Smile Like You Mean It

(Bhavani from India. 3D image is a fetus with similar defect)

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Remember that scene in Doc Hollywood when Dr Ben Stone (Michael J Fox) finally gets to LA and has his first day with the super successful plastic surgeon, Dr Halberstrom, played by the ever-over-tanned George Hamilton. I haven't seen the movie lately, but I can always recall Dr Halberstrom holding the liposuction cannula like a golf-club and saying "Cleft palates, you live for those!"

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Many sonographers are doing 3D scans of babies' faces these days. Tom Cruise even bought a 3D machine for... what's 'is wife's name these days.

Sometimes, you get the feeling families only attend the ultrasound examination in order to get their orange-colored printout or CD of the semi-profile view of their baby, all pretty and healthy.



All day the sonographers are busy scanning for 'real' rather than cosmetic reasons, such as confirming the due date and checking for things like undiagnosed twins, placenta previa, heart defects, growth failure, and other signs of life-threatening problems. When the inevitable question comes up about whether a 3D picture of the face is available, most sonographers are happy to oblige, or are forced to by their employers, even though it might add 5-10 minutes of what the sonographer may secretly think of as 'wasted time' to the already long study. About a third of mothers will be disappointed because that is the failure rate of the 3D scan - baby will be face down or there's not enough fluid around the face, or the image for whatever reason is unobtainable. By the way, studies have shown that "bonding" is no better with or without a 3D scan...

However, if the baby is in a good position and unfortunately DOES have a cleft lip and palate, the sonographer will become quite excited, even though, hopefully, they may not show this overtly.

Cleft palates, you see - You live for those.

Lots of pictures will be taken to verify the findings and with a hope to get a nice view for next week's clinical meeting. Fetal facial deformities such as clefts provide pretty much the only valid medical use of this incredibly popular scan.

But what do the parents do about it once you've found this problem? They wait. But at least it's an informed waiting. No surprises. This is what your baby is going to look like. Those high-flying cosmetic surgeons will fix it when baby is born. (I wouldn't get Michael Fox to do it nowadays though!)

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So what happens if the mother lives in an inaccessible region or is desperately poor or in a third world country? She might not have even seen a doctor during her pregnancy, let alone be uploading her 3D scans to Facebook. Her baby is born with what appears at first as a frightening deformity. Does she abandon the child, or does she protect it from the prejudices of those in her town/village/family? Does she leave it at an orphanage or with another family member who might or might not be able to care better for the baby? Even if the baby survives the difficulties of feeding and grows well, she or he is going to marked out as special, even unlovable, an object of peer ridicule.

In the NYT today, Nicholas Kristof quotes a a fair bit from a favorite book of mine, Jonathon Haidt's The Happiness Hypothesis. If you wonder why Ayn Rand followers all look so grumpy and unhappy in their externally successful lives, it is because they have forsworn against charity. Their philosophy is simple: "take".

Haidt's thesis however is that giving is one of the essential foundations of true, gut-deep happiness. Drugs work well against depression, as do Zen meditation and behavioral therapy. But being happy is more that not being unhappy. If you do things that occupy your mind and allow you to concentrate, shutting out distractions for an extended period of time, you will probably feel satisfied. Making little castles for role-playing games and painting little soldier figurines, for example. But such solitary pleasures only go so far. We are social creatures and need be involved in the world outside our skulls. Not only involved, but active in a positive, constructive way.

One of the great ways to be positive and use the benefits of our cultural capitalism, living in a prosperous nation, is that we can give generously to charitable organisation without losing or compromising anything of significance, like our blatantly sybaritic lifestyle.

Participating in the good works of charitable organisations, even from the distance of an online credit card payment, can provide you with a sense of connectedness to the world. Peter Singer's latest book The Life You Save argues that there is a "clear-cut moral imperative for citizens of developed countries to give more to charitable causes that help the poor." Wikipedia. Dr Singer donates 25% of his salary to UNICEF and Oxfam. Moral imperative or not, it can make you feel good to donate even a little bit to a good cause. It can be a step towards happier life, knowing you are making someone else happier, healthier, better educated, better sheltered or less hungry.

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The Haitian earthquake is an obvious current example. Reliable charities like Oxfam or World Vision or the World Food Program enable you to direct your donation to a specific cause, such as Haiti, if you want to it that way.

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However, Kristof's article goes on to mention the work of the Smile Train, a group that helps children in rural areas of Africa, the subcontinent and Eastern Europe with untreated cleft lip and palate. What a great way to get involved in the world.



Stop picking your nose and help some child get a new smile.

Want to make yourself happy? Make a child smile.

(Bhavani after operation)

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Any libertarians or Randians who think this is wrong can kiss my ever-smiling arse.

E@L