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"content": "\u003cp>ou might not suspect that the success of the emerging field of precision medicine depends heavily on the couriers who push carts down hospital halls.\u003c/p>\n\u003cp>But samples taken during surgery may end up in poor shape by the time they get to the pathology lab — and that has serious implications for patients as well as for scientists who want to use that material to develop personalized tests and treatments that are safer and more effective.\u003c/p>\n\u003cp>Consider the story of a test that's commonly used to choose the right treatment for breast cancer patients. About a decade ago, pathologists realized that the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706184/\">HER2 test\u003c/a>, which looks for a protein that promotes the growth of cancer cells, was \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20524868\">wrong about 20 percent of the time\u003c/a>. As a result, some women were getting the wrong treatment. The trouble wasn't with the test itself — problems arose because the samples to be tested weren't handled carefully and consistently.\u003c/p>\n\u003cp>To reduce the error rate, doctors established guidelines in 2007 to assure that breast cancer specimens are handled correctly. But a decade later, that's still the only test that has such strict guidelines.\u003c/p>\n\u003cp>\u003cstrong>The weakest link in the quality chain\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Why are breast cancer patients special?\" asks Dr. \u003ca href=\"https://sols.asu.edu/people/carolyn-compton\">Carolyn Compton\u003c/a>, a pathologist and professor at Arizona State University. She has been pressuring her colleagues to improve tissue-handling standards for all types of cancer.\u003c/p>\n\u003cp>That means collecting samples quickly from the operating room, monitoring their condition, and getting them through the hospital to the pathology lab without delay.\u003c/p>\n\u003cp>\"I don't think physicians think this way about their entire medical system,\" she says. The process of delivering tissue samples to the pathology lab \"may be the weakest link in the quality chain.\"\u003c/p>\n\u003cp>This is not just a question about making sure each and every patient gets the most appropriate treatment. It affects the science behind new tests and treatments. Those tissue specimens often end up being preserved in huge collections called biobanks, which are a foundation for the field of precision medicine.\u003c/p>\n\u003cp>\"I don't see how we're going to get precision medicine at the end of the day, when everything under the hood is so imprecise,\" Compton says.\u003c/p>\n\u003cp>She is not alone in her concerns.\u003c/p>\n\u003cp>\"We need to be sure that the stuff they're looking at is valid, accurate, reliable and reproducible,\" says Dr. \u003ca href=\"https://www.baystatehealth.org/education-research/academic-departments/pathology/friedberg\">Richard Friedberg\u003c/a>, who has just finished his term as president of the College of American Pathologists. He is also chairman of pathology at the University of Massachusetts Medical School-Baystate.\u003c/p>\n\u003cp>And he agrees with Compton that the quality of samples ending up in biobanks is simply unknown.\u003c/p>\n\u003cp>\u003cstrong>'Garbage in, garbage out'\u003c/strong>\u003c/p>\n\u003cp>This isn't just about surgical samples. For example, he says, you can't tell just by looking at a tube of blood whether it's OK. \"If it was left on a window sill and hit 100 degrees, a lot of things change.\"\u003c/p>\n\u003cp>The fact is, you can still run a test and still get what looks like a valid result, \"but if it's garbage in, it's garbage out,\" Friedberg says.\u003c/p>\n\u003cp>Compton's concerns also extend to the complex, expensive equipment at the core of precision medicine, including machines that read DNA sequences. Results from one test are not necessarily comparable to results from another, run on an identical sample. And because each company that makes a sequencer uses proprietary algorithms to identify genetic mutations, it's not possible for laboratory scientists to make an independent judgement about which reading is more likely to be correct, she says.\u003c/p>\n\u003cp>The good news is that DNA samples are less sensitive to being affected by poor treatment, so sample handling is less of an issue for genetic studies. But when there are problems, \"you can't make up for a bad sample,\" Compton says. \"So even with all of this technological magic, you can't turn straw into gold with this machine.\"\u003c/p>\n\u003cp>And results from pathology labs are not even the biggest source of error in the growing field of precision medicine. Compounding the uncertainty is that patients' \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550/\">electronic medical records are littered with all sorts of errors,\u003c/a> and that further complicates efforts to extract reliable results from this pool of \"big data.\"\u003c/p>\n\u003cp>But not everyone in the new world of precision medicine is so concerned about these quality-control issues.\u003c/p>\n\u003cp>\"I am not a believer in garbage-in, garbage out at all,\" says Dr. \u003ca href=\"http://profiles.ucsf.edu/atul.butte\">Atul Butte\u003c/a>, director of the Institute of Computational Health Sciences at the University of California-San Francisco. (He also holds a chair endowed by Mark Zuckerberg, who made himself rich by exploiting big data with Facebook).\u003c/p>\n\u003cp>\"I know that no one scientist, no one clinician or pathologist is perfect,\" Butte says. \"But I'd rather take 10 or 100 so-called mediocre data sets and find out what's in common, then to take one who says they're perfect at doing this kind of measurement.\"\u003c/p>\n\u003cp>\u003cstrong>Finding meaning in the 'noise' of big data\u003c/strong>\u003c/p>\n\u003cp>It's easier to find real things in clean data. But in the real world, he says, data are always full of errors. So when you find something in noisy data, it's more useful in real-world settings.\u003c/p>\n\u003cp>In Butte's view, it's far more important to make lots of noisy data available, and to as many scientists as possible. \"To me, I really want to see a world where I don't just see five or 10 or 20 companies working in particular area, I want a thousand drug companies. I want 10,000 drug companies.\"\u003c/p>\n\u003cp>Butte himself used noisy public data to identify genetic markers he says could be the basis for a test to help diagnose a serious complication of pregnancy, high blood pressure or preeclampsia. He founded a company to exploit that idea and then sold the company, so Butte considers his discovery a qualified success, even though human studies have not yet determined whether the test will be valid and useful.\u003c/p>\n\u003cp>Carolyn Compton says she's heard similar arguments about the value of noisy data from colleagues. She says one argued that if you have a pile of manure, maybe there's a pony in there somewhere. \"I don't see bending over backwards to create algorithms to do all the work to sort through all the manure when, in fact, you could have a pile of diamonds from the outset,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Funding agencies prize exploration over quality control research\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Compton has been pushing for more rigorous standards in specimen handling since she was an official at the National Cancer Institute a decade ago. But she says funding agencies are more interested in providing support for exploring new ideas than in funding basic research on a seemingly boring subject, such as understanding the consequences of mishandling tissue samples.\u003c/p>\n\u003cp>Concerns about quality control of tissue samples were a major subject of conversation at the College of American Pathologists' annual meeting in October. \"We are moving faster and faster and faster as this whole precision medicine train is moving down the track,\" says Dr. \u003ca href=\"https://www.utmb.edu/pathology/clinical/anatomic_pathology/\">Tim Allen\u003c/a>, a pathologist at the University of Texas Medical Branch in Galveston.\u003c/p>\n\u003cp>The struggle now is that there simply isn't enough data to make science-based recommendations, but \"I suspect standardization of these things is going to become a reality much quicker than I would have expected even a few years ago,\" Allen says.\u003c/p>\n\u003cp>In the meantime, samples of unknown quality continue to flood into biobanks. That's problematic because discoveries based on noisy data often turn out to be just plain wrong. So this enterprise inevitably will generate many false leads. And the expensive and most time-consuming part of research is finding out whether something that looks great in the lab actually works in people.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris via \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">email\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Precision+Medical+Treatments+Have+A+Quality+Control+Problem&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The goal is to customize treatments for cancer and other diseases to a patient's own biology. But something as simple as failing to take care of tissue samples en route to the lab can derail that.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>ou might not suspect that the success of the emerging field of precision medicine depends heavily on the couriers who push carts down hospital halls.\u003c/p>\n\u003cp>But samples taken during surgery may end up in poor shape by the time they get to the pathology lab — and that has serious implications for patients as well as for scientists who want to use that material to develop personalized tests and treatments that are safer and more effective.\u003c/p>\n\u003cp>Consider the story of a test that's commonly used to choose the right treatment for breast cancer patients. About a decade ago, pathologists realized that the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706184/\">HER2 test\u003c/a>, which looks for a protein that promotes the growth of cancer cells, was \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20524868\">wrong about 20 percent of the time\u003c/a>. As a result, some women were getting the wrong treatment. The trouble wasn't with the test itself — problems arose because the samples to be tested weren't handled carefully and consistently.\u003c/p>\n\u003cp>To reduce the error rate, doctors established guidelines in 2007 to assure that breast cancer specimens are handled correctly. But a decade later, that's still the only test that has such strict guidelines.\u003c/p>\n\u003cp>\u003cstrong>The weakest link in the quality chain\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Why are breast cancer patients special?\" asks Dr. \u003ca href=\"https://sols.asu.edu/people/carolyn-compton\">Carolyn Compton\u003c/a>, a pathologist and professor at Arizona State University. She has been pressuring her colleagues to improve tissue-handling standards for all types of cancer.\u003c/p>\n\u003cp>That means collecting samples quickly from the operating room, monitoring their condition, and getting them through the hospital to the pathology lab without delay.\u003c/p>\n\u003cp>\"I don't think physicians think this way about their entire medical system,\" she says. The process of delivering tissue samples to the pathology lab \"may be the weakest link in the quality chain.\"\u003c/p>\n\u003cp>This is not just a question about making sure each and every patient gets the most appropriate treatment. It affects the science behind new tests and treatments. Those tissue specimens often end up being preserved in huge collections called biobanks, which are a foundation for the field of precision medicine.\u003c/p>\n\u003cp>\"I don't see how we're going to get precision medicine at the end of the day, when everything under the hood is so imprecise,\" Compton says.\u003c/p>\n\u003cp>She is not alone in her concerns.\u003c/p>\n\u003cp>\"We need to be sure that the stuff they're looking at is valid, accurate, reliable and reproducible,\" says Dr. \u003ca href=\"https://www.baystatehealth.org/education-research/academic-departments/pathology/friedberg\">Richard Friedberg\u003c/a>, who has just finished his term as president of the College of American Pathologists. He is also chairman of pathology at the University of Massachusetts Medical School-Baystate.\u003c/p>\n\u003cp>And he agrees with Compton that the quality of samples ending up in biobanks is simply unknown.\u003c/p>\n\u003cp>\u003cstrong>'Garbage in, garbage out'\u003c/strong>\u003c/p>\n\u003cp>This isn't just about surgical samples. For example, he says, you can't tell just by looking at a tube of blood whether it's OK. \"If it was left on a window sill and hit 100 degrees, a lot of things change.\"\u003c/p>\n\u003cp>The fact is, you can still run a test and still get what looks like a valid result, \"but if it's garbage in, it's garbage out,\" Friedberg says.\u003c/p>\n\u003cp>Compton's concerns also extend to the complex, expensive equipment at the core of precision medicine, including machines that read DNA sequences. Results from one test are not necessarily comparable to results from another, run on an identical sample. And because each company that makes a sequencer uses proprietary algorithms to identify genetic mutations, it's not possible for laboratory scientists to make an independent judgement about which reading is more likely to be correct, she says.\u003c/p>\n\u003cp>The good news is that DNA samples are less sensitive to being affected by poor treatment, so sample handling is less of an issue for genetic studies. But when there are problems, \"you can't make up for a bad sample,\" Compton says. \"So even with all of this technological magic, you can't turn straw into gold with this machine.\"\u003c/p>\n\u003cp>And results from pathology labs are not even the biggest source of error in the growing field of precision medicine. Compounding the uncertainty is that patients' \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550/\">electronic medical records are littered with all sorts of errors,\u003c/a> and that further complicates efforts to extract reliable results from this pool of \"big data.\"\u003c/p>\n\u003cp>But not everyone in the new world of precision medicine is so concerned about these quality-control issues.\u003c/p>\n\u003cp>\"I am not a believer in garbage-in, garbage out at all,\" says Dr. \u003ca href=\"http://profiles.ucsf.edu/atul.butte\">Atul Butte\u003c/a>, director of the Institute of Computational Health Sciences at the University of California-San Francisco. (He also holds a chair endowed by Mark Zuckerberg, who made himself rich by exploiting big data with Facebook).\u003c/p>\n\u003cp>\"I know that no one scientist, no one clinician or pathologist is perfect,\" Butte says. \"But I'd rather take 10 or 100 so-called mediocre data sets and find out what's in common, then to take one who says they're perfect at doing this kind of measurement.\"\u003c/p>\n\u003cp>\u003cstrong>Finding meaning in the 'noise' of big data\u003c/strong>\u003c/p>\n\u003cp>It's easier to find real things in clean data. But in the real world, he says, data are always full of errors. So when you find something in noisy data, it's more useful in real-world settings.\u003c/p>\n\u003cp>In Butte's view, it's far more important to make lots of noisy data available, and to as many scientists as possible. \"To me, I really want to see a world where I don't just see five or 10 or 20 companies working in particular area, I want a thousand drug companies. I want 10,000 drug companies.\"\u003c/p>\n\u003cp>Butte himself used noisy public data to identify genetic markers he says could be the basis for a test to help diagnose a serious complication of pregnancy, high blood pressure or preeclampsia. He founded a company to exploit that idea and then sold the company, so Butte considers his discovery a qualified success, even though human studies have not yet determined whether the test will be valid and useful.\u003c/p>\n\u003cp>Carolyn Compton says she's heard similar arguments about the value of noisy data from colleagues. She says one argued that if you have a pile of manure, maybe there's a pony in there somewhere. \"I don't see bending over backwards to create algorithms to do all the work to sort through all the manure when, in fact, you could have a pile of diamonds from the outset,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Funding agencies prize exploration over quality control research\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Compton has been pushing for more rigorous standards in specimen handling since she was an official at the National Cancer Institute a decade ago. But she says funding agencies are more interested in providing support for exploring new ideas than in funding basic research on a seemingly boring subject, such as understanding the consequences of mishandling tissue samples.\u003c/p>\n\u003cp>Concerns about quality control of tissue samples were a major subject of conversation at the College of American Pathologists' annual meeting in October. \"We are moving faster and faster and faster as this whole precision medicine train is moving down the track,\" says Dr. \u003ca href=\"https://www.utmb.edu/pathology/clinical/anatomic_pathology/\">Tim Allen\u003c/a>, a pathologist at the University of Texas Medical Branch in Galveston.\u003c/p>\n\u003cp>The struggle now is that there simply isn't enough data to make science-based recommendations, but \"I suspect standardization of these things is going to become a reality much quicker than I would have expected even a few years ago,\" Allen says.\u003c/p>\n\u003cp>In the meantime, samples of unknown quality continue to flood into biobanks. That's problematic because discoveries based on noisy data often turn out to be just plain wrong. So this enterprise inevitably will generate many false leads. And the expensive and most time-consuming part of research is finding out whether something that looks great in the lab actually works in people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris via \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">email\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Precision+Medical+Treatments+Have+A+Quality+Control+Problem&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Should Police Violence Be Viewed as a Public Health Issue?",
"title": "Should Police Violence Be Viewed as a Public Health Issue?",
"headTitle": "The California Report | KQED News",
"content": "\u003cp>\u003cem>This piece has been updated to correct information regarding the American Public Health Association’s position and action.\u003c/em>\u003c/p>\n\u003cp>On Dec. 2, 2017, community members gathered to mark the second anniversary of \u003ca href=\"https://ww2.kqed.org/news/2016/02/11/medical-examiners-report-on-mario-woods-shooting-released/\">Mario Woods’ death\u003c/a>. Gwen Woods, hands on her hips and donning a T-shirt with her son’s face on it, marched the crowd down the T-Sunnydale streetcar tracks on San Francisco's Third Street to the site of her son’s death.\u003c/p>\n\u003cp>“I can’t let it go, you guys, because he didn’t deserve that,” Woods said, tears streaming down her face, after arriving at the site. “One thing I taught him, no matter what the plight, you have a voice. We all have a voice.”\u003c/p>\n\u003cp>The impact of her son's death sent shock waves throughout the community, which is still mourning his death.\u003c/p>\n\u003cp>Some local health professionals are advocating that the impact of police violence should be studied and treated as a public health issue. Advocates say people of color are the most at risk, yet the responsibility for providing healing resources has fallen on community members to take care of their own.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"\u003cspan style=\"font-weight: 400\">There is a disconnect between more traditional public health and the growing field of health equity,\" said Sari Bilick, public health organizer at \u003ca href=\"https://humanimpact.org\">Human Impact Partners\u003c/a>. \"[There's] the folks who are really trying to transform the field of public health to look at health inequities that exist, versus the people who are more in the traditional field of public health that looks at health as a result of genetics and individual behaviors.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11638137\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg\">\u003cimg class=\"size-full wp-image-11638137\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg\" alt=\"\" width=\"600\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg 600w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-160x120.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-240x180.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-375x281.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-520x390.jpeg 520w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The American Public Health Association governing council voted not to adopt a policy statement addressing police violence as a public health issue. \u003ccite>(Courtesy of Sari Bilick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>No Longer Written Policy\u003c/strong>\u003c/p>\n\u003cp>In November, the \u003ca href=\"https://www.apha.org\">American Public Health Association\u003c/a> governing council voted against permanently adopting a policy statement that identified a four-part strategy for preventing law enforcement violence, which the statement called a “significant” public health issue across the country.\u003c/p>\n\u003cp>The policy statement was temporarily adopted last year, but came up for vote again at the APHA’s last annual meeting. The association's governing council voted 65 to 35 percent against the policy's adoption, although there was a strong showing of support by some APHA members who held a rally and wore pins for the policy at the conference, according to Bilick.\u003c/p>\n\u003cp>\"The fact that they're not passing this statement that directly impacts black and brown communities sends a message that they're not willing to stand up for those communities,\" Bilick said.\u003c/p>\n\u003cp>However, the APHA’s \u003ca href=\"http://www.publichealthnewswire.org/?p=19468\">Joint Policy Committee\u003c/a> reviews proposed policy statements and makes recommendations to the governing council prior to the vote to determine if the statement is evidence-based and meets the \u003ca href=\"https://www.apha.org/~/media/files/pdf/policy/authorinstructions_2017.ashx\">submission guidelines\u003c/a>. The committee advised against the council’s adoption of this policy with a call for substantive improvement.\u003c/p>\n\u003cp>“These are people’s bodies, that’s our jurisdiction,” said Rupa Marya, faculty in the division of hospital medicine at UCSF and organizer with the \u003ca href=\"http://www.donoharmcoalition.org\">Do No Harm Coalition\u003c/a>. “I think that in general the governing bodies of the APHA are largely white, and they’re largely not affected by police violence.\"\u003c/p>\n\u003cp>The \u003ca href=\"https://endpoliceviolence.squarespace.com/the-statement/\">“Law Enforcement Violence as a Public Health Issue” policy statement\u003c/a> has since been removed from the association's website.\u003c/p>\n\u003cp>\"In this moment, I think it's really important that, as the largest public health organization, APHA takes a bold stand and doesn't shy away from publicly condemning police violence,\" Bilick said. \"If the biggest public health org in the country takes a stand on it, that will prompt more research, more journal articles, more responses within public health to police violence.\"\u003c/p>\n\u003cp>A rewritten version of the statement is slated to be presented in fall 2018, according to Megan Lowry, a spokeswoman for the association.\u003c/p>\n\u003cp>Though the APHA’s policy statements shape the association’s stance on a wide range of public health topics, it \u003ca href=\"http://www.publichealthnewswire.org/?p=19468\">does not necessarily mean the APHA is against the topic or aim\u003c/a> of a proposal that is not adopted.\u003c/p>\n\u003cp>“We have policy statements on the books that allow us to address many aspects of this issue,” the association’s executive director, Georges Benjamin, said in an interview with \u003ca href=\"http://thenationshealth.aphapublications.org/site/misc/PoliceViolencePublicHealth.xhtml\">The Nation’s Health\u003c/a>. “Police violence is absolutely a public health issue that we have been working on for many years and one we will continue to work on.”\u003c/p>\n\u003cp>The association is convening a work group of members to create a new policy statement about the issue for a future vote that meets the evidence-based standard in order to pass, \u003ca href=\"http://thenationshealth.aphapublications.org/site/misc/PoliceViolencePublicHealth.xhtml\">according to Benjamin\u003c/a>. He said the APHA \"will continue to speak out and work to protect the public from police violence.\"\u003c/p>\n\u003cp>In the meantime, there are not enough studies addressing the relationship of police interactions to people’s health or exploring prevention techniques, according to Rhea Boyd, a pediatrician who practices in Palo Alto. But she hopes the health community will still take action based on the evidence that is available.\u003c/p>\n\u003cp>“We don’t need data to start doing things about it,” Boyd said. “I think we can use data that we already know about exposures to violence. We can use data that we already know about racial disparities in police interactions and just put two and two together and start putting together initiatives to actually start addressing it.”\u003c/p>\n\u003cfigure id=\"attachment_11639683\" class=\"wp-caption alignnone\" style=\"max-width: 436px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg\">\u003cimg class=\"size-full wp-image-11639683\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg\" alt=\"\" width=\"436\" height=\"758\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg 436w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-160x278.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-240x417.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-375x652.jpg 375w\" sizes=\"(max-width: 436px) 100vw, 436px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhea Boyd is a pediatrician in Palo Alto. \u003ccite>(Courtesy of Rhea Boyd)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Local Stance?\u003c/strong>\u003c/p>\n\u003cp>On a local level, Boyd and other health advocates penned a letter to the San Francisco Police Commission to urge the city to create a coordinated effort to address all acts of violence, including police violence.\u003c/p>\n\u003cp>“I think there’s a lot of city agencies that would benefit from the conversation,” Boyd said. “Given the stature of the health department and the police department, they have the power to do more and to convene meetings to make a prioritized list of how we might go about this.”\u003c/p>\n\u003cp>This led to the Police Commission encouraging then-Mayor Ed Lee to facilitate a wraparound effort of the Police Department, Police Commission, Department of Children, Youth and Families, Department of Public Health and other city agencies to create a better public health response to violence.\u003c/p>\n\u003cp>“Without a meaningful public health response that intervenes in the cycle of violence, too many of our communities will continue to experience the predictable, poor outcomes that come from sustained exposure to chronic adversity and trauma,” the \u003ca href=\"http://sfmayor.org/sites/default/files/FileCenter/Documents/484-Suhr%20_%20Loftus%20Letter1.pdf\">letter\u003c/a> said.\u003c/p>\n\u003cp>It was in December 2015 that SFPD officers \u003ca href=\"https://ww2.kqed.org/news/2016/02/11/medical-examiners-report-on-mario-woods-shooting-released/\">shot and killed Mario Woods\u003c/a> in the Bayview district. His death spurred an uprising of community action, use-of-force reforms and a Justice Department review of the police department.\u003c/p>\n\u003cp>The SFPD also adopted a \u003ca href=\"http://sanfranciscopolice.org/sites/default/files/Documents/PoliceDocuments/DepartmentGeneralOrders/sfpd-dgo-5.21-cit.pdf\">memorandum\u003c/a> with the Department of Public Health for a coordinated approach when dealing with incidents that involve people in crisis, creating a \u003ca href=\"https://sanfranciscopolice.org/crisis-intervention-team\">Crisis Intervention Team\u003c/a>.\u003c/p>\n\u003cp>Police commissioner Joe Marshall said he is not aware of any meeting between the agencies listed in the letter to address the topic at hand, though the creation of the CIT shows effort.\u003c/p>\n\u003cp>“I think the department has reached out in the spirit of what they suggested in the letter to create a spirit of practices that are actually put in place by using the best in public health thinking,” Marshall said. “Those things that have happened are major and have gone way beyond what was suggested in that letter because they've now become either policy or practice.”\u003c/p>\n\u003cp>While Boyd said the CIT and joint trainings are a step in the right direction, the effort her group hoped for hasn’t come to fruition when specifically addressing police encounters.\u003c/p>\n\u003cp>“Those programs can be expanded, not just to individuals who have mental illness but to everyone, really,” Boyd said. “If you would rather, when a crisis shows up in your home, have a neighbor respond to your crisis rather than an armed, militarized officer, then I think that needs to be a new service line that a collaboration between our health departments and our police departments could provide.”\u003c/p>\n\u003cp>The San Francisco Public Health Department declined to comment about police violence for this article.\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_11638142\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0021.jpg\">\u003cimg class=\"size-medium wp-image-11638142\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0021-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gwen Woods is embraced on Dec. 2, 2017, the second anniversary of her son's death in San Francisco. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Long-Term and Pervasive Impact\u003c/strong>\u003c/p>\n\u003cp>Asantewaa Boykin, a registered nurse and co-founder of \u003ca href=\"https://ww2.kqed.org/news/2017/09/22/meet-the-people-mobilizing-against-white-supremacy-in-the-bay-area/\">the Anti Police-Terror Project,\u003c/a> recalls her earliest memory of the police. It brings her back to being a young girl, as she watched an officer’s dog chew through a neighbor’s leg.\u003c/p>\n\u003cp>She still has nightmares about it.\u003c/p>\n\u003cp>“As someone who understands what witnessing violence does to health, as somebody who thinks through the greater implications of any one act of violence in a community, that certainly it affects the victim who’s involved,” Boyd said. “But it has collateral damage to the immediate community and to all those who are now at risk because that type of violence is deemed in some ways acceptable or OK.”\u003c/p>\n\u003cp>Images of police use of force reach farther than ever before. In some cases they appear at the touch of people’s fingertips while scrolling through their news feeds, and in some cases they’ve even appeared in \u003ca href=\"http://www.cnn.com/videos/us/2016/07/07/graphic-video-minnesota-police-shooting-philando-castile-ryan-young-pkg-nd.cnn\">real time on Facebook Live\u003c/a>.\u003c/p>\n\u003cp>“When you talk about trauma, [it can occur] knowing that someone down the street got murdered by police ... or when these videos go viral, and you think about how many people are impacted by these videos,” said Boykin.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>The first steps toward creating accessible healing for the communities who are most impacted by police violence begin with bringing in more diverse therapists and tailoring services toward the people who most often need them, according to Boykin.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.bls.gov/cps/cpsaat11.htm\">U.S. Department of Labor’s 2016 statistics\u003c/a>, 5.8 percent of psychologists are African-American, 4.2 percent are Asian and 6.9 percent are Latino.\u003c/p>\n\u003cp>“I know, for instance, I’ve seen a therapist, and I’m much more comfortable if that person resembles me,” Boykin said. “The traditional Western sense of therapy is not something that a lot of people of color can identify with or feel comfortable with.”\u003c/p>\n\u003cp>\u003cstrong>Taking Research into Their Own \u003c/strong>\u003cb>Hands\u003c/b>\u003c/p>\n\u003cp>Marya has teamed up with other health professionals to take a study, requested by the Justice for Mario Woods Coalition, into their own hands. They plan to explore levels of trauma faced by communities impacted by police violence, especially in cases where people do not feel they experienced justice.\u003c/p>\n\u003cp>“I have yet to hear anyone at the Department of Public Health in San Francisco speak up about these issues in a concerted, consistent way, to be that voice in the city demanding that not only are the police trained differently, but that there’s some accountability and transparency,” Marya said.\u003c/p>\n\u003cp>The \"justice study\" will begin with an online survey that Marya and her team members will analyze.\u003c/p>\n\u003cp>A separate study that was published last year, titled “\u003ca href=\"http://www.trustnottrauma.org\">SOS: Stress on the Streets\u003c/a>,” explored police practices in Ohio with a specific focus of the impact on black people. The study was conducted by three nonprofit organizations: \u003ca href=\"https://humanimpact.org\">Human Impact Partners\u003c/a>, \u003ca href=\"http://www.ohiojpc.org//\">Ohio Justice and Policy Center\u003c/a> and\u003ca href=\"http://ohorganizing.org\"> Ohio Organizing Collaborative\u003c/a>.\u003c/p>\n\u003cp>“This report shows that for many black people in the United States the perceived color of their skin means more uneasy interactions with police than others in our society, and stress and anxiety that in turn result in poorer physical and mental health,” it reads.\u003c/p>\n\u003cp>The report’s recommendations rang true with the calls from local health advocates: Involve public health departments to enhance transparency and study the health impacts of policing practices and help resolve systemic issues.\u003c/p>\n\u003cp>But Bilick said this approach is not apparent in most local public health departments.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"That first step of getting public health departments to even prioritize this as something that they should be collecting data on is a big jump from what people are doing now,\" Bilick said.\u003c/span>\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_11638143\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8853.jpg\">\u003cimg class=\"size-medium wp-image-11638143\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8853-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Police commissioner Joe Marshall sits in his office at the Alive and Free building in San Francisco on Sept. 19, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>The Question of the Role of Police\u003c/strong>\u003c/p>\n\u003cp>There are differing opinions as to whether police have a place in collaboration with health providers in the healing process from their impact.\u003c/p>\n\u003cp>Although Boykin would like to see more health care professionals facilitate healing from trauma induced by law enforcement, she does not want police institutions to be involved.\u003c/p>\n\u003cp>“That’s like asking someone who has been abused to go sit down and have a conversation with the person that abused them,” Boykin said. “We would not apply that equation in any other situation. It would be considered ridiculous.”\u003c/p>\n\u003cp>Marshall, on the other hand, believes police should be involved. “Absolutely, because they’ve caused a lot of damage,” he said. “This is what I tell people. Police aren’t going anywhere. So you gotta make it work. You gotta change it if you want to make it work.”\u003c/p>\n\u003cp>The next important focus for the department, he said, is getting all officers trained in crisis intervention. Currently about a quarter of the department is trained. He added, “I think we’re making strides here, but it's something you have to work at all the time.”\u003c/p>\n\u003cp>And some believe the police have more work to do when it comes to reform and transparency to allow people to truly heal.\u003c/p>\n\u003cp>“Without that accountability, there’s no reason for people to feel like they’re safe within their communities,” Marya said.\u003c/p>\n\u003cfigure id=\"attachment_11638144\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8910.jpg\">\u003cimg class=\"size-medium wp-image-11638144\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8910-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Community members hold signs at the Anti Police-Terror Project's monthly meeting, held in Frank H. Ozawa Plaza in Oakland on Sept. 20, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Community Fills the Gap\u003c/strong>\u003c/p>\n\u003cp>Thirty years ago, Marshall co-founded an organization, \u003ca href=\"https://stayaliveandfree.org\">Alive and Free\u003c/a>, which created a unique approach to addressing trauma in young people. He authored a prescription that treats violence like a social disease by identifying and addressing risk factors.\u003c/p>\n\u003cp>“Therapy is a bad word to them because they’ve been involved with therapists who look at them like they’re crazy,” Marshall said.\u003c/p>\n\u003cp>Through weekly peer meetings, he creates a sense of trust.\u003c/p>\n\u003cp>Marshall said he sees therapy-like results without labeling the meetings as such. It has become an outlet for young people to talk about issues they face without feeling judged.\u003c/p>\n\u003cp>“They’ve been to funerals, the neighborhood is decimated, death is all around them, their fathers are in jail and now they have a lot of emotional residue,” Marshall said. “These young people are faking it all the time because they’re hurting all the time. This is literally the walking wounded pretending like they got it all together. They don’t.”\u003c/p>\n\u003cp>Boykin, co-founder of the APTP, also helped to create an group with a goal of sustainability.\u003c/p>\n\u003cp>The coalition focuses on ending murder and violence against communities of color by law enforcement agents. Boykin described it as a multigenerational and multi-ethnic group of organizations and community members that is “unapologetically black-led.”\u003c/p>\n\u003cp>“It kind of started to feel like we were waiting for black folks to be murdered by police and then we were reacting to that murder, versus doing something that was sustainable,” Boykin said.\u003c/p>\n\u003cp>The coalition trains first responders to teach them how to treat injuries, conduct trauma-informed investigations and connect people with support and means of healing. The group believes this approach works as a preventative measure that addresses the need for healing before and after anticipated trauma.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">They provide those affected by police violence with their database of healers, such as acupuncturists, marriage family counselors, nurses and massage therapists to make available for victims and their families. The coalition holds monthly support groups with leaders who are people of color. \u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cfigure id=\"attachment_11638461\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0044.jpg\">\u003cimg class=\"size-medium wp-image-11638461\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0044-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A sign hangs at a gathering for the second anniversary of Mario Woods' death in San Francisco, California on Dec. 2, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Still, health advocates hope to alleviate some of this responsibility that has fallen on the community.\u003c/p>\n\u003cp>“It’s our job as health care professionals,” Boyd said. “This is the gap where community organizing has stepped in, but the weight of this belongs on health care professionals.”\u003c/p>\n\u003cp>Boyd also believes that health care professionals have the responsibility to give validity to the mental and physical effects police violence has on communities.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“All of the rest of the people who hold fear, who hold shame, who don’t feel secure in their daily environment, that’s real and it’s not in your head,” Boyd said. “And it could affect you long term, and I think people are owed something because it will affect them long term.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This piece has been updated to correct information regarding the American Public Health Association’s position and action.\u003c/em>\u003c/p>\n\u003cp>On Dec. 2, 2017, community members gathered to mark the second anniversary of \u003ca href=\"https://ww2.kqed.org/news/2016/02/11/medical-examiners-report-on-mario-woods-shooting-released/\">Mario Woods’ death\u003c/a>. Gwen Woods, hands on her hips and donning a T-shirt with her son’s face on it, marched the crowd down the T-Sunnydale streetcar tracks on San Francisco's Third Street to the site of her son’s death.\u003c/p>\n\u003cp>“I can’t let it go, you guys, because he didn’t deserve that,” Woods said, tears streaming down her face, after arriving at the site. “One thing I taught him, no matter what the plight, you have a voice. We all have a voice.”\u003c/p>\n\u003cp>The impact of her son's death sent shock waves throughout the community, which is still mourning his death.\u003c/p>\n\u003cp>Some local health professionals are advocating that the impact of police violence should be studied and treated as a public health issue. Advocates say people of color are the most at risk, yet the responsibility for providing healing resources has fallen on community members to take care of their own.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"\u003cspan style=\"font-weight: 400\">There is a disconnect between more traditional public health and the growing field of health equity,\" said Sari Bilick, public health organizer at \u003ca href=\"https://humanimpact.org\">Human Impact Partners\u003c/a>. \"[There's] the folks who are really trying to transform the field of public health to look at health inequities that exist, versus the people who are more in the traditional field of public health that looks at health as a result of genetics and individual behaviors.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11638137\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg\">\u003cimg class=\"size-full wp-image-11638137\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg\" alt=\"\" width=\"600\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI..jpeg 600w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-160x120.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-240x180.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-375x281.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/0v1WGgh5ij-A92xoI.-520x390.jpeg 520w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The American Public Health Association governing council voted not to adopt a policy statement addressing police violence as a public health issue. \u003ccite>(Courtesy of Sari Bilick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>No Longer Written Policy\u003c/strong>\u003c/p>\n\u003cp>In November, the \u003ca href=\"https://www.apha.org\">American Public Health Association\u003c/a> governing council voted against permanently adopting a policy statement that identified a four-part strategy for preventing law enforcement violence, which the statement called a “significant” public health issue across the country.\u003c/p>\n\u003cp>The policy statement was temporarily adopted last year, but came up for vote again at the APHA’s last annual meeting. The association's governing council voted 65 to 35 percent against the policy's adoption, although there was a strong showing of support by some APHA members who held a rally and wore pins for the policy at the conference, according to Bilick.\u003c/p>\n\u003cp>\"The fact that they're not passing this statement that directly impacts black and brown communities sends a message that they're not willing to stand up for those communities,\" Bilick said.\u003c/p>\n\u003cp>However, the APHA’s \u003ca href=\"http://www.publichealthnewswire.org/?p=19468\">Joint Policy Committee\u003c/a> reviews proposed policy statements and makes recommendations to the governing council prior to the vote to determine if the statement is evidence-based and meets the \u003ca href=\"https://www.apha.org/~/media/files/pdf/policy/authorinstructions_2017.ashx\">submission guidelines\u003c/a>. The committee advised against the council’s adoption of this policy with a call for substantive improvement.\u003c/p>\n\u003cp>“These are people’s bodies, that’s our jurisdiction,” said Rupa Marya, faculty in the division of hospital medicine at UCSF and organizer with the \u003ca href=\"http://www.donoharmcoalition.org\">Do No Harm Coalition\u003c/a>. “I think that in general the governing bodies of the APHA are largely white, and they’re largely not affected by police violence.\"\u003c/p>\n\u003cp>The \u003ca href=\"https://endpoliceviolence.squarespace.com/the-statement/\">“Law Enforcement Violence as a Public Health Issue” policy statement\u003c/a> has since been removed from the association's website.\u003c/p>\n\u003cp>\"In this moment, I think it's really important that, as the largest public health organization, APHA takes a bold stand and doesn't shy away from publicly condemning police violence,\" Bilick said. \"If the biggest public health org in the country takes a stand on it, that will prompt more research, more journal articles, more responses within public health to police violence.\"\u003c/p>\n\u003cp>A rewritten version of the statement is slated to be presented in fall 2018, according to Megan Lowry, a spokeswoman for the association.\u003c/p>\n\u003cp>Though the APHA’s policy statements shape the association’s stance on a wide range of public health topics, it \u003ca href=\"http://www.publichealthnewswire.org/?p=19468\">does not necessarily mean the APHA is against the topic or aim\u003c/a> of a proposal that is not adopted.\u003c/p>\n\u003cp>“We have policy statements on the books that allow us to address many aspects of this issue,” the association’s executive director, Georges Benjamin, said in an interview with \u003ca href=\"http://thenationshealth.aphapublications.org/site/misc/PoliceViolencePublicHealth.xhtml\">The Nation’s Health\u003c/a>. “Police violence is absolutely a public health issue that we have been working on for many years and one we will continue to work on.”\u003c/p>\n\u003cp>The association is convening a work group of members to create a new policy statement about the issue for a future vote that meets the evidence-based standard in order to pass, \u003ca href=\"http://thenationshealth.aphapublications.org/site/misc/PoliceViolencePublicHealth.xhtml\">according to Benjamin\u003c/a>. He said the APHA \"will continue to speak out and work to protect the public from police violence.\"\u003c/p>\n\u003cp>In the meantime, there are not enough studies addressing the relationship of police interactions to people’s health or exploring prevention techniques, according to Rhea Boyd, a pediatrician who practices in Palo Alto. But she hopes the health community will still take action based on the evidence that is available.\u003c/p>\n\u003cp>“We don’t need data to start doing things about it,” Boyd said. “I think we can use data that we already know about exposures to violence. We can use data that we already know about racial disparities in police interactions and just put two and two together and start putting together initiatives to actually start addressing it.”\u003c/p>\n\u003cfigure id=\"attachment_11639683\" class=\"wp-caption alignnone\" style=\"max-width: 436px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg\">\u003cimg class=\"size-full wp-image-11639683\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg\" alt=\"\" width=\"436\" height=\"758\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot.jpg 436w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-160x278.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-240x417.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/Rhea20Boyd27s20Head20Shot-375x652.jpg 375w\" sizes=\"(max-width: 436px) 100vw, 436px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhea Boyd is a pediatrician in Palo Alto. \u003ccite>(Courtesy of Rhea Boyd)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Local Stance?\u003c/strong>\u003c/p>\n\u003cp>On a local level, Boyd and other health advocates penned a letter to the San Francisco Police Commission to urge the city to create a coordinated effort to address all acts of violence, including police violence.\u003c/p>\n\u003cp>“I think there’s a lot of city agencies that would benefit from the conversation,” Boyd said. “Given the stature of the health department and the police department, they have the power to do more and to convene meetings to make a prioritized list of how we might go about this.”\u003c/p>\n\u003cp>This led to the Police Commission encouraging then-Mayor Ed Lee to facilitate a wraparound effort of the Police Department, Police Commission, Department of Children, Youth and Families, Department of Public Health and other city agencies to create a better public health response to violence.\u003c/p>\n\u003cp>“Without a meaningful public health response that intervenes in the cycle of violence, too many of our communities will continue to experience the predictable, poor outcomes that come from sustained exposure to chronic adversity and trauma,” the \u003ca href=\"http://sfmayor.org/sites/default/files/FileCenter/Documents/484-Suhr%20_%20Loftus%20Letter1.pdf\">letter\u003c/a> said.\u003c/p>\n\u003cp>It was in December 2015 that SFPD officers \u003ca href=\"https://ww2.kqed.org/news/2016/02/11/medical-examiners-report-on-mario-woods-shooting-released/\">shot and killed Mario Woods\u003c/a> in the Bayview district. His death spurred an uprising of community action, use-of-force reforms and a Justice Department review of the police department.\u003c/p>\n\u003cp>The SFPD also adopted a \u003ca href=\"http://sanfranciscopolice.org/sites/default/files/Documents/PoliceDocuments/DepartmentGeneralOrders/sfpd-dgo-5.21-cit.pdf\">memorandum\u003c/a> with the Department of Public Health for a coordinated approach when dealing with incidents that involve people in crisis, creating a \u003ca href=\"https://sanfranciscopolice.org/crisis-intervention-team\">Crisis Intervention Team\u003c/a>.\u003c/p>\n\u003cp>Police commissioner Joe Marshall said he is not aware of any meeting between the agencies listed in the letter to address the topic at hand, though the creation of the CIT shows effort.\u003c/p>\n\u003cp>“I think the department has reached out in the spirit of what they suggested in the letter to create a spirit of practices that are actually put in place by using the best in public health thinking,” Marshall said. “Those things that have happened are major and have gone way beyond what was suggested in that letter because they've now become either policy or practice.”\u003c/p>\n\u003cp>While Boyd said the CIT and joint trainings are a step in the right direction, the effort her group hoped for hasn’t come to fruition when specifically addressing police encounters.\u003c/p>\n\u003cp>“Those programs can be expanded, not just to individuals who have mental illness but to everyone, really,” Boyd said. “If you would rather, when a crisis shows up in your home, have a neighbor respond to your crisis rather than an armed, militarized officer, then I think that needs to be a new service line that a collaboration between our health departments and our police departments could provide.”\u003c/p>\n\u003cp>The San Francisco Public Health Department declined to comment about police violence for this article.\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_11638142\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0021.jpg\">\u003cimg class=\"size-medium wp-image-11638142\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0021-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0021-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gwen Woods is embraced on Dec. 2, 2017, the second anniversary of her son's death in San Francisco. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Long-Term and Pervasive Impact\u003c/strong>\u003c/p>\n\u003cp>Asantewaa Boykin, a registered nurse and co-founder of \u003ca href=\"https://ww2.kqed.org/news/2017/09/22/meet-the-people-mobilizing-against-white-supremacy-in-the-bay-area/\">the Anti Police-Terror Project,\u003c/a> recalls her earliest memory of the police. It brings her back to being a young girl, as she watched an officer’s dog chew through a neighbor’s leg.\u003c/p>\n\u003cp>She still has nightmares about it.\u003c/p>\n\u003cp>“As someone who understands what witnessing violence does to health, as somebody who thinks through the greater implications of any one act of violence in a community, that certainly it affects the victim who’s involved,” Boyd said. “But it has collateral damage to the immediate community and to all those who are now at risk because that type of violence is deemed in some ways acceptable or OK.”\u003c/p>\n\u003cp>Images of police use of force reach farther than ever before. In some cases they appear at the touch of people’s fingertips while scrolling through their news feeds, and in some cases they’ve even appeared in \u003ca href=\"http://www.cnn.com/videos/us/2016/07/07/graphic-video-minnesota-police-shooting-philando-castile-ryan-young-pkg-nd.cnn\">real time on Facebook Live\u003c/a>.\u003c/p>\n\u003cp>“When you talk about trauma, [it can occur] knowing that someone down the street got murdered by police ... or when these videos go viral, and you think about how many people are impacted by these videos,” said Boykin.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>The first steps toward creating accessible healing for the communities who are most impacted by police violence begin with bringing in more diverse therapists and tailoring services toward the people who most often need them, according to Boykin.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.bls.gov/cps/cpsaat11.htm\">U.S. Department of Labor’s 2016 statistics\u003c/a>, 5.8 percent of psychologists are African-American, 4.2 percent are Asian and 6.9 percent are Latino.\u003c/p>\n\u003cp>“I know, for instance, I’ve seen a therapist, and I’m much more comfortable if that person resembles me,” Boykin said. “The traditional Western sense of therapy is not something that a lot of people of color can identify with or feel comfortable with.”\u003c/p>\n\u003cp>\u003cstrong>Taking Research into Their Own \u003c/strong>\u003cb>Hands\u003c/b>\u003c/p>\n\u003cp>Marya has teamed up with other health professionals to take a study, requested by the Justice for Mario Woods Coalition, into their own hands. They plan to explore levels of trauma faced by communities impacted by police violence, especially in cases where people do not feel they experienced justice.\u003c/p>\n\u003cp>“I have yet to hear anyone at the Department of Public Health in San Francisco speak up about these issues in a concerted, consistent way, to be that voice in the city demanding that not only are the police trained differently, but that there’s some accountability and transparency,” Marya said.\u003c/p>\n\u003cp>The \"justice study\" will begin with an online survey that Marya and her team members will analyze.\u003c/p>\n\u003cp>A separate study that was published last year, titled “\u003ca href=\"http://www.trustnottrauma.org\">SOS: Stress on the Streets\u003c/a>,” explored police practices in Ohio with a specific focus of the impact on black people. The study was conducted by three nonprofit organizations: \u003ca href=\"https://humanimpact.org\">Human Impact Partners\u003c/a>, \u003ca href=\"http://www.ohiojpc.org//\">Ohio Justice and Policy Center\u003c/a> and\u003ca href=\"http://ohorganizing.org\"> Ohio Organizing Collaborative\u003c/a>.\u003c/p>\n\u003cp>“This report shows that for many black people in the United States the perceived color of their skin means more uneasy interactions with police than others in our society, and stress and anxiety that in turn result in poorer physical and mental health,” it reads.\u003c/p>\n\u003cp>The report’s recommendations rang true with the calls from local health advocates: Involve public health departments to enhance transparency and study the health impacts of policing practices and help resolve systemic issues.\u003c/p>\n\u003cp>But Bilick said this approach is not apparent in most local public health departments.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"That first step of getting public health departments to even prioritize this as something that they should be collecting data on is a big jump from what people are doing now,\" Bilick said.\u003c/span>\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_11638143\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8853.jpg\">\u003cimg class=\"size-medium wp-image-11638143\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8853-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8853-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Police commissioner Joe Marshall sits in his office at the Alive and Free building in San Francisco on Sept. 19, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>The Question of the Role of Police\u003c/strong>\u003c/p>\n\u003cp>There are differing opinions as to whether police have a place in collaboration with health providers in the healing process from their impact.\u003c/p>\n\u003cp>Although Boykin would like to see more health care professionals facilitate healing from trauma induced by law enforcement, she does not want police institutions to be involved.\u003c/p>\n\u003cp>“That’s like asking someone who has been abused to go sit down and have a conversation with the person that abused them,” Boykin said. “We would not apply that equation in any other situation. It would be considered ridiculous.”\u003c/p>\n\u003cp>Marshall, on the other hand, believes police should be involved. “Absolutely, because they’ve caused a lot of damage,” he said. “This is what I tell people. Police aren’t going anywhere. So you gotta make it work. You gotta change it if you want to make it work.”\u003c/p>\n\u003cp>The next important focus for the department, he said, is getting all officers trained in crisis intervention. Currently about a quarter of the department is trained. He added, “I think we’re making strides here, but it's something you have to work at all the time.”\u003c/p>\n\u003cp>And some believe the police have more work to do when it comes to reform and transparency to allow people to truly heal.\u003c/p>\n\u003cp>“Without that accountability, there’s no reason for people to feel like they’re safe within their communities,” Marya said.\u003c/p>\n\u003cfigure id=\"attachment_11638144\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8910.jpg\">\u003cimg class=\"size-medium wp-image-11638144\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_8910-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_8910-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Community members hold signs at the Anti Police-Terror Project's monthly meeting, held in Frank H. Ozawa Plaza in Oakland on Sept. 20, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Community Fills the Gap\u003c/strong>\u003c/p>\n\u003cp>Thirty years ago, Marshall co-founded an organization, \u003ca href=\"https://stayaliveandfree.org\">Alive and Free\u003c/a>, which created a unique approach to addressing trauma in young people. He authored a prescription that treats violence like a social disease by identifying and addressing risk factors.\u003c/p>\n\u003cp>“Therapy is a bad word to them because they’ve been involved with therapists who look at them like they’re crazy,” Marshall said.\u003c/p>\n\u003cp>Through weekly peer meetings, he creates a sense of trust.\u003c/p>\n\u003cp>Marshall said he sees therapy-like results without labeling the meetings as such. It has become an outlet for young people to talk about issues they face without feeling judged.\u003c/p>\n\u003cp>“They’ve been to funerals, the neighborhood is decimated, death is all around them, their fathers are in jail and now they have a lot of emotional residue,” Marshall said. “These young people are faking it all the time because they’re hurting all the time. This is literally the walking wounded pretending like they got it all together. They don’t.”\u003c/p>\n\u003cp>Boykin, co-founder of the APTP, also helped to create an group with a goal of sustainability.\u003c/p>\n\u003cp>The coalition focuses on ending murder and violence against communities of color by law enforcement agents. Boykin described it as a multigenerational and multi-ethnic group of organizations and community members that is “unapologetically black-led.”\u003c/p>\n\u003cp>“It kind of started to feel like we were waiting for black folks to be murdered by police and then we were reacting to that murder, versus doing something that was sustainable,” Boykin said.\u003c/p>\n\u003cp>The coalition trains first responders to teach them how to treat injuries, conduct trauma-informed investigations and connect people with support and means of healing. The group believes this approach works as a preventative measure that addresses the need for healing before and after anticipated trauma.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">They provide those affected by police violence with their database of healers, such as acupuncturists, marriage family counselors, nurses and massage therapists to make available for victims and their families. The coalition holds monthly support groups with leaders who are people of color. \u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cfigure id=\"attachment_11638461\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0044.jpg\">\u003cimg class=\"size-medium wp-image-11638461\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/12/IMG_0044-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/12/IMG_0044-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A sign hangs at a gathering for the second anniversary of Mario Woods' death in San Francisco, California on Dec. 2, 2017. \u003ccite>(Audrey Garces/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Still, health advocates hope to alleviate some of this responsibility that has fallen on the community.\u003c/p>\n\u003cp>“It’s our job as health care professionals,” Boyd said. “This is the gap where community organizing has stepped in, but the weight of this belongs on health care professionals.”\u003c/p>\n\u003cp>Boyd also believes that health care professionals have the responsibility to give validity to the mental and physical effects police violence has on communities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“All of the rest of the people who hold fear, who hold shame, who don’t feel secure in their daily environment, that’s real and it’s not in your head,” Boyd said. “And it could affect you long term, and I think people are owed something because it will affect them long term.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Precision Medicine Skeptic: Are We Building 'Biological Tower of Babel'",
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"content": "\u003cp>The Mayo Clinic is building its future around high-tech approaches to research known as \"precision medicine.\" This involves gathering huge amounts of information from genetic tests, medical records and other data sources to ferret out unexpected ideas to advance health. But one longtime scientist at the Mayo Clinic isn't playing along.\u003c/p>\n\u003cp>Dr. \u003ca href=\"http://www.mayo.edu/research/faculty/joyner-michael-j-m-d/bio-00078027\">Michael Joyner\u003c/a> is a skeptical voice in a sea of eager advocates. Joyner's lab studies exercise. It is, fittingly enough, in a hospital building founded in the 1880s. While Mayo has built all sorts of new labs at its sprawling campus in Rochester, Minn., Joyner can conduct his work without glitzy DNA sequencers and other high-tech tools of precision medicine.\u003c/p>\n\u003cp>And it's not simply that he's an old-school devotee. He believes that the solution to our most pressing health problems lies in thinking about whole human beings, not breaking everything down to DNA sequences.\u003c/p>\n\u003cp>\"The enthusiasm for this [precision medicine] is occurring in a country where life expectancy is \u003ca href=\"https://www.npr.org/sections/health-shots/2017/12/21/572080314/life-expectancy-drops-again-as-opioid-deaths-surge-in-u-s\">actually falling\u003c/a>,\" he says as he walks through the old linoleum-tiled halls of St. Mary's hospital.\u003c/p>\n\u003cp>That fact alone leads Joyner to ask whether the money being poured into high-tech medical research is really solving the nation's stark health problems, like obesity, heart disease, high blood pressure, diabetes, Alzheimer's disease and cancer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Joyner says there are certainly appropriate places to use this technology, and he doesn't dispute the individual stories of success his colleagues tout. But he believes the best way to address the health concerns facing the nation is by studying — and treating — whole people, not by breaking the problems down to billions of genetic bits and pieces.\u003c/p>\n\u003cp>He practices what he preaches in both his personal life — his thorough exercise routine includes commuting by bicycle — and his physiology lab.\u003c/p>\n\u003cp>On the day I visited at the end of August, volunteer Greg Ruegsegger was outfitted with monitors, a catheter threaded into a vein and a mask to capture his breath. He would exercise to the point of exhaustion while scientists studied him. This is far more informative than any genetic test, Joyner says.\u003c/p>\n\u003cp>\"People have looked at 3,000 elite endurance athletes — these are people who compete in the Tour de France and win Olympic medals in cross-country skiing and distance running — and [scientists] have been unable to find any genetic marker for superior performance.\"\u003c/p>\n\u003cp>And when it comes to the health of ordinary people, Joyner talks about \u003ca href=\"http://www.bmj.com/content/349/bmj.g4887\">real-world studies\u003c/a>, which show that walking or biking to work has four- or fivefold more influence on a person's body mass index than that person's genetic profile.\u003c/p>\n\u003cp>Joyner is focused on how the body's systems work together during exercise, but the same interconnectedness applies to many diseases. That's why cancer drugs that target one biological pathway generally don't last long. Tumor cells simply find workarounds, exploiting the redundancies deeply embedded in biology. And that's why Joyner has so little faith in science that keeps trying to focus down on smaller and smaller details.\u003c/p>\n\u003cp>\"One of the things we have to ask ourselves when we get these big initiatives is, 'What's the definition of success?' \" he says.\u003c/p>\n\u003cp>Scientific discoveries alone don't do it for him. Doctors need to build effective treatments — and patients need to follow along. This is the promise of precision medicine in the long run, but Joyner has published articles (\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2344586?redirect=true\">like this one\u003c/a>) skeptical of the drive to collect vast piles of information, hoping to make sense of it later.\u003c/p>\n\u003cp>\"Is this just going to be a biological Tower of Babel,\" he asks, or will this information also lead to discoveries that translate beyond the laboratory and actually change public health for the better?\u003c/p>\n\u003cp>He doesn't doubt that DNA sequencing and other tools of precision medicine are useful in specific instances, such as for diagnosing rare diseases. There are a few uses in cancer treatment, but so far there has been just \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00188-6/abstract\">one randomized study\u003c/a> of patients assigned to treatments based on their tumor's DNA profile, and it showed no advantage over traditional medical judgment.\u003c/p>\n\u003cp>This isn't a popular point of view elsewhere at the Mayo Clinic, which is sinking hundreds of millions of dollars a year into precision medicine. The shiny new labs across campus seem a world apart from Joyner's physiology lab.\u003c/p>\n\u003cp>After my conversation with Joyner, Mayo public affairs officers eagerly led me to a series of scientists there who disagree with him. One stop was at the Medical Genome Facility.\u003c/p>\n\u003cp>This room is chock-full of machines that cost many hundreds of thousands of dollars apiece. They can analyze DNA from a person, a tumor or even a single human cell. They can read out an entire genome, or just a subset, which is called the exome.\u003c/p>\n\u003cp>\"I really do believe that understanding our genome is fundamental,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/cunningham-julie-m-ph-d/bio-00078368\">Julie Cunningham\u003c/a>, one of the facility's three co-directors. Like other scientists at Mayo, she has had swaths of her own exome sequenced.\u003c/p>\n\u003cp>\"I learned that by and large I'm really lucky, but I learned that I have two [genetic] variants that affect how I respond to particular drugs that are out there.\" She had actually known that before for one of those drugs, \"but now I know exactly why I have it and it's potentially serious. That has to be good. There's nothing wrong with that.\"\u003c/p>\n\u003cp>Bad drug reactions are a serious medical problem, so in principle, a genome profile should help reduce that risk. The reality, though, is that the vast majority of genomic tests for drug sensitivity \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351041/\">give ambiguous answers\u003c/a>.\u003c/p>\n\u003cp>One of the most carefully studied examples involves the blood thinner warfarin. Four separate studies show that people who got genomic testing for this susceptibility \u003ca href=\"https://www.nih.gov/news-events/nih-research-matters/genetic-testing-doesnt-improve-warfarin-dosing\">did no better\u003c/a> — \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2654820?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jama.2017.11465\">or only marginally better\u003c/a> — than patients whose dosages were determined by traditional strategies.\u003c/p>\n\u003cp>This lack of strong data is a problem for many areas of precision medicine.\u003c/p>\n\u003cp>\"Although we think conceptually this is going to be of high value, and it will ultimately improve health care with better quality and lower cost, we have to prove that,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/stewart-keith-m-b-ch-b/bio-00027952\">Keith Stewart\u003c/a>, a hematologist who directs Mayo's Center for Individualized Medicine. \"If it doesn't all pan out the way we expect that's OK. But I think there will be plenty of unexpected areas that we haven't conceptualized yet, so I think it's a very worthwhile investment on the taxpayers' point of view.\"\u003c/p>\n\u003cp>Whether precision medicine is going to be a boom or a bust, \"right now it's just speculation on both sides,\" he says.\u003c/p>\n\u003cp>\"It is somewhat inevitable that every person in this country will have their genome sequenced.\" he adds.\u003c/p>\n\u003cp>Gianrico Farrugia, a gastroenterologist who is chief executive officer of the Mayo Clinic in Florida, agrees.\u003c/p>\n\u003cp>\"What we're beginning to see is that technology is invading and replacing traditional testing,\" says Farrugia. For example, it is already used to determine treatments for lung cancer and diagnose rare diseases.\u003c/p>\n\u003cp>And, in any event, he says medicine is already moving aggressively into this new territory and there's no going back. \"That's not only wrong,\" he says, \"it's impossible.\"\u003c/p>\n\u003cp>With the momentum now built up behind this enterprise, precision medicine will be judged like much of modern medicine: in hindsight, after it becomes entrenched in clinical practice.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris via \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">email\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Will+Gathering+Vast+Troves+of+Information+Really+Lead+To+Better+Health%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Mayo Clinic is building its future around high-tech approaches to research known as \"precision medicine.\" This involves gathering huge amounts of information from genetic tests, medical records and other data sources to ferret out unexpected ideas to advance health. But one longtime scientist at the Mayo Clinic isn't playing along.\u003c/p>\n\u003cp>Dr. \u003ca href=\"http://www.mayo.edu/research/faculty/joyner-michael-j-m-d/bio-00078027\">Michael Joyner\u003c/a> is a skeptical voice in a sea of eager advocates. Joyner's lab studies exercise. It is, fittingly enough, in a hospital building founded in the 1880s. While Mayo has built all sorts of new labs at its sprawling campus in Rochester, Minn., Joyner can conduct his work without glitzy DNA sequencers and other high-tech tools of precision medicine.\u003c/p>\n\u003cp>And it's not simply that he's an old-school devotee. He believes that the solution to our most pressing health problems lies in thinking about whole human beings, not breaking everything down to DNA sequences.\u003c/p>\n\u003cp>\"The enthusiasm for this [precision medicine] is occurring in a country where life expectancy is \u003ca href=\"https://www.npr.org/sections/health-shots/2017/12/21/572080314/life-expectancy-drops-again-as-opioid-deaths-surge-in-u-s\">actually falling\u003c/a>,\" he says as he walks through the old linoleum-tiled halls of St. Mary's hospital.\u003c/p>\n\u003cp>That fact alone leads Joyner to ask whether the money being poured into high-tech medical research is really solving the nation's stark health problems, like obesity, heart disease, high blood pressure, diabetes, Alzheimer's disease and cancer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Joyner says there are certainly appropriate places to use this technology, and he doesn't dispute the individual stories of success his colleagues tout. But he believes the best way to address the health concerns facing the nation is by studying — and treating — whole people, not by breaking the problems down to billions of genetic bits and pieces.\u003c/p>\n\u003cp>He practices what he preaches in both his personal life — his thorough exercise routine includes commuting by bicycle — and his physiology lab.\u003c/p>\n\u003cp>On the day I visited at the end of August, volunteer Greg Ruegsegger was outfitted with monitors, a catheter threaded into a vein and a mask to capture his breath. He would exercise to the point of exhaustion while scientists studied him. This is far more informative than any genetic test, Joyner says.\u003c/p>\n\u003cp>\"People have looked at 3,000 elite endurance athletes — these are people who compete in the Tour de France and win Olympic medals in cross-country skiing and distance running — and [scientists] have been unable to find any genetic marker for superior performance.\"\u003c/p>\n\u003cp>And when it comes to the health of ordinary people, Joyner talks about \u003ca href=\"http://www.bmj.com/content/349/bmj.g4887\">real-world studies\u003c/a>, which show that walking or biking to work has four- or fivefold more influence on a person's body mass index than that person's genetic profile.\u003c/p>\n\u003cp>Joyner is focused on how the body's systems work together during exercise, but the same interconnectedness applies to many diseases. That's why cancer drugs that target one biological pathway generally don't last long. Tumor cells simply find workarounds, exploiting the redundancies deeply embedded in biology. And that's why Joyner has so little faith in science that keeps trying to focus down on smaller and smaller details.\u003c/p>\n\u003cp>\"One of the things we have to ask ourselves when we get these big initiatives is, 'What's the definition of success?' \" he says.\u003c/p>\n\u003cp>Scientific discoveries alone don't do it for him. Doctors need to build effective treatments — and patients need to follow along. This is the promise of precision medicine in the long run, but Joyner has published articles (\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2344586?redirect=true\">like this one\u003c/a>) skeptical of the drive to collect vast piles of information, hoping to make sense of it later.\u003c/p>\n\u003cp>\"Is this just going to be a biological Tower of Babel,\" he asks, or will this information also lead to discoveries that translate beyond the laboratory and actually change public health for the better?\u003c/p>\n\u003cp>He doesn't doubt that DNA sequencing and other tools of precision medicine are useful in specific instances, such as for diagnosing rare diseases. There are a few uses in cancer treatment, but so far there has been just \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00188-6/abstract\">one randomized study\u003c/a> of patients assigned to treatments based on their tumor's DNA profile, and it showed no advantage over traditional medical judgment.\u003c/p>\n\u003cp>This isn't a popular point of view elsewhere at the Mayo Clinic, which is sinking hundreds of millions of dollars a year into precision medicine. The shiny new labs across campus seem a world apart from Joyner's physiology lab.\u003c/p>\n\u003cp>After my conversation with Joyner, Mayo public affairs officers eagerly led me to a series of scientists there who disagree with him. One stop was at the Medical Genome Facility.\u003c/p>\n\u003cp>This room is chock-full of machines that cost many hundreds of thousands of dollars apiece. They can analyze DNA from a person, a tumor or even a single human cell. They can read out an entire genome, or just a subset, which is called the exome.\u003c/p>\n\u003cp>\"I really do believe that understanding our genome is fundamental,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/cunningham-julie-m-ph-d/bio-00078368\">Julie Cunningham\u003c/a>, one of the facility's three co-directors. Like other scientists at Mayo, she has had swaths of her own exome sequenced.\u003c/p>\n\u003cp>\"I learned that by and large I'm really lucky, but I learned that I have two [genetic] variants that affect how I respond to particular drugs that are out there.\" She had actually known that before for one of those drugs, \"but now I know exactly why I have it and it's potentially serious. That has to be good. There's nothing wrong with that.\"\u003c/p>\n\u003cp>Bad drug reactions are a serious medical problem, so in principle, a genome profile should help reduce that risk. The reality, though, is that the vast majority of genomic tests for drug sensitivity \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351041/\">give ambiguous answers\u003c/a>.\u003c/p>\n\u003cp>One of the most carefully studied examples involves the blood thinner warfarin. Four separate studies show that people who got genomic testing for this susceptibility \u003ca href=\"https://www.nih.gov/news-events/nih-research-matters/genetic-testing-doesnt-improve-warfarin-dosing\">did no better\u003c/a> — \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2654820?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jama.2017.11465\">or only marginally better\u003c/a> — than patients whose dosages were determined by traditional strategies.\u003c/p>\n\u003cp>This lack of strong data is a problem for many areas of precision medicine.\u003c/p>\n\u003cp>\"Although we think conceptually this is going to be of high value, and it will ultimately improve health care with better quality and lower cost, we have to prove that,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/stewart-keith-m-b-ch-b/bio-00027952\">Keith Stewart\u003c/a>, a hematologist who directs Mayo's Center for Individualized Medicine. \"If it doesn't all pan out the way we expect that's OK. But I think there will be plenty of unexpected areas that we haven't conceptualized yet, so I think it's a very worthwhile investment on the taxpayers' point of view.\"\u003c/p>\n\u003cp>Whether precision medicine is going to be a boom or a bust, \"right now it's just speculation on both sides,\" he says.\u003c/p>\n\u003cp>\"It is somewhat inevitable that every person in this country will have their genome sequenced.\" he adds.\u003c/p>\n\u003cp>Gianrico Farrugia, a gastroenterologist who is chief executive officer of the Mayo Clinic in Florida, agrees.\u003c/p>\n\u003cp>\"What we're beginning to see is that technology is invading and replacing traditional testing,\" says Farrugia. For example, it is already used to determine treatments for lung cancer and diagnose rare diseases.\u003c/p>\n\u003cp>And, in any event, he says medicine is already moving aggressively into this new territory and there's no going back. \"That's not only wrong,\" he says, \"it's impossible.\"\u003c/p>\n\u003cp>With the momentum now built up behind this enterprise, precision medicine will be judged like much of modern medicine: in hindsight, after it becomes entrenched in clinical practice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris via \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">email\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Will+Gathering+Vast+Troves+of+Information+Really+Lead+To+Better+Health%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Four Thought-Provoking Book Excerpts You May Have Missed",
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"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Here at \u003cem>Future of You\u003c/em> headquarters, also known as my desk, we've posted what we think are some compelling and thought-provoking \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/book-excerpts/\" target=\"_blank\" rel=\"noopener\">book excerpts\u003c/a> over the past couple of years. If you are looking to clear your post-New Year's Eve haze, give these a read ...\u003c/p>\n\u003cp>1. \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\">\u003cstrong>Stanford's Virtual Reality Lab Turned Me Into a Cow, Then Sent Me to the Slaughterhouse\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel='\"noopener'>\u003cimg class=\"aligncenter wp-image-150203\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/I-Am-a-Cow-1180x467.png\" alt=\"\" width=\"639\" height=\"253\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-1180x467.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-400x158.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-800x317.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-768x304.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow.png 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-960x380.png 960w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"We Have the Technology: How Biohackers, Foodies, Physicians, and Scientists are Transforming Human Perception, One Sense at a Time,\" by Kara Platoni\u003c/em>\u003c/p>\n\u003cp>If you become a nonhuman in virtual reality, will you gain empathy? This was Platoni's experience at Stanford's Virtual Human Interaction Lab, where she was, through the magic of VR, turned into a cow then unceremoniously killed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A wave of sadness and horror hits me with the word 'slaughterhouse.' The suddenness of the announcement, the feeling of being trapped, the guilt and responsibility I feel for my cow avatar, who I somehow feel is me ... it's remarkably heavy for having been in this virtual life only a few minutes.\"\u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\"> \u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>2. \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">\u003cstrong>In the Era of Instagram, Narcissism as the New Norm\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">\u003cimg class=\"aligncenter wp-image-304140 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/12/HillarySelfies-1020x675.jpg\" alt=\"\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-1020x675.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-800x530.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-768x508.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-1180x781.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-960x636.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-240x159.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-375x248.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-520x344.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"The Attention Merchants,\" by Tim Wu\u003c/em>\u003c/p>\n\u003cp>Social media has created an 'attention economy' that's \"devolved into a chaotic mutual admiration society, full of enterprising Narcissi,\" writes Wu. With the advent of the smartphone and Instagram, \"much of the power of a great film studio was now in every hand attached to a heart yearning for fame; not only could one create an image to rival those of the old icons of glamour, but one could put it on a platform where millions might potentially see it.\" This, Wu argues, \"warps our understanding of our own existence and its relation to others. That this should become the manner of being for us all is surely the definitive dystopic vision of late modernity.\"\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>3. \u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/28/how-technology-ruined-the-radiology-profession/\" target=\"_blank\" rel=\"noopener\">Has Technology Ruined the Radiology Profession?\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003ca style=\"font-weight: bold;background-color: transparent\" href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/radiology1-e1476734001207.jpg\">\u003cimg class=\"wp-image-264973 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/radiology1-1180x818.jpg\" alt=\"\" width=\"640\" height=\"444\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,\" by Bob Wachter\u003c/em>\u003c/p>\n\u003cp>Because radiology was the first medical specialty to computerize, what has happened to the profession is our canary in the digital coal mine, Wachter writes. Radiology was once the \"beating heart\" of hospitals, where \"everybody from the lowliest student to the loftiest transplant surgeon\" brought films for deciphering. Now? Game changing technology has created powerful new functionality that has some wondering if radiologists have not been turned into “disembodied functionaries, more akin to servicing technicians than professional colleagues.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/28/how-technology-ruined-the-radiology-profession/\" target=\"_blank\" rel=\"noopener\">Read the excerpt.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>4. \u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">\u003cimg class=\"wp-image-436849 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2029/11/abortion_genetics1-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-520x293.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"The Gene Machine,\" by Bonnie Rochman\u003c/em>\u003c/p>\n\u003cp>Advanced prenatal genetic testing has transformed every fetus into an \"at risk\" entity, says Rochman. \"While there are women who’d never opt for an abortion, it’s disingenuous to ignore the fact that terminating a pregnancy is one possible outcome of earlier, more sophisticated genetic tests. The issue of how people feel about disability and, in turn, how that impacts their decisions regarding abortion is an essential aspect of any discussion about advances in prenatal testing.\"\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>More excerpts from Future of You:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/will-computers-ever-be-able-to-make-diagnoses-as-well-as-physicians/\" target=\"_blank\" rel=\"noopener\">Will Computers Ever Be as Good as Physicians at Diagnosing Patients? \u003c/a>from “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,\" by Bob Wachter\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/29/clinical-trials-on-trial-the-ethics-of-withholding-life-saving-treatment/\" target=\"_blank\" rel=\"noopener\">The Ethics of Withholding Lifesaving Treatment\u003c/a>, from “Algorithms to Live By: The Computer Science of Human Decisions,” by Brian Christian and Tom Griffiths\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/07/can-taking-tylenol-help-you-get-over-a-romantic-breakup-maybe/\" target=\"_blank\" rel=\"noopener\">Taking Tylenol for Heartache: The Relationship Between Emotional and Physical Pain\u003c/a>, from \"We Have the Technology: How Biohackers, Foodies, Physicians, and Scientists are Transforming Human Perception, One Sense at a Time,\"\u003cem> \u003c/em>by Kara Platoni\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/08/23/the-online-life-as-both-liberation-and-imprisonment/\" target=\"_blank\" rel=\"noopener\">The Online Life, as Both Liberation and Imprisonment\u003c/a>, from \"The Four-Dimensional Human,\" by Laurence Scott\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/05/12/how-the-media-came-to-embrace-clickbait-an-internet-history/\" target=\"_blank\" rel=\"noopener\">How the Media Came to Embrace Clickbait: An Internet History\u003c/a>, from \"The Attention Merchants,\" by Tim Wu\u003c/li>\n\u003c/ul>\n\n",
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"excerpt": "Stanford's VR lab turns one author into a cow then kills her; digital narcissism as the new norm; advanced prenatal testing's real topic: abortion; and ... has technology ruined the radiology profession?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here at \u003cem>Future of You\u003c/em> headquarters, also known as my desk, we've posted what we think are some compelling and thought-provoking \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/book-excerpts/\" target=\"_blank\" rel=\"noopener\">book excerpts\u003c/a> over the past couple of years. If you are looking to clear your post-New Year's Eve haze, give these a read ...\u003c/p>\n\u003cp>1. \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\">\u003cstrong>Stanford's Virtual Reality Lab Turned Me Into a Cow, Then Sent Me to the Slaughterhouse\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel='\"noopener'>\u003cimg class=\"aligncenter wp-image-150203\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/I-Am-a-Cow-1180x467.png\" alt=\"\" width=\"639\" height=\"253\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-1180x467.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-400x158.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-800x317.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-768x304.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow.png 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/I-Am-a-Cow-960x380.png 960w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"We Have the Technology: How Biohackers, Foodies, Physicians, and Scientists are Transforming Human Perception, One Sense at a Time,\" by Kara Platoni\u003c/em>\u003c/p>\n\u003cp>If you become a nonhuman in virtual reality, will you gain empathy? This was Platoni's experience at Stanford's Virtual Human Interaction Lab, where she was, through the magic of VR, turned into a cow then unceremoniously killed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A wave of sadness and horror hits me with the word 'slaughterhouse.' The suddenness of the announcement, the feeling of being trapped, the guilt and responsibility I feel for my cow avatar, who I somehow feel is me ... it's remarkably heavy for having been in this virtual life only a few minutes.\"\u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\"> \u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/22/stanfords-virtual-reality-lab-turned-me-into-a-cow-then-sent-me-to-the-slaughterhouse/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>2. \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">\u003cstrong>In the Era of Instagram, Narcissism as the New Norm\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">\u003cimg class=\"aligncenter wp-image-304140 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/12/HillarySelfies-1020x675.jpg\" alt=\"\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-1020x675.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-800x530.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-768x508.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-1180x781.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-960x636.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-240x159.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-375x248.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/12/HillarySelfies-520x344.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"The Attention Merchants,\" by Tim Wu\u003c/em>\u003c/p>\n\u003cp>Social media has created an 'attention economy' that's \"devolved into a chaotic mutual admiration society, full of enterprising Narcissi,\" writes Wu. With the advent of the smartphone and Instagram, \"much of the power of a great film studio was now in every hand attached to a heart yearning for fame; not only could one create an image to rival those of the old icons of glamour, but one could put it on a platform where millions might potentially see it.\" This, Wu argues, \"warps our understanding of our own existence and its relation to others. That this should become the manner of being for us all is surely the definitive dystopic vision of late modernity.\"\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/03/for-first-week-january-on-social-media-the-self-as-its-own-object-of-worship/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>3. \u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/28/how-technology-ruined-the-radiology-profession/\" target=\"_blank\" rel=\"noopener\">Has Technology Ruined the Radiology Profession?\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003ca style=\"font-weight: bold;background-color: transparent\" href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/radiology1-e1476734001207.jpg\">\u003cimg class=\"wp-image-264973 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/radiology1-1180x818.jpg\" alt=\"\" width=\"640\" height=\"444\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,\" by Bob Wachter\u003c/em>\u003c/p>\n\u003cp>Because radiology was the first medical specialty to computerize, what has happened to the profession is our canary in the digital coal mine, Wachter writes. Radiology was once the \"beating heart\" of hospitals, where \"everybody from the lowliest student to the loftiest transplant surgeon\" brought films for deciphering. Now? Game changing technology has created powerful new functionality that has some wondering if radiologists have not been turned into “disembodied functionaries, more akin to servicing technicians than professional colleagues.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/28/how-technology-ruined-the-radiology-profession/\" target=\"_blank\" rel=\"noopener\">Read the excerpt.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>4. \u003cstrong>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">\u003cimg class=\"wp-image-436849 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2029/11/abortion_genetics1-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2029/11/abortion_genetics1-520x293.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cem>From \"The Gene Machine,\" by Bonnie Rochman\u003c/em>\u003c/p>\n\u003cp>Advanced prenatal genetic testing has transformed every fetus into an \"at risk\" entity, says Rochman. \"While there are women who’d never opt for an abortion, it’s disingenuous to ignore the fact that terminating a pregnancy is one possible outcome of earlier, more sophisticated genetic tests. The issue of how people feel about disability and, in turn, how that impacts their decisions regarding abortion is an essential aspect of any discussion about advances in prenatal testing.\"\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/\" target=\"_blank\" rel=\"noopener\">Read the excerpt\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>More excerpts from Future of You:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/will-computers-ever-be-able-to-make-diagnoses-as-well-as-physicians/\" target=\"_blank\" rel=\"noopener\">Will Computers Ever Be as Good as Physicians at Diagnosing Patients? \u003c/a>from “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,\" by Bob Wachter\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/29/clinical-trials-on-trial-the-ethics-of-withholding-life-saving-treatment/\" target=\"_blank\" rel=\"noopener\">The Ethics of Withholding Lifesaving Treatment\u003c/a>, from “Algorithms to Live By: The Computer Science of Human Decisions,” by Brian Christian and Tom Griffiths\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/07/can-taking-tylenol-help-you-get-over-a-romantic-breakup-maybe/\" target=\"_blank\" rel=\"noopener\">Taking Tylenol for Heartache: The Relationship Between Emotional and Physical Pain\u003c/a>, from \"We Have the Technology: How Biohackers, Foodies, Physicians, and Scientists are Transforming Human Perception, One Sense at a Time,\"\u003cem> \u003c/em>by Kara Platoni\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/08/23/the-online-life-as-both-liberation-and-imprisonment/\" target=\"_blank\" rel=\"noopener\">The Online Life, as Both Liberation and Imprisonment\u003c/a>, from \"The Four-Dimensional Human,\" by Laurence Scott\u003c/li>\n\u003cli>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/05/12/how-the-media-came-to-embrace-clickbait-an-internet-history/\" target=\"_blank\" rel=\"noopener\">How the Media Came to Embrace Clickbait: An Internet History\u003c/a>, from \"The Attention Merchants,\" by Tim Wu\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Daughter Helps Create Her Mother's Death Experience (Video)",
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"content": "\u003cp>https://www.youtube.com/watch?v=W86mLuvWU30&list=PLScdkSzWmRHz8HIA-v1MiTwla5jhqqpMn\u003c/p>\n\u003cp>As a professional designer, Elaine Fong has worked with many brands. But, she asked at this \u003ca href=\"https://www.tedxsanfrancisco.com/\" target=\"_blank\" rel=\"noopener\">TEDx San Francisco\u003c/a> talk in October, \"What happens when the experience you've been asked to design is death, and the face behind that brand is your very own mother?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'She was so happy. She was glowing the whole night.'\u003c/aside>\n\u003cp>The question presented itself to Fong and her family after her mother was diagnosed with stage 4 cancer and decided to forego her remaining months of life, as was her right under Washington state's \u003ca href=\"https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct\" target=\"_blank\" rel=\"noopener\">Death With Dignity Act. \u003c/a>The law allows patients with less than six months to live to end their lives by taking a lethal dose of medication.\u003c/p>\n\u003cp>The 21-minute presentation above encompasses all the aching drama and emotional devastation you might find in such a situation, including a doctor who won't sign off on her mother's request and her mom's description of what it's like to suffer from stage 4 cancer: \"My bones are on fire and everywhere under my skin is burning, and every time I move it just makes it worse.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you could design your own death, what would you want the experience to be like, and how would you want it to feel?'\u003ccite>Elaine Fong, TEDx presenter\u003c/cite>\u003c/aside>\n\u003cp>Yet, there are beautiful and even celebratory moments, too\u003cb>. \u003c/b>Because her mother was able to choose the time and place of her death, the family was able to help her experience her last days exactly as she wished.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"She was so happy,\" Fong says of her mom's mood during a dinner party the night before her death. \"She was glowing the whole night.\"\u003c/p>\n\u003cp>The next day, her mom took a cupful of medication, \"with two hands, and pounded it like a shot of whiskey. She looked at my dad and smiled, closed her eyes, and in 45 minutes, she was gone.\"\u003c/p>\n\u003cp>This is one of a very few TED talks we have published this year. I saw it live, surrounded by weeping audience members, and it was not hard to imagine many thinking seriously about Fong's\u003cb> \u003c/b>challenge:\u003c/p>\n\u003cp>\"If you could design your own death, what would you want the experience to be like, and how would you want it to feel?\"\u003c/p>\n\u003cp>According to \u003ca href=\"https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct/DeathwithDignityData\" target=\"_blank\" rel=\"noopener\">annual reports\u003c/a> compiled by Washington's department of health, the number of state residents who have opted to take lethal medication under the Death With Dignity Act has risen from 36 in 2009 to 192 in 2016.\u003c/p>\n\u003cp>A handful of \u003ca href=\"https://www.deathwithdignity.org/learn/death-with-dignity-acts/\" target=\"_blank\" rel=\"noopener\">states\u003c/a>, including\u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/07/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going/\" target=\"_blank\" rel=\"noopener\"> California\u003c/a>, have passed similar legislation, and many legislatures \u003ca href=\"https://www.deathwithdignity.org/take-action/\" target=\"_blank\" rel=\"noopener\">around the country\u003c/a> are currently considering their own versions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>How would \u003cem>you\u003c/em> design your own death?\u003c/p>\n\n",
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"excerpt": "Her mother's cancer diagnosis forced brand designer Elaine Fong to answer the question, 'What happens when the experience you've been asked to design is death, and the face behind that brand is your very own mother?'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/W86mLuvWU30'\n title='//www.youtube.com/embed/W86mLuvWU30'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>As a professional designer, Elaine Fong has worked with many brands. But, she asked at this \u003ca href=\"https://www.tedxsanfrancisco.com/\" target=\"_blank\" rel=\"noopener\">TEDx San Francisco\u003c/a> talk in October, \"What happens when the experience you've been asked to design is death, and the face behind that brand is your very own mother?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'She was so happy. She was glowing the whole night.'\u003c/aside>\n\u003cp>The question presented itself to Fong and her family after her mother was diagnosed with stage 4 cancer and decided to forego her remaining months of life, as was her right under Washington state's \u003ca href=\"https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct\" target=\"_blank\" rel=\"noopener\">Death With Dignity Act. \u003c/a>The law allows patients with less than six months to live to end their lives by taking a lethal dose of medication.\u003c/p>\n\u003cp>The 21-minute presentation above encompasses all the aching drama and emotional devastation you might find in such a situation, including a doctor who won't sign off on her mother's request and her mom's description of what it's like to suffer from stage 4 cancer: \"My bones are on fire and everywhere under my skin is burning, and every time I move it just makes it worse.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you could design your own death, what would you want the experience to be like, and how would you want it to feel?'\u003ccite>Elaine Fong, TEDx presenter\u003c/cite>\u003c/aside>\n\u003cp>Yet, there are beautiful and even celebratory moments, too\u003cb>. \u003c/b>Because her mother was able to choose the time and place of her death, the family was able to help her experience her last days exactly as she wished.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"She was so happy,\" Fong says of her mom's mood during a dinner party the night before her death. \"She was glowing the whole night.\"\u003c/p>\n\u003cp>The next day, her mom took a cupful of medication, \"with two hands, and pounded it like a shot of whiskey. She looked at my dad and smiled, closed her eyes, and in 45 minutes, she was gone.\"\u003c/p>\n\u003cp>This is one of a very few TED talks we have published this year. I saw it live, surrounded by weeping audience members, and it was not hard to imagine many thinking seriously about Fong's\u003cb> \u003c/b>challenge:\u003c/p>\n\u003cp>\"If you could design your own death, what would you want the experience to be like, and how would you want it to feel?\"\u003c/p>\n\u003cp>According to \u003ca href=\"https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct/DeathwithDignityData\" target=\"_blank\" rel=\"noopener\">annual reports\u003c/a> compiled by Washington's department of health, the number of state residents who have opted to take lethal medication under the Death With Dignity Act has risen from 36 in 2009 to 192 in 2016.\u003c/p>\n\u003cp>A handful of \u003ca href=\"https://www.deathwithdignity.org/learn/death-with-dignity-acts/\" target=\"_blank\" rel=\"noopener\">states\u003c/a>, including\u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/07/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going/\" target=\"_blank\" rel=\"noopener\"> California\u003c/a>, have passed similar legislation, and many legislatures \u003ca href=\"https://www.deathwithdignity.org/take-action/\" target=\"_blank\" rel=\"noopener\">around the country\u003c/a> are currently considering their own versions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>How would \u003cem>you\u003c/em> design your own death?\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feeling Blue Around the Holidays? You're Not Alone",
"title": "Feeling Blue Around the Holidays? You're Not Alone",
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"content": "\u003cp>This time of the year brings a lot of changes to the usual day-to-day life of hundreds of millions of people: The weather is colder, trees are naked, snowy days become plentiful and friendly critters are less visible around the neighborhood. Especially in the Western Hemisphere, this time of the year is also linked to a lot of joyous celebrations and traditions. Most children and many adults have been excited for this time of the year to come for months, and they love the aura of celebrations, with their gatherings, gifts, cookies, emails and cards.\u003c/p>\n\u003caside class=\"pullquote alignright\">While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting.\u003c/aside>\n\u003cp>Alas, there are also millions who have to deal with darker emotions as the world literally darkens around them.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.psychologytoday.com/blog/evidence-based-living/201712/what-we-know-about-the-holiday-blues\" target=\"_blank\" rel=\"noopener\">holiday blues\u003c/a> – that feeling of being in a lower or more anxious mood amid the significant change in our environment and the multitude of stressors that the holidays can bring – is a phenomenon that is yet to be researched thoroughly. However, as academic psychiatrists and neuroscience researchers, we have seen how several factors contribute to this experience.\u003c/p>\n\u003cp>\u003cstrong>Why feel blue in the red and green season?\u003c/strong>\u003c/p>\n\u003cp>There are many reasons to feel stressed or even downright overwhelmed during this time of year, in addition to the expectations set around us.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"2WRTWL17rLowdkqqZ0Ov6Hyxeef7nWVh\"]Memories of holidays past, either fond or sad, can create a sense of loss this time of year. We may find ourselves missing people who are no longer with us, and carrying on the same traditions without them can be a strong reminder of their absence.\u003c/p>\n\u003cp>The sense of burden or obligation, both socially or financially, can be significant. We can get caught up in the commercial aspects of gift giving, wanting to find that perfect item for family and friends. Many set their sights on special gifts, and we often can feel stretched thin trying to find a balance between making our loved ones happy and keeping our bank accounts from being in the black.\u003c/p>\n\u003cp>It’s also a time for gathering with those close to us, which can stir up many emotions, both good and bad. Some may find themselves away from or without close connections and end up isolated and withdrawn, further disconnected from others. On the other hand, many people find themselves feeling overwhelmed by the combination of potlucks and Secret Santas stacking up through multiple invitations, be it at school, work, or from friends and family – leaving us with the difficult position of not wanting to disappoint others, while not getting totally depleted by all the constant socializing.\u003c/p>\n\u003cp>\u003cstrong>Great expectations\u003c/strong>\u003c/p>\n\u003cp>[contextly_sidebar id=\"A4J6sCzzeaq033SaQDb2urG0j3Nl9TdB\"]People often feel disappointed when reality does not meet expectations. The larger the mismatch, the worse the negative feelings. One of us (Arash) often finds himself telling his patients: Childhood fairy tales can set an unrealistic bar in our minds about life. I wish we were told more real stories, taking the bad with the good, as we would get hurt less when faced with difficult realities of life, and learn how to especially appreciate our good fortunes.\u003c/p>\n\u003cp>These days viewers are showered with Christmas and New Year’s Eve movies, almost all of which sound and feel like fairy tales. People get married, get rich, fall in love or reconnect with their loved ones. Even unhappy events within “A Christmas Carol” conclude with a happy ending. These all, besides exposure to only happy moments and beautiful gifts (courtesy of Santa), dazzling Christmas decorations, and picturesque family scenes on social media, often set an unrealistic expectation for how this time of the year “should” feel.\u003c/p>\n\u003cp>Reality is different, though, and at its best is not always as colorful. There may be disagreements about hows, wheres, whats and whos of the celebration, and not all family members, friends and relatives get along well at parties. And as we feel lonelier, we may find ourselves spending more time immersed in TV and social media, leading to more exposure to unrealistic views of the holidays and feeling all the worse about our situation.\u003c/p>\n\u003cp>\u003cstrong>When is blue a red flag?\u003c/strong>\u003c/p>\n\u003cp>While many experience the more transient “holiday blues” this time of year, it is important not to miss more serious conditions like seasonal mood changes, which in its most severe case leads to clinical depression, including \u003ca href=\"https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml\" target=\"_blank\" rel=\"noopener\">Seasonal Affective Disorder\u003c/a>. SAD consists of episodes of depression or a worsening of existing depression during the late fall and early winter. The person may feel depressed and hopeless, or they may find it difficult to focus, sleep, or be motivated – they can even feel suicidal. As our emotions can color our thoughts and memories, a depressed person may remember more negative memories, have a more negative perception and interpretation of the events, and feel upset about the holidays.\u003c/p>\n\u003cp>In such cases, the sadness is “coincident” with the holidays and not caused solely by its circumstances. It is important to seek professional help with SAD, as we have effective treatments available, such as medications and \u003ca href=\"https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604\" target=\"_blank\" rel=\"noopener\">light therapy\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>What to do to minimize the blues?\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Set realistic expectations: One readily available strategy is simply reframing the beliefs we have about what the holidays “should” be like. Not all parties will go perfectly. Some decorations may break, or kids may wake up grumpy or not be exhilarated by their gifts – but it doesn’t have to stop us from enjoying all the good moments.\u003c/li>\n\u003cli>Set firm boundaries: Too many invitations to social events? Too many financial demands? Set clear limits about what you are able and willing to do, whether that means declining some social events and setting your own limit on spending this year, focusing more on meaningful experiences over expense. This can be spending time with loved ones or getting creative with homemade gifts.\u003c/li>\n\u003cli>Feeling alone? There are many ways to steer clear of isolating this time of year. Reaching out to friends, volunteering at animal shelters, local charities or attending community meetups or religious events can be a great way to stay connected while also bringing happiness to ourselves and others.\u003c/li>\n\u003cli>Making new memories: Starting a new tradition, either solo or with loved ones, can help create fond new memories of the holidays, no longer overshadowed by the past.\u003c/li>\n\u003cli>Take care of yourself: It’s important to remember the value of self-care, including eating and drinking in moderation (as alcohol can worsen a depressed mood), exercising (even a short walk), and treating yourself this holiday season by doing something you enjoy.\u003c/li>\n\u003c/ul>\n\u003cp>While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting. It also impairs daily functioning. For these symptoms it is often helpful and necessary to seek professional help. This can consist of counseling or use of medications, or both, to help treat symptoms.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Linda Saab is an Assistant Professor of Psychiatry at Wayne State University. Arash Javanbakht is an Assistant Professor of Psychiatry at Wayne State University. This article was originally published in \u003ca href=\"http://theconversation.com/\">The Conversation\u003c/a> on Nov. 21, 2017. Read the \u003ca href=\"https://theconversation.com/what-psychiatrists-have-to-say-about-holiday-blues-89210\">original article\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This time of the year brings a lot of changes to the usual day-to-day life of hundreds of millions of people: The weather is colder, trees are naked, snowy days become plentiful and friendly critters are less visible around the neighborhood. Especially in the Western Hemisphere, this time of the year is also linked to a lot of joyous celebrations and traditions. Most children and many adults have been excited for this time of the year to come for months, and they love the aura of celebrations, with their gatherings, gifts, cookies, emails and cards.\u003c/p>\n\u003caside class=\"pullquote alignright\">While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting.\u003c/aside>\n\u003cp>Alas, there are also millions who have to deal with darker emotions as the world literally darkens around them.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.psychologytoday.com/blog/evidence-based-living/201712/what-we-know-about-the-holiday-blues\" target=\"_blank\" rel=\"noopener\">holiday blues\u003c/a> – that feeling of being in a lower or more anxious mood amid the significant change in our environment and the multitude of stressors that the holidays can bring – is a phenomenon that is yet to be researched thoroughly. However, as academic psychiatrists and neuroscience researchers, we have seen how several factors contribute to this experience.\u003c/p>\n\u003cp>\u003cstrong>Why feel blue in the red and green season?\u003c/strong>\u003c/p>\n\u003cp>There are many reasons to feel stressed or even downright overwhelmed during this time of year, in addition to the expectations set around us.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Memories of holidays past, either fond or sad, can create a sense of loss this time of year. We may find ourselves missing people who are no longer with us, and carrying on the same traditions without them can be a strong reminder of their absence.\u003c/p>\n\u003cp>The sense of burden or obligation, both socially or financially, can be significant. We can get caught up in the commercial aspects of gift giving, wanting to find that perfect item for family and friends. Many set their sights on special gifts, and we often can feel stretched thin trying to find a balance between making our loved ones happy and keeping our bank accounts from being in the black.\u003c/p>\n\u003cp>It’s also a time for gathering with those close to us, which can stir up many emotions, both good and bad. Some may find themselves away from or without close connections and end up isolated and withdrawn, further disconnected from others. On the other hand, many people find themselves feeling overwhelmed by the combination of potlucks and Secret Santas stacking up through multiple invitations, be it at school, work, or from friends and family – leaving us with the difficult position of not wanting to disappoint others, while not getting totally depleted by all the constant socializing.\u003c/p>\n\u003cp>\u003cstrong>Great expectations\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>People often feel disappointed when reality does not meet expectations. The larger the mismatch, the worse the negative feelings. One of us (Arash) often finds himself telling his patients: Childhood fairy tales can set an unrealistic bar in our minds about life. I wish we were told more real stories, taking the bad with the good, as we would get hurt less when faced with difficult realities of life, and learn how to especially appreciate our good fortunes.\u003c/p>\n\u003cp>These days viewers are showered with Christmas and New Year’s Eve movies, almost all of which sound and feel like fairy tales. People get married, get rich, fall in love or reconnect with their loved ones. Even unhappy events within “A Christmas Carol” conclude with a happy ending. These all, besides exposure to only happy moments and beautiful gifts (courtesy of Santa), dazzling Christmas decorations, and picturesque family scenes on social media, often set an unrealistic expectation for how this time of the year “should” feel.\u003c/p>\n\u003cp>Reality is different, though, and at its best is not always as colorful. There may be disagreements about hows, wheres, whats and whos of the celebration, and not all family members, friends and relatives get along well at parties. And as we feel lonelier, we may find ourselves spending more time immersed in TV and social media, leading to more exposure to unrealistic views of the holidays and feeling all the worse about our situation.\u003c/p>\n\u003cp>\u003cstrong>When is blue a red flag?\u003c/strong>\u003c/p>\n\u003cp>While many experience the more transient “holiday blues” this time of year, it is important not to miss more serious conditions like seasonal mood changes, which in its most severe case leads to clinical depression, including \u003ca href=\"https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml\" target=\"_blank\" rel=\"noopener\">Seasonal Affective Disorder\u003c/a>. SAD consists of episodes of depression or a worsening of existing depression during the late fall and early winter. The person may feel depressed and hopeless, or they may find it difficult to focus, sleep, or be motivated – they can even feel suicidal. As our emotions can color our thoughts and memories, a depressed person may remember more negative memories, have a more negative perception and interpretation of the events, and feel upset about the holidays.\u003c/p>\n\u003cp>In such cases, the sadness is “coincident” with the holidays and not caused solely by its circumstances. It is important to seek professional help with SAD, as we have effective treatments available, such as medications and \u003ca href=\"https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604\" target=\"_blank\" rel=\"noopener\">light therapy\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>What to do to minimize the blues?\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Set realistic expectations: One readily available strategy is simply reframing the beliefs we have about what the holidays “should” be like. Not all parties will go perfectly. Some decorations may break, or kids may wake up grumpy or not be exhilarated by their gifts – but it doesn’t have to stop us from enjoying all the good moments.\u003c/li>\n\u003cli>Set firm boundaries: Too many invitations to social events? Too many financial demands? Set clear limits about what you are able and willing to do, whether that means declining some social events and setting your own limit on spending this year, focusing more on meaningful experiences over expense. This can be spending time with loved ones or getting creative with homemade gifts.\u003c/li>\n\u003cli>Feeling alone? There are many ways to steer clear of isolating this time of year. Reaching out to friends, volunteering at animal shelters, local charities or attending community meetups or religious events can be a great way to stay connected while also bringing happiness to ourselves and others.\u003c/li>\n\u003cli>Making new memories: Starting a new tradition, either solo or with loved ones, can help create fond new memories of the holidays, no longer overshadowed by the past.\u003c/li>\n\u003cli>Take care of yourself: It’s important to remember the value of self-care, including eating and drinking in moderation (as alcohol can worsen a depressed mood), exercising (even a short walk), and treating yourself this holiday season by doing something you enjoy.\u003c/li>\n\u003c/ul>\n\u003cp>While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting. It also impairs daily functioning. For these symptoms it is often helpful and necessary to seek professional help. This can consist of counseling or use of medications, or both, to help treat symptoms.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Psychedelic drugs are getting a makeover, with scientists exploring their potential in treating debilitating conditions like cluster headaches, addiction or anxiety, with promising results.\u003c/p>\n\u003cp>That's despite the fact that very few researchers are legally allowed to study psychedelics, largely because of LSD's decades-old reputation as a counterculture drug that sparked bad trips.\u003c/p>\n\u003cp>Back in the 1960s, LSD was touted as a tool to shed social conventions and fast-forward to enlightenment – or as LSD advocate Timothy Leary memorably said, \"Turn on, tune in, drop out.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"Y62bP7N4rAZf0wVWIiXnJDweibkHKwpr\"]He was hardly the first to feel the chemical's allure. Back in the 1930s, Swiss chemist Albert Hofmann had shelved LSD after first testing it as a treatment for heart disease. But he couldn't shake the feeling that there was something more to it. After accidentally ingesting a bit and having a mild psychedelic experience, Hofmann decided to go further.\u003c/p>\n\u003cp>He eats 250 micrograms of LSD and, scientist that he is, starts\u003ca href=\"https://www.maps.org/images/pdf/books/lsdmyproblemchild.pdf\"> journaling his experience\u003c/a>. He only gets one entry down before he starts having really intense hallucinations. As he bikes home, he feels like time and space are standing still and objects around him are warping and wavering in weird shapes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next day, he writes, \"A sensation of well-being and renewed life flowed through me... everything glistened and sparkled in a fresh light.\"\u003c/p>\n\u003cp>LSD seems to shut off certain controls in the brain, allowing signals from one part of the brain to flow unchecked to other regions – particularly the regions that process sensory inputs from the outside world and the regions that define our sense of self. This might explain \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">why LSD can cause hallucinations\u003c/a>. It's also why it could plausibly be beneficial to treat depression or anxiety, allowing signals in the brain to bypass pathways that aren't working so well.\u003c/p>\n\u003cp>Years of experimentation with LSD both in the laboratory and as a recreational drug suggest that it is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/\">physically and mentally safe\u003c/a> for healthy individuals. But it can also bring on terrifying hallucinations and sensations, including anxiety and paranoia, especially if people aren't prepared for the experience.\u003c/p>\n\u003cp>In the 1950s, the \u003ca href=\"https://www.npr.org/sections/pictureshow/2010/12/01/131724898/lsd-testing\">U.S. Army\u003c/a> tested LSD's potential to incapacitate enemy soldiers, but it turned out to be too expensive and difficult to deliver by aerosol. The CIA also tested it as tool for mind control by administering it to people, sometimes illegally and without their knowledge or consent, in the notorious \u003ca href=\"https://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">Project MKUltra\u003c/a>.\u003c/p>\n\u003cp>In the early 1960s, it was embraced by a growing counterculture movement searching for mind-altering experiences through art and music from groups like Jefferson Airplane and the Grateful Dead. LSD became simultaneously the most studied psychoactive drug in history and a leading cause for young people ending up in the emergency room. When the federal government \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">banned LSD\u003c/a> as a dangerous drug in 1971, it also restricted any further research on the drug and other known psychedelics.\u003c/p>\n\u003cp>But scientists hadn't forgotten its early promise.\u003c/p>\n\u003cp>Researchers have successfully fought for approval to study LSD, as well as other psychedelics such as psilocybin (the active compound in magic mushrooms) and MDMA, also known as the club drug ecstasy.\u003c/p>\n\u003cp>Carefully controlled studies have shown that LSD helps relieve debilitating cluster headaches, that \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/03/504136736/how-a-psychedelic-drug-helps-cancer-patients-overcome-anxiety\">psilocybin alleviates depression\u003c/a> in terminal cancer patients, and that \u003ca href=\"https://www.npr.org/2015/09/13/439963019/researchers-turn-to-popular-club-drug-to-treat-ptsd\">MDMA can help relieve the trauma of PTSD\u003c/a>. Earlier this year, the FDA gave MDMA a \"\u003ca href=\"https://www.maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials\">breakthrough therapy\u003c/a>\" designation, fast-tracking its path to Phase 3 clinical trials and and if all goes well, approval as a legal treatment.\u003c/p>\n\u003cp>\u003cem>Angus Chen is a journalist in New York. He's on Twitter @angrchen.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Freddy Arenas is an \u003ca href=\"http://www.freddyarenas.com/\">independent director\u003c/a> who has created animations for \u003c/em>The New York Times, California Sunday Magazine\u003cem>,\u003c/em> Google\u003cem> and \u003c/em>HBO Documentaries\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> Meredith Rizzo produced this animation for NPR.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=VIDEO%3A+For+LSD%2C+What+A+Long+Strange+Trip+It%27s+Been&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next day, he writes, \"A sensation of well-being and renewed life flowed through me... everything glistened and sparkled in a fresh light.\"\u003c/p>\n\u003cp>LSD seems to shut off certain controls in the brain, allowing signals from one part of the brain to flow unchecked to other regions – particularly the regions that process sensory inputs from the outside world and the regions that define our sense of self. This might explain \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">why LSD can cause hallucinations\u003c/a>. It's also why it could plausibly be beneficial to treat depression or anxiety, allowing signals in the brain to bypass pathways that aren't working so well.\u003c/p>\n\u003cp>Years of experimentation with LSD both in the laboratory and as a recreational drug suggest that it is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/\">physically and mentally safe\u003c/a> for healthy individuals. But it can also bring on terrifying hallucinations and sensations, including anxiety and paranoia, especially if people aren't prepared for the experience.\u003c/p>\n\u003cp>In the 1950s, the \u003ca href=\"https://www.npr.org/sections/pictureshow/2010/12/01/131724898/lsd-testing\">U.S. Army\u003c/a> tested LSD's potential to incapacitate enemy soldiers, but it turned out to be too expensive and difficult to deliver by aerosol. The CIA also tested it as tool for mind control by administering it to people, sometimes illegally and without their knowledge or consent, in the notorious \u003ca href=\"https://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">Project MKUltra\u003c/a>.\u003c/p>\n\u003cp>In the early 1960s, it was embraced by a growing counterculture movement searching for mind-altering experiences through art and music from groups like Jefferson Airplane and the Grateful Dead. LSD became simultaneously the most studied psychoactive drug in history and a leading cause for young people ending up in the emergency room. When the federal government \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">banned LSD\u003c/a> as a dangerous drug in 1971, it also restricted any further research on the drug and other known psychedelics.\u003c/p>\n\u003cp>But scientists hadn't forgotten its early promise.\u003c/p>\n\u003cp>Researchers have successfully fought for approval to study LSD, as well as other psychedelics such as psilocybin (the active compound in magic mushrooms) and MDMA, also known as the club drug ecstasy.\u003c/p>\n\u003cp>Carefully controlled studies have shown that LSD helps relieve debilitating cluster headaches, that \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/03/504136736/how-a-psychedelic-drug-helps-cancer-patients-overcome-anxiety\">psilocybin alleviates depression\u003c/a> in terminal cancer patients, and that \u003ca href=\"https://www.npr.org/2015/09/13/439963019/researchers-turn-to-popular-club-drug-to-treat-ptsd\">MDMA can help relieve the trauma of PTSD\u003c/a>. Earlier this year, the FDA gave MDMA a \"\u003ca href=\"https://www.maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials\">breakthrough therapy\u003c/a>\" designation, fast-tracking its path to Phase 3 clinical trials and and if all goes well, approval as a legal treatment.\u003c/p>\n\u003cp>\u003cem>Angus Chen is a journalist in New York. He's on Twitter @angrchen.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Freddy Arenas is an \u003ca href=\"http://www.freddyarenas.com/\">independent director\u003c/a> who has created animations for \u003c/em>The New York Times, California Sunday Magazine\u003cem>,\u003c/em> Google\u003cem> and \u003c/em>HBO Documentaries\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> Meredith Rizzo produced this animation for NPR.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=VIDEO%3A+For+LSD%2C+What+A+Long+Strange+Trip+It%27s+Been&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean?",
"title": "A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean?",
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"content": "\u003cp>You may have seen recent news of a survey finding that 27 percent of California youth ages 12 to 17 are \"gender nonconforming.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Gender nonconforming is not a synonym for transgender. Rather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example.'\u003ccite>Kristina Olson, University of Washington.\u003c/cite>\u003c/aside>\n\u003cp>That sounds pretty high. I might even put the word \"whopping\" before \"27 percent.\"\u003c/p>\n\u003cp>But I have to say, I've been covering the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">gender story\u003c/a> for more than a year, and when I saw the headlines, I wasn't \u003cem>quite\u003c/em> sure what gender nonconforming meant. Gender terminology, like gender itself these days, can be fairly fluid.\u003c/p>\n\u003cp>So here is the exact question that was asked of California adolescents:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">A person’s appearance, style, dress, or the way they walk or talk may affect how people describe them. How do you think other people at school would describe you? \u003c/span>\u003c/p>\n\u003cp>Very feminine\u003c/p>\n\u003cp>Mostly feminine\u003c/p>\n\u003cp>Equally feminine and masculine\u003c/p>\n\u003cp>Mostly masculine\u003c/p>\n\u003cp>Very masculine\u003c/p>\u003c/blockquote>\n\u003cp>This is a measure of what gender researchers call \"gender expression,\" or the way individuals manifest what you might call the trappings of masculinity and femininity: clothes, hair, makeup, posture. As some of the UCLA researchers involved in the survey put it, those who are \"seen as resisting dominant expectations around gender expression\" are considered gender nonconforming.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype.”\u003ccite>Alison Gill, Advocates for Youth\u003c/cite>\u003c/aside>\n\u003cp>You might think that someone who is gender nonconforming is necessarily transgender. But that is not the case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“ ‘Gender nonconforming' \" is not a synonym for transgender,” says Kristina Olson, d\u003c/span>\u003cspan style=\"font-weight: 400\">irector of the TransYouth Project at the University of Washington. \u003c/span>\u003cspan style=\"font-weight: 400\">“R\u003c/span>\u003cspan style=\"font-weight: 400\">ather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example\u003c/span>\u003cspan style=\"font-weight: 400\">.\"\u003c/span>\u003c/p>\n\u003cp>Many people may also confound gender nonconformity with being lesbian, gay or bisexual. But Alison Gill, a consultant on gender for the nonprofit Advocates for Youth, says \u003ca href=\"http://advocatesforyouth.org/storage/advfy/documents/YRBSS.pdf\" target=\"_blank\" rel=\"noopener\">research\u003c/a> shows most gender nonconforming kids are actually heterosexual.\u003c/p>\n\u003cp>\"There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype,” she said.\u003c/p>\n\u003cp>In other words, you can be gender nonconforming without being L, G, B or T.\u003c/p>\n\u003cp>\u003cstrong>Study Results\u003c/strong>\u003c/p>\n\u003cp>The gender expression question was included on the recent \u003ca href=\"http://healthpolicy.ucla.edu/chis/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">California Health Interview Survey\u003c/a>, conducted by UCLA on a continuous basis. The telephone survey covers dozens of health topics.\u003c/p>\n\u003cp>The CHIS has been going strong since 2001, but this was the first time a question on either youth gender identity or gender expression had been included.\u003c/p>\n\u003cp>Why now?\u003c/p>\n\u003caside class=\"pullquote alignright\">'A lot of bullying is around expression and not sexuality. A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.' \u003ccite>Phil Hammack, University of California, Santa Cruz\u003c/cite>\u003c/aside>\n\u003cp>Researchers at UCLA's Center for Health Policy Research and The Williams Institute, which conducts research on sexual orientation and gender identity law, said in a health policy \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2017/gncadolescents-factsheet-dec2017.pdf\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a> that levels of gender conformity are \"known to be a particularly salient factor in the safety and well-being of youth. Yet, data about gender nonconforming youth remain rare.\"\u003c/p>\n\u003cp>The question was asked of 1,594 adolescents, ages 12 to 17, across California.\u003c/p>\n\u003cp>There were two categories for respondents coded as gender nonconforming. One was \"highly gender nonconforming\" and the other was \"androgynous.\"\u003c/p>\n\u003cp>Male respondents who answered \"very feminine\" or \"mostly feminine,\" and female respondents who answered \"very masculine\" or \"mostly masculine,\" were categorized as \"highly gender nonconforming.\"\u003c/p>\n\u003cp>Those who answered \"equally feminine and masculine\" were coded as “androgynous.”\u003c/p>\n\u003cp>The androgynous outnumbered those who were highly gender nonconforming by more than 3 to 1.\u003c/p>\n\u003cp>Total nonconforming youth came out to 27 percent of all the adolescents queried. That \u003cspan style=\"font-weight: 400\">would equate to 796,000 gender nonconforming youth in the state of California today.\u003c/span>\u003c/p>\n\u003cp>The margin of error was about 6 percent, so that number could be substantially greater or fewer.\u003c/p>\n\u003cp>\u003cstrong>California and Gender\u003c/strong>\u003c/p>\n\u003cp>Combined surveys asking the same question in L.A., San Diego, Chicago and Florida’s Broward County provide a larger population of 9,265 youth, and that data shows high health risks associated with gender nonconformity. For example, GNC males were between two and three times more likely to attempt suicide than conforming males, and for females the rate was 1 1/2 times greater for those who were GNC.\u003c/p>\n\u003cp>While the California survey showed nonconforming youth reporting more than twice the level of severe psychological distress as their conforming peers, it showed no statistically significant difference when it came to suicidal ideation and suicide attempts.\u003c/p>\n\u003cp>Why the big difference related to suicide between nonconforming and conforming youth in the larger sample, and hardly any in the Californian-only data?\u003c/p>\n\u003cp>The California researchers speculated that the state's social environment may be contributing to better mental health outcomes.\u003c/p>\n\u003cp>“(H)igher levels of social acceptance and the presence of protective policies in California may impact rates of victimization and bullying, which, in turn, may confer some protection for gender minority youth in the state,\" reads the fact sheet.\u003c/p>\n\u003cp>\u003cstrong>The Next Frontier\u003c/strong>\u003c/p>\n\u003cp>Phil Hammack is a professor of psychology and researcher at the University of California, Santa Cruz, who specializes in sexual and gender identity. He thinks that when it comes to bullying, gender expression is the new sexual orientation.\u003c/p>\n\u003cp>“A lot of bullying is around expression and not sexuality,” he said. “A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.”\u003c/p>\n\u003cp>Even though there is much greater visibility for gender nonconforming youth, Hammack said, “the culture is in a state of anxiety around this revolution.”\u003c/p>\n\u003cp>\"This is the next frontier for us to address among people who care about young people’s well-being.”\u003c/p>\n\u003cp>The gender researchers I spoke to agreed that gender nonconformity often causes bullying and mental health distress independent of sexual orientation and gender identities.\u003c/p>\n\u003cp>\u003cstrong>A Quarrel With the Question\u003c/strong>\u003c/p>\n\u003cp>One gender researcher who doesn’t think the question resulted in precise enough data is Charlotte Tate, from San Francisco State. Tate said that because there was no question about sexual orientation on the survey, it's impossible to tease apart how much of the mental distress exhibited by GNC youth stems from being lesbian, gay or bisexual and how much from an unconventional gender expression.\u003c/p>\n\u003cp>\"So [the researchers] haven’t sufficiently demonstrated that the stress is linked to gender; it could be about sexual orientation,\" Tate said.\u003c/p>\n\u003cp>Bianca Wilson, \u003cspan style=\"font-weight: 400\">a senior public policy scholar at The Williams Institute, \u003c/span>agrees inserting a sexual orientation question would be useful to understand the \"unique and compounding levels of distress\" by non-heterosexual youth who also do differ in their gender expression.\u003c/p>\n\u003cp>In any event, there will be more data. Gill says the number of sites that have now asked the gender nonconforming question has increased to 16, and that the results will start coming in during the first half of 2018.\u003c/p>\n\u003cp>Hammack, the researcher from UC Santa Cruz, says it's obvious that gender nonconformity is booming. He recently completed a study of teen LGBT youth in the Central Valley and the Bay Area, and he was surprised to find how easy it was to sign up those who were nonconforming.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We had to cap the number of gender nonconforming youth who participated to make sure we got enough gender conforming youth,\" he said.\u003c/p>\n\n",
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"excerpt": "A recent survey shows 27 percent of 12- to 17-year-olds in California thought they were perceived as more or equally like the opposite sex.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>You may have seen recent news of a survey finding that 27 percent of California youth ages 12 to 17 are \"gender nonconforming.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Gender nonconforming is not a synonym for transgender. Rather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example.'\u003ccite>Kristina Olson, University of Washington.\u003c/cite>\u003c/aside>\n\u003cp>That sounds pretty high. I might even put the word \"whopping\" before \"27 percent.\"\u003c/p>\n\u003cp>But I have to say, I've been covering the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">gender story\u003c/a> for more than a year, and when I saw the headlines, I wasn't \u003cem>quite\u003c/em> sure what gender nonconforming meant. Gender terminology, like gender itself these days, can be fairly fluid.\u003c/p>\n\u003cp>So here is the exact question that was asked of California adolescents:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">A person’s appearance, style, dress, or the way they walk or talk may affect how people describe them. How do you think other people at school would describe you? \u003c/span>\u003c/p>\n\u003cp>Very feminine\u003c/p>\n\u003cp>Mostly feminine\u003c/p>\n\u003cp>Equally feminine and masculine\u003c/p>\n\u003cp>Mostly masculine\u003c/p>\n\u003cp>Very masculine\u003c/p>\u003c/blockquote>\n\u003cp>This is a measure of what gender researchers call \"gender expression,\" or the way individuals manifest what you might call the trappings of masculinity and femininity: clothes, hair, makeup, posture. As some of the UCLA researchers involved in the survey put it, those who are \"seen as resisting dominant expectations around gender expression\" are considered gender nonconforming.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype.”\u003ccite>Alison Gill, Advocates for Youth\u003c/cite>\u003c/aside>\n\u003cp>You might think that someone who is gender nonconforming is necessarily transgender. But that is not the case.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“ ‘Gender nonconforming' \" is not a synonym for transgender,” says Kristina Olson, d\u003c/span>\u003cspan style=\"font-weight: 400\">irector of the TransYouth Project at the University of Washington. \u003c/span>\u003cspan style=\"font-weight: 400\">“R\u003c/span>\u003cspan style=\"font-weight: 400\">ather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example\u003c/span>\u003cspan style=\"font-weight: 400\">.\"\u003c/span>\u003c/p>\n\u003cp>Many people may also confound gender nonconformity with being lesbian, gay or bisexual. But Alison Gill, a consultant on gender for the nonprofit Advocates for Youth, says \u003ca href=\"http://advocatesforyouth.org/storage/advfy/documents/YRBSS.pdf\" target=\"_blank\" rel=\"noopener\">research\u003c/a> shows most gender nonconforming kids are actually heterosexual.\u003c/p>\n\u003cp>\"There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype,” she said.\u003c/p>\n\u003cp>In other words, you can be gender nonconforming without being L, G, B or T.\u003c/p>\n\u003cp>\u003cstrong>Study Results\u003c/strong>\u003c/p>\n\u003cp>The gender expression question was included on the recent \u003ca href=\"http://healthpolicy.ucla.edu/chis/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">California Health Interview Survey\u003c/a>, conducted by UCLA on a continuous basis. The telephone survey covers dozens of health topics.\u003c/p>\n\u003cp>The CHIS has been going strong since 2001, but this was the first time a question on either youth gender identity or gender expression had been included.\u003c/p>\n\u003cp>Why now?\u003c/p>\n\u003caside class=\"pullquote alignright\">'A lot of bullying is around expression and not sexuality. A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.' \u003ccite>Phil Hammack, University of California, Santa Cruz\u003c/cite>\u003c/aside>\n\u003cp>Researchers at UCLA's Center for Health Policy Research and The Williams Institute, which conducts research on sexual orientation and gender identity law, said in a health policy \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2017/gncadolescents-factsheet-dec2017.pdf\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a> that levels of gender conformity are \"known to be a particularly salient factor in the safety and well-being of youth. Yet, data about gender nonconforming youth remain rare.\"\u003c/p>\n\u003cp>The question was asked of 1,594 adolescents, ages 12 to 17, across California.\u003c/p>\n\u003cp>There were two categories for respondents coded as gender nonconforming. One was \"highly gender nonconforming\" and the other was \"androgynous.\"\u003c/p>\n\u003cp>Male respondents who answered \"very feminine\" or \"mostly feminine,\" and female respondents who answered \"very masculine\" or \"mostly masculine,\" were categorized as \"highly gender nonconforming.\"\u003c/p>\n\u003cp>Those who answered \"equally feminine and masculine\" were coded as “androgynous.”\u003c/p>\n\u003cp>The androgynous outnumbered those who were highly gender nonconforming by more than 3 to 1.\u003c/p>\n\u003cp>Total nonconforming youth came out to 27 percent of all the adolescents queried. That \u003cspan style=\"font-weight: 400\">would equate to 796,000 gender nonconforming youth in the state of California today.\u003c/span>\u003c/p>\n\u003cp>The margin of error was about 6 percent, so that number could be substantially greater or fewer.\u003c/p>\n\u003cp>\u003cstrong>California and Gender\u003c/strong>\u003c/p>\n\u003cp>Combined surveys asking the same question in L.A., San Diego, Chicago and Florida’s Broward County provide a larger population of 9,265 youth, and that data shows high health risks associated with gender nonconformity. For example, GNC males were between two and three times more likely to attempt suicide than conforming males, and for females the rate was 1 1/2 times greater for those who were GNC.\u003c/p>\n\u003cp>While the California survey showed nonconforming youth reporting more than twice the level of severe psychological distress as their conforming peers, it showed no statistically significant difference when it came to suicidal ideation and suicide attempts.\u003c/p>\n\u003cp>Why the big difference related to suicide between nonconforming and conforming youth in the larger sample, and hardly any in the Californian-only data?\u003c/p>\n\u003cp>The California researchers speculated that the state's social environment may be contributing to better mental health outcomes.\u003c/p>\n\u003cp>“(H)igher levels of social acceptance and the presence of protective policies in California may impact rates of victimization and bullying, which, in turn, may confer some protection for gender minority youth in the state,\" reads the fact sheet.\u003c/p>\n\u003cp>\u003cstrong>The Next Frontier\u003c/strong>\u003c/p>\n\u003cp>Phil Hammack is a professor of psychology and researcher at the University of California, Santa Cruz, who specializes in sexual and gender identity. He thinks that when it comes to bullying, gender expression is the new sexual orientation.\u003c/p>\n\u003cp>“A lot of bullying is around expression and not sexuality,” he said. “A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.”\u003c/p>\n\u003cp>Even though there is much greater visibility for gender nonconforming youth, Hammack said, “the culture is in a state of anxiety around this revolution.”\u003c/p>\n\u003cp>\"This is the next frontier for us to address among people who care about young people’s well-being.”\u003c/p>\n\u003cp>The gender researchers I spoke to agreed that gender nonconformity often causes bullying and mental health distress independent of sexual orientation and gender identities.\u003c/p>\n\u003cp>\u003cstrong>A Quarrel With the Question\u003c/strong>\u003c/p>\n\u003cp>One gender researcher who doesn’t think the question resulted in precise enough data is Charlotte Tate, from San Francisco State. Tate said that because there was no question about sexual orientation on the survey, it's impossible to tease apart how much of the mental distress exhibited by GNC youth stems from being lesbian, gay or bisexual and how much from an unconventional gender expression.\u003c/p>\n\u003cp>\"So [the researchers] haven’t sufficiently demonstrated that the stress is linked to gender; it could be about sexual orientation,\" Tate said.\u003c/p>\n\u003cp>Bianca Wilson, \u003cspan style=\"font-weight: 400\">a senior public policy scholar at The Williams Institute, \u003c/span>agrees inserting a sexual orientation question would be useful to understand the \"unique and compounding levels of distress\" by non-heterosexual youth who also do differ in their gender expression.\u003c/p>\n\u003cp>In any event, there will be more data. Gill says the number of sites that have now asked the gender nonconforming question has increased to 16, and that the results will start coming in during the first half of 2018.\u003c/p>\n\u003cp>Hammack, the researcher from UC Santa Cruz, says it's obvious that gender nonconformity is booming. He recently completed a study of teen LGBT youth in the Central Valley and the Bay Area, and he was surprised to find how easy it was to sign up those who were nonconforming.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We had to cap the number of gender nonconforming youth who participated to make sure we got enough gender conforming youth,\" he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Say you're on a Tinder date and the situation turns weird.\u003c/p>\n\u003cp>\"You're thinking, I need to get out, I no longer feel safe,\" says Celine Guedj, a senior at the University of New Hampshire in Durham. She's role-playing the use of a new app, \u003ca href=\"https://usafeus.org/\">uSafeUS\u003c/a>.\u003c/p>\n\u003cp>\"That's when you open the app,\" Guedj explains. One feature called Time to Leave is designed to give you a quick out. \"You get a fake call\" or text, Guedj says. It sounds like it's your mom or your roommate interrupting you with an urgent request.\u003c/p>\n\u003cp>There are several preprogrammed \"interruption messages\" such as, \"Hey, I'm locked out, can you come let me in.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'What the students have told us over and over is that they really want a discreet way to take themselves out of a situation, or help a friend.'\u003ccite>Sharyn Potter, sociology professor, University of New Hampshire\u003c/cite>\u003c/aside>\n\u003cp>\"It seems real,\" Guedj says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Another feature, called Expect Me, will alert a friend if you don't show up to a destination when you're expected. And, one more, called Angel Drink, is a quick way to signal to a bartender or server that you want help to exit a situation or separate yourself from a person who is making you feel uncomfortable.\u003c/p>\n\u003cp>So why the ruse? Why wouldn't you just bolt or walk out of a situation at the first instinct of potential trouble or bad vibe?\u003c/p>\n\u003cp>\"What the students have told us over and over is that they really want a discreet way to take themselves out of a situation, or help a friend,\" says \u003ca href=\"https://cola.unh.edu/faculty-member/sharyn-potter\">Sharyn Potter\u003c/a>, a sociology professor at University of New Hampshire who directs research on sexual violence prevention. She helped develop the app with a team of students, designers and a retired state trooper.\u003c/p>\n\u003cp>Potter says students often don't want to make a scene or they may feel intimidated. \"They're not ready to ... directly call somebody out. They want to do it subtly.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"jlo1DGhfkrSnsjmvcJh75cg88gwAdLQY\"]The uSafeUS app is free for everyone to download. However, only colleges and institutions that license the app can customize the content to connect users to local resources and support, such as counseling and local law enforcement. The customized app is available for students, faculty, staff, parents/guardians, community members and alumni of universities to use. In addition, the app includes step-by-step information and guidance about what to do in the aftermath of a sexual assault.\u003c/p>\n\u003cp>The app was piloted on New Hampshire campuses last year and was launched nationally this fall., and beginning in January the team behind the uSafeUS app will be reaching out to campus leaders and high schools around the country to spread the word about the platform. The effort is being funded by a grant from the National Science Foundation.\u003c/p>\n\u003cp>Still, advocates say that even the best app can't replace human interaction – or help from a person.\u003c/p>\n\u003cp>\"In theory, apps like this sound like a good idea,\" says Sabrina Sugano, a student at Cornell University who is co-president of \u003ca href=\"http://cornellconsented.strikingly.com/i/construction\">Consent Ed\u003c/a>, a peer-to-peer education program. She's never used safety apps like this one, but says she can see how they could be useful.\u003c/p>\n\u003cp>[contextly_sidebar id=\"5suwNTnCjxXNU76jd48N4F1wTb8oTYo0\"]\"We have a big emphasis on bystander intervention,\" Sugano says. \"We talk a lot about ways [students] can intervene, say, in a party situation\" to help someone who appears to be in an uncomfortable situation. If the app can help aid this bystander approach, Sugano says this could be beneficial.\u003c/p>\n\u003cp>But she has hesitations, too. Safety apps are just one tool.\u003c/p>\n\u003cp>\"We shouldn't rely completely on them, because we should be able to have our peers acting as a community to help us.\" Sugano says. She says human interactions are important, especially since someone who's been drinking at a campus party and becomes incapacitated might not have the clarity of mind or the ability to launch an app if they're in an unsafe situation.\u003c/p>\n\u003cp>This isn't the first effort to create tools to help people protect themselves against sexual aggression or assault. Existing safety apps such as \u003ca href=\"https://getbsafe.com/\">bSafe\u003c/a> and \u003ca href=\"https://www.circleof6app.com/\">Circleof6\u003c/a> are getting a second look in workplaces, communities and on military bases.\u003c/p>\n\u003cp>Circleof6, which won the Obama administration's \"\u003ca href=\"https://obamawhitehouse.archives.gov/blog/2011/11/01/announcing-winners-apps-against-abuse-technology-challenge\">Apps Against Abuse\u003c/a>\" technology challenge back in 2011, was originally designed for college students. Now, it's marketed as a safety app \"for everyone.\"\u003c/p>\n\u003cp>\"Circleof6 was designed, really mirroring what friends, especially women, have always done for each other,\" says \u003ca href=\"https://www.circleof6app.com/about/#member1\">Nancy Schwartzman\u003c/a>, chief executive officer of Tech 4 Good, LLC the company behind the app. \" 'Where are you going to be, check in with me later, call me if you need me,' we say to our friends. We just brought this to the mobile context,\" Schwartzman says.\u003c/p>\n\u003cp>Users pick up to six friends to join their circle. Features include Come Get Me, which sends a text to your circle of friends with your exact location using GPS coordinates. Another option, Call Me, sends a text to your circle that says. \"Call and pretend you need me. I need an interruption.\" The app also connects users to national hotlines and has helpful links to information about sexuality, relationships and safety.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Schwartzman acknowledges that sexual assault is a complex problem. \"Apps can't solve it,\" she says. But her hope is that the technology can help.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Feel+In+Danger+On+A+Date%3F+These+Apps+Could+Help+You+Stay+Safe&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Say you're on a Tinder date and the situation turns weird.\u003c/p>\n\u003cp>\"You're thinking, I need to get out, I no longer feel safe,\" says Celine Guedj, a senior at the University of New Hampshire in Durham. She's role-playing the use of a new app, \u003ca href=\"https://usafeus.org/\">uSafeUS\u003c/a>.\u003c/p>\n\u003cp>\"That's when you open the app,\" Guedj explains. One feature called Time to Leave is designed to give you a quick out. \"You get a fake call\" or text, Guedj says. It sounds like it's your mom or your roommate interrupting you with an urgent request.\u003c/p>\n\u003cp>There are several preprogrammed \"interruption messages\" such as, \"Hey, I'm locked out, can you come let me in.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'What the students have told us over and over is that they really want a discreet way to take themselves out of a situation, or help a friend.'\u003ccite>Sharyn Potter, sociology professor, University of New Hampshire\u003c/cite>\u003c/aside>\n\u003cp>\"It seems real,\" Guedj says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Another feature, called Expect Me, will alert a friend if you don't show up to a destination when you're expected. And, one more, called Angel Drink, is a quick way to signal to a bartender or server that you want help to exit a situation or separate yourself from a person who is making you feel uncomfortable.\u003c/p>\n\u003cp>So why the ruse? Why wouldn't you just bolt or walk out of a situation at the first instinct of potential trouble or bad vibe?\u003c/p>\n\u003cp>\"What the students have told us over and over is that they really want a discreet way to take themselves out of a situation, or help a friend,\" says \u003ca href=\"https://cola.unh.edu/faculty-member/sharyn-potter\">Sharyn Potter\u003c/a>, a sociology professor at University of New Hampshire who directs research on sexual violence prevention. She helped develop the app with a team of students, designers and a retired state trooper.\u003c/p>\n\u003cp>Potter says students often don't want to make a scene or they may feel intimidated. \"They're not ready to ... directly call somebody out. They want to do it subtly.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The uSafeUS app is free for everyone to download. However, only colleges and institutions that license the app can customize the content to connect users to local resources and support, such as counseling and local law enforcement. The customized app is available for students, faculty, staff, parents/guardians, community members and alumni of universities to use. In addition, the app includes step-by-step information and guidance about what to do in the aftermath of a sexual assault.\u003c/p>\n\u003cp>The app was piloted on New Hampshire campuses last year and was launched nationally this fall., and beginning in January the team behind the uSafeUS app will be reaching out to campus leaders and high schools around the country to spread the word about the platform. The effort is being funded by a grant from the National Science Foundation.\u003c/p>\n\u003cp>Still, advocates say that even the best app can't replace human interaction – or help from a person.\u003c/p>\n\u003cp>\"In theory, apps like this sound like a good idea,\" says Sabrina Sugano, a student at Cornell University who is co-president of \u003ca href=\"http://cornellconsented.strikingly.com/i/construction\">Consent Ed\u003c/a>, a peer-to-peer education program. She's never used safety apps like this one, but says she can see how they could be useful.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"We have a big emphasis on bystander intervention,\" Sugano says. \"We talk a lot about ways [students] can intervene, say, in a party situation\" to help someone who appears to be in an uncomfortable situation. If the app can help aid this bystander approach, Sugano says this could be beneficial.\u003c/p>\n\u003cp>But she has hesitations, too. Safety apps are just one tool.\u003c/p>\n\u003cp>\"We shouldn't rely completely on them, because we should be able to have our peers acting as a community to help us.\" Sugano says. She says human interactions are important, especially since someone who's been drinking at a campus party and becomes incapacitated might not have the clarity of mind or the ability to launch an app if they're in an unsafe situation.\u003c/p>\n\u003cp>This isn't the first effort to create tools to help people protect themselves against sexual aggression or assault. Existing safety apps such as \u003ca href=\"https://getbsafe.com/\">bSafe\u003c/a> and \u003ca href=\"https://www.circleof6app.com/\">Circleof6\u003c/a> are getting a second look in workplaces, communities and on military bases.\u003c/p>\n\u003cp>Circleof6, which won the Obama administration's \"\u003ca href=\"https://obamawhitehouse.archives.gov/blog/2011/11/01/announcing-winners-apps-against-abuse-technology-challenge\">Apps Against Abuse\u003c/a>\" technology challenge back in 2011, was originally designed for college students. Now, it's marketed as a safety app \"for everyone.\"\u003c/p>\n\u003cp>\"Circleof6 was designed, really mirroring what friends, especially women, have always done for each other,\" says \u003ca href=\"https://www.circleof6app.com/about/#member1\">Nancy Schwartzman\u003c/a>, chief executive officer of Tech 4 Good, LLC the company behind the app. \" 'Where are you going to be, check in with me later, call me if you need me,' we say to our friends. We just brought this to the mobile context,\" Schwartzman says.\u003c/p>\n\u003cp>Users pick up to six friends to join their circle. Features include Come Get Me, which sends a text to your circle of friends with your exact location using GPS coordinates. Another option, Call Me, sends a text to your circle that says. \"Call and pretend you need me. 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"content": "\u003cp>Researchers have taken the first step toward a possible cure for \u003cspan class=\"example\">Lou Gehrig's disease \u003c/span>based on gene editing. The study, though limited in scope, provides a possible way forward to address some genetically driven cases of the disease.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Zj5jMJb0LrYIQhKiETUb8gCvIGVfUWhp\"]An estimated 20,000 Americans live with the disease, which is also called amyotrophic lateral sclerosis, or ALS. The condition causes muscles to waste away and is fatal. Eventually sufferers lose use of muscles essential for breathing. Two drugs have been approved by U.S. health officials, but they are minimally effective, increasing survival by \u003ca href=\"https://link.springer.com/article/10.1007/s00415-003-1026-z\" target=\"_blank\" rel=\"noopener\">only a few months\u003c/a>.\u003c/p>\n\u003cp>The researchers, at UC Berkeley, the University of Illinois and the University of Pittsburgh, are working on a new approach: altering a mutated gene that contributes to some cases of the disease. In mice, the technique increased average life span by about 25 percent and delayed onset of the disease by nearly 40 percent. The \u003ca href=\"http://advances.sciencemag.org/content/3/12/eaar3952\" target=\"_blank\" rel=\"noopener\">study\u003c/a> is published the Dec. 20 issue of\u003cem> Science Advances\u003c/em>.\u003c/p>\n\u003cp>\"If this were to translate to humans it would be clinically very meaningful for patients,\" says co-author David Schaffer, of UC Berkeley.\u003c/p>\n\u003cp>[contextly_sidebar id=\"gi0jm5XjbAQNm096mmQndorYwApHqftD\"]The mice used in the study were genetically engineered to express a mutated human gene, known as SOD1, that causes 1 in 5 inherited cases of ALS. To disable the mutation, the researchers engineered a virus carrying a pair of molecular scissors in the form of a Cas9 protein, designed to knock out the SOD1 gene. The scientists targeted the neurons in the spinal cord, which the SOD1 mutation cause to prematurely die.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Schaffer and others are now at work optimizing the technique for humans.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers have taken the first step toward a possible cure for \u003cspan class=\"example\">Lou Gehrig's disease \u003c/span>based on gene editing. The study, though limited in scope, provides a possible way forward to address some genetically driven cases of the disease.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>An estimated 20,000 Americans live with the disease, which is also called amyotrophic lateral sclerosis, or ALS. The condition causes muscles to waste away and is fatal. Eventually sufferers lose use of muscles essential for breathing. Two drugs have been approved by U.S. health officials, but they are minimally effective, increasing survival by \u003ca href=\"https://link.springer.com/article/10.1007/s00415-003-1026-z\" target=\"_blank\" rel=\"noopener\">only a few months\u003c/a>.\u003c/p>\n\u003cp>The researchers, at UC Berkeley, the University of Illinois and the University of Pittsburgh, are working on a new approach: altering a mutated gene that contributes to some cases of the disease. In mice, the technique increased average life span by about 25 percent and delayed onset of the disease by nearly 40 percent. The \u003ca href=\"http://advances.sciencemag.org/content/3/12/eaar3952\" target=\"_blank\" rel=\"noopener\">study\u003c/a> is published the Dec. 20 issue of\u003cem> Science Advances\u003c/em>.\u003c/p>\n\u003cp>\"If this were to translate to humans it would be clinically very meaningful for patients,\" says co-author David Schaffer, of UC Berkeley.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The mice used in the study were genetically engineered to express a mutated human gene, known as SOD1, that causes 1 in 5 inherited cases of ALS. To disable the mutation, the researchers engineered a virus carrying a pair of molecular scissors in the form of a Cas9 protein, designed to knock out the SOD1 gene. The scientists targeted the neurons in the spinal cord, which the SOD1 mutation cause to prematurely die.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>On a recent shift in in the emergency department, I evaluated a young woman who had been raped a few summers ago. The shift before that, I’d met with a teenager who had been sexually abused by her father. And just before meeting her I had tended to a middle-schooler who had been sexually assaulted at school.\u003c/p>\n\u003cp>These three women came to the hospital for variety of reasons — they struggled with issues ranging from truancy to substance abuse to thoughts of suicide. Part of my job as a psychiatry resident is to explore the stressors that influence suffering. More often than not, I find those stressors stem from sexual violence.\u003c/p>\n\u003cp>I’m learning that for my patients, sexual violence is an abnormal commonality: It happens to almost everyone, even though it should happen to no one.\u003c/p>\n\u003caside class=\"pullquote alignright\">The task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/aside>\n\u003cp>The #MeToo movement has been a powerful reckoning of the damage of unwanted sexual behavior. It’s given a voice to an incredible amount of pain, and freed some women of the burdens they have borne for years. With the Time Person of the Year Award going to the Silence Breakers, the movement seems to have hit a peak of cultural awareness.\u003c/p>\n\u003cp>But in the halls of my hospital, and in my day-to-day work as a second-year resident, the task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am angry on behalf of the women in my care. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As patients relay the details of these violent encounters, it’s hard not to internalize their horror stories. I feel impotent in my ability to make the world a less hostile place to live, and on some days I just feel incompetent because it’s so hard to keep absorbing these stories.\u003c/p>\n\u003cp>The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences. I also recognize that I may be experiencing secondary trauma, and that it might impact the care I give my patients.\u003c/p>\n\u003cp>While I was treating the young woman who had been assaulted by her father, I gave her room to share her story. She didn’t reveal much. I was secretly relieved.\u003c/p>\n\u003caside class=\"pullquote alignright\">Is it better to be sensitive or better to be detached?\u003c/aside>\n\u003cp>Later, while presenting information about this patient to my attending, I couldn’t answer some of her questions about my patient’s abuse. I had convinced myself I was being compassionate by not forcing the patient to relive her trauma, but really, I was hiding behind her silence to not have to absorb another harrowing story.\u003c/p>\n\u003cp>I reported what I could to the Department of Children and Families, while telling myself that the next time, I would do better. But, the whole experience was disheartening because I didn’t know if I could actually be better about managing my emotions.\u003c/p>\n\u003cp>I’ve been trying for a long time.\u003c/p>\n\u003cp>I remember standing over an incubator in the neonatal intensive care unit, afraid to examine the tiny baby girl inside. Born out of incest and rape, she barely weighed 4 pounds. I was a medical student, tending to the outcome of the physical impact of sexual violence, but I didn’t know what to do with all the pain this little baby embodied.\u003c/p>\n\u003cp>I couldn’t bring myself to touch her. She wasn’t crying, and I used that as an excuse to distance myself from her story of sexual violence. I didn’t know how to help her. I decided in that moment that it would be better if neither of us started crying.\u003c/p>\n\u003cp>But, is it better to be sensitive or better to be detached? I’ve \u003ca href=\"https://www.statnews.com/2017/10/19/kidney-stone-medicine/\">written before\u003c/a> about the numbing effect of medical training. We learn to distance ourselves from our patients’ pain and practice detached concern so that we can do our jobs and focus on the problems at hand without freaking out. As physicians, we must work to hold onto our empathy — the capacity to put ourselves in our patient’s shoes and share in their experiences.\u003c/p>\n\u003cp>Yet, I doubt I will ever be able to hear a patient’s story of sexual violence and not be angered, not be revolted. Too many of us are intimately familiar with this misogynistic and metastatic cruelty, and I’d never considered what it would be like when we actually do share in those experiences.\u003c/p>\n\u003cp>When I was a little girl, I took tennis lessons. One summer, before fifth grade, when I was 9, the instructor said sexually explicit things to me. At the time, I didn’t understand why he said these things to me. Yet I knew enough to be ashamed, to feel compromised. I never reported him. I quit tennis instead.\u003c/p>\n\u003cp>This wasn’t the first — or the last — experience I remember when I think about #MeToo. But it’s the only one I feel safe enough to write about.\u003c/p>\n\u003cp>[contextly_sidebar id=\"JLHugSZUKIVVE8gXX4IbdyVIlukTf9dL\"]To be a woman in this world is to be vulnerable. I know my patients’ struggles, even when I don’t know the damning details. But, if I want to treat them well, as a female physician, subject to the very same societal forces, I need to figure out how to manage those details, and their impact on my well-being. Otherwise, self-preservation will not allow me to serve my patients in the way they deserve.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://abcnews.go.com/Politics/unwanted-sexual-advances-hollywood-weinstein-story-poll/story?id=50521721\" target=\"_blank\" rel=\"noopener\">news poll\u003c/a> found that 1 in 2 women surveyed said they had been sexually harassed. The Centers for Disease Control and Prevention says that 1 in 5 women have been \u003ca href=\"https://www.cdc.gov/ViolencePrevention/pdf/SV-DataSheet-a.pdf\" target=\"_blank\" rel=\"noopener\">raped\u003c/a> in their lifetimes.\u003c/p>\n\u003cp>I need to find, for myself and my patients, that way to bolster strength in lifetimes of vulnerability and that way to find dignity in oceans of shame. Then, I need to help them believe, as I work on this with myself, in their value as women —that they have a right to be heard and a right to be understood, and a right to heal, if that is possible.\u003c/p>\n\u003cp>But first, I have to deal with my grief that sexual trauma ever happens to us, at all.\u003c/p>\n\u003cp>\u003cem>This story has been changed to reflect that the statistic from the Centers for Disease Control and Prevention indicates past experience.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/12/18/metoo-patients-trauma/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On a recent shift in in the emergency department, I evaluated a young woman who had been raped a few summers ago. The shift before that, I’d met with a teenager who had been sexually abused by her father. And just before meeting her I had tended to a middle-schooler who had been sexually assaulted at school.\u003c/p>\n\u003cp>These three women came to the hospital for variety of reasons — they struggled with issues ranging from truancy to substance abuse to thoughts of suicide. Part of my job as a psychiatry resident is to explore the stressors that influence suffering. More often than not, I find those stressors stem from sexual violence.\u003c/p>\n\u003cp>I’m learning that for my patients, sexual violence is an abnormal commonality: It happens to almost everyone, even though it should happen to no one.\u003c/p>\n\u003caside class=\"pullquote alignright\">The task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/aside>\n\u003cp>The #MeToo movement has been a powerful reckoning of the damage of unwanted sexual behavior. It’s given a voice to an incredible amount of pain, and freed some women of the burdens they have borne for years. With the Time Person of the Year Award going to the Silence Breakers, the movement seems to have hit a peak of cultural awareness.\u003c/p>\n\u003cp>But in the halls of my hospital, and in my day-to-day work as a second-year resident, the task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am angry on behalf of the women in my care. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As patients relay the details of these violent encounters, it’s hard not to internalize their horror stories. I feel impotent in my ability to make the world a less hostile place to live, and on some days I just feel incompetent because it’s so hard to keep absorbing these stories.\u003c/p>\n\u003cp>The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences. I also recognize that I may be experiencing secondary trauma, and that it might impact the care I give my patients.\u003c/p>\n\u003cp>While I was treating the young woman who had been assaulted by her father, I gave her room to share her story. She didn’t reveal much. I was secretly relieved.\u003c/p>\n\u003caside class=\"pullquote alignright\">Is it better to be sensitive or better to be detached?\u003c/aside>\n\u003cp>Later, while presenting information about this patient to my attending, I couldn’t answer some of her questions about my patient’s abuse. I had convinced myself I was being compassionate by not forcing the patient to relive her trauma, but really, I was hiding behind her silence to not have to absorb another harrowing story.\u003c/p>\n\u003cp>I reported what I could to the Department of Children and Families, while telling myself that the next time, I would do better. But, the whole experience was disheartening because I didn’t know if I could actually be better about managing my emotions.\u003c/p>\n\u003cp>I’ve been trying for a long time.\u003c/p>\n\u003cp>I remember standing over an incubator in the neonatal intensive care unit, afraid to examine the tiny baby girl inside. Born out of incest and rape, she barely weighed 4 pounds. I was a medical student, tending to the outcome of the physical impact of sexual violence, but I didn’t know what to do with all the pain this little baby embodied.\u003c/p>\n\u003cp>I couldn’t bring myself to touch her. She wasn’t crying, and I used that as an excuse to distance myself from her story of sexual violence. I didn’t know how to help her. I decided in that moment that it would be better if neither of us started crying.\u003c/p>\n\u003cp>But, is it better to be sensitive or better to be detached? I’ve \u003ca href=\"https://www.statnews.com/2017/10/19/kidney-stone-medicine/\">written before\u003c/a> about the numbing effect of medical training. We learn to distance ourselves from our patients’ pain and practice detached concern so that we can do our jobs and focus on the problems at hand without freaking out. As physicians, we must work to hold onto our empathy — the capacity to put ourselves in our patient’s shoes and share in their experiences.\u003c/p>\n\u003cp>Yet, I doubt I will ever be able to hear a patient’s story of sexual violence and not be angered, not be revolted. Too many of us are intimately familiar with this misogynistic and metastatic cruelty, and I’d never considered what it would be like when we actually do share in those experiences.\u003c/p>\n\u003cp>When I was a little girl, I took tennis lessons. One summer, before fifth grade, when I was 9, the instructor said sexually explicit things to me. At the time, I didn’t understand why he said these things to me. Yet I knew enough to be ashamed, to feel compromised. I never reported him. I quit tennis instead.\u003c/p>\n\u003cp>This wasn’t the first — or the last — experience I remember when I think about #MeToo. But it’s the only one I feel safe enough to write about.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>To be a woman in this world is to be vulnerable. I know my patients’ struggles, even when I don’t know the damning details. But, if I want to treat them well, as a female physician, subject to the very same societal forces, I need to figure out how to manage those details, and their impact on my well-being. Otherwise, self-preservation will not allow me to serve my patients in the way they deserve.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://abcnews.go.com/Politics/unwanted-sexual-advances-hollywood-weinstein-story-poll/story?id=50521721\" target=\"_blank\" rel=\"noopener\">news poll\u003c/a> found that 1 in 2 women surveyed said they had been sexually harassed. The Centers for Disease Control and Prevention says that 1 in 5 women have been \u003ca href=\"https://www.cdc.gov/ViolencePrevention/pdf/SV-DataSheet-a.pdf\" target=\"_blank\" rel=\"noopener\">raped\u003c/a> in their lifetimes.\u003c/p>\n\u003cp>I need to find, for myself and my patients, that way to bolster strength in lifetimes of vulnerability and that way to find dignity in oceans of shame. Then, I need to help them believe, as I work on this with myself, in their value as women —that they have a right to be heard and a right to be understood, and a right to heal, if that is possible.\u003c/p>\n\u003cp>But first, I have to deal with my grief that sexual trauma ever happens to us, at all.\u003c/p>\n\u003cp>\u003cem>This story has been changed to reflect that the statistic from the Centers for Disease Control and Prevention indicates past experience.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/12/18/metoo-patients-trauma/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear",
"title": "Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear",
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"content": "\u003cp>When President Donald Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. The declaration allows for doctors to prescribe addiction medicine virtually, without ever seeing the patient in person.\u003c/p>\n\u003cp>In Indiana, this kind of virtual visit has been legal since early 2017. But among a dozen addiction specialists in Indiana contacted by a reporter, just one had heard of doctors using telemedicine for opioid addiction treatment: Dr. Jay Joshi.\u003c/p>\n\u003cp>[contextly_sidebar id=\"HTWa6DDHbA3jbwATNMZV5X1BLHSB9M0O\"]At Joshi’s practice, \u003ca href=\"http://prestigepatient.com/\" target=\"_blank\" rel=\"noopener\">Prestige Clinics\u003c/a> in Munster, Ind., a telemedicine consultation takes place in what looks like a standard exam room with a computer. On Tuesdays, Joshi’s patients have video chats with a psychologist who lives 140 miles away.\u003c/p>\n\u003cp>Elizabeth Hall is one of those patients. “The only issue I really had with it was [that] it would freeze, which is kind of inconvenient and a little bit awkward,” she said. “When it freezes you’re like, ‘What do I do? Just sit here and stare at the lady?'”\u003c/p>\n\u003cp>But she said she appreciates the counseling. She’s a former nurse’s assistant and has been going to Joshi for back pain and to treat a heroin addiction for about a year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’m in a good place, you know?” she said. “I’m not doing nothing I shouldn’t be doing. I’m not lying to nobody. I’m not sneaking around. Plus, I have a baby. I’m really busy!”\u003c/p>\n\u003cp>To get her insurer to cover her addiction medicine, Hall has to prove she’s engaged in counseling. Local counselors are hard to find. By having a telepsychologist available, Joshi helps patients clear that hurdle.\u003c/p>\n\u003cp>Hall’s insurance also requires urine tests for drug use to keep covering her medication. But she failed her latest urine test — she had used drugs the previous week. Joshi asked Hall to talk to the telepsychologist about the relapse.\u003c/p>\n\u003cp>“I know you know that I haven’t done anything since last week, and I told them I’m not doing nothing no more. I can’t screw up my life,” Hall said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"SEwDMDxgBXjgSpzLw5kL4C8gZO5SgWlc\"]Because of the failed test, her insurance may refuse to pay for Suboxone, her addiction medication. Joshi’s staff may need to intervene with the insurer by phone to keep Hall’s treatment covered. “It’s one of those situations where she’s not taking any other controlled substance,” Joshi said. “We’re seeing her every two weeks. She’s participating in the counseling. It’s just one thing.”\u003c/p>\n\u003cp>Hall said, “I’ve been doing really good, it’s just, you know, it’s hard.”\u003c/p>\n\u003cp>This is why Joshi requires in-person visits — to begin and maintain his patients’ Suboxone prescriptions. He prefers to see these patients every two weeks and will even arrange transportation before going too long without seeing them.\u003c/p>\n\u003cp>Occasionally he’ll prescribe Suboxone remotely, but typically only for a refill once or twice during a patient’s treatment. Seeing the patient in person is critical to their treatment, he said.\u003c/p>\n\u003cp>“You’re not going to get a good system of health care for primary care in these high-risk areas unless you invest time and energy into these patients,” he said.\u003c/p>\n\u003cp>The face-to-face interaction establishes trust, allows him to pick up on body language. Plus, it’s hard to do a urine drug test screen remotely and be sure that the sample actually belongs to the patient. A proper screen lets him know if his patients are taking their medication, instead of selling it.\u003c/p>\n\u003cp>He asked Hall if she mentioned her recent drug use to the counselor.\u003c/p>\n\u003cp>“I really don’t remember if I talked to her about it or not,” she said. Joshi said to make sure she comes in for her next counseling session.\u003c/p>\n\u003cp>Joshi said he has a lot of conversations that aren’t billable.\u003c/p>\n\u003cp>[contextly_sidebar id=\"2CUFegfbIEou2wrq8oAFahU0vF2tkX89\"]That’s partly why there is a shortage of addiction treatment doctors, said Dr. Emily Zarse. She runs the addiction treatment program at Eskenazi Health in Indianapolis.\u003c/p>\n\u003cp>“Telemedicine is a great idea in theory, but it doesn’t fix the workforce shortage problem,” she said.\u003c/p>\n\u003cp>Insurance billing takes up a lot of time and so do the complexities of addiction treatment, she said.\u003c/p>\n\u003cp>There is one area where Zarse thinks telemedicine would be helpful — as a tool to train providers. “That takes one expert’s time for a couple of hours a week, maybe, and you can reach 10, 15, 20 people all at one time,” she said.\u003c/p>\n\u003cp>In fact, Zarse plans to launch a course to train Indiana doctors to treat addiction. In January, she’ll learn more about how to do it, from \u003ca href=\"https://echo.unm.edu/\" target=\"_blank\" rel=\"noopener\">Project Echo\u003c/a>, a resource for clinicians seeking virtual training tools. Zarse envisions a place where doctors from around the state can call in to video chat and walk through cases with trained psychiatrists like herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"https://www.wfyi.org/\" target=\"_blank\" rel=\"noopener\">WFYI\u003c/a>, \u003ca href=\"http://www.sideeffectspublicmedia.org/\" target=\"_blank\" rel=\"noopener\">Side Effects Public Media\u003c/a>, \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When President Donald Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. The declaration allows for doctors to prescribe addiction medicine virtually, without ever seeing the patient in person.\u003c/p>\n\u003cp>In Indiana, this kind of virtual visit has been legal since early 2017. But among a dozen addiction specialists in Indiana contacted by a reporter, just one had heard of doctors using telemedicine for opioid addiction treatment: Dr. Jay Joshi.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>At Joshi’s practice, \u003ca href=\"http://prestigepatient.com/\" target=\"_blank\" rel=\"noopener\">Prestige Clinics\u003c/a> in Munster, Ind., a telemedicine consultation takes place in what looks like a standard exam room with a computer. On Tuesdays, Joshi’s patients have video chats with a psychologist who lives 140 miles away.\u003c/p>\n\u003cp>Elizabeth Hall is one of those patients. “The only issue I really had with it was [that] it would freeze, which is kind of inconvenient and a little bit awkward,” she said. “When it freezes you’re like, ‘What do I do? Just sit here and stare at the lady?'”\u003c/p>\n\u003cp>But she said she appreciates the counseling. She’s a former nurse’s assistant and has been going to Joshi for back pain and to treat a heroin addiction for about a year.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I’m in a good place, you know?” she said. “I’m not doing nothing I shouldn’t be doing. I’m not lying to nobody. I’m not sneaking around. Plus, I have a baby. I’m really busy!”\u003c/p>\n\u003cp>To get her insurer to cover her addiction medicine, Hall has to prove she’s engaged in counseling. Local counselors are hard to find. By having a telepsychologist available, Joshi helps patients clear that hurdle.\u003c/p>\n\u003cp>Hall’s insurance also requires urine tests for drug use to keep covering her medication. But she failed her latest urine test — she had used drugs the previous week. Joshi asked Hall to talk to the telepsychologist about the relapse.\u003c/p>\n\u003cp>“I know you know that I haven’t done anything since last week, and I told them I’m not doing nothing no more. I can’t screw up my life,” Hall said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Because of the failed test, her insurance may refuse to pay for Suboxone, her addiction medication. Joshi’s staff may need to intervene with the insurer by phone to keep Hall’s treatment covered. “It’s one of those situations where she’s not taking any other controlled substance,” Joshi said. “We’re seeing her every two weeks. She’s participating in the counseling. It’s just one thing.”\u003c/p>\n\u003cp>Hall said, “I’ve been doing really good, it’s just, you know, it’s hard.”\u003c/p>\n\u003cp>This is why Joshi requires in-person visits — to begin and maintain his patients’ Suboxone prescriptions. He prefers to see these patients every two weeks and will even arrange transportation before going too long without seeing them.\u003c/p>\n\u003cp>Occasionally he’ll prescribe Suboxone remotely, but typically only for a refill once or twice during a patient’s treatment. Seeing the patient in person is critical to their treatment, he said.\u003c/p>\n\u003cp>“You’re not going to get a good system of health care for primary care in these high-risk areas unless you invest time and energy into these patients,” he said.\u003c/p>\n\u003cp>The face-to-face interaction establishes trust, allows him to pick up on body language. Plus, it’s hard to do a urine drug test screen remotely and be sure that the sample actually belongs to the patient. A proper screen lets him know if his patients are taking their medication, instead of selling it.\u003c/p>\n\u003cp>He asked Hall if she mentioned her recent drug use to the counselor.\u003c/p>\n\u003cp>“I really don’t remember if I talked to her about it or not,” she said. Joshi said to make sure she comes in for her next counseling session.\u003c/p>\n\u003cp>Joshi said he has a lot of conversations that aren’t billable.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>That’s partly why there is a shortage of addiction treatment doctors, said Dr. Emily Zarse. She runs the addiction treatment program at Eskenazi Health in Indianapolis.\u003c/p>\n\u003cp>“Telemedicine is a great idea in theory, but it doesn’t fix the workforce shortage problem,” she said.\u003c/p>\n\u003cp>Insurance billing takes up a lot of time and so do the complexities of addiction treatment, she said.\u003c/p>\n\u003cp>There is one area where Zarse thinks telemedicine would be helpful — as a tool to train providers. “That takes one expert’s time for a couple of hours a week, maybe, and you can reach 10, 15, 20 people all at one time,” she said.\u003c/p>\n\u003cp>In fact, Zarse plans to launch a course to train Indiana doctors to treat addiction. In January, she’ll learn more about how to do it, from \u003ca href=\"https://echo.unm.edu/\" target=\"_blank\" rel=\"noopener\">Project Echo\u003c/a>, a resource for clinicians seeking virtual training tools. Zarse envisions a place where doctors from around the state can call in to video chat and walk through cases with trained psychiatrists like herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"https://www.wfyi.org/\" target=\"_blank\" rel=\"noopener\">WFYI\u003c/a>, \u003ca href=\"http://www.sideeffectspublicmedia.org/\" target=\"_blank\" rel=\"noopener\">Side Effects Public Media\u003c/a>, \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
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