Our Changing Culture

I attend college at KVCC. At our downtown and Texas Township campuses we have a couple of Unisex bathrooms.

These are not the unisex bathrooms of our past, these are multistall bathrooms. The really funny thing is that the bathrooms are all laid out in pairs and usually have a male and female bathroom. Where we have unisex bathrooms however there is a female and a unisex bathroom. I have only used the unisex once and had women in there at the same time.

It is interesting that there is a female and unisex and not a male and unisex there. If this were the case then I believe there would have been an outcry against making the women college students walk to another bathroom to use it in samesex conditions. Why was the assumption made that men would not mind. I personally don't care one way or the other.......although I probably would not use it in cases of massive gastrointestinal distress.

The one time that I used it a girl was taking a very noisy poop, and I wondered whether the girl was self-consious about using it and having guys realize that they have noisy poops too.

Something to ponder.........Until next time.

Death and Life in the USA

• Lately, I have been thinking about death. My aunt Clara just passed away after a two year fight with colon and liver cancer. Clara was diagnosed with stage four colon and liver cancer about two years ago. She probably had the cancer in her body for three to four years before the diagnosis was made due to a some symptoms that she was having that led her doctors to perform a colonoscopy. Her chances for survival were rather small, due to the advanced nature of her disease at the time of diagnosis. The doctors gave her a year to live and a minuscule chance of survival, even with treatment they thought that they might be able to gain a year of life for her. Clara sought more advanced treatment options at the U of M Medical Center in Ann Arbor. The doctors in Ann Arbor treated her with chemotherapy and radiation. In the end, the original doctors were proven right in their initial diagnosis and prognosis. This in my mind raises some questions.
  
  
• Was it worth it to try the advanced treatments in Ann Arbor?
• First, the cost of Clara's treatments were largely met my Medicaid and later by private insurance. So, in both systems the costs were spread out amongst many people who pay into the systems involved. So the barrier to seek treatment was low enough to allow her to do so.
• Secondly, we can apply Pascal's Wager to examine the philosophical arguments of whether or not to seek treatments in Clara's case. In the first case we can look at what would happen if she did not seek treatment, traditionally in Pascal's Wager there are both good and bad scenarios for each choice but in this case we can diminish the likelihood of the good outcome to be negligible, leaving the bad outcome of death at one year from diagnosis with all the consequences of that outcome. In the second scenario we see Clara seeking treatment. In the good outcome we see her cancer fought into remission and her quality and quantity of life improved for her and all the consequences of that outcome, we have to realize that the probability are small but they are significantly higher with treatment than without. In the bad outcome after seeking treatment, we see Clara gaining a little time but succumbing to cancer anyway, with all the consequences of that outcome. It is not hard to look at this and decide just based on probabilities that the best decision is to seek treatment. Not only are your chances of survival greater, but at worst case you get a little more time with your family and friends. We can attempt to compare the cost of treatment with the extension of life for a arbitrary amount of time. But this is a fallacious comparison, life and money are not two things that can be compared in any objective way, because there are too many subjective arguments for the value of life that have their own merit and cannot be discounted.
  
• Would Clara's disease have progressed differently had she been diagnosed earlier?
• This is the question that has been nagging at me for two years...........If Clara had been diagnosed three to four years earlier the probability of survival increases dramatically. So why not get regular colonoscopies? First, we cannot make the assumption of a rational actor in this situation, as we as humans rarely act in a rational manner.
• The barriers to this procedure are financial and emotional. Financially the cost of the procedure is high without health insurance, but it is less than that of treating a advanced case of cancer. But, is it high enough to create a legitimate barrier to those without insurance? I believe that it is. It is easy to second guess the decisions that people make and find fault after the fact. It would be easy to say that of course Clara should of sought this procedure no matter the cost, as it would have possibly led to her beating her cancer. But, what are the consequences of that decision? Where should the money come from? Rent? Food? Electricity? When you look at it from her perspective you can see the choice to spend money on guarding against a really low probability outcome with consequences that are almost certain to have a negative impact on her family's financial well being. This I see as the most cogent argument for a single payer health system, with regular health screening for the low probability health risks the costs of treating the diseases will decrease overall as well. In our country we spend the most on treatment per capita world wide, yet we do not get the best care. We are ranked 37th worldwide for quality of health care delivered.
• Emotionally, the barriers to getting the colonoscopy are relatively easy to see. I know that Clara had symptoms for years before she was checked out. Why wait this long? It is easy to rationalize and say that this is just a small problem probably related to diet........but that is not what it was. Clara had problems with bowel movements for a number of years, always believing that it was just a problem with her diet. We all do this in a number of ways every day in our lives. "Oh, what is the worst that can happen? I only smoke a pack a day. I am young yet, I don't have to worry about cancer or heart disease untill I get old." I am a smoker. If I do not quit, it will kill me in a painfull and slow way. This is a guarunteed outcome, yet we still see people that smoke, eat in an unhealthy manner, don't get enough exercise, and the list goes on and on. This is the same rationalization that Clara made. "Ok, so I don't have the stamina that I could. I am a little overweight. But, otherwise I feel healthy." The sad truth is that we are all complicit. Another sad truth is that I could die driving home tonight.