The city trees were at their peak of color when I moved back to Boston after a year in Maine, where I had taken an extended consulting contract. I felt I was beginning again in Boston, although I’d lived there before for nearly a decade. The day I was raped I was settling into a new apartment in a familiar neighborhood, and enjoying the feeling
of putting my world in order, leafing through books before placing them on the shelves, polishing candlesticks and washing dishes.

The bird that sang from the cherry tree felt welcoming. I wanted to identify it, but my field guide was hopelessly inaccessible, still packed up in the jumble of boxes stacked in the living room. So I closed my eyes and listened. I remember still that the notes were tumbling down one after the other. They seemed to carry a singular joy, as if the light of the Indian summer day were becoming sound.

As suddenly as it had appeared, the bird — a migrant, perhaps, on its way south — flew away and the mutterings of the city returned — traffic on the busy avenue a block away, a distant siren, the shouts of children playing baseball. I returned with renewed concentration to my tasks. I unpacked my kitchen utensils and put them in a drawer. I sharpened my kitchen knives and laid them on the counter. Then I filled a plastic bag with packing paper and dragged it out of the back door to the metal garbage cans at the side of the house. The air was a summery dream, sweeter still because a New England winter paced impatiently in the wings. As I stuffed the trash bag into a can, my back to the kitchen door, I listened for the bird, but it was gone. When I returned to the kitchen, I locked the back door behind me.

There is nothing more reassuring than a locked door — unless you’ve locked the devil in with you.

I am standing at the sink, washing a pan. I see my kitchen knives on the counter. I am always seeing my kitchen knives. I am still standing at the sink, washing a pan.

A storm from behind, and impact. It sucks away the air around me in a great rush. I cannot breathe. Rage is turning the air to pumice. I cannot hear. Something in my eyes. The pain is in my eyes. I am closing my eyelids but they do not meet. Something is in my eyes, something is coiling around my neck, something alive. Something furious and terrible. Words, but I cannot bear them. I am thrashing in the air. There is a foul odor. My body is on fire from inside. My blood is rushing as if trying to escape. I hear only it. There is no air. It is all going out of me. Who is screaming? I do not know who is screaming. I cannot breathe.

Now I hear the words. These are the words I hear: Shut up shut the fuck up you bitch you dirty bitch you fucking cunt shut up do you hear me you fucking dirty bitch I’m going to kill you if you don’t shut up you bitch I’m going to kill you.

Now I am sucking air into my lungs. I am prey, grasping for air.

Now I have a thought: So this is Death.

Now I have a feeling: Anything to live.

Now I feel something hard pressing against my back. I know what it is. It is a penis.

Later I wondered, Did the man who raped me hear the bird’s song? And if so, what did the notes sound like in his ear? How could he have heard what I heard and still be what he was? Was the bird a warning that I should have heeded? How could I have felt so alive and not have sensed his shambling darkness drawing near? Had I not been awake at all, but asleep? I could not trust even my most fundamental perceptions. The feelings of wholeness evoked by my connection with nature, feelings that had been a glimpse of heaven since my childhood, were transformed in an instant into feelings of foreboding.

In a single moment, I was robbed of what had always soothed me. A bird’s song became a harbinger of evil, the prelude to a season in the underworld.

The rapist was wearing slippers. This, the police said, suggested he had planned his attack. The slippers were enormous and my description of them was all the police had to go on. It wasn’t enough. He attacked from behind and from the first instant had the advantage — stealth and surprise. His right arm held my neck in a stranglehold and I could not extricate myself. The fingers of his other hand dug into my eyes. After he had me immobilized, only my feet kicking out wildly, he hesitated for an instant. It came to me then that my mouth was still free. Words. I still had words. I spoke words as he began to push me toward the bedroom. Words that tried to reason where there was no reason. I was struggling against the movement forward with all my strength and speaking the words. His fingers slipped from my eyes briefly and I saw his foot, a dirty, worn slipper. To this day the sight of a dirty slipper makes me gag.

He threw me on the bed face down, his knee in the middle of my back. He pressed down with his full and great weight so that I thought he might snap my spine in two, like a twig. At this point I became intensely focused on him and a strange calmness suddenly displaced my terror. He grabbed my arms and bound them together behind me with duct tape. Then he jerked my head up by grabbing a handful of hair and spun the tape around my head, over my eyes. “Don’t do this,” I said. “Shut up, you bitch, or I’ll break your arms.” He pulled my bound hands upward toward my head to demonstrate, but I felt no pain. Then he threw me over on my back, and sitting on my hips, tore open my shirt, jerked my bra up around my neck, unzipped my jeans, and pulled them down as far as he could without shifting his position. He then had to stand beside the bed to get them all the way off, fighting against my shoes, flats that fit snugly. Then he yanked off my underpants. At that moment, time disappeared into a continuous present.

Over the next three hours he raped me and tormented me with descriptions of how he would kill me with a knife, telling me exactly where he would cut me. Or maybe, he said, he would smother me with my pillow. He seemed undecided about the method. Many times he did cover my face with the pillow and press it down so that I could not draw a breath. Each time I expected to die, but he always relented just before I lost consciousness. He slapped my head with open palms after these episodes, the way you swat a fly.

In the scheme of things, his penis, although employed as a bludgeon, did not make much of an impression. What he did with it was the least of my worries. Those parts of my body that hitherto had been reserved and private were no longer mine, but in this they were indistinguishable from the rest of my body, also no longer mine. It was his rage, a fierce, unearthly tempest, that cast me into an immensity of dread.

Sometimes he left me and vented his fury on my possessions. He hurled a wooden jewelry box that my father had made for me against the wall, shattering it. He broke lamps, kicked chairs, threw glasses. His frenzy increased when he couldn’t find any cigarettes in the house. I had finally quit smoking just a week earlier. As he demanded them over and over I contemplated the irony that I would be murdered because for the first time in 20 years I didn’t have a cigarette handy.

Twice before he finally left, he pretended to leave. By then, hours had passed and I had acquired another sense. Although I was blindfolded, I could “see” everything clearly. I could see around corners. I could see my entire apartment as if it were a hologram I could walk around. I had no attachment at all to my body, although I wanted only one thing: to preserve it. It seemed this was something my body wanted and I had become nothing but body. Whatever part of me was “watching” did not feel alive because it no longer seemed to possess a body. When he pretended to leave, I didn’t move because I knew he was hiding in the small pantry off the kitchen. I could “see” him standing there. I knew he was playing cat to my mouse. I lay there, exposed and bound, waiting, bracing as best I could for the next attack.

The first time he did this, he waited a long time before rushing from his hiding place and leaping upon me. The knife, he said, was at my throat. But instead of cutting, he held the pillow over my face and then vanished again, back into his lair. While he was gone, I turned over on my face, so that my back was exposed. I calculated that I might survive a knife thrust in my back and began to rehearse the move I would make when he returned with the knife — how I would thrust up my left shoulder at the precisely right moment so that the knife would strike my shoulder blade rather than plunge into my heart. I waited, gathering strength, “watching” him tiptoe across the kitchen and hover at the door to the bedroom. He seemed to hesitate. Then he sprang onto the bed and began slapping the top of my head, as if he were putting out a raging fire. And then, for reasons I shall never know, he ran to the back door, unlocked it, and disappeared into the sunlight.

- – - – - – - – - – - – - – - – - – - -
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Just before he left, he demanded that I tell him where his knife was. He kept slapping me on the head, making this absurd demand. I knew there were four excellent knives sitting on my kitchen counter, the ones I had cleaned and sharpened just before I took out the trash. What he really meant was that his rage, this hungry beast that drove him, was satisfied — for the moment. He’d lost, as it were, his edge.

“How am I supposed to know where you put the knife?” I said, sounding bored and not responding to his blows. “I can’t even see you.”

He seemed to consider this. Then he said, “Don’t you move. I’ll be watching you. Don’t you move for an hour, you stupid cunt.” He had said these words before, but there was something different this time. I knew that he meant to leave. He was now afraid. I knew he was too afraid to kill me.

“Why would I move?” I replied in a ho-hum tone of voice, as if I were perfectly content to be wrapped up like a UPS package. He hovered for an instant and then fled. I lay still for no more than a minute.

Getting the tape off my wrists was difficult because they were taped together behind my back. I pulled one hand down, the other up, until I could work the thumb of my right hand over an edge. My efforts seemed to be in slow motion. Finally my hands were free. I tore the tape off my head, pulling out hair in clumps. I was beginning to feel pain, a distant dull pain that was like hearing a train in the distance.

The instant I was free, the seed of terror that had been planted in those hours burst open, spitting out an uncharted island where I was now stranded. Its peaks and valleys, its shores and streams would take a lifetime to explore, but I didn’t know that. I stood on its shore bewildered. Terror overwhelmed me. My body shook uncontrollably. My thoughts were flawed in structure, like cups without bottoms. Words fell through them. Words no longer referred to anything, even themselves. My shock was so great that I could not walk. I crawled to the back door, expecting it to burst open again, expecting him to be there. If his rage fed on terror, now there was terror in abundance. All I could focus on was locking the door. This I did with great effort. Then I crawled back through the bramble of overturned chairs toward the bedroom for my clothes. It was now as unbearable to be naked as it had been moments before to be in an unlocked apartment. My shirt was torn, but I was still wearing it. My bra was dangling under my armpits. I secured it and crawled around in the debris of my bedroom looking for my underpants and jeans. The air on my naked flesh seemed to burn, like dry ice. I found my jeans under the bed, but could not find my underpants — this thin membrane of cloth, the margin of safety, the ledge that if regained might keep me from plunging into the abyss. I thought that if I put my underpants back on, I could undo the thing I could not yet name. But my underpants were gone, sucked down into the vortex of violence. I did not remember that other underpants were in a suitcase, the contents of which were dumped on my dresser. Defeated, I pulled on my jeans, sitting on the floor. My hands shook so violently I could not zip them, but somehow I managed to secure the snap at the waist.

The phone was in the living room, a continent away. I crawled to it. I could not remember the three-digit emergency number, 911. Later, I recalled this lapse with shame, as if it were a measure of my inadequacy. I dialed the operator because there were letters on the “O” button — OPER — and I could still read them. The part of me that had detached continued to drift. She did not seem to know the trembling person who was using the telephone.

I do not remember what I said to the operator who responded when I pressed the OPER button on the telephone. The sound of a human voice, even one trained to be inhuman, was a shock. I felt myself falling inward. I must have asked for the number of the local police station because the operator gave me a seven-digit phone number. I hung up. The only thought in my mind was the phone number. I’m notoriously bad at remembering numbers. But if I forgot the number, I was sure the rapist would return. I dialed the number. Then there was another voice on the line, a male voice. The voice said, “Good afternoon.”

To say that I had been raped, to use the word, required that I sort out the incubi from the saber-tooths from whatever it was that had just destroyed my apartment. I was choking on the word.

“Who are you?”

“Shut up, you shut up, you bitch, or Ill kill you.”

“Theres something I have to tell you.”

“What?”

“I have a disease. It’s very contagious. I’m really sick. Thats why I’m home.”

“What is it?”

“It’s called hepatitis B. It’s very contagious. Rare. Deadly.”

“Shut up, you fucking bitch. Shut up. I’m going to kill you. Im going to break your fucking arms and then I’m going to cut you up, you fucking cunt.”

So much for words.

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Through the living room window I see the squad car pull up, but I cannot move. I am holding the phone. Someone is telling me to open the door, but the voice is dead and unreal. Someone is pounding on the back door. Someone is opening the back door. It is me, backing away from the door, holding my torn shirt together with one hand. A tall, overweight man in his 50s is standing in the doorway. He is wearing black shoes the size of fish poachers, a dark uniform. He stares at me and I recoil. He is afraid of me. I can feel his fear. I can see he doesn’t know what to say. Silence. He doesn’t speak. I am terrified of him.

A woman appears behind him and he steps aside, relieved. She is carrying a medical kit. I see more policemen behind her. They follow her into the kitchen. I think if I do not speak to any of these people I will wake up. Police come and go while the woman talks to me. I am in a bubble of air and all these people are in the water around me. I am like the pond spider that builds a nest of bubbles on the stems of reeds underwater. The spider grabs air and takes it down, one bubble at a time until the nest is done. Then the spider crawls inside. Inside is safe.

The woman is gently urging me to go with her to the hospital. She helps me find a jacket and a change of clothes, including another bra and pair of underpants I pull from the heap of clothes on my dresser. She suggests that I zip my jeans. I am humiliated because I am not wearing underpants.

“I can’t find my underpants,” I tell her. “He stole my underpants.” I’m down on my hands and knees looking for them. What a terrible thing to do, to steal someone’s underpants, I am thinking.

The woman wants them, too. “What color are they?”

“White and blue. Little flowers.” We both hunt for them.

“We have to go,” the woman finally says.

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I want water. My thirst is vicious. I am in the kitchen now. I turn on the faucet at the kitchen sink. My mouth is full of dirt. “Was there oral penetration?” the woman asks.

“Yes,” I say.

“No water,” the woman replies. “You might wash away evidence.”

Her words are terrible. I want to wash my mouth out with fire. What is in my mouth? Dirt is in my mouth. In my body. His dirt.

Everything is upside down. Words are backwards. The floors are littered with debris everyone is stepping over. My jewelry box is in pieces. “My father made that for me,” I say to everyone, gathering up the pieces. I hold two together, but when I let go, they fall apart again. The policemen stare at me. I don’t want to go to the hospital. I say I have to clean up the apartment. I can’t leave it like this. I have to find underpants. The woman helps me gather together the contents of my purse because I am going to the hospital. My wallet is empty and on the floor. My purse is under the bed.

When I finally get in the ambulance it is dusk. The sky is lavender and gray. The first thing I do is ask the woman for a cigarette. Miraculously, she has one. A Salem. The menthol is cleaning my mouth, burning my throat. Smoke is water. All the birds are dead.

Open your legs. Go on, you dirty bitch. Groan. That’s not good enough. I’ll cut you. Groan good. Now suck it. You bite me and you die, you fucking bitch. You gag and I’ll kill you. Tell me how good it was. Now you die.

) 1998 by Nancy Venable Raine. Used with permission of the publisher.

After watching so many of his fellow inmates die, he says he has become wiser about HIV. He uses a condom whenever he can get one, which is about once every other week. It’s not enough, but Wells is better off than most of the nation’s inmates. San Francisco is one of six places in the United States (the others are Vermont and Mississippi, and the cities of Washington, New York and Philadelphia) where condoms are distributed. In the rest of the country’s prisons and jails, the condom is contraband. In some prisons, there is even a small black market for them — going for about $10 apiece, says one ex-con.

The problem with all this is pretty basic, say AIDS activists and health officials: Inmates are having unprotected sex where there are six times more HIV/AIDS cases than in the general population, according to a 1995 report by the U.S. Department of Justice. Another more recent report estimates that the prison population has doubled in the last 12 years to 1.8 million. Inmates live, eat and breathe in close quarters, sharing everything from shower areas to food from the commissary to sleeping quarters. Compounding the problem is the fact that most of those incarcerated eventually get out and return to their communities — which means from a public health perspective, their problem is our problem.

“Corrections could be where the next major health crisis is going to be, but it’s not just about HIV and Hepatitis C,” says John Miles of the Centers for Disease Control and Prevention. “This is a population that has been out on the streets, and hasn’t had the health care that most of us have had. It’s a context where we can access people who have been ill-served. If we don’t take advantage of that, corrections could become a health crisis.”

To many AIDS activists and prisoner advocacy groups, there’s no need to wait for the Big Crisis to arrive. They say it’s already here. Even the international community has recognized the problem. The major worldwide health organizations have called for condom distribution in prisons, and many countries, primarily in Europe, have listened.

“The reality is that condoms save lives because they’re known as an HIV barrier,” says Romeo Sanchez, director of the prison project of the Latino Commission on AIDS. “Because a person goes to prison doesn’t mean that they stop having sex. There are marriages in prison, prostitution, prisoners having sex with prisoners, prisoners having sex with prison guards, documented cases of women becoming pregnant in prison — which shows that the male guards are having sex, too.”

In February, Sanchez’s nonprofit group released the results of a survey of 108 former inmates of New York state prisons. Sixty-three percent said they had seen prisoners having sex; 31 percent reported knowing someone who became infected in prison through unprotected sex. But since most inmates are not tested both when they arrive and before they’re released, it’s difficult to estimate the actual rate of infection.

“We do not have an HIV ‘health crisis’ in the federal prison system,” responds Dave Good, national health systems administrator for the Federal Bureau of Prisons. In the last 10 years, despite the increased number of those incarcerated, Good says the number of those who have tested positive has remained steady at 1 percent.

He attributes this to the bureau’s infectious disease education program, which teaches prisoners about the dangers of, among other things, illegal needle use and sexual activity. And while activists will point the finger at agencies like the BOP if a prisoner gets infected, Good places the culpability on the inmate who makes the decision to have sex. “Inmates are responsible for their own actions. If an inmate has sexual relations or participates in illegal blood exposures, then they are putting themselves at risk.”

Many health officials say the number of HIV/AIDS cases is much higher than the figure Good cites, since not all prisons and jails test inmates. In fact, in many places, it’s a voluntary test — one that inmates aren’t rushing to take, because if they test positive, they might be stigmatized or put in a special HIV wing.

And even in the HIV wing, there are risks, like picking up a new strain or another disease, says Jerry Larson, an ex-con who is HIV-positive. While he and others sometimes used cut-up surgical gloves as protection, they had what amounted to unprotected sex. Larson, recently released after serving four years at Vacaville and San Quentin for holding another person captive, considers himself lucky. “I find it revolting that they know what’s going on and are just ignoring it. You’re talking about a group of people with years of their lives spent inside. You aren’t going to get abstinence, so you’ve got to do something.”

Other countries are doing something. Canada, for example, distributes condoms in all federal prisons — in the shower areas (a popular place to have sex), in the canteen and in the entranceways to health services. Needles, bleach and dental dams are also provided. (Canada’s federal system, unlike the United States’, is reserved for those sentenced to more than two years.)

“Let’s just say that condoms are available in all countries in the Western industrialized world, with very few exceptions, and the United States is the big gap on the map,” says Ralf Jurgens, executive director of the Canadian HIV/AIDS Legal Network, and coordinator of the Canadian government’s 1994 study on the topic. In fact, Australia and most European countries distribute condoms, and international organizations from the World Health Organization to the United Nations AIDS program to the president’s own advisory committee on AIDS have recommended it.

The CDC advises condom use for everyone who is sexually active, although it has never issued a formal recommendation for the incarcerated community. So why, given the HIV/AIDS rates in penal institutions, is the use of condoms by the incarcerated one of the most contentious issues facing corrections departments in the United States?

“Internationally it’s seen as a pragmatic measure because of HIV and the fact that we know that many prisoners engage in sexual activity,” says Jurgens. “Often the argument in the U.S. is that, ‘We can’t condone sexual activity behind bars.’ Some people say not making condoms available is condoning the spread of HIV behind prison walls.”

The problem is more complex for corrections officials, who see condoms as a security threat and a penal conundrum. First the conundrum: Sex is outlawed in prisons, so “we would be saying ‘Don’t do this,’ but ‘Here is something to use’” if they do, says Carole Young, vice chairman of the Texas Board of Criminal Justice. When looking at the issue of HIV/AIDS in the Texas prison system in 1997, Young was on a committee that looked at prevention methods and decided not to condone condoms. “I don’t think there’s a public health crisis going on in our facilities,” says Young. “Prisoners are at the highest risk of getting HIV in the population. There is no question about that. While we would not rule [condom distribution] out forever, we felt that the downside was greater than the positive, and making this available would create another set of problems.”

The other worry is security. In a jail or prison setting, corrections officials say, those thin, tubular pieces of latex are dangerous. Prisoners are creative with almost everything they get, and could use condoms as strangulation devices, sling shots, fingerprint barriers or drug-stashing vehicles.

“I would not be concerned about it as a weapon, but I would as far as drugs are concerned,” says Bob Houston, warden of Douglas County Correction Center in Omaha, Neb. “They could use it like a balloon. We’ve had visitors put the drugs in a balloon in their mouth and then kiss the inmate, or pass it through some other way, and the inmate swallows it. At the end of the visit, the inmate can successfully go through the strip search and then vomit it up at a later point.”

Even in facilities where condoms are offered, they aren’t being handed out in every cell. Some make them available at commissaries; others give one out only after the inmate goes through an HIV/AIDS education program. Each facility tends to do it differently. In Mississippi, where condoms have been distributed for years because of the state’s conjugal visit policy, their presence is almost a non-issue with prison officials. “It’s an item, like chewing gum or candy bars,” says Ken Jones nonchalantly. Jones, spokesman for the Mississippi Department of Corrections, says condoms are not the hottest commodity for sale at the canteens. In the last quarter of1998, they sold only 30 packs of three condoms each.

Washington was the last place to authorize distribution, in 1992. And the BOP does not foresee changing its policy in the future. “The issue is a political hot potato,” says Nic Howell, spokesman for the Illinois Department of Corrections. “I think my neighbors would go absolutely ape-shit if they even suspected that we were providing inmates with condoms. It would be construed by the taxpayer that we were urging them to have sex. And believe me, the next director of corrections would not allow condoms to be distributed, because it wouldn’t be long that before the director of corrections who allowed that to happen would be looking for a job.”

So getting support for distribution has been difficult. In the mid-’80s, San Francisco Sheriff Michael Hennessey struggled to make them available in San Francisco County, where he oversees seven jails. Many of his deputies had AIDS. Hennessey wanted to do something to stem the disease’s spread.

Getting permission was harder than he thought. He was bounced back and forth between local attorneys and the state attorney general, and never did get a “green light,” as he calls it, but only a “yellow” one. The district attorney told him to walk a fine legal line: It was not a crime to distribute condoms, but it could be if a staff person handed a condom to someone knowing that the person intended to use it to have sex. Hennessey had a staff official quit over the issue, but looking back more than 10 years later, he says it was worth it. “People had all kinds of fears about what it would lead to — promiscuous sex, sexual assault, condoms used to smuggle drugs, or to strangle someone. There were all those fears and concerns, but frankly, none of them have happened. We’ve probably distributed between 20-25,000 condoms and we’ve never had anyone misuse one in those illegal fashions.”

Even in San Francisco, many inmates said they did not know condoms were available. “I’m HIV-positive and I didn’t know that they gave them out here,” says 35-year-old Terry Havro, who tested positive while at San Quentin 10 years ago.

Jackie Walker, AIDS information coordinator for the ACLU National Prison Project, receives letters from inmates all over the country who claim to have become infected after having sex with another prisoner. The stories, she says, basically mirror those on the outside — they had sex, didn’t know the other person was infected, then they test positive. But, she says, there is a big difference between what happens on the inside and the outside. “Prisons are the only place in the community where you can’t protect yourself,” Walker says. “There’s no way you could practice this idiotic reasoning except with prisoners. That should not be the attitude — these folks will be returning to the community.”

In fact, according to Hennessey, 98 percent of the inmate population gets out again, going back to their lovers, homes, neighborhoods, friends, wives, boyfriends and girlfriends, not to mention meeting new ones. It’s a statistic he calls “one of the best-kept secrets of the criminal justice system.”

“You don’t see that on TV,” says Hennessey. “You see people arrested in the news, or on television shows, you see people walked away and given sentences. But the fact of the matter is almost all of them eventually get out and come back into the various communities. People come out who either obtained the disease in prison or were diseased before they were in prison and now they’re getting back out, and I think it’s to the community’s benefit to understand better how to prevent the spread of disease.”

Jerry Larson is a perfect example of that. He’s been out for nine months now, and has continued to have sex. Of course, he says he uses a condom now because he can buy one. But the time inside without them continues to haunt and infuriate him. “I consider it the most foolish thing I’ve ever witnessed. You have the power to prevent the spreading of diseases or [the introduction of] new diseases. Especially since these people are going to take it home to their families. Just because someone said years ago that it wouldn’t happen, or shouldn’t happen, doesn’t mean it’s not going to. This disease doesn’t stop at the prison door.”

Yet a small, vocal group of women are taking up the cause of menstruation. More specifically, they’re protesting the pink and blue rows of menstrual products available at your local pharmacy. In an odd meshing of environmental, health, feminist, New Age and anti-corporate activism, these women claim that feminine hygiene products not only harm the environment, but put women at an unnecessary risk for everything from toxic-shock syndrome to cancer. They are calling on women not only to reconsider their attitudes toward the “curse,” but to toss out their boxes of pads, tampons and liners, and go — no joke — reusable.

As in reusable tampons such as the Keeper and the Sponge, both of which collect menstrual blood and can be emptied and used again. These women also promote washable cotton pads, attached to underwear by either an old-fashioned belt or a snap-on fastener.

Sound gross? Perhaps. But the women who use these nondisposable menstrual products swear that once you make the switch you’ll never go back to disposable again.

Lorie Kellogg, a graphic designer from Los Angeles, is one such convert. She started using the Keeper a year ago after reading about it on a Web page for environmental activists. Kellogg says she was tired of shelling out $5 or $10 a month on disposables and worried about the environmental impact of tossing out hundreds of applicators and packaging each year. The Keeper, which for a onetime payment of $40 lasts up to 10 years, seemed a financially sound and socially responsible choice.

But, Kellogg adds, there was a hidden bonus. “It’s very convenient. You don’t have to worry about packing supplies with you. Once you have it with you, you just empty it out and keep using it.”

Francine Chambers saw an advertisement for the Keeper five years ago and decided to give it a try. She was so impressed, she bought the business and has been running it full time from her home in Ontario, Canada.

“I’d been using those other products and I hated them every time,” Chambers says. “When you use pads and tampons, you’re sitting right in those icky pads. That’s why they smell so bad. They are expensive and they chafe. You get sore.” Chambers says she was also bothered by the environmental impact of disposable products and worried by the bleaches used in most feminine hygiene products.

But as she describes her product there’s a hint of religious fervor in her voice that goes beyond the average endorsement. “It’s a lifesaver,” she says. “Once women try it they are in awe of it just like I am … It’s fantastic. I’ve got so many testimonials.”

Perhaps calling the Keeper a “lifesaver” is taking things too far, but it is reasonable to say that it saves money, reduces landfill and, if lugging around a few tampons is a bother, is more convenient — because you basically tote the Keeper inside you. Also in its favor, the Keeper is no more messy to use than tampons, which must be changed more regularly and can require a panty-liner as backup. (Although some women still use the Sponge, problems with blood squirting out of it made it unpopular.) But why would anyone choose reusable pads, when you have to soak and wash them before you can reuse them?

For Susanna Eve, a member of Moonwit, a collective of women in Canada who make and sell reusable cloth menstrual pads, her motivation to go reusable was more than environmental and financial, though both figured in her decision.

The pads are generally made from washable cotton and terry cloth and are attached either by snaps or a belt. They cost around $7 a piece, depending on where you purchase them, and Eve recommends having about a dozen on hand. Unlike store-bought pads, these come in a variety of patterns — from flowers to zebra stripes to blood red. Eve calls her pads “menstrual lingerie” and compares them to clothing items. “Why shouldn’t it be fun and pretty?”

“Fun” and “pretty” are not adjectives normally associated with periods. But Eve’s views on menstruation are not exactly mainstream. Growing up, Eve says, she was taught to hide menstruation. “When you took off your pad you double-, triple-wrapped it in toilet paper and hoped your father never noticed. You didn’t talk about it unless you were sick to the point that you were debilitated.”
The pads’ colorful patterns bring an aspect of fun to her cycle, Eve says. “I went to a bead store and picked some fancy stones to make a bracelet to wear while I was bleeding,” she says, explaining that such activities are positive diversions from cramps and fatigue. Other women, according to Eve, water their plants with their menstrual blood (gathered from the soaked pads) and even use their blood to make artwork.
Eve calls these acts “empowering,” and says they help women “cope” with menstruation. While there’s nothing inherently wrong with these methods of dealing, most women would just call them gross. Although few may find it necessary to do more with their blood than flush it, Kellogg says women do need to get over their stereotypes of female bodily functions.
Chambers doesn’t recommend anything so radical as blood art, but she does say that emptying menstrual blood puts women in better contact with their bodies and overall health. “It’s a really good indicator if you’re having a problem,” she says. “Some women I’ve talked to, they’ll use the Keeper, they’ll empty it three or four times a day and it’s like totally full. I tell them that’s not normal; you’ve got to talk to a doctor.”
Dr. Cristina Muñoz, an assistant professor of OB/GYN at Duke University, agrees that the Keeper can be useful for women who are bleeding excessively, but adds that these cases are rare. “There are people who are so anemic they just hemorrhage. For them, [the Keeper] might be useful to get an idea that they really are bleeding large amounts so they’ll have an idea that they need to replace all that iron.”
Proponents of reusable tactics also point to toxic-shock syndrome, a bacterial disease associated with tampon use, and the presence of chlorine bleaches, rayon and cancer-causing dioxins (which form in wood pulp during the bleaching process) in tampons as reasons to switch to nondisposable products. Web sites like S.P.O.T. and many of the sites selling alternative products devote themselves to educating women on the dangers of tampons.
The problem is, most doctors agree there’s no serious danger at all.
“The vast majority of people who use tampons correctly don’t get toxic-shock syndrome,” Muñoz says. And although there are no recorded cases of women getting toxic-shock from alternative products, including bleach-free disposable tampons, Muñoz says the tiny percentage of women who use such products could account for the lack of cases.
As for the claim that chemicals found in disposable products are harmful to women, Muñoz says there simply isn’t data to support or disprove such claims. “We don’t know if those chemicals are risk factors,” she says. “When they complain about rayons and dioxins, which are bleach byproducts, the theory sounds very good. They say use natural tampons that are made without bleach, or maybe all cotton instead of with rayon. But they basically have no data.”
Elaine Plummer, a spokeswoman for Procter and Gamble, Tampax’s corporate parent, expresses outrage at claims that tampons are dangerous. “I’m a little bit appalled when they’re making that type of a statement. They’re not basing it on good science. There are a lot of people I work with who assess the product for safety.” The American Cancer Society backs up Plummer.
Muñoz does say there’s no medical reason why women shouldn’t try alternatives. She even recommends alternative products, including bleach-free tampons, to women with severe allergies or chronic vulvar pain.
With no overwhelming medical arguments against disposable tampons and pads, it’s unlikely that many women will be eager to switch from mainstream products to reusable items. Even environmental and financial arguments fall apart under scrutiny. Tampons biodegrade when flushed, so the only waste comes from the packaging and applicators — all of which is recyclable, especially if you use cardboard rather than plastic applicators. (Some products, like O.B., are applicator free.) The onetime purchase of the Keeper or cotton pads might seem like a smart financial choice at first, but working women may find it impossible to invisibly scrub or soak their menstrual devices at the office.
“Women just don’t want to have to soak things overnight, wash them the next day — they basically want menstruation to be as invisible as possible, which I guess I can understand,” says Harry Finley, founder of the Museum of Menstruation, located in Hyattsville, Md. (Finley has documented the history of menstruation paraphernalia and advertising in his museum, which he created after noticing the different ways menstrual hygiene products were advertised from country to country during a 13-year stay in Germany.)
Indeed, the disposable products — tampons in particular — that flooded the market after World War I were viewed by women as liberating them from burdensome, often nondisposable, pads.
Reusable products “are a tough sell to mainstream women,” Finley notes. Francine Chambers, despite all her optimism over the Keeper, agrees that the market for her product is small. “Let’s face it. Selling the Keeper is not going to make anybody rich. You only need one.” Not to mention, the market for alternative products is so small that few stores sell them and few women have even heard of them. (Almost all marketing and sales are now done over the Web, where the cost of advertising to a large audience is minimal.)
Lorie Kellogg, the Keeper convert from Los Angeles, says nobody she’s told about the product has been interested in trying it. “I try to share the information, but people have these ‘ick’ walls that you can’t get past,” she says.
But Chambers says she’s not bothered by lack of interest. “I’m not really in it for the money,” she says of her business selling the Keeper. “Why does everything have to be about money? Sure it’s nice to make a profit, but where are people’s consciences?”

Although the two studies are not scheduled for publication in Pediatrics until later this fall, their findings became news last week with the release of the book by Richard Firstman and Jamie Talan. “The Death of Innocents” also details the case of Waneta Hoyt, whose five infants mysteriously died more than 25 years ago. All of Hoyt’s children were believed to have died of SIDS, forming the basis for a widely accepted theory that the syndrome runs in families. But Hoyt later confessed to having killed her children and two years ago was convicted on five counts of murder.

In Southall’s study,
surveillance cameras were installed in hospital rooms to observe parents with their babies who were being hospitalized because they had stopped breathing in the past. In 39 cases over the course of several years, mothers were videotaped choking their infants.

Truman’s study examined cases of apparent life-threatening events, also called “near-miss SIDS” cases (defined as instances when a baby stops breathing), and any SIDS-related diagnoses over a 23-year period at Massachusetts
General Hospital, one of the most prominent SIDS centers in the nation. He concluded that a third of 155 apneic cases had suspicious circumstances, possibly indicating
child abuse. Such circumstances include a number of near-death episodes,
siblings who died
of SIDS and repeated events that were witnessed by only one
parent or caregiver.

Although some SIDS activists have been quick to claim that the latest information will only increase the persecution of SIDS parents, the studies do not just point a finger at parents; they call into question both the medical community’s largely uncritical acceptance of the theory that SIDS runs in families and the responsibility of individual doctors who might have ignored repeated near-death episodes instead of stepping in and saving lives. So far, the response from the medical community to the news has been a resounding silence; Mass General, for one, has not commented.

With an extremely heated emotional issue such as SIDS, will this news create a witch hunt or help reduce the cloud of suspicion over innocent parents? Salon spoke with Thomas Truman and National SIDS Alliance spokeswoman Phipps Cohe and got very different answers — an indication that the controversy around SIDS is unlikely to let up any time soon.

Although the two studies are not scheduled for publication in Pediatrics until later this fall, their findings became news last week with the release of the book by Richard Firstman and Jamie Talan. “The Death of Innocents” also details the case of Waneta Hoyt, whose five infants mysteriously died more than 25 years ago. All of Hoyt’s children were believed to have died of SIDS, forming the basis for a widely accepted theory that the syndrome runs in families. But Hoyt later confessed to having killed her children and two years ago was convicted on five counts of murder.

In Southall’s study,
surveillance cameras were installed in hospital rooms to observe parents with their babies who were being hospitalized because they had stopped breathing in the past. In 39 cases over the course of several years, mothers were videotaped choking their infants.

Truman’s study examined cases of apparent life-threatening events, also called “near-miss SIDS” cases (defined as instances when a baby stops breathing), and any SIDS-related diagnoses over a 23-year period at Massachusetts
General Hospital, one of the most prominent SIDS centers in the nation. He concluded that a third of 155 apneic cases had suspicious circumstances, possibly indicating
child abuse. Such circumstances include a number of near-death episodes,
siblings who died
of SIDS and repeated events that were witnessed by only one
parent or caregiver.

Although some SIDS activists have been quick to claim that the latest information will only increase the persecution of SIDS parents, the studies do not just point a finger at parents; they call into question both the medical community’s largely uncritical acceptance of the theory that SIDS runs in families and the responsibility of individual doctors who might have ignored repeated near-death episodes instead of stepping in and saving lives. So far, the response from the medical community to the news has been a resounding silence; Mass General, for one, has not commented.

With an extremely heated emotional issue such as SIDS, will this news create a witch hunt or help reduce the cloud of suspicion over innocent parents? Salon spoke with Thomas Truman and National SIDS Alliance spokeswoman Phipps Cohe and got very different answers — an indication that the controversy around SIDS is unlikely to let up any time soon.