In the summer of 2000 I was diagnosed with a brain tumor.
I had developed double vision because a benign tumor, a meningioma, was pressing on the nerve that controlled the movement of one of my eyes. The tumor was small, but located deep in my brain. That meant that surgery to remove it would likely lead to significant nerve damage.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Under the guise of what’s best for women, midwives & lactation professionals recommend what’s best for themselves.[/pullquote]
Surgery was, up through the 1990’s, the only treatment. However, as a physician I had access to those who knew about the latest options. A dear friend, a neuro-radiologist, told me about stereotactic (“gamma knife”) radiosurgery, which is not surgery at all, but a one day course of radiation to kill the tumor.
I consulted a neurosurgeon, widely reputed to be one of the best in the US, to find out what he recommended. He recommended surgery.
I asked him:
Which treatment had the highest cure rate? He told me that surgery had a cure rate of 85% and radiation had a cure rate of 95%.
Which treatment had the highest complication rate? He told me that surgery would likely lead to loss of sensation on the left side of my face and deafness in my left ear. Radiation had no complications beyond local irritation.
If radiation treatment failed, would that make subsequent surgery more risky? He told me that it would have no effect.
So I asked him why he was recommending surgery if radiation had a higher cure rate and a lower complication rate. To his credit, he replied honestly:
“I don’t do the gamma knife.”
In other words, under the guise of recommending what was best for me, the surgeon recommended what was best for HIM. His financial and non-financial conflicts of interest led him to recommend the application of his personal skills.
But here’s the key point: I don’t doubt that he believed surgery was best.
Because of his personal experience, he believed implicitly in his surgical skills. Because of his lack of experience with the new form of radiation treatment he distrusted it. Because too much of medical practice is doing what you have been taught to do — in his case surgery — he recommended surgery.
That’s also the ethical problem at the heart of contemporary midwifery and lactivism. Under the guise of what’s best for women, they recommend what’s best for themselves.
And here’s the key point: I don’t doubt that they believe it.
Because of their personal experience, midwives and lactation consultants believe implicitly in their own skills. Because of lack of broader experience with complications, they are sure they don’t exist or are “variations of normal.” Because too much of midwifery and lactation medicine is recommending what they’ve been taught to do, they always recommend themselves and their limited skills.
Midwives like Sheena Byrom and Hannah Dahlen consistently recommend the application of midwifery to just about every situation. Byrom and Dahlen consistently demonize anything they can’t bill for — such as epidural anesthesia or C-section. If they can’t do it, they fervently believe, you don’t need it.
They are blind to the fact that their financial and non-financial conflicts of interest cause them to recommend what is best for midwives, NOT what is best for mothers and babies.
Lactation professionals like Amy Brown, Jack Newman or Natalie Shenker relentlessly recommend breastfeeding and greater financial support for lactation professionals. It doesn’t matter what the situation might be, the answer is ALWAYS more lactation support and more breastfeeding and pumping. They consistently demonize formula because they can’t bill for it and it undercuts their own economic wellbeing. As far as they’re concerned, if they can’t do it, you don’t need it.
They are blind to the fact that their financial and non-financial conflicts of interest cause them to recommend what is best for them, NOT what is best for mothers and babies.
Most women don’t have the luxury I had, not merely the ability to consult multiple providers, but the professional contacts to know whom to call. Ultimately, I chose to have the radiation treatment, a 9 hour marathon in a machine like an MRI, involved having a metal frame anchored into my skull. The results — as I had been counseled — were not immediate since it took time for the tumor to shrink and die. It was three months before I noticed any improvement and six months before the double vision completely resolved.
On the other hand, there was no surgical recovery. No drilling into my skull. No bleeding or infection. No hearing loss or loss of feeling in my face.
I do not begrudge the neurosurgeon for his recommendation to have a major surgical procedure that I didn’t need and could have harmed me. He was honest and I was aware that surgeons tend to recommend surgery even when there are other (sometime better) treatment options available. They know their own skills and trust them. They don’t trust technologies that are new and with which they are unfamiliar.
But a better surgeon, with greater awareness of his own financial and non-financial conflicts of interest, would have made it his business be thoroughly familiar with treatment options beyond those he could offer. He would have recommended the radiation treatment — or counseled me about it at the very least — since that was an option I deserved to have. It was also the option that was best for me, far better than what he could offer.
Ethical midwives, with greater awareness of their own financial and non-financial conflicts of interest, would counsel women about all options and not demonize the ones they can’t offer. I don’t doubt that they believe with every fiber of their being that midwifery care is almost always best. They can’t see the truth that just because it is best for them, doesn’t mean it is best for babies and mothers.
Ethical lactation professionals, confronted with the fact that they have single handedly made exclusive breastfeeding the leading cause of newborn re-hospitalization, would offer formula to any woman who wants it, not demonize formula and certainly not insist that what women need is more of the “support” that harmed their babies. I don’t doubt that they believe with every fiber of their being that breastfeeding is almost always best. They can’t see the truth that just because it is best for them, doesn’t mean that it is best for babies and mothers.
It was my brain tumor, in my head, and I deserved to know all the options for treatment so I could make MY choice.
When it comes to birth and breastfeeding: her body, her baby, HER choice … free from pressure by those who stand to benefit from offering only what they can do.
