Sunday, 28 August 2016

Paying the price of a mid-life crisis and the potential pleasure and pain of gardening

It's that really funny time of year for those of us who work in academia – it’s the lull between celebrating our completing students at the Graduation Ceremonies, and our new students starting. There is a kind of hedonistic rhetoric to this time which is about being, free from teaching and so on, can just get on with our research and and so doing get refreshed and ready for the new academic year. I may be totally out of order here, but most academics will prioritise taking the chance to re-connect with families and friends, take a holiday and chill out.

This lull, between being set free from the pain of an increasingly controlled academic life, and the pleasure of personal fulfillment, is a form of post-modernist academic hedonism.  It was the ancient philosopher Epicurus who set out the notion that pleasure is the only intrinsic good and pain is the only intrinsic bad. According to Epicurus, something (a tangible object), experience or a state of being becomes intrinsically valuable if it is good simply because of what it is. Intrinsic value is not the same as instrumental value. Last Friday my neighbours Lamborghini was delivered. It was second hand but still cost over £200k to buy.   

Now if I was having a mid-life crisis and fancied buying one of these magnificent cars, I would need to keep working for a few more years, and even forget about retiring in 2019. I like my job, but if for a moment we imagined I was in a job that I didn't like doing, to get my Lamborghini, I would need to continue working as my salary is instrumentally valuable only because of what I can gain by it. In simple terms, I will endure the pain of whatever in order to obtain and enjoy the pleasure. 

There were a couple of stories last week, which as they lingered in my consciousness, probably sparked this thinking around the pain and pleasure notion. One was a follow up to a story I first heard a couple of years ago in Australasia. It concerned an initiative aimed at reducing the rate of teenage pregnancy. Over 1000 teenage girls took part in the virtual infant parenting programme which included sexual health education, contraception and the examining the financial costs of having a baby. The programme also included caring for a lifelike model of baby which cried when it needed to be fed, burped or changed.

The 'reality pain' of looking after a baby as teenager was meant to modify the girl’s behaviour and choices. The story, update, published in the Lancet, showed that the girls that took part in the programme were more likely to get pregnant than those not taking part in the programme. When the girls were tracked up to the age of 20, 8% had given birth at least once and 9% had had an abortion. This compared to 4% of girls giving birth and 6% having an abortion in girls not taking apart in the programme. Such programmes are not common in the UK. In the UK, between 1998 and 2013 there was actually a fall of 48% in conception rates among under 18s from 47.1 per 1000 to 24.5 per 1000.

It's not clear what has caused this change, but a reduction in alcohol consumption leading to unprotected sex has perhaps helped, as has the rise in socialising on-line. And that’s the second story. I picked up on one Cara Delevingne's crusade last week. Before last week, I didn't know who she was – apparently a 24 year old model and film star (latest film, bizarrely entitled Suicide Squad). Well last week social media was alive with the news that she is raising awareness for gynaecological cancer by posing on the front cover of the Sunday Times Style magazine wearing a sun flower covering her vagina in support of the Lady Garden campaign. 

The Lady Garden campaign is a good one. It recognises that many women are too embarrassed to talk about such personal issues and many will avoid seeking access to screening services as a consequence. Current screening services are said to prevent up to 5000 deaths a year. Even so approximately 3,100 cases of cervical cancer (the commonest form of gynaecological cancer) are diagnosed in the UK each year. Nearly all of which are related to the human papilloma virus (HPV). Up to 8 out of 10 people will be infected with the virus at some point in their lives – and for most people the infection it causes will get better on its own and they will never know they had it.

Cara Delevingne's crusade is well timed. Last week the NHS announced that its cervical screening programme will switch to first testing women for signs of infection caused by HPV rather than looking for abnormal cells. This change in approach to screening should result in those women found to have a high risk HPV infection being identified and dealt with earlier. Since 2008, girls aged 12-13 have been offered a vaccination against the 2 most common 'high risk' types of HPV. The vaccination, is not currently available to men despite the risk of men developing cancer due to HPV. A truly avoidable Epicurean hedonistic pleasure /pain situation.