Empathy matters

Women: Imagine you’ve been having problems with pre-menstrual depression or unpleasant menopausal symptoms. Men: Imagine you’re having problems that are probably prostate-related, or maybe you’re having trouble getting it up. All else being equal (though of course it never is), would you rather see a male or a female physician?

Empathy matters. That’s why I’m not worried about the line from Sonia Sotomayor’s 2001 lecture, “I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn’t lived that life.”

Yes, she needs to explain what she did and did not mean—and I’m sure she’ll be given the opportunity to do so. Chances are, she did not mean that she would toss objective law out the window whenever a Latina woman walked into the courtroom. After all, in 1997 Sotomayor told Senator Jeff Sessions, “I do not believe we should bend the Constitution under any circumstance. It says what it says. We should do honor to it.”

And I’m guessing she didn’t mean she thinks that, all things being equal, Anglo-Saxon men make inferior judges. In the 2001 lecture, in fact, she said she believes “that we should not be so myopic as to believe that others of different experiences or backgrounds are incapable of understanding the values and needs of people from a different group. Many are so capable.”

The point is, all things are never equal, and with a diversified set of justices, unconscious prejudices—whether on the part of white males, Latina females, black males, Jewish females, or anyone else—are inevitably held up to the light.

In “The Waves Minority Judges Always Make,” New York Times legal correspondent Adam Liptak quotes several studies showing that not only do female and African-American judges often rule differently from their white male colleagues, their very presence also affects the way their colleagues understand the issues at stake.

“Anyone who has ever sat on a bench with other judges knows that judges are supposed to influence each other, and they do,” Justice Souter wrote in a 1998 dissent in a death penalty case. “One may see something the others did not see, and then they all take another look.”

I agree with Washington Post pundit Michael Gerson’s contention that “a court should be a place where all are judged impartially, as individuals.” However, when he goes on to say that “the Obama/Sotomayor doctrine of empathy challenges this long-established belief,” he shows a serious misunderstanding of how impartial judgments are made.

Without empathy, writes conservative columnist David Brooks, people “are not objective decision makers. They are sociopaths.”

As Dan Kahan of Yale Law School has pointed out, many disputes come about because two judges look at the same situation and they have different perceptions about what the most consequential facts are. One judge, with one set of internal models, may look at a case and perceive that the humiliation suffered by a 13-year-old girl during a strip search in a school or airport is the most consequential fact of the case. Another judge, with another set of internal models, may perceive that the security of the school or airport is the most consequential fact. People elevate and savor facts that conform to their pre-existing sensitivities.

For Brooks, the crucial question is how empathy is used: “Sonia Sotomayor will be a good justice if she can empathize with the many types of people and actions involved in a case, but a bad justice if she can only empathize with one type, one ethnic group or one social class.”

Right on, Mr. Brooks. Similarly, a well-trained, widely empathetic doctor can treat many symptoms and both genders—and indeed, I have had excellent male doctors. Nevertheless, when almost all doctors were males, diseases that afflicted mainly females remained largely unstudied, while studies on equal-opportunity diseases often used only male subjects. Medical science may have been objective, but without the necessary empathy, the practice of medicine was not.

I am not saying you should be thrilled about Sonia Sotomayor. Honestly, I don’t know enough about her to say one way or the other. I’m just saying—if we want objective, impartial judgments that result in equal justice for all, we’d better not throw empathy out the window.

Saving African mothers

“Pregnancy and childbirth kill more than 536,000 women a year, more than half of them in Africa,” writes Denise Grady from Tanzania in this morning’s New York Times. In her article, “Where Life’s Start Is a Deadly Risk,” she contrasts the World Health Organization’s estimation of Tanzania’s maternal mortality rate - 950 maternal deaths per 100,000 live births - with Ireland’s: 1 per 100,000.

Looked at another way, a Tanzanian woman has a 1 in 24 lifetime risk of dying in childbirth; an Irish woman’s risk is 1 in 47,600. (U.S. statistics, which you can check at the WHO website: a mortality rate of 11 deaths per 100,000 births, with a 1 in 4,800 lifetime risk.)

“The women who die are usually young and healthy, and their deaths needless,” Grady writes. “The five leading causes are bleeding, infection, high blood pressure, prolonged labor and botched abortions.”

Most women give birth at home (50%) or in local clinics (30%), going to a hospital—sometimes by bicycle!—only when they have been in labor for days and realize they need a Caesarean. Because hospitals are understaffed and overcrowded, the surgery may be performed by a physician’s assistant, and the woman may end up sharing a twin bed with another woman. This is scary enough to read about, but the shock value is even higher in the series of 21 photos, “Childbirth in Tanzania,” accompanying the article.

And yet “to persuade more women to give birth at the hospital instead of at home, [Berega] hospital is sending health workers with that message to marketplaces, churches, village elders and religious leaders.” For women who live far away, they are creating a maternity waiting home and are trying to get government funds for an ambulance.

As I read this, I wondered if this is an example of well-intentioned Westerners making a bad situation worse. It’s good to improve hospitals, to make them more easily accessible, to train health-care workers. But will better hospitals make a big difference in infant and maternal mortality rates in a culture where many women prefer to use traditional birth attendants, where many men insist that their wives give birth at home, where the journey to the hospital is long and difficult, where most people can’t afford even the low hospital fees, and where the hospitals themselves have high rates of infection?

Google sent me straight to the Horizon Solutions website. An article by Joyce Mulama titled “Africa: Upgrading Traditional Midwives’ Skills” discussed the high mortality rates, the conflict between traditional birth attendants and hospitals, attempts made to discourage the use of midwives, and the eventual realization that midwives and hospitals need to work together.

According to Warren Naamara, country coordinator in Ghana for the Joint United Nations Programme on HIV/AIDS, drawing traditional birth attendants into the health system will involve providing them with the means to work in a clean, safe environment—and also with education.

“It is all about training TBAs in how far they can and cannot go. There are some things they cannot do, like surgery,” he noted.

“Where they anticipate complications, let them refer such cases to the nearest delivery point, because their work has trained them to detect a woman who may not deliver smoothly.”

Interestingly, 30% of Dutch births take place at home, whereas fewer than 1% of U.S. births are home based. And yet the maternal death rate in the Netherlands is only about half that of the United States. Improving African hospitals is good, but training African midwives may save more mothers.

Review: Dark Fire

In C.J. Sansom's first Matthew Shardlake novel, Dissolution (reviewed here), the hunchback lawyer investigates evil events at a monastery that Henry VIII and his chief councillor, Thomas Cromwell, are planning to destroy. In this sequel, Dark Fire, Shardlake reluctantly sets off on another mission for Cromwell--and discovers a plot that will result in Cromwell's disgrace and death.

That last sentence was not a spoiler. The novel is set in 1540, and that was indeed the year that Lord Cromwell lost his head to an incompetent hatchet man who had to swing several times before the head was fully severed. King Henry was not pleased by the German wife (this would be number four) that Cromwell had found him, and he was no doubt irritated by his councillor's heavy-handed evangelicalism. (Cromwell may have been a reformer, but he was not a nice guy.) Besides, the king was infatuated by Catherine Howard, niece of the duke of Norfolk, a leader of the Catholic faction and ipso facto an enemy of Cromwell.

That said, the novel's plot is entirely invented, as good historical fiction should be; and this novel is exceptionally well-crafted with its strong characters; intricate, page-turning plot; and evocation of the sights, sounds, and smells of 16th-century London. Mysteries abound: Who pushed Ralph into the well? Why won't Elizabeth talk? What is being hidden in the well? What is dark fire? Why are all these people being killed? What's the connection with vodka? Can anybody be trusted?

Well, Shardlake can be--though he sometimes has a hard time realizing that his employees are human being with needs of their own. Guy, the dark-skinned apothecary, is solid. Joseph, the kindly uncle, is thoroughly good. And Barak? Oh, just go ahead and read the book.

The ministry of intercessory worry

Mr Neff and I used to say that our mothers practiced the ministry of intercessory worry. Nowadays that's called Generalized Anxiety Disorder (GAD!), and one of our descendants thinks she has it. She believes it was not handed down through the paternal line.

So I went to a web page at Helpguide.org, "How to Stop Worrying: Self-Help Strategies for Anxiety Relief," and read the six self-help tips, and then I clicked through to "Emotional Intelligence" and read about four core abilities and five key skills and three steps to stress busting, and then I decided to go to the library and check out The Feeling Good Handbook, which my descendant said was quite helpful.

But first I looked it up on amazon and discovered how to take the self-diagnosis quiz without actually buying the book. Hint: click "search inside this book," type in "Burns anxiety inventory," and click on the link for page 33. According to the inventory, I am mildly anxious. Given the questions, I believe that may indicate that I have a pulse.

Anyway, I headed off to the library, and by the time I got there, I could no longer remember the name of the book I had come to check out (did I mention that one of my worries is that some day I will develop Alzheimer's disease?). So I went to the new books display instead, and there I found Patricia Pearson's funny, wise, and informative little memoir, A Brief History of Anxiety: Yours and Mine. I was hooked when I read the last sentence of the author bio on the back jacket flap: "She lives in Toronto with her husband, her two children, and her dread."

The New York Times ran a good review and Salon.com ran an even better one, and rather than reviewing the book here I'll just refer you to those and let you know that I'm returning it in just a few minutes, so you can check it out if you hurry. And then I'll quote a paragraph from page 81 that I liked very much. It helps explain why "a person is four times more likely to suffer from generalized anxiety disorder in the United States than in Mexico."

"In Mexico," Margaret muses, "it is said that people work in order to have holidays." By this, she means that they do not work for material gain or for personal status, so much as for the freedom to be with their families and friends. Imagine that, I think to myself, having just read an article in the Toronto Globe and Mail warning that "Family life interference at work can lead to a stalled career." In Toronto it is best not to have families. In Mexico it is best not to have careers."

The Story of Stuff: a study guide

A year and a half ago, Annie Leonard released The Story of Stuff, a 20-minute video about the dangers of over-consumption. It "has become a sleeper hit in classrooms across the nation," Leslie Kaufman wrote in Sunday's New York Times: "So far, six million people have viewed the film at its site, storyofstuff.com, and millions more have seen it on YouTube. More than 7,000 schools, churches and others have ordered a DVD version, and hundreds of teachers have written Ms. Leonard to say they have assigned students to view it on the Web."

Critics object to the video's negative portrayal of big business, inaccuracies, and oversimplification. Even if you agree with Leonard’s main point—that we buy far too much, and that this is bad for us, for others, and for the earth—you may find the video unnecessarily confrontational.

Like it or not, chances are your kids (friends, relatives, coworkers) are going to watch this video, and it may come soon to a church near you. Stick with it, even if the first three minutes appall you. Leonard raises issues that Christians are already discussing (see, for example, the discussion of fair trade at the Ten Thousand Villages web site) and that we need to talk more about with our kids. For example:

• Let’s assume that some businesses do operate for the benefit of humankind and the earth. How do these businesses care for the environment? What are their policies on work hours? Wages? Health benefits? Child labor? The products they make? The way they market their products?
• Can a business care for the environment and its employees and still make a profit?
• How much of my identity is related to things I buy? Which of my purchases have made me happier? Am I happier today because of anything I bought last year?
  

My parish offers a two-year class in church history, and today we read an encyclical letter, “On the Development of Peoples,” written by Pope Paul VI in 1967. Noting that justice “calls for great generosity, willing sacrifice and diligent effort,” he made the discussion personal:

• Are we “prepared to support, at [our] own expense, projects and undertakings designed to help the needy?
• [Are we] prepared to pay higher taxes so that public authorities may expand their efforts in the work of development?
• [Are we] prepared to pay more for imported goods, so that the foreign producer may make a fairer profit?”

After thinking about these questions for a while, read the New Testament letter of James. It sounds like it was written directly to us.

Review: Animals Make Us Human

If you've read Animals in Translation, you already know author
Temple Grandin's theory that animals and people with autism perceive the world in similar ways. In their newest book, Animals Make Us Human, Grandin and co-author Catherine Johnson continue this theme, focusing on meeting animals' basic emotional needs in order to help them have the best possible life.

The book begins with dogs and cats, and I expected to lose interest when it moved on to horses, cows, pigs, and poultry. I figured I'd skim those chapters and slow down again when I got to wildlife and zoos. I was pleasantly surprised--the farm animals turned out to be as fascinating as the others. Best of all were the pigs.

"Almost everyone who spends a lot of time around pigs ends up thinking they're very smart animals," Grandin writes. "That's why George Orwell made the pigs the leaders of the revolution in Animal Farm. It's probably also why Winston Churchill said, 'I like pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.'" (174)

Unfortunately, all too often we treat pigs (and other farm animals) as raw material, with no concern for the animals' welfare. A sow, for example, is put in a gestation stall, where she is "kept confined during her entire pregnancy. The sow can lie down and stand up, but she cannot turn around. It's like being stuffed into the middle seat of a jam-packed jumbo jet for your whole adult life, and you're not ever allowed out in the aisle." (176)

Sow stalls were developed when pig farming was moved indoors. Farmers didn't know how to group the pigs so that they would live peaceably together (in another place Grandin explains how to do this), so they devised computerized feeders that allowed pigs access to the trough one at a time. "Electronics hadn't been miniaturized yet, so the sows had to wear a great big huge transponder the size of a tennis ball [attached to seat-belt strapping] around their necks to signal the gate." The devices were uncomfortable, though, so many of the pigs would chew through the strapping and remove them. "Some of the pigs figured out that the transponder was the key to the gate, so they'd pick up a chewed collar from the ground and carry it over to the gate and get to eat double rations while the other pig went hungry." (201)

You've got to love an animal as devious as that.

Grandin, who is autistic, nevertheless earned a PhD in animal science and is now an associate professor at Colorado State University. According to one of her web sites, "she has designed the facilities in which half the cattle are handled in the United States, consulting for firms such as Burger King, McDonald's, Swift and others." Thanks to her work, a lot of animals have much happier lives--and, as she points out, happier animals produce more and better meat.

To pastors, about your Mother's Day remarks

I don’t know how many pastors have noticed this, but as Mother’s Day approaches, a flurry of female bloggers are writing about the stress it can cause—especially for churchgoing women. See, for example, Vinita Hampton Wright’s post that begins, “I will not be attending church this Sunday, because it’s Mother’s Day... ,” or Caryn and Carla’s post on The Mommy Revolution titled “Mother’s Day Sermons ... Ugh.”

Here’s an idea, pastors. It’s partly mine, but it was inspired by e-mailed comments from a dear friend who will remain unnamed until she gives me permission to quote her. If you’re going to honor the mothers, do it like this:

1. First, do what you always do: have the mothers stand, give them roses (or chocolate, which is better), let them sit in peace but say nice things about them, whatever. Hint: avoid singling out the oldest mother or, heaven forbid, the mom with the most kids. Keep it brief.

2. Then honor all women who have ever loved a child. These may be aunts, big sisters, grandmothers, godmothers, foster mothers, cousins, family friends, teachers, catechists, nurses, therapists, nannies, librarians, doctors, neighbors, volunteers, coaches, social workers, house cleaners, crossing guards, school cafeteria employees... Be sure to give them chocolate too.

3. Finally, talk about the children in your parish and neighborhood who need love. My friend listed “hungry children; cocaine-addicted babies who need rocking; kids who need tutoring and school supplies; kids who need a Big Sister, foster mom, or adoptive mom.”

Suggest agencies that potential volunteers can contact. Where I live, that could include CASA (Court Appointed Special Advocates for Children) , the Evangelical Child and Family Agency, Outreach Community Ministries, People’s Resource Center , Marianjoy Rehabilition Hospital, and the Glen Ellyn Children’s Resource Center —to name just a few.

Pastors, it’s good to honor mothers (step one), but if you stop there, a lot of us feel left out. Keep going to steps two and three, and we can all feel included. Even the guys.

The matriarchal blessing

With Mother’s Day just around the corner, I’ve been thinking about the matriarchal blessing—the moment when an old woman, staring death in the eye, communicates to a younger female relative or friend that life is good and love is eternal.

As far as I know, the only mention in the Bible of an older woman blessing a younger woman is when Elizabeth says to her young, unwed, pregnant relative Mary: “Blessed are you among women, and blessed is the fruit of your womb” (Luke 1:42). Elizabeth probably wasn’t the matriarch of her family, and she wasn’t about to die, but her Spirit-inspired words were still similar to a matriarchal blessing. She welcomed the new life growing in Mary, and her loving hospitality surely must have given courage to the baffled young mother-to-be.

The more typical matriarchal blessing, however, is a deathbed event (think of Isaac blessing Esau and, inadvertently, Jacob; or Jacob blessing his own sons and grandsons).

“The last time I saw my mother alive was very, very special,” my friend Kathleen told me. Her mother, who was 90 years old, had been declining from Alzheimer’s disease for several years. “She was trying to talk about something but couldn't make words that were comprehensible, so she just decided to go to sleep. She must have napped for about a half hour. I stayed with her and held her hand. Her skin was so transparent that I wondered if she would die right then. But no. She woke up and squeezed my hand, and we had a chance to tell each other how much we loved each other. It was one of the best times I ever had with my mother.”

Kathleen and her mother exchanged very few words that day, but the message of love and continuity was clear. And sometimes the blessing is given with no words at all.

A week or so before my wedding date, my 91-year-old grandmother was taken to the hospital. She was not in pain, but she seemed to be in a coma. The doctors said she was dying. “Should I postpone the wedding?” I asked my parents. “No,” they said, “she would want you to go ahead.”

A few days before the wedding, I visited Grandma in the hospital. I took her hand, wondering if she sensed I was there. I spoke, wondering if she could hear. “Grandma,” I said, “I’m going to get married on Sunday.” She opened her eyes, pushed herself up on her elbows, and gave me a great big smile. I knew without a doubt that she had just given me her blessing.

My grandmother died about three weeks later, in April. Almost exactly 27 years after her death, my first grandchild was born. When Katie was five weeks old, she met my 85-year-old mother, her great-grandmother, for the first and only time. Mother had been suffering for six years with dementia. For more than a year, following a series of small strokes, she had been unable to speak. I visited her at the nursing home nearly every day, but it was impossible to know if anyone was at home behind her sad, blank eyes.

On Mother’s Day, four of us gathered in her room to honor her: me, my two daughters, and Katie. Mother was sitting in her recliner, and Molly carefully laid Katie on her lap, arranging Mother’s arms around the baby since Mother was unable to arrange them herself. (The picture at the beginning of this post shows my mother with her great-granddaughter.) Molly stepped back to look at the exhausted old woman cradling the healthy new baby—and suddenly Mother bent her head down and planted a kiss on baby Katie’s forehead.

That was a matriarchal blessing beyond all hoping.

Mother died quietly the following month. Katie is now a teenager. Life is good, and love is eternal.

Self-righteousness

I believe everything I wrote yesterday: torture is always wrong. No matter what.

However, last night I got to thinking about how very easy that is for me to say. I have never tortured anybody. I have never wanted to torture anybody. I have never even pulled the wings off a butterfly.

Nor am I in a position where I have the power to torture anybody, or to decide that anybody should be tortured, or to judge whether or not torture is legally permissible.

So, yes, torture is always wrong. But it's not something I've ever personally struggled with, so in making that judgment--the right judgment to make! and one that every Christian should agree with!--I can very easily slip into self-righteousness. I am right! (And I am, of course.) Those other Christians are wrong! (As indeed they are.) I am so much better than they are. (Whoa... not likely.)

Here's what I'm thinking I should do: pick a book of the Bible, any book. Read it for its big ideas. Try to identify its major ethical teachings, whether they are explicitly stated or implicit in the stories related. Look especially for areas where I clearly do not measure up. Ask myself why not, and see if I can do something about it--change an attitude, change a habit, add or subtract some activity, whatever.

I say I should do that. I don't know if I will. I expect it would be ever so much more difficult than saying torture is always wrong. Though of course it is very wrong, without exception.

Torture and white Christians

I am distressed by the Pew survey showing that of all religious groups, white evangelicals are most likely to approve of torture and white Catholics are second most likely. Yes, Catholics had the Spanish Inquisition and Puritans had the pillory, stocks, and branding, but I’d hoped we’d gotten past all that. Perhaps the survey results are just one more indication that the doctrine of total depravity is correct.

Fortunately, the survey doesn’t tell the whole story. The post by Mr Neff on CT’s LiveBlog notes that in 2006, Christianity Today magazine ran a cover story called “Five Reasons Torture Is Always Wrong,” and in 2007 a wide range of evangelical leaders signed a document called “An Evangelical Declaration Against Torture: Protecting Human Rights in an Age of Terror.” Many evangelicals are appalled by torture and have been speaking out against it for years.

Likewise, the Catechism of the Catholic Church said in 1997 that "Torture which uses physical or moral violence to extract confessions, punish the guilty, frighten opponents, or satisfy hatred is contrary to respect for the person and for human dignity," and the U.S. Conference of Catholic Bishops issued a document in February 2008 that began, "The Church stands firm in denouncing torture as it undermines and debases the dignity of both victims and perpetrators. Pope Benedict XVI said 'the prohibition against torture cannot be contravened under any circumstance.'"

What would the world think of Christians if we stood up for human rights for the poor as well as the rich, for the unborn as well as the born, for the old and sick as well as the young and healthy, for women and children as well as men, for the guilty as well as the innocent, for immigrants as well as citizens, for gays as well as straights, for Muslims as well as Christians, for enemies as well as friends—even when doing so is unpopular among our friends or downright dangerous, and even when we disagree with the people whose rights we are protecting?

Most Christians, thanks be to God, already stand up for human rights in most of those situations. Unfortunately, all of us (being human) find some causes more compatible than others, and all of us have blind spots. Perhaps the Pew survey will challenge us to reexamine our attitudes in those areas where our politics and the views of our friends may be at odds with the teachings of Jesus.