ANTIGONOS' BRAIN

Your Brain is Green
Of all the brain types, yours has the most balance. You are able to see all sides to most problems and are a good problem solver. You need time to work out your thoughts, but you don't get stuck in bad thinking patterns. You tend to spend a lot of time thinking about the future, philosophy, and relationships (both personal and intellectual).

Friday, September 02, 2011

Pencil Me In



Nate Beeler
Washington Examiner
Sep 2, 2011

Not to mention conflicts with the NFL SEASON OPENER!!! Which is guaranteed to be, if not more important, vastly more entertaining than political shenanigans...fortunately, Obama folded. I can see him now, addressing a joint session of Congress with all its members watching the game on the smartphones on their desks...

Thursday, August 18, 2011

Ras Burqa, Again

Back in 1978, when I was in Ulpan Etzion, my Hebrew teachers were delirious with joy because of Sadat's visit to Jerusalem, and the peace with Egypt. It was the beginning of the end of hostility against Israel. The other Arab States would follow. I was roundly criticized when I said I thought that any "peace" with Egypt would not survive either a change of government or more than 20-30 years.

It quickly became obvious what peace with Egypt meant. No Egyptians visited Israel. No Egyptian trade agreements with Israel. No Israeli businesses opened branches in Egypt, although Israelis seemed to fall over themselves in the first years trying to do the Exodus in reverse, taking holidays over Passover along the Nile. The official government line continued to be anti-Semitic. There were no invitations for Israeli authors to show their works at Egyptian book fairs, and so on. With the exception of certain tourist sites along the coasts, and the highways, the Sinai became a virtual no-man's land again.

Then, in 1985, there was the Ras Burqa incident, which shocked Israelis. According to Wikipedia,



On October 5, 1985, an Egyptian soldier, Sulayman
Khatir
, machine-gunned a group of Israelis, killing three adults
and four young children, on the dunes of Ras Burqa.
[1]
The only survivor was 5-year old Tali Griffel, whose mother, Anita, shielded her
with her body.
[2]
According to eye witnesses, the Egyptian
Central Security
Forces
who were nearby refused to help the wounded; furthermore,
they stopped an Israeli doctor and other tourists at gunpoint from administering
any aid to the victims of the shooting, and the wounded Israelis were left to
bleed to death.
[3]
Egyptian authorities countered that the Israelis bled to death "because this
crazy soldier refused to let anyone near the area that some of the victims
lay".
[4]
The gunman killed one of the Egyptian policeman who tried to arrest him."
[5]
Israel protested the Egyptian refusal to allow the victims to be treated by
Israeli doctors or transferred to hospitals in Israel.
[6]
Khatir
said the killings were not intentional. He said he could only see a group of
people coming towards him in the dark, refusing his orders to stop.
[7]

Seven people were killed in the attack: Anita Griffel, a Canadian-born
sociologist at
Hebrew
University of Jerusalem
; Hamman Shelach, an Israeli judge, his wife
Ilana and their daughter, Tzlil; Amir Baum, Dina Bari and Ofri Turel. The
Shelachs' oldest son, Oz Shelach, was not with them, and is the only surviving
family member.
[8]Hamman
Shelach was the son of Israeli poet
Yonatan
Ratosh
, founder of the Canaanite movement.

After the shootings, Egyptian authorities claimed that the perpetrator
Sulayman Khatir was mentally ill.
[9]
During the initial interrogations, Khatir claimed that he had been unaware of
the identity or nationality of the people he had shot and that they had made no
offense or provocation toward him. The only reason why he had opened fire was
that, as Khatir said, they had trespassed on a prohibited territory.
[3]
He was tried by a closed military tribunal and on December 28, 1985 sentenced to
life in prison at hard labor. Ten days later, on January 8, 1986, Khatir was
found dead in his prison hospital room hanging by a strip torn from a sheet of
plastic. The authorities declared his death a suicide.
[10]Opposition
parties in Egypt claimed that he had been murdered.
[11]

Egyptian opposition politicians hailed Khatir as "hero of Sinai"
for committing the massacre of Israelis.
[10]
The glorification of Khatir as a national hero in the Egyptian opposition press
was echoed in other
Arab countries, and
mass demonstrations were held in his support. Attempting to justify his actions,
the press did not report that all but one of the victims were women or children,
but instead invented miscellaneous pretexts for the shootings. The press claimed
that the Israeli tourists were spies caught photographing secret military
installations, that they spat upon and tore up an Egyptian flag, that half-naked
Israeli women offended Khatir's
Muslim conscience, or
that the tourists attacked him. The pro-governmental press remained silent
regarding the facts of the massacre, leaving the claims unchallenged. Many
Egyptian intellectuals and religious leaders joined in extolling Khatir and his
act. Umar al-Tilimsani, the leader of
Muslim
Brotherhood
, said that "if every Muslim would do what Sulayman did,
Israel would no longer exist". Farid Abd al-Karim, one of the leaders of the
Arab Socialist
Party
, called Khatir "the conscience of this nation", whose bullets
"washed away the shame" of the
Camp David Peace
Accords
between Israel and Egypt. Ahmad Nasir of the Egyptian Bar
Association claimed that history would always honor Khatir as "a living model of
a noble Egyptian who refused to be led astray by the treaties of betrayal and
surrender".
[12] [The numbers refer to footnotes documenting sources in the original article]


Today, due to as-yet-undetermined circumstances, two Israeli buses were attacked just outside of Eilat, not in the Sinai but where Israel comes to a "point" at the Red Sea. The country is only a couple of kilometers wide there, tapering toward the port, so it is easy to infiltrate, either from Egypt or Jordan. The current supposition, as I write this, is that the terrorists are Hamasniks from Gaza who crossed into the Sinai via the laxly controlled border with Egypt, rather than Egyptian soldiers or Egyptian terrorists based in the Sinai. But the gas pipeline has been sabotaged 4 times in the past months, since Mubarak's government has been overthrown, and there are definitely voices in Egypt calling for an end to the peace treaty with Israel, just as I predicted 33 years ago.



On this issue, I'd rather not be right, but I think there is little if any room for optimism.

Tuesday, August 09, 2011

How Absurd! Or, Thank You, Lush

There's an article today in Hudson NY which decries Lush Cosmetics' boycott of Israel. I first discovered Lush when in the UK years ago, and I do indeed like their products [as well as the funny and self-mocking language of their advertisments and descriptions]. Their signature fragrance, Karma, for example, which is claimed to make me smell like an "aging hippie" is absolutely accurate. I may not be a hippie, [well, I was at Woodstock] but I am certainly aging. The shampoo bars are marvelous when traveling, and who can resist a "bath bomb" with a name like "Waving Not Drowning"?

Two separate Israeli entrepreneurs decided to imitate Lush. Neither is as "green" or "organic" as Lush, but both sell much the same range of body and fragrance products. One is called "Sabon shel Paam" ["old fashioned soap"] and the other is Laline. They are very high quality; the stores have lovely decor and do-it-yourself gift package arrangements. I don't have to import bath bombs any more. I can buy soaps by weight, sliced off giant blocks and wheels, etc.

Our shopping malls are thronged with Arab women. Some are indistinguishable from secular Jewish Israelis [until you hear them talk and realize they are speaking Arabic], many wear Western clothes [often quite expensive ones] and the hijab, some are in "classic" dress [floor-length duster-style overcoat and hijab] typical of the region. In Jerusalem, at any rate, they are both Israeli Arabs and Palestinians who have the right papers to enter Israel. They LOVE Laline and Sabon shel Paam. So who, exactly, are Lush "punishing" with their boycott of Israel?

Lush deserves a vote of thanks for creating a new Israeli industry!

Friday, August 05, 2011

(Gadi) Taub and the Taub Center

The only connection between this link to an article by Gadi Taub and this link is that one refers to an article about the origins of Israel's current social protests and the other is by a professor at the Taub Center which makes many valid points about Israel's education system, which is also in a very bad way. Both are worth reading.

Thursday, July 28, 2011

Two Parades

Today Jerusalem saw a Gay Pride Parade, and a "stroller parade". The former, of course, promoted a form of sexuality which would end the human race without assisted reproductive technology, while the latter bemoaned how expensive it is to raise kids in Israel -- the unspoken corollary being that if children were more affordable in our society we would probably have more of them. Certainly a large proportion of the couples pushing strollers, being heterosexuals, would like more children.

The juxtaposition of these two "causes" both amuses and fascinates me. The government, you know, actively supports fertility treatment, and not just for classically heterosexual married couples. Single women, and lesbians can have subsidized treatment, and male homosexuals can find surrogate mothers if they wish. It undoubtedly spends more money on the subsidies than on assisting working mothers who need child care but can't afford it.

Chelm, anyone?

Just Another Gazan Fun Day

This is a very bizarre story. Not because Gazan children might enter the Guinness Book of Records [gee whiz!] but because the organization which has sponsored the event was trashed in protest, apparently. I can't really see the connection between setting such a record and statehood, but I guess the Palestinians think this is how civilized countries behave all the time.

There are times when I think the Palestinians really don't know what they are doing, and times when I think they know all too well what they are doing. In this case, it's biting the hand that feeds them.

And this is what they consider normalcy?

Wednesday, July 27, 2011



Mike Smith
Las Vegas Sun
Jul 27, 2011

This is going to be a weird autumn and winter, between the NFL which hasn't had its usual warm-up, and global warming, which needs to cool off. We haven't had a decent winter in Israel since 1992 -- I mean one in which I had to actually wear a coat.

Wednesday, July 20, 2011

Underdone?

The clinic telephone rings.

"Hello, my name is blah-blah and I came to the emergency clinic yesterday because I had sex with my boyfriend two weeks ago and I wanted to know if I'm pregnant. The doctor sent me for a blood test but I don't understand the results".

So far, nothing out of the ordinary. I'm not allowed to give results over the phone, but I can explain them if the patient has gotten them off the internet. It is a bit tricky, because the norms are given immediately below the actual result, and [1], you'd be amazed how many Israeli women don't understand the meaning of a decimal point ["but it says 0.59, isn't that 59?"], and [2] they insist on reading me the normal values and arguing that it does or does not mean they are pregnant [less than 3 international units of human gonadotropin is "negative" for pregnancy; more than 25 means 100% definitely pregnant]

I walk her through the results ["Look for the line which reads HCG QUANT., etc"], which usually takes a few minutes as most Israelis have trouble with the Latin alphabet, especially with abbreviations. Finally she announces that the result is "Three". I ask her how late her period is. She tells me it isn't. I explain that it therefore is too early to have a definitive result and she needs to repeat the test, if she doesn't get her period, in a week or so. She's not exactly happy to hear this: she doesn't like getting stuck for a blood sample [who does?]

"Can't the lab use the blood I've already given?" she asks, at which point I realize that she thinks if the sample "cooks" longer, she'll get a positive result. Sadly, I have to inform her that it doesn't work that way. "Why not?" she asks, and frankly, I can't think of a really good way to answer her. There is a kind of mad logic here -- it IS the blood of a woman who is possibly already pregnant, the sample simply hasn't "matured" enough, like a good wine which improves with age.

Saturday, June 25, 2011

Just for Fun

http://www.youtube.com/watch?feature=player_embedded&v=MTwq1_9VH68

Friday, June 10, 2011

Sunday, June 05, 2011

Roundup: It's Been A Busy Day

Today, the Six Days' War began 44 years ago. It ought to be called the "44 Years' War" because we are still fighting it. Here are some links to relevant articles:

http://www.jpost.com/Defense/Article.aspx?id=223726

http://www.jpost.com/VideoArticles/Video/Article.aspx?id=223730

And, in other news:
http://www.jpost.com/NationalNews/Article.aspx?id=223728 I'm sure those who sympathize with Palestinian terrorists can justify these "freedom fighters".

Hopefully, this is the beginning of the end of the much-vaunted reconciliation:
http://www.jpost.com/MiddleEast/Article.aspx?id=223723

An Interesting Map

I downloaded the free sample of a Kindle book -- Charles Freeman's "A New History of Early Christianity"
today,

and there is a VERY interesting map in the first chapter, showing where the two indigenous peoples, during the Roman occupation, the Samaritans and the Jews, lived. Of course, the period of Jesus' life and the early Church was a good 700 years before Mohammad so there were no Muslims or "Palestinians" in the area.

Not to put too fine a point on it, but the Jews inhabited what is today the Galilee -- and the area known as the West Bank [we don't call it Judea without reason] It is very striking. I invite you to do the same as I did, and then ponder on where, exactly, is the Jewish heartland. It isn't Tel Aviv. And how fraudulent Arab claims really are.

I can accept that the farther into the past one goes, the chances of mythology swallowing up historical evidence increases. I too am somewhat skeptical of the existence of the Biblical Abraham [but not a tribal leader, or series of them, who did what Abraham is supposed to have done; I think that's quite real] and even of there having been a real individual named Moses [although I do think there was an Exodus, probably of a small enough band that the Egyptians didn't get too upset about it]. But by the Roman period there is no doubt whatsoever of the Jewish presence in what is now Israel and the West Bank. Indeed, predominantly the West Bank.

Sunday, May 22, 2011

Confusion Reigns Supreme

Obama put his foot in his mouth when he made his Middle East speech; today, to AIPAC, trying to redeem himself, he made it worse. Commentary magazine has three excellent comments: here , here, and here, and there will probably be more to link to in the next few days.

Fortunately for us, the Palestinians are as unwelcoming for Obama's cockamamie ideas as are the Israelis. Fatah has already announced that there won't be any talks at all until Israel retreats to the 1948 armistice lines and that includes relinquishing Jerusalem's Old City. As Bibi so simply said, Israel will not accept indefensible borders. Tourists have often asked me why Ben Gurion Airport is so close to Tel Aviv -- should there be an accident, the civilian casualties on the ground would be horrific. When I explain that Israel was exactly 17 miles wide at this point between 1948 and 1967 and the airport could not be sited farther from Tel Aviv as it was on the border, mouths gape open in astonishment.

Flying time from Amman, Jordan to Tel Aviv is 20 minutes. In the event of an attack the Israeli Air Force has 20 seconds to scramble, which is why a substantial portion of it is always in the air. Driving time from Jerusalem to Tel Aviv is about 40 minutes (except when traffic is heavy, which is just about always). It takes about as long to drive the entire length of Israel from the Lebanese border to Eilat as it does to drive from Boston to Washington, DC --and that's on pretty bad roads, if we had decent highways through the Jordan Valley and the Negev, the trip would take 6 hours or less. Flying time from BG to Eilat is half an hour. Even with all the territory Israel gained in the Six Days' War, Israel is still a very small country. But Obama thinks we will commit suicide for him. Hah.

Saturday, May 21, 2011

"Medwife" and Proud of It

Midwife is a generic word for a person who attends a woman in labor and delivers the baby (do NOT ever use the word "birth" as a transitive verb around me. It is a noun). Roughly speaking, midwives come in two varieties in the US: "direct entry" midwives and Certified Nurse Midwives. "Direct entry" midwifery can mean just about anything: any woman who is either apprenticed to someone who calls herself a midwife, or who does a "course" (which may be anything at all --there is no governing body -- ranging from hippie nonsense to basic obstetrics). She may never have had to pass any examination, either theoretical or practical to demonstrate that she has a requisite level of knowledge and ability.

At the time I studied midwifery in the UK (1974-75), there were no accredited or licensed midwives in the US except for graduates of two institutions, one of which was the Frontier Nursing School in Kentucky. It was a post-graduate school for those who were holders of certificates from 3 year diploma nursing courses (academic degrees in nursing having only begun a few years previously; the vast majority of registered nurses were diploma holders) and who were licensed, after examination, as Registered Nurses in one or more states. (When I finished nursing school in 1967, there weren't any accredited midwives at all in New York and most other states). The Frontier Nursing School provided midwives originally to remote, rural regions like Appalachia where women had no access to doctors at all. Even as late as the 1940s they made their rounds on horseback in some places.

The reason I chose Cambridge in the UK was because the British had a reputation for a very high level of excellence in their midwives. One of the texts I used, the classic "Maggie Myles" (Textbook of Midwifery by Margaret Myles, 8th edition) actually stated that trained midwives were one of the UK's "major exports", especially to the Commonwealth countries and former colonies of the now-defunct British Empire. It was a year course, 9 months in hospital, three months "on the district" (i.e. doing home visits and home births), open only to those who had the British equivalent (SRN) of the American RN. A State Certified Midwife had certain legal obligations, her code of practice was extremely clear and precise, so that we worked with, not for, doctors, and had considerable autonomy about giving medications, etc. Once, however, certain parameters had been crossed, we could no longer be the main care provider. When I returned to the US, my SCM was the full equivalent of a CNM. Now, with all nurses being required to be the holders of at least a BA, courses to become a Certified Nurse Midwife in the US is a Masters' degree program. My British SCM was accepted unconditionally in Israel and I was granted a license by reciprocity; since I came to live in Israel in 1976, I've never practiced as a midwife in the US, although I worked as an RN in Labor and Delivery from nursing school graduation until 1974, so that I've never worked outside of maternity nursing in 44 years.

The current situation in the US is a mess. Some states do not permit midwives of any type to attend births; some define anyone attending a birth as a midwife even if she has had no education of any variety, some states allow CNMs, and lastly there are states which grant privileges to holders of a bewildering assortment of qualifications and licenses: CM, CPM, PM, LM, etc. Unlike the UK, there is no national professional body which sets curricula, or registers, or supervises midwifery practice.

Why do I bother to delineate the various categories of midwifery in a country I will never live in, God willing, again? Why should it matter, especially as I am coming to the end of my career? Because there are great misconceptions about midwifery, and the role a midwife plays in the care of women.

I tend all sorts of women, in all stages of pregnancy, whether they are high risk or low risk, whether they want medication in labor or do not. (For me, the issue of home birth does not exist: I do not think it is safe under existing conditions, in the US. The trend, in those European countries where it is permitted, under strict regulation, is away from home birth -- but that is another topic, which I hope to deal with in a separate post). Direct entry midwives lack the knowledge to care for any but the simplest, low-risk situation. They certainly do not have the requisite knowledge to safely deliver at home, and no hospital will employ them. The fact that some women do successfully deliver at home is sheer luck. In point of fact, it isn't very many. Less than 1% of births in the US are at home. But the biggest problem with direct entry midwives, as opposed to CNMs lies in the fact that, for the untrained midwife, ideology plays a much larger role than for a CNM. This ideology can be regarded as either inspiring or ominous.

It goes something like this: hospitals have medicalized what is a normal, uncomplicated biological phenomenon; have turned pregnancy and labor into a form of illness from which the average woman needs to be rescued. That pregnant women have been brainwashed into believing that they need medical and/or surgical intervention in order to deliver their babies; that doctors won't allow them to have the "glorious", spontaneous, uncomplicated "birth experience" that women are entitled to have. Usually some reference is made to how simple it all was "back in the good old days" before "medicalization" of labor. As evidence, the ever-rising incidence of Caesarean Section is referred to, called the "unnecessarean", often performed by the "slice and dice" doctor in order to free him to get to his dinner or the golf course. "Trust birth" is one mantra, and much too often, "female empowerment". The term "birth rape" has been coined by radical women who complain of being powerless in the labor room, as if they had more knowledge than the professionals who tend them.

An old, very experienced OB/GYN once said to me that one could only claim that a birth was complicated or uncomplicated in retrospect, and he was right. Things can, and do, go wrong in even the lowest of low-risk births. (This is one of the reasons I like obstetrics: while the vast majority of births will go as expected, when the axe falls, it falls fast and everyone has to be instantly ready; anyone working in midwifery has to wear multiple hats) The stakes are high: women do still die in childbirth, although the numbers are miniscule from the second half of the 20th century onwards, compared to the period before that. Babies die, or are damaged in birth, women may survive but lose their ability to ever become pregnant again. Birth is a kind of Russian Roulette and anyone who does not respect birth's negative potential is an idiot, or willfully blind.

Prior to about 1920 there were few statistics. Birth was indeed thought of as so normal as not to require research or record keeping, beyond the legal requirement for a birth certificate and perhaps a parish register. In the 18th century, it has been noted, the average marriage in certain British parishes lasted for 17 years -- men died from illness or accident, women died in childbirth. It wasn't uncommon for men to marry as many as three times with two wives dying in childbirth, but death in childbirth was regarded as fate, not pathology. These are the wonderful "old days" today's super-natural birth advocates refer back to. I've got a host of stories of deaths and traumatic deliveries, some of which changed the course of history, that simply wouldn't happen today.

Along with better record-keeping, and advances in medical knowledge, came two very important technological improvements: the advent of general anesthesia in the mid-1850s, and antibiotics, namely Penicillin, in the 1940s. Until then, while obstetric forceps had been around since the 18th century (and were often used in extremely traumatic ways in situations that otherwise would have called for intrauterine destruction of the fetus as the only way to get it out), Caesarean Section was virtually impossible unless one was willing to sacrifice the mother to hemorrhage, shock, and/or infection. Suddenly, both the woman and her baby were likely to survive. Maternal deaths plummetted; so did the mortality and morbidity statistics for the baby, although not by such a large amount. Women came to believe that every birth would result in a perfect outcome. And that birth could be painless.

In the 1960s the concept of "natural childbirth" came into being. The drawback of the combination of medications (Demerol --pethidine, scopolamine, and phenergan), given intravenously, called "Twilight Sleep", was that the baby was often born very depressed and needed resuscitation; the medication crossed the placental barrier and into the baby very rapidly. Research claimed that the first half hour after birth was an essential "bonding" time for mother and infant, and with a mother doped up, she was deprived of this (how nearly all of us, born to mothers during the era of heavy medication, ever bonded with our mothers and they with us, was ignored -- just as the generation of bottle-fed infants, often on strict schedules, ever grew up normal is another question). Various techniques, such as Lamaze, were developed to assist the woman to cope with her contractions without getting medication. Up to a point, they worked. A lot depended on the kind of labor the woman was experiencing, and her pain threshold.

It was now known, through statistics, that women having certain kinds of labor had the best outcomes. Contractions and cervical dilatation could be plotted on a graph (the Friedman curve) and if a woman's labor deviated radically, it was shown that medical intervention such as pitocin augmentation, increased the chance of good outcomes. Prolonged labor resulted in a substantial number of cases in increased fetal morbidity and lasting disabilities. The March of Dimes, which originally was set up to deal with cerebral palsy sufferers, which was most often a consequence of prolonged labor, changed its target to birth defects as the number of CP kids declined. The ability to resort to C/S also decreased maternal and fetal mortality and morbidity. Earlier generations simply did not have the technology, or they would have availed themselves of it. Along with improvements in obstetrics came the idea that any bad outcome must be someone's -- usually the doctor's -- fault, and Americans, in general, are very litigious. I can remember when the tools of fetal monitoring and ultrasound were introduced (early 1970s). It was a mixed blessing. It could give warning of impending complications; it could also lead a doctor to the OR faster than he might otherwise have gone -- and if the baby was born pink and screaming, the parents often felt that the operation had been unnecessary. Epidurals, pioneered in the Vietnam War, brought the concept of "painless birth" much closer, too.

And suddenly, what I can only call the "Luddite response" to childbirth came into being. "Natural" childbirth became "childbirth without any medical intervention whatsoever" and appealed to women who had never seen the pre-modern carnage that attended childbirth before modern techniques. To be fair, both doctors and hospitals had managed, by now, to alienate many women, through poor communication and an emphasis on sterility and technology. Delivery rooms which had white-tiled walls had a tough time even admitting that pastel colors might be preferable. Delivery positions other than lithotomy were regarded as primitive. And a husband who wanted to be with his wife in labor was thought very odd indeed, not to mention probably a potential contaminant of the aseptic atmosphere. This is still going on, in places. It's no wonder home birth looks attractive to someone who has no knowledge of the potential dangers of giving birth where there is no instant availability of emergency care. It's no wonder a woman resents a doctor who uses a line like "don't worry your pretty little head" or a variant thereof since the rise of feminism. I've never understood the attraction of suffering unnecessary pain as being "empowering", but I do know there are many women who do so. Sometimes I think it is just to make the doctor, especially if male, uncomfortable.

The history of obstetrics in the US is a very interesting subject. Doctors -- accoucheurs -- were first gaining a foothold among aristocratic women in Europe when America was in its infancy. Wanting only the "best", American women demanded obstetricians to the exclusion of midwives and it's been that way ever since. Indeed, in the 1930s, the only midwives licensed to practice in Louisiana, for example, were black women who tended other poor black women who could not afford a (white) doctor. We were shown a film about one of these when I was in nursing school ("All My Children") and it was appalling.

The super-"natural" school of thought regards persons like myself, who think there is a middle-of-the-road approach to pregnancy and labor not as "midwives" -- that title being reserved for those who eschew all modern advances in medicine -- but as "medwives", midwives who are in thrall to the hated medical establishment. My philosophy is simple: my goal is a healthy mother and baby. Whatever it takes, I'll do. When I can act in accordance with the mother's wishes, I am happy to do so, but my responsibility as a professional will not allow for undue risk to either patient. In my experience, when patients are properly informed, there usually is little opposition to my suggestions. In situations where I am caring for a patient in conjunction with a doctor because of some high-risk condition, I usually find that the doctor and I have a good working relationship; we respect each other's boundaries. The patient benefits from a joint approach. Communication, trust, and respect are of the utmost importance. The practice of obstetrics is both an art and a science. The knack is knowing which to employ in any given situation.

Much has been made of midwives --almost always the direct entry variety -- who accept patients who are patently unsuitable for exclusive midwife care. Right now there is a huge hullabaloo about Karen Carr, who accepted a woman after more responsible midwives refused to take her as a client, due to more than one high-risk condition that made home birth extremely dangerous. In the event, Ms. Carr actually delivered the baby, who died, in a state where she is not licensed to practice, yet she has aroused a surprising degree of support for her action, and the woman's right to take a course of action which caused her baby's death. (The mother, btw, is not being prosecuted for manslaughter, since an unborn fetus has no legal rights. I find this also reprehensible) Due to a plea bargain, Ms. Carr is now able to wreak havoc on more babies and mothers, btw. This is one of the reasons that there should be nationwide licensing, nationwide supervision, nationwide standards of practice. In European countries this is so. But non-CNM midwives in the US resent having any restrictions put on their method of working, and as I stated at the beginning, the US is a patchwork of regulations, or lack of them, for midwifery practice.

So I stand by the title of this post: the term "medwife" is not a negative term, in spite of attempts to make it so. With the increasing shortage of doctors specializing in obstetrics, midwifery will become more common. I only hope that the practitioners are Certified Nurse Midwives, who are real professionals, and that the incompetent, under-educated, unsupervised, "cowboy" midwives are relegated to history.


Gordon Campbell
Freelance
May 21, 2011

Do you understand this cartoon? I confess I do not. Does the cartoonist think Obama is betraying Israel by a pro-Palestinian stance, or is he being insufficiently pro-Palestinian [as Abu Mazen has gone on record as saying] Just goes to show the confusion surrounding what exactly Obama said, IMHO.


Rob Smith, Jr.
The Glenn Beck Program
May 21, 2011

Why There's Been a Gap in the Blogging

My son, quite rightfully, has complained that I haven't blogged in a long time. It's true. Not for want of subject matter, however.

An average Antigonos day begins about 7:30 in the morning, when I crawl or stagger from my bed. It usually takes me about 2 hours to sufficiently limber up to the point when all my joints stop screaming at me and my vertebrae stop feeling like a Slinky toy going downstairs (as long as I'm horizontal, the vertebrae are loose enough to only ache; once vertical, I feel them all compressing downward, due to the influence of gravity. I have several ruptured discs in my lumbar spine, with corresponding degenerative changes. Hell, I'm a nurse and I'm in my mid-60s. I've had back pain since I was in my first year in nursing school). After the usual ablutions, I have to check my blood sugar, and take my medications (type 2 diabetes, hypertension, congenital high cholesterol, gastric reflux, and an antidepressant because of all my other chronic conditions). Then, I eat breakfast while watching the news on Sky (British and world) and the BBC. When the antidepressant and my pain medication have kicked in, it's time to begin cleaning up yesterday's mess. And there is always a mess: the Holy One, Blessed Be He, has decreed that for giving my ultra-neat mother, z"l, many years of anguish with my slovenly habits, I should marry a slob and produce slob children. The children are all adults, but we still have a married daughter and husband living with us -- and, as of mid March, a further distraction:


My granddaughter, Shir. Yes, I've become a savta.



By this time, if I'm lucky, it is about 11 a.m. Now I rush to the bank, the shops, the market, etc. Fill the car with gas, get more credit in my E-Z Park device, in short, do everything else. And, not forget to arrange for some lunch to take to work. The life of a diabetic is obsessed with food; you can't skip meals or even delay them much or there will be an attack of hypoglycemia.



At 2 p.m. I'm at work. It isn't physically demanding work, in the main, but the pressure is steady and constant. Every woman who comes to the Women's Health Center I work for wants instant attention. I give instruction about injections, or the injections themselves, to women undergoing fertility treatment; do regular antenatal checks on women who have appointments with one of our high-risk specialists as well as give instruction to those diagnosed with gestational diabetes on how to check their blood sugar properly; and handle all those women who come to the walk-in "emergency" part of the clinic. (Rarely are these women actual emergencies, but nearly all of them are anxious and do not want to wait in line for the doctor. Some are downright crazy; some are physically aggressive)



When I get home at 7:30 p.m., my husband wants pampering and by the time I fix him a meal (we had an agreement that he'd eat his main meal during his working day, but he has long ago forgotten that), and my own, I fall into bed at about 11 p.m., having made the mess I'll have to clean up tomorrow. Let's not talk about laundry.



In between all this, I read my emails and a lot of internet journals and blogs. Often I say to myself, that I simply must reply to this or that article -- but never get around to it, and events usually overtake me long before I have the time to compose anything. Right now I badly need to revise my blogosphere list, as well as post links to my favorite commentators and news analyses. Ah well, I'll get to it when I retire, I say, much as Scarlett would think "tomorrow is another day". The only problem with this is that, although legally I reach retirement age in October, I doubt that, for financial reasons, I can stop working then.



I belong to a number of internet lists. Some are literary, dealing with the works of Dorothy Dunnett and Diana Gabaldon. The Dunnett lists have sub-lists for discussion of other topics, notably politics, and the Compuserve Writers' Forum actually is involved with much more than Diana's writing. I've made, over the years, some great friends on these lists; in 2000 I got to meet other Dunnettophiles in a Gathering in Edinburgh; next time I'm in NYC to visit my son I hope to meet some Gabaldonians.



My other interests include midwifery: two notable blogs are At Your Cervix and Navelgazing Midwife, although I find myself philosophically at odds with both, more or less. These bloggers probably have reservations about me, too. I can only point to my 40 years of experience in the field in defense. I also read some medical blogs written by both American and British doctors --it makes me sad to read what the Brits have to say about the NHS. When I was part of it in the mid-70s there was a lot of grousing about excessive politicization, but in Cambridge at least, it worked well, and there's nothing wrong with the concept.



The first internet list I ever belonged to (and still do) is Tachlis, which is a list devoted to giving practical answers to questions about all aspects of aliyah. "I'm coming to live in Israel in 4 years --should I bring my pressure cooker?" is one of the more meshuggeneh questions asked on the list, but many posters have real concerns that the various aliyah agencies can't, or won't answer. The list is very wide ranging.



The list of online magazines I read is long, tending to political analysis, particularly about Israel, but also about US and European politics, since those issues affect us eventually. My son was particularly concerned about what I thought of Obama's speech the day before yesterday. I'll deal with that in a separate post.



And now it's back to the @#$%^&* dishes....

Saturday, January 29, 2011

Somethin's Happenin' Here....

What it is ain't exactly clear...

At this point, 7 p.m. on Saturday evening in Israel, whatever I write will be overtaken by events, but America, no less than we are, should be afraid, very afraid of the domino effect caused by the popular uprisings in Tunisia, and now Egypt.

Tunisia will likely be under the thumb of Islamic radicals shortly, even though this is not what the protesters wanted, and Mubarak is finished, and Egypt is likely to turn much more fundamentalist as well.

About 40 years ago an Israeli, Rafael Patai, wrote a very good book called "The Arab Mind" in which he noted the degree to which there was an almost total disconnect between the educated and uneducated classes in the Arab world, particularly in Egypt. The educated emulated Western culture, felt considerable shame for the "primitive" fellah, were usually less fanatic and more secular. The peasantry, however, which constitutes the vast majority of the population, saw the educated and wealthier classes as something not quite "Egyptian", something alien. Whoever comes out on top now, one of the first things they will do, once the looting stops, is to close as many Western-style institutions as they can. Incidentally, that will destroy one of Egypt's main sources of income, the tourist industry. Moslem Brotherhood terrorists have already targeted foreign, "decadent" tourists repeatedly. One can only hope that, in the name of Islam, Egypt's ancient treasures won't be damaged as being "idolatrous". Certainly the 10% of Egyptians who are Coptic Christians have reason to be very fearful for their very lives in a Islamic Egypt.

We, of course, are similarly worried. Although the peace treaty signed with Sadat has never actually been a peace treaty -- much more an agreement of non-belligerence, as Egyptians cannot visit Israel nor has there ever been any common business ventures between Israel and Egypt [indeed, the flow of money has been only one way, with Israelis visiting Egypt] and in fact there is rampant, vicious, and government-sponsored anti-Semitism in Egypt -- any change of government in Egypt brings with it a possible abrogation of that treaty. In the case of an Islamic state, it will be almost a certainty. [That's why, when all Israel was in ecstasy over the end of the formal state of war Egypt claimed to be in with Israel, I was opposed to the treaty, back in 1977-78. I was sure it would not survive Sadat. In that I was wrong, because when Mubarak took over after Sadat's assassination, he endorsed it. But I was sure -- am sure -- that the treaty would not last after the Mubarak era]

What is happening in the Middle East is that the traditional fault line between Shi'a and Sunni is reasserting itself. There is huge poverty and corruption in both populations, in all the countries from Turkey to North Africa. The simple folks see Islam as the solution, not the cause, because they are told so, from the mosques. And they are ignorant enough to believe the demagogues who will find a scapegoat for their own inability to give the people what they want. Israel sits, as a kind of mini-America in their midst like a bone in the throat. Now that Obama has shown, in his speech endorsing Mubarak, that he's not only weak but stupid, and that the Americans, fleeing Iraq, aren't to be feared anymore, animosities that are nearly a millennium old are reviving.

Israel is like a pimple, not a cancer. If you are Shi'a, the cancer is any Muslim not Shi'a. If you are Sunni, the cancer comes from certain heretical views held by the Shi'ites. And so on. And, it must be remembered that the Middle East is far from homogenous ethnically. Those who revolted in Tunisia are Berbers; Lebanon is a patchwork of ethnic groups, the Turks are yet another distinct group, as are the Syrians and the Iranians. The modern Egyptian is only marginally racially related to the Egyptian of the Pharaonic period [the most pure are in the remotest villages that never were touched by the Hellenistic or later periods], and the so-called Palestinians are a really mongrel people, with more than twenty distinct ethnic groups participating in their composition, from as far away as the Sudan and the Balkans. The only true Arabs are the Saudis. All are linked by Arabic [it is forbidden to translate the Koran so every child learns enough Arabic to understand it] but Arabic is not the mother tongue of Turks, Tunisians, Iranians, Iraqis, or Kurds, who have very unique cultures.

There's not a lot we can do but sit quietly at present, but like a pimple which constantly reminds you of its existence by pain, needs to be squeezed for relief, and ultimately will be. Watch and see how Iran re-directs its venom from Israel to Sunni nations who attempt to thwart its march toward hegemony of the northern part of the Levant. Watch and see how a resurgent Islamic Egypt and North Africa try to delegitimize those countries with large Shi'a populations and governments, like Lebanon and Iran.

And in the midst of it all, like a tiny amount of flavoring for a cake, sits Al Qaeda, ready to "purify" all Islam in its crusade to conquer the entire Infidel world for the True Faith.

It will take a while for all this ferment to have concrete effects on the US; but it will come, because the adherents of Islam aren't "politically correct" and do not believe in tolerance. But it will come. Welcome to the medieval world of resurgent Islam at the end of the Crusades.

[to be continued, as things, in the words of Howard Cosell, "eventuate".