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Sound and pictures

Remember This American Life? Remember how cool it was, like, ten years ago? Before you realized that it was, like, just another clique of snotty post-ironists, and that you maybe knew people who knew people who had slept with some of the regulars? Well. This past weekend's show:

Yeah, yeah, yeah, each week we choose a theme, and bring you three or four stories on that theme. Or one big epic story on that theme. That's our show. Except for this one. We throw all that away and bring you twenty stories, yes twenty, in sixty minutes. Featuring works by Jonathan Goldstein, Etgar Keret, Chuck Klosterman, David Lipsky, Jay Allison and Atlantic Public Media, and David Sedaris. One story – made by a teenager locked up in juvenile detention – came from Blunt Radio. Inspiration for this week's show came from the Neo-Futurists, whose long-running Chicago show Too Much Light Makes the Baby Go Blind promises 30 plays in 60 minutes every single weekend.

It turns out that I have no internal ability to judge the length of a This American Life segment. The voice drones on in front of the excessively hip bass, and I just go into a trance. Hence, this program, with its twenty-odd stories, each of which might as well have beeen twenty minutes long, just felt like the longest damn This American Life ever. It nearly killed me.

Meanwhile:

Things that annoy me, and that are therefore signs of the impending collapse of civilization

Car seats. Car seat statistics. Car seat regulations for car manufacturers. Infant car seat user manuals. The portions of car user manuals about infant seats.

(Proximate problem: the only remotely reasonable way to install our used Graco Snugride in our snotty European sedan is using the inner outboard LATCH points to secure it in the center of the backseat (scroll down the page for relevant discussion). There are no center LATCH points, quite likely because car manufacturers are not required to intall them. Since the points we're using are 15.25" apart, we're violating the Graco manual. So we're among the 80% of car-seat users with incorrectly installed seats. Where does that number come from? Everyone cites it, and even says it comes from NHTSA, but I can't find the original study anywhere. And what does it mean? Are those 80% of seats totally useless? Would five times as many babies survive crashes if all those seats were correctly installed? Or is the whole mess simply a reguatory and user-accessible-design disaster?)

Health insurance paperwork. Copays. Did I say paperwork?

(Beaker's employer has just decided to start offering its employees health insurance. While this is unquestionably a good thing for the rest of the company, it has the potential to make our lives much, much, much worse. See, Granolan requires spouses whose employers offer coverage to take it; then Granolan's (basically pretty good) plan becomes secondary coverage. So we'll pay two premiums, and sort through awful awful paperwork for double submission of everything, to end up with the same coverage we already have. If we're lucky. God. Just thinking of what it may take to get Beaker's drugs covered—we currently get them through the mail-order pharmacy run by Granolaton's insurer—makes me want to cry.)

Credit card companies, how they don't really want you to send in more money, how their interest rate mechanations are about as transparent (and probably about as effective) as mainstream airline pricing.

(Ever check on whether your credit card company includes the payment address anywhere on the statement besides the payment stub, the part you send back to them? Mine doesn't. Mine has also jacked up my interest rate in response to the ludicrously high activity over the last couple of months—travel, baby crap, house stuff, etc. What's extra-peculiar is that Beaker's card from the same company, which has shown the same spike in activity, but has had a couple of late payments in the last nine months—due to incompetence during periods of geographic instability—has had the rate lowered by about the same amount.)(And yes, abusive phone calls have been moderately effectively in ameliorating both the situation and my mood.)

Stories that shouldn't have surprised anyone

—Chickadees are actually communicating useful information about the presence of predators as they twitter:

Likewise, chickadees relay similar details about the threats posed by predators and the response required. The songbirds' encode the information in their namesake "chick-a-dee" call.

The greater the threat, the larger and more aggressive the feathered mob that forms to harass the predator away.

"It's like they're saying, Hey, there's a perched or terrestrial predator over here, come harass it," said Christopher Templeton, a biology doctoral student at the University of Washington in Seattle. "Subtle variations of the call elicit the level of threat the predator poses."

Templeton and his colleagues say their findings, described in tomorrow's issue of Science, demonstrate an unexpected level of complexity and sophistication in songbird communication.

Susan Smith, a leading authority on black-capped chickadees who was not involved in the study, said she wasn't surprised by the discovery.

In an e-mail to National Geographic News, the Mount Holyoke College biologist said the finding "demonstrates a level of sophistication that I suspect is very common among bird vocalizations."

—Pesticide-resistance genes can move sideways, from crop plants to weed plants:

A reviewer of the paper has appended to its front page: "The frequency of such an event [the cross-fertilisation of charlock] in the field is likely to be very low, as highlighted by the fact it has never been detected in numerous previous assessments."

However, he adds: "This unusual occurrence merits further study in order to adequately assess any potential risk of gene transfer."

Brian Johnson, an ecological geneticist and member of the government's specialist scientific group which assessed the farm trials, has no doubt of the significance. "You only need one event in several million. As soon as it has taken place the new plant has a huge selective advantage. That plant will multiply rapidly."

Dr Johnson, who is head of the biotechnology advisory unit and head of the land management technologies group at English Nature, the government nature advisers, said: "Unlike the researchers I am not surprised by this. If you apply herbicide to plants which is lethal, eventually a resistant survivor will turn up."

(The mechanism appears to be ordinary hybridization between two plants so distantly related that the hybridization was thought to be impossible.)

—Patches of skin grown from 14-week fetal cells appear to stimulate burned areas to generate new skin:

Normally, to replace tissue severely damaged by burns, surgeons borrow skin from another part of the patient's body. But that skin regenerates poorly, in a painful and sometimes disfiguring process called grafting. The Swiss researchers had initially hoped that the layers of fetal skin cells might be a substitute graft material.

Instead, to their astonishment, they discovered that the fetal skin panels - which dissolved and had to be replaced every few days - seemed to confer restorative power to the damaged tissue underneath, allowing it to heal itself, against the odds.

"We had expected that the fetal skin would act as a graft and it did not," said Dr. Hohlfeld. "Instead we found that it acted more like a biological bandage that stimulated healing."

[...]

All the children in the study had deep second- and third-degree burns, which would normally be expected to require grafting and to cause serious scarring after they healed. Grafted skin is normally thick and stiff, so it often limits the movements of fingers and joints. It does not expand as a child's body grows, so children who sustain serious burns often need painful, repeated surgeries as they get older.

In contrast, the children treated with the fetal skin were able to heal their wounds with skin that appeared more or less normal, with normal pigment and mobility. "It was supple, there was no scarring or retraction - it was really different than grafted skin," Dr. Hohlfeld said.

And since the fetal skin layers were merely placed on the wounds, the young patients required no surgery. There was no pain, so there was no anesthesia - except for the very young, who needed anesthesia so they would stay still.

Slate has already reminded everyone that Will Saletan recently exhaustively discussed the potential and implications of using tissues from older fetuses.

—Meanwhile, Britain is struggling with a lack of gamete donors, after getting rid of anonymous donation:

"We are seeing longer and longer waiting lists because of the loss of anonymity," Prof Ledger said. "The situation has become so bad, that we are looking at importing anonymous sperm from abroad."

This issue has a poor interaction with the issue of what services should be available to single women, or to same-sex couples. Most NHS fertility clinics work only with heterosexual couples:

But Prof Ledger said the reluctance of many clinics to offer treatment to single women and lesbians and the change in anonymity law had fuelled the rise of websites selling sperm.

"The reason they've sprung up is that we as clinics have failed to meet the need, and as long as there's a shortage of anonymous sperm donors, that will continue," he said.

(The websites, most notoriously Man Not Included, fit through a loophole in existing regulation, since they provide fresh, not frozen, sperm.)

The government there is doing a huge review of how fertility treatment and related issues are regulated. All the questions are hard, and it's fascinating to see how differently they're being handled by another country. Mostly I feel like the U.S. underregulates all sorts of stuff. But, despite the nutsos trying to take over the politics of reproduction, in the U.S. anyone with enough money (and yes, that's a huge, ethically troubling de facto restriction that breaks an awful lot of hearts) can choose just about any reproductive technology that's been figured out.

Decisions made while dizzy

Doula The first doula we spoke with, Nancy, spent several years running medical studies, many involving children, or pregnant women, or pregnant diabetic women. So she knows about CF and diabetes self-care—all the things Beaker may need to do to keep going during an extended, um, birth process. She's attended many births at our chosen hospital. She's the director of a group of childbirth professionals, and her "backup" will come along to the other prenatal meetings. And we really, really liked her.

The second doula we spoke with, Lisa, is a sole practitioner based in Granolaton. She's coming from a "bodywork" background and is currently apprenticed to a homebirth midwife. We liked her a lot, too, and it would be much more geographically reasonable for her to show up pre-hospital—but there were some notes of automatic antagonism towards mainstream medicine in what she said—and she's never attended a birth at our hospital.

Advantage: Nancy. (Although I might try getting a massage from Lisa.)

Doctor vs. midwife Well, there's no resolution on this one yet, and there won't be for at least another week. It's not helping at all that, as I sit here and sip my raspberry yogurt shake and type, my left ear is flickering in and out, with the room spinning whenever it flickers out... but anyway.

Dr. Intermittent-Cheer responded pretty darn well to the questions we threw at her on Wednesday. She could count the number of epistotomies she's done at this hospital on the fingers of one hand; she's comfortable with starting an epidural pretty much as early, or as late, as one desires; when I poked hard, she conceded that she might let me go past 41 weeks without inducing, as long as I submitted to a lot of monitoring. All fine with me.

When I asked about her perception that IVF pregancies are at higher risk for, well, everything in labor, she admitted that she wasn't basing her belief on studies, but on personal experience. I think she's been through some hairy births with post-IVF patients, and in some sense that's not surprising: as a class, we're older, and many women have, well, female factor problems that might well play out later: hormonal oddities, pelvic scarring, etc. etc. Since she's the doctor, if anything goes wrong, she's the one who has to deal.

We talked more about the dizzy spells. Two weeks before she'd proposed that they might have something to do with my migraines. This time she seemed more convinced that it was some sort of harbinger of a blood presssure problem, and (as we found out the next day) noted in my file that she thinks an OB should keep following me because of them.

At the end of the appointment, she sort of broke the mood by casually offering to strip my membranes in a couple of weeks if I wasn't progressing.

On Thursday we met Betty, one of the three midwives in the hospital practice. She was awesome. I think all three in the practice were labor-and-delivery nurses before going CNM. They're happy working at a big hospital, and acknowledge that one might go full medical at any moment, and it's fine. They seemed happy with my file, happy at skipping the internal exam (since I'd had one the day before), and, just, well, happy. A little palpation of the basketball was done to try to figure out position. Dr. Intermittent-Cheer had said head down the day before; when my belly got poked on Thursday, it ignited a huge kickstorm. The midwife stood back; Beaker gawped; eventually we were all just laughing as the violent squirms continued. "Head down, yes, but I think we can be pretty sure she's still floating around," was the final conclusion.

The midwife practice is fine with me switching this late, modulo the notes Dr. Intermittent-Cheer had left in my file (advising against water birth, too). I have appointments with both again on Wednesday and we'll try to hash this out. I'm also going to try to get an ENT referral, 'cause damnit, I think it's my inner ear gone wonky.

Advantage: midwives. Both Beaker and I feel safe going the midwife route, both because we hope I'm pretty healthy and because we'll still be at the giant hospital surrounded by more doctors than we can count. While I'm glad Dr. I-C was honest about her fears regarding IVF patients, and I'm sure she's come by them honestly, I'd prefer to start off having my care managed by someone who has faith that things can, and should, go normally.

Consumer silliness followup (go on, spy on our lifestyle!) below the fold.

This ex-New-Yorker is angry

I've never really gotten used to reservists with giant guns wandering around Grand Central Station. But I accept it—as I basically would accept the kind of CCTV surveillance now standard in all public locations in England (on my last visit there, I would amuse myself trying to count cameras: 16 around a university parking lot?!).

But this is going too far:

New York City will begin making random checks of bags and backpacks at subway stations, commuter railways and on buses, officials announced today in the wake of a second wave of bombings on the London transit system. The checks will begin on Friday morning. [...]

The city's subway system alone has 468 stations and carries some 4.5 million passengers on an average weekday. Some of the larger stations have at least half a dozen entrances and exits. In New York City, relatively few people own cars, and the majority of those who commute via subway carry a bag of some sort filled with items needed for the entire day, including computers, business documents, gym clothes and makeup. Many people carry two bags. It is unclear how invasive the searches will be.

"We live in a world where sadly these types of security measures are necessary," Mr. Bloomberg said. "Are they intrusive? Yes, a little bit. But we're trying to find the right balance."

So invasive. So futile. (The more random the searches are, the more futile, too.)

But yes—this crosses a line for me, not because I've hammered out a theory of what the government should or should not do in balancing privacy and security, but because I can so easily imagine myself back on those trains with a giant backpack. Because when I go back to visit I see the current crop of high school students hauling their giant backpacks up and down the stairs. They've come for people like me.

Meanwhile, much as I hate vigilantism, much as I deplore concealed carry laws, etc. etc., I have to wonder about this:

At least one of the bombs was being carried on a tube train in a rucksack by a man who shouted in surprise when it failed fully to explode, and who appears to have then vanished in the scenes of panic and confusion that followed. A second was carried on to a tube by a man who dodged fellow passengers and fled when its detonator apparently went off.

Police and anti-terrorist officials were clearly delighted at the "forensic bonanza" which they say the bombers' failure offers, and each of the devices will be examined for clues to the identity of the bomb-makers. But the failure to capture any of the men at the scene means that a group of dedicated would-be bombers remains at large.

In the U.S.—heck, in New York, 'cause where the hell else in the U.S. would something like this ever happen—would all four have gotten away? The rest of the Guardian story portrays the underground panic very clearly—so yes, of course, perhaps. But perhaps not.

Mission creep

My goal this morning: scraping and painting a medicine cabinet we picked up off the street several years ago. (It needs to go into the upstairs bathroom, which has no storage and which will be our only bathroom for the foreseeable future, since no one is willing to tile the downtairs bathroom until the new wallboard is ripped off and replaced with even newer wallboard whose walls are, say, perpendicular to each other.)

Beaker's goal this morning: getting a doorbell working. (We keep missing deliveries of important things, like faucets.)

Beaker starts by mixing some shellac.

Then we both work to clear space in the basement for me to work. Our workbench is covered with construction dust, so Beaker hauls it up to the backyard and drags out the power washer.

What else needs to be power washed? All the furniture from the side porch! And the side porch deck, too. The power washer removes a truly horrifying amount of mud from the (coir embedded in rubber) doormat—it's hard it believe the manufacturer would have authorized the method, though.

The birdseed lives on the side porch, so I start refilling the feeders. Beaker notices the birdfeeder pole is awfully askew, so he pulls it up and screws it back into the ground. This ultimately requires three trips back the basement for tools: once for a mallet to pound it down, again for a screwdriver to use as a lever arm, and finally for a wrench to undo the damage caused the by mallet, so the next piece of the pole will fit on the base piece again.

Time for lunch! (Hey—at least we can sit on the porch now. That's progress.)

I'm going home

(Sing it, Frankie!)

I. Beaker reports that, at a party last weekend, four people (three female, one male—a former chair of my department!) independently said to him, "Emma's always so thin. I can't wait to see her pregnant."

II. My granite-like futon. My cotton sheets. All the pillows I could ever want.

III. Beaker!

IV. Temperatures in the 90's. Have I mentioned that my ankles don't swell in British Columbia?

V. No downstairs bathroom—hence, no shower. No kitchen counters, or cabinets, or dishwasher. Washer and dryer are hooked up, but the dryer vent must be threaded through a nearby window. Fridge and stove are hooked up, but the kitchen sink is some utility sink our contractor picked up, like, out of someone else's dumpster.

VI. Boxes and boxes and boxes. Boxes we shipped from California that Beaker has been ignoring. Boxes of useful books, yarn, and baby stuff I've been ordering on-line during my long lonely evenings here. Boxes from when we moved into the house five years ago, too, but we're used to those boxes by now.

Mixed messages

I. The Centre for Ergonomics here

1. runs a nice little Coffee Hour every morning for all members and visitors,

2. at which they serve lovely pastries: croissants, chocolate croissants, scones, (American style) muffins, and even some things that are sort of like flat round croissants with the fillings of a nice little fruit tart placed on top—complete with glaze. (Perhaps those last are a Canadian standard? I think I remember them from Toronto, too.)

3. However, all the pastries are about a quarter of the size that they would be in the U.S,

4. and the only beverages offered are highly caffienated: (unpleasant) coffee and (even more unpleasant) strong-brewed black tea.

II. I spoke too soon in my last entry. Today Dr. Wow reiterated that the approach I'd taken in Section 7.6 did, perhaps, have certain expository advantages. But it needs to be reworked completely, as follows:...

III. I'm allowing myself a Caramilk bar before dinner.

Too many doctors

We're flying out tomorrow morning, and I am a complete basket case. So many boxes have gone to FedEx ground already! There's still so much crap to deal with! And it's so damn long until I really get home, and even then the damn kitchen won't be close to done!

List for OB appointment today:

1. Request a copy of my records, to hand-carry to Canada and to Ohindinois.

2. Request to fax out referral form to Canada. I've found a lovely family maternity practice (and they're so apologetic, in their cute little Minnesota-on-steroids-plus-a-hint-of-Scotland accents, about having to bill—bill!—me), but I can't make an actual appointment without a referral.

3. Request an order for a three hour glucose tolerance test, and possibly a set of gestational diabetes diet guidelines and a prescription for a glucometer and strips. My 1-hour results won't be back, most likely, and there's a good enough chance I failed that I want it to be easy to get a 3-hour test done in NY next week.

4. Sing LA LA LA loudly after I'm weighed; you know, our friends fed us really well last weekend, and this hip pain has been making it harder for me to walk miles and miles, and I just don't want to hear about it.

If you're ever planning to sublet your house for six months or so:

1. Please do not forget that your tenants gave you a multi-thousand-dollar deposit check, six months before they moved in.

2. Please remember to take along your prescription painkillers when you leave. And your passport.

3. Please do not leave your collection of vibrators out next to the bed.

What we don't usually talk about

I love it when other bloggers talk about the deep history of their families. Even more when they have a larger point in mind—as Jody always does. Go check out her entry on class (and mobility, and where academics sit). (And check out the comments, too.)