Categories
Commentary

Blue Wavelength Light Exposure on Sleep and Recovery

By Ilma Khan

Published 9:58 EST, Tues November 30th, 2021

Introduction

Dealing with trauma has negative changes and effects on our health such as sleep deprivation and loss of brain function. This article allows us to visualize the use of wavelengths to recover brain structure and brain function. A variety of assessments such as an MRI, PVT, and DTI were completed on different participants who have gone through mild traumatic brain injury, to see if they were eligible to be part of the experiment. The experiment lasted seven weeks, participants took three laboratory visits, which included two full-day neurocognitive assessments plus neuroimaging scans. After the assessment process, the participants were randomly assigned to complete a 6-week at-home light treatment procedure with either daily blue or amber light therapy each morning. Keeping in mind that this experiment was a randomized and double-blind trial participant was not educated that there were two different colors of lights. Plus all of the trial staff that had direct contact with participants were blind to the color of the light device assigned to each participant. By using two colors of wavelength light, a placebo, and by not allowing the participants to know about the two different light colors, a blind trial, this trial gave us more unbiased and promising results. After concluding the experiment the researchers found that daily exposure to morning blue-wavelength light offers an effective technique for recovering the circadian system and progressing recovery among individuals with a recent mTBI. The 6-week trial helped us find out that 30-min of morning blue-wavelength light was more effective than amber-wavelength light. The signs of progress and advances they saw in the participants include reducing subjective and objective sleepiness and improving cognitive performance among participants recovering from mTBI.

General Analysis

This research paper was indulged with tons of information and detail. The researchers didn’t miss anything out, they told their audience every little detail, every little variable that played a role in the journey of completing this experiment. This paper was a good read for our club because it took wavelengths into a scientific perspective, changing our perspectives and allowing us to look at many different things from a scientific point of view. It allowed us as readers to see everything that goes into conducting research and experiment. From starting with one person’s thought process and background research to the number of participants who completed the trial. The diagrams and graphs displayed in this article allow for a deeper understanding of how the experiment was conducted, and the detailed descriptions allowed us to visualize the comparison between the participants with blue wavelength light vs. the participants with amber wavelength light. In today’s society trauma is a very major thing, things such as PTSD and mTBI are very common. From concussions to plane crashes, people have traumatic experiences that they need to live with, they need to deal with it. These moments will always live in their brain, make them feel as if they are crumbling from inside. If we can even do one little thing to help them such as sit in blue wavelength light for 30 minutes a day, it will make a difference. Bringing awareness and finding little subtle ways to help can make someone’s quality of life better. This research does exactly that, it brings awareness to these topics and discovers a way to help people with mild traumatic brain injuries. Little things can lead to big things, we do not know what the future holds for us and PTSD patients.

Evaluation of Methods Used

The methods and system of techniques used in this experiment are effective and efficient. They begin and set off our journey into finding new and different ways to help traumatized patients. The methods used in this paper allow us to have a clear visualization of every step of the experiment plus the differences between the blue light results and amber light results. This can be used to solve other problems by allowing us to question and research the effects of blue light wavelength on other different diseases and injuries. The methods and techniques used in this trial can be used to solve future problems by allowing us to use all of the steps and procedures in this experiment towards other trials. It can be used as an example or template for future experiments and the results can come in handy to future researchers. In this trial, the researchers answered the question they were asking themselves in a simpler form, is blue wavelength light more effective in recovering brain function or amber wavelength light? According to the results, blue wavelength light shows more effective outcomes on patients with mild trauma over amber wavelength light. After looking at all the steps of the experiment as well as the conclusion and results, the researchers completely answered and solved their problem. The methods they used to showcase the experiment and results, as well as the methods used to conduct the experiments, played a role in solving the entire problem, helping showcase which wavelength light is better and why it is more effective.

Audience

One concern that would arise through the trial and experiment would be the small number of participants (32 adults). Finding patients with trauma is easy in today’s society but putting different requirements on the type of trauma and when it occurred makes it hard to find participants for the trial, who are willingly wanting to participate. However, to genuinely display the effectiveness of blue wavelength vs. amber wavelength more participants are needed to further demonstrate and prove their methods. Another concern that can arise from this experiment would be the variables used by patients at home by themselves. What if they are not using the light correctly, or positioning it right, or changing the time it is being used? All the little details play a role and can affect the results and data we receive, changing the conclusion and solution. I do not think this article was published in the right journal for the right audience. This journal focuses on the study of the biology of the nervous system, whereas the journal talks more about trauma and the brain which isn’t as closely related to the topic of the journal. Considering mTBI, it is not a disease, it is an injury. It is very common in the U.S at almost 3 million U.S cases per year. This journal, on the other hand, focuses on the nervous system and its diseases. Trauma affects the nervous system but finding the right audience for this paper would be difficult through this journal.

Problems and Admirations

Methods and techniques I enjoyed and admired in this paper would include the amount of information and the depth of the paper. Understanding every step the researchers took to experiment was easier compared to other papers I have read. The variety of assessments completed to find the correct batch of participants displayed the effort the researchers put into the trial to make everything go smoothly. Through the use of a placebo and blind trial, the results show a guarantee that it was unbiased. The graphs and diagrams used throughout the paper allowed for a deeper look into the trial and its components. Another thing I appreciated in this article was the extensive comparison displayed between the patients who received the amber light placebo vs. the patients who received blue wavelength light. The future is a mystery, what the future holds for us is a mystery but we know that unique advances will be made and innovations and techniques will be created. After the publication of this research people will put more awareness on traumatized patients and look at the little things that help their daily lives. People will start doing the little things that help such as sitting under blue wavelength light for 30 minutes to find a little relief and get a good sleep. After this paper is published future researchers will conduct more research to verify and add

on to this conclusion.

Ilma Khan, Youth Medical Journal 2021

References

“A Randomized, Double-Blind, Placebo-Controlled Trial of Blue Wavelength Light Exposure on Sleep and Recovery of Brain Structure, Function, and Cognition Following Mild Traumatic Brain Injury – ScienceDirect.” ScienceDirect.Com | Science, Health and Medical Journals, Full Text Articles and Books., https://www.sciencedirect.com/science/article/pii/S0969996119303547?via=ihub. Accessed 5 Aug. 2021.

Categories
Commentary

Multiracial-ethnic Identity Development: Salient Adolescent Experiences

By Olivia A. Vinckier

Published 4:02 EST, Mon November 16th, 2021

Olivia A. Vinckier  

Abstract- This article examines how different childhood experiences can affect multiracial-ethnic identity and impede the developmental process. With the growing number of multiracial individuals in America, previously published literature was reviewed and synthesized. The purpose of this review is to shed light on the impact that racial experiences in a multiracial individual’s adolescence can have on their multiracial-ethnic identity, as well as the development of such an identity and mental health. Findings show that physical appearance, racial miscategorization, and racial questioning, as well as being an outsider of their monoracial group, are all salient factors that affect multiracial-ethnic identity development. The review also examines how confidence and security in personal multiracial-ethnic identity can benefit their mental health. Overall, salient childhood racial experiences can affect multiracial-ethnic identity development, which impacts one’s well-being.   

Keywords: adolescent, race, microaggressions,

ethnicity, multiracial-ethnic identity, passing 

  1. INTRODUCTION

Salient childhood experiences can dramatically affect one’s multiracial-ethnic identity (MR-EI) in adulthood, as well as prompt exploration of their heritage and culture. Microaggressions like racial questioning and miscategorizations are common experiences among multiracial individuals. These encounters and other influential variables, such as physical appearance and family, impact the development of MR-EI in adolescence and the understanding of their identity in adulthood. The reviewed literature is formulated on multiracial individuals in the United States, for it is an ethnically diverse country with a growing number of multiracial citizens. The paper will also discuss race as a term and its flexibility, as well as its existence or use in the United States.

  1. Defining the Terms

In the presented paper, the term adolescent or adolescence is frequently referenced to describe the group in discussion. The majority of the reviewed papers here used data from the National Longitudinal Study of Adolescent Health, which characterized adolescence from 12-18 years of age. Race and ethnicity are key terms that are the basis of the entire discussion. Race is defined as a socially constructed group based on physical characteristics and their shared history due to these features [1]. Since the concept of race is simply a social construct, it changes over time and in different contexts. Ethnicity is defined as the social construct which uses ancestry, geographic origin, and culture to form groups and identify differences [2]. The noted difference is that race is based on physical differences while ethnicity is based on geography and culture. Along with race, there is racism, defined by Harrell [3] as “a system of dominance, power, and privilege based on racial group designations; rooted in the historical oppression and a group defined or perceived by dominant group members as inferior”. Monoracism is a unique form of racism where multiracials are oppressed simply because they do not fit into monoracial categories [4]. In this paper, microaggressions are defined as intentional or unintentional, brief verbal, behavioral, or environmental degradations, that are insults towards people of color [5]. 

Root [6] refers to multiracials as people of two or more racial heritages. Due to the similarity and overlap of both racial and ethnic identity, this paper often refers to the term multiracial-ethnic identity (MR-EI), since distinctions are unlikely to be made, and both are equally relevant [7]. Passing as monoracial is defined as when one changes, implies, conceals, or is dishonest about their self-expression to fit in and become acceptable to the targeted audience in context [8]. Racial terms might not have a genetic meaning; however,  they are still a categorical illusion carrying a significant social purpose, i.e., the basis of hierarchy in America. The truth is not in the categories themselves but the realness of their prejudice, racism, and discrimination that comes with association and categorization [9].

  1. Purpose 

The purpose of this paper is to understand the impact childhood experiences can have on a multiracial person’s identity development, security, and understanding. For multiracial people to completely understand their MR-EI and have a secure identity in adulthood ,they must be aware of how they came to their identity [10]. It is noted that a strong ethnic identity yields better overall well-being, mental health [11; 12; 13; 14]. Additionally, ethnic- and//or racial-based discrimination is associated with lower self-esteem and higher depressive symptoms [11].

This paper will cover salient factors that can affect the development and security of a multiracials identity: physical appearance, education,  and environment Physical appearance is one of the most salient factors in identity development. It can be influenced by personal perspective about one’s physical appearance and knowing outsiders’ assumptions about them. Feeling foreign in their race, especially within family and peer groups, can lead to negative experiences such as hazing [6] and microaggressions [14]. Environments include neighborhoods, households, and peer groups.

Thus, the research question of this literature review is: How do salient racial experiences in multiracial adolescents affect multiracial-ethnic identity development?  

II. METHODOLOGY

I used certain key terms within the Google Scholar database to discover peer-reviewed articles. The key words were “multiracial”, “identity”, “racial experiences”, and “psychological”. I then evaluated and selected articles based on methodology, relevant salient racial experiences (ie; physical appearance, family, peers, neighborhoods,) and overall quality of study. Over the span of four months,  I reviewed 24 relevant articles that covered 10-15 years. I utilized Poston’s Biracial Identity Developmental Model [15] to frame the effects of salient racial experiences on multiracial-ethnic identity development. Poston’s [15] model consists of the following stages: personal identity, choice of group categorization, enmeshment/denial, and integration. 

III.     FORMULATING A SYNTHESIS 

  1.  Race 

Due to the similarity and overlap of both racial and ethnic identity [7], this paper often refers to the term multiracial-ethnic identity (MR-EI) since distinctions in the literature are unlikely to be made, and both are equally relevant. How one develops a secure and individualized MR-EI is complex and different from how a monoracial individual develops their racial identity. Therefore, will be able to understand how multiracial individuals decide their multiracial-ethnic identity by exploring the history of race and reviewing Poston’s Biracial Identity Developmental Model, which is described later on in the paper. 

Race is not just a term that incorrectly socially differentiates people. Children are taught that race is an accurate classification of genetic and biological differences. These views are all inaccurate and outdated. Outsiders may think that they see phenotypical differences in skin color, hair texture, and eye shape. They, therefore, use that to build and support an illogical relationship between biology and racial identification. Yet the divisions we see in society are not natural because they are not biological. Race is simply a social construct, although mistaken as phenotypic differences, that has fluctuated for centuries in America [1]. The different criteria in almost every United States census since 1790 just shows these are not scientific categories, but political ones [16]. However, it is not to say that race is an illusion since race is the social base in American society and culture. We have allowed it to impact our daily lives with no real correlation to a person’s genetics [9; 17; 18]. 

Overall, the importance of racial categorization is merely to fit or to be placed into a socially constructed group.

  1. MR-EI Development and Poston’s Model 

In this paper, I used Poston’s Biracial Identity Developmental Model to describe multiracials’ development as well as biracial individuals. Poston’s Biracial Identity Developmental Model [15] is a five-step developmental process. Poston created this model by comparing  monoracial whites  to minorities and multiracial individuals in adolescence by studying their relationships with their parents. He used samples from the data of The National Longitudinal Study of Adolescent Health, conducted by.

The process begins at a young age when one chooses their (1) personal identity, whether that is gender, sexuality, or race. Membership in any group is just becoming salient, and identity is based on self-esteem and self-worth as they develop and learn from their family. Then during a time of separation and pressure, there is a (2) choice of group categorization. Society pushes them to choose an identity, commonly of one racial or ethnic group. They force them to choose to feel a sense of belonging or lose a chance to participate with peers, family, and social groups. Hall [19] identifies that factors used to make this decision begin with (a) group status. This factor could be families’ ethnic backgrounds, neighborhood demographics, and the ethnic influence of peers. Next, (b) social support factors come into play, such as cultural and parental/family acceptance and social participation within schools or communities in general. Finally, and arguably most critical are (c) personal factors. These can include language and cultural knowledge, physical appearance, age, political involvement, and overall personality [19]. At this point, it would be very unusual, but not impossible, for the adolescent to choose a multiracial-ethnic identity. Following their group categorization, confusion and guilt about one’s choice and how they feel it does not fully represent them would lead to(3) enmeshment and denial. A lack of acceptance, self-hatred, and guilt projected from one or more racial groups come during this stage. As time passes, feelings of appreciation (4) might arise. The individual will begin to value their multiple identities and broaden the scope of their group orientation. At this stage, they still tend to identify with a single racial group. However, exploration about their racial or ethnic heritage and culture is likely. Finally, the biracial (although truly multiracial-ethnic) identity developmental process is concluded with (5) integration. They finally can experience wholeness in one’s identity and appreciate all their racial and ethnic attributes. At this level, a secure and integrated MR-EI develops [15].

IV.     SALIENT RACIAL EXPERIENCES

Racial experiences in adolescence that affect MR-EI can vary from person to person. However, consistently, findings show that physical appearance and experiences within one’s racial community (family, neighborhood, and peers) can impact MR-EI development and the security of their identity in adulthood.

  1. Physical Appearance 

In Carwell’s et al.’s, [13] study on critical incidents that are central to a person’s MR-EI development, a participant recalls that her friend commented that her hair is too long for her to be Black. This microaggression on her physical appearance causes the participant to question her own racial identity [13, pp. 1669]. We see that microaggressions like these can impede the developmental process and insecurity in one’s multiracial-ethnic identity. 

It is estimated that as many as one in five Americans could identify as multiracial by 2050 [20], and yet people still make assumptions based on how others look. Being faced with constant miscategorization and racial questioning can lead one to constantly explain and justify their physical appearance, even if it might seem obvious to them. Doing so can trigger individuals to think differently about their racial attributes, affecting their clarity and security about their identity. Multiracial individuals might also feel rejected and therefore disassociate from their race group if they believe they do not look or “fit in” with their peers. One may feel they are supposed to look the same as the racial group they identify with and feel misplaced if they do not. However, those who are more aware of how they racially look to others show consistency in their identity over time. They also tend to internalize the constant assumptions made about their race [21].These individuals might prefer to  “hide” part of their identity to avoid questioning and miscategorization about their race.

  1. Passing 

Hiding or concealing one racial identity can also be referred to as “passing”: a choice made to maximize benefits, life chances, and quality of life, or even avoid discrimination. Multiracials can make this drastic change in identity either temporarily or permanently, shifting from a more mistreated minority to a more acceptable minority or simply from minority to majority. Multiracial individuals’ physical and cultural ambiguity allows them to permanently, or situationally “pass” into a socially-defined, pre-existing, racial, or ethnic group [8, pp. 62]. However, this privileged opportunity creates an exclusive, unequal tool that is only realistic for multiracial and not monoracial individuals. While it benefits the individuals who can pass, monoracial and less ambiguous multiracials do not get the luxury of passing and are still left to struggle with discrimination. 

  1. The One Drop Rule 

Throughout time, physical appearance has impacted the way one is racially classified. A century-old example is when multiracial individuals with even a drop of Black heritage are considered Black due to the one-drop rule. The one-drop rule, also known as the rule of hypodescent, was used throughout United States history to classify individuals into socially constructed race groups. Anyone with a “drop” of African ancestry would be considered Black (or at least to have it stated on their birth certificate) [22].

In records, we see many individuals with White and Black racial ancestry label themselves as Black due to the one-drop rule, claiming a Black identity unaware of their European genetics. An estimate of 75%-90% of the American Black identifying population has White ancestry. Roughly 6% of the whole American White identifying population has Black lineage. Therefore, centuries of relations between Europeans, Africans, and indigenous Americans in the United States have caused these individuals to claim a monoracial identity when they could very well be multiracial [9]. 

States determined blackness by a variance of fractions: 1/32, 1/16, 1/8, 1/4, 1/2 An individual’s racial classification could actually change when they crossed state borders. The fluidity of racial categorization in America shows the absurdness of such classification [9]. 

The one-drop rule can become problematic for multiracials by forcing them into predetermined, socially constructed race categories because of this stigma created over time. It gives the outdated racist “rule” a chance to grip modern-day diversity. Not only does this create opportunities for division and discrimination, but it also prevents multiracials from expressing their ambiguous selves [8]. 

V.     RACIAL COMMUNITY

Racial community is a broad group that can largely impact an individual’s multiracial-ethnic identity development. One’s racial community can include peers, family, and neighbors. Multiracial individuals may feel rejected by a single race group that is a part of their identity [21]. Rather than feelings of rejection, they may instead feel pressure from their racial community to identify with a specific race group, usually related to the parent of color [23]. 

Miville, Constantine, Baysden, and SoLloyd [23] interviewed ten multiracial adults about their childhood experiences. Many interviewees reporte feeling peer-pressure from associated racial communities to define themselves within the pre-existing racial categories.The researchers also found that peer groups and communities who view and accept one as multiracial provide an escape when faced with multiracial-targeted racism. Therefore, a lack of such a community can take away access to relatable racial experiences, causing one to remove themself from their multiracial-ethnic identity.  

  1. Hazing 

These multiracial individuals discussed might also experience hate crimes. A common and extreme incident, mostly reported within Black communities, is hazing. Hazing is an example of when actions are performed to prove that one is an insider. It is a degrading process usually to show racial and ethnic authenticity. The test is pass/fail, and results are fluid since the giver of the test determines the outcome and already has assumptions about the (multiracial) person. The tasks or tests tend to be cruel and require submission of aspects of their multiracial-ethnic identity. Two examples from the Black community are stealing and denying all White people or parents. These incidents tend to occur in mid- to late adolescence. It is traumatic and derails one’s identity development [6].

  1. Experiences Within Family 

Being multiracial with two monoracial parents can be a unique challenge. Not only is this individual beginning to explore two new cultures and the combination of them both, but they are also the pinpoint of the union of two completely different families and cultures. This section will explore how rejection and microaggressions projected from monoracial sides of the family can affect MR-EI development. It also covers the positive effects that discussions about their mixed-race heritage can have on their identity and finally, how immersion in one’s multiracial and monoracial community can also benefit overall well-being and MR-EI. 

Studies show that favoritism and isolation from monoracial family members can lead to a negative sense of self and a less-developed multiracial-ethnic identity. Participants in a Nadal et al., [14] study on nine multiracial participants described how family members from one side made them feel isolated from the other and questioned their MR-EI. Feeling less favored by monoracial family members had negative impacts on the participants’ mental health. Racial microaggressions from family members are another critical factor that impacts multiracial-ethnic identity in adolescents. These microaggressions either (a) can impede the multiracial-ethnic identity developmental process, or (b) significantly affect one’s mental health and identity. Sometimes monoracial family members do not acknowledge what they’re doing since they might not be fully aware of their monoracial biases. As defined early in the paper, this bias refers to monoracism. The acts of prejudice, accidental or purposeful, lead multiracials to feel isolated from their family. The impact is particularly strong for only children or children who are the only multiracial individual in their lineage.

Discussions about race and ethnicity can lead to a more positive sense of self and a more developed MR-EI. It is critical to address these topics instead of avoiding them to show support towards the child’s MR-EI. Supportive interactions with multiracial family members can also reaffirm and uphold the child’s decision involving their multiracial-ethnic identity [14]. Findings also show that becoming involved with extended family, multiracial or not, can increase confidence in individuals’ multiracial identities, and their multiracial self-understanding strengthens [26].   

VI.     CONCLUSION 

The purpose of this literature review was to synthesize research on salient racial experiences in adolescents and the effects of such experiences on multiracial-ethnic identity development and security of identity in adulthood. It is important to understand how childhood racial experiences within a family, neighborhood, and peer group affect an adolescent’s MR-EI development. Physical appearance is a critical factor in this process due to the lack of understanding that race is a social construct [24]. Assumptions about one’s race based on the way they look, talk, or act, can lead to racial miscategorization and questioning, two things that can lead to personal questioning and insecurity [13]. This insecurity directly affects mental health, diminishing the overall quality of life for multiracial youth.

With a plethora of research about salient childhood racial experiences that can affect multiracial adolescents, the state of the literature reviewed is positive and informative. However, there is a significant gap in research about the idea of new racial categorization. There are few articles [8] about whether there should or should not be new race groups and what they could be. 

Further researchers could conduct a qualitative study of multiracial individuals’ opinions on the importance of proper racial categorization for multiracial individuals. Current research that does explore racial miscategorization and questioning also supports the idea that there is a lack of proper racial categorization for multiracial individuals [10]. Therefore, it is critical for research to study the narratives of multiracial individuals on this topic.

 Do we need new categories with the rise of multiracial-ethnic individuals year by year? When combining the colors yellow and blue, we do not call it yellow and blue, but green, a color different from the original two. So this begs the question, do we need a new green? 

Olivia Vinckier, Youth Medical Journal 2021

REFERENCES

[1] Atkin, A. L., & Yoo, H. C. (2019). Familial racial-ethnic socialization of multiracial American          youth: A systematic review of the literature with multicrit. Developmental Review, 53, 100869. https://doi.org/10.1016/j.dr.2019.100869

[2] Perez, A. D., & Hirschman, C. (2009). The changing racial and ethnic composition of the US population: Emerging American identities. Population and Development Review, 35, 1–51. 

[3] Harrell, Jules P., Hall, Sadiki, Taliaferro, James (2003). Physiological Responses to Racism and Discrimination: An Assessment of the Evidence. American Journal of Public Health 93, no. 2: pp. 243-248. https://doi.org/10.2105/AJPH.93.2.243

[4] Johnston, M. P., & Nadal, K. L. (2010). Multiracial microaggressions: Exposing monoracism in everyday life and clinical practice. In D. W. Sue (Ed.). Microaggressions and marginality: Manifestation, dynamics, and impact (pp. 123–144). New York, NY: Wiley & Sons.

[5] Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4),271-286. https://doi.org/10.1037/0003-066X.62.4.271

[6] Root, M. P. P. (1998-1999). Glossary. In M. P. P. Root (Author), The multiracial experience: Racial borders as the new frontier (4th ed., pp. ix-xi). Sage. 

[7] Cokley, K. (2007). Critical issues in the measurement of ethnic and racial identity: A referendum on the state of the field. Journal of Counseling Psychology, 54(3), 224–234. https://doi.org/10.1037/0022-0167.54.3.224

[8]Williams, T. K. (1997) Race-ing and Being Raced: The Critical Interrogation of “Passing”, Amerasia Journal, 23:1, 61-66, DOI: 10.17953/ amer.23.1.a72v118t3xhq7121

[9]Khanna, N. (2011). A Note on Terminology. In N. Khanna (Author), Biracial in America: Forming and performing racial identity. Lexington Books.

[10]Newcomb, Shirley A., “The Impact of Racial Miscategorization and Racial Ambiguity on Multiracial Identity and Well-Being: A Qualitative Study” (2017). Dissertations (1934 -). 737. https://epublications.marquette.edu/dissertations_mu/737

[11]Sladek, M. R., Umaña-taylor, A. J., Oh, G., Spang, M. B., Tirado, L. M. U., Vega, L. M. T., Mcdermott, E. R., & Wantchekon, K. A. (2020). Ethnic-racial discrimination experiences and ethnic-racial identity predict adolescents’ psychosocial adjustment: Evidence for a compensatory risk-resilience model. International Journal of Behavioral Development, 44(5), 433-440. https://doi.org/10.1177/0165025420912013

[12]​​Shih, M., & Sanchez, D. T. (2005). Perspectives and Research on the Positive and Negative Implications of Having Multiple Racial Identities. Psychological Bulletin, 131(4), 569–591. https://doi.org/10.1037/0033-2909.131.4.569

[13] Cardwell, M. E., Soliz, J., Crockett, L. J., & Bergquist, G. L. (2020). Critical incidents in the development of (multi)ethnic-racial identity: Experiences of individuals with mixed ethnic-racial backgrounds in the U.S. Journal of Social and Personal Relationships, 37(5), 1653-1672. https://doi.org/10.1177/0265407520906256

[14] Nadal, K. L., Sriken, J., Davidoff, K. C., Wong, Y., & Mclean, K. (2013). Microaggressions within families: Experiences of Multiracial people. Family Relations, 62(1), 190-201. https://doi.org/10.1111/j.1741-3729.2012.00752.x

[15] Poston, W. S. C. (1990). The biracial identity development model: A needed addition. Journal of Counseling and Development: JCD, 69(2), 152-155.

[16] Wright, Lawrence. 1994. “One Drop of Blood.” New Yorker, July 25. Wright, Richard, Serin Houston, Mark Ellis, Steven Holloway, Margaret Hudson. 2003. 

[17] DiAngelo, R. (2012). Chapter 6: What Is Race? Counterpoints, 398, 79-86. Retrieved July 26, 2021, from http://www.jstor.org/stable/42981486

[18] Brubaker, R. (2009). Ethnicity, race, and nationalism. Annual Review of Sociology, 35(1), 21-42. https://doi.org/10.1146/annurev-soc-070308-115916

[19] Hall, C. C. I. (1980) The ethnic identity of racially mixed people: A study of Black-Japanese. Unpublished doctoral dissertation, University of California, Los Angeles.

[20] Jackson, K. F., & Samuels, G. M. (2011). Multiracial competence in social work: Recommendations for culturally attuned work with multiracial people. Social Work, 56(3), 235-245. https://doi.org/10.1093/sw/56.3.235

[21] Doyle, J., & Kao, G. (2007). Are Racial Identities of Multiracials Stable? Changing Self-Identification among Single and Multiple Race Individuals. Social Psychology Quarterly, 70(4), 405-423. Retrieved July 26, 2021, from http://www.jstor.org/stable/20141804

[22] Davis, F. James. 1991. Who is Black? One Nation’s Definition. University Park, PA: Pennsylvania University Press. 

[23] Miville, M. L., Constantine, M. G., Baysden, M. F., & So-Llyod, G. (2005). Chameleon changes: An exploration of racial identity themes of multiracial people. Journal of Counseling Psychology, 52(No. 4), 507-516.

[24] Pauker, K., & Ambady, N. (2009). Multiracial faces: How categorization affects memory at the boundaries of race. Journal of Social Issues, 65(1), 69-86. https://doi.org/10.1111/j.1540-4560.2008.01588.x

Categories
Commentary

The Terrible Trio: An Intersection of Social Media, Physical Inactivity, and Mental Illness

By Lily Kangas

Published 5:44 EST, November 13th, 2021

Social media and sedentarism

As the world undergoes a cultural revolution towards technology, we see an increasing number of youth trading in their jump ropes and outdoor toys for the newest iPad or phone. While it can be argued that this shift is an inevitable result of our evolving society, we also must acknowledge why it is a problem. Today, federal guidelines recommend about 75 minutes of exercise each week, which only amounts to about 10-11 minutes per day. Despite this seemingly low benchmark, only about a quarter of people are reaching those 75 minutes (Ducharme, 1). In comparison, the average person spends a hefty 285 minutes on their phone or another cellular device per week (Zalani, 1). To make this worse, most of this screen time is spent while sitting or lounging because of the all-consuming nature of social media and technology. 

How Can This Affect My Mental Health? 

Now, you may be wondering, is having more screen time and less exercise really that much of an issue? To that, the answer would be an astounding yes. Not only can a sedentary lifestyle affect your physical health by increasing the risk of heart attack, obesity, and more, it can also be detrimental to your mental and emotional wellbeing. In a number of studies, researchers have identified a link between brain health and physical activity levels, specifically with depression and anxiety. In fact, sedentary adolescents have a ~10% higher chance of developing depressive symptoms before they become adults (Thomas, 1). This increased risk can be chalked up to an absence of feel-good hormones such as serotonin that one would typically receive during exercise. Regular physical activity has been shown to increase serotonin levels within the brain, and because many mental illnesses stem from a serotonin deficit, exercise is thought to be among the most effective methods to combat these mental disorders. Therefore, when we are allocating such a substantial amount of our time to screen use, a notoriously sedentary activity, and ignoring our physical health needs, we are essentially losing a key part of brain hormone stabilization. Additionally, both extensive social media use and lack of activity are often synonymous with staying indoors, meaning less exposure to sunlight and nature, which are also important in boosting serotonin and are needed to get adequate levels of vitamin D. In fact, conditions like seasonal affective disorder (SAD) and vitamin D deficiency both have substantial impacts on one’s psyche and both arise specifically as a result of lack of sunlight. Consequently, there is a higher prevalence of the condition in sedentary individuals (Danahy, 1). 

What Can Be Done?

In society, we have created a system that encourages social media to use above even the most essential aspects of our health, such as exercise. When our health needs are ignored, we can see them reflected in our psyche. So, in order to reverse the harm you are inflicting on your brain, you need to focus on your health and evaluate how you are spending your time. If you find that your social media usage has become excessive, or you can feel your anxiety creeping in, maybe try jogging or going for a bike ride. Even replacing just ten minutes of screen time a day with gentle exercise will create a drastic difference in how you feel mentally, enabling you to lead a happier, healthier life. 

Lily Kangas, Youth Medical Journal 2021

Sources

Csatari, Jeff. “What Can Happen To Your Body If You Don’t Exercise.” Eat This Not That, 8 Sept. 2020, http://www.eatthis.com/side-effects-not-exercising.

Florido, Roberta, et al. “Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure.” Circulation, vol. 137, no. 20, 2018, pp. 2142–51. Crossref, doi:10.1161/circulationaha.117.030226.

Thomas, Liji. “A Sedentary Lifestyle Increases the Risk of Adolescent Depression.” News-Medical.Net, 12 Feb. 2020, http://www.news-medical.net/news/20200211/A-sedentary-lifestyle-increases-the-risk-of-adolescent-depression.aspx#:%7E:text=The%20findings&text=Correlating%20the%20physical%20activity%20with,time%20they%20entered%20early%20adulthood.

Ulery, Gina. “Seasonal Affective Disorder: Diet and Lifestyle Interventions.” Pdresources.Org, 19 Nov. 2015, blog.pdresources.org/seasonal-affective-disorder-diet-and-lifestyle-interventions.

Categories
Commentary

A Short Analysis of How Mental Disorder and Instability are Portrayed in Alfred Hitchcock’s Psycho

By Melle Hsing

Published 2:15 EST, Sun November 7th, 2021

Warning: spoilers of this film are contained in this article.

Often when we talk about mental illness we may view it in a scientific light — the pathophysiology, symptoms, and consequences of the illness. However, one advantage of film is its ability to portray the realistic and humanistic side of mental illness in a cohesive manner through mise-en-scene, characterization, dialogue, and sounds which pull the audience into the world of those suffering from the mental illness. Such is the case of Alfred Hitchcock’s Psycho, in which the curious psyche of Norman Bates is heavily explored through stylistic devices. Instead of understanding mental disorder from a scientific perspective, this article explores how mental disorder — dissociative identity disorder in this case — presents itself directly through the character of Norman Bates, a peculiar antagonist with a traumatic childhood.

Excerpt 1 – The Last Conversation between Norman Bates and Marion Crane

“She just goes … a little mad sometimes… we all go a little mad sometimes! Haven’t you?” – Norman Bates

Psycho | Cinema Sips
Norman Bates talking to Marion Crane as one of his stuffed birds stares threateningly at the audience

In this scene where Norman Bates talks about his mother with Marion Crane, there is a disturbing atmosphere created by the tense non-diegetic sound of the strings being played in the background as well as Bates’ quietly menacing tone at the suggestion by Marion Crane that he should put his mother into a mental institution. The tension within this scene suggests that behind the formalities there is a mysteriously dark and ugly side to Norman Bates, which has not yet been revealed (also shown through the darkness of the room). Throughout the play, the music changes based on the tension of the scene, particularly in the presence of Bates which hints at the fact that the music may be a motif for Bates’ disturbed mental state. The music in this scene thus foreshadows Bates’ mental instability which is further supported by the unusually anxiety-inducing environment even demonstrated through Crane’s increasingly concerned facial expression in the close-up shots as Bates carries on the conversation. 

We can observe the slight transition from the persona of Bates to the persona of his mother, as Bates’ speech becomes much slower and more dragged out just like how his mother speaks at the mention of a mental institution. Furthermore, the jealousy of “his mother” is hinted at by the cold stare which Bates imposes on Crane, emphasized by the protruding white in his eyes against a very dark background, suggesting that he is tethering on the border between his identity and his mother’s identity (or at least his mother as perceived by him). This scene can therefore be a representation of Bates’ dissociative identity disorder early on in the film before it is finally revealed at the end, hinted to the audience through the clever use of music, tone, and lighting.

For an audience who is not familiar with dissociative identity disorder at the start of this film, such clever use of film techniques to foreshadow the central mental disorder in the film would not have been obvious during the first time watching it. However, I believe that this notion of a mental disorder or instability “going under the radar of awareness” is intentionally portrayed in order to reflect the fact that such mental disorder often go unnoticed to a passersby in real life and that they do not present themselves obviously to the eye.

Psycho revamp changes 'transphobic' shower scene | News | The Times
orman Bates dressed up as “Mother”

Excerpt 2 – The Final Scene

“They’re probably watching me. Well, let them. Let them see what kind of a person I am. I’m not even going to swat that fly. I hope they are watching. They’ll see… they’ll see… and they’ll know… and they’ll say… ‘why, she wouldn’t even harm a fly…’”

This simple yet extremely unsettling scene of Bates’ narration using his mother’s voice reveals his dissociative identity disorder in its clearest state to the audience, completely reigning over Bates’ own personality. The huge negative space in the long shot of him sitting in a chair creates a sense of isolation where he seems detached from reality, left to roam silently in his own thoughts. Furthermore, the window with bars to the right can be viewed both as a symbolism for the prison of Bates’ mind as well as the opening with which people may view and judge people who are mentally disoriented. The irony of Bates talking cynically about his murder crimes in his mother’s voice further shows his alienation from his personal identity at the end as he truly believes that he is his mother. Finally, his chilling smile cross-dissolved with his mother’s skull clearly depicts the fact that his alternate identity and his identity as Bates are inseparable to him as a whole, and that he would continue to cope with his condition even after his crimes have been exposed.

Norman Bates - Alchetron, The Free Social Encyclopedia
Norman Bates’ terrifying smile 

The traumatic past including the death of Bates’ father and his own severe attachment to his mother influenced the development of his dissociative identity disorder which demonstrates the detrimental impacts of a poor family network on a child’s mental stability. Indeed, dissociative identity disorder is quite rare but is still able to be developed under extremely severe childhood circumstances.

Melle Hsing, Youth Medical Journal 2021

References

“Dissociative Identity Disorder (Multiple Personality Disorder).” Cleveland Clinic, my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder.

Norman Bates. Alchetron, alchetron.com/Norman-Bates.

Norman Bates Dresses in His Mother’s Clothes to Kill a Guest in the 1960 Original. The Times, http://www.thetimes.co.uk/article/psycho-revamp-changes-transphobic-shower-scene-025tpcflx.

Psycho, 1960. Cinema Sips, cinemasips.com/2020/10/26/psycho/.

Categories
Commentary

The present and future role of 3D printing in medicine

By Samara Macrae

Published 11:23 EST, Weds October 13th, 2021

Introduction:

3D printing, also known as additive manufacturing, is a process that holds enormous potential – and is not only currently used in medicine, but it will undoubtedly continue to revolutionise this field in the future. The process of 3D printing began in the 1980s, and this technology has been implemented into various areas of medicine – for example, medical imaging apparatus can often be fed into a 3D printer to form a physical model of the digital image. In 2016, the use of 3D printing in medicine was valued at $713.3 million, but this is predicted to rise to $3.5 billion by only 20251.  Within the field of medicine, 3D printing can additionally be used to produce implants as well as in bio-printing. Other major applications of 3D printing in medicine include producing artificial human organs for transplants and making surgical procedures faster and more efficient.

How does 3D printing work?

To begin with, before a physical 3D model can be created, a graphic model has to first be designed. This can be done using programs such as TinkerCAD and Fusion360. This digital model then needs to be ‘sliced’ in order for the printer to process the designs for the many layers – as it cannot fully conceptualize a 3D model in its entirety. This process is called ‘slicing’2. Once divided into layers, the design for each individual layer is fed into the printer, typically via a USB stick or can be done wirelessly. This is an example of an additive process, which is where a 3D object is created through placing many layers of material on top of one another. Each layer is a cross-section of the 3D object that has been created. 3D printing began as creating prototypes but has escalated into large-scale manufacturing due to how rapid the process is compared to other forms of industrial production.3 Manufacturing using a 3D printer can also be cheaper, as iterations are easier and there is no need for expensive tools nor high labour costs to manage the machines. 3D printing is utilized extensively in the car manufacturing industry, in order to produce individual vehicle parts on demand and en-masse. 3D printing is used in a multitude of other industries, including aviation and consumer products, such as eyewear and footwear.

Bioprinting and organ transplantation:

Bioprinting is a process similar to 3D printing, as it is an additive manufacturing process through which cells and other biomaterials are ‘printed’ to create biological structures in which living cells are able to divide and multiply4. The cells used to create complex bodily structures – such as skin, bones, and other organs – can be extracted directly from a patient. Adult stem cells can also be used, and they are cultivated into a bioink; this is a material used to produce artificial living tissue via 3D printing. Bioink can consist solely of the cells but can also contain a carrier material – typically a biopolymer gel. This will provide a 3D framework which the cells are able to attach to and spread out as they multiply5. The result of this scaffolding being in place means that the cells can be moulded into the desired shape. 

Bioprinting is a technique that is being researched currently, and Swansea University in the UK, has recently developed a bioprinting process6 by which bone matrix can be artificially produced using a regenerative biomaterial. This material is comprised of calcium phosphate, polycaprolactone, gelatine, agarose, and collagen alginate. This can potentially be used to correct severe and complex bone fractures, where otherwise the missing or damaged bones would be replaced with synthetic materials. This is part of the surgical procedure known as ‘bone grafting’. If the 3D-printed bone matrix is used instead, over time it will fuse with the patient’s bones and result in greater strength, compared to when synthetic materials would have been used instead.

In addition, the prospects of bioprinting extend further: for instance, the development of artificial corneas. Globally, there were approximately 12.7 million people in 2013 awaiting a corneal transplant, with 7 million of these individuals in India alone7. 8 In South Korea, in 2019, there were approximately 2000 people requiring a cornea donation – and the average wait time for surgery there is 6 years. This is due to the lack of cornea donations in the country as well as the problems associated with the current synthetic corneas available. These synthetic corneas are made from recombinant collagen or other chemical substances, like synthetic polymers, and one predominant problem with them is the fact that they are not always transparent after being implanted. This is due to the present inability to synthetically replicate the natural structure of the cornea being that of a lattice of collagen fibrils, which affects its transparency.

8However, a research team at the Pohang University of Science and Technology in South Korea, in conjunction with researchers at the Kyungpook National University School of Medicine also in South Korea, have worked to 3D print a cornea. This was done using a tissue-derived bioink, and this meant it is biocompatible with an individual’s eye. Bioprinting was utilised to create this artificial cornea in such a way that its transparency is akin to that of a natural human cornea. The joint research teams noticed, while working to develop a 3D printed cornea, that the collagen fibrils which were produced by the process of 3D bioprinting were similar to the lattice pattern found in human corneas.

9In other areas of bioprinting, the accomplishment of developing artificial organs suitable for transplantation remains a more futuristic hope. An example of this is a research project using 3D bioprinting of stem cells in order to create artificial, biocompatible kidney tissue. This research was led by the Murdoch Children’s Research Institute (MCRI) in Australia, alongside the American biotech company, Organovo. A 3D bioprinting process was used, in which a bioink created from stem cells was formed, and this produced an artificial kidney approximately the size of a human fingernail. Despite the small size, these bio-printed kidneys did contain very similar structures to human kidneys – including having nephrons and the division between the cortex and medulla being identifiable. While the research needs to continue to create artificial kidneys suitable for human transplantations, these kidneys are still functional for drug testing, predominantly for toxicity, instead of animal testing. Professor Melissa Little from the MCRI stated: “The pathway to renal replacement therapy using stem cell-derived kidney tissue will need a massive increase in the number of nephron structures present in the tissue to be transplanted.” This shows that the research is auspicious but requires considerably more time and effort.

The use of 3D printing in surgery:

3D printing is currently in use for many surgical procedures, and this will continue to increase as this technology develops. An example of this is using 3D printing to create patient-specific implants (PSIs) which are the exact complementary shape for the patient. For example, 10craniomaxillofacial reconstruction implants, which are used predominantly in head and neck surgery. These implants have to be bent into shape during surgery, which is time-consuming and is likely to place unnecessary stress on the implant as it has to be bent multiple times. In an article published in ScienceDirect entitled ‘A Systematic Approach for Making 3D-Printed Patient-Specific Implants for Craniomaxillofacial Reconstruction’10, the researchers discuss how they have devised an approach to this form of surgery, which has resulted in 41 successful surgeries using patient-specific implants which have been 3D-printed. This approach begins with using SolidWorks software to create a graphic design model to then print. The 3D-printed product undergoes a series of treatments – including heat and tension treatments – before being sterilised. The implant is then used in the surgery, and this article furthermore states that the use of these 3D-printed patient specific implants “reduces surgery time and shortens patient recovery time”.

A specific example of the use of 3D printing patient specific implants is a lower jaw implant, which was created for a child in China in 201811. This child had a mandibular tumour in his lower jaw which, if removed, would cause a severe facial malformation. However, this child needed to have this tumour removed as he struggled greatly with tasks such as talking, eating, and even opening his mouth. This led to him undergoing a surgery in which the tumour was removed, and the part of his lower jaw which was also removed was replaced using a titanium alloy implant. This implant had been 3D printed, using models of the child’s jaw, in order to create a patient-specific implant for him.

A further example is the use of a 3D printed patient-specific implant of an ossicle, in 2019. This implant was made, again, of titanium, and replaced the ossicles of the patient – as they had been damaged during a car accident and led to the patient losing their hearing. The medical team carrying this innovative surgical procedure was led by Professor Mashudu Tshifularo, a professor at the University of Pretoria in South Africa. As a result of this work, the patient’s hearing was restored11. This 3D-printed middle-ear replacement surgery was the first in the world, and according to the news platform ‘Good Things Guy’, Professor Mashudu Tshifularo said: “By replacing only the ossicles that aren’t functioning properly, the procedure carries significantly less risk that known prostheses and their associated surgical procedures”12.

Conclusion:

To conclude, while the technology of 3D printing in medicine can certainly progress in the future, it is still in use and being researched further currently. The promising nature of this process means that surgical procedures can continue to develop, becoming safer and more time-efficient, and there are the hopes of artificially creating biocompatible tissues and organs. This could revolutionise organ transplantation – not only reducing waiting times but additionally decreasing the risks of rejection. Furthermore, this technology could mean that implants are a better fit for the patient – as hip and knee replacements are some of the most common surgical procedures performed worldwide. The research for this technology is boundless and is one of many examples of computer technology merging with, and arguably, dominating the field of medicine in order to improve every aspect of it.

Samara Macrae Youth Medical Journal 2021

References:

  1. Medical Device Network: “3D printing in the medical field: four major applications revolutionising the industry” – https://www.medicaldevice-network.com/features/3d-printing-in-the-medical-field-applications/
  2. Interesting Engineering: “How Exactly Does 3D Printing Work?” – https://interestingengineering.com/how-exactly-does-3d-printing-work
  3. 3DPrinting.COM: “What is 3D Printing?” – https://3dprinting.com/what-is-3d-printing/
  4. Cellink: “Bioprinting Explained” – https://www.cellink.com/blog/bioprinting-explained-simply/#:~:text=Bioprinting%20is%20an%20additive%20manufacturing,that%20let%20living%20cells%20multiply.
  5. All3DP: “What Exactly is Bioink?” – https://all3dp.com/2/for-ricardo-what-is-bioink-simply-explained/#:~:text=Bioink%20is%20the%20material%20used,as%20a%203D%20molecular%20scaffold.
  6. Medical device Network: “The future of bioprinting: A new frontier in regenerative healthcare” – https://www.medicaldevice-network.com/features/future-of-3d-bioprinting/?utm_source=Army%20Technology&utm_medium=website&utm_campaign=Must%20Read&utm_content=Headline
  7. JAMA Network: “Global Survey of Corneal Transplantation and Eye Banking – https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2474372
  8. Medical Device Network: “3D-printed artificial corneas could replace donor transplants” – https://www.medicaldevice-network.com/news/3d-printed-corneas/
  9. XINHUANET: “Aussie research on bioprinting mini kidney raises hope for lab-grown transplantation – http://www.xinhuanet.com/english/2020-11/24/c_139540203.htm
  10. ScienceDirect: “A Systematic Approach for Making 3D-Printed Patient-Specific Implants for Craniomaxillofacial Reconstruction” – https://www.sciencedirect.com/science/article/pii/S2095809920302794#:~:text=Patient%2Dspecific%20craniomaxillofacial%20reconstruction%20implants%20are%20made%20using%20a%20selective,quality%2Dcontrol%20procedure%20is%20needed.
  11. 3Dnatives: “Top 12 3D Printed Implants” – https://www.3dnatives.com/en/best-3d-printed-implants-230720195/#!
  12. AFROTECH: “Mashudu Tshifularo Makes History By Performing World’s First 3D-Printed Middle-Ear Transplant” – https://afrotech.com/mashudu-tshifularo-makes-history-by-performing-worlds-first-3d-printed-middle-ear-transplant
Categories
Commentary

Green Practices: Whose Responsibility Is It

By Saharsh Satheesh

Published 10:14 EST, Thur September 9th, 2021

Introduction

Modern society emphasizes the importance of conservation of resources and sustainable development, instilling these virtues from a young age for the betterment of society. However, in what ways beyond simply awareness could the movement towards conservation be encouraged? With the importance of resource conservation becoming apparent in recent years, some argue that conservation remain a suggestion, whereas others propose the government create a requirement for all citizens to conserve resources. While the involvement of the government may be futile unless large corporations begin to conserve more, the government should persist in creating rewards for citizens and discourage those who neglect new standards, all the while establishing a precedent for conservation.

Methods for Cultivating Green Practices

For example, motivating citizens by means of incentives may propel the cause of cultivating green practices. In 2003, Germany implemented a system known as pfand, an additional deposit [one pays] as part of the price of a bottle or can [that] gets reimbursed when [one returns] the container to a vendor,” which caused “recycling rates for cans [to rise to] 99% [in Germany]” (Oltermann). If citizens were left to themselves to decide where to dispose cans, perhaps only a small percentage of the population may dispose of them in an environmentally friendly manner. However, when the government takes action and creates a system where citizens themselves can benefit, which in this case is monetary compensation, they are motivated to support the cause. In addition, with the emission of greenhouse gases from cars becoming an issue, “the [Singaporean] government [began giving] a lump sum tax rebate of 40% of the price of a vehicle to Singaporeans who opt for hybrids” (Webber). Singapore’s solution to combating the emission of greenhouse gases is ingenious; citizens, for the most part, are unconcerned with whether they purchase a traditional gas vehicle or a hybrid vehicle, and with the right compensation, one may be even be seen as significantly better option than the other. Since cars are one of the most common means for transportation, by enforcing a law that saves citizens money while simultaneously upholding green principles, citizens may be compelled to contribute to the cause of conservation. Thus, when the government establishes laws and practices such that citizens can benefit from them, it becomes more appealing, and this increases the likelihood of successfully cultivating green practices.

In addition, when the government takes initiative and penalizes those who do not exercise green practices, it strengthens the cause for the adoption of environmentally friendly practices. For example, when the “Princess Cruise Lines” in 2016 “[dumped] oil-contaminated waste into the sea” and attempted to cover it up, “[they] agreed to pay $40 million”, as the waste is hazardous to marine life, reduces oxygen concentration in water, and contradicts the principles of green practices (Mervosh). The government has strict guidelines, and any deviation from that, as seen in the example with Princess Cruise Lines, is punishable by law. This ensures that companies and individuals will obey guidelines in the future, as they are aware of what consequences they may face. However, some claim that even with measures in place such as fines for pollution, large corporations will continue to disregard laws, and without the cooperation of these large corporations, it is futile to ask individuals to contribute to conservation. However, an act that directly disproves this theory is the cap-and-trade system, in which “the government first creates a ‘cap’ on the total amount of pollutants emitters may release,” which in Europe caused “emissions [to reduce] by 29% in 2018” (“Cap-and-Trade”). This cap-and-trade system also allows corporations to, as its name implies, trade their caps so that the total pollution emitted remains the same; corporations can, however, trade within themselves, so they do not exceed their maximum permitted pollution level, as exceeding so would result in heavy fines. By allowing corporations to trade their caps, the government ensures that corporations are appeased, as those who need to pollute more can simply purchase from other companies. As a result, corporations, for the most part, are not majorly impacted, and green principles are maintained. Furthermore, these actions by the government are instrumental in establishing a precedent for conservation. In a 2007 survey of residents in different countries, it was found that over 85% of residents in the United States and Japan voluntarily recycle (Rheault). The high rate of conservation-centered residents is undoubtedly the result of government actions that fostered green principles. Due to the various systems and incentives implemented, citizens were motivated to contribute to the cause of conservation. Thus, when the government interferes and creates a system where consequences are imminent for those who do not follow implemented standards, the goal of enriching green principles is achieved.

Conclusion

Although it may seem that the efforts to conserve resources and practice sustainable methods will not have a significant impact unless large corporations begin to follow those standards, if the government creates a system for citizens to benefit from conservation and devises consequences for those who break conservation laws, the creation of a society that is concerned with holding onto green principles will naturally occur, setting a precedent for future generations. With the urgency for conservation being observed in recent years, it is becoming evident that the government should be responsible for leading citizens and corporations to better manage resources. After all, these resources do not exist in infinite quantities, and in order to allow future generations to have the same rights to the resources used in the present-day, it is imperative that the government cultivates green practices.

Saharsh Satheesh, Youth Medical Journal 2021

Sources

“Cap-and-Trade.” Legal Information Institute, Legal Information Institute, May 2020, http://www.law.cornell.edu/wex/cap-and-trade.

Mervosh, Sarah. “Carnival Cruises to Pay $20 Million in Pollution and Cover-Up Case.” The New York Times, The New York Times, 4 June 2019,

http://www.nytimes.com/2019/06/04/business/carnival-cruise-pollution.html.

Oltermann, Philip. “Has Germany Hit the Jackpot of Recycling? The Jury’s Still Out.” The Guardian, Guardian News and Media, 30 Mar. 2018,

http://www.theguardian.com/world/2018/mar/30/has-germany-hit-the-jackpot-of-recycling-the-jurys-still-out.

Rheault, Magali. “In Top Polluting Nations, Efforts to Live ‘Green’ Vary.” Gallup. Gallup, Inc., 22 Apr. 2008. Web. 18 Aug. 2009

Webber, Alan M. “U.S. Could Learn a Thing or Two from Singapore.” Editorial. USA Today. USA Today, 14 Aug. 2006. Web. 17 Aug. 2009.

Categories
Commentary

River Pollution: Endocrine Disruptors, Eutrophication, and Solutions

By Saharsh Satheesh

Published 11:40 EST, Monday September 6, 2021

Introduction

River pollution and water pollution, in general, has become a major focus of the public in recent decades. In fact, just this month, a fire broke out in the Gulf of Mexico following a gas leak. These events can be environmentally destructive, and as a result, it is imperative that we find solutions to these catastrophic events. 

Potomac River

The Potomac River has recently come under scrutiny for the increasing levels of pollution in it. About a decade ago, the river earned a D grade, a poor score that suggested high pollution levels. Over the last decade, my advancements have been made to decrease pollution and spread awareness so that the situation does not worsen to such an extreme again.

One cause of this pollution is the fact that PCBs do not break down easily, and as a result, PCBs, which have not been manufactured since 1979, still pollute the Potomac and other rivers. Polluted urban runoff is another major issue for the Potomac. A proposed solution for this was to set limits for the quantity of pollution in the river, which would reduce the amounts of sediment, nitrogen, and phosphorus deposited into the river. There are many consequences of these pollutants entering the water including overstimulation of aquatic plants, eutrophication, and reduced water flow, among a plethora of others. There have also been findings of alteration of animal hormones due to these excess pollutants. Specifically, this is caused by endocrine-disrupting chemicals. Furthermore, when there is high rainfall, sewage pipes overflow and this causes bacteria to enter the river, such as E. Coli.

Economic services that occurred on the Potomac, such as kayaking and boat tours, may reduce the increasing pollution out of the understandable fear of pollution’s harmful effects on humans. Ecological services on the Potomac attempt to spread awareness about these issues, such as Outward Bound, which educates middle schoolers on various things including service projects and river ecology. 

Many solutions have been proposed and/or implemented to combat pollution. One is to plant streamside trees. These trees will be able to capture the polluted runoff. Another solution is to reduce the maximum amount of allowed urban and farm runoff to reduce the total amount of pollutants entering the Potomac.

Through all these efforts, in 2018, Potomac’s grade was increased up to a B. Unfortunately, however, it dropped to a B- in 2020. That being said, Greater awareness and efforts will aid in the journey towards increasing the Potomac’s grade. 

Cuyahoga River

On a summer day in 1969, a train blazed through tracks near the Cuyahoga River. As the train sped along the tracks, a few sparks from the contact between the train and track flew into the Cuyahoga River. Within minutes, the river caught on fire, although it was extinguished within the next hour. However, this brought numerous questions and concerns: why did the river catch on fire, how severe was the damage, and how can this be avoided in the future?

When the fire occurred, it was not initially a cause for concern in the community. According to National Geographic, “When fire broke out on the river again in 1969, it seemed like business as usual. ‘Most Clevelanders seemed not to care a great deal,’ write environmental historians David Stradling and Richard Stradling. ‘Far too many problems plagued the city for residents to get hung up on a little fire…The ’69 fire didn’t represent the culmination of an abusive relationship between a city and its environment. It was simply another sad chapter in the long story of a terribly polluted river.’”

However, the situation was brought to the interest of the public again following the publishing of Rachel Carson’s iconic book “Silent Spring,” which highlighted the importance of environmental conservation and exemplified the drawbacks of DDTs. 

With this renewed interest in the fire, it was discovered that the cause of the fire was largely due to the pollution accumulating in the river in the decades prior to the fire. The dumping of oils and other flammable materials was at such an extreme degree that the spark from the train was able to set the river on fire. Undoubtedly, this fire was very detrimental to the organisms living in the river. That being said, there were very thorough efforts to rectify the damage done and to prevent this in the future.

According to the New York Times, “The cleanup of the river advanced on many fronts. A year before the fire, Cleveland residents voted to tax themselves an additional $100 million for river restoration. Since then, local industries and the Northwest Ohio Regional Sewer District have spent $3.5 billion to reduce sewage and industrial waste pollution, Mr. White said.”

Through these efforts, the Cuyahoga River is in the process of healing. Pollution levels have significantly decreased since the fire of 1969. These efforts have increased awareness for river pollution worldwide, and hopefully, no river reaches pollution levels of such an extreme degree again.

Saharsh Satheesh, Youth Medical Journal, 2021

References

“2020 Potomac River Report Card.” 2020 Potomac River Report Card | #Potomacreportcard, http://www.potomacreportcard.org/.

“2020 Potomac River Report Card.” Potomac Conservancy, potomacreportcard.org/pollution/.

Blakemore, Erin. “The Shocking River Fire That Fueled the Creation of the EPA.” History.com, A&E Television Networks, 22 Apr. 2019, http://www.history.com/news/epa-earth-day-cleveland-cuyahoga-river-fire-clean-water-act. 

Board, Editorial. “Opinion | The Potomac River Is Getting Cleaner. Now’s Not the Time to Take Away Funding.” The Washington Post, WP Company, 30 Mar. 2018, http://www.washingtonpost.com/opinions/the-potomac-river-is-getting-cleaner-nows-not-the-time-to-take-away-funding/2018/03/30/40ad4194-338d-11e8-94fa-32d48460b955_story.html.

Cooper, Rachel. “Things to Know About Washington DC’s Potomac River.” TripSavvy, http://www.tripsavvy.com/washington-dc-potomac-river-waterfront-1038693.

“CUYAHOGA RIVER FIRE: Encyclopedia of Cleveland History: Case Western Reserve University.” Encyclopedia of Cleveland History | Case Western Reserve University, 14 Jan. 2020, case.edu/ech/articles/c/cuyahoga-river-fire#:~:text=The%20blaze%20apparently%20was%20caused,hill%2C%20SE%2C%20in%20Cleveland. 

Lugbill, Stephanie. “Ask the Expert: Is It Safe to Swim in the Potomac?” Potomac Conservancy, Potomac Conservancy, 6 Aug. 2018, potomac.org/blog/2018/6/19/potomac-river-swimmings-laws-regulations-washington-dc.

​​Maag, Christopher. “From the Ashes of ’69, a River Reborn.” The New York Times, The New York Times, 21 June 2009, http://www.nytimes.com/2009/06/21/us/21river.html. 

Nitrogen and Water, http://www.usgs.gov/special-topic/water-science-school/science/nitrogen-and-water?qt-science_center_objects=0.

“Potomac River Canoeing: Environmental Service Leaders.” 8-Day Canoeing Environmental Leadership Program | Outward Bound, http://www.outwardbound.org/course/potomac-river-canoeing-environmental-service-leaders/654/.

Written by Jane Recker | Published on October 29, 2020. “For the First Time in a Decade, the Potomac River’s Health Is in Decline: Washingtonian (DC).” Washingtonian, 29 Oct. 2020, http://www.washingtonian.com/2020/10/29/for-the-first-time-in-a-decade-the-potomac-rivers-health-is-in-decline/.

Categories
Commentary COVID-19 Health and Disease

The Exoticization of Epidemics

By Rhea Argwal

Published 1:30 EST, Tue August 24, 2021

Abstract: 

During an epidemic, scientists tend to search for sources of the outbreak. If the outbreak has foreign origins, scientists often enlist the help of anthropologists to study local practices and customs since cultural awareness is necessary for any public health campaign or outbreak control. However, the role of anthropologists seems to extend further than that. Anthropologists identify ‘risky behaviours’ present within a society which may escalate an outbreak. Yet, these ‘risky behaviours’ always tend to be rooted in cultural contexts. Scholars tend to ignore socioeconomic factors, such as overcrowding, poverty, etc., which may have a greater hand to play in the proliferation of a disease through a population. This instinctive ignorance lets slip the presence of racism and Eurocentric bias in the subconscious beings of scientists and researchers. 

Ebola and Africa [1980s]

The Ebola Virus Disease (EVD), a rare and fatal disease, was first discovered in 1976 in the Democratic Republic of Congo (DRC) (Centers for Disease Control and Prevention , 2021). After an incident on a shipping boat in 1989, Western media’s interest in the virus erupted. Due to its foreign origins, media and Western society linked the source of the outbreak to practices in African culture (Jones, 2011). 

The Ebola virus is a zoonotic disease meaning that the virus had been transferred from animals — specifically nonhuman primates (monkeys, gorillas, and chimpanzees) — to people. Thus, enlightened with this information, scholars proposed the Bushmeat Hypothesis: “hunting, slaughtering, and eating infected gorilla or monkey meat is the primary cause of the virus’s entrance to a new population (Jones, 2011).

This argument became one of the dominant explanations of the Ebola outbreaks as it provided a correlation between cultural practice and a viral outbreak. However, doing so overshadowed other arguments which may have been greater factors at play; factors such as overcrowding, poor sanitation, and inadequate provision of healthcare, exacerbated by a legacy of colonialism were responsible for much of Ebola’s spread. However, cultural factors were emphasised more than sociopolitical and economic factors. Africans were presumed to have beliefs rooted in witchcraft and superstitions which may have hindered efforts by doctors and scientists to control the outbreak (Jones, 2011). Disputing this notion was a Harvard professor and a medical anthropologist, Paul Farmer, who was at the forefront of the Ebola epidemic control. The failure to control the outbreak did not occur due to local customs and traditions but rather due to distrust in the healthcare system and the government. 

People fled the medical system, not because of superstitions, but mostly when the medical system was unable to rescue or treat its patients as constituted.”

(Paul Farmer in an interview with Ashish Jha on Lessons from Ebola)

Due to the lack of adequate hospital infrastructure, doctors had implemented a disease control paradigm that concentrated its efforts on isolating suspected cases and confirmed cases without providing actual care (unlike the current COVID-19 care centres). This approach was rendered ineffective. Distrust in the healthcare system further grew and people started turning to traditional healing systems as a desperate resort. 

The erroneous depictions of the Western media and the presumptions of Western society of the Ebola outbreak reveal the lingering presence of racism in our society and the remnants of colonialism. Additionally, it affirms the presence of bias in biomedical research.

AIDS as a Haitian Disease [the 1980s]

It is the 1980s. Haiti, a Caribbean country, has been receiving widespread publicity as the possible birthplace for AIDS. Acquired Immunodeficiency Virus (AIDS) is a chronic and fatal condition caused by the human immunodeficiency virus (HIV); HIV is a sexually transmitted infection (STI) that weakens one’s immune system. A severely damaged immune system progresses into AIDS as it is unable to protect the body from infections or cancers that a person with a healthy immune system wouldn’t normally acquire (Mayo Clinic, 2020). Upon the emergence of an AIDS epidemic, scientists begin investigating the sources of the outbreak. In an eruption of imagination, Western society and media speculated that voodoo rites, sacrificial practices, the eating of cats, and ritualized homosexuality, were the causes of the epidemic – “a rich panoply of exotica” (Farmer & Kim, Anthropology, Accountability, and the Prevention of AIDS, 1991). The speculations gave rise to stereotypes that were enforced time and time again by the U.S. press. Also notable was the media representation of Haitian-Americans: black, poor, immigrants, and associated with cult-like religious practices. As media sensationalized and misrepresented the Haitian-American community, incidents of harassment began to propagate. People of Haitian origin bore the stigma of a fatal condition. The statement of one Haitian-American physician mirrors this sentiment: 

“After all the wild theories of voodoo rites and genetic predisposition were aired and dispelled, and the slip-shod scientific investigation was brought to light, the public perception of the problem remained the same that if Haitians have AIDS, it is very simple because they are Haitians (Farmer & Kim, Anthropology, Accountability, and the Prevention of AIDS, 1991).”

However, none of the speculations and gossip surrounding the epidemic had any epidemiological research to back them up.  As a matter of fact, declarations of plausible theories of the sources of the outbreak by scientific researchers had slowly begun unravelling the lies illustrated by the press. On December 1, 1982, the following statement was made: 

“Homosexuals in New York take vacations in Haiti, and we suspect that this may be an epidemic Haitian virus that was brought back to the homosexual population in the United States.” 

(Dr. Bruce Chabner of the National Cancer Institute, 1982) 

At the 1988 conferences of the American Anthropological Association, researchers congregated to discuss “Ethical Considerations in Anthropological Research.” The focal point of the meetings was the failure to lighten the burden of stigma on the Haitian-American community, aggravated by the spread of misinformation. Further addressed was the economic damage of Haitian businesses, which were boycotted by tourists and investors, and the rise in unemployment within the Haitian-American community. Nevertheless, in February 1990, the Food and Drug Administration (FDA) ruled that no person of Haitian origin will be allowed to donate blood (Farmer & Kim, Anthropology, Accountability, and the Prevention of AIDS, 1991). The incessant discrimination against the community, not only resulted in economic damage but also a decline in the mental and emotional health of members of the ethnicity. All this, due to the deep-rooted racism in a system that embraced popular societal opinion rather than verified scientific research. 

SARS – CoV – 2 (COVID-19) Pandemic [2020]: Hate Crimes Against South East Asians

SARS-CoV-2, colloquially known as COVID-19, originated in Wuhan, the capital city of the Hubei province, China. The virus evidently has zoonotic origins (similarly to Ebola) with genetic similarities to bat genomes. The COVID-19 virus first caused a viral outbreak in the Hubei province region, soon spread to surrounding provinces and all over China. In China, it has declared an epidemic. Subsequently, the virus infiltrated borders and crossed seas through international travel and infected millions of people; On March 11, 2020, the World Health Organization (WHO) had declared the COVID-19 viral outbreak, a pandemic (World Health Organization, 2020). 

Proclaimed as a zoonotic disease, researchers began investigating the source of the animal-to-human transfer and traced it back to the Wuhan Southern China Seafood Market where wild animals were being sold. The bushmeat theory, first proposed during the Ebola outbreak, found new ground almost 40 years later in the SARS-CoV-2 epidemic. However, the magnitude of this viral outbreak significantly surpassed the Ebola epidemic; millions, if not billions, of lives, have been affected around the world; trillions of dollars are being spent on reviving an economy that has seen its deepest slump since the Great Depression. Now, at a very vulnerable state, with dear lives lost, people need someone to take blame and responsibility. Hate incidents and crimes against the Chinese and Asian communities increased. The pandemic had given rise to stigma and discrimination. News media picked up on this sentiment and began referring to the SARS-CoV-2 virus as the “Chinese virus,” or the “Wuhan virus.” Associations of such may have provoked people to detest a community that was struggling with an outbreak, too (Xu, et al., 2021). 

“Pandemics do not materialise in isolation. They are part and parcel of capitalism and colonisation. The countries that struggled to contain and control major epidemics in the recent past, from Haiti to Sierra, had deficient public health systems prior to these crises, partially as a result of their colonial histories. Moreover, products of capitalism – from war to migration to mass production and increased travel – contribute massively to the proliferation of diseases.”

(Edna Bonhomme, Postdoctoral Fellow at the Max Planck Institute for the History of Science in Berlin, on the topic of COVID-19 and Inequality (Bonhomme, 2020))

In the three occurrences discussed above, there seems to also be three recurrent themes. Firstly, the sudden media interest in the three cases amplified the racialization of these epidemics. Arguably, the media played the biggest role in the dramatization of the epidemic’s events. Unexpectedly, scholars often also shared the view proposed by the popular press. The prejudices and biases present in these scholars subconsciously affected their judgements in an epidemic control centre or a research centre, thus adversely influencing the healthcare quality available in these countries. Additionally, in the media frenzy, the western way of living was enforced as the norm, painting foreign cultures as exotic. This is where the remnants of colonialism become apparent once again. Lastly, through analysis of media reports and scholarly articles or journals, one can understand that some researchers subliminally undermine indigenous knowledge and accept biomedical research as the divine truth. 

Media Manipulation: Sensationalism 

Western media portrayals in each of the three case studies seem to have subconsciously depicted Western ways of living as norms by contrasting them with the ways of living of other ethnic communities. This juxtaposition depicts the complex and vibrant cultures of various ethnic groups around the world as simply exotic. Exotic, meaning interesting, different, and ‘other’. The exoticization of an ethnic community and its practices alienates its members, thus leaving them more susceptible to racial discrimination. This dramatization is not only demeaning for an ethnic community but also an exploitation of the credibility the masses of people associate with news media reporting. 

Systematic Racism, Stigma, & Discrimination

The existence of systematic racism, ingrained within institutions — in the laws, policies, and decisions — are mainly what hinders the provision of healthcare in epidemic control centres; it is what distorts epidemiological research. The erroneous conclusions of such scientific and anthropological research attribute the causes of an epidemic to local practices, traditions, and customs of an ethnic community while hardly considering sociopolitical or economic factors. This, in addition to media sensationalism, places a degrading spotlight on a community that may be suffering as well. Stemming from such situations is stigma and racial discrimination. At a moment when people are at their most vulnerable state, systematic racism and media sensationalism give rise to hate crimes as currently seen occurring against the South East Asian community due to the COVID-19 pandemic. 

Worth Found in Indigenous Knowledge 

When planning epidemic centre controls in different countries, scientists and anthropologists often study the local practices, customs, and traditions — indigenous knowledge. However, the lens with which this body of knowledge is viewed indicates that scholars believe indigenous knowledge serves to hinder the provision of healthcare rather than aid its use. Subliminally, all scholars undermine indigenous knowledge and regard it as ‘backwards’. Associated with many of these communities is a cumulative body of knowledge and know-how honed through years of observations, experiments, and reflections. Although these practices have been developed through years of observations, it is not possible to ascertain their reliability or accuracy since they have not been assessed by the wider intellectual community as of now due to there being notions that indigenous knowledge is retrogressive and anti-development. If we aspire to put in the effort to inspect the accuracy of indigenous knowledge, we may be able to verify that the majority of their claims may be accurate and, in fact, useful in developing future theories or innovations, instead of labelling them as regressive. 

Conclusion

In conclusion, the notion that any ethnic community’s customs or traditions hamper epidemic control efforts should be challenged. Publishing unverified scientific information that may be linking the source and spread of an outbreak to an ethnic community can prove to be very degrading and even detrimental for members of a community, leaving them predisposed to scorn and resentment. Although our world has come a long way from its colonizing history, the legacy and remnants of it can still be seen today in the form of the exoticization of ethnic practices through systematic racism. 

Rhea Agarwal, Youth Medical Journal, 2021 

Bibliography

Altman , L. (1983). The New York Times Archives Newspaper July 31, 1983, Section 1, Page 1 . DEBATE GROWS ON U.S. LISTING OF HAITIANS IN AIDS CATEGORY. https://www.nytimes.com/1983/07/31/us/debate-grows-on-us-listing-of-haitians-in-aids-category.html. 

Bonhomme, E. (2020, May 18). COVID-19 and Inequality: The Racialization of Pandemics. (t. G. (GRIP), Interviewer)

Centres for Disease Control and Prevention. (2018). Hospital with Ebola Patients (Drc, 1976). https://www.dw.com/en/ebola-outbreak-who-puts-10-countries-on-high-alert/a-43746378. https://www.dw.com/en/ebola-outbreak-who-puts-10-countries-on-high-alert/a-43746378. 

Centres for Disease Control and Prevention. (2021). History of Ebola Virus Disease. Retrieved June 27, 2021, from https://www.cdc.gov/vhf/ebola/history/summaries.html

Economic Development Department. (2020). Systematic Racism. Cabinet Secretary Keyes on Systemic Racism & the Role of Businesses. https://gonm.biz/stories/cabinet-secretary-keyes-on-systemic-racism-the-role-of-businesses. 

Elkins, R. (2017). Protests Against FDA Ban on Blood Donations from Haitians and people of Sub-Saharan African origin, 1990. Trump Reopens an Old Wound for Haitians. https://www.newyorker.com/news/news-desk/trump-reopens-an-old-wound-for-haitians. 

Jones, J. (2011). Ebola, Emerging: The Limitations of Culturalist Discourses in Epidemiology. The Journal of Global Health.

Farmer, P. (2010). The Exotic and the Mundane: Human Immunodeficiency Virus in Haiti (1990). In P. Farmer, Partner to the Poor . California : University of California Press .

Farmer, P., & Kim, J. Y. (1991). Anthropology, Accountability, and the Prevention of AIDS. The Journal of Sex Research Vol. 28, No. 2, Anthropology, Sexuality and AIDS .

Mayo Clinic. (2020). HIV/AIDS. Retrieved June 29, 2020, from https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

Scotti , E. (2014). Ebola Investigation Team in Drc, 1976. The Original Ebola Hunter. https://www.thedailybeast.com/the-original-ebola-hunter. 

Unknown , U. (2021). Stop Asian Hate . Amid Rise in Anti-Asian Attacks, Advocates Call For Black and Asian Solidarity. https://www.ny1.com/nyc/all-boroughs/news/2021/03/18/amid-rise-in-anti-asian-attacks–advocates-call-for-black-and-asian-solidarity-. 

World Health Organization . (2020). Coronavirus Disease 2019 (COVID-19) . Retrieved June 29, 2021, from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200423-sitrep-94-covid-19.pdf?sfvrsn=b8304bf0_4#:~:text=All%20available%20evidence%20for%20COVID,be%20handled%20by%20humans.

Xu, J., Sun, G., Cao, W., Fan, W., Zhihao Pan, Z. Y., & Li, H. (2021). Stigma, Discrimination, and Hate Crimes in Chinese-Speaking World amid Covid-19 Pandemic. Asian Journal of Criminology, 16(1 ), 51-74.

Categories
Commentary

What Makes a Good Doctor? The Balancing Act Between IQ and EQ

Introduction

Many would argue that medicine is a prestigious career. A doctor is expected to treat, improve and save patient lives. But does this cookie-cutter definition really describe a “good” doctor? 

There is no doubt that the medical profession is not for the faint-hearted. So, what sets apart this profession, and what differentiates the ‘good’ doctor from the “bad”? In this essay, I am hoping to explore this rather complex, intriguing question and analyze whether this perceived notion of a doctor, in reality, is ‘good’.

Medicine is an intellectually demanding career. After years of hard work at medical school, doctors are expected to apply their skills to patients with conditions of varying complexities. A doctor at times may not have a clear and immediate solution as exemplified by Covid-19. 

The key here is the problem-solving aptitude, ability to cope with difficult & demanding situations by being resilient and empathetic to patient wellbeing. The Intelligence Quotient (IQ) that measures academic or cognitive intelligence may be too narrow to cover all the skills required, individuals with a high Emotional Quotient (EQ) may achieve higher success. EQ refers to the person’s ability to perceive, control, evaluate, and express emotions.1 Evidence is emerging that EQ is as important for patient outcomes as it is for business and relationship success.2 

Therefore, the perfect concoction of qualities of a good doctor is formulated by IQ and EQ – the Intelligence and Emotional Quotients. 

So how does EQ contribute? 

Emotional intelligence can best be described as the ability to monitor one’s own and other people’s emotions, to discriminate between different emotions and label them appropriately, and to use emotional information to guide thinking and behaviour.3 

In fact, in the UK much of this is evaluated as early as the application to medical school. Physicians work in both emotionally demanding and highly complex environments. A Loyola Medicine study4 demonstrates that an educational curriculum for physicians in training improves their emotional intelligence, which may help protect against burnout.

Key competencies of a good doctor: 

Communication and Social Skills 

Doctors need to first communicate to understand their patient’s issues and then effectively explain the diagnosis, using clear, simple language emptied of medical jargon. Physicians with high EQ have the ability to recognize, relate and influence a patient’s emotions to make them feel empowered and hopeful. 

Relationships and Caring 

It’s important to not view patients as a list of medical problems but as opportunities to build confidence and trust between patient and doctor. When patients are cared for and listened to, they are more likely to comply with medical recommendations and return for follow-up visits, leading to strong relationships and positive interactions with clinicians and health care administrators. 

Self-Awareness and Self-Regulation 

EQ can help prevent emotions affecting clinical decisions. This self-awareness can be critical in ensuring each patient is treated with respect & dignity and is provided the highest quality care, thereby covering two of the six core NHS values.5 

Leadership and Teamwork – To be a physician is to lead6

In addition to clinical responsibilities, physicians serve as leaders and advocates and medicine involves leadership responsibilities at various levels i.e. individual, community, and societal levels. 

EQ accounts for 67% of the abilities needed for leaders and mattered twice as much as IQ. 7 Besides leadership, teamwork is essential for best patient outcomes and high EQ individuals create better connected and motivated teams. A lack of EQ, a source of failure as a leader, results in being overly defensive, resolving conflict poorly, and not connecting well with your team.8 

Despite the unfocused attention towards leadership, it can make an important difference in better clinical outcomes, experiences, increased empathy, and financial sustainability; not only this, but it also affects physician well-being. EQ and higher levels of leadership can help make physicians more resilient to the stresses of professional burnout and result in greater professional satisfaction. Overall, higher EQ increases both influence and change and helps physicians become the type of leader that others want to follow.

Conclusion: What is important – EQ or IQ? 

Let us picture it: High IQ but can’t get along with others? Or high EQ but unable to make the correct diagnosis? Without the other, achieving success would be a huge struggle. 

Instead of focusing on one aspect of intelligence, the greatest benefit may lie in learning to improve the less dominant one.

A successful doctor cannot have one but not the other. Instead of focusing on one aspect of intelligence, the greatest benefit will come from striving to learn the one lacking. 

Doctors with EQ besides IQ demonstrate greater influence, deliver positive results and create leaders. In the future, new technologies based on Artificial Intelligence and surgical robots will enhance technical expertise, but not the ability to emulate emotions, making EQ more valuable than ever. 

EQ can also be enhanced9 and IQ can be increased10, so what does this mean? 

Multiple aspects of intelligence are all essential to the growth in the field of medicine. The perfect balance of the qualities which lie in both is what makes not only ‘good’, but a ‘great’ doctor. 

Asmita Anand, Youth Medical Journal 2021

References

1https://www.verywellmind.com/what-is-emotional-intelligence-2795423
2https://www.cognitiveinstitute.org/get-smart-about-emotional-intelligence/
3https://www.oxfordreference.com/view/10.1093/oi/authority.20110803095749954
4https://www.dovepress.com/promoting-wellness-and-stress-management-in-residents-through-emotiona-pe
er-reviewed-article-AMEP

5https://www.hee.nhs.uk/about/our-values/nhs-constitutional-values-hub-0
6https://hbr.org/2018/10/why-doctors-need-leadership-training
7Goleman, D. (1998). Working With Emotional Intelligence. New York, NY. Bantum Books
8https://leanforward.hms.harvard.edu/2019/06/13/emotional-intelligence-for-physician-leaders/

9https://greatergood.berkeley.edu/article/item/can_emotional_intelligence_be_taught
10https://www.psychologytoday.com/gb/blog/iq-boot-camp/201605/newevidence-iq-can-be-increased-brain-training

Categories
Commentary

An Analysis of the Impact of Alcohol on Mental Health in “Streetcar Named Desire”

Text below taken from Streetcar Named Desire by Tennessee Williams, 1986:

BLANCHE:

Mitch!–just a minute.

[She rushes about frantically, hiding the bottle in a closet, crouching at the mirror, and dabbing her face with cologne and powder. She is so excited that her breath is audible as she dashes about. At last, she rushes to the door in the kitchen and lets him in.]

Mitch!–Y’know, I really shouldn’t let you in after the treatment I have received from you this evening! So utterly un cavalier! But hello, beautiful!

[She offers him her lips. He ignores it and pushes past her into the flat. She looks fearfully after him as he stalks into the bedroom.]

My, my, what a cold shoulder! And such uncouth apparel! Why you haven’t even shaved! The unforgivable insult to a lady! But I forgive you. I forgive you because it’s such a relief to see you. You’ve stopped that polka tune that I had caught in my head. Have you ever had anything caught in your head? No, of course, you haven’t, you dumb angel-puss, you’d never get anything awful caught in your head!

[He stares at her while she follows him while she talks. It is obvious that he has had a few drinks on the way over.]

MITCH:

Do we have to have that fan on?

BLANCHE:

No!

MITCH:

I don’t like fans.

BLANCHE:

Then let’s turn it off, honey. I’m not partial to them!

[She presses the switch and the fan nods slowly off. She clears her throat uneasily as Mitch plumps himself down on the bed in the bedroom and lights a cigarette.] I don’t know what there is to drink. I–haven’t investigated.

MITCH:

I don’t want Stan’s liquor.

BLANCHE:

It isn’t Stan’s. Everything here isn’t Stan’s. Some things on the premises are actually mine! How is your mother? Isn’t your mother well?

MITCH:

Why?

BLANCHE:

Something’s the matter tonight but never mind. I won’t cross-examine the witness. I’ll just–[She touches her forehead vaguely. The polka tune starts up again.]–pretend I don’t notice anything different about you! That–music again…

MITCH:

What music?

BLANCHE:

The “Varaouviana”! The polka tune they were playing when Allan–Wait!

[A distant revolver shot is heard. Blanche seems relieved.] There now, the shot! It always stops after that.

[The polka music dies out again.]

Yes, now it’s stopped.

MITCH:

Are you boxed out of your mind?

BLANCHE:

I’ll go and see what I can find in the way of–[She crosses into the closet, pretending to search for the bottle.]

Oh, by the way, excuse me for not being dressed. But I’d practically given you up! Had you forgotten your invitation to supper?

MITCH:

I wasn’t going to see you anymore.

BLANCHE:

Wait a minute. I can’t hear what you’re saying and you talk so little that when you do say something, I don’t want to miss a single syllable of it… What am I looking around here for? Oh, yes–liquor! We’ve had so much excitement around here this evening that I am boxed out of my mind!

[She pretends suddenly to find the bottle. He draws his foot up on the bed and stares at her contemptuous]

Analysis

The impact of alcohol on mental health is a prevalent global issue throughout the world. It is also seen through many literary texts. For instance, this issue is explored in the play “Streetcar named desire” and mentions of such issues are deeply layered to discover and inspect the human mind. This is seen throughout this dialogue and that Blanche is on the influence of the drug, and as a result her physiological and mental state are deterred, which is coupled with Mitch’s rejection of her love. Tennessee Williams effectively portrays this through various literary devices such as juxtaposition and employing music to develop Blanche’s mental deterioration and her dependence on alcohol. For example, in the first dialogue, William utilizes the polka music to demonstrate Blanche’s instability and the resulting halt of the music coupled with Mitch’s entrance showcases the emotional connection and affection that Blanche has for Mitch, and it further illustrates that Mitch’s company is the only way for Blanche to escape her guilt from her husband’s death; however, her attempt later falters as her facade, symbolized by the makeup, crumples as Mitch realizes about her past. Thus, this action parallels Blanche’s failure to kiss Mitch and capture his love which also juxtaposes Mitch’s contemplation to kiss her in scene 6. This rejection comes as a shock to Blanche because she is not used to being rejected to be intimate with men. This is revealed in scene 9 where she confirms the fact that she uses sexual encounters with random strangers to fill up the hole in her heart after the fact that her husband had died. This superficial attempt, subsequently, resulted in Blanche’s dependence on alcohol and her ensuing guilt for her husband’s death to fill the gaping hole. Her tolerance for alcohol is shown as she appears on one side to be agitated but then also reverses to being welcoming and giddy. She then becomes delusional and lies about where her drink is like in Scene 1 to her sister Stella and then pretends to worry about Mitch’s mother. Her instability comes to a boiling point and hence the polka music resumes again and even Mitch couldn’t stop this repetitive music that seems to inevitably drive Blanche to insanity. This shift results in Blanche to become reliant on alcohol and risking her mental sanity to solve her problems and cope with the foreboding music that alludes to the guilt of her husband’s death.

Frank Liu, Youth Medical Journal 2020

References

Reis, Kurt, and Tennessee Williams. A StreetCar Named Desire. 1986.