What We Missed

New patronizing guidelines for mammograms have been implemented by a government task force, recommending that women over 40 shouldn’t get routine mammograms because of certain risks like women’s “anxiety.” Community poster jluther has much more.
The Washington Times Wes Pruden’s racist-ass remarks about the president’s lack of “blood impulse” only further proves we live in what is very far from a post-racial America.
A suspect was arrested for the brutal murder of Jorge Steven Lopez Mercado, a gay teenager in Puerto Rico.
Remember the swimming club in PA that kicked out a group of black and Latino campers for fear that they would “change the complexion” of the club? Looks like they’ve filed for bankruptcy.

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  1. Lily A
    Posted November 17, 2009 at 6:07 pm | Permalink

    I don’t agree that the “anxiety” concern in the new guidelines is patronizing at all. Getting a false positive and having to undergo more tests and potentially painful procedures is not fun. Having an abnormality removed because it might be cancerous in the future (even though there’s a very high chance that it will never become harmful) is not fun. Going through painful exams and unnecessary surgeries is anxiety provoking, and anything that saves women the pain and suffering involved (without putting them at much higher risk) seems like a good thing to me.

  2. Brittany
    Posted November 17, 2009 at 6:09 pm | Permalink

    “I’ve already expressed my feelings on people who believe being “American” is a genetic exclusivity that belongs solely to whites, and I won’t repeat those arguments here.”
    Couldn’t have said it better myself.
    Racism is never okay, no matter if you think Obama himself is or not.

  3. UhOhitzSaro
    Posted November 17, 2009 at 6:34 pm | Permalink

    Not to make it too personal, but my mother was diagnosed with stage III breast cancer at the age of 45. Her initial tumor would have been very apparent on a mammogram a year or two before if she had gone for one, and could have prevented the cancer from spreading. Her 8 years of chemotherapy, radiation and multiple surgeries before she died in April were “not fun.” Because of that, I make the choice to go for those tests that can cause lots of anxiety because, to me, the chance for early detection outweighs the risk of unnecessary worry.
    There are no blanket “rules” that are right for everyone. What is right for me is certainly not best for everyone. But medical associations recommending that women not receive mammograms until they are 50 will discourage women from even considering it, and may even lead to insurance companies not covering women under 50 who DO choose to have a mammogram. Anything that can limit the choices women will have over their own health is no good.

  4. aleks
    Posted November 17, 2009 at 6:59 pm | Permalink

    Did you ever come up with some non-racist reasons for calling the Obamas unpatriotic? Or is racism okay if it’s only a dog-whistle that would wake the dead?

  5. Brittany
    Posted November 17, 2009 at 7:11 pm | Permalink


  6. MiriamCT1
    Posted November 17, 2009 at 7:14 pm | Permalink

    I thought that I heard that the new recommendations for no routine mammograms until 50 instead of 40 is for women who have no risk factors. Having a family history is a risk factor, obviously.
    This is a tricky thing; both you and Lily A have good points about this issue. The biggest thing I’m concerned about is that insurance companies might use this as an excuse to not pay for women’s mammograms before 50, even if they have risk factors, or even if they don’t and want to be checked out. After all, it seems like the insurance industry is looking for ways to deny paying for anything whenever possible.

  7. RES
    Posted November 17, 2009 at 7:16 pm | Permalink

    Which is why if you actually read the guidelines they make sense. It is not women ages 40-49 should not get tested. All the guidelines are saying is that if you have no family history or other factors that put you at a high risk of breast cancer then you should consider opting out of the test.
    ” ‘All we are saying is, at age 40, a woman should make an appointment with her doctor and have a conversation about the benefits and harms of having a mammography now versus waiting to age 50,’ said Dr. Diana Petitti, vice chair of the task force.” From the article cited. Maybe most women cant make random appointments with their doctors to discuss these issues but it is not saying mammograms from younger women are worthless just that without other factors the average woman does not benefit much.

  8. Brittany
    Posted November 17, 2009 at 7:17 pm | Permalink

    I think I know what you’re talking about…I wasn’t calling Obama racist myself, I was talking about the fact that Wes Pruden has called Obama racist before. But this is the same man that also criticized the Senate for apologizing for not enacting an anti-lynching law…

  9. Oskar
    Posted November 17, 2009 at 7:29 pm | Permalink

    Also, one thing that has to be kept in mind is that this is in no way “patronizing” to women, insulting to women’s capability to handle anxiety or anything like that.
    Why? Because AMA guidelines say the same thing with regards to the PSA test when it comes to men who have low risk of developing prostate cancer.
    The fact is, too many tests can be more dangerous. The tests themselves have non-zero risk of creating illnesses, and in many cases it leads to overtreatment, which is not only dangerous but also very expensive (hence healthcare being 20% of US GDP).
    Please, let’s not call people sexist if they’re not actually being sexist. It’s a unfair and insulting accusation to doctors just trying to do their jobs, and it lessens the impact of the accusation when real sexism is going on.

  10. aleks
    Posted November 17, 2009 at 7:36 pm | Permalink

    Did you ever come up with some non-racist reasons for calling the Obamas unpatriotic?

  11. Brittany
    Posted November 17, 2009 at 7:39 pm | Permalink

    Please name racist reasons that I called Obama unpatriotic.

  12. aleks
    Posted November 17, 2009 at 7:49 pm | Permalink

    Are you unaware of the long and continuing history of white people assuming that blacks weren’t real patriotic Americans? In light of that history, why on earth would you think it was okay to accuse the first black First Family of being unpatriotic without having any sort of case to make for it?
    Don’t get me wrong, I don’t think that you’re a self-aware racist. You’re parroting racist talking points without a clue what they mean. But is that really a whole lot better?

  13. Brittany
    Posted November 17, 2009 at 8:01 pm | Permalink

    Way to assume I’m racist for calling Obama unpatriotic with no proof that I am.
    And I actually called Michelle the unpatriotic one, due to this particular golden quote:
    “For the first time in my adult lifetime, I’m really proud of my country … not just because Barack has done well, but because I think people are hungry for change,” she said. “I have been desperate to see our country moving in that direction and just not feeling so alone in my frustration and disappointment.”
    And may I include the gem of Obama himself not holding his hand over his heart?
    But since that’s apparently not much proof, I only called Michelle unpatriotic.
    And Obama is as much white as he is black, so I don’t understand why anyone against Obama is automatically labeled racist?

  14. Brianna G
    Posted November 17, 2009 at 8:41 pm | Permalink

    While I think that’s ridiculous (there is nothing more patriotic in a free nation than admitting your country’s flaws and weaknesses– it is how you can prove you are free), I will say, it’s not racist.
    Ignoring the fact that traditionally ANY black ancestry means black regardless of one’s culture, physical appearance, or parentage, though, makes you very racist, or at least woefully ignorant. According to cultural tradition in this country, Obama is 100% black, as is anyone who has a drop of black African ancestry. Indeed, the definition of black has always been based not on actual ancestry, but on parentage. He’s not “as much white as he is black,” he’s black. He is as much Kenyan as is his European, though.

  15. Comrade Kevin
    Posted November 17, 2009 at 8:45 pm | Permalink

    Regarding the racist talk, it was in The Washington Times. End of argument.

  16. Brittany
    Posted November 17, 2009 at 8:45 pm | Permalink

    Hmm. It appears as if you’re right, I forgot that “one drop” rule.
    That rule is ridiculous, but I suppose I can’t argue it.

  17. Brianna G
    Posted November 17, 2009 at 8:47 pm | Permalink

    I think people are grossly underestimating the psychological harm of thinking you have cancer when you don’t. It’s incredibly scary– not because women are weak, but because cancer is scary. As Oskar says, all they are doing is making the guidelines more fair– instead of assuming everything female will break at the slightest provocation, they’re considering that MOST women won’t get cancer so it’s unfair to say that men’s emotions and fears should be considered but women’s shouldn’t.
    Personally, I’m glad they’re not exposing healthy women to biopsies, radiation, and the terror of suspecting you have cancer if they don’t need to. Hopefully they’ll eventually stop requiring women to get constant vaginal exams to get birth control, even if they aren’t actually sexually active (because OH NO THE VAGINA MUST BE CHECKED CONSTANTLY FOR PROBLEMS).
    And of course, they still recommend it for women with family histories, so this does NOT give insurance companies a reason to deny coverage for mammograms to at-risk groups.
    Yay for healthcare becoming less sexist!

  18. aleks
    Posted November 17, 2009 at 8:59 pm | Permalink

    Way to assume I’m racist for calling Obama unpatriotic with no proof that I am.
    I didn’t assume you were racist, you demonstrated that you are.
    “For the first time in my adult lifetime, I’m really proud of my country … not just because Barack has done well, but because I think people are hungry for change,” she said. “I have been desperate to see our country moving in that direction and just not feeling so alone in my frustration and disappointment.”
    And you were told that this was proof of un-American sentiment by the same circus freaks who suggest Obama was born in Africa, which didn’t set off a single warning bell for you because you don’t see any difference between pointing out that some of the attacks on the Obamas are objectively racist versus labeling “anyone against Obama” a racist.
    And Obama is as much white as he is black,
    Because racists totes love mixed race children as long as they’re partially white.
    so I don’t understand why anyone against Obama is automatically labeled racist?
    BECAUSE POLITICAL CORRECTNESS IS OUT TO GET YOUR FREEDOM! Good grief. Lots of non-racists are against Obama. It’s the things you specifically say that make you a racist, or at best an unwitting and unresisting conduit for the racism of those whose talking points you apparently swallow and regurgitate without any independent thought.
    Seriously, if that’s all the evidence you need to call the first black First Couple unpatriotic, you have some truly fucked up (although not uncommon among you Palinesque “real Americans”) ideas about how American black people can be.

  19. cattrack2
    Posted November 17, 2009 at 10:17 pm | Permalink

    Brittany–You seem to think critically about the issues, so let me suggest 3 things, in all seriousness. One, calling black people unpatriotic is older even than MLK, who was called a communist by many whites, including Reagan(among the nicer things he was called :-) Second, wrt to putting your hand over your heart during the Nat’l Anthem. That’s made up. Unlike the Pledge of Allegiance there’s no standard for doing that nationwide (and even wrt the PoA we didn’t place our hand over hearts until the 40s). I certainly never have placed my hand over my heart singing the SSB.
    But the most important thing, if you’re a minority in this country it can be awfully hard to be proud of your country on a day to day basis. So while I’m sure the hyperbole got the best of Michelle, try facing the various racist insults, significant or subtle, on a daily basis, and you’ll find it hard to feel 100% patriotic every darn day. Anyways, I’m not accusing you of being a racist by any stretch, just offering some food for thought.

  20. JLu
    Posted November 17, 2009 at 10:42 pm | Permalink

    This is what the reports says about anxiety: “Anxiety, distress, and other psychosocial effects can exist with abnormal mammography results but fortunately are usually transient, and some research suggests that these effects are not a barrier to screening. False-negative results occur at a relatively low rate for all ages.”
    While I understand that having a false-negative and undergoing a biopsy on a benign tumor is a difficult experience, I know too many women that go through that process and end up with cancer, and some of them were far from 50. I also happen to know that insurance companies will fight you tooth and nail to deny you preventive care even if you have all the possible reasons to get that care based on the smallest of reasons, forget having specific guidelines from the USPSTF. So, the task force can say whatever it wants about this not affecting insurance, but we have no reason to trust that that is true. None.
    Plus, the research is far from conclusive. Plenty of completely reputable groups that deal with cancer patients on a daily basis think that the USPSTF is wrong and are calling for mammograms to continue for women 40+. But those groups have NO say in what insurance companies decide. It’s not as simple as saying that these tests are psychologically hard to deal with this and it’s not denying that fact, either.
    But I am just not convinced that the risk of afalse positive and possibly a biopsy for some women (leading to an anxiety that the report itself claims is “transient”) is worth the risk to another woman’s health and possibly life, especially when groups that I do trust tell me it’s not.
    I don’t see any of this as easy and I don’t want to deny anyone’s personal experience with false negatives but I also can’t let go of my own which scream to me that this is a scary shift in medical policy.

  21. SaraLaffs
    Posted November 17, 2009 at 10:46 pm | Permalink

    I agree with you that having to go in for a yearly pelvic exam just to get a BC refill is a pain in the ass… but the one time I skipped a year (I wasn’t on BC at the time), my next exam found abnormal cells. Having to get a colposcopy, and getting exams every few months for the next year to make sure it wasn’t progressing into cervical cancer – that was a MUCH more traumatic experience. I will gladly go in for a pap every year from now on. Luckily, I have health insurance that covers it.
    This mammogram recommendation hit me on the wrong day (I just learned that my uncle has cancer of the esophagas), so I’m very much in the “get check-ups, exams, etc., as often as you can” camp right now. My more rational side understands the need to reduce unnecessary medical tests. But how can they possibly discourage self-exams? It’s not like they cost anything.

  22. aleks
    Posted November 17, 2009 at 11:46 pm | Permalink

    Much older than MLK, Dred Scott was decided partly on the theory that even free blacks could never truly be Americans. Fast forward 152 years and we have the TEA Party claiming that the first black president isn’t really an American citizen and Brittany trying to indict the First Family as unpatriotic on the basis of evidence that would make Joe McCarthy blush.

  23. Oskar
    Posted November 18, 2009 at 2:59 am | Permalink

    All of these are fair arguments: it’s certainly possible that with more analysis, more science and more thinking about this issue, these guidelines will turn out to be flat out wrong (or they may not).
    There is certainly a debate to be had here, about whether low-risk patients should get tested at all. Instinctively, most people think that more tests are always better, and they may well be right. Certain doctors say otherwise, and they may be right.
    However, what is totally wrong is to call doctors with the latter opinion sexist and patronizing to women, because it’s highly insulting and just flat out wrong. The opinion stands regardless of what gender the patient has. It’s bringing the debate down to the level of childish name-calling, and it’s frankly unfair to act that way towards people that have dedicated their lives to women’s health.

  24. Brianna G
    Posted November 18, 2009 at 8:34 am | Permalink

    If you have a history of cancer, of course you should go in… I think the issue with self-exams is that they are SO often wrong, and women waste tons of their money and time following up on “lumps” that aren’t really there. I’ve gone in for lumps before and each time my doctor rolled her eyes and said “You’re not even 25, you don’t have breast cancer” then checked and confirmed that I just have lumpy breasts. The cost isn’t the exam itself, it’s following up all the time, especially since breasts are so variable in texture and benign lumps are common.
    The thing that got me was that I had to go in and get a pelvic exam BEFORE I was sexually active and five years before normal recommendations for yearly paps begin, just to get birth control, yet the same place wouldn’t give my friend an intra-vaginal ultrasound (ie, put the tool up her vagina) to check her uterus for suspected endometriosis because she was a virgin– she had to go to another doctor and they made her sign all kinds of waivers. Trust me, at 20 years old and not sexually active, the pelvic exams are punishment for thinking about sex, not actually useful diagnostic tools.
    This assumption that women are prone to breakage and should get checked all the time, even when young, is the justification insurance companies use to raise women’s rates. It’s based in the idea that men are the norm, so the female system must be this weird, complicated thing.

  25. m00se
    Posted November 18, 2009 at 4:37 pm | Permalink

    I think people are underestimating the psychological harm of actually having cancer and then realizing that perhaps it could have been diagnosed sooner. I keep hearing the term “unnecessary biopsy” but conceptually that’s kind of a ridiculous term because the point of a biopsy is to see if there’s a problem. It’s unfortunate that the battery of tests that are currently available for breast cancer suck, but that’s what we’ve got. The most concrete test is an actual tissue sample. Other tests can try to determine whether that biopsy is necessary but a biopsy can only be determined unnecessary until you know there’s no problem. Frankly, the sense of relief from that should far outweigh the sheer terror of hearing that the biopsy came back positive.
    It’s true that mammograms are easily faulty. Mammograms return false positives and often miss cancer that can be detected in other, admittedly more expensive tests. I actually agree with the new mammogram guidelines for the most part. However, I don’t think that the answer is to say don’t make the attempt to be aware of changes in your body and that includes your breasts. A formal, previously recommended self-exam may not be the answer but I feel as if these new guidelines kind of send a message that one shouldn’t trust one’s body and there’s simply no way to know if you may have an problem that might be cancer. I am concerned that women will hear these guidelines and instead of pursuing a consultation with their doctor when they experience a symptom which could be breast cancer, they will instead fear an “unnecessary biopsy”. I assure you, actual cancer is worse than a biopsy which might provide the ability to breathe easy.

  26. Brittany
    Posted November 18, 2009 at 6:04 pm | Permalink

    Thank you very much, Cattrack2. It’s refreshing to see someone handle the issues politely. Aleks doesn’t seem to know how to do anything but rudely attack people personally.
    I’m aware that calling black people unpatriotic is quite old, though that wasn’t the reason that I was calling Michelle unpatriotic…to me, despite color or anything else, or even if you were born here, you’re an American if you live here. I suppose it looked bad, however.
    Ah, it appears as if you’re right about the heart thing…I was just used to holding my hand over my heart during the National Anthem growing up, and it struck me as strange to see him not doing it. Not to mention that whole flag pin controversy…
    I understand that it’s impossible to feel 100% patriotic as well! I’ve felt that way sometimes, as I’m sure every person does about their country. It’s just the “for the first time…” part that got me. So she’s never been proud of America?
    I understand that I was misinformed on some parts, and thank you for correcting it. :-)

  27. aleks
    Posted November 18, 2009 at 8:15 pm | Permalink

    Why on earth should I be polite about whiny, ignorant racism? Your Real Americans attitude gets far too much deference and “polite” regard. You don’t even understand what you’re saying or why it’s unacceptable. You need an intervention to save you from yourself, some rudeness to warn you about what you’re doing is the least one can do for you.

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