Sunday, November 25, 2012

Everything You Never Wanted To Know About Birth In America- But Probably Should

"A good obstetrician needs two things: a big, round bottom and the sense to know when to sit on it."
- Husband Coached Childbirth by Dr. Bradley
    • In the United States, roughly 1% of all births are planned home births, birth centers are slightly more common, but the overwhelming majority of births for both low-risk and high risk women take place in hospitals.
    • The Cesarean section rate in the United States is over 30% with elective c-sections being only a very small percentage of all c-sections. A 5-10% c-section rate is considered optimal.
    • The United States has one of the worst rates of neonatal mortality in the developed world at 6 deaths per 1,000 births. (On par with Croatia, Bosnia and Herzegovina, and Lithuania.)
    • There has been much debate about whether the Netherlands is, in fact, a good case study for the safety of home birth. What is true is that planned home births attended by a doctor or midwife are very common in the Netherlands (most sources place it at roughly 1/3) and that the Netherlands rate of neonatal deaths is 3.73 deaths per 1,000 births. They are by no means in the "top ten" of low infant mortality (those spots belong to Monaco, Japan, Bermuda, Singapore, Sweden, Hong Kong, Macau, Iceland, Italy, and Spain, in that order with rates ranging from 1.8/1,000 to 3.37/1,000), but their infant mortality rate is still almost half of what America's is right now.
    • The United States has the worst maternal death rate of any developed country. In 2007, the maternal death rate was 12.7/1,000 in the United States. In 2009, it jumped to 16.1/1,000.
    • Approximately 19% (roughly 1 in 5) low-risk mothers end up with a c-section in U.S. hospitals.
    • A 1998 report from the CDC found that maternal deaths from obstetrical causes are widely underreported, estimating that they are missing about 2/3 of maternal deaths from the currently reported rates of maternal death. A 2005 Massachusetts study estimated a 93% underreporting in maternal deaths for that state.
    • For all American women the maternal death rate is 5 times what it should be and for black women, it is 10 times what it should be.
    • The United States spends more on hospitalization and health care than any other country in the world.
Wow. Not the rosy picture we're used to hearing. What can be done to fix the abysmal state of maternity care in America? The general consensus seems to be that we need more and new laws, more contraception availability (is it just me or does that seem to be the answer we get for all women's health issues?), and of course more money from the government. I really don't think that any of those will actually solve the problem. Here are my thoughts on what the medical profession can do to save the lives of more mothers and babies:
  • Focus more of doctors' education on natural birth and low-intervention techniques...  Medical organizations point with pride to the fact that doctors may attend as many as 20 births a week. But most, if not all, of those are births with medications, other interventions or c-sections. Since that is how most women in America give birth right now, that is what the average intern or resident thinks birth is. Medical schools don't train doctors on how to deal with natural birth, they train them how to use medications, forceps, vacuum extraction, and c-sections to get births accomplished in the time limits the hospital mandates for second-stage labor. The reality is that most OB-GYN's have no idea what a physiologically normal birth looks like or what to do during one. By educating OB-GYN's about what normal birth is like, they will be able to give better care to low-risk women.
  • ...while educating them to better spot and handle true emergencies. One of the things I often hear people say is that the vast majority of problems with American obstetrical care concern poor and minority women. Maybe this is comforting if you are white and live in a middle or upper class neighborhood, but it isn't actually true. (See the above statistic about how all women in the U.S. are at a 5 fold risk for death.) Pre-eclampsia, for example, can and does kill thousands of babies and mothers  every year, and one of the biggest reasons why is that doctors and nurses often fail to notice the symptoms or excuse them as hypochondria or even healthy signs of pregnancy. I really recommend that you read Jamie Grumet's experience with HELLP syndrome at her blog I Am Not the Babysitter. Jamie is a white woman living in Beverly Hills, California with great access to health care. She was seeing both a midwife and an OB, plus a slew of doctors and nurses at the ER and by the time she was finally able to get a life-saving c-section, it was almost too late. In fact, the nurses accused her of being hypochondriac and told her that her sudden weight gain was healthy because skinny women need to gain more weight during pregnancy. This is just one example of how lives could be saved by better educating doctors and nurses recognize and effectively intervene in genuine emergencies.
  • Reserve c-sections, medications, forceps and vacuum extraction for emergencies. I know this is really tough for us women to hear because in America we are so used to being told that we can't get through labor without an epidural or that we need to be induced or that a c-section is the safest way to get the baby here, but in countries like Japan that have really low rates of maternal and infant deaths, medications, surgery and mechanical extraction are reserved for emergencies and women are encouraged to deliver naturally. (I think I understand where you're all coming from, up until a few years ago, I thought women who gave birth naturally were pretty much nuts. Why put yourself through unnecessary pain?) All these interventions have their place. My mother-in-law, and by that token my husband, are here today because she was able to have an emergency c-section for placenta previa with her first baby. I think we as Americans tend to look at technology as being a solution, and if a little is good in certain situations, then a lot in all situations is better. But the more interventions you start adding, the more chances you have for something to go wrong. In a life or death situation, the risks are worth taking, but these are rare and most problems in labor can be solved through simpler, less invasive means. There are women who have died when a bag of another medicine was accidentally injected into them instead of an epidural or an epidural was improperly administered. C-sections increase the risk of hemorrhage after the birth and deadly blood clots- and the risk goes up with subsequent c-sections. C-sections also increase the risk of hysterectomy, uterine infection, and placenta previa. So, I know that many of you have had c-sections, I don't think you're bad mothers, I don't think any less of you, all I'm trying to do is call attention to an issue that is affecting the lives of mothers and babies across the country.
  • Do away with continuous electronic fetal monitoring for most mothers. EFM gives a false sense of security to doctors and parents. "We can monitor the baby's heart with every contraction and never miss anything!" The problem is that EFM requires that mom lie on her back throughout labor which puts the baby in danger. Remember how you're not supposed to lie on your back after 12 weeks because it will cut off the blood flow and oxygen supply to the baby? Well the same thing goes when you're in labor, which may be why EFM has been found to lead to higher emergency c-section rates. But how, ask OB-GYN's, will you detect fetal bradychardia (drop in baby's heart rate)? Well, I will now share with you my ultra-dramatic fetal bradychardia story. Malamute and I had been at the birthing suite for about two hours and I had been lying on my side laboring and doing a little pushing for about a half hour-ish. The midwives were using a handheld doppler to monitor Duckling's heart rate about every other contraction. And then it happened. Duckling's heart rate dropped. Did the midwives start freaking out? Did they start rushing me to the hospital for c-section? Nope. They had me switch to an upright position. That was it. I know, loads of excitement. Duckling's heart rate went right back up and holy cow, my labor really accelerated! Within about 15 minutes or so of moving upright, I had a baby in my arms! Unfortunately, when you're hooked up to a machine, that really isn't an option. The other problem with EFM is that it puts mom and baby in an unnatural and far more difficult position for labor. Medical professionals love the lying down position because it makes it easier to give medications,  utilize EFM, and perform forceps or breech extractions, but unfortunately women are not physiologically designed to give birth lying down. (Have you ever been told to "push like you're having a bowel movement?" during birth? Have you tried to poop lying down? Not so easy...) And lying down in a hospital bed compresses your tailbone and narrows your pelvis so that you're baby is now having to fight gravity to get out of the birth canal. So, imagine you're on a hike to the top of a mountain. There's a beautiful vista up at the top, but it's definitely some work getting up there. Now imagine that someone has just added several large stones into your pack in addition to the water and snacks you've brought. That hike just got a lot harder. That's what happens when you labor on your back! This is why so many babies "get stuck" in the birth canal. EFM has not been found to improve the outcome of the birth or the health of the baby.  The biggest reasons that doctors are still using EFM is that they don't know how to monitor intermittently and they're afraid of being sued for malpractice if they don't use EFM.
  • Rethink working hours for doctors and nurses. This may come as a surprise to the medical community (who are very well-versed in anatomy, biochemistry, and physiology), but the human body has not evolved to perform well without regular, restful sleep. There is something appealing about the idea of the doctor who sacrifices everything- including sleep- to care for her patients. Television dramas glorify it, and within the community the ability to go for long hours without sleep and keep working seems to be a point of pride. But as attractive as this archetype is, it has no grounding in research as a safe or effective way to care for patients. In fact, the idea of working extremely long shifts is nothing more than a tradition dating back to the 1890's. It was originated by William Halstead, the first chief of surgery at Johns Hopkins, who required that his residents be on-call 362 days a year. (History has revealed that Halstead was able to put up such a manic schedule because he was using cocaine. Studies show that as many as 1 in 10 medical professionals- including anesthesiologists and neurosurgeons- are following in Halstead's  footsteps by abusing drugs to get through their day.) Sleep research shows that missing one night of sleep causes as much impairment as a legally intoxicating blood-alcohol level. So, chances are that by the time you get to the hospital in labor, at least some of the nurses and the newer doctors are already operating with the capabilities of a drunk driver- and that's if they're clean. Even the decrease in residents' hours from 30 hour shifts to 16 hours hasn't been shown to be enough to prevent sleep deprivation slip-ups- some of them very serious. In the case of sixteen year old Jasmine Gant, the nurse who administered the lethal bag of penicillin instead of an epidural was very experienced but had been working two consecutive eight hour shifts. I really think that health care professionals (both doctors and nurses) need to be limited to one eight hour shift per day. If that means extending out the actual number of months that it takes to complete a medical residency, I think it's worth it to protect the safety of patients and the health of doctors. Just like other businesses that need to be open 24/7, the eight hour shifts can be any time of the day or night, preferably on a regular schedule for each individual, but only one eight hour shift in a 24 hour period.
  • No more time limits on second stage labor. No, it's not a good thing to have a long second stage of labor, but imposing an artificial time limit really doesn't help the problem- especially since a lot of couples rush off to the hospital way too soon, sometimes even in first stage labor. Research indicates that time limits on second stage labor don't actually improve outcomes, and that using a more woman-centered approach actually is more beneficial

Tuesday, November 20, 2012

The Big Flu Post

There's a chill in the air, the leaves have changed, lights are starting appear on houses, and there has even been a dusting of snow. You know what that means... It's cold and flu season! Yes, it's that special time of year when noses run and wadded up tissues adorn wastebaskets! I hear you all rejoicing!  (End ironic remarks.)

My first semester at BYU I took this totally amazing class called Wildlife Ecology and Range Management for my Biology GE instead of Bio 100. (It truly was AWESOME! It completely changed the way I looked at deer hunting, prairie dog poaching, large predators, wool sweaters vs. leather jackets, Mad Cow Disease, and a number of other issues.)

While all my other freshman compatriots were off learning about cell walls, my good friend Kim and I were learning about wildlife diseases. One of our first assignments was to basically pick five diseases we considered to be the biggest threats to humanity talk about why we considered them to be huge epidemiological threats. Of course a lot of the articles we had been reading talked about AIDS. However, in my paper, I chose influenza as being the most threatening disease.

Now, I really do think you can make a case for AIDS, but I chose influenza because the flu can be contracted more easily (casual contact vs. sexual contact, contaminated blood products, or hypodermic needles). You could be a nun and still get the flu and even die (maybe not as easily if you're one of those nuns who never leaves the convent, but I digress.) However, it probably would surprise most people that flu season actually ranks pretty low on my list of things to stress about. It's not that I don't think flu is a potential problem, it's just that we take a lot of care to prepare for and prevent disease.

One thing you have to understand about the flu is that there is a lot of misinformation out there. For example, did you know that there is compelling evidence that many of the deaths in the 1918-1919 H1N1 flu epidemic may have actually been due to lethal aspirin doses administered by well-meaning physicians? Or that the 1976 H1N1 scare actually only resulted in the death one person- an extremely motivated army private in basic training who had been confined to quarters due to illness but nevertheless snuck out, shouldered a fifty pound pack, went out for a several mile hike in the dead of winter and subsequently collapsed and died? (I think I would die under those circumstances too.) Because a post-mortem showed that he was carrying the H1N1 strain of flu and a few other privates tested positive for the same strain, public health authorities assumed that a pandemic must be coming. Another interesting fact, the young private's drill sergeant performed CPR on him when he collapsed and didn't get sick.

If you'd like to read a full, fascinating history of the H1N1 flu and a number of other relatively recent diseases, I highly recommend Laurie Garret's The Coming Plague, a recommendation from my Wildlife Ecology and Range Management professor.  I will say that while I feel Garret does an excellent job of documenting the history of outbreaks of mysterious diseases, she's very weak on actually coming to conclusions of why these diseases are spreading and how to stop them. At the end of her book when she attempts to briefly address these questions, she mostly parrots the typical mumbo-jumbo that the world is over-populated as a cause and that drugs and research are the answer.

So what am I doing (and not doing) to batten down the hatches and prepare for "the most wonderful time of the year"? Well here goes:

  • Food- I guess one thing you should probably understand about my views on healthcare is that I take tiered approach. The way I see it, diet changes are the first thing to look at with health problems. Then structural work (chiropractic, crania-sacral, acupuncture, massage, etc.). Then herbs, essential oils, homeopathics, and other natural substances. My last line of defense is more conventional things like ER visits, drugs, surgery and the like. But really, I believe diet is the most foundational component in immune function. It only makes sense that just like what we take into our bodies can affect things like our respiratory, nervous and circulatory systems, that the same applies to our immune system. Just like we can't expect our lungs to function well with tar and tobacco smoke or our heart to function well on a diet of mostly deep fried stuff and meat, we can't expect our immune system to function well when we don't give it the right fuel. We pretty much don't eat any refined sugar. As it gets cold, we tend to add a little meat into our diet, but keep it to a few times a month. We keep up on the greens but we've switched from smoothies to salads lately. I've noticed that the times in my life when I've tended to get sick have almost always been when I was eating badly or very stressed or both. Holidays like Christmas, Valentines' Day and Halloween tended to be the biggest times I got sick as a kid and I don't think it's a coincidence that those are the big candy holidays.
  • Stress reduction- As I said, the times when I have gotten sick have tended to be when I was eating badly, was stressed or both. A few years ago I go the flu when I was pregnant with Duckling. Malamute's brother and sisters and all their kids and pets (and drama) were all staying over at his parents place and it was something I had been dreading for months. On top of all the stress, we started giving in and eating chips and cookies and other things to be more sociable. We had just started doing green smoothies, so the whole thing was pretty new to us. Anyway, I did get sick. However, out of any time I have been sick, I did recover the quickest that time. (I think it was the fact that despite all the stress and diet lapses, we kept up our greens and fruit intake.) My stress level has actually hit an all time low since Malamute resigned from his previous tech job and we've started pursuing other avenues. So that's one really great thing about the coming cold and flu season that is in our favor.
  • Flu shot- OK, I'm going to get this one out of the way because I know a lot of people will be extremely upset over what I have to say here and I'm pretty much scared to death to even say this, so here goes. I personally have chosen not to get the flu shot. I don't think any less of you if you do. Some of the people I care about most get flu shots. But I have personally made the decision not to get a flu shot. One big problem I have with getting a flu shot is that as much as public health officials try to include the strains that they predict will be the most prevalent, there is still a very real possibility that you could contract another strain. I do understand that doctors and public health officials claim that the flu shot may help reduce the severity of the flu if you do contract a strain that the vaccine doesn't cover, but there really isn't a whole lot of evidence backing this up. Also, it takes two weeks for the vaccine to actually take effect, so until then you are fair game for any and all flu strains, both giving and receiving. With all of these limitations, I feel like if I were to get a flu vaccine, I would really need to use a second plan of extra precautions to protect me and others during the first two weeks and for the duration against the strains the vaccine doesn't cover, and at that point, why get it at all if I can just use other means to protect myself against the flu?  People really, really hate hearing this, but I am also not comfortable with the ingredients in the flu vaccine either. Afluria contains beta propiolactone, a chemical for which little data exists regarding its effects on humans, though animal studies have found tumors resulting in subcutaneous injection. It also contains potassium chloride, which can be used to treat extreme salt depletion, but is also used as the third and final drug in the lethal injection process and in smaller doses to induce late term abortions, something I am just not comfortable with during pregnancy. It also contains calcium chloride, which according to the Materials Safety Data Sheet is mutagenic and carcinogenic. Fluvirin also contains beta propiolactone. Fluarix, Fluzone and Flulaval all contain formaldehyde. FluMist seems slightly better, but I'm really not crazy about ingredients like MSG and hydrolyzed porcine gelatin. So as I said, I know many of you feel differently, but for me, I am just not comfortable with the flu shot  and feel there are other options available. And as I have refrained from criticizing anyone who gets a flu shot, I do hope that those of you in the pro- flu shot camp can return the favor and maybe even understand where I'm coming from. If anyone is interested, you can find a comprehensive list of vaccines (including flu shots) and their ingredients from the CDC here. If you or a loved one have allergies or sensitivities to certain antibiotics or egg products, it might be wise to consult a table like this before getting a flu shot to make sure you choose one free of any potentially allergenic ingredients.
  • Handwashing- Yeah, this is important. I think sometimes when we imagine the 1918-1919 flu pandemic, we have this vision of people in sanitized facilities dying helplessly while legions of citizens bravely washed their hands at every opportunity. The reality is actually quite different. Idea of washing your hands to prevent infections and the spread of disease is actually still fairly new and didn't really start to take off until around the middle of the 20th century. In fact, Laurie Garrett talks about how counsel from doctors during the 1918-1919 flu pandemic about how to avoid the flu didn't cover washing your hands. (However, medical advice to avoid dusty old books, German fish, Chinese people, open windows, closed windows, washed pajamas, and unwashed pajamas abounded. We think this is ridiculous now, but it was considered "science" then.) Evidence of the efficacy of hand washing against disease has actually been around since the late 18th century when ex-naval surgeon Alexander Gordon wrote a largely ignored treatise about how puerperal fever was spread by doctors not washing their hands in attending laboring women. In the early 1800's Dr. Ignaz Semmelweis published evidence from his own hospital showing how deaths from puerperal fever decreased dramatically after he began requiring that all doctors and visitors wash their hands before seeing patients. Unfortunately, Dr. Semmelweis was laughed to scorn by the medical establishment because everyone knew that the scientific explanation for puerperal fever deaths was women's tendency to become overly excitable and emotional (Inside the Victorian Home, Judith Flanders). Other "medical facts" of the day were that "Doctors are gentlemen and gentlemen's hands are always clean". The scorn from the medical community was so extreme that Semmelweiss later moved to a mental asylum where he died. One of the novel things that Florence Nightingale did in the middle of the 19th century was to simply mandate clean hospital facilities. At the time, this wasn't backed up by the "science" of the day, all she knew is that she couldn't stand to live and work in filth and didn't think sick people should either. I know, all this seems like a "duh" to us, but at the time, it was really new and not widely practiced, thus the massive spread of disease. Oh and once summer hits be sure to keep washing your hands. Those "summer colds" are usually non-polio enteroviruses. They are second only to the common cold virus in prevalence and some of them can cause paralysis, heart problems, and brain infection, just like polio. The CDC says hand washing is the best way to protect yourself from non-polio enteroviruses.
  • Hand sanitizer- I also include Clorox wipes and the like under this too. So these aren't bad ideas, but I don't really use them much. I think it goes back to when I got my food handlers' permit ten years ago in preparation to work as a banquet server the summer before college. So I was sitting there in food handlers' permit class and the instructor started talking about hand sanitizers and she said, "I actually cite facilities that have too many hand sanitizing stations because people tend to use those in place of hand washing and hand sanitizer is nowhere hear as effective as hand washing." OK, I thought. And then I started hearing about studies on the real world effectiveness of hand sanitizer.  Turns out that hand sanitizer kills 99.9% of all germs under laboratory settings. In real life, it's more like 46-60%. Wow. All those Young Women's rough camps where we used nothing but hand sanitizer for everything felt just a little bit germier. (But, hey, we all had an awesome time nonetheless!) So once you've thoroughly washed your hands or a surface, applying hand sanitizer or a Clorox wipe can kill some additional germs, but if you're touching a surface like the handrail of a public bus, a shopping cart handle, etc., you're still picking up a lot of microbes. Your best line of defense is still frequent hand washing, but if you work work with kids or in health care, hand sanitizers and wipes can give you an extra boost in fighting the flu.
  • Homeopathy- I have used homeopathic remedies for myself and my family with lots of success. However, I have to admit that I haven't used them for flu specifically. In fact, homeopathy has been used to both prevent and cure a number of epidemic diseases, from polio to pertussis to meningitis. There are a number of flu fighting and immune boosting homeopathic formulas that you can get at your local grocery or health foods store. I have used both Hyland's and Boiron brands of homeopathic remedies and do recommend them. One drawback to "OTC" homeopathic formulas is that they might not meet your specific needs. Homeopathy treats very specific symptoms. For example, if you go to a homeopath for a flu remedy, she will ask you what kind of coughing are you experiencing (dry, wet, productive, unproductive), when you're feeling nauseated, what kind of foods, if any, you do feel like eating, what kind of stomach pain you're feeling (dull, throbbing, aching, sharp), what your nasal passages feel like, are you feeling hot or cold, do you want to lie down or sit up to rest, which side of the body you want to lie down on, what your mood is like, etc, and based on all of these very specific symptoms, she'll prescribe a remedy or remedies. Then she'll have you return for a follow-up visit because as the disease heals, the symptoms will change and the type of remedy you'll need to help you will change. So this is why getting an OTC homeopathic flu remedy can be somewhat hit or miss, but can help you give you an extra "oomph" in fighting off a case of the flu. I often like to consult the online homeopathic Materia Medica to get an idea of which remedy will be best. You can get homeopathic preventatives for a number of diseases from a qualified homeopath and there has been some promising research done on the use of them during epidemics
  • Chiropractic- This is just kind of general habit for us. Certain subluxations can hamper your immune and respiratory function. Since we're pretty tight on money, we've been doing home adjustments on each other. (Not so much on me since I got pregnant, but I can do my neck and stretch my back.) I don't recommend doing home adjustments unless you've actually been to a supportive chiropractor quite a bit. All that being said, if you've had some good exposure to and knowledge of chiropractic, knowing how to do a home adjustment can be invaluable in treating your family, especially when someone isn't feeling well. Subluxations don't always come during office hours, so being able to administer chiropractic "first aid" can be extremely useful. I've used home adjustments on everyone in our family, but they actually seem to make the biggest difference with Malamute's mood and energy level. Whenever he's feeling sick or moody, he usually asks to be adjusted, something pops into place, and he feels much better. (Especially helpful when he's been carrying Duckling in the backpack carrier on a hike.)
  • Herbs and supplements- We don't tend to use these very often since we're not around a lot of crowds or young children other than Duckling. But if I were a schoolteacher, had kids who went to school, worked somewhere where I was around a lot of people, had a vocal recital coming up, or was super-stressed out, I would probably use some herbal immune boosters for myself and my family. One year when I was taking voice lessons in college, my teacher recommended Airborne to me, and I was able to fight off a cold with it. I've also had good experiences with Dr. Christopher's formulas and they do have an immune booster for both kids and adults. Traditional Medicinals makes some great therapeutic teas and they have an echinacea tea, a couple of cold care formulas, and several sore throat formulas. (I love their Lemon Echinacea Throat Coat, but then I love the taste of black licorice, so I know this won't be everyone's cup of tea- pun intended.) If you're especially enterprising, you can even make your own teas from loose herbs from a health food store. Get yourself a tea ball for a few dollars and you're set to go!

Sunday, November 18, 2012

A Radio and a Gun: Why "Skyfall" Rocks!

Bond: A radio and a gun? Not exactly Christmas is it?
Q: What were you expecting? An exploding pen? We don't do that sort of thing anymore
Bond: Brave new world...

I went with Malamute to see Quantum of Solace on opening day. That was a disappointment. I'm not really a Bond fan (Malamute is), so I wasn't expecting much.

And even then I was disappointed.

The movie industry has often fallen prey to deluding themselves into thinking that if they can just spend enough money and pull off enough explosions, they'll have a blockbuster. Quantum of Solace was an example of this. The plot was so overly complex I couldn't keep track of what was going on or why the "Bond girl" was even there or what purpose she even served. Malamute was really disappointed. So we didn't have very high hopes for Skyfall until we started hearing about how they had done a lot of revamping. After seeing some of the behind the scenes footage and interviews, we were actually pretty excited about seeing the latest Bond flick. We were expecting it to be pretty good.

Skyfall actually exceeded our expectations!

One of the interesting things is that Skyfall actually cost $50 million less than Quantum of Solace. I'd say it's one of the best scripts for a Bond film that I've seen (and I've seen quite a few.) Malamute also commented on how he felt the cinematography was some of the best he'd seen for a Bond film. They started with a great story and character development for this film and that has made all the difference. Story and character development really don't cost anything extra except time and creativity, but they really are the most crucial elements in a successful film.

The focus on what the human brain brings to the table is just the sort of thing that is beginning to permeate our action flicks of late. Critics have commented on how gadget-free Skyfall is. Even Q is defined more by his intellect than the gadgets he has at his disposal. This latest version Bond focuses on Bond's ability to navigate tough situations using mostly his brains and strength.

But take a look at other action heroes over the last ten years or so. We're no longer as entranced by technology as audiences were 20, 30, and 40 years ago. We live with it every day and see its flaws and threats. We like heroes who are mostly defined by their character and intelligence. We like Maximus in Gladiator who manages to take down Commodus through sheer strength of will- even while mortally wounded. We like Peter Parker losing his powers in the second Spiderman movie and realizing that what makes him a hero is the courage to stand up and face danger to help others. We love Katniss Everdeen, Peeta Mellark and Rue who are plunked down in an arena with people twice as strong, fast and well-funded and face it all with nothing more than some night-vision sunglasses, an empty water bottle, and their wits to see them through. Even when our heroes have cool gadgets like Batman in Dark Knight, what we really love is seeing him sweat over making moral decisions. When is it appropriate to take a life? How far do we go to protect the common good? Does the end justify the means? Is there redemption? (Feel free to listen to "Go the Distance" from the Disney Hercules while you're reading this paragraph.)

I think we like these kinds of heroes because they remind us that we can all be heroes, even without super powers or a Batmobile. But don't get me wrong, a Batmobile would be cool. So here's to the hero who faces the forces of darkness with nothing more than his or her wits and maybe a radio and a gun.

Tuesday, November 13, 2012

The Best WWII Movies You Haven't Seen!

Happy belated Veterans' Day! I have a couple of posts in the works and things just haven't seemed to calm down over here. But in honor of Veterans' Day here is a special post!

When my maternal grandfather died earlier this year, a veterans' group came to perform part of the graveside service- 21 gun salute and taps. The whole bit. They mentioned how more and more World War II veterans are passing on and that we are seeing an end to that generation of veterans. I'd heard this before and knew it, but it really didn't sink in until I was at my grandfather's graveside service seeing the coffin. By twenty years' time, we will probably say goodbye to the last World War II veteran.

The passing of "the greatest generation" is inevitable and part of life, but we will never forget World War II and the lasting impression that it has made on humanity. One great way to remember World War II is to watch a good movie. And guess what, there are a lot of great movies out there besides Saving Private Ryan, The Great Escape, and Schindler's List (which are awesome movies, but this post is dedicated to movies you probably haven't seen.) I am leaving Bridge Over the River Kwai off because I just could not get into it after the first half. (I know, boo- hiss from some of you classic manly movies fans.) And Pearl Harbor (a.k.a. Twilight without vampires set in Hawaii in December 1941) is not on this list for obvious reasons.

Why have you probably never heard of these movies? Most of these are older movies, many of them concern the war with Japan in the Pacific arena, something Americans are very uncomfortable with delving into.

So first, here are the dramas.

Empire of the Sun- 1987, PG-13. Before Steven Spielberg did Schindler's List and before Christian Bale played Bruce Wayne, they both worked on Empire of the Sun. I honestly can't say enough good things about this movie. It's one of my top 10 favorites of all time. I think the reason this hasn't gained as much popularity as Spielberg's other WWII films is that it deals with life as a European citizen in Japanese occupied China. Every nation has something to be ashamed of, and Japan has the imprisonment of European citizens in poverty stricken and disease ridden internment camps. (Interesting bit of trivia for those of you who have seen Chariots of Fire, Eric Liddel, the Christian runner who refused to run on Sunday in the Olympics, actually perished in one of these camps. He and his family were Christian missionaries in China when the Japanese took over. Liddel sent his wife and daughters away in time, but felt that he should stay and help others as best as he could. He took care of the elderly and taught Bible classes and science to children in the camps. He died of an inoperable brain tumor, probably hastened by malnourishment and overwork, five months before liberation.) Christian Bale plays a twelve year old boy who is accidentally separated from his parents as the family tries to flee the Japanese forces. He comes of age in an internment camp, helping others and even befriends a Japanese boy. The music, the cinematography, and the performances are all superb (a special award was actually created for Christian Bale for his outstanding performance). If you watch closely, you can even see Ben Stiller in a bit part as an American interred in the camp- one of the first screen performances of his career.

A Bridge to the Sun- 1961, PG. This is movie based on the memoirs of Gwen Terasaki, an American who married a Japanese diplomat before the war. When Japan and America go to war, her husband is sent back to Japan and Gwen follows him along their daughter. The movie follows Gwen's experiences living among the Japanese and her husband's tireless efforts to bring about peace between Japan and America. This is a tear-jerker, but it is an absolutely beautiful love story, and I think is a good introduction for Americans to what life was like in WWII Japan. Seriously, you have to see it.

Sayonara- 1957, PG. Oh boy. This is the tear jerkiest of all the movies I'm going to recommend. The end will have you bawling. And it's not actually about WWII, but takes place during the Korean War. But really, you should see this. Marlon Brando (in one of the few roles I can stand) plays a GI in love with a Japanese woman, Red Buttons plays a GI married to a Japanese woman he dearly loves, and Patricia Owens plays the daughter of an American diplomat who strikes up a deep friendship with a Japanese Kabuki  actor. At the time, this movie was considered very progressive because it openly discussed and sympathized with interracial marriage. Now, many scholars argue that it's just another racist relic from the '50's because the women aren't portrayed as being feminist enough. I think it's a beautiful and tragic love story that makes you think.

The Memphis Belle- 1990, PG-13. This is a dramatization of the story of the crew of the Memphis Belle- bomber squadron who actually managed to fulfill all their bombing missions with no losses in the days before bomber escorts. (See my post on the story of the Memphis Belle.) This isn't a documentary or a complete factual account, but rather is meant to show what it was like to be on a bomber crew (pretty much a suicide mission) during the first part of WWII. Ladies, you may not be as interested in this as A Bridge to the Sun or Sayonara, but I think the gents out there might find it an engaging and action-packed ride through the skies over Europe.

There are actually some really great comedies set in World War II as well. Most of them seem to take place on ships in the Pacific or involve Cary Grant.

Mister Roberts- 1955, probably PG. This film stars Henry Fonda and several other '50's legends. The title character is a sailor on board the Navy's most boring cargo ship in the Pacific with a slacker crew and tyrannical captain (with a pet palm tree) who refuses to sign transfers so Roberts can get on a real ship with real action. The movie follows the misadventures of the crew and their battles with the captain. And trust me- you will never get more satisfaction from seeing a small tree be thrown overboard.

Operation Petticoat- 1959, PG. This movie is hilarious! Seriously! (Seriously hilarious, that's an oxymoron.) Cary Grant plays the captain of an unfortunate submarine that limps its way around the Philipines coast after being seriously damaged in a Japanese air raid. As the crew tries to make repairs, they find that they don't have enough red or white paint to serve as an undercoat- and no time to put on an overcoat. So they mix the two and voila!- the pinkest submarine in the Navy. Along the way, they take on stranded and accident-prone Army nurses, expectant Filipino women and children, and a goat (the children need milk.) Tony Curtis plays the supply officer who is adept at getting anything the sub needs- through the use of theft, poaching, trading favors, and an illegal casino.

Father Goose- 1964, PG. Well, we started with one of my top ten favorites and we're going to end with one of my top ten favorites. I have seen a ton of Cary Grant movies, but this is my favorite role of his. In this movie Grant plays a bum and he does it really, really well. Yes, the suave Mr. Grant does plays an awesome bum. The aforementioned bum is Walter Eckland, an American who has fled to the northern Australian coast wanting nothing more than to escape civilization, live on his boat and drink rum. His plans are interrupted when World War II breaks out and an officer in the Royal Navy blackmails/bribes Eckland to give something to humanity by serving as an aircraft spotter on an isolated island. Walter's life is further complicated when he picks up a French schoolmarm and several little girls who were accidentally stranded on a neighboring island during the evacuation of the foreign embassy in Australia. What ensues is a battle of the sexes for control of the resources of the island. This movie also contains one of the most interesting and exciting wedding scenes I have ever seen in a movie.

So, there you have it. Enjoy!

Wednesday, November 7, 2012

The Post-Election Fall Out...

It matters not how straight the gate, how strait the gate,
How charged with punishments the scroll.
I am the master of my fate:
I am the captain of my soul.
-William Ernest Henley

Well it's the day after and everyone has an opinion about the results. My MIL has been in mourning all day. Last night as the results were coming in she was lamenting about how Obama is going to ruin the country. When I said that ultimately, Obama isn't in control, God is and that the scriptures show that He has always prepared a way for the righteous, and that worrying only serves Satan's purposes, she actually seemed to get huffier about the whole situation. I guess I forgot for a moment that as a partially active twenty-something with lots of weird ideas I'm not supposed to talk to a rabidly Republican sixty-something temple worker about faith- even when I think I'm giving words of comfort.

I think MIL has been thinking that the Republican party was the last hope for redemption for our nation. I've come to the conclusion that it's not a president that defines our country- it's us as a people and as individuals. My life has been far more impacted by the actions of individuals around me than by any president. My in-laws' failure to teach their kids about money and life did far more harm for us than any of the economic policies from any president. Malamute's ex-boss' refusal to pay us for the work he did in September impacted us more than a recession. On the other side, information we found from a number of sources about raw and vegan eating along with food sensitivities have done more to help our family's health than any universal healthcare plan Obama (or Romney) have come up with. Same with a great chiropractor and the Dr. Christopher's herbal formulas for Duckling's spina bifida. Books on success and positive thinking have done more to create job opportunities for our family than any legislation. Ultimately, I believe it's up to each of us to create the kind of life we want and to "be the change we wish to see in the world." No president can make your life better.

My life has been impacted for the better by the number of people who have bought local and organic produce thereby creating more of a demand and greater availability. They built a new hospital not far from where I live and sent out all sorts of info about how the maternity wing has adjustable beds, birthing balls, birthing bars, and nicer rooms, a direct result of a number of women turning to midwives who offer the same services. I donate to charities who actually rescue women and girls from sex-trafficking and provide emotional counseling and career guidance and training to help them move on with their lives, something we don't need to wait for legislation to make a reality.

Also, I really don't think the country is totally headed down the toilet. Montana and Alabama both passed nullification measures for "Obamacare". Other states have passed measures about marijuana and then take a look at the number of states that have passed pro- or anti- same sex marriage legislation. Now, I have no desire to use marijuana or get a same-sex marriage, but I support the right of the people of these states to decide what they want to see happen in their states. I don't think we should have blanket legislation from the federal government for most things. And hey, if you don't like the laws, work to get people to see your perspective or move elsewhere if you choose. (One reason I don't want to move to Alabama, for example, is their strict anti-midwife laws. I don't agree with them, but I support the state of Alabama's right to set its own laws and I don't want a federal amendment forcing all states to OK home birth.) With the number of controversial issues coming up, people seem to be taking more initiative on the state level to decide things for themselves.

As for our little family, we make the decision about how to use our finances, educate our children, take care of our health, and to treat each other with love, kindness and respect. And no matter what happens, that will put us in a good spot. No one can take away our ability to choose how we will react to our circumstances.