Julie L. Kessler
lawyer traveler writer


Practice…if you can get to the courthouse

Oct. 30, 2013

My article "Practiceif you can get to the courthouse," which covered the historically groundbreaking move of the Saudi Arabian Minister of Justice that granted the first four Saudi women licenses to practice law in the kingdom, appeared on the front page of yesterday’s edition of The L.A. Daily Journal. The article also discussed in detail the irony of this historic event in light of the fact that women in the kingdom still do not possess the right to drive themselves to the courthouse where they may now finally enter. Saudi Arabia remains the only country in the world where women are not issued driver’s licenses.


Full article off copyright and now available:


A lovely honor from the Isaac Brock Society

Oct. 28, 2013

As you may know, I recently wrote about the Foreign Account Tax Compliance Act (FATCA) in an article that appeared on October 18th in the Los Angeles Daily Journal. The Isaac Brock Society, a group of “individuals who are concerned about the treatment by the United States government of U.S. persons who live in Canada and abroad,” has awarded me a place in its Hall of Fame for this piece. While I was not aware of the Society before having written this article, I was very pleased to learn of the award. The unintended ramifications of FATCA for Americans living abroad–and, in some cases, their spouses and dependents, even if those people aren’t American citizens–are serious, and I am glad that my article has helped to raise awareness of the Act and its collateral effects.

The expats’ dilemma–article published in the L.A. Daily Journal

Oct. 24, 2013

An article I wrote on the impact of the Foreign Account Tax Compliance Act (FATCA) on U.S. citizens living abroad was picked up for publication by the Los Angeles Daily Journal and appeared in its October 18, 2013 edition. I’m very pleased to have my work appear in the LADJ, the premier legal publication on the west coast. The LADJ  is a subscriber newspaper in both its print and on-line formats; however, the article is now off copyright, and you may read it below:


The college conundrum

Oct. 23, 2013

The November 1st deadline for early-decision college applications is fast approaching. Thankfully, the two remaining teen people — Irish twins — who live in our home and for some odd reason keep calling us Mom and Dad have both completed their college essays and supplemental information, and have turned everything in with eight days to spare. In terms of earthly miracles, and setting aside the ten plagues visited upon Pharaoh, that’s on par with the parting of the Red Sea by Moses himself. Getting something done and sent in before the deadline is, for a teenager, the equivalent of a Herculean sprint. Now, however, is the real test: the mad marathon to hurry up and wait for the finish line — the acceptance letters. Which, of course, in reality, represents only the starting gate for their respective futures.


And what a process it is. There are the AP course exams, the PSAT testing, the SAT test and the SAT subject tests. Then there is the CommonApp (which this year was replete with blood-pressure-busting techno-errors), the general essays, the specific university essays, arranging for teacher and academic counselor recommendation letters, and on and on and on. The last few months of their lives have been utterly consumed with drafts, rewrites, computer glitches, Office Depot runs, and the requisite Starbucks pit-stops to refuel. This was all in addition to their regular senior workloads, hospital volunteer work for one, portfolio accumulation for the other, club fund-raising, babysitting, and tutoring gigs, with a bi-weekly or so reminder to us of their respective names, since they were spotted upright only on rare late-night refrigerator raids. Our teenaged daughter actually gets less sleep than I do, and I hardly get any, so I have no real understanding of how she manages to get the grades she does and cram all of the activities and commitments she has into her conscious hours without keeling over; this is apparently the province of the young and hormonally over-endowed.


Such is the final year of the early-21st-century high school senior—incredibly busy, neurotically competitive, and a more than a bit chaotic. My husband and I have often commented on how much more insane it is now then when we were approaching the end of high school back in the dark ages, long before cell phones, computers, and social media invaded our universe. (For those of you under 30 and wondering how we survived, I had a behemoth IBM Correcting Selectric — the very mother of all electric typewriters—and my husband, who is still today is a proud two-fingered typist, had a Dictaphone and a perpetual roll of dimes for the payphone!)


Now it also seems that the idea of college discovery and the fostering of one’s passion has been replaced with the concept that a student’s passion must already be fully developed and, as a practical matter, wholly realized before he or she even gets to university. How can that be? How on earth can a 17-year-old possibly know, much less be absolutely resolute about, what precisely is his or her calling? When did things change so drastically?


I suppose I will really sound like a T. rex here, but it used to be that the whole point of going off to university was to uncover, discover, and polish what it was that floated your boat. Not so any more. With the competition as fierce as it is, high-school seniors today not only have to have their personal road maps and necessary prerequisites firmly in place, but also have to compete with kids who have discovered new diagnostic methods for pancreatic cancer screenings (as seen last week on 60 Minutes), climbed Kilimanjaro earning the trip’s expenses through massive on-line fundraising via kickstarter, or spent the last four years manning (or rather womaning) the telephones at a community rape crisis center.


These are all, of course, wonderful and commendable, but it seems that something has gotten lost along the way. Sometimes you need to just be, to explore and question in order to find your real passion and your place. To take courses in foreign languages because they tickle your tongue’s fancy, to study literature because it feeds your soul, to learn history because as a society we make the same damned mistakes over and over and over again anyway, to understand world religions so one can grasp the genesis of so many of those mistakes, to study ethics so we can think about the vexing problems we face, and of course to study the arts so we can fully appreciate humanity’s enormous contributions to the beauty that surrounds us, despite the gargantuan problems that plague us.


As a parent I am hopeful (okay—on my knees, lost in resolute prayer) that these two remaining at home are competitive enough so that they will get into one of their top choice schools (if for no other reason than to end the seemingly never-ending conversation on the topic that threatens the very vestiges of what remains of my sanity).

Then, of course, will come the next huge hurdle: getting a job.


The anemic job market these young people will probably face when it comes time for them to seek employment means that the markets will disproportionately recompense those who graduate in the STEM fields (science, technology, engineering, and math). There are countless studies reminding us practically daily of how far and how fast we in America are falling behind our counterparts in Europe and Asia in these arenas. I don’t doubt this, especially given the state of many public schools in the U.S., and the over all standardized test scores seem to prove it.


As a parent who wishes the front door of our home to be open for meals, holidays, and family gatherings, I also wish not to manage a perpetual boarding house into my own retirement at the ripe young age of 106. So of course I wish for them to find rewarding jobs after university that will not only feed their souls, but also pay their mortgages (and hefty student loans). So while medicine, business, and computers will probably do the latter, I truly hope they will have a shot at the former by having the opportunity to study the humanities in depth while at university. What is sometimes lost in the translation of the books-for-bucks mentality is that the humanities provide an essential context for students’ understanding of and participation in the world. The next generation of leaders in a world connected at virtually the push of a button will require not just a desire to be part of the shared common experience, but also a worldly perspective born of curiosity, intelligence and sensitivity. Those traits come from, among other things, the ability to think and express those ideas by connecting with one another emotionally, and by grasping and understanding cultures, histories, languages, and stories different from our own. And without a thorough study of the humanities and the balance those studies provide to the STEM fields, we will all be poorer, even if the mortgage gets paid.


So while one of the Irish twins hopes to be a physician, and the other a business-oriented computer maven, this parent hopes that the humanities will be explored with the same fervor as the mad race for the dwindling possibility of the proverbial brass ring. Cogito, ergo sum.

Complaining about the complainer

Oct. 11, 2013

I have often written on various aspects of foreign travel. Those musings appear in my book Fifty-Fifty, The Clarity of Hindsight and elsewhere. It is a subject which obviously is quite near and dear to my heart.


I recently came across an article of various complaints received from Thomas Cook Vacations from dissatisfied customers. The list was long and, frankly, quite shockingly funny in a sad and pathetic way.


Here are a few of those complaints, along with some possible solutions to rather sticky situations:

1. From visitors to Spain. “There were to many Spanish people there. The receptionist spoke Spanish, the food was Spanish. No one told us there would be so many foreigners.”


Really? No one at Thomas Cook made any mention there would be so many foreigners in a foreign country? It must have been really stunning for these tourists to find not only Spanish people in the great nation of Spain, but Spanish speakers to boot! Imagine that? This traveler should definitely request, and be granted, a full refund from Thomas Cook Travel. Serious cultural omissions like this should simply not be tolerated by traveling members of the public, and someone of course should pay for this dereliction of duty. Or perhaps this traveler should have stayed home where there are no foreigners; and instead communed with like-minded (or perhaps non-minded) non-foreigners. Just a thought.


2. From visitors to Jamaica. “It took us nine hours to fly home from Jamaica to England. It took the Americans only three hours to get home. This seems unfair.”

Indeed, I agree with this tourist that it is in fact patently unfair. After all, why should things be so easy for us Americans? It seems to me that it would be far more fair if the travel operator had instead arranged for a rocket to beam this tourist up to a very far away galaxy, where he might find some basic books on geography. Or perhaps even an almighty atlas. How about a one-way trip to a public library with an umbrella-laden drink?


3. From visitors to an island resort. “I was bitten by a mosquito. The brochure didn’t mention mosquitoes.”

Now why on God’s green earth would there be mosquitoes on a tropical island? Or on an African safari? Or in a park in L.A. in the summer time? Might that be, pray tell, where mosquitoes actually live their short lives? The nerve of mosquitoes, inhabiting a traveler’s airspace! Clearly, those island mosquitoes have no manners whatsoever, and certainly they don’t know their proper buzzing place. In the interest of fundamental fairness, I’m thinking that the travel brochure should also tell prospective visitors to take toothpaste, because (one never knows), the tourist might want to engage in the odd activity of brushing his or her teeth. This reminder would be done simply as a public service, of course. The travel operator might also want to suggest visitors take sunglasses, because there may in fact be sunshine present on an island. After all, that does happen sometimes. Finally, they should probably suggest that visitors with impaired vision pack glasses and/or contact lenses, in case they have a strange desire to see anything. Just saying.


4. From visitors to a beach resort. “The beach was too sandy. We had to clean everything when we returned to our room.”

Now this one really upset me. No one, and I mean no one, should have to engage in any kind of washing when on holiday, as that defeats the whole purpose of going on vacation. Talk about bad business practices! I simply cannot imagine what the marketing department at Thomas Cook was thinking when they wrote up their brochure. Clearly they weren’t thinking at all. Had I been employed in the marketing department and asked to draft the brochure, I certainly would have added some clear disclaimer language. Something like, “Please be summarily advised that, sadly, should you elect to actually participate in the reckless and dirty activity of beach-going, YOU WILL FIND REAL SAND ON THE BEACH. The Company is not, will not, and shall not be held in any way responsible or liable for any or all cleaning of such sand, or related activities or expenses associated therewith.” There. Now that seems much clearer.


5. My perennial favorite. “My fiancé and I requested twin beds when we booked, but instead we were placed in a room with a king bed. We now hold you responsible and want to be reimbursed for the fact that I became pregnant. This would not have happened if you had put us in the room we booked.”

This letter renders me completely shocked by the outrageous corporate behavior of Thomas Cook. Of course the hotel in this instance should be held responsible. And perhaps Thomas Cook Travel as well. After all, had there been twin beds in the guest room in question, there of course would have been a zero chance of anyone EVER becoming pregnant. Nosireebob. It is very well-known that there has never been a single reported pregnancy ever in a university dormitory, frat or sorority house, military base, rehab facility, or any other housing situation where there are multiple beds and occupants under one roof. Nope. This is simply corporate irresponsibility of the highest magnitude.


Frankly, I think this tourist should consider retaining an attorney. Why? To sue the traveler’s parents. The cause of action would be for the intentional infliction of stupidity. Or if they can’t prove that on the facts at hand, then perhaps the unintentional infliction of moronic conduct. As an alternative, the tourist’s parents could perhaps be sued for the many times this tourist was apparently dropped (very hard, it would seem), on her head as a small child. Only that could account for such a post-holiday letter to a travel operator.


Travel safe, travel well, travel on and bon voyage. And please, don’t forget your glasses.

Fifty-Fifty now available in Taiwan!

Oct. 5, 2013

Fifty-Fifty: The Clarity of Hindsight is now available in Taiwan through the Readmoo platform. This is great news! Here’s hoping readers of English in that vibrant country will enjoy the book! If you’re a reader in Taiwan, please feel free to send me feedback via comments or on my contact form.

Sausages, the law, and SLAPP

Oct. 3, 2013

There’s an old saying I heard with regularity while in law school: “There are two things the public should never see being made: one is sausage, and the other is the law.” The origin of this statement is clouded in historical fog, but it has been attributed to, among others, Otto von Bismarck, the Prussian statesman who dominated German and European affairs in the late 1800s, and Benjamin Disraeli, the learned British Conservative politician, writer, and aristocrat of the same period, who served twice as Britain’s Prime Minister. We may never know who actually uttered these descriptive words, but their meaning is clear: certain things are simply better left forever unseen.


On September 27, 2013, I wrote “What price justice?” about Michael Jackson’s family’s claims against entertainment behemoth AEG Live for both non-economic damages ($290 million) and economic damages ($1.6 billion) arising out of MJ’s death.


The Jackson family attorney argued in closing that the lure of riches turned AEG Live and Dr. Conrad Murray into mercenaries. AEG Live, for its part, argued the angle of personal choice: Michael Jackson had made bad choices and bad decisions, about the drugs he used and the physician who provided them, and was, in effect, the architect of his own early demise.


The five-month trial finally ended when the jury came back after three days of deliberations with its verdict, and a surprising message: The jury found AEG Live not liable in the wrongful death suit brought by MJ’s family, and did not believe cardiologist Dr. Conrad Murray was unfit or incompetent. After the verdict was read, the jury foreman was quick to point out that the jury followed the verdict form language and instructions, but said that that “doesn’t mean we felt he [Dr. Murray] was ethical.”


There were five questions the jury had to respond to in the affirmative in order to find AEG liable. They agreed that AEG had hired Dr. Murray — but on the next question, asking whether Dr. Murray was incompetent or unfit, the jury decided in the negative, making the remaining three questions legally irrelevant. (This civil decision does not alter Dr. Murray’s criminal case — he was convicted of involuntary manslaughter and sentenced in 2011 to four years for his involvement in MJ’s death, but because of prison overcrowding, will be released later this month.)


In this case, saner heads prevailed, forcing issues of personal responsibility and accountability squarely to the forefront where they belonged. The net result was a verdict that, while it no doubt made MJ’s family very unhappy, was nevertheless a sound one. This long-drawn-out final chapter of a sad and tragic book is finally closed.


On the other side of the country, late last year, Jonathan Schanzer, an American author, scholar in Middle-Eastern studies, and president of the Washington-based Foundation for Defense of Democracy, had written an online opinion for the magazine Foreign Policy concerning the two sons of Palestinian Authority President Mahmoud Abbas, Yasser and Tarek.


A few months later, Yasser filed a libel suit in federal court in Washington, D.C. against Schanzer and the magazine. Last week, a U.S. district judge threw the case out, concluding that Schanzer’s statements in Foreign Policy were either not capable of defamatory meaning or were protected opinion statements under the First Amendment, thus applying D.C.’s anti-SLAPP (Strategic Lawsuit Against Public Participation) statute. These types of statutes are intended to guard against suits aimed at quashing the court of public opinion. This enormous victory will act as a strong deterrent to influential foreigners who seek to stamp out critics and commentators.


In tossing the case, the judge noted that the Abbas brothers had filed defamation suits or threatened libel actions three times previously against an Israeli television channel, Reuters, and Al-Jazeera. In this case, the focus was limited: Were Schanzer’s questions concerning the source of Yasser’s wealth libelous? The court answered in the negative, holding that the case involved claims about a public figure and touched on a public-interest issue — “the relationship between the United States and the Palestinian Authority.” Hence this case squarely fit within D.C’s “strategic lawsuit” definition. The court noted that while the questions concerning the Abbas family’s wealth raised by Schanzer may have been “embarrassing or unpleasant,” they were simply questions. Continuing, the judge made clear that even if those questions rose to the level of assertions, Schanzer’s questions were opinions protected by the Constitution.


It was a good week for the First Amendment and the court of public opinion — and, no doubt, also a very good week for Mr. Schanzer. And in an overly entitled world, it was also a good week for the confirmation of personal accountability and responsibility. So while Bismarck, Disraeli, and their learned brethren may often turn in their respective graves with increasing regularity as the wheels of justice inch forward, this may also be a week when they may rest comfortably and in peace. And one where the making of law, and perhaps even sausage, can indeed be viewed by the public without too much stomach or other upset.

The Shadowy White Widow and Morning Coffee.

Sep. 30, 2013

The other day, at precisely 6:15 a.m., I was sitting in my kitchen reading The Wall Street Journal when my 17-year-old daughter stormed in and abruptly stated, in the way that only a teenager can, “Oh my God, I can’t believe she just didn’t join a NORMAL cult!”


Under “normal” circumstances I, of course, would have had no idea what she was talking about. However, it was at literally that same moment that I had just finished reading a WSJ article about 29-year-old British national Samantha Lewthwaite, who has become known in media circles as “The White Widow.” This somewhat odd moniker was given to her following her husband’s participation in the 2005 suicide bombings in London, which killed 56 people and injured more than 700. A few days after the Westgate Mall siege ended in Nairobi last week, Interpol issued an “international wanted persons alert,” also known as a “red notice,” for Ms. Lewthwaite, stemming from Kenyan charges in December 2011 for possession of explosives and conspiracy to commit a felony resulting from an alleged bomb plot in Mombasa that police ultimately foiled. Police also believe that Lewthwaite has links to Al-Shahab, the Somali militant group that carried out the attack at Westgate Mall. Lewthwaite  is also under investigation for alleged possession of a fraudulently obtained South African passport, and for a possible role in the Westgate Mall attack.


As it turned out, my daughter’s “normal cult” comment was in reference to Ms. Lewthwaite; she had read a similar article online about her before she came downstairs for breakfast. My daughter, who has spent nearly as much time abroad as she has in the U.S., and possesses native-tongue fluency in more than one language, was completely dumbfounded that a Western-educated Caucasian woman would opt for communing with militants who plan terror plots and, if the criminal charges prove to be true, would engage in participation in wholesale murder, on soil not even her own.


Needless to say, a rather spirited, caffeine-fueled early morning conversation ensued. About economics, displacement, disenfranchisement, religion, revolution, the London bombing, the Boston Marathon massacre, and, further back in history, the Symbionese Liberation Army’s Patty Hearst and Sara Jane Olsen, white supremacy groups the world over, and the more “normal” cults (to which my daughter was initially referring), such as certain ashrams in the Pacific Northwest. This led to a far more inclusive discussion than I had ever intended at that early hour; however, the common thread of the conversation was really about how it is that certain individuals can be swayed to engage in extreme conduct in which they perhaps would not otherwise partake. (In Ms. Lewthwaite’s case, she apparently became despondent at the age of 17 over her parent’s 1994 divorce and converted to Islam; she then married the man who became one of the four London suicide bombers. Thereafter, she moved to East Africa with her children, where authorities believe she commenced facilitating terrorist activities in operational roles.)


How does one even begin to explain to a young woman in her final year of high school, with university looming and a bright future on the horizon, what it would take to make a woman only ten years her senior, and with two young children in tow, engage in such behavior? What was it about Lewthwaite’s upbringing or background that made her uniquely vulnerable to starting down the road to extremist behavior? What were the triggers, latent or otherwise, that finally pushed Lewthwaite over the edge and changed forever the course of her personal history — and that of her children? And, of course, her victims?


This, of course, is not an easy conversation to have at any hour, much less long before significant amounts of coffee have been digested and have taken effect. But it is a necessary one nevertheless.


A common thread of discussion among parents of teenaged children who are about to go out into the world is how we have somehow managed (not volitionally of course) to present our children with a far more complex and frightening world than the one we faced when we came of age. (I won’t even bring up geopolitical issues such as global warming and economic ones such as the various financial and banking meltdowns around the globe, all of which together play a role, however tenuous, in the culmination of the impulses of the disenfranchised, the disappointed, the disillusioned and the dispirited.) While probably every generation since Adam and Eve has uttered similar phrases as its young sail off into uncharted waters, somehow, the problems du jour seem far more daunting and damning now than at any time in recent history. And it’s not just access to 24/7 news that makes me think that.


Interpol’s red notice will circulate to the organization’s 190 member countries and will, in effect, act as a global trip wire for Lewthwaite, who is now deemed an international fugitive. The rest of us will send out the next generation of young people into a world where the new normal is not a thing like the old normal. We will also hope against hope that, as they confront the enormous obstacles that face them, the idea behind Golda Meir’s statement, made in a completely different context in 1957 at the National Press Club in Washington, D.C., will one day take hold. While Ms. Meir was of course referring to the Arab/Israeli conflict when she said, “Peace will come when the Arabs love their children more than they hate us,” this statement can be altered slightly to have universal meaning, application, and appeal. That peace will come when our enemies love their children more than they hate us. It is indeed a very good place to start.

What price justice?

Sep. 27, 2013

$85 Million. That is the amount that Brian Panish, the attorney for the Jackson clan, urged jurors to award each of Michael Jackson’s three children in the case against AEG Live. Plus another $35 million to Jackson’s 83-year-old mother for “non-economic” damages, e.g. loss of love and comfort. On top of this $290 Million “urging” were the “economic” damages. And while an exact figure was not proffered by Panish, the family’s claim is $1.6 billion–simply mind-boggling beyond any rational belief.


More laughable perhaps was Panish’s comments that “We’re not looking for sympathy, we’re looking for justice.” Really? What price, pray tell, would that be? Five hundred million? Seven hundred and fifty million? The combined GNP of several emerging nations?


Central to the determination of the case is the critical question of who hired Dr. Conrad Murray. Was it AEG Live or was it MJ himself? (Dr. Conrad, a cardiologist, was convicted of involuntary manslaughter in the death of Michael Jackson in 2011 and sentenced to a four-year prison term.) MJ’s mom says AEG Live negligently hired an inappropriate and incompetent doctor, and missed a series of red flags about his failing health in the run-up to his death. AEG Live says it didn’t contract with Dr. Murray, and that a promised $150,000 a month for his medical services were to have come from an advance it was making to MJ, meaning, effectively, that Michael Jackson hired his own physician.


One has to ask a basic question here: How long would any physician in MJ’s employ (regardless of who actually hired him) have lasted had that doctor not provided MJ with the powerful and inappropriate drugs he insisted on receiving to aid his insomnia? MJ actually referred to the anesthetic narcotic Propofol, which he took with frightening frequency, as “milk.” This is by no means in defense of Dr. Conrad; clearly the Hippocratic Oath was misplaced, lost, or forgotten in his care of MJ. However, in arguing damages, why does MJ’s family completely ignore the role of MJ himself?


Despite the well-known and wide variety of personal problems that MJ had at the time of his death, the fact remains that he was a 50-year-old man and, as an adult was, like the rest of us, ultimately responsible for his own health when he died, as AEG Live attorney Marvin Putman has argued to the jury. While Dr. Conrad’s sad or bad role in this seemingly never-ending legal trauma drama is reprehensible–while financially convenient for MJ’s heirs–it’s difficult to dismiss the role that MJ’s complete abdication of personal responsibility played in his own demise, as Panish would like the jury to do in deciding the damages in this case.


Sadly, the Jackson children lost their father, and MJ’s parents, their son. This is clear. That the world lost a talented performer with MJ’s death also goes without saying. And AEG Live probably did certain things in handling its talent that are very regrettable at best. But at a certain point, one cannot really completely ignore MJ’s own hand and his long-standing demons in this dark story. Both personal responsibility and accountability have to be taken into account during the damages phase of this trial. Otherwise, the numbers are simply pulled out of a magician’s hat and based purely on emotions and the quality of counsel. This then has the collateral effect of tipping the scales of justice to the point where justice has virtually no relevance and perhaps worse, no meaning at all.

Guns, guns everywhere . . . .

Sep. 24, 2013

This article has been removed as it was accepted for publication by The L.A. Daily Journal and appeared on December 4, 2013. The article discussed the mass killing by Al-Shabab gunmen at the Westgate Mall in Nairobi, Kenya, leaving over 60 dead, the shooting by a mentally unstable navy reservist and contractor with a security access clearance who opened fire at US Navy Yard in Washington, leaving twelve dead and many wounded, the Sandy Hook murders, the Empire State Building shooting, the Norway mass murders and several other high profile, high murder count shootings. It also discussed the NRA, its official mouth piece Wayne Lapierre, and his undeniably offensive rhetoric. Finally, the article discussed the ways in which we try to lead normal lives while inhabiting the new normal.

For the love of a child

Sep. 16, 2013

In the seemingly endless newsfeed to which so many of us find ourselves exposed, becoming sufficiently hardened to the onslaught of shockingly bad news appears to be a method of self-preservation. However, sometimes the bad news is so heartbreaking, so gut-wrenching, so unconscionable, that the air you breathe seems literally stolen from you.


That is what happened to me last week when I learned of an eight-year-old Yemeni girl who was forced to marry a forty-year-old man. If that were not awful enough, the young girl died of internal bleeding and uterine rupture on her wedding night.


Most of us in the West almost don’t possess the parameters within which to process such news, much less accept it.


The Republic of Yemen, the poorest country in the Middle East, has a relatively recent genesis. In 1990, the traditional North and Communist South merged after years of clashes. Modernization attempts have been slow at best, and the country still retains much of its tribal character. The intervening years since the unified country’s birth have seen a civil war in 1994 that left 250,000 dead, and in 2011, protests inspired by the Arab Spring ultimately resulted in the resignation of President Ali Abdullah Saleh, a man who had run North Yemen, and then the unified country, for a total of thirty years. Following the closure of their bases in Pakistan and Afghanistan, Al Qaeda filtered into Yemen, and it became a major Al Qaeda stronghold.


Yemen also has the highest illiteracy rate in the region. The literacy rate for women is approximately 40 percent, compared to 70 percent for men. This gap is explained by traditional views on female education, which is thought at best to be inconsequential, and at worst to be in direct opposition to a girl’s good morals.


Poverty, tribal warfare, political instability, illiteracy. A veritable guaranteed recipe for disaster of the type to which we have just borne witness.


Human Rights Watch reports that 14 percent of Yemeni girls are married before the age of fifteen; however, the Social Affairs Ministry in 2010 reported that number to be 25 percent. Although Yemen passed a law in 2009 making it illegal for girls under seventeen to marry, the law was ultimately repealed after conservatives said it went against the teachings of Islam.


Is it the teachings of Islam against which the Minimum Age Law went? Or was it patriarchal and impoverished rural families’ inability to resist “bride prices” for their daughters that caused the law’s repeal?


For the eight-year-old Yemeni girl named Rawan, the reason (I simply cannot type the word rationale in this context) behind the law’s repeal matters not a damn. She was sold by her parents and now she is dead; killed by her purchaser in, without a doubt, the worst possible way. It is utterly impossible to try to imagine what her last thoughts were — or perhaps even her first, once her little eight-year-old mind began to grasp the truth of the awful, amoral transaction to which her parents had subjected her.


To add insult to injury, Yemen security officials deny the incident took place.


While we would especially like to in cases like this, we cannot legislate morality outside our borders. And although the EU foreign policy chief demanded that Yemen ban child marriage and reinstate the repealed Minimum Age Law in keeping with international norms, in all likelihood it will not happen anytime soon. Certainly we will hear of another child like Rawan dying a horrible and senseless death.


Simply put, only when a society values its girls to the same extent as it does its boys will this hideous type of child abuse finally commence its long-overdue dark ride into the annals of ancient history.

What’s in a name? Part II

Sep. 13, 2013

On August 20, 2013, I posted an article entitled “What’s in a name?” about the Baby Messiah case in Tennessee in which a bench officer unilaterally changed a toddler’s first name in a family law case involving determination of paternity and child support. The bench officer stated that she based her decision to change the toddler’s name from Messiah to Martin as Tennessee had so many Christians, and many people in the state she believed would be offended by the toddler’s given name.


My article received many comments from readers, the overwhelming majority of whom agreed that a sitting bench officer had no business changing a child’s given name, especially on religious grounds. There was one reader (an eighth-decade Episcopalian minister turned evangelical) who wrote that while he “was preparing [himself] to be offended by [my] article, he thought it was well written.” Which I took to be a sort of backhanded compliment offered, to my relief, without his religious views or objections on the matter.


After reviewing the mail on the issue and upon further reflection, I realized perhaps even more than before just how important our given names are to our sense of self in general and our sense of identity in particular — perhaps even more important than our surnames, which are handed down without much agency or deliberation.


Our surnames are bestowed upon us by ethnic background or region, and historically, by the professions of our forbears (Shoemaker, Blacksmith, Kaufman [meaning trader], Cohen [indicating one from the rabbinical caste], etc.) However, our given names clearly represent choices, those of our parents. They thus represent a far more important element of familial desire and identity than our surnames, and are often selected based on the popular first names du jour, on some special family meaning, in memory of a deceased loved one, or on a myriad of other modern-day and often odd choices (Gwyneth Paltrow’s daughter Apple, anyone?)


Throughout all but the most recent history of immigration to the United States, many given names were changed upon arrival at Ellis Island by lazy or bigoted entry officers, following perhaps the same rationale expounded by the Tennessee bench officer in the Baby Messiah case. My paternal grandfather, for example, arrived at Ellis Island with his wife and three teenaged children in the midst of WWII. His first name was Ignatz, at the time a fairly common Austro-Germanic given name. However, the immigration officer on duty that day at Ellis Island simply didn’t like his first name or couldn’t pronounce or spell it, and thus my grandfather, a Holocaust survivor who arrived stateless in the U.S. and had already lost so much, had then also lost his first name that day with the brisk stroke of a careless man’s pen. My grandfather thus unceremoniously became Nat, and he kept that name for the rest of his very long and abundantly happy life. In retrospect (and my grandfather never once complained about the name change — he often just rehashed the story as part of family lore), it seems an extremely small price to pay: losing one’s given name in exchange for the chance of entry into a hospitable country and a good life while ethnic annihilation is happening elsewhere. But that’s not really the point.


The point is choice. It is always about choice in a democracy. As a law professor friend of mine says repeatedly in her Constitutional law classes, “Democracy without freedom is like two wolves asking a sheep, What’s for lunch?”


It is also the freedom to make a bad choice. And this is true even in the commercial sector. I recall many moons ago when Chevrolet began marketing a midsize car called the Nova. That was just fine for the US market. However, Chevrolet then started exporting it south of the border. That, Chevrolet quickly learned, was a huge problem, as “no va” in Spanish means “it doesn’t go.” Not your best bet for a motor vehicle. And then there was the Korean restaurant my husband and I loved mainly because it was the site of our first date. We returned there regularly out of a sense of nostalgia and the need for fiery bulgogi and burning kimchi. Years later, the restaurant changed hands and the new owner changed the decor. He also had the brilliant idea to rename the restaurant. When I drove by one day a few months later, I could hardly believe my eyes. In a city that hosts an enormous and vibrant Latino population, the new owner chose the name Moku, which in Spanish means, to be anatomically correct, nasal detritus. Predictably, the restaurant closed shortly thereafter.


The freedom to keep one’s given name and bestow names upon our children seems so obvious that the discussion almost seems absurd. But clearly it is a discussion that must take place, as a judicial maverick, under color of authority and a sense of religious self-righteousness, has purported, however misguidedly, to have a legal basis on which to alter this most basic freedom of parental choice and identity. Personally, I would never name a son of mine Messiah, chiefly because I don’t share the religious connection, and from a more pragmatic perspective, I would fear that as he grew up his friends would call him Messy or Mess for short. Nevertheless, I hope Baby Messiah’s mother’s appeal in Tennessee to unload the name Martin will be successful in short order. Because what’s in a name is a fundamental personal choice — the choice to bestow it, to keep it, or to change it.

Unjustifiable invasion of privacy; or, no clowns in the operating theater, please.

Sep. 9, 2013

When I think of life’s greatest moments of vulnerability, I think of birth (as in giving it), death (though since I still possess a beating pulse I have no true empirical evidence on that event), and being unconscious — as when one is under general anesthesia in an operating room setting.


Those extremely vulnerable moments in life force the vast majority of us in the West to rely completely on physicians. We rely on them to keep us comfortable, safe, and, at least with regard to childbirth and surgery, to help us come out on the other side of the event with our dignity and honor intact, and hopefully also with a healthy child and without whatever it was that required the surgery in the first place.


There is of course the “normal” anxiety that one has when facing these challenges. For example, will one’s pre-authorized insurance ultimately cover the procedure when the claim is finally submitted? Will there be any complications from the birth or the surgery or the anesthesia? And will all the people in the operating room remember exactly why they are there and what to do and operate on the correct body part, and also remember not to leave anything behind in the surgical site, such as sponges, instruments, etc.? Without a doubt, that is a very tall order indeed. But by and large, day in and day out, the vast majority of doctors and nurses in this country do their best every day, and in the exercise of their sound professional judgment, based on years of education and clinical experience, they also do the right thing. There are always however, in medicine as in law and the other professions, the outliers.


One must watch out for the outliers. But how do you do that when you are unconscious and intubated in an operating room having surgery?


In 2011, at a large regional hospital in Torrance, California, Dr. Patrick Yang, a board-certified anesthesiologist with over 20 years of experience, not only forgot why he was in the operating room, he also lapsed into the behavior of a twelve-year-old, and not a very mature one. When the patient, a long time employee of the hospital, was under general anesthesia, he cut out and colored some stickers and then stuck them on the patient, giving her a black mustache and yellow tear drops under her left eye. If that weren’t bad enough, he then permitted a nurse’s aide to take photos of the defiled patient with the aide’s smart phone. (The propriety of smart phones in operating rooms are a subject best left for another day.)


Should we be at all surprised that a lawsuit followed against the anesthesiologist, his medical group practice and the hospital? In his deposition, Dr. Yang said, “I thought she would think this is funny and she would appreciate it.” Did he grow up in a cave and then attend medical school in a galaxy where lame schoolyard pranks are an acceptable expression of scientific prowess?


My anesthesiologist friends have told me more than once that they liken their specialty to that of a long-haul airline pilot — incredible stress at intubation (takeoff) and extubation (landing) that book-end hours and hours of sitting accompanied by undeniable boredom on those occasions when there are (thankfully) no complications (as in flying over the Pacific or Atlantic with a full tank of fuel in clear skies). That may be true, but if one doesn’t want the book-end stress/boredom roller coaster and prefers instead constant stress, then perhaps one might want to consider a different specialty, such as emergency medicine or trauma surgery. Or if one wanted substantially less stress, then perhaps a change to a specialty in dermatology or pathology would make more sense. Or maybe a different profession altogether should be selected.


Engaging in this kind of unprofessional conduct is morally offensive at best and utterly reprehensible at worst. It also flies in the face of some of the very basic tenets of the Hippocratic Oath to do no harm. As in all professions, one bad apple taints the others. Of course thousands of physicians go to work every day and bust their medical chops for their patients, often with little or no fanfare, and very often with reduced insurance reimbursements or payments that are far less than in preceding years, while their expenses and malpractice insurance coverage, of course, have increased exponentially.


The group practice in which Dr. Yang participates suspended him for two weeks, but he remains in good standing at the hospital where the offensive behavior occurred.


Even though I’m a lawyer, I am often the first one in the room to advise against filing suit against someone else. This is so not because I’m a pacifist or afraid of a fight, but because sometimes the price is simply too high and a friend or client’s best interests are often better served in other ways, such as mediation, arbitration, or sometimes by simply walking away from a toxic situation despite the loss. That said, in a case such as this, where the hospital did virtually nothing and the self-policing of the anesthesiologist’s group practice didn’t do all that much, John and Jane Q. Public are best served by this private suit brought by the patient, whose privacy rights were invaded and thoroughly disregarded. And I don’t believe this is lawsuit lottery, as has been suggested by attorneys for the hospital in their motion to dismiss the patient’s case. Sadly, sometimes the only messages people and institutions can truly understand are ones they receive where they can hurt them most — in their wallets.


If this patient litigant is successful in her case, it will hopefully have a chilling effect on a physician possessing the desire to engage in pubescent pranks at the most inappropriate time possible — while a patient is under their care and completely vulnerable and dependent on the physician’s education, experience and sound professional judgment. Here’s hoping.

Re-victimizing the victim

Sep. 6, 2013

In Montana in 2008, a 14-year-old girl was raped in a schoolhouse by a 49-year old teacher. At the sentencing phase, the prosecution had asked for a 20-year prison term with 10 years suspended. Last week, Montana District Judge G. Todd Baugh handed down his decision on the sentence: 31-days, with credit for one day served.


No, your eyes did not deceive you there. Judge Baugh gave the rapist a 30-day sentence for the rape of a child not even old enough to possess a learner’s permit to drive her mother’s car. Judge Baugh also said in the same case that the victim was “older than her chronological age” and “as much in control of the situation” as her rapist. Protest organizers have since demanded that the judge resign, and the Montana branch of the National Association for Women and others have called on both the governor and the state’s attorney general to review Judge Baugh’s actions in the case.


I can’t begin to understand what the judge meant when he said that the victim was “older than her chronological age.” She was tall? She looked older? Acted older? Even if all of that were true, under Montana state law (as in many other states), this would be irrelevant, as minors under the age of 16 cannot consent to sex. Thus, what she looked like or how she acted or whether she were six feet tall and still growing by an inch a second can’t be considered; she was legally incapable of consenting to sex. Period.


Let’s assume for the sake of argument that she looked and acted 25. Let’s even go one step farther and say (contrary to all presented evidence) that she wanted to have sex with a man old enough to be her grandfather. Statutory rape laws are ones of strict liability; thus, even if the victim looked 25, said she was 25, acted 25, even provided a fake ID reflecting that false age, and stated plainly that she wanted to have sex with an older man, the man would still be convicted of rape in a state with these laws.


That this case is beyond tragic goes without saying. And it was made even more so by the fact that the rape victim committed suicide in 2010, just short of her 17th birthday. Apparently, she wasn’t “as much in control of the situation” as the judge had previously thought. The only positive aspect of this tragedy is that the rape victim can’t be victimized again by this ongoing travesty of justice.


This, of course, doesn’t even begin to address the more fundamental issue of a teacher’s fiduciary responsibility to his students in a place of learning. The teacher was in a position of trust and authority and he abused that trust horribly in the worst possible way by raping a child in a school house, the one place other than our homes where our children should be safest in an often frightening world.


The fire the protest organizers and the NOW ignited following the sentencing phase must have gotten pretty damned hot in Billings, Montana. This week Judge Baugh has ordered a new sentencing to take place Friday, now saying that Montana state law appears to require a two-year mandatory minimum prison term; he wrote that “imposing a sentence which suspends more than the mandatory minimum would be an illegal sentence.” Ya think??? One would also think that logic, precedent, decency, and accountability might play a role in sentencing statutory rape, too.


Judge Baugh may now not even be able to impose a sentence longer than 30 days, since, under Montana state law, an illegal sentence must be processed as an appeal.


Stay tuned.

The One Prostate Solution

Sep. 3, 2013

On Tuesday, August 20, 2013, a show I never watch, “Fox & Friends,” aired what has turned into a massive gender-baiting exchange. Fox News medical contributor Dr. David “One Prostate” Samadi, a urologist at Lenox Hill Hospital in New York, argued in the Fox segment that women should pay more than men for health insurance. Why? Because we women have more body parts that need to be checked out. To quote Samadi, “Women have the breasts, they have the ovaries, they have the uterus, they get checked in every part.”


I could say something utterly snide and snarky here, but I am engaging in body-part control.


Samadi’s remarks on Fox so stunned me that I had to sit through the offensive video clip twice just to make sure I wasn’t having an auditory hallucination. Then, in a gender-twisting experiment of my own, as soon as my “one prostate” attorney husband came home from slaying corporate dragons, I had him watch the Fox interview also. My husband (who happened to receive his undergraduate degree from Hofstra University, where Samadi is a professor) was likewise mortified.


I posted the link to the offending interview on my personal Facebook page and that of my book, and tweeted about it as well. I then received messages from several people I did not know, including a Reuters reporter in NY espousing the virtues of Lenox Hill Hospital (with which I happen to agree). Then late Saturday night—actually around 2:00 a.m. New York time—I started receiving Twitter messages from Samadi himself. The first stated that he “was trying to educate men out there to go for screening just like women, not trying to offend anyone.” His second message to me a minute later (in response to the Reuter’s reporter that Lenox Hill is a great hospital) said, “This is not the view of Lenox Hill. I am pointing out that men need to go for screening like women.” In, I imagine, an effort to remove itself from the escalating and damning controversy, the marketing department at Lenox Hill probably told him to clarify that the explosive views he expounded on Fox were solely his own. When I responded to Samadi that his comments were “pure damage control, as he never once mentioned men and screening on Fox,” in that context and that “Lenox must be outraged,” he immediately wrote me (and I am presenting this verbatim) that I should “watch the segment and do not be so judgmental. started by saying that men do not go to doctors like women. Women go for pap smear, mammogram e that is what should do. attacking me will not bring more awareness be smart.”


In an attempt to end this absurd, going-nowhere late-night exchange, I wrote “Sadly for me I have seen it twice. And so has the rest of America. Good night.” He couldn’t control himself, however; he had to have the last word, and wrote, “yes it is sad. It may take you three times to really get the message Didn’t think it was that complex.” Oh, what a guy.

The next morning as I was answering emails, I stumbled upon an unbelievable twist in this saga. One angry viewer of the Fox segment wrote on Samadi’s twitter feed that Samadi is “The most sexist physician in America….Then [if women should pay more for health insurance] women should get paid at least as much as men too, dont’cha think?” Astonishingly (and I am still utterly blown away by his response), Samadi wrote to that viewer on his feed, “Not sexist at all. You mean Sexiest doctor in America. I was actually complementing [sic] women for going for screening unlike men.” What??? Even if he believes he is the sexiest man on Planet Earth, how can this possibly be considered an intellectually honest, or appropriate, response to the Pandora’s Box he so unceremoniously opened?


If you take Samadi’s logic one step farther, should Congress be lobbied to impose a birth tax on women who bear two-ovaried babies, or a double tax on those who have twin girls? How about a tax credit on those who give birth to one-prostate babies? Or perhaps the federal dependent tax credit we Americans currently enjoy should be modified contingent upon the dependent child’s number and/or type of anatomical body parts: two testicles, tax credit; two breasts, tax imposition.


You see where this is going; it’s absurd, unfair, undemocratic, and, frankly, altogether un-American. Given that as of the 2011-12 academic year, women (with ovaries) accounted for 47% of U.S. medical school graduates, my best guess is that none of that nonsense would ever come to pass.


In fairness, people make enormous blunders all the time, even on television, and perhaps especially often on Fox. However, the key is what you do with those blunders after they rear their ugly heads. An honest apology usually suffices, with the requisite mea culpa—or as one of our teenagers (three prostates, one uterus) would say, “My bad.” But such a blatant attempt to engage in ex post facto damage control in such an intellectually dishonest way simply serves to smear the doctor and his name further, irrespective of his technical (urologically speaking) skills. People with such blatantly sexist ideas, regardless of what degrees they hold from prestigious universities, should not be given a television platform from which to disseminate Neanderthalean positions under the disingenuous guise of allegedly educating the public about Obamacare, the healthcare delivery system, and the all-important, holy grail of prophylactic screening.


Perhaps Samadi subscribes to the school of thought that says that any publicity is good publicity. I don’t know about that, although my dual-ovarian instinct says no dice. What I do know however is that Lenox Hill is indeed a very good hospital. I also know that I happen to really like my thus far non-fiscally taxed ovaries. Both of them.

Working Women in Japan

Aug. 26, 2013

At long last, a Japanese leader has finally figured out a way to boost economic growth in that country and address Japan’s diminishing labor pool. To shore up the country’s numbers, Japanese Prime Minister Shinzo Abe will not be artificially maintaining near-zero loan interest rates, nor will he be “importing” inexpensive labor from nearby Vietnam, Indonesia, or the Philippines. Instead, Mr. Abe has a plan to take advantage of an available resource which Japan has had access to all along, just ready for the taking, but summarily bypassed. He wants Japanese women to participate in the work force in greater numbers.


Japan is, by far, the most developed and modern country in Asia. It enjoys the same 99% literacy rate as the U.S., France and Denmark. It is also extremely ethnically homogenous. Japan is an island nation consisting largely of ethnic Japanese. By design, it is a country to which people very rarely immigrate. Of the approximately 128 million people currently living in Japan, only about two million are expatriates. It is also not a country from which many emigrate; it has one of the lowest emigration rates in the world. Despite high literacy and an excellent and inclusive educational system, however, it is still a very difficult place for women to embrace both a career and a family. This is partially due to age-old concepts of the household and long-standing Confucian ideals regarding family. But it is also due to simple economics — there is almost no affordable childcare in Japan, and corporations simply make it impossible for women to return to work after the birth of their first child.


If all goes according to Prime Minister Abe’s plan, this is about to change, though no doubt it will be a very slow process. Abe’s plan promotes maternity leave, and would increase government-sponsored childcare facilities. In addition, corporations would receive pecuniary incentives to hire more women. All lofty ideals in theory, and even grander in practice.


A further problem, however, is the income differential between Japanese men and women. In 2010, the OECD reported that Japanese women made the equivalent of 71 cents to every Japanese man’s dollar (compared to American women’s 81 cents to their American male counterparts).  Japanese men also participate in household activities to a substantially lower degree than their American brethren (which isn’t really all that much if we’re being honest here). Add to this an aging Japanese population in which the vast majority of the burden of elder care falls on Japanese women, and it’s not difficult to see that 24 hours in a day can almost never be enough for the juggling act in which Japanese women would have to engage to complete their tasks.


Although there are many well-educated women who want to return to work after having children to maintain their career paths, the obstacles are many. Thus, despite their desires and abilities, the number of women in high-level positions in government and business is far lower than that of women in other advanced economies.


Prime Minister Abe’s plan is a beginning, made possible by his recognition and acknowledgement of the problem. However, there will need to be other changes in Japan’s domestic law as well if his plan is to succeed. Those would include changes in the tax code, which now penalizes dual income earners, and other wholesale structural changes to promote far more equality than exists currently.


The bigger problem, however, may be a cultural one, for which it is, of course, nearly impossible to legislate any meaningful correction. Japan is, at its very core, a society that abhors conflict in literally all manner of discourse. That is the case in familial, social, and commercial settings. (How else can one explain that there are at least half-a-dozen ways in the Japanese language of saying no, none of which actually means “no,” but all of which are instead indirect variants of something much less than “yes”?) So even though certain corporate conduct in the employment arena is illegal, for example, violations against women employees which in effect prohibit their return to work are rarely reported, since that goes against these very notions of conflict avoidance. This cultural prohibition, coupled with the national allergy to any aspect of discovery or litigation, will render the financial incentives to corporations to hire and maintain women in the work force even more critical to the success of Prime Minister Abe’s plan.


Japan has long been blessed with a highly talented, dedicated, skilled, and hard-working labor pool. However, demographics have shifted so that Japan’s current and future employment needs will not be met as long as the old status quo remains.  I applaud Prime Minister Abe’s efforts to start a dialogue about and formulate a plan to tap into this enormous resource of women, which has been present and available all along. The success of his plan, however, will require a cultural shift, domestic law changes, and corporate compliance. With an aging population, diminishing labor pool, and significant gaps in certain market sectors, it will be very tough for Japan to maintain its place in the world economy in their absence. Indeed, a return to the labor force of a significant number of Japanese women would probably not only save its economy but substantially propel it. As any good captain knows, it’s very tough to sail a ship employing only half a mast even in fair weather, no matter how great or sturdy that half mast is. Under somewhat stormy skies, all hands should be on deck.

The boobie blunders no more!

Aug. 22, 2013

The U.S. Court of Appeals for the 3rd Circuit has spoken. They have spoken in favor of boobies.


Well, not really. This month, in the “I ♥ Boobies” case, the 3rd Circuit Court of Appeals in Philadelphia decided, in part, that the rubber bracelets two teens wore to school who were then suspended, were only “ambiguously lewd” and not “plainly lewd.” The 3rd Circuit cited Tinker v. Des Moines School District in its decision, an important 1969 U.S. Supreme Court case that involved students protesting the Vietnam War who were suspended for donning black arm bands to school.


Of course the usual and sundry constitutional arguments were raised and argued. Here, as with Tinker, few in a democracy would argue that educational institutions should require students to “shed their constitutional rights to freedom of speech or expression at the school house gate.” That, of course, would be absurd.


The Court in the I ♥ Boobies case came to the correct decision from a constitutional law standpoint. Of course the 3rd Circuit was not really concerned with boobies or breast cancer, nor should it be. But if the I ♥ Boobies case brings even a scintilla more publicity where it should be directed–to the issue of breast cancer awareness for John and Jane Q. Public and their elected officials who can try to squeeze some more funds out of Congress for more breast cancer research–then hail to the 3rd Circuit, I say.


The fact that these two middle-school girls were even conscious enough of the subject in the first place to wear those rubber bracelets to school reflects just how far the fight against breast cancer has come in this country in the last two decades. Heck, I recall when you couldn’t even say the word “breast” at a dinner or cocktail party–unless of course you were referring to the main course. My, my how times have changed. So now that we have some of the best and brightest black-robed constitutional jurists speaking and writing lengthy published opinions about boobies, perhaps we can get the suits inside the beltway to figure out how to cough up some more money for research and bring us closer to a day when, as one of my dearest friends remarks every time before he commences yet another Komen 3-day, 60 mile walk for the cure, “the beast can be slain.” Once and for all. Here’s hoping. Walk on.

Healthcare in Vietnam

Aug. 20, 2013

I am an incredibly lucky traveler in that, despite having traveled to sixty countries, I have never really gotten sick. Perhaps I should rephrase that. I have had the occasional stomach upset while tasting street vendor delicacies in Indonesia, and I once got food poisoning from some bad fruit juice in the former Yugoslavia. And one time I got a fairly nasty exhaust pipe burn on my calf from a rickety old motorcycle I was stupidly riding somewhere up in the hills of Northern Thailand. But nothing more serious than that, and nothing that required a trip to a hospital or even to a clinic — that loud sound you hear is me knocking profusely against the wood desk at which I am sitting.


I was in-house counsel to a surgical facility for several years, and often inadvertently saw plenty of surgical detritus; my brother is a doctor, and my mother’s second career was nursing. To even my surprise, however, I don’t think much about healthcare while traveling overseas. Perhaps it’s blind luck, or perhaps it’s simply magical thinking.


Last month, seven years after my first visit to Vietnam and Cambodia with my then ten-year-old daughter, I took my husband to Vietnam. We started the trip in chaotic Saigon in the south, and traversed the beautiful coast in Nha Trang and the sleepy island of Ninh Van. Then, following the hustle and bustle of Hanoi in the north, we ended up 400 kilometers to the very northwest of the country in the hills of Sa Pa, not far from the Chinese border. The good news is that we had a great time. And no, other than one nasty spider bite of unknown origin on an overnight  boat junket in the World Heritage Site of Ha Long Bay in the east of the country at the very end of the trip, no one got sick.  The bad news is that we learned that one never, ever wants to get sick anywhere in Vietnam.


There has been incredible economic progress in many sectors of Vietnam since its doors opened to foreign travelers in the mid-1990’s. One sees everywhere the ready appearance of Communism “light,” at least from a market standpoint: business is simply booming and construction in rampant. However, one sector in Vietnam which is far, far behind even that of other emerging nations is its healthcare delivery system.


In a country of approximately 91 million people, as of the end of 2012, there were only 1.2 physicians per 1,000 inhabitants; this reflects virtually no increase since 2008. For comparison purposes, Greece has 6.2 physicians per 1,000 people, and the U.S. 2.4 per 1,000. In several state-built and state-run “hospitals” in Vietnam, especially in the more remote northern regions of the country, there simply are no doctors at all, not even visiting doctors, just a few nurses to tend to a wide variety of the population’s ailments. And in the bigger city hospitals in Saigon and Hanoi, there are precious few nurses as well. But that, of course, is only one part of the problem. Another, perhaps potentially more systemic problem is the rationing of services to those best able to pay bribes to physicians and their staff. One should keep in mind that the average public school teacher (and teaching is considered by many to be a good job) makes the equivalent of $150 per month. Indeed, Vietnam’s GNI for 2012 was the equivalent of $1,400. Many working people, especially those who work for large companies, have state health insurance, at least in theory; in reality, however, it may not provide them with care, or at least not with care that is acceptable.


We know a Vietnamese couple who live in Hanoi, both of whom work in tourism. The wife works for a large French hotel chain which provides her with health insurance. When she was about to have their first child, she learned it would be necessary to schedule a Caesarian section. Had she gone to the public hospital for the delivery, she would have had to share a hospital bed with another female patient, and that bed would have been in an unbelievably overcrowded ward. She would have also had to bring several family members to tend to her pre- and post-operatively around the clock, because of the severe nursing shortage. Those family members would not have been given so much as a chair, but would instead have to sleep under the patient’s bed on the floor, usually on a straw mat which they would likewise have to tote along. They would have also been required to bring supplies, including food, water, and other items for the patient. So instead, our friend took his wife to a private hospital where he paid bakshish in an amount equivalent to $300 to the physician (paid in cash in secretly following the successful birth). An additional $200 went to the hospital for use of the operating room and medicines, and $80 went to the semi-private room at $20 per day.  Following the birth, our friend was subsequently reimbursed the sum of $25.00 by his wife’s insurer. This was, ostensibly, the amount that would have been paid directly to the public hospital had the delivery occurred there. A friend of the couple had a child two months ago at the same private hospital with the same physician, but this was a normal vaginal delivery. The bakshish to the doctor in that case was “only” $150. However, the friend’s infant was born with a lung infection which required anti-biotics, costing an extra $300, and requiring a three-night stay, for an additional $60.


While the numbers are, of course, minimal by U.S. healthcare cost standards, they are shocking when viewed in light of the average Vietnamese person’s annual income. Clearly there is nothing in a U.S. hospital that costs $20, except perhaps the daily parking charges. However, I have certainly received a reimbursement check from an insurance company in the U.S. for $25, though I think the submitted charges were something like $500 — or perhaps it was $5,000.


In case this story seems hard to believe, take a gander at the photos below, all of which were taken at Bach Mai hospital in Hanoi. Here you see the line to get in to the hospital, a photo of the corridors, and one taken of the wards.

So if you are heading east, pack along a good first aid kit, travel safe, and take a pass on the ever-present motorcycle taxi should you find yourself in Vietnam. And the next time you think to complain about health care delivery in the U.S. in general, or Obamacare in particular — and if you do, you will need to get line right behind me — you may want to take a look at these photos again. Then thank your lucky stars that our health care is as “awful” as it is.

What’s in a name?

Aug. 20, 2013

Some of you may recall that back in 2008, a New Jersey man made headlines when he made a ruckus about a bakery that refused to frost his son’s birthday cake with his name–which just happened to be Adolf Hitler Campbell. (One of Adolf Campbell’s sisters was named Joyce Lynn Aryan Nation Campbell.) Mr. Campbell was in the news again thereafter when his fourth wife got pregnant and they publicly discussed naming their unborn child Eva Braun. Clearly, there was a familial theme going on there in New Jersey.


All of these given names are, of course, perfectly legal. Their legality, perfect or imperfect, does not mean that it does not require herculean strength not to vomit up yesterday’s dinner at the thought of those morally bereft moniker selections. Not to mention the enormous parental curse with which one can endow one’s offspring in engaging in such naming practices. When parents do something seriously lame, regardless of context, one often hears the silly though often pertinent joke circulate that “a license is required by the state to drive a car, but not to have children.” But I digress.


In Tennessee last week, during a family court proceeding to determine paternity and child support for a toddler named Messiah, the child’s unwed parents also fought over his last name. The magistrate, in an act which can only be described as demonstrating unmitigated chutzpah, also decided to change Messiah’s first name to Martin. In doing so, the bench officer cited the often overused “best interests of the child” catch-all phrase for judicial imposition, arguing that since Cocke County, Tennessee has “a large Christian population . . . it is highly likely that he [the child] will offend many citizens . . . .”


Frankly, is the name Messiah any different from naming a child Moses, Mohammad, or Jesus? All of those are fairly common given names in today’s religious melting pot. But really, that’s beside the point. The point is that if a society’s culture can be viewed as a house (or, for that matter, a condominium or apartment), then language is the key to opening the front door. The question is, who gets to decide which language is acceptable? It is our duty as members of a sane society to open and have the conversation about the correctness of such names, and ultimately to judge people like Mr. Campbell, and to a certain extent, perhaps, the parents of baby Messiah. But society’s ability to judge a person’s character content or religious choices does not have legal repercussions, nor should it. Ever. Those decisions can never be made by judicial fiat determined in a court of law under color of it. Not only are courts not the place for religious promotion, they are also not the place for proselytization, religious dogma, or persuasion. It’s one thing for courthouses to have “One nation under God” plastered on their walls and even to use Christian Bibles to swear witnesses in before they take the stand to give testimony. It is, however, something else altogether for a judicial officer to say with regard to your offspring’s first name, “It’s my way or I’m changing the highway.”


As I come from a family some of whose members were Holocaust survivors, no doubt I would have very serious issues if I went, for example, to a school function and were introduced to the Campbell family by their given names. But that’s me, and I would simply have to deal with it. However, bumping into Jesus at Home Depot, Moses at the Israeli market I go to, or Mohammad at the local Lebanese restaurant bothers me not at all. But that too is me, since I am not religious. The key is that this is what rational, thinking people do: they decide for themselves what they can tolerate and what they cannot, and then adjust their universe accordingly in keeping with those sensibilities. God help us all if instead those choices fall into the hands of our courts of law to decide.

Kennedy’s Nomination as Ambassador to Japan. Really???

Aug. 12, 2013

When I heard late last month that President Obama had announced his nomination of former first daughter Caroline Kennedy as U.S. Ambassador to Japan, I remember thinking “Really?”


I have absolutely nothing against Ms. Kennedy, a fellow attorney, talented writer, and of course, daughter of Camelot, who is by all accounts, smart, dedicated, and an incredible fundraiser. However, as someone who has lived in Japan, and who has studied the language and culture, I am left scratching my head as to Obama’s choice for such a vitally important posting.


I understand of course the politics of these appointments. After all, Ms. Kennedy was instrumental in propelling Obama to the 2008 Democratic nomination, and in the 2012 race, served as one of 35 national co-chairs of his re-election campaign. That said, I’m thinking the more appropriate ambassadorial post for her would be something along the lines of, say, Belize, or perhaps, Bermuda. Or like her aunt Jean Kennedy Smith, to Ireland.


If Kennedy is confirmed, she would be the first woman in this post to a fellow G-8 nation. That of course is not in and of itself telling. Although Japan has a history of being quite slow to accept women in professional capacities, that stance is shifting, little by little. And besides, Japan holds gaijin in general, and gaijin women in particular, to a different standard than that of Japanese women. But the real issue is that Japan is one of America’s most important international partners, both commercially and militarily. To have someone at this level of posting with virtually no Japan experience, and about the same amount of foreign policy experience, is, well, just plain silly. This is especially so given that there is an abundance of professionals with far more foreign policy experience and with real and close connections to Japan that would make them far more effective in the Asian arena. Granted, they may not have the political panache or the household name recognition of the Kennedy clan. But from an economic and military standpoint, especially given North Korean nuclear capabilities and continuing disputes with China, do we really care?

As many Japan experts will agree, it is a wonderful country, but it is also a very complex one, historically, socially, culturally, and linguistically. And it takes a long time and a significant commitment to understand its ways and to be successful there professionally and personally. In my opinion, it is insufficient, as some have suggested, that Kennedy will overcome her significant deficiencies in foreign policy, language, and cultural connection by having an experienced staff and a Japan expert shadow aide her while she is ambassador. It is also offensive to me that Kennedy’s celebrity appeal, close relationship with Obama, and her gender have been argued as her main selling points for this position. This is form over substance at a time and in a place with no room for that.


Those selling points may be just fine for an ambassadorial post in Belize, but not for an envoy as important as one to the land of the rising sun, which also happens to be our greatest and strongest ally in Asia. Really.