Spanking Your Brains Instead of Your Butt

by B.J. on 7/20/2008 05:58:00 PM 0 comments Print this post

Key quote: "For years, parents and school maams were limited to spanking their butts, now were spanking their brains."

What was interesting was that after that quote, he was talking about how the kids would be easier to control. You could make kids more obedient. You can flip a switch that would turn off the gay button.



I'm not sure how parents are reacting or if they actually are overmedicating their children, but I do know that all these chemical psycho-social "solutions" are more readily available than they ever were. I have to wonder how the human race has made it so far presumably without its help for over 2 million years.

Every and anything in this age of microbiological-pharmaceutical corporation growth can be defined as a "sickness" or weakness and then "fixed." But fixed seems to mean acting "normal". "Normal" in our context seems to mean "controllable." Oddly enough though, it's only the people in the extremes who we ever seem to acknowledge or talk about.

Thanks to the idea from this post.

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Making Sense of the Topic Are L.A.'s Hospital's Safe?

by B.J. on 7/16/2008 12:47:00 PM 1 comments Print this post

What I saw in this lecture was a very real tension between the real suffering of the patient and the heavy dose of expectations and standards to be met within these enormous factory-like hospital systems.

The topic centered around hospital-induced infections in Los Angeles.

The panelists, three. One from the people's perspective, a patients-rights advocate. Two from the practitioner's perspective, a director from UCLA Medical Center and some kind of Risk Management/PR person from Kaiser Permanente.

The fireworks officially set ablaze when the patients-rights advocate demands transparency in hospitals.

"Transparency" in the sense that the general public know of the shortcomings and limitations that hospitals and doctors have. Transparency is just another means of making sure that the hospitals are "accountable." "Accountable" meaning reliable and trustworthy.

Trustworthy hospitals mean that doctors, nurses, and other caregivers are treating their patients/everyone well.

Treating their patients/everyone well. Keyword "/everyone."

Meanwhile, on the flip-side, from a doctor or health-care giver's perspective, what the patients' rights advocate was advocating was probably just one more teardrop of annoyance to a bucket load of them. I felt that with every joke the UCLA Medical Center guy was making and the corresponding audience laughter on topics such as making the patients pay for their care.

Years of medical school, internships, paying loans, generally in attempt to help people's wellbeing, 24-hour workdays, no holidays or weekends, seeing countless patients a year and having to treat everyone individually. It's only a matter of time before everyone becomes anyone, which you don't mean to, but you're too tired to care. On top of that, hospitals in LA are going bankrupt and closing down. There seem to be less and less doctors and other resources around to do anything.

But these people on the outside, the patients, their advocates don't see any of this struggle. They probably struggle to, but that isn't seen at all and even more variable outside of the hospital context. Not when that medical practitioner's top-rated hospital is moving into a billion-dollar state-of-the-art facility in the broken neighborhood of Westwood. This prestige and wealth only serves as fuel to the fire --- more reason for the advocate to run full force at the system yelling at the practitioner to stop fucking up! If they can fight the big fish, the patients will be heard.

All that the UCLA dude and Kaiser woman could talk about were the way they managed their hospitals. He was keen to point out that he was like a "mayor" of a small town. The woman was proud to report that they had taken steps in Kaiser to improve safety as adapted from the airline industry, which I thought was something of an odd connection to make from a patient/consumer perspective because airlines give no shit at all about how you're doing even if you do pay to be pampered. Actually, on second thought, maybe there is a connection after all!

They were very specific about the management improvements they've implemented in each of their hospital systems. They were very much in love with the systems implemented. UCLA dude was happy to talk about all the numbers achieved in his time as top dog. #3 rated Medical Center in the United States. Hitting the 99th percentile on public health measures intra-hospital.

Essentially, he was hitting on stuff that patients don't give a beer dump about, which he actually knows intuitively and mentions, but as a defense mechanism has to bring up anyway. All he could point out were these rankings and numbers, which is impressive. But anytime someone's argument of defense relies entirely on numbers, usually there's something weak underneath the argument. Numbers and standards ideally should never be an ends to meet, especially in a field that depends on individual well-being.

...but unfortunately it seems that's what these large bureaucratic systems inevitably entail...some blind adherence and satisfaction to an abstraction, numbers that are highly relative, which say virtually nothing about the quality of care. There's nothing wrong with him or any other hospital manager focusing on numbers as a means to show that you're doing well, but as long as these hospitals are overworked and remain underresourced thanks to the HMO system, they're never going to progress to a level where doctors en masse will see eye to eye with patients.

Inicidentally, UCLA guy mentioned that 1 out of 3 people still wouldn't recommend UCLA Medical Center to a friend, but it's odd that this wasn't a focus of the discussion.

Inevitably, the UCLA and Kaiser people's involvement with the management end elicits talk about the responsibility laying with individuals. System works fine, our standards work fine, its the individuals who fuck up. Individual doctors, whom they weren't going to talk about at all in this public lecture setting. And the faceless individual impatient patients. This is where the tension flares up.

In addressing the specific concern of hospital-induced infections, Kaiser woman could only stress the importance of washing hands, as if this was the cure to AIDS. UCLA man said washing hands was important but not visiting the hospital was probably best. Patient advocate presses on these big level administrators to give more specifics about how things apply to the patients.

With so much rancor flying between the patients-rights advocate and the hospital admins, it usually means that both sides expect too much from each other and don't get what they want.

The patients expect too much from the hospital admins/doctors/staff, and hospital admins/doctors/staff expect too much from the patients.

Patients expect doctors to be nice, they want better working facilities, they expect everything to be perfect, they don't pay etc. etc.

However, it's always easy to blame the individual patient for being in the wrong. What makes it appear this way is that patients usually aren't the united front and powerful organization that a hospital is. An impersonal, methodologically organized group of people who have been in the business for years dealing with numerous people can't possibly be wrong over some individual patient's judgement can they?

Moreover, there's this American idea that you must pay for everything with money. Like other industries, it also seems as though patients should pay for all the work and extra anguish that doctors go through. It's a business, no free lunch. Patients should be grateful for whatever service they get and being so open to taking patients in.

Patients are "consumers" in the sense that they do demand a limited resource --- the doctors' service. However, they are NOT consumers in the sense that they will keep demanding a good or service. They are not really ready, willing, and able consumers, but people who believe that they are not well and thus seek an avenue to be well.

There is not much sympathy in American public discourse for patients, and this extends towards the attitude toward the patient in the hospital.

Judging from my mom's stories and the discourse in this dialogue, hospital staff seem to expect that patients should understand what they personally go through as doctors/etc. They seem to expect patients to know how things in the hospital work. They expect patients to check for conditions online as if they were the ones who went to medical school and could diagnose and treat themselves. And the kicker is that they actually want people out of the hospital. Doctors thinking everyone is invested in healthy like they are, expect too much of their patients, so they get tired and frustrated as well.

Thus the equilibrium of tension between doctors and patients in LA hospitals continues. It seems that nobody really gets what they want at a hospital, but it's there because it's business. What strikes me is that doctors really don't want patients to come to the hospital cause they have enough people coming over, but they also want to make sure that they keep up business, especially if they could pay for it.

In the end, the management folks at UCLA and Kaiser could only talk about how patients need to "arm" themselves with information.

There isn't much taught in the public discourse about handling health crises yourself. The internet and google search might be changing that a bit, but not everyone has the internet nor search abilities necessary quite yet. People generally aren't wired to practices of folk remedies, etc.

In America's education system and public discourse, we see and we learn that it is hospitals that we must go to first for any and all health care needs. It's the most visible object. So then here comes the patient expectation system. It's big, it's grand, somebody's got to know something when you go there, right? Doctors know what they're doing, they're rich, they'll help me.

People generally DO NOT want to be in the hospital, but they simply do not know any viable options and hospitals seem to have been marketed as the place to be when sick. There isn't any curriculum in schools for home remedies, alternative medicines, and public health measures are kind of a joke.

The business of healing strikes me as crisis-oriented, kind of like calling a plumber to unclog your sink. It makes me wonder whatever happened to the home visit doctor that I would see in Lassie and other assorted 50s television shows.

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Reflections on In Search of Memory by Eric Kandel

by B.J. on 6/23/2008 02:45:00 PM 0 comments Print this post

I'm not very far in what I think is a career towards the brain and mind sciences or arts.

Spent most of undergrad criticizing the sciences in a minor that I thought would be devoted to just that.

But here I am, 2 years later, needing to learn it...

I bought the book In Search of Memory by Eric Kandel because:

a) I had been given a 2nd Barnes & Noble Giftcard thanks to my friend Nancy
b) I figured I would probably take a class in auto repair...(or just rent a book from the 'brary)
c) I wanted something that would encourage my interest in memory studies
d) I didn't want something that I felt comfortable with and could read in an entire day

Yes, I've figured out something specific...I like the brain...and specifically I like memory.

Memory, because of its multifacetedness.

Short-term working memory has implications for intelligence, which is what I've always been interested in. Long-term memory shows what really lies deep within ourselves. Memory is a reflection of what we give meaning to, what we place importance on. Highly emotional, highly subjective states are what we remember most, because they are packed with meaning, and ultimately that's what we go on.

Overall, I didn't understand a lot of the biological language, but certainly, I became more interested in learning about them. I was interested in the insights he had into the science profession, the mind. Generally speaking, it's stuff you've heard before in the public discourse...our brains are plastic, you can learn a lot no matter what age you are, just in more detail.


On the book's interesting points:

1) Interesting stuff he said about the work of scientists.

First was a comment on scientific research work. He often described those he held in esteem as "creative", as if they were artists, rather than neurological or molecular biologists.

"There are scientists...who are very strong technically but who do not necessarily have the deepest insights into the biological questions they are studying (68)."

Then he mentioned the motviation of scientists; they are no different than any other human beings.

"If pure scientists were motivated by curiosity alone, they should be delighted when someone else sovles the problem they are working on---but that is not the usual reaction. Recognition by their peers and esteem come only to those who have made original contributions to the common stock of knowledge.(68)"

Scientists have a need to prove and validate themselves just like any other human being. However, the specialized, high-level language they use to describe their work, their findings, etc. makes it appear as if they are disconnected from the regular world.

2) On Learning: "Different forms of learning give rise to different forms of memory." (198) I have no clue as to what he's referring to here, but it could be interesting some day.

3) On Synapses and Learning: He mentions the strength of synaptic connections as being the key to learning.

Very important chapter in the book of neuro-bio for unbelievably moronic wankers.

"We found that learning leads to a change in the strength of synapctic connections---and therefore in the effectiveness of communication---between specific cells in the neural circuit that mediates the behavior.(200)

Strength---the long-term effectiveness of synaptic connections---is regulated by experience. This view implies that the potential for many of an organism's behaviors is built into the brain and is to that extent under genetic and developmental control; however, a creature's environment and learning alter the effectiveness of the preexisting pathways, thereby leading to the expression of new patterns of behavior.(202)"

He connects the idea that we have built-in knowledge to Immanuel Kant as opposed to John Locke's tabula rasa.

4) On Synapses: "Synaptic connections between two neurons can be...strengthened or weakened---by different forms of learning. Thus habituation weakens the synapse, whereas sensitization or classical condition strengthens it (204)."

So from this it sounds like habits make you have less synaptic connection because the synapse grows in itself, which means weaker connections between neurons, which means less likely to associate with another thing, which means that your habit becomes more engrained and exaggerated.

In contrast, being sensitized to something means stronger synapctic connections between neurons, which means more likely to associate with another thing, which means that your sensitization and association becomes more engrained and exaggerated.

In conclusion, associative and explicit learning arises from sensitization, while implicit learning arises from habituation.

5) On Neuro-bio: "Long-term memory required the synthesis of a new protein (212)." As opposed to the electrical charges that keep firing from neurons.

6) On Science and Evolution: Evolution does not have any higher purpose than its immediate adaptation for something.

"Evolution does not require new, specialized molecules to produce a new adaptive mechanism" (234).

...The Biochemical actions underlying memory did not arise apecifically to support memory. Rather neurons, simply recruited an efficient signaling system employed for other purposes in other cells and used it to produce the changes in synaptic strength required for memory storage.

7) On Evolution and Neuro-bio: The stuff that makes us what we are...our genes are ALSO subject themselves to the environment in which they live (264).

8) On Memories: A characteristic of age related memory loss is the inability to consolidate long-term memories (266).

9) On Synapses and Memory: The growth and maintenace of new synaptic terminals makes memory persist (276).

10) On Perception: Sensation is an abstraction not a replication, of the real world (Mountcastle via Kandel 302)

11) On the Hippocampus: Hippocampus is concerned with perception of the environment and represents a multisensory experience (308).

12) On Dopamine: Blocking dopamine blocks the stablization of the spatial map in an animal (313).
Dopamine seems like the chemical for explicit learning and memory whereas serotonin represents the chemical for implicit learning.

13) On the Amygdala and Hippocampus: "Damage to the amygdala, which is concerned with the memory of fear, disrsupts the ability of an emotionally charged stimulus to elicit an emotional response. In contrast, damage to the hippocampus, which is concerned with conscious memory, interferes with the ability to remember the context in which the stimulus occurred. (342)"

14) Depression compromises the memory (361).

15) What science lacks are rules for explaining how subjective properties (consciousness) arise from the properties of objects (interconnecte nerve cells) (381).

Reflections:

1) On learning: As he was talking about studying analogs of learning, I was thinking about how people in general, learn. I think at the most ideal level, we learn by figuring out meanings. And then once we "learn" that it means something, we commit it to memory.

He mentioned habituation, sensitiation, and classical conditioning as the basis or most primordial form of learning.

2) On Habituation: Then I began thinking about habituation in my own world. The cycles of the world. I began thinking about the habits of people in the housing developments. What were their habits? What are the habits of the people in the middle and high classs? How did they develop them? What was the geography and environment that forced them to exhibit those habits that they did have?

3) On Sensitization: Then he mentioned sensitatization, and I began thinking about that in my own world. "After hearing a gun go off, a person will show an exaggerated response and will jump when he hears a tone or senses a touch on the shoulder (169)." Essentially, the gun going off acts as a sign and/or a symbol for someone to elicit a response.

4) On Brain studies of the past: I was curious about how this idea ever made sense in American Education in the 1950s:

"We were taught that the map of the somatosensory corex discovered by Wade Marshall is FIXED and IMMUTABLE throughout life." When and why did they think that it was fixed and mutable (216)? Was that informed by religion?

5) On Hippocampus and Spatiality: I also wondered about the hippocampus and spatial information that he mentioned(282).

6) On Intelligence: I was wondering how this fuses into Jeff Hawkins theory of brain and mind in his book On Intelligence.

7) On Fear: Fear is the easily most detectable emotion across species (339). It seems as though this is the emotion that what we give most the meaning to, and so we respond accordingly. It's really a disjointed event from anything were used to, so were likely to give a response out of the ordinary.

He brings in a dose of the breakthrough psychologit William James:

"We do not experience fear until after we have run away from the bear. We first act instinctively and then invoke cognition to explain the changes in the body associated with that action." (340)

Essentially, what he says is that emotion happens afterward, after an event. After the event is finished we build meaning off of that emotion via language expression which is then encoded into our memories.

8) On Learning: I began thinking of the social/asocial aspects of learning.

Learning is a very social activity, and that social activity is one way we build meanings. Learning in isolation is the most fruitful, but it's very difficult because we don't have the benefit of other people affirming your correctness in a belief or whatnot. You're forced to come up with your own meanings, definitions, labels for things and events which might be valid, but might not be recognized by anyone else.

Example: I watch a bunch of NBA basketball, but since I don't really have cable, it's often over the internet via international TV where they're speaking some other language other than English. So I don't watch a lot of basketball in English, which is good.

I don't have annoying commentators like Jeff Van Gundy telling me, indoctrinating me, on how unathletic, but intelligent the whiteboy Kirk Hinrich is, I just see what's on the basketball screen and make meaning out of what's happening all by myself. Therefore I learn what's happening in isolation, relatively speaking vs. other fans. I gain my knowledge of the game by my own observations, interpretations, and analysis. I "learn" what's happening basically on my own.

Realizing that I can learn either socially or asocially kind of annoyed me. Institutions seem to have a monopoly on social learning and will charge the hell out of you just for that. If you're not learning via an institution (and paying at least 20 dollars a unit), you feel like you don't know any avenue to learning what you need to learn.

The library is there, but it's limited and you still wouldn't know where to look.

But I digress.

9) On the feelings of disjointedness vs. fluidity: From Leo Tolstoy: "Happy families are all alike; every unhappy family is unhappy in its own way" (349).

From this quote, I became concerned with the idea of disjointedness in the unhappy family and explicitness vs. fluidity and implicitness in the happy family. Everything seems to be a disruption for the unhappy family whereas, everything seems to work in harmony for the happy family.

The discourse about the unhappy family, and explicitness triggered personal memories of the kids in the housing developments yet again. What types of disjointedness have they experienced and how have they dealt with them? I would think a quality of disjointedness towards long-term ventures, not because it's innate, but because it's been learned.

10) On Working Memory: "When normal individuals are challenge by a task that requires working memory, metabolic function in their prefrontal areas increases dramatically (354)."

Working memory seems to be a tool of social moderation --- they say "intelligence" is just working memory, and prefrontal areas with which it is associated with are associated with planning and judging.

Doubts and Questions:

1) On Kandel's Observations and Reductionist Methods: I wondered if Kandel just colored in stereotypical sexist interpretations in his interpretation of results for the differences between male and female brains.

"He [Some scientist named O'Keefe] has found clear differences in the way women and men attend to and orient themselves in the space around them. Women use nearby cues and landmarks. Thus when asked for directions, a woman is likely to say, "Turn right at the Walgreen's drugstore, and then drive until you see a white colonial houe on the left with green window shutters. Men rely more on an internalized geometric map. They are likely to say 'Drive five miles north, then turn right and head east for another half mile.' Brain imaging shows activation of different areas in mean and women as they think about space: the left hippocampus in men, and the right parietal and right prefrontal cortex in women. (315-316)"

That's pretty much a hegemonically sexist thing to say: women are the fluffy, artistic, right-side thinkers, while males are the logical, left-side thinkers.

I consider myself a male and masculine and all that other shit, but I definitely don't give directions like the cold hard-cut logical male. I currently don't have the means to argue against what he says, but I just know that what he says doesn't seem to represent the truth.

2) On Kandel's Memory and Perception of this growing epidemic of "disorders of memory"...disorders of memory are more evident today than they were when I began practicing medicine fifty years ago because people are living longer now (327)"

This brings up other questions related to medical anthropology and health care that cut across time and space.

Perhaps more people are just diagnosing more, prescribing more, just to make more money, which gives off the feeling that "disorders of memory are more evident today."

After all, the guy is in the pharmaceutical biz...

Also, people probably are living longer, but how is he sure that a connection can be made between the fact that there are more memory disorders and a longer life expectancy?

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