Vegetative State

It’s hard to know what to do with people when they are in a vegetative state. By vegetative, I don’t mean that they are spending all day sitting on the couch and eating Oreos. A clinically vegetative state is diagnosed if a patient does not respond to any sort of external stimuli, whether visual, auditory, tactile, or noxious. This can occur after severe brain injury, if a patient wakes up from the fully comatose state but is not actually conscious, a state known as “wakefulness without awareness.”

Okay. So we have a person sitting over here, and they are not responding to anything we do to try to evoke a reaction from them. What do we next?

            Ethically, this is a very complex question. Some people eventually regain their awareness, and recover from this state. Others stay that way forever, in which case it would hardly seem worthwhile to keep them alive. But the question is, how can you know?

            People who are able to react on some levels, perhaps following a command, but not able to fully interact, are described as being in a “minimally conscious state.” This is the key state in clinical assessment. If someone is fully vegetative, they no longer possess the facilities to be able to respond to any stimuli, to be aware. However, if they are minimally conscious, they have the capacity to respond.

            It seems like it should be simple to distinguish between these to states. Poke them with a stick; if they respond, they are conscious. Obviously, there’s more to it than that. It’s difficult to tell if a response is voluntary, even on a subconscious level, or is merely a reflex – a kneejerk reaction. In the past, medical officials have had to rely completely on motor responses, as in a physical action. It’s very possible that a physical response is not actually a sign of awareness, and is merely a reflex, and on the other hand it is very possible that the patient has some bare minimum awareness, but is not able to physically move. Basically, it seems like it is impossible to know – we need some way to actually communicate with these unconscious patients, and, of course, they are not conscious for us to do so.

            With technology continually developing, though, we may not need to. A study a few years ago monitored brain activity of a series of presumed vegetative patients as they were asked to imagine two situations – playing tennis (a motor imagery task) and walking around their house (a spatial imagery task). Theoretically, imagining these two different tasks would activate different parts of the brain, visible in an MRI scan. A small number of the patients did seem to be actually able to imagine these tasks when told, i.e. their brain activity changed when they were told to do a certain thing. This implied that they had some level of awareness – they were at the above-mentioned minimally conscious state, rather than being vegetative.

            Okay. So we’ve figured out whether this person is actually conscious at all. Why do we care? What can we do with that?

            It turns out that this simple information is enough to actually communicate with the unconscious patients. For the next part of the study, the patients who seemed to be able to respond were asked a series of yes and no questions. They were told to answer, substituting the tennis or house imagery for “yes” and “no.” They were able to correctly answer several questions about their personal lives, which had been previously confirmed. This method of communication was considered, with further development, able to allow patients in this state to express their thoughts and opinions and generally improve their quality of life.

            An example of the application of this occurred quite recently. A Canadian patient, Scott Routley had been vegetative and incommunicative since getting into a car crash twelve years ago. Undergoing interrogation in this method, Routley was able to communicate to the doctors that he was not in any pain. It seems like such a simple thing, but the ability to communicate with minimally conscious patients could open many doors in improving their quality of life.

Original report of the study here: http://www.nejm.org/doi/full/10.1056/NEJMoa0905370

- Megan Berry

The Big Bang

First there was nothing.  Scientists believe that was the case approximately 14 billion years ago.  Then, there was “something” very, very small, very, very hot, and very, very dense. Inside this “something” was equal parts matter and antimatter.  This “something” then inflated and expanded and then cooled.   This was the Big Bang.  One second later antimatter had virtually disappeared.  Matter remained and formed our current Universe. 

Scientists are not sure why the “something” appeared or where it came from.  However, conditions and energies that existed after the Big Bang are being recreated underground in a tunnel under the Swiss/French border near Geneva.  The tunnel, which is 27km (16.5 miles) long and 100 meters (109 yards) underground, contains a collider called the Large Hadron Collider. 

The Large Hadron Collider (LHC) is the world’s most powerful particle accelerator.  Inside the collider, two beams of atomic particles (protons or lead nuclei) are accelerated in opposite directions at high speeds head on into each other.  When the particles reach their highest speed, the LHC allows them to collide.  The collision produces other particles. Detectors inside the collider are able to track the collisions and record what is created and how the new particles behave. Computers then process the data.  The more energy that is produced from the collisions, the more similar the collider simulates what occurred after the Big Bang.

The LHC will help scientists understand how and why the universe developed the way that it did.  It may answer the question, what happened to the antimatter.  Aside from testing theories, the project will also have other benefits particularly in the fields of medicine and technology.  Take a look at the LHC.  It’s pretty cool.  http://www.boston.com/bigpicture/2009/11/large_hadron_collider_ready_to.html
- Celine Delaunay

Über Notes

I know that there are countless guides up on how to manage time and things like that, but I hope that this specific description of a technique for organization will help others in my Commonwealth community.

           
 My innovation was the implementation of highly distilled “Über Notes.” These notes make it easy to see the main ideas of class discussions and reading assignments. I have two kinds of Über Notes, one is something akin to a study guide and one is a simple cheat sheet. (I’ve found that my Science classes are the ones that benefited the most from both types of notes, but that they are applicable to any subject.)

My study guide Über Notes tend to just be main ideas pulled from other notes. I know for me, when I’m taking notes in class or as I read textbooks I tend to write everything the same size and the same way, which makes it hard to see the main ideas of a source of information. Über Notes let me emphasize bigger points and carefully sub-label details that I need. On top of that, I can omit small things that aren’t important; this allows me to consolidate my notes onto one sheet. The main difference between Über Notes and a regular study guide is that I make study guides only at the end of a unit, when a test is near. Über Notes work best if they are constructed the whole way through a unit. The upside of this is that you can add to them everyday when things are still fresh in your mind, but it does require a fair bit of effort to carve out that time-slice to get it done every day. On something of a formatting note, I like to keep the heading of notes “Über Notes” because there really should only be one set of Über Notes per class. Don’t make a different one for each unit (You can make different pages if you like, but make sure to either paperclip them together or have a special place in your binder where all of your Über Notes go) and defiantly make sure that your Über Notes don’t become anywhere as plentiful as your “normal” notes.

For me, I prefer the “cheat sheet” Über Notes. If you are taking or teaching a class which requires a lot of little bits of information that are crucially important (Chemistry equations, theorems, kingdoms of organisms, important people, countries, vocabulary words, etc.) then making a simple list is very helpful. For me, as I take Chemistry, it makes it easy to see everything I need to know. I have one side where I put all of the equations that I need to know to find energy or other things about atoms. On the other side, I put a key of all of the symbols, what they mean and, for some of them, their values. The difference between these sheets and regular ones is that on Über Notes it is imperative that I put minimal to no explanation of what the equations meant, so that when you review them, you will be testing yourself to identify which one would help with a specific problem. Also, I can use these notes as a quiz, to see if I can identity what each equation does and when I would use it. This allows Über Notes to play both the role of a reference sheet and a study guide.

Though Über Notes are powerful tools, they cannot replace regular notes outright. Notes taken in class are pieces of information that need to be captured rapidly; Über Notes require planning of the structure of both the content and page layout, neither of which should be taken lightly. Naturally this takes too much time to do in class, and must be done at home after school. While it is helpful to start to move your regular notes towards Über Notes, the two should ultimately be different.  The nice thing about this structure is that the Über Note itself is just a concept and framework of what you end up putting down on paper. Each one should be unique in both layout and porous to a certain extent, but if they get too specialized, it kind of takes the point out of having standardized fact sheets. The specifics of Über Notes are up to you, so you don’t have to do annoying work that you don’t like. As a guide, I’ve posted a picture of what some of my Über Notes look like. I suggest you draw yourself a template for your own before comparing with others, so that they won’t influence you too heavily.  

- Gabriel Seltzer

The Poisoner’s Handbook

Did you know that radium gets absorbed into the human body by disguising itself as calcium? Did you know that carbon monoxide poisoning leaves its victims’ blood an unnaturally vivid scarlet? Did you know that strychnine poisoning makes the victim’s insides look like they got mauled by a bear?

                  Did you know someone wrote a book about all this?

                  It’s called The Poisoner’s Handbook, and the author is Deborah Blum.

                  If you’ve read this far, I assume you are fascinated by forensics. Excellent. This book is about the growth and development of forensic medicine during the 1920’s in New York City. The 20s are always depicted as a glamorous era – the jazz, the bootleg alcohol, the flappers and the gangsters – but this book delves into the criminal underside of it, graphically describing the poisons people drank when they were desperate for alcohol and how people would poison their own friends and relatives to get money ; poison in those days was relatively difficult to detect in a body.

                  However, when medical examiner Charles Norris took the office, he did his best to change this. He ran experiments with every new kind of poison until he could detect a minute amount from a couple of grams of flesh. He worked at all hours of the day and night to catch criminals.

                  Of course, the fact that poisons became easier to detect didn’t mean that people stopped poisoning others. It just meant that they came up with more creative methods. I can’t go into detail here because, well, this is the Internet and everyone is reading this, but suffice to say this book will make you incredibly paranoid about accepting gifts from others for a while.

                  I enjoyed this book because, although it is, in essence, a history of science book, it doesn’t read like one. Instead, in Deborah Blum’s hands, the historical figures take on personalities and stories of their own, and even the criminals are fully fleshed out and frighteningly real figures. This is one of those books you will stay up all night to finish, and a book that will stay on your mind for weeks after you’re done.

 Feyga Saksonov

Vive le Québec Libre?

Québecois independence has once again taken on a sense of urgency with the election of Pauline Marois as Premier of Québec, the first member of the secessionist Parti Québecois to hold the office.  But we, as New Englanders, are surprisingly ignorant of the struggle of our provincial neighbor to the north.  The issue certainly carries little weight in my French Canadian family.  I’ve always wondered why.

The answer developed somewhat subconsciously as I came to realize the lack of publicity the secessionist movement was receiving, especially in social media and other free-sharing pockets of the Internet.  I felt removed from the issue; the outcries of the Parti Québecois seemed to be buried beneath other diverse, open, and rebellious social discussions and demonstrations that spread all over the Internet in the form of “memes.”  In fact, in this Internet connected generation that values individualism, it is even trendy to be on the side of the oppressed minority.  Where was the Parti Québecois in all this?

And then it dawned on me:  the Québec secessionist movement represents a society of people who feel that their identity is threatened by the integration and development of ideas that the Internet represents.  Put simply, the Québecois cling to old-fashioned and conservative ideas of nationalism.  Everything suddenly made perfect sense.

The Parti Québecois was founded in 1957, at the beginning of an age of unprecedented globalization, and, for the diverse United States, an expansion of influence in the West.  These two features of the mid-century world rattled the foundation of the distinct culture of Québec, a society that had been, for hundreds of years, preserved in its isolation, content in its uniqueness, and even proud of its standing as a special part of Canada.

Now, only when they feel their preciousness is being suffocated by the global community growing around them do the Québecois suggest secession.  Instead of embracing a new identity in a diverse and connected world, they intensify their long existing difference of cultural and language and retreat behind them as justification for separation.  In reality, the Québecois are scared.   

I used to love to piece together clues about my French Canadian ancestor’s motives for immigration from the attitudes they imprinted on their children, my grandmother and her siblings.  It didn’t take much mumbling of now mixed sarcastic French Canadian and shrill Bostonian accents for me to realize that my ancestors loved the Unites States, its diversity, and cultural stew.  It’s the reason they emigrated here.

The reason Americans, and New Englanders in particular, are so removed from the movement for an independent Québec is because it represents an alternative to the inclusive and global community we have created. 

--Thomas MacDonald

Pick On Someone Your Own Orientation

Walking down the hallway to my public school’s auditorium as a young seventh-grader, I could hardly contain my glee.  We had an assembly, a very rare and very exciting event, mainly because we got to miss multiple periods of class.  My frivolity abruptly stopped as an unassuming, middle aged man walked on the stage of the auditorium with tears in his eyes and introduced himself.  His name was John Halligan, and his son, Ryan, had recently taken his life in response to bullying after a false rumor was spread in his school that he was gay.

At the same time, 1,500 miles away in Minnesota’s Anoka-Hennepin school district, parents just like Halligan were grieving over the loss of their children whose lives were cut short by the same toxic bullying Ryan had endured.  In the course of two years (2009-2011), nine students in this Minnesotan school district committed suicide.  All of the deceased students either identified as members of the LGBTQ community or were perceived to be queer, and therefore bullied by their peers at school.  At one school in the district, a boy was called “fag” by three kids and assaulted in the hallway of school, as a teacher looked on and did nothing to stop the violence.  A middle schooler reported to the principal that multiple boys urinated on him in the public restroom.  The principal responded that it was probably just water.

How could these adults, these people expected to lead and exemplify good behavior, let these horrendous attacks happen without consequence?  The school district, before and through 2011, had in place a strict “neutrality policy” regarding sexual orientation and gender identity.  This policy declared that all teachers had to remain absolutely neutral on the topic of sexual orientation.  And, in my opinion, what this policy stated was fair enough – when teachers discuss religion or politics, for example, they are expected to remain neutral on these topics.  But the neutrality policy in action was a different story.  It obliterated any sort of safe space for students identifying as LGBTQ.  It provided no help or guidance to students grappling with their sexual orientations or gender identities.  And it gave the teachers permission to ignore any sort of bullying directed at the queer population.

In February of 2012, the district repealed the policy after the Southern Poverty Law Center and National Center for Lesbian Rights filed a lawsuit at the school district on the policy.  The school instated a new policy.  Although still requesting neutrality from teachers on the subjects of gender identity and sexual orientation, this new policy allows open discussion of these topics, presented factually by the teachers.  This change gives students a safe space to voice their opinions and personal beliefs, if found appropriate to the subject.  The school district also instituted an anti-bullying task force.  Win, right? 

Wrong.  One of the adults on the board, Bryan Lindquist, is vehemently anti-gay, promoting “gay therapy” and leading an anti-gay hate group called “Parents Action League.”  So, the school district allowed a man aggressively anti-gay on the anti-bullying committee created solely for the protection of all students who identified as queer.  To me, it seems as if the district lacked any sort of commitment to actually protecting the rights of LGBTQ students.  Their change in policy seems more like a response to the legal action against the school than a genuine concern for this population.  Nine lives were lost, nine lives.  Is that number still not large enough for the school to feel the need to implement real protection for their students?

Recently hearing this news, I was brought back to my seventh-grade assembly.  The town where I lived was tiny and I didn’t know anyone who openly identified as anything other than a cisgender heterosexual, but even in this extremely homogenous town, my school found it necessary to dedicate a rare assembly to focusing on the struggles of teens who are bullied for their perceived sexual orientations or gender identities. Studies have found that between 30-40% of teens identifying as LGBTQ have tried to commit suicide at least once in their life.  And I truly believe that most important way we can reduce these numbers is by adding curriculum on the LGBTQ community to every single school system so that those who don’t understand and bully in response can be enlightened, and the LGBTQ youth can have guidance and acceptance in at least one of their formative environments.

-- Zoe Meyers

Eid-Al-Adha: The Festival of Sacrifice

Eid-El-Adha, which is one of the most important Islamic holidays, commemorates Abraham’s complete faith and obedience towards Allah in his willingness to sacrifice his own son, Ismail. Rather than running away (which is what I would’ve done!), Ismail kneeled and waited for his father to kill him. At this moment, Allah sent the angel Gabriel with a sheep for Abraham to slaughter instead.

Eid is a beautiful time of complete bliss in all Muslim countries. Starting on the night of Eid, Muslims begin to thank Allah until the next morning, when Muslims gather to perform the Eid prayer together. After this prayer, the entire community is united in one place and smiles fill the air as everyone talks and begins to celebrate together. In Mecca, Eid is the last day of the pilgrimage (hajj).

After the prayer, families who have enough money must slaughter a sheep in a halal manner. One third of the sheep is donated to the poor, one third is for the family and the extended family, and the final third is for friends. Throughout the next four days of Eid, it is custom for families to visit each other and exchange gifts for the children.

Eid-el-Adha allows me to realize the importance of community, generosity, obedience, and the spread of happiness.

This year, Eid-el-Adha begins on the night of Friday, October 26^th! Happy Eid, everyone!!!

-- Diana Abbas