Doctors, Definitions, and Decency

August 9, 2018
Posted by Jay Livingston
So there I am, sitting on the table, wearing nothing but one of those smocks. And the doctor comes in. My new dermatologist. I’d been to him once before. Young. Looks like maybe he’ll be eligible for a bar mitzvah in a couple of years. And with him are these three girls – women, females, whatever. Also young. “This is my team,” he says.
My friend Martin [not his real name] is about my age. He has some skin condition that requires periodic check-ups.
He says they’re interns or residents or med students, maybe it was one of each, and do I mind if they observe. What can I say? So he does the whole examination. I close my eyes, partly ’cause of the bright examination light, but really, I don’t want to be making eye contact with anyone.

It’s a thorough exam – head to toe. Literally. I mean he’s looking at my scalp, my toes, front and back. You never know where another one of these damn things might turn up. So basically I’m naked.

Then it’s all finished. I sit up, wrap the gown around me. He says it’s all good. He found nothing. And then it’s time for him and the team to leave, and he says,, “We’ll just let you get decent . . . “

So I say, “You didn’t seem to mind when I was indecent two minutes ago.” He gives a little embarrassed laugh. So do the women.
So here’s the thing. Two minutes before, they were all looking at me naked, and that was OK, decent. But now that I’m in my gown, for me to change back into my clothes while they’re in the room would be indecent. In fact, maybe he was saying that me wearing just the gown was not decent.

It’s Joan Emerson, I tell him.

            *                    *                    *                    *
In 1970, Joan Emerson published what became a classic article on how doctors and nurses in gynecological exams make sure nothing seems sexual. The full title of the article is “Behavior in Private Places: Sustaining Definitions of Reality in Gynecological Examinations.” As the title suggests, the definitions and reality — what something is —  are sometimes up for grabs. In a gynecological exam, doctors do things that in other circumstances would be seen as sexual. For the exam to run smoothly, the medical staff have to make sure that the patient too defines all the looking and touching and questioning as medical and not sexual.

The major definition to be sustained for this purpose is this is a medical situation” (not a party, sexual assault, psychological experiment, or anything else). If it is a medical situation, then it follows that no one is embarrassed” and no one is thinking in sexual terms.”


The medical demeanor extends to even to the choice of  the rather than your —  “the vagina,” not “your vagina” — and “the vulgar connotation of ‘spread your legs’ is generally metamorphosed into the innocuous ‘let your knees fall apart.’”

My friend’s dermatologist and his students sustained the medical definition of nakedness. They didn’t really have to do anything. Everyone just accepted that definition. But once the examination was over, that definition no longer applied. His nakedness or near-nakedness was closer to what it would be outside the examination room – not decent.

In the situations Emerson observed too, the fabric of the medical definition could become threadbare.

Some patients fail to know when to display their private parts unashamedly to others and when to conceal them like anyone else. . . . .  The medical definition is supposed to be in force only as necessary to facilitate specific medical tasks. If a patient becomes nonchalant enough to allow herself to remain uncovered for much longer than is technically necessary she becomes a threat.

My friend’s comment about indecency posed a similar threat. After the medical definition was no longer necessary, he was reminding the women that they had in fact been looking at his genitals — the genitals of a man who was no longer covered by the medical definition of the situation.

            *                    *                    *                    *
In the movie, “Love and Other Drugs,” Anne Hathaway goes to see her doctor. In the examination, she has to remove her blouse and bra. Also in the room is Jake Gyllenhall. She assumes that he is another doctor, so it’s OK. But a minute or two later, when she realizes that he is a drug salesman, not a doctor, she is less accepting.




Note  Gyllenhall’s line about “all the arrogant, faceless, cut-off asshole doctors out there who’ve treated you like a non-person while peeking at your breasts.” Doctors too, not just drug salesmen, may be hiding voyeuristic motives under their white-coat medical definitions of the situation.

Pointers on the Zero Point (à la Jonah Goldberg)

August 5, 2018
Posted by Jay Livingston

As cheap tricks in data visualization go, leaving out the zero point is one of the easiest and most common ways to make a molehill of difference appear to be a mountain. Here’s an example I’ve used before — the Fox News graph showing that a tax rate 39.6% is five times the size of a tax rate of 35%

(Click on an image to enlarge it.)

I’ve blogged on this before (here and here), and as some of the comments on those posts argue, cutting the y-axis down to size is not always deceptive. But in most cases, it’s good to include the zero-point.

Jonah Goldberg, the conservative political writer, has learned that lesson. Sort of. Philip Cohen, in his review (here) of Goldberg’s latest book Suicide of the West: How the Rebirth of Tribalism, Populism, Nationalism, and Identity Politics is Destroying American Democracy, has provided examples of Goldberg’s data-viz facility. The problem: how to exaggerate effects while yet including the zero point. Goldberg’s solution: simple – just truncate the y-axis as usual, but then stick a label of zero on the lowest point.



From these graphs we learn
  • In 1960, life expectancy worldwide was nearly 0.
  • By 2015, infant mortality worldwide had decreased to nearly 0
In a mere 55 years, we went from a world where nearly all infants died to a world in which almost no infants died.

As Philip Cohen notes, the book’s blurbs from conservative pals and colleagues (e.g., John Podhoretz, Arthur Brooks) mention Golberg’s “erudition.” Apparently, this erudition stops short of knowing that the distance between 54 and 56 is not the same as the distance between 0 and 54.
                       

Tribal Politics, Tribal Morality

August 3, 2018
Posted by Jay Livingston

Paul Krugman today points out something I’d missed. Trumps famous line —“I could stand in the middle of 5th Avenue and shoot somebody and I wouldn’t lose voters” — is a slur on the morality of his followers. Krugman sees the quote as another instance of Trump’s more general “contempt for his working-class base.” In essence, Trump is saying that the level of morality among his followers is primitive, entirely tribal. The Trumpsters’ only criterion in making moral judgments, no matter how heinous or harmful the action being judged, is whether the person who committed it is one of their own.

After all, if Evangelicals and their leaders have nothing to say about Trump’s lust, greed, anger, sloth, gluttony, envy, and pride; if they are fine with his multiple breaking of the Sixth Commandment, then why would they mind his breaking the Fifth Commandment in the middle of Fifth Avenue?

Tribal morality flourishes when a group feels that it is under attack. The group sharpens the lines between “us” and “them,” as George Bush did after 9/11. “Every nation, in every region, now has a decision to make. Either you are with us, or you are with the terrorists.” Under these conditions, the group has to direct its attention outward towards the enemy. The only crime by a group member is disloyalty.
                                                                   
Much of Trump’s rhetoric plays to this feeling that “we” are under attack. The threat comes from many sources — Mexicans, Muslims, immigrants, the media, Hillary, China, and others (though not, of course, Russia) —  and Trump supporters chant enthusiastically about what we must do to these enemies —  wall them out or lock them up or whatever. It is the genius of Trump, his supporters, and Republicans generally that they can maintain this perception of themselves as embattled defenders trying to “take back” their country* even when they control all three branches of the federal government and most state governments.

As long as Trump’s supporters continue to perceive themselves and the world as “us” against “them,” his low estimate of their morality may well remain accurate.

---------------
* “Taking back” the country that rightly belongs to them and not to all these other people who cast more votes has been a constant theme among Republicans at least since Obama’s election and perhaps before. See this 2011 post, “Repo Men.”

Hank Jones, b. July 31, 1918

July 31, 2018
Posted by Jay Livingston

The great jazz pianist Hank Jones was born 100 years ago today. He recorded with Bird and Diz and other beboppers, but as you can hear in this excerpt from a masterclass he gave at NYU at age 85, he never abandoned his roots in stride, especially when he was playing solo.




I saw Hank a few times in the 1980s playing duos with bassists Ron Carter or Red Mitchell at Bradley’s or The Knickerbocker in The Village. I also saw him in “Ain’t Misbehavin’,” the Broadway shoq based on the music of Fats Waller, Hank was the ontage pianist, and he wore a vest and derby hat like Fats. He had one line – at the end of the show, I think – Fat’s famous “One never knows, do one?”

Like other jazz musicians,* he is uncredited in what is probably his best-known performance – accompanying Marilyn Monroe singing “Happy Birthday” and “Thanks for the Memories” for JFK in 1962. You can hear him and see her here.


-------------
* Other examples include Bud Shank  on “California Dreamin’”  and Phil Woods on “Just the Way You Are.”