“I Never Thought I’d Be Able to See the Other Side of Infidelity….”

Paula always thought that infidelity should be “a deal breaker” in marriage—until two good friends confided in her about their unfaithful husbands. “I had a hard time wrapping my head around how you could possibly stay with someone who could not be faithful to you,” she said, “someone who could bring that betrayal into your life. But once you have children, custody most often comes with a split, so the reality that you’re never really free from the person tends to be a huge factor in encouraging or pressuring people to stay together after infidelity. I was just amazed,” Paula concluded. “I never thought that I would be able to see the other side, but marriage with children is really different than marriage without children.”

Is this an admirable stance of forgiveness, a navigation of the heart’s ambiguities, or a dubious case of what one woman once described to me as the “craven” act of putting up with a marital outrage?

I lean toward the former. It seems to me that we’re more imaginative, tolerant and attuned to marital ambiguity in real life than we are in our imaginations. We talk about marriage in black and white terms, but we live it in shades of gray. This is most obvious in sexual mores and, as with Paula’s view, more common in marriages with children.

On the one hand, Americans famously disapprove of extramarital sex, although we commit it with some frequency, in anywhere from 20 to 50 percent of marriages (and the infidelity “gender gap” has now closed, with both men and women straying in roughly equal numbers). A fascinating 1994 research study finds that Americans are among the most infidelity-intolerant people in the world, with a near unanimous 94 percent judging extramarital sex to be “always or almost always wrong,” and just 6 percent “only sometimes wrong or not wrong at all.”

On the other hand, we forgive extramarital sex fairly often. A suggestive 2008 survey found that nearly half of wives surveyed thought they’d be forgiven for having an affair, and more than half would forgive their husbands, after the fact, if they did. This isn’t what we say we’d do, but it’s what we privately imagine we’d do, nonetheless.

A therapist I talked to for Marriage Confidential observes these secret ethical ambiguities all the time. He noted that some of his clients do want to work things out in their marriages, but were “ashamed of having positive attachments” to their unfaithful spouses, or seeing what happened in multi-faceted ways, because they feared they'd be perceived as meek or deluded for doing so.

Maybe the problem isn’t that we never live up to the black and white, Boots Are Made for Walkin’ ultimatums, but that we don’t permit ourselves to embrace the gray in marriage. We fear it might look weak or pathetic to forgive a lapse; we think we’d look gullible or naive if we questioned the rules of monogamy with our spouses, or strayed from the received ethics.

All the same, the gray zone is where a lot of marriages reside, and have resided historically. Spouses tolerate a few transgressions over the course of a married lifetime. In other cases, they practice don’t ask, don’t tell when it comes to non-monogamy—they know but they don’t know about other intimate attachments that their spouses might have, and they’re not overly threatened by it. In other cases, if a betrayal happens, they contextualize it within the whole history of the marriage. Is this weak, or adaptive?

We all should try to live by ethical standards, and the most important in marriage are probably trust and honesty, but I don’t think it’s wise to live post-millennial marriage like a cartoon, in black and white, or a caricature, with Saints and Jerks and ultimatums. It’s the sort of talk that we engage in with our heartbroken girlfriends, or boyfriends, and it serves an important function because it expresses our disapproval of bad behavior.

But real life is always getting drawn outside of the cartoonish lines, and secretly, we know this. Couples slide down into crisis, together. They conspire to become imperfect, together. Sometimes they end up deceptive, surly, or angry toward each other in ways that neither of them ever, ever thought they’d feel. I don’t condone any of this, but I understand it.

Many (50% of younger Americans) think marriage is “becoming obsolete.” Does it feel obsolete to these people because we fall short of the ideals too often, or perhaps because we’ve not considered how the ideals might change to fit with the 21st century? As with a suspension bridge, strength comes from being able to sway a bit with the winds, rather than bracing rigidly against them.

These are new survival skills for the post-romantic age: flexibility, imagination, perhaps even a love for shades-of-gray, complicated intimacies. I’m reminded of a woman with two children whose husband had had an affair. And, after he had an affair, she had one, too. His lasted longer, and still occasionally goes on, but she wasn’t terminally perturbed, and nor was he. When it started, “he’d been monogamous with me for 19 years, after all,” and they had a good marriage, in so many ways, and wanted to raise their children together. They ended up with a different marriage than what they imagined they’d have. But they’re still contentedly married.

Real marriage is rarely encapsulated in an adage that fits on a billboard. Decent people end up with vexatious, imperfect, flawed, complex relationships. And some are still married, even so. 

'Upstreamism': Your zip code affects your health as much as genetics

Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."

Sponsored by Northwell Health
  • Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
  • Patients from low-income neighborhoods are most at risk of negative health impacts.
  • Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
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  • A huge segment of America's population — the Baby Boom generation — is aging and will live longer than any American generation in history.
  • The story we read about in the news? Their drain on social services like Social Security and Medicare.
  • But increased longevity is a cause for celebration, says Ashton Applewhite, not doom and gloom.

After death, you’re aware that you’ve died, say scientists

Some evidence attributes a certain neurological phenomenon to a near death experience.

Credit: Petr Kratochvil. PublicDomainPictures.net.
Surprising Science

Time of death is considered when a person has gone into cardiac arrest. This is the cessation of the electrical impulse that drive the heartbeat. As a result, the heart locks up. The moment the heart stops is considered time of death. But does death overtake our mind immediately afterward or does it slowly creep in?

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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.