 p.m.

Well, my husband is a man with a job and a tight schedule, so he left.  Further calls revealed that the center has no non-walk-in options for the initial evaluation appointment.  That wasn’t going to work.

So we tried a different place.  The friendly assistant on the phone informed us that yes, Dr. M. was taking new patients, but the earliest available appointment was in January 2016.  What?!

Health care in the U.S. always tends to be a maze of referrals and insurance verifications, but mental health care seems to be the worst of all.  You see, to see a psychiatrist (or a psychologist, or a therapist or counselor), you have to do go through the following steps:

1.  Find a practitioner who sounds like a good fit for you.

You would think that you could just get a recommendation from your regular doctor.  You would think.  That’s how other specialties seem to work.  When I was referred to a physical therapist for some long-term hip problems, the referring doctor sent me to a specific person.  Someone they thought might be appropriate.

Mental health?  Nope.  When I talked to my OB-GYN about postpartum depression, I got some vague hand-waving about how they couldn’t recommend anyone in particular because they didn’t know who took my insurance.  When I walked into my university’s student counseling center – the people who handle all student insurance referrals for mental health – and asked to be referred to a therapist for postpartum depression, they had no idea to whom they should send me.  After a long while of awkward searching, I asked if they could just give me a blank referral and let me find someone.  They did.

2.  Check that the practitioner in question accepts your health insurance and is taking new patients.

The health insurance question seems to be particularly problematic with therapists, who often practice alone and may only contract with a handful of insurance companies.  And the only way to get a solid answer is to call the practitioner’s office and ask.  I’ve yet to encounter a health-insurance-created online “provider search” that is user-friendly in any way.

3.  Get the official, insurance-approved referral from your primary care physician.  [May be optional depending on how your health insurance works.]

That’s right, you have to make a completely separate appointment with your primary care physician, just to get the piece of paper / electronic signature saying that your mental health care is medically necessary.  Or in my case, you have to go through triage at the student health center again and re-answer a bunch of irrelevant questions about your drinking habits.

4.  Call to make an appointment.

Theoretically straightforward.  Often frustratingly not.  Sometimes, like The Mort Mommy, you face a bureaucracy so unorganized that you never get through.

5.  Wait for the appointment.

Maybe the soonest they could get you in was a few weeks from now.  Maybe it was eight months away.  It’s not like mental health issues are ever urgent, right?

6.  Attend appointment.  Decide if you feel comfortable enough to make another.  If not, rinse and repeat the entire cycle.

Comfort level is important with any medical professional, but especially when it comes to mental health.  If you don’t mesh with your therapist, it’s not going to work very well.  My latest attempt at therapy ended after just five sessions because it became clear that he didn’t have a frame of reference for my issues and so we were going over and over and over the same things with no forward progress.

This whole process is hard enough when you’re sane and have your life together.  It gets exponentially harder when you’re depressed.  When it feels like every little task takes an overwhelming amount of energy and it all seems hopeless anyway.  Or when you’re so anxious that every phone call to a stranger leaves you panicking that you’ve said something wrong.

It’s ridiculous.  My husband and I have decent health insurance.  We can afford the $25-a-visit co-pays.  We live in a moderately-sized city, and we have the job flexibility to make appointments during the work day.  Even at our worst, we have each other for support and the presence of mind to say to a doctor, “I am depressed and need help.”  And we still struggle to access mental health care.  Imagine how much harder it must be for those who don’t have the same level of support and privilege.

In which I am not really surprised by statistics

On Friday, the New York Times described the results of a Harvard Business School study about the effect of working mothers: across the developed world, the grown daughters of working moms are more likely to work themselves, and the grown sons of working moms spend more time on child care and housework.  No one should be shocked by this – after all, parents are their children’s greatest role models.

I don’t want to harp on this particular study.  I’m secure in the knowledge that my own choice to work outside the home is the right choice for my family, and I don’t want to imply that stay-at-home parents can’t be strong models of gender equity as well.  (This particular study didn’t differentiate between working full-time, part-time, long-term, short-term, at home, or out of the home.  It counted as a “working mother” any mom who “ever work[ed] for pay” before her kids were 14.  That includes everyone from high-powered attorneys to stay-at-home moms who babysit.)

No, what I want to talk about is the third sentence of that New York Times article.

… 41 percent of adults say the increase in working mothers is bad for society, while just 22 percent say it is good, according to the Pew Research Center.

Uh, what?

I clicked on the link and spent some time reading the Pew study, which was conducted in 2007.  Yup, turns out if you’re a working mother in the U.S., that disapproval you think you’re feeling from society isn’t all in your head.  Interestingly, there’s no statistical difference in the opinions of men and women on this subject, and there was very little change in attitudes from 1997-2007.

It also turns out that almost nobody (men, women, stay-at-home moms, or working moms) thinks that mothers working full-time is best for the children, although 41% say that a mother working part-time is ideal.  They didn’t ask the “what’s best for the kids” question about fathers, because of course not.

On the plus side, 36% of the respondents said that “more fathers staying home with children so their wives can work full-time” was good for society, with just 21% saying that was bad.

Wouldn’t it be nice if we didn’t have to make this distinction?  If longer and PAID maternity and paternity leaves were readily available in the U.S.?  If we didn’t have a working culture that assumes long hours = more dedicated = better employee, so that moms and dads (and people without kids) didn’t have to choose between “work” and “life outside work” but could have some of both instead?

While we’re working on that, we need to get over the idea that working moms are bad for society.  Seriously, America.  You’re better than that.

Rage against the IT

A now-defunct, grad-student-written help page for printing in my department began with the sentence, “Printing doesn’t really work at [this department].”  It went on to describe some options that might, if one were lucky, produce pieces of paper with ink, and where those pieces of paper might be found in the building.

When I first arrived, I was assigned a “new” desktop computer.  This computer, like those of my fellow students, refused to speak to any of the printers in the building.  After a good deal of pestering, I convinced one of our IT guys to provide me with a program that would allow computer-printer communication (I have no idea why this program was not given to everyone by default).  This program had to be re-run every time my machine was restarted, and it would only allow printing directly from the command line, never from within an application.

Several years later, I installed a new operating system on my computer (because it was faster and less hair-pullingly frustrating that waiting for the IT guys to fix what was wrong with the old one).  This included setting up printing myself.  For a brief and glorious period, I was able to print from any application.

Then my officemates and I were booted out to a portable trailer.  For exactly three days, I was still able to send documents to the fancy printers in the main building as well as to an old black-and-white printer that had been set up for us in the trailer.

When I returned from maternity leave, the trailer printer was not broken, but it was no longer talking to my computer.  The other printers’ network had been subtly changed, for reasons the IT guys chose not to share.  After some fiddling with settings, I could still print from any program, but I had to hike outside to pick it up.  This set-up probably encouraged me to save paper.

Recently, the most-used printer was “helpfully” upgraded to a newer model.  Not only can I no longer print to that machine, but I apparently can no longer print to ANY printer on the network.  If I can’t figure this out or find another student who can help me, I might have to break my current rule of IT avoidance.

“Printing doesn’t really work,” indeed.

Where the pro-breastfeeding movement gets it wrong

Little Boy and I have been very lucky when it comes to breastfeeding.  I don’t say that to brag; quite the opposite, in fact.  Our success at breastfeeding is due to little more than luck and genetics.  Sure, I did a few things that helped – attending a breastfeeding class, for instance, and pumping after a few feedings a day once my milk came in.  But I didn’t work harder or want it more than any other mother.  Actually, since things went relatively smoothly for me, I worked a lot less hard than many new moms do.

I like breastfeeding.  It’s cheap and it’s portable, it gives my kiddo the benefit of my immune system, and it means that I don’t have to decide among the 85 different types of formula available at Target.  Avoiding complicated decisions is one of my favorite things.

However, I’m getting really, really fed up with the all the rhetoric surrounding breastfeeding.  There was another round in the news this week:  Breastfed babies have higher IQs!  Breastfed babies grow up to make more money!  Here’s some more guilt if you couldn’t or didn’t want to breastfeed!

That guilt is a big deal.  I know several women who were unable to exclusively breastfeed despite trying past the point of exhaustion.  I have read the stories of many, many more such women, some of whom cite breastfeeding problems as major factors in their postpartum depression.  The strident pro-breastfeeding messages seem to actively encourage this guilt – I’ve seen discussions on mommy forums where the attitude “I’d like to breastfed if I can, but if not, formula is fine” is dismissed as “doomed to failure.”  Anything less than 100% dedication must mean that you’re going to pull out the Enfamil the minute things get tough.

That’s not true.  And it’s horribly counterproductive.  We should be supportive of all interest in breastfeeding, not trying to make it into an elite club.  Breastfeed for a week?  Good job!  Breastfeed for six months?  Good job!  Breastfeed for three years?  Good job, but it doesn’t make you “better” than other moms.

“Formula is fine” is not only a healthy attitude, it’s the truth.  Let’s take a look at that latest study, shall we?  “The difference in IQ between the most extreme groups [breastfed for less than 1 month vs. breastfed for 6-12 months] was nearly four points, or about a third of a standard deviation.”  Woah, a whole third of a standard deviation?  In my field that would get you laughed out of the room; even results at the level of 2 or 3 standard deviations can be suspect.  Moreover, mean IQ actually goes back down a few points for babies breastfed longer than 12 months (vs. 6-12 months; see the study’s Table 3).  Is anyone jumping up and down to say that mothers should stop breastfeeding after a year?  Didn’t think so.  (On a related note, breastfeeding longer than 12 months is also associated with a small increase in rates of celiac disease.)

For comparison, that same study shows that a higher family income leads to IQs up to 15 points higher, or more than 3x the effect of breastfeeding for 6-12 months.  (See Figure 1 in the study linked above if you’re visually inclined.)  This is a common theme in breastfeeding research.  It turns out that not all women are equally likely to breastfeed; those who do are typically of higher socioeconomic status, meaning they have access to more resources, better childcare (or they have the money to stay home), more educational opportunities, etc. etc. etc.  Their children could be healthier/smarter/whatever because of all those things, not just because of the breast milk.  In fact, when breast-fed kids are compared to their bottle-fed siblings, the differences are negligible, strongly suggesting that family environment is the true key.  Similarly, another study noted that the apparent IQ boost of breastfeeding disappears when you account for mothers’ IQs.

So let’s stop making formula-feeding parents feel like they’re dooming their children to an inferior life.  That’s not what the evidence says at all.

Moreover, let’s stop acting like giving your baby any formula inevitably ruins your attempt to breastfeed.  Yes, it has to be done carefully (and admittedly, it wasn’t done carefully 40 years ago), and yes, nipple confusion can be an issue in the first few weeks, but there’s some evidence that judicious formula supplementation can actually dramatically increase breastfeeding rates.  Plus plenty of parents combo-feed (some breast milk, some formula) for long periods.  It’s not an all-or-nothing situation, and presenting it that way hurts rather than helps. 

And don’t even get me started on the reverence of breastfeeding as “natural.”  Arsenic is natural, folks.  So are grizzly bears.  So is dying in childbirth, and so are high rates of infant mortality.  And yet so many doulas and lactation consultants (definitely not all lactation consultants, but a vocal subset) seem to harbor a bias against modern medicine, the very thing that is keeping those last two “natural” events at wonderfully-low levels.

Just yesterday, I ran across a blog, which I won’t link here, written by a lactation consultant.   One of her posts was a long warning about the dangers of birth “interventions” and elaborating at length about how important the hormones of labor are when it comes to successfully establishing breastfeeding.  The post was directed at moms-to-be, not doctors.  Here you go, moms: one more thing to feel guilty about!  Make sure to suffer through your labor – stay away from that pain relief!  And if you have to have a Cesarean, well, you’re totally screwed.

Again, this kind of attitude hurts mothers.  I had a C-section without ever going into labor, and yet had no trouble breastfeeding.  There is some evidence breastfeeding in the first 24-48 hours can be less successful if you’ve had an epidural (see here, for instance), but the long-term effects are unstudied and there could easily be other confounding factors.  Maybe mothers who ask for epidurals are already less likely to be interested in breastfeeding.

Even if epidurals are the direct cause, no mother should be made to feel guilty about easing her labor pain.  Change the medical culture to ensure epidurals aren’t pushed on women?  Yes.  Encourage further research into pain management options?  Yes.  Limit women’s choices and make them feel bad?  No.

As I said above, breastfeeding shouldn’t be a club of martyrs.  Nor should it be presented as though you have to do everything just right or else everything will go wrong.  You can gently guide your breastfed baby into a feeding schedule once your milk supply is established.  Your breastfed six-month-old doesn’t NEED to be fed every 2 hours all night.  It’s possible to breastfeed without sacrificing yourself, and it’s possible to be an excellent parent without exclusively breastfeeding. 

Because when it comes down to it, the question that matter is this: is your baby getting enough to eat?  If yes, then you’re doing a good job.