Cosmetic surgery and ethnicity

The Atlantic has featured a couple of good articles about this topic recently,  so I put together a roundup of related pieces:

The K-Pop Plastic Surgery Obsession from The Atlantic (24 May 2013).  This thorough article includes some quotes from anthropologist Eugenia Kaw and a reference to her work Medicalization of Racial Features: Asian American Woman and Cosmetic Surgery.  From the article: “Dr. Kang’s philosophy is about helping nature along. ‘I always try to copy the natural look, give face the ideal shape it should have been born with,’ he said.”

SBS Dateline (Australia) had a segment on the K-pop cosmetic surgery phenomenon a couple of months ago:

This Reddit thread about the 2013 Miss Korea contestants is interesting as some comments come from people living in Korea, trying to give a perspective from inside the culture.  They also reference this story from China in which a man sued his beautiful wife for marrying him under false pretenses, after she gave birth to a less-than-lovely child and then revealed she had had about $100K worth of surgery before meeting him (sounds like an urban legend to me).

Looking beyond Korea, in 2011 the New York Times published the article Ethnic Differences Emerge in Plastic Surgery. It’s not an academic or researched article;  it basically groups together a bunch of generalizations by surgeons about immigrant surgery preferences.

The Atlantic went back to the cosmetic surgery topic for today’s article Bringing Beverly Hills Cosmetic Surgery to the Middle East.

And to return to my home country, I offer you this Gawker post from 2011: A Guide to the Fake Faces of Real Housewives.  Perhaps there’s something to be said about trying to look like those seen as successful  trendy role models among those of your subculture — whether they be pop stars, actors, or trophy wives — and the dominant story isn’t that people are trying to look Caucasian, at least not anymore.

Michael J. Fox as a public figure with Parkinson’s… a fictional one

I don’t watch many sitcoms, but the upcoming Michael J. Fox Show will have a spot on my DVR.  You’ve already seen the trailer above, haven’t you? It’s sweet, irreverent, and funny.  The dinner table moment that starts at 3:10 in the video just slays me.

Outside of interviews and cameos, we rarely get to see disabled people on television. I have to believe that a beloved actor with Parkinson’s disease will ensure that the details about his condition are portrayed with reasonable accuracy. It’s refreshing to see a representation of someone living with a degenerative disease; not coping, not surviving, but living.

Surgery as prophylaxis

The world buzzed yesterday with the news that Angelina Jolie underwent a double mastectomy to greatly diminish her risk of breast cancer. I’ve been a fan for a long time, but she has my respect for the editorial she penned for the New York Times revealing her procedure. It’s intelligently written, explains the tests and procedures she went through, acknowledges other treatment options and choices, and thanks her loving family. It can be difficult to understand having such a dramatic procedure done with no sign of current illness, but as one woman who made the same choice put it, “If someone said your flight was 86% likely to come down, you wouldn’t get on that plane.”

With better knowledge about risk factors and a decrease in the cost of  genetic testing, an increasing number of people are proactively seeking surgery with no evidence of disease.  A presentation at the American College of Surgeons Annual Clinical Conference last year analyzed data on this trend from 2004-2009.  The number of hospitalizations related to genetic susceptibility increased 16-fold during that time, and prophylactic surgeries more than doubled. Insurance plans are increasingly covering these surgeries as a cancer risk reduction strategy based on family history, pre-disease symptoms, and/or genetic testing. This policy sheet from provider Priority Health is one example; it describes criteria not only for prophylactic mastectomy but also removal of the ovaries, stomach, uterus, or thyroid.

Jolie isn’t the only public figure in the news recently for surgery to reduce illness risk.  New Jersey governor Chris Christie revealed last week that he had undergone bariatric surgery in which a band is used to section off part of the stomach, reducing the quantity that can be eaten at one time. Though some have questioned his motive, Christie made this decision at age 50 and while morbidly obese, at increased risk for heart disease, stroke, some cancers, and concerns from joint problems to sleep disorders. Though the surgery isn’t a cure-all (I was told recently by a specialist in this area that more than 50% of the procedures now performed are revisions to previous surgeries; not because of a problem with the surgery, but to increase effectiveness for a patient who has stopped losing or started regaining weight), Christie has a good chance of dropping enough weight to make a significant difference in his risk of disease.

There are many issues to consider here and many frameworks that can be applied, but I’ve been thinking about identity. People who undergo major surgery as a risk reduction strategy will wear the scars and/or have lifestyle changes forever. Their lives are different because of a disease they feared, which becomes part of their embodied identity nonetheless. I think there must be an identity shift that precedes that, from seeing oneself as healthy to envisioning the body as vulnerable and imminently diseased.  The presentation mentioned above noted an association between surgery-seeking and level of anxiety about disease. I wonder if that anxiety marks an identity borderline, from a woman who sees herself as fine but at risk and chooses vigilance and lifestyle alterations, for example, and one who sees herself as having a disease that hasn’t yet surfaced and seeks surgery to remove tissues already considered unhealthy.

How Diseases Keep You Healthy

The doctor comes into the exam room and looks at you with that stern but sympathetic look; his hands hold your test results and you feel the worst must be coming.

“I’m sorry Mrs. Smith, your test results came back you have Phenylketnonuria, more commonly known as PKU. With proper diet the effects on your neurological system can be controlled. (Then he grins) On a brighter note it protects you from miscarriages so you and the mister don’t have to worry about that family line!”

“I’m sorry Mr. Greenspan, your son Samuel has Tay-Sachs. As lipids begin to build and store in your sons brain and nervous tissue, he will become blind, deaf, and eventually be unable to swallow. (Then he grins) On a brighter note because you and your wife are both carriers of the gene you are both well protected against Tuberculosis!”

“Mr. Humanitarian, I’m sorry to say your breathing problems are due to Cystic Fibrosis, or CF. You will probably experience more repeated lung infections during your life which may lead to severe lung damage. (Then he grins) but your upcoming mission to Africa don’t you worry about those Cholera outbreaks, while you may catch it like other people you CF will protect you from it it killing you! Have a fun trip!”

All of these sound like horrible jokes; yet there is research that shows different allele mutations that occur in populations lead to immune protection against other diseases and conditions. In fact there is a strange effect that occurs that may even explain why some diseases are prone to certain groups or communities and not others. Factors that are related not only to the diseases themselves but the environment that they interact in also.  In a 2008 article by Dr. Pardis Sabeti entitled Natural Selection: Uncovering Mechanisms of Evolutionary Adaptation to Infectious Disease, he shows the relation between sickle-cell anemia and its resistance to Malaria. As those that have sickle-cell escape death from Malaria those without  the condition die off. This causes an increase in sickle-cell in the surviving group, because those without could not fight the Malaria. The population left with only a members that most likely carry sickle-cell now has a disease or condition that can be attributed to their group whereas it might not another where Malaria is not prevalent in the other groups environment weeding out non-sickle cell members.

This can also be shown in why Tay-Sachs is a condition that is normally associated with Jewish populations versus other groups and communities. In Jewish History living in ghetto like conditions was not something that singularly arose during WWII. Those conditions had occurred before, yet if for this post one wants to focus on just WWII the point still can be driven across. Crowded living conditions with bad air is a perfect breeding ground for Tuberculosis (TB). The mutation that causes Tay-Sachs has a built in defense against TB. As those in the ghettos who did not have Tay-Sachs to defend their health against TB outbreaks died, the remaining Jewish survivors were more likely to have Tay-Sachs as a result of its ability to side step the TB. Other communities or groups that did not have both conditions present in their enviroment would not have the build up of Tay-Sachs in their genetic community. This leads to Tay-Sachs associations more with people of Jewish heritage then perhaps other groups.

Some of the reasons for cross-disease protection are a result of the specific way a mutated allele may affect the surface of a blood cell to how it changes the way ones body performs a specific function i.e. an organ or its ability to breakdown specific chemical. Why some of these diseases though are more prevalent in some groups versus others though does bring into the wonders of its protection from other diseases causes an increase of its occurrence in certain populations. Remembering outside factors that contribute to a disease being carried on to future generations while non-carriers die out should be an important thought when focusing on the how and a why one person or group has/gets something while others seem to breeze through unaffected.

Two webpages at this moment discuss in small detail these occurrences, I will find some journal articles that also detail this and tag them on later. To get started though is this interests you:

Dr. Sabeti’s article from Nature Education can be found at:

http://www.nature.com/scitable/topicpage/natural-selection-uncovering-mechanisms-of-evolutionary-adaptation-34539

PBS also has a quick comment page on a few conditions that provide protection from other, it can be found at:

http://www.pbs.org/wgbh/evolution/educators/course/session7/explain_b_pop1.html

Mechanical metaphors of the body- in advertising.

I love this link.

Tattoos in American Culture

As far back as I can remember, I have always romanticized tattoos. The idea of permanently etching a symbols I held dear was great. Even if my views did change, the tattoos would stand as a reminder of who I was. Anyone who has tattoos, and grew up in a more conservative city knows that tattoos are not viewed in a positive light.  The article here talks about tattoos introduction into America, and how far they have progressed in the past few years. This next one here is Sofya Gladysheva’s personal opinion, but I am 100% behind her. After a brief reintroduction of tattoos origins in America, she goes on to talk about tattoos significance to the individual.

The last article is about Vladimir Franz. Vladimir is a drama professor running for the presidency in the Czech Republic. 90% of his body is inked, and is currently in 3rd place. This article was very refreshing to me, and I hope Vladimir’s campaign helps push for a wider acceptance of tattoos.

Perils of quantification

New Year’s Resolution season is upon us again and with it, many of us will be setting goals that are tied to our behavior or self-improvement.  With a goal there should be a way to measure progress, and watching a number change can provide potent motivation.

That’s part of the basis for the quantified self movement, consisting of people who use self-tracking to collect data about how their bodies and minds work (we’ll debate duality another time), often for the purpose of understanding and optimization  This is introspection and self-disclosure taken to a new level.  Some use an artistic approach, like Buster Benson, who – among many other things – takes a picture of himself at the same time each day.  J. Paul Neeley, seen in this video from the Mayo Clinic Center for Innovation Transform 2012 conference, has put a lot of thought into optimizing his happiness based on observations from self-tracking.  Others take a hardcore medical approach, tracking weight, heart rate, respiration, blood pressure, sleep hours, caloric intake and balance, and other objective numbers.

Many of the methods used by quantified self practitioners could be found in a social science textbook, but they are applied to a sample size of one.  Some of the findings apply no further.  Other data, shared and aggregated, could lead to discoveries that improve the lives of many.  I’ve seen the movement described as little more than a herd of narcissists, but my opinion is that it’s a display of millennial attitudes of curiosity, openness, introspection, and embrace of technology (which are not limited to an age range, but worldview).  Perhaps it’s microanthropology or micropsychology as well.

That said, I was struck by a short essay by Jeff Wise on the last page of the November 2012 issue of Red Bulletin magazine (produced by the energy drink company yet a fun, free read; see their website).  His piece, entitled “The Measure of a Man”  begins by talking about the difference between subjective methods of self-awareness, such as “I have trouble fitting into my clothes” and objective ones like “I weigh 233 pounds.”  Seeing the number on the scale go down to 232 provides immediate external positive reinforcement and a sense of control.  It’s strong motivation to keep moving that number in the preferred direction.

However, Wise points to the danger of focusing on a particular metric.  He compares it to the use of a district-wide test to measure student performance.  “The first year… their scores offer a rough measure of the overall quality of their education.  But in subsequent years, those scores will increasingly measure something else: Teachers’ ability to prepare their pupils for that particular exam.”  Applied to tracking weight, he warns that “what you measure becomes what you do, and what you do becomes who you are,” with the potential for eating disorders, substance abuse or neglecting other aspects of good health.

In reading blogs of the quantified self crowd, I’ve frequently seen this in confessions that the trackers have changed behavior to make one particular metric “look better”, often at the expense of others.  Even in our introspective attempts to understand human nature, we display it.

Can two people share a mind?

This article is mind-blowing: there’s no hard proof, but a lot of intriguing evidence that two little girls are in some way sharing each other’s consciousness.

Born with an extremely rare (the rarest- there are no other cases in medical history) form of conjunction at the head (craniopagus), Krista and Tatiana Hogan seem to share mental and physical experience through a thalamic bridge.  Their neurosurgeon hypothesizes that when either of the girl’s bodies experiences sensory input, the signal passes to both brains.

It’s hard not to speculate on the big questions this medical anomaly engenders: on the nature of the self, and on the nature of consciousness.  And these big philosophical questions are ones that Krista and Tatiana have to negotiate continually at a very practical level: what pronoun should the girls use to refer to themselves, and what does it mean?  What if their connectivity extends beyond basic sensory input, to higher-order thoughts and preferences?  There are some good links in the article to philosophers and neurobiologists who had been thinking about these kinds of problems before the extraordinary case of Krista and Tatiana.

2012 Wired Health Conference, simulcast tomorrow & Tuesday

This year, the Wired Health Conference will be exploring personalized medicine, which includes the fascinating growing area of the quantified self:

The theme of the event is “Living By Numbers” — the notion that new data and analytics are enabling better healthcare delivery and research. The idea is straightforward on its face: By paying heed to our health, and taking advantage of new tools for self-monitoring, feedback, and community, we can empower our own actions and skirt the disease risks that life throws at us. But this potential is only just upon us, with the combination of new computing power, ample data storage, and having the right questions at hand. This technology is just beginning to enable the new frontier of personalized medicine: combining the insights of epidemiology with our own personal metrics to customize medical science to individuals.

You can watch the simulcast live, free.  Talks begin at 4:00pm Eastern on Monday, and run from 9:00am-5:00pm Tuesday, with an exciting roster of speakers.

Prague is very nice in May…

…and this conference looks pretty interesting, too- although “probing” might not be the best word choice:

Call for Presentations: 1st Global Conference–Probing the Boundaries
of Reproduction

Origins, Bodies, Transitions, Futures

Sunday 12th May – Tuesday 14th May 2013 Prague, Czech Republic

This conference seeks to explore the boundaries of reproduction, not
merely as physical birth but more broadly as an agent of change, of
bodily, sexual, cultural (and even viral) transitions.