Okay, the latest news. A large number of Americans follow the “don’t ask don’t tell” theory when it comes to STDs–you know, those sweet little diseases that you spread by screwing around. According to a survey conducted by MSNBC.com and Zogby International, of 56,000 adult men and women, only about one-third ask their partner if they’ve got insidious microbes crawling around their private parts.

Just 39 percent of people who took the survey always ask whether a new partner is infected with HIV, the virus that causes AIDS, or other STDs. Nearly one-third said they never check on a prospective partner’s sexual health status, and among those with less than a high school education, almost 50 percent never discuss the issue of STDs with a new partner — troubling statistics given the deadliness of AIDS and rising rates of genital herpes and other diseases.

I would agree, it’s nice if everyone can sit down and discuss the various microbes growing in their body, and it would be really nice if everyone was honest enough to admit what they’ve got cooking “down there.” But there is a great deal missing from this survey.

Let’s face it, a lot of people just want to get laid. And that may prevent them from being totally honest, especially when plied with alcohol or other drugs. Another major factor to consider is that many people haven’t a clue what they’re infected with, especially women. An example is gonorrhea. While guys generally get these painful lesions on their dick, a woman’s lesions may occur internally and painlessly. She may remain blissfully unaware that she’s got the clap until more serious damage occurs. But by the time that occurs, she may have infected the entire line-up of the UCLA Bruins.

The same with HIV. Unless you have been tested, or perhaps are aware that a person you recently had sex with is infected, there is no way of telling your HIV status. So merely asking someone if they are HIV positive may get you an honest “no” answer, simply because your perspective partner doesn’t know, or doesn’t think so, or never considered the possibility.

So unless you’ve got the test results in hand, and know that you’re partner hasn’t screwed anyone else between the date the tests were done and right now, you’re best friend is the lowly little condom. Personally, I think it’s a great leap of faith to take someone you don’t know very well at his or her word–that they’re squeaky clean.

You can read about the highlights of the survery at MSNBC.com

Religion and medicine. The clash of absolutes. Not all the time, but some of the time, when heads and brains that are made of steel refuse to yield or compromise.

There is a delightful essay in today’s NY times, write by a cardiac surgeon who had an Orthodox Jew as a patient. Things turned out quite differently than he anticipated. Religious laws, rules and regulations are often interpreted quite differently when it comes to health and medicine. For example, Jehovah’s Witnesses refuse blood transfusions. An adult in their right state of mind is entitled to make a choice, and there the story ends. But when it comes to an infant, it is another matter.

Working in the NICU, the situation arose several times and in all cases, the baby received a transfusion. In the majority of cases, I would have to say that the parents appeared relieved that the decision had been taken out of their hands. They didn’t want to go agains their faith, but they didn’t want their baby to die either. There was only one case where the parents abandoned the infant after he had received blood, declaring that now he “was tainted.” Whether that is part of JW doctrine, I have no idea. But the baby was put up for adoption, and the parents never returned.

So here we have different interpretations of the faith. In the NY Times essay, the surgeon confronts the patient, an Orthodox Jew, who needs a heart valve replaced.

“The kind: two choices,” I said. “Mechanical, made of plastic and metal, or biological, a pig valve.”

He surprised me. No rage, no rejection. A tiny smile.

“So doctor, what do you suggest?” he asked.

“You are 77,” I said. “A pig valve would be best. You would not need blood thinners; it’s safer. Is a pig valve O.K.?”

I expected a long discussion of the laws of keeping kosher. No. His head straightened, a direct look, not a blink. A quick response. “Jews believe, above all, that saving lives is the most important,” he said. “Please save mine. Use a pig valve.”

The surgeon expected a very different answer, according to stereotypes that of course, the Orthodox Jew would be horrified by the thought of a non-Kosher pig part in his body. But as the patient explained, there are times when one must go beyond the day to day rules and regulations–and in fact, his religion even requires that one do so.

And so, the surgeon successfully performs the procedure. But the surgeon is still concerned–despite what the man says, will having a pig valve sitting in his chest cause him some deep psychological trauma? Will he have second thoughts?

I remove the valve of rock and suture in the pig valve. A nice fit, I think. Perfect for his heart. But for his mind?

Several days later, the intensive care unit behind him, back in his room, close to discharge.

I dare to ask him, “How are you with your pig valve?”

He smiles, a garden grin. “I am stronger, better, alive,” he says. “One does not always need to keep kosher.”

I can’t help myself. I can’t stop laughing; only grabbing the chair keeps me from collapsing on the floor.

This really is one of the best essays I’ve read in a long time.

NY Times