The Power (& Responsibility) of Idea-Sharers

25 04 2011

The cartoon above is by David Horsey, from the Seattle Post-Intelligencer.

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“An idea is like a virus: resilient, highly contagious.  The smallest seed of an idea can grow. It can grow to define, or destroy you.”
Inception (2010)

It is worth mentioning, again, that vaccines have been scientifically proven over and over to not be a cause of autism.  I mention this here today because even though the original scientific paper that suggested MMR vaccinations as a potential cause of autism has been retracted, and the author completely discredited, this idea is still alive and well today.

An article by Generation Rescue (the anti-vaccine organization supported by Jenny McCarthy) published a month ago (March 30, 2011) protested a new vaccination requirement against pertussis, diphtheria, and tetanus in California, with one argument being that there was no diphtheria outbreak last year in the US.  Yes, there was no outbreak, but that’s because widespread vaccinations largely eradicated this illness in many industrialized nations.  If herd immunity (i.e., the vaccination of a significant portion of a population provides a measure of protection for individuals who have not developed immunity) did not exist to protect the entire community, illnesses like diphtheria would be allowed to return to our communities.

But my post today is not about the ridiculous arguments against vaccinations, or how these incorrect notions are extremely detrimental to public health and our society, though I’m always happy to be part of those conversations.

No, my post today is about the infectiousness of an idea, just like they described in the movie Inception.  An individual’s ideas can determine the course of one’s life – his or her ambitions, decisions, careers, and passions.  A society’s ideas shape a community’s laws, morals, dreams, and beliefs.

Barack Obama arguably became the President of United States because of a campaign of ideas: “For Obama is a man who recognizes the power of ideas, and in particular the idea of hope.”

China bans Facebook, Twitter, YouTube, and censors Hong Kong news when it mentions certain instances of rebellion against the government, because they are afraid of the spread of ideas.  Every city in China has a mayor in charge of maintaining and solving the problems of the city, but every city also has an appointed governmental official more powerful than the mayor, in charge of maintaining the minds and political beliefs of the citizenry so they are in line with what the Chinese government wants.

I mention the above as examples of how powerful ideas are, and how they shape our world.

Ideas can obviously be used for both good and evil (yes, and shades in between), and I believe it is this notion that TED talks were predicated on.  TED is all about “ideas worth spreading”: free talks available online given by great thinkers and doers, challenged to give the best talks of their lives.  I value TED for its inspiration and their belief that good ideas belong free to the community so that they can be built upon by others, but most importantly, I see TED as an organization that promotes ideas that are well-founded and truly novel over ideas that are fear-mongering and false.

It is because of my shared passion of discovering and spreading good ideas that I decided to get involved with the 2011 TEDxMcGill, an independently-organized local event in the Montreal and McGill communities that is licensed by TED.  My hope is that we will find some undiscovered, phenomenal idea-sharers in our community and help propel their thoughts to the world.

If you are similarly passionate about the power of ideas and you’re interested in volunteering with TEDxMcGill this year, please check out www.tedxmcgill.com and apply before the end of this month (April)!

This was a well-disguised promo piece, don’t you think?

I leave you today with two TED talks.  The first is about the dangers of denying science (where the anti-vaccine movement is featured).  The second is about how science can answer questions of morality.

Good ideas, in my opinion, are not necessarily ones that everyone will agree upon or even believe in 100%, but they are thought-provoking and relevant conversation starters that change an individual or community’s perspective on matters of daily importance, based upon sound evidence and building upon previous ideas of the world.

Thus, I present the two TED talks below because they certainly are fascinating thoughts…

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How To Sell Science

11 12 2010

The above poster was created to promote the Rock Stars of Science campaign!

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One of my favourite shows of all time, the West Wing, had the President discussing the fact that despite solid scientific evidence suggesting that the existing drug policy should be changed to reverse the 2-to-1 funding ratio for narcotics law enforcement to treatment, science simply doesn’t sell, and the public will not buy what science has to say about the issue.  They will simply see a change in policy as the government becoming soft on drugs and crime.

Setting aside my own thoughts on drug law enforcement versus treatment, the salient issue for me today is how do we make science sexier?  How do we make people care?  How do we convince the public that what we have to say is valid and useful and directly applicable to their everyday lives?

I’ve always believed that part of the problem is that as scientists, we are trained to explain the significance of our findings in a reasonable, measured manner, so we cannot simply say that we found an HIV vaccine (just to be clear, we haven’t really found one yet…), for example, without qualifying that it only worked for a small proportion of people and only for a year because that’s how long the study lasted for.  In the fast-paced world of today, the public has no time and no interest, and perhaps not enough scientific education to understand the details of the findings.  The media knows what the public wants, and so it takes advantage of the disconnect between scientist and public to distort findings and create sensationalized news.

Scientists are constantly frustrated with our inability to engage the public, because without public interest and attention, there is less government funding for the research, and our findings make less of an impact in how the world is seen and run.  This frustration can force us to make mistakes in hopes of reaching out to the public, such as the recent NASA gaffe about how finding bacteria grown in arsenic opens the possibility of finding life in parts of the universe that might otherwise be considered uninhabitable.  I think part of the issue is that the findings may not have been as conclusive as it was announced to be, but the other part is the huge leap to the conclusion that this finding greatly increases the possibility that there is life on other planets.

Of course, the scientists aren’t really saying that the findings, if true, would mean that life has been found on another planet, but certainly, NASA would have known that the way in which they presented their findings would lead to the media spinning the story to insinuate to the public that finding these arsenic-resistant organisms means we are one step closer to finding alien life, essentially sensationalizing the story.

As a result of this news, both NASA and the scientists are being attacked by other scientists, questioning the validity of the study and the way in which the news was revealed to the public.

In short, my point is that communicating science accurately to the public and getting the public to care and understand the findings is a huge challenge that we, as scientists, are not very good at, but this is a problem that needs to be tackled, because it affects everyone.

How to communicate science is a topic that is very near and dear to my heart (because I think scientific findings can be so beneficial to progress in the world in all domains of life if politicians and policy makers could understand the findings and take them seriously), so I have blogged about this before, but the point of my post today is that I actually have some examples of how some people are finally tackling this important issue!

The Rock Stars of Science campaign pairs well-known celebrities, like Sheryl Crow, Timbaland, Josh Groban, Bret Michaels, and Keri Hilson, with leading scientists to bring more awareness to the scientists and the research that they do in hopes of engaging the public.  I think this is a great start to building these types of relationships, but my greatest critique about the project is that it’s unclear what the organization does other than make these great posters.  From what I can gather, online donations are collected and donated to research.  It would be great, though, if the stars could be leveraged in other ways, such as with tv ads, concerts, etc., for the same cause.  This may be happening, but it’s just unclear from the website that it has been.

My other critique of the campaign is that it seems to focus on medical research, which is great because their message is on giving back by helping find cures and taking science from bench to bedside.  However, if other similar organizations can focus on the importance of basic research in areas like physics and chemistry, that could really help the public understand that all research builds upon each other, and without basic research in very remote areas of science, there would not be any medical advances at all.

Now if only they got all the stars together and created a nerdy theme song with the scientists…like this one:

The other fantastic initiative related to science communication that I discovered was started by the great Alan Alda, the actor from M*A*S*H, the West Wing, and many other credits.  Essentially, he started a program that trains research scientists in improvisational acting in hopes of improving their skills in communication to the public.  I think this program is exactly the type of thing we need in science, and I can’t decide between wanting to be part of this program and helping organize it!  Probably both!

If you’re interested, please read the article, because I think it does a great job of summarizing why the program was instigated and why it’s important. As Alan Alda, who first realized this communication problem when he interviewed hundreds of the world’s top scientists about their discoveries for Scientific American Frontiers (a show on public television from 1993-2005), puts it, “We need to talk to the public.  This is holding back the country, and it’s holding back the world from making progress on what we now know…The affect, facial expression, body language — these are things that you wouldn’t think are part of a scientific presentation.  Emotion is so important.  In scientific communication, emotion is probably trained out of us, but there’s no reason why it can’t be included.  Science is a great detective story, especially when you’re talking to the public.  You want them to get involved in this interesting, emotional tangle.”

I am now applying to study at the Centre for Communicating Science at Stony Brook University =).

I think a next step should be for governments to hire more scientists (and/or involve them and value them more) so that they can have regular conversations with policy makers and explain the significance of certain findings, both to downplay findings that are overinflated and trumpet the ones that didn’t have great PR.

In essence, I think we need more scientists to help government officials see more clearly the value and objective truths of science.

Of course, scientists are still human, and thus we also have political biases just like everyone else.  The trick, I think, would thus be to select a panel of scientific advisors that as a group have relatively balanced political opinions.  However, as a recent news article from the journal Science brings up, the vast majority of scientists are liberal-minded, so finding conservative scientists to fill these positions may be a challenge.  If there could be more scientists with more conservative political ideologies, the hope is that they could better convince their governmental colleagues of what science brings to the table.

Why most scientists are left-leaning is an interesting question by itself, but I think I will hold that thought for another day…





Rock the SAD Away

28 11 2010

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Apologies for the long hiatus since the last post: I believe I have been suffering from SAD (seasonal affective disorder), which is the onset of symptoms of depression (e.g., overeating of carbs, oversleeping, general lack of motivation to do anything) during the winter months (although it is also possible for SAD to manifest as spring-summer depression rather than autumn-winter depression).  Some have designated SAD as a leftover adaptive trait akin to hibernation while others have postulated about vitamin D deficiency and/or melatonin hypersecretion during the winter months as a risk factor of SAD (due to low levels of sunlight).  I think November is a bad month for me because the days are shorter than in almost any other month, the sky is darker, and the oversleeping means that I miss most of what little daylight there is.  The overeating and the lack of motivation to go to the gym or dress nicely means that my self-confidence has also taken quite a hit, which just feeds right into the delightful cycle of overeating, oversleeping, anhedonia, and unproductivity.

Of course, it doesn’t help that artificial lighting has been linked to overeating and obesity, because the decrease in natural light during November means the increase in artificial lighting.

But my point of this post is two-fold.  First, it was to explain and apologize for my lack of updating this site (but I’m getting better so expect more ramblings asap!).  But second and more importantly, it’s to point out that SAD can affect anyone, especially students who are already stressed at this time of year as it is (because of exams, assignments, papers, and balancing school, life, family, extracurriculars, and everything else during the holiday season).  SAD has been found to affect somewhere between 1% to 10% of North American populations.  So if you are like me, and you have been feeling particularly unproductive (I’ve pretty much just stayed at home watching old episodes of “The Nanny” while ignoring most academic, social, and personal responsibilities), it’s sometimes helpful just to know that there’s a reason for it that’s not your fault.  It’s good to know that I’m not just getting fat and lazy because something has changed in my personality and in my ambitions, but because I’m suffering from an illness.

And if you are suffering from SAD, November is almost over, so hopefully it’ll get better once the holidays arrive and the Winter Solstice has passed (meaning that the days will become longer).  But if you are strongly affected by SAD (or even if you just want it to go away), there are things you can do to fight it.

For me, what has worked is forcing myself to sleep earlier and wake up when there is sunlight.  Maximizing sunlight exposure makes a world of difference; regardless of whether it’s the placebo effect, vitamin D production, the sociocultural effect of being with my community during the daytime, or some other effect altogether.  What has also worked for me is making the effort to exercise, dress up, and be with people I care about, because doing things that make me happy and give me confidence will hopefully feed into a positive cycle of feeling less depressed and more energetic.  I’ve also been experimenting with turning on the heat in my apartment, because I realize that part of the reason I overeat and feel lethargic may be due to the fact a lot of my resting metabolic energy is dedicated to producing heat to keep my body and brain warm, which diverts attention away from other matters, like thinking and studying (good excuse, eh? =D).

If those tricks don’t work for you, you can try taking vitamin D supplements, using light therapy (bright light, or perhaps green light, which may suppress melatonin production – I’m buying a light box as I type!), dawn simulation (having lights gradually turn on just before the alarm rings to wake you up), and high-density negative ionization (releasing charged particles into the sleep environment – my light box also emits negative ions!), although I would suggest going into the primary literature to look at clinical trials to learn more about how effective these treatments are and whether they are likely to work for your demographic.

If these therapies still don’t work, you can visit a psychiatrist, who can then help with diagnosis and treatment, and may prescribe antidepressants, timed melatonin doses, cognitive behavioural therapy, or other treatments, depending on what is right for you.

I think the unknown is the scariest thing.  Knowing what we’re dealing with is half the battle.  And now, I can try to treat myself for a psychiatric condition (although it’s not really a stand-alone condition in the DSM-IV, and I don’t know that I would actually qualify as suffering from it according to the DSM…).

Hopefully with the onset of snow, the white, bright, cleanliness of it all will help me fight this SADness.

On a related note, I have decided to start petitioning for clocks not to be put back during the fall, for the sake of health!

November is almost over…





Of Autism And Vaccines – How Do We Communicate Science Better?

30 08 2010

There are very few things that I get full-out angry about, but the allegation that vaccinations cause autism is one of those few topics that make me furious.

A BBC article today posted that a mother of a brain-damaged teenager in the UK received a £90,000 payout from the government in response to the complaint that the teenager suffered his first epileptic fit 10 days after getting the MMR (mumps, measles, and rubella) vaccine as an infant.  I am not upset that the mother received the money; in fact, I’m glad that she has some funding to help deal with what must be a difficult illness with her son.  What I am upset with is the fact that this payout is, in my opinion, inaccurately publicized by an international news source, and the money is termed as a “compensation award”.

I have nothing against the BBC reporting what happened.  Unfortunately, my concern is that those who read this article will use it as evidence that vaccinations cause brain damage, because they might think, “Why would the government pay for it otherwise?”  I’ve always believed that scientists do a poor job in translating research findings to the public, and that is our fault.  However, the media doesn’t help when they publish articles like this.  I think I go too far if I try to say that it is irresponsible journalism, because they did put in the clarifications that the “decision reflects the opinion of a tribunal on the specific facts of the case and they were clear that it should not be seen as a precedent for any other case” and that “the ruling had no relevance to the question of a link between the vaccine and autism”.  Unfortunately, none of these explanations happen in the headline or the first six sentences.  I could be wrong, but I don’t think everyone reads to the bottom of every news article, and I’m concerned that society’s diet for sensationalized news and the media’s need to keep up with our appetite means that this article was meant to attract readers who want to use this news to fuel the anti-vaccine campaign.

Maybe I’m completely wrong about this – I hope I am wrong, but with celebrities like Jenny McCarthy strongly supporting organizations that encourage parents to doubt the validity of vaccines, I’m worried that there is a large subpopulation of people who buy the bad PR of vaccinations.  The reason this topic enrages me is because if babies are not vaccinated due to this type of misinformation, not only can the babies get sick and possibly die from those diseases, but herd immunity is lost and it puts entire communities at risk.

Misinformation of this nature is completely irresponsible and it kills, and it simply breaks my heart to know that babies are possibly suffering deaths that could have been prevented, not because of their fault, not because of their caretakers’ fault, but because poor communication between researchers, the media, and the public have led to poor reporting and other irresponsible actions that put all of society at risk.

I put the greatest burden on researchers, because I feel that we, as scientists, have an obligation to properly publicize our findings in order to educate the public on the relevance of our work to their lives.  We should not exaggerate our findings, nor undervalue them.  We are the source of information, so we need to be the most responsible, because if we start off the game of telephone with the wrong words, there is no way that the game can end well for anyone.

To illustrate the power and the necessary responsibility of the researcher, one needs only look at the Wakefield paper published in the Lancet journal in 1998, suggesting a link between the MMR vaccine and autism.  This paper lent great support to the anti-vaccine movement, and even though there were many concerns later on about the study’s tiny sample size, Wakefield’s conflicts of interest, and allegations that he manipulated the data, the damage was done as soon as the press conference occurred.  As with the chaos theory, once the butterfly flaps its wings, it can no longer control the results of its own actions.  Thus, despite the Lancet paper being completely retracted this year and Wakefield being found guilty of professional misconduct through unethical research, the bad seeds have long been sewn, and the anti-vaccine movement continues as a beast of its own.

In a small group session at school last week, we discussed whether press releases for scientific research should be peer reviewed the way that scientific journal articles are peer reviewed.  My opinion was and is that there is an even greater need for press releases to be peer reviewed, because scientists may have some existing knowledge background from which to judge the validity of a study’s findings, but many in the general population do not, so it’s extra crucial for the scientific information to be explained to the media and the public in an accurate, concise, clear, and cohesive manner.

I guess my frustration and sensitivity with this issue lies in my inability to think of how we can go about rectifying this huge gap between research findings and public understanding of science.

Any ideas?

P.S. Please read this peer-reviewed article for a review of the hypotheses and evidence (or lack thereof) surrounding the link between vaccinations and autism.

P.P.S. Below is a video news report on how US federal judges this year found that there is clearly no scientific link between vaccinations and autism.





My Final Paper @ UBC!

27 06 2010

That’s it.  I’m done.  Today, I have officially finished my last course at UBC (at least for the foreseeable future), and I become an alumnus.

I have had several conversations about being essentially graduated and I have mostly avoided talking about it.  Mostly avoided confronting this reality, because it should be a happy occasion, and it’s not.  But more on that later…

For now, I wanted to share my final paper for my HIV course below.  We were allowed to write on pretty much any topic we wanted in relation to HIV, and I wanted to explore why HIV transmission is still so high in the gay population even though education, prevention, and treatment programs have been targeted at this population for a very long time.

Please feel free to share any thoughts and comments!

Exploring the Role of Psychological Factors in Decision Making for HIV Transmission & HAART Adherence in Homosexual Males

1. Introduction: Why Psychological Factors Matter for HIV in Gay Men

AIDS became thought of as a gay man’s disease starting around 1980, when gay men showed symptoms of PCP and the HIV virus was not yet discovered or attributed to AIDS.  To this day, in BC, there are over 150 new cases of HIV in men who have sex with men (MSM) per year, around 50% of all new diagnoses.  MSM also has the highest total HIV prevalence, ahead of intravenous drug users and heterosexual contact.  The question then becomes why HIV is still such a problem in the gay community today even though its members were many of the first to receive monitoring, treatment, and education for HIV. 

Our preventative and educative measures are failing because sexual decision making is a particularly complicated psychological issue for homosexual males, and this complexity extends to HAART adherence.  Here a distinction is made to focus exclusively on men who identify as gay, which is a subset of the MSM population.

2. Psychological Factors on Transmission

A study in Rio de Janeiro, Brazil (Elkington et al. 2010) distinguished between three domains of mental illness stigma and how each domain associated with sexual activity.  The domains included personal experiences of stigma (e.g., “Has anyone made fun of you because you have a mental illness?”), perceived attractiveness (e.g., “I am an attractive man/woman”), and the belief that having a mental illness restricts opportunities for romantic relationships (e.g., “People think men/women with mental illness are sexually undesirable”).  Even though there were three domains, only those who reported greater relationship discrimination stigma were significantly more likely to be sexually active and to have unprotected sex.  Even though these findings were regarding mental illness, they hold important implications for HIV risk behaviours in homosexual males.

The aforementioned study clearly outlined how stigma affects sexual behaviour, potentially contributing to the continual prevalence of HIV in the gay population.  Roehr (2010) describes how institutionalized homophobia and religious extremism have fuelled Africa’s HIV epidemic, as a gay Kenyan wedding leads to riots shutting down an HIV clinic for two days, two gay Malawians are sentenced to 14 years’ hard labour for hoping to wed, and Uganda proposes capital punishment for homosexual acts as well as punishment for families, friends, and colleagues who do not report them.

Though to a lesser extent, such institutionalized homophobia can be witnessed even in the developed world, with examples including the Don’t Ask, Don’t Tell policy and state bans on gay marriage in the United States.  Even in Canada, where gay marriage is legal, institutionalized homophobia still exists with such antiquated policies as banning men who have had sex with at least one man since 1977 for blood donations.  This blood donation policy saved many lives when technology failed to accurately screen blood for the HIV virus.  However, that is no longer the case, and the policy today stands as discriminatory behaviour against MSM, an institutionalized judgment that MSM, even though they were born this way, are all public health risks regardless of the individual.  Martucci (2010) describes how in the US, federal Committee members used the underlying flexibility in the meanings behind the term MSM to justify continuous support of a similar policy there.  Just because there is a higher prevalence of a virus in a certain population, it does not justify such institutionalized discrimination.

Unfortunately, although reversing institutionalized homophobia is important, that is only the first step in eliminating homosexual stigma, as individual homophobia will still exist in the community.  On Britain’s Tonight programme, Afraid to Be Gay, members of a community admitted to accepting gays in public but not being comfortable with seeing homosexuals holding hands on the street or performing in sports.  This type of individual homophobia is passed on within families and within communities, and it will take governmental policies and support to educate and eradicate this homophobia over many generations.

Homophobia in the community also leads to internalized homophobia in the individual, and this has been linked to unprotected anal sex when individuals believe that getting the virus is based on fate rather than choice, or when they are overly optimistic about the effectiveness of HAART (Yi, Sandfort, & Shidlo 2010).

In the aforementioned study about mental stigma in Brazil, an interesting point that was articulated was that being victims of stigma (e.g., being made fun of for being gay) and having a low self-image (e.g., not feeling sexy) do not necessarily lead to risky sexual behaviour.  However, feeling that others will not find them attractive or will not want to be in a relationship with them led the individuals to unprotected sex and multiple partners.  This is a key finding that can be applied to the gay population, because it addresses one of the reasons why gay males may not use condoms or be monogamous even though they may understand these risks for HIV.  Part of the issue is again that stigma has forced many men to hide their sexuality and lose hope in ever having an open relationship with another man.  This created a culture of substituting multiple-partner sex for relationships, and many gay males may find sex as the only form of validation for their attractiveness to other males – the extent of a relationship for many.  Thus, when long-term relationships seem unattainable and sex becomes the highly valued substitute, it becomes difficult to negotiate safer sex.  This is confounded by the low proportion of gay males in the male population to begin with.

The ability to negotiate safer sex as a vulnerability to HIV transmission is often a psychological barrier for homosexual males.  For younger gay males, selecting older partners is common for many reasons, including because the proportion of males coming out increases with age group and because of personal partner preferences.  Coburn and Blower (2010) describe how the selection of older sex partners is an important risk factor for HIV infection for young MSM because HIV prevalence is very age stratified, with prevalence in older men (over 30) almost twice as high as in younger MSM (less than 30 years old).  However, young gay men with older partners are at risk for HIV not only because of the greater chance of encountering HIV, but because young men are at a disadvantage when negotiating safe sex.  This could be because of trust for the older man in terms of sexual decision making, physical inability to refuse unsafe sex, a heightened desire to please his partner, and/or other reasons.  This imbalance of power in decision making is reminiscent of a similar gender imbalance in many heterosexual couples.

3. Psychological Factors on Adherence       

Unfortunately, stigma not only plays a role in how HIV is transmitted, but it affects treatment decisions, as well.  For example, internalized heterosexism, or the internalization of societal anti-homosexual attitudes, are not only associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, but also with HAART non-adherence indirectly, through increased negative affect and more regular stimulant use (Johnson et al. 2008).  Interestingly, this highlights the common conflict between internalized homophobia and being the receptive gay male partner.  However, more importantly, it underlines the need for mental health experts to help address potential internalized heterosexism in HIV prevention and treatment with HIV-positive, and –negative, gay men. 

Adherence in HIV-infected gay men is dependent on a complex and interrelated set of circumstances, including the availability of “MSM-friendly” health providers, cultural factors (such as fear of being deported or family/religious repercussions), concerns about physical appearance, practical considerations (like being able to remember to take the drugs), motivational prerequisites (believing in HAART and wanting to treat the HIV), and the availability of emotional support (Brion & Menke 2008).  A key observation is that all of these factors influencing adherence is directly or indirectly related to the need to feel accepted and embraced in one’s community.

One successful method of maintaining adherence to HAART has been the practical support of gay male partners (Wrubel, Stumbo, & Johnson 2008).  This support included reminders that were regular or situational; instrumental assistance, such as setting out medications at dose time and picking up refills; and coaching support, including situational problem-solving and shaping behaviour by offering affirmations.  Unfortunately, the prevalence of long-term monogamy in gay males is low, in part due to the previously described stigma, thus limiting the practicality of partner support for many in the HIV-positive gay male population.

One type of counselling intervention administered prior to initiation of HAART and combined with follow-up phone support during HAART suggested cost-effective prolongation of the individuals’ lives, but only modest benefit for prevention of HIV transmission (Zaric et al. 2008).  Such an intervention may be an avenue to explore, but the study also suggests the need to clarify how individuals view treatment versus transmission.  Whether individuals see treatment as prevention or completely separate the two will help dictate future health policies and programs to educate and treat the public.

4. Conclusion: Implications for Change

Walch et al. (2010) looked at community attitudes toward homosexuality as a function of age, education, race/ethnicity, religious affiliation, political party affiliation, and personal contact with homosexual individuals and persons living with HIV/AIDS.  All factors, besides race/ethnicity, were associated with homophobia, but a significant portion of the variance in homophobia was predicted by having personal contact with homosexual individuals.  This finding is important because it suggests that eradicating homophobia simply requires getting to really know, and one presumes to like, a homosexual individual.  This helps explain the importance of gay celebrities, like Adam Lambert and Neil Patrick Harris, in changing the tide of public opinion, and it also points to potential directions for government intervention, such as leveraging gay celebrities to have discourse with students in schools about homosexuality and homophobia.  In Afraid to Be Gay, famous rugby player Gareth Thomas had a dialogue with students about how homophobic comments hurt him, and he was able to start helping students understand why their actions and words matter.

It is this author’s opinion that homophobia is the single most important underlying issue leading to the prevalence of HIV transmission in the gay male population.  In order to change this, education about homosexuality, HIV, and homophobia needs to happen in high school, when students are starting to think independently from their parents and are starting to form lasting values and opinions about the world.  This stage of life is where governments need to intervene to start eliminating homophobia from this generation on.”

IHHS Final Paper References





Why All University Courses Should Be Like This.

20 06 2010

I learned about the video above from the HIV course I’m taking at UBC (IHHS 402).

The video is of our former Canadian Minister of Health (and current Minister of other portfolios), Tony Clement, talking about InSite at the 2008 International AIDS Conference.  InSite is a centre on E. Hastings where addicts can come with their drugs to a place with nurse supervision, clean needles and other drug use equipment, and non-judgmental support.  It has treated over 1000 overdoses (and prevented deaths), it has encouraged more members of the community into detox programs (there is a detox centre upstairs called OnSite), and there are dozens of peer-reviewed scientific articles supporting its necessity and success (I suggest starting with a search on “Insite” or “harm reduction” on pubmed.com or Google Scholar).  InSite is based on a model of harm reduction, which is about reducing the harmful consequences associated with recreational drug use, but that is not what this post is about.  I could comment on how both the BC Supreme Court and the BC Court of Appeals both supported the continued operation of InSite but the federal government still intends to use taxpayers’ money to appeal to the Supreme Court of Canada, but that is not what this post is about, either (but I invite you to read about it).

In the video above, Mr. Clement loses some cool near the end, concerned that someone will put this video on YouTube (he was right to think that someone would).  I could write about how I believe he is misinformed about some of the issues surrounding harm reduction, such as his belief that harm reduction is akin to palliative (end-of-life) care, but that is not what this post is about.  I could describe how I think Mr. Clement’s views on harm reduction may be due to the misunderstanding that addiction is a choice rather than a mental illness (and often a manifestation of a long history of psychological isolation, neglect and/or abuse), but that is not what this post is about, either.

Those who know me would know that I would do anything to avoid confrontation, and this post touches on a controversial topic much more than I am usually comfortable with, but that is what this blog post is about.  This HIV course has taught me enough to make me speak up, and I think that is what all university courses should strive to do with their students.

University courses are not just supposed to educate, they are supposed to bring awareness of subjects so that we, as students, can be inspired to take that knowledge and change the world with it.

University courses should tell us about issues in the world that make us excited, angry, depressed, and frustrated so that we are motivated to do something with our bountiful knowledge.  We are privileged to be able to go to university, and I think we have an obligation to take our position of privilege and do something with it.  We may run into walls or even run the wrong way for a little while when we’re impassioned and on fire, but I think that is what we are supposed to do, at least when we are just starting out.

I wanted to share the following journal entry for my HIV course, because writing this was when I realized how this course has changed my life.

“As I reflect on my progress through this course, I realize that my first week was about being overwhelmed with information and feeling powerless.  My second week was about realizing that education equals power to make important changes.  And this week, my third week, has been about passion.

This course is really more of a journey than a course.

Going to the Eastside Pharmacy was life-changing.  Never have I thought that I would be interested in working at a pharmacy, but that was because I never visited a pharmacy that was so integrated into the community.  By integrated, I mean that members of the community literally cannot survive without the pharmacy.  Every staff member knows every client by name and knows exactly what each client wants.  Alex, the owner, happily gives out timbits when they’re available, and he fed me a delicious lunch even though I should be paying for their food to thank them for the amazing knowledge and experiences bestowed upon me.  I learned more there about the harsh realities facing members of the community than at any other placement, and it may have been because the clients there were willing to divulge stories of their lives to the pharmacy staff the way they would unload on family members or close friends.  Alex lets women sleep in his pharmacy because he knows that they need their rest during the day if they are to be able to protect themselves at night.  What other pharmacy would do that?  What other pharmacy would console, hug, and then personally make an appointment for a patient at a clinic that doesn’t make appointments just so the patient could deal with her anxiety?  What other pharmacy would urge their patients on the streets to go home when it’s late and waive drug dispensing fees for them when necessary?  When we heard that a woman died after being beat up by her pimp, the staff members mourned the passing like they would a dear friend.  Eastside Pharmacy does all of this because these individuals are not their clients or patients, but their extended family.  The staff members work there at lightning pace because they know their family members cannot stand to wait too long.  They are all grateful to be able to work there and make a difference for their extended family.  I may be wrong, but I think very few pharmacies in the world are this valuable to their community.  I am thankful to have been able to have been part of such a cornerstone for the community, even just for one day.

At Eastside, a client told a pharmacist that another pharmacy in the DTES was offering to “lend” $20 a day for methadone clients.  I did not fully understand the ramifications until it was explained to me…  Since methadone is the prescribed substance (often mixed with Tang orange juice!) most often used as part of heroin replacement therapy, the government offers extra money incentive to pharmacies that will accept methadone prescriptions, for fear that not enough pharmacies are willing to serve drug addicts.  The problem with this incentive is that it allows for criminals to take advantage of the system.  Pharmacies that “lend” $20 a day to methadone clients are essentially drug dealers that want to make the extra money from the government and will bribe clients to go to them.  Furthermore, these pharmacies are legally obligated to watch their clients consume the methadone to ensure that they are getting the medicine they need and not selling the substance outside, but the drug-dealing pharmacies often do not care whether the clients use the methadone or not.  Learning about such criminal activity makes me angry, not just because they are stealing tax payers’ money, but because they are ruining people’s lives.  When you have a pharmacy that is out to make money rather than care for their patients, you mess with the community’s lives, and that is not ohkay.  It is infuriating, and learning about this crime was one strong reason for why I have decided to pursue lifelong work in public policy.

The other bit of inspiration that has led me to wanting to dedicate part of my life to health policy came from Thomas Kerr.  When he explained how the RCMP repeatedly paid researchers to try to overturn evidence for harm reduction, how the government used their influence and power to discourage and ban funding for harm reduction, and how the former Minister of Health Tony Clement completely misunderstood what harm reduction is all about, I realized that scientists need more people on the inside of government and policy making to help translate fact into policy.  I do not really believe that government officials would intentionally deny scientific fact – they are simply at the mercy of public opinion and the media.  They need experts who can help them understand the scientific evidence for important matters like harm reduction (and climate change) and how policies need to change, but they also need these same experts to work with them to develop a strategy on how to educate the public and garner popular support for these controversial decisions.  This is a niche that I believe needs to be filled, and it is a niche that I think I belong in.

I have looked up McGill’s Health Policy Fellowship program, and I will be finding out more information about how I could possibly integrate an education in public policy into my MD-PhD.

So you see, this week to me has been about passion.  Passion to not let this course just be like any other course.  Passion to take what I have learned and do something important with it.  Passion to take action, get out there, and make a change.”





Learning to Embrace the Scientist in Me…

4 06 2010

As my peers graduate this week, I think about what my B.Sc. will mean to me.

As a scientist, I am equipped to question the accepted beliefs of today and create questions to direct the future.  Just because marijuana is illegal, is it more dangerous than nicotine or alcohol?  How do we rectify national and international stigma (and lawsuits) surrounding InSite and other harm reduction centres with scientific evidence that it works much better than prohibition of drugs?

We, as scientists, are taught to base our beliefs on the evidence rather than the norms of the day.  We are made to understand the importance of critically assessing the primary literature instead of solely embracing Wikipedia.  Some of us are inspired to do the research ourselves, which will inform environmental, health, and even political policy.  These lessons are some of the distilled essences of what we have learned in our years.  This is the value of our degree that will carry us into success in whatever profession we end up in – law, medicine, student development, science, business, public policy, government, advocacy, NGOs, community development, or whatever the case may be.

As a scientist, I’ve noticed a tendency in myself (and others) to avoid being labeled as just a scientist, because it carries a lot of stigma.  “You are a scientist, so you must be wanting to go into medical school.  Everything you do must be a calculated move to go to medical school.”  And so to avoid such judgment, we identify as everything else before we identify ourselves as scientists.  We avoid talking about our love for science or medicine, because in some ways we are forced to feel ashamed about it or fear the pressure of telling others coming back to bite us if we end up not applying or not being accepted into medical school.  We, as science students, are forced to live through the assumption that we are all applying to medical school (which carries all sorts of negative connotations) and then we are also judged if we decide that we genuinely do not want to do medicine (“Aww…it’s because you weren’t accepted, isn’t it?”)

Every one of our journeys is unique, and we should not have to justify our decisions to anyone but ourselves.  I realize as I’m writing this that as I am taking an intensive course on HIV/AIDS this month, my vocabulary and strong ideas around lingering stigma in the community have carried over into this blog post about scientists and doctors.  It is a little bit of a stretch to compare the stigma around IV drug users or HIV+ patients or homosexuality to that of scientists, but I’m taking the metaphor there anyway!

The bottom line: Yes, I love science.  Yes, I am going into medicine.  And no, that does not define who I am, but it is certainly an important part of it.

I am embracing the scientist (and the future doctor) in me, and no one is going to stop me!  I encourage you to do the same =).  My very good friend, Ms. Nancy Yao Yao, certainly knows how to embrace her inner medical nerd (or is it geek?  I hear there are big differences…).

My B.Sc. in Pharmacology at the University of (Beautiful) British Columbia prepared me uniquely for the world, and you are going to know it!

So congratulations to my amazing classmates and friends who are graduating this month – celebrating the incredible personal and professional journeys together for the last four or five or six or seven years of our lives.  I encourage everyone to embrace their inner scientist, artist, human kineticist, Sauder-ist or whatever you may be, and find the lesson(s) in your degree that you can use for the rest of your life, in whatever profession, conventional…or not!