On Trump and Tylenol

Tortured Musings on modern mysteries, asteroids, and ASD

- I -

At some point, we all experience an asteroid dropping into our lives. We’re moving along, managing the everyday problems, making the best of the hand we’ve been dealt. Then suddenly, without warning, the roof falls in, and there sits an asteroid: a diagnosis, an accident, words that can’t be unsaid, violence, a disaster.

Whatever it is, the asteroid can’t be removed. It lives here now. Slowly, we repair the roof. We sweep the floor. We move the furniture around. We learn everything we can about the asteroid. We figure out how to live with it. For a while, the everyday problems seem suspicious. The sink drips and we wonder, is it actually the asteroid? The mail doesn’t come—has the asteroid affected the Postal Service, too?

Because we are such an adaptable species, we learn to accept the asteroid. Maybe sometimes we joke that it’s a work of art. Maybe sometimes we even mean it. Maybe sometimes it’s true. The universal experience is that the asteroid comes, and it changes us.

- II -

I started writing this newsletter about the President’s comments on Tylenol. I sent a draft to Maggie and Alise. We went back and forth:

• It’s a little dry, I know.

• Is the reading level too high?

• Are we missing the opportunity to comment on people’s pain?

• How do you comment on pain without being condescending?

• Don’t people just want the facts and to decide on their own?

• Aren’t we actually really bad at deciding on our own?

• What are we trying to do here?

• What actually serves our community?

- III -

I am not a medical expert. When I feel myself reacting to anything under the Make America Healthy Again umbrella, I rely on my research skills. I read the President’s remarks from September 22 in full¹. I wanted to understand what problem he thinks he’s solving and how Tylenol figures into his solution.

He said a lot of things, as he does. I understand him to believe that autism rates are skyrocketing, that Tylenol taken during pregnancy maybe-probably-maybe-not-but-probably causes autism, and that his administration is courageously saying that hard truth out loud.

On social media, I watched people respond, characterizing autism as everything from completely debilitating to a rich way of understanding and interacting with the world. It’s disorienting, so I consulted the Cleveland Clinic. It defines Autism Spectrum Disorder as “a difference in brain functioning that affects how you communicate and interact with others…Autism isn’t a disease…Autism is a spectrum…Autism is often misunderstood.” It turns out social media may have this one right: autism can be completely debilitating and a rich way of understanding and interacting with the world, and a whole lot more.

I wonder how the President understands autism. I wonder if he’s searching for a cause or a cure or for the elimination of autism in the future or a reduction in diagnoses or something else altogether.

- IV -

Most ways of being human deviate from a statistical norm. Some of those come with serious distress, others with real perks. Often, it’s a mixed bag. Autism is not part of my nuclear family experiences. I do know what it’s like to live with a “disorder.” Fibromyalgia, which I was diagnosed with in 2007, is mysterious, poorly understood, and managed using a variety of medications and modalities.

Figuring out a single cause for multifactorial, somewhat ambiguous, constantly shifting ways of inhabiting a body and processing the world feels a little like asking where asteroids come from. I’m not saying we can’t or shouldn’t — I have no idea. I just wonder about our aim. Do we think we can live in a world with no asteroids? Do we think we can keep them from falling into our houses? What would it mean to be human if we could?

- V -

I consulted the Cleveland Clinic and the Mayo Clinic on autism causation. In my first draft of this post, I included information about possible risk factors, genetics, and co-occurring conditions. As I stare at that draft, I realize it’s essentially useless. So few of the factors are within anyone’s reach. None are completely predictive or exclusive. All need more study.

As much as we know about autism, it remains a mystery.

- VI -

You know what else remains a mystery? Tylenol.

Acetaminophen was accidentally discovered in the search for a treatment for intestinal worms. It doesn’t help with the worms, but it does relieve pain and fever². We’re not sure why. It seems to work on the central nervous system, which is why you can take it if your back hurts, or your tooth, or your toe. There are two main theories. It might interfere with a particular kind of enzyme production in the brain, blocking the transmission of pain impulses. It might act on body chemicals called endogenous cannabinoids, which would also impact pain perception. Or maybe it’s something else. We just don’t know.

- VII -

You know what else-else remains a mystery? Pregnancy.

You could fill the entire gilded Oval Office with aspects of pregnancy that we don’t understand. We can’t predict labor and don’t understand the precise biological triggers for it. We don’t know why babies are born prematurely. The things we don’t know about the placenta! We might as well call the placenta a product of witchcraft. Since discussing neurology is all the rage this week, we’re at the very beginning of seriously considering pregnancy’s impact on the mother’s brain. We have major gaps in understanding miscarriages.

Sometimes I think we tell women to avoid wine and brie during pregnancy because it makes us feel good to say anything concrete.

- VIII -

Is this now the longest newsletter in Pantsuit Politics history? I better chat with Alise and Maggie about that. I don’t even have a cute meme in this draft. This is all wrong.

- IX -

I don’t remember if I took Tylenol during my two pregnancies, but I would put the likelihood that I did at approximately 99%. I also drank caffeine with abandon. Frozen Coke was the only form of nourishment I could keep in my body for more than 5 minutes during trimesters 1 and 2.

Most advice about pregnancy struck me as insulting. That is both because I had read enough to know how little we actually know and because I resent most forms of authority.

Life is full of asteroids. Miss me with your worries about deli turkey. I’m not recommending this motto; I’m just telling on myself.

- X -

Here’s how I understand medical studies to date: we have observed some association between frequent, long-term uses of acetaminophen during pregnancy and neurological development. We also know that acetaminophen is the best of limited options to manage fever and pain during pregnancy. The risks associated with fever and pain during pregnancy probably outweigh other risks. So, consult with your physician. Take the lowest dose needed to address the issue. And then live the rest of your life³.

- XI -

I don’t know what to write now because I find myself feeling defensive and angry at almost everything in the zeitgeist.

It feels like the White House thinks women are delicate little flowers who also have control over every aspect of our children’s lives from the moment of conception forward. Even reading the President’s remarks, I flashed back to the patronizing sentiments that surround a pregnancy: “now, now, little lady, tough it out for the baby.”

It feels like a lot of autism commentary from people who do not live with it is either romanticizing or catastrophizing.

It feels like a lot of the anti-mom-guilt commentary is condescending and obstinate. “Stop it, everyone, because women can’t handle any more criticism! Why is everyone always picking on us?”

Women can stand on business, always. If randomized controlled studies concluded with a high degree of certainty that acetaminophen is a risk factor for autism or anything else, we could handle that. We would adapt. We would move forward. It would not mean that anyone in the past who took boatloads of Tylenol during pregnancy did something wrong. It would not mean that anyone who had a headache during pregnancy and passed on Tylenol did something right.

It would mean that we have new information. That’s it.

We get new information all the damn time. We roll with our physical interiors being rearranged during pregnancy, labor, and the aftermath. We roll with our bodies and our children’s bodies and our loved ones’ bodies changing constantly. We roll with the everyday problems, and we rearrange the living room to accommodate the asteroids. We persevere.

Robert F. Kennedy, Jr., has a number of suspicions and enough data to confirm his biases in his own mind. He does not have information that persuades the majority of the medical world. Last week, most medical professionals would have said that Tylenol is appropriate during pregnancy to manage fever and pain, but not in large quantities all day, every day. That’s still true this week.

More studies will be done. We will get new information about our health, prescriptions, and the environment all the time. We will adapt. If I could speak with the President, I would ask him to wait for a press conference that will freak people out until we have more to go on than Bobby’s gut. We’re already a little stressed out here. We have enough on our plates, and we know another asteroid will come.

- XII -

The President believes autism rates are skyrocketing. I believe that the medical world expanded the definition of autism, so, yes, the numbers are higher. I’m not sure if that’s a problem to solve or just what is.

I know the scientific method is frustrating, slow, and often unsatisfying. I know our bodies are weird. I know that medical decisions are like all other decisions--they involve complicated, imperfect cost-benefit analyses, risk assessment, emotions, and luck.

The best we can do, I think, is make decisions with people we trust (a) studied the issues; (b) know us as individuals; and (c) will communicate their recommendations about the intersection of what’s “out there” and “right here” with respect for us. That (and the rest of this tortured post) is a long way of saying that I’ll read the President’s remarks as a citizen, and I’ll consult my physician as a patient.

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107 Days

Beth is continuing her 2024 Election Reading Retrospective. She shared her notes on the book in our subscriber chat and discussed it with Alise on More to Say this week.

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Low Stakes Controversy

We had some great conversation last week about Pride and Prejudice adaptations⁴ , and we at Pantsuit Politics would like to formally apologize for excluding Bride and Prejudice from our poll. This week, in honor of my favorite little friend with ASD: these modern animals all lived at the time/are descended from dinosaurs. Which one is the best?

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What We’re Reading and Listening To This Week

Awake by Jen Hatmaker

You may have heard that our longtime friend and cheerleader Jen Hatmaker wrote a book that came out this week.

Jen joined Sarah and Beth to celebrate their 1000th episode earlier this year and talk about her new book Awake. If you’re just now reading the book and want to revisit the conversation, here it is!

Copyright (C) 2024 Pantsuit Politics. All rights reserved.

1. You can find those remarks here. I strongly prefer reading this President to watching him.

2. Traditionally, acetaminophen’s starting materials come from coal tar. Scientists are looking for ways to make it from a polymer in plant cell walls. It will be expensive to make this switch. Right now, the world consumes 80,000 metric tons of acetaminophen each year from cheap fossil fuel-based materials. Researchers know that we will eventually reach the end of that road.

3. This is obviously not medical advice.

4. Justice for Bridget Jones’ Diary!!!!