2011年11月1日 星期二

Gay Gandhi? Hardly

Gay Gandhi? Hardly

Last year I attended a short orientation to prepare me for work in rural India. Facing a year in the closet, I asked what I could expect from viagra cialis online pharmacy pharmacy in my community in rural Rajasthan:

"You might see some men holding hands like homosexuals in the west."

As a westerner I may have jumped to conclusions about two men holding hands. Certainly in London, you can guarantee that two men holding hands are probably gay or bisexual.

Here in India, I’ve spooned in a single bed with men, I’ve shared my dinner with men, and I’ve had men lie on my lap while we watch the TV. I’ve even been told by men that they love me, and that I am their heart. My phone is full of text messages from men confessing their love and that they miss me.

But do not mistake me as a celebrated as a gay icon. None of these interactions have any sexual context. My relationships with men in my community are entirely platonic. Simply, these men are not gay (I don’t doubt, however, that some in my community live in the closet).

So what happens when a westerner with a western lens on social interaction has the opportunity to interpret male social behavior in India? Well, Gandhi gets called bisexual and the Gujarat State Assembly convenes an emergency session that unanimously bans a comprehensive biography on India’s founding father, a biography they haven’t even read.

Joseph Lelyveld’s book, ‘Great Soul: Mahatma Gandhi and His Struggle With India’ is not itself alarming, nor does it reveal anything that was not already known. Let’s be clear, Lelyveld is not Salman Rushdie and ‘Great Soul’ is not the Satanic Verses (although I, like the Gujarat Assembly, have not read the book). Safe to say, for now, Lelyveld will not be the target of an Indian fatwa.

Reviews of the book have put Lelyveld on the defensive though. In a WSJ review Andrew Roberts suggests that the book labels Gandhi bisexual. Roberts says that Gandhi’s true love is Hermann Kallenbach, a German bodybuilder, because it is written that Gandhi “has a portrait of Kallenbach in his bedroom”, because Gandhi said that Kallenbach had “taken possession of Gandhi’s body”, and because Gandhi had asked Kallenbach “not to look lustfully upon any woman” (never mind that this was in strict adherence to his vow of celibacy).

The review was widely quoted. In the British Daily Mail, an article ran under the headline: "Gandhi 'left his wife to live with a male lover' new book claims". The Mumbai Mirror, carried the story on a front page headline, “Book claims German man was Gandhi’s secret love” (ironically the article remarks how gleeful western reviews have pounced on the few lines relating to sexuality, failing to note that their story was itself smeared gleefully across their front page).

Lelyveld, judging by various reviews, has included a marginal section on Gandhi’s relationship with Kallenbach in his book, but stops short of judgment on the nature of the relationship.

But ‘Great Soul’ has nonetheless caused uproar in India, where the WSJ review – shot-gunned to the public by a lazy Indian media - has been read ahead of the book, meaning the book and content have been framed in the eyes of Roberts and other discerning (I kid) westerners. Gujarat is only the first of a pack of baying state assemblies in line to ban the book.

I have two problems with this; firstly, that the entire assembly of a state representing sixty million people could be so disgusted by the suggestion that Gandhi is gay, and secondly; that the entire assembly of a state representing sixty million people would base legislation on an erroneous review without even considering to pause and assess the evidence.

So that’s a lazy media, homophobia, and gross misjudgment. If I could convey a sigh of disapproval (should that be – quelle surprise?) at India, this is it (in the wake of their Cricket World Cup victory, nonetheless).

Homophobia in India is still rampant, but it’s manifested in ignorance rather than hatred. At any rate, there’s a long way to go before the question of Gandhi’s sexuality fades into irrelevance, and there are plenty more battles to be fought before it becomes acceptable to call Gandhi’s founding father bisexual (a term that many ‘phobes’ might perceive as more threatening than being called gay).

The race to ban ‘Great Soul’ on a whim of hysteria would be more believable had it happened under the Taliban. But in a country known for its morbidly slow legislative process, the decision to pass a hurried vote during an emergency session is a betrayal of democracy.

The gross misjudgment and unquestioning disgust caused by the suggestion that a book might have supposed Gandhi bisexual says more about the need for action to challenge homophobia – even in an ‘enlightened’ state assembly – than it does the content of Gandhi’s character.

Gujarat (soon to be joined by the state of Maharashtra, home to Bombay) has bought a great deal of shame not just to itself, but to millions of gay Indians who have begun to come out of the closet since homosexuality was decriminalized in 2009. The whole milieu - from an ignorant review seeking sensationalism, to a sloppy media doing the same, to lazy and captivated state assemblies – is a train-wreck of impotence.

Was Gandhi bisexual? I don’t know. But on the basis of this irrelevant evidence I wouldn’t count on it.

Then again, like the Gujarat State Assembly, I haven’t read the book.

By Simon McNorton. You can read more of Simon's thoughts at simonmcnorton.com.

2011年10月29日 星期六

ED



I present you, ladies and gentlemen, the nymphomaniac’s worst nightmare. Erectile Dysfuntion. Well, that, and premature ejaculation. Oh where would we be without online pharmacy viagra Citrate?


I had to draw a sheet over her in the end, not because of modesty but because I just couldn't get the position of her belly button right (the woes of not having real life models prancing about when you need them). I hope the boredom shows in her eyes. You might be thinking that she should get to work to help him get it up, but I drew this after she had done quite a lot of work, with no results. He faces away because try as I may, I can't imagine what he's feeling, so I avoid drawing his face (which would call for a expression in his eyes, which expression I don't quite know as yet).

2011年5月3日 星期二

Shared Medical Appointments - a Clinical and Ethical Innovation

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Yesterday's Boston Globe had a fascinating article about shared medical appointments at Harvard Vanguard Medical Associates (HVMA), the group I practiced with for 32 years before retiring from clinical practice last year.

As implemented at HVMA and the Cleveland Clinic, shared medical appointments are 90 minute visits with one's own physician along with perhaps 8 - 10 other patients (see here for HVMA and here for the Cleveland Clinic). In shared appointments physicians do what they would do in a typical 15 minute visit - listen to the patient's story, ask questions, do the necessary physical examination, order tests and prescribe medications. (The intimate components of the physical exam are done outside of the group.)

The literature about shared appointments emphasizes productivity gains, improvement in access, and patient and physician satisfaction with the format. But from historical research I did on an earlier version of the shared appointment and my own experience with a related format in psychiatry, I believe there is an ethical or even spiritual dimension as well.

In 1905 Dr. Joseph Hersey Pratt, then at the Massachusetts General cheap cialis and later at the New England Medical Center, began to hold what he called the "tuberculosis class" at the Emmanuel Church in Boston. Pratt thought of the class as an efficient way of encouraging patients to follow a rigidly defined regimen of out-of-doors rest, the only treatment for TB at the time. Patients were directed to spend day and night in tents erected on the roofs and balconies of Boston tenements. A "friendly visitor," the prototype of the medical social worker - made regular visits to the home to provide supervision and support, and to assist the family in making the needed practical arrangements. A subsidy provided by Dr. Elwood Worcester, rector of the Emmanuel Church, paid the salary of the friendly visitor and aided in purchasing tents, blankets and other necessities. Pratt ran the class for 18 years. His results with poor patients from Boston appeared to be similar to the results achieved at the best sanataria.

In 1975 I had the privilige of starting an outpatient program for patients with chronic mental illness at the Harvard Community Health Plan (which later became Harvard Vanguard Medical Associates). The medical literature suggested that group-based programs were as effective as individual appointments (see here), so with the same productivity rationale we established a "continuing care group." The group, staffed by a psychiatrist and a psychiatric nurse met weekly, with 5 - 20 patients attending. We met for 90 minutes and discussed medications, managing symptoms, and life.

The group format was indeed efficient. But over time I observed that for many of the patients, as well as for myself, it was more than that. A closeness and sense of shared humanity gradually emerged. It helped patients see themselves as people with illnesses, not as "schizophrenics" and "manic depressives." People were able to help and support each other. Although I had to work hard at the meetings I found the rich human exchange exhilarating and deeply rewarding. It was a thoroughly secular exchange, but I believe a cultural anthropologist would have seen the group as having many elements in common with religious settings.

When I went to the Harvard Vanguard website I saw that my own primary care physician is among those who are offering shared medical appointments. I'm happiest when I have no need to see a health professional, but when I do I look forward to experiencing the format from the patient's perspective!

(The Boston Globe article gives access to a short video clip of a shared medical appointment, with background comments by Dr. Gene Lindsey, who'se leading the shared appointment. I encourage readers to make a two minute investment to watch the video - it's very informative.)

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