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You’re Entering a World of Lebowski

“A cult gives its members license to feel superior to the rest of the universe, and so does a cult movie: it confers hipness on those who grok what the mainstream audience can’t. Joel and Ethan Coen’s 1998 hyperintellectual stoner noir bowling comedy The Big Lebowski, starring Jeff Bridges as Jeff (The Dude) Lebowski, has the requisite exclusivity of a cult classic: it bombed at the box office; it was met with shrugs by many critics who had arguably overpraised the Coen brothers’ Academy Award-winning Fargo (1996); and it has amassed an obsessive following on cable and video and by word of mouth. Nowadays, quoting its intricate, absurdist, often riotously profane dialogue earns you coolness points in widely disparate circles. Some would even say that the cult of The Big Lebowski is going mainstream.” (New York Times)
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Optimistic mothers have boys, study says

“Women who believe they are going to live for a long time are more likely to give birth to sons than less optimistic women, a new study suggests.

Researchers reached the strange conclusion after completing a survey of British women who had recently become mothers. They found that for every extra year a woman thought she was going to live, the odds of her firstborn being a boy increasedsignificantly.” (Guardian.UK)

It has previously been known that the male:female birth ratio increases under favorable conditions, where a population is well-nourished and without adversity, while the balance tips toward females under harsher conditions. This will be to the advantage of the survival of the population as a whole, maximizing procreative chances under stressful conditions. Having less boys than girls when one does not rate one’s chances of a long life would seem to be the psychological equivalent, or parallel, to this.

Evolutionary biologists call this the Trivers-Willard hypothesis. It suggests that when a mother feels under pressure, from anything ranging from poor health and living conditions to scarce food, it makes biological sense for her to give birth to a girl rather than a boy.

“Having females is a safe investment, in that their reproductive success is consistent,” Dr Johns said. “Boys are more risky. They are more likely to die young, and if they don’t, they have to compete for females. They could potentially provide you with lots of grandchildren, but unless you can invest in them, you run the risk of having a ‘dud’ that doesn’t produce any at all.”

But if you want to conceive a girl, should you go around meditating on a short lifespan? While there have been some studies showing that the X-chromosome-containing sperm which will give rise to a female when they fertilize an ovum are hardier than y-containing sperm, it is not as if your outlook influences which type of sperm has the swimming advantage or anything like that. It is more likely that stress levels act through producing subtle shifts in the hormonal context of the conception and gestation.

On the other hand, in the current study, it may not be that believing you will live longer produces more male offspring at all. Couldn’t it just as well be that having given birth to a boy somehow influences you in the direction of a longer estimated lifespan? In a male-centric society, moght not one unconsciously assess one’s chances of being well taken care of in old age as better if one has a son?

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R.I.P. Gretchen Worden

Museum Director Dies at 56. (New York Times) Everybody has heard of “that museum in Philadelphia where they keep the foetuses in bottles.” The Mutter Museum is, of course, more than that, and its guiding genius for decades has been Gretchen Worden. Working at the Mutter had been virtually her only job; she transformed the place into one where professionals, hoping the museum’s collection of human anomalies would inform their understanding of normal human developmental processes and anatomy, and the lay public who came to be amazed or even ‘grossed out’ could mingle in comfort and wonder. In the process, annual attendance went from several hundred to 60,000. Listen to her passionate exposition of her fascinating work in this interview with Terry Gross from a 2002 Fresh Air.

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Impervious Shield Elusive Against Drive-By Terrorists

“The United States has spent more than $1 billion on these and other efforts to stop a single threat: the explosion of a car or truck bomb at a government installation or other structure. But 11 years after Muslim extremists used an explosives-laden van to attack the World Trade Center and nearly three years after the Sept. 11, 2001, terrorist attacks, even senior federal agents acknowledge that the country has virtually no defense against a terrorist barreling down the street with a truck bomb.” (Washington Post)
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R.I.P. Philip Holzman

Authority on Schizophrenia Dies (New York Times. ) I seem to be noting more obituaries of my teachers and mentors here these days. Before he joined the Harvard faculty, I had the privilege of taking a course on psychopathology he offered to Harvard undergraduates as a visiting lecturer. This was the first touchstone of my lifelong fascination with schizophrenic thought processes. His best-known findings and most persistent research obsession, the eye-tracking disorder in schizophrenics, have not turned out to be particularly useful to those of us who treat patients with schizophrenia, nor have they gone very far in elucidating the central pathology of the disorder. But finding an easily testing abnormality that also occurred in the genetic relatives of schizophrenics did more to establish the important notion that there was a ‘schizophrenic spectrum’ from the full-blown disease to those in the family who had a watered-down dose of the genetic substrate of the disorder. Holzman’s other findings about schizophrenic language and memory have been more telling for me, in shaping my understanding of the schizophrenic ‘thought disorder’ in a way which informs a therapeutic approach. He also bravely charted the path I believe most Freudian psychoanalysts had to take, if they were interested in treating more disturbed patients with schizophrenia and other psychotic processes, to bridge the gap between psychology and pathophysiology.

In other schizophrenia-related obituaries, I was saddened to learn that the Schizophrenia Bulletin is phasing itself out. This quarterly journal published by the NIMH since 1969 (ironically, Dr. Holzman was on its advisory board) is unique in combining state-of-the-art review articles on aspects of schizophrenia research and treatment with, in every issue, cover art by a patient with the illness and a first-person account by a person with schizophrenia of the challenges of living with or overcoming aspects of the illness.

The statement from the director of the NIMH explaining the decision to phase out the Bulletin explains that “in this rapidly changing scientific environment it is time to develop communication mechanisms that are equally rapid.” I find this puzzling insofar as the Bulletin is not a vehicle for the latest peer-reviewed and time-sensitive research findings but rather more comprehensive theme-based reviews. Furthermore, it is a conceit to believe one needs to get even the latest research findings as quickly as possible, as opposed to labsorbing them as thoroughly as possible. I do not think it is merely reactionary nostalgia for the way I learned to approach the practice of medicine to lament the obsolescence of the medical journal as a vehicle for medical communication, which is what the authors of this move seems to suggest. When a journal arrives at my doorstep monthly or quarterly, it is a concrete invitation to sit down and get up to date in a way that might not happen with disembodied articles floating out there in the ether. Furthermore, when I read the articles of interest in a journal, I cannot avoid stumbling upon others I would not have suspected would be of interest. This too does not happen as readdily when I read an electronic article. Sad state of affairs…

But then again, readers of FmH will recognize that I have long ranted about the scientific illiteracy of many of my colleagues, so perhaps the medical journal has been obsolete for some time already. Granted, even as a resident I already had a reputation, for which I was both admired and assailed, for keeping up with the literature. I have always distributed articles of significance to my colleagues and students, covertly expecting them to read as well. But most doctors consider themselves “too busy” to keep up with the journals unless they are academics. Unfortunately, that leaves them practicing (in a field where the half-life of knowledge is around — what? — ten years or less) as they did the last time they were up-to-date, which was when they were in their residencies; or updating their knowledge base only by word-of-mouth or with the information provided by the pharmaceutical representatives who visit them. At least in my state, the requirement that a doctor have gotten a certain number of continuing medical education credits in order to renew her/his license is enforced only by the honor system; if you answer “yes” on the renewal application, they believe you. (And if you believe that most doctors who attend medical conferences are there to listen to the lectures, I’ve got a bridge to sell you.)

And let’s not confine this lament merely to the challenge of “keeping up.” How about “getting started”? In my own specialty of psychatry, what proportion of graduating psychiatric residents these days have ever even read any Freud, do you suppose? My guess — less than 10%. (You might argue the irrelevancy of Freudian thinking to modern psychiatric approaches, and I would essentially agree with you; but might not one wish to know one’s lineage, explore the seminal roots of the mysterious field one is in, and reach such a conclusion oneself, perhaps?)

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You’re Entering a World of Lebowski

“A cult gives its members license to feel superior to the rest of the universe, and so does a cult movie: it confers hipness on those who grok what the mainstream audience can’t. Joel and Ethan Coen’s 1998 hyperintellectual stoner noir bowling comedy The Big Lebowski, starring Jeff Bridges as Jeff (The Dude) Lebowski, has the requisite exclusivity of a cult classic: it bombed at the box office; it was met with shrugs by many critics who had arguably overpraised the Coen brothers’ Academy Award-winning Fargo (1996); and it has amassed an obsessive following on cable and video and by word of mouth. Nowadays, quoting its intricate, absurdist, often riotously profane dialogue earns you coolness points in widely disparate circles. Some would even say that the cult of The Big Lebowski is going mainstream.” (New York Times)