Light and Momentary

Not so fast

A new study by Colen and Ramey has been getting a lot of buzz: they argue that the long-term effects of breastfeeding have been exaggerated. In their study they looked at discordant siblings, pairs in which one child was breastfed and another was not. They found that the effects of breastfeeding were attenuated and that statistical significance evaporated.

As I've been writing this post in my head, it's been getting longer and longer. I am going to compel myself to be brief, and I also need to be clear that I don't yet have the full text of the paper. I'll report back when I get it. A few considerations:

1. Breastfeeding is not important because it is The Magic Elixir That Prevents All Ills. Breastfeeding is important because it has modest but statistically robust effects across a surprisingly large number of domains. Don't go looking for big effect sizes in long-term breastfeeding studies.

2. Especially don't go looking for big effect sizes in long-term breastfeeding studies of siblings. Of course you're going to see attenuated effects in discordant sibling pairs. Many traits are predicted by a mix of genetic and environmental factors. Siblings share, on average, 50% of their genes and a variable but important proportion of their environment. Breastfeeding doesn't override those predictors with its Magic Elixir-ness; it influences them to a modest but meaningful degree in population-based samples.

Two parents who each have a BMI of 25 are less likely to produce offspring with BMIs of 17 than two parents who each have a BMI at the low end of the normal range. Even if one of their kids is breastfed for 5 years, the mix of other genetic and environmental predictors is really important. It doesn't mean that breastfeeding can't influence BMI across populations just because you don't see big differences in their particular children.

3. "Statistical significance" is a moving target. It is not unusual at all to see attenuated effects and loss of statistical significance when you substantially reduce your sample size, as they did for the portion of the study that looked explicitly at siblings vs. the portion of the study that didn't. Something I can't tell from the abstract: how did they correct for multiple comparisons? When you look at a bunch of different outcomes in a single study, you have to account for the fact that you're running a lot of statistical tests. You don't want to say, "Hey, look! This is significant!" when it's really just random noise in your data. If, hypothetically, I wanted to publish a null finding on breastfeeding, I would look at several outcomes known to have modest effect sizes and use a Bonferroni correction for multiple comparisons. This would mean that instead of a p < .05, I'd need a much smaller (and thus less likely) p value to report statistically significant findings. Highly unlikely that a reviewer would complain; highly unlikely that I'd find statistically meaningful results (Again, I'll report back about what they actually did.) 

4. If you must look at breastfeeding outcomes in discordant sibling pairs, then please don't look at them in the 1979 NLSY cohort. Remember when Der et al. looked at IQ in discordant sibling pairs and were roundly criticized for their methodology? Like Colen and Ramey, they used -- wait for it! -- data from the 1979 NLSY cohort. Again, I can't say for sure what's going on without the full text. But it seems implausible that the issues raised in this comment by Melissa Bartick have been addressed adequately in the present analysis. A brief snip for those who don't want to click over: "All we can conclude from this study is that breastfeeding for a very short duration, with unspecified doses of breastmilk, in non-low birthweight children, had no effect." (P.S. about that quote: No idea if excluding LBW kids was a Der et al. decision that might be different in the Colen/Ramey study or a 1979 NLSY decision that affects both sets of results.)

To sum up: no one should breastfeed her baby because she thinks breastfeeding will cause him to stand head and shoulders above his peers, impervious to pain, suffering, and B-minuses on his report cards. At the very same time, no one should pay a whole lot of attention to a single study examining outcomes in a cohort where the median breastfeeding duration was 3 months. As I said at the beginning of this post, the long-term effects of breastfeeding are modest. Women need to do what works for their families and not worry that they are costing their child 15 IQ points by not breastfeeding him. But the effects of breastfeeding are also statistically robust, even in studies that address problematic covariates. (Half a standard deviation in verbal IQ! Best available study and it still blows my mind.) We owe it to ourselves, and to our kids, to build a culture in which breastfeeding can work for most families.

Tick-tock

Darn it, I was drafting a post about that new breastfeeding study when I suddenly noticed that it was almost 10:00. Its working title, "In which I opine that social scientists are more likely to do dodgy breastfeeding studies," will perhaps give you an idea of its content. 

If not for the 7 x 7 challenge I would glide off silently to bed. But I said I would post something today, so...here you go?

By request: getting better at knitting

Colette asked me to write about moving beyond the novice knitter stage, and I am happy to do so.

FIRST: find company. For me this was initially the Mason-Dixon ladies, whose first book I picked up serendipitously at the library in late 2006. Smart funny women who looked at their piano benches and said, "Hm, I think I'll knit a cushion cover for that"? Who knew? Ravelry has also made me a much better knitter, although I don't spend much time there. I don't have any local pals who like to knit as much as I do, but online acquaintances can share your enthusiasm too.

SECOND: learn new techniques on small projects. When I first I tried stranded colorwork and intarsia I was making kids' hats; the first time I felted something it was a little purse just large enough to hold my checkbook and keys. (How cute is Petely in that purse picture?) Kids' socks can teach you all kinds of things: using tiny needles, knitting in the round, slip-stitch patterning, short rows, picking up stitches, reading your decreases. They can get you started with grafting on a small scale, and if you mess it up it is unlikely that anyone will peek into the toes of your kids' socks to call you on it. It's still a drag if a small project is a total fiasco, but it's a small investment of time and money that can teach you something even as you gnash your teeth.

THIRD: look for projects that push your "MUST CAST ON" button. For me the first time this happened was Knitty's Ice Queen. I was so excited about putting on the finished product (which I still wear all the time, by the way) that I was willing to learn the stuff I didn't know. It felt a little extravagant to buy the skein of Kidsilk Haze, but OH did I want that cowl.

FOURTH: budget for good materials. I am not an extravagant person, I don't think, but I don't spend my knitting time with cheap yarn. I don't give up any of my limited stash space to acrylic; I rarely use cotton. I could buy a fair amount of bulky weight Red Heart for the cost of a skein of nice wool sock yarn, but I don't. I watch for sales; I peek in on eBay if I'm looking for a particular yarn that's out of my price range (score!); I bought a kit I really wanted from a destashing Raveler for a price I could stomach when the actual price tag left me wobbly. I recommend this strategy for two reasons: first, you are going to be spending a double-digit number of hours with the yarn running through your hands. The tactile experience matters. Second, wool is so much more forgiving than acrylic. You can't block acrylic; what's done is done.

FIFTH: consider your process/product balance. Hardcore process knitters may not finish projects; hardcore product knitters may develop tunnel vision. I have dialed back my product-knitter-ness a lot, and I am happier and more relaxed as a result. If the only goal is to finish with all speed, you may wind up stressed if something is harder than you expected or if you hit a snag.

SIXTH: learn to fix mistakes. I was making my mother a Seascape when I got a decrease backwards. I was so mad at myself (see above re: perfectionist product knitter). I was lying in bed feeling grouchy when it dawned on me that I could totally fix that mistake without tinking back. The next day...I did it! If you are not a novice knitter, you may wonder at that exclamation point. But I'm here to tell you, one exclamation point is restrained. If there's one thing that has made me a mellower and more fearless knitter, it is the knowledge that most mistakes can be fixed. I may not want to fix them. I may in fact burn through a number of pixels complaining loudly about fixing them. But fix them I usually can. So why worry about trying something new?

The Darwins' Immediate Book Meme

1. What book are you reading now?

Barchester Towers. I should have read it years ago. My husband and I share many tastes, but he is unreasonably squeamish about the 19th century. He told me for years that the only Dickens novel he liked was Tale of Two Cities, because it wasn't like any other Dickens novels. (But really, it is SO much like other Dickens novels.) Way back in 1991 he practically retched when I told him the senior seminar for comparative lit majors was on the 19th-century historical novel -- I do believe he'd have preferred to have a couple of fingernails ripped out. (Mostly I enjoyed the readings, although I did not love Salammbô.) I should have learned early to filter out his anti-19th-century bias. But when he talked about Trollope as reading one would only undertake as penance, I believed him. When he gave me a copy of Barchester Towers and said, "Here, I thought you might like this," in the same tone one might use while handing a box of laundry starch to a pica sufferer -- I said thank you wanly and put the book on the shelf.

But! I love it! I should have known I would. It is so witty, and the characters so interesting, that I can't wait to read more about the wily machinations of imaginary English clerics. Go figure. It's possible that 600 pages might be a whole lot of machinating, but I'm happy for now. 

2. What book did you just finish?

Have His Carcase. Finals prompted a Lord Peter Wimsey binge, because the idea of a world full of careful observations and sparkling language usage and a right answer that no one can argue with has a certain appeal at finals time. 

Stolen. This was a Lissa recommendation. In contrast to most Lissa recommendations, it didn't grab me.

Thea Gallas Always Gets Her Man. A budding lactation consultant solves a murder mystery! This must be the first time that the Journal of Human Lactation has featured in a book about body-hiding hoarders with dark personal histories.

When We Were On Fire. A memoir of growing up evangelical and becoming disillusioned. I think that this one and the previous one were both recommended by Rixa.

3. What do you plan to read next?

Stephanie Pearl-McPhee's newest is coming out on Monday.

4. What book do you keep meaning to finish?

Oh, ugh. In the fall of 2011 I bought Diane Ackerman's One Hundred Names for Love. I'm two-thirds of the way through. I also have had My Peace I Give You sitting partially read on my iPod for, like, ever. I'm generally a little obsessive about finishing books I buy from the Kindle store. We will not discuss my dusty pile of book-books.  

5. What book do you keep meaning to start?

Romola. I keep thinking that George Eliot should be my next multi-year reading project, and then I keep not reading George Eliot. I loved Adam Bede and Mill on the Floss and Silas Marner, but all of them took me a good long while to warm to. I did not love Middlemarch. Is that heresy?

6. What is your current reading trend?

Other bloggers' recommendations. I am a reed in the wind lately.

Here we go

I am going to do Jen's 7 x 7 thing. I am starting small.

Olympic glory, after a fashion

Have you been watching the Olympics, dear readers? Have you been saying to yourself, Yes, this triumph of the human spirit is all very well, and the things these people can accomplish while awash in lactic acid are remarkable, and the amount of body waxing undertaken by ice dancers is truly astonishing, but what I really want to know is this: HOW are Jamie Gladly's TEFKAR knitting projects coming along? Did she conquer that little sweater that went from vexing to utterly intolerable, or did she stab herself in the eye with a DPN/strangle herself with some superwash in an effort to avoid the disgrace of failing to complete the event?

I'm so glad you asked! I did indeed finish half of the projects I had on the needles, but not quite the half I expected. I did indeed finish my nephew's sweater, although the finished project contains a substantial fraction of my leached-out will to live. This sweater, man. It was one thing after another, culminating in the moment when I CUT A BIG HOLE in the cable panel with my very own scissors. But I? Prevailed. And? I timed the completion so I don't have to take it to the post office. That's Olympic spirit for you, I'm telling you. Details and pictures here for the knitters.

Dishcloths for our newly married favorite babysitter should have been a gimme. I just needed to weave in the ends. I wanted to glue them in place because cotton yarn + frequent washings = reappearing ends. My fabric glue is drying out, though, which makes using it trickier. During the Olympics I spent an absurd number of days thinking, "You should suck it up and find a toothpick or something. But fabric glue feels so icky when you get it on your fingers. Let's deal with that tomorrow." I finally smacked this one down during the closing ceremonies. Let's award me an 11 for procrastination and move along, shall we?

The surprise contender in this year's Games was a scarf I'd had languishing on the needles since June. I frogged it once to add garter borders. If I were really dedicated I would frog it again to knit it with three pattern repeats per row instead of four. It could use the extra length. Honestly, I don't see that happening.

The happiest project of the four was my mystery shawl. Dernit, I thought I had told you all about my mystery shawl in progress (sunshine, daffodils, trilobites), but a quick search fails to ratify this memory of mine and I don't have time for a longer search. Anyway: Ysolda did a mystery knitalong. I love her patterns and I am a sucker for a good MKAL. After some weirdness (on the pattern's part) and disgruntlement (on mine), the fifth clue was awesome (albeit lengthy) and all is forgiven.

Everything I have on the needles now is a big project. I am declaring this week Sweater Week. I'll let you know how it goes.

A letter to my former self, about getting in better shape

Hi, former self, this is your more fit future self with some thoughts for you.

1. Be patient. Fitness isn't something you can accomplish any more than laundry is something you can accomplish. You keep working at it. Some days it goes better than others. It's not about hitting a particular target as fast as possible and then resting on your laurels.

2. Sort out the medical stuff first. You are not having trouble running and swimming because you are lazy and out of shape. (Well, you are out of shape, but you're not that out of shape.) Get your arrhythmia diagnosed and treated and you'll be so much happier. It's considerably easier to run with a heart rate in the 140s-150s than to run with a heart rate in the 180s.

3. Groups are good. Let go of all those bad memories of junior high PE class. You are not the worst or the slowest. And if you were? The people leading the group are getting paid to help you make progress. "Torment students" is not written into their contracts like it was (or so I infer) for 80s PE teachers. Having a pal who expects you to show up and commiserates with you when you are sore afterward is worth gold.

4. Build a base. Slowly. (See point 1, though this is more about the physical and less about the psychological.) It takes time for your body to adapt to new things, but it will adapt. Give it enough time, and the thing that felled you in the first attempt will seem easy. Your first Pilates class will seem like a cruel joke, but a few years later you'll be listening for the instructor to say, "Now for those of you who need extra challenge..."

5. Listen to your body, but not too much. This is about being good to your body. So if your body says "No! Ouch! Bad!" -- pay attention. Injuries will interfere with the long-term goal of staying fit, so avoid the wishful thinking approach to pain. On the other hand, it's just a body and it's not in charge of higher reasoning. If it has been a body at rest, it will tend to stay at rest -- just like Newton said. When you make it go and it says "Noooooo, I was resting!" you can tell it to hush up already and stay in motion.

6. Get smart. Things have changed since junior high. Don't assume you know what you're doing. Read. Take classes. Watch. Listen to people with more experience. (And if you could just skip that whole thing where you try to run faster by lengthening your stride, it would save you a fair amount of hip pain.)

7. Build it into the budget. This is the only body you will ever have. Tend it well. It is worth investing your time and your money and your energy into staying fit. It will pay dividends in unexpected ways, influencing your anxiety level (downward), your confidence* (upward), and the frequency of your husband's appreciative comments (way way upward). A really hard workout may mean that your Saturday is less productive. It's still worth working out hard some Saturdays.

*The confidence part is not about having a rock star body or winning any races. The confidence part is about knowing that you can persist in the face of discomfort and discouragement, and about inhabiting your body with gratitude and a measure of grace.

8. Don't give too much weight to any one workout. Sometimes exercise feels great. Sometimes it feels like a steaming pile of futility. (Let's agree not to talk about today's run, okay?) Don't let a bad run get you down. Or when you finish a happy endorphin-buzz-y run in which you can see real progress, don't assume that your next run will be like that too. Just keep showing up.

9. Be brave. One day you will go to the adult swim clinic and you will say, "I was always a weak swimmer, and then somehow I forgot how to sequence stroke + breathing." The instructor will not laugh. It will pretty much suck to be working on rotary breathing again, but you will be glad you did it. Mix it up. Stretch yourself. It's probably salutary to feel like an idiot every now and again.

10. Accept yourself, strengths and liabilities. Your particular soul has been joined to your particular body, and they are a package deal. Your particular body is weirdly flexible, which is great for yoga. It is not so great for running speed. That's okay. Running can be a joyful thing even on the days when you wish you could do it faster.

11. You can aim for the middle. In every class you attend, you will notice the experts and the newbies. You will worry that you are too much like the newbies and not enough like the experts. You won't pay as much attention to the women in the middle. But for you, a person with five kids and a job, the middle is a good place to aim. You won't stay a newbie. You won't be an expert, or at least not at this writing. But something important will change: instead of being eager to leave, you'll be eager to come back.

Salt

Once in college I decided to cook red beans and rice for my roommates. These days that's a meal I could cook in my sleep, but back then it felt like A Project. I shopped and cooked and chopped onions and peeled garlic and when it was just about time to eat I tasted a spoonful.

If my oldest son had been there he would have said, "This tastes like sadness and despair." It tasted like nothing. It tasted like bleakness. It dawned on me that I had not salted the beans, and although I did not expect a big difference I added salt to the pot. And behold: angels sang, taste buds danced, and I sighed with relief.

Salt -- who knew?

I think about that moment whenever I hear the salt-of-the-earth gospel: I think about how in Christ we can be most authentically ourselves. It's been on my mind this winter-- maybe as I've been thinking over the fears that I was just blogging about, and trying to balance my ingrained fear of rejection against my conviction that God has good work for me to do in this position, and so I need to do it with the closest approximation of fearlessness that I can muster. (That clause needs to be smacked around with the cyber-version of a blue pencil, but I think I am going to focus on getting this written rather than getting it edited.)

Three specific stories:

1. It is too cold for our older car to start. Elwood and Alex take the van, leaving me to walk Stella down to preschool. It's only half a mile, but she doesn't like the cold and she doesn't like walking, and there's no way to push the stroller in this much snow. I am tempted to succumb to dread and hand-wringing, but I resolve to make the best of it. We have the nicest walk. We are polar explorers. We are brave lumberjacks. We make it to school with nary a tear shed, and I walk home happy for the time together. On the way home I keep seeing her little bootprints, and they stir up such tender thoughts for me. I think about her golden hair and her little girl voice and how much I love to see her smile. I think about how much I want her to know that she is loved. I am almost home when I see one of my own bootprints, right behind hers, and I am swamped with a surge of knowing: God loves me like that, only more so. 

2. This winter I remembered something I hadn't thought about in years. When I was a kid my parents were convinced that my hair could be persuaded to lie down flat if I just kept at it. The reality is that my hair doesn't do flat; it doesn't do lying down. I have crazy curly fountains of hair, and my life got a lot easier when I accepted that it would never be sleek. The memory was of a high school retreat, in which I discovered on arrival that I'd forgotten my hairbrush. I didn't know anyone there, and I felt awkward about borrowing a brush, so I just let it curl for the first time ever. I remember seeing my silhouette, with ringlets shooting off in all directions, and feeling simultaneously awkward and pleased. That was the weekend when I first encountered God as a Person, and just a couple of weeks ago it occurred to me that the timing made perfect sense: God as a Person made us to be persons. To be real. (Not that you can't be real if you brush your hair. I fear I am sacrificing sense for speed here.)

3. Last night my oldest took the younger kids to the Lego movie, and Elwood and I went out together for some adult conversation. We had this moment in the car that feels too intimate for me to describe here (a completely non-sexual kind of intimate, but so tender and goofy and hilarious that I want to keep it close), and as I was laughing almost too hard to steer Elwood said something that he says more often than I deserve. He said, "Oh, Jamie, I love being married to you." And it occurred to me that marriage is a powerful metaphor for Christ and the Church in part because marriage is about being known, inside and out, and loved anyway.

Approximately Seven Quick Takes: Nameless Winter Games Edition

1. It is time, my friends, for my very favorite sporting event. Not the thing in Russia: the very best sporting event. It used to be called the Ravelympics, but then the IOC got all cease-y and desist-y about that. Now it is technically called the Ravellenic Games, I think, but you and I know that it is still really the Ravelympics. There's a festival of knitting for the summer games, too, but do you want a big pile of wool in your lap in the middle of August? Maybe you do if you live in New Zealand. 

2. I do not live in New Zealand. I live in the Midwest, and it is really cold. Brrr. Bring the wool, baby!

3. During TEFKAR (The Event Formerly Known As Ravelympics) I am planning to finish half of my UFOs (unfinished objects, for all y'all non-knitters, though you probably skipped town in the first sentence, and maybe went searching for the unsub setting in Feedly, because DANG I am talking a lot about knitting so far in 2014).This is ambitious, but not insane. Or at least not very insane. Due for smiting: one baby sweater, one grown-up sweater (as of this morning, it was just a swatch), one wackadoodle shawl/wrap/lacy trilobite thing, and a pair of potholders that just need to have some ends woven in.

4. I think my job might interfere with these plans, potentially. Or at least the adult sweater part of these plans. There are always more stitches in an adult sweater than I seem to remember from the last time I made an adult sweater. 

5. All week I have been thinking about writing a work-related post and then feeling like a dork about the whole thing. So I will just tuck it into this post as a quick take. Here's the deal: my college has meetings for first-year professors about every six weeks. We come together, there's a topic and a little panel, and the idea is that we can talk about what we need to do to get tenure.

6. Last week the topic was networking, and the last question was "What are barriers to effective networking for you?" The question hung there in the silence for a moment, and then I answered it. The #1 barrier to effective networking for me is that there's a mental hurdle involved. Every time you reach out to establish contact, you're putting yourself and your ideas out there. And sure, some people say, "That's a great idea and I would love to work with you." 

Lots of people don't. And I'm not, like, wishing that the hospital administrators would be my best friends and have coffee with  me every Tuesday, but I still feel some reluctance about sending them my protocol and asking them to help me with recruitment because what if they hate it and say no? I don't let this keep me from doing it, but I have to acknowledge that this creates a mental barrier for me and I need to keep pushing past it.

7. So I said this and the room was silent-- nobody else, not one person, said, "Yeah, the rejection thing is a drag" or "Getting started means there's a lot of that." I have been trying not to let the awkward feeling get me down, because surely I'm not the only one even if I was the only one who spoke up. But still: awkward moment. 

7.5 But also a helpful moment. This week, in planning what I was going to do when, I said, "Okay, self, it's not realistic to send out the whole batch of protocols in one day. Mental load, and all that. Break it up. It's okay." 

More quick takes at Jen's.

Reformed. And not in a good way.

Last night while the rest of America was watching large men in tights hurl themselves at each other, I went to Sunday night PIlates class. I used to be a regular at Sunday night Pilates class, but I hadn't been in a while. I expected it would hurt, in a good way. (<- we got your foreshadowing right here, folks)

The parking lot was empty and there were only three people on the cardio equipment, so I was expecting a cozy group for class. There were seven of us, and as the teacher counted heads she said, "Would you guys like to go up and use the reformer equipment?" We agreed.

It was all right at first. The abs exercises were different but not brutal. The upper body stuff hurt, but then I don't have a lot of upper body strength. The teaser is easier on the reformer than the mat. But then we used the Chair of Doom, a torture device that left me gnashing my teeth as the lactic acid washed through me. I thought I had reasonably strong legs. I guess not.

After class there was an unexpected test of strength and balance. Under ordinary circumstances I would call it "walking downstairs to my car," but these were not ordinary circumstances. I got home and called a weak hello from the back door. I was hoping Elwood would come and rig up a pulley to get me up the four steps to the kitchen. Alas, I had to hoist my own sorry carcass up those steps.

Usually the mat class leaves me with a pleasant soreness in my abs and triceps, starting around noon the next day. The reformer class has left me aflame: quads, hamstrings, glutes, triceps. The ab soreness is almost incidental.

I was determined to run tonight, and so I plowed my way through 2.3 miles while counting every tenth. But I tell you what: I am more sore than I was after the births of my three youngest children. I am limping around like an old old lady who got hit by a couple of trucks. Come to think of it, I am more sore than I was the time I actually did get hit by a truck. (Have I ever told you that story?)

The marketing materials for reformer classes all say "You won't believe how quickly you see results!" and so I've been curious about what went on in the reformer room, but I never wanted to pay extra for a reformer class when mat class was included in the membership fee. I was pleased to be offered a chance to try the reformer, but it has shown me an important truth: sometimes when they offer you something for nothing, the thing they're really offering you is a hernia.

Freedom vs. freedom

The West Virginia water crisis has faded from the news, but it's not over. Freedom Industries relocated the MCHM to the town of Nitro. (Because I guess 5 Superfund sites aren't enough for a town of 7,000?) Their Nitro facility, where the last-resort containment wall has holes in it, has the advantage of not draining directly into the Elk River. Oh, no -- the Nitro facility drains into a ditch. Which drains into the Kanawha River. Aren't we glad that's under control?

Senator Joe Manchin was in the New York Times earlier this winter, talking about gun control. I thought about sending him an email after I read the article: he was trying to come up with some solutions after the Newtown shootings, and the NRA shut him right down. “That’s classy,” I thought, “to sponsor legislation like that when you’re from a state with such an established gun culture. That’s exactly what we need in this conversation, is some legislators who understand that you might want to go deer hunting in the fall but you surely don’t want kids getting shot in their school.” 

I won’t be calling him classy again anytime soon.

The next time I saw Joe Manchin in the New York Times he was thumbing his nose at the EPA. The people in my state want to be free, he said. That’s our motto: mountaineers are always free.

In my mind’s eye he is saying these earnest words with his mouth, while over his head he is holding flash cards. “Dear Chemical Industry,” they say. “We’re still friends, right? It won’t be long until my next campaign and I’m counting on your support.”

It doesn’t get much less classy than that. 

Southern West Virginians are in a bind: the coal and chemical industries keep them in groceries. It’s true even for people who aren’t directly employed by the mines and the plants—if you’re running a barbershop or a clothing store or a medical practice, you depend on the business of the people who make their living mining coal or hauling MCHM. If you’re a legislator from West Virginia, you want to keep these employers happy. So it might not surprise you to learn that two of the top three contributors to Manchin’s last Senate campaign were the mining and electric industries. The contributions from the chemical industry are smaller but not chump change, and they include personal contributions from executives at Freedom Industries. 

The thing that enrages me is the refusal to be transparent, to acknowledge the hazards of this dependence. When the CDC said pregnant women in WV shouldn’t drink the water, state officials rushed in to say they were overreacting. Memo to pregnant women in WV: go with the source that’s not taking money from the chemical industry.

Gestating babies and young children are uniquely vulnerable to toxin exposure, a fact unacknowledged by officials calling the CDC overcautious. Minor disruptions to fetal brain development can have lifelong effects. Because of their size, fetuses and children are exposed to higher toxin doses per unit of body weight, and their immature excretory systems are less able to filter foreign substances.

Often the effects of toxin exposure on cognition are modest, at least at the individual level. Still, while a 5-point drop in IQ won't make much difference for one child, the population effects are huge. Landrigan and Garg point out that "a 5-point drop in population mean IQ reduces by 50% the number of gifted children (IQ above 120) and increases by 50% the number with borderline IQ (IQ below 80). These are differences that have profound consequences for the intelligence and the accomplishment of a society." (There's a visual on p. 27 of this WHO document if you're interested.)

West Virginia legislators generally characterize themselves as pro-life, but where is the pro-life-ness in allowing their attention to industry concerns to outweigh their duty to protect unborn babies? Women seeking abortions in West Virginia are legally required to view an ultrasound of their baby, but where is the legal protection for all those other unborn babies? Miscarriage rates are higher in toxin-exposed populations, and diverse and worrisome effects can be measured in the babies who survive and the children they grow into.

Toxin exposure doesn’t only affect babies, of course. For adults, toxin exposure is associated with an increased risk of various forms of diseases including cancer. In the wake of the Freedom Industries spill, West Viriginians who have been assured that their water is safe may be breathing in carcinogens when they shower. I am no epidemiologist, but anecdotally I can tell you the trend is striking: cancer is rampant among my WV friends and acquaintances. I clicked on a Facebook page for dead alumni of my high school and it was sobering to see: cancer cancer cancer cancer cancer cancer cancer.

The real human costs are enormous and hard to measure. It makes me angry enough that they are less important than the industry profits, but the choice to re-label a refusal to protect citizens as “guarding their freedom” — that makes me incandesce every time I think about it. Be free—to miscarry that baby. Be free—to deal with your baby’s delayed development. Be free—to struggle through an ADHD diagnosis. Be free—to wonder why your child is struggling in school Be free— wander as far as your chemo infusion line will let you.

What the hell kind of freedom is that?

It's easy to think of this dependence on industries that generate hazardous substances as a problem confined to poor and backward southern West Virginia, but we are all part of it. If you are storing data in the cloud (and who isn’t?) you are participating in the increasing need for energy from coal-fired power plants. You probably didn’t know the guy from my high school who died in the horrible Massey explosion in 2009, but our collective demand for electricity played a role in his working conditions. And there isn’t really a great solution; it isn’t like West Virginians are saying, “Gee, I have lots of jobs to choose from but I think I’ll go expose myself to hazardous substances on a full-time basis.”

I wish the state’s elected officials would look at that truth squarely. I wish they could admit it: the management may have changed, but too many West Virginians are still in debt to the company store.