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By Robert Hatcher, MD, MPH
Professor Emeritus, Gynecology and Obstetrics
Emory University School of Medicine, Atlanta
It has been reported that the 12,000 employees of the Centers for Disease Control and Prevention (CDC) have been told not to use seven words in budget proposals. These seven words are:
The Washington Post reported that a CDC analyst said the word ban was issued at a briefing held in preparation for upcoming federal budget requests. CDC scientists and staffers were said to be “in-credulous” at the news.1 (Editor’s note: Brenda Fitzgerald, MD, CDC Director, took to social media following the story to assure that “there are no banned words at CDC.” However, the newspaper stands firmly by its reporting.)
How do you feel about the use of these seven words? I really like the word vulnerable for two reasons. First, it is a word that suggests that compassion, love, tenderness, understanding, and listening are important in helping people.
Second, it is one of the adjectives that could be used to describe the thousands of women I have cared for at Grady Memorial Hospital in Atlanta. I have felt compassion for these women as I have tried to meet their contraceptive needs. The individuals we have served are vulnerable to unintended pregnancies for a variety of reasons.
If one goes to Webster’s New Collegiate Dictionary, one learns that vulnerable is derived from the Latin verb vulnerare, “to wound.” Then one finds two possible meanings of vulnerable: 1. capable of being physically wounded; e.g., The people of Santa Barbara continue to be vulnerable to the flames of a massive fire that has already destroyed hundreds of homes. 2. open to attack; e.g., Haiti will be vulnerable to the winds and rain of this major tropical storm if it continues on its current path.
In moving on to the next words, I think of the two years I served at the CDC as an Epidemic Intelligence Service officer. These years changed my life. Why? Not only did I learn just how important public health is:
Good science-based practices, I was taught, require rigorous research.
Furthermore, I was taught that people who are vulnerable may be vulnerable for reasons over which they have no control and must receive the same high-quality care as afforded to others.
There is everything to be said for a good beginning to life, which means careful attention to that extraordinarily complicated little fetus that is favorably and unfavorably responding to so many influences throughout pregnancy, during delivery, and then during the postpartum period and the first years of life.
At the CDC, I was taught that women were entitled to receive contraceptive services in a completely voluntary manner and that birth control was important for their health and the health of their family.
Transgender was not discussed when I was at the CDC, but I participated several years later in a seminar at the Morehouse School of Medicine, where focus was given to six transgender individuals. One man was a little girl at birth. His parents made a short movie of their 3-year-old daughter to send to her grandparents in Europe. She was asked, “What do you want to be when you grow up?” She didn’t say “an actress” or “a mother of two children.” She answered, “I want to be a man.”
I feel OK about the word transgender. As my wife, Maggie says: “Transgender people are transgender people, period.” And their educational, health, and social needs are important — as important as anyone else’s needs.
So, what should be done about the “Don’t use these seven words” edict? Gandhi is credited with saying, “Big problems require small solutions.” Perhaps one six-word solution to this horrendous suggestion might be: Tomorrow, decide to disregard it completely. That is what I will do. I no longer work for the CDC.
Financial Disclosure: Consulting Editor Robert A. Hatcher, MD, MPH, Nurse Planner Melanie Deal, MS, WHNP-BC, FNP-BC, Author Rebecca Bowers, Executive Editor Shelly Morrow Mark, Copy Editor Savannah Zeches, and Editorial Group Manager Terrey L. Hatcher report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.