Dynamist Blog

Kidney Blogging, Cont'd

041807kidney.jpg_20070417_19_36_13_1663-Over the past few months, I've been correspnding with Tom Simon, an FBI agent in Chicago who decided he wanted to give someone a kidney. He now has a blog with a great explanation of how he came to make the decision and why he decided to choose a specific person, Brenda Lagrimas, through MatchingDonors.com, rather than simply donate to the next person on his local transplant center's list. The transplant surgeries are tomorrow, April 19.

Tom is well known to the local press from his FBI work, and his donation has gotten coverage in the Sun Times, the Tribune, and the local Fox affiliate. The articles do a good job of capturing his basic thought process and his important point that donating a kidney is not an especially risky procedure or unthinkable sacrifice. That doesn't mean everyone should run out and give someone a kidney--any more than everyone should take a job in law enforcement. But we need to start thinking of kidney donors as normal people taking reasonable risks for great benefits, not as crazy or heroic.

That giving up a kidney is an inconceivable sacrifice is one of several false assumptions behind Will Saletan's recent article on organ markets in Slate and the WaPost Outlook section. Consider his lead:

If you lose your job, you can sell your home. If you lose your home, you can sell your possessions. If you lose your possessions, you can prostitute yourself. And if you lose everything else, you can sell one more thing: your organs.

I guess that makes Tom Simon and me kidney sluts, since we didn't even charge. Having gone through the process, I can in fact imagine that selling a kidney would be for many people, especially the young and healthy, a far more desirable option than, say, giving up a home and certainly better than becoming a hooker. Within the U.S. transplant system, where laparoscopic surgery is the norm and malpractice and financial protections are in place, paying for organs would not mean exploitation of donors--any more than paying firefighters means exploitation of desperate men with a taste for danger and doing good.

Saletan is right that "transplant tourism" is a growing problem, but not because there's something inherently wrong with paying people money for their organs. The problem is that--thanks to gray or black markets--kidney vendors receive only a fraction of the market value of their organs and have few, if any, legal or financial protections. And that's not to mention the dubious sources of the cadaver organs China is offering.

But Saletan is wrong that paying for organs discourages donation. Nephrologist Ben Hippen, who has a forthcoming piece in Transplantation on the subject, notes in an email that the claim is "empirically false in the only country (Iran) where commercialization is legal. From 2000 - 2005, deceased organ donation increased from < 1% of all transplants to 10% of all transplants. The obstacle, it turns out (a la Kieran Healy) was that no procurement organizations for deceased donors were up and running until about 5 years ago." (Ben has also written a letter to the editor of the Post.)

The worst part of Saletan's article is the well-meaning but dangerously ignorant conclusion: "The surest way to stop him from selling his kidney is to make it worthless, by flooding the market with free organs. If you haven't filled out a donor card, do it now. Because if the dying can't get organs from the dead, they'll buy them from the living."

As advice, this is fine. Sign your donor card. Maybe it will do some good. As policy analysis, it is complete b.s. It might make a little more sense if Saletan added, "Then make sure you do a lot of helmetless motorcycle riding in the rain around lots of drunk drivers." Signing a card is not enough, even if your family honors your wishes. You have to die in just the right circumstances, usually from some head trauma that preserves the blood supply to your organs. Cadaver organs are great, and certainly essential for people who need, say, hearts. But not enough people die in the right circumstances to supply the need for kidneys. Any serious policy must focus on living donors.

Just to rehearse the statistics once again: As of this moment, there are 71,181 Americans on the waiting list for kidneys--a number that is bigger every time I look at the statistics. In January alone, 319 people died waiting for kidneys and 138 became too sick for transplantation. [Note: This has been corrected. The post previously attributed the numbers to the year so far.] Every year about 4,000 people die on the list, more than the number of U.S. military personnel who have been killed since the beginning of the Iraq war. On or off the list, living with kidney disease requires devoting your life to dialysis treatments--the kidney equivalent of the iron lung. It's a debilitating and disruptive way to live. As Bill "Epoman" Halcomb, the founder of I Hate Dialysis.com, wrote:

I understand HATE is a strong word, and I understand some people will be turned off from this site just because this site is named I Hate Dialysis.com, but I ask those of you who are reading this to have an open mind and realize that living with kidney failure is a terrible thing and it takes its toll on a person's physical and emotional well-being. There is a saying that goes around, "A person will NOT die from kidney failure, however, he or she will die from complications of kidney failure.

He died last month at the age of 34.

UPDATE: Northwestern Memorial Hospital, where Tom Simon and Brenda Lagrimas are having their transplant surgeries, has a terrific video on its living donation program.

A Logical Thinker With a Messy Desk

You Are 55% Left Brained, 45% Right Brained
brain.jpg
The left side of your brain controls verbal ability, attention to detail, and reasoning.
Left brained people are good at communication and persuading others.
If you're left brained, you are likely good at math and logic.
Your left brain prefers dogs, reading, and quiet.

The right side of your brain is all about creativity and flexibility.
Daring and intuitive, right brained people see the world in their unique way.
If you're right brained, you likely have a talent for creative writing and art.
Your right brain prefers day dreaming, philosophy, and sports.

Are You Right or Left Brained?

Actually, I don't like dogs or sports--but I guess that just shows I'm balanced. Via Pat Matthews, who sent me a comment about Nancy Pelosi's scarves:

I noticed Nancy Pelosi's headscarf was tied exactly the way schoolgirls of the 1940s tied theirs, so I knew at once she'd supplied herself with the sort of square scarves that fold into a triangle.

And even better solution is the sort of long, narrow rectangular scarf that looks good around the neck but unfolds into a headscarf you don't have to tie. You just flip the left end over your right shoulder and vice versa, tweakl a little, and - instant hijab. I own several which have served me well in everything from SCA events to a visit to a gurudwara and they can be beautiful.

Pelosi's Seven (or so) Veils

PH2007040600561.jpgThere is nothing intrinsically degrading or unattractive about a headscarf. Selected and tied properly, a scarf can be quite glamorous, adding just the right amount of mystery. (I've seen some Muslim women on the streets of L.A. who should do ads for hijab.) But I agree with the wise Manolo's advice "for the future...the Speaker Nancy should tie the scarf behind the head, instead of under the chin, and push it back slightly from the forehead so that she does not look so much like the tiny little Sicilian peasant woman out for the afternoon of grape-stomping." Robin Givhan is right about being prepared but too kind about the photos. (A Republican wearing the same outfits wouldn't have fared as well under her scrutiny.) It's not enough to bring Hermes. You have to tie it right.

Make That "Katie Couric's Flunky's Notebook"

So "Katie Couric's Notebook", subtitled "A look into Katie's notebook," ran an essay about kids and libraries that was copied from a WSJ article. According to the NYT, "CBS has fired the producer who wrote the piece for Ms. Couric, and said yesterday it was investigating to see if the producer, whose name CBS has not disclosed, had written any previous commentaries for Ms. Couric that had been plagiarized....CBS News executives said they were stunned that anyone would so blatantly copy someone else's work."

No word on whether they were embarrassed that CBS would blatantly pretend that Katie Couric writes her own notebook.

This double standard is an old bugaboo of mine. I don't care when actors, athletes, and CEOs hire ghostwriters, though I do think they should give their ghosts credit, but people who pretend to be journalists and public intellectuals should do their own damn work.

Why Be Optimistic?

TCS Daily features an interview with Freeman Dyson by Benny Peiser. A couple of excerpts:

[T]he western academic world is very much like Weimar Germany, finding itself in a situation of losing power and influence. Fortunately, the countries that matter now are China and India, and the Chinese and Indian experts do not share the mood of doom and gloom. It is amusing to see China and India take on today the role that America took in the nineteen-thirties, still believing in technology as the key to a better life for everyone....

It is also interesting in this connection to observe the similarity, in optimistic mood and rapid material progress, between China and India. Although China is traditionally non-religious and India is traditionally permeated with religion, this does not seem to make much difference. In both countries, rapidly growing wealth and technological progress create a mood of optimism, with or without religion.

Read the whole thing. (It's short.) [Via Arnold Kling.]

Inspired by Dyson's mention of it, I'm off to the library to get Bernal's The World, the Flesh, and the Devil, which, judging by its prices on Amazon, could probably support a reprint.

Museum Fashion

My new Atlantic column looks at the increasing prominence of fashion exhibitions in art museums. (Link good for three days.) Here's an excerpt:

Behind the criticism of fashion as an artistic medium is a highly ideological prejudice: against markets, against consumers, against the dynamism of Western commercial society. The debate is not about art but about culture and economics. Critics who decry fashion collections are less troubled by the prescribed costumes of dynastic China or the aristocratic dress of baroque France than by the past century's clothes. With its fluctuating forms and needless decoration, fashion epitomizes the supposedly unproductive waste that inspired 20th-century technocrats to dream of central planning. It exists for no good reason. But that's practically a definition of art.

Prejudice aside, it's hard to come up with objections to fashion collections that don't apply to other museum departments. Fashion is mass produced? So are prints and posters, often more so than haute couture. Ephemeral? So are works on paper. Utilitarian? So are pots and vases. Customized to an individual? So were suits of armor. As for the fickle­ness of fashion, the history of Western art is a story of changing styles. And however much critics may despise commerce, many undisputed masterpieces were works for hire. "Paintings were marketable goods which competed for the attention of the purchaser," writes the historian Michael North in Art and Commerce in the Dutch Golden Age. Michelangelo and Ghiberti got paid.

The real question is not whether museums are too good for fashion but whether they're good enough. Clothes are unique sculptures, dependent on a supporting human form and created to move. Yet museum mannequins stand still. Clothing is made to be seen and touched—the tactile qualities of fabric are as essential to the art as a garment's color or shape—but light and fingertips dim colors and degrade fabrics. The first rule of fashion exhibitions is Do not touch.

Any fashion exhibition is thus a compromise. But, of course, altarpieces weren't meant to be ripped from their candlelit sacred context and put up on museum walls to be admired by non­believers. The Elgin Marbles were supposed to be on the Parthenon. For many works of art, a museum is an artificial setting— a zoo, not a natural habitat. Some zoos, however, are worse than others.

The Atlantic's website also features a slideshow (free link) of photos from recent exhibitions, along with some audio from me. (The site's editors adeptly cut my 28 minutes of comments down to eight.)

A free archive of my past Atlantic columns is now available here.

Obama or Osama?

That's the ingenious title the editors at The New York Post put on my latest essay, which examines the difference between glamour (Obama) and charisma (Osama). Although it is packaged as one, the piece is not in fact a review of Philip Rieff's very strange "new" book Charisma: The Gift of Grace, and How It Has Been Taken Away from Us. For that, I recommend Chris Caldwell's NYTBR piece, although it is far kinder to Rieff than I would have been. Along with an appalling writing style, the book has many analytical problems and even worse empirical shortcomings. Rieff appears completely ignorant of the contemporary existence of charismatic religious leaders and, perhaps because he wrote the book 35 years ago and stuck it in a drawer, of the substantial scholarship on religious charisma that has come out in the past two decades. What dates the book isn't its use of terms like "women's lib" and "hang loose" but its mid-century conviction that religion is dead as a lived experience and that without religious authority all hell will break loose. I had this book in mind when I wrote on Cato Unbound that "Surviving the 21st century with our sanity and civilization intact will require less Nietzsche and more Hume."

If you really want to understand charisma, I recommend the other scholarly book I cite, Prophetic Charisma: The Psychology of Revolutionary Religious Personalities by Len Oakes. It's a dispassionate yet sympathetic treatment, with insights that apply beyond purely religious leaders. (Ayn Rand and her circle kept coming to mind.)

Sharp-eyed readers will note from the author author credit on the Post piece that I've made a deal with The Free Press to write my long-delayed book on glamour. If you've got a lot of bandwidth and would like a preview, you can read the proposal here. UPDATE: Thanks to advice from reader Lawrence Rhodes, the file is now a more manageable size.

I Hate Verizon

I am writing this from Kinko's in LA--even though I supposedly have DSL service in my condo. Verizon's service has been down for the past four days, out of the seven I've been in town. And, of course, they have no one to answer their phones.

Overheard at an L.A. Starbucks

Two screenwriters working over a script that features both the CIA and some kind of evil mercenary hired by...a pharmaceutical company. You can't say there's no originality in Hollywood.

Do I Repeat Myself?

My apologies to those of you on my Yahoo Groups list. I sent out a message today about recent articles and upcoming speeches--a single message that turned into eight or so copies once it went through Yahoo Groups. The same thing seems to be happening throughout Yahoo Groups. I also got multiple copies of a message my next door neighbor sent to our condo association's list. I'd send an apology to the list, but I'm afraid the same thing would happen to it, and I don't want to further clutter your in boxes.

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