Should We Care How Beyoncé Gave Birth?

Update: after posting this, Beyoncé released a statement saying that she had a “natural” birth.

Right now, the blogosphere, facebook, and apparently the entire internet, are all on fire about how Beyoncé gave birth to her baby. Does it matter? Should we care? My answer is, yes… and no.

Celebrity is a two-edged sword. The same people that want tons of attention when it comes time to sell an album, star in a movie, or play a game, can’t just suddenly plead the interests of privacy, and desire inattention, when it comes to their personal lives. That sort of sucks, but there you are. I wouldn’t want to be stalked by paparazzi, either, and have every bad photo of me and my cellulite plastered over every tabloid, but for the most part, that is unfortunately the price to pay for celebrity. We can argue over whether it should or shouldn’t be, but the reality is, for the moment, that is what is.

I remember a reply by John Lennon, in an interview in which he and the rest of the Beatles were asked if they would like to be able to walk down the street without anyone recognizing them or without anyone causing an uproar; his response demonstrates that he understood the reality that he couldn’t have it both ways; he said: “We used to do that all the time, without any money in our pockets. Why would we want to go back to that?”

Beyoncé, and certainly every other celebrity, justly or unjustly are put under the microscope, and fortunately or unfortunately thousands of people will follow the example of one famous person. In that aspect, those of us who care about issues of birth and pregnancy, and especially those of us who support and promote vaginal birth, unmedicated birth, and/or home birth — “natural child birth” folks — are frequently (and rightly, I believe) dismayed at the high rate of C-sections, and what we perceive as almost the promotion of it in celebrity births.

So, thinking about how that many people (particularly today’s generation of teenage and young girls) may look up to Beyoncé, and possibly may be influenced by reports of her C-section, to plan on having their babies by C-section, it is possible that every celebrity C-section today may result in an increased percentage of C-sections in the future, and therefore, it does matter, and we should care about how others, particularly celebrities, give birth, because of that influence; and while Beyoncé’s C-section may have been the best choice for her (either for medical benefit/necessity or personal preference), and she may have no negative repercussions from it, almost everybody who takes an interest in birth realizes that C-sections as individual choices may be better, but C-sections as an aggregate tend to have worse outcomes for both mother and baby, particularly repeat pregnancies and C-sections.

Unfortunately, births don’t happen in aggregate — they happen to individuals. So, in dissecting birth as a whole, we end up trampling on individual births. This is one reason it’s so difficult to talk about many birth topics, such as C-section vs. vaginal birth, because no matter what you say, there will always be at least one person who said, “I did that, and it turned out horrible!” or “I did that, and it was the best decision I ever made!” Many women report that their C-sections were horrible, with nightmarish recoveries; and many other women report that their C-sections were a breeze; and some women who have had both C-section and vaginal births will say diametrically opposite things — that some found their C-sections to be easier recoveries, and others that their vaginal births were easier to recover from. Unfortunately, there is no 100% certainty in any decision made, no matter what, so women just have to choose what they believe to be best for them (and I hope that they will be given accurate information, and not pressured or coerced in any way).

I don’t know why Beyoncé made the choice she did, though there may have been some medical reason (I haven’t read any of the reports because, quite frankly, I don’t care; I’m not “into” pop culture, and she’s basically just a name to me, though I *think* she was in the Pink Panther movie with Steve Martin some years ago, and I did watch that). I did read this and this commentary on the blowback she has received, which, along with a few headlines, is the sum total of what I’ve read, and several people threw out in her defense that there may have been unreported medical reasons, such as pre-eclampsia or breech baby. I must admit that when I saw that she had had the baby already, I was a tad worried that the baby might be early [it seems just a month or two ago, I saw some headline about her being pregnant, so I thought at first it might be **really** early], and if she had an elective induction/section at or before 37 weeks, I was concerned on her baby’s account, because I know in aggregate, these early births are worse for the baby, though in particular, it may not be horrible for any individual baby. Also, someone suggested that they intentionally gave the wrong due date, to avoid increased press scrutiny at the time of the correct due date, and the baby may have been 40 weeks, or possibly even over 42 weeks, instead of the reported 37 weeks.

Whatever. I don’t care. I really don’t.

I don’t care why she chose it, whether there was a true medical need, too posh to push, desire for being able to schedule the birth, the belief that it was safer, the desire for privacy, or whatever her reason(s) were. [Although I must admit, that if there was a real medical reason, I hope it will be told, because I think the last thing our society needs is another high-profile celebrity having a medically unnecessary C-section, and making it look like it’s the smarter, better, easier choice.] For Beyoncé as a person, it makes no difference; for her as a celebrity with influence, it does make a difference to the thousands she may influence.

Her desire for privacy could be the sole reason for choosing a C-section, and I would understand that. I’m not a celebrity, so I can’t pretend to have the same knowledge base or experiences a celebrity has, but I have a pretty good imagination, coupled with sufficient knowledge of the paparazzi and how they work. What wouldn’t one of these people do, to get a picture of Beyoncé in labor, giving birth, having a C-section, holding her baby, or anything else related to this time? It would be pretty hard to impersonate a labor nurse or otherwise infiltrate the L&D floor, but it could be done, by someone with the knowledge and desire to do it. However, it could be easier to pay off an employee to break regulations and get such a picture. Also, put yourself into a celebrity’s place, and imagine trying to relax through the contractions, or push your baby out, with the fear that somebody somewhere had planted a hidden camera and/or microphone, and would be selling it for thousands upon thousands of dollars to some tabloid magazine somewhere. Yeah, that would make renting out a hospital floor and scheduling a C-section more appealing to me, too.

I also don’t have a problem with her renting out the entire floor — it’s her money, she can spend it as she wishes. I’d spend it differently, but that’s me; this is her choice — she can do with it whatever she wants, as long as it isn’t harming anybody else and is not illegal.

Ah, but there’s the rub, isn’t it? Her choice to take over the hospital floor *did* harm others — apparently there were many stories from parents who were not allowed to visit their babies in the NICU, because of this. She went to such lengths to choose what she felt was best for herself and her baby, but in so doing, the rights of other parents to even see their fragile newborns (most of them probably preemies, many of them with serious, even potentially lethal, conditions) was trampled on. It is my hope that she didn’t know what was happening, and when she chose to rent the entire floor so that she could have privacy, that she did not intend for other parents to be separated from their precious babies.

One of the articles I linked to above was sarcastically “Beyoncé Must Be a Terrible Mother” [it was a collection of various comments from people on facebook, reacting to the news that she had had a C-section, though no reason was stated, and that she had rented out an entire hospital floor to do so], and I agree with the blogger’s point of view — that having a C-section, even a medically unnecessary one, does not make one a bad mother. However, I would say, that keeping parents from their children does make you at best an unthoughtful human. I don’t say that’s Beyoncé’s fault; I think that was the hospital’s fault, plain and simple. Even if Beyoncé knew that many parents would be separated from their NICU babies and didn’t care (which would be pretty heartless, if true), it is still the hospital’s ultimate responsibility, so I lay most if not all of the blame at their feet, because the hospital folks should have known what the result would be, and they chose to put money and fame (having Beyoncé pick *them* to have her baby in), over principles, and also over the benefit of the many parents, who likewise entrusted their births and their babies to this hospital, and deserved more consideration.

Skin-to-Skin in the O.R. after a C-section

Being born vaginally is good for babies, in part because it colonizes them with the mother’s good bacteria, setting them on the road to health; a C-section bypasses this normal process and may be part of the reason why babies born by Cesarean have higher rates of things like asthma. But putting the baby skin-to-skin with the mom, especially after a Cesarean, can restore some of this good colonization; otherwise, the baby will be colonized only with hospital bacteria. Skin-to-skin contact is also beneficial in facilitating breastfeeding. Typically, when babies are born, they have an innate ability and desire to get to the breast and self-attach; wrapping babies up in a blanket like a burrito prevents this. All too often, whether the baby is born vaginally or by C-section, babies are only briefly shown to the mom right after birth, and then are taken across the room for the newborn assessment and procedures, before finally being returned to their mothers securely swaddled in a hospital blanket. Then, many times, babies are taken to the nursery soon after birth for a bath, then kept in the nursery under the warmer for a few hours to warm back up, and then finally taken back to their mothers… just in time for them to fall asleep for a few hours. But it doesn’t have to be that way. Healthy babies can — and should — be placed skin-to-skin with their mothers immediately after birth, even with a C-section.

Update: Here’s a video showing skin-to-skin after a C-section

If you had a C-section, were you able to have your baby put skin-to-skin in the operating room? Did you even know that was a possibility? If you are a nurse or midwife, do you ever put babies skin-to-skin on their moms, even if they have a C-section?

Weigh in on this topic on the Breastfeeding with Comfort and Joy fan page [currently, it’s the most recent post, dated May 28]. Laura Keegan, the author of Breastfeeding with Comfort and Joy, will be giving Grand Rounds in June/July, so will have the opportunity to talk about this important topic to attending physicians, L&D nurses, and residents in OB, pediatrics, and family practice. She would love to have input from women about their experiences with skin-to-skin contact (or the lack thereof) after both vaginal and Cesarean births, to pass along to the doctors, nurses, and doctors-in-training. What did it mean to you to be able to hold your baby with nothing between you, and just a blanket put over both of you? What did it mean to you to be denied this? Please comment on the fan page post, and also spread the word (blog, share on facebook, Tweet about it, etc.), so that doctors and nurses can find out from you and other women what they otherwise might not hear.

Cesarean Scar Website

Barb from Navelgazing Midwife has launched a new website dedicated to the “story” your Cesarean scar tells. From the “About” page on the website:

Something told me the cesarean scar needed a place to speak.

As this site was being born, I asked three things:

-1. Take a picture of your scar.

-2. What does your scar say when you look at it?

-3. What does your scar say when you touch it?

What followed was a steady trickle of photos and stories… tender, painful, wonderful, awful stories.

Here, I humbly offer space for the stories to find their way to light.

I’ve read a few of the stories, and already there is a wide range of emotions: “I hate my scar,” “My scar mocks me,” “I’m now at peace with my scar,” “I love my scar because that means my child(ren) are alive,” etc. Everyone has a story to tell…

“Safety net” or trampoline?

What if there were no C-sections? What if that simply wasn’t an option? Do you think doctors would practice differently? I do.

No one discounts that C-sections can be beneficial, saving the lives of mothers and/or babies. However, our country is currently experiencing its highest C-section rate, with maternal mortality increasing right alongside the C-section rate (not saying necessarily that it’s causative; however, if these C-sections were life-saving to the mother, one would expect the maternal mortality rate to be decreasing or at least staying the same), and perinatal mortality not doing that much better either. [If you want some state-by-state breakdowns, Jill at the Unnecesarean has compiled several, with the most recent one being California.] Most people agree that the C-section rate is too high, and could safely be brought down. There are many factors going into the increase incidence — some of which may be valid and beneficial reasons, but others that are not.

Carla Hartley recently wrote a note in which she cleared up some misconceptions that have apparently been told about her and “what she believes.” Among other things, it appears that some have said that she thinks midwives ought not take Pitocin with them to home births (for postpartum hemorrhage). She said (paraphrasing), “But what if you as a midwife had no Pitocin in your bag? Would that change your practice style? Knowing that you didn’t have that as a backup, would you be less tempted to act in a way that might cause a postpartum hemorrhage?” That’s food for thought.

Taking this out of the birth realm, we see that when there is a safety net, it changes people’s behavior — how many of you would walk across a tightrope without a safety net below? Some do; but far fewer people would risk crossing if they knew that there was a real risk of death, as opposed to a slight risk of death and a real likelihood of safely bouncing on a net if they fell. There are always adventurous people, daredevils, pushing the envelope — doing things that are dangerous or downright deadly, just because they can. But most people only do something if they think or know that there is a reasonable chance for them to succeed and come back alive.

In another, much more mundane vein, we see banks and other companies loaning people money for various reasons, including education, buying a house, buying a car, etc. The more collateral you put up, the more they’ll lend you; the more you earn, the more they’ll give you; or if the government guarantees that they’ll pay the loan should you default or die, they’ll gladly loan you the money you ask. Why? There really isn’t that much risk involved, if the government is the guarantor; and the risk to the lender is dramatically lowered if you have something valuable that they can take if you can’t pay your bills. It’s a safety net for them.

Back to birth — I wonder how it would affect doctors’ practice style if they knew that there was no “safety net” of a quick, easy, safe Cesarean. I’m reminded of something one of my email doula friends said — she’s attended hundreds of births, many of which became necessary C-sections, but none of which were necessary at the outset of labor. This is not to say that the only time C-sections become necessary during labor is if they were interfered with — sometimes the most natural labors end up requiring C-sections, and sometimes interventions can help preserve a vaginal birth when otherwise a C-section might be necessary; but frequently, it is the interventions which lead to a C-section then becoming necessary. We all have heard of “Pit to Distress” — the practice of increasing the dosage of Pitocin until the baby is born, or becomes so distressed by the unnatural labor that the doctor then has a reason to call for a “necessary” C-section. What if doctors didn’t have easy access to surgery, in the event the baby was distressed? Do you think they’d be so quick to give Pitocin to a baby that is tolerating labor, just to speed things up? I don’t. It’s relatively easy to say that it’s no big deal if the baby becomes distressed due to X, Y, or Z, because “she can always be given a C-section.” But what if she can’t? Then, if the baby becomes distressed because of something the doctor did, it’s all on him if the baby is injured or dies.

If there were no C-sections, doctors would still be taught how to best manage vaginal breech births and vaginal twin births. I think of one snippet of media coverage I saw in the aftermath of the Haiti earthquake. An American woman (probably an OB, maybe not), was attending births in the street “hospital,” and a Haitian woman was in labor. Probably the baby began “crowning,” except that it wasn’t the head, but the rump that was presenting. The American wailed, “It’s breech! I don’t know what to do!!” She had probably never seen a vaginal breech birth before — even assuming she was a trained and practicing obstetrician, she likely was trained in100% C-section for breech, rather than how to safely assist a vaginal breech birth. All well and good for America, with plenty of hospitals and operating rooms, technology and antibiotics — but when the OB is removed from all of that, what skills does she really have to help make birth safe?

If there were no fetal monitors, doctors would not feel safe with administering Pitocin, particularly in high doses, because they would have no way of knowing how the baby was tolerating it. If there were no C-sections available should the baby become distressed, doctors would be more cautious to keep the baby from distress, don’t you think?

I’m afraid that our safety net of technology and interventions has become more of a “trampoline” — rather than being used only to save someone’s life or health in rare events, it is being used on a regular basis, as if it’s meant to be bounced on. And, no, I’m not calling for a complete ban on the use of Pitocin, C-sections, or any other intervention — they have their place. However, if they were reduced only to what was necessary (which we as fallible humans cannot know with 100% certainty which are truly necessary and which are not, so we could not truly reduce the rate of unnecessary intervention to zero; but looking at some things like mortality and morbidity with and without C-sections, and retrospective studies showing that most inductions were not medically necessary [and failed inductions certainly increase the rate of C-sections], we can see that it certainly can be reduced), we would see a very different (and, I think, better) picture in labor and birth, compared to what it is now.

One time my sister was talking to a police friend of ours, and sort of complaining about getting pulled over for speeding tickets. [At the time, she did have a “cop magnet” — a sweet little black T-top Thunderbird.] And our friend said, “Always drive like there’s a cop behind you.” That’s good advice, isn’t it? We often don’t — relying on radar detectors just to keep from getting caught; but if we drove safely and cautiously, within the speed limit, and obeying all laws, we’d likely never get a traffic ticket, and we’d reduce the likelihood that we’d end up in an accident. Maybe if doctors, midwives, and nurses would “practice like there are no C-sections,” we’d be able to safely reduce the C-section rate much closer to the minimum necessary.

Prevent C-sections — learn about cervical scar tissue

This was an interesting post, and I thought I’d pass it along. If you’ve ever had a procedure done on your cervix (including, surgery to remove pre-cancerous cells, and, rarely, a D&C), you may have scarring, which can cause slow or no dilation, despite adequate contractions. One to save in the files…

Don’t just do something — stand there!

We’re used to the saying, “Don’t just stand there — do something!” and many times it’s true. Many times, however, it’s not. We value action — as measured by clichés like “He who hesitates is lost.” But we also understand the value of assessing a situation, to determine the best course of action — “Look before you leap.”

The father of a former coworker is a good example of not rushing into doing the first thing that pops into your mind. One time, there was a small kitchen fire that somehow started and caught the window curtains on fire. He rushed in, saw the fire, and pulled the curtains down. With his bare hands. Severely burning his hands, and if I remember correctly, requiring hospitalization. Far better would it have been for him to pause half a second longer, and grab a broom or some other object to get the burning curtains away from the walls and into the sink. Other similar stories abound of people throwing water on a grease fire, and spreading the fire instead of stopping it. They just reacted to the immediate situation… and reacted wrongly.

A great medical example is that of a nurse, pharmacist, or anyone else handling medication to double-check to verify that the medication they are dispensing is the medication they are intending to dispense to that patient. Or do an ultrasound to make sure that the baby really is breech before doing a C-section for a supposed breech baby (who may have flipped sometime in the past few minutes or few days).

Sometimes, it is better to pause, take a breather, and really think before acting. Or not to act at all.

What is commonly trumpeted by obstetricians is that maternal, neonatal and infant mortality dropped during the 20th century, for which they claim sole credit; what is not commonly told is that in the first part of the century, maternal and infant mortality increased under the care of doctors and particularly with births in the hospital. There are numerous quotes which demonstrate this, and show that it was known by some of “the powers that be” at the time, but I’ll just include a few [emphases mine]:

~ “Why bother the relatively innocuous midwife, when the ignorant doctor causes many more absolutely unnecessary deaths”. [1911-B; Dr.Williams,MD,p.180]

~ “In NYC, the reported cases of death from puerperal sepsis occur more frequently in the practice of physicians than from the work of the midwives’”. [Dr. Ira Wile, 1911-G, p.246]

And from the same source, later quotes from a 1975 study on the topic:

~ “Whether because midwives provided more skilled care or because obstetricians were too eager to interfere in labor and birth, obstetric mortality rates often rose as … midwife practice declined.” [DeVitt, MD; 1975]

And then from this document, quoting a conclusion made about midwives, a report presented to the White House,

“…untrained midwives approach and trained midwives surpass the record of physicians in normal deliveries has been ascribed to several factors. Chief among these is the fact that the circumstances of modern practice induce many physicians to employ procedures which are calculated to hasten delivery, but which sometimes result in harm to mother and child.

On her part, the midwife is not permitted to and does not employ such procedures. She waits patiently and lets nature take its course.”

While the doctors’ motto was, “First, do no harm,” the reality was that oftentimes, they caused harm by acting, when less harm would have come to mother and/or child had they not acted. “Well,” you might say, “that was then! A lot of things have changed since then.” Yes, and no.  Sometimes waiting patiently is still the best course of action:

Sometimes acting and intervening and speeding things up is the best course of action; but how often is slowing down and waiting on nature to take its course much better! When you have technology and gadgets and other things at hand, it’s easy to use them even when unnecessary. “When all you have is a hammer, everything looks like a nail.” And the ever-excellent quote from Jurassic Park via Jeff Goldblum, “Yeah, but your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.”

First make sure you’re right, then go ahead. — Davy Crockett

Follow the Money

“Follow the money” is a catch-phrase that people (including myself) often say, as they point out some problem that they perceive — “look to see who is benefiting monetarily.” And there is a certain element of truth to that — greed is a powerful force. People will do a lot of things for money. So it is wise to “follow the money” and make sure that the people who are selling something (literally or figuratively) have anything to gain by it.

A frequent accusation against people of one stripe or another (and probably both, if the truth were told!), is that the person can’t be believed, because he is making money off it. For example, scientists employed by Exxon or other gas companies are frequently disbelieved by the folks at Greenpeace, because of course the scientists would say that their company isn’t causing environmental problems, or else they’d lose their job! But then, what about scientists who are employed by environmentalist groups? — the same thing could be said about them! After all, if being “environmentally conscious” doesn’t actually do anything or help the environment, then why should they exist?

Then you’ve got the whole swine flu and Tamiflu stuff — H1N1 doesn’t seem to be as bad as was first believed — follow the money? where? The vaccine manufacturers, sure. The maker of Tamiflu, which may not be as good as it first appeared? Certainly. All this hype, lining the pockets of… but wait a minute. What if there had been no hype and no hysteria, and the disease really was as bad as was predicted, only nobody had talked about, it to avoid mass hysteria (sort of like not shouting “fire” in a crowded theater)? Then what? Conspiracy theory would fault… probably the same people, saying they wanted thousands of people dead, so that everyone else would line up for shots and drugs. Or blame the eeeevil government (here or there or somewhere else) for covering things up, to kill off the weak, who just end up costing the government money with food stamps and medical care, or cost all of society in larger medical bills. Or whatever.

It only takes a couple of facts to make a really good conspiracy theory. In fact, the most believable ones have the fewest facts… but the most suspicion. Facts are stubborn things, and can trip you up because they might be able to be disproven; suspicion is impossible or at least difficult to allay. It’s easy to start a rumor that somebody fathered a child with a mistress — but that can be proven or disproven with a paternity test. But did Lee Harvey Oswald act alone? Ah, the suspicions!

Recently, a scientific panel concluded that mammograms are not warranted until a woman turns 50, and then only every other year — that the risks of mammography (including radiation exposure, false positives, medical error, finding slow-growing cancers that would never cause any problems but treating them anyway, etc.) are not worth the benefit (the rare younger woman who would actually have cancer). Personally, I’m not a big fan of mammograms, and hope never to have one — perhaps the technology will improve to the point that mammography will become a relic of the past, by the time I turn 40 or 50. But I have a friend whose mother died of breast cancer, who, in her early or mid-30s gave herself a “birthday present” of a mammogram, and will probably have one every year or every other year for the rest of her life.

When the news hit that this panel had made this conclusion, I thought, “Good! Less radiation!” but then I started wondering if there might be some “dark side” to the recommendation (perhaps I have an unhealthy dose of skepticism??). On one forum (not birth-related) that I’m on, someone started off the conversation on this topic by saying that she had previously been against mammograms (mostly because of the radiation exposure, and being a pretty “natural living, whole foods” kind of person), but now that they were being recommended against, she was sure that there was something nefarious about it! She said that had this panel come out saying that “mammograms are bad and should be discontinued because they cause cancer,” then she would have supported it; but she didn’t like the reasoning they gave, so had some alternate explanation for it. I think she blamed insurance companies, because if mammograms are beneficial, they have to pay for it; but if they’re “not supported by the evidence” and “not necessary,” then that’s less money they have to pay out, and more money in their pockets. “Follow the money,” she said.

Only problem is, this works both ways! I bet she or somebody else had previously complained about mammograms being done for no good reason, and pointed at doctors who made money off of mammograms, saying, “Follow the money!” Who makes money by mammograms being standard? Presumably the doctors who order them, the technicians who perform them, the medical equipment companies who make the machines (and the X-ray films, and the developing machines, and whatever other paraphernalia that goes with them), and perhaps other people or companies as well. Who makes money by them not being used? Insurance companies spend less, but so do consumers (who don’t have a co-pay). What if, for the past decade or two, doctors have been colluding with scientists to fudge the data, to make it look like mammograms are beneficial, and, finally, the jig is up! Could be. Why not? Most doctors do what they learned in med school, and what they might occasionally read about in journals (assuming they read any), but mostly just do what everybody else is doing; and what everybody else is doing, is following “the guidelines” of recommending mammograms starting at 40. They may even have thought they were doing the right thing, but never critically examined the evidence (or, the evidence may have been false or misleading, or nonexistent), just doing what they were told to do, by those whom they trusted. Think it couldn’t happen? If not, how did episiotomies come to be seen as needful or at least beneficial 100% of the time? and pubic shaves? [However, as someone pointed out in one of the articles or blogs I read about this, even though the science does not support things like elective C-sections and inductions and other birth-related non-necessary things, insurance companies are still paying for them, so that doesn’t necessarily mean that insurance companies will stop paying for mammograms in younger women.]

A similar controversy arises over C-section rates. Some people claim that doctors like to perform C-sections because they can get done faster and make more money per birth, while others claim that a vaginal birth is really the quickest and easiest birth for doctors to attend. I can see it going both ways, and “the truth” may depend on the situation. If a doctor comes into a hospital and is with the woman 10 minutes before the baby is born, and his job is done in another 10 after the birth, then that is much less time than would be spent on a C-section, which takes about an hour, depending on circumstances. But, if the doctor is going to be interrupted at supper, or dragged out of bed in the middle of the night to attend a vaginal birth, he may very well spend more time driving back and forth to the hospital, and/or waiting for the mom to finish dilating or to push for a couple of hours than he would spend on a quick C-section. And he’d make more money since he used his surgical skills, rather than just receiving the baby in a vaginal birth. So, a doctor might have a reason other than a true medical reason, to speed up a birth or to call for a C-section — both in making more money, as well as in being able to go home and just relax.

“Follow the money” may have some truth in it. However, there are two very important caveats that immediately leap out at me. First, not everybody who stands to gain from something will do something wrong just because there is the possibility of money. True, “a bribe blinds the eyes of justice,” but there is a thing called integrity, which some people have. Let’s not be too quick to condemn our fellow man, just because he receives money. And usually, the person who creates something or provides a service actually benefits others. Plumbers and electricians come to mind. They could be crooked, but just because they stand to earn money by fixing your toilet or wiring your house doesn’t mean that they will sabotage their job, so that you’ll call them back. [And, actually, while you can make a quick buck by being crooked, you’ll also be quickly put out of business as word gets around that you can’t be trusted; the real way to get money is by being honest and trustworthy, so you get repeat business and referrals — that’s a steady income stream!] Also, many people do things out of charity, or altruism. Many people will provide a service for free, or at a reduced price, to those who cannot afford it. Or just because they’re nice. And this includes doctors. Don’t you sometimes do things without money, just because it’s the right thing to do? or just because it’s nice? Are you motivated solely by money? Would you do something you knew to be wrong, if someone offered you a few hundred dollars, or a few hundred thousand dollars?

What if I told you that the American Cancer Society, despite their high-sounding words about being “dedicated to eliminating cancer” was a bunch of hooey? What if I said that they had a vested interest in cancer being common and prevalent, because if cancer were actually defeated, then there would be no more reason for them to exist, and they’d be out of a job? What if instead of fighting cancer, they were actually dedicated to fighting alternative medicines or therapies that actually cured cancer?  Sound wacky? I’ve heard it! And who’s to say it’s wrong? After all — “follow the money”! The ACS gets a lot of money every year in donations, after all!

No, I don’t really think that the American Cancer Society is a corrupt organization. But based solely on “follow the money,” it could be! Based solely on “follow the money,” there is ample space for either proponents or detractors of annual mammograms to point fingers at the other side for being wrong. As well as global warming (there is a lot of money available for “going green,” — just ask Al Gore; but there is probably enough money for corruption on the “skeptic” side, as well). And just about everything else, as well. But just because there isn’t a lot of money doesn’t mean that a person or organization is right or not corrupt, either! After all, many panhandlers will take your money you give them for food and use it to buy liquor. A lot of people have a vested personal interest (monetary or not) in a particular ideal. I daresay that most of the people involved in Greenpeace or other environmental organizations do not make a lot of money from it, but they are as deeply committed to the environment and the ideals of the group as if they stood to earn millions from it. It doesn’t make them wrong; but it doesn’t necessarily mean that they’re right, just because they don’t make money from it.

Some people are just jerks who like to screw around with people — take the guys that are always introducing viruses and worms and trying to hack data. Some of the programs are done just for the heck of it. Sure, some of them are done to steal people’s financial information and to make/take money; but not all of them. Some people are just mean, and do it because they get a thrill out of screwing up people’s lives, or getting away with something, or just because they like to make a mess bogging down email servers. Childish. Low. But just because they don’t make a dime off of it, doesn’t mean they’re fine, upstanding citizens. Nor that just because Norton and McAfee make a lot of money on virus protection, that they’re somehow colluding with the hackers, to provide a reason for people to buy their product.

I’m sure “follow the money” is accurate some of the time. But not all of the time; so be careful what conspiracy theories you read about. Just because someone makes money doesn’t mean they’re unethical, any more than if someone does not make money, that he’s correct. Yes, money can be a very powerful draw; but sometimes, the money trail could be hidden (deliberately or accidentally), so just because you can’t see it, doesn’t mean it isn’t there. And it doesn’t always have to be “filthy lucre” — it could be power, prestige, or some less tangible asset. Accusations can be very powerful, though. And all the worse because often they can’t be disproven. How could you disprove the accusation that the American Cancer Society was actually happy that cancer kills thousands of Americans per year, because that meant that more money would likely be given to them? You couldn’t. So, be careful. Just be careful.