The value of tinkering

David Walmer was a fertility specialist at Duke University who went on a mission trip to Haiti in the early 1990s. While there, he was shocked to learn of the high rate of cervical cancer among Haitian women. A disease that is highly preventable was killing some 250,000 women a year in developing nations, and Haiti led the world in deaths from cervical cancer. Walmer knew he had to get involved.

Walmer returned to work in North Carolina and learned everything he could about cervical cancer, mainly that it can be detected for a decade before becoming untreatable. Detection is easy because unlike many cancers, it grows in a visible spot: on the outside of the cervix. Routine screening via Pap smears is the norm; before Pap smears became the de facto screening tool, cervical cancer killed more women than any other form of cancer.  Since the adoption of Pap smears, the death rate from cervical cancer has dropped by 70 percent. The CDC reports that in 2010 in the United States, 11,818 women were diagnosed with cervical cancer. Of those, less than 4,000 cases were fatal. Compare that to the CDC’s breast cancer stats for the same year: 206,966 women and 2,039 men were diagnosed with breast cancer. Of those, 40,996 women and 439 men died from breast cancer.  Therein lies the inherent value of a highly visible cancer

If a Pap smear detects abnormal cells, the next step is to examine the cervix via a special magnifying lens called a colposcope. Walmer realized that outfitting underdeveloped nations with colposcopes could make all the difference in preventing cervical cancer deaths, but that getting colposcopes into the hands of doctors in those nations would be unrealistic because of cost, size, and dependence on electricity. Undeterred, he opted to get creative.

He realized that a common surgical tool — the loupe — could provide magnification without electricity. To provide the contrast needed to detect suspicious cellular activity on the cervix, Walmer bought a Halogen bike headlamp and a green filter for a camera and began to tinker.

Giulia Forsythe

Giulia Forsythe

A colleague at Duke who taught biomedical engineering got wind of Walmer’s pet project and lent some muscle: namely students in his Engineering World Health club. One of those students, Theo Tam, recruited four other students to work on Walmer’s portable colposcope. These four young men were some of the brightest minds in the sciences and engineering student world, yet they were freaked out by the prospect of working on something so closely tied to the most intimate part of female anatomy. Tam says the other guys were willing to take on a multitude of projects designed to improve medical conditions in third-world countries, but not the portable colposcope.  “Anything but the V-word,” Tam says. “Imagine the horror.”

Tam also got creative, and convinced the guys to get involved with the parts of Walmer’s project not related to “the V-word”: marketing, finance, and other “safe” parts. Once they got past the horrifying idea of the female body part, the guys got to work. They assembled a prototype colposcope using lenses from a $2 pair of reading glasses, magnification from a $10 pair of binoculars, and lights from a $16 battery-powered LED. The first portable colposcope, named the CerviScope, was born. After a few more tweaks, it was ready to go. With help from a grant from an investment bank, the CerviScope was ready for mass production.

Walmer created a nonprofit, called Family Health Ministries, from his North Carolina home, to get the CerviScope into healthcare facilities in impoverished countries. FHM’s goal is to screen for and prevent cervical cancer. An integral part of achieving that goal is advocating for the HPV vaccine. The American Cancer Society also advocates for the HPV vaccine; read more about it here. The CDC provides compelling evidence for the HPV vaccine: A 2013 study shows that in the 8 years since the vaccine’s introduction, the virus has decreased 56 percent among girls ages 14 to 19. CDC Director Tom Frieden estimates that two-thirds of American girls aged 13 to 17 have not been vaccinated, and that the 2013 study proves that “the HPV vaccine works well, and the report should be a wake-up call to our nation to protect the next generation by increasing HPV vaccination rates.” Frieden warns that the low vaccination rates in the United States will equate to 50,000 new cases of cervical cases; cases that would be prevented with the vaccine.

There are many take-away messages from David Walmer’s story. That easily-visible cancers are much preferred to those that burrow deep into the body’s nooks & crannies. That even the most brilliant scientific male minds are rendered powerless by the female honey pot. That one finds one’s calling in the most unlikely places. And that tinkering definitely pays off. In a very big way.

 


The “Caged Bird” sings no more

Maya Angelou is dead. The world has lost a phenomenal woman. mayaangelou

 

Many tributes will be recited, many glasses will be raised, and we will mourn this phenomenal woman. Much will be said and memories will be traded about this phenomenal woman. Lovers of well-crafted poems and admirers of carefully honed words will re-read the vast catalog of work produced by this phenomenal woman.

Maya Angelou’s dear friend Oprah Winfrey offered this statement: “What stands out to me most about Maya Angelou is not what she has done or written or spoken, it’s how she lived her life. She moved through the world with unshakeable calm, confidence and a fierce grace.”

Fierce grace. Only a phenomenal woman can move in that way.

Although her pedigree was short, her accomplishments were long: she was San Francisco’s first female and first black streetcar conductor. She was a singer, a dancer, a novelist, a succesful single mom, an actress, a civil rights activist, a poet, a teacher, a playwright, a university professor, and a holder of 30 honorary doctoral degrees. She was nominated for a Pulitzer and a Tony and three Grammys. She was awarded the Presidential Medal of Freedom. She was a bad-ass. 

This phenomenal woman spoke from the heart and did not mince words. Her friend James Baldwin paid her a high compliment when he said that she could hold both her liquor and her positions. 

Two of Maya Angelou’s quotes ran through my head often while I was enduring the shit-storm that is cancer: “We may encounter many defeats, but we must not be defeated.” And “You may not control all the events that happen to you, but you can decide not to be reduced by them.” She came to know the truth in those profound statements from the earliest days, when she was raped by her mother’s boyfriend at age 7. Yes, you read that right: age 7. Seven. An incident she described as “a breaking and entering when even the senses are torn apart.” Yet this phenomenal woman would not be broken by it. Instead, she wrote I Know Why the Caged Bird Sings, which won the National Book Award in 1970 and was on the NYT bestseller list for two years. “The caged bird sings with a fearful trill, of things unknown but longed for still.”

Despite her early, unimaginable hardship, this phenomenal woman lived to teach and to give. She said, “I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands; you need to be able to throw something back.”

I for one am immeasurably grateful for all she threw back.

She refused to be discouraged by the many obstacles standing in the way of a young black woman in the South in the early days of civil rights. In her poem “Still I Rise,” she challenged and persevered:

Does my sassiness upset you?

Why are you beset with gloom?

‘Cause I walk like I’ve got oil wells

Pumping in my living room.

Just like moons and like suns,

With the certainty of tides,

Just like hopes springing high,

Still I’ll Rise.

You may shoot me with your words,

You may cut me with your eyes,

You may kill me with your hatefulness,

But still, like air, I’ll rise.

My all-time favorite Maya Angelou poem is “Phenomenal Woman.” It’s too good to excerpt, so here it is, in its entirety. If I ruled the world, I would make it required reading for every girl and women on this earth, in hopes of it curing insecurity and self-doubt. I would require every male on this earth to memorize this poem, in hopes of eradicating crimes against women, both emotional and physical.

Phenomenal Woman
Pretty women wonder where my secret lies.
I’m not cute or built to suit a fashion model’s size
But when I start to tell them,
They think I’m telling lies.
I say,
It’s in the reach of my arms,
The span of my hips,
The stride of my step,
The curl of my lips.
I’m a woman
Phenomenally.
Phenomenal woman,
That’s me.
I walk into a room
Just as cool as you please,
And to a man,
The fellows stand or
Fall down on their knees.
Then they swarm around me,
A hive of honey bees.
I say,
It’s the fire in my eyes,
And the flash of my teeth,
The swing in my waist,
And the joy in my feet.
I’m a woman
Phenomenally.
Phenomenal woman,
That’s me.

Men themselves have wondered

What they see in me.

They try so much
But they can’t touch
My inner mystery.
When I try to show them,
They say they still can’t see.
I say,
It’s in the arch of my back,
The sun of my smile,
The ride of my breasts,
The grace of my style.
I’m a woman
Phenomenally.
Phenomenal woman,
That’s me.

Now you understand

Just why my head’s not bowed.
I don’t shout or jump about
Or have to talk real loud.
When you see me passing,
It ought to make you proud.
I say,
It’s in the click of my heels,
The bend of my hair,
the palm of my hand,
The need for my care.
’Cause I’m a woman
Phenomenally.
Phenomenal woman,
That’s me.

maya-angelou-2

All quiet on the southern front

There’s no one reason for my blogging hiatus. Once we got settled into the new house, I could have resumed blogging. I thought about it many times, and even bookmarked several articles as good potential blog fodder. Fodder or no, my heart has not been in it. I’m a believer in this statement by Gandhi:

google images

google images

If something is truly important, that’s what we do. That which is most important is what we make happen. So as much as I have thought about blogging, I haven’t made it happen. A recent conversation with a dear friend helped me realize that I miss blogging, and that it provides a necessary outlet for thoughts, fears, and ideas. And venting.

A few weeks ago, I realized that the anniversary of my cancer diagnosis was approaching. Yesterday was the fourth anniversary of my bilateral mastectomy.

mastectomy day -- hooray!

mastectomy day — hooray!

Four years a survivor. Somehow that doesn’t have quite the emotional “oomph” as Twelve Years a Slave, yet we mark the events in our lives — both positive and negative — in years, and we celebrate or commemorate anniversaries.

I’m not sure how I feel about another year of survivorship. It’s a prickly issue, and one in which the face of a very public disease gives way to a very personal struggle. The obvious-seeming emotion about surviving cancer would be relief, to be glad it’s gone. But here’s the prickly part: it’s never really gone. Instead, it’s the monkey on my back that manifests in every twinge or symptom that might possibly signal a recurrence; a random bone ache is surely a sign of mets. It’s the generalized anxiety about if or when recurrence will strike. It’s the niggling thoughts in the dark of night about the presence of micromets in the area formerly known as my breasts. It’s the questioning of every decision made along this “cancer journey.” Did I do enough? How much is enough?

Does it ever get easier, this uneasy survivorhood? Perhaps. Like grief, it becomes less raw, less all-consuming. But it doesn’t go away. As I’ve written about before, it’s never over. While some like to celebrate the anniversaries of survivorhood, I’m leaning more toward ignoring them, to not calling attention to them in hopes of not jinxing myself. It’s a personal choice, with no right or wrong status. I notice the dates as they approach, but instead of stopping to acknowledge them and the myriad emotions they evoke, I keep my eyes on the horizon.