Fearfully & Wonderfully Body Scanned

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“Take off all of my clothes?” My voice intonates the last word as a question, rather like a child who asks her teacher if she has to complete all of the homework assignment.

I am sitting on an exam table under fluorescent lights in a clinic.  I feel cold, not only because it is an unseasonably cold April, but also because there is a deep loneliness associated with clinic visits and full body scans.

You lie naked as a stranger examines every bit of your skin. They concentrate on freckles, moles, and imperfections with frowns and furrowed brows. A magnifying glass assists them on the troubling areas and a computer helps them document what they see.

I feel an indignity as I wait, a feeling of vulnerability and loss. An indignity manifest in a naked body, the words of Adam and Eve reverberating through the centuries “I was naked and ashamed.”

I am acutely conscious of my own frailty and humanity during these times. I am astute at covering my imperfections, at dressing and acting my part in the world where I daily interact. But these moments erase all of that.

And yet, I have come here voluntarily. I have come here because I know that a short time of discomfort is far better than a diagnosis of a skin cancer. I know this well because a few years ago I was diagnosed with a skin cancer. Caught early, I now bear a beautiful scar, a war wound of sorts reminding me that scars are evidence of battles fought and souls made stronger.

We live in a world where our aging bodies betray us and tell a different story than the story that we feel. We watch as through the years people begin to respond to us differently. First, we are masters of the universe, we are young, and we are beautiful in our youth, even if we are not beautiful in our looks. We walk through this time with little thought to the older among us, or to the ones who have bodies that do not work as ours do. We may interact with a grandmother or a cute, elderly neighbor, but in our age-segregated society, we do not really know them. Out of embarrassment, discomfort, or just plain ignorance we avoid those who are trapped in bodies that do not function the same as ours do.

Then middle age comes along and the jokes begin. “Look how she’s aged” we whisper with giggles, certain that we don’t bear those same marks. But then, we catch sight of ourselves in car windows, and we wonder who we are and how we got so old, so fast. We continue to live, but the reflection that looked back at us from the car window showed us a reality that we would rather avoid.

And then the phone calls begin to come. One friend has had a heart attack; another friend is given four months to live when cancer is found throughout their body. Friends are diagnosed with diabetes and heart disease, arthritis, and cataracts. Funerals that used to be for others are now for us and ours.

We are eternal souls in temporary bodies that will need a new heaven and a new earth to redeem a broken process.

We still think we are immune – except for those now yearly physicals or body scans, where we lie naked before God and a stranger. Perhaps it is in those undignified moments that we realize that we aren’t so different from our friends. Then someday, the phone call will be about us. It’s in those times that we realize the reality of our humanity. Our scars, our freckles, and our moles on our earth suits are more pronounced, and we wonder how it will all end.

My faith tradition affirms that I am “fearfully and wonderfully made”.  And I don’t think that just means the young and able among us. Even as those who are fearfully and wonderfully made, we still need medical exams and physicals, body scans and preventive health checkups. We who are fearfully and wonderfully made need to brush our teeth and wash our bodies, eat healthy foods and exercise. In coming to earth in a human body, Jesus too was bound by his earth suit. He got hungry, tired, and dirty. He needed food, rest, and soap. He watched people get sick and die, and he didn’t heal all of them.

We are eternal souls in temporary bodies that will need a new heaven and a new earth to redeem a broken process.

How does one embrace every stage of life, appreciating what was and what is? How does one move gracefully through these seasons, putting trust in the Creator not the created; believing that there is something profoundly beautiful in our aging bodies? What does a theology of aging look like? What does holiness look like as I face my birthday and my body scan every year?

Before I have figured out the answers to those questions, the body scan is over. I am told that I don’t need to come back for another year. I am left alone with my body and my thoughts in a room that is still cold.

I get up and get dressed, inhaling a breath of thanksgiving. I am fearfully and wonderfully body scanned, and right now, that is enough.

Immigrant Families – A New Report

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Photo Credit: http://www.fhcw.org/en/Home

In the last two years, the immigration debate has become louder and arguably less civil. Political platforms and decisions based on fear have dominated the conversation, but behind the conversation are approximately 23 million people. The number includes those lawfully present as well as those who are undocumented. It includes around 12 million children who are legal citizens born in the United States, but whose parents are non-citizens.

How does the current climate affect the health and daily lives of these millions of people?

Kaiser Family Foundation wanted to find out more, and so began work with a research company to interview families in 8 cities in 4 states. They also interviewed pediatricians who work closely with immigrant families in these cities.

Their findings are significant and troubling. Among those findings are these:

  • Fears of deportation and overall uncertainty have increased in the last year. These fears extend to those who are here lawfully.

“I feel unsettled. Even though we already have the green card, if we do not apply for citizenship, I don’t think we can be at ease.” –Korean Parent, Chicago, Illinois

“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California

“There’s no stability. [The President] could write a tweet on Twitter tomorrow and turn things upside down.” –Arabic-speaking Parent, Anaheim, California

  • Children are facing increased fear that their parents will be deported and/or that they will end up having to uproot their lives and go to their parent’s countries.

“My children would come home from school and say that at school they were saying that all parents would be deported…” –Portuguese-speaking Parent, Chicago, Illinois

“All the children, even if they were born here, are fearful. They fear that anytime they’ll come back from school and won’t find their parents there.” –Latino Parent, Chicago, Illinois

“In Brownsville we have about 1,700 homeless children in the schools. Many of those children are homeless because of a parent that was deported or placed in detention.” –Pediatrician, Texas

  • Pediatricians and participants said that bullying and discrimination at work and at school has increased in the past year.

“They get bullied…told things like, ‘now you and your family will have to leave.’….And so, even though those kids don’t actually have to worry about their immigration status, I think obviously a child, they don’t know the details of how the system works.” –Pediatrician, Pennsylvania

“I work in landscaping, and we’re working and they see you working…and they just start yelling stuff at you…” –Latino Parent, Fresno, California

  • Families are making changes in their daily lives and routines base on fear.

 

“I am also concerned because if anything happens to us on the street, if we get assaulted or something, we won’t even be able to call the police because they will see we are immigrants.”      –Latino Parent, Boston, Massachusetts

“…but now around six or seven in the evening you won’t find anyone in [the neighborhood]… due to the fear we all feel about what is going to happen.” –Latino Parent, Chicago, Illinois

  • Increased fear in kids is resulting in behavioral issues, mental health problems, and psychosomatic symptoms.

“The kids who come in with concerns that you can kind of trace back to anxiety are usually the upper elementary age students, like the 3rd, 4th graders, to middle school students… 7th and 8th grade, who have nonspecific complaints like abnormal pain or headaches or decreased appetites… And then, in kids that are in the junior high to high school age range, it’s a little more overt: sadness, decreased appetite, not wanting to engage in usual activities, decreased in-school performance, those sorts of things.” –Pediatrician, Arkansas

  • Across the board, pediatricians are concerned with the long-term consequences of this environment.

“I think that we are going to have a generation of kids, who, especially in our immigrant homes, who are going to have more adverse childhood experiences than they would have. So, I think that we’re just setting up this generation of kids to have higher incidence of chronic disease, higher incidence of poor mental health, higher incidence of addiction…” –Pediatrician, California

“I think a huge worry is that children who have problems that are minor and fixable now… that, if those children go untreated, those could end up being bigger problems in the future that are going to be harder to treat and are really going to impact the child’s quality of life.” –Pediatrician, Pennsylvania


The health and well-being of immigrant and refugee communities is something I care deeply about. Yes, it is my daily work as a public health nurse, but it is more than that. It is something that is deeply embedded into who I am as a person. I have only benefitted from the many in my life who are immigrants and refugees, and it is troubling to me that there is documented fear and anxiety that is affecting the daily lives of those I care about.

What might we do to change this? What might we do to help those whose anxiety is affecting their health and the health of their families? The answer is bigger than any one of us, but some of the things that can help are these:

  • Know the law* and be able to point people to the law. Some of the fear is based on rumor. It is important to squash rumors and to point people to laws.
  • Sensitive locations. Both ICE (Immigration and customs enforcement) and CBP (Customs and Border Patrol) consider hospitals and other health care facilities to be “sensitive locations.” Both agencies have issued memoranda that say that immigration enforcement actions are to be avoided at sensitive locations, including at hospitals and other health care facilities, unless urgent circumstances exist or the officers conducting the actions have prior approval from certain officials within the enforcement agencies.
  • Right to remain silent. While immigration enforcement at health care facilities is limited by the “sensitive locations” guidance, immigration agents may enter a public area of a health care facility without a warrant or the facility’s consent and may question any person present, but those people have the right to remain silent.
  • Reassure your patients. Educate and reassure patients that their health care information is protected by federal and state laws.

An appeal to those of us who are Christians:

Caution and compassion are not incompatible; instead it is reasonable to assume that they work well together.  The state is not the master of the church. If you are part of a faith community, none of this prohibits you and your faith community from reaching out to those who may be affected. They do not prohibit you from reaching out, in love, to refugees and immigrants in your midst. It is a lot easier to wear a sign and yell than it is to make a hot meal and take it to strangers, to check in with sick neighbors, to pray for those who are anxious and fearful. We must be willing to do more than react emotionally. We must be willing to put our loudly voiced news feeds into real action.

“The ability to love refugees well doesn’t require a certain party affiliation. It doesn’t require you to vote a certain way. But it does require us to show up, to step across “enemy” lines, and to choose love over fear.” from Preemptive Love


*See this document for more information.

Note: Communicating Across Boundaries has never been, and never will be, a political blog, but I see this not as a political issue, but as a human health care issue. The brief is much longer and more detailed than this blog post. This post is simply to raise awareness of the issues that result from an environment of fear and anxiety.

Some Thoughts on Teen Pregnancy

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If you were giving a talk on teen pregnancy to a conservative, faith-based group who cares, what messages would you want to convey?

A couple of years ago I asked this question of someone in our family planning division at work. I was serious. I wanted her perspective. She did not hesitate.

I would tell them we live in a sex-saturated society, and everyone else is talking about sex – they need to be part of the conversation. I would tell them that you are not giving a teenager a mixed message if you tell them what you believe and what you would want them to do, and yet arm them with tools and knowledge about contraception if they make a different choice.”  It was a great conversation.

So armed with this, as well as facts and figures that tell more of the story of teen pregnancy I ended up leading a discussion at our church.

Along with the facts, I wanted to give a face to the story. I chose to show a clip from a documentary called “The Gloucester 18”.

In 2008 Gloucester, Massachusetts – a seaport city known for its lobster, fishing and The Perfect Storm found itself in the center of a world-wide media frenzy. Reporters from as far away as Australia and Brazil descended on the town with cameras,microphones and all the other apparatus needed for a sensational story. The reason?  There were four times the number of teen pregnancies than previous years and word had surfaced that 18 teenage girls had made a pact to become pregnant. As the nurse practitioner at Gloucester High School said “People love scandal”.

News networks preyed on this story like hawks and the girls and their families were deluged with phone calls from CNN to Dr. Phil.

So what is the real story behind these Gloucester teenagers? More importantly what’s the story behind teen pregnancy in general?

What we know:

We know several things. We know that teen pregnancy is a complicated issue and those that ignore the complexity are living in denial. “Just Don’t Do It” or teaching kids about sex by showing them Barbie and Ken in a shoe box seem to be  ineffective ways to deal with teens and sex, teens and pregnancy. While the United States has seen a significant decline in recent years, the lowest rate in 70 years, we still have the highest rate in the developing world, surpassing Great Britain, France, The Netherlands and Sweden.

We know other things as well….

  • that 50% of teen mothers get a high school diploma by age 22, compared with 90% of teen girls who do not give birth.
  • that teen childbearing costs U.S.taxpayers about $9 billion each year.
  • that girls born to teen mothers are about 30% more likely to become teen mothers themselves.
  • that children of teen parents are more likely to do poorly in school and to drop out of school
  • that half of teen pregnancies end up in abortion – if we care about abortion we need to face and care about the issue of teen pregnancy
  • that southern states have a higher rate of pregnancy than northern states
  • that less teens are having sex now then in 1988
  • that when money is put into sex education and birth control, the abortion rate goes down.

So when the discussion comes around to “Do we expect abstinence only programs to work in the world as we know it” I would say no. Any good sex education program has abstinence as a part of the curriculum, but the operative word is part not the entire curriculum.

Back to the Gloucester 18 – a face to the problem.  The truth is, there was no pact. There was no conspiracy to all get pregnant at the same time. Most of the girls found out about a pact by watching the nightly news. The stories portrayed are poignant and real. In the spirit of a good documentary there is a raw and compelling truth that comes through and you can’t stay detached through facts and figures because they now have names and faces and most of all, babies. Beyond the newspaper stories were kids having kids. Girls searching for meaning and purpose, girls looking for stability and love, girls trying to please boyfriends and parents, friends and school authorities. Girls who were still trying to grow up and ended up facing the task of motherhood and parenting.

God doesn’t force his boundaries on anyone; He may long for us to stay within them, but He doesn’t force us.

As much as I may want to wave my wand and make teenagers make different choices, I don’t have that ability. But I can understand the problem, present my view passionately and at the same time be willing to recognize the world we live in, a world we must respond to in ways that are wise. We live in a broken world, a world that is not as it should be. Our world is made up of people who have choices. God doesn’t force his boundaries on anyone; He may long for us to stay within them for our own protection, but He doesn’t force us. So what should my response be? Compassion? Common sense? Tough Love? Interest? All that and perhaps more? 

As I think about the issue of teen pregnancy and teen sexuality I think about sex as a china cup. A fragile, expensive china cup created by a Master Craftsman, with a unique and beautiful design. But once passed from the Craftsman to us to care for, the china cup broke into many pieces. And each of us try to put together these broken pieces, try to put back a pattern and restore a sense of what was.

Teen pregnancy is just one broken piece of the many. Can the Church be part of a solution to put it back together?

Note: This blog has been revised from a post written in 2012. I chose to repost because of the decision to cut millions of dollars from prevention programs.

The Full Time Job of Healing 


I am on medical leave. For the first time in many, many years I have time. I am not moving. I am not job hunting. I am not on limited vacation time. Instead, my full time job right now is to heal. 

It is one of the hardest jobs I’ve ever done. 

Here’s why: 

  1. Healing takes discipline. It takes discipline to set aside time for physical therapy. It takes discipline to eat properly, discipline to not just veg out and binge on television shows. It takes effort to get up in the morning when you hurt, discipline to put your feet on the ground. I am not disciplined and at heart, I’m pretty lazy. I would far rather have a quick fix then a slow, steady process. But healing has its own agenda and schedule., and it demands discipline. 
  2. Healing takes rest. So much of physical and emotional healing is about resting. And true resting is when both your body and soul are at rest. I find myself trying to rest, but my mind buzzes anxiously with thoughts about what I think I should be doing, how I think I should be reacting. Rest is uncommon in the Northeast. Instead, what is applauded is achievement, academic success, graduating from top schools, busy and successful career paths. Rest is something that we don’t talk about or give permission for, instead opting to glorify busy. But healing demands rest. Our bodies have undergone trauma – whether it be from surgery, from illness, or from an accident. The body’s needs for rest increase. Our bodies also need proper nutrition to augment the rest. 
  3. Healing takes humility. Giving up control is hard. Having to have others help you dress, bathe, cook, drive, clean, even put on your shoes is deeply humbling. Actively watching out for self-pity is also humbling. It’s easy to clothe self-pity into “well I’m just being honest about how I feel..” But at the end of the day, it’s still self-pity. It takes humility to follow the guidelines and restrictions of others, to trust medical personnel. It takes humility to allow strangers into your home to see how you live, and to give you suggestions and ideas of how to live better. It takes humility to accept that healing doesn’t happen on the timeline we request. It takes humility to respond to questions about our bodies, to use assistive devices when we go out the door. 
  4. Healing takes time. Above all, this is true.  Neither physical nor emotional healing comes quickly. Instead it’s a long journey.  Yes, there are things we can do to heal as quickly as possible, but ultimately it still takes time. 

And so I have time – and my only job during this time is to heal. 

Years ago, I listened to a recording of a woman who spoke on suffering. It was a powerful talk and I probably listened to it over fifty times in the course of the next few years. One of the many things she said was this: 

Our churches are full of wounded and hurting people who have never taken a season to heal. 

These words are profoundly true – true for the ones who need physical healing, true for the ones who need emotional healing. 

So I will not fight this season, nor will I wish it away. Instead, I gratefully accept my season to heal, and the gift of time. 

Hospital Time


I’ve woken early today. Only the birds sing outside, alerting me that it is spring. 

I have been on hospital time since Friday. It’s a strange, twilight time where what we think of as important vanishes, in its place comes a subdued submission to all of life. 

Hospital time is well-known to many – the cancer patient going for weekly chemotherapy; the dialysis patient praying for a kidney; the family of the child in an accident, an induced coma taking the child away for a time. 

Hospital time is part of the human experience, a definite part of aging. We are seen by doctors, recommended to surgeons, and humbly, like sheep being led, go to classes and appointments, lest we be the .3% who doesn’t do well. 

On Friday last week I entered into hospital time. I had a 3-week lead time, so in a sense, hospital time came on slowly, incrementally. 

But on Friday, it was real. Friday I was stripped of my normal identity and became a woman who was being prepared for surgery. With the signing of my paperwork, hospital time began. 

Outside, the world rushed on. Social media erupted over something, the stock market rose and fell, news stations put their overly dramatic news teams onto things both menial and important. 

But none of that mattered. What mattered was hospital time. 

When I think about Eternity, I think about hospital time redeemed; a time when all creation is healed and time surrenders to the Creator. No longer are our moments filled with rage at injustice, fear of the unknown, sadness of loss, or worry about the millions of things that are out of our control. Because time is redeemed and reconciled to our creator. 

In the meantime, I am still in my other world of hospital time, taking the moments to heal and rest, realizing that life will go on without me at its center. And in this time, I am enveloped in grace. 


Readers- I would love it if you entered this book giveaway for Passages Through Pakistan at Goodreads! 

Enter here! 

On Vanity and “Skiing Accidents”


“I think surgery is the best, maybe only, option.” 

I’m not surprised to hear these words from the surgeon sitting across from me. Aside from his appearance (he looks like he is 12) I think I trust him. I did the google on him, and evidently his competent 12 year old hands and brain have a brilliant success rate. 

For months now I have had increasing pain in my hip. When treatments, physical therapy, and sheer grit did not work, I decided to see a surgeon. 

So I find myself sitting across from a stranger who is showing me an X-ray of my hip. What I see is not pretty. 

“Can I tell people it’s a skiing accident?” I ask. I think I whined, but I can’t remember. He laughs. He thinks I’m joking. 

But my pride is hurt. My vanity is wounded. I feel far too young to have a hip replacement, especially when I can blame it on nothing but arthritis. If only I was an athlete – a runner, a skier, an aerobics instructor! 

I am none of these things. 

I am a 57 year old woman with arthritis. 

Just saying it makes me want to curl up in dismay. 

Secretly, I think we all believe that aging is for other people, not for us. We secretly remark on how “grey and wrinkled so and so is getting,” while in the mirror the wrinkles hide under the perfect make up foundation – denial. 

Denial paints our bodies and skin in the flawless glow of youth, even as we marvel at the years weighing others down. 

Aging is not for the timid, not for the fearful, and I fear I am both. 

In late February I visited my parents in Florida. Though they live in Rochester, New York, they have tried to get away for a couple of months the last few winters. Rochester is cold, snowy, and icy. It’s a fall waiting to happen and the prospect of warmer weather drew them to warmer climates. So at the end of February I found myself visiting them in Panama City Beach.

This area is known for its incredible turquoise water and white sand. The contrast is stunning. Along with this contrast is the contrast between the young and beautiful and the snow bird aging population. 

The weekend did not turn out the way we expected, but we still deeply enjoyed each other’s company.  As I looked with eyes of love on my parents I realized that I don’t like the aging process. But as I watched them, I recognized that I am not afraid for them – I’m afraid for me. I don’t have the kind of stamina and courage they do. I don’t have the faith that they do. I am not brave. I do not want to age.

It is a relief to admit this. I do not want to age. It’s not about the wrinkles, though they are tough. It’s about the body. 

Aging is hard work, and I am lazy. Aging is for the courageous, and I am not. 

I don’t feel sorry for my parents. They have taken all the changes with incredible grace. Their minds are alert and active. They live independently. They take their pills with discipline and a good deal of humor and grace. 

I feel sorry for me – because I clearly have some things to learn about life and the body, and I better learn them quickly. 
Perhaps being honest about this surgery is my first step. Perhaps admitting publicly that I am vain, that I have to have a hip replacement, and that it is NOT because of a skiing accident, or a marathon run, or a heroic act of physical courage is the best first step. 

I wake up this morning and I take off the make up of denial, and I pray for courage and strength to face a reality that every human being who lives longer than 50 has to face: The reality of aging. 

But I still may tell people that it’s because of a skiiing accident….,

Dear Seema: The Politics of Prevention

 

Note: Seema Verma is President Trump’s nominee to lead the Centers for Medicare and Medicaid Services in the United States.

Dear Seema,

I’m a Registered Nurse who works in Boston, Massachusetts. I have witnessed first-hand what it is like for people to go without insurance, to delay preventive health screening only to find out that cancer is a far more expensive problem.

There are not a lot of things that make my proverbial blood boil, but reducing access to preventive healthcare, including maternity benefits, does. It makes me so angry I can’t see straight.

Look, I get it. Health care is expensive. Someone has to pay for it. But everyone bears the burden of an unhealthy society and while the Affordable Care Act (aka Obama Care) was not perfect, it began to put some policies in place that have been needed for a long time.

I come to this not from any political party line. I am a proudly independent voter – in fact, prouder by the day that I don’t buy into that assanine system called “two party.” I also live in Massachusetts where a Republican governor put health care reform as a top priority over 8 years ago and we are slowly reaping the benefits.

 

When, at your confirmation hearing, you mentioned that coverage for maternity benefits should be optional, I shook my head in disbelief.

Optional? Optional? I had to repeat it to myself to believe that you actually said it. The argument goes that if you’re a man or too old to get pregnant, then why should you have to pay for someone to have a baby? The lack of logic and understanding in that idea astounds me! The logical conclusion is that I shouldn’t have to pay for any of the choices that others make. So, by your logic, I shouldn’t have to pay for the business man who has a heart attack and needs bypass surgery. After all, I wasn’t the one who ate and drank too much. It was him.

Maternity benefits are an essential part of a healthy society. Maternity benefits speak to the value of family and children, they provide essential care for a future generation.

As Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women says: “We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs,”  But insurance is not designed to be an  “a la carte approach”. “Women don’t need prostate cancer screening, but they pay for the coverage anyway.”

When as a nation did we allow politics to co-opt our health, to feed us misinformation about insurance and that terror-producing term ‘socialized medicine’? Truth is the term ‘socialized medicine’ is a made up phrase. It was first heard in the early 1900’s but came into wide use when the American Medical Association fought against a national health insurance plan proposed by President Truman. It conjured images of a hammer and sickle approach to health care that would lead us down the slippery slope to communism. That was in 1947 – and it was a public relations coup, for in the six and a half decades since that time we have allowed the term to rule us, to be thrown around willy nilly to produce fear and anger, obnoxious and ignorant voices leading the way.

Here’s what happens when you let politics coopt prevention: 

A breast cancer lump ulcerates and eats away the flesh of a breast; a cervical lesion, easily removed, grows and turns into a completely preventable cancer; a gnawing indigestion and bloated feeling turns into cancer eating away at your colon – fully preventable had screening taken place early in the disease process. You know what else happens when politics coopts prevention? Abortion rates, already far too high, go up. You can’t have it both ways – you can’t want abortion rates to go down and yet reject the notion of maternity care and birth control coverage.

Preventive health is not about being Republican or Democrat or Independent or Green Party or Libertarian. Preventive health is about the health of a society as a whole; it is about being human, living in a broken world where illness and death and “pre-existing” conditions are a reality. Preventive health and being sick is not about politics. When will we in the United States get that?

What you should want to do in your tenure is make the Affordable Care Act better! You should want to expand on it and leave a legacy that puts Obama Care into the water. You should want to make a name for yourself as a person who makes health care great, not just tolerable.

Instead, I’m shaking my head and saying: “What in the name of Sam Hill is she thinking?” 

C’mon Seema! Be a Woman. Stand up for what is right.