Category Archives: diversity equity inclusion

Uninhibited

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I effuse.

Anyone who knows me will tell you so. They will describe my facial expressions, gesticulations, profanity, and hyperbole. I feel strongly and express accordingly. I posted yesterday about how it’s all elevated and amplified (though still regulated) recently: I hug stronger and longer. I praise freely. I call people ‘love’ with accelerating frequency. And I talk about love, sex, and relationships a lot more. I attribute much of this to my now two year-old romance audio immersion.

American culture is such a paradox. At the same time that we hypersexualize both men’s and women’s bodies from a young age, we also harbor a collective and insidious Puritanical streak that shames sexuality in general, and for women in particular. I thought I had overcome the latter years ago. But these two years of spicy romance consumption have shown me my blind spots, for which I am eternally grateful.

Early in my career I met a woman patient who was very open about her sex practices. She had both male and female partners, sometimes multiple at a time. I can’t remember whether her practices were protected or not, but she had no active sexually transmitted infections while I knew her. Looking back, I’m sure my words centered around health risks and relationship safety. But if I’m honest, I judged her. I was young in career and life and could not relate to her behaviors and practices. I am sure she felt my negative moral vibrations, and I regret that to this day. Somewhere along the way I let go that judgment and have since made intentional efforts to make it safe for patients to tell me anything. As long as it’s consensual, lucid, and mutually satisfying, I want you to do whatever you want and enjoy your sex life as fully as possible! There is no standard, and my wish is for all partners to feel maximally fulfilled.

Romance novels have opened my eyes to diverse practices and experiences that I did not know to consider before: polyamorous, dominant-submissive, and asexual, among others, and all of the social, emotional, and relational implications thereof. I have shared my transformations of awareness and openness with patients and friends, and the response has been overwhelmingly positive. Both men and women get curious and then share their own experiences–desires, inhibitions, disconnects, accommodations, sacrificies, epiphanies/discoveries, etc. These days I talk even more openly than before and with anybody about libido, erectile (dys)function, emotional and carnal connection and their intersection, menopause, penile implants, and anything else that matters to someone’s sexual health. I thought I was uninhibited before and Whoa Nelly, watch me now. Based on conversations with fellow spicy romance enthusiasts, my experience is anything but unique.

Romance narrator Victoria Connolly addresses American purity culture, growing up in and now healing from it. She has invited listeners to share their stories; the voluminous response reveals the prevelance of experience and the value of acknowledging and naming it. See her Instagram post and comments c. August 12, 2024: “‘It wasn’t until I started reading primarily spicy romance that I finally got fed up/brave enough to ask him if it’d be okay if I touched myself or used a vibrator during sex because I’d like to come too.’ | If your story sounds like this, you’re in the right place. | Just share the book in the comments that rewired you forever. The one that made you believe you deserved pleasure.”

I mentioned the Quinn app in my recent Women Elevating Women post. Quinn describes itself as “a mobile app and website where you can listen to audio erotica… spicy audio stories, guided masturbation, dirty talk, and more. The audios on Quinn are designed to help you get there, but they also involve fun and interesting plots.” The New York Times reports, “Apps like Dipsea and Quinn have become popular destinations, particularly for some women who find them safe spaces to explore their sexuality.” Hallelujah!
Readers of this blog know my deep admiration for romance narrator Shane East and his strong allyship of women. His second ever Quinn audio dropped two days ago and has already been played more than 3500 times. Asked, “What inspired the move to create on Quinn?” he answered, “[Quinn] came to me after hearing my work. After discussing things with them and checking things out on the site, seeing what I would like to put out there and gathering a script and audio crew to help me do that, I decided to go for it. I’m all for anything that enables women to own their sexuality without the judgment or shame that can be handed out by others. I’m here of course for everyone being free to own their sexuality and desires in a judgment free, safe and accepting way; however and with whomever they like. Speaking of women specifically though, historically they have been repressed by societal restraints and patriarchal ideology for so long that I think it’s wonderful to be part of something — be that romance books or something like Quinn— that utterly goes against that and gives women (in particular) ownership of what they want. I think it’s fantastic to have the[m] out there.”

*sigh*

This is all such a good thing, all of us embracing our whole, wonderful, beautiful, sexually awake and aware selves–every person of any gender, both individually and in community. Life is simply too short to repress such important and fundamental aspects of identity and connection. Fiction in general and romance in particular help us receive perspectives (as opposed to taking them, as David Brooks writes) other than and different from our own, and empathize with the full scope of human emotional and relational experience.

Inhibitions are not empirically harmful. Restraints can serve us sometimes. And when they outlive their usefulness, shedding them elevates us, frees our spirit, and allows our whole selves to emerge in full glory and actualization. I hope this evolution of collective openness continues. The more we can eliminate shame and empower everyone to own their sexuality, foster deep and meaningful connections fully in mind, body, and spirit, and simply embrace all that makes us our whole human selves, the better all of our lives will be.

The Code of Us: Opening Mind and Heart to Difficult Possibility

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Spoilers likely, dear readers!
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The best books make me both feel and think deeply. The Code of Us by Liv Evans has done so to such a degree that I will not do it justice in this post–I’m still hung over! But processing the story must start somewhere, and if I can move someone here to read or listen to it and discuss, then it will be worth the effort.

Mia, a dedicated neuropsychologist, researches artificial intelligence. Her husband, Arden, creates beautiful sculptures out of things people throw away. Their devoted love story serves as the steadfast anchor for a novel that throws into question everything we may think we know about cognition, memory, technology, relationship, and evolution–about how we think and feel about humanity itself.

Arden agrees to serve as Mia’s alpha subject for her ‘replicated intelligence’ project, meant to preserve and enhance human memory in service of improving people’s quality of life–eventually, when the product is fully developed. When a traumatic brain injury renders him essentially brain dead and on the brink of actual death, she and her two colleagues and close friends rush to implant Arden with a chip that brings him back to life, body and mind, with the still nascent but fully functional technology. Told in alternating present day and flashback, a complex journey of loving intentions, ethical dilemma, grief and loss, unintended consequences, and social implication unfolds.

While the plot engages, stimulates, and challenges me intellectually, it’s the emotional and relational evocativeness–the human(e) relatability–that makes this book an instant treasure in my library. In a mere 188 pages (5:37 hours, narrated by the multitalented Jodie Harris and Steve West), Evans examines–presciently, brilliantly–myriad potential complications and consequences of artificial intelligence–intellectual, social, legal, psychological, and corporeal, among others.

To ground the exploration in an unwavering love story, though, centers readers’ attention on the relational implications, which speak directly to my raison d’etre. Of all the questions that emerged in 10 pages of journaling on this book, the one I most wish for us all to consider is, “How does AI, in any given space, uphold and protect the humanity of all whom it touches?” I almost dismissed it as too difficult a question to attempt answering. But the more I consider the complexity, inevitability, and acceleration of this technology, the more I feel convicted that we, the human creators and consumers of AI, must step up to ask and answer exactly such challenging and overwhelming questions. We are called to be more thoughtful, considerate, inclusive, and complexity-tolerant than we have ever been, by a long shot.

Whatever we do will always be imperfect. There will always be unintended benefits and harms, and our attempts to weigh, compare, and justify it all will always leave many unsatisfied and frustrated. So how do we proceed? How do we show up to engage with the most complex adaptive problem that many of us can ever fathom? What mindset(s) will minimize the risk of nefarious, greedy, and inhumane forces overtaking the altruistic, humanitarian, and egalitarian ones?

Last fall was the first time I thought and wrote in any depth about how AI will change medical practice. Since then I open more and more to the potential benefits, led by my astute and altruistic colleagues in primary care, who model thoughtfulness, compassion, and critical (neither blind nor cynical) appraisal and application.

As my own learning progresses, some key concepts emerge that I will hold in front. They will evolve, obviously, and I ground them always in the commitment to enhancing human to human connection, no matter what tool is considered.

Acceptance with conditions

Humans innovate. We create. We aspire, imagine, and push boundaries. It is the greatest gift of our intellect, and also a potentially fatal flaw. What’s done cannot usually be undone. I accept it all in iterations, fear and trepidation giving way slowly to cautious possibility. That said, nobody should be given carte blanche to advance technology unfettered. Banning development only drives it underground, where the presence and risk of nefarious forces increases, in my estimation. Thus, we must accept and embrace our discomfort with the unknown and uncertain, ask the hard questions, and grapple with the ardent persistence of true infinite game masters.

Transparent and mindful accountability

Ethics committees are a good start. Checks and balances on the runaway flaws of primarily capitalist ventures must be established and maintained. Open source data and outcomes sharing will be key for minimizing harm, I think. That conflicts directly with the competitive financial drivers of innovation, I know. So we must, somehow, wrestle earnestly, honestly, openly, and in good faith with the novel humanitarian complexities and problems that AI creates. We must do accountability better than we ever have which, sadly, is not saying much.

Agile and adapative commitment

There are no words better than exponential acceleration to describe the march of modern technology. We have built this kite that flies ever higher and faster, and if we hope to influence its path at all, it will take more than the string and gym shoes we started with. We must invent the tethering, weighting, and conveyance materials, structures, and vehicles in real time. The faster and more fully we accept the inexorable progress of AI, the more effectively we may flow with it rather than against, to move swiftly and smoothly to manage its ethical, humanitarian, and social implications and consequences.

Critical hope and optimism

Be warned: The Code of Us is not a romance novel, despite its love story core. The book does not end happily, though the end of the book is not necessarily the end of the story. It took a few days for me to identify all of my emotions, led by sadness in depth and intensity. Liv Evans summons, with incredible economy of language, a viscerally, if not cognitively coherent (and thus quintessentially human) cacophony of feelings that at once proves the undeniable shared humanity that fiction evokes, and yet wholly defies full articulation. I don’t think I have ever journaled ten pages about any book, and I’m still intellectually, emotionally, and existentially entangled. Surprisingly, it feels light rather than heavy. This book teaches me a lesson that recurs: With every degree of acceptance, I gain a commensurate measure of liberation. Despite so many egregious examples to the contrary, I still believe humans can transcend our most self-serving, collectively self-destructive tendencies. I believe we have the capacity to collaborate for the common welfare. We just don’t readily exercise it. I have called myself a cynical optimist. Today I choose critical optimist, because we simply must proceed. We must hold onto that kite and not allow ourselves be dragged. In medicine we learn critical appraisal skills: how to evaluate data and evidence for validity and application. When the data is good, we accept it and apply, until new and better data shows us otherwise.

My opitimism is not blind. It is realistic and evidence-informed, if not fully evidence-based. I will deepen my acceptance, demand transparency and accountability, and train for adaptive cognitive and emotional agility. I intend to run with rather than get dragged or trampled.

We humans may destroy ourselves in the end, and that will be what it will be.
Until then, however, I still have hope that we may yet save ourselves.

Helper Coda: Shane’s Vespa

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Here is an example of helping in the form of allyship, however inadvertent.

Shane East is now back in LA, returned from Readers Take Denver. He posted a video from his Big Deck immediately on arrival, with a little reflection and invitation:

“Now, how I got my arse from home to the airport and back with all my stuff including a 3ft wide banner was on my trusty Vespa. Strapped and wrapped and ready. People are always surprised when I tell them and often think I can’t possibly fit what I do on there. So in honour of that, what things have you been told you can’t do/make work and you fookin’ went and did it and did, indeed, make it work or more than make it work, made it a success??”

Shane often posts videos asking followers questions like this, that occur to him out of his own, real time experience and observation. When a pair of very old shorts finally died, he asked us what’s in our closets that we refuse to part with. He noticed himself having little outbursts while driving, and asked us about our own road rage. This time he’s calling it his ‘Curiosity for the week’. It makes me happy that we seem to have this in common, as my blog posts also often originate from me wondering about something and then writing to invite you all to wonder about it, too (see Helper post yesterday).

So I wonder whether Shane intended for this post to empower women? He certainly knows that his following is predominantly female, but the vibe of his videos is generally lighthearted and fun rather than overt advocacy of any kind. That said, comments immediately arrived showing in no uncertain terms what his women followers have had to overcome to get what they want in life. They were told they could not do sports, join or survive military service, go back to school, have successful marriages and families, much less while working, and myriad other random ‘you can’t’s. Two that came up for me were playing volleyball well at 5’2″, and doing primary care and loving it. I still roll my eyes at these today.

He was told he couldn’t/shouldn’t carry all the things on his Vespa. He knew better. He exercised his own judgment and agency and proved others wrong. And as usual, he turned that awareness outward, offering us all a chance to reflect on our own agency and self-efficacy, despite the naysayers. Phrases that emerged in the comments included, “Watch me,” and, “I’ve never looked back.” I tell the story that writing these brief comments, recalling the struggles overcome, boosted our sense of accomplishment and pride–gave us a little hit of serotonin. I might have sat up a little straighter or curled my lip a little as I typed my response. I imagine all of us standing a little taller in our resilience and independence, with gumption, just considering his question–an effect that, if repeated, informs our presence in greater society. In this way, I see his post as a man using his platform to empower us women, with our own strengths. To top it off, he has responded to just about every comment with words of affirmation and validation, which tells me he cares. He is an ally by nature, and he manifests it by simply being who he is. What a treasure; I’m so proud to call myself a follower.

So what is up with the naysaying, anyway? Simply, we all do it. It’s our own fears, limiting assumptions, and biases that we project onto others (and ourselves). It’s human, and we don’t have to judge it. We can simply accept that it is likely inevitable in most scenarios. That may seem defeatist, but it’s actually empowering in itself. If I understand that your discouragement is about you, not about me, then I am free to *respectfully* ignore it. I can choose to engage in disagreement and debate or politely excuse myself and get on with it. Of course it’s a different story if you actually stand in my way, but if not, then I am less affected by your negativity; I can brush it off, let it go. Neutral awareness and acceptance are my Teflon. At the same time, however, in advanced human connection practice, I can also query your warning and rationale for any nuance and benefit to my perspective. That is an exercise in maturity and strategy, among other things.

So Shane, in his ever cheerful, observant, and curious way, empowers us women simply by asking open, honest questions that help us remember and reinforce our own strengths and ablities. And what I love most about these posts (both his and mine) is that I only came to these conclusions while writing my morning pages today, Day 103. I revised my morning routine after his suggestion in yet another video on January 3. He helps me in so many ways, and I could not be more grateful. Thank you, Shane!