Medicine and Literature

Back in 2002, Stanford medical student Jennifer Przybylo traveled from her home state of Illinois to Washington, DC to attend the Prudential Spirit of Community Awards, which honors middle- and high-school students for outstanding community service. During an ice-breaker session, she met West Virginia resident Nina Vasan, and the two became fast friends. They remained close through college and medical school, and this week the duo are releasing their first book, Do Well Good.

As Przybylo explains in the following Q&A, the book aims to sow the seeds of social responsibility by guiding “young adults through the process of effecting positive, sustainable change in their communities starting from square one.” Do Well Good helps readers understand their core values and personal strengths, identify causes matching their interests and skill set, and generate and refine potential solutions with a strong emphasis on “out-of-the-box” thinking. It also includes major tenets to consider when formulating and implementing an action plan and “how-to” chapters on everything from fundraising to establishing a 501(c)(3). Mixed in are anecdotes, humorous illustrations and case studies to keep things interesting.

Below Przybylo discusses what inspired her and Vasan, who starts her residency at Stanford in July, to author the book and how she hopes to advance the larger public movement toward greater social responsibility.

What was the catalyst for writing the book?

The seed was actually planted at the same ice-breaker session where we met. Discussion in our group had turned to the lack of what we felt was a good “how-to” manual for social change. All the existing resources were either too theory-based and not accessible to the average student or way too simplistic. There was a need for a book that combined theory and evidence-based practice with real experience, personal anecdotes and skill-building exercises. Nina and I took up this challenge in college, hoping to create a resource that would help students and young adults make lasting, sustainable changes in their communities. Along the way, we asked other students whose work we respected to join the effort and take the helm of a subset of chapters related to their specific areas of expertise. The end result is a cooperative effort built on the collective experiences (both successes and failures!) of many young leaders from founders of non-profits to social entrepreneurs and political activists. And because we wanted the book to be a fun read, we made sure to add a dash of humor and good spirit wherever possible!

How did your commitment to social responsibility take root and evolve over the years?

My first community service experiences were those sponsored by my grade school, the Academy of the Sacred Heart in Chicago. The school made a number of service opportunities available to us and encouraged us to complete a certain number of volunteer hours by graduation. These experiences made a strong impression on me at an early age. When I went through a particularly difficult time in high school, I found that I naturally gravitated toward volunteer work to help the homeless. It was a great comfort to know that I could help others, even if only in some small way. In college, I began to incorporate my longstanding interest in medicine into my activities, working to advance the efforts of Students for Organ Donation and serving as a peer health educator on campus. It was also during college that my co-author and I began work on this book. We felt that while our individual service experiences were personally fulfilling and a big part of who we were (and are!), we could make an even bigger impact by writing a book to help fill the void in the young adult literature on this topic. Seven years and several units of blood, sweat, and tears later, it’s our hope that Do Good Well will help those with an interest in social responsibility turn their good intentions into effective, lasting change in their communities.

I also don’t think it’s any coincidence that both my co-author and I are medical students. Medicine is a phenomenal career path for those interested in social responsibility. We both feel extremely lucky to be in a field that allows us to serve others on a daily basis, with ample opportunities for both patient and political advocacy. This is a particularly exciting time for medicine with many opportunities to work for changes that will lead to better care and ultimately healthier patients.

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I felt a little guilty about pushing my colleague John Sanford to confront his blood phobia as part of a story he was writing for Stanford Medicine magazine. I feel fine about it now, though. While writing it, John overcame the phobia! And the story turned out very well too. In fact, it was recently singled out by long-form journalism curator Longreads as a story worth reading.

Here’s how it starts:

I awoke close to midnight. It was the middle of August, in 1992, and the windows were open in the room of the Paris hostel where I was staying. The air was warm and still. My chest felt moist with — sweat? I touched the substance with an index finger and pressed it to my thumb. It felt tacky. Blood!

(That’s John in the photo, by the way. Yes, he’s holding a test tube of blood.)

Previously: New issue of Stanford Medicine magazine asks, What do we know about blood? and Programmed to fear spiders?
Photo by Erin Kunkel

There’s an interesting guest post on the SA Incubator blog about a publication created by medical students for medical students. In the piece, Ajay Major and Aleena Paul from Albany Medical College describe their motivation for launching in-Training, which they call the “the first online newspaper for medical students.” The co-founders write:

…With in-Training, we recognized the need for a proper forum for medical students to showcase their literary and artistic endeavors. Without such a forum, the knowledge accumulated by medical students who experiment in the humanities would remain fixed and incapable of flowing to peers. Medical schools would continue to sit like islands in the fray of a tumultuous health system, isolated from one another in thought and expression.

in-Training seeks to meet this dire need for a communal gathering place for medical students. We are the agora of the medical student community, and as such, we strive to publish innovative thought in the arts, politics, science, and literature. We provide a virtual forum for medical students to participate in the shared experience of being a physician-in-training and to learn from the reflections and wisdom of their peers. Since we went live last year, we have published over 100 articles from medical students at over 30 institutions in the United States and Canada.

Topics of posts range from physician burnout to the health benefits of yoga to training on LGBT health issues. A past entry examined the importance of reading fiction while in medical school and highlighted a talk by Stanford physician-author Abraham Verghese, MD.

If you need to spice up your day with some reading suggestions, Annalee Newitz, PhD, editor-in-chief of the science (and science fiction) blog io9 has just the thing - a list of 23 science books that hold their own with the best fictional cliff hangers. According to Newitz:

Some of the greatest nonfiction books about science read like novels. They borrow tropes and narrative tricks from science fiction, fantasy, horror, and more — turning great discoveries into great adventures. Here are twenty-three science books that are better than genre fiction because they’re true.

The list includes classic reads like Darwin’s “On the Origin of Species” and Rachel Carson’s “Silent Spring.” But there are also newer offerings, including “The Poisoner’s Handbook” by Deborah Blum and “The Immortal Life of Henrietta Lacks” by Rebecca Skloot. If that last one sounds familiar, it could be because it’s been wildly popular since its publication in 2010. We’ve written about it several times on the blog, and my boss, Paul Costello, interviewed Skloot for a 1:2:1 podcast.

I love lists like these, and - although most of the titles are familiar - I’m embarrassed by how many I haven’t read. There’s a way to fix that, though…

Previously: Do you have a ‘HeLa’ story? Share it with Rebecca Skloot, The Immortal Life of Henrietta Lacks wins Wellcome Trust Book Prize, Will Henrietta Lacks now get her due? and Vector offers recommended reading for the holidays

As the editor of Stanford Medicine, I think a lot about new research, new discoveries, new treatments. So it’s no wonder I find stories of long ago a refreshing change when I’m reading for pleasure. A look at my 10 favorites this year shows my predilection, though there’s lots of new here too. History fan or not, if you read just one, read about the immortal jellyfish! I can’t stop thinking about them.

Undead: The rabies virus remains a medical mystery, by Monica Murphy and Bill Wasik, Wired
An account of a modern attempt to cure rabies, with lots of history woven in.

Can a jellyfish unlock the secret of immortality? by Nathaniel Rich, New York Times Magazine
Including wondrous jellyfish that grow younger and a researcher who breaks the mold, and it’s told with humor and lyricism.

Two hundred years of surgery, by Atul Gawande, New England Journal of Medicine
For gems like this: “Liston operated so fast that he once accidentally amputated an assistant’s fingers along with a patient’s leg, according to Hollingham. The patient and the assistant both died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300% mortality.”

Post-Prozac nation: The science and history of treating depression, by Siddhartha Mukherjee, New York Times
Everything we knew about antidepressants like Prozac was wrong. But that’s OK.

The nature of the Knight Bus, by Chris Gunter, Story Collider
A look behind the scenes at top science journal Nature from one of the journal’s editors.

The island where people forget to die, by Dan Buettner, New York Times Magazine
On mellowing out on a Greek island to live to 100. It got me thinking about how to bring more mellowness into my life.

Fear fans flames for chemical makers, by Patricia Callahan and Sam Roe, Chicago Tribune
A great investigation into a chemical industry-funded front group’s deceptive campaign that fueled demand for flame retardants in furniture, electronics and baby products among many other items. The whole four-part series is worth reading. It also explains that the chemicals have been linked to cancer, neurological deficits, developmental problems and impaired fertility — and not only that, but they don’t work.

The measured man, by Mark Bowden, The Atlantic
On one man’s effort to use big data as a tool to guide him to better health. This is either insane, the future, or both.

A family learns the true meaning of the vow ‘in sickness and in health’, Washington Post Magazine
A heartrending, inspiring read for me, though not for all - as evident by the comments.

Previously: My top medical reads of 2011 (aside from those I edited)

From Dec. 24 to Jan. 7, Scope will be on a limited holiday publishing schedule. During that time, it may also take longer than usual for comments to be approved.

Stanford neurosurgeon John Adler, MD, has launched a new open-source medical journal that leverages crowdsourcing to make scientific research more readily available to the general public. “The average Joe has little to no access to the medical literature today,” he said in a San Francisco Chronicle story published yesterday. “It’s not right. It should be a human right.”

The Chronicle article goes on to explain the journal’s publishing model and Adler’s vision for the new publication:

Curēus (pronounced “curious”) is an “open source” online medical journal that shares material, is available and free to anyone, and allows researchers to publish their findings at no cost within days - rather than the months or even years it typically takes for research to be made public. It’s built on a “crowdsourcing” platform that allows readers to rate material based on the article’s quality, rather than the mere fact it was published in a prestigious publication.

“We’re trying to take the huge revolution in communication and blend it with the medical world,” said Adler, who has published more than 200 papers in traditional medical journals throughout his career. “Nowadays, you wouldn’t go to a restaurant without Yelping it first. You wouldn’t go see a movie without seeing what Rotten Tomatoes had to say about it. But medical journals are still stuck in this 200-year-old paradigm.”

…

Adler said he sees everyone benefiting from the expanded access to information, except possibly the traditional medical journals. “We aspire to be the journal, not just a journal,” he said.

Curēus joins the ranks of a growing number of open-access journals including PLoS, which was founded a decade ago by UC Berkeley and Stanford scientists. Peter Binfield, former PLoS One editor and co-founder of PeerJ, discussed how open-access publishing can accelerate scientific research in this past Medicine X blog entry.

Previously: Stanford scientist sets sail on new publishing model with launch of open-access, embargo-free journal, Discussing the benefits of open access in science, How open access publishing benefits patients, PeerJ open access publishing platform launches today and A guide to transitioning scholarly journals to an open access model

Last month, Kristin Sainani, PhD, a clinical assistant professor at the School of Medicine, launched an online science-writing class that teaches researchers how to clearly and concisely communicate their work. The course, titled Writing in the Sciences, is available through Coursera, and it drew thousands of students shortly after being introduced.

Curious to know more about what prompted Sainsani to develop the class and her teaching methods, I contacted her to discuss the project. Below she talks about the importance of teaching researchers how to explain their work to broad audiences and offers some tips for conveying complex scientific concepts in a reader-friendly manner.

A recent article states that your mission is to enable scientific literature to change. What motivated you to pursue this goal?

I am partly motivated to change the literature because, like all scientists, I have to read it. It’s frustrating that so many papers are unnecessarily difficult to get through. Scientists assume that because they are talking about complex ideas, the language also must be complicated and unreadable. This is simply untrue.

A second motivation is that better writing improves transparency. As a peer reviewer, I encounter lots of poorly written papers. I often wonder if the authors are intentionally being obscure in places to hide flaws or shortcomings in their methods. I wonder how many errors slip through peer review as a consequence of obscure language.

A final motivation is that better writing increases access to the knowledge. When you get your ideas across to as many scientists as possible, from as many diverse disciplines as possible, this moves science forward. If your article can only be understood by a handful of other people, this lessens its impact.

Why is it important that scientists be able to easily communicate their work to the general public?

The public needs to be adequately informed about science to rationally debate issues from genetically modified foods to global warming to health-care economics. Scientists have a responsibility to communicate effectively with the general public to help inform the public discourse, as well as to help increase general scientific literacy.

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Comedian John Lutz, who plays a sketch writer on the popular TV series “30 Rock,” is often the fall guy for others’ mischief and the target of practical jokes on the show. So when I read in a recent Arts Beat blog entry about a new endeavor called “The Lutz Experiment,” I naturally assumed he’d be the lead role in some sort of new reality TV show where he would eat strange and unusual foods, perform death-defying acts and, in general, test his emotional and physical limits.

But, as the article explains, there’s more depth to the actor and his latest project, which he is working on with Stanford psychologist Jamil Zaki, PhD. Zaki’s work focuses on the cognitive and neural bases of social behavior, and:

The men are now collaborators on a new book tentatively titled “The Lutz Experiment,” which was recently acquired by the Free Press imprint of Simon & Schuster. It’s a project they hope will make social psychology more accessible while it runs Mr. Lutz through a battery of experiments, teaches him a few lessons about himself and perhaps helps him conquer some long-held fears.

…

For their book, Dr. Zaki said it was still to be determined what experiments he would run on Mr. Lutz, and even then he could probably not tell his partner exactly what he would be getting into.

“So many of our studies depend on people not knowing the hypotheses ahead of time,” Dr. Zaki said. “I get to deploy him to these different, weird parts of the country. ‘Meet this person, and they’ll bring you into a basement testing room.”

Photo by Jason Anfinsen

This image comes from a manga comic produced by Ian Roberts, MB, a professor of epidemiology and public heath at the London School of Hygiene and Tropical Medicine.

As the New York Times reported this week, Roberts created the comic to increase awareness among emergency physicians about recent scientific evidence showing the clot-boosting drug tranexamic acid can increase survival rates among trauma patients.

In the Times piece, Conor Rabinovitz, a die-hard manga fan and the 19-year-old son of Scope contributor Jonathan Rabinovitz, also offers his thoughts on the comic’s storyline.

Photo by Emma Vieceli

Throughout history, mankind has been making predictions about what the future will hold. While many of us only think a few years ahead, two enterprising interns working in 1949 at STAT, a publication from the Stanford School of Nursing (which no longer exists), daydreamed what life would be like at the start of the new millennium.

A colleague of mine stumbled upon the authors’ fun and satiric article (.pdf) not long ago, and I decided to take a moment to compare their predictions with reality. The story is set in the year 2000, where everything is done on screens and the world runs on the latest technologies of a fictitious technology conglomerate named Tele-Tele Inc.

While the story presents a lot of far-fetched and comical ideas of life in 2000, the imagined world of Tele-Tele Inc. actually has a few similarities to modern-day life. In one part of the story, the narrator explores how the School of Medicine has changed:

…I decided to take a look at the old Med School. Surely, this would not be changed by Tele-Med. But to my utter amazement, I found only a large Tele-Transmitter, which I was to learn later, would be used to send Tele-Lectures to the New Tele-Med Students. I was also to learn that these Tele-Lectures could only be received on specially built ceiling screens, designed to put the students in an obviously comfortable position.

Could this have been an early prediction of YouTube and Skype as a way for students to follow lectures?

The article also foretells the impact that advancements in technology would have on patient health care. I spoke about this with article co-author Eldon Ellis, a 90-year-old retired surgeon, who told me:

It’s really important to not let the relationship between doctor and patient get lost in all the technology. Unfortunately, the good features of technical changes sometimes get overwhelmed, and the first thing someone gets is a batch of X-rays and lab studies. What we really need to do is look at the patient and talk to the patient.

The full article is worth a read.