Wemberly, Kevin Henkes’ anxious little girl mouse, has been on my mind recently. The thing to know—book title, Wemberly Worried, tells us so—is that Wemberly isn’t a cool cucumber. She worries. She worries about all kinds of things, from whether people will like her to separating from her parents for preschool mornings. Her stuffed snuggly friend, Petal, is a good companion to Wemberly—and Petal also gives Wemberly someone else to worry about. Wemberly’s kind of jazzy grandma wants her—and her parents, for that matter—to relax. That’s not so easy for Wemberly (or for her parents).
One of Henkes’ board books for toddler literary enthusiasts is Wemberly’s Ice-Cream Star (and you haven’t really read this book unless you do it at least five times in a row, but Saskia understands this and makes sure I do, regularly). I love the very short narrative—and I think I finally get it: Wemberly worries that the ice cream treat she’s been given will leave Petal wishing for some, too, and so Wemberly lets the ice cream melt into soup, pours it into two bowls so they may share, and then finishes Petal’s portion (sorry for giving away the plot, but I have my reasons).
What I’m sure Henkes wants me to think about is what a great friend Wemberly is—and indeed, she is. In his gentle way, Henkes is also reminding parents to worry less, trust more (here’s a link to my favorite song for reminding me of this). It’s one of those messages parents—actually, all adult and many child people—require these days, like a mantra.
There’s been a lot of women’s health news and some controversy going on over the past month or so, right in the midst of a very disturbing and frightening and frustrating struggle to get meaningful health care reform enacted (as of last night, with the latest round of the flip-flopping, angry little man Joe Lieberman’s protracted tantrum within the gigantic Senate complex, things don’t look so good for the people; the insurance companies stand to come out of this process doing just fine, though).
As is the case with all science news, you can read studies and recommendations any which way (I learned this at Hampshire College, where one of the first things I was taught to do was read primary sources and question the researchers’ assumptions). To keep things confusing and controversial, have some of the recommendations—say, start mammograms at 50 now rather than 40—be endorsed by a smattering of women’s health or cancer-research groups but not by others. Throw in what seems a kind of dastardly piece of counsel—that’d be telling women not to do Breast Self-Exams—and add another recommendation made a few days later to raise the age for pap smears to 21, and you can read it—somewhat credibly, I might add—as sheer cost-cutting measures. Sarah Palin’s death panels can be proven to be not through abortion but through refusal to treat or test or screen…
However, before getting into the sinister conspiracy theory, remember that recommendations to decrease the frequency of pap smears are not new news. Health care providers would quickly point out that there are two reasons to consider the changing the annual Pap smear protocol carefully. First off, it’s more critical that a woman get this screening if she is sexually active with different partners (or her one partner has different partners). Providers realize that denial is such a powerful force that to ask women to come for pap smears based upon sexual activity is not effective. Laurie Green, OB/Gyn from California Pacific Medical Center is quoted in a news story: "A woman who's never been sexually active probably doesn't need a Pap smear at all. On the other hand, someone at the age of 20 who has already had multiple partners probably does need a Pap smear. And of course, at the time of the Pap smear we do screening for sexually transmitted diseases like Chlamydia, which can be silent, and gonorrhea. We also council women about the whole breadth of their healthcare and their healthcare needs.” The second concern is this: scheduling. Annual is easy to remember (and easier to adhere to than, say, remembering something every third year) and so ensuring that a less regular schedule is kept merits consideration. On the other side, there is evidence that treating something too early may not actually be the best choice—and that’s a very compelling, serious concern.
Now, anyone incredulous about whether women, young women especially, who are the most vulnerable to sexually transmitted infections to unintended pregnancies need look no further than the season premiere of MTV’s reality show, Teen Mom. Catelynn, still able to count in weeks how long it’s been since she gave birth and ceded her baby, Carly, to adoption (a choice made with her boyfriend and in opposition to the boyfriend’s father and her mother’s wishes; those parents happen to be together, too) goes to her doctor for birth control. Catelynn wants Mirena, which is practically a foolproof method of contraception. The doctor asks whether she could possibly be pregnant before inserting the device. Catelynn answers emphatically: “No.” Cut to her and boyfriend and his asking her why she lied to the doctor about having had unprotected sex. “I was scared she wouldn’t give me the birth control,” Catelynn explained.
I get it, having gone to be fitted for my first-ever diaphragm just weeks after becoming sexually active at age seventeen and discovering I had become pregnant in that very short window.
As with every intersection of health care and sexuality, how to responsibly join the reality of people’s behaviors—including their denial—along with actual and accessible education that might be effective, and health care delivery-related issues, including cost, including access is a tall order.
The mammogram news is possibly even more confusing. Intuition could lead a person (woman) either direction: toward screening earlier and more regularly or away from it (read Gail Collins’ wonderful piece, The Breast Brouhaha). You have respectable groups advocating for both approaches. You have a month each year of pink ribbons waving and pink ribbon products (a portion of the proceeds go to support a cure, we are promised) being flogged (as in, buy these pretty Hershey kisses and you’ll be contributing to positive social change). You may have mixed feelings about pink ribbons (I know I do, for myriad reasons, the buy junk for change message just being one of them). You have, we all do by the time we’re in our forties, stories, anecdotes, and ultimately sorrow, because the statistics about how many of us will endure breast cancer are daunting.
In The New York Times Magazine this past week, John Edgar Paulos, a mathematics professor at Temple University, laid out the numbers in his piece Mammogram Math, which quite possibly fly in the face of your gut reaction to check for breast cancer early and often because you can. Numbers are cold, in that even if they are “good,” they include the truth that if you go by numbers, some people will not have their disease detected in a timely enough manner. Numbers, so far, cannot calculate the risks run by more radiation in the form of more frequent (and early) mammograms, because we really don’t know enough. And legitimate are the fears that if a recommendation is made for less testing, then an individual may not be able to be reimbursed for more testing if she sees fit, for whatever reason.
How we navigate numbers, unknowns about exposure to radiation and other hormones we may have taken (contraceptives, HRT, fertility treatments), access to tests, and those very compelling, very real personal stories—each person’s narrative is different, remember—is one of the “it’s complicated” story of our times.
Henkes, through Wemberly, offers us some good pointers, I am certain. Care about your friends—that would be, let’s continue to lobby for reform that allows us to care about and for one another—and worry less—let’s try not to be so hard on ourselves and each other for struggling with hard questions in complicated times. Let’s understand each other better and let’s somehow, figure out how to become collectively less afraid, and collectively more joyful, because there’s something in the message—not just Wemberly’s or her grandma’s—that tells us, savoring what we have each day is more healthful than worrying or fighting. It’s not simplistic to posit that we are too entwined by fear and outrage at times to care for ourselves in tried and true ways, like smiling and moving and sleeping and eating right and loving one another.