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So, Mary Elizabeth Williams has called me hysterical and claimed I’m ruining feminism with my supposed irrationality because, on Twitter, I criticized a piece she wrote about her pediatrician accidentally giving her daughter the first dose of HPV instead of the scheduled meningitis shot.  When a cascade of people attacked me, I defended my point of view, both that the heavy drama surrounding this was unnecessary and, far more importantly, that Williams’ choice to treat the HPV shot as somehow separate and more fraught than every other vaccine fed a very dangerous narrative about this vaccine, and she should have been more responsible.  Her response minimized and distorted her original piece, and overplayed my reaction, in my opinion.  But let’s take my objections one at a time, for clarity’s sake.

Objection #1: Dramatics

This one’s on me.  I accused Williams of being overdramatic by turning a minor mistake into a big deal that upset her daughter so much that she was, in Williams’ words “scared and sobbing and, on a very primal level, angry and betrayed.”  Even though Williams swears she was calm and acknowledges mistakes happen, she describes wanting to “throttle” the nurse, and claimed her daughter was “robbed” not just of a childhood so far free of minor medical errors, but of her right to make choices about her own sexuality.

I was raised in a “suck it up” culture, and my first inclination in situations like this would be to remember that medical errors are incredibly common, and be grateful that when my number came up, the worst thing that would happen to me is that I have a significantly reduced chance of dying of cervical cancer.  But I fully admit this is a personal choice.  There are good and bad sides to the chilled-out approach and good and bad sides to making a big deal out of stuff.  My irritation at the dramatics was unfair; I should apply the “suck it up” mentality to other people’s dramatics and say, “No big deal. That’s just how they are.”

Objection #2: Toxic narratives about the HPV vaccine

In fact, sucking it up when someone else’s dramatics irritate me is usually what I do, with a side dose of reminding myself that dramatic people often stand up against everyday injustices to the betterment of us all.  But the reason this pissed me off was that Williams juiced up her story by invoking a toxic narrative about the HPV vaccine, that it’s the “sex shot” and therefore is unique amongst all other vaccinations, requiring a lot of hand-wringing about personal choice.  My problem with this narrative is that it feeds the notion that sexual health is separate from other kinds of health, and that continues the politicization of it and feeds right wing narratives that sexual health care is morally corrupt in a way that other health care isn’t.

I think that responsible journalists should not add to the pile.  STIs are not different than other diseases; the only difference is political, not biological.  HPV in particular is ridiculous to politicize, since it’s so common that it’s wise to treat getting it as an inevitability if you don’t get the vaccination. Indeed, the most important difference between the HPV vaccination and other vaccination isn’t the sex stuff, but the fact that you probably get more individual protection from the HPV vaccination.  Most people have measles and whooping cough vaccines, offering the unvaccinated herd immunity.  But with the HPV vaccine, there’s only 11% compliance, meaning that your unvaccinated kid’s chance of getting HPV as an adult should still be treated as an inevitability.  Sadly, we’ll be seeing 4,000 deaths and 12,000 cases of cervical cancer a year for some time yet.

If you read that link, you’ll see that there are many reasons for the low vaccination rate, including cost and ignorance.  However, the perception that this is the “sex shot” has a lot to do with it.  The belief that getitng the vaccination has some sort of sexual implications for your child makes people uncomfortable and unwilling to engage; Williams added to the pile by using the sex aspects of the shot to turn up the interest in her story.

This particular criticism stung, I’m guessing, since Williams objected to it on Twitter and engaged in a little retcon about the sex stuff, claiming that this is solely about the fact that the HPV vaccine is “optional”.  She minimized the way that she treated the HPV vaccine as somehow fundamentally different than other vaccines, and in her follow-up piece, continued to minimize and imply that she treats all “optional” medical decisions as belonging to an 11-year-old and not her parents.

But that is  not how the original story read.  Let’s start with Williams’ attitude towards vaccinations that prevent non-sexual infections.

Meanwhile, she still needs to get that meningitis shot, and I’m going to make damn sure that’s the shot she gets.

Light, fluffy, no big deal, right?   Vaccinations are something responsible parents make “damn sure” that their kids get, because responsible parents understand not just the importance of preventive health care, but also that their kids are members of a large community and owe it to that community to do their part in providing herd immunity.  You, as a responsible parent, would never consider skipping the MMR or the meningitis shot, because duh, vaccinations are a private and public good.

Interestingly, this common sense approach was in the same paragraph as this language about the HPV vaccination:

While my daughter and I are not ruling out changing pediatricians, she has decided to proceed with the course of vaccination. She didn’t come to it lightly; she slept on it and shyly told me her wishes the next day. She is a serious girl, and treated this is a serious choice.

I’m sure Williams was completely consistent and also had her daughter sleep on the serious decision of whether or not to take her chances with meningitis.

Williams’ claim was that she treated these shots differently because the HPV vaccine is optional and meningitis is not.  On Twitter I pointed out that the HPV vaccine should be mandatory, and the only reason it’s not is sex hysteria.  When things aren’t mandated because of political bullshit, but should be mandated, it’s different than something that can be considered truly optional.  When I was a kid, it was legal to ride in a car without a seatbelt, but my parents didn’t believe it was optional in our house, because they believed it should be the law.  I imagine if  conservatives get their way and public schooling stops being mandatory, Williams would also keep sending her kids to school.

In a sense, all this is irrelevant, because in the original story, the fact that HPV is the “sex shot” loomed large as to why it had to be a big deal.  A telling quote:

And though I believe in the logic of getting the HPV vaccine, I have also long felt strongly that any decision involving their future sexual lives should be theirs to make.

That’s the major problem. The choice of whether or  not to get HPV as an adult is more about your future health than your future sex life.  (And that’s setting aside the logic of giving an 11-year-old the right to decide for her 20-year-old self whether or not to invite the possibility genital warts, cervical scrapings, infertility and even cancer into her life.)  Government officials and drug developers designed and regulated the vaccine to minimize the psychological association between the shot and having sex.  Part of that is scheduling the first vaccination years before the average girl starts having sex, in part to get complete coverage, but also so that it’s not fraught like the conversation of whether or not to put a girl on birth control.  You just start getting the shots at 12; if you have sex at 14 or 21, it doesn’t matter.  The choice to have sex and choice not to get HPV are decoupled.  And this is how it should be, since virginity is politically loaded, but that women shouldn’t die or lose their fertility to cervical cancer should be completely apolitical.

To be fair, I don’t know if Williams treats all vaccinations with this gravity.  As I noted, perhaps her daughter was also expected to sleep on the decision of getting the meningitis shot, in order to make sure she knows that she could always have the option not to spend time around people who are sneezing or wiping their mouths.  Perhaps the tetanus shot was only administered after her daughter spent a day thinking about her future life around rusty metal and biting insects; after all, we don’t want to presume for her that she wouldn’t consider simply avoiding the easily identifiable situations where you can get tetanus (rusty objects, hiking, tubing, outdoor barbeques).

To be clear, the emphasis on the “sex” aspect of the shot was heavy in this story.  It wasn’t just the one strange sentence about her future sex life.

And then I’d had to, with all the calm I could muster, have a lengthy conversation about how the doctor had made a mistake, but it was OK, and everything was fine, and now we were going to talk about sexually transmitted diseases.

My daughters know the facts of life. They know where babies come from, and how people can get AIDS. Often, their knowledge hasn’t come from carefully planned birds-and-bees heart-to-hearts but from spontaneous opportunities — a confusing scene in a movie, a rumor a kid spread on the playground. Life does not always keep children in a bubble until both you and they are at your optimum moment of emotional preparedness. Stuff happens, and being a parent means being there to talk about it. It wasn’t the conversation I minded having. It was the harrowing realization of how easily a sloppy mistake, from someone we trusted implicitly, could have meant something far more serious than what we’d just experienced. It was being robbed of choice. Not mine. Hers.

Look, I get that talking about sex with kids is a big deal.  I really do.  I’m 100% sure Williams is responsible and tries to be natural about this stuff.  I think the HPV vaccine is just as good a time as any to have this discussion.

But this isn’t about child-rearing practices.  This is about responsible journalism about important public health issues.  Williams did more than link sex and this shot with her daughter—which again, I can see arguments for it—but she reinforced the link the public mind.  That’s another ball of wax.  When discussing the HPV vaccine, we have two frames to work with: “sexual choices” or “routine health care”.  The first is a loaded frame that allows right wing narratives about choice to seep in.  If you’re working with the “sexual choices” framework, it’s easy for people to say that X isn’t really health care, because the proper choice is to abstain from sex, and there should be consequences for those who make the “wrong” choice.  In fact, as I pointed out over and over again on Twitter, the fact that the vaccine is characterized as a sexual choice is a major reason it’s not mandatory.  People are looking at it with the same nervous eye that they look at putting their kids on birth control with.  The sexual choice frame allows people to think that withholding the shot signals sexual values.

I prefer the “routine health care” frame, which is incidentally the typical frame used in handling the effects of how widespread HPV is.  When you get a Pap smear, for instance, it’s not really treated like a matter of sexual choice-making, but more like getting your oil changed, just part of being female.  Once you characterize a form of health care as being about sexual choice-making, you start to have people not get the routine care they should, because they perceive that care as being something that’s only necessary if you’re a “slut”.  Which is, incidentally, a big reason that a lot of women lose their fertility to chlamydia, because they don’t get care in a timely fashion due to unwillingness to believe STDs can happen to good girls like themselves.

And that is, above all other things, my main concern.  Whatever private decision-making looks like in the Williams’ household is certainly not my business.  But once you write something and publish it, it’s a matter of public concern.  Endorsing the “sexual choices” frame of HPV over the “routine health care” frame is a highly political choice.  You personally may not weigh one sexual choice more heavily than another, but that’s simply not true of most of the public, where the belief that women should avoid “sluttiness” is still the strongly-held majority opinion, as is the belief that STDs are indicative of immoral sexual choice-making.

In addition, in both of Williams’ pieces, she didn’t do a scrap of reporting on the actual safety and efficacy of the vaccination, just noting that there are “pros and cons”, without noting something important, such as the pros way outweighing the cons (with the cons mainly being it’s expensive and it hurts to get a shot).  She mentions that she’s been “following” its evolution, but doesn’t mention that both the FDA and the CDC report that the vaccine is very safe, and that the only verifiable side effects of the vaccine are common to all vaccines—basically a reaction to getting a shot, like when squeamish adolescents faint in the doctor’s office.  She didn’t note the widespread medical opinion that vaccinations are very safe, and in fact, invoked negative reactions to penicillin, as if the two were comparable, even though in terms of risk, penicillin is much more dangerous than vaccines.   If we care about the health of the next generation, we should be more thoughtful than this.  While most people who get HPV are fine and the infection clears up on its own, there are enough adverse effects that we shouldn’t be cavalier about this: 4,000 deaths a year from cervical cancer, 12,000 cases of cervical cancer.  And that’s on top of all the various miseries women have to endure so they don’t become a statistic, including having to endure cervical biopsies and having cervical scrapings of pre-cancerous cells.  Incidentally, those scrapings sometimes also cause infertility in cases where aggressive treatment to prevent cancer is the only real option. A woman who has to choose between not getting cancer and not having babies in the future is someone whose choice has truly been robbed from her—and all because she didn’t get to have the HPV vaccine when she was a kid as part of her routine medical care.

The Terri Schiavo case should have put to rest, I hope, any objections to paying attention to right wing stunt-stories that are flying through right wing media but not getting much mainstream attention.  I’ve never been a fan of the “ignore it and they’ll go away” philosophy when it comes to these things.  On the contrary, the fact that there are stories and theories known to pretty much everyone on the right but are rarely examined or even acknowledged by anyone else should trouble us. The urge is to ignore this stuff because it’s so clearly wrong/sadistic/morbid/stupid that you can’t take seriously the people who invest in it. Also, I think it’s painful to believe that your fellow Americans can be so incredibly mean-spirited, stupid, and nosy.  (Certainly, an unwillingness to accept this has fed the mainstream tendency to ignore the anti-contraception beliefs of the anti-choice movement.) But millions of people are making their voting decisions based on these lies and myths.  I do think increased media attention to birtherism and Glenn Beck’s ravings is helping wake everyone up to the fact that ignoring the right wing media and social media that flies under the radar of thinking people is just a poor idea.

With that disclaimer out of the way, I want to talk about a case that I doubt ignoring will make it go away: the baby Joseph situation.  Kevin Keith has a rundown of the situation, and one of the most critical things to understand is most of the information coming out about it is coming through the anti-choice movement, and so it should be assumed up front that it’s full of lies, holes, and distortions.  If you have questions about why anti-choicers lost the benefit of the doubt, please go do some reading and come back here.  And remember in the Schiavo case that the right wingers painted Terri Schiavo as practically walking and talking, and it was only when the brain scans that showed how little brain she had left came out that it became clear how much they were lying about her condition.

So what’s going on is more a rough guess than anything else, but piecing together the right wing hysteria, the best guess is this: A bay in Canada was born with a disease that it seems likely put him in a vegetative state from birth on.  As Keith explains, the odds are high that right wingers are downplaying the severity of this baby’s condition, but we don’t know the exact diagnosis.  What we can be reasonably sure of is that baby Joseph is terminal, and the fight between his parents and the hospital is over whether or not to take him off the ventilator now or administer a tracheotomy and a home ventilator so that he can be taken home to undergo a much longer but just as certain death.  As far as I can tell, once you peel away all the right wing hysterics, this is the crux of the fight.  The right is painting the “die at home” side as “Save Baby Joseph”, but this is a lie.  There is no saving baby Joseph.  It’s all very sad, and worse, it seems this is the second child that this has happened to with these parents.

The problem is that Frank Pavone of Priests for Life—a truly wretched and ghoulish man who was practically dancing on Dr. George Tiller’s grave within hours of the announcement of his murder—has involved himself.  (If the pedophilia scandals didn’t terminate any faith you have in the judgment of the leadership of the Catholic church, then spending some time with Pavone’s videos and writings should do it.  That they gave this man a collar should indicate that they have no standards whatsoever when it comes to hiring people who are supposed to be ministering others.) Oh yeah, and so has Terri Schiavo’s brother.  So we’re talking a three ring circus of lies and bullshit, and the people whose hard choices about their son are at stake are being swiftly reduced to pawns to use to score points.

And the people that are being scored on are, ultimately, Democrats.  Even though Democrats have nothing to do with this.  Not just because it’s a matter of a family versus a hospital bureaucracy (that may be in the right—read Keith’s post for more), but because this is happening in Canada.  But for right wingers opposed to health care reform, Canada is a stand-in for Democrats.  Bashing Canada is a way to bash Democrats.  At least, it is when you’re talking about health care.  Even though Democrats actually pushed for a system that preserves private health insurance, a high percentage of right wingers believe that we’ve got a Canadian-style single payer system coming down the pike.  They also believe that this means that the government will be doing things like executing old people or retarded people in order to save money.  That’s what the whole “death panels” thing was about.  And so if they can find a story that “proves”—even through lies and distortion—that Canada is willing to kill babies that have a chance to live, they can score some points on the Democrats. That this is not what Canada is doing is beside the point.  The truth never matters one bit.  (What appears to be going on is that baby Joseph has been declared a futile situation, which is something that goes on in all sorts of medical settings, both private and public, and is more about medical ethics than funding sources.)

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Yesterday, I wrote a lengthy post debunking an almost-shockingly deception-thick article written by Kirsten Powers, and the reason is to show that this is what it, frankly, takes.  Which is why lies get disseminated so far and are rarely checked in any way, because, as I estimated, it’s five times harder to actually check lies than to tell lies.  (Which is why even egregious hacks like Powers make money in the lying business.) Which means it literally can’t be done, since most people in a position to check lies are busy with other work, and even as they’re busy fact-checking one lie, five more are being generated to take its place.But honestly, the time-effort gap may not even be the largest problem that those of us dedicated to reality-based politics face.  What may be more disturbing is the increasing willingness of the mainstream media to entertain the lies of people who have been thoroughly demonstrated, through the painstaking and time-consuming work of truth-telling, to be pernicious liars who should never be trusted ever again.  Like James O’Keefe.  For what it’s worth, I thought paying attention to the ACORN videos without a thorough fact check was unforgivable.  Maybe I could forgive some writers for it, but anyone who works in television knows for a fact that it’s easy to manipulate video, and could tell at 100 paces that these videos were not only manipulated, but not even that good at disguising their manipulations.  (Distorted audio, weird cuts that indicate that something is being concealed, an unwillingness to show O’Keefe in the videos.) But okay, he got one pass based on the assumption of good faith.

But after it was demonstrated that O’Keefe had manipulated the ACORN videos beyond all recognition of what had actually happened?  After investigations demonstrated that people in the videos were portrayed saying one thing, but often were saying the opposite?  (Such as advice given to a woman to hide money from an abusive boyfriend/pimp was edited to suggest the advice was to hide money from the IRS.) And then it was discovered his compatriot Andrew Breitbart was willing to promote a video the purported to show Shirley Sherrod saying one thing, when she was, you guessed it, saying the exact opposite thing.  Plus, O’Keefe’s arrests and his attempt to sexually harass and threaten, through implication, to assault a journalist, with the intention to tape the whole thing on the grounds that this would embarrass her.  (Which really goes to show how distorted his worldview is, though I suppose with heavy editing to erase the man who is striking threatening poses in a woman’s direction, you could somehow make it about her, though how I don’t know.) After that, the only reasonable, rational thing to do is to take everything that O’Keefe produces, and put it in the trash without wasting your time.  Whatever potentially “shocking” stuff on there is definitely going to be manipulated and dishonest.

We know this.  This is not a mystery.  There is no excuse any more.

Which is why I was shocked and appalled when the latest video trying to ding NPR came out, and people took it at face value, as if we didn’t know for a fact that it was deceptively edited.  I saw people approach it with the assumption that it was mostly lies, but they figured they could somehow tease some relevant truth out of it, and judge it on that.  This is especially true if you’re unwilling to watch all two hours of footage that O’Keefe got, which 99.9% of journalists are unwilling to do.  (See: Lies, Time It Takes To Debunk Them.) Instead, people decided that Schiller said a couple of things that were inexcusable under any circumstances, and that was good enough for them.  Never mind that the Sherrod example should teach us that context can literally mean that someone is saying “up” when, if you extracted just a fraction of their overall quote, it seems they are saying “down”.

O’Keefe has learned that he can come in, lie his fool head off, create damage, and when the accounting is done, it’s too late to fix all the damage he’s done.  His is amply, and repeatedly rewarded for lying.  Unsurprisingly, a few days after the NPR video came out and people were fired and all that jazz, a thorough accounting of the video demonstrates that it is stuffed with lies. Which anyone at this point could have told you, sight unseen, even people that bought into it.  Lindsay did what almost no one else did, and watched all two hours of the taped con job.

If you watch the entire conversation, it becomes crystal clear that O’Keefe’s provocateurs didn’t get what they were looking for. They were ostensibly offering $5 million to NPR. Their goal is clearly to get Schiller and his colleague Betsy Liley to agree to slant coverage for cash. Again and again, they refuse, saying that NPR just wants to report the facts and be a nonpartisan voice of reason. Schiller pointedly informs the fake donors that NPR broke with some very generous Jewish benefactors who had supported NPR for over a decade because they tried to tell NPR that it “couldn’t have so much Palestinian coverage.”

“And we said, ‘sorry,’” Schiller says, “And we lost their funding, and it’s gone.”

During the ACORN days, O’Keefe actually tried to conceal the original videos, knowing that they proved he was a liar.  Now he’s realized that being a known liar doesn’t actually make any difference.  He doesn’t even perform a charade of being ashamed for being such a terrible liar.  At this point, he releases a video, everyone knows up front that he’s a liar, and everyone will just pretend that he’s not for the 12-24 hours it takes for the video to ruin someone’s life.  And he’ll basically gloat in public by releasing the full video, as if to say, “Hey, we all know I’m lying, but no one seems to give a flying fuck!”

And on that, he’s right.

How do you fight against that?