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"disqusTitle": "Horrific Ghost Ship Fire Tests Oakland Firefighters' Culture of Not Seeking Help",
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"content": "\u003cp>The day was dawning clear and sunny as Dan Robertson picked his way through the remnants of the inferno. The veteran firefighter was with a few of the other guys, making a final sweep to check that all the flames were out, when morbid curiosity got the better of them. He was cold and wet from water and sweat, and his knees told him it was time to go home. But he wondered, what does a warehouse look like, all burnt up from the inside out?\u003c/p>\n\u003cp>They walked over charcoal debris; some stuff they could recognize, like rugs and alarm clocks. Other stuff had melted into dark indecipherable shapes. The winter air smelled like that moment when you pour water on a big log-filled campfire, but with scents of burning plastic and chemicals mixed in.\u003c/p>\n\u003cp>What Robertson noticed most were the pianos. There were singed pianos everywhere, at least four or five in the front, near the doorway. He remembered being inside six hours earlier, at the height of the blaze, a piano blocking his path as he tried to carry a hose through the crackling flames.\u003c/p>\n\u003cp>[contextly_sidebar id=\"FWeW0K2AmQ9JTRMadzqx4CF7Jv6E82U1\"]By the time they had finished exploring the Ghost Ship warehouse that morning of Dec. 3, 2016, nine people had been confirmed dead; 27 more victims would be found by the end of that week in the building, which had been converted into an artists collective.\u003c/p>\n\u003cp>It wasn’t until Robertson was back at the firehouse, showering and changing into fresh clothes, that his experiences that night finally caught up to him. He drove his Toyota Tundra home and found his wife, Cheri, awake. She had just heard about the fire, and asked whether he was OK. He tried to speak, but nothing came out. He just started sobbing.\u003c/p>\n\u003caside class=\"pullquote alignright\">Many Oakland firefighters told STAT they are still struggling with the emotional fallout from that night six months ago.\u003c/aside>\n\u003cp>Many Oakland firefighters told STAT they are still struggling with the emotional fallout from that night six months ago. But few have sought mental health treatment, because of stigma within the department, combined with a limit on free counseling sessions provided by the city.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now the Ghost Ship fire has become a catalyst for change in the Oakland Fire Department, where Robertson, a 54-year-old lieutenant and the president of the Oakland firefighters union, and other firefighters are pushing to create a peer counseling program. Firefighters in general are at high risk of developing post-traumatic stress disorder, which can lead to anxiety, substance abuse and even suicide, and that has spurred firefighters in numerous cities to demand that their mental health be treated as urgently as any other injury sustained on the job.\u003c/p>\n\u003cp>Oakland fire officials insist that existing mental health services are sufficient but underused. Deputy Chief Mark Hoffmann pointed to the city’s “incredibly robust workers comp system,” and noted that firefighters who were at the Ghost Ship fire have been offered extra employee assistance program sessions, though few have claimed them.\u003c/p>\n\u003cp>Robertson disagrees. The fact that few firefighters use the current services, he said, is proof that they aren’t working. “Is it underutilized because it’s not needed, or is it underutilized because people have no faith in it?” Robertson asked.\u003c/p>\n\u003cfigure id=\"attachment_403984\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-403984\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Firefighters clear debris from the entrance to the Ghost Ship warehouse in Oakland, where a fire killed 36 people on Dec. 2, 2016. \u003ccite>((Elijah Nouvelage/Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘That Was Going to Sit With Me’\u003c/strong>\u003c/p>\n\u003cp>After the fire came the search for bodies. Eight men and women who participated in the recovery efforts said it was the most difficult aspect of the whole week. One fire captain, who has been with the department for more than 20 years, said thinking about it still makes him feel like he is teetering on the edge of a breakdown. He could see 10 bodies in the ash and rubble when he arrived, and he knew from the way the building collapsed that there would be more.\u003c/p>\n\u003cp>The victims died of smoke inhalation, not fire, so all their features were recognizable. The firefighters could see every detail: The cellphones in their pockets flooded with missed calls. Their tattoos. Their eyelashes. “There was no question,” said another firefighter, “that was going to sit with me for a while.”\u003c/p>\n\u003cp>All of them spoke about that day on condition of anonymity because they weren’t authorized to speak to the news media.\u003c/p>\n\u003cp>The firefighters were quick to emphasize that the Ghost Ship fire was just one in a long series of traumatic events over the course of their careers. In a big city like Oakland, they respond to everything from stubbed toes to heart attacks, from shootings to wildfires to structure fires. When asked to think back on a call that stuck with them, all the firefighters were able to conjure up several memories in perfect detail.\u003c/p>\n\u003cp>There was the firefighter-paramedic who still remembers the faces of two teenage girls shot in the head execution-style on a street. Another firefighter, in the department for less than five years, described a day when they drove an alcoholic to the hospital to get detoxed; as the man left the hospital that evening to go home, he was shot in a botched robbery, and the same team was called back to the scene to pronounce him dead.\u003c/p>\n\u003cp>Firefighters have a metaphor for their emotional baggage: the backpack. After every traumatic event, more junk is thrown into their symbolic backpacks for them to carry around each day. Eventually it will get too heavy; it will drag them down. “My backpack’s full,” said a firefighter still in his 18-month probation period. “It’s super full.”\u003c/p>\n\u003cp>PTSD and other post-trauma mental health issues can be tricky to identify in first responders, said psychologist Mark Kemena, a lead clinician for the West Coast Post-trauma Retreat, because it often builds up over time. It is like having a car alarm that is triggered when even the slightest wind passes by, said Michael Palmertree, a psychologist who has worked extensively with the Oakland Police Department.\u003c/p>\n\u003cp>There have been many studies about rates of PTSD in veterans and police, but reliable statistics for mental trauma in firefighters are hard to find. Suzy Gulliver, director of the Warriors Research Institute, is one of the few clinicians who has done studies on firefighter mental health. Over the course of a lifetime, she said, 20 to 22 percent of firefighters in the United States will experience PTSD — the same rate as returning combat veterans.\u003c/p>\n\u003cp>The consequences can be tragic. According to estimates from the National Fallen Firefighters Foundation, firefighters are three times more likely to die of suicide than in the line of duty. And many PTSD sufferers self-medicate with drugs or alcohol. Robertson said excessive drinking and substance use, including marijuana, have always been common in the fire department, particularly in young members. He himself had to go to drug rehab early in his career.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you do this for a little while, you’re scarred mentally for sure'\u003ccite>Chris Foley, Veteran fire captain\u003c/cite>\u003c/aside>\n\u003cp>“When you do this for a little while,” said Chris Foley, a veteran fire captain helping Robertson start the peer counseling program, “you’re scarred mentally for sure.”\u003c/p>\n\u003cp>\u003cstrong>Firefighters Wary of \u003c/strong>\u003cstrong>Treatment\u003c/strong>\u003c/p>\n\u003cp>Firefighters like to say that the fire service is 150 years of tradition, unimpeded by progress. When Robertson was a new recruit in the early 1990s, mental health wasn’t talked about in the firehouse. Back then, veterans from World War II, Korea, and Vietnam were on the crew, men who had already experienced their fair share of trauma.\u003c/p>\n\u003cp>“You can’t handle it?” Robertson recalled them saying if they saw a new crew member getting emotional after a run. “Then you need to go somewhere else.”\u003c/p>\n\u003cp>The culture has started changing, Robertson said, but many firefighters still won’t admit that a call affected them, fearing it would be seen as weakness and make their coworkers trust them a little less. In a recent survey conducted by the NBC Bay Area investigative news team, almost 50 percent of the 700 firefighters that responded said that concerns about colleagues not trusting their judgment contributed to the stigma of seeking mental health treatment.\u003c/p>\n\u003cp>Only one of the eight firefighters STAT interviewed who were at the scene that night has sought regular mental health treatment. For the few who do try to seek help, options are limited and, they say, often confusing.\u003c/p>\n\u003cp>Firefighters in Oakland are offered the same counseling program that every Oakland city employee gets: three free therapy sessions every six months through their employee assistance program (EAP). Tom Farris, president of Claremont EAP, which runs the city’s program, said it is designed to be a bridge to longer-term care, though firefighters have to pay for additional sessions through insurance copayments or out of pocket.\u003c/p>\n\u003cp>Complex mental health problems like PTSD are “absolutely not” resolved within three sessions, said Farris, who is a licensed psychologist. But “that’s not really what EAPs are scoped out to handle,” he said. Farris noted that in many cities, first responders are offered six to 10 EAP sessions, not three. More benefits for public safety employees “is a good idea,” he said.\u003c/p>\n\u003cp>Another resource in the fire department is a Critical Incident Stress Management team that is dispatched to fire stations after big events such as the Ghost Ship fire. The team members can vary from priests to other firefighters to experienced psychologists to brand-new therapists trying to boost their resume, and firefighters are required to sit together and debrief the incident.\u003c/p>\n\u003cp>Reactions to CISM are mixed. While psychologists say it can be very helpful, some firefighters say the team members often can’t relate to their experiences. Robertson said many of the CISM therapists wouldn’t be able to hold their own in a burning building. “Why the hell would I open up to you?” he said.\u003c/p>\n\u003cp>Hoffmann, the deputy chief who has been in the fire department 37 years, acknowledged that CISM has been “poorly applied at times” and said team members hadn’t received training “in about two years,” but he believes that it is an effective behavioral health tool.\u003c/p>\n\u003cp>Unsatisfied with the current treatment options, Robertson, along with Foley, has made it his mission in his last two years before retirement to launch a peer counseling program. They want to follow in the steps of other departments, including Phoenix and New York City, that have been using this model for years. Several other Bay Area cities have these programs, including neighboring Berkeley.\u003c/p>\n\u003cp>The International Association of Fire Fighters (IAFF) started offering peer counseling training courses last year and so far has offered 24 courses across North America. Elaine Viccora, a behavioral specialist at IAFF, said it plans to offer three to four trainings each month.\u003c/p>\n\u003cp>Robertson hopes to model the Oakland peer counseling program after the one in Phoenix. Brian French, a Phoenix firefighter, helped develop it in 2010 after four members of the department committed suicide within seven months.\u003c/p>\n\u003cp>Their model, French said, is “listen, refer, support.” Peer counselors are trained to reach out to individual station members after a critical incident and encourage them to get professional counseling if they think it is needed. French also oversees the day-to-day operations of a website called Firestrong, an online portal where fire departments around the country can list area-specific mental health resources for their members.\u003c/p>\n\u003cp>Robertson faces two main barriers as he tries to get the peer-counseling program off the ground: persuading the firefighters to admit when they need help, and convincing Hoffmann and other city administrators to pay for it.\u003c/p>\n\u003cp>It costs more than $250 for one firefighter to be trained as a peer counselor through the IAFF program, and membership to the Firestrong website is an additional $1,500 per year. So far, the union has paid for the training, and Robertson plans to push for city money in union negotiations this August.\u003c/p>\n\u003cp>But Hoffmann said he is worried that the peer counseling program won’t be inclusive and that the people chosen as counselors could just be winners of a popularity contest within the union. “The way they’re describing doing their program,” Hoffman said, “I can’t spend city money on that.”\u003c/p>\n\u003cp>\u003cstrong>‘Just Doing Our Job’\u003c/strong>\u003c/p>\n\u003cp>In early April, Robertson attended an IAFF conference in Phoenix and was surprised to receive a plaque commending the Oakland firefighters on their actions the night of the Ghost Ship fire. The honor made him distinctly uncomfortable. It was weird, he said, to get a plaque “for us just doing our job.” Especially, he added, on a night when 36 people lost their lives.\u003c/p>\n\u003cp>Robertson frowns at any mention of leaving a legacy in the department. That’s not why he’s creating the peer counseling program, he said, though it’s hard for him to come up with the words to describe why firefighter PTSD is such an important issue for him personally.\u003c/p>\n\u003cp>“It’s probably because I’m all fucked up myself by it,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was \u003ca href=\"https://www.statnews.com/2017/06/02/ghost-ship-firefighters/\" target=\"_blank\" rel=\"noopener noreferrer\">originally published by STAT\u003c/a>, 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>The day was dawning clear and sunny as Dan Robertson picked his way through the remnants of the inferno. The veteran firefighter was with a few of the other guys, making a final sweep to check that all the flames were out, when morbid curiosity got the better of them. He was cold and wet from water and sweat, and his knees told him it was time to go home. But he wondered, what does a warehouse look like, all burnt up from the inside out?\u003c/p>\n\u003cp>They walked over charcoal debris; some stuff they could recognize, like rugs and alarm clocks. Other stuff had melted into dark indecipherable shapes. The winter air smelled like that moment when you pour water on a big log-filled campfire, but with scents of burning plastic and chemicals mixed in.\u003c/p>\n\u003cp>What Robertson noticed most were the pianos. There were singed pianos everywhere, at least four or five in the front, near the doorway. He remembered being inside six hours earlier, at the height of the blaze, a piano blocking his path as he tried to carry a hose through the crackling flames.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>By the time they had finished exploring the Ghost Ship warehouse that morning of Dec. 3, 2016, nine people had been confirmed dead; 27 more victims would be found by the end of that week in the building, which had been converted into an artists collective.\u003c/p>\n\u003cp>It wasn’t until Robertson was back at the firehouse, showering and changing into fresh clothes, that his experiences that night finally caught up to him. He drove his Toyota Tundra home and found his wife, Cheri, awake. She had just heard about the fire, and asked whether he was OK. He tried to speak, but nothing came out. He just started sobbing.\u003c/p>\n\u003caside class=\"pullquote alignright\">Many Oakland firefighters told STAT they are still struggling with the emotional fallout from that night six months ago.\u003c/aside>\n\u003cp>Many Oakland firefighters told STAT they are still struggling with the emotional fallout from that night six months ago. But few have sought mental health treatment, because of stigma within the department, combined with a limit on free counseling sessions provided by the city.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now the Ghost Ship fire has become a catalyst for change in the Oakland Fire Department, where Robertson, a 54-year-old lieutenant and the president of the Oakland firefighters union, and other firefighters are pushing to create a peer counseling program. Firefighters in general are at high risk of developing post-traumatic stress disorder, which can lead to anxiety, substance abuse and even suicide, and that has spurred firefighters in numerous cities to demand that their mental health be treated as urgently as any other injury sustained on the job.\u003c/p>\n\u003cp>Oakland fire officials insist that existing mental health services are sufficient but underused. Deputy Chief Mark Hoffmann pointed to the city’s “incredibly robust workers comp system,” and noted that firefighters who were at the Ghost Ship fire have been offered extra employee assistance program sessions, though few have claimed them.\u003c/p>\n\u003cp>Robertson disagrees. The fact that few firefighters use the current services, he said, is proof that they aren’t working. “Is it underutilized because it’s not needed, or is it underutilized because people have no faith in it?” Robertson asked.\u003c/p>\n\u003cfigure id=\"attachment_403984\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-403984\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/RS23048_GettyImages-627450192-qut-800x534-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Firefighters clear debris from the entrance to the Ghost Ship warehouse in Oakland, where a fire killed 36 people on Dec. 2, 2016. \u003ccite>((Elijah Nouvelage/Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘That Was Going to Sit With Me’\u003c/strong>\u003c/p>\n\u003cp>After the fire came the search for bodies. Eight men and women who participated in the recovery efforts said it was the most difficult aspect of the whole week. One fire captain, who has been with the department for more than 20 years, said thinking about it still makes him feel like he is teetering on the edge of a breakdown. He could see 10 bodies in the ash and rubble when he arrived, and he knew from the way the building collapsed that there would be more.\u003c/p>\n\u003cp>The victims died of smoke inhalation, not fire, so all their features were recognizable. The firefighters could see every detail: The cellphones in their pockets flooded with missed calls. Their tattoos. Their eyelashes. “There was no question,” said another firefighter, “that was going to sit with me for a while.”\u003c/p>\n\u003cp>All of them spoke about that day on condition of anonymity because they weren’t authorized to speak to the news media.\u003c/p>\n\u003cp>The firefighters were quick to emphasize that the Ghost Ship fire was just one in a long series of traumatic events over the course of their careers. In a big city like Oakland, they respond to everything from stubbed toes to heart attacks, from shootings to wildfires to structure fires. When asked to think back on a call that stuck with them, all the firefighters were able to conjure up several memories in perfect detail.\u003c/p>\n\u003cp>There was the firefighter-paramedic who still remembers the faces of two teenage girls shot in the head execution-style on a street. Another firefighter, in the department for less than five years, described a day when they drove an alcoholic to the hospital to get detoxed; as the man left the hospital that evening to go home, he was shot in a botched robbery, and the same team was called back to the scene to pronounce him dead.\u003c/p>\n\u003cp>Firefighters have a metaphor for their emotional baggage: the backpack. After every traumatic event, more junk is thrown into their symbolic backpacks for them to carry around each day. Eventually it will get too heavy; it will drag them down. “My backpack’s full,” said a firefighter still in his 18-month probation period. “It’s super full.”\u003c/p>\n\u003cp>PTSD and other post-trauma mental health issues can be tricky to identify in first responders, said psychologist Mark Kemena, a lead clinician for the West Coast Post-trauma Retreat, because it often builds up over time. It is like having a car alarm that is triggered when even the slightest wind passes by, said Michael Palmertree, a psychologist who has worked extensively with the Oakland Police Department.\u003c/p>\n\u003cp>There have been many studies about rates of PTSD in veterans and police, but reliable statistics for mental trauma in firefighters are hard to find. Suzy Gulliver, director of the Warriors Research Institute, is one of the few clinicians who has done studies on firefighter mental health. Over the course of a lifetime, she said, 20 to 22 percent of firefighters in the United States will experience PTSD — the same rate as returning combat veterans.\u003c/p>\n\u003cp>The consequences can be tragic. According to estimates from the National Fallen Firefighters Foundation, firefighters are three times more likely to die of suicide than in the line of duty. And many PTSD sufferers self-medicate with drugs or alcohol. Robertson said excessive drinking and substance use, including marijuana, have always been common in the fire department, particularly in young members. He himself had to go to drug rehab early in his career.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you do this for a little while, you’re scarred mentally for sure'\u003ccite>Chris Foley, Veteran fire captain\u003c/cite>\u003c/aside>\n\u003cp>“When you do this for a little while,” said Chris Foley, a veteran fire captain helping Robertson start the peer counseling program, “you’re scarred mentally for sure.”\u003c/p>\n\u003cp>\u003cstrong>Firefighters Wary of \u003c/strong>\u003cstrong>Treatment\u003c/strong>\u003c/p>\n\u003cp>Firefighters like to say that the fire service is 150 years of tradition, unimpeded by progress. When Robertson was a new recruit in the early 1990s, mental health wasn’t talked about in the firehouse. Back then, veterans from World War II, Korea, and Vietnam were on the crew, men who had already experienced their fair share of trauma.\u003c/p>\n\u003cp>“You can’t handle it?” Robertson recalled them saying if they saw a new crew member getting emotional after a run. “Then you need to go somewhere else.”\u003c/p>\n\u003cp>The culture has started changing, Robertson said, but many firefighters still won’t admit that a call affected them, fearing it would be seen as weakness and make their coworkers trust them a little less. In a recent survey conducted by the NBC Bay Area investigative news team, almost 50 percent of the 700 firefighters that responded said that concerns about colleagues not trusting their judgment contributed to the stigma of seeking mental health treatment.\u003c/p>\n\u003cp>Only one of the eight firefighters STAT interviewed who were at the scene that night has sought regular mental health treatment. For the few who do try to seek help, options are limited and, they say, often confusing.\u003c/p>\n\u003cp>Firefighters in Oakland are offered the same counseling program that every Oakland city employee gets: three free therapy sessions every six months through their employee assistance program (EAP). Tom Farris, president of Claremont EAP, which runs the city’s program, said it is designed to be a bridge to longer-term care, though firefighters have to pay for additional sessions through insurance copayments or out of pocket.\u003c/p>\n\u003cp>Complex mental health problems like PTSD are “absolutely not” resolved within three sessions, said Farris, who is a licensed psychologist. But “that’s not really what EAPs are scoped out to handle,” he said. Farris noted that in many cities, first responders are offered six to 10 EAP sessions, not three. More benefits for public safety employees “is a good idea,” he said.\u003c/p>\n\u003cp>Another resource in the fire department is a Critical Incident Stress Management team that is dispatched to fire stations after big events such as the Ghost Ship fire. The team members can vary from priests to other firefighters to experienced psychologists to brand-new therapists trying to boost their resume, and firefighters are required to sit together and debrief the incident.\u003c/p>\n\u003cp>Reactions to CISM are mixed. While psychologists say it can be very helpful, some firefighters say the team members often can’t relate to their experiences. Robertson said many of the CISM therapists wouldn’t be able to hold their own in a burning building. “Why the hell would I open up to you?” he said.\u003c/p>\n\u003cp>Hoffmann, the deputy chief who has been in the fire department 37 years, acknowledged that CISM has been “poorly applied at times” and said team members hadn’t received training “in about two years,” but he believes that it is an effective behavioral health tool.\u003c/p>\n\u003cp>Unsatisfied with the current treatment options, Robertson, along with Foley, has made it his mission in his last two years before retirement to launch a peer counseling program. They want to follow in the steps of other departments, including Phoenix and New York City, that have been using this model for years. Several other Bay Area cities have these programs, including neighboring Berkeley.\u003c/p>\n\u003cp>The International Association of Fire Fighters (IAFF) started offering peer counseling training courses last year and so far has offered 24 courses across North America. Elaine Viccora, a behavioral specialist at IAFF, said it plans to offer three to four trainings each month.\u003c/p>\n\u003cp>Robertson hopes to model the Oakland peer counseling program after the one in Phoenix. Brian French, a Phoenix firefighter, helped develop it in 2010 after four members of the department committed suicide within seven months.\u003c/p>\n\u003cp>Their model, French said, is “listen, refer, support.” Peer counselors are trained to reach out to individual station members after a critical incident and encourage them to get professional counseling if they think it is needed. French also oversees the day-to-day operations of a website called Firestrong, an online portal where fire departments around the country can list area-specific mental health resources for their members.\u003c/p>\n\u003cp>Robertson faces two main barriers as he tries to get the peer-counseling program off the ground: persuading the firefighters to admit when they need help, and convincing Hoffmann and other city administrators to pay for it.\u003c/p>\n\u003cp>It costs more than $250 for one firefighter to be trained as a peer counselor through the IAFF program, and membership to the Firestrong website is an additional $1,500 per year. So far, the union has paid for the training, and Robertson plans to push for city money in union negotiations this August.\u003c/p>\n\u003cp>But Hoffmann said he is worried that the peer counseling program won’t be inclusive and that the people chosen as counselors could just be winners of a popularity contest within the union. “The way they’re describing doing their program,” Hoffman said, “I can’t spend city money on that.”\u003c/p>\n\u003cp>\u003cstrong>‘Just Doing Our Job’\u003c/strong>\u003c/p>\n\u003cp>In early April, Robertson attended an IAFF conference in Phoenix and was surprised to receive a plaque commending the Oakland firefighters on their actions the night of the Ghost Ship fire. The honor made him distinctly uncomfortable. It was weird, he said, to get a plaque “for us just doing our job.” Especially, he added, on a night when 36 people lost their lives.\u003c/p>\n\u003cp>Robertson frowns at any mention of leaving a legacy in the department. That’s not why he’s creating the peer counseling program, he said, though it’s hard for him to come up with the words to describe why firefighter PTSD is such an important issue for him personally.\u003c/p>\n\u003cp>“It’s probably because I’m all fucked up myself by it,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was \u003ca href=\"https://www.statnews.com/2017/06/02/ghost-ship-firefighters/\" target=\"_blank\" rel=\"noopener noreferrer\">originally published by STAT\u003c/a>, 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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"content": "\u003cp>\u003cstrong>Update June 5, 2017 \u003c/strong>\u003c/p>\n\u003cp>From The New York Times Sunday: Charles Duhigg \u003ca href=\"https://www.nytimes.com/2017/06/04/business/angry-about-epipen-prices-executive-dont-care-much.html\" target=\"_blank\" rel=\"noopener noreferrer\">writes\u003c/a> that last year's outrage over Mylan ratcheting up the price of the EpiPen, so that patients\u003ca href=\"http://www.reuters.com/article/us-health-epipen-costs-idUSKBN16Y24O\" target=\"_blank\" rel=\"noopener noreferrer\"> out-of-pocket costs\u003c/a> increased by over 500 percent in a few years, has not resulted in the company lowering the price of the product. Duhigg writes:\u003c/p>\n\u003cblockquote>\u003cp>Mylan has been called out again and again over the years — by the company’s own employees, regulators, patients, politicians and the press — and hasn’t changed, even as revenue has skyrocketed, hitting $11 billion last year. The firm is a case study in the limits of what consumer and employee activism, as well as government oversight, can achieve.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile last week, Iowa Republican Sen. Charles Grassley\u003ca href=\"https://www.grassley.senate.gov/news/news-releases/grassley-latest-estimate-taxpayers-overpaid-127-billion-epipen\" target=\"_blank\" rel=\"noopener noreferrer\"> announced\u003c/a> that the government has estimated Mylan may have overcharged Medicaid by as much as $1.27 billion for the EpiPen under the agency's drug rebate program.\u003c/p>\n\u003cp>\u003cstrong>Original post from Jan. 23, 2017\u003c/strong>\u003c/p>\n\u003cp>Should we be free, as individuals, to make and take our own medicine at home? Who’s responsible if we get hurt or die? Do we have to right to do what we wish with our bodies in the interests of survival, healing and self-care? For years, such questions have been at the heart of public health debates over euthanasia – the right to die – and even drug addiction.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They also lie at the center of the infamous Mylan EpiPen pricing scandal. Last fall, Mylan CEO Heather Bresch appeared before the House Oversight Committee to explain the company’s 548 percent price hike for a simple device that injects a lifesaving anti-allergy hormone, FDA-approved epinephrine.\u003c/p>\n\u003cp>The cost drove desperate allergy patients to seek alternatives, including \u003ca href=\"http://www.thedailybeast.com/articles/2016/09/22/please-do-not-hack-your-own-epipen.html\">the dangerous practice\u003c/a> of shooting epinephrine straight from a vial into a muscle.\u003c/p>\n\u003cp>Enter a new challenger: the pharmaceutical hacking collective \u003ca href=\"https://fourthievesvinegar.org/\">Four Thieves Vinegar.\u003c/a> The group is led by Michael Laufer, a math professor by day at Menlo College in Atherton, California, who shot to internet fame overnight last August when he uploaded a DIY instructional video that went viral, showcasing his homemade version of a copycat EpiPen he called the EpiPencil. \u003ca href=\"https://www.the-parallax.com/2016/09/19/epipencil-hack-costs-fraction-epipen-exclusive/\">His device costs around $35 to construct\u003c/a>– a fraction of Mylan’s $600 brand name dual-pack EpiPen. Anyone can make it at home for personal use, he claims.\u003c/p>\n\u003cp>Laufer isn’t a medical doctor and doesn’t pretend to be. But he’s a numbers guy, well versed in computer science, and has dipped into biology and chemistry. It took him two weeks to research and assemble the plastic components of the EpiPen, an auto injector created by a NASA researcher and marketed in 1980 for $20. Mylan later picked up the patent and has benefited from a monopoly.\u003c/p>\n\u003cfigure id=\"attachment_323237\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-323237\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg\" alt=\"Close-up of packaging used in the Epi-Pencil. \" width=\"800\" height=\"1013\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-160x203.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-768x973.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1020x1292.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1920x2432.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1180x1495.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-960x1216.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-240x304.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-375x475.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-520x659.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Close-up of packaging used in the EpiPencil. \u003ccite>(Four Thieves Vinegar Collective)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Four Thieves Vinegar is named after a folk remedy made from vinegar and spices to ward off bubonic plague. The collective is part of the fast-growing DIY Biology movement, a subculture in which tech meets pharma--a Maker Faire for bio-geeks. In the video, Laufer carefully demonstrates how anyone can do what he did: combine a cheap off-the-shelf needle injector made for diabetics that is easy to buy on the internet, and combine it with a syringe that can be preloaded with a $1 dose of epinephrine.\u003c/p>\n\u003cp>Under fire, Mylan soon released\u003ca href=\"http://newsroom.mylan.com/2016-12-16-Mylan-Launches-the-First-Generic-for-EpiPen-epinephrine-injection-USP-Auto-Injector-as-an-Authorized-Generic\"> a $300 generic of its EpiPen\u003c/a>, but that did little to quiet critics. Georgia Congressman Buddy Carter accused the company of failing to disclose the truth about its profiteering. “There is no transparency, that's the problem here,\" he declared.\u003c/p>\n\u003cp>Leaders also criticized the FDA for its slow-paced approval of generic rivals. Teva Pharmaceutical Industries failed to get approval \u003ca href=\"https://consumerist.com/2016/09/12/teva-will-try-again-to-get-fda-approval-on-epipen-competitor-by-2018/\">for its generic EpiPen\u003c/a> in late 2016, but expects approval by 2018. Meanwhile, CVS Pharmacy has just released a $109.99 generic \u003ca href=\"http://www.pharmacytimes.com/sap-news/cvs-offers-2pack-adrenaclick-for-fraction-of-epipen-price\">two-pack EpiPen called Adrenaclick\u003c/a>. At $55 a pen, it’s close to Laufer’s DIY price -- and provides consumers with a safe, FDA-approved product.\u003c/p>\n\u003cp>That’s exactly what Laufer hoped might happen. As he sees it, his EpiPencil hack was a classic example of The Emperor Has No Clothes: It revealed the actual cost of the plastic auto injector – and showed others how they could make such a device cheaply.\u003c/p>\n\u003cp>It’s a mixed victory, though. The media spotlight gained supporters for Laufer's collective, but also opened him up to criticism. “I get a lot more fan mail then hate mail,” he says, including from parents. But others sharply condemn his actions, and his hacking group’s broader mission: making medicine at home.\u003c/p>\n\u003cp>\u003cstrong>Home Pharma Hacks Raise Safety Questions\u003c/strong>\u003c/p>\n\u003cp>Shortly after Laufer’s hack, the FDA issued a strongly worded warning against its use: “Using unapproved prescription drugs for personal use is a potentially dangerous practice,” an FDA spokesperson \u003ca href=\"http://www.in-pharmatechnologist.com/Regulatory-Safety/US-FDA-warns-against-30-alternative-to-Mylan-s-EpiPen\">told\u003c/a> the website in-PharmaTechnologist. “Unapproved drugs may be contaminated, sub-potent, super-potent or counterfeit.”\u003c/p>\n\u003cp>Critics agree. Yvette d’Entremont, known as SciBabe, is a former chemist-cum-blogger who quickly labeled the EpiPen hack a potential major fail if misused. “It seems like such a bad idea,” she told the Daily Beast. “It’s all fun and games until your product gets contaminated and you get a giant abscess in your muscle.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'I believe in empowering people, in sharing information. We need to talk about alternatives to expensive medication regimens.’\u003ccite>Michael Laufer\u003c/cite>\u003c/aside>\n\u003cp>Contamination and improper dosing can happen with approved drugs too. Epinephrine is a serious drug, used to shock the heart. Laufer defends his device as safe. “In most ways it is equivalent” to Mylan’s EpiPen, he argues, pointing out that it features a safety cap like approved EpiPens, and only carries a single dose.\u003c/p>\n\u003cp>But it’s still untested. And as the father of toxicology himself, Paracelsus, famously warned: all medicine is poison at a certain dose.\u003c/p>\n\u003cp>Oncologist Ezekiel Emanuel, a bioethicist and senior fellow at the Center for American Progress, adds to the chorus of concern, cautioning strongly against using the device.\u003c/p>\n\u003cp>“We have the FDA for a reason. We want to protect the American public from dangerous drugs, which they have no ability to evaluate independently,” he says. “So now we’re going to have some guy who’s going to make a drug and a drug delivery device, put it out there -- no testing, no evaluation of whether it’s safe or effective -- and who the hell knows how many people are going to be hurt -- or not.”\u003c/p>\n\u003cfigure id=\"attachment_323239\" class=\"wp-caption aligncenter\" style=\"max-width: 678px\">\u003cimg class=\"size-full wp-image-323239\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg\" alt=\"Michael Laufer demonstrates how to lead the Epi-Pencil in a DIY video posted to YouTube.\" width=\"678\" height=\"487\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg 678w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-160x115.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-240x172.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-375x269.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-520x374.jpg 520w\" sizes=\"(max-width: 678px) 100vw, 678px\">\u003cfigcaption class=\"wp-caption-text\">Michael Laufer demonstrates the EpiPencil in a DIY video posted to YouTube. \u003ccite>(Anne-christine d'Adesky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adds Emanuel: “In this case he may turn out to be lucky and no one’s hurt. But we don’t want that regime.”\u003c/p>\n\u003cp>He said the solution to high pharmaceutical prices was \"not this cockamamie 'let people throw drugs out there untested,'\" but to reduce the market power that drug companies rely on to set prices.\u003c/p>\n\u003cp>\"We give drug companies monopolies through the patent law, and marketing exclusivity,\" he said. \"No other country gives a monopoly and then expects good behavior on pricing.\u003c/p>\n\u003cp>\"So what we’ve done is say, 'Oh we’re giving drug companies monopoly pricing power and then we’re like shocked, shocked they're raising prices.\"\u003c/p>\n\u003cp>Margaret McLean, director of bioethics at the\u003ca href=\"https://www.scu.edu/ethics/focus-areas/bioethics/\"> Markkula Center for Applied Ethics\u003c/a> in Santa Clara, also agrees using Laufer's device could be dangerous. She herself, carries an EpiPen. It carries a higher copay than her other medicines, so she sympathizes with parents who can’t afford even generic versions. But the safety risks remain serious.\u003c/p>\n\u003cp>“There is always user error,” says McLean, citing incorrect dosing as a concern. “That is true with FDA-approved drugs too. But the error is less if I don’t have to draw up the right amount of epinephrine myself. I’m grateful for the standardization and check on the injector itself, and that the dose in there is appropriate for me.” She doesn’t want to worry about bubbles in the syringe, which are very dangerous. “There are a lot of steps here,” she says of Laufer’s DIY epinephrine device, “where sitting at home in your kitchen, never having done this before, it puts you in a higher risk category then buying it from the pharmacy.”\u003c/p>\n\u003cp>Still, she understands the urgent unmet need for affordable EpiPens. “The FDA is not able to move things through in an expeditious way, so people rightly get antsy.”\u003c/p>\n\u003cp>Perhaps surprisingly, Laufer agrees about the warnings on safety. “Chemistry is science. So, yes, it’s a concern. You have to think immediately, ‘What if it’s misused?’ But that’s a first-order reaction,” he says. “Ideologically, I believe that more access to more information is inherently better for everyone.” He supports FDA safety reviews and clinical trial tests for new drugs and devices that are marketed to consumers. But he stresses, he’s not marketing anything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have the FDA for a reason. We want to protect the American public from dangerous drugs which they have no ability to evaluate independently.'\u003ccite>Ezekiel Emanuel, Center for American Progress\u003c/cite>\u003c/aside>\n\u003cp>Where Laufer draws a hard line – and marks his battleground -- is the domain of the private individual. “What I’m saying is, here is something you can think about... If you decide you’d like to adopt it, then that’s the whole ethic: Here is an idea, play with it, if you like -- no strings attached.”\u003c/p>\n\u003cp>\u003cstrong>More Drug Hacks On the Horizon\u003c/strong>\u003c/p>\n\u003cp>In his cramped faculty office, Laufer greets visitors with a warm smile, eager to share his mission and rebut critics who, he feels, have misperceptions about the true goals and the impact of his hacking action. Online, he looks like a steampunk rebel hero in a metal-studded leather jacket, rimless glasses shoved high on his forehead. Offline, he’s natty in a dark suit, purple tie and tie pin, and fancy abacus-shaped cuff links befitting a math geek.\u003c/p>\n\u003cp>“I believe in empowering people, in sharing information,” Laufer says, citing his hacker creed. “We need to talk about alternatives to expensive medication regimens.” He compares the need for a cheap drug delivery device like his EpiPencil to IKEA furniture: something that should be easy to make, with simple instructions for the average consumer.\u003c/p>\n\u003cp>What people do with that information is not his business, he declares. “I don’t know if anyone has built it besides me,” he says of the EpiPencil. “I don’t want to know. I believe in giving people information they can use to make important decisions about their self-care. That’s what I can offer.”[contextly_sidebar id=\"ucdOGkeG5JNKwxC6hhmw4jS3XUbH2VRU\"]\u003c/p>\n\u003cp>Anyone who copies a patented device risks running afoul of patent law. It's a form of civil disobedience with life-or-death stakes. That make it easy to justify, according to Laufer's group, whose \u003ca href=\"https://fourthievesvinegar.org/faq\">website asks\u003c/a>, \"If the choices presented to you are to die, because you cannot afford medication, or violate a copyright, which would you choose?\"\u003c/p>\n\u003cp>Four Thieves Vinegar is presently focused on “small batch” chemistry--medicines that are easy to make with at-home equipment. Laufer’s first successful hack was pyrimethamine (brand name Daraprim), a decades-old drug used to treat toxoplasmosis in AIDS, cancer and malaria patients. Turing Pharmaceuticals purchased the patent in August 2015 and, a month later, \u003ca href=\"http://www.cbsnews.com/news/generic-drug-price-increases-5000-percent-overnight/\">hiked the price for a single Daraprim pill overnight\u003c/a> by 5,000 percent, from $13.50 to $750. Turing CEO Martin Shkreli became a Big Pharma pariah. In response, Laufer made a batch of DIY Daraprim for $2 a pill. So did a group of \u003ca href=\"https://qz.com/851416/why-martin-shkreli-and-turings-daraprim-still-costs-750-in-the-us-when-australian-schoolkids-can-make-it-for-2/\">Australian high school students\u003c/a>.\u003c/p>\n\u003cp>Laufer has now set his sights on several drugs he feels urgently merit greater public access, including the\u003ca href=\"http://www.rawstory.com/2016/05/american-women-increasingly-turn-to-diy-abortion-drugs-after-gop-laws-shut-down-health-clinics/\"> abortion drugs RU-486 (Mifepristone) and Misoprostol\u003c/a>; Solvadi, a hepatitis C drug; and Glaxo’s HIV prevention pill, GSK-744. He’s keenly aware his choices remain controversial and politically charged.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Looking ahead, Laufer foresees a future of medicine more like Socrates, less like Big Pharma: “Maybe in not too long, the idea of doing chemistry on a personal and individual level and applying it to medicine will be more commonplace. I like dreaming about that.”\u003c/p>\n\n",
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"description": "Their work may skirt the law, but pharma hacking collective Four Thieves Vinegar says their DIY medicine demos serve a greater good. ",
"title": "Was the EpiPen Hack Ethical? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update June 5, 2017 \u003c/strong>\u003c/p>\n\u003cp>From The New York Times Sunday: Charles Duhigg \u003ca href=\"https://www.nytimes.com/2017/06/04/business/angry-about-epipen-prices-executive-dont-care-much.html\" target=\"_blank\" rel=\"noopener noreferrer\">writes\u003c/a> that last year's outrage over Mylan ratcheting up the price of the EpiPen, so that patients\u003ca href=\"http://www.reuters.com/article/us-health-epipen-costs-idUSKBN16Y24O\" target=\"_blank\" rel=\"noopener noreferrer\"> out-of-pocket costs\u003c/a> increased by over 500 percent in a few years, has not resulted in the company lowering the price of the product. Duhigg writes:\u003c/p>\n\u003cblockquote>\u003cp>Mylan has been called out again and again over the years — by the company’s own employees, regulators, patients, politicians and the press — and hasn’t changed, even as revenue has skyrocketed, hitting $11 billion last year. The firm is a case study in the limits of what consumer and employee activism, as well as government oversight, can achieve.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile last week, Iowa Republican Sen. Charles Grassley\u003ca href=\"https://www.grassley.senate.gov/news/news-releases/grassley-latest-estimate-taxpayers-overpaid-127-billion-epipen\" target=\"_blank\" rel=\"noopener noreferrer\"> announced\u003c/a> that the government has estimated Mylan may have overcharged Medicaid by as much as $1.27 billion for the EpiPen under the agency's drug rebate program.\u003c/p>\n\u003cp>\u003cstrong>Original post from Jan. 23, 2017\u003c/strong>\u003c/p>\n\u003cp>Should we be free, as individuals, to make and take our own medicine at home? Who’s responsible if we get hurt or die? Do we have to right to do what we wish with our bodies in the interests of survival, healing and self-care? For years, such questions have been at the heart of public health debates over euthanasia – the right to die – and even drug addiction.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They also lie at the center of the infamous Mylan EpiPen pricing scandal. Last fall, Mylan CEO Heather Bresch appeared before the House Oversight Committee to explain the company’s 548 percent price hike for a simple device that injects a lifesaving anti-allergy hormone, FDA-approved epinephrine.\u003c/p>\n\u003cp>The cost drove desperate allergy patients to seek alternatives, including \u003ca href=\"http://www.thedailybeast.com/articles/2016/09/22/please-do-not-hack-your-own-epipen.html\">the dangerous practice\u003c/a> of shooting epinephrine straight from a vial into a muscle.\u003c/p>\n\u003cp>Enter a new challenger: the pharmaceutical hacking collective \u003ca href=\"https://fourthievesvinegar.org/\">Four Thieves Vinegar.\u003c/a> The group is led by Michael Laufer, a math professor by day at Menlo College in Atherton, California, who shot to internet fame overnight last August when he uploaded a DIY instructional video that went viral, showcasing his homemade version of a copycat EpiPen he called the EpiPencil. \u003ca href=\"https://www.the-parallax.com/2016/09/19/epipencil-hack-costs-fraction-epipen-exclusive/\">His device costs around $35 to construct\u003c/a>– a fraction of Mylan’s $600 brand name dual-pack EpiPen. Anyone can make it at home for personal use, he claims.\u003c/p>\n\u003cp>Laufer isn’t a medical doctor and doesn’t pretend to be. But he’s a numbers guy, well versed in computer science, and has dipped into biology and chemistry. It took him two weeks to research and assemble the plastic components of the EpiPen, an auto injector created by a NASA researcher and marketed in 1980 for $20. Mylan later picked up the patent and has benefited from a monopoly.\u003c/p>\n\u003cfigure id=\"attachment_323237\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-323237\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg\" alt=\"Close-up of packaging used in the Epi-Pencil. \" width=\"800\" height=\"1013\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-160x203.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-768x973.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1020x1292.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1920x2432.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1180x1495.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-960x1216.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-240x304.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-375x475.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-520x659.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Close-up of packaging used in the EpiPencil. \u003ccite>(Four Thieves Vinegar Collective)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Four Thieves Vinegar is named after a folk remedy made from vinegar and spices to ward off bubonic plague. The collective is part of the fast-growing DIY Biology movement, a subculture in which tech meets pharma--a Maker Faire for bio-geeks. In the video, Laufer carefully demonstrates how anyone can do what he did: combine a cheap off-the-shelf needle injector made for diabetics that is easy to buy on the internet, and combine it with a syringe that can be preloaded with a $1 dose of epinephrine.\u003c/p>\n\u003cp>Under fire, Mylan soon released\u003ca href=\"http://newsroom.mylan.com/2016-12-16-Mylan-Launches-the-First-Generic-for-EpiPen-epinephrine-injection-USP-Auto-Injector-as-an-Authorized-Generic\"> a $300 generic of its EpiPen\u003c/a>, but that did little to quiet critics. Georgia Congressman Buddy Carter accused the company of failing to disclose the truth about its profiteering. “There is no transparency, that's the problem here,\" he declared.\u003c/p>\n\u003cp>Leaders also criticized the FDA for its slow-paced approval of generic rivals. Teva Pharmaceutical Industries failed to get approval \u003ca href=\"https://consumerist.com/2016/09/12/teva-will-try-again-to-get-fda-approval-on-epipen-competitor-by-2018/\">for its generic EpiPen\u003c/a> in late 2016, but expects approval by 2018. Meanwhile, CVS Pharmacy has just released a $109.99 generic \u003ca href=\"http://www.pharmacytimes.com/sap-news/cvs-offers-2pack-adrenaclick-for-fraction-of-epipen-price\">two-pack EpiPen called Adrenaclick\u003c/a>. At $55 a pen, it’s close to Laufer’s DIY price -- and provides consumers with a safe, FDA-approved product.\u003c/p>\n\u003cp>That’s exactly what Laufer hoped might happen. As he sees it, his EpiPencil hack was a classic example of The Emperor Has No Clothes: It revealed the actual cost of the plastic auto injector – and showed others how they could make such a device cheaply.\u003c/p>\n\u003cp>It’s a mixed victory, though. The media spotlight gained supporters for Laufer's collective, but also opened him up to criticism. “I get a lot more fan mail then hate mail,” he says, including from parents. But others sharply condemn his actions, and his hacking group’s broader mission: making medicine at home.\u003c/p>\n\u003cp>\u003cstrong>Home Pharma Hacks Raise Safety Questions\u003c/strong>\u003c/p>\n\u003cp>Shortly after Laufer’s hack, the FDA issued a strongly worded warning against its use: “Using unapproved prescription drugs for personal use is a potentially dangerous practice,” an FDA spokesperson \u003ca href=\"http://www.in-pharmatechnologist.com/Regulatory-Safety/US-FDA-warns-against-30-alternative-to-Mylan-s-EpiPen\">told\u003c/a> the website in-PharmaTechnologist. “Unapproved drugs may be contaminated, sub-potent, super-potent or counterfeit.”\u003c/p>\n\u003cp>Critics agree. Yvette d’Entremont, known as SciBabe, is a former chemist-cum-blogger who quickly labeled the EpiPen hack a potential major fail if misused. “It seems like such a bad idea,” she told the Daily Beast. “It’s all fun and games until your product gets contaminated and you get a giant abscess in your muscle.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'I believe in empowering people, in sharing information. We need to talk about alternatives to expensive medication regimens.’\u003ccite>Michael Laufer\u003c/cite>\u003c/aside>\n\u003cp>Contamination and improper dosing can happen with approved drugs too. Epinephrine is a serious drug, used to shock the heart. Laufer defends his device as safe. “In most ways it is equivalent” to Mylan’s EpiPen, he argues, pointing out that it features a safety cap like approved EpiPens, and only carries a single dose.\u003c/p>\n\u003cp>But it’s still untested. And as the father of toxicology himself, Paracelsus, famously warned: all medicine is poison at a certain dose.\u003c/p>\n\u003cp>Oncologist Ezekiel Emanuel, a bioethicist and senior fellow at the Center for American Progress, adds to the chorus of concern, cautioning strongly against using the device.\u003c/p>\n\u003cp>“We have the FDA for a reason. We want to protect the American public from dangerous drugs, which they have no ability to evaluate independently,” he says. “So now we’re going to have some guy who’s going to make a drug and a drug delivery device, put it out there -- no testing, no evaluation of whether it’s safe or effective -- and who the hell knows how many people are going to be hurt -- or not.”\u003c/p>\n\u003cfigure id=\"attachment_323239\" class=\"wp-caption aligncenter\" style=\"max-width: 678px\">\u003cimg class=\"size-full wp-image-323239\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg\" alt=\"Michael Laufer demonstrates how to lead the Epi-Pencil in a DIY video posted to YouTube.\" width=\"678\" height=\"487\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg 678w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-160x115.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-240x172.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-375x269.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-520x374.jpg 520w\" sizes=\"(max-width: 678px) 100vw, 678px\">\u003cfigcaption class=\"wp-caption-text\">Michael Laufer demonstrates the EpiPencil in a DIY video posted to YouTube. \u003ccite>(Anne-christine d'Adesky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adds Emanuel: “In this case he may turn out to be lucky and no one’s hurt. But we don’t want that regime.”\u003c/p>\n\u003cp>He said the solution to high pharmaceutical prices was \"not this cockamamie 'let people throw drugs out there untested,'\" but to reduce the market power that drug companies rely on to set prices.\u003c/p>\n\u003cp>\"We give drug companies monopolies through the patent law, and marketing exclusivity,\" he said. \"No other country gives a monopoly and then expects good behavior on pricing.\u003c/p>\n\u003cp>\"So what we’ve done is say, 'Oh we’re giving drug companies monopoly pricing power and then we’re like shocked, shocked they're raising prices.\"\u003c/p>\n\u003cp>Margaret McLean, director of bioethics at the\u003ca href=\"https://www.scu.edu/ethics/focus-areas/bioethics/\"> Markkula Center for Applied Ethics\u003c/a> in Santa Clara, also agrees using Laufer's device could be dangerous. She herself, carries an EpiPen. It carries a higher copay than her other medicines, so she sympathizes with parents who can’t afford even generic versions. But the safety risks remain serious.\u003c/p>\n\u003cp>“There is always user error,” says McLean, citing incorrect dosing as a concern. “That is true with FDA-approved drugs too. But the error is less if I don’t have to draw up the right amount of epinephrine myself. I’m grateful for the standardization and check on the injector itself, and that the dose in there is appropriate for me.” She doesn’t want to worry about bubbles in the syringe, which are very dangerous. “There are a lot of steps here,” she says of Laufer’s DIY epinephrine device, “where sitting at home in your kitchen, never having done this before, it puts you in a higher risk category then buying it from the pharmacy.”\u003c/p>\n\u003cp>Still, she understands the urgent unmet need for affordable EpiPens. “The FDA is not able to move things through in an expeditious way, so people rightly get antsy.”\u003c/p>\n\u003cp>Perhaps surprisingly, Laufer agrees about the warnings on safety. “Chemistry is science. So, yes, it’s a concern. You have to think immediately, ‘What if it’s misused?’ But that’s a first-order reaction,” he says. “Ideologically, I believe that more access to more information is inherently better for everyone.” He supports FDA safety reviews and clinical trial tests for new drugs and devices that are marketed to consumers. But he stresses, he’s not marketing anything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have the FDA for a reason. We want to protect the American public from dangerous drugs which they have no ability to evaluate independently.'\u003ccite>Ezekiel Emanuel, Center for American Progress\u003c/cite>\u003c/aside>\n\u003cp>Where Laufer draws a hard line – and marks his battleground -- is the domain of the private individual. “What I’m saying is, here is something you can think about... If you decide you’d like to adopt it, then that’s the whole ethic: Here is an idea, play with it, if you like -- no strings attached.”\u003c/p>\n\u003cp>\u003cstrong>More Drug Hacks On the Horizon\u003c/strong>\u003c/p>\n\u003cp>In his cramped faculty office, Laufer greets visitors with a warm smile, eager to share his mission and rebut critics who, he feels, have misperceptions about the true goals and the impact of his hacking action. Online, he looks like a steampunk rebel hero in a metal-studded leather jacket, rimless glasses shoved high on his forehead. Offline, he’s natty in a dark suit, purple tie and tie pin, and fancy abacus-shaped cuff links befitting a math geek.\u003c/p>\n\u003cp>“I believe in empowering people, in sharing information,” Laufer says, citing his hacker creed. “We need to talk about alternatives to expensive medication regimens.” He compares the need for a cheap drug delivery device like his EpiPencil to IKEA furniture: something that should be easy to make, with simple instructions for the average consumer.\u003c/p>\n\u003cp>What people do with that information is not his business, he declares. “I don’t know if anyone has built it besides me,” he says of the EpiPencil. “I don’t want to know. I believe in giving people information they can use to make important decisions about their self-care. That’s what I can offer.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Anyone who copies a patented device risks running afoul of patent law. It's a form of civil disobedience with life-or-death stakes. That make it easy to justify, according to Laufer's group, whose \u003ca href=\"https://fourthievesvinegar.org/faq\">website asks\u003c/a>, \"If the choices presented to you are to die, because you cannot afford medication, or violate a copyright, which would you choose?\"\u003c/p>\n\u003cp>Four Thieves Vinegar is presently focused on “small batch” chemistry--medicines that are easy to make with at-home equipment. Laufer’s first successful hack was pyrimethamine (brand name Daraprim), a decades-old drug used to treat toxoplasmosis in AIDS, cancer and malaria patients. Turing Pharmaceuticals purchased the patent in August 2015 and, a month later, \u003ca href=\"http://www.cbsnews.com/news/generic-drug-price-increases-5000-percent-overnight/\">hiked the price for a single Daraprim pill overnight\u003c/a> by 5,000 percent, from $13.50 to $750. Turing CEO Martin Shkreli became a Big Pharma pariah. In response, Laufer made a batch of DIY Daraprim for $2 a pill. So did a group of \u003ca href=\"https://qz.com/851416/why-martin-shkreli-and-turings-daraprim-still-costs-750-in-the-us-when-australian-schoolkids-can-make-it-for-2/\">Australian high school students\u003c/a>.\u003c/p>\n\u003cp>Laufer has now set his sights on several drugs he feels urgently merit greater public access, including the\u003ca href=\"http://www.rawstory.com/2016/05/american-women-increasingly-turn-to-diy-abortion-drugs-after-gop-laws-shut-down-health-clinics/\"> abortion drugs RU-486 (Mifepristone) and Misoprostol\u003c/a>; Solvadi, a hepatitis C drug; and Glaxo’s HIV prevention pill, GSK-744. He’s keenly aware his choices remain controversial and politically charged.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Looking ahead, Laufer foresees a future of medicine more like Socrates, less like Big Pharma: “Maybe in not too long, the idea of doing chemistry on a personal and individual level and applying it to medicine will be more commonplace. I like dreaming about that.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How the Back Pain Industry is Taking Patients for a Dangerous Ride",
"title": "How the Back Pain Industry is Taking Patients for a Dangerous Ride",
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"content": "\u003cp>For the majority of us, it's not a question of whether we'll someday experience back pain; it's a question of when.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.'\u003c/aside>\n\u003cp>But searching for solutions can lead sufferers into an expensive and sometimes dangerous maze of ineffectual treatments, procedures and pills, as journalist and investigative reporter Cathryn Jakobson Ramin found. For years, she searched for ways to alleviate her own intractable back pain. Then she began to investigate the entire back pain ecosystem: doctors, chiropractors, surgery centers, pharmaceutical companies, \"posture mavens,\" collusion between personal injury attorneys and doctors ... you name it. [contextly_sidebar id=\"JG48iB524FEZTdlnUCsiXnLPWkVrjosK\"]\u003c/p>\n\u003cp>Her new book, \"\u003ca href=\"http://www.cathrynjakobsonramin.com/books/\" target=\"_blank\" rel=\"noopener noreferrer\">Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery,\u003c/a>\" explores what she found, while also telling the story of how she overcame her chronic suffering. When it comes to people making money on -- literally -- the backs of other people, \"A lot of things didn't add up,\" she says. \"That generally means something is wrong.\"\u003c/p>\n\u003cp>Ramin recently spoke about her investigation with Eric Westervelt on \u003ca href=\"https://ww2.kqed.org/forum/2017/05/19/cathryn-jakobson-ramin-on-the-crooked-back-pain-industry/\" target=\"_blank\" rel=\"noopener noreferrer\">KQED's Forum\u003c/a> program. Here is some of what she said.\u003c/p>\n\u003cp>\u003cstrong>Beware the One Surgeon Who Says Yes\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ramin, who had ineffective minor surgery for her back pain, said the post-surgical woes of Tiger Woods and Golden State Warriors' coach Steve Kerr serve as prime examples of what can go wrong with back surgery.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Minimally invasive surgery' is a marketing term. 'The damage beneath the skin will be exactly the same as it would be in traditional spine surgery.'\u003c/aside>\n\u003cp>She said some athletes do have successful surgery for back pain, but that it's unlikely their example would apply to the rest of us. \"Those athletes are highly, highly trained and in excellent condition,\" she says.\u003c/p>\n\u003cp>Ramin says the fee-for-service payment system in the U.S. incentivizes unnecessary and potentially damaging spine surgery, where in other countries, spine surgery is rare.\u003c/p>\n\u003cp>And beware the surgeon who agrees to operate on you after other reputable doctors have turned you down. She gave the example of author, physician and marathon runner Jerome Groopman, who, after five surgeons had told him there was nothing they could do for his back injury, found a sixth who claimed he could operate and get him up and running in six weeks.\u003c/p>\n\u003cp>\"He spent the next 19 years in extraordinary pain,\" Ramin says.\u003c/p>\n\u003cp>Ramin also warns against taking the description \"minimally invasive spine surgery\" literally, calling it a marketing term.\u003c/p>\n\u003cp>\"These are sexy buzzwords,\" she says. \"Perhaps the incision is small -- and it isn't always. If in fact you do have a small incision, good for you, you might look better in a bathing suit. The damage beneath the skin will be exactly the same as it would be in regular, traditional, conventional spine surgery.\"\u003c/p>\n\u003cp>These procedures are often done in outpatient surgery centers , she says. \"If anything goes wrong afterward, you're not in a hospital environment.\"\u003c/p>\n\u003cp>\u003cstrong>Chiropractors: A Very Mixed Bag\u003c/strong>\u003c/p>\n\u003cp>Ramin says some chiropractors are completely ineffectual while some are treating patients the right way. Of the latter, \"They have stopped seeking vertebral subluxations [partial dislocations] which don't actually exist on any X-ray or any type of scan, and have moved onto the very excellent practice of rehabilitation. They may ultimately be a back patient's best hope because they have studied exercise science and they have worked hard on it.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">On yoga: 'One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do.'\u003c/aside>\n\u003cp>However, \"If you see a chiropractor more than one or two sessions, you are wasting your time if you are being cracked, adjusted or walked over. Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.\"\u003c/p>\n\u003cp>She said the World Health Organization has come up with a long list of all the diagnoses for which chiropractic is contra-indicated.( See page 20 \u003ca href=\"http://apps.who.int/medicinedocs/documents/s14076e/s14076e.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.) \"And it's probably anything that would take you to a chiropractor.\"\u003c/p>\n\u003cp>Neck adjustments, she said, \"are to be avoided at all costs. There is no reason to let a chiropractor anywhere near your neck.\"\u003c/p>\n\u003cp>\u003cstrong>Pharmaceutical Companies: Painkilling Pill Pushers\u003c/strong>\u003c/p>\n\u003cp>In the 1990s, Ramin says, pharmaecutical companies embarked on a well-funded campaign to get primary care doctors to ask all their patients if they were experiencing any pain.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no reason to let a chiropractor anywhere near your neck.'\u003c/aside>\n\u003cp>Oftentimes they were experiencing some back pain, \"because it is a human condition,\" she says. \"The answer to that from the primary care doctor's perspective, because of the active marketing from pharmaceutical companies, was to say 'Well, we can take care of that pain.' \"\u003c/p>\n\u003cp>Doctors often started out with short-acting pain killers, such as Vicodin, a potent and addictive narcotic. This was often followed by longer-acting, extended-release painkillers, such as the opioid-based Oxycodone -- which has led thousands into heroin addiction.\u003c/p>\n\u003cp>But, Ramin says, opioid painkillers don't work well for people with back pain.\u003c/p>\n\u003cp>\"They cause those patients to become very unmotivated and very sleepy,\" she says.\u003c/p>\n\u003cp>Plus, a condition called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21412369\" target=\"_blank\" rel=\"noopener noreferrer\">opioid-induced hyperalgesia\u003c/a> can arise, in which the brain generates pain independent of the original injury.\u003c/p>\n\u003cp>\u003cstrong>Expensive Chairs and Standing Desks\u003c/strong>\u003c/p>\n\u003cp>Ergonomic \"experts\" rely on what Ramin calls \"smoke and mirrors.\"\u003c/p>\n\u003cp>For instance, many back sufferers will try new office chairs.\u003c/p>\n\u003cp>\"I had a stable of office chairs,\" she says. \"One after another, expensive office chairs parading through my office, and I found most of them to be not very good.\"\u003c/p>\n\u003cp>These chairs are \"often built for 250-pound men,\" she says.\u003c/p>\n\u003cp>\"I realized you could have a chair from Costco for $25 that could keep you in the right position.\"\u003c/p>\n\u003cp>The standard, erect typing position, she says, is actually a relic from when you had to press hard on typewriter keys to get them to work.\u003c/p>\n\u003cp>Regarding the use of standing desks, Ramin says those come with their own problems. \"It's a nice variation from sitting. But remember, if you are standing, you are putting tremendous pressure on possibly a different set of ligaments,\" she says. \"But still you're asking your ligaments to hold you up for a really extended period of time. We're seeing all kinds of problems related to standing desks, now. They tend to be knee and hip problems, but those will lead to back problems.\"\u003c/p>\n\u003cp>If you have a standing desk, you still need to move around every so often, she counsels.\u003c/p>\n\u003cp>\u003cstrong>The Yoga Trap\u003c/strong>\u003c/p>\n\u003cp>Some tremendous benefits can be gained from doing yoga, Ramin says, but there is potential harm, as well.\u003c/p>\n\u003cp>\"One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do. Most of us who are even remotely competitive will experience that.\"\u003c/p>\n\u003cp>She says if you have back pain, there are limitations to what you should do in class, and you need an instructor who can give you variations on postures to suit your condition.\u003c/p>\n\u003cp>\"Be very careful about finding yourself in a flow yoga class where things are moving very fast and there's no way the teacher can keep a close eye on you.\"\u003c/p>\n\u003cp>Two type of yoga she recommends for back sufferers: Iyengar yoga and Viniyoga.\u003c/p>\n\u003cp>\"Both of them have a very powerful orthopedic focus,\" Ramin says.\u003c/p>\n\u003cp>\u003cb>So What Does Work? \u003c/b>\u003c/p>\n\u003cp>Two things: Exercise and changing the way you think about back pain.\u003c/p>\n\u003cp>\"Understanding that hurt does not mean harm,\" Ramin says. \"You can continue to live an active life. The most dangerous thing you can do for yourself is take to the couch or take to your bed or take to pain management. But of course that is what most people do.“\u003c/p>\n\u003cp>Ramin recommends finding a \"back whisperer\"--someone who understands the musculoskeletal system and is able to help people build strength, balance their gaits and move effectively.\u003c/p>\n\u003cp>Moving is the key. Our bodies are not built to sit or stand in one place for hours at a time, she says. \"The best posture is your next posture.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>For more info: Ramin's website features an extensive \u003ca href=\"http://www.cathrynjakobsonramin.com/resource-search\" target=\"_blank\" rel=\"noopener noreferrer\">resources section\u003c/a> directing people to information, videos and medical professionals who may be able to help alleviate back pain.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the majority of us, it's not a question of whether we'll someday experience back pain; it's a question of when.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.'\u003c/aside>\n\u003cp>But searching for solutions can lead sufferers into an expensive and sometimes dangerous maze of ineffectual treatments, procedures and pills, as journalist and investigative reporter Cathryn Jakobson Ramin found. For years, she searched for ways to alleviate her own intractable back pain. Then she began to investigate the entire back pain ecosystem: doctors, chiropractors, surgery centers, pharmaceutical companies, \"posture mavens,\" collusion between personal injury attorneys and doctors ... you name it. \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Her new book, \"\u003ca href=\"http://www.cathrynjakobsonramin.com/books/\" target=\"_blank\" rel=\"noopener noreferrer\">Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery,\u003c/a>\" explores what she found, while also telling the story of how she overcame her chronic suffering. When it comes to people making money on -- literally -- the backs of other people, \"A lot of things didn't add up,\" she says. \"That generally means something is wrong.\"\u003c/p>\n\u003cp>Ramin recently spoke about her investigation with Eric Westervelt on \u003ca href=\"https://ww2.kqed.org/forum/2017/05/19/cathryn-jakobson-ramin-on-the-crooked-back-pain-industry/\" target=\"_blank\" rel=\"noopener noreferrer\">KQED's Forum\u003c/a> program. Here is some of what she said.\u003c/p>\n\u003cp>\u003cstrong>Beware the One Surgeon Who Says Yes\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ramin, who had ineffective minor surgery for her back pain, said the post-surgical woes of Tiger Woods and Golden State Warriors' coach Steve Kerr serve as prime examples of what can go wrong with back surgery.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Minimally invasive surgery' is a marketing term. 'The damage beneath the skin will be exactly the same as it would be in traditional spine surgery.'\u003c/aside>\n\u003cp>She said some athletes do have successful surgery for back pain, but that it's unlikely their example would apply to the rest of us. \"Those athletes are highly, highly trained and in excellent condition,\" she says.\u003c/p>\n\u003cp>Ramin says the fee-for-service payment system in the U.S. incentivizes unnecessary and potentially damaging spine surgery, where in other countries, spine surgery is rare.\u003c/p>\n\u003cp>And beware the surgeon who agrees to operate on you after other reputable doctors have turned you down. She gave the example of author, physician and marathon runner Jerome Groopman, who, after five surgeons had told him there was nothing they could do for his back injury, found a sixth who claimed he could operate and get him up and running in six weeks.\u003c/p>\n\u003cp>\"He spent the next 19 years in extraordinary pain,\" Ramin says.\u003c/p>\n\u003cp>Ramin also warns against taking the description \"minimally invasive spine surgery\" literally, calling it a marketing term.\u003c/p>\n\u003cp>\"These are sexy buzzwords,\" she says. \"Perhaps the incision is small -- and it isn't always. If in fact you do have a small incision, good for you, you might look better in a bathing suit. The damage beneath the skin will be exactly the same as it would be in regular, traditional, conventional spine surgery.\"\u003c/p>\n\u003cp>These procedures are often done in outpatient surgery centers , she says. \"If anything goes wrong afterward, you're not in a hospital environment.\"\u003c/p>\n\u003cp>\u003cstrong>Chiropractors: A Very Mixed Bag\u003c/strong>\u003c/p>\n\u003cp>Ramin says some chiropractors are completely ineffectual while some are treating patients the right way. Of the latter, \"They have stopped seeking vertebral subluxations [partial dislocations] which don't actually exist on any X-ray or any type of scan, and have moved onto the very excellent practice of rehabilitation. They may ultimately be a back patient's best hope because they have studied exercise science and they have worked hard on it.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">On yoga: 'One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do.'\u003c/aside>\n\u003cp>However, \"If you see a chiropractor more than one or two sessions, you are wasting your time if you are being cracked, adjusted or walked over. Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.\"\u003c/p>\n\u003cp>She said the World Health Organization has come up with a long list of all the diagnoses for which chiropractic is contra-indicated.( See page 20 \u003ca href=\"http://apps.who.int/medicinedocs/documents/s14076e/s14076e.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.) \"And it's probably anything that would take you to a chiropractor.\"\u003c/p>\n\u003cp>Neck adjustments, she said, \"are to be avoided at all costs. There is no reason to let a chiropractor anywhere near your neck.\"\u003c/p>\n\u003cp>\u003cstrong>Pharmaceutical Companies: Painkilling Pill Pushers\u003c/strong>\u003c/p>\n\u003cp>In the 1990s, Ramin says, pharmaecutical companies embarked on a well-funded campaign to get primary care doctors to ask all their patients if they were experiencing any pain.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no reason to let a chiropractor anywhere near your neck.'\u003c/aside>\n\u003cp>Oftentimes they were experiencing some back pain, \"because it is a human condition,\" she says. \"The answer to that from the primary care doctor's perspective, because of the active marketing from pharmaceutical companies, was to say 'Well, we can take care of that pain.' \"\u003c/p>\n\u003cp>Doctors often started out with short-acting pain killers, such as Vicodin, a potent and addictive narcotic. This was often followed by longer-acting, extended-release painkillers, such as the opioid-based Oxycodone -- which has led thousands into heroin addiction.\u003c/p>\n\u003cp>But, Ramin says, opioid painkillers don't work well for people with back pain.\u003c/p>\n\u003cp>\"They cause those patients to become very unmotivated and very sleepy,\" she says.\u003c/p>\n\u003cp>Plus, a condition called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21412369\" target=\"_blank\" rel=\"noopener noreferrer\">opioid-induced hyperalgesia\u003c/a> can arise, in which the brain generates pain independent of the original injury.\u003c/p>\n\u003cp>\u003cstrong>Expensive Chairs and Standing Desks\u003c/strong>\u003c/p>\n\u003cp>Ergonomic \"experts\" rely on what Ramin calls \"smoke and mirrors.\"\u003c/p>\n\u003cp>For instance, many back sufferers will try new office chairs.\u003c/p>\n\u003cp>\"I had a stable of office chairs,\" she says. \"One after another, expensive office chairs parading through my office, and I found most of them to be not very good.\"\u003c/p>\n\u003cp>These chairs are \"often built for 250-pound men,\" she says.\u003c/p>\n\u003cp>\"I realized you could have a chair from Costco for $25 that could keep you in the right position.\"\u003c/p>\n\u003cp>The standard, erect typing position, she says, is actually a relic from when you had to press hard on typewriter keys to get them to work.\u003c/p>\n\u003cp>Regarding the use of standing desks, Ramin says those come with their own problems. \"It's a nice variation from sitting. But remember, if you are standing, you are putting tremendous pressure on possibly a different set of ligaments,\" she says. \"But still you're asking your ligaments to hold you up for a really extended period of time. We're seeing all kinds of problems related to standing desks, now. They tend to be knee and hip problems, but those will lead to back problems.\"\u003c/p>\n\u003cp>If you have a standing desk, you still need to move around every so often, she counsels.\u003c/p>\n\u003cp>\u003cstrong>The Yoga Trap\u003c/strong>\u003c/p>\n\u003cp>Some tremendous benefits can be gained from doing yoga, Ramin says, but there is potential harm, as well.\u003c/p>\n\u003cp>\"One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do. Most of us who are even remotely competitive will experience that.\"\u003c/p>\n\u003cp>She says if you have back pain, there are limitations to what you should do in class, and you need an instructor who can give you variations on postures to suit your condition.\u003c/p>\n\u003cp>\"Be very careful about finding yourself in a flow yoga class where things are moving very fast and there's no way the teacher can keep a close eye on you.\"\u003c/p>\n\u003cp>Two type of yoga she recommends for back sufferers: Iyengar yoga and Viniyoga.\u003c/p>\n\u003cp>\"Both of them have a very powerful orthopedic focus,\" Ramin says.\u003c/p>\n\u003cp>\u003cb>So What Does Work? \u003c/b>\u003c/p>\n\u003cp>Two things: Exercise and changing the way you think about back pain.\u003c/p>\n\u003cp>\"Understanding that hurt does not mean harm,\" Ramin says. \"You can continue to live an active life. The most dangerous thing you can do for yourself is take to the couch or take to your bed or take to pain management. But of course that is what most people do.“\u003c/p>\n\u003cp>Ramin recommends finding a \"back whisperer\"--someone who understands the musculoskeletal system and is able to help people build strength, balance their gaits and move effectively.\u003c/p>\n\u003cp>Moving is the key. Our bodies are not built to sit or stand in one place for hours at a time, she says. \"The best posture is your next posture.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>For more info: Ramin's website features an extensive \u003ca href=\"http://www.cathrynjakobsonramin.com/resource-search\" target=\"_blank\" rel=\"noopener noreferrer\">resources section\u003c/a> directing people to information, videos and medical professionals who may be able to help alleviate back pain.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Leaving Segregated Areas Lowered African-Americans' Blood Pressure",
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"content": "\u003cp>African-Americans experience a significant drop in their blood pressure after they move out of highly segregated neighborhoods and into more integrated neighborhoods, researchers reported recently.\u003c/p>\n\u003cp>A \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2017.1226\">study\u003c/a> involving more than 2,000 African-Americans found that those who moved from the most-segregated neighborhoods to less-segregated neighborhoods later experienced lower systolic blood pressure, a factor in heart attacks and strokes.\u003c/p>\n\u003caside class=\"pullquote alignright\">The researchers found the difference in blood pressure persisted after accounting for other factors that could have played a role, such as changes in income and education.\u003c/aside>\n\u003cp>\"The big message here is that this study shines a light on one of the root causes of heart disease and stroke in our country,\" says \u003ca href=\"http://www.cardiovascularbusiness.com/topics/practice-management/nhlbi-names-david-goff-director-division-cardiovascular-sciences\">David Goff\u003c/a>, director of the division of cardiovascular diseases at the National Heart, Lung, and Blood Institute, which funded the study. It was published in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\n\u003cp>Doctors have known for a long time that African-Americans are prone to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024199/\">high blood pressure\u003c/a>. And previous research had found that people living in segregated places tended to have higher blood pressure.\u003c/p>\n\u003cp>The new study is the first to follow people over time to see how leaving segregated communities could affect the risk of heart disease. This kind of before-and-after study strengthens the observations made in the earlier studies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kiarri Kershaw, an assistant professor of preventive medicine at Northwestern University, and her colleagues followed 2,280 African-Americans participating in the \u003ca href=\"https://www.nhlbi.nih.gov/research/resources/obesity/population/cardia.htm\">Coronary Artery Risk Development in Young Adults\u003c/a> study.\u003c/p>\n\u003cp>The subjects were living in highly segregated neighborhoods in Chicago, Minneapolis, Birmingham, Ala., and Oakland, Calif., when the study began in 1985. They were between the ages of 18 and 30 when the study started.\u003c/p>\n\u003cp>The researchers followed the study subjects for 25 years, when they reached the ages of 43 to 55. Those who moved away from highly segregated neighborhoods to less-segregated neighborhoods and stayed there during that period had significantly lower blood pressure.\u003c/p>\n\u003cp>Their systolic blood pressure, the first of the two numbers used to measure blood pressure, was one to five points lower, the researchers reported.\u003c/p>\n\u003cp>While the differences in blood pressure may seem small, that difference among a large number of people could translate into thousands fewer heart attacks and strokes over time. Systolic blood pressure is thought to be the more important number when it comes to developing cardiovascular disease.\u003c/p>\n\u003cp>\"I think it's pretty powerful in the sense that the reasons for their moves were not necessarily for their health, but it has these other added benefits,\" Kershaw says.\u003c/p>\n\u003cp>The study did not examine how moving to less-segregated neighborhoods could affect blood pressure. But Kershaw thinks it's probably because of a combination of factors, including experiencing less stress from being exposed to less violence.\u003c/p>\n\u003cp>\"There's a decent-size body of evidence relating stress to blood pressure and that's one pathway that we hypothesize that segregation influences health — through exposure to violence, things like that — that could increase your stress level and then potentially influence blood pressure,\" Kershaw says.\u003c/p>\n\u003cp>Less-segregated neighborhoods may also provide more economic opportunities for people and their children and access to better schools, which could also reduce stress, she says.\u003c/p>\n\u003cp>In addition, those neighborhoods may also make it easier to live healthier lifestyles by having more access to parks, sidewalks, gyms, grocery stores with more fresh produce and pharmacies to get medication.\u003c/p>\n\u003cp>The researchers found the difference in blood pressure persisted after accounting for other factors that could have played a role, such as changes in income and education.\u003c/p>\n\u003cp>Kershaw acknowledges, however, that moving to less segregated neighborhoods could increase stress in at least one way — by potentially exposing African-Americans to more racism.\u003c/p>\n\u003cp>\"It's certainly possible that those who move to less segregated neighborhoods experience more exposure to racism, which could be one reason why some African-Americans choose to stay in more segregated neighborhoods,\" she wrote in an email. She noted that African-Americans living in more segregated neighborhoods tend to have better mental health.\u003c/p>\n\u003cp>But Kershaw says her study found there was an overall beneficial ffect on blood pressure of leaving a segregated neighborhood.\u003c/p>\n\u003cp>\"The take-home message is that policies that can allow people who are living in segregated neighborhoods to move and live in more integrated neighborhoods have some spillover effects that influences health like blood pressures,\" Kershaw says.\u003c/p>\n\u003cp>Others agree. \"This study is really important,\" says \u003ca href=\"https://www.hsph.harvard.edu/ashish-jha/\">Ashish Jha\u003c/a>, who studies health policy at the Harvard T.H. Chan School of Public Health and was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It helps us really feel much more confident that there's something about segregation itself that's leading to worse health outcomes,\" Jha says. \"And this study says that we really do have to tackle segregation if we're going to really improve the health of minorities in America.\"\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=Leaving+Segregated+Neighborhoods+Lowers+Blacks%27+Blood+Pressure&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>African-Americans experience a significant drop in their blood pressure after they move out of highly segregated neighborhoods and into more integrated neighborhoods, researchers reported recently.\u003c/p>\n\u003cp>A \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2017.1226\">study\u003c/a> involving more than 2,000 African-Americans found that those who moved from the most-segregated neighborhoods to less-segregated neighborhoods later experienced lower systolic blood pressure, a factor in heart attacks and strokes.\u003c/p>\n\u003caside class=\"pullquote alignright\">The researchers found the difference in blood pressure persisted after accounting for other factors that could have played a role, such as changes in income and education.\u003c/aside>\n\u003cp>\"The big message here is that this study shines a light on one of the root causes of heart disease and stroke in our country,\" says \u003ca href=\"http://www.cardiovascularbusiness.com/topics/practice-management/nhlbi-names-david-goff-director-division-cardiovascular-sciences\">David Goff\u003c/a>, director of the division of cardiovascular diseases at the National Heart, Lung, and Blood Institute, which funded the study. It was published in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\n\u003cp>Doctors have known for a long time that African-Americans are prone to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024199/\">high blood pressure\u003c/a>. And previous research had found that people living in segregated places tended to have higher blood pressure.\u003c/p>\n\u003cp>The new study is the first to follow people over time to see how leaving segregated communities could affect the risk of heart disease. This kind of before-and-after study strengthens the observations made in the earlier studies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kiarri Kershaw, an assistant professor of preventive medicine at Northwestern University, and her colleagues followed 2,280 African-Americans participating in the \u003ca href=\"https://www.nhlbi.nih.gov/research/resources/obesity/population/cardia.htm\">Coronary Artery Risk Development in Young Adults\u003c/a> study.\u003c/p>\n\u003cp>The subjects were living in highly segregated neighborhoods in Chicago, Minneapolis, Birmingham, Ala., and Oakland, Calif., when the study began in 1985. They were between the ages of 18 and 30 when the study started.\u003c/p>\n\u003cp>The researchers followed the study subjects for 25 years, when they reached the ages of 43 to 55. Those who moved away from highly segregated neighborhoods to less-segregated neighborhoods and stayed there during that period had significantly lower blood pressure.\u003c/p>\n\u003cp>Their systolic blood pressure, the first of the two numbers used to measure blood pressure, was one to five points lower, the researchers reported.\u003c/p>\n\u003cp>While the differences in blood pressure may seem small, that difference among a large number of people could translate into thousands fewer heart attacks and strokes over time. Systolic blood pressure is thought to be the more important number when it comes to developing cardiovascular disease.\u003c/p>\n\u003cp>\"I think it's pretty powerful in the sense that the reasons for their moves were not necessarily for their health, but it has these other added benefits,\" Kershaw says.\u003c/p>\n\u003cp>The study did not examine how moving to less-segregated neighborhoods could affect blood pressure. But Kershaw thinks it's probably because of a combination of factors, including experiencing less stress from being exposed to less violence.\u003c/p>\n\u003cp>\"There's a decent-size body of evidence relating stress to blood pressure and that's one pathway that we hypothesize that segregation influences health — through exposure to violence, things like that — that could increase your stress level and then potentially influence blood pressure,\" Kershaw says.\u003c/p>\n\u003cp>Less-segregated neighborhoods may also provide more economic opportunities for people and their children and access to better schools, which could also reduce stress, she says.\u003c/p>\n\u003cp>In addition, those neighborhoods may also make it easier to live healthier lifestyles by having more access to parks, sidewalks, gyms, grocery stores with more fresh produce and pharmacies to get medication.\u003c/p>\n\u003cp>The researchers found the difference in blood pressure persisted after accounting for other factors that could have played a role, such as changes in income and education.\u003c/p>\n\u003cp>Kershaw acknowledges, however, that moving to less segregated neighborhoods could increase stress in at least one way — by potentially exposing African-Americans to more racism.\u003c/p>\n\u003cp>\"It's certainly possible that those who move to less segregated neighborhoods experience more exposure to racism, which could be one reason why some African-Americans choose to stay in more segregated neighborhoods,\" she wrote in an email. She noted that African-Americans living in more segregated neighborhoods tend to have better mental health.\u003c/p>\n\u003cp>But Kershaw says her study found there was an overall beneficial ffect on blood pressure of leaving a segregated neighborhood.\u003c/p>\n\u003cp>\"The take-home message is that policies that can allow people who are living in segregated neighborhoods to move and live in more integrated neighborhoods have some spillover effects that influences health like blood pressures,\" Kershaw says.\u003c/p>\n\u003cp>Others agree. \"This study is really important,\" says \u003ca href=\"https://www.hsph.harvard.edu/ashish-jha/\">Ashish Jha\u003c/a>, who studies health policy at the Harvard T.H. Chan School of Public Health and was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It helps us really feel much more confident that there's something about segregation itself that's leading to worse health outcomes,\" Jha says. \"And this study says that we really do have to tackle segregation if we're going to really improve the health of minorities in America.\"\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=Leaving+Segregated+Neighborhoods+Lowers+Blacks%27+Blood+Pressure&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”\u003c/p>\n\u003cp>The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to mine,” a respondent marvels to a fellow trainee. “Before you quit, think about what motivated you in the first place, and what changed,” cautions an emergency physician to an early-career doctor.\u003c/p>\n\u003cp>[contextly_sidebar id=\"oX3HffwtSsMXOm6p0o45RTEG7oKjUthT\"]This networking site, and others like it, is where doctors come to discuss the verboten: leaving the medical profession. There are posts from medical school students questioning their career path, and from trainees unable to find a full-time job. And predominantly there are posts by physicians who, after years in the field, are desperate, at the end of their rope, looking for a way out.\u003c/p>\n\u003cp>Some of them are suffering from what doctors know simply by the shorthand of \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1351351\" target=\"_blank\" rel=\"noopener noreferrer\">burnout\u003c/a> — loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Burnout is on the rise among doctors: One \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00716-8/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found that over half of all U.S. physicians are experiencing it, for \u003ca href=\"http://www.medscape.com/viewarticle/838437_3\" target=\"_blank\" rel=\"noopener noreferrer\">reasons\u003c/a> such as long work hours and an increasing burden of bureaucratic tasks. With no nationally available, peer-reviewed data on physician turnover, it’s not clear precisely how many doctors leave because of burnout.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The hardest part of leaving was accepting that it didn’t mean I was a failure.'\u003c/aside>\n\u003cp>But more than most, doctors may find a career change daunting. There’s the time invested — four years of medical school and as many as \u003ca href=\"https://www.aamc.org/download/68806/data/road-doctor.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">nine more years\u003c/a> of specialty training — and perhaps a lucrative salary that’s hard to leave behind. Doctors’ specialized skills may seem less obviously transferable to another field. And the perceived virtuousness of a career in medicine may make some feel guilty to consider leaving.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So they come to \u003ca href=\"https://www.dropoutclub.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Drop Out Club\u003c/a> to air their worries, seek solace from those who’ve made the leap — and just feel less alone. The site’s forum is where they ask for and offer advice; there’s also a job board where employers post positions, and members can converse privately in individual messaging. Among its 37,000 members, about half are doctors, said Heather Clisby, a company spokesperson.\u003c/p>\n\u003cp>Two recently established Facebook groups aim to meet a similar need. Since their founding last year, Physician Nonclinical Career Hunters and PMG Physicians and Non-Clinical Careers have amassed nearly 3,000 members combined. (The latter group is visible only to those who are invited by current members.)\u003c/p>\n\u003cp>“The frustration with medicine is fueling our growth,” said Dr. Laura Fijolek McKain, the founder of Physician Nonclinical Career Hunters. “Doctors are frustrated with how much time they’re spending on paperwork and other activities that have little to do with patient care.”\u003c/p>\n\u003cp>And on the web they can find what is often hard to come by in daily life: a ready-made community of people grappling with the same questions.\u003c/p>\n\u003cp>\u003cstrong>Finding Solidarity Online\u003c/strong>\u003c/p>\n\u003cp>Dr. Maryam Shapland initially loved her job as an emergency physician. It was busy, exciting, and important. But after a few years, the work felt less exciting and more stressful. She reduced her work hours, but still felt worn out all the time. Then, seven years into her practice, one of her patients sued her.\u003c/p>\n\u003cp>Devastated, she decided to start searching for a new career.\u003c/p>\n\u003caside class=\"pullquote alignright\">'People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?'\u003c/aside>\n\u003cp>At first, she felt guilty for wanting to leave. “People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?”\u003c/p>\n\u003cp>Then she found Drop Out Club. She quickly became a “lurker” on the member forum, reading messages posted by others. “Reading all these stories of people trying to leave made me realize I wasn’t crazy for being unhappy in this career I had worked so hard for,” she said.\u003c/p>\n\u003cp>Shapland hired a career coach, started actively using LinkedIn, and in 2015 was hired as a medical director at a life insurance company. “Leaving medicine felt like giving up a big part of my identity,” she said. “But I’m proud of what I do now. Most importantly, I’m happy and thriving.”\u003c/p>\n\u003cp>And now that’s a message she’s hoping to transmit to others in her shoes. In retrospect, Shapland said, Drop Out Club suffered from too many mentees and not enough mentors. Once she made it to the other side, she decided to regularly provide career advice — and her email address — on the forum. Since her first post in 2015, she said she gets approximately one new person a week emailing her to seek advice on leaving medicine.\u003c/p>\n\u003cp>\u003cstrong>Grappling With Leaving\u003c/strong>\u003c/p>\n\u003cp>One of those was Dr. Ashwini Zenooz, a radiologist who had practiced for over 10 years. Surrounded by colleagues who seemingly loved their jobs, Zenooz felt that she couldn’t discuss wanting to leave medicine with them. Finding Drop Out Club “was a way to extend my network to people closer to my needs,” she said. Browsing the forum, Zenooz saw Shapland’s email address and sent her a note — which became an extended email conversation, and, eventually, an hourlong phone call one afternoon. Zenooz ultimately took a job in health policy.\u003c/p>\n\u003cp>Many of the inquiries Shapland receives are related to financial concerns. Medical education can leave doctors with up to a half million dollars of debt, making many feel tied to a high-paying job. Others struggle with the “golden handcuffs” of medicine, unable to leave lifestyles supported by comfortable incomes.\u003c/p>\n\u003cp>Fear of the unknown can also be daunting, especially to those who have spent their entire careers in medicine. “Leaving behind the familiar and going into the unknown was scary at first. I had been doing this job for decades, and there was a certain comfort level with that,” says Dr. Joshua Schechtel, a hospitalist who left clinical practice this year.\u003c/p>\n\u003cp>Dr. K.K., an oncologist who requested anonymity in case she returns to clinical practice in the future, found Drop Out Club while trying to make sense of the various nonclinical career options. She posted questions and read stories of members’ career paths out of medicine. “I saw proof that a lot of people who left medicine found other jobs and were happy,” she said. “It made me realize that I, too, could find a way out.” She recently left clinical practice and now works as a consultant for health insurance companies. “Leaving my patients and their families was very hard,” she said — but “my new role allows for a much healthier work-life balance.”\u003c/p>\n\u003cp>Long hours, grim tasks: Doctors in training face high risk of depression\u003c/p>\n\u003cp>Still, not everyone finds meaningful support through online communities.\u003c/p>\n\u003cp>Some simply want more hands-on support than a peer-to-peer site can provide. Dr. Mary Schultheis, a colorectal surgeon, joined Drop Out Club after 10 years in private practice. “The hardest part of leaving was accepting that it didn’t mean I was a failure,” she said. “Drop Out Club couldn’t help me come to terms with this, but working with a career coach did.” She left clinical practice this year and now balances part-time consulting and health insurance industry roles.\u003c/p>\n\u003cp>Others find there aren’t enough people to provide advice. “There were a lot of people who piled on to commiserate, but it was hard to find actionable advice on Drop Out Club,” said a dermatologist in California. She reverted to networking the “old-fashioned way, meeting people locally and building a Rolodex,” which ultimately led to her current mix of part-time consulting and part-time medicine.\u003c/p>\n\u003cp>Shapland agrees that the site — and the medical field more generally — needs doctors who have left clinical practice to speak up and share their unconventional career paths. They need to make themselves available to help as she did, she said. “Just being a living, breathing example of someone who made it to the other side and will answer a couple questions can help someone take that leap of faith.” She’s proof of it.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/05/24/doctors-burnout-online-community/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”\u003c/p>\n\u003cp>The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to mine,” a respondent marvels to a fellow trainee. “Before you quit, think about what motivated you in the first place, and what changed,” cautions an emergency physician to an early-career doctor.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>This networking site, and others like it, is where doctors come to discuss the verboten: leaving the medical profession. There are posts from medical school students questioning their career path, and from trainees unable to find a full-time job. And predominantly there are posts by physicians who, after years in the field, are desperate, at the end of their rope, looking for a way out.\u003c/p>\n\u003cp>Some of them are suffering from what doctors know simply by the shorthand of \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1351351\" target=\"_blank\" rel=\"noopener noreferrer\">burnout\u003c/a> — loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Burnout is on the rise among doctors: One \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00716-8/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found that over half of all U.S. physicians are experiencing it, for \u003ca href=\"http://www.medscape.com/viewarticle/838437_3\" target=\"_blank\" rel=\"noopener noreferrer\">reasons\u003c/a> such as long work hours and an increasing burden of bureaucratic tasks. With no nationally available, peer-reviewed data on physician turnover, it’s not clear precisely how many doctors leave because of burnout.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The hardest part of leaving was accepting that it didn’t mean I was a failure.'\u003c/aside>\n\u003cp>But more than most, doctors may find a career change daunting. There’s the time invested — four years of medical school and as many as \u003ca href=\"https://www.aamc.org/download/68806/data/road-doctor.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">nine more years\u003c/a> of specialty training — and perhaps a lucrative salary that’s hard to leave behind. Doctors’ specialized skills may seem less obviously transferable to another field. And the perceived virtuousness of a career in medicine may make some feel guilty to consider leaving.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So they come to \u003ca href=\"https://www.dropoutclub.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Drop Out Club\u003c/a> to air their worries, seek solace from those who’ve made the leap — and just feel less alone. The site’s forum is where they ask for and offer advice; there’s also a job board where employers post positions, and members can converse privately in individual messaging. Among its 37,000 members, about half are doctors, said Heather Clisby, a company spokesperson.\u003c/p>\n\u003cp>Two recently established Facebook groups aim to meet a similar need. Since their founding last year, Physician Nonclinical Career Hunters and PMG Physicians and Non-Clinical Careers have amassed nearly 3,000 members combined. (The latter group is visible only to those who are invited by current members.)\u003c/p>\n\u003cp>“The frustration with medicine is fueling our growth,” said Dr. Laura Fijolek McKain, the founder of Physician Nonclinical Career Hunters. “Doctors are frustrated with how much time they’re spending on paperwork and other activities that have little to do with patient care.”\u003c/p>\n\u003cp>And on the web they can find what is often hard to come by in daily life: a ready-made community of people grappling with the same questions.\u003c/p>\n\u003cp>\u003cstrong>Finding Solidarity Online\u003c/strong>\u003c/p>\n\u003cp>Dr. Maryam Shapland initially loved her job as an emergency physician. It was busy, exciting, and important. But after a few years, the work felt less exciting and more stressful. She reduced her work hours, but still felt worn out all the time. Then, seven years into her practice, one of her patients sued her.\u003c/p>\n\u003cp>Devastated, she decided to start searching for a new career.\u003c/p>\n\u003caside class=\"pullquote alignright\">'People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?'\u003c/aside>\n\u003cp>At first, she felt guilty for wanting to leave. “People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?”\u003c/p>\n\u003cp>Then she found Drop Out Club. She quickly became a “lurker” on the member forum, reading messages posted by others. “Reading all these stories of people trying to leave made me realize I wasn’t crazy for being unhappy in this career I had worked so hard for,” she said.\u003c/p>\n\u003cp>Shapland hired a career coach, started actively using LinkedIn, and in 2015 was hired as a medical director at a life insurance company. “Leaving medicine felt like giving up a big part of my identity,” she said. “But I’m proud of what I do now. Most importantly, I’m happy and thriving.”\u003c/p>\n\u003cp>And now that’s a message she’s hoping to transmit to others in her shoes. In retrospect, Shapland said, Drop Out Club suffered from too many mentees and not enough mentors. Once she made it to the other side, she decided to regularly provide career advice — and her email address — on the forum. Since her first post in 2015, she said she gets approximately one new person a week emailing her to seek advice on leaving medicine.\u003c/p>\n\u003cp>\u003cstrong>Grappling With Leaving\u003c/strong>\u003c/p>\n\u003cp>One of those was Dr. Ashwini Zenooz, a radiologist who had practiced for over 10 years. Surrounded by colleagues who seemingly loved their jobs, Zenooz felt that she couldn’t discuss wanting to leave medicine with them. Finding Drop Out Club “was a way to extend my network to people closer to my needs,” she said. Browsing the forum, Zenooz saw Shapland’s email address and sent her a note — which became an extended email conversation, and, eventually, an hourlong phone call one afternoon. Zenooz ultimately took a job in health policy.\u003c/p>\n\u003cp>Many of the inquiries Shapland receives are related to financial concerns. Medical education can leave doctors with up to a half million dollars of debt, making many feel tied to a high-paying job. Others struggle with the “golden handcuffs” of medicine, unable to leave lifestyles supported by comfortable incomes.\u003c/p>\n\u003cp>Fear of the unknown can also be daunting, especially to those who have spent their entire careers in medicine. “Leaving behind the familiar and going into the unknown was scary at first. I had been doing this job for decades, and there was a certain comfort level with that,” says Dr. Joshua Schechtel, a hospitalist who left clinical practice this year.\u003c/p>\n\u003cp>Dr. K.K., an oncologist who requested anonymity in case she returns to clinical practice in the future, found Drop Out Club while trying to make sense of the various nonclinical career options. She posted questions and read stories of members’ career paths out of medicine. “I saw proof that a lot of people who left medicine found other jobs and were happy,” she said. “It made me realize that I, too, could find a way out.” She recently left clinical practice and now works as a consultant for health insurance companies. “Leaving my patients and their families was very hard,” she said — but “my new role allows for a much healthier work-life balance.”\u003c/p>\n\u003cp>Long hours, grim tasks: Doctors in training face high risk of depression\u003c/p>\n\u003cp>Still, not everyone finds meaningful support through online communities.\u003c/p>\n\u003cp>Some simply want more hands-on support than a peer-to-peer site can provide. Dr. Mary Schultheis, a colorectal surgeon, joined Drop Out Club after 10 years in private practice. “The hardest part of leaving was accepting that it didn’t mean I was a failure,” she said. “Drop Out Club couldn’t help me come to terms with this, but working with a career coach did.” She left clinical practice this year and now balances part-time consulting and health insurance industry roles.\u003c/p>\n\u003cp>Others find there aren’t enough people to provide advice. “There were a lot of people who piled on to commiserate, but it was hard to find actionable advice on Drop Out Club,” said a dermatologist in California. She reverted to networking the “old-fashioned way, meeting people locally and building a Rolodex,” which ultimately led to her current mix of part-time consulting and part-time medicine.\u003c/p>\n\u003cp>Shapland agrees that the site — and the medical field more generally — needs doctors who have left clinical practice to speak up and share their unconventional career paths. They need to make themselves available to help as she did, she said. “Just being a living, breathing example of someone who made it to the other side and will answer a couple questions can help someone take that leap of faith.” She’s proof of it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Tech Insiders Call Out Facebook for Literally Manipulating Your Brain",
"title": "Tech Insiders Call Out Facebook for Literally Manipulating Your Brain",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>In today's world, you'd have to be looking at your phone all the time not to notice that people are looking at their phones all the time.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The tycoons of social media have to stop pretending that they're friendly nerd-gods building a better world, and admit they're just tobacco farmers in t-shirts selling an addictive product to children.'\u003ccite>Bill Maher, on his HBO show\u003c/cite>\u003c/aside>\n\u003cp>Some device owners are so enamored of their digital companions that even \u003ca href=\"https://www.youtube.com/watch?v=fTOZjXjaCaE\" target=\"_blank\" rel=\"noopener noreferrer\">crossing a busy street\u003c/a> doesn't merit a little look-see at the 3-D world. Last year, when it came to \u003ca href=\"//ww2.kqed.org/futureofyou/2016/07/22/the-number-of-accident-reports-related-to-pokemon-go-is-getting-scary/\" target=\"_blank\" rel=\"noopener noreferrer\">playing\u003c/a> Pokémon Go, \u003ca href=\"https://www.youtube.com/watch?time_continue=1&v=KvA9ZgC73vc\" target=\"_blank\" rel=\"nasioopener noopener noreferrer\">driving a car\u003c/a> or \u003ca href=\"http://www.cnn.com/2016/07/15/health/pokemon-go-players-fall-down-cliff/\" target=\"_blank\" rel=\"noopener noreferrer\">walking toward a cliff\u003c/a> didn't rate some people's full attention, either.\u003c/p>\n\u003cp>[contextly_sidebar id=\"uCXUgpDo1aspjSPrtQWwsV2HUIwMUSVL\"]Recently, a former Google \"design ethicist\" named Tristan Harris has been on a crusade of sorts calling out tech companies like Facebook, Google and Apple for using behavioral techniques and neuroscience to keep you compulsively glued to your phone and computer screens.\u003c/p>\n\u003cp>Harris' campaign is starting to get a lot of media attention -- last month, \"60 Minutes\" ran a \u003ca href=\"http://www.cbsnews.com/news/brain-hacking-tech-insiders-60-minutes/\" target=\"_blank\" rel=\"noopener noreferrer\">segment\u003c/a> looking at the issue. That was followed by the comedian and tele-muckraker Bill Maher making it the subject of one of his HBO commentaries.\u003c/p>\n\u003cp>\"The tycoons of social media have to stop pretending that they're friendly nerd-gods building a better world, and admit they're just tobacco farmers in t-shirts selling an addictive product to children,\" Maher opined. \"Because let's face it, checking your 'likes' is the new smoking.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Apple, Google, Facebook? They are essentially drug dealers.\"\u003c/p>\n\u003cp>Here's Maher's take (replete with his signature politically incorrect raunch):\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=KDqoTDM7tio\u003c/p>\n\u003cp>While the comedian's view may seem over-the-top, KQED's Lesley McClurg recently reported the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/17/theres-growing-consensus-the-internet-is-addictive/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> of a middle-school girl who became hooked on watching YouTube, before her parents sent her to to an actual addiction recovery clinic. The cost: $60,000, paid partly from their retirement accounts.\u003c/p>\n\u003cp>In reporting that story, McClurg interviewed Harris, the former Google ethicist. He called the practice of tech companies using scientific techniques that foster compulsivity \"brain hacking.\" Harris now runs a nonprofit called\u003ca href=\"http://www.timewellspent.io/\" target=\"_blank\" rel=\"noopener noreferrer\"> Time Well Spent\u003c/a>, whose home page invites people to \"reclaim our minds from being hijacked by technology.\"\u003c/p>\n\u003cp>https://www.youtube.com/watch?list=PLtLeT9oxQnyqag7AVKQn1-WYUhKAHzj-b&v=tf9ZhU7zF8s\u003c/p>\n\u003cp>Speaking about the current power of Google, Facebook and Apple to command our collective gaze, Harris tells McClurg: \"Never before in history have a handful of technology designers working at three tech companies ... influenced how a billion people spend their attention.\"\u003c/p>\n\u003cp>Harris says that good, ethical design is being trumped by the quest for profit.\u003c/p>\n\u003cp>\"If your company’s goal and your stock price is based on how much attention they get from someone, it’s not really about ethics,\" he says. \"\u003cspan style=\"font-weight: 400\">They just have to do whatever it takes to get attention.\"\u003c/span>\u003c/p>\n\u003cp>And that has created an eyeballs-seeking arms race.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Asking technology companies, asking content creators to be less good at what they do feels like a ridiculous ask.'\u003ccite>Gabe Zichermann, author of 'The Gamification Revolution,' speaking to '60 Minutes'\u003c/cite>\u003c/aside>\n\u003cp>\"After you finish watching a YouTube video,\" Harris notes, \"it auto-plays the next one right away, so you don't have to make a conscious choice. Let's say that creates a 5 percent lift in how much time people spend on YouTube. So Facebook is sitting there watching their traffic get siphoned away, and Facebook says we have to make our videos auto-play, too.\" (Neither Google nor Facebook returned a request for comment.)\u003c/p>\n\u003cp>Facebook, meanwhile, has every incentive to keep you mousing through its news feed so it can sell more ads. Harris says that's one reason the company uses continuous scroll, so that new content will keep opening up as you hit the bottom of the page. But he thinks a more ethical design would be to enable what an individual user wants to do at any given moment.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Let's say \u003c/span>\u003cspan style=\"font-weight: 400\">your friend texts you that dinner's off,\" he says. \"\u003c/span>\u003cspan style=\"font-weight: 400\">So there you are with \u003c/span>\u003cspan style=\"font-weight: 400\">no plans, and you\u003c/span>\u003cspan style=\"font-weight: 400\"> open up Facebook. A\u003c/span>\u003cspan style=\"font-weight: 400\">t that moment, Facebook has \u003c/span>\u003cspan style=\"font-weight: 400\">about 1,000 people whose job is to get you to just click and scroll and \u003c/span>\u003cspan style=\"font-weight: 400\">watch stuff on the news feed. And that will work. You'll probably end up \u003c/span>\u003cspan style=\"font-weight: 400\">sitting there, an hour later, just kind of having scrolled through the news feed.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At which point, says Harris, you will have fulfilled Facebook's mission, but perhaps not your own. \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's not that we \u003cem>shouldn't\u003c/em> be concerned about book burning, but we \u003cem>should\u003c/em> be concerned about a society that distracts us from even wanting to read.' \u003ccite>Tristan Harris, former Google design ethicist\u003c/cite>\u003c/aside>\n\u003cp>But what if Facebook actually asked you what you wanted to do, apart from just using Facebook? Like perhaps finding other people who have no plans?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"It’s about agency,\" says Harris. \"Facebook would have to have some way before you just get dropped in the newsfeed, to say, 'What do you want right now?'\u003c/span>\u003c/p>\n\u003cp>B.J. Fogg runs the Persuasive Technology Lab at Stanford, which teaches students to use these sticky techniques. Many employees of top tech companies, including a cofounder of Instagram, have participated in the lab.\u003c/p>\n\u003cp>Fogg says he got to know some of the early Facebook employees, and found them genuinely motivated by a desire to do good.\u003c/p>\n\u003cp>\"The individual people at Facebook, the people that I met, really wanted to make the world more harmonious, bring people together, create empathy and so on,\" he says.\u003c/p>\n\u003cp>\"Where I think Tristan (Harris) and I would agree a lot is that often their business goals can be at odds with the human-centered approach to design. There's a conflict there between what they need to do as an advertising company and what's going to be really good for people.\"\u003c/p>\n\u003cp>\u003cstrong>Amusing Ourselves to Death\u003c/strong>\u003c/p>\n\u003cp>The reason this matters so much is that technology is going to get more and more persuasive, says Harris.\u003c/p>\n\u003cp>\"We're sitting \u003cspan style=\"font-weight: 400\">at the very edge of what will become a virtual reality and \u003c/span>\u003cspan style=\"font-weight: 400\">augmented reality world. \u003c/span>\u003cspan style=\"font-weight: 400\">If those worlds are e\u003c/span>\u003cspan style=\"font-weight: 400\">ven more persuasive in getting us to spend our time there, where is hum\u003c/span>\u003cspan style=\"font-weight: 400\">an agency in that process?\" \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And then a warning.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"We have to have that conversation now because right now it's \u003c/span>\u003cspan style=\"font-weight: 400\">driving toward not a good direction.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have now developed a rigorous technology of the human mind, and that is both exciting and terrifying. We have the ability to twiddle some nobs in a machine learning dashboard we build, and around the world hundreds of thousands of people are going to quietly change their behavior ... .'\u003ccite>Ramsay Brown, co-founder, Dopamine Labs\u003c/cite>\u003c/aside>\n\u003cp>He cited a 1985 book, \"\u003ca href=\"https://en.wikipedia.org/wiki/Amusing_Ourselves_to_Death\" target=\"_blank\" rel=\"noopener noreferrer\">Amusing Ourselves to Death\u003c/a>,\" by Neil Postman, that distinguished between two dystopian visions.\u003c/p>\n\u003cp>\"There's one that most people already know: the \"1984\" Big Brother, surveillance future. We have all been trained to look out for that.\u003c/p>\n\u003cp>\"But there is this subtler second vision of power, which was the Aldous Huxley vision in \"\u003ca href=\"https://en.wikipedia.org/wiki/Brave_New_World\" target=\"_blank\" rel=\"noopener noreferrer\">Brave New World\u003c/a>,\" that's so good at giving us amusement and little bits of trivia. In other words, it's not that we \u003cem>shouldn't\u003c/em> be concerned about book burning, but we \u003cem>should\u003c/em> be concerned about a society that distracts us from even wanting to read.\"\u003c/p>\n\u003cp>\u003cstrong>It's the Dopamine\u003c/strong>\u003c/p>\n\u003cp>Ramsay Brown is the co-founder of \u003ca href=\"https://usedopamine.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Dopamine Labs\u003c/a>, which uses artificial intelligence and neuroscience to help app writers attract and retain users.\u003c/p>\n\u003cp>Dopamine Labs makes no bones about what it's trying to do. From a \u003ca href=\"https://usedopamine.com/assets/pdf/Dopamine%20Labs%20Case%20Studies.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">promotional document\u003c/a> on its website.:\u003c/p>\n\u003cblockquote>\u003cp>Keeping users engaged isn’t luck: it’s science. Give users the right \u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/burst.jpg\">\u003cimg class=\"alignnone size-full wp-image-392383\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/burst.jpg\" alt=\"\" width=\"71\" height=\"63\">\u003c/a> of dopamine at the right moment and they’ll stay longer and use your app more.\"\u003c/p>\u003c/blockquote>\n\u003cp>Dopamine is a neurotransmitter associated with rewards and addictive substances. The company is not just being glib when it says it will deliver the chemical to users. Dr. Elias Aboujaoude, the director of Stanford’s Obsessive Compulsive Disorder Clinic, told KQED's McClurg that dopamine and other feel-good brain chemicals spike in people who compulsively use the internet.\u003c/p>\n\u003cp>Brown told me that social media companies use a concept known as variable rewards, something that slot machines use to hook gamblers, to similarly keep users clicking.\u003c/p>\n\u003cp>\"The brain isn't particularly craving any one little feel-good signal as much as it does a really good rhythm and pattern,\" Brown said. Both he and Harris say Facebook and Instagram tailor the timing of the \"notifications\" they deliver to users -- the messages you get that are indicated by a number in red at the top right of the screen -- in order to deliver shots of dopamine to users at times determined by an algorithm.\u003c/p>\n\u003cp>\"Sometimes there’s nothing waiting for you, sometimes there’s a friend request or someone wrote on your wall,\" Brown told me. \"Sometimes there’s just kind of like filler crap. It’s not pertinent to your life, but Facebook's algorithms have figured out that showing it to you then is going to be slightly more surprising then not showing it to you at all or showing it to you later.\"\u003c/p>\n\u003cp>These patterns will keep you coming back.\u003c/p>\n\u003cp>I asked Brown how he knew that's what Facebook was doing.\u003c/p>\n\u003cp>\"It's obvious to anyone who knows the techniques,\" he said.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=gvQxtotEX-M\u003c/p>\n\u003cp>In the \"60 Minutes\" segment, Larry Rosen, a professor of psychology at California State University, Dominguez Hills, who researches the psychology of tech, said typically, people check their phones every 15 minutes or less. They're not just craving dopamine; he said they're seeking relief from the stress hormone cortisol.\u003c/p>\n\u003cp>\"Half of the time, they check their phone, there’s no alert, no notification,\" said Rosen. \"It’s coming from inside their head, telling them, 'Gee I haven’t checked on Facebook for a while, I haven’t checked on this Twitter feed for a while. I wonder if someone commented on my Instagram post. That then generates cortisol and it starts to make you anxious. Eventually your goal is to get rid of that anxiety, so you check in.\"\u003c/p>\n\u003cp>As Anderson Cooper of \"60 Minutes\" put it: \"Their research suggests our phones are keeping us in a continual state of anxiety in which the only antidote is the phone.\"\u003c/p>\n\u003cp>\u003cstrong>Doing Good\u003c/strong>\u003c/p>\n\u003cp>Ramsay Brown says his own company uses this type of research to help only businesses or organizations it has determined are trying to do good.\u003c/p>\n\u003cp>\"To break the habits we don't want in ourselves or make the habits we do want in ourselves,\" as he puts it.\u003c/p>\n\u003cp>To that end, Dopamine Labs created an \u003ca href=\"http://youjustneedspace.com/\" target=\"_blank\" rel=\"noopener noreferrer\">app\u003c/a> called \"Space,\" intended to help users break troublesome online habits by creating a delay before certain apps will open.\u003c/p>\n\u003cp>Apple initially denied the app for placement in its app store. Brown says he was told by an Apple rep that the rejection came because any app that encouraged people to use other apps less was inappropriate for the store. After the \"60 Minutes\" segment aired, Apple \u003ca href=\"https://itunes.apple.com/us/app/space-because-you-need-a-breather/id1187106675?mt=8\" target=\"_blank\" rel=\"noopener noreferrer\">accepted \u003c/a>the app. (An Apple spokesperson said the rejection had to do with a technical issue and that \"The adjustment had nothing to do with whether the app discouraged people from using other apps or not.\")\u003c/p>\n\u003cp>Even though Dopamine Labs might choose clients according to its own definition of doing good, I wondered if the application of techniques that are as powerful and potentially insidious as he and other researchers say they are is justified, no matter what the product.\u003c/p>\n\u003cp>\"We are in a bit of a Robert Oppenheimer moment,\" Brown said, citing the scientist who is often called the father of the atomic bomb, and who later expressed a deep ambivalence about his work\u003cb>.\u003c/b>\u003c/p>\n\u003cp>\"We have now developed a rigorous technology of the human mind, and that is both exciting and terrifying. We have the ability to twiddle some nobs in a machine learning dashboard we build, and around the world hundreds of thousands of people are going to quietly change their behavior in ways that, unbeknownst to them, feel second-nature but are really by design.\"\u003c/p>\n\u003cp>\"Which means that there's a deep ethical imperative for us to use it for good.\"\u003c/p>\n\u003cp>\u003cstrong>So What's the Harm?\u003c/strong>\u003c/p>\n\u003cp>As KQED's McClurg reported, addictions to social media, video games, texting, shopping and pornography are not officially listed disorders in the Diagnostic and Statistical Manual of Mental Disorders. A consensus is growing, however, that compulsive online behavior is doing real harm.\u003c/p>\n\u003cp>Hundreds of papers have been written on the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/06/does-facebook-really-make-you-depressed/\" target=\"_blank\" rel=\"noopener noreferrer\">negative consequences of using Facebook\u003c/a>, alone. While some studies have also shown positive effects, Jean Twenge, a professor of psychology at San Diego State University and the author of \"Generation Me,\" says more rigorous research has come to a more negative conclusion.\u003c/p>\n\u003cp>“Its pretty clear these days that spending more time on social media leads to a\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28093386\" target=\"_blank\" rel=\"noopener noreferrer\"> more negative mood\u003c/a>,” she said.\u003c/p>\n\u003cp>Twenge says her research shows that the proliferation of the smartphone is having big effects on people born around 1995. She say that's when the millennial generation morphs into \"iGen\" -- also known as \u003ca href=\"https://en.wikipedia.org/wiki/Generation_Z\" target=\"_blank\" rel=\"noopener noreferrer\">Generation Z\u003c/a>.\u003c/p>\n\u003cp>She pointed to the \u003ca href=\"https://www.bls.gov/emp/ep_table_303.htm\" target=\"_blank\" rel=\"noopener noreferrer\">plummeting employment rate of young men\u003c/a> as one macro-development related to iGen, and \u003cspan style=\"font-weight: 400\">cited \u003c/span>the work of University of Chicago economist Erik Hurst. Last year, in a university \u003ca href=\"https://bfi.uchicago.edu/news/scholar-profile/faculty-spotlight-erik-hurst\" target=\"_blank\" rel=\"noopener noreferrer\">profile\u003c/a>, Hurst discussed his research on the dwindling percentage of young males without a college degree in the labor force and this trend's connection to leisure-time technology:\u003c/p>\n\u003cblockquote>\u003cp>In the 2000s, employment rates for this group dropped sharply – more than in any other group. We have determined that, in general, they are not going back to school or switching careers, so what are they doing with their time? The hours that they are not working have been replaced almost one for one with leisure time. Seventy-five percent of this new leisure time falls into one category: video games. The average low-skilled, unemployed man in this group plays video games an average of 12, and sometimes upwards of 30 hours per week. This change marks a relatively major shift that makes me question its effect on their attachment to the labor market.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Attention Economy\u003c/strong>\u003c/p>\n\u003cp>BJ Fogg says a lot of persuasion methods that Facebook and other tech companies use are not really new.\u003c/p>\n\u003cp>He gave the example of Facebook birthday reminders, which often draw people back into the site to wish someone happy birthday. \"Reminders are not new,\" he said, citing Hallmark TV commercials about mother's day, for example. \"W\u003cspan style=\"line-height: 1.5\">hat ‘s different today is that machines are being created to use these techniques.\"\u003c/span>\u003c/p>\n\u003cp>At this point, I am reminded that those of us who create text for public consumption have also been in the business of attention-grabbing for quite some time. This \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/05/12/how-the-media-came-to-embrace-clickbait-an-internet-history/\" target=\"_blank\" rel=\"noopener noreferrer\">excerpt\u003c/a> we recently posted from Tim Wu's book \"The Attention Merchants,\" is instructive; it takes you through the evolution and eventual mainstream adoption of clickbait -- those headlines that contain just the right words to whet your appetite for a click.\u003c/p>\n\u003cp>While we here at KQED have yet to hire a an actual neuroscientist to help us craft the perfect syntactic arrangement to make our post on the \u003ca href=\"https://ww2.kqed.org/science/2017/04/25/volunteer-brown-pelican-count-aims-to-measure-recovery-of-once-endangered-birds/\" target=\"_blank\" rel=\"noopener noreferrer\">California brown pelican count\u003c/a> irresistible to a mass audience, we have sat through any number of workshops led by self-styled audience-whisperers. And we do use software tools to try to figure out what works and what doesn't in terms of getting people to read an article.\u003c/p>\n\u003cp>Isn't that, crudely, \u003cem>some\u003c/em> form of brain hacking?\u003c/p>\n\u003cp>The point being: \u003cem>Everyone\u003c/em> is in quest of your eyeballs. The question is how far will people go to get them. Where the line gets crossed from superior business model to dirty rotten trick is the subject of much debate, from the halls of government to academia to Thanksgiving brouhahas.\u003c/p>\n\u003cp>On the \"60 Minutes\" segment, Gabe Zichermann, who consults for companies on how to use \"\u003ca href=\"https://en.wikipedia.org/wiki/Gamification\" target=\"_blank\" rel=\"noopener noreferrer\">gamification\u003c/a>\" to make their digital products more appealing, argued that attracting audience is simply the name of the game.\u003c/p>\n\u003cp>\"Asking technology companies, asking content creators to be less good at what they do feels like a ridiculous ask,\" he said. \"It feels impossible. And also it’s very anti-capitalistic. This isn’t the system that we live in.\"\u003c/p>\n\u003cp>The other side of that, expressed by Bill Maher in his televised rant:\u003c/p>\n\u003cp>\"The moral rot in this country began when corporate America decided it wasn’t enough to just successfully sell your product; people needed to be addicted to it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Meantime, while you wait for society to figure this issue out, it's probably best to take matters into your own compulsively typing hands. If you've ever said \"I wish I knew how to quit you\" to your phone, see Lesley McClurg's post, '\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/24/help-my-phone-is-ruining-my-life-8-tips-for-the-addicted\" target=\"_blank\" rel=\"noopener noreferrer\">Help! My Phone is Ruining My Life!\u003c/a>' for \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/19/help-my-phone-is-ruining-my-life-8-tips-for-the-addicted/#tips\" target=\"_blank\" rel=\"noopener noreferrer\">eight tips\u003c/a> on how to detach.\u003c/p>\n\n",
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"excerpt": "A former Google ethicist is on a crusade to make people aware of what he says are manipulative techniques by tech companies to foster compulsive use of their products. The issue is now getting plenty of media play.",
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"description": "A former Google ethicist is on a crusade to make people aware of what he says are manipulative techniques by tech companies to foster compulsive use of their products. The issue is now getting plenty of media play.",
"title": "Tech Insiders Call Out Facebook for Literally Manipulating Your Brain | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In today's world, you'd have to be looking at your phone all the time not to notice that people are looking at their phones all the time.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The tycoons of social media have to stop pretending that they're friendly nerd-gods building a better world, and admit they're just tobacco farmers in t-shirts selling an addictive product to children.'\u003ccite>Bill Maher, on his HBO show\u003c/cite>\u003c/aside>\n\u003cp>Some device owners are so enamored of their digital companions that even \u003ca href=\"https://www.youtube.com/watch?v=fTOZjXjaCaE\" target=\"_blank\" rel=\"noopener noreferrer\">crossing a busy street\u003c/a> doesn't merit a little look-see at the 3-D world. Last year, when it came to \u003ca href=\"//ww2.kqed.org/futureofyou/2016/07/22/the-number-of-accident-reports-related-to-pokemon-go-is-getting-scary/\" target=\"_blank\" rel=\"noopener noreferrer\">playing\u003c/a> Pokémon Go, \u003ca href=\"https://www.youtube.com/watch?time_continue=1&v=KvA9ZgC73vc\" target=\"_blank\" rel=\"nasioopener noopener noreferrer\">driving a car\u003c/a> or \u003ca href=\"http://www.cnn.com/2016/07/15/health/pokemon-go-players-fall-down-cliff/\" target=\"_blank\" rel=\"noopener noreferrer\">walking toward a cliff\u003c/a> didn't rate some people's full attention, either.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Recently, a former Google \"design ethicist\" named Tristan Harris has been on a crusade of sorts calling out tech companies like Facebook, Google and Apple for using behavioral techniques and neuroscience to keep you compulsively glued to your phone and computer screens.\u003c/p>\n\u003cp>Harris' campaign is starting to get a lot of media attention -- last month, \"60 Minutes\" ran a \u003ca href=\"http://www.cbsnews.com/news/brain-hacking-tech-insiders-60-minutes/\" target=\"_blank\" rel=\"noopener noreferrer\">segment\u003c/a> looking at the issue. That was followed by the comedian and tele-muckraker Bill Maher making it the subject of one of his HBO commentaries.\u003c/p>\n\u003cp>\"The tycoons of social media have to stop pretending that they're friendly nerd-gods building a better world, and admit they're just tobacco farmers in t-shirts selling an addictive product to children,\" Maher opined. \"Because let's face it, checking your 'likes' is the new smoking.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Apple, Google, Facebook? They are essentially drug dealers.\"\u003c/p>\n\u003cp>Here's Maher's take (replete with his signature politically incorrect raunch):\u003c/p>\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/KDqoTDM7tio'\n title='//www.youtube.com/embed/KDqoTDM7tio'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>While the comedian's view may seem over-the-top, KQED's Lesley McClurg recently reported the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/17/theres-growing-consensus-the-internet-is-addictive/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> of a middle-school girl who became hooked on watching YouTube, before her parents sent her to to an actual addiction recovery clinic. The cost: $60,000, paid partly from their retirement accounts.\u003c/p>\n\u003cp>In reporting that story, McClurg interviewed Harris, the former Google ethicist. He called the practice of tech companies using scientific techniques that foster compulsivity \"brain hacking.\" Harris now runs a nonprofit called\u003ca href=\"http://www.timewellspent.io/\" target=\"_blank\" rel=\"noopener noreferrer\"> Time Well Spent\u003c/a>, whose home page invites people to \"reclaim our minds from being hijacked by technology.\"\u003c/p>\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/tf9ZhU7zF8s'\n title='//www.youtube.com/embed/tf9ZhU7zF8s'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Speaking about the current power of Google, Facebook and Apple to command our collective gaze, Harris tells McClurg: \"Never before in history have a handful of technology designers working at three tech companies ... influenced how a billion people spend their attention.\"\u003c/p>\n\u003cp>Harris says that good, ethical design is being trumped by the quest for profit.\u003c/p>\n\u003cp>\"If your company’s goal and your stock price is based on how much attention they get from someone, it’s not really about ethics,\" he says. \"\u003cspan style=\"font-weight: 400\">They just have to do whatever it takes to get attention.\"\u003c/span>\u003c/p>\n\u003cp>And that has created an eyeballs-seeking arms race.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Asking technology companies, asking content creators to be less good at what they do feels like a ridiculous ask.'\u003ccite>Gabe Zichermann, author of 'The Gamification Revolution,' speaking to '60 Minutes'\u003c/cite>\u003c/aside>\n\u003cp>\"After you finish watching a YouTube video,\" Harris notes, \"it auto-plays the next one right away, so you don't have to make a conscious choice. Let's say that creates a 5 percent lift in how much time people spend on YouTube. So Facebook is sitting there watching their traffic get siphoned away, and Facebook says we have to make our videos auto-play, too.\" (Neither Google nor Facebook returned a request for comment.)\u003c/p>\n\u003cp>Facebook, meanwhile, has every incentive to keep you mousing through its news feed so it can sell more ads. Harris says that's one reason the company uses continuous scroll, so that new content will keep opening up as you hit the bottom of the page. But he thinks a more ethical design would be to enable what an individual user wants to do at any given moment.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Let's say \u003c/span>\u003cspan style=\"font-weight: 400\">your friend texts you that dinner's off,\" he says. \"\u003c/span>\u003cspan style=\"font-weight: 400\">So there you are with \u003c/span>\u003cspan style=\"font-weight: 400\">no plans, and you\u003c/span>\u003cspan style=\"font-weight: 400\"> open up Facebook. A\u003c/span>\u003cspan style=\"font-weight: 400\">t that moment, Facebook has \u003c/span>\u003cspan style=\"font-weight: 400\">about 1,000 people whose job is to get you to just click and scroll and \u003c/span>\u003cspan style=\"font-weight: 400\">watch stuff on the news feed. And that will work. You'll probably end up \u003c/span>\u003cspan style=\"font-weight: 400\">sitting there, an hour later, just kind of having scrolled through the news feed.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At which point, says Harris, you will have fulfilled Facebook's mission, but perhaps not your own. \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's not that we \u003cem>shouldn't\u003c/em> be concerned about book burning, but we \u003cem>should\u003c/em> be concerned about a society that distracts us from even wanting to read.' \u003ccite>Tristan Harris, former Google design ethicist\u003c/cite>\u003c/aside>\n\u003cp>But what if Facebook actually asked you what you wanted to do, apart from just using Facebook? Like perhaps finding other people who have no plans?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"It’s about agency,\" says Harris. \"Facebook would have to have some way before you just get dropped in the newsfeed, to say, 'What do you want right now?'\u003c/span>\u003c/p>\n\u003cp>B.J. Fogg runs the Persuasive Technology Lab at Stanford, which teaches students to use these sticky techniques. Many employees of top tech companies, including a cofounder of Instagram, have participated in the lab.\u003c/p>\n\u003cp>Fogg says he got to know some of the early Facebook employees, and found them genuinely motivated by a desire to do good.\u003c/p>\n\u003cp>\"The individual people at Facebook, the people that I met, really wanted to make the world more harmonious, bring people together, create empathy and so on,\" he says.\u003c/p>\n\u003cp>\"Where I think Tristan (Harris) and I would agree a lot is that often their business goals can be at odds with the human-centered approach to design. There's a conflict there between what they need to do as an advertising company and what's going to be really good for people.\"\u003c/p>\n\u003cp>\u003cstrong>Amusing Ourselves to Death\u003c/strong>\u003c/p>\n\u003cp>The reason this matters so much is that technology is going to get more and more persuasive, says Harris.\u003c/p>\n\u003cp>\"We're sitting \u003cspan style=\"font-weight: 400\">at the very edge of what will become a virtual reality and \u003c/span>\u003cspan style=\"font-weight: 400\">augmented reality world. \u003c/span>\u003cspan style=\"font-weight: 400\">If those worlds are e\u003c/span>\u003cspan style=\"font-weight: 400\">ven more persuasive in getting us to spend our time there, where is hum\u003c/span>\u003cspan style=\"font-weight: 400\">an agency in that process?\" \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And then a warning.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"We have to have that conversation now because right now it's \u003c/span>\u003cspan style=\"font-weight: 400\">driving toward not a good direction.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have now developed a rigorous technology of the human mind, and that is both exciting and terrifying. We have the ability to twiddle some nobs in a machine learning dashboard we build, and around the world hundreds of thousands of people are going to quietly change their behavior ... .'\u003ccite>Ramsay Brown, co-founder, Dopamine Labs\u003c/cite>\u003c/aside>\n\u003cp>He cited a 1985 book, \"\u003ca href=\"https://en.wikipedia.org/wiki/Amusing_Ourselves_to_Death\" target=\"_blank\" rel=\"noopener noreferrer\">Amusing Ourselves to Death\u003c/a>,\" by Neil Postman, that distinguished between two dystopian visions.\u003c/p>\n\u003cp>\"There's one that most people already know: the \"1984\" Big Brother, surveillance future. We have all been trained to look out for that.\u003c/p>\n\u003cp>\"But there is this subtler second vision of power, which was the Aldous Huxley vision in \"\u003ca href=\"https://en.wikipedia.org/wiki/Brave_New_World\" target=\"_blank\" rel=\"noopener noreferrer\">Brave New World\u003c/a>,\" that's so good at giving us amusement and little bits of trivia. In other words, it's not that we \u003cem>shouldn't\u003c/em> be concerned about book burning, but we \u003cem>should\u003c/em> be concerned about a society that distracts us from even wanting to read.\"\u003c/p>\n\u003cp>\u003cstrong>It's the Dopamine\u003c/strong>\u003c/p>\n\u003cp>Ramsay Brown is the co-founder of \u003ca href=\"https://usedopamine.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Dopamine Labs\u003c/a>, which uses artificial intelligence and neuroscience to help app writers attract and retain users.\u003c/p>\n\u003cp>Dopamine Labs makes no bones about what it's trying to do. From a \u003ca href=\"https://usedopamine.com/assets/pdf/Dopamine%20Labs%20Case%20Studies.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">promotional document\u003c/a> on its website.:\u003c/p>\n\u003cblockquote>\u003cp>Keeping users engaged isn’t luck: it’s science. Give users the right \u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/burst.jpg\">\u003cimg class=\"alignnone size-full wp-image-392383\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/burst.jpg\" alt=\"\" width=\"71\" height=\"63\">\u003c/a> of dopamine at the right moment and they’ll stay longer and use your app more.\"\u003c/p>\u003c/blockquote>\n\u003cp>Dopamine is a neurotransmitter associated with rewards and addictive substances. The company is not just being glib when it says it will deliver the chemical to users. Dr. Elias Aboujaoude, the director of Stanford’s Obsessive Compulsive Disorder Clinic, told KQED's McClurg that dopamine and other feel-good brain chemicals spike in people who compulsively use the internet.\u003c/p>\n\u003cp>Brown told me that social media companies use a concept known as variable rewards, something that slot machines use to hook gamblers, to similarly keep users clicking.\u003c/p>\n\u003cp>\"The brain isn't particularly craving any one little feel-good signal as much as it does a really good rhythm and pattern,\" Brown said. Both he and Harris say Facebook and Instagram tailor the timing of the \"notifications\" they deliver to users -- the messages you get that are indicated by a number in red at the top right of the screen -- in order to deliver shots of dopamine to users at times determined by an algorithm.\u003c/p>\n\u003cp>\"Sometimes there’s nothing waiting for you, sometimes there’s a friend request or someone wrote on your wall,\" Brown told me. \"Sometimes there’s just kind of like filler crap. It’s not pertinent to your life, but Facebook's algorithms have figured out that showing it to you then is going to be slightly more surprising then not showing it to you at all or showing it to you later.\"\u003c/p>\n\u003cp>These patterns will keep you coming back.\u003c/p>\n\u003cp>I asked Brown how he knew that's what Facebook was doing.\u003c/p>\n\u003cp>\"It's obvious to anyone who knows the techniques,\" he said.\u003c/p>\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/gvQxtotEX-M'\n title='//www.youtube.com/embed/gvQxtotEX-M'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>In the \"60 Minutes\" segment, Larry Rosen, a professor of psychology at California State University, Dominguez Hills, who researches the psychology of tech, said typically, people check their phones every 15 minutes or less. They're not just craving dopamine; he said they're seeking relief from the stress hormone cortisol.\u003c/p>\n\u003cp>\"Half of the time, they check their phone, there’s no alert, no notification,\" said Rosen. \"It’s coming from inside their head, telling them, 'Gee I haven’t checked on Facebook for a while, I haven’t checked on this Twitter feed for a while. I wonder if someone commented on my Instagram post. That then generates cortisol and it starts to make you anxious. Eventually your goal is to get rid of that anxiety, so you check in.\"\u003c/p>\n\u003cp>As Anderson Cooper of \"60 Minutes\" put it: \"Their research suggests our phones are keeping us in a continual state of anxiety in which the only antidote is the phone.\"\u003c/p>\n\u003cp>\u003cstrong>Doing Good\u003c/strong>\u003c/p>\n\u003cp>Ramsay Brown says his own company uses this type of research to help only businesses or organizations it has determined are trying to do good.\u003c/p>\n\u003cp>\"To break the habits we don't want in ourselves or make the habits we do want in ourselves,\" as he puts it.\u003c/p>\n\u003cp>To that end, Dopamine Labs created an \u003ca href=\"http://youjustneedspace.com/\" target=\"_blank\" rel=\"noopener noreferrer\">app\u003c/a> called \"Space,\" intended to help users break troublesome online habits by creating a delay before certain apps will open.\u003c/p>\n\u003cp>Apple initially denied the app for placement in its app store. Brown says he was told by an Apple rep that the rejection came because any app that encouraged people to use other apps less was inappropriate for the store. After the \"60 Minutes\" segment aired, Apple \u003ca href=\"https://itunes.apple.com/us/app/space-because-you-need-a-breather/id1187106675?mt=8\" target=\"_blank\" rel=\"noopener noreferrer\">accepted \u003c/a>the app. (An Apple spokesperson said the rejection had to do with a technical issue and that \"The adjustment had nothing to do with whether the app discouraged people from using other apps or not.\")\u003c/p>\n\u003cp>Even though Dopamine Labs might choose clients according to its own definition of doing good, I wondered if the application of techniques that are as powerful and potentially insidious as he and other researchers say they are is justified, no matter what the product.\u003c/p>\n\u003cp>\"We are in a bit of a Robert Oppenheimer moment,\" Brown said, citing the scientist who is often called the father of the atomic bomb, and who later expressed a deep ambivalence about his work\u003cb>.\u003c/b>\u003c/p>\n\u003cp>\"We have now developed a rigorous technology of the human mind, and that is both exciting and terrifying. We have the ability to twiddle some nobs in a machine learning dashboard we build, and around the world hundreds of thousands of people are going to quietly change their behavior in ways that, unbeknownst to them, feel second-nature but are really by design.\"\u003c/p>\n\u003cp>\"Which means that there's a deep ethical imperative for us to use it for good.\"\u003c/p>\n\u003cp>\u003cstrong>So What's the Harm?\u003c/strong>\u003c/p>\n\u003cp>As KQED's McClurg reported, addictions to social media, video games, texting, shopping and pornography are not officially listed disorders in the Diagnostic and Statistical Manual of Mental Disorders. A consensus is growing, however, that compulsive online behavior is doing real harm.\u003c/p>\n\u003cp>Hundreds of papers have been written on the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/06/does-facebook-really-make-you-depressed/\" target=\"_blank\" rel=\"noopener noreferrer\">negative consequences of using Facebook\u003c/a>, alone. While some studies have also shown positive effects, Jean Twenge, a professor of psychology at San Diego State University and the author of \"Generation Me,\" says more rigorous research has come to a more negative conclusion.\u003c/p>\n\u003cp>“Its pretty clear these days that spending more time on social media leads to a\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28093386\" target=\"_blank\" rel=\"noopener noreferrer\"> more negative mood\u003c/a>,” she said.\u003c/p>\n\u003cp>Twenge says her research shows that the proliferation of the smartphone is having big effects on people born around 1995. She say that's when the millennial generation morphs into \"iGen\" -- also known as \u003ca href=\"https://en.wikipedia.org/wiki/Generation_Z\" target=\"_blank\" rel=\"noopener noreferrer\">Generation Z\u003c/a>.\u003c/p>\n\u003cp>She pointed to the \u003ca href=\"https://www.bls.gov/emp/ep_table_303.htm\" target=\"_blank\" rel=\"noopener noreferrer\">plummeting employment rate of young men\u003c/a> as one macro-development related to iGen, and \u003cspan style=\"font-weight: 400\">cited \u003c/span>the work of University of Chicago economist Erik Hurst. Last year, in a university \u003ca href=\"https://bfi.uchicago.edu/news/scholar-profile/faculty-spotlight-erik-hurst\" target=\"_blank\" rel=\"noopener noreferrer\">profile\u003c/a>, Hurst discussed his research on the dwindling percentage of young males without a college degree in the labor force and this trend's connection to leisure-time technology:\u003c/p>\n\u003cblockquote>\u003cp>In the 2000s, employment rates for this group dropped sharply – more than in any other group. We have determined that, in general, they are not going back to school or switching careers, so what are they doing with their time? The hours that they are not working have been replaced almost one for one with leisure time. Seventy-five percent of this new leisure time falls into one category: video games. The average low-skilled, unemployed man in this group plays video games an average of 12, and sometimes upwards of 30 hours per week. This change marks a relatively major shift that makes me question its effect on their attachment to the labor market.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Attention Economy\u003c/strong>\u003c/p>\n\u003cp>BJ Fogg says a lot of persuasion methods that Facebook and other tech companies use are not really new.\u003c/p>\n\u003cp>He gave the example of Facebook birthday reminders, which often draw people back into the site to wish someone happy birthday. \"Reminders are not new,\" he said, citing Hallmark TV commercials about mother's day, for example. \"W\u003cspan style=\"line-height: 1.5\">hat ‘s different today is that machines are being created to use these techniques.\"\u003c/span>\u003c/p>\n\u003cp>At this point, I am reminded that those of us who create text for public consumption have also been in the business of attention-grabbing for quite some time. This \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/05/12/how-the-media-came-to-embrace-clickbait-an-internet-history/\" target=\"_blank\" rel=\"noopener noreferrer\">excerpt\u003c/a> we recently posted from Tim Wu's book \"The Attention Merchants,\" is instructive; it takes you through the evolution and eventual mainstream adoption of clickbait -- those headlines that contain just the right words to whet your appetite for a click.\u003c/p>\n\u003cp>While we here at KQED have yet to hire a an actual neuroscientist to help us craft the perfect syntactic arrangement to make our post on the \u003ca href=\"https://ww2.kqed.org/science/2017/04/25/volunteer-brown-pelican-count-aims-to-measure-recovery-of-once-endangered-birds/\" target=\"_blank\" rel=\"noopener noreferrer\">California brown pelican count\u003c/a> irresistible to a mass audience, we have sat through any number of workshops led by self-styled audience-whisperers. And we do use software tools to try to figure out what works and what doesn't in terms of getting people to read an article.\u003c/p>\n\u003cp>Isn't that, crudely, \u003cem>some\u003c/em> form of brain hacking?\u003c/p>\n\u003cp>The point being: \u003cem>Everyone\u003c/em> is in quest of your eyeballs. The question is how far will people go to get them. Where the line gets crossed from superior business model to dirty rotten trick is the subject of much debate, from the halls of government to academia to Thanksgiving brouhahas.\u003c/p>\n\u003cp>On the \"60 Minutes\" segment, Gabe Zichermann, who consults for companies on how to use \"\u003ca href=\"https://en.wikipedia.org/wiki/Gamification\" target=\"_blank\" rel=\"noopener noreferrer\">gamification\u003c/a>\" to make their digital products more appealing, argued that attracting audience is simply the name of the game.\u003c/p>\n\u003cp>\"Asking technology companies, asking content creators to be less good at what they do feels like a ridiculous ask,\" he said. \"It feels impossible. And also it’s very anti-capitalistic. This isn’t the system that we live in.\"\u003c/p>\n\u003cp>The other side of that, expressed by Bill Maher in his televised rant:\u003c/p>\n\u003cp>\"The moral rot in this country began when corporate America decided it wasn’t enough to just successfully sell your product; people needed to be addicted to it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Meantime, while you wait for society to figure this issue out, it's probably best to take matters into your own compulsively typing hands. If you've ever said \"I wish I knew how to quit you\" to your phone, see Lesley McClurg's post, '\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/24/help-my-phone-is-ruining-my-life-8-tips-for-the-addicted\" target=\"_blank\" rel=\"noopener noreferrer\">Help! My Phone is Ruining My Life!\u003c/a>' for \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/19/help-my-phone-is-ruining-my-life-8-tips-for-the-addicted/#tips\" target=\"_blank\" rel=\"noopener noreferrer\">eight tips\u003c/a> on how to detach.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When Logan Snyder got hooked on pills after a prescription to treat pain from a kidney stone, she joined the millions already swept up in the nation's grim wave of addiction to opioid painkillers.\u003c/p>\n\u003cp>She was just 14.\u003c/p>\n\u003cp>Youth is a drawback when it comes to kicking drugs. Only half of U.S. treatment centers accept teenagers and even fewer offer teen-focused groups or programs. After treatment, adolescents find little structured support. They're outnumbered by adults at self-help meetings. Sober youth drop-in centers are rare. Returning to school means resisting offers to get high with old friends.\u003c/p>\n\u003cp>But Snyder is lucky: Her slide ended when her father got her into a residential drug treatment program. Now 17 and clean, she credits her continued success to Hope Academy in Indianapolis, a tuition-free recovery school where she's enrolled as a junior.\u003c/p>\n\u003cp>\"I am with people all day who are similar to me,\" she says. \"We're here to hold each other accountable.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The opioid epidemic, which researchers say is the worst addiction crisis in U.S. history, has mostly ensnared adults, especially those in their 20s, 30s and 40s. But teens have not been spared: Each day, 1,100 start misusing pain pills. Opioids killed 521 teens in 2015, federal data show.\u003c/p>\n\u003cp>Not enough is known about opioids and teen brains. But getting hooked early is trouble — the vast majority of adults in treatment report they started using as teenagers.\u003c/p>\n\u003cp>Researchers say young recovering addicts do better at places like Hope, special schools that use peer communities to support sobriety. There are only about three dozen such schools in the U.S., but interest is growing among educators and health officials because of the opioid epidemic.\u003c/p>\n\u003cp>\"I get a phone call every day from somebody who wants to start a recovery high school,\" says Rachelle Gardner, an addiction counselor who helped found Hope in 2006 as a charter school through the mayor's office. \"It's horrible to watch young people die. And who wants that to be our legacy?\"\u003c/p>\n\u003cp>Hope's 41 teenagers have abused marijuana, alcohol, painkillers and heroin. Most, like Snyder, have been through residential treatment, some more than once. Others, like 17-year-old Aiden Thompson, arrive with no treatment after a crisis.\u003c/p>\n\u003cp>\"I was really pissed off because I didn't want to be here,\" says Thompson, who came to Hope last year after his mom discovered his vodka and pill stash. \"Everything they said, I was like: 'That can't be true. No. No way.'\"\u003c/p>\n\u003cp>A week later, though, he found himself talking in group meetings. Now, he said, \"I don't even want to think about where I would be\" without the school.\u003c/p>\n\u003cp>Teens like Snyder and Thompson can change in these settings, even after years of drug abuse, in part because social acceptance is a fundamental need for people their age. The sway of positive peer pressure — what students at Hope call \"the community\" — is quiet, almost intangible. It's as simple as two teens passing in the hall: \"You all right?\" says one boy. The other nods, \"Yeah, I'm all right.\"\u003c/p>\n\u003cp>A student council plans events like coffee-and-music mornings. To join the council, a student must have 30 days of sobriety.\u003c/p>\n\u003cp>Random drug tests keep it real. Failing a urine test prompts a meeting with recovery coach Brad Trolson, who employs a technique called motivational interviewing, using open-ended questions and reflective listening to encourage students to think for themselves.\u003c/p>\n\u003cp>\"They're not used to anyone saying, 'What do you think you should do next?'\" Trolson says.\u003c/p>\n\u003cp>It's a daily fight, he says. Many have addicted parents or histories of abuse or neglect, key risk factors for addiction.\u003c/p>\n\u003cp>\"Their wounds will start to heal and they'll come open again,\" he says. \"You end up addressing those wounds over and over again.\"\u003c/p>\n\u003cp>Thompson, who relapsed over winter break, says he's learning to focus on one day of recovery at a time. \"I'm clean for today and that's all that matters,\" he says. \"I don't want to put all this weight on my shoulders to feel like I have to stay clean forever. I can just take it a day at a time and not be freaked out by it.\"\u003c/p>\n\u003cp>\"Just for today\" and other Alcoholics Anonymous slogans are the common language at Hope.\u003c/p>\n\u003cp>The school also embraces treatment with medication and doesn't see it as a crutch, as some AA adherents do. Two students get monthly shots of Vivitrol to block opioid cravings and one takes Suboxone, another anti-craving drug.\u003c/p>\n\u003cp>\"Whatever mechanism our students need in order to maintain a life of sobriety we will support,\" Gardner says.\u003c/p>\n\u003cp>Nationally, teen drug use is in long-term decline, according to an annual federal youth assessment of risky behaviors. But about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone. Other federal data show about 1.3 million adolescents, ages 12 to 17, need treatment for alcoholism or drug addiction.\u003c/p>\n\u003cp>As part of research funded by the National Institute on Drug Abuse, Andy Finch of Vanderbilt University is studying whether kids who've been treated for addiction do better in recovery schools. Early evidence shows recovery-school students are less likely to relapse than students who attend traditional schools after treatment.\u003c/p>\n\u003cp>\"There's a place in every community for a school like this,\" says Finch, who expects to publish his findings later this year.\u003c/p>\n\u003cp>On a recent morning at Hope, students and teachers gather for an all-school meeting called \"circle.\" A golden retriever named Banks pads about, then sits beside 18-year-old Ian Lewis, who hugs him with a tattooed arm.\u003c/p>\n\u003cp>\"Animals give unconditional love and sometimes that's hard for other people to give to each other,\" Lewis says. He wants to be a vet someday. His owl-and-skull tattoo reminds him to be wiser than two user friends who overdosed and a third who died driving drunk.\u003c/p>\n\u003cp>Today's circle is led by Snyder, who still has \"a lot of hard days\" and fears ending up like her user friends who died. She, too, has her eyes on graduation and college.\u003c/p>\n\u003cp>\"We don't get perfect,\" she reads aloud, \"but we do get better.\"\u003cbr>\nSnyder's hardest days are when she wakes up and skips her inner pep talk. Also hard are days when family problems close in, and days when she sees others escaping through drugs and wants to join them. Days when she can't imagine how she's going to solve her problems. Days when she feels alone.\u003c/p>\n\u003cp>Her new friends pull her back from the edge. They remind her that she doesn't want others to feel around her the way she feels around an addicted family member in her life.\u003c/p>\n\u003cp>\"That helps me to want to get better,\" she says.\u003c/p>\n\u003cp>There are no magic words, Snyder says, for those desperate to rescue a young addict.\u003c/p>\n\u003cp>\"Presence helps me rather than words,\" she says. \"If I don't want you to talk, then don't talk. Listen to me.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Above all, she wants to hear she's not alone \"because I often feel like that.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Logan Snyder got hooked on pills after a prescription to treat pain from a kidney stone, she joined the millions already swept up in the nation's grim wave of addiction to opioid painkillers.\u003c/p>\n\u003cp>She was just 14.\u003c/p>\n\u003cp>Youth is a drawback when it comes to kicking drugs. Only half of U.S. treatment centers accept teenagers and even fewer offer teen-focused groups or programs. After treatment, adolescents find little structured support. They're outnumbered by adults at self-help meetings. Sober youth drop-in centers are rare. Returning to school means resisting offers to get high with old friends.\u003c/p>\n\u003cp>But Snyder is lucky: Her slide ended when her father got her into a residential drug treatment program. Now 17 and clean, she credits her continued success to Hope Academy in Indianapolis, a tuition-free recovery school where she's enrolled as a junior.\u003c/p>\n\u003cp>\"I am with people all day who are similar to me,\" she says. \"We're here to hold each other accountable.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The opioid epidemic, which researchers say is the worst addiction crisis in U.S. history, has mostly ensnared adults, especially those in their 20s, 30s and 40s. But teens have not been spared: Each day, 1,100 start misusing pain pills. Opioids killed 521 teens in 2015, federal data show.\u003c/p>\n\u003cp>Not enough is known about opioids and teen brains. But getting hooked early is trouble — the vast majority of adults in treatment report they started using as teenagers.\u003c/p>\n\u003cp>Researchers say young recovering addicts do better at places like Hope, special schools that use peer communities to support sobriety. There are only about three dozen such schools in the U.S., but interest is growing among educators and health officials because of the opioid epidemic.\u003c/p>\n\u003cp>\"I get a phone call every day from somebody who wants to start a recovery high school,\" says Rachelle Gardner, an addiction counselor who helped found Hope in 2006 as a charter school through the mayor's office. \"It's horrible to watch young people die. And who wants that to be our legacy?\"\u003c/p>\n\u003cp>Hope's 41 teenagers have abused marijuana, alcohol, painkillers and heroin. Most, like Snyder, have been through residential treatment, some more than once. Others, like 17-year-old Aiden Thompson, arrive with no treatment after a crisis.\u003c/p>\n\u003cp>\"I was really pissed off because I didn't want to be here,\" says Thompson, who came to Hope last year after his mom discovered his vodka and pill stash. \"Everything they said, I was like: 'That can't be true. No. No way.'\"\u003c/p>\n\u003cp>A week later, though, he found himself talking in group meetings. Now, he said, \"I don't even want to think about where I would be\" without the school.\u003c/p>\n\u003cp>Teens like Snyder and Thompson can change in these settings, even after years of drug abuse, in part because social acceptance is a fundamental need for people their age. The sway of positive peer pressure — what students at Hope call \"the community\" — is quiet, almost intangible. It's as simple as two teens passing in the hall: \"You all right?\" says one boy. The other nods, \"Yeah, I'm all right.\"\u003c/p>\n\u003cp>A student council plans events like coffee-and-music mornings. To join the council, a student must have 30 days of sobriety.\u003c/p>\n\u003cp>Random drug tests keep it real. Failing a urine test prompts a meeting with recovery coach Brad Trolson, who employs a technique called motivational interviewing, using open-ended questions and reflective listening to encourage students to think for themselves.\u003c/p>\n\u003cp>\"They're not used to anyone saying, 'What do you think you should do next?'\" Trolson says.\u003c/p>\n\u003cp>It's a daily fight, he says. Many have addicted parents or histories of abuse or neglect, key risk factors for addiction.\u003c/p>\n\u003cp>\"Their wounds will start to heal and they'll come open again,\" he says. \"You end up addressing those wounds over and over again.\"\u003c/p>\n\u003cp>Thompson, who relapsed over winter break, says he's learning to focus on one day of recovery at a time. \"I'm clean for today and that's all that matters,\" he says. \"I don't want to put all this weight on my shoulders to feel like I have to stay clean forever. I can just take it a day at a time and not be freaked out by it.\"\u003c/p>\n\u003cp>\"Just for today\" and other Alcoholics Anonymous slogans are the common language at Hope.\u003c/p>\n\u003cp>The school also embraces treatment with medication and doesn't see it as a crutch, as some AA adherents do. Two students get monthly shots of Vivitrol to block opioid cravings and one takes Suboxone, another anti-craving drug.\u003c/p>\n\u003cp>\"Whatever mechanism our students need in order to maintain a life of sobriety we will support,\" Gardner says.\u003c/p>\n\u003cp>Nationally, teen drug use is in long-term decline, according to an annual federal youth assessment of risky behaviors. But about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone. Other federal data show about 1.3 million adolescents, ages 12 to 17, need treatment for alcoholism or drug addiction.\u003c/p>\n\u003cp>As part of research funded by the National Institute on Drug Abuse, Andy Finch of Vanderbilt University is studying whether kids who've been treated for addiction do better in recovery schools. Early evidence shows recovery-school students are less likely to relapse than students who attend traditional schools after treatment.\u003c/p>\n\u003cp>\"There's a place in every community for a school like this,\" says Finch, who expects to publish his findings later this year.\u003c/p>\n\u003cp>On a recent morning at Hope, students and teachers gather for an all-school meeting called \"circle.\" A golden retriever named Banks pads about, then sits beside 18-year-old Ian Lewis, who hugs him with a tattooed arm.\u003c/p>\n\u003cp>\"Animals give unconditional love and sometimes that's hard for other people to give to each other,\" Lewis says. He wants to be a vet someday. His owl-and-skull tattoo reminds him to be wiser than two user friends who overdosed and a third who died driving drunk.\u003c/p>\n\u003cp>Today's circle is led by Snyder, who still has \"a lot of hard days\" and fears ending up like her user friends who died. She, too, has her eyes on graduation and college.\u003c/p>\n\u003cp>\"We don't get perfect,\" she reads aloud, \"but we do get better.\"\u003cbr>\nSnyder's hardest days are when she wakes up and skips her inner pep talk. Also hard are days when family problems close in, and days when she sees others escaping through drugs and wants to join them. Days when she can't imagine how she's going to solve her problems. Days when she feels alone.\u003c/p>\n\u003cp>Her new friends pull her back from the edge. They remind her that she doesn't want others to feel around her the way she feels around an addicted family member in her life.\u003c/p>\n\u003cp>\"That helps me to want to get better,\" she says.\u003c/p>\n\u003cp>There are no magic words, Snyder says, for those desperate to rescue a young addict.\u003c/p>\n\u003cp>\"Presence helps me rather than words,\" she says. \"If I don't want you to talk, then don't talk. Listen to me.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Above all, she wants to hear she's not alone \"because I often feel like that.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nearly a Third of FDA-Approved Drugs Had Safety Problems",
"title": "Nearly a Third of FDA-Approved Drugs Had Safety Problems",
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"content": "\u003cp>The Food and Drug Administration is under pressure from the Trump administration to approve drugs faster, but researchers at the Yale School of Medicine found that nearly a third of those approved from 2001 through 2010 had major safety issues years after they were widely available to patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Issues were more common among psychiatric drugs, \u003ca href=\"https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cber/ucm133077.htm\">biologic\u003c/a> drugs, drugs that were granted 'accelerated approval' and drugs that were approved near the regulatory deadline for approval.\u003c/aside>\n\u003cp>Yale professor Dr. Joseph Ross and his colleagues reported in JAMA last week. \u003ca href=\"http://click.alerts.jamanetwork.com/click/g1lfu-asi8fi-5n5d0de4/\">The study\u003c/a> included safety actions through Feb. 28.\u003c/p>\n\u003cp>“While the administration pushes for less regulation and faster approvals, those decisions have consequences,” Ross said. The Yale researchers’ previous studies concluded that the FDA approves drugs \u003ca href=\"http://news.yale.edu/2017/04/05/fda-approves-drugs-more-quickly-peer-agency-europe\">faster\u003c/a> than its counterpart agency in Europe, and that the \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/1817794\">majority\u003c/a> of pivotal trials in drug approvals involved fewer than 1,000 patients and lasted six months or less.\u003c/p>\n\u003cp>It took a median time period of 4.2 years after the drugs were approved for these safety concerns to come to light, and issues were more common among psychiatric drugs, biologic drugs, drugs that were granted “accelerated approval” and drugs that were approved near the regulatory deadline for approval.\u003c/p>\n\u003cp>Drugs ushered through the FDA’s accelerated approval process were among those that had higher rates of safety interventions. These approvals typically rely on surrogate endpoints, meaning that researchers measured something other than survival, such as tumor size, to determine whether the drugs worked.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This [finding on surrogate endpoints] has the greatest relationship to policy today,” Ross said. “In the 21st Century Cures Act, there’s a push to have the FDA move to further support the use of surrogate markers … [but] they’re more likely to have concerns in the post-market setting.”\u003c/p>\n\u003cp>Former President Barack Obama signed the act into law on Dec. 13. Among other things, it offers ways to speed drug approval by pushing the FDA to consider different kinds of evidence beyond the three phases of traditional clinical trials. The new process has made some researchers worry that it will open the door for more unsafe approvals.\u003c/p>\n\u003cp>“I’m actually sympathetic to the idea that there are ways in which the FDA can be more streamlined and do a quicker job,” said Dr. Vinay Prasad, a hematologist-oncologist and professor at Oregon Health and Sciences University who did not work on the study. “The one place you don’t want to cut a corner is safety and efficacy prior to coming to market.”\u003c/p>\n\u003cp>Given criticism of the FDA’s mostly voluntary system for reporting new drug- and device-related health problems, it’s possible there are more unknown adverse side effects of which neither the FDA nor the general public is aware. The reports are not verified, and \u003ca href=\"https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=100\">critics\u003c/a> say this system is underutilized and filled with incomplete and late information. The FDA also monitors other available studies and reports to determine whether it needs to take action on a particular drug.\u003c/p>\n\u003cp>FDA spokeswoman Angela Hoague said the agency is reviewing Ross’ findings.\u003c/p>\n\u003cp>“In general, the FDA does not comment on specific studies, but evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health,” she said.\u003c/p>\n\u003cp>Regardless, some observers may find the proportion of safety concerns alarming and others may be breathing a sigh of relief that it’s not higher, Ross said.\u003c/p>\n\u003cp>“That’s the million-dollar question: What’s the right amount? What’s the appropriate level of safety concerns to have identified only once the product is out of the gate?” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. He did not work on the study.\u003c/p>\n\u003cp>Surprisingly, drugs approved in under 200 days were less likely to have safety issues, which the authors speculate could be because “some approval packages provide clearer evidence of safety, allowing for more rapid regulatory approval.”\u003c/p>\n\u003cp>The study included market withdrawals of three drugs: the anti-inflammatory drug Bextra, a drug called Zelnorm that treats irritable bowel syndrome and the psoriasis drug Raptiva. Bextra and Zelnorm were withdrawn over cardiovascular risk, and Raptiva was withdrawn because of increased risk of a rare and fatal infection that damages material in the brain.\u003c/p>\n\u003cp>Still, it’s important to keep in mind that the post-approval safety issues cover the spectrum from relatively minor to serious, Alexander said. A good next step would be to dig into the extremely serious safety problems, determine whether the FDA could have flagged them sooner and how they might have been missed, he said.\u003c/p>\n\u003cp>Alexander commended the researchers, saying their study “underscores the importance of surveillance” after a drug has been launched. This helps researchers find new problems — and new benefits — associated with a drug.\u003c/p>\n\u003cp>“All too often, patients and clinicians mistakenly view FDA approval as [an] indication that a product is fully safe and effective,” he said. “Nothing could be further from the truth. We learn tremendous amounts about a product only once it’s on the market and only after use among a broad population.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration is under pressure from the Trump administration to approve drugs faster, but researchers at the Yale School of Medicine found that nearly a third of those approved from 2001 through 2010 had major safety issues years after they were widely available to patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Issues were more common among psychiatric drugs, \u003ca href=\"https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cber/ucm133077.htm\">biologic\u003c/a> drugs, drugs that were granted 'accelerated approval' and drugs that were approved near the regulatory deadline for approval.\u003c/aside>\n\u003cp>Yale professor Dr. Joseph Ross and his colleagues reported in JAMA last week. \u003ca href=\"http://click.alerts.jamanetwork.com/click/g1lfu-asi8fi-5n5d0de4/\">The study\u003c/a> included safety actions through Feb. 28.\u003c/p>\n\u003cp>“While the administration pushes for less regulation and faster approvals, those decisions have consequences,” Ross said. The Yale researchers’ previous studies concluded that the FDA approves drugs \u003ca href=\"http://news.yale.edu/2017/04/05/fda-approves-drugs-more-quickly-peer-agency-europe\">faster\u003c/a> than its counterpart agency in Europe, and that the \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/1817794\">majority\u003c/a> of pivotal trials in drug approvals involved fewer than 1,000 patients and lasted six months or less.\u003c/p>\n\u003cp>It took a median time period of 4.2 years after the drugs were approved for these safety concerns to come to light, and issues were more common among psychiatric drugs, biologic drugs, drugs that were granted “accelerated approval” and drugs that were approved near the regulatory deadline for approval.\u003c/p>\n\u003cp>Drugs ushered through the FDA’s accelerated approval process were among those that had higher rates of safety interventions. These approvals typically rely on surrogate endpoints, meaning that researchers measured something other than survival, such as tumor size, to determine whether the drugs worked.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This [finding on surrogate endpoints] has the greatest relationship to policy today,” Ross said. “In the 21st Century Cures Act, there’s a push to have the FDA move to further support the use of surrogate markers … [but] they’re more likely to have concerns in the post-market setting.”\u003c/p>\n\u003cp>Former President Barack Obama signed the act into law on Dec. 13. Among other things, it offers ways to speed drug approval by pushing the FDA to consider different kinds of evidence beyond the three phases of traditional clinical trials. The new process has made some researchers worry that it will open the door for more unsafe approvals.\u003c/p>\n\u003cp>“I’m actually sympathetic to the idea that there are ways in which the FDA can be more streamlined and do a quicker job,” said Dr. Vinay Prasad, a hematologist-oncologist and professor at Oregon Health and Sciences University who did not work on the study. “The one place you don’t want to cut a corner is safety and efficacy prior to coming to market.”\u003c/p>\n\u003cp>Given criticism of the FDA’s mostly voluntary system for reporting new drug- and device-related health problems, it’s possible there are more unknown adverse side effects of which neither the FDA nor the general public is aware. The reports are not verified, and \u003ca href=\"https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=100\">critics\u003c/a> say this system is underutilized and filled with incomplete and late information. The FDA also monitors other available studies and reports to determine whether it needs to take action on a particular drug.\u003c/p>\n\u003cp>FDA spokeswoman Angela Hoague said the agency is reviewing Ross’ findings.\u003c/p>\n\u003cp>“In general, the FDA does not comment on specific studies, but evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health,” she said.\u003c/p>\n\u003cp>Regardless, some observers may find the proportion of safety concerns alarming and others may be breathing a sigh of relief that it’s not higher, Ross said.\u003c/p>\n\u003cp>“That’s the million-dollar question: What’s the right amount? What’s the appropriate level of safety concerns to have identified only once the product is out of the gate?” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. He did not work on the study.\u003c/p>\n\u003cp>Surprisingly, drugs approved in under 200 days were less likely to have safety issues, which the authors speculate could be because “some approval packages provide clearer evidence of safety, allowing for more rapid regulatory approval.”\u003c/p>\n\u003cp>The study included market withdrawals of three drugs: the anti-inflammatory drug Bextra, a drug called Zelnorm that treats irritable bowel syndrome and the psoriasis drug Raptiva. Bextra and Zelnorm were withdrawn over cardiovascular risk, and Raptiva was withdrawn because of increased risk of a rare and fatal infection that damages material in the brain.\u003c/p>\n\u003cp>Still, it’s important to keep in mind that the post-approval safety issues cover the spectrum from relatively minor to serious, Alexander said. A good next step would be to dig into the extremely serious safety problems, determine whether the FDA could have flagged them sooner and how they might have been missed, he said.\u003c/p>\n\u003cp>Alexander commended the researchers, saying their study “underscores the importance of surveillance” after a drug has been launched. This helps researchers find new problems — and new benefits — associated with a drug.\u003c/p>\n\u003cp>“All too often, patients and clinicians mistakenly view FDA approval as [an] indication that a product is fully safe and effective,” he said. “Nothing could be further from the truth. We learn tremendous amounts about a product only once it’s on the market and only after use among a broad population.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People in North America and Europe who are infected with HIV and who begin treatment with a triple-drug cocktail can expect to live nearly as long as people who aren’t infected by the virus, a new study suggested.\u003c/p>\n\u003cp class=\"danger-zone\">A combination of factors — including less toxic drugs and better medical management — have resulted in longevity gains for people who are HIV-positive, concluded \u003ca href=\"http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext?elsca1=tlpr\" target=\"_blank\" rel=\"noopener noreferrer\">the study\u003c/a>, published in the journal Lancet HIV.\u003c/p>\n\u003cp class=\"danger-zone\">“Between 1996-99 and 2008-10, life expectancy in people living with HIV starting [antiretroviral therapy] increased by around 10 years for both sexes, in Europe and North America,” wrote the authors, who work at a variety of academic institutions through North American and Europe.\u003c/p>\n\u003cp class=\"danger-zone\">The findings reflect a trend that has been apparent for some time among people with HIV and their health care providers. A disease that was once a death sentence has become a chronic condition for people who have access to and the ability to stick with an HIV drug regimen.\u003c/p>\n\u003cp>“We’re just getting better at what we do,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci, who was not involved in this study, is a leader in HIV research; he continues to see HIV-positive patients who get treatment at the National Institutes of Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have better drugs. … People are adhering better because they know these drugs really work,” he told STAT. “I think the combination of all of those [factors] easily explains in a logical way the results of that study.”\u003c/p>\n\u003cp>The authors also suggested patients may be more motivated to take care of their health — quitting smoking, say — and their doctors more motivated to aggressively treat other health conditions because both understand that HIV treatment is effective.\u003c/p>\n\u003cp>The researchers pooled data from 18 studies that followed or are following HIV-positive people in 10 countries in Europe and North America, giving them information on roughly 88,500 people. They compared survival and longevity data for people who began taking triple-drug therapies during three periods of time — 1996 to 1999, 2000 to 2003, and 2008 to 2010.\u003c/p>\n\u003cp>The researchers looked at both death figures in the first year of treatment — when patients were typically at their sickest — and then life expectancy of people who survived the first year of treatment.\u003c/p>\n\u003cp>They concluded that an HIV-positive 20-year-old who started antiretroviral therapy between 2008 and 2010 and whose infection was well controlled by the drugs could expect to live to the age of 78.\u003c/p>\n\u003cp>Still, a commentary published with the study noted that these gains, while impressive, aren’t being made by all infected with HIV, particularly by individuals who are not white, have a history of injection drug use, or began treatment with low white blood cell counts.\u003c/p>\n\u003cp>Ingrid Katz of Harvard Medical School and Brendan Maughan-Brown of the University of Cape Town in South Africa wrote that in order to make additional gains in life expectancy, early detection of HIV and commencement of treatment will be needed.\u003c/p>\n\u003cp>Fauci said he thinks that further life expectancy gains can be made for people with HIV. But he believes the damage the virus does can’t be completely erased by early treatment. “I think we’re going to get really close to a normal life expectancy,” he said. “I would be surprised if it would be exactly the same. But I think it will be close enough to be dramatic.”\u003c/p>\n\u003cp>The study was funded by Britain’s Medical Research Council and the UK Department of International Development as well as the European Union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/10/hiv-life-expectancy-study/\">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>People in North America and Europe who are infected with HIV and who begin treatment with a triple-drug cocktail can expect to live nearly as long as people who aren’t infected by the virus, a new study suggested.\u003c/p>\n\u003cp class=\"danger-zone\">A combination of factors — including less toxic drugs and better medical management — have resulted in longevity gains for people who are HIV-positive, concluded \u003ca href=\"http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext?elsca1=tlpr\" target=\"_blank\" rel=\"noopener noreferrer\">the study\u003c/a>, published in the journal Lancet HIV.\u003c/p>\n\u003cp class=\"danger-zone\">“Between 1996-99 and 2008-10, life expectancy in people living with HIV starting [antiretroviral therapy] increased by around 10 years for both sexes, in Europe and North America,” wrote the authors, who work at a variety of academic institutions through North American and Europe.\u003c/p>\n\u003cp class=\"danger-zone\">The findings reflect a trend that has been apparent for some time among people with HIV and their health care providers. A disease that was once a death sentence has become a chronic condition for people who have access to and the ability to stick with an HIV drug regimen.\u003c/p>\n\u003cp>“We’re just getting better at what we do,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci, who was not involved in this study, is a leader in HIV research; he continues to see HIV-positive patients who get treatment at the National Institutes of Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have better drugs. … People are adhering better because they know these drugs really work,” he told STAT. “I think the combination of all of those [factors] easily explains in a logical way the results of that study.”\u003c/p>\n\u003cp>The authors also suggested patients may be more motivated to take care of their health — quitting smoking, say — and their doctors more motivated to aggressively treat other health conditions because both understand that HIV treatment is effective.\u003c/p>\n\u003cp>The researchers pooled data from 18 studies that followed or are following HIV-positive people in 10 countries in Europe and North America, giving them information on roughly 88,500 people. They compared survival and longevity data for people who began taking triple-drug therapies during three periods of time — 1996 to 1999, 2000 to 2003, and 2008 to 2010.\u003c/p>\n\u003cp>The researchers looked at both death figures in the first year of treatment — when patients were typically at their sickest — and then life expectancy of people who survived the first year of treatment.\u003c/p>\n\u003cp>They concluded that an HIV-positive 20-year-old who started antiretroviral therapy between 2008 and 2010 and whose infection was well controlled by the drugs could expect to live to the age of 78.\u003c/p>\n\u003cp>Still, a commentary published with the study noted that these gains, while impressive, aren’t being made by all infected with HIV, particularly by individuals who are not white, have a history of injection drug use, or began treatment with low white blood cell counts.\u003c/p>\n\u003cp>Ingrid Katz of Harvard Medical School and Brendan Maughan-Brown of the University of Cape Town in South Africa wrote that in order to make additional gains in life expectancy, early detection of HIV and commencement of treatment will be needed.\u003c/p>\n\u003cp>Fauci said he thinks that further life expectancy gains can be made for people with HIV. But he believes the damage the virus does can’t be completely erased by early treatment. “I think we’re going to get really close to a normal life expectancy,” he said. “I would be surprised if it would be exactly the same. But I think it will be close enough to be dramatic.”\u003c/p>\n\u003cp>The study was funded by Britain’s Medical Research Council and the UK Department of International Development as well as the European Union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/10/hiv-life-expectancy-study/\">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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"content": "\u003cp>If you were a former NASA scientist and current biohacker afflicted with severe and irresolvable gastrointestinal woes, what would you do?\u003c/p>\n\u003cp>(a) Live with the problem as best you could\u003cbr>\n(b) Attempt to replace all the bacteria in your body by taking antibiotics then swallowing a capsule of someone else’s poop\u003c/p>\n\u003caside class=\"pullquote alignright\">An experiment no one recommends: Killing your bacteria with antibiotics, then performing a fecal transplant on yourself.\u003c/aside>\n\u003cp>The correct answer — well, it isn’t (a). Not if you’re Josiah Zayner.\u003c/p>\n\u003cp>Zayner’s experiment was the subject of a short New York Times \u003ca href=\"https://www.nytimes.com/video/opinion/100000005015342/gut-hack.html\" target=\"_blank\" rel=\"noopener noreferrer\">documentary\u003c/a> last month and it is pretty interesting, to say the least. (Disclosure: Danielle Venton was acquainted with one of the filmmakers in high school.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" width=\"640\" height=\"361\" src=\"//static01.nyt.com/video/players/offsite/index.html?videoId=100000005015342\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"#interview\">See below for our interview with Zayner\u003c/a>, a year after the experiment. Future of You first met the mid-30s, erstwhile NASA Ames bio-researcher, upon the launch of his business, providing \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/22/gene-editing-coming-to-a-kitchen-counter-near-you/\" target=\"_blank\" rel=\"noopener noreferrer\">in-home CRISPR/Cas9 gene-editing kits\u003c/a> to the public. That was\u003ca href=\"https://www.digitaltrends.com/cool-tech/the-odin-diy-crispr-kit/\" target=\"_blank\" rel=\"noopener noreferrer\"> controversial\u003c/a> enough.\u003c/p>\n\u003cp>Then last May, Zayner, who has suffered from ulcers, irritable bowel syndrome and frequent diarrhea that have not responded well to conventional treatments, decided to take matters into his own hands — or guts — in an attempt to replace his microbiome and mitigate his bad GI problems.\u003c/p>\n\u003cp>Bacteria are “almost an extension of you that can be helpful or harmful,” Zayner says. “It’s like this moving cloud that comes with you wherever you go. We and bacteria are like one organism.”\u003c/p>\n\u003cp>Watch the video and you’ll see him replacing part of that organism by taking antibiotics to eradicate his own bacteria, then ingesting the feces of a friend (“\u003ca href=\"http://www.urbandictionary.com/define.php?term=Yolo\" target=\"_blank\" rel=\"noopener noreferrer\">Yolo\u003c/a>,” he says at the moment of truth, the biohacker equivalent of “Down the hatch.”) He also swabbed his body and mouth with a saline solution containing the donor’s bacteria.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\" target=\"_blank\" rel=\"noopener noreferrer\">Fecal transplants\u003c/a> are now an accepted therapy for a certain type of infection. The thing is, Zayner didn’t bother to test his donor’s sample. That puts him at risk, as the documentary warns, for “\u003cspan class=\"s1\">transference of parasites and pathogens, and even blood-borne illnesses like hepatitis.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">“S\u003cspan class=\"s1\">ometimes there’s this thin line, you know, between being crazy and being knowledgeable,” Zayner admits. “And I can’t tell.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Verge covered the experiment at the time. Writer Arielle Duhaime-Ross thought the process was less than scientifically rigid:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">I couldn’t help but notice Zayner cutting corners. After drying off, he put on a brand-new Hanes white T-shirt to prevent his old microbiome from recolonizing his body, but an old — though freshly laundered — pair of jeans. He sampled his arms, nose, and mouth, but he didn’t bother to take microbial samples from his genitalia, and didn’t plan on applying Michael’s skin bacteria to his penis or testicles. He told me that there just isn’t much scientific value in gathering that information. Over the course of his experiment, Zayner would only take a third of the poop pills that someone undergoing a standard FMT [Fecal Microbiota Transplantation\u003cem>] \u003c/em>procedure would, stretched over a longer period of time.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">Says a podcaster from The Verge: “T\u003cspan class=\"s1\">his guy is doing something that is legitimately dangerous and probably kind of stupid.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The experiment, according to Zayner, as well as genetic sequencing from an independent lab, was at least a partial success. (But need we say it: Don’t try this at home.)\u003ca id=\"interview\">\u003c/a>\u003c/p>\n\u003cp>Now that about a year has passed, we wanted to catch up with Zayner to see how he’s feeling about his health, the procedure and his critics. The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>In the video, that did not look too fun.\u003c/strong>\u003c/p>\n\u003cp>Yeah. The original plan wasn’t to have people document it. I was going to document it myself. But other people got involved, including a reporter and the people who made the documentary. So in the hotel room there’s like four other people that you can’t see who are badgering me with questions, taking pictures, and I’m just like ‘Oh my gosh, I just feel sick. Can’t you people leave me alone?’ ”\u003c/p>\n\u003cp>\u003cstrong>How are you feeling now?\u003c/strong>\u003c/p>\n\u003cp>I was really amazed by the results. There’s been no blood in my stool since the transplant, which just kind of blows me away; prior to the transplant it had been multiple times a week.\u003c/p>\n\u003cp>\u003cstrong>While the transfer of the gut microbes seemed to be successful , the bacteria in your skin and nasal passages were unchanged. Why do you think that is? \u003c/strong>\u003c/p>\n\u003cp>I think I was recolonized by my own bacteria when I got back home to my own apartment.\u003c/p>\n\u003cp>\u003cstrong>Have you noticed any personality or mood changes? \u003c/strong>\u003c/p>\n\u003cp>I asked people close to me to say if they saw any changes. It doesn’t seem like there’s anything aside from an addiction-level sugar craving. I’ve never encountered a craving like this. At first I didn’t fight against it. I’d go to the grocery store and find myself buying 50 candy bars.\u003c/p>\n\u003cp>\u003cstrong>Does your donor friend have a sweet-tooth? \u003c/strong>\u003c/p>\n\u003cp>I asked him if he had sugar cravings, too, and he said, “I could eat a box of Oreos in one sitting.”\u003c/p>\n\u003cp>\u003cstrong>Have any microbiome researchers reached out to you? \u003c/strong>\u003c/p>\n\u003cp>A ton, but none of them want me to mention their name or talk about them publicly — people from MIT, UCLA, Harvard, University of Chicago, UC Irvine, UC Davis, the FDA. They might be a little bit critical, but they’re mostly interested.\u003c/p>\n\u003cp>\u003cstrong>Have you heard of other people trying this? Is that a concern, or even a hope of yours?\u003c/strong>\u003c/p>\n\u003cp>It is a little bit of a concern, because what I did was pretty drastic. I wasn’t just trying to do a fecal transplant. I was trying to do a whole-body microbiome transplant.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>You weren’t just trying to supplement, you were trying to wipe out and replace… \u003c/strong>\u003c/p>\n\u003cp>A lot of people focused just on the fecal transplant. And that was the thing that provided the greatest benefit to me and worked. But I was also trying as hard as I could to wipe out all of the bacteria on my body and in my body, which — most people thought I would either die or end up hospitalized, which is crazy. That didn’t happen.\u003c/p>\n\u003cp>\u003cstrong>But were you worried about safety?\u003c/strong>\u003c/p>\n\u003cp>Based upon my planning, I thought the chances of something bad happening\u003cstrong> \u003c/strong>were pretty small. But when you have a lot of people around…mostly the people who were documenting it were really worried about a lot of things. Their attitude rubbed off on me and I got more and more worried.\u003c/p>\n\u003cp>\u003cstrong>The donor’s samples — why didn’t you have those tested for things that could be dangerous?\u003c/strong>\u003c/p>\n\u003cp>I really thought about that. A part of it might have been foolhardy, but part of me was like the whole purpose of this experiment was to create an idea of how somebody could do something like this. A lot of people don’t have access to getting donors tested.\u003c/p>\n\u003cp>I thought the process I went through was pretty stringent. If you go to \u003ca href=\"http://www.openbiome.org/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenBiome\u003c/a>, the website that takes fecal transplants from people and they freeze them to give to people, they have a questionnaire you can fill out to see if you qualify as a donor. It’s pretty extensive and it’s something I mimicked.\u003c/p>\n\u003cp>The major things that you’re probably worried about are more blood-borne diseases and illnesses. People always say you should be afraid of feces because of hemorrhagic E. coli. Honestly, I don’t think there is anybody who has hemorrhagic E. coli colonizing them and doesn’t know about it. So I wasn’t too concerned about that.\u003c/p>\n\u003cp>Maybe this sounds crazy, but there is a certain amount of trust that you want to be able to place in humanity or other people.\u003c/p>\n\u003cp>\u003cstrong>The donor was also your \u003cem>friend\u003c/em>. \u003c/strong>\u003c/p>\n\u003cp>Totally. It was kind of symbolic in that way. If I can’t trust this person, then we’re all screwed.\u003c/p>\n\u003cp>\u003cstrong>You said you want this kind of experiment to be accessible to people. Is that because you want people to be able to understand it easily, or do you see this as a prototype?\u003c/strong>\u003c/p>\n\u003cp>Kind of a prototype, but you have to understand, I don’t recommend this to people.\u003c/p>\n\u003cp>The position I’m in right now is really strange where I’ve become this “biohacker” figure. I get contacted by a ton of people all the time, and a lot of those are people with medical issues. And they have no treatment, no cure, and they’re just looking for help. They’re looking for some way they can treat themselves.\u003c/p>\n\u003cp>The U.S. unfortunately has decided to not allow doctors to prescribe feces to people for any disease other than Clostridium difficile infections that haven’t been able to be treated with antibiotics.\u003c/p>\n\u003cp>To me, that’s kind of disturbing. And the fact that people have the opportunity to seek treatment themselves, I think, is empowering. So what I really wanted to do was say, “Hey look, I tried to do something in a very scientific way. And I’m not saying it works, I’m not saying it’ll work for you or your disease or cure your ailments at all. But maybe you can also try to take your health into your own hands. Maybe if there’s no hope from the medical community, no hope for cures, you can perhaps figure out something on your own — through experimentation, through reading scientific papers — and help yourself.\u003c/p>\n\u003cp>\u003cstrong>The podcasters at \u003cem>The Verge \u003c/em>had some pretty harsh words for you. What did you think about that? \u003c/strong>\u003c/p>\n\u003cp>You know, I understand from a professional point of view what they were trying to do. But some of the stuff they said just cracked me up.\u003c/p>\n\u003cp>They said that what I was doing was stupid — which is hilarious when you’re talking about a person who is suffering from something. It’s like, “Hey, you’re suffering from some problem and I think you trying to help yourself is the stupidest thing you could do.”\u003c/p>\n\u003cp>They don’t know what it’s like when you have to go to the bathroom five times in an hour and\u003cb> \u003c/b>blood is spewing out of your butt and you’re in terrible pain.\u003c/p>\n\u003cp>People always bring up this issue about whether what I did was “scientific” or not. That critique is very dogmatic about the way that science is or should be done. What’s important about what I did was whether it works or not, right? I mean, if this actually worked, why wouldn’t people be interested? And look, I’m not trying to publish any of this, I’m not trying to have it peer-reviewed in any normal terms.\u003c/p>\n\u003cp>\u003cstrong>But you would like it if people took a look at what you did and said, ‘Maybe there’s something here.’\u003c/strong>\u003c/p>\n\u003cp>Yeah, but I think they know there is. There are clinics oversees, in the UK and other places that actually will give fecal transplants to people suffering from gastrointestinal illness. It’s something interesting that in the U.S. isn’t allowed.\u003c/p>\n\u003chr>\n\u003cp>We reached out to a handful of microbiome researchers for their thoughts on Zayner’s experiment. One, Owen White from the University of Maryland School of Medicine, responded.\u003c/p>\n\u003cp>“If I had a molecular biology background and was suffering from problems like Josiah, I would find it irresistible not to want to at least try some type of intervention on myself,” wrote White in an email.\u003c/p>\n\u003cp>“(T)here is something inherently deserving about exerting your own agency over things that you cannot ordinarily control,” White said. “That being said, I strongly agree with all the criticisms that were shown in the video.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>For more, see Josiah Zayner’s \u003ca href=\"http://www.ifyoudontknownowyaknow.com/2016/05/i-transplanted-someone-elses-microbiome.html\" target=\"_blank\" rel=\"noopener noreferrer\">blog post about the transplant\u003c/a>, his \u003ca href=\"https://www.reddit.com/r/IAmA/comments/4i5euw/im_dr_josiah_zayner_former_scientist_at_nasa/\" target=\"_blank\" rel=\"noopener noreferrer\">AmA (Ask me Anything) entry on Reddit\u003c/a> or Arielle Duhaime-Ross’s \u003ca href=\"https://www.theverge.com/2016/5/4/11581994/fmt-fecal-matter-transplant-josiah-zayner-microbiome-ibs-c-diff\" target=\"_blank\" rel=\"noopener noreferrer\">coverage for The Verge\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Catching up with Josiah Zayner, the biohacker who attempted to replace his microbiome as part of an experiment to help irresolvable gastrointestinal woes. And need we say it: Don't try this at home.",
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"title": "After Ingesting Someone Else’s Feces, Biohacker Feels Like New Man",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you were a former NASA scientist and current biohacker afflicted with severe and irresolvable gastrointestinal woes, what would you do?\u003c/p>\n\u003cp>(a) Live with the problem as best you could\u003cbr>\n(b) Attempt to replace all the bacteria in your body by taking antibiotics then swallowing a capsule of someone else’s poop\u003c/p>\n\u003caside class=\"pullquote alignright\">An experiment no one recommends: Killing your bacteria with antibiotics, then performing a fecal transplant on yourself.\u003c/aside>\n\u003cp>The correct answer — well, it isn’t (a). Not if you’re Josiah Zayner.\u003c/p>\n\u003cp>Zayner’s experiment was the subject of a short New York Times \u003ca href=\"https://www.nytimes.com/video/opinion/100000005015342/gut-hack.html\" target=\"_blank\" rel=\"noopener noreferrer\">documentary\u003c/a> last month and it is pretty interesting, to say the least. (Disclosure: Danielle Venton was acquainted with one of the filmmakers in high school.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" width=\"640\" height=\"361\" src=\"//static01.nyt.com/video/players/offsite/index.html?videoId=100000005015342\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"#interview\">See below for our interview with Zayner\u003c/a>, a year after the experiment. Future of You first met the mid-30s, erstwhile NASA Ames bio-researcher, upon the launch of his business, providing \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/22/gene-editing-coming-to-a-kitchen-counter-near-you/\" target=\"_blank\" rel=\"noopener noreferrer\">in-home CRISPR/Cas9 gene-editing kits\u003c/a> to the public. That was\u003ca href=\"https://www.digitaltrends.com/cool-tech/the-odin-diy-crispr-kit/\" target=\"_blank\" rel=\"noopener noreferrer\"> controversial\u003c/a> enough.\u003c/p>\n\u003cp>Then last May, Zayner, who has suffered from ulcers, irritable bowel syndrome and frequent diarrhea that have not responded well to conventional treatments, decided to take matters into his own hands — or guts — in an attempt to replace his microbiome and mitigate his bad GI problems.\u003c/p>\n\u003cp>Bacteria are “almost an extension of you that can be helpful or harmful,” Zayner says. “It’s like this moving cloud that comes with you wherever you go. We and bacteria are like one organism.”\u003c/p>\n\u003cp>Watch the video and you’ll see him replacing part of that organism by taking antibiotics to eradicate his own bacteria, then ingesting the feces of a friend (“\u003ca href=\"http://www.urbandictionary.com/define.php?term=Yolo\" target=\"_blank\" rel=\"noopener noreferrer\">Yolo\u003c/a>,” he says at the moment of truth, the biohacker equivalent of “Down the hatch.”) He also swabbed his body and mouth with a saline solution containing the donor’s bacteria.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\" target=\"_blank\" rel=\"noopener noreferrer\">Fecal transplants\u003c/a> are now an accepted therapy for a certain type of infection. The thing is, Zayner didn’t bother to test his donor’s sample. That puts him at risk, as the documentary warns, for “\u003cspan class=\"s1\">transference of parasites and pathogens, and even blood-borne illnesses like hepatitis.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">“S\u003cspan class=\"s1\">ometimes there’s this thin line, you know, between being crazy and being knowledgeable,” Zayner admits. “And I can’t tell.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Verge covered the experiment at the time. Writer Arielle Duhaime-Ross thought the process was less than scientifically rigid:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">I couldn’t help but notice Zayner cutting corners. After drying off, he put on a brand-new Hanes white T-shirt to prevent his old microbiome from recolonizing his body, but an old — though freshly laundered — pair of jeans. He sampled his arms, nose, and mouth, but he didn’t bother to take microbial samples from his genitalia, and didn’t plan on applying Michael’s skin bacteria to his penis or testicles. He told me that there just isn’t much scientific value in gathering that information. Over the course of his experiment, Zayner would only take a third of the poop pills that someone undergoing a standard FMT [Fecal Microbiota Transplantation\u003cem>] \u003c/em>procedure would, stretched over a longer period of time.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">Says a podcaster from The Verge: “T\u003cspan class=\"s1\">his guy is doing something that is legitimately dangerous and probably kind of stupid.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The experiment, according to Zayner, as well as genetic sequencing from an independent lab, was at least a partial success. (But need we say it: Don’t try this at home.)\u003ca id=\"interview\">\u003c/a>\u003c/p>\n\u003cp>Now that about a year has passed, we wanted to catch up with Zayner to see how he’s feeling about his health, the procedure and his critics. The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>In the video, that did not look too fun.\u003c/strong>\u003c/p>\n\u003cp>Yeah. The original plan wasn’t to have people document it. I was going to document it myself. But other people got involved, including a reporter and the people who made the documentary. So in the hotel room there’s like four other people that you can’t see who are badgering me with questions, taking pictures, and I’m just like ‘Oh my gosh, I just feel sick. Can’t you people leave me alone?’ ”\u003c/p>\n\u003cp>\u003cstrong>How are you feeling now?\u003c/strong>\u003c/p>\n\u003cp>I was really amazed by the results. There’s been no blood in my stool since the transplant, which just kind of blows me away; prior to the transplant it had been multiple times a week.\u003c/p>\n\u003cp>\u003cstrong>While the transfer of the gut microbes seemed to be successful , the bacteria in your skin and nasal passages were unchanged. Why do you think that is? \u003c/strong>\u003c/p>\n\u003cp>I think I was recolonized by my own bacteria when I got back home to my own apartment.\u003c/p>\n\u003cp>\u003cstrong>Have you noticed any personality or mood changes? \u003c/strong>\u003c/p>\n\u003cp>I asked people close to me to say if they saw any changes. It doesn’t seem like there’s anything aside from an addiction-level sugar craving. I’ve never encountered a craving like this. At first I didn’t fight against it. I’d go to the grocery store and find myself buying 50 candy bars.\u003c/p>\n\u003cp>\u003cstrong>Does your donor friend have a sweet-tooth? \u003c/strong>\u003c/p>\n\u003cp>I asked him if he had sugar cravings, too, and he said, “I could eat a box of Oreos in one sitting.”\u003c/p>\n\u003cp>\u003cstrong>Have any microbiome researchers reached out to you? \u003c/strong>\u003c/p>\n\u003cp>A ton, but none of them want me to mention their name or talk about them publicly — people from MIT, UCLA, Harvard, University of Chicago, UC Irvine, UC Davis, the FDA. They might be a little bit critical, but they’re mostly interested.\u003c/p>\n\u003cp>\u003cstrong>Have you heard of other people trying this? Is that a concern, or even a hope of yours?\u003c/strong>\u003c/p>\n\u003cp>It is a little bit of a concern, because what I did was pretty drastic. I wasn’t just trying to do a fecal transplant. I was trying to do a whole-body microbiome transplant.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>You weren’t just trying to supplement, you were trying to wipe out and replace… \u003c/strong>\u003c/p>\n\u003cp>A lot of people focused just on the fecal transplant. And that was the thing that provided the greatest benefit to me and worked. But I was also trying as hard as I could to wipe out all of the bacteria on my body and in my body, which — most people thought I would either die or end up hospitalized, which is crazy. That didn’t happen.\u003c/p>\n\u003cp>\u003cstrong>But were you worried about safety?\u003c/strong>\u003c/p>\n\u003cp>Based upon my planning, I thought the chances of something bad happening\u003cstrong> \u003c/strong>were pretty small. But when you have a lot of people around…mostly the people who were documenting it were really worried about a lot of things. Their attitude rubbed off on me and I got more and more worried.\u003c/p>\n\u003cp>\u003cstrong>The donor’s samples — why didn’t you have those tested for things that could be dangerous?\u003c/strong>\u003c/p>\n\u003cp>I really thought about that. A part of it might have been foolhardy, but part of me was like the whole purpose of this experiment was to create an idea of how somebody could do something like this. A lot of people don’t have access to getting donors tested.\u003c/p>\n\u003cp>I thought the process I went through was pretty stringent. If you go to \u003ca href=\"http://www.openbiome.org/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenBiome\u003c/a>, the website that takes fecal transplants from people and they freeze them to give to people, they have a questionnaire you can fill out to see if you qualify as a donor. It’s pretty extensive and it’s something I mimicked.\u003c/p>\n\u003cp>The major things that you’re probably worried about are more blood-borne diseases and illnesses. People always say you should be afraid of feces because of hemorrhagic E. coli. Honestly, I don’t think there is anybody who has hemorrhagic E. coli colonizing them and doesn’t know about it. So I wasn’t too concerned about that.\u003c/p>\n\u003cp>Maybe this sounds crazy, but there is a certain amount of trust that you want to be able to place in humanity or other people.\u003c/p>\n\u003cp>\u003cstrong>The donor was also your \u003cem>friend\u003c/em>. \u003c/strong>\u003c/p>\n\u003cp>Totally. It was kind of symbolic in that way. If I can’t trust this person, then we’re all screwed.\u003c/p>\n\u003cp>\u003cstrong>You said you want this kind of experiment to be accessible to people. Is that because you want people to be able to understand it easily, or do you see this as a prototype?\u003c/strong>\u003c/p>\n\u003cp>Kind of a prototype, but you have to understand, I don’t recommend this to people.\u003c/p>\n\u003cp>The position I’m in right now is really strange where I’ve become this “biohacker” figure. I get contacted by a ton of people all the time, and a lot of those are people with medical issues. And they have no treatment, no cure, and they’re just looking for help. They’re looking for some way they can treat themselves.\u003c/p>\n\u003cp>The U.S. unfortunately has decided to not allow doctors to prescribe feces to people for any disease other than Clostridium difficile infections that haven’t been able to be treated with antibiotics.\u003c/p>\n\u003cp>To me, that’s kind of disturbing. And the fact that people have the opportunity to seek treatment themselves, I think, is empowering. So what I really wanted to do was say, “Hey look, I tried to do something in a very scientific way. And I’m not saying it works, I’m not saying it’ll work for you or your disease or cure your ailments at all. But maybe you can also try to take your health into your own hands. Maybe if there’s no hope from the medical community, no hope for cures, you can perhaps figure out something on your own — through experimentation, through reading scientific papers — and help yourself.\u003c/p>\n\u003cp>\u003cstrong>The podcasters at \u003cem>The Verge \u003c/em>had some pretty harsh words for you. What did you think about that? \u003c/strong>\u003c/p>\n\u003cp>You know, I understand from a professional point of view what they were trying to do. But some of the stuff they said just cracked me up.\u003c/p>\n\u003cp>They said that what I was doing was stupid — which is hilarious when you’re talking about a person who is suffering from something. It’s like, “Hey, you’re suffering from some problem and I think you trying to help yourself is the stupidest thing you could do.”\u003c/p>\n\u003cp>They don’t know what it’s like when you have to go to the bathroom five times in an hour and\u003cb> \u003c/b>blood is spewing out of your butt and you’re in terrible pain.\u003c/p>\n\u003cp>People always bring up this issue about whether what I did was “scientific” or not. That critique is very dogmatic about the way that science is or should be done. What’s important about what I did was whether it works or not, right? I mean, if this actually worked, why wouldn’t people be interested? And look, I’m not trying to publish any of this, I’m not trying to have it peer-reviewed in any normal terms.\u003c/p>\n\u003cp>\u003cstrong>But you would like it if people took a look at what you did and said, ‘Maybe there’s something here.’\u003c/strong>\u003c/p>\n\u003cp>Yeah, but I think they know there is. There are clinics oversees, in the UK and other places that actually will give fecal transplants to people suffering from gastrointestinal illness. It’s something interesting that in the U.S. isn’t allowed.\u003c/p>\n\u003chr>\n\u003cp>We reached out to a handful of microbiome researchers for their thoughts on Zayner’s experiment. One, Owen White from the University of Maryland School of Medicine, responded.\u003c/p>\n\u003cp>“If I had a molecular biology background and was suffering from problems like Josiah, I would find it irresistible not to want to at least try some type of intervention on myself,” wrote White in an email.\u003c/p>\n\u003cp>“(T)here is something inherently deserving about exerting your own agency over things that you cannot ordinarily control,” White said. “That being said, I strongly agree with all the criticisms that were shown in the video.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>For more, see Josiah Zayner’s \u003ca href=\"http://www.ifyoudontknownowyaknow.com/2016/05/i-transplanted-someone-elses-microbiome.html\" target=\"_blank\" rel=\"noopener noreferrer\">blog post about the transplant\u003c/a>, his \u003ca href=\"https://www.reddit.com/r/IAmA/comments/4i5euw/im_dr_josiah_zayner_former_scientist_at_nasa/\" target=\"_blank\" rel=\"noopener noreferrer\">AmA (Ask me Anything) entry on Reddit\u003c/a> or Arielle Duhaime-Ross’s \u003ca href=\"https://www.theverge.com/2016/5/4/11581994/fmt-fecal-matter-transplant-josiah-zayner-microbiome-ibs-c-diff\" target=\"_blank\" rel=\"noopener noreferrer\">coverage for The Verge\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Life Expectancy Gap in U.S. Grows: Find the Numbers in Every U.S. County",
"title": "Life Expectancy Gap in U.S. Grows: Find the Numbers in Every U.S. County",
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"content": "\u003cdiv class=\"show-for-small-only\">\n\u003cp>On Monday an \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2626194\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> was published in JAMA Internal Medicine that showed a growing gap between counties with the highest and lowest life expectancy.\u003c/p>\n\u003cp>The paper, from researchers at the Institute for Health Metrics and Evaluation, revealed that 13 counties have shorter expected lifespans than their parents did.\u003c/p>\n\u003cp>Citizens of Aglala Lakota County, South Dakota who were born in 2014 have an average life expectancy of 66.8 years, the lowest in the nation. That's lower than the life expectancy in Sudan, India and Iraq, IHME said. The county includes the Pine Ridge Native American reservation.\u003c/p>\n\u003cp>Various counties in Appalachia, parts of the southeast and other counties in South Dakota also fared poorly.\u003c/p>\n\u003cp>Parts of central Colorado had the highest life expectancy.\u003c/p>\n\u003cp>From 1980 to 2014, these counties had the greatest increase in life expectancy:\u003c/p>\n\u003cul>\n\u003cli>Aleutians East Borough, Aleutians West Census Area, Alaska (+18.3%)\u003c/li>\n\u003cli>North Slope Borough, Alaska (+17.9%)\u003c/li>\n\u003cli>New York County, New York (+15.2%)\u003c/li>\n\u003cli>Sumter County, Florida (+13.8%)\u003c/li>\n\u003cli>San Francisco County, California (+13.5%)\u003c/li>\n\u003cli>Kings County, New York (+13.2%)\u003c/li>\n\u003cli>Kodiak Island Borough, Alaska (+13.2%)\u003c/li>\n\u003cli>Northwest Arctic Borough, Alaska (+12.8%)\u003c/li>\n\u003cli>District of Columbia, District of Columbia (+12.8%)\u003c/li>\n\u003cli>Loudoun County, Virginia (+12.4%)\u003c/li>\n\u003c/ul>\n\u003cp>And the worst decreases:\u003c/p>\n\u003cul>\n\u003cli>Owsley County, Kentucky (-3%)\u003c/li>\n\u003cli>Lee County, Kentucky (-2%)\u003c/li>\n\u003cli>Leslie County, Kentucky (-1.9%)\u003c/li>\n\u003cli>Breathitt County, Kentucky (-1.4%)\u003c/li>\n\u003cli>Clay County, Kentucky (-1.3%)\u003c/li>\n\u003cli>Powell County, Kentucky (-1.1%)\u003c/li>\n\u003cli>Estill County, Kentucky (-1%)\u003c/li>\n\u003cli>Perry County, Kentucky (-0.8%)\u003c/li>\n\u003cli>Kiowa County, Oklahoma (-0.7%)\u003c/li>\n\u003cli>Perry County, Alabama (-0.6%)\u003c/li>\n\u003c/ul>\n\u003cp>In January a \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/2598772\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> published in \u003cem>JAMA\u003c/em> highlighted the geographical disparities within the U.S. regarding cancer death rates. Researchers at the Institute for Health Metrics and Evaluation looked at the country's more than 19.5 million cancer deaths in every one of 3,144 U.S. counties from 1980-2014. The study found that while the overall cancer mortality rate decreased by about 20 percent, in 160 counties the rate actually increased.\u003c/p>\n\u003cp>All of the data from the latest studies and more are incorporated into IHME's \u003ca href=\"https://vizhub.healthdata.org/subnational/usa\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. Health Map\u003c/a>, launched in 2013 with a look at mortality rates by county. Since then the institute has supplemented the map with additional data as more research has been conducted. Big data geeks, health researchers, and those with a morbid propensity to delve into who-dies-where-from-what have been parsing the data, which includes live expectancy, mortality rates and different risk factors, ever since.\u003c/p>\n\u003cp>Click on the image for the map. Not a great experience on mobile, so you may want to bookmark or send to yourself for later viewing.\u003ca href=\"https://vizhub.healthdata.org/subnational/usa\">\u003cimg class=\"alignright size-medium wp-image-327126\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/01/mapgraphic-800x512.jpg\" alt=\"mapgraphic\" width=\"800\" height=\"512\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-800x512.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-160x102.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-768x492.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-960x615.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-240x154.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-375x240.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-520x333.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic.jpg 965w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003c/div>\n\u003cp>The Institute for Health Metrics and Evaluation on Monday released another in a series of its big-data analyses of who-dies-where-from-what, and like so much else in the country, the news is good or bad depending on where you live.\u003c/p>\n\u003cp>The \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2626194\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a>, published in \u003cem>JAMA Internal Medicine\u003c/em>, showed a growing gap between counties with the highest and lowest life expectancy.\u003c/p>\n\u003cdiv>\u003cem>Interactive map: Mortality rates, life expectancy and risk factors by every U.S. county, 1980-2014\u003c/em>\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe style=\"border: 0; width: 100%; height: 800px;\" src=\"https://vizhub.healthdata.org/subnational/usa\" width=\"100%\" scrolling=\"yes\" height=\"500\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>The study from IHME researchers revealed that in 13 counties, residents have shorter expected lifespans than their parents did.\u003c/p>\n\u003cp>Citizens of Aglala Lakota County, South Dakota who were born in 2014 have an average life expectancy of 66.8 years, the lowest in the nation. That's worse than the life expectancy in Sudan, India and Iraq, IHME said. The county includes the Pine Ridge Native American reservation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Various counties in Appalachia, parts of the southeast and other counties in South Dakota also fared poorly.\u003c/p>\n\u003cp>Parts of central Colorado had the highest life expectancy.\u003c/p>\n\u003cp>From 1980 to 2014, these counties had the greatest increase in life expectancy:\u003c/p>\n\u003col>\n\u003cli>Aleutians East Borough, Aleutians West Census Area, Alaska (+18.3%)\u003c/li>\n\u003cli>North Slope Borough, Alaska (+17.9%)\u003c/li>\n\u003cli>New York County, New York (+15.2%)\u003c/li>\n\u003cli>Sumter County, Florida (+13.8%)\u003c/li>\n\u003cli>San Francisco County, California (+13.5%)\u003c/li>\n\u003cli>Kings County, New York (+13.2%)\u003c/li>\n\u003cli>Kodiak Island Borough, Alaska (+13.2%)\u003c/li>\n\u003cli>Northwest Arctic Borough, Alaska (+12.8%)\u003c/li>\n\u003cli>District of Columbia, District of Columbia (+12.8%)\u003c/li>\n\u003cli>Loudoun County, Virginia (+12.4%)\u003c/li>\n\u003c/ol>\n\u003cp>And the worst decreases:\u003c/p>\n\u003col>\n\u003cli>Owsley County, Kentucky (-3%)\u003c/li>\n\u003cli>Lee County, Kentucky (-2%)\u003c/li>\n\u003cli>Leslie County, Kentucky (-1.9%)\u003c/li>\n\u003cli>Breathitt County, Kentucky (-1.4%)\u003c/li>\n\u003cli>Clay County, Kentucky (-1.3%)\u003c/li>\n\u003cli>Powell County, Kentucky (-1.1%)\u003c/li>\n\u003cli>Estill County, Kentucky (-1%)\u003c/li>\n\u003cli>Perry County, Kentucky (-0.8%)\u003c/li>\n\u003cli>Kiowa County, Oklahoma (-0.7%)\u003c/li>\n\u003cli>Perry County, Alabama (-0.6%)\u003c/li>\n\u003c/ol>\n\u003cp>From our friends at \u003ca href=\"http://www.npr.org/sections/health-shots/2017/05/08/527103885/life-expectancy-can-vary-by-20-years-depending-on-where-you-live\" target=\"_blank\" rel=\"noopener noreferrer\">NPR Shots\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>There's no sign of the gap closing. In fact, it appears to be widening. Between 1980 and 2014, the gap between the highest and lowest life spans increased by about two years.\u003c/p>\n\u003cp>\"With every passing year, inequality — however you measure it — has been widening over the last 34 years,\" [IHME's Christopher} Murray says. \"And so next year, we can reliably expect it'll be even more than 20.\"\u003c/p>\n\u003cp>\"That is probably the most alarming part of the analysis,\" he adds.\u003c/p>\n\u003cp>The reasons for the gap are complicated. But it looks as if the counties with the lowest life spans haven't made much progress fighting significant health problems such as smoking and obesity.\u003c/p>\n\u003cp>\"It's this steady process where many parts of the country have been steadily getting better, and then there's a segment of America where things have not progressed in a generation and a half,\" Murray says.\u003c/p>\u003c/blockquote>\n\u003cp>In January a study published in JAMA highlighted the geographical disparities within the U.S. regarding cancer death rates. Researchers at IHME looked at the country's more than 19.5 million cancer deaths in every one of 3,144 U.S. counties from 1980-2014. The study found that while the overall cancer mortality rate decreased by about 20 percent, in 160 counties the rate actually increased.\u003c/p>\n\u003cp>All of the data from the latest studies and more are incorporated into IHME's U.S. Health Map, which you can peruse at your leisure above. Launched in 2013 with a look at mortality rates by county, the IHME has supplemented the map with additional data as more research has been conducted. Big data geeks, health researchers, and those with morbid propensities have been parsing the data ever since.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The IHME is funded in large part by the Bill & Melinda Gates Foundation and the state of Washington. The website will give you access to \u003ca href=\"http://www.healthdata.org/results/data-visualizations\" target=\"_blank\" rel=\"noopener noreferrer\">more data visualizations\u003c/a>, \u003ca href=\"http://www.healthdata.org/results/research-articles\" target=\"_blank\" rel=\"noopener noreferrer\">research papers\u003c/a> and how the institute's data is being \u003ca href=\"http://www.healthdata.org/acting-on-data\" target=\"_blank\" rel=\"noopener noreferrer\">used internationally\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv class=\"show-for-small-only\">\n\u003cp>On Monday an \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2626194\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> was published in JAMA Internal Medicine that showed a growing gap between counties with the highest and lowest life expectancy.\u003c/p>\n\u003cp>The paper, from researchers at the Institute for Health Metrics and Evaluation, revealed that 13 counties have shorter expected lifespans than their parents did.\u003c/p>\n\u003cp>Citizens of Aglala Lakota County, South Dakota who were born in 2014 have an average life expectancy of 66.8 years, the lowest in the nation. That's lower than the life expectancy in Sudan, India and Iraq, IHME said. The county includes the Pine Ridge Native American reservation.\u003c/p>\n\u003cp>Various counties in Appalachia, parts of the southeast and other counties in South Dakota also fared poorly.\u003c/p>\n\u003cp>Parts of central Colorado had the highest life expectancy.\u003c/p>\n\u003cp>From 1980 to 2014, these counties had the greatest increase in life expectancy:\u003c/p>\n\u003cul>\n\u003cli>Aleutians East Borough, Aleutians West Census Area, Alaska (+18.3%)\u003c/li>\n\u003cli>North Slope Borough, Alaska (+17.9%)\u003c/li>\n\u003cli>New York County, New York (+15.2%)\u003c/li>\n\u003cli>Sumter County, Florida (+13.8%)\u003c/li>\n\u003cli>San Francisco County, California (+13.5%)\u003c/li>\n\u003cli>Kings County, New York (+13.2%)\u003c/li>\n\u003cli>Kodiak Island Borough, Alaska (+13.2%)\u003c/li>\n\u003cli>Northwest Arctic Borough, Alaska (+12.8%)\u003c/li>\n\u003cli>District of Columbia, District of Columbia (+12.8%)\u003c/li>\n\u003cli>Loudoun County, Virginia (+12.4%)\u003c/li>\n\u003c/ul>\n\u003cp>And the worst decreases:\u003c/p>\n\u003cul>\n\u003cli>Owsley County, Kentucky (-3%)\u003c/li>\n\u003cli>Lee County, Kentucky (-2%)\u003c/li>\n\u003cli>Leslie County, Kentucky (-1.9%)\u003c/li>\n\u003cli>Breathitt County, Kentucky (-1.4%)\u003c/li>\n\u003cli>Clay County, Kentucky (-1.3%)\u003c/li>\n\u003cli>Powell County, Kentucky (-1.1%)\u003c/li>\n\u003cli>Estill County, Kentucky (-1%)\u003c/li>\n\u003cli>Perry County, Kentucky (-0.8%)\u003c/li>\n\u003cli>Kiowa County, Oklahoma (-0.7%)\u003c/li>\n\u003cli>Perry County, Alabama (-0.6%)\u003c/li>\n\u003c/ul>\n\u003cp>In January a \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/2598772\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> published in \u003cem>JAMA\u003c/em> highlighted the geographical disparities within the U.S. regarding cancer death rates. Researchers at the Institute for Health Metrics and Evaluation looked at the country's more than 19.5 million cancer deaths in every one of 3,144 U.S. counties from 1980-2014. The study found that while the overall cancer mortality rate decreased by about 20 percent, in 160 counties the rate actually increased.\u003c/p>\n\u003cp>All of the data from the latest studies and more are incorporated into IHME's \u003ca href=\"https://vizhub.healthdata.org/subnational/usa\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. Health Map\u003c/a>, launched in 2013 with a look at mortality rates by county. Since then the institute has supplemented the map with additional data as more research has been conducted. Big data geeks, health researchers, and those with a morbid propensity to delve into who-dies-where-from-what have been parsing the data, which includes live expectancy, mortality rates and different risk factors, ever since.\u003c/p>\n\u003cp>Click on the image for the map. Not a great experience on mobile, so you may want to bookmark or send to yourself for later viewing.\u003ca href=\"https://vizhub.healthdata.org/subnational/usa\">\u003cimg class=\"alignright size-medium wp-image-327126\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/01/mapgraphic-800x512.jpg\" alt=\"mapgraphic\" width=\"800\" height=\"512\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-800x512.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-160x102.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-768x492.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-960x615.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-240x154.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-375x240.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic-520x333.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2014/01/mapgraphic.jpg 965w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003chr>\n\u003c/div>\n\u003cp>The Institute for Health Metrics and Evaluation on Monday released another in a series of its big-data analyses of who-dies-where-from-what, and like so much else in the country, the news is good or bad depending on where you live.\u003c/p>\n\u003cp>The \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2626194\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a>, published in \u003cem>JAMA Internal Medicine\u003c/em>, showed a growing gap between counties with the highest and lowest life expectancy.\u003c/p>\n\u003cdiv>\u003cem>Interactive map: Mortality rates, life expectancy and risk factors by every U.S. county, 1980-2014\u003c/em>\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe style=\"border: 0; width: 100%; height: 800px;\" src=\"https://vizhub.healthdata.org/subnational/usa\" width=\"100%\" scrolling=\"yes\" height=\"500\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\n\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>The study from IHME researchers revealed that in 13 counties, residents have shorter expected lifespans than their parents did.\u003c/p>\n\u003cp>Citizens of Aglala Lakota County, South Dakota who were born in 2014 have an average life expectancy of 66.8 years, the lowest in the nation. That's worse than the life expectancy in Sudan, India and Iraq, IHME said. The county includes the Pine Ridge Native American reservation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Various counties in Appalachia, parts of the southeast and other counties in South Dakota also fared poorly.\u003c/p>\n\u003cp>Parts of central Colorado had the highest life expectancy.\u003c/p>\n\u003cp>From 1980 to 2014, these counties had the greatest increase in life expectancy:\u003c/p>\n\u003col>\n\u003cli>Aleutians East Borough, Aleutians West Census Area, Alaska (+18.3%)\u003c/li>\n\u003cli>North Slope Borough, Alaska (+17.9%)\u003c/li>\n\u003cli>New York County, New York (+15.2%)\u003c/li>\n\u003cli>Sumter County, Florida (+13.8%)\u003c/li>\n\u003cli>San Francisco County, California (+13.5%)\u003c/li>\n\u003cli>Kings County, New York (+13.2%)\u003c/li>\n\u003cli>Kodiak Island Borough, Alaska (+13.2%)\u003c/li>\n\u003cli>Northwest Arctic Borough, Alaska (+12.8%)\u003c/li>\n\u003cli>District of Columbia, District of Columbia (+12.8%)\u003c/li>\n\u003cli>Loudoun County, Virginia (+12.4%)\u003c/li>\n\u003c/ol>\n\u003cp>And the worst decreases:\u003c/p>\n\u003col>\n\u003cli>Owsley County, Kentucky (-3%)\u003c/li>\n\u003cli>Lee County, Kentucky (-2%)\u003c/li>\n\u003cli>Leslie County, Kentucky (-1.9%)\u003c/li>\n\u003cli>Breathitt County, Kentucky (-1.4%)\u003c/li>\n\u003cli>Clay County, Kentucky (-1.3%)\u003c/li>\n\u003cli>Powell County, Kentucky (-1.1%)\u003c/li>\n\u003cli>Estill County, Kentucky (-1%)\u003c/li>\n\u003cli>Perry County, Kentucky (-0.8%)\u003c/li>\n\u003cli>Kiowa County, Oklahoma (-0.7%)\u003c/li>\n\u003cli>Perry County, Alabama (-0.6%)\u003c/li>\n\u003c/ol>\n\u003cp>From our friends at \u003ca href=\"http://www.npr.org/sections/health-shots/2017/05/08/527103885/life-expectancy-can-vary-by-20-years-depending-on-where-you-live\" target=\"_blank\" rel=\"noopener noreferrer\">NPR Shots\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>There's no sign of the gap closing. In fact, it appears to be widening. Between 1980 and 2014, the gap between the highest and lowest life spans increased by about two years.\u003c/p>\n\u003cp>\"With every passing year, inequality — however you measure it — has been widening over the last 34 years,\" [IHME's Christopher} Murray says. \"And so next year, we can reliably expect it'll be even more than 20.\"\u003c/p>\n\u003cp>\"That is probably the most alarming part of the analysis,\" he adds.\u003c/p>\n\u003cp>The reasons for the gap are complicated. But it looks as if the counties with the lowest life spans haven't made much progress fighting significant health problems such as smoking and obesity.\u003c/p>\n\u003cp>\"It's this steady process where many parts of the country have been steadily getting better, and then there's a segment of America where things have not progressed in a generation and a half,\" Murray says.\u003c/p>\u003c/blockquote>\n\u003cp>In January a study published in JAMA highlighted the geographical disparities within the U.S. regarding cancer death rates. Researchers at IHME looked at the country's more than 19.5 million cancer deaths in every one of 3,144 U.S. counties from 1980-2014. The study found that while the overall cancer mortality rate decreased by about 20 percent, in 160 counties the rate actually increased.\u003c/p>\n\u003cp>All of the data from the latest studies and more are incorporated into IHME's U.S. Health Map, which you can peruse at your leisure above. Launched in 2013 with a look at mortality rates by county, the IHME has supplemented the map with additional data as more research has been conducted. Big data geeks, health researchers, and those with morbid propensities have been parsing the data ever since.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The IHME is funded in large part by the Bill & Melinda Gates Foundation and the state of Washington. The website will give you access to \u003ca href=\"http://www.healthdata.org/results/data-visualizations\" target=\"_blank\" rel=\"noopener noreferrer\">more data visualizations\u003c/a>, \u003ca href=\"http://www.healthdata.org/results/research-articles\" target=\"_blank\" rel=\"noopener noreferrer\">research papers\u003c/a> and how the institute's data is being \u003ca href=\"http://www.healthdata.org/acting-on-data\" target=\"_blank\" rel=\"noopener noreferrer\">used internationally\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The SF Giants Are Zapping Their Brains With Electricity. Will It Help?",
"title": "The SF Giants Are Zapping Their Brains With Electricity. Will It Help?",
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"content": "\u003cp>The San Francisco Giants, with the worst record in the National League, could probably use a shot of electricity about now.\u003c/p>\n\u003cp>Actually, they're already getting a shot of electricity\u003cspan style=\"font-weight: 400\">—\u003c/span>literally.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>About a third of the major league roster, including \"some big-name players,\" are working out while using high-tech headgear that sends a weak electric current to the brain, says Geoff Head, the team's official sports scientist. The technology, called transcranial direct current stimulation, or tDCS, theoretically improves athletic performance.\u003c/p>\n\u003cp>So ... which players?\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/science/2017/05/WebTDCS.mp3\" program=\"Listen to the radio version of this story by clicking below\" image=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/05/SciencePlayer_BG.jpeg\"]\u003c/p>\n\u003cp>Head wouldn't name names, but said if the technology showed results by the end of the season, some players would probably go public saying they used it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Tyler Beede, at least, is a believer. Watching a promotional video in which the Giants' top pitching prospect hurls pitch after pitch while wearing a set of headphones, you'd think he was listening to tunes. But he's not -- instead, he's getting the juice, tDCS-style.\u003c/p>\n\u003cp>“It’s a very unique feeling,\" Beede explains in the video. \"You put it on, and it does have that kind of tickling, zapping feeling on your brain, but that’s kind of the reason you know its working.”\u003c/p>\n\u003cp>Beede, currently playing for the Giants' Sacramento AAA team, credits his \u003ca href=\"http://www.milb.com/player/index.jsp?player_id=595881#/career/R/pitching/2017/ALL\" target=\"_blank\" rel=\"noopener noreferrer\">improved pitching\u003c/a> in 2016 at least in part to the technology.\u003c/p>\n\u003cp>\u003cstrong>Tech Central\u003c/strong>\u003c/p>\n\u003cp>The headphones, from Halo Neuroscience, are just the latest health tech the team has sampled. Being in San Francisco, digital health startups frequently approach the club in hopes of getting a major league tryout, and Halo is located just blocks from the Giants' AT&T Park.\u003c/p>\n\u003cfigure id=\"attachment_385549\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching.jpg\">\u003cimg class=\"size-large wp-image-385549\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg\" alt=\"\" width=\"320\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-800x1000.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-768x960.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1920x2400.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1180x1475.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-960x1200.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-240x300.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-375x469.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-520x650.jpg 520w\" sizes=\"(max-width: 320px) 100vw, 320px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sacramento River Cats catcher Austin Slater giving his brain a little electrical juice. \u003ccite>(Halo Neuroscience)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Head says his role as sports scientist is to \"weed through\" a lot of the gadgets that companies send the team's way. Plenty of them, says Head, \"overpromise and underdeliver.\"\u003c/p>\n\u003cp>But Head decided to try the headset, called Halo Sport, during spring training last year\u003cspan style=\"font-weight: 400\">—he gave them to s\u003c/span>ome minor leaguers to wear as they sprinted 20-yard dashes. After two weeks, Head analyzed the results and found that the players who wore the equipment had\u003cstrong> \u003c/strong>shaved off a few one-hundredths of a second compared to a control group.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In the promotional video, Beede says, \"Your brain just becomes so in tune with what you’ve been doing that it can memorize your movements to help you go to that next level.\"\u003c/p>\n\u003cp>\u003cstrong>Targeting the Motor Cortex\u003c/strong>\u003c/p>\n\u003cp>Using Halo's headset is kind of like plugging your brain into a 9-volt battery\u003cstrong>,\u003c/strong> giving your neurons a little extra jolt and priming them for action.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Brain stimulation has been around since recorded history. They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.’ \u003ccite>Theodore Zanto, UCSF neuroscientist\u003c/cite>\u003c/aside>\n\u003cp>The earphones are actually just for show, allowing the wearer to use the technology \"without necessarily displaying it to the world,\" a spokesperson for Halo said. The electrodes in the $750 headset are hidden inside the band that connects the earphones. The electrodes target the motor cortex, which is the region of the brain located across the top of your head, spanning ear to ear. The motor cortex sends electrical signals from your neurons to targeted groups of muscle fibers, causing them to contract.\u003c/p>\n\u003cp>“People like to say that electricity is the currency of the brain and that in many ways the brain is a circuit,\" says Marom Bikson, a professor of biomedical engineering at City College of New York. \"So when we apply electricity to the brain, we interact with that circuit, and we can change how that circuit works.\"\u003c/p>\n\u003cp>Theodore Zanto, director of the Neuroscape Neuroscience Research Program at UCSF, thinks applying electricity to the motor cortex enables it to \"trigger the 'execute movement' signal faster,\" he says.\u003c/p>\n\u003cp>Wiring the brain received a pretty bad rap last century when \u003ca href=\"http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161\" target=\"_blank\" rel=\"noopener noreferrer\">electroconvulsive therapy \u003c/a>was used to deliberately induce brain seizures in order to treat mental illness.\u003c/p>\n\u003cp>But tDCS uses a very low-voltage electrical charge\u003cb>. \u003c/b>Researchers say the major concerns are minor burns, itching, fatigue and nausea. Most of the known injuries have occurred in the the do-it-yourself community, from people who constructed homemade tDCS headsets after watching YouTube tutorials.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Jury's Still Out\u003c/strong>\u003c/p>\n\u003cp>Even though companies like \u003ca href=\"https://www.haloneuro.com/\">Halo\u003c/a>, \u003ca href=\"http://www.thync.com/\">Thync\u003c/a> and \u003ca href=\"https://www.foc.us/edge-tdcs-headset\">Focus\u003c/a> promise their brain-boosting headsets will reduce fatigue, sharpen focus and improve muscle endurance, experts are cautious.\u003c/p>\n\u003cp>More than a thousand peer-reviewed studies have looked at how a mild brain jolt from electricity improves everything from \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17614951\" target=\"_blank\" rel=\"noopener noreferrer\">physical actions\u003c/a> to \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004959\" target=\"_blank\" rel=\"noopener noreferrer\">memory\u003c/a> to \u003ca href=\"https://www.sciencedaily.com/releases/2016/04/160414095949.htm\" target=\"_blank\" rel=\"noopener noreferrer\">creativity\u003c/a>, and the results are highly inconsistent.\u003c/p>\n\u003cp>“One of the reasons why we believe the effects are highly variable is because everyone has slightly different thicknesses of scalp, thicknesses of skull, different amounts of cerebrospinal fluid, and that’s what the current has to travel through before it even gets to the brain,\" says Zanto. He also says age, gender, ethnicity and illness can influence results.\u003c/p>\n\u003cp>Bikson says marketing claims about tDCS often exaggerate the results from lab studies. For example, researchers may measure how fast someone can press a sensor with their finger before and after wearing a tDCS device.\u003c/p>\n\u003cp>\"And we may see a positive effect,\" says Bikson. \"But that is a world away, though, from a professional basketball player having a marginal improvement in their three-point success percentage after tDCS.\"\u003c/p>\n\u003cp>Even though a lot of the data is conflicting, the most positive results do support using tDCS to improve motor control. Hence the slew of startups targeting athletes.\u003c/p>\n\u003cp>The Giants' Head says even a tiny advantage can help win games at the major league level. An improvement of two-hundredths of a second can be \"the difference between safe and out sometimes,\" he says.\u003c/p>\n\u003cp>\u003cstrong>'This is My Brain on Fire'\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_383008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-383008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/IMG_1879-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">World record holding powerlifter Emily Hu wears Halo Sport headphones while she warms up at Boss Barbell gym in Mountain View. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At a Mountain View gym recently, Emily Hu, a world record holder in power lifting, tightened her silent black Halo headphones before sliding underneath a bar to bench press 220 pounds.\u003c/p>\n\u003cp>\"If I feel the tingling sensation I think, ‘OK. This is my brain on fire,\" says Hu. \"Let’s go!’”\u003c/p>\n\u003cp>About a year ago she tried stimulating her brain for the first time, while doing squats. Usually she adds just a few pounds to the bar between workouts, but the week she tried tDCS she was able to add nine, peaking at 295 pounds.\u003c/p>\n\u003cp>“Some people say, 'You know that could have been a fluke because that was only one data point,' \" says Hu. \" But for me it was a positive enough change that I thought, 'Well, I am going to stick with this device.' ”\u003c/p>\n\u003cp>Even though Hu hasn’t seen the same kind of improvement every week, she wears the headphones routinely while warming up. “I think it gives me a false sense of confidence to feel the device work,” she says, grinning.\u003c/p>\n\u003cp>\u003cstrong>Here to Stay?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Neither Zanto nor Bikson, both academics, are popping tDCS devices onto their own heads -- not to improve athletic performance, anyway. But they both predict the technology is here to stay.\u003c/p>\n\u003cp>“Brain stimulation has been around since recorded history,\" says Zanto. \"They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.\"\u003c/p>\n\u003cp>But the hype around tDCS inspires a lot of new questions. What are the long-term effects of wiring your brain daily? When you zap one part of the brain, are you influencing another region unknowingly, maybe even destructively?\u003c/p>\n\u003cp>And might using tDCS one day be considered a form of cheating?\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Maybe years from now we’ll look back at what we’re doing today and we’ll just say to ourselves we really were just feeling around in the dark,\" says Zanto.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The San Francisco Giants, with the worst record in the National League, could probably use a shot of electricity about now.\u003c/p>\n\u003cp>Actually, they're already getting a shot of electricity\u003cspan style=\"font-weight: 400\">—\u003c/span>literally.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>About a third of the major league roster, including \"some big-name players,\" are working out while using high-tech headgear that sends a weak electric current to the brain, says Geoff Head, the team's official sports scientist. The technology, called transcranial direct current stimulation, or tDCS, theoretically improves athletic performance.\u003c/p>\n\u003cp>So ... which players?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Head wouldn't name names, but said if the technology showed results by the end of the season, some players would probably go public saying they used it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Tyler Beede, at least, is a believer. Watching a promotional video in which the Giants' top pitching prospect hurls pitch after pitch while wearing a set of headphones, you'd think he was listening to tunes. But he's not -- instead, he's getting the juice, tDCS-style.\u003c/p>\n\u003cp>“It’s a very unique feeling,\" Beede explains in the video. \"You put it on, and it does have that kind of tickling, zapping feeling on your brain, but that’s kind of the reason you know its working.”\u003c/p>\n\u003cp>Beede, currently playing for the Giants' Sacramento AAA team, credits his \u003ca href=\"http://www.milb.com/player/index.jsp?player_id=595881#/career/R/pitching/2017/ALL\" target=\"_blank\" rel=\"noopener noreferrer\">improved pitching\u003c/a> in 2016 at least in part to the technology.\u003c/p>\n\u003cp>\u003cstrong>Tech Central\u003c/strong>\u003c/p>\n\u003cp>The headphones, from Halo Neuroscience, are just the latest health tech the team has sampled. Being in San Francisco, digital health startups frequently approach the club in hopes of getting a major league tryout, and Halo is located just blocks from the Giants' AT&T Park.\u003c/p>\n\u003cfigure id=\"attachment_385549\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching.jpg\">\u003cimg class=\"size-large wp-image-385549\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg\" alt=\"\" width=\"320\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-800x1000.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-768x960.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1920x2400.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1180x1475.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-960x1200.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-240x300.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-375x469.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-520x650.jpg 520w\" sizes=\"(max-width: 320px) 100vw, 320px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sacramento River Cats catcher Austin Slater giving his brain a little electrical juice. \u003ccite>(Halo Neuroscience)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Head says his role as sports scientist is to \"weed through\" a lot of the gadgets that companies send the team's way. Plenty of them, says Head, \"overpromise and underdeliver.\"\u003c/p>\n\u003cp>But Head decided to try the headset, called Halo Sport, during spring training last year\u003cspan style=\"font-weight: 400\">—he gave them to s\u003c/span>ome minor leaguers to wear as they sprinted 20-yard dashes. After two weeks, Head analyzed the results and found that the players who wore the equipment had\u003cstrong> \u003c/strong>shaved off a few one-hundredths of a second compared to a control group.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In the promotional video, Beede says, \"Your brain just becomes so in tune with what you’ve been doing that it can memorize your movements to help you go to that next level.\"\u003c/p>\n\u003cp>\u003cstrong>Targeting the Motor Cortex\u003c/strong>\u003c/p>\n\u003cp>Using Halo's headset is kind of like plugging your brain into a 9-volt battery\u003cstrong>,\u003c/strong> giving your neurons a little extra jolt and priming them for action.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Brain stimulation has been around since recorded history. They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.’ \u003ccite>Theodore Zanto, UCSF neuroscientist\u003c/cite>\u003c/aside>\n\u003cp>The earphones are actually just for show, allowing the wearer to use the technology \"without necessarily displaying it to the world,\" a spokesperson for Halo said. The electrodes in the $750 headset are hidden inside the band that connects the earphones. The electrodes target the motor cortex, which is the region of the brain located across the top of your head, spanning ear to ear. The motor cortex sends electrical signals from your neurons to targeted groups of muscle fibers, causing them to contract.\u003c/p>\n\u003cp>“People like to say that electricity is the currency of the brain and that in many ways the brain is a circuit,\" says Marom Bikson, a professor of biomedical engineering at City College of New York. \"So when we apply electricity to the brain, we interact with that circuit, and we can change how that circuit works.\"\u003c/p>\n\u003cp>Theodore Zanto, director of the Neuroscape Neuroscience Research Program at UCSF, thinks applying electricity to the motor cortex enables it to \"trigger the 'execute movement' signal faster,\" he says.\u003c/p>\n\u003cp>Wiring the brain received a pretty bad rap last century when \u003ca href=\"http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161\" target=\"_blank\" rel=\"noopener noreferrer\">electroconvulsive therapy \u003c/a>was used to deliberately induce brain seizures in order to treat mental illness.\u003c/p>\n\u003cp>But tDCS uses a very low-voltage electrical charge\u003cb>. \u003c/b>Researchers say the major concerns are minor burns, itching, fatigue and nausea. Most of the known injuries have occurred in the the do-it-yourself community, from people who constructed homemade tDCS headsets after watching YouTube tutorials.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Jury's Still Out\u003c/strong>\u003c/p>\n\u003cp>Even though companies like \u003ca href=\"https://www.haloneuro.com/\">Halo\u003c/a>, \u003ca href=\"http://www.thync.com/\">Thync\u003c/a> and \u003ca href=\"https://www.foc.us/edge-tdcs-headset\">Focus\u003c/a> promise their brain-boosting headsets will reduce fatigue, sharpen focus and improve muscle endurance, experts are cautious.\u003c/p>\n\u003cp>More than a thousand peer-reviewed studies have looked at how a mild brain jolt from electricity improves everything from \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17614951\" target=\"_blank\" rel=\"noopener noreferrer\">physical actions\u003c/a> to \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004959\" target=\"_blank\" rel=\"noopener noreferrer\">memory\u003c/a> to \u003ca href=\"https://www.sciencedaily.com/releases/2016/04/160414095949.htm\" target=\"_blank\" rel=\"noopener noreferrer\">creativity\u003c/a>, and the results are highly inconsistent.\u003c/p>\n\u003cp>“One of the reasons why we believe the effects are highly variable is because everyone has slightly different thicknesses of scalp, thicknesses of skull, different amounts of cerebrospinal fluid, and that’s what the current has to travel through before it even gets to the brain,\" says Zanto. He also says age, gender, ethnicity and illness can influence results.\u003c/p>\n\u003cp>Bikson says marketing claims about tDCS often exaggerate the results from lab studies. For example, researchers may measure how fast someone can press a sensor with their finger before and after wearing a tDCS device.\u003c/p>\n\u003cp>\"And we may see a positive effect,\" says Bikson. \"But that is a world away, though, from a professional basketball player having a marginal improvement in their three-point success percentage after tDCS.\"\u003c/p>\n\u003cp>Even though a lot of the data is conflicting, the most positive results do support using tDCS to improve motor control. Hence the slew of startups targeting athletes.\u003c/p>\n\u003cp>The Giants' Head says even a tiny advantage can help win games at the major league level. An improvement of two-hundredths of a second can be \"the difference between safe and out sometimes,\" he says.\u003c/p>\n\u003cp>\u003cstrong>'This is My Brain on Fire'\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_383008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-383008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/IMG_1879-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">World record holding powerlifter Emily Hu wears Halo Sport headphones while she warms up at Boss Barbell gym in Mountain View. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At a Mountain View gym recently, Emily Hu, a world record holder in power lifting, tightened her silent black Halo headphones before sliding underneath a bar to bench press 220 pounds.\u003c/p>\n\u003cp>\"If I feel the tingling sensation I think, ‘OK. This is my brain on fire,\" says Hu. \"Let’s go!’”\u003c/p>\n\u003cp>About a year ago she tried stimulating her brain for the first time, while doing squats. Usually she adds just a few pounds to the bar between workouts, but the week she tried tDCS she was able to add nine, peaking at 295 pounds.\u003c/p>\n\u003cp>“Some people say, 'You know that could have been a fluke because that was only one data point,' \" says Hu. \" But for me it was a positive enough change that I thought, 'Well, I am going to stick with this device.' ”\u003c/p>\n\u003cp>Even though Hu hasn’t seen the same kind of improvement every week, she wears the headphones routinely while warming up. “I think it gives me a false sense of confidence to feel the device work,” she says, grinning.\u003c/p>\n\u003cp>\u003cstrong>Here to Stay?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Neither Zanto nor Bikson, both academics, are popping tDCS devices onto their own heads -- not to improve athletic performance, anyway. But they both predict the technology is here to stay.\u003c/p>\n\u003cp>“Brain stimulation has been around since recorded history,\" says Zanto. \"They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.\"\u003c/p>\n\u003cp>But the hype around tDCS inspires a lot of new questions. What are the long-term effects of wiring your brain daily? When you zap one part of the brain, are you influencing another region unknowingly, maybe even destructively?\u003c/p>\n\u003cp>And might using tDCS one day be considered a form of cheating?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"order": 9
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"id": "fresh-air",
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"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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"order": 15
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"order": 18
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"source": "American Public Media"
},
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
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"meta": {
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 11
},
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"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.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"possible": {
"id": "possible",
"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.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"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.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
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