Drug-induced comas can enable life-saving medical operations such as extensive brain surgery. Yet, it is difficult to get normal work done while you are anesthetized. You can’t write, can’t work, can’t keep tabs on the world in all its fast-clicking glory. But what is getting done is pretty important, too.
So it was that my beloved mom and stepdad visited from the U.S. last month to shower their only grandchildren (my baby and my big kid) with the softest of lovies, the ooey-gluey-est of crafting projects, the finest of next-season fashions, and (naturally) more sugar than Mommy.
It’s not all their fault that this past month was its own kind of coma. It was a mix of summer fun, visiting family, childcare holidays, the stresses of exes and xenophobes, and the kind of exhaustion that tingles all the way from your tongue down to your toes. It was different.
Someone else cooked. I slept in a few mornings for a change. I got my biannual haircut, in tandem with my big kid — a new ritual, I hope. I attended a few long-postponed medical appointments. My baby got her walker and high chair. I lay on the floor with my kids and laughed. And I got the MMR vaccine.
There must be a tradition of individualist medicine, but I don’t know it yet. A body of work that backs me up when I say, I know enough about the literature to make my own medical decisions. And when I go in, it’s not to reassess those decisions. It’s to execute them.
But what happens instead in the social dance is that I say the magic words to get what I want, like (most) everybody else, amid performances of power and deference.
I got an MMR booster last week even though I had the full series as a kid, because it might better protect me and my small children amid worldwide measles outbreaks.
But that was a secondary reason. I really got it for the possible non-specific effects. I hope to need fewer antibiotics for sinus infections because the measles vaccine is live, and live vaccines may train the immune system to respond more effectively against a variety of infections.
Of course I’m not telling an overworked GP who often doesn’t know the guidelines and isn’t very nice that this is what I’m doing. I’m not explaining this to a travel vaccine clinic worker who’s not sure I can have vaccines because of my autoimmune disorder and treatment (which any rheumatology clinic would agree are non-issues).
My first principle is taking care of my health so I can take care of my kids. This sometimes requires gaming the system to get what makes sense. That gaming is at odds with the dominant narrative about informed consent, which says patients go to their doctors for information and advice about medical decision-making. Everyone knows that narrative sits in uncomfortable tension with the realities of client dynamics in fragmented, pay-to-play medical care systems at worst, and heterogeneous webs of relationships that color evidence interpretation at best. Everyone knows you’re not supposed to say the quiet part out loud: that we don’t know nearly enough about the possible costs and benefits of most interventions. That the breast ultrasound my private gyn randomly hawked (and then billed for recommending) could do more harm than good.
I’m still under, so to speak. On holiday hiatus with my kids. Reevaluating what makes sense in life, given how valuable family is. Wondering what I’ll carry forward when I come to next month.