The Human Condition

From Ft. Hood to Florida: Lots of Questions, Few Answers on the Psyche of Shooters

Newsweek — Fri, 06 Nov 2009 22:35:15 GMT

by Rabeika Messina

We don’t know much about suspected Ft. Hood killer Nidal Malik Hasan: there are reports he gave away his possessions. There are reports he was terrified of being deployed. And there’s the fact that prior to his killing spree, Hasan worked as a psychiatrist, treating war-affected patients at both Walter Reed and Ft. Hood. Shouldn’t a psychiatrist have seen his own unraveling coming? Or are psychiatrists more likely to unravel than anyone else? What turns a man professionally endowed to treat the mental ailments of others into one who goes mental himself? And in his addled state, what did he think he’d achieve by opening fire into a crowd?

We may never fully know what Hasan was thinking the morning before his alleged killing spree, but we do know that some of his professional colleagues frustrated that this attack may be perceived as yet another black mark against their industry. Psychiatrists have long been plagued by jokes about instability, and while most are quite sane, there's some truth to the rumors: studies show that these doctors have the highest suicide rate among physicians. They are most likely to suffer from depression compared to surgeons and GPs, and they’re more likely to be critical of themselves and others. It makes sense: unlike an orthopedic surgeon, treats a broken bone, fixes it, and moves on, a psychiatrist, working to help people make peace with themselves and their troubled psyche, doesn’t get that same closure, the same sense of accomplishment, may feel helpless and frustrated as a result.

Being a psychiatrist doesn’t mean one holds all the keys to mental stability. While the majority of psychiatrists are well-balanced individuals, and according to an article in Psychology Today, an American Psychiatric Association study stated that those with emotional disorders are more drawn to the field than other types of medicine.

“Just because someone is a psychiatrist [does not mean] they’re not prone to the same evolvement of a mental illness,” said Dr. Kathryn Moss, a psychiatrist from the New York Presbyterian Hospital and the Weill Cornell Medical Center. Especially if Hasan was suffering from a something like a Pre-Post-Traumatic Stress Disorder. By routinely treating troops with disturbing experiences, he could have experienced enough strain and trauma to cause PTSD, even without deploying. “Exposure is not just to visceral traumas, but also to constant, ongoing stress,” explains Dr. Nancy Sherman, a Georgetown University professor with expertise on PTSD and the emotional and mental health of soldiers. “The mental health workers who are dealing with the current wars are under enormous stress, and it simply isn’t often recognized. Their needs must be addressed as much as those of the troops up for deployment,” she states.

But while PTSD can lead to violent outbursts in many returning troops, it has yet to result in such a gruesome, public crime. And there are plenty of depressed and dejected docs who don’t go on shooting rampages.

That’s because mass killers aren’t likely to be driven by conditions like anxiety, depression or bipolar disorder, which aren’t normally characterized by violent fits. Instead, says Moss, someone who inflicts this type of harm on other humans is under a much greater, more troubling psychosis. “They are delusional about what is going on in their environment,” says Moss. “They don’t share a view the reality that other people share, so they act in ways that other people wouldn’t act,” she says.

Nothing made that point more tragically clear than the shooting that occurred almost 24 hours later in Orlando, Florida. There, Jason Rodriguez turned himself in after cops surrounded his home, accusing him of shooting six people, killing one, in a Florida high rise. Rodriguez had no military background. He worked in at an engineering firm, not as a mental health profession. But he, like Hasan, was purportedly compelled to pull the trigger and shoot into a crowd. The only thing they likely had in common was a deep, troubling mental illness. “Mass shooters are impelled by a mental disorder, revenge, some type of ideological motivation or even perversion,” says Dr. Jeffrey Lieberman, chairman and professor at the Department of Psychiatry at Columbia University.

But to what end? What satisfaction do these killers get from attacking people in a public setting? “Sometimes, if they have some kind of delusion, these people feel that the group is a person,” explains Dr. Moss. “They see everyone as part of a conspiracy, out to get them. In the shooter’s mind, it is specific, because he chose that group.”

If these two men really are guilty of such crimes, could Hasan’s actions have impacted Rodriguez? Perhaps, says Lieberman. For those unstable enough to be considering such a thing, recent attacks can be triggering. “There is a contagion effect; there’s enough people out there who are mentally unstable and emotionally fragile that they can be influenced by the cultural environment,” he says.

A scary thought in a country that's seen more than ten mass killings in the past ten years. Something is triggering these killers, whether it's internal conflict, external stimulus, or a combination of both. Either way, the challenge is to discover what's motivating the shooters ahead of time, instead of wondering why after tragedy strikes.

"This Is a Betrayal": A Chaplain Discusses the Long Recovery From Ft. Hood and the Lasting Legacy of PTSD

Eve Conant — Fri, 06 Nov 2009 14:12:11 GMT

An ordained Baptist chaplain and army captain, Roger Benimoff spent two tours of duty in Iraq and months between deployments counseling soldiers in the U.S. During his career, he provided spiritual guidance to American soldiers through crises of faith, bereavement, and trauma until he himself broke down. While training and working as a chaplain at Walter Reed during the height of its crisis, Benimoff was diagnosed with chronic PTSD and spent months of treatment at some of the facilities where he trained as a caretaker. NEWSWEEK's Eve Conant has tracked Benimoff's experiences over the years, starting with his time at Walter Reed, and recently in a book about his experiences, Faith Under Fire. Benimoff retired from the army earlier this year. He spoke with Conant from Dallas, where he is a hospital chaplain, about what might have happened in Ft. Hood, how the military families will cope with tragedy on the homefront, and why the army pushed him so far he had to leave.

Is "contact" or "secondary" PTSD a genuine problem?

Oh yes, definitely. I didn't have much time to counsel before I was deployed—I had only three weeks active duty before going over—but I would debrief my soldiers in Iraq all the time about events I was not present at. I remember when Eagle Troop had lost a soldier to a sniper and I did the CISD [Critical Incident Stress Debriefing]. I still have those images in my head. Or when one of Fox Troop's tanks went over a land mine. The soldiers told me about how the IED blew through their tank, how the driver's body was completely destroyed, how it was like spaghetti, and they were desperately trying to pull him out of the driver's seat while their command told them to leave the scene. They didn't leave him behind. But the tension of that, and their descriptions of that moment stay with me. When Eagle Troop lost a sergeant to an RPG, they told me about running into the hospital, seeing Iraq soldiers vomiting on the stairs after what they had just seen—walls covered in blood, brain matter on the floor. These images don't go away and I wasn't even there that day.

Besides the images, what does it feel like when you remember what the soldiers told you about, and how long did the feelings last?

Scared. It was haunting. People I cared about were suffering, which causes stress, but then you also get scared and depressed yourself. You are constantly having to respond and help even when you are feeling helpless. I remember just an overwhelming sense of all my feelings colliding at once, of not being able to compartmentalize. And when you are surrounded by tanks and equipment, whether in Iraq or at a base at home, it's even harder to compartmentalize.

Were you diagnosed with secondary PTSD as well as chronic PTSD? How does something like Ft. Hood affect you?

I know that my psychologist at Walter Reed talked to me about it, but I don't think it ever made it into the paperwork. But absolutely it was part of it. It's constantly being in that environment that is so hard. Even now, thinking about Fort Hood I'm depressed today. I can just picture people in the Readiness Center, because I've been in so many myself. I've led sessions. I know there was a chaplain there who must have responded to this. I'm 100 miles away from Ft. Hood right now, but I'm depressed and worried. I feel the same way today as I did back in the desert. I heard a soldier's wife talking on the radio about how they were supposed to be safe at home. This is such a betrayal.

Is it harder for army families—already so strained—to bounce back from something like this?

Military families have more resources than other families in a tragedy. But at the same time they are back in the U.S., and this is not supposed to happen here. Even in Iraq you don't often have 12 soldiers killed at once and here it's happened on our own soil. I don't think the families can bounce back from this. This shatters the paradigm that—wow—my loved one is back and finally safe.

How do you feel now, as a chaplain at a hospital?

I'm still in the healing process. But I'm reframing my experience—it's not that God abandoned me but that God provided space for me. My family stayed with me, my mentors and friends, even when I was lashing out.

Is it hard for caretakers to get help for themselves?

Yes. I didn't want to be judged. When people tried to help me I would study how they would engage me—if I sensed any canned statements or if I felt they were uncomfortable with me I would back off and close up.

What do you think was in the shooter's mind at Ft. Hood? Were you both at Walter Reed at the same time, since you both studied there?

I didn't know him, am not sure if we were at Walter Reed at the same time. But I know anyone there would have experienced a lot of secondary stress. After all, I became an inpatient soon after starting work at Walter Reed. But I can't imagine shooting anyone. I also don't know what role his religion played, if any.

Why did you leave the army?

I could not stay in the army any longer and do good. There was a part of me who hated all of humanity because I could not understand the atrocities that people would commit, the horrors that people are capable of. I hated humanity and I hated God and I hated myself. I was so burned out, so angry with God and with the army I knew I had to get away from that culture. I could not be an army chaplain any longer without doing harm to others. But I can't imagine how someone would shoot their own soldiers. When I say I would do harm I mean emotionally—I was closed off and cold. I could not give the spiritual and emotional care that soldiers needed.

Is Fort Hood a Harbinger? Nidal Malik Hasan May Be a Symptom of a Military on the Brink.

Andrew Bast — Fri, 06 Nov 2009 13:30:20 GMT

What if Thursday's atrocious slaughter at Fort Hood only signals that the worst is yet to come? The murder scene Thursday afternoon at the Killeen, Texas, military base, the largest in the country, was heart-wrenching. Details remained murky, but at least 13 are dead and 30 wounded in a killing spree that may momentarily remind us of a reality that most Americans can readily forget: soldiers and their families are living, and bending, under a harrowing and unrelenting stress that will not let up any time soon. And the U.S. military could well be reaching a breaking point as the president decides to send more troops into Afghanistan.

It's hard to draw too many conclusions right now, but we do know this: Thursday night, authorities shot and then apprehended the lone suspect, Maj. Nidal Malik Hasan. A psychiatrist who was set to deploy to Iraq at the end of the month, Hasan reportedly opened fire around the Fort Hood Readiness Center, where troops are prepared for deployments to Iraq and Afghanistan. And though this scene is a most extreme and tragic outlier, it comes at a time when the stress of combat has affected so many soldiers individually that it makes it increasingly difficult for the military as a whole to deploy for wars abroad. In an abrupt news conference, Lt. Gen. Robert Cone, the top commander at Fort Hood, said in response to the shooting that authorities would "increase the security presence" on the military base. On the surface, it seemed like a logical enough plan. But it makes one wonder how much any kind of lockdown will either get at the root causes of soldier stresses or better prepare them for more battle.

Hasan's perspective is unknown. He had yet to fight abroad. But the accusations against him can't help but bring to mind the violence scarring military bases all over the country after the duration of two long, brutal wars. In May, Fort Campbell—a major military base in Kentucky and the home of the "Screaming Eagles" of the 101st Airborne Division—went into a three-day stand-down after a soldier killed himself, the 11th suicide since the beginning of the year, more than on any other base. "Suicidal behavior is bad," Brig. Gen. Stephen Townsend said at the time. In black shorts, a T shirt, and running shoes, he climbed atop a podium in a field and addressed his troops. "It's bad for soldiers, it's bad for families, bad for your units, bad for this division and our Army and our country, and it's got to stop now." The pep talk and accompanying posters, imploring soldiers to take care of one another, had limited effect. Another six soldiers have killed themselves since the stand-down.

That the two wars currently being waged are taking a psychological toll on soldiers is no surprise. Some studies report that as many as a third of returning soldiers suffer from posttraumatic stress disorder, a constant, tension-inducing malady that leaves men and women detached from their family lives, numb to their peaceful life stateside, and, let it be said, sometimes angry as hell. "No one comes home from war unchanged," says the Iraq and Afghanistan Veterans of America. And while those who have faced multiple deployments are the most likely candidates to lash out irrationally after returning, it's impossible to discount how the grind of an eight-year war has affected the rest of the military, who see friends leave whole and return in pieces; who wonder constantly if they'll be next. (As a psychiatrist, Hasan may have been particularly vulnerable: there have been numerous accounts of chaplains suffering from depression and PTSD after counseling returning soldiers. Hearing their horror stories, sharing their pain, and being unable to help often pushed these men over the edge. The fact that they were supposed to be healers, that they had never seen combat themselves, made it much harder to ask for help.)

While policymakers discuss troop levels in an anesthetic language of numbers in the tens of thousands, a bone-rattling truth underlies so many of the lives of soldiers and their sons, daughters, wives, husbands, and families. Theirs is an insufferable emotional existence. "Deployment seems more and more to signal divorce," one wife of an Army soldier said privately. Statistics back up her claim in an unexpected way: divorce rates of female soldiers are spiking; they are now three times that of their male counterparts. There are also reports of domestic violence, of an increase in bar fights. Buffalo, N.Y., has set up its own court for returning vets to handle an increasing number of criminal, often violent, behavior from soldiers.

Of course, Hasan had not yet been deployed, and the true cause of Thursday's tragedy is still unknown. And yet some are already suggesting that Major Hasan's lack of combat experience precludes us from assuming the crimes were at all influenced by the stress of war. "They weren't in Iraq," author Dinesh D'Souza said on television Thursday night, analyzing the culprit. "They were living a normal, everyday life." But he is wrong. In the midst of two wars, those living as military and military family experience a different—often, more distressing—everyday experience of "normal." And forgetting that, either in understanding this singular case, or making a decision about more deployments, is dangerous at best, and morally bankrupt at worst.

The U.S. is drawing down troops in Iraq at a quick clip, but Gen. Stanley McChrystal has requested tens of thousands more to fight in Afghanistan. Though President Obama has made no decision about the way forward, some suggest that as many 80,000 more could be sent in as reinforcements. That would put nearly 150,000 American soldiers in country for at least the foreseeable future, pushing a thumb down on an already stressed-out military. Of course, the vast majority of those under that stress, no matter how brutal, will not pick up a gun and shoot indiscriminately, like Hasan did. But the situation is bad, and getting much worse. From there, it isn't much of a leap to argue that to further tax our military would do as much as anything to guarantee that the homegrown terror on display today could well repeat itself in the future.

In Letter, CDC Head Thomas Frieden Tries to Head off the Looming H1N1 Vaccine Wars

Newsweek — Thu, 05 Nov 2009 16:37:36 GMT

by Claudia Kalb

The H1N1 vaccine shortage isn’t just frustrating. It’s unleashing an ethical and emotionally charged debate about people’s shot-worthiness. Back in August, the CDC announced recommendations on who should be first in line for vaccination. The list: pregnant women, caregivers for babies under 6 months, health-care workers, anybody 6 months to 25 years old, and people with health conditions like asthma and diabetes. But we all know that vaccine distribution hasn’t gone perfectly—lines have been long, supplies have run out, and, yes, some Americans have gotten the shot when they shouldn’t have.

All of this blew up into a vitriolic exchange on a local moms bulletin board in Washington, D.C., after a mother said she’d gotten vaccinated at a Virginia clinic even though she didn’t qualify. And she urged other moms to do the same to protect their kids. Hello swine-flu mommy wars. One woman called her selfish. (And there were choicer words, too.) Another warned there would be a “day of reckoning” for people like her. And this: “To the people who have gotten the H1N1 vaccine and are not in the CDC priority groups—WHAT YOU DID IS DISGUSTING. YOU ARE DISGUSTING.”

The calmer posts said she wasn’t at fault: at least some health-care workers at the clinic, they reported, were encouraging people to get the vaccine while they could—even if they weren’t in one of the priority groups. But that’s not supposed to happen, at least not until more ample supplies of vaccine are available. Moms aren’t the only ones at war. A report that Goldman Sachs and other big New York companies have received vaccine has some people up in arms, even though Goldman says it’ll provide it only to high-risk groups. And then there’s the news that Gitmo detainees will get vaccines, too. House Republican John Boehner isn’t too happy about that—and neither are a lot of other people.

Now, CDC Director Dr. Thomas Frieden is pulling out his megaphone and trying to bring some order. In a letter sent to state and local health officers and released by the CDC today, Frieden said, “It is more important than ever to focus on ensuring equitable access to the vaccine for the priority groups.” He went on to ask local health officials to review their plans immediately and “work to ensure that the maximum number of doses is delivered to those at greatest risk as rapidly as possible.”

Frieden does a good job walking the line between thanking public health officials for their hard work—they are, after all, on the receiving end of vaccine frustration—and making it clear that they need to abide by the recommendations. Now it’s up to the vaccinators to listen.

Frieden’s letter in full:

November 5, 2009

Dear State/Local Health Officer:

Today we have 35.6 million doses of 2009 H1N1 vaccine allocated for ordering, with more coming every day. As you know all too well, at present, demand for the vaccine in your communities still exceeds the supply we have received from manufacturers. That means it is more important than ever to focus on ensuring equitable access to the vaccine for the priority groups identified by the Advisory Committee on Immunization Practices: pregnant women, caretakers of infants less than
6 months of age, health care workers, children and adults with health conditions such as asthma or diabetes, and people under the age of 25.
These are the people who are most vulnerable to 2009 H1N1 influenza, and it's our job to do everything we can to keep them safe this flu season.

I know you have been working hard to distribute vaccine to the people who need it most. You are on the front lines of the fight, and no one knows better than you how to reach people in your communities. I especially appreciate the many innovative ways you've found to reach them, including school-located vaccine clinics, special clinics for pregnant women, outreach to children with special needs, and making vaccine available to community- and faith-based organizations serving these high-risk populations.

The goal of the H1N1 vaccination program is to protect our population - focusing first on these high-risk groups and ensuring equitable access to the vaccine. While vaccine supplies are still limited, any vaccine distribution decisions that appear to direct vaccine to people outside the identified priority groups have the potential to undermine the credibility of the program.

It is important to make it clear to the public that we are all committed to the science-based vaccination recommendations established by the Advisory Committee on Immunization Practices. This may include making clear to the public as well as health care providers how the vaccine available to you is being targeted, and the basis for targeting. CDC expects all grantees to ensure that all vaccinators chosen by state and local health departments adhere to those recommendations. Toward that end, and in light of changing projections of vaccine availability, I ask each of you to review your plans immediately and work to ensure that the maximum number of doses is delivered to those at greatest risk as rapidly as possible.

I know how difficult your jobs are; we are ready and willing to help you any way we can.
Sincerely,
Thomas R. Frieden, M.D., M.P.H.
Director, Centers for Disease Control and Prevention, and Administrator, Agency for Toxic Substances and Disease Registry

Claudia Kalb is a NEWSWEEK Senior Writer

Health Care's Prayer Provision: How Complementary and Alternative Medicine Fits Into Obama's Evidence-Based Model

Sarah Kliff — Thu, 05 Nov 2009 14:24:46 GMT

Should health-care reform require insurers to cover chiropractors? Acupuncturists? Yoga? Spiritual healers? These are the questions raised by a recently noticed health-care amendment requiring insurers to consider covering "religious and spiritual health care."

The amendment, covered in this Los Angeles Times article, comes with backing from Senate heavyweights like Orrin Hatch, John Kerry, and the late Ted Kennedy. And while it does not mention Christian Science by name, it's been widely interpreted as a protection of the church's prayer treatments, which it encourages as an alternative to medical help. Others have understood the provision as even more far-reaching as to include any health provider acting within the scope of their license.The Freedom From Religion Foundation has criticized the amendment as an unconstitutional violation of church and state.

Even with its powerful supporters, the amendment seems unlikely to make the final bill; Pelosi already dropped it from the House version. But just the suggestion of covering religious health care highlights a difficult question for reformers: how, exactly, does prayer fit into the president's support for evidence-based medicine? Or, more broadly, is there a place for any sort of unproven, alternative medicine, religious or otherwise, in health-care reform?

Requiring insurers to cover therapies with unknown outcomes runs counter to the White House's push for medicine with a proven track record. The basic idea behind evidence-based medicine is that doctors ought to use treatments that have the best possible evidence that they work. What counts as the best possible evidence? Randomized clinical trials. "The random clinical trial is the gold standard for any kind of medical knowledge," explains Stefan Timmermans, a sociologist at UCLA who has written extensively on evidence-based medicine. "They show whether treatment works and allow doctors to make decisions based on evidence."

Clinical trials work fine for drugs, where trials can quantify and compare outcomes. But for alternative treatments, things like prayer or even yoga, the evidence gets much less clear; randomized trials are more difficult to conduct. "For drugs you have placebos and double-blinded studies," says Timmermans. "But you cannot have a placebo for testing behavioral interventions." So alternative treatments are essentially on an uneven playing field when it comes to evidence-based medicine. Timmermans admits that "it's not an equal-opportunity methodology."

Religious organizations have attempted to run their own trials, to prove the efficacy of their methods, but none so far have panned out. "There's a big body of research trying to show that religion improves health, but there isn't much empirical evidence coming out of it," says Wendy Cadge, a sociologist at Brandeis who studies the relationship between religion and health care. "So that raises questions about how we as a society think about what should be paid for."

Requiring insurers to cover prayer treatment may be a bit too extreme for health-care reform. More interesting to explore though, are other forms of nontraditional medicine, floated in reform bills, that have a stronger claim to an evidence base. Take, for example, complementary and alternative medicine, a field often criticized for unproven therapies. Some 38 percent of Americans use some form of it. Moreover, the field has increasingly embraced traditional research methods. Just a decade ago, the government established a National Center for Complementary and Alternative Medicine. The center studies "alternative healing practices"—anything from the use of echinacea to treat colds, to acupuncture for irritable bowel syndrome—"in the context of rigorous science." They use that gold standard Timmermans mentioned: randomized, clinical trials.

So is complementary and alternative medicine deserving of a place in health-care reform? Depends whom you ask: the bill Sen. Tom Harkin introduced includes "licensed complementary and alternative medicine providers" in the definition of the "health-care workforce," but the consolidated House and Sen. Max Baucus bills do not. More so than the prayer provision, it will interesting to see how—or whether—alternative medicine fits into the final reform bill.

Swine Flu: When to Head to the Hospital, When to Stay Home

Kate Dailey — Wed, 04 Nov 2009 23:02:32 GMT

Have a fever, a sore throat, and flulike symptoms? It could be H1N1, as 46 states now report widespread H1N1 infection, and the president has declared the virus a national emergency. And now, the Journal of the American Medical Association (JAMA) has released a study showing that of those who are hospitalized for H1N1, 30 percent require intensive care, and 10 percent die─and that the flu kills people in all age groups. Scary stuff, enough to make one run to the doctor at the slightest runny nose. But if you get the flu, in most cases you should probably stay under the covers and away from the ER.

That's because, for most patients with H1N1, trips to the ER—or even a primary-care physician—are unnecessary, says Carl Schultz, professor of emergency medicine at the University of California, Irvine, School of Medicine. “A vast majority of people are doing fine even if they get no [medical] intervention, so it seems inappropriate to bring them to ER where negative things could happen,” says Schultz. For instance: the chance of infecting someone with a compromised immune system waiting in that ER, or the chance that you—who may just have a cold—could contract H1N1 from someone else.

The JAMA research shows that H1N1 can have very serious consequences for the people it infects, says study author Dr. Janice Louie, chief of the influenza and respiratory-syndrome section for the California Department of Health. The hospitalization rates are similar to those for the seasonal flu, and those who do require hospital care are in pretty bad shape. “We’re seeing a rapid progression and onset of illness. People are in the ER within three to four days of feeling sick,” she says, noting that all of the hospitalized patients are suffering from pneumonia. “More severe cases of pneumonia result in the patient being intubated, and having fairly long courses of illness, sometimes being hospitalized for months.”

Louie’s study, which analyzed 1,088 people who were hospitalized or died from H1N1 infection, did not address what percentage of all patients with H1N1 end up in the hospital. But if H1N1 is following patterns set by the seasonal flu, only about 1 to 2 percent of those infected will need emergency services.

If you head to the doctors with a mild case, your doctors may not provide much relief. They most likely won’t even confirm the diagnosis. Most individual physicians aren’t testing for H1N1, since there are so many cases so early in the flu season, doctors just assume that if you have the flu, it's of the swine variety. Tamiflu, once a readily available prescription for flu sufferers, is being shelved by most doctors. Since the flu is considered an epidemic, and a larger section of the population may become infected, giving the drug to such large numbers at the same time could lead to the emergence of a powerful, more deadly strain of the disease. “Most people will get better whether they get Tamiflu or not, so it’s not worth administering and possibly causing a drug resistance,” says Shultz.

So those who do head to the doctor will likely hear this advice: Get some rest. Drink some fluids. Stay home until you feel better.

However, there are some people who should seek medical care if they start feeling fluish, and the American College of Emergency Physicians just released guidelines to help determine who they are. Senior citizens who develop symptoms should seek treatment, since, despite earlier reports, the elderly do seem to be at increased risk: the majority of those in the JAMA study who died in the hospital of swine flu were older than 50.

Other risk groups: those with medical conditions that compromise the immune system, such as HIV. Those with chronic respiratory issues, sickle-cell anemia, or chronic heart disease should also get checked out, as should patients on dialysis or those who have recently completed chemotherapy. (A full list of the conditions are available here.) “These individuals are at much higher risk of having something go wrong with them, and we’re not comfortable having them make the decision about [whether they need medical attention] on their own, since the odds that they are sick are greater,” says Schultz. It’s possible that those with these conditions could be suffering from H1N1 and need no extra attention, but it’s “better to give primary-care provider a call and get checked out,” says Shultz, who is also a member of the ACEP.

Though the guidelines are intended only for adults, many of the concerns are the same for children. If a child with flulike symptoms has trouble breathing, appears blue, can’t stay hydrated (due to vomiting or inability to take in fluids) is less responsive than normal, or relapses after a few days of seeming to improve, take her to a doctor, says Dr. Nathan Litman, a pediatric infectious-diseases specialist at Montefiore Medical Center in New York City. The same goes for children with underlying illnesses like heart disease, asthma, lung diseases, kidney disease, or neuromuscular diseases.

“It’s not a trivial illness that you shouldn’t be worried about at all,” says Litman. “[But] it is a minor illness. If a child is doing well, not having difficulty breathing, those children can be managed at home with [a fever-reducing drug] like ibuprofen and the old remedy: chicken soup.” Good advice—for most of us.

Can You Hit a Curveball? Can You Even See One?

Newsweek — Wed, 04 Nov 2009 22:38:24 GMT

By Johannah Cornblatt

Baseball fans have been enjoying a great World Series marked by exceptional pitching and some notably iffy offense. Yankees slugger Mark Teixeira, who led the American League this year in home runs and RBI, was hitting a meager .105 through the first five games. His Phillies counterpart, Ryan Howard, who led the National League in RBI the last two seasons, has been equally woeful, batting just .158 so far. We can only speculate about the underlying reasons for this power outage, and both players could turn things around before the Series ends. But could their struggles at the plate be traced, at least in part, to problems transitioning from foveal to peripheral vision? In other words, are curveballs driving them nuts? Arthur Shapiro from American University, Zhong-Lin Lu from USC, and two colleagues won first place in the Vision Sciences Society's Best Visual Illusion of the Year contest for this very cool animation, which offers a theory about how the human eye perceives curveballs. To better understand why batters can't always trust what they see, follow the instructions and read the brief explanation.

Do Fat Parents Have Taller Babies? Mice study indicates surprising relationships between food, height, and families.

Patrice Wingert — Wed, 04 Nov 2009 18:58:41 GMT

Could your height be determined (at least in part) by your grandma’s weight? That’s the startling implication of a new study published in the November issue of the journal Endocrinology. The study showed that mothers who were fed a high-fat diet had taller children, and that those children—both sons and daughters—can pass along this trait to their own progeny. If both parents' mothers are heavy, the offspring will be even taller.

But before you conclude that this is the secret to raising your own basketball team, there are some caveats.

First of all, the research conducted by the University of Pennsylvania’s Tracy Bale, associate professor of neuroscience, and graduate student Gregory Dunn was performed on mice, not humans. Dunn and Bale began with nearly 200 normal-size mice. For four weeks, they fed a high-fat diet to one group of adult females and a typical low-fat diet to the rest. They were then bred with normal-size males and continued on their particular diet for the duration of the pregnancy and the nursing period.

Not surprisingly, the females fed the high-fat diet quickly gained weight and had higher blood glucose and insulin levels than the control group. The offspring of the high-fat moms turned out to be heavier than those born to the moms fed the normal diet, but it wasn’t because they were fatter. Instead, they turned out to be 10 to 15 percent longer than the other offspring. After feeding both groups of the offspring a normal diet, Bale and Dunn bred them together, noting which couplings included a female or male offspring of a high-fat mom and which consisted of two offspring of the heavier moms. The second generation of the high-fat moms were longer than the descendants of the normal-diet moms, and surprisingly, this trait persisted through both the maternal and paternal lines.

While Bale thinks the chances are high that human studies will show the same thing (“It would shock me if it didn’t”), those studies have not yet been done. Bale also says that researchers don’t know yet whether the trait will persist beyond the second generation. Studies to determine that are currently underway.

Secondly, a lot of factors influence height. Heredity, diet, exercise, living conditions, and general health all have an effect on height, and some have an effect on each other. For instance, without an adequately healthy diet, children may never realize the height they were genetically programmed to achieve, and children of shorter parents with poor nutrition can grow to be much taller than those parents if given access to proper nutrition.

Finally, this type of height advantage comes at a high health cost. In the study, the first- and second-generation offspring of the mice moms fed a high-fat diet had greater body length, but they also had reduced insulin sensitivity, which means they were at higher risk of developing diabetes, high cholesterol, heart disease, and obesity. “The disease risks far outweigh the benefits of being taller,” Bale said.

From a scientific point of view what makes this study particularly interesting is that it “shows how maternal and paternal lineages can pass (altered) genes on.” Scientists have known for a while that various environmental exposures (nutrition, stress, etc.) during pregnancy and infancy can alter the programming of inherited genes in future generations, a process known as “epigenetics." For instance, while many studies have implicated the behavior of moms-to-be in creating problems like the current childhood obesity epidemic, fathers’ impact has been much less clear.

The study also gives us one more reason why human height has increased so much in the past 150 years. Over the past century-plus, says Bale, “food has not only become more available, it has become more fat ladened, and we’ve seen heights escalate as a result.”

In Memory of Michael Goldsmith, Baseball Fan and ALS Activist

Kate Dailey — Tue, 03 Nov 2009 05:32:58 GMT

Michael Goldsmith, the baseball fan who penned the NEWSWEEK My Turn column that became a game-changer for major league baseball, died this week at the age of 58.

Goldsmith suffered from and finally succumbed to amyotrophic lateral sclerosis, or ALS. Also known as Lou Gehrig's disease, the degenerative condition robbed the Hall of Famer of his life and robs 30,000 Americans at any given time of their ability to walk, speak, and eventually breathe. It's a rare disease—striking two out of 10,000—but a brutal one, agonizing for those who suffer from the disease and those who love them.

Gehrig is the most famous face of ALS, but it was Goldsmith who suggested, in a NEWSWEEK My Turn column that ran on Nov. 1, 2008, that baseball join the fight in a more public and organized way:

Major League Baseball has never taken comprehensive action against ALS. Defeating ALS will require the same type of determination, dedication and drive that Gehrig and Cal Ripken demonstrated when they set superhuman records for consecutive games played. With this in mind, why not make July 4, 2009, ALS-Lou Gehrig Day? Dedicate this grim anniversary to funding research for a cure; every major- and minor-league stadium might project the video of Gehrig's farewell, and teams, players and fans could contribute to this cause.

The column soon caught the attention of The New York Times and MLB Commissioner Bud Selig, and the plan Goldsmith envisioned was put into action. On July 4 this season, the 70th anniversary of Lou Gehrig's "Luckiest Man" speech, players wore commemorative patches. ALS groups sold awareness buttons, and ballparks played video of Gehrig's noble farewell on the JumboTrons. Goldsmith was honored at Yankee Stadium that day, throwing out the ceremonial first pitch. His family later recalled how much he savored that experience—despite his being an Orioles fan.

Selig issued a statement about Goldsmith's passing, saying he was "deeply saddened" and offering his condolences. Game 5 of the World Series, played last night in Philadelphia, was dedicated to Goldsmith's memory. Throughout the game, fans were encouraged to donate to ALS charities by visiting the MLB blog 4ALS Awareness. According to the George Vecsey, who wrote about Goldsmith's NEWSWEEK column in the Times, "Commissioner Bud Selig said Goldsmith believed in the power of one person to make an impact, and he promised that Goldsmith’s aspirations would continue to be honored."

It would be a tribute to both Gehrig and Goldsmith and a testament to the enduring power of sports, teamwork, and camaraderie if baseball took that "comprehensive action" Goldsmith suggested. It's worth noting that the Philadelphia Phillies, who are currently trying to battle their way out of a 3-2 deficit against the Yankees in the World Series, have raised more than $11 million in the past 25 years through their charity work with The Greater Philadelphia ALS Society. A baseball-wide campaign to actively fight ALS and support those who suffer from it would go a long way to aid the cause and to bring back some lost dignity to America's pastime.

Aside from being a baseball fan, Goldsmith was the Woodruff J. Deem professor of law at Brigham Young, and a husband, father, son, and brother. We at NEWSWEEK offer his friends and family our deepest sympathies.

One Last Thought on Zahara's Hair: Patrice Grell Yursik Weighs In

Newsweek — Mon, 02 Nov 2009 21:15:48 GMT

The author's nieces and their natural hair. (Courtesy of Lindsay Grell)

By Patrice Grell Yursik

Can I be honest? If the opportunity presented itself to meet Allison Samuels in person, I might respectfully decline. At the very least I'd be a little nervous. Not because I'd be intimidated by such an esteemed journalist (whose work I have admired in the past) but because apparently she'd look at me and deem my hair to be "a hot mess." And according to her most recent rebuttal, other people are apparently looking at me and thinking the same thing "...because like or not, how we look has a huge impact on how people see us and ultimately judge us. Is it fair? No. But is it reality? Yes, it very much is."

Wow. That's enough to give anyone self-esteem issues.

Just about every day of the week, my hair looks quite similar to Zahara Jolie-Pitt's. Yes, it's true, I live in a wash-and-go world. It exists. And it's wonderful here.

I look at pictures of Zahara Jolie-Pitt and see an adorable, sassy little girl who's obviously got personality, fashion sense, and both of her parents wrapped around her finger. (Hello, she's most often seen being carried out of a toy store!) She’s usually wearing a dress that I’d totally rock myself, and a bright smile. Ms. Samuels looks at these same photos and sees "...this cute little girl, with ruffles on her dress, bracelets on her arm, and hair that clearly hasn't been attended to...uncombed, unconditioned, and unbrushed." She sees a little girl condemned to grow up feeling less-than, despite having the kind of childhood upbringing most of us would dream of.

Are we looking at the same photographs?

It’s interesting what we choose to assume, and which celebrity children bear the scorching heat of the spotlight. I have yet to read a piece lamenting the hairdo of supermodel Liya Kebede’s daughter, who is also of Ethiopian descent and wears her hair in free, loose spirals. Nobody says a word about Will Smith’s or Heidi Klum’s sons, and their hair shares textural similarities to Zahara’s. Or Chris Rock’s daughters, who wear their hair natural and whose own hair insecurities led their father to make a documentary about the black-hair industry. Zahara bears the burden because she is an African girl who was adopted by arguably the most famous caucasian couple in the world.

What else do we need to see, to be satisfied in the knowledge that this child is obviously being tended to and therefore will grow up with a healthy self-esteem? Do we need to see a paparazzi photo of Angelina sitting with baby Z between her knees, armed with a tub of grease and an array of colorful barrettes at her ankle, and a rat-tail comb in her hand as she works assiduously on Zahara's mane? What hairstyle would make everyone stop offering their opinions about the parenting of the Jolie-Pitt family? Braids—who wants to see Zahara in braids? What about Afro puffs? Or cornrows? Or a Pebbles-esque ponytail on top of her head? Maybe some two-strand twists?

Why is it our business? Why can't we just let baby Z and her freestyle 'fro be great? Why do we have to saddle her with our expectations?

There are some telling and painful scenes in the docucomedy Good Hair. In one of them, a group of African-American high-school girls discuss their employment prospects based on hair texture. The students turn toward the one girl with natural hair and tell her that hair texture wouldn’t be deemed professional enough for her to get a job. In another scene, a child about 4 years old—right around Zahara Jolie-Pitt’s age—explains that she gets her hair relaxed “because you’re supposed to.” Even Chris Rock stops smiling at that point. Good Hair was a film fraught with inconsistencies and flaws, but it made one salient point crystal clear: these particular hair-related self-esteem issues in the black community take root early and are as a direct result of our own conditioning.

We teach our children at an early age that their hair isn’t beautiful in its natural, unfettered state. We teach them that they need chemicals that require the use of plastic gloves to “tame” their hair into something “presentable.” And somewhere along the path in our own conditioning, we start assuming that “we know best” how to take care of our hair, even though so many of us use relaxer and wear weaves in order to “manage” our own natural hair. And when we wind up with images like this, some of us even find ways to excuse that kind of abuse by blaming the behavior of a child.

It’s up to us to stop handing down this baggage. It’s up to us to “remove the kinks from our brains,” to paraphrase a memorable Marcus Garvey quote. If Zahara Jolie-Pitt grows up to have self-esteem issues, it won’t be because of her parents. It’ll be because of people who look at her with judgment in their eyes and make assumptions about her life, her upbringing, and her grooming habits based on a photograph.

Patrice Grell Yursik is the creator of beauty-and-culture blog Afrobella.com, and the AOL Black Voices hair blogger at BVHairTalk.com.

My Pit-Bull Conversion: Joan Raymond on Her Decision to (Probably) Adopt a Pit Bull

Newsweek — Mon, 02 Nov 2009 19:02:05 GMT

It’s hard out there for a pit.

Talking pit bulls is as polarizing as talking about health-care reform. Each side—the pro- and anti-pit-bull devotees—has a lot to say. And like health-care reform, some stuff being spewed by both the devotees and the haters is just plain wrong. Some advocates think these dogs are imbued with incredible judgment, rendering them incapable of doing anything wrong. And their people-loving nature makes them the right dog for just about everyone. They also believe the media are responsible for the pits’ poor image. First, any dog is capable of doing a bad thing—even your precious pit bull. Second, no one dog is right for every person. And third, bad owners are responsible for the pits’ problems. The media have bigger problems right now—like whether we can keep our jobs.

Some anti-pit people think the world would be a safer place if every pit on the planet ceased to exist. They buy into bite statistics and bite fatalities, which are notoriously unreliable. Even the Centers for Disease Control acknowledges that. The anti-pit contingent thinks a pit is a super-freak of a dog that has locking jaws and a brain that grows too big for its head, causing fits of incredible aggression. Oh, puhleeze.

Until the past few weeks, I fell somewhere in the middle. A pit bull was a fine dog—as long as it wasn’t living next door to me. I’m ashamed of that, especially since an American pit-bull terrier is responsible for some of my most cherished childhood memories. But I didn’t care. Pit bulls today just seemed different, and some small, secret part of me believed the hype.

My reporting revealed that my issue isn’t with the dog—it’s with people. We are the ones who are ultimately responsible for the dogs, including their reputation. Pit-bull owners have to be realistic about the potential for their dogs to do damage. It’s a dog. If you can concede that all dogs can potentially cause problems, that means yours can too. And haters, don’t go into a feeding frenzy of misinformation. It’s ugly.

Someday, when the time is right, I’m getting a pit. That’s something I never thought I’d say. I’ll go to a reliable rescue and get hooked up with a pit bull that is right for me. And me, right for it. I won’t leave it unattended among other animals. I won’t let it run off leash to scare the hell out of people. I’ll get it altered, and I’ll go to every single class I can possibly attend to get the right tools that will ensure that my pit and I are doing something positive for the breed’s credibility.

Is it fair that I would have to be the poster child for responsible dog ownership because I have a pit bull? Hell, no. But to do less just contributes to the problem. And as far as I’m concerned, the pit has enough problems already.

Bystanders No More: Teaching Kids to Respond to Violent Crime

Newsweek — Fri, 30 Oct 2009 15:51:03 GMT

The picnic area at Richmond high, the scene of the alleged crime. PHOTO: Noah Berger / AP

by Johannah Cornblatt

Last Saturday night, according to police in Richmond, Calif., as many as two dozen teenagers watched the alleged gang rape of a 15-year-old girl outside her school homecoming dance in Richmond, Calif., but no one did anything. Police have arrested six people in connection with the attack, which lasted two-and-a-half hours. The girl was found semiconscious under a bench only after an individual who overheard witnesses discussing the assault notified the police.

Experts in the prevention of sexual violence say that although this was an extreme and particularly horrific case, the fact that the witnesses failed to intervene isn’t too surprising. “They’re not anomalies,” says Dorothy Edwards, director of the Violence Intervention and Prevention Center at the University of Kentucky. “Everyone likes to think, ‘If I were there, I would’ve done something.’ But being passive is not atypical.”

That’s why a small but growing group of educators is trying to bring what’s called “bystander education” to American schools. While sexual-violence-prevention programs have typically focused on the victim (discouraging women from walking alone at night, for example) or the perpetrator (reiterating the fact that no means no), the bystander approach emphasizes the role witnesses can play in either supporting or challenging violence.

The MVP (Mentors in Violence Prevention) program, which was developed in 1993 at Northeastern University’s Center for the Study of Sports in Society, tries to teach students how to stop violence when they see it. The MVP program involves a two-day training period for teachers, coaches, and administrators, who then return to their schools equipped to train their students. “Most people think they only have two choices for intervention,” says Jackson Katz, a cofounder of the program and an architect of the bystander approach. “One is to intervene physically right at the point of attack, and the other is to do nothing. And that’s a false set of choices.” As part of the MVP program, students sit in a classroom and talk about the menu of options—from getting a group of friends together to calling 911—available to them. At the heart of the program is a set of scenarios that allow students to imagine what they might do in a variety of situations. Each scenario comes with a list of viable interventions for bystanders.

Dozens of schools in a number of states are now implementing the MVP program, and similar initiatives are popping up across the country. The Green Dot program, launched at the University of Kentucky three years ago, has “spread like wildfire” to more than 20 states, according to Edwards. Green Dot encourages students to think of the “3Ds” (direct action, delegation, or distraction) when witnessing violence. While socially confident students might be able to address the problem directly, shy bystanders could make an anonymous phone call, send a text to a friend, or divert the perpetrator. “You can be just as effective by delegating," Edwards says.

For teenagers, who are often particularly concerned about social acceptance from their peers, Green Dot promotes distracting the perpetrator(s) as another option. One student who completed the Green Dot bystander training later prevented one of his friends from taking advantage of an intoxicated girl at a party by telling him that the police were towing his car outside, Edwards recalls. The friend, who had been in the process of persuading the girl to accompany him upstairs, stopped what he was doing and ran outside to check on his car. By the time he came back, the girl’s friends had taken her home. “Most people want to do the right thing,” Edwards says. “You can’t just say to teenagers that it shouldn’t have mattered if they were afraid to stand up in front of their friends—because it does matter. We need to give people a broader tool chest that takes into account their obstacles.”

Research is still needed to determine the effectiveness of bystander-awareness programs in schools, but the initial results are promising. One study found that after the Sioux City School District in Iowa implemented the MVP program, the number of freshman boys who said they could help prevent violence against women and girls increased by 50 percent. The number of ninth-grade boys who indicated that their peers would listen to them about respecting women and girls increased by 30 percent. The Centers for Disease Control recently gave $2 million to Green Dot as part of a long-term study to see if the bystander-education program does in fact diminish violence in high-school populations. The study will involve about 28,000 students in 26 Kentucky high schools. Half the schools will receive Green Dot training, and the other half will serve as a control group. The study’s hypothesis is that students who receive Green Dot training will show improved bystander skills, allowing them to recognize and reduce tolerance for violence among their peers.

Some experts in sexual-violence prevention think that more stringent bystander laws might make people think twice before walking away from the scene of a crime without so much as dialing 911. But Victoria Banyard, codirector of Bringing In the Bystander, a bystander-intervention program at the University of New Hampshire, says that parents and teachers should remember that “good” kids can become bystanders, too. So how can you prevent your kid from becoming a bystander? Banyard says that bystander awareness, in many cases, really needs to be taught. “We need to help people develop and practice the specific skills so that when they’re in the moment, they’re doing something positive to help,” she says.

Katz says we can’t wait for another incident like the alleged one in California to happen again before starting to think about preventing future crimes. “In the moment, a lot of the people freeze and don’t think creatively,” he says. “Educators and parents need to help our kids think critically about the different choices they have before the fact—not after the fact.”

For Kids, Being Uninsured Can Be A Killer

Mary Carmichael — Fri, 30 Oct 2009 14:37:11 GMT

It’s easy to get lost in the dismal statistics coming out of the new study on children and health insurance: there are 7 million uninsured kids in America; they’re 60 percent more likely to die in the hospital than insured kids are; basic insurance could have saved 17,000 of them from dying over the last two decades. But let’s step back from the numbers for a minute. Let’s say you’re the parent of a 5-year-old boy.

One day you notice that your son’s breathing is ragged, that he can’t run around for long before he starts to gasp for air. You take him to the pediatrician’s office, where he’s diagnosed with asthma. You live just below the poverty line, and your son is insured by Medicaid, which pays for the inhaler he needs.

The next year, your son needs a refill on his inhaler. But now, he no longer has Medicaid because you didn’t fill out the raft of paperwork required to re-enroll him every year. You work two jobs that pay under the table, and you couldn’t pull together all the pay stubs and birth certificates and other documents the government requires for your kid to remain eligible. You can’t afford the inhaler on your own. Your son can probably scrape by without it for a few months, you think. He’ll have to.

Three months later, he’s doing worse. He wheezes; sometimes he can’t breathe at all. But without insurance, you can’t take him to the pediatrician, and there’s no nearby free health clinic. Finally, one night, your son collapses, and you rush him to the emergency room. It’s too late. He’s so sick that the hospital can do little for him, and he dies.

Now multiply that story by 17,000, and you’ll have an idea of what the numbers mean.

In the age of Medicaid and SCHIP, amidst political promises to get every child insured, why are there still 7 million children without health insurance? And why are these kids so much more likely to die when they land in the hospital? Most problems in health-care reform are complex; they don’t have clear-cut answers. But these two questions do, and the fact that we still have to ask them is “heartbreaking,” says Dr. Fizan Abdullah, the new study’s lead author and a pediatric surgeon at Johns Hopkins Children’s Center.

The reason 7 million children are uninsured is simple: the bureaucratic government apparatus that should be helping them has failed them. Medicaid and SCHIP (now sometimes called CHIPRA, after recent legislation that expands the program) do manage to cover millions of children—two million more today than they did in 2006. But they still don’t reach all the kids who are eligible. And there are still a swath of children whose parents make too much to qualify for programs like SCHIP but can’t afford family health insurance.

Why? Some families simply never hear about the programs because “outreach is so poor,” says Dr. Paul Wise, director of Stanford University’s Center for Policy, Outcomes, and Prevention. “There’s also a large number of these families who have been beneficiaries at some point but fall off the programs or are kicked out, because some states make it very difficult for families to remain enrolled.” Many states require families to prove, either every six months or every year, that they’re still eligible—a process that requires them to furnish dozens of documents while filling out paperwork so complex that “you need a lawyer just to understand it,” says Laura Shone, a pediatrician at the University of Rochester who has studied the issue extensively.

Families with two working parents or only one parent often can’t keep up with the requirements. They lose track of time or papers. They move around and change jobs. They may not even realize their kids have lost their insurance until long after it happens; the break in coverage is “in most cases entirely unintentional,” according to a 2007 study in Health Affairs. The re-enrollment process could be simplified to help these parents out, says Wise, but “state budgets are under enormous pressure, and one way to put a cap on spending is to create administrative barriers to families staying enrolled.” In other words, it’s cheaper not to pay for insurance for kids who need it.

Without insurance, these kids and their families can’t manage their health properly. The lucky ones find care at free clinics, although it’s not necessarily as good as what they’d get with insurance: “People who are funneled to facilities specifically set up to take care of poor patients don’t always get high-quality care,” says Wise. The really unlucky ones don’t get any care at all. Shone’s work has found that children who are uninsured for a year are twice as likely to go without any medical help the entire time—preventive care, acute care, or prescriptions—as children who have insurance all year.

Here lies the answer to the second question, why are uninsured kids more likely to die in the hospital? By the time they show up in the ER, they’re often too sick to be saved.

The new study is explicitly about correlation, not causation: it doesn’t say that kids are dying specifically because they lack insurance. But if you look closely at the data, it might as well. Kids who show up in the hospital with complications that might have been warded off by preventive care, like chronic diseases such as asthma and diabetes, or once-mild colds that have devolved into pneumonia, are much more likely to die if they don’t have insurance. But among kids hospitalized because of trauma (say, from car wrecks), having insurance or not doesn’t make much of a difference; the death rates are the same. That means the health effect of not having insurance is “occurring in a pre-hospital setting,” says Abdullah. These kids need preventive care, and if they don’t get it, they become critically ill.

And they do show up sicker than kids with insurance: they die more quickly, with shorter and less expensive hospital stays. “You’d think the hospital would spend more money on them because they’re sicker,” says Abdullah. “but the hospitals don’t even get that opportunity to provide the care. The kids are already too far gone.”

Abdullah is a doctor, not a policymaker, and his study is written in the measured, data-heavy language of science. But he sees young patients every day who live out the numbers he’s analyzing, and he’s very, very angry. “Our civilization and our nation will be judged by how we treat our most vulnerable,” he says. “For us, with all the societal resources and wealth we have, to not prioritize children’s health care is almost unforgivable.”

Wise, too, is worried about the kids behind the numbers. “Everybody in the child-health world has applauded the progress that’s been made with this administration and this Congress,” he says. “Nobody’s 'for' infant mortality. My concern, however, is that when the bare-knuckle political fighting over health-care reform gets going, children’s issues may go unprotected. They’ve already been largely marginalized.” It will take more than studies, however troubling, to put children’s health where it belongs—at the forefront.

Tami Winfrey Harris: Natural Hair Is Not Unhealthy

Newsweek — Fri, 30 Oct 2009 10:47:01 GMT

As part of NEWSWEEK's Good Hair Week, senior writer Allison Samuels discussed Zahara Jolie-Pitt and the politics of natural hair and interracial adoptions. Her article, which implored the Jolie-Pitt parents to pay more attention to Zahara's hair, and its follow-up were much discussed at NEWSWEEK and on the Internet. We invited three bloggers to offer their own opinion on the topic. -KD

I once wrote about my natural hair:

My hair is nappy. It is coarse and thick. It grows in pencil-size spirals and tiny crinkles. My hair grows out, not down. It springs from my head like a corona. My hair is like wool. You can't run your fingers through it, nor a comb. It is impenetrable. My hair is rebellious. It resists being smoothed into a neat bun or ponytail. It puffs. Strands escape; they won't be tamed. My hair is nappy. And I love it.

I may love my hair. But common wisdom, even among people with hair just like mine, is that my hair isn't "good," at least as it naturally grows from my head. It needs to be tamed, preferably by straightening, but at the very least, especially in young children, hair like mine should be restrained somehow--in plaits or cornrows or something that hides its unruly nature. It should be shiny. You should be able to run a comb through it. All this in defiance of the natural properties of most black hair.

I suspect NEWSWEEK writer Allison Samuels follows this common wisdom.

Two weeks ago she sparked furor around the Net with an article taking Angelina Jolie to task for her daughter Zahara's allegedly uncared-for tresses. In the face of considerable backlash, Samuels didn't back down. In a NEWSWEEK online exclusive this week, Samuels answers her critics.

There is a lot I could challenge in Samuels's articles, but I will confine this post to one point: Samuels seems to embrace the notion, a gift of society's Eurocentric beauty standards, that tamed hair = healthy hair, and unfettered black hair = hot mess. What's worse, she wants little Zahara to learn to embrace this thinking, too--a terrible lesson for a girl with tresses that naturally feature fuzzy parts and curls that spring akimbo.

In a society with Eurocentric beauty standards, it is natural that hair common to people of European ancestry would be the marker for beauty, professionalism, and good grooming. And it is natural, though I think not good for us, that those of minority cultures have absorbed the standards of the dominant culture and adopted beauty rituals that support those standards.

This is why so many of us have memories of sitting at our mother's or grandmothers' knees, holding our ears, and listening to sizzling grease, as our hair was tamed into a straight, shiny, combable mass and woven into multiple neat plaits. Most of us remember this bonding time fondly. But, in reality, straight, shiny, combable, and neat are NOT markers of whether black hair is cared for or not. That so many of us, including Samuels, think these descriptors are related to hair health shows how much we have absorbed the idea that hair common to people of European ancestry is the norm by which all other hair must be judged. As I type this, my ginormous twist-out is shiny, but not straight, combable, or neat, And, I promise you, my hair is very well cared for.

Yes, I know that braiding has deep roots in African culture and is an ingrained part of black American culture. My beef isn't with plaiting; my beef is with the fear of the nap--the idea that unrestrained black hair, apart from other hair, is unacceptable. To many of us with natural hair, Zahara seems to be wearing a wash-and-go. But we are taught that black women can't simply wash their hair and go. Our hair has to be "fixed," made presentable. I think this hair hatred was born and nurtured right here in Western culture where the yardstick by which we judge our hair's beauty, health, and rituals of care is invariably a white one.

There is no way of knowing whether Zahara's hair is conditioned by scanning paparazzi shots. You can't assess its softness. You can't check for split ends. You can't see breakage. What Samuels is reacting to, I think, is the fact that Zahara's hair is "wild" and unrestrained. And black women and girls are taught that this isn't okay. It isn't pretty. It isn't proper. It isn't professional. It isn't ladylike.

I'll say this--I agree with Samuels that most little, black girls would NOT be comfortable wearing their natural hair loose as Zahara does. That is, in great part, because of the unrelenting messages they get, within and without our black culture, that their hair is inherently wrong. Must Zahara adopt these feelings of self-hatred to earn her black card? I like to think, as a black woman who has wrestled and come to terms with her own hair issues, my job is to help free the girls in my life from damaging self-hatred, not encourage it as a litmus test for fitting in.

My hair is nappy. It is soft and cottony, a mass of varying textures. My hair is fun to play with. I like to pull at the spiral curls and feel them snap back into place. My hair defies the laws of gravity. It reaches energetically toward the sky. My hair is unique. In a fashion culture that genuflects to relaxed, flat-ironed tresses and stick-straight weaves, my fluffy, puffy, kinky mane stands out. It is revolutionary. My hair is natural. It is the way God made it. My hair is nappy. And it is beautiful.

Winfrey Harris blogs at What Tami Said.

Roslyn Hardy Holcomb: Hair Don'ts Hold Us Back

Newsweek — Fri, 30 Oct 2009 10:40:48 GMT

As part of NEWSWEEK's Good Hair Week, senior writer Allison Samuels discussed Zahara Jolie-Pitt and the politics of natural hair and interracial adoptions. Her article, which implored the Jolie-Pitt parents to spend more attention on Zahara's hair, and its follow-up were much discussed at NEWSWEEK and on the Internet. We invited three bloggers to offer their own opinion on the topic. —KD

The issue of African-American hair is difficult and complex. Throughout our years in this country it has been used to scorn and belittle us. Given the long duration of this oppression it’s not surprising that many of us have absorbed this disdain for our hair texture and seek to impose this tyranny on others. bell hooks, author of Happy to Be Nappy and dozens of other books, talks about traditions and behaviors in the African-American community that are holdovers from slavery and Jim Crow. Many of these cultural adaptations, while necessary then, are damaging and downright dangerous now. Most assuredly this notion that little girls should have their hair subdued into an “acceptable” standard is one of them. Many of these hairstyles can take hours; hours that are utter torture to most children. What could be more damaging to a little girl’s self-esteem than the notion that her hair is so “bad” it must be “styled” into traction alopecia?

For too long little black girls have been told we can’t swim, can’t play in the sand box, can’t get caught in the rain for fear that our hair would “revert.” Our lives are a never-ending series of can’ts. Many of these are downright dangerous: black children drown at substantially higher rates than others, and we struggle with an obesity epidemic that is directly attributable to lack of exercise. How many black women don’t work out for fear that their hair will “revert”? We are told that we don’t have wash-and-go hair, when in fact we do as long as we don’t expect to look like a Breck Girl afterward, and why should we? God forbid that anyone should see our hair in its natural, free state. African-textured hair is puffy and billowy. It fluffs. It blows free in the breeze like cotton candy, and it is just as sweet. Instead of making our hair some type of bondage to conformity, why can we not celebrate it for the unique confection that it is?

Rather than trying to force Zahara Jolie-Pitt into some box of what it means to be an African-American girl, can we not accept her as who she is? She is a little black girl who has white parents; her experience will be different, as will that of many other little African-American girls. She is one little girl, and a privileged one at that. What about the countless little black girls out there being tortured every day in the name of hair submission? We’ve all seen the notorious “Nappy Ass Hair” video on You Tube. I submit that what is being done to that child is far more damaging than the fact that the Jolie-Pitts take Zahara out with bed head.

What we’ve been doing for generations has resulted in millions of black women with “hair issues.” Isn’t it time that we tried something else? We can perpetuate the madness that currently exists, or we can address the issue and try to rectify it. Is it possible that seeing Zahara Jolie-Pitt and other little black girls for whom hair is just hair can help us get over this insanity? If nothing else, we’ll have at least one little black girl who is free.

Holcomb's latest book is Morning Star.