Medicine Can Soothe a Troubled Mind, but Not Without Costs

Parul Sehgal in The New York Times:

BookThe world’s first transorbital lobotomy was performed in 1946 by Walter Freeman, in his Washington office. Using an ice pick from his own kitchen, he went through the eye sockets into the brain of his patient, a 29-year-old severely depressed housewife, and cut into her frontal lobes. Then he sent her home in a cab. The history of mental illness treatments reveals medicine at its most inventive, desperate and disturbing. There have been awe-inspiring discoveries — of the healing properties of lithium, for example, a soft, silvery metal produced in the first 20 minutes after the Big Bang. But remedies generally seem to have run a narrow gamut from the unpleasant (Cotton Mather’s prescription for depression: “living swallows, cut in two, and laid hot reeking unto the shaved Head”) to the outright sadistic. Aside from Freeman’s lobotomies, there is a long tradition of poisoning patients or inducing comas to “reset” the brain. In one notorious treatment, turpentine was injected into a patient’s abdominal wall in the hope of encouraging a fever high enough to burn away her hallucinations.

We’re lucky to live in more evidence-based, scientific times. Or do we? In “Blue Dreams,” a capacious and rigorous history of psychopharmacology, the psychologist and writer Lauren Slater looks at the fact that despite our ravenous appetite for psychotropic medications (about 20 percent of Americans take some psychotropic drug or other), doctors don’t really understand how they work or how to assess if a patient needs them. In the case of antidepressants, two-thirds of patients taking an S.S.R.I. (Prozac, Zoloft, Celexa, etc.) would improve on a placebo alone.

More here.

Love Poems for the Border Patrol

Amitava Kumar in The New Yorker:

Kumar-Love-Poems-for-the-Border-PatrolI am trying now to remember when it was that I stopped thinking of myself as a new immigrant.

Was it after three years? Five? Fifteen?

I have a narrative in my mind that is teleological—I think the word for this, from my graduate-student days, is “Hegelian”—and it culminates in my becoming a writer. A writer of immigritude. I cannot put a date to it, but I suspect that the rawness of always feeling out of place, of not belonging—that fighting sense I had of forever being on edge—diminished or even disappeared once I reached the understanding that I no longer had a home to which I could return. This went hand in hand (and this is part of the Hegelian schema I’m inhabiting here) with my finding a home in literature.

I arrived in the U.S., for graduate study, in literature, in the fall of 1986. I was twenty-three. After a year, I began to paint, even though I had come to the U.S. intending to become a writer. I painted small canvases, abstract forms that sometimes had words, often in Hindi, written on them. Why did this happen? Maybe because one day, in the college bookstore, I had seen a coffee-table book that had the word “India” printed on it in large letters.

More here.

20 years ago, research fraud catalyzed the anti-vaccination movement

Julia Belluz in Vox:

ScreenHunter_2978 Feb. 28 19.18Exactly 20 years ago this month, an esteemed medical journal published a small study that has become one of the most notorious and damaging pieces of research in medicine.

The study, led by the now discredited physician-researcher Andrew Wakefield, involved 12 children and suggested there’s a link between the measles, mumps, and rubella vaccine — which is administered to millions of children around the world each year — and autism.

The study was subsequently thoroughly debunked. The Lancet retracted the paper and Wakefield was stripped of his medical license. Autism researchers have shown decisively again and again that the developmental disorder is not caused by vaccines.

Still, public health experts say the false data and erroneous conclusions in that paper, while rejected in the scientific world, helped fuel a dangerous movement of vaccine skepticism and refusal around the world.

Since its publication, measles outbreaks have erupted in Europe, Australia, and the US in communities where people refuse or fear vaccines. Vaccine refusal has become such a problem that some countries in Europe are now cracking down, making vaccines mandatory for children and fining parents who reject them.

But there’s more to the story.

More here.

The World Must Act Now on Syria: An Open Letter to the NYRB

From the New York Review of Books:

GettyImages-921962392The United Nations says it has run out of words on Syria, but we, the undersigned, still have some for the governments, parliamentarians, electorates, and opinion leaders of the powers upon whom the international legal order has hitherto depended.

The world is a bystander to the carnage that has ravaged the lives of Syrians. All has happened in full view of a global audience that sees everything but refuses to act.

Through Russian obstruction and western irresolution, the UN Security Council has failed to protect Syrians. To the extent that it has been able to pass resolutions, they have proved ineffectual. All they have done is provide a fig leaf to an institution that appears moribund. Perhaps conscious of the stain this might leave on its legacy, the UN has even stopped counting Syria’s dead. After seven years, these nations appear united only in their apathy.

It will be redundant to list the nature and magnitude of all the crimes that the Assad regime has committed against Syrians, aided by local and foreign militias, by Iranian strategic and financial aid, by Russian airpower and mercenaries—and by international indifference. The world that watched and averted its eyes is its passive enabler.

More here.

Wednesday Poem

A Certain Slant of Sunlight

In Africa the wine is cheap, and it is
on St. Mark’s Place too, beneath a white moon.
I’ll go there tomorrow, dark bulk hooded
against what is hurled down at me in my no hat
which is weather: the tall pretty girl in the print dress
under the fur collar of her cloth coat will be standing
by the wire fence where the wild flowers grow not too tall
her eyes will be deep brown and her hair styled 1941 American
will be too; but
I’ll be shattered by then
But now I’m not and can also picture white clouds
impossibly high in blue sky over small boy heartbroken
to be dressed in black knickers, black coat, white shirt,
buster-brown collar, flowing black bow-tie
her hand lightly fallen on his shoulder, faded sunlight falling
across the picture, mother & son, 33 & 7, First Communion Day, 1941–
I’ll go out for a drink with one of my demons tonight
they are dry in Colorado 1980 spring snow.

by Ted Berrigan
from Selected Poems
Penguin Poets, publisher

Willa Cather, Pioneer

Unnamed-1Jane Smiley at The Paris Review:

Willa Cather was not a flashy stylist, and though she was ambitious in her work, she did not attach it to a publicity-worthy life like some of her contemporaries, such as Ernest Hemingway and F. Scott Fitzgerald. Cather’s first book of poetry came out in 1903, when she was twenty-nine; her first book of stories followed a couple years later, when she was thirty-one. Her last novel appeared in 1940, and a volume of three more stories was published in 1948, shortly after she died. Forty-five years is a long career for a novelist, but she possessed an intensity of observation and a curiosity about human psychology, especially as it relates to nature, that never waned. My Ántonia is one of her best-loved books, and it displays all the characteristics that make Cather both elusive and fascinating even as it depicts a world that vanished almost as soon as the novel was published.

Willa Cather was born in an interesting spot in the mountains of Virginia, near Winchester, on the banks of a tributary of the Potomac, Back Creek. The family properties (one owned by her grandfather, another given to her father by her grandfather) were about ninety miles from Washington, D.C., and fifty miles from prosperous plantation regions like Loudon County.

more here.

the literature of grace paley

DownloadLidija Haas at the LRB:

Born in 1922 to Russian Jewish parents who had left Ukraine 16 years earlier, Grace Goodside (originally Gutseit) grew up in the Bronx, hearing Russian and Yiddish and all the clamourings of New York City. Her parents were socialists and so was she, although she notes in the first essay collected here that, after her mother made nine-year-old Grace pull out of a play her youth group were doing on account of her awful singing voice, ‘in sheer spite I gave up my work for socialism for at least three years.’ She did all kinds of jobs and at 18 studied at the New School with W.H. Auden, who did her the great favour of encouraging her to write the way she talked. She married Jess Paley in 1942, in her late twenties had Nora and a son, Danny, and in her thirties began to write fiction and take part in the political activism that would continue to absorb much of her time and energy until her death in 2007. The Vietnam War, nuclear proliferation, US actions in Central America, the Israeli occupation of the West Bank and Gaza, and eventually the war in Iraq: she protested and organised against them all, and those fights marked her fiction. Her last collection has characters disagreeing about Golda Meir and discussing Mao. She taught writing at various universities from the mid-1960s onwards and, after separating from Jess Paley, married the writer Bob Nichols. She also published three books of fiction, though the novel her publishers hoped for never materialised. It seems fair to say that the short story was her form. The talent for nonchalance and compression that allows her to stretch out a brief chat to encompass several lives might be wasted if it extended much further. As it is, in her work possibilities proliferate rather than narrow. Paley often reuses the same narrator, but that person never needs to have learned from or remembered what seemed to define her last time round.

more here.

On Israel’s crackdown on migrants and refugees

11609047695_5ebc15d1f8_zJoshua Leifer at n+1:

ON THE LAST DAY OF AUGUST, Benjamin Netanyahu, dressed in a wide navy suit and flanked by security guards, toured the muggy streets of south Tel Aviv. It had been several years since Netanyahu, whose net worth is an estimated $11 million, last visited the area, home to some of the city’s poorest neighborhoods and where tens of thousands of refugees and migrant workers have settled since the 1990s. The purpose of the tour, according to Netanyahu’s office, was “to identify with the residents and to hear their distress.” By residents, Netanyahu did not mean the migrant workers and refugees. “Our task,” he declared, “is to return the area to the citizens of Israel.”

An estimated 38,000 asylum seekers, mostly from Eritrea and Sudan, live in Israel today. Together with around 100,000 migrant workers, mainly from Eastern Europe and Southeast Asia, they make up Israel’s population of non-Jewish migrants. Indian, Nepalese, Filipino, and Sri Lankan migrants work as home health aides for elderly Israelis and as domestic workers in Israeli households.

more here.

African Americans in Medicine in the Civil War Era

From BlackPast.Org:

Anderson_R__AbbottThe involvement of African Americans in medicine in the Civil War era is an untold chapter in our history. Up to that time most practitioners had learned medicine by apprenticeship but this began to change in the early Nineteenth Century. James McCune Smith was the first African American to obtain a medical degree when, in 1837, he was graduated from the University of Glasgow in Scotland. In 1847 David James Peck was the first to receive a medical degree in the United States. By the end of the Civil War at least 22 African Americans had obtained degrees and were practicing medicine. At least twelve of these physicians served with the Union Army.

Three men were commissioned officers while the remaining nine served as acting assistant surgeons (contract physicians). Alexander Thomas Augusta from Norfolk, Virginia, was unable to obtain admittance to a United States medical school so he went to Ontario, Canada. There he was successful in gaining admittance to Trinity College, Ontario University. In 1860 he became the first person of African ancestry to receive a medical degree in Canada. He received his commission as a surgeon (with the rank of major) in April 1863 in the 7th United States Colored Infantry (known popularly by the initials, USCT, for U.S. Colored Troops). Augusta was the first African American to obtain this rank in the U. S. Army. At the end of the war he was brevetted to lieutenant colonel, a promotion for meritorious service. When Howard Medical College opened in 1868, he was the only African American on its original faculty. Nine years later he left the medical school for private medical practice in Washington, D.C. Augusta died in 1890 and was the first African American officer to be buried in Arlington National Cemetery.

More here. (Note: Throughout February, at least one post will be dedicated to honor Black History Month)

Roth Agonistes

Nathaniel Rich in the New York Review of Books:

Philip-roth_2000-06-15Why write? Philip Roth answered the question in a 1981 interview with Le Nouvel Observateur. He wrote, he said, in order “to be freed from my own suffocatingly boring and narrow perspective on life and to be lured into imaginative sympathy with a fully developed narrative point of view not my own.”

A more intriguing question: Why not write? For this is what Roth, since 2009, has chosen to do: not write. When asked to explain his decision, he has tended to summon a Bartlebyesque detachment: “I have no desire any longer to write fiction,” he told one disappointed interviewer in 2014. “I did what I did and it’s done.” He elaborated slightly a month later, in a conversation with Sweden’s Svenska Dagbladet, crediting his self-imposed silence to

a strong suspicion that I’d done my best work and anything more would be inferior. I was by this time no longer in possession of the mental vitality or the verbal energy or the physical fitness needed to mount and sustain a large creative attack of any duration on a complex structure as demanding as the novel.

“Attack” is the word that rises, three-dimensionally, from the text. It recurs often throughout Roth’s nonfiction, invoked to describe the various aggressions he has absorbed, his resentment toward his critics, and his assault on the blank page that faced him each morning. During his early writing years in Chicago, Roth began each morning by shouting at the young face peering out from the mirror at him: “Attack! Attack!”

More here.

Which problems make good research problems?

Sabine Hossenfelder in Back Reaction:

NormalScience_KuhnCycleScientists solve problems; that’s their job. But which problems are promising topics of research? This is the question I set out to answer in Lost in Math at least concerning the foundations of physics.

A first, rough, classification of research problems can be made using Thomas Kuhn’s cycle of scientific theories. Kuhn’s cycle consists of a phase of “normal science” followed by “crisis” leading to a paradigm change, after which a new phase of “normal science” begins. This grossly oversimplifies reality, but it will be good enough for what follows.

During the phase of normal science, research questions usually can be phrased as “How do we measure this?” (for the experimentalists) or “How do we calculate this?” (for the theorists).

In the foundations of physics, we have a lot of these “normal problems.” For the experimentalists it’s because the low-hanging fruits have been picked and measuring anything new becomes increasingly challenging. For the theorists it’s because in physics predictions don’t just fall out of hypotheses. We often need many steps of argumentation and lengthy calculations to derive quantitative consequences from a theory’s premises.

A good example for a normal problem in the foundations of physics is cold dark matter. The hypothesis is easy enough: There’s some cold, dark, stuff in the cosmos that behaves like a fluid and interacts weakly both with itself and other matter. But that by itself isn’t a useful prediction. A concrete research problem would instead be: “What is the effect of cold dark matter on the temperature fluctuations of the cosmic microwave background?” And then the experimental question “How can we measure this?”

Other problems of this type in the foundations of physics are “What is the gravitational contribution to the magnetic moment of the muon?,” or “What is the photon background for proton scattering at the Large Hadron Collider?”

Answering such normal problems expands our understanding of existing theories. These are calculations that can be done within the frameworks we have, but calculations can be be challenging.

The examples in the previous paragraphs are solved problems, or at least problems that we know how to solve, though you can always ask for higher precision. But we also have unsolved problems in this category.

More here.

Yanis Varoufakis’s lessons for reasserting European social democracy

J. W. Mason in the Boston Review:

YaniIn the spring of 2015, a series of debt negotiations briefly claimed a share of the world’s attention that normally goes only to events where celebrities give each other prizes. Syriza, a scrappy left-wing party, had stormed into office in Greece on a promise to challenge the consortium of international creditors that had effectively ruled the country since its debt crisis broke out in 2010. For years, austerity, deregulation, the rolling back of labor rights and public services, the rule of money over society, had been facts of life. Now suddenly they were live political questions. It was riveting.

Syriza was represented in these negotiations by its finance minister, Yanis Varoufakis. With his shaved head, leather jacket, and motorcycle, he was not just a visual contrast to the gray-suited Eurocrats across the table. His radical but rigorous proposals for a different kind of Europe—one based on meeting human needs rather than rigid financial criteria—offered a daily rebuke to the old refrain “there is no alternative.”

The drama was clear, but the stakes were a little obscure. Why did it matter if Greece stayed in the euro? Orthodox economic theory, after all, gives little role for money or finance. What matters are real wants and real resources, for which money is just a convenient yardstick. University of Chicago economist John Cochrane probably spoke for much of the profession when he asked why it made any more sense to talk about Greece leaving the euro than about Greece leaving the metric system.

But money does indeed matter—especially in economic relations between countries, as Varoufakis himself has convincingly shown. In his three books—The Global Minotaur (2011), And the Weak Suffer What They Must (2016), and Adults in the Room (2017)—Varoufakis offers a fascinating lens on the euro system and its masters.

More here.