Sharon Lerner

How Rural, Conservative Oklahoma Built the Nation's Best Model for Early Education

Four-year-old John Kaykay is a serious and quiet boy—“my thoughtful one,” his dad calls him. When the official greeters at the front door of the McClure early-childhood center in Tulsa welcome him with their clipboards and electric cheer—“Good morning, John! How are you today?”—he just slowly nods his small chin in their direction. When he gets to Christie Housley’s large, sunny classroom, he focuses intensely on signing in, writing the four letters of his name with a crayon as his dad crouches behind him. When he’s asked the question of the day—“Do you like music?”—he pauses for a minute before putting his magnetic nameplate in the “no” section. 

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How Our Health System Screws Over Women

To be sure, no group is doing well under our network of private insurers, which is more holes than net. But women fare particularly badly in terms of health, being more likely than men to leave a prescription unfilled; forgo seeing a needed specialist; and skip a medical test, treatment or follow-up. Financially, women are worse off, too, in large part because they earn less money. Despite the fact that they skimp on their care to cut costs, three in five women are still unable to pay their medical bills. All of which makes it surprising that men and women support health reform in almost equal numbers (38 versus 40 percent consider it a top priority, according to a recent Kaiser poll). Odder and ickier still is the sight of Sarah Palin, Betsy McCaughey and other women leading, or sometimes blindly following, the wacko town hall movement against reform.

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A Post-Roe Postcard

Thirty-two years ago the right to have an abortion was affirmed by the Supreme Court. Gov. Haley Barbour of Mississippi is marking the anniversary of Roe v. Wade with an official proclamation declaring the seven days leading up to the anniversary "a week of prayer regarding the sanctity of human life." Barbour also authorized the placement of tiny white crosses on the lawn of the state Capitol "in memory of the unborn children who die each day in America," according to the decree. The crosses have been planted for the past three years, though this year Barbour will be at President Bush's inauguration during the official anniversary event, and the display was moved to a nearby churchyard. Barbour is a Republican, but it should be noted that the tradition of transforming the Capitol lawn into a symbolic mini-graveyard was begun by the previous governor of Mississippi, who was a Democrat.

With eight of nine U.S. Supreme Court Justices over 65 and one seriously ill with cancer, much of the country is understandably focused on the possibility that their soon-to-be-appointed replacements will overturn the decision upholding the right to abortion. But in Mississippi, in many ways, Roe has already fallen. Abortion is legal here, of course, as it must be throughout the country while the landmark ruling stands. Yet, for many women, the ability to terminate a pregnancy is out of reach, buried under state laws that make the process unnecessarily difficult, discouraged by a sense of shame enforced by practically every public authority, and inaccessible for many who lack money to pay for it.

How Mississippi all but outlawed abortion is a story people on both sides of the abortion debate are still struggling to understand. Few would expect this famously conservative Southern state to be prochoice. And Texas, Louisiana and a few other states have been competing for the dubious distinction of being the worst place to be if you want or need to end a pregnancy. But Mississippi has gone further in its hostility to abortion even than other Bible Belt states. A small, mostly rural population and the absence of local prochoice organizations have helped turn Mississippi into the perfect laboratory for antiabortion strategists.

Virtually every possible restriction on the procedure exists here, from a mandatory 24-hour waiting period after counseling, to a requirement that minors obtain the consent of both parents to have an abortion, to 35 pages of regulations dealing with such physical characteristics as the width of a clinic's hallways and the size of its parking lot. The mounting restrictions (Mississippi passed six anti-abortion laws last year alone) have delighted anti-abortion activists all over the country, who have hailed – and copied – the state's innovations.

Meanwhile, pro-choice activists see Mississippi as a glimpse of what might become the norm in a possible post-Roe future. "It's the canary dying in the mine," says Nancy Northrup, president of the Center for Reproductive Rights. If the Supreme Court were to reverse the decision, abortion would likely become illegal in 30 states, including Mississippi, according to a 2004 report by the center. Across what can seem like a great divide, the 20 other states have laws, constitutions or court decisions that would protect the basic right to abortion even if Roe falls. While some of these, including New York and Washington State, which both decriminalized abortion before 1973, will likely remain strongly pro-choice, others may pass restrictive laws like Mississippi's.

Even while Roe stands, Mississippi is a cautionary tale for the rest of the country. "It's what can happen if the constant strategy of chipping away at Roe is not met with sufficient push-back from the pro-choice movement," says Northrup. So in order to preserve the right to abortion, prochoice Americans would do well to learn how Mississippi all but eliminated it.

Jackson Women's Health Organization occupies a small stucco building on a quiet, tree-lined street. If not for a handful of people holding "I'll Pray for You" and "Don't Kill Your Baby" signs, you'd hardly know it was Mississippi's only remaining abortion provider. There used to be others. In 1996, there were six medical facilities providing abortions in Mississippi. But since last August, there has been only the Jackson clinic, which is staffed by three part-time physicians, only one of whom lives in Mississippi. (Two others fly in from other states to work for a few days at a time.)

Many of the chairs in the clinic's waiting room are full on the four days a week that abortions are done, but the Jackson Women's Health Organization is not overly busy. That's because the number of abortions performed in the state has plummeted as restrictions have mounted. While there were 21.3 abortions for every thousand women of reproductive age nationwide in 2000, in Mississippi there were only six, down from more than thirteen in 1991.

With the third-highest teen pregnancy rate in the country, Mississippi's low number of abortions is not an illustration of the "safe, legal and rare" ideal that many talk about, in which a decline in unwanted pregnancies creates a corresponding drop in abortions. Rather, it is the direct consequence of concerted opposition to abortion from the grassroots to all levels of government.

Such concern for the rights of fetuses does not appear to translate into a commitment to promoting the well-being of the children they may become. The uncomfortable irony for an opposition movement purportedly concerned with saving "innocent babies" is that restrictions on abortion are associated with worse outcomes for actual babies. Indeed, children fare terribly in Mississippi. The state with arguably the least access to abortion also has the second-highest rate of child poverty in the country, according to the Children's Defense Fund. Mississippi's infant mortality rate – a good indication of the health of both women and children – is the highest in the country. For every 1,000 live births, 10.5 infants under age 1 die in Mississippi. In parts of the impoverished Delta region, that number ranges up to 18. (The national infant mortality rate, by comparison, is 6.8.) Interestingly, a post-election comparison found that "red" states had higher infant mortality rates than "blue" ones. In general, states that restrict abortion spend far less money per child than prochoice states on services such as foster care, education, welfare and the adoption of children who have physical and mental disabilities, according to a 2000 book by political scientist Jean Reith Schroedel.

Schroedel also found that women in anti-abortion states are worse off than their counterparts in pro-choice states. They suffer from lower levels of education, higher levels of poverty and a larger gender gap in earnings. They are also less likely to enjoy mandated insurance coverage for minimum hospital stays after childbirth. Together, the conditions make for an abysmal reality for women in Mississippi, which came in 51st in a 2004 ranking of the status of women in the 50 states and Washington, DC, published by the Institute for Women's Policy Research.

The poverty of women in Mississippi both increases their need for abortions and their difficulty in obtaining them. In the poorest state in the country, where more than one in five women lack health insurance and live below the poverty line, girls and women are often unable to get birth control. Only about two in five women and teens in Mississippi who need publicly financed contraception receive it, according to the Alan Guttmacher Institute, which does research on reproductive issues. Though the inability to prevent unwanted pregnancies makes women only more likely to want abortions, many of the forces behind the anti-abortion movement here also oppose contraception. Pro-Life Mississippi, for instance, regularly protests the only Planned Parenthood office in Mississippi, which is in Hattiesburg, even though it provides only birth control, not abortion.

Because of the intensely hostile climate toward abortion, 60 percent of Mississippi women who want to end their pregnancies go out of state to do it, according to the Guttmacher Institute. Some others may even resort to illegal abortions. In the Delta, the poorest region in the state, parts of which are four hours from Mississippi's one clinic, "lay midwives" minister to unwanted pregnancies, according to several sources. Many others want the procedure but simply cannot afford to pay for it.

Betty Thompson hears from these women regularly. Thompson, who worked as counselor and then director of the Jackson Women's Health Organization for years and is now a consultant to the clinic, says women often call saying they want abortions but don't have the money to pay for them, and delay the procedure because they lack the funds. (The clinic charges from $380 to $615 for an abortion, depending on the stage of pregnancy.) About once or twice a week, she says, the clinic gets calls from women who, while trying to gather money or arrange to travel to Jackson, have passed the sixteen-week gestation point, beyond which the clinic can't provide abortions. "There's nothing we can do then," she says.

Thompson, a stately grandmother who had her first child when she was 16, says the National Women's Health Foundation used to provide money to help women who couldn't afford abortions at the clinic. But since the funds dried up last year, she often finds herself encouraging resourcefulness among women desperate for abortions. "I have to play the social worker," she explains. But hers is an unusual sort of social work. "I say to them, have you tried to borrow money from everyone you could? Have you tried to sell your jewelry yet?"

Mississippi forbids facilities that receive public money from performing abortions and bans Medicaid funding for them. Though the law officially makes exceptions for cases of rape, incest, fetal anomaly and danger to the woman's life, clinic staff say they have not once succeeded in collecting Medicaid reimbursement in these cases. "We've filed for it and we've never been paid for them, and so we don't even file anymore," says Susan Hill, the Jackson Women's Health Organization's president. Hill, who was a social worker before Roe, says, "Mississippi is like the rest of the country was before 1973." Women who arrive at her clinic "have that same look in the eye now," she explains. "They have to go through the same kind of struggles."

Some, for instance, end up spending the night in their cars after driving to the Jackson clinic. Mississippi requires that everyone seeking an abortion wait at least 24 hours after an informational session before having the procedure. Because 98 percent of women here live in a county without an abortion provider and some live several hours away, getting an abortion can turn into a two-day ordeal, and many patients struggle to find childcare and a place to stay while they're away.

The mandatory delay has also lowered the number of abortions and caused many to be performed later in pregnancy. The abortion rate in the state declined from 11.3 percent to 9.9 percent in the six years after the law was enacted in 1992, according to a study published in Family Planning Perspectives in 2000. (Another study compared Mississippi's abortion rates to those of South Carolina and Georgia during the same period and found the drop to be specific to the state, suggesting that the policy change was responsible.) The study also showed that after the law went into effect, the proportion of second-trimester abortions increased by 53 percent among women whose closest provider was in Mississippi.

In case the waiting period and the cost aren't enough to discourage teens from ending unwanted pregnancies, Mississippi also has a well-enforced requirement that minors get the permission of both parents before having an abortion. The only way a girl can get around the law – one of only two in the country – is to go before a judge and explain why she wants an abortion and can't tell her parents. One attorney, who has represented minors in such judicial reviews and did not want to be identified, said her clients, who have included an 11-year-old whose mother was a crack addict, were "scared to death" by the process. "It's a huge deterrent," she said.

Doctors who perform abortions, meanwhile, bear the brunt of the organized anti-choice movement's wrath. Consider what happened to Donald Whitaker, a young doctor who until January 2004 was part of an OB-GYN practice in Hattiesburg and also provided abortions on a volunteer basis at the Planned Parenthood clinic in Mobile, Ala. Last winter, protesters in Mobile identified the doctor, tracked down the address of his Hattiesburg office and began protesting in front of it – even though neither Whitaker nor his colleagues performed abortions there. The protests were led by anti-abortion activist Father Edward Markley, who spent time in federal prison after attacking clinic employees and taking a sledgehammer to a clinic in Alabama. Weeks after these protests began, the doctor resigned from his job and left the state.

An unmistakable undercurrent of violence runs through the anti-abortion movement in Mississippi. Roy McMillan, for instance, who can be found most afternoons in a lawn chair across from the clinic in Jackson, has been arrested 62 times in his 25-year career as an activist. He has threatened clinic staff, and put his fingers in the shape of a gun and "shot" them, earning himself a federal injunction that requires him to remain at least 25 feet from the building. McMillan also signed a declaration calling the murder of abortion providers justifiable and was a longtime friend of Paul Hill, the anti-abortion activist who was executed for murdering Florida abortion provider Dr. Bayard Britton and his clinic escort, 74-year-old Jim Barrett.

McMillan, who was dressed in a Santa outfit when I met him on a 50-degree day in December ("This is a time for peace on earth, not war in the womb," he explained), seems happy to play the part of extremist. He shouts "For shame!" at women heading toward the clinic, carries a plastic baby doll with him and hasn't held a job in 19 years. Yet, nutty and dangerous as he may seem to many, McMillan enjoys a certain legitimacy in Jackson. He is married to a prominent local physician, who after providing the first abortions in the state had a religious conversion (and married McMillan) and is now one of several OB-GYNs in the area who refuse to prescribe birth control. And though McMillan says he would like the state to move more quickly to become the first to be "abortion-free," he says he feels his state government is on his side.

This is not McMillan's imagination. The governor has made his anti-abortion passions perfectly clear. The local circuit courts have repeatedly shown themselves to be negatively inclined toward abortion. And I was unable to find any Mississippi legislators who openly identify themselves as pro-choice. "Either you say you're pro-life or you don't say anything," explains Erik Fleming. A Democratic state representative who was described to me as the most likely state legislator to call himself pro-choice, Fleming bristled at the term. "I don't like to be put into that label thing, because when you put a moniker saying you're against life, that's pretty strong," says Fleming, who supports limiting abortion and has sponsored legislation that would ban abortions after the first trimester of pregnancy.

The equivocation of folks like Fleming, who works as an abstinence educator when the legislature is not in session, is still better than the outright terror of the issue some other Mississippi politicians display. In the November election for state lieutenant governor, the incumbent, Republican Amy Tuck, accused the Democratic candidate, State Sen. Barbara Blackmon, of being pro-choice. Blackmon, who does support abortion rights, might have said, "One in three American women has an abortion by age 45. I support keeping it safe and legal for them." Or maybe even simply, "Yes, I'm pro-choice. Next question?" Instead, she responded by accusing Tuck of having had an abortion herself, and challenged her to sign an affidavit swearing she hadn't. Tuck signed the affidavit and won the election.

The fear of being associated with the issue extends beyond government officials. Even Mississippians who are outraged about how their state has handled abortion were afraid to be named in an article about it. ("I'm a Catholic, my priest would kill me," is how one explained it.) And the issue is "too divisive" for the Mississippi Coalition on Women to address, according to one of the group's founders. Meanwhile, the few willing to work openly on the issue are overwhelmed. Susan Hill, who runs clinics in Wisconsin, Indiana, Delaware, Georgia and North Carolina, in addition to Mississippi, says she saves her energy for the big fights. Currently she's leading the battle against a renewed push to ban abortions after the first trimester of pregnancy, which ends around the twelfth week. Already, the state limit is 16 weeks, though Roe allows abortions until the point of fetal viability, at least 20 weeks into pregnancy. Sixteen weeks is a significant cutoff, since amniocentesis and other tests for fetal abnormalities are performed at that point. As a result, women cannot get abortions in the state because of problems discovered through these tests.

Operating in triage mode has meant that no one in Mississippi has found the time to sue over highly questionable state policies. So, by law, clinic doctors must give the scientifically unfounded warning that having an abortion might increase the risk of breast cancer. The state issues "Choose Life" license plates despite the fact that the practice has been found unconstitutional in other states. And the governor's proclamation, which declares that "the time has come" to overturn Roe v. Wade in addition to authorizing the display of the crosses, has gone unchallenged.

Mississippi, the proclamation tells you, lives by a different law from the rest of the land – for now, anyway. And even while they challenge it simply by running Mississippi's last remaining abortion facility, Susan Hill and Betty Thompson have been forced to accept that reality. In his lawn chair outside the clinic, Roy McMillan rejoices in it. And the women of Mississippi, who sleep in their cars, shuttle out of state and bear unwanted children in poverty, live it.

When There Was No Choice

At 77, Dr. Harry S. Jonas can still pinpoint the exact moment when he understood the importance of making abortion legal. The year was 1952 and he was an eager, young obstetrics-gynecology intern in Independence, Miss.. The specialty promised exciting pregnancies and bouncing babies, but his very first patient entered the hospital extremely sick. A mother of 12 children, she had tried—unsuccessfully—to induce an abortion. "She came into the hospital with her intestines hanging out her vagina," recalls Jonas. "Then she died."

For Mildred Hanson, the belief that abortion laws had to change came more gradually, even after she first learned about the danger of illegal abortions as a girl in rural Wisconsin. In 1935, when Hanson was 11, a woman on a neighboring farm died at home after having an illegal abortion. Hanson remembers her mother going next door to help the ailing woman, holding her while she died. The widower was left with six children, two of them in diapers.

By the time she finished her medical training in 1959, Hanson was seeing many patients with complications from illegal abortions. Some had gone to illegal practitioners. Others attempted the procedure themselves using rubber tubes, knitting needles, or potassium permanganate—a corrosive substance that could end a pregnancy but all too often only caused bleeding, ulcers and burns. And of course there were the wire hangers. Hanson eventually developed a reputation for being among a minority who would treat these women. She tended to their infections, bleedings, and wounds for almost two decades. And by the time abortions became legal, Hanson knew she would perform them.

Eugene Glick's first experience with illegal abortion was personal. His wife, who was then his girlfriend, was 19 when she got pregnant in 1951. Neither was ready to have a baby—she wanted to finish college and he was planning on going to medical school. They thought they were lucky to find an OB-GYN willing to perform the procedure illegally, but "he didn't even sterilize the instruments," as Glick remembers. Glick's wife got a serious infection and wound up needing major surgery.

When he got to medical school, Glick noticed his teachers willfully ignored the consequences of illegal abortions. "They didn't want it to even appear that they knew what to do," he remembers. But Glick couldn't overlook the desperation—and began finding ways to perform abortions even before they were legal. His hospital had an abortion committee, which would approve the procedure if a doctor determined that a pregnancy threatened a woman's physical or mental health. "We all knew which psychiatrist to send them to," says Glick. "All of us sort of bent the rules." Eventually, in 1977, after delivering 5,000 babies as an obstetrician, Glick started performing abortions full-time.

If their paths toward providing abortions were different, Hanson, Glick and Jonas have a few things in common. Like many other doctors committed to choice, they witnessed the devastating consequences of illegal abortions firsthand. This week, the 32nd anniversary of Roe v. Wade, the Supreme Court decision establishing the constitutional right to end a pregnancy, will occur just two days after our anti-abortion president celebrates his inauguration. With several Supreme Court appointments potentially at stake, it's worth remembering what those pioneering physicians learned through treating thousands of women who'd had unsafe abortions: Outlawing the procedure doesn't make it go away.

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Abortions were common well before New York decriminalized them in 1970 and Roe made them legal in the rest of the country in 1973. The Alan Guttmacher Institute, which does research on reproductive issues, reports that in 1930 almost 2,700 women died from illegal abortions—and that's just the number who had abortion recorded as their official cause of death. Almost one in 10 low-income women in New York City reported having attempted to end a pregnancy with an illegal abortion, according to one study done in the 1960s. In 1962 alone, almost 1,600 women were treated for incomplete illegal abortions in at Harlem Hospital. And there's plenty of current evidence showing the danger of outlawing the procedure. According to the World Health Organization, an estimated 80,000 women around the world still die each year of complications from illegal abortion.

Roe v. Wade quickly cleared up this country's illegal-abortion mess, almost overnight. Deaths from botched abortions slowed dramatically. The number of women admitted for unexplained miscarriages dropped precipitously. And doctors could finally spare their patients the dangers of untrained, illegal practitioners or self-inflicted injuries without risking jail time or their medical licenses.

Yet some physicians, especially younger ones, don't seem to grasp the grim situation women faced before 1973. "Doctors who weren't practicing before Roe don't fully understand about the kind of degradation and death that really resulted from illegal abortion," says Wendy Chavkin, chair of Physicians for Reproductive Choice and Health, and a professor of OB-GYN and public health at Columbia University. "As a result, they're more likely to be vulnerable to the attacks on abortion and decide that performing them is too much trouble. What they don't know is that, without legal abortions, their patients will suffer, die, or have drastically reduced life options."

The fading of collective memory helps explain why the number of doctors willing to perform the procedure is falling. There were only 1,819 abortion providers in 2000, down 11 percent from the 2,042 abortion providers in 1996, according to the Guttmacher Institute. And these days, as legal restrictions on abortion mount, most doctors who do abortions are over 65. Rather than performing the procedures in their offices or in hospitals, they've been forced to do them in freestanding clinics, where they and their patients are exposed to violence and harassment.

Hanson, who lived through darker times, has noticed the shift. "To perform an abortion in a hospital is harder today than it was before Roe," says Hanson.

"Before 1973, I had no trouble scheduling them. You just had to find two doctors to sign the form," she says, referring to the paperwork declaring that a pregnancy threatened a woman's mental health. "Now if you want to do an abortion in a Minnesota hospital, you have trouble finding an anesthetist and a circulating nurse who will do it. There's more anti-abortion sentiment." Nevertheless, Hanson still performs abortions at 81 because of "personal commitment," as she puts it.

In New York, William Rashbaum, a 78-year-old obstetrician and gynecologist, also continues to work well past what many think of as retirement age. As with other veteran abortion doctors, Rashbaum's career has spanned many eras. He saw "gobs and gobs" of women with complications from illegal abortions during his training in New York City in the 1950s. Then Rashbaum went on to provide medical advice and backup to illegal abortionists before Roe. (One, in New Jersey, sent a limousine containing a pale, bleeding patient and the piece of her intestine he had accidentally cut off to Rashbaum's office.) And after abortions became legal, he provided them. Now as his practice winds down, Rashbaum worries that the right to safe, legal abortion is slipping away. "You'd be crazy not to worry," says the white-haired physician. "Abortion has always had a stigma. And now, instead of things getting better, they're getting worse."

Romancing the Coconut

So your standoffish therapist isn't helping that much in the romance realm. "Well, what do you think?" she asks, smiling noncommittally, as if you'd be there if you knew why you were dating the guy who was afraid to take off his pants. Or maybe she throws out that other conversation stopper: "That's an interesting question." Really, why go round and round about interesting questions when you have immediate, pressing, and deeply annoying love problems to solve? And while we're being honest, why do all that problem solving yourself when you could have someone else do it for you?

Maybe they can't do all the heavy lifting, but an array of spiritual guides, coaches, and renegade romantic consultants are doing their damnedest to help fix your love life. Depending on your financial situation, skepticism level, and particular vexation, this varied bunch of practitioners will summon relief through "lucky oil," life-partner-envisioning sessions, or the energy of your very own body. And while your therapist may sidestep the sticky questions of what you should actually do about your dilemmas (way too directive), some of the guides listed here will not only tell you how you should solve your problems, but also draw on higher powers to help you with them.

Take Papo, for instance. A practitioner of his own special blend of Santería and espiritualismo, a belief that centers on communicating with the spirits of the dead, Papo's happy to dole out predictions, if he's feeling them. At age 10 the young psychic, who then lived in the Rockaways, started having visions of what would happen, including a dead-on premonition that his mother's workplace would burn down. (Papo swears he didn't set the fire.) Next, his mother's friends started coming to him for guidance. And he's been reading cards (brisca, the Mexican kind, not tarot), filling pumpkins with lucky oil, and lighting candles for a steady stream of clients ever since.

In almost 30 years on the job, Papo, who was born Carlos Altuz, has applied his intuition to illnesses, tax problems, and even a workers' compensation lawsuit. (After more than two years and several candle lightings and prayers, his client -- the plaintiff -- ultimately prevailed.) But this "spiritual psychiatrist," as Papo calls himself, says most of his clients journey to his East New York living room for his "white magic" love spells. Just bring him a picture of your beloved and an item of his or her clothing -- and pay about $25 -- and Papo will contact the appropriate spirits through the shell of a coconut to see that the arrows fly in the right direction. "The coconut has an oracle in it," he says. "The spirits do talk through it."

How does he hear them? "You have to believe," says Papo, smiling from his green velvet couch as his next appointment appears at the door.

At first the mood in Deborah Roth's peach-colored office seems slightly less mystical than at Papo's place. Talking on her headset telephone while thumbing through a binder, the interfaith minister, life transition coach, and relationship coach can seem all business. But beside her computer you may notice a container of yellow oil and roots. A towering blond who used to work in corporate personnel, Roth, it turns out, devised the love potion herself. (This one, which a couple will soon use to anoint one another at their wedding, contains cloves for protection and the root ylang-ylang, which Roth says she put in for "great sex.")

Personal coaching, which has exploded over the last decade, takes a direct approach to life's problems. Focusing on the present -- as opposed to psychotherapy, which traditionally deals more with childhood wounds -- a life coach might give you an assignment like "Join a gym by Wednesday" or "Write down the five reasons you want to change jobs." Roth began by applying her practical guidance in such straightforward areas, but soon found herself drawn into her clients' love lives. "Initially they'd come in and say they're not happy work-wise," says Roth. "But often we'd end up talking about their relationships."

As she saw more and more clients who were either struggling to work things out with their partners or trying to get into relationships, Roth began searching for a structured approach to working with them, ultimately taking up a meticulous relationship-coaching program designed by the California-based company LifePartnerQuest. The five-session course (for which Roth charges $595) begins with "readiness coaching," in which a single person examines his or her relationship history, develops a profile of an ideal life partner, and according to the manual, develops a "Relationship Plan to manifest/ attract Life Partner." After "Attraction Coaching," which includes where and how to meet potential life partners, and "Pre-Commitment Coaching," in which a client figures out whether someone they're dating is right for them, the search for satisfaction ends with both partners participating in "Bliss Coaching."

This resolutely no-nonsense approach can seem to treat love like Ikea furniture: Follow the directions and you'll end up with something at least serviceable. Indeed, some might find the content of relationship coaching sessions surprisingly banal; coaches talk to their clients about which Internet dating service to use, for instance, or whether they should get a haircut. But by adding in her interest in both rituals and astrology, Roth has built a strange amalgam of love tools. She helped one client come up with a ceremony to rid herself of her ex (the woman wrote his name on a stone and tossed it into her favorite lake). For others, she customizes candles with glitter and leaves to symbolize their relationships. And she's now putting together a group of both men and women who will go through the LifePartnerQuest coaching together, though Roth is emphatic that group members won't be allowed to date one another.

Perhaps that's fine, though. "First you have to be able to love yourself," says Laurie Bell, who has what she calls an intuitive gift for helping people and conducts workshops on self-love (not the physical kind). Bell also works with individuals and couples, doing everything from healing touch and body work to meditation -- all of which, she says, is rooted in learning to love. "Every single person from Bush to you and me is learning how to love ourselves," says Bell. "That's how we'll love others better."

"It's an exploration," Bell says of relationship struggles from the petty to the presidential. And as this alternative healer is warning you that the process is never easy and that, no, she can't really do it for you, you're reminded of your therapist. "No matter who you're with, your journey is about your own development," she says. "What do you think?"

Sharon Lerner is a regular contributor to The Village Voice, where this article originally appeared.

Hormonal Outrage

You'd think she'd be happy. After more than 15 years of challenging the dogma that all women need hormone replacement to prevent heart disease and bone breaks after menopause, Maryann Napoli has been vindicated.

Last week, after its findings revealed that the combination of hormones taken by some 6 million women was doing more harm than good, causing an increase in heart attacks, breast cancer, blood clots, and strokes, a national study was halted mid-stream. Wyeth, which has raked in more than $2 billion a year from its top-selling hormone therapies -- and received its share of precisely worded, critical letters from Napoli over the years -- is now watching its stock price dive. Doctors who once eagerly prescribed the treatment are admitting their error. Yet Napoli, associate director of the Center for Medical Consumers in Manhattan and one of a handful of women's health advocates who have tirelessly played David to the hormonal establishment's Goliath, seems a little sad.

"I just wish there had been more caution about giving women this drug combination in the first place," she says, looking up at the shoes passing by the window of her tiny, donated office space in a West Village basement. Instead, "they turned a stage of life into a disease for which you're supposed to take drugs every day for the rest of your life," she says. "It was a pharmaceutical industry's dream come true."

For many women, though, the treatment of menopause has been a nightmare. Greed and misogyny dovetailed in a massive marketing campaign for products that turned out to be both dangerous and unnecessary. Introduced more than 50 years ago as a remedy for hot flashes and other irritations of menopause, estrogen therapy (to which another hormone, progesterone, was later added) was subsequently promoted as a way for women to remain youthful and sexy. In "Forever Feminine," a 1965 book funded by Wyeth-Ayerst (the precursor of Wyeth), the pills were touted as a way of keeping women's breasts and genitals from shriveling.

In recent years, the ageism and sexism driving the push for hormones grew more insidious, as the desire to "correct" women's bodies was couched in scientific terms. Though hormone therapy's effect on the heart was unclear (and is now known to be harmful), aggressive, multi-layered marketing campaigns convinced many doctors to recommend hormones to prevent heart disease even in healthy patients. As a result, for the better part the last decade, Wyeth's estrogen pill Premarin has been the bestselling drug in the country.

"A lot of [doctors] actually believed that estrogen prevents heart disease," says Cindy Pearson, executive director of the National Women's Health Network, a Washington, D.C.-based nonprofit that published "The Truth About Hormone Replacement Therapy." "They read review articles and didn't realize that the author had accepted a fee. They went to conferences and didn't realize that the drug companies had inserted slides into presenters' talks. Some doctors got continuing education materials funded by drug companies that make unproven claims."

For activists, the struggle over hormone replacement came to epitomize the power of pharmaceutical interests to steamroll patients' concerns. As one might expect in a battle with billions at stake, those who challenged that consensus were marginalized. In her basement office, Maryann Napoli quietly pored over the journal articles, circling the unsubstantiated claims in hormone ads and firing off letters to the drug companies, many of which went unanswered. She fielded phone calls from women across the country who were made to feel like outlaws for questioning the treatment. Barbara Seaman, author of the 1977 book "Women and the Crisis in Sex Hormones," found her work increasingly unwelcome in mainstream publications as she became more outspoken about the issue. And the National Women's Health Network's Pearson attended countless medical and pharmaceutical meetings -- though she was rarely invited.

"We almost never were asked to speak," says Pearson. "At women's conferences, yes, but not at the big Washington meetings. I can't tell you how many times I've sat on the aisle as close to the open mic as possible so I can jump up just before the last speaker stops. I've even approached female doctors in the women's room."

If the activists' urgency sprouted from the feminist conviction that women deserve to be heard, their message was scientific: The proof that hormone replacement prevented heart disease was too weak to support the routine promotion of the drugs, they argued, and the long-term effects were still unknown. Their prodding was partly responsible for the study that showed them to be right. In an article in the July 10 issue of the Journal of the American Medical Association, the national study's researchers reported that heart attacks and other "coronary events" went up 29 percent in women on the drug combination compared to those taking placebos; they also had twice the rate of blood clots in the lung and 26 percent more breast cancer.

Which is why the victory is bittersweet. For Maryann Napoli, the should-I-take-estrogen inquiries have been almost instantly replaced by worried calls "from women who have breast cancer and want to know if they got it from the hormones," she reports. She can't answer that question -- no one can -- but Napoli does have one hopeful message for patients everywhere: "We should all be skeptical of the next thing they try to sell us in a big way."

Even that seemingly obvious lesson may be difficult to retain amid the power flow of messages from profit-driven companies. "Though their product is dangerous, the drug companies still have all the resources . . . to cloud the issue," says Pearson. "On the day the news broke, they had two of their people stationed at the doors of the National Press Club offering industry experts. At the Network, we're still just five people with three phone lines and one photocopier."

Sharon Lerner is a contributing writer for the Village Voice.

Underage and Under Siege

Ask Judith Levine when a kid ought to start having sex, and she'll respond like the levelheaded, Brooklyn- and Vermont-based liberal she is: "There are some 16-year-olds who can handle it, and there are some who aren't ready for sex at 20," said Levine. "People at 13 and 14 are generally not mature enough to carry out safe sex. And if a 10-year-old is engaging in what you or I might call real sex, that's a real problem."

Utterly reasonable stuff. But read the press coverage of Levine's book, Harmful to Minors: The Perils of Protecting Children From Sex, and the public intellectual somehow morphs into a crazed pedophile. The madness began before Levine's book was even published. Arguing for recognition of young people's sexual pleasure, Harmful to Minors was rejected by a string of publishers (one dubbed it "radioactive") before being picked up by the University of Minnesota Press. Various outraged Minnesotans then demanded that the academic publisher stop printing the book (it hasn't) and begin a review of its editorial policies (that's under way). The ultra-right Concerned Women for America decreed Harmful to Minors an "evil tome." And Dr. Laura, the fang-toothed radio conservative, went on air to accuse Levine of condoning child molestation.

The New York Times explained the witch-hunting of Levine by her book's release in the midst of the Catholic Church's explosive sexual abuse scandal. From a publicist's perspective, at least, the timing was a boon; Levine's footnoted, scholarly work made it up to No. 25 on the Amazon.com bestseller list and has gone into a 20,000-copy second printing. But what's so frustrating about the hysteria (aside from giving groups like the conservative Family Institute an excuse to host press conferences with lurid titles like "Pedophilia Book") is that it obscures Levine's astute analysis of what's gone wrong between adults and children in the U.S.

Drawing on social science and history, Levine makes a strong case that the denial of sexuality is the true cause of harm to minors. The book uses most of its 300 pages to detail the mounting anxiety over sex play between children, the restriction of youth access to the Internet, and a blackout on critical sexual information in the name of government-funded abstinence education. But Levine might just as well have focused on abusive priests. "If I wanted to design a historically accurate, long-term study to prove the point of my book, [the subject] would be the Catholic Church," the author sighed wearily.

Indeed the same prudishness that has backfired wildly in parishes across the country has dominated social policy in recent years. Harmful to Minors' most important contribution is tying that protective impulse to adults' deep-rooted discomfort with their own sexuality. In the section that secured her a central spot on the right's radar, Levine teases apart the disproportionately large spot the pedophile occupies in the American psyche. She doesn't deny that strangers sometimes rape children ("I can't believe I've had to clarify that," said the exasperated author), but points out that such crimes are far more often committed by family members. Levine describes the obsession with pedophiles as stemming both from a reluctance to confront incest and the rampant sexualization of children throughout the culture. Rather than focus on ourselves, she says, adults "project that eroticized desire outward, creating a monster to hate, hunt down, and punish."

For this intellectual take on such primal stuff, Levine has been branded a member of the "media elite"--and the charge of hyper-intellectualization contains a nugget of truth. Hers is an academic take on an issue about which few are willing to be totally rational. And while her criticisms of statutory-rape laws, say, are astute (she points out that age-of-consent laws originated to protect girls' virginity as their fathers' property and now define sex as nonconsensual solely on the basis of age), her own sexy camp tale, is worth several such tightly reasoned analyses. "Jake," the 26-year-old embodiment of the gray areas in sexual relations, photographed a 14-year-old Levine with her shirt off. As she tells it, the experience was thoroughly enjoyable, though today such an encounter has been made all but impossible by the panic over sexual predators.

Talk to three female friends and you're bound to turn up at least one story of getting bedroom eyes and back rubs from the camp counselor (or friend's older brother, or windsurfing instructor, etc.). The problem is, it's almost as easy to hit upon the version in which the older guy doesn't refrain from sex with his camper (or student, or the baby-sitter). And often these stories have fairly messy endings. Levine's lack of sensitivity for the real problems -- from crushed emotions to pregnancies -- wrought by these relationships is partly to blame for the frenzied response to her book. Similarly, the book's vagueness about age -- a fuzziness that could have been cleared up with a few clear statements like the one at the top of this piece -- leaves unnecessary room for panic. And, since she never approvingly writes about young children having sex, she could have just as easily used the less provocative words teen or adolescent instead of child in the subtitle.

Levine does write about young children's sexual pleasure through masturbation and touch, though, defending the exploration of their bodies as natural and -- gasp! -- good. Perhaps the saddest chapter details how adult discomfort with children's sex play has, in some cases, turned kids' curiosity into pathology and crime, with hundreds of juvenile sex offender programs springing up to accommodate this new "epidemic." Levine tells of Tony Diamond, an unfortunate nine-year-old who was diagnosed with a sexual behavior problem and made to live in a foster home after touching his younger sister's genitals and poking her butt cheek with a pencil. Other kids caught up in the punitive mania include a 13-year-old boy accused of rubbing against his sister, and an eight-year-old girl who sent a note to a classmate asking if he wanted to be her boyfriend.

Even progressives have been cowed by this conflation of sexual expression and abuse -- and Levine is as hard on them as she is on the religious zealots. She chews out sex educators for adopting new blend-in-with-the-conservatives names for their curricula like "abstinence plus" and "abstinence-based." She criticizes the nonprofit Sexual Information and Education Council of the U.S. -- a frequent target of the right -- for recommending that parents intervene if they stumble on their five-year-old consensually touching his friend's penis. (Better just to have "no reaction at all.") Even Planned Parenthood has apparently been running scared. Levine says the group's pamphlet "Birth Control Choices for Teens" originally contained a list of "outercourse" options, including reading erotica, fantasizing, and role play. But the racy suggestions were later deleted, and while the sanitized version was distributed, according to Levine, the contraband copies were burned.

Levine has a vision for swinging the pendulum back in the other direction. Adults are central to this plan, both because children eventually grow up and because the shame and secrecy about their sexuality start with adults' feelings about their own bodies and pleasure. Levine would have adults first reckon with their own desire. It's more utterly reasonable advice; were the tortured Catholic Church ever to take it to heart, it could be downright cathartic.

That's not likely, of course. With the possible exception of a few incendiary bits, Harmful to Minors will probably go unread by those who could benefit from it most. The missed opportunity brings to mind the image of those sex ed pamphlets burning in a warehouse somewhere, with so much hard work and daring effort being lost to the fiery shame around sex.

Feminists Agonize Over War in Afghanistan

A year ago, when women's rights and peace advocate Hibaaq Osman was giving a speech at the United Nations, she cited only one cause for which the use of military force might be justified: to oust the oppressive Taliban regime from Afghanistan. Now that the bloody effort is under way, however, Osman, who heads the Center for Strategic Initiatives in Washington, feels differently.

"I said it, but I was just making a point," a distraught Osman recalls. "This predicament is a test for feminists. We have seen our worst nightmare -- women being dehumanized and shot in public -- and it makes us more radical. It makes us angry enough to entertain the idea of war. But do I support war?" Osman pauses to consider her own country, Somalia, with its brutal history, before bursting out with an emotional "No. No. No. War is not OK under any circumstances," and then concluding, "The whole thing simply breaks my heart."

The four-week-old military attack on Afghanistan is proving to be an excruciating dilemma for feminists. In heart-wrenching conversations and e-mail exchanges across the city and the globe, feminists find themselves split over how to handle possibly the most misogynistic regime in history. Many are deeply uncomfortable with the specter of a wealthy nation bombing a poor and already ravaged one -- a discomfort that is only deepened by the knowledge that more women than men die as a result of most wars. And as national loyalties are stoked by current events, feminists are further strained to reconcile their patriotism with the desire to reach out to women throughout the globe.

Perhaps most frustrating has been the world's failure to heed feminists' urgent warnings about the Taliban, which they've been decrying since it took power in 1996. Under the fundamentalist militia's rule, women have been publicly executed for such "crimes" as traveling with men who are not their relatives and being suspected of adultery. The government has banned women from work, education, and examination by male doctors. Women have even been forbidden from making noise when they walk (the sound draws men's attention, according to Taliban rulers).

Back in 1997, the Feminist Majority's Eleanor Smeal was among the first to sound alarms about the ghastly treatment of Afghan women, urging the U.S. against diplomatic recognition of the Taliban and to halt construction of a pipeline through Afghanistan that would have supplied millions in profits to the regime. The pipeline project was eventually stopped, but others of the group's suggestions, including a U.S. designation of the Taliban as an international terrorist organization, have yet to be carried out.

Perhaps it's no surprise that some feminists, including Smeal, now feel the backward and violent regime deserves whatever it gets. The rare overlap between feminist and military interests made for particularly warm relations in the greenroom at an NBC station in Los Angeles when Smeal met up with three generals who were about to appear on Chris Matthews's Hardball. "They went off about the role of women in this effort and how imperative it was that women were now in every level of the air force and navy," says Smeal, who found herself cheered by the idea of women flying F-16s. "It's a different kind of war," she says, echoing the president's assessment of Operation Enduring Freedom.

Indeed, the gender gap in support for this U.S. military effort is unusually small. Historically, female support for war has lagged between 10 and 15 percent behind men's, according to Joshua Goldstein, author of War and Gender: How Gender Shapes the War System and Vice Versa. But in a recent survey released by the Pew Research Center for the People and the Press, 79 percent of women, compared to 86 percent of men, said they support the ongoing military intervention, a near parity Goldstein believes may be explained by the fact that the Taliban is anathema to women.

Still, many women are unwilling to translate their opposition to the Taliban into support for war. The U.S. air strikes against the country and the recent addition of ground troops -- which, depending on the estimate, have together resulted in anywhere from a few dozen to almost a thousand civilian casualties -- clash with long-held feminist sensibilities. Some worry that bombing will further endanger Afghanistan's already brutalized women, who account for 70 percent of Afghanistan's refugees.

Feminists also have a pragmatic argument: that missiles and soldiers won't topple the Taliban. "I continue to wish with all my heart for the regime to be overthrown; I just don't think the U.S. military can do it," says author Susan Sontag, whose September 18 article in The New Yorker set the tone for criticism of U.S. military policy. The choice "isn't bombs or nothing," says Sontag, who doesn't consider herself a pacifist. "The world is a complicated place. We can put pressure on our allies and offer bribes and rewards."

The peace position was also taken by the Worldwide Sisterhood Against Terrorism and War, an organization of about 80 feminists that includes women from Central Asia as well as such U.S. notables as Gloria Steinem, Alice Walker, and Susan Sarandon. In a petition headlined "Not in Our Name," the group declared, "We will not support the bombing or U.S. invasion of Afghanistan, for it would only punish suffering people and increase the hatred on which terrorists feed."

While the wording leaves open the possibility of support for UN-sponsored military intervention -- an option many find more palatable than U.S. and British forces acting independently -- reaching consensus even on that phrasing took days of rapid-fire e-mails and skillful negotiation. Questions about the future of Afghanistan have been even thornier.

Sunita Mehta and Fahima Danishgar, who recently cofounded Women for Afghan Women -- the first grassroots group for women from Afghanistan and its neighbors living in New York -- were among the dozens of feminists who gathered for a post-September 11 meeting at the Manhattan apartment of Eve Ensler. But, coming from the region -- Mehta is Indian and Danishgar, 23, left Afghanistan at age nine -- they found they had less of an us-versus-them perspective than many Americans reacting to the recent terrorist attacks.

"We are us and we are them," says Mehta. "We came in feeling very close to the land that was going to be bombed." That closeness -- and a superior knowledge of history and politics that comes with it -- allowed her to temper the more utopian dreams of Western feminists. While some at the meeting seriously suggested that the Revolutionary Association of the Women of Afghanistan should rule the country, for instance, Mehta pointed out that the 2000-member RAWA is "a small, Maoist organization." It would be nice if women could be in charge, she says, "but we don't have the luxury of dreaming big dreams right now."

Indeed, the women of Afghanistan -- for whom makeup, forbidden by the Taliban, is a symbol of liberatio -- have different priorities from their Western counterparts. RAWA, whose members have documented Taliban atrocities through slits in their Taliban-mandated robes, has thrown its own political support behind the exiled Afghan king. And although many Westerners have focused on that robe, the burqa, as an emblem of women's oppression, Afghan women don't always see it that way. "Some women choose to wear it. It can be a symbol of respect" for tradition, says Danishgar, whose own mother sometimes wore a burqa.

The burqa has been a touchy subject before, particularly when Oprah Winfrey lifted one off an Afghan woman in a performance of Ensler's Vagina Monologues, instead of letting the woman perform the symbolic liberation herself. For some, the gesture reeked of Western arrogance, even though the talk-show star has been credited with raising awareness of the Taliban in the TV-watching core of our country by having RAWA members on her show. (RAWA's Web site, www.rawa.org -- a fascinating cross-cultural women's effort that features digital video of Afghan women being executed -- welcomes Oprah viewers specifically.)

Osman, who wears a head scarf and robes, sees the East-West tension as rooted in religion. "I love my Western feminists," she says, "but I'm just finding out how ignorant they are." Osman, a Muslim, offers a definition of feminist many Western women might share: "A woman who is very comfortable with who she is and believes the sky is the limit." Still, she says, "Every now and then I hear 'What is it with Islam that makes your men this way?' And I think to myself, 'What is it with Christianity that makes your men this way?'"

No doubt, many Americans are feeling somewhat smug about our heroic, enlightened men just now. Ironically, though, the crisis seems to be inspiring a reversion to traditional gender roles. While the press dubbed first lady Laura Bush the "comforter-in-chief," Peggy Noonan giddily declared that "men are back." "I'm speaking of masculine men," the former Reagan aide wrote in The Wall Street Journal, "men who push things and pull things and haul things and build things."

Of course, men have never really gone away. The power structure remains overwhelmingly male -- a fact that was highlighted by the never ending emergency press conferences featuring wall-to-wall men. Indeed, National Security Adviser Condoleezza Rice is one of only four women among 19 cabinet-level officials. Roughly one in seven members of Congress is female. All of the 23 committee chairs in the House of Representatives are male, as are all of the Senate's 22 chairs. And a mere six out of 189 ambassadors to the UN are female.

The numbers are, not surprisingly, more skewed when it comes to conflict. "After childbirth, war making has possibly been the most segregated of activities along gender lines," says Felicity Hill, director of the UN office of the Women's International League for Peace and Freedom. Perhaps that doesn't have to be true. Last year, the UN passed a resolution calling for women's participation in decision making about war and peace. Nevertheless, "war remains the domain of men," says Hill. "Women's voices are missing from decisions on priorities in peace processes."

These days, it's hard for anyone to stray from the political mainstream, and harder still for women. Like many others on the left, Canadian activist Sunera Thobani accused the U.S. of "unleashing prolific levels of violence all over the world," but unlike many other lefties, Thobani was subject to the Canadian equivalent of citizen's arrest and, intriguingly, sent porn by her critics. The Canadian secretary of state for the status of women, Hedy Fry, almost lost her job for just listening to Thobani's speech.

The response to Susan Sontag's New Yorker piece neared witch-hunt pitch. The New York Post suggested that Sontag be drawn and quartered. A scrawled sign recently posted in Manhattan's Old Town bar referred to the author as "an old battle-axe." And a piece in The New Republic began, "What do Osama Bin Laden, Saddam Hussein, and Susan Sontag have in common?" (The desire to dismantle America, it turns out.)

While Sontag sees the reaction mostly in political terms, she also sees a gender-related biliousness she likened to that aimed at Hillary Clinton. "It has to do with the very deep anxiety and fear and dislike of a woman who seems to be very smart and powerful," Sontag said of the Hillary hatred. Smart women "arouse huge feelings of resentment and dislike on the part of a lot of people," added Sontag. "Why should I think I'm exempt?"

The public clobbering is yet another reminder that despite having a common enemy, the U.S. government and feminists are not necessarily friends. "Everything is being manipulated to get what the U.S. wants, which isn't primarily women's rights," says Jessica Neuwirth, president of Equality Now, a New York-based women's group. "The U.S. military did not intervene to remove the Taliban because of anything to do with women."

That divergence of interests is becoming clearer as the U.S. considers including "moderate Taliban forces" in a future coalition government and joins forces with countries where female genital mutilation is widespread (Egypt) and women are forbidden from driving cars (Saudi Arabia). Our rising political partners, the Northern Alliance, are particularly horrendous to women. The group's No. 2 political leader, Abdul Rasul Sayyaf, reportedly believes so strongly in the inferiority of women he doesn't even speak to them. And Ahmed Shah Massood, the recently assassinated Northern Alliance leader, partook in campaigns of systematic rape that predated Taliban rule.

"The only difference between the crimes they committed and the Taliban is that the Taliban officially announced the restrictions on women," says a RAWA member who does not reveal her name. "The Northern Alliance committed many, many crimes against women -- rapes, forced marriages. Women were afraid of going outside when they were in control," she continues, referring to the period between 1992 and 1996, before the Taliban seized power.

Back then, RAWA, which was founded in 1977, had already been trying to call attention to women's plight for years, though few were listening. The RAWA representative worries that her country's next government might be as woman hating as its predecessors. Perhaps it's a cultural difference, but the Feminist Majority's Smeal is optimistic that this calamity will finally change things for women. "Next time women speak about international issues, they'll listen," she says hopefully. "Our credibility will have gone up."

Sharon Lerner is a contributing writer for the Village Voice. Additional research for this article was conducted by Whitney Kassel and Sarah Park.

Magnets Unplugged

Feeling achy? Tired? Nauseous? Have pain in your (insert body part here)? Maybe you need a magnet.

Therapeutic magnets resemble refrigerator magnets, though without the decorative doohickeys and presumably with some health benefit beyond their magnetic ability to pull in over $4 billion in sales worldwide in 1999, half a billion of that in the U.S.

Discerning just what these bits of charged metal offer is a challenge for the most open-minded. Take the "depression magnet cap," which looks like something Woody Allen wore out of the Orgasmatron in Sleeper ($159 at buyamag.com). Buyamag's Web site says the cap, which has Velcro closures and 57 gold-plated magnets, is comfortable, but nowhere does it mention what the cap does. The potential wearer is likely expected to divine its purpose from the list of frontal-lobe brain functions -- including "emotions," "behavior," and "problem-solving" -- posted beneath the illustration.

The Food and Drug Administration's prohibition on unfounded medical claims partly explains the vague tone of many magnet ads. Magnetic mattress pads for the sleep-deprived (up to $520 on mags4pain.com) are described only as restoring energy and promoting restful sleep. A magnetic eye massager ($74.95 from lifeandlight.com) is billed as addressing the decidedly nonmedical problem of "baggy eyes," while magnetic earrings, bracelets, and necklaces are promoted as "pretty and effective."

Effective at what? Well, according to the many testimonials scattered over the Internet and mail-order magnet catalogues, magnets can do almost anything, including normalize blood pressure, stimulate nerves, repair muscles, reduce the need to go to the bathroom, promote healing, increase energy, even -- perhaps inevitably -- cure cancer. The most common claims are about pain relief, which is the goal of applying magnetic patches to acupuncture points and wearing magnetic belts around backs, shoulders, knees, ankles, and feet.

There are lots of ideas about how magnets achieve these feats. A popular theory is that magnetic fields penetrate cells and, by magnetizing blood, increase the flow of oxygen throughout the body. Another is that magnets block pain by stimulating the nervous system. One overarching explanation of magnets' health value might be called the Cuisinart theory, which posits that modern electrical appliances have diminished the earth's natural magnetic force, and that therapeutic magnets restore it to the more healthful levels of olden days.

Oddly, back in that idyllic past healers were already playing with magnets. Sixteenth-century physician Paracelsus figured that magnets might be able to draw diseases from the body based on their ability to attract iron. Later, Franz Anton Mesmer came up with "animal magnetism," the idea that humans and animals could be healed through magnets or even leather or wood exposed to them. Though that concept was soon trashed by a panel of experts, believers persisted. An 1886 mail-order catalogue offered a complete magnet-coated costume that provided "full and complete protection of the vital organs of the body" (and wouldn't look half bad with the right magnet-studded cap).

Perhaps therapeutic magnetism continues to draw because it makes some sense -- with emphasis on the word some. The earth does indeed exert magnetic force on humans; that force has diminished over the years, and many animals do have built-in magnetic receptors (though none have been discovered yet in humans).

Indeed, one offshoot of magnetism has proven useful. Decades ago, the FDA approved the use of electromagnetic fields from pulsed magnets to stimulate bone growth and heal fractures. But while therapeutic electromagnetism -- which involves generating a magnetic field by running electrical current through wire -- has ascended to widespread acceptance, therapeutic magnets of the weaker, nonelectric sort remain on the fringe.

It's not just that no one really understands how magnets work -- understanding isn't necessary for effectiveness; no one had a good grasp of radiation when it was first used, nor do we understand yet how some cancer drugs, like thalidomide, work. Most careful studies show that magnets don't work. One comparison found no difference in pain relief in patients who wore sham versus magnetic insoles; another that magnetic necklaces had no effect on neck or shoulder pain; another that dental magnets didn't affect blood flow in the cheek.

Amid piles of evidence that they don't work, though, is one study demonstrating that magnets did relieve pain in patients who'd had polio. Researchers at the Baylor Institute for Rehabilitation Research in Houston used fake magnets on some patients and real ones on others, a design that cuts out the possibility of the placebo effect. Nevertheless, they found a significant reduction in pain among the patients who used real magnets.

Though the Baylor results have yet to be duplicated -- and most researchers consider a repeat performance the real test of validity -- the Baylor study leaves the door open to the possibility that some magnets do have health benefits. Needless to say, many an eager patient and retailer have walked right through.

In addition to the celebrities who have embraced magnets -- including Regis Philbin and baseball players David Cone and Hideki Irabu -- big retailers like Kmart are now getting into the market. There wouldn't be a magnet market if not for the buyers, of course. And that's where optimism comes in.

Robert Lane, a massage therapist and psychic healer who practices on the Upper East Side, uses industrial magnets to treat colds and flu, wrapping them in cloth and hanging them around his neck. He came up with this through his own reading and creativity. He constructed a magnetic bed to treat his chronic fatigue syndrome, sleeping on a metal cart full of magnets for months -- a treatment he happily credits with banishing his exhaustion.

Like many magnet aficionados, though, Lane is skeptical about magnetic therapies different from his own and especially questions their pain-relieving powers.

Manhasset-based physical therapist Murray Olansky is similarly dubious about some claims. Olansky uses what he calls "rare earth magnets" to reduce patients' pain and swelling in his practice, but dismisses magnetic products made by Nikken, a Japanese company that uses a pyramid sales scheme and relatively weak magnets: "Most of the positive effects of those are psychological rather than physiological."

Olansky and Lane do agree on one thing: Magnets have relatively few side effects. Most magnet mongers warn against using their product around a pacemaker, which it can disrupt, as well as during pregnancy. Lane also suggests separating powerful magnets with cloth, so skin doesn't get pinched between them.

But on the whole, magnets don't seem terribly risky. "There have really been no harmful effects of therapeutic magnets," says Olansky. Almost no effect at all, you might say. Unless, of course, you consider that detrimental pull they can have on the wallet.

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