The Genetic Lottery: Why DNA Matters for Social Equality

Paige Harden, Kathryn

Last Updated: Mar-28-2022

Trachtman, Howard

Primary Category: Literature / Nonfiction

Summary:

The Graduate is a movie classic from what seems like a bygone era. It is accompanied by great music by Simon and Garfunkel and has one of the most famous one-word lines in cinema history. When Benjamin Braddock is wandering aimlessly around the pool at a graduation party thrown in his honor, a friend of his parents asks him what he plans to do with his post-collegiate life. Another family friend jumps in and volunteers, “Plastics.” There are many who will also give a one-word answer to any medical school graduate searching for a career – Genetics.

In this important new book, Kathryn Harden provides staunch support for the key role of genetics in health, disease, and in human well-being. She provides a remarkably clear primer on genetics in accessible language. Harden begins with statistical issues like the normal distribution and Bayesian priors. In her capable intellectual hands, she uses analogies that effectively move the teaching agenda forward. With recipes as a framing image for genetics, she demonstrates the relationship between the coding material in the DNA nucleotide sequence and the actual building blocks, namely the proteins that do the heavy lifting inside cells. Concepts like genetic recombination, linkage disequilibrium, and monogenic versus polygenic disorders are introduced and make perfect sense. She then builds on this foundation to consider genome-wide association studies (GWAS) which represent the powerful tool that has been introduced to explore the relationship between genetic endowment and health. That is where things start getting complicated.

When people think of medical genetics, they usually have classical Mendelian disorders in mind. They are caused by mutations in a single gene that disrupts a protein pivotal to normal health. Examples are sickle cell disease, hemophilia A, or muscular dystrophy. However, many health problems like hypertension that are associated with significant global disease burden are polygenic. This means that they are caused by less dramatic mutations in a number of genes that in the aggregate lead to the disease. Harden details how quantitative assessment of the contribution of these minor variations in a large array of discrete genes enables the formulation of polygenic risk scores (PRS) for these conditions. These measures provide estimates of susceptibility to developing other polygenic conditions like obesity, cardiovascular disease, and diabetes.

As a psychologist, Harden’s work focuses on the application of PRS to non-medical aspects of human behavior such as impulsivity, attentiveness, job satisfaction, and executive function. The waters remain relatively calm until Harden’s fellow psychologists venture into the realm of educational achievement and lifetime income status. Harden methodically reviews relevant studies that have been done with siblings, twins, adoptees, and family trios. She dissects them and highlights when investigators have misinterpreted their data. There is a steady drumbeat of data, almost too much at times. But the overall consensus that emerges is that PRS and other measures of heritability continue to show a genetic component for these psychosocial outcomes in large population studies. The challenge that Harden raises is how to incorporate this knowledge about genetics into a better understanding of these aspects of human behavior and if and how to address abnormal manifestations.

Questions remain concerning how genetics “causes” these changes and how to interpret the findings. What is determinative? Is it genetics i.e., nature, or is it all environment i.e., nurture? There are those, like Harden, who advocate for thoughtful analysis and utilization of all the GWAS data. She highlights the difference between use of PRS to assess outcomes within populations versus between populations. In sharp contrast, there are others who resist the introduction of genetics into psychology. Pointing to the sordid history of eugenics and its degeneration into the creation of racial hierarchies, the opponents of the Harden’s work dismiss it as unscientific at best and destructive at worst. Harden makes a compelling case for the validity of the science and a spirited defense of the thoughtful use of genetics dismiss it as unscientific at best and morally repugnant at worst.

Harden provides a strong defense of the science and statistical methods and offers a spirited argument that without acknowledging the role of genetics in human achievement, society will be unable to thoughtfully address inequalities and restore balance. Her work touches on many other pressing issues including human autonomy, agency, freewill and the role of government intervention. She outlines a social agenda that acknowledges the importance of genetics as a contributing factor. But it incorporates a recognition that its distribution in the population is solely a matter of luck and does not serve as the basis for a hierarchy of human worth. I leave it to readers to judge for themselves the validity of her proposals, but her commitment to making this world a better place is not in question.

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Blood in the Water: The Attica Uprising of 1971 and its Legacy

Thompson, Heather Ann

Last Updated: Nov-09-2021

Trachtman, Howard

Primary Category: Literature / Nonfiction

Genre: History

Summary:

1971 seems like a very long time ago. Richard Nixon was President, the Vietnam War was still raging, and China and Russia were the sworn enemies of the United States. Fifty years have passed, and at first blush, the world seems like a different place. Unfortunately, the more things change, the more they can stay the same.

One of the most horrifying events of that year was the prisoner revolt at the Attica State Prison in upstate New York in early September. I did not live in New York at the time and have only a vague recollection of reading the newspaper reports of what happened. But ask anyone living in New York who was at least 15 years old at the time and they will tell you that they have vivid memories of what transpired over the five days from September 9-13. In this extraordinary book, Heather Ann Thompson recounts in all its gory detail the prisoner uprising, the bloody retaking of the prison by state troopers, and the nearly thirty years of investigation and legal wrangling that occurred in its wake.

By the late summer of 1971, there had been prisoner rebellions in state penitentiaries across the country including a nearby high security facility in Auburn NY. There was increasing tension and escalating prisoner protests against the inhumane conditions in all prisons including overcrowded cells, limited access to food and fresh air, and routine brutal treatment at the hands of the correction officers. Finally, Attica prison erupted on September 9 after a minor skirmish between guards and prisoners. The prisoners took 38 hostages and over a thousand prisoners escaped their cells and crowded into the prison yard. They created a communal space to take care of each other that was equipped with meager resources. There was a central meeting area for the leaders of the uprising. They created a human shield around the hostages to protect them from harm.

Over the next four days, there were intense negotiations between prison officials and the prisoners. A team of observers including Tom Wicker was bought in at the request of the prisoners to serve as witnesses and act as potential mediators. Finally, after negotiations fell apart over the prisoner demand for amnesty, without warning, the troopers dropped tear gas cannisters from helicopters and stormed the yard. Tragically, when the dust had settled, 32 prisoners and 11 hostages had been killed by bullets fired by the troopers. This terrifying sequence of events is described in the first third of the book. The remaining part details how prison wardens destroyed critical forensic evidence and collaborated with state politicians up the chain to Governor Nelson Rockefeller’s office to portray the events as a successful suppression of a radical-supported attack against the state. They solicited false testimony and pursued a one-sided prosecution of the prisoners for the murder of one guard and several prisoners. There are too many villains in the story but also some true heroes – a coroner who refused to back down from his post-mortem examination showing that all the victims were killed by gunfire, knowing that only the state troopers had firearms. The prisoners who confronted the legal system, defense lawyers willing to take up the cause of the prisoners, a brave state lawyer who was an essential whistleblower, all were vital in the pursuit of truth. At the end, the justice system failed nearly everyone involved, and Attica Prison remained an important part of the New York State correction system. The only monument is a stone at the entrance to the prison memorializing the hostages who died.

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Secret Wounds

Berlin, Richard

Last Updated: Aug-06-2021

Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In Secret Wounds, his second full length collection of poetry, psychiatrist Richard Berlin continues his exploration of the inner world of medicine with a sequence of 73 poems that flow seamlessly, uninterrupted by grouping into topics or sections. In the first poem, “Lay Down Sally,” the author attends a man dying on dialysis, and concludes with “A nurse hangs the morphine. / I write my blue notes.” In the last, “The Last Concert of Summer,” he reflects on his long experience with the sick and suffering, ending the poem with, “I place a stethoscope in my ears and listen / to the heart when I’ve run out of things to say.” In between, the poems reflect varied incidents, topics, conflicts, and wounds, as they occur from medical education (“Teaching Rounds,” “Touch,” “On Call, 3 AM”) through a life in medical practice (“Rage,” “The Scientists,” “How a Psychiatrist Parties”) to something like enlightenment (“Note to Pablo Neruda,” “A Psychiatrist’s Guitar,” “End of Summer”).

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Crip Camp: A Disability Revolution

Newnham , Nicole; LeBrecht, James

Last Updated: Jun-21-2021

Schilling, Carol

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Crip Camp: A Disability Revolution is an exuberant film by and about people who have been marginalized on screen and in their lives. It opens with black and white archival footage of Camp Jened, a quirky, free-spirited, counter-culture summer camp for disabled teenagers in New York’s Catskilll Mountains. One camper called it a utopia. The second and longer part of the film follows several former campers into their adult lives. They become parents, spouses, professionals, and disability rights activists at a crucial historic moment for disability legislation. Both parts of the film propose that the liberty and solidarity experienced at Jened emboldened several of the campers to seek opportunity and equality, for themselves and others, in the world beyond their camp.

Located near Woodstock, geographically and culturally, Jened offered a space free from the discrimination the summer residents encountered elsewhere. Campers could engage in uninhibited physical activities, uncensored storytelling, self-governance, mutual caretaking, real friendships, irreverent insider humor, romance, and fun. One powerful scene allows viewers to overhear campers with diverse disabilities share common experiences: being disrespected or ignored at school, overly protected at home, isolated everywhere. Another tracks the campers’ hilarity and pride over an outbreak of “crabs.” One camper declares his counselor’s demonstration of how to kiss, “Best physical therapy ever!”

While the film’s co-director, former camper Jim Lebrecht, narrates the film, Judy Huemann is its political and moral center. A wheelchair user, she rose from camper to counselor. Huemann was revered around camp for successfully suing the New York City Department of Education for the right to teach. She and several post-campers reunited in Berkeley, California, where they became involved in the Independent Living Movement. An astute leader, Heumann is represented as central to a remarkable 25-day sit-in at the San Francisco Department of Health, Education and Welfare (HEW) offices in 1977. She and her disabled colleagues risked their health and their lives—they slept on the floor and improvised medical necessities—to convince HEW to approve regulations essential for enforcing the anti-discrimination section of the 1973 Rehabilitation Act. The scene of Heumann’s standoff with the HEW representative is unforgettable. As are the deliveries of food, supplies, and solidarity that the Black Panthers and other marginalized groups in San Francisco provided daily. Other archival footage, including of Heumann and demonstrators stopping traffic in New York City to demand accessible taxis and of protestors abandoning their wheelchairs to pull themselves up the steps of the nation’s Capitol, are startling images of the struggle to secure disability civil rights in the United States. Recently filmed interviews with several of the former campers affirm that, despite the work toward disability justice that remains, they live fuller, more vibrant lives as a result of their experiences at Jened and the legislation they insisted on.

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The Arrow Tree: Healing from Long COVID

Weliver, Phyllis

Last Updated: May-18-2021

Clark, Mark

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The title of this memoir derives from the Native American custom of bending a tree’s growth in order to indicate a direction of safe passage. The custom represents a reverent cooperation with nature through which a compassionate communication is accomplished: a message to other journeying souls as to how they might find a way to their flourishing. The title is exquisitely apt for this memoir, which echoes the gesture of the arrow tree, testifying to a safe passage through the wilderness of COVID. The author, a first-rate, published Victorian scholar, contracted COVID-19 in March 2020 upon her return from a sabbatical at the University of Cambridge, which was cut short as a result of the pandemic.

Weliver has suffered from symptoms ever since: hers is the experience of living with long COVID. The condition warrants her taking a leave from her university, and she returns to her childhood home of Interlochen, in northern Michigan. Her living in and engaging with the natural world there encourages her to undertake meditations about that world and her place in it as she lives with her illness. The writing—the foundational means of her healing—inclines her, crucially, to think with the stories of the Odawa (Ottawa) and the Ojibwe (Chippewa), Anishinaabek ("Original Man") of the region, which she researches as a means of deepening her understanding of her home, her origins, and the nature of her identity. Her quest for understanding turns not only to these stories, but to an integration of them with the wisdom of other guides in her life: authors of the Romantic and Victorian periods, poets and thinkers of Taoism and other ancient Eastern philosophies, mentors in her rich journey of studying both literature and music (she attended Interlochen Center for the Arts, Oberlin, where she double-degreed in English Literature and Voice (Music), Cambridge, and the University of Sussex), and her own family, particularly her mother. Her prose is accessible and welcoming, not at all the erudite sort one might anticipate from a reputable scholar: it invites curiosity and encourages insight that is, at times, breathtaking and joyous. This “arrow tree” memoir points its readers in the direction of a safe passage to the home of our natural world, where, in finding union with that world, we may experience healing not only from COVID but from habits of the heart that have left us more broken than we know.

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Main Street: How a City's Heart Connects Us All

Thompson Fullilove, Mindy

Last Updated: Apr-19-2021

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Ethnography

Summary:

Mindy Thompson Fullilove, MD, is a Black social psychiatrist with wide-ranging interests; her book analyzes factors that support or diminish the health of cities as places that sustain its citizens. Over many years, she has visited and studied 178 cities in 14 countries, and she draws on the work of experts from several disciplines to address the fundamental question: how may we best live together?

Her discussion moves through five concepts for understanding the health of a city by describing a dozen cities ranging from Paris to Jersey City. Each features a “Scroll,” a two-page presentation of photos, graphics, and text. Her discussions give an inductive basis for her concepts that become criteria for assessing the health of any city.

(1) Box (“in all sizes and shapes”): the surrounding shape of buildings, street, and sky; it gives an identity to the city’s center with its useful assets such as stores, post office, bank, food, and entertainment.

(2) Circle: the larger area surrounding a Box—maybe a half a mile in radius. Its health requires ease of travel to and from the box.

(3) Line: usually the Main Street that runs through the box, therefore a central path to town. Good transportation is important, and the main street can be quite long, for example Palisades Avenue in Englewood, New Jersey.

(4) Tangle: a dense network of streets and highways that connect to main streets and the Box.
(5) Time: no city is static; as years go by, there are changes for good or ill.

Fullilove mentions politics, capitalism, poverty, disincentives, tribalism, racism, highways, malls, interstates, and “urban renewal” that destroyed neighborhoods of minorities, as well as redlining against Blacks and gerrymandering school districts to segregate Black and white students.

In “Naming and Framing the Problem,” she turns to a larger overview of challenges for cities in many places, but especially in the US: (1) “deep structure of inequality” (p. 211), such as the legacies of slavery, lynching, the 3/5 Compromise, and the Trail of Tears, as well as white supremacy today (2) ecological damage, including industrial farming, deforestation, and global warming, and (3) the inertia of the status quo.

Citing Dr. Martin Luther King, Jr., and Father Richard Rohr, Fullilove affirms love as the root for social justice, political activism (p. 211) so that cities might become what Thomas Edison termed “factories of invention” that will support the mental health and well-being of all of its citizens.

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Collective

Nanau, Alexander

Last Updated: Mar-29-2021

Bruell , Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Colective was a popular nightclub in Bucharest, Romania. In 2015, a fire broke out during a band performance killing 27 people and injuring 180. The public protests that erupted over the lack of fire exits in the club led to the resignations of government officials, including the Minister of Health. Within four months of the fire, 37 of the critically burned died, not as originally thought from the burns they suffered, but from hospital- acquired infections.

The feature documentary follows Catalin Tolontan, an investigative journalist at a sports newspaper and his team as they track down the cause of the fatal infections. They are aided by doctors from the hospital who come forward to voice their suspicion that the infection control agents used by the hospital were diluted to the point of being ineffective. The journalists bring samples to a lab which verifies that the agents were diluted to 10% of their effective strength. The owner of the company supplying the agents had been engaged in the practice for years.

We hear tragic stories from parents whose children died, prevented by “communication errors” from having them transferred to other, better equipped burn units in other European countries. And we meet the survivors, among them, Tedy Ursuleanu, who, despite her disfigurement, bravely poses for photographs for an exhibit about the event. The film returns to Tedy at several moments--- she is a reminder of the human tragedy that has caused so much suffering. And we listen to the despair of a doctor who says, “We’re doctors; but we are no longer human. All that matters is money,” as she describes how politics, bribery and greed have taken over the health system and made patients’ lives expendable.

This is a story without a happy ending. Vlad Voiculescu, the newly appointed health minister who previously worked in patient advocacy tries to reform the system and install safeguards against hospital procedures that fall short of accreditation requirements. But the system proves too strong. This time political corruption wins over people’s health.

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Camouflage

Nisker, Jeffrey

Last Updated: Mar-19-2021

Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

The Flight Portfolio

Orringer, Julie

Last Updated: Jan-29-2021

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It’s 1940, and France has fallen to the Nazis, leaving the country divided between occupied France in the north, and so-called “Free France,” with its government at the spa town of Vichy, in the south. The Vichy government is headed by Marshall Phillippe Petain, a collaborationist puppet of the Germans running a collaborationist puppet state. But unlike the north, the south is still technically unoccupied, and people fleeing the Nazis from all over Europe make their way there in the hope of finding a way off the European continent, and so a kind of black market in emigration develops, centered in the port city of Marseille.

Among the groups working out of Marseille is the Emergency Rescue Committee, an organization set up by the journalist and editor Varian Fry and his friends, and with the support of Eleanor Roosevelt. The ERC has sent Fry to Marseille with a list of names of people to be assisted to emigrate, and the list is a Who’s Who of the European cultural elite: artists, writers, philosophers, and the like, many of whom are Jewish and/or have opposed the Nazis and are thus wanted by the Gestapo. It is Fry’s job to shelter them, get them fake transit visas, and ultimately smuggle them out, usually to neutral Spain or Portugal, or even directly to the States. The Vichy government, which has an agreement with Germany to surrender any identified fugitives, knows this is going on, and together with their German allies, is always hot on the trail of these now stateless refugees, and thus hot on Fry’s trail also.

The Flight Portfolio is based on several of the thirteen months Fry spent in Marseille as the representative of the ERC. Along with his staff, he “brings in” (and successfully gets out) Marc Chagall and his wife, Franz Werfel and Alma Mahler Gropius Werfel, Max Ernst, Lion Feuchtwanger, a young Hannah Arendt (“Name?” “Johanna Arendt. My friends know me as Hannah”), and others. All the while, he and his staff are but one step ahead of the agents of Vichy and the Gestapo. And during this time, Chagall has been compiling the flight portfolio, a collection of artworks which testify to the humanitarian crisis in Europe, to be smuggled out as a warning to the free world.

Complicating the issue—and a major part of the story line—is the fact that Fry, whose wife Eileen had stayed behind in New York City, has reconnected with a Harvard classmate named Elliot Grant with whom he had been romantically involved as an undergraduate. Grant has come to Marseille to be with Gregor Katznelson, a fellow Columbia University professor who has returned to Europe to find his son Tobias who has disappeared. Tobias is a brilliant young Berlin physicist and is wanted at all costs by the Gestapo for his scientific acumen and his value to weapons development. Gregor is desperate to secure his safe passage to New York. Fry promises Grant that he will get Katznelson’s son to safety. When the elder Katznelson returns to the United States, Fry and Grant resume their relationship, and Varian finds himself becoming increasingly emotionally involved with Grant and distanced from Eileen, although he still loves her. Ultimately Tobias shows up in Marseille; but there is another fugitive, a world-renowned and respected artist, who has been waiting, is in immediate danger, and needs to get out of Europe. And only one can leave on the waiting ship.

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The City We Became

Jemisin, N.K.

Last Updated: Dec-07-2020

McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel