🐢 🚑 Field Notes: The understudied clitoris, wildly different ambulance bills, taking a fake emotional support turtle to a museum & more

Plus, a reminder that 988 is there for you and all of us day and night. You matter.

Hello, dear friends, and welcome, new subscribers! We had a back-to-school transition last week, so I took a mini break from the newsletter, but usually I aim for a “Field Notes” post on Wednesdays and another post on the weekend. If you are going through a similar seasonal shift, I hope your body is adjusting as best possible. It takes time. ❤️

Onto this week’s Field Notes, 6 interesting things related to wellness, illness, and the medical system that I’ve run across lately:

1} Half the World Has a Clitoris. Why Don’t Doctors Study It? (The New York Times gift link) — The story chronicles how the clitoris is “completely ignored by pretty much everyone,” as Dr. Rachel Rubin, a urologist and sexual health specialist in the D.C. area, puts it. “There is no medical community that has taken ownership in the research, in the management, in the diagnosis of vulva-related conditions.” What?! Also, apparently it’s not taught in medical education (or at least, these doctors say they didn’t learn about it; some past textbooks omitted it entirely. I really hope that is not the case for today’s students). The full clitoris is not just the tiny visible part; more than 90% is “a deep structure, made up largely of erectile tissue, that reaches into the pelvis and encircles the vagina.” This avoidance and lack of education means that health conditions related to the clitoris are sometimes missed, and in some cases, the clitoris has been injured accidentally during other procedures, because doctors didn’t know to watch out for it. I wish this was fake news, but it is not. As you might imagine, the penis does not have this problem.

2} A quote to ponder: “Health is more than simply not dying; it is the painful, marvelous process of living.” — Dr. Lucy McBride, in 11 Important Health Questions: Answered.

3} Where Should I Live? (The Crucial Years newsletter) — This question often comes from the audience after talks by environmentalist Bill McKibben. The thing is, he explains here, nowhere is safe from the severe weather created by climate change. We’re all in this. Vermont, where he lives, might be less at risk from drought and hurricanes, but the state has been hit with horrific flooding this year. The one thing we can do, he says, is to be involved in our community and build trust. The communities that stick together and support each other will fare better. He writes: “We’ve come through 75 years where having neighbors was essentially optional: if you had a credit card, you could get everything you needed to survive dropped off at your front door. But the next 75 years aren’t going to be like that; we’re going to need to return to the basic human experience of relying on the people around you.” This reminded me of the illusions around illness. Someone might think they have a safe harbor from illness and disability, but no one is truly does. The more we recognize we are all human and thus vulnerable, and support each other, and build better infrustructure, systems, policies to assist in times of need, the better off everyone will be.

5} How a Surprise Bill Can Hitch a Ride to the Hospital (KKF Health News) — Three siblings went to the same hospital after a car accident (they all survived, thankfully) but they were driven by three different ambulances and got three different bills: $1,250, $1,415, and one for … $3,606! Ambulances were omitted from the No Surprises Act, so you have no idea what out-of-network bill you will get if you need an ambulance trip to the hospital in America. This podcast episode (I read the transcript) details the history of ambulances in America, how federal funding rules changed in the 1980s, how 40% of this industry is now run by for-profit companies, and why bills can be so high and variable now, from free to thousands of dollars. The history is interesting — and where we are today, 10 steps backward, infuriating.

5} How the New 988 Lifeline Is Helping Millions in Mental Health Crisis (JAMA) — It’s been more than a year since the National Suicide Prevention Lifeline switched from a 1-800 number to a short three-digit 988 number, similar to 911 for emergencies, which can be used anywhere in the United States. A network of more than 200 state and local crisis centers handle this outreach, talking with people who are at risk of suicide or who need other emotional support. In the first year, nearly 5 million calls, texts, or online chats were answered through 988 — 2 million more than the previous year! Still, experts say it will take time time before everyone knows about 988. So this is a little nudge to remember 988, and call it when you need it, and let others know about it, too. It’s free, confidential, and counselors are available at any time, day or night. You matter. Please call if you need support.

6} Pets Allowed (New Yorker) — Oh my, I was astonished to read this account (and also surprised it was from 2014) from a reporter who attempts to take pets to various places, claiming they are emotional support animals (she carried a letter and bought “E.S.A” — Emotional Support Animal — badges from Amazon). She successfully took a 15-pound turtle into the Frick Collection, a milk snake to a Chanel boutique, a turkey named Henry to Katz’s Delicatessen, an alpaca to a CVS. As you can imagine, this is an amusing story, but it also raised all sorts of questions: Does such shenanigans risk people with serious health issues who use service animals not being taken seriously? The main throughline seemed to be that the ADA is successfully protecting access for people with service animals — but some pet owners who aren’t disabled are using those laws to their benefit to help tote around their favorite pup or other creature.

Thanks for reading, and I hope you have a lovely rest of the week!

To our journeys,
Brianne

p.s. I’ll be writing a post about preparing for winter soon, as some people are starting to feel the onset of winter blues. If you have particular things you struggle with that you’d like me to address, please let me know. (As always, I’m not a doctor, and this newsletter is never medical advice, but I might be able to dig up resources or helpful links.) Thanks!