Posts (21)

Thu, Aug 15 11:33am · Book Review of: So you want to talk about race, by Ijeoma Oluo (And comments on hobbies)

By Josiane Joseph

Last year, while moving through the realm of a fast-pace M.D.-Ph.D. student I was gifted something I did not know I needed. It was a book—a really good book. As I read it, I found time to reflect on new perspectives and savor a different flavor of thinking, the non-scientific variety. It was then that I realized that by buying into the myth of “I don’t have the time” to read new stories, I was neglecting myself. Ever since my youth, I was an avid reader of everything; reading is woven into the fabric of my being. It is probably the most direct contributor to any success I experience in life, and has shown me many aspects of the world before I could live it for myself.  After realizing what a disservice to me it would be to put off fun reading, I vowed to resurrect my oldest most reliable hobby by reading 12 great books in the year 2019. What follows is my evaluation of book number 10.

Whenever I read a book, particularly if it is a good one, I will look for more information on the author. The background of a writer interest me because sometimes it alludes to what might be shaping their views and enhances the work overall. Ijeoma Oluo is a mixed raced woman (which surprised me somewhat). She is a mother, was a wife, is a sister, identifies as part of the LGBTQ community, has a bachelor’s in political science, and has a platform that allows her to make her living as an advocate for equity and justice. In So you want to talk about race we see stories of her in all of these roles which adds new dimension to the topics she broaches and speaks to the passion that inspired the novel.

For someone who may not have much time to devote to reading,
this book is perfect because it has seventeen discrete chapters that can each
be enjoyed individually. If I was the type to skip around to parts that most
interested me, I could easily do so because a neat table of contents was
included. Many of the topics listed such as privilege, police brutality, and
the definition of racism are commonly discussed in diversity meetings which I often
make an effort to attend. Therefore at the start of the novel, I was a little
weary of redundancy but simultaneously intrigued because it was not clear which
direction Oluo might take. By the end of the book, I was impressed with the
broad range of subjects she was able to address, several of which I never
considered (for example, the model minority myth); I was also relieved that many
conclusions it might take years of investment for someone like me to accept
were boldly and rationally presented. This is definitely a timely novel with
something to offer everyone.

From the very first chapter Oluo drives home the point that
pretty much all aspects of life for humans are influenced by race (though race
is not the only influencing factor). As a rising professional who—due to the
paucity of diversity in my field—must always work with people who are very
different from me, I am learning more and more that this assertion is true. To
quote Oluo “…being a person of color in white-dominated society is like
being in an abusive relationship with the world.” Throughout the novel,
she speaks to the pain that many people of color experience while existing as
unwelcome citizens, gave salient recommendations about appropriate ways to
respond during conversations about race, and also provided insights to what
might be driving adverse behaviors when the topic of race comes up. The
parallels she made for several concepts and the scientific work she cited made
Oluo’s work a useful tool to do just as the title suggests: talk about race.

It is worth commenting on Oluo’s writing style because it may
be reflective of how she came to prominence as a writer. The language Oluo uses
in her writing is both direct and casual which made the piece overall more
relatable. As she discussed issues of non-black people touching black women’s
hair without permission or the over-persecution of children of color in schools,
I was mentally snapping my fingers in approval because these are topics that I
know from experience that many of my peers never took the time to discuss. Reading
Oluo’s work felt as though she and I were swapping stories in a serious
conversation about race (though it was clearly one sided). Overall her book is
humorous and the informal approach, rather than detracts, compliments the
seriousness of the subject matter.

In the past, I have read several books about health
disparities and social justice which, like So
you want to talk about race
, were extremely enlightening. What makes this
book unique is how much the authors personality shines through the work, how
clear it became from the breadth of the novel that issues of race is a topic
that Oluo has pondered and experienced for years, and how useful the
suggestions she included may be to a broad audience. Simple pointers, such as
listening without invalidated the experiences of minorities and using the
internet to gain knowledge rather than demanding it from minorities, were
thoughtfully included in this book. Each component combined made for a great
read that I would recommend (and will be recommending) to others.

Generally speaking, reading So you want to talk about race was informative and a valuable use of my time. With all of this said, I would like to end by paying homage to my once neglected hobby by reminding readers this: make the time for yourself. If busyness is the excuse to abandon the activities you love, then you are probably missing out on a great part of your only life.

About the Author: Josiane Joseph is a Haitian-American M.D.-Ph.D. student at Mayo Clinic. She was born in Miami, Florida and earned her B.S. at the University of Florida in 2015. During her free time she enjoys movies, writing, attending church, and learning about what makes other individuals unique. Josiane values discussions of meaningful issues and looks forward to sharing diverse views with others.

Sat, Jun 1 10:36am · Book Review: The Autobiography of a Transgender Scientist by Ben A. Barres

By: Samantha M. Bouchal

I came upon Ben Barres’
autobiography completely by chance, while conducting a literature review on
glia. A paper published in Nature by
his laboratory, “Neurotoxic reactive astrocytes are induced by activated
microglia”, had been cited no less than 853 times, and I had wanted to learn
more about the exciting work this group was doing. To my chagrin, I learned
that Dr. Barres had passed away in December of 2017 of pancreatic cancer, at
age 63. Wanting to learn more about his life and legacy, I read Andrew
Huberman’s 2018 eulogy (https://www.nature.com/articles/d41586-017-08964-1), which told a beautiful story. In addition to making
groundbreaking contributions to our understanding of glia in both normal
physiology and disease, Dr. Barres had been a lifelong advocate for women and
minorities in science. Using the power and prestige only a principal
investigator (PI) could wield, he convinced powerful people to make meaningful
change (such as changing the nomination and selection procedures for the NIH
Pioneer Award and Howard Hughes Medical Investigator appointments).

It was in reading about his advocacy that I stumbled across Dr. Barres’ book, The Autobiography of a Transgender Scientist. Born as Barbara in 1954, Dr. Barres knew from childhood that his biological (assigned) sex did not match his “brain sex”, or conception of gender. He details in the “Life” section of his memoir the shame he carried and suicidal ideation he experienced as a result of having to hide who he was, and the deep fear he felt when, at age 43, he made the decision to transition from female to male and come out to his Stanford colleagues.

Photo Credit: Amazon

Dr. Barres’ transition gave him
a unique perspective on the treatment of women in science and society. Having
completed scientific, medical, and postdoctoral training as Barbara, Dr. Barres
had experienced plenty of gender discrimination as a woman. Nancy Hopkins
writes in the Foreword: “As an MIT undergrad, Barbara was the only student in a
class to solve an unusually challenging math problem, but the professor refused
to give her credit. He accused her of cheating, saying her boyfriend must have
solved it.” The difference in the treatment of men and women in science became
truly unambiguous to Dr. Barres after transitioning. After giving a talk on his
world-renowned research on glia at a conference, Ben Barres overheard an
attendee remark that his work was clearly much better than that of his sister’s
(referring, of course, to Barbara!).

To the benefit of the scientific community, Dr. Barres would not stand for this nonsense. He wrote the withering “Does Gender Matter?” in 2006 (https://www.nature.com/articles/442133a) as a response to a speech given by Harvard president Larry Summers in 2005. Summers had asserted that few women were tenured in STEM at Harvard because they were innately inferior and chose family over careers in science. Dr. Barres dedicates an entire section of his autobiography to his advocacy work and visions for a truly egalitarian future in science. It should be noted too that his sensitivity to the great need for diversity in science extends beyond the challenges women and transgender folks face; he calls for greater efforts to tear down barriers faced by ethnic minorities as well as low-income and first-generation college students.

True to his roots as a great
scientist and deep thinker, Dr. Barres includes a review of the incredible
research his lab completed from his appointment at Stanford in 1993 until his
death in 2017. Following their journey – from finding a way to culture and
maintain pure CNS neurons to detailing the role of astrocytes and microglia in
synapse formation, maintenance, and loss in normal physiology and disease – is
riveting. Perhaps even more beautiful, however, is that Dr. Barres mentions
each trainee by name and contribution to the aforementioned science. He knew
where every trainee came from, what they were interested in, and where they
went after their time in his lab. He encouraged independent thought and allowed
his trainees to advance their own lines of inquiry. He writes, “I did not
realize when I started my own lab at Stanford that this was going to be, by
far, the most rewarding part of the job… it is even more exhilarating to watch
young people develop into independent scientists and to play some role in
guiding that process.”

Science is in sore need of more
people like Ben Barres – people who are willing to fight bigotry and
incompetence from positions of power while implementing ideas about diversity
in their own labs and lives. Undoubtedly we have come a long way since Barbara
Barres attended MIT in the early 1970s, but we have a long way to go. (For a
comprehensive report on the progress made by women, minorities, and persons
with disabilities in STEM until 2016, please visit https://ncses.nsf.gov/pubs/nsf19304/digest/field-of-degree-women#physical-sciences.)

I’ll close this review with my
favorite anecdote from the book, included in the Foreword as an example of the
tour de force that was Ben Barres. Having been asked to speak about advances in
“glioscience” at a university in the Netherlands with a particularly unsavory
record of excluding females, Dr. Barres responded to the invitation with the
following (again from Nancy Hopkins’ Foreword):

“Dear Sir,

You have a hell of a lot of
nerve inviting me after sending me that speaker list.

   it looks like out of your last 35 speakers,
only 1 has been a woman??!

   I wouldn’t visit your school if you were the
last school on earth. Do you think that women are not doing equally good
science? And what about the half of your trainees that are women (not to
mention the men)? Do you really mean to teach them that the only ones worthy of
inviting are men??

  I would suggest that if you want to hear a
really great talk about glia that you invite some of my previous women trainees
to come speak in my place … [here Ben names three women]. Any of them would
give a tremendously good talk. Looks like your faculty is not particularly diverse
either (1 woman out of 17?????!!!!). I always thought Netherlands was one of
the good places. Looks like I was wrong.

   I am going to decline your invitation but
perhaps in 5-10 years if you have cleaned up your act. I won’t be holding my
breath. Something is really rotten about your department.

  Please don’t invite me again

                                                                                                                                                Ben”

It is a mark of how well-known and respected an advocate Ben Barres was that the response he received was apologetic. With more advocates like Dr. Barres taking a stand in STEM, we will move further towards the diverse, inquisitive, and inclusive field we all deserve to work in.

About the author: Samantha Bouchal is a senior at Duke University and current summer student in Isobel Scarisbrick’s lab at Mayo Clinic. She loves neuroscience, and is especially excited about the biology of brain disease. When she’s not at the bench, Samantha enjoys playing the piano, spending time with dogs, and working on her artistic project, Seeing Science: Exploring Humanity in STEM.

Thu, Apr 11 4:48pm · Anonymous Science

By: Marina Walther-Antonio

THE PROBLEM: SCIENCE AS A PRIVATE CLUB

Science is an activity reserved to the intellectuals, the “smart ones”. This is the general perception, which let’s be honest, is reinforced, if not cherished by most scientists and the scientific establishment. And while the scientific profession certainly requires the understanding of what the scientific method is, and how to properly and ethically conduct scientific activities, none of those concepts are out of reach to any living human being. Formulating and testing a scientific hypothesis can be rigorously performed by a child, a plumber, a teacher, a physician, an astronaut. In fact, most of us formulate and test hypotheses on a daily basis: “Which of these knifes cuts this pineapple better?”, followed by “I wonder why this knife is better, perhaps because it is serrated?”, “Let me check if it is also the best one to cut bread?”. Simple questions like these are part of the inquisitive human nature, and reflect the foundations of scientific thinking and approaches. However, most people do not think of themselves as having a scientific mind, or of being capable of having one. Why is that?

The scientific profession, just like any other, protects their professional ranks and activities by necessitating training and degrees to prove competency. This is appropriate. But is it appropriate to alienate others from their activities? Why is the primary means of scientific communication (scientific journals) largely closed access?

The closed access is not only to non-professional scientists and general population, but also to other scientists in other scientific fields, to scientists working within Institutions not subscribing to those journals, scientists working for industry, and even retired scientists. Why should this information be so protected? Some will say that others would not understand those scientific articles anyway, because they are so specialized and filled with technical jargon. But if that is the case, why protect the content anyway? It seems like the content of those journals protects itself by the use of code vocabulary either way. Instead, the societal impact at large is that if it were not for journalists and a few scientists, no one knows what is actually happening in a specific scientific field, and it all starts to look like magic. With no information flow, locked documents, and no translation of the code words being used, science has become an enigma to most people. The enigma is such that the significance or relevance to our World becomes questionable, including to those people deciding what should happen to scientific activities.

So, there is a policy of restricted dissemination that the scientific establishment has created and enabled that has escalated through time with the increased sub-specialization of scientific fields. This in essence has transformed science into a private club that only certain paying members can access and belong to. The second layer to this problem relates to the legitimacy and authorization for science, which creates a second private club, which is the one that funds and supports scientific activities. Scientific activities at the governmental level are largely funded based on reputation. Only individuals belonging to reputable organizations, who have published in reputable journals, and who are connected to reputable scientists have the opportunity to achieve sizable scientific funding for their research proposals. All of these factors are openly scored and are part of the criteria for evaluation of the scientific proposal. Yet, should they? Why is a scientific approach and proposed solution to a problem being evaluated based on the reputation of the Institution, prior accomplishments, and the peers of said individual? Shouldn’t science be evaluated for exactly that, the science?

This has created and reinforced a culture of an “old boys club” where only those with connections to the establishment can gain entry. This second privatization of science further aggravates the rift between society and professional scientists and even between scientists, as it disenfranchises and delegitimizes scientific activities, alienating large portions of it. While the policies may have been put in place to protect scientific professionalism and lead to the development of science that builds upon a solid foundation, the negative and societal consequences of these policies are plentiful. These define 1) who belongs in a scientific career tract, 2) the types of agencies where science can be performed, and 3) what type of science can be conducted. This leads to 1) lack of background and thought diversity in the scientific workforce, 2) institutional hegemony and monopolization of resources for scientific activities, and 3) restricting the space of questions that can be asked and approaches that can be pursued, particularly if they conflict with past strategies or established body of knowledge. In essence, these represent barriers to scientific dissemination, and influx of innovative individuals, concepts, and approaches.

 

THE SOCIAL PROBLEM IN SCIENCE

As discussed in Oh et al. (2015) and Carli et al. (2016), the scientific field as a whole has marked discrimination against minorities and women. This is directly linked to the fact that the scientific establishment was 1) created by white men, 2) which took place at Institutions managed by white men, 3) who studied matters relevant to them. The policies put in place were never meant to accommodate anything different. And that has not changed. Furthermore, scientific education was historically a privilege of the upper classes, which also held the political and military power. Restricting the dissemination of knowledge that could result in the empowerment of lower classes was therefore desirable. And hence, the privatization of scientific activities and restricted dissemination took hold. Times changed meanwhile and the democratization of political life and dissemination of information became a norm of conduct. Institutions change slowly however. And the scientific establishment has been particularly resistant to change. While scientific dissemination is said to be a priority, and the scientific method is addressed in schools, only the students that perform the best, in the best schools, in standardized tests, are given the opportunity to pursue science as a scientific career. The underlying explicit or implicit implication is that average students are not capable of becoming scientists. This is in direct opposition to the known fact that some of the most revolutionary scientists in history were just average students, such as Albert Einstein and Charles Darwin. They were not great students, they were simply creative. And creativity often manifests itself in poor school performance because creative students can become bored and disengaged with topics that do not interest them, and that merely regurgitate established knowledge. Poor school performance is not a predictor of scientific ability. Interest and motivation to pursue solutions to problems is likely the best predictor of scientific aptitude. Compounding on this is the problem that minorities and women may be very motivated in pursuing solutions to problems, just different problems than the ones that the current scientific establishment considers important. This does not mean they are less important, it just means, they are less important to those making those decisions, which will also determine the next generation of important problems to continue to pursue. The lack of diversity in background and thought perpetuates itself. This is the first problem: who is and will continue to be allowed to do science.

This first problem merges into the second, which is the Institutions performing science. Because only the best students gain access to reputable Institutions, which are already part of the scientific establishment and “private club”, these Institutions are the ones that continue to propose the science that should be done. Of course, not only are these Institutions the ones proposing the science, they are also the ones who decide which science is funded, since the scientific review process is performed by peers. And so, an Institutional “brotherhood” emerges, and is openly acknowledged, scored, and factored into any proposal for funding. But is there evidence that the science performed at Ivy leagues is better than at other Institutions? No. There is evidence for more expensive science being performed at those Institutions, but transformative science often takes place at resource limited Institutions, despite that. One can wonder whether that happens because resource limited Institutions cannot compete with more reputable Institutions when proposing incremental knowledge and low-risk ideas that more reputable Institutions are perceived as being more competent to pursue. Because the reputable Institutions continually receive higher funding, they continue to be perceived as more competent, based largely on that self-created and maintained metric.

The third problem, what type of science is funded, is a direct result of the prior factors. Science being proposed that is too disruptive or conflictive with the current body of knowledge or approaches is inherently undesirable because it is detrimental to those in the scientific establishment whose careers and activities depend on the continuation of those paradigms. This type of science is deemed “high-risk”, “exploratory”, and “open-ended”. When did these adjectives become detrimental to the scientific endeavor? Shouldn’t all scientific pursuits be high-risk, and exploratory, and open-ended? Instead, what they represent is a threat to the scientific establishment, and those currently funded by it. So, in essence, these 3 pinnacles, 1) the who, 2) the where, and 3) the what, function as gatekeepers of the scientific establishment, and social structures that reinforce each other, preventing transformative change from occurring. Of notice, this takes place without any explicit policy that supports any of these directives. They represent the scientific culture, which is maintained by all who participate in it. Changing these social structures and their impact in the scientific establishment and society at large will require conscious collective effort to enforce change.

 

ANONYMIZING SCIENCE

While the problem at hand is complex, the solution may not have to be. The first and second problem which are who gets to do science and where, can be addressed by simply anonymizing scientific proposals. The current grant system is single blinded, meaning that the identity of the reviewers is unknown to the applicants. This is beneficial to allow an open review and protect the reviewers from retaliation, but it also opens the door to individual and institutional discrimination by the reviewers that is not scientifically based because they know the identities of the applicants and are protected from retaliation by that same anonymity. However, if the system were double-blind, they would be left with having to judge the science, and nothing but the science.

This system has been adopted by a few foundations, including The Gates Foundation, and high-risk proposals at the governmental level, by the Department of Defense. NIH and NSF, the major agencies providing government science funding to institutions claim that they are interested in solid science with high feasibility prospects and productivity outcomes, and to judge that the reviewers need to know who and where the individuals are. But if that is truly the reason for this system, then why not judge feasibility after the proposals receive a scientific score? That is the way The Gates Foundation operates. Once a proposal receives a fundable score, officials from the foundation will visit the applicant and verify whether the conditions to undertake the proposed work are in place. I do not know of a single case where that was not verified. If the scientific establishment is interested in the best science, as it should, then there is no real barrier to implementing this process. Through a double-blind review process, which should extend to the publication setting as well, the best science should be the one being funded and published.

The third problem of what type of science is funded is more difficult to solve, but a double-blind system will resolve it, given enough time. Once the individual and institutional diversity increase in the number of funded proposals, so will in the number of reviewers. This diversity of thought will generate reviewers that are more open-minded to transformative science and that do not have to protect the current scientific dogma. So, a larger percentage of high-risk, exploratory, and open-ended science will begin to receive funding, creating an influx of transformative science into the mix. Change may take some time, but in this scenario, as the makeup of the scientific establishment would change to reflect that of the current times, so would other policies that relate to scientific communication with non-professional scientists, and their open and active participation in scientific activities. For the sake of continued progress in the future generations, it is imperative that it becomes clear that science is for all. You do not have to be the best student in the class, you do not have to be a man, you do not have to be white, you do not have to agree with what others think. All you have to be is someone with a problem to solve and an idea to fix it.

Thu, Feb 21 2:20pm · What is a mob?

By Josiane Joseph

“…a riot is the language of the unheard. And what is it America has failed to hear? … It has failed to hear that the promises of freedom and justice have not been met. And it has failed to hear that large segments of white society are more concerned about tranquility and the status quo than about justice and humanity.”

            Martin Luther King Jr.

In the present climate where people—whether they be women, minorities, immigrants, school-aged children, weapon owners, religious individuals, etc.—feel threatened, many important conversations have begun to take place. One theme that I have encountered frequently among friends and even on television is that mobs are impeding our freedom of speech. That is a loaded statement, full of fear and indignation. To be on the same page, first we have to define mob.

Mob has a negative connotation. Before looking up the term, I associated the word mob with anger and riots. A quick internet search confirmed that mob is commonly defined as a crowd that is not only violent but a source of trouble and disorganization. Using this definition, we can contemplate whether there is some truth to today’s mob issue or if there might be something else going on that is also worth considering.

In recent times when people mention mobs, they may use it to denounce the actions of a collection of individuals using social media to speak out against employing people who are guilty of or using goods and services from entities where at least one instance of sexual misconduct or racism occurred. In order for this dissenting internet crowd to be considered a mob, based on our former definition, their actions would have to be wildly negative. So that bears the question: is it bad to speak out against people or entities en masse on behalf of victims?

Perhaps, it is not merely that the people are speaking out that earns some folks behind the screens membership to the mob. Some have said that it is the demand for those involved in the two previously mentioned egregious acts (sexual misconduct or racism) to be terminated or criminally prosecuted that draws concerns. Though this does not directly impact free speech privileges, the issue could be that we have a judicial system that—if working properly—is responsible for prosecuting criminals based upon evidence. Such evidence is not usually accessible to our mob members that demand consequences with language that is not always friendly. Furthermore we have seen on multiple occasions that those requests for consequences or termination may spillover onto the supporters of the possibly guilty party. Here, the issue may seem plainer because it is mostly factual that by working, people earn the means to make the purchases that sustain their existence.  So it is possible that out of fear of compromising their livelihood, some people are choosing to stifle their true views of highly publicized accusations. Not many, whether they be criminals or otherwise, can maintain a productive life without being able to work. This makes the term mob seem more permissible; however, in order to understand the dynamics of the mob issue there are several other historical and social problems that should concurrently be considered.

Let’s speculate on how we could have come to a place where if a student wears blackface there is a swift push for expulsion, or if a guy takes a knee on the field there is a push for exclusion from a sports league. Passing over the controversial 2016 election and the present political chaos as potential contributors, we can consider how things were handled before the rise of social media mobs.

Consider how many times during those former days that we would hear of (or see) college students wearing blackface as Halloween costumes? Their black friends were granted the opportunity to party with gross caricatures of themselves on a day that celebrates all things that are scary or total jokes. And what would happen if those individuals were reported to their institutions? They might go through due process  whereby they have a meeting with a stern student conduct staff member and usually get what amounts to a slap on the wrist; at best the offender is provided some training on inclusivity. Then the same blackface scenario would take place again somewhere in the US (and possibly again at the same institution). Leaving us back to where we began with people wandering around society with a potent symbol of hate smeared all over their skin; a symbol that marks a period of time where the humanity of a multitude of people was questioned and mocked; a symbol much like the swastika. (Whether or not these young people know this does not change what the symbol represents nor does it ameliorate any of the additional trauma it incites.) Are repeated offenses like this enough to make people angry or lash-out mob-style? Could this subscription to passive ineffectual correction be the root cause of our mob issue? These are questions that people who cry mob should consider.

It is probably not necessary to discuss specific instances of sexual misconduct because we have all heard of or witnessed these often mishandled situations. Many of us might have even experienced the harassment and watched the perpetrator go on to live full lives— perhaps as Supreme Court Justices or as wealthy producers. (In case the assumption that we can forego an in-depth discussion about sexual misconduct is incorrect then consider the case of Brock Turner.) Which brings us to several questions that were alluded to in Dr. King’s quote: do mobs, particularly our current social media mobs, serve a purpose? Is it possible that instead of a mob issue, we have a neglected racism or sexual harassment issue?

Last thing that we should consider is this: is it healthy for people to avoid other people that have exhibited potential to cause them great harm? Should the answer to this question be yes, that implies that people have a right to NOT work alongside other people that are blatantly racist or that support sexual misconduct. Which then begs the question of whether or not “mobs” are too extreme by demanding the termination of offenders?

This piece is in no way in support of mobs (which inherently cause harm which is never a good solution). Rather it is something borne out of reflecting on multiple conversations and grappling for understanding. Understanding is something that may be lacking in today’s environment where people are struggling to meet their peers on an equal plain and move towards progress. If we do have a mob issue, to resolve it we must first understand it.

PS: Happy BLACK HISTORY month.

 

About the author: Josiane Joseph is a Haitian-American MD/PhD student at Mayo Clinic. She was born in Miami, Florida and earned her B.S. at the University of Florida in 2015. During her free time she enjoys movies, writing, attending High Point church, and learning about what makes other individuals unique. Josiane values discussions of meaningful issues and looks forward to sharing diverse views with others.

Thu, Jan 17 4:09pm · Pathway to peace

By: Andrew M. Harrison, MD, PhD

P2P. Surely this acronym has not yet been claimed.

I met a clown recently. As Patch Adams was the only clown I knew of, also a physician on the side, I joined him for the recent holiday season in the backwoods of West Virginia at the Gesundheit! Institute for their annual Health Care Justice Celebration/Workshop. In a place with no cellular and (effectively) no internet reception, I learned at least as much in these few days as the past 17 years of Wikipedia (happy birthday) combined. More important, in a world of death and destruction, I discovered a beautiful vision of hope for the future of humanity. I am not a clown, or hippie, but can aspire, so here it goes:

The dacha (and some other stuff) at the Gesundheit! Institute. As a former photo tech, back when film was still a thing, I do not believe any photograph shall ever capture the beauty experienced by the human eye. In other words, see it for yourself. Of course, only if a transformational life experience is your sort of thing 🙂

Make love, not war. I live in a world where access to education is not a basic human right. In this same world, access to health care is also not a basic human right. This occurs at a time and place when the combined wealth of the four wealthiest men (emphasis on men) approximately equals the combined wealth the four billion poorest people on this small planet. This is wrong. Whether I shall present a solution here or not, it must first be stated this is wrong, and thus fundamentally rejected as an unacceptable state of affairs, for great power exists in the (seemingly simple) act of saying “no” (Beautiful Souls: The Courage and Conscience of Ordinary People in Extraordinary Times by Eyal Press, 2013).

Although less important than education and health care, privacy is also not a basic human right. Whether humanity is forced to confront some form of Terminator-style (and/or benevolent) technological singularity before global warming (politically correct vogue “climate change”), and/or nuclear holocaust, destroy society and civilization as it is currently known, the absence of this basic human right grows increasingly odd to me. At least, in the context of delusions ranging from colonizing Mars to fantasies such as human immortality. In my opinion, we should first focus our time, energy, and effort toward matters such as rape, murder, mass death by starvation, genocide, which I think only comes in a mass variety, etc.

I needed to swing by The Punchline Comedy Club in Atlanta (again) on my drive from Minnesota to West Virginia, a place riddled with humor, jokes, and comedy. If these experiences are not your sort of thing either, perhaps—from the safety of your cyber bubble house hopefully home—Patch Adams at Mayo Clinic (Transform 2010), or Patch Adams at TEDx (multiple).

One solution is to spend years to [however many decades humans have remaining] meticulously and individually arguing each of the matters above. Another option is the restoration of community. An end to mass isolation and loneliness. These factors are the drivers of the modern diseases of the modern (first/developed…) world, both individual and communal.

A special plea to physicians: Lead the movement to end titles. In a world of peace and love, there is no need or place for titles, or post-nominal letters. Also, LEAD. Stop studying yourselves. Stop “researching” your supposed burnout. Stop talking about imposter syndrome. When nature (literally) burns out, there occurs a simultaneously beautiful act of destruction and creation (rebirth). If you are concerned you are an imposter, try hugging a tree. As for unconscious bias, microaggression, and “constructive communication”, try swimming out as far as the ocean will permit you to go and feel what is present (and absent) there.

Anatomic Pathology headquarters at the Rochester MN campus of Mayo Clinic (Sept 2016). My condolences to Rochester physicians, but suits must go. The Mayo Brothers swapped white coats for suits to bring clinicians *closer* to patients (in the late 1800s). For anyone in this modern world more out of touch with it than me, the 1800s are over, you appear as corporate clowns. For the more concrete and/or practical minded: Standard 55 has been obsolete for decades (and sexist forever). Save the money (energy too). Also, ties are simply filthy. Not the good sort of whoopie cushion (fart bag) filthy. Note: Traditionally pathologists (and radiologists) are considered physicians but not clinicians; titles.

Wikipedia has popularized the concept of small monetary donations. The Gesundheit! Institute adopts a similar approach. Although I am not religious, this approach, at least here and now, has a feel to me of Natural Order, Natural Law (Mere Christianity by CS Lewis, 1952). If this approach seems too simple, it is not (The Simple Life by Ernst Wiechert, 1939). Wikipedia aims to continue making freely available all the [data/information but not necessarily knowledge] of the world. Patch Adams desires to reopen his visionary hospital, which has been closed since before my birth.

If I have failed to convince you to adopt peace via love, write a letter to Patch Adams. He really does respond to ALL letters, seriously. (Clowns do not joke.) His address can be found via Dr. Google, or me. One difference, I give free hugs. Alternatively, Dr. Google has the capacity to generate a more substantial electrical shock.

From The Cultivation of Christmas Trees by TS Elliot (1954):
The accumulated memories of annual emotion
May be concentrated into a great joy
Which shall be also a great fear, as on the occasion
When fear came upon every soul:
Because the beginning shall remind us of the end
And the first coming of the second coming.

About the author: Andrew M. Harrison is a graduate of the Medical Scientist Training Program at Mayo Clinic, former co-manager of Mayo Clinic’s Diversity in Education Blog, former Policy Chair of the American Physician Scientists Association, and current postdoc with Critical Care at Mayo Clinic.

Dec 11, 2018 · How do we improve the status of mental health in graduate school?

A recent article in The Atlantic covering the mental health disorders people suffer with in graduate school recently popped up on my suggested articles on Google, and on my Facebook timeline (I will give up Facebook, eventually). In the Facebook comments, and in the post sharing this article, people overwhelmingly agreed that this was nothing new. The overwhelming response was, “well, duh!”. The Atlantic, also published letters to the writer, Alia Wong, discussing the issues they have seen during their education regardless of the field of study.

This brings about a bigger problem seen in academia. I see at least one article every few months with new data concerning the mental health of students in graduate school published in Nature or Science, and indeed the data is concerning. It is a major issue that we do not really talk about. The Atlantic article references a Harvard-affiliated study that followed Ph.D. candidates at eight universities in the economics field where 18% of graduate students reported they experienced symptoms of moderate or severe depression and anxiety.

Source: Evans, et al, 2018. Nature Biotechnology.

Earlier this year, a Nature Biotechnology study called the mental health status of students in graduate schools a “crisis”, and called for possible interventions to help students suffering from these mental health issues. The data in this study surveyed 2279 individuals of which 90% of individuals were enrolled in Ph.D. and 10% enrolled in Master’s programs (these individuals represented 26 countries, and 234 institutions) based on clinically standardized surveys (GAD-07 for anxiety, and PHQ-9 for depression). The not-so shocking results of the study showed that 41% of individuals surveyed reported moderate to severe anxiety whereas 39% reported moderate to severe depression. To put this in perspective, and the authors pointed this out well, 6% of the general population reports moderate to severe depression. Transgender individuals (including gender non-conforming), and women, also showed higher rates of depression and anxiety, which mirrors rates of that seen amongst non-research cohorts. Work-life balance, and the mentor/mentee relationship also impacts rates of depression and anxiety among graduate students (supplementary information provided by the group).

Now, I have thought about this a lot since I read that original The Atlantic article, which was a few weeks ago at this point (this topic is particularly heavy for me, and it has taken me time to comb through the plethora of articles on this subject). Based on what I read, I noted that while there is a substantial amount of science on the numbers of students who suffer from mental illness, and there are other studies that are yet to be done that could give us more insight into particular institutions, and fields.  With the exception of the Nature Biotechnology article, not many of these articles point to a solution, which I admit is tricky to come up with an overarching solution for each person in every field.  So, what can we do as individuals to improve the situation of mental health in graduate school? 

Raise awareness. We recently had a graduate school mental health session campus provided by our Graduate Student Association in collaboration with Initiatives for Maximizing Student Development (IMSD) program. This experience, which I’ll discuss in a future blog post, brought awareness to students of what mental illnesses are, and what they aren’t. I think the most important part was the point of raising awareness to what depression and anxiety are, and how they can manifest in graduate school.

Fight the stigma and share your story. The articles I read on the status of mental health in graduate school not only include the staggering statistics of mental health-related conditions affecting graduate students, but touching personal stories from students sharing their own personal struggles. If your own institution does not offer resources for mental health support (or if they are limited), it may be helpful to read about someone else’s experiences to help you feel less alone. This avenue of sharing also helps fight the stigma that mental health disorders may make you seem weak, or lesser than others. They absolutely do not. Having a mental health disorder absolutely does not make you less of a person, scientist, friend, significant other, or any sort of identifier you can think of. By sharing our experiences, we can encourage each other to speak more openly about the issues we face as individuals.

Demand resources for graduate students and postdocs. Many institutions have taken note of the current situation concerning mental health of trainees, and have employed resources for graduate students to take advantage of if they are experiencing mental health issues. Our institution provides mental health clinicians to talk to, access to licensed counselors, and started a Wellness Program specifically for graduate students. Sharing the resources with others who may not know how to utilize them, is also beneficial, especially if someone is scared or concerned about confidentiality or concerned about the services offered at each institution.

Check on friends and create a supportive network. We all have the best intentions when wanting to keep up with all of our friends, but life and grad school can get in the way of that. Being kind to our friends, neighbors, lab mates, and peers could make a magnitude of difference when it comes to mental health. Making networks of people that lift each other up, help one another out when things get tough, and are just there for each other has drastically improved my mental health. Further than this, graduate schools can implement safe spaces for students to share their stories, personal struggles, and interact with potential mentors who can provide advice, or their own experiences.

If you have any comments on how we can improve the situation of mental health in graduate school, please let us know. We would love for this to be an open forum for discussion. What would you like to see in your institution?

About the author: Crystal Mendoza is a graduate student in the Virology and Gene Therapy program doing her thesis on the development of therapeutics for tickborne viral diseases. She enjoys traveling, reading, and spending time with her corgi, Chente.

Oct 19, 2018 · Book Review: Lab Girl by Hope Jahren

By: TL Jordan

Representation is incredibly important. Not just in our media, but in our everyday lives. When we are young we look up to people and dream about seeing ourselves in their shoes. Young children look to see themselves reflected in everyday life as teachers, astronauts, politicians, actors, artists, scientists, and so much more. It is also just as important that we continue to see representation as we get older.  Lab Girl is an extremely good example of the honest representation of a woman in science.

Courtesy of MPR and Knopf

Though we have moved forward in seeing more women in tenured research positions, but that portrayal is not always honest. We see these women, but we don’t see the struggle, the harassment, the pain. We don’t see the odds that they overcame, and the hard work they put in to keep their heads above water in a field that is dominated by white cishet men.

Hope Jahren, a Minnesota native, lays out her entire journey from child to tenured researcher in this memoir and interlaces every memory with eloquent narratives on trees and the life of a plant. Anyone who has ever had any aspirations of moving into science, particularly as a person assigned female at birth, will relate to Jahren’s recounting of being a young inquisitive scientist, as she learns from various people in her life and eventually grows into the scientist she is now. Her story recounts relationships that are difficult to not relate to people in your own life, and absurd scenarios that are so specific you wonder how they even happened to the author herself.

The most important part of this journey, in addition recounting her struggle becoming scientist as a woman, is becoming and continuing to be a scientist while battling mental illness. Jahren recounts her own experiences shadowboxing her invisible demons, and still trying to continue being productive and move her career forward. She does not make her experiences sound pretty, but gives you each difficult detail that truly depicts what it is like to live with mental illness. Mental illness is not talked about enough in science, despite awareness becoming more common place, and mental illness is certainly not talked enough amongst high ranking scientists. As students we hear article on article reminding us that graduate students are the most vulnerable population for depression and anxiety, but we see our mentors and superiors succeeding with no sign that any of them could possible carry the same internal pain. Lab Girl does a great job of smashing that barrier.

Hope Jahren is a very successful scientist, but that success was not handed to her. Her writing is as honest as it is inspiring, and anyone who is a minority in science will find this book to be relatable and important as they fight through their own battles in academia.

About the author: TL Jordan (They/Them) is a second year immunology graduate student working in the Ramirez-Alvarado lab. They passionate about science communication, science advocacy, and LGBTQ equality. In addition to their graduate studies they are the Social Media representative of the Graduate Student Association, the Chair of the LGBTI MERG Student Group, and the assistant goalkeeper coach at RCTC. They believe firmly that science should be accessible to everyone.

Oct 4, 2018 · Voting Supports Our Wellness

By: Josiane Joseph

In 2008, I was an unassuming teenager with serious goals that included finding ways to get to the beach and hoarding enough clothes to ensure that I always had a unique ensemble to wear. My understanding of the three branches of government was fair, but I harbored an excessive amount of apathy for those who contributed as leaders. This apathy persisted because, though it was not perfect, life was comfortable and I had no experiences with anything better.

What I failed to see then was how the civic motions shaped everything around me from my relationships to the food I was offered at school. For example, on a 100 degree day I might ask a classmate “hey, do you want to get ice cream from the vending machine” and immediately it could be shot down with: “Listen, it’s a recession. People are losing their homes out there. I can’t be using my lifesavings on a popsicle when water is free”. The other heads around would nod as the words “true” or “for real” rung out. Who could argue with that?  In fact I often used similar retorts to avoid dinner or movie plans. Gas was also costly then so in addition to calculating the cost to fund activities; I would have to factor in a few dollars to contribute to my friend’s tank. (It was better and easier to be broke at home.)

Photo Credit: Pexels

Amidst that recession, I witnessed a national first. After November 4th, 2008 the truth of Young Jeezy’s lyrics “My president is black, my lambo’s blue” blasted out of cars almost weekly, and celebration was rampant. The day of the election, I watched as minorities stood in tears on television screens; everyone was talking about our new president. Meanwhile I was trying to understand why people were making a big deal over something so simple as an election. Back then, I was blind to how my life would soon change for the better.

With that election I gained a First Lady truly concerned with the health of American people. For the first time I recognized her as she danced on my favorite shows to promote physical activity. Before my eyes was a reminder of how much I loved to dance. Though I would cringe while watching her eat kale chips, by 2013 she nearly had me convinced that kale was human food, and more incredibly I was almost sure that it was acceptable to have kale as the major portion of a meal. When I wore a pretty dress, rather than being compared to a professional twerker/singer, I was now likened to a woman with a law degree who supported someone in the highest office in the United States (though I rarely appreciate a comparison to another woman, at least I was associated to someone highly educated as I aspired to be).

In 2015, I got a new car and moved to Rochester, Minnesota. Instead of lamenting the gas prices as I was used to doing with friends in 2008, I was giggling over the phone with my sister about my plans to hold off on filling my tank until prices were back to somewhere below $1.50. There was no need to worry about how much gas I was burning from perpetually being lost in a new city because I had no substantial debt and was enrolled in a program with enough provision for my present and my future. That is the legacy I have from the Obama administration. An education entirely covered by merit based scholarships and government funding mechanisms. In 2015 I even had free health insurance. Financially, I could see nothing to hinder my ability to pursue my ambitions.

Leading up to the 2016 election, one of the major benefits touted by republican supporters was the economic benefit that would come from having a businessperson in office. But since then I have been watching (as I always do) for gas prices to fall below even $2, and I have not been granted the opportunity to giggle with my sister about those savings. I am paying for health insurance that I avoid using (because of cost among other valid concerns). Compounding this offense is the constant news of budget cuts to education (which often affect STEM programs like those I benefited from) and FEMA (which is particularly pertinent to the ability of Floridians to bounce back after disasters), and no good plan for making healthcare accessible. All of these trends have continued while republicans have held an advantage in at least the legislative branch of government (but more recently all three branches).

At my current stage in life, I can no longer accept my life as comfortable. Not when I have experienced executive leadership without bullying and scandal attached. Not after I have personally improved from an active and honorable first lady. And especially not after I nearly had affordable healthcare in my sight and lived the life of someone never denied a quality education. That is why I am planning to show up for midterm elections on November 6th.

That people with higher education and access to primary care have better health outcomes is a well-established concept. Furthermore, a healthy and educated demographic is more likely to support the economy. Considering this information those concerned with the economy should see that it just makes sense to support candidates that take human health and education seriously.

From 2008-2016 the US was represented by a pair of individuals that have tangibly improved my health through health advocacy and legislation. The economic circumstances they (or at least the president) contributed to freed my mind of unrealistic financial obligations so that I had room to mature as a dancing adult that understood that my health is my business. And by simply existing the Obamas changed the language around me so that I knew to aspire to more for myself and for others. It alarms me that children after me might be influenced by lack (like we all were in the era before 2008) and will have to develop without examples of integrity in the white house. It is for all of these reasons that I am looking forward to future elections. America is a great home where many citizens and residents benefit greatly from the present democracy. But can we improve circumstances for the next generation? “Yes we can.” So let’s move “forward” on November 6th.

About the author:

Josiane Joseph is a Haitian-American MD/PhD student at Mayo Clinic. She was born in Miami, Florida and earned her B.S. at the University of Florida in 2015. During her free time she enjoys movies, writing, attending High Point church, and learning about what makes other individuals unique. Josiane values discussions of meaningful issues and looks forward to sharing diverse views with others.

 

From the Editor in Chief:

For voting in Minnesota, please visit:

https://www.sos.state.mn.us/elections-voting/

For voting in Arizona, please visit:

https://azsos.gov/elections/voting-election/register-vote-or-update-your-current-voter-information

For voting in Florida, please visit:

https://dos.myflorida.com/elections/for-voters/

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