Counting the Days

It is never easy watching a parent die. And even more difficult watching them suffer a slow and painful death that could take their life tomorrow or take them in another 40 years. And what can make it even worse, knowing that you will likely achieve that same level of agony at some point before you die, because you too have that same medical condition. But hopefully you will know you can choose your death, even if you can’t choose the manner you are delivered to it.

I remember going with my mother to the first pain specialist in 2001. “You have Parkinson’s,” the doctor said. Parkinson’s explained her stuttering and shaking, but it didn’t explain the random pain and the doctor wasn’t sure either. He handed her a prescription for Neurontin 5 mg to be taken once daily. “We’ll see if this helps with it and address it further if this doesn’t resolve the symptoms.”

It was four years, three doctors, one new diagnosis, and many  more medications added later before the pain specialists managing my mother had finally decided that the Neurontin was not the appropriate drug for her medical conditions. But at this point, there was one problem. My mother had been on it so long and was increased so many times that her dosage now sat at 800mg daily.

The doctor who had recently taken over her care stared appalled at her. He was concerned that the previous doctors allowed her to remain on this medication for so long without trying a different one despite the fact it obviously was not effective. He requested she try to use a half dosage of Neurontin and supplement with a potentially more effective new medication. She tried. But after 14 hours the agony from her lack of Neurontin and the side effects from the new medication nearly drove her to suicide. She pleaded I call the doctors because her body hurt so bad from the pain that she feared she would not be coherent enough to express her needs to the staff. I did so and they promptly stopped trying to alter her medicine regiments. It has since become a “treat the pain and sedate the soul” until the time comes. My mother lives out of a little box filled with pain pills and antidepressants to get day in and day out.

Holidays, she will visit the family for maybe an hour and then she is spent, emotionally and physically. She fears the burden of her presence on the family will bring others down. So she returns to her small apartment where she keeps her gun and her medications to keep her from using it. I’ve watched my mother go through tests, experimental procedures, and excruciating pain for the last 8 years. She has given up. And now I have it.

The biggest differences between her and I. She was improperly treated by doctor after doctor; we knew the proper precautions to avoid triggering mine or at least advancing it. She was one of the first people to really be treated with many of the experiments’ now known to make the condition worse; I have had a few years to have results of the tests be published to research online. And lastly, my mother fears being a burden on her family and would sooner be dead to us now while she still lives than feel she is causing us despair seeing her deteriorate. I don’t care if my family feels that way, because those of my family and friends who really care will be there as I will always be there for them. Even if I can’t physically do what I once could have.

I know my mother is going to die. And it might seem odd or maybe uncaring, but I hope it’s soon. The doctors are giving her so many pills, that my mother is barely a human anymore. I can count one of three things each time I try to call my mother; she’ll be pushing herself too hard because the pains subsided for a few hours, she will be exhausted from the pain from fighting the atrophy of her legs trying to use them, or nearly dead from taking a medication at the wrong time one of these times. I just hope that when she goes, it’s not because of the pain and because of the fact her body was done. I count each day as one more my son has gotten to have with her and one more he will have with me.

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Conquest Disease

The Unseen Weapon of Mass Destruction

America, today, is a hemisphere with such an array of ethnic backgrounds but still shares one common link, immunity. This link, like many of the inhabitants, is an imported item to the Americas. This item was imported along with the cause for its existence. That cause, disease, would become the most inexpensive, effective weapon the conquests have.

Even in modern day, when a person gets sick, their loved ones care for them. Many times these loved ones are family and share similar strengths and weaknesses as those who fall ill. And with the seclusion from the rest of the world, it wasn’t just one or two diseases that those original inhabitants were weak against. And as a family member would fall to an illness they would expose the rest of their family. Those family members who were weak would eventually face a similar fate, those who were lucky to have immunity would likely go reside with other family members who were more resistant to the current strain and assist them.

But the bombardment of the new strains hitting the Americas was like a wild fire. As one strain seemed to burn out, two more would pop up unexpectedly. “Influenza, small pox, measles, mumps, and pneumonic plague arrived first, followed by typhus, diphtheria, malaria, and yellow fever” Butzer pg 351. Each disease with a swarm of symptoms, some minor and likely already treated in the old world, but others too aggressive to address. Eventually leading the populations to catastrophic levels of fatalities that delivered the old world’s inhabitants to their gods, and sparing so very few to watch their societies crumble under the new rule.

The first and still very prominent today, influenza, is easily spread through the air. Today, the symptoms are well known and are often dismissed by those infected as medicine and treatment is so readily available. Symptoms of high fever, headaches, exhaustion, cough, sore throat, running or stuffy nose, body aches, vomiting, and diarrhea for those of the ancient world without effective medicines were likely improperly addressed or under estimated and the body worsened.

With today’s medical knowledge people are still dying from dehydration and bacteria caused pneumonia and those who do live suffer advancements or are struck down by “congestive heart failure, asthma, and/or diabetes” according to the CDC. Even these health issues can lead to death today, before we had the medical treatments and diagnosis of our modern medicine, the damage of the “flu” alone was staggering to a society with no immune systems against it or knowledge of how to treat it.

Even as the flu created chaos and weakened the immune systems of the inhabitants, other diseases were waiting to flood in. The mumps and measles were airborne pathogens that with any exposure could be transferred to the inhabitants. Additional symptoms were now bombarding the locals leading to more problems of pneumonia, meningitis, encephalitis, seizures; all which without proper medicines and treatment even today can cause death. And those who lived faced blindness, deafness, and in the case of mumps, even sterilization.

Other diseases such as small pox and pneumonic plague still required physical contact, maybe not always of the person to person type, but rather bedding to person, it still was capable to giving very horrible ends to those who would be otherwise be unexposed. Rashes from small pox could be over looked as something less extensive and treated improperly leading to exposure of others in the family or worse yet, infection of the blisters for the ill. It was a war zone for each individual body, let alone each household and each city.

Even today, these diseases run rampant in parts of the world despite our attempts to vaccinate.  An outbreak of mumps 2 years ago, despite his complete vaccination record, left my son with permanent signs of his personal battle with this disease. He lived, but must be constantly watched to insure other problems have not been caused. In other places with less access to the vaccinations, the measles takes the life of 1 in every 4 lives it touches.

There is no question the ancient societies of the Americas were being murdered by unseen enemies, but those remaining were being demoralized. They watched loved ones die and in some cases, worse yet, live. It was excruciating. Their societies were being enveloped and falling into ruin under the hand of the visitors, regardless of if they wanted to fight back or not. There was no protection from this weapon. Guns were intimidating but the bullets had to strike you, but with so many of the diseases requiring only the breath of a symptomless but carrying person to touch the immuno-deficient, there was no stopping it.

The pain of knowing there is nothing you can do to fight back. Nothing you can do to reassure those who you love and care about that they aren’t going to die, is agonizing.  I can only imagine what those who lived through the wild fires of disease felt as they watched their worlds, their lives, their families fall. I was able to have faith my son would live, but for them with each death, that hope with each new victim of the diseases, that faith must have been shattered for those people.

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There’s Always a Time to Die, Rarely Time to Live

“I’m dying!?!  Wait, is he sure its brain cancer?  Is there anything else it could be?  I need to see for myself.  OK, time to get on WebMD.  What symptoms should I have?  What symptoms am I displaying?  Heck is there even enough symptoms to be sure I have it and not something else?”  These are all things that I need the answers to before I can count on the doctor telling me anything viably true.  I’m not unfamiliar with the capabilities of doctors making misdiagnoses.  “OK, let’s see, if I have fewer than 50% of the symptoms, it’s time to visit a second opinion.  Heck, even if I only have 50%, I’m going anyway.  Anymore than that; I’ve got to think.”

After spending the rest of the afternoon reading, understanding the causes, the treatments, and the likely side effects of treatment or no treatment, I decide on comfort care.  I’ve never liked pain, at least not inflicted by outside forces.  I have always had an amazing pain tolerance to my own bodies pain, just not to needles or treatments delivered by doctors unless I’m put under.  The treatments the doctors are offering are going to just be too much for me.  I mean a chance for survival is a nice thought.  But even if I recovered from this, the pain I would go through would likely still leave me debilitated because of the RSD.  Not to mention what it would put my children through, my loved ones.  I just don’t feel that the chance of recovery from this outweighs what I’m likely going to have to relive daily if the cancer doesn’t get me.

I spend the next few hours thinking, “How am I going to tell Joe?”  I get to thinking of how he has dealt with others deaths.  At first he did so well, and the depths to which he feels the sorrow of their being gone.  Heck, we have spent hours we discussing death, and what happens, and even my own death.  I choose to go somewhere special, somewhere we some great times and give him a way to try and enjoy this.  When I was pregnant I used to go to the park where his dad takes him now regularly in his home town, but unfortunately I can’t handle the drive anymore because of the pain.  So I decide to go to the park here in Cedar Falls on Franklin.  He loved the one just north of Main and First Streets, but the floods of 2008 really did it in.  For Joe’s sake, I ask his dad to come down to help Joe through this with me, because with me gone, Joe is going to depend on him a lot more now.

I break it to Joe gently asking him if he remembers swinging with me and I tell him about what I did that fall before he was born.  I talk about how we all are born and remind him that we all die.  That is when I let him know that the doctors feel that I am going to be leaving him soon and that I want to spend extra time with him doing things he enjoys, like when I went swinging with him all those years go before he was even born.  Dave’s trying to soak it in.  He has known that with my RSD so much has happened to stop my ability from doing things, but it really hasn’t him that soon Joe will be in his care for the rest of his adolescent and teen life.  My being able to be alive was the last thing he thought RSD would stop me from doing.

I express to Joe that as I get sicker, dependant on how his dad feels, any schooling he needs to do might be best done at his dads.  I want to see him every waking hour I can but he knows that we all have to make our mark in history and life, and it’s much easier to do that if we are educated.  But I make it very clear that if he wants to stay with me, he must promise me to do his homework and not try to take care of me all the time because there will be people to help with that.

I also take this time to explain that my body won’t always look like I do now.  I will get tired more often, my skin’s color will most likely change, and I will still hurt, maybe even more so.  But no matter what I am still myself inside, even if my body limits me.

Many times Joe and I have discussed that life only ends when we let it, and that as long as he loves me, then I will live forever.  In the past, I have known some very vivacious elderly and some very dead youth.  Our family and our friends keep us alive as long as they remember what we taught them and gave them throughout the time they spend with us.  It would be now that I would finally become more honest about what I believe, because what do I have to worry about, someone killing me for being too outspoken?

Personally, what little faith I have has led me on a path to learn about belief and religions in general, to try and find answers according to whatever omnipotent being there might be and to live life that way.  One of those things I have come to believe that the way we are, we act, we think is bound to the soul/spirit.  And one of my greatest fears is of being trapped, my spirit bound to my body in which I could no longer do the one thing I live for.  I desire to bring a genuine smile to someone’s face every day.  Being in a place where I could not interact with others; that would be worse than any torture hell could devise.

After telling Joe, I break the news to my father and mother; they try handle it as best they can, but I can tell it hurts them deeply, especially my mother.  I let them choose to break news to the rest my family, I let my brother and close friends know.  It is these people whom have been there through the rough times, standing by me through the pain of the RSD, that I owe them the information in person.  So I ask them to come over for dinner to discuss the philosophy of life for an opening break it to them.  For those at a distance, I attempt to at least do it over the phone so I could comfort them in some small way.

Time moves along and I start to become weary of life, the pain would steepen, amplified by the RSD.  At points I feel life is worth living and again consider suicide again or even assisted suicide.  As I have so many times before, considered them both for present and future means, I remember that even if we don’t enjoy my life, we are going to die, so why rush fate.  Even now I still believe everything has a reason it happens, even if it doesn’t make any sense now, those events have a place in history, unknown to future generations or not.

I try to keep a diary from the day of diagnosis till my death of the love, the joys, the pains, and the tears.  I want my family to know the depths I love them and this book gives that to them.  I have already “died” once, the second time around isn’t so scary.

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Death and the Living, a Fatal Attraction

Yes, it is a morbid way to look at it, but it’s true. Those who are living often die when their family members die. They become so focused in the loss that many of the living have been known to stop living themselves. Recently, I lost two people very close, my father’s mother and my counterpart’s mother.

My grandmother we knew was falling away, and it didn’t hurt at all. It was almost a comfort to see her leave her body. She had 5 children, 9 grandchildren and a herd of great grandchildren to leave behind her legacy of her teachings. She was a spiritual person and very much believed in faith being a driving force in life. This is one of the facts she and I very much disagreed on but in the end I think my differences of opinion gave her the knowledge she didn’t have to lie to me, as I will tell you later.

Avis, my counterpart Leo’s mother, the loss of her took a little bit for the shock to wear off before I realized what happened. But once I was told by my counterpart and Avis’s husband what happened the day before, I knew it was going to happen. Avis apparently had a fantastic day of recovery on the 4th of July. So fantastic even the rehabilitation center was amazed she was doing so well. This bit of information threw up a red flag for me that had I known I would have encouraged Leo, my counterpart, to go to his mother and spend this GREAT day with her.

You see, I used to work in a medical office and did all the filing work for a small office. The doctor would document on how those in the nursing home that he would visit were doing. I would, in turn, file in these reports in the patients files. As I would put these notes away, I would read over them to see how our patients were doing. Often times, 9 out of 10 times in fact, the last entry remarked there were remarkable strides by the patients’ emotional & physical well being. Also one of the more common things I learned while working in this office was that many of those who pass, happen to occur on crucial birthdays, holidays or some sort of anniversary that is emotionally tied to that person.

Avis’s fantastic recovery from a double bypass surgery less than two weeks after 6 pins being put in her shattered hip, just over a year after having a partial amputation to her foot due to gang green and not quite a year from having a stroke and bad medical treatment/follow up. With all these events in such a short period of time she had such a weakened immune system this notification of great standings would have told me everything. Her body was giving her one last final great day and no one saw it. Since then Leo has suffered a lot of remorse based on “lost time.” Whereas, her husband Lonnie, wasn’t as stricken with grief, because he did go and visit her the night before.

It’s sad what people miss out when they don’t live every day as if it’s their last. People always seem to count on “tomorrow” to be the day they tell those they love how they really feel. The truth is so easy but so hard that often times people choose silence than to speak out what they feel and think.

At both passing’s funerals there was a family time to discuss the deceased. It was an uncomfortable silence by both families until I spoke out on my experiences. Avis and I had discussed this last Christmas her passing, in which she expressed her only fear was if it would hurt. My grandmother, I had a few moments with her privately about two weeks ahead her day. My grandmother confessed to me she had lied to my aunt for my aunt’s sake. Grandma had been claiming about how she must have fallen at some point and hurt herself because she needed her pain pills. When I asked her about it she just looked at me slyly and said she knew she was dying, and that she only said that to ease the pain on my aunt who was caring for her.

Death is easy for the dead and occasionally the dying, but so hard for the living. To accept the passing of someone when you have so much you want to say. That is why I cannot express enough how important it is to say what you think when you think it. We only live once, and we will die. So why leave the world silent and not stirring the waters?

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Jung Test results

 

Introverted (I) 66.67% Extroverted (E) 33.33%
Intuitive (N) 54.05% Sensing (S) 45.95%
Thinking (T) 50% Feeling (F) 50%
Perceiving (P) 50% Judging (J) 50%

Your type is: INTP

 

INTP – “Architect”. Greatest precision in thought and language. Can readily discern contradictions and inconsistencies. The world exists primarily to be understood. 3.3% of total population.

 

Flora Langel, your Personality Summary

Key Areas of your Personality

Your personality stands out from the average person’s particularly in the areas of:

  • Your High Curiosity Level
  • Your Low Emotional Reactivity Level
  • Your Low Distractibility
  • Your High Need for Control/ Predictability

One chapter of your 100-page Personality Report is dedicated to how you compare to the average woman and the average man in the 8 main areas of personality, and how this affects the way that people interact with you.

 

Your Interaction Style:

You scored 10 in the area of extroversion/ introversion, which means that your energy is directed primarily inward, rather than outward. You prefer to have one or two good friends instead of a large group of superficial friends.

Researchers have discovered that extroversion levels come from the sensitivity of a part of the brain called the amygdala. People who are low in Extroversion have a very sensitive amygdala. As a result, you notice things that other people don’t notice.

Social patterns: You are right-brained when it comes to interacting with people and recognizing emotions in other people. This means, for example, that when someone takes a photograph of you, you probably prefer to turn your right cheek towards the camera, rather than your left cheek. If someone were talking behind a closed door and you needed to put your ear on the door in order to hear, you would tend to use your right ear instead of using your left.

 

 

 

Freedom – Merleau-Ponty

Freedom in Sartre’s conceptual perspective is too limited to recognize certain specifics. It also requires a limited-to-the-instant perspective that closes out past and future intention’s relationships out.

Three concepts Merleau-Ponty stresses alternately to Sartre’s are:

  • Freedom can only be true if it is of a fluid existence; to be broken up into individual related events.
  • Obstacles don’t appear to form obstacles, they show alternative optional paths.
  • “The real choice is that between our whole character and our manner of being in the world.” Pg 438.

Merleau-Ponty sees a non-separational perspective to freedom which opens up recognition of the past and how it influences the present as well as future projects. Living only in the now is a limiting concept on freedom.  The strongest thing about this is that our past is influential in our day to day lives regardless of our consciousness of the reactions occurring. For example, my entire life there has been a rift between my eldest uncle and myself, which for many years I had no clue why. After discussing my near “fear” of him with my mother I learned when I was 10 months old he had played peek-a-boo with me and scared me. After that point in time, I avoided him. There is no other explanation for my shyness with this particular uncle, which is a key example that the consciousness and the choice to allow the past to influence yourself cannot occur.

He also touches on the concept that obstacles are more a mountain in the middle of a plain. You do not have to go over; you can go around it or just stop there. You cannot consider it a limiting factor without looking at the entire environment and the future perspectives you have.

He also seems to feel that the only real factor to where the concept of freedom occurs is the point where one must choose how to live their lives. Whether that choice should be to focusing the self character and which concepts are the most important to our being, and how we live our world around us.

I guess I would ask Merleau-Ponty why he chooses to view probability as non-existent and rather just as only being phenomena. It seems that with all options there is a semi-finite listing of what could occur, so they seem semi-predictable and concrete.

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The Philosophy of Others

Now I know Simone said that she was a student of Sartre’s philosophy, but I think she was in fact his mentor, and he was the student who only half listened to the teachings. Simone not only produced the initial work that Sartre then expanded on for his Being and Nothingness, but also he used many examples from her book to emphasize his perspective. Often times Sartre did no expanding his arguments beyond that particular example.

Her writings in Ethics of Ambiguity definitely highlight the depths of her differences from Sartre while carefully hiding her thoughts in obscure contrasts and word choices. In uses of the words tragic, joy, and nature she highlights things that would otherwise be passed over by others as typical adjectives and words in common sentences.

How do these words accentuate her concepts any differently than if another were to write the same words. Well, being that “nature” is part of the in-itself it really can not be a stand alone being so there for bringing it into the foreground to Sartre would be giving up your own freedom and be giving it to “nature.” Also joy is an emotion which Sartre seems to have a large problem with. Tragic implies fate, which for Sartre would be detrimental to his concepts in Being and Nothingness which depend on freedom from everything.

These concepts not only does she use in her text but she also is very passionate about her discussions on them. She argues that ethics and actions on the individual level are still conscious regardless of the aspect of God being in place or not.  She also discusses the paradoxical concept that once man considers himself free, he gives up the capability to wish.

Simone also discusses the concept of human spontaneity and the fact that despite it’s capability of being free, normally there is an intended direction that that being is striving for. That this intention to be free still hinders our freedom in the fact that any project we take up limits us on what projects we might have else taken up in its stead.

Sartre defines being as taking up projects and taking up projects to make yourself free despite any situation should in turn allow you to be free when that project is completed. But if this were the case, the next project taken up could define our being and again cause a lack of freedom.

Simone also argues disclosure is the path to finding freedom not simply defining what the obstacle is not. To list everything that something is not to determine its being just creates it, but does not give it the status of for-itself. You have to disclose it to the world to give it its being.

Sartre had a hard time arguing much of his concepts between the differences between the for-itself and the in-itself due to the conflict he perceived in having more than one for-itself in existence. He did not argue there was not the capability of being more than one, but he asserts that in order for two entities to be in one room, one must give way to being an in-itself for the for-itself to emerge.

This is also a topic that Simone discusses in Ethics of Ambiguity that expresses a conflict with Sartre’s book. She discusses fairly frankly in the fact that in order to become an in-itself the person who opts to do so, does willingly, and that it does not require shame to occur. This is a concept that Sartre depended on in his arguments to define the concept of for-itself and in-itself. To choose to give up your self at your own will, is a freedom and that in acting the right to do so is one of several things that not only did Sartre not discuss, but Simone seems to have a conflict with him not doing so.

Simone also touches on topics that Sartre does not that are very commonly seen themes in her book She Came to Stay. She points out the personalities and interactions with people and the 5 general stages of being and how they inter-relate. Subhuman, serious, nihilist, adventurer, and the passionate, express different aspects of being that Sartre vaguely touched upon.

Passionate is very closely related to the masochistic concept in the aspects of how they relate to each other, but Sartre leaves it as masochistic and sadistic as it’s opposite. He doesn’t discuss the concept that there is a concept of thought that can lead to or it can become after it has been satiated, which Simone calls the “serious” person.

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Torturing the Torturer  

Victims and those who commit the crimes against them are directly related. You cannot have one without the other and are dependant on each other to be. Sartre’s discussion on the concepts of freedom, oppression, and human nature will help explain and supplement much of this concept, but the tortured and torturer will give them a new light.

Anyone who has ever been tortured would argue that the gruesome acts done to them restrained them that would not allow them to be free. The physical state of being is definitely potentially a state of freedom that might have been subdued, but Sartre would argue that every being has the capability to recognize their freedom in all situations. “Therefore this suffering can not be in itself a motive for his acts. Quite the contrary, it is after he has formed the project of changing the situation that it will appear intolerable to him.” (B&N pg 562) This freedom is always present regardless of your physical state of being. The torturer can not invade the mind of the tortured unless the tortured chooses. Separation of the mind from the body is something that Sartre utilizes in justification that freedom is something that each person must possess in order to retain the for-itself.

Those who have been tortured would also disagree that they created the torturer. This perspective can definitely be understood as they had no direct relationship with the person. On the contrary, Sartre would argue this creation of the torturer occurs long before and escalates up to the point that the torture occurs. “Exploitation makes the exploiter dependent on the exploited… this dependence is at the heart of racism.” (Victory pg 75) Without some sort of conflict between the two to initiate the situation, neither the torturer nor the tortured could become who they do.

This leads us to the how the torturer becomes this vile creation. It is often said by the torturers that they do not know why they did what they did. Often times the torturers are declared by those who know them as acting completely out of their normal range of self when these incidents occur. But this is not to say they did not do these acts or to excuse their actions. This Sartre would explain as being part of an attempt to exert freedom. “The perpetrators… would like to convince themselves and their victims of their total dominance: at times they are super-humans who have people at their mercy, and at times they are strict and strong men who have been give in the task of taming the most obscene, the most ferocious, the most cowardly of animals: the human animal.” (Victory pg 67) The mind set of what occurs with those who are acting as torturers is that they are compelled to do such violent acts out of doing what is best for those whom the tortured are a threat to.

Torturers are often victims of older torture against themselves that these events now offer an outlet to exert their freedom; or offers a feeling that allows them a chance to regain their lost freedom and  they make a project to do so. “The sadist discovers that it was that freedom which he wished to enslave, and realizes the futility of his efforts.”(B & N pg 527)  This freedom is sought after and is the object which everyone desires to regain when they loose it. In the end the torturer feels no satisfaction in the torture because he realizes he can not enslave someone else’s freedom in order to regain his own.

This is not to say the tortured themselves are the threat but the class of people they are a member of, be it religious, racial or social standing based. Those who have been tortured often feel that the victimization has unjustly occurred. These events are not disputed as that the topic of torture is wrong but the events that lead up to the situation that occurred were just as immoral.

The two suffer torment together, be it the physical gruesome that the tortured often goes through or the mental anguish of the acts being done to someone by the hands of the torturer. The torturer has been convinced in his mind that there are secrets in this person and there sole objective has become to save others by extracting these secrets. “Useless violence: whether the victim talks or dies beneath the blows, the vast secret is elsewhere, always elsewhere, out of reach.” (Victory pg 73) The violence done by the torturer and taken by the tortured is futile, but at the time seems needed by the torturer based on the violence around them.

Opponents of the incidents of the torture that has occurred might argue that something has to be done and that those who did such things should be punished harshly. But those who find themselves in the position as torturers are often in a situation they are not prepared for. They have become members of a troop they did not enlist for and often really do not want to be a part of. “We would be fortunate if these crimes were acts of a handful of violent individuals: in truth, torture creates torturers… soldiers did not join an elite corps in order to torture the defeated enemy.” (Victory pg 70)

The events that occur between a tortured and the torturer are unpleasant for all involved, but Sartre sums it up well. “What is the use of troubling the conscience of the torturers? If one of them faltered, his superiors would replace him: there are plenty more where they came from.” (Victory 77) So despite the fact you always have you freedom, if it is used to extract a morality of those who are around you, you can not guarantee your project will be successful.
Works Cited

 

Sartre, Jean-Paul. Being and Nothingness. New York: Washington Square Press, 1956.

—. “A Victory.” Colonialism and Neocolonialism. 2001: 65-77.

 

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Russian Childcare and Vaccination

Russian Healthcare & Reform
29 March 2006

Childcare and Vaccination

The comparison of the approach of Russian healthcare in regards of their children with the United States will show that the vaccinations are a necessity and in some cases lacking on the part of the Russian society. This will be described via a detailed listing of time periods when certain vaccinations are given, be reflected by the types of vaccinations and certain problems that have arisen from administering one type of vaccination over another. The youth of a child will determine their life and how they will live once they hit maturity. An unhealthy childhood can and will leave a life long impact and in some cases the lack of life to have.

To start with the discussion of the different forms of vaccinations and how they function is necessary. There is “killed whole organisms” which is used in order to make the organism completely harmless but allows the body to learn to recognize it and protect against it. This particular type is used when they make the vaccination against typhoid. This is a very safe but not always effective vaccination. There is a chance the body might not deem the threat as such and put it into its memory to be protected against.

Then there is the “attenuated organisms” which is a cultured form of a threat and is in a weakened state when given in the inoculation. This is how they design tuberculosis vaccination, BCG, which is a bacterium which has been known to cause tuberculosis in cows. This particular vaccination we will discuss in more detail later as that it is used in Russia but not in the United States. The downfall to this particular type of vaccination is the threat is still present to get the disease from the vaccination but is not strong enough in most situations to post any threat at all to the person being injected.

“Toxoids” are a type that has been damaged by toxins to weaken them to the point that the threat can not release the proteins that would normally trigger the disease. They allow for the molecule to retain some of its properties and epitopes so that the threat will be recognized by the defense system but at the same time weakens it to a point that it is not a threat. This is how the healthcare industry deals with creating vaccinations for diphtheria and tetanus.

 

The industry also uses a form of weakening process that uses the surface of the molecule to allow it to be recognized as a threat while added multiple forms of strains of threats to be within the vaccination so that many of the same threat are all recognized but not requiring an injection of each different strain. This process is used for Hepatitis B, Influenza and even with a multitude of the common and threatening strains of Streptococcus pneumoniae.

The “inactivated virus” is similar to the killed bacteria in that it contains a whole particle but has been treated similar to the toxiod so that the epitopes are still present and easy for the body to recognize. This is how the Salk (IPV) vaccine is made to protect against polio.

“Attenuated virus” is used in vaccines to provide a form of the threat but still a threat to ensure the recognition by the body’s defense system. Sadly these weakened forms of the virus, though very rarely, can revive to their full strength and it only takes on to cause the disease. This has been used in treating the polio virus through a oral vaccination which allows for other members of the polio family to be immunized against as well but because of this small but still potentially life changing threat, the United State uses the Salk vaccination over the OPV. This is also how the vaccination of measles, mumps, and rubella (MMR) is formed.

The schedule on how these medications are administered determines how soon you are covered by them. That schedule is left up to the head of our country to determine but the World Health Organization (World Health Organization) determines what must be administered and keeps track of statistics on how many are complying and how well they are complying with this guide to health.

As you can see in the chart provided, there is some variation between countries on when they should be provided. The other difference between the Russian and United States is that the Russian immunizations are the base requirements according to World Health Organization. The United States listing is what is required by the state of Iowa before you can enter the educational system.

 

Russia Scheduled immunization United States (Iowa)
BCG Birth7-14 years
DTwP (Tetracoq)(3 dosages required) 3 months4.5 months6 months 18 months 2 months4 months6 months15-18 months4-6 years DTaP
  2 months4 months6 months15-18 months4-6 years DTaPHepIPV(combination option)
  2 months4 months6 months15-18 months DTaPHib(combination option)
  Based on risk HepA
HepB Birth1 month6 months Birth-2 months1-4 months6 months HepB
HIB3 dosages 2months4 months6 months12-15 months Hib
6-23 months24 months – 49 years>=50 years Influenza
IPV 3 months4.5 months6 months18 months20 months14 years 2 months4 months6 months12-15 monthsIowa requires at age 4-6 years IPV 
Measels 12 months6 years
MM 12 months6 years
MMR 12 months6 years 12-15 months4-6 years MMR
Mumps 12 months6 years
OPV 3 months4.5 months6 months18 months20 months14 years
  2 months4 months5 months12-15 months Pneumo_conj (PCV)
Pneumo_ps Based on risk >=65 yearsBased on risk Pneumo_ps
Rubella 12 months6 years13 years
Td 14 yearsFollowed by every 10 11-18 yearsBooster every 10yrs Td
Typhoid Based on risk
12-18 monthsAnd susceptible adults     Iowa requires another dose about 11-16 years Varicella

 

To clarify what these medications do for a child I will discuss the diseases they protect from and what their chances to cause permanent harm to their life.

DTaP and DTwP are two different forms of the same type of treatment for diphtheria, pertussis, and tetanus. These three diseases are easily spread, the first two being spread by human contact and the third through a cut or wound on the skin’s surface. Diphtheria forms a thick covering in the back of the throat that can cause problems such as difficulty breathing, paralysis, heart failure and sometimes even death. Pertussis also causes problems with your breathing in the form of horrible coughing spells that can make it extremely difficult to eat, drink, and breathe at all. Pertussis can last for weeks and move into pneumonia, seizures, brain damage and even death. The third component, tetanus, causes excruciating painfully tightening of the muscles all over the body, but is nicknamed “lockjaw” due to the stiffening of a jaw can make it nearly impossible to drink or eat due to the inability to move the jaw or throat muscles. Death occurs in about 1 out of every 10 cases. These immunizations are not a permanent and boosters for the diphtheria and tetanus are given approximately ever 10 years. If you are exposed to threats, such as in the medical field or your work causes lots of abrasions, it is advised every 6 years.

The HepB vaccination is often advertised as the first cancer vaccination. This is because it can stop the virus that attacks the liver and in many cases leads to liver cancer later in life. Hepatitis B, which is how the vaccination got its name, has its highest chance of long term chronic damage if it can successfully infect infants and children under the age of 4. HepB is transferred via exposure to infected blood or body fluids. Most infection occurs in newborns due to infected mothers transferring the infection. The chances of a chronic infection drop drastically as children get older, so early immunization is imperative.

Hib is a vaccination that helps protect against a multitude of different threats while also minimizing potential additional threats which the Haemophilus influenzae often lead to meningitis. This vaccine also protects against pneumonia, pericarditis (an infection affecting the membrane covering the heart), and potential infections of the bones, blood and joints caused by bacteria.

IPV and OPV are two different forms of prevention for the polio virus. Unfortunately the OPV is highly dangerous in that it, as said before, can lead to getting the polio virus due to the weakened state but not dead form it can regain full strength and infect the person taking it orally. Polio is potentially fatal but is also life changing in that it can permanently paralyze if you do survive the infection. It has been found that IPV is much safer, but does not keep the virus from being transmittable in the case someone who is immunized with IPV does contract the virus but is not affected by the virus due to the immunization.

Measles, mumps, and rubella (also known as the German measles) are protected by the MMR vaccination. This is a very effective vaccination but is still necessary because these diseases are still prevalent in other countries. Measles is highly contagious and very unpleasant. The main treatment before was complete isolation and medication to minimize fevers, syrup to help with the coughing and lotions to combat the skin’s dryness and itch. Rubella is known as the German measles due to its similarity to the measles symptoms and unpleasantness to have. The rubella virus normally only lasts a few days compared to week long pains from the measles. Rubella was not as prevalent but when it did surface it would become a small epidemic. Mumps vaccination is also included with the MMR series to protect against a viral disease that attacks the salivary glands, causing fever and swelling. This particular topic will be covered again later in the paper for an example of the differences world wide and the potential harms. It’s believed that once having this vaccination the defense against these viruses is life long.

Pneumo_conj vaccination is short for pneumococcal conjugate which has been a leading cause of pneumoncoccal infections as well as a step stool for meningitis, ear infections and blood infections. These can cause permanent hearing loss, pneumonia, brain damage, and even death. Vaccinations start early to protect against this.

Varicella is a commonly known as chicken pox and was considered a “rite of passage”. This minimal annoyance at younger ages which is when it is normally contracted by residents did not warrant a vaccination until recently. Due to the large quantities of immigrants coming into the United States that had not been exposed to the chicken pox prior entry are often dieing from the exposure. At younger ages the cases are mild and rarely more than just dermal. As the age of the person exposed so does the chance of fatality due to its extreme spread. At older ages it has been known to get under the eyelids, down throats, up the sinus passages and into the lungs. With this level of exposure the inability to eat, difficulties breathing often cause death.

There has been a fairly steady decline of diphtheria in Russia, with approximately 505 cases in 2004. The measles took a huge hit in 2002 dropping it down to under 600 cases but as of 2004 there is approximately 2500 cases. Pertussis also has had a similar jump to the Measles. Rubella has been on a fairly steady decline over the last 5 years by almost 1/3 of its previous listings.

Tetanus is sadly not declining despite the fact they do immunize. The low numbers are probably the reason they have not increased the amount of vaccinations to be comparable to the five required dosages unlike their three required. The standard reported vaccination schedule according to what World Health Organization has been notified by Russian officials actually entails a fourth dosage at the age of 18 months. This information conflicts with the report on a Russian hospitals prenatal information site that states that World Health Organization only requires a total of 3 immunizations.

In the United States, the strain of diphtheria has been nearly eradicated with no reports of any cases in 2004. So far there have been no more than 50 cases of the measles in the United States since 2001, and compared to 1990’s near 28,000 cases, that is less than 1% of the previous infections. Infections with the mumps in recent years have actually been fluctuating between 200 and 400 cases per year. This year, 2006 will be a record breaker and I will discuss shortly what the potential reasons for this and explain in detail the issue at hand. Pertussis was actually slowly increasing until the year 2004. Unlike Russia the United States had an explosion but not to the extent Russia’s population did. There was 235% increase in the United States compared to the near 415% increase in Russia. Polio has also been nearly eradicated in the United States with no reports of infection since 1980. Rubella has fluctuated on a very minute scale over the last 5 years, with fewer than 25 infections per year reported. Tetanus as well has been a steady problem in the United States but its numbers are lower than Russia’s. Comparably the ratio of the United States population to the Russian would suggest that there would be need for an increase of necessity of an extra dosage implemented for Russia.

Now there are some who have suggested and even formed collations to argue that vaccinations are not worth while and that we should not do such things to our children. The following facts suggest otherwise.

  • Average annual number of smallpox cases in 1900-1904: 48,164.
    United States cases per year since 1950: 0.
    Worldwide cases per year since 1977: 0.
  • Average annual number of diphtheria cases in the U.S. in 1920-1922: 175,885.
    U.S. cases in 1998: 1.
  • Average annual number of pertussis cases in 1922-1925: 147,271.
    U.S. cases in 1998: 6,279.
  • Estimated average annual number of tetanus cases in 1922-1926: 1,314.
    U.S. cases in 1998: 34.
  • Average annual number of paralytic polio cases in 1951-1954: 16,316.
    U.S. cases of wild type poliovirus in 1998: 0.
  • Average annual number of measles cases in 1958-1962: 503,282.
    U.S. cases in 1998: 89.
  • The number of mumps cases in 1968: 152,209.
    U.S. cases in 1998: 606.
  • Average annual number of rubella cases in 1966-1968: 47,745.
    U.S. cases in 1998: 345.
  • Estimated average annual number of cases of congenital rubella syndrome in 1966-1968: 823.
    U.S. cases in 1998: 5.
  • Estimated average annual number of Hib cases before vaccine licensure: 20,000.
    U.S. cases in 1998: 54. (Barrett)

If you look at the time periods offered and then compare to the later dates and the amounts of people infected it suggests that that not only is there a need but as I said before many of these diseases we are immunizing against can be fatal or can lead to another disease that is known to cause fatalities. No parent wants their child to die. I doubt many of the people involved in these anti-immunization groups have children or have children that were not influenced by the shot in a negative way. In the discussion of the OPV I pointed out that there has been a very small percentage, but one to recognize that children were in fact infected with the polio virus because of regaining enough strength to pose a threat. As a parent, I recognize the risk and the factors that could cause my son to have gotten infected with the shots. But I also look at the statistics of how fast it can infect and even kill and the risk is worth it.

Now as said before, I was going to discuss the current issues of the mumps outbreak here locally. “300 confirmed or suspected cases of mumps have been reported in 39 Iowa counties since Jan. 1,” Courier writer Jens Krogstad says. It was posed in this article as well that there is potential that this strain that is affecting our state and now spreading out of our state boundaries actually came from the United Kingdom.

With the large amounts of foreign exchange students that come here to study and the many students that go over seas, it is quite possible someone contracted the virus and brought it back to expose the United States population. Ironically this strain is attacking primarily late teens and early twenty year olds. Similar age ranges to those of the college years, leading this assumption to be a strong possibility of being the starting point.

Many of those contracting the virus have been immunized and not actually contracted the virus itself, which means their body has a 95% chance of immunity to the measles, mumps, and rubella. Due to a close tie between the University of Northern Iowa and Malcolm Price Laboratory School the virus has since moved into this all age school. The close interactions with those from the University of Northern Iowa in most cases would not be a threat but as of the 6th of April, over half of the reported cases in the county were located at the university. It’s safe to suggest the entire population of children at this school have been exposed; due to the more recent exposure to the immunizations the younger populations are not suffering as extreme symptoms.

This, I have reason to believe, is because my son, Joseph, is currently suffering from some minor fevers and swellings on his throat that showed up early evening April 12th, 2006. Now being that they were hard to see I sent him to school the next day thinking they were gone and it was just a bug bite. Apparently they were not gone and the school had me pick him up and take him into the physician to have him checked out. They ran three different types of tests and told us it takes 3 days for the tests to be processed for mumps.

There is a requested quarantine of 5 days after the onset of symptoms being implemented. After speaking with a county health official on the 18th after a positive test result finally came back, I learned that they are actually requiring all swelling to be gone which in most cases 5 days is enough. Unfortunately, my son is home for his 7th day and the swelling increased in size due to a joyful and incapable-to-sit-still day occurred which used a lot of his energy to combat the virus. It is my understanding that the mumps incubation period is usually 16 to 18 days, although it may vary from 14 to 25 days. The health officials believe that the contraction of the virus occurred right around the time of the school’s spring break. To ensure it was not a public event he got it at they asked if he had been at any events during that time. To my knowledge there were no such events.

Mumps is contagious seven days prior to and up to nine days after the onset of symptoms. The movement of people in society makes this disease capable of spreading very easily and very fast, especially with the fact that there is such a long period of being contagious without any signs or symptoms for warning.

There is suggestion that this is a strain based out of Europe; potentially a super bug that has built up potency against the vaccinations. Now if this is the case it only proves my argument that there needs to be a universal standard that is absolutely being implemented across the world. The current standards appear to be working in almost all cases, but for the sake of the Russian population being sure to get all the vaccinations, not just one and call it good, is a necessity for the country to protect its place in the world. Without a population, there isn’t a country.

 

Krogstad, Jens Manuel. “Mumps Epidemic Continues to Spread.” Waterloo Cedar Falls Courier. 6 April 2006 <http://www.wcfcourier.com/ >

Downing, Eric. “Russian Vaccination Schedule”. 8 Jan. 2001. 17 April 2006 <http://www.russianadoption.org/Rusvac.htm>

Medem International Clinic and Hospital. Well-Baby Program. 2005. MEDEM International Clinic & Hospital.12 March 2006 <http://www.medem.ru/english/program/baby/>

World Health Organization. 2006. World Health Organization. 12 March 2006 <http://www.who.int/en/>

Centers for Disease Control and Prevention. Vaccine Information Statements. 25 April 2006 Center for Disease Control. 12 April 2006 <http://www.cdc.gov/nip/publications/VIS/>

Advisory Committee on Immunization Practices, American Academy of Pediatrics, and American Academy of Family Physicians. “Recommended Childhood Immunization Schedule”. 1999 Iowa Department of Public Health. 17 April 2006 <http://www.idph.state.ia.us/isiis/99sched.htm>

Iowa Department of Public Health. “Public health officials identifying approaches to stop spread among Iowans”. 13 April 2006. Iowa Department of Public Health. 17 April 2006 <http://www.idph.state.ia.us/common/press_releases/2006/mumps_investigation_041306.asp>

Iowa Department of Public Health.  “Mumps Cases Continue to Increase”. 17 March 2006. Iowa Department of Public Health. 17 April 2006 <http://www.idph.state.ia.us/common/press_releases/2006/mumps_031706.asp>

Centers for Disease Control and Prevention. “Parents’ Guide to Childhood Immunization” 2006. Every Child by Two. 17 April 2006 <http://www.ecbt.org/parents.htm#guide>

Barrett, Stephen M.D. “Misconceptions about Immunization”. 21 April 2001.Quakewatch.17 April 2006 <http://www.quackwatch.org/03HealthPromotion/immu/immu00.html>

Kids Health. “Common Children Illnesses and Infections”. 2001. Prairie Public Broadcasting. 12 April 2006 <http://www.prairiepublic.org/features/healthworks/kids/mumps.htm>

The Facts Will Speak for Themselves

The Azande and Salem societies have many differences and some similarities, but with a few changes with the Salem society things could have been a lot harder to escalate to the point they did. Both communities believed in witches; to the Azande witches are common occurrence and are discomfort to lives but their magic can be easily rectified. In Salem, to be a witch was a conscious choice and a threat to the community and their holy pact with their god. I feel its safe to say that the hysteria of Salem Village could have been minimized had their legal processes required more solid evidence.

Their legal process was not their only factor in what failed to stop the hysteria, but it was a large factor in what made it so easy to accuse and convict people of witch craft. The society of the Azande is not nearly as concerned with who the witch is but more in stopping the curses. In their society, being a witch is a congenital issue, like any genetic disorder. Either you are or you are not a witch; you can’t cure it – only suppress it into a state of submission. This process is quite similar to taking medication for HIV to make sure it doesn’t become full blown AIDS. It’s something of an inconvenience, but it is not something that completely hinders you from being a fully functional member of society and does not say that you are a bad person.

In Salem, to be a witch you must choose to be one and thus were going against the society to do so. The social structure was based on following the ways of their god, and in becoming a witch you turned your back on their societal ways and their religious practices to assist the polar opposition of their god. This choice of where you stood religiously also determined where you would stand socially. A “those who are not with us are against us” mentality was ready and only needed a gentle push from someone to move the concern into full hysteria. But there were some positive things that both societies did in handling the situation of witch accusations.

The Azande and Salem communities dealt with witches in a similar fashion; doing court proceedings with “evidence” from the spiritual and physical planes. The court proceedings were overseen by a head representative of the society who delivers fair punishments based on the evidence provided to them. Those in these positions were placed in this power by the social requirements. Azande had a birth determined status; in Salem it was a decision by the social group. Unfortunately, the Salem village community initially decided to allow the church to have a large influence over their proceedings. This decision escalated the concern of identifying witches into a religious manhunt of individuals who were not active enough in the society/church or did not meet the standards of the church representatives.

Initially, one of the problems Salem’s overseers made was allowing spectral evidence. This evidence was quite easily tampered with and also was based on only the afflicted’s accounts. “In the course of an extended dispute with a neighbor, she pronounced a curse upon her adversary…the spell was successful until the victim moved to another town.” (Weisman 139) This accusing party was expected to tell the truth in the court of law.

But had the specter appeared as someone else there was no check-and-balance system for validating or invalidating information from the other realm. In a case where one person was on trial and another was actually the tormentor, the accuser could identify the person on trial out of denial that the true tormentor would or could do that to them. For example, had “Fine Upstanding Citizen A” been doing the tormenting, a good citizen would believe it a “trick” or believe it impossible because of how “good” he was so the accuser would blame another for the apparition’s appearance being such. Lack of collaborating or disproving evidence made these trials very hard for those overseeing to approach in a fair manner.

Unlike the Azande, the Salem community had no concrete evidence that could not be tampered with from the other plane of existence. The Azande societal laws called for not only another person to be present to witness the consultation, but also many times there were multiple people consulting the poison oracle at once. “The operator does not moisten the poison till the rest of the party arrive.” (Evans-Pritchard 135) This put a control on the poison and how it was concocted so should all the birds live or die at a consultation; they can safely say that the poison was improperly formed. “…The failure of the oracle was attributed its failure to (1) the wrong variety of poison having been gathered, (2) breach of a taboo, (3) witchcraft, (4) anger of the owners of the forest where the creeper grows, (5) age of the poison, (6) anger of the ghosts, (7) sorcery, (8) use,” (Evans-Pritchard 155) making it explainable for errors and how they might have come about.

The other good thing about the Azande approach to consulting the other plane was their requirement of three major forms of validating proof. They were all of a physical form that could be used to argue for or against the accusations of a witch. The fact there was multiple options for dialogue with the other plane also played a role as an alternate source if an unlikely answer were to come forward. Giving a form of check and balance system. These forms of evidence were also physical so they could be provided to a court if there was any question of the validity. This allows the Azande to commune, as well as verify, what they are told for the courts to ensure that the other plane gets proper representation in the house of law.

This practice of approaching the spiritual plane for information beyond just the afflicted’s account gives a chance for a more balanced reference as well as a better chance of odds. With only one source being approached it is a 1:2 chance of a specific outcome. With two sources it makes it a 1:4 chance and with three it’s a 1:8 to get a specific outcome. A 12.5% chance to for sure get the same outcome versus a 50% sounds far more pleasant if your life is on the line.

A faith based society with no outlet for venting negativity or dealing with bad situations was a volatile situation waiting to explode. Increasing tensions, difficulty in communications, unsure status in the society both on earth and in the eyes of god, it was an unstable situation. The verification process of the Azande could have helped protect the citizens from mass hysteria; due to the religious extreme’s of Salem village, those who operated any form of protection or consultation of the other planes was a witch and there for a threat to their perfect society. And thus there was no saving them from themselves.