Unethical Behavior in Medical and Psych Research Is Depressing

by hkatz, posted in Research

Fraud, negligence, misguided good intentions combined with poor study design, intellectual conformity… these are among the problems plaguing research.

A couple of links as examples:

  • Possible fabricated evidence in Alzheimer’s research.
  • A chemical imbalance theory of depression, pushed for years by many psych professionals and the media, doesn’t have much evidence to back it up. (By the way, if you’re currently on antidepressants, please discuss any concerns with your doctor and don’t just abruptly stop taking them. That itself could be harmful.)
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Not Having to Set a Target Weight for Weight Loss

by hkatz, posted in Self-Development

There are many reasons to eat healthier and exercise more, though weight loss is often the top reason people give for wanting to get into better shape.

Even if weight loss is your main goal, you may not want to set a target weight. Maybe you aren’t sure what it should be. Or maybe you don’t want to focus too much on a particular number, especially if you think you’ll start weighing yourself obsessively and anxiously. You may also want to make a more holistic assessment of your progress, including improvements to your health-related habits.

Whether or not you’ve set a particular target weight, there are alternative goals you can keep track of, such as:

  • Reducing or eliminating unhealthy oils from your diet.
  • Reducing the amount of added sugar you consume each day.
  • Increasing the amount of time you exercise each week.
  • Increasing the number of steps (or miles) you walk each day.
  • Increasing the number of servings of vegetables you eat each day.

Using these kinds of alternatives as fitness goals will still contribute to healthy weight loss, but you won’t have to focus only on a particular number. Even if you have no target weight in mind, you can start getting healthier now. You’ll be placing your emphasis on establishing habits that are good to maintain for your overall health.

Sensitivity Reading and the Aim for Thoughtfulness Versus Inoffensiveness

by hkatz, posted in Writing

From what I’ve read and from how some people have explained it to me, it seems the purpose behind sensitivity readers is a noble one. If, for example, you’re writing a story that features a Chinese-American character growing up in NYC, then you work with a sensitivity reader from a similar cultural background, and they’ll give you feedback about potential biases and thoughtless stereotypes in your writing.

At best, the process may be similar to any sort of useful feedback you receive on your book, especially if the sensitivity reader understands the qualities of good writing. Sensitivity reading may help you spot things you’ve missed or haven’t thought about. But it also has its pitfalls, especially when the aim is to make your book “less offensive.” These potential problems include the following:

  • A sensitivity reader is one person. They may be part of a larger group in some demographic sense (race, sex, sexuality, etc.) but they’re still one person sharing their own viewpoint on what may or may not be offensive, and they’re subject to their own biases and ignorance. They aren’t a spokesperson for millions of people.
  • There’s always a strong element of subjectivity to what’s offensive. Yes, there are occasions when most people can agree that a character is written as a grotesque stereotype. But other times, there’s much more disagreement, especially when you consider the complexities of literature. Books contain irony and satire, and they convey real-life observations, such as the unpalatable things said or done by people (including individuals who are part of minority groups). When characters reflect how contradictory, flawed, and complex people can be, the results may prove offensive to some, but the writing is often better for the messiness.
  • The recommendations of sensitivity readers don’t occur in a vacuum. There’s a temptation to minimize subtlety, ambiguity, and humor, to not leave room for misinterpretation and the possibility of offense, especially in our charming age of social media, when mobs form over excerpts taken out of context, and influential people act as if they’re on patrol for offenses. The collective result is writing that’s more flat, more homogenous in opinions, and more timid, with characters sanitized to the point of dullness, and with authors tempted to sermonize to prove that they’re attuned to certain fashionable attitudes.
  • Hiring sensitivity readers may make authors feel complacent, even though sensitivity reading isn’t a guarantee that your work is good from a literary standpoint, free of mistakes, or a palatable offering to the most influential self-appointed judges of what’s offensive and what isn’t. It doesn’t guarantee you zero offensiveness. (Nothing does.)
  • Sensitivity readers aren’t a substitute for actual research and fact checking.

This last point is what I want to build on further. When people write about past eras or different cultures or socioeconomic groups, a critical problem is lazy writing. This includes falling back on popular myths or stereotypes instead of making an effort to get to know your subject matter better and think of your characters as three-dimensional people.

Feedback from a sensitivity reader may catch some of the problems of lazy writing, but getting your book vetted by a sensitivity reader isn’t the same thing as conducting research or giving your characters greater thought. A well-researched and thoughtful book may still be considered offensive, for various reasons; and it can remain a worthwhile book to read.

A lot of times, what jars me in the middle of a book is an obvious fact that an author has gotten wrong – like the meaning or practice of a holiday, or a technological anachronism. Other times, it’s a historic character who sounds like they’re a 21st century transplant (something I just wrote about) and has the same values and concerns; the character may be less offensive that way, at least in certain respects, but they’re also less convincing.

I can be forgiving of mistakes in a book, especially if the book as a whole has many good points, but I think it’s important to invest more resources in fact-checking and research, which includes talking to people thoughtfully about their experiences. These activities do, in certain ways, overlap with the purported aims of sensitivity reading – catching laziness or thoughtlessness. And the result can be fiction that’s richer and more complex. But you aren’t promised inoffensiveness.

Inoffensiveness isn’t the main aim of writing anyway, I hope.

(Also, let’s face it, there’s never going to be a book that gets it all right. Even with an enormous amount of research, there are probably things you’ll miss, like little period details you may get wrong. You can still tell a good story with characters worth reading about. Will people criticize your work? Of course, but that’s part of sharing your writing.)

Problems With Making Historical Characters Relatable

by hkatz, posted in Writing

How relatable does a historical character need to be to a modern audience?

With historical fiction, one of the problems is when characters sound like 21st century transplants. (Like when you’re watching a show set in small-town 1950s England, and the protagonists neatly share the viewpoints of a liberal Twitter commentator.)

I understand why writers don’t want to create protagonists who heartily endorse all the common prejudices of their era. But you don’t have to do this in order to write a good piece of historical fiction. You don’t need to go out of your way to make a character (especially a heroic character) deeply bigoted or hateful. You can also write about harsh historic realities without resorting to slurs or lazy stereotypes (for example, you can write a servant as a more well-rounded character and not a caricature with a Cockney accent).

But you don’t need to use characters as a vehicle for preaching certain opinions. Or soothe modern audiences by promising them that they won’t encounter anything truly different in fiction – they’ll see themselves or people just like them wearing historic costumes, like at a Renaissance fair. Reassuringly familiar, even if it’s also more boring and the story loses some truth, becomes flattened.

Why does every character need to be completely relatable anyway? Humans have always been humans, but thoughts, beliefs, and emotional expressions are all shaped by culture and historic period. I can enjoy a story from the 19th century and gain insight from it without needing to pretend that the protagonists would see eye-to-eye with me on everything (or even most things). In many ways, including how they think of words like “honor,” they’re drawing on different conceptions, different interpretations. It’s possible to find some common ground with these characters without pretending at sameness. 

As for showing a protagonist’s relative lack of prejudice or greater compassion, it’s best to use actions rather than preachiness. Even subtle actions can convey understanding, humanity, and good-natured humor, and there’s less risk of the character sounding like they time traveled.

When Even the Trustworthy Sources Aren’t Trustworthy

by hkatz, posted in General Learning

It’s common wisdom to be skeptical about conspiracy theories and fringe views. At the same time, mainstream sources can be disturbingly inaccurate or dishonest too. Although I’m not going to make the blanket claim that everything you read in reputable publications is a lie (it isn’t), what you read warrants healthy skepticism.

I recently read Dreamland by Sam Quinones, a book on how the opioid crisis got underway in the U.S. There’s a lot that’s eye-opening and depressing in that book, including how medical professionals, academics, and mainstream publications repeated a Pharma-friendly claim that only a tiny fraction of opioid users develop an addiction (less than 1 percent!). The statistic is based on gross misrepresentations, including this one: a brief letter to the editor published in the New England Journal of Medicine that got referred to as a “landmark study.”

The letter to the editor wasn’t a full-fledged study. It communicated the observations a doctor and a grad student made about a population of hospitalized patients who received painkillers in a controlled and supervised way that also accounted for a prior history of drug abuse – a far cry from how painkillers later got prescribed to the general population.

Why did no one bother to look into this “landmark study”? Academic journal archives have always existed. You wouldn’t have needed the Internet to fact check, although yes, you would have had to look up a physical copy of the journal in an academic library.

Repeated until it seemed like established fact, this is just one example of a lie – a devastating one – that uncritically became mainstream. Many people, including journalists and highly educated experts, can be shaky investigators. Publications often don’t prioritize investigative work (or don’t have the budget for it). Also, it’s easier to be a mouthpiece than it is to ask uncomfortable questions and uncover awful answers. Fear, money, laziness, conformity, and an abundance of misplaced trust are all influential forces. So are ideological biases.

I don’t want to argue that there’s no truth at all in mainstream publications. That would be a ridiculous claim. But healthy skepticism is always warranted, even when you’re reading from a respected source. Even if you largely agree with something, leave some room mentally for a correction and updated knowledge.

Eliminating cliches through careful observation

by hkatz, posted in Writing

I previously posted a version of this piece on a defunct blog of mine, so I’m sharing it here.

Cliches often result from inattentiveness or from indifference. They’re readymade and easy to grab at as you write.

While they save you effort or time, they cost you in other ways. If you use too many cliches, your writing becomes less memorable. Your voice seems more dull, your thoughts less worthy of attention.

One of the ways to limit cliches in your writing is to carefully pay attention to the world. Specific details and concrete examples can deepen your writing. Observations of texture, shape, and color enrich the text and give it more flavor.

As an example, let’s consider Sightlines, a collection of essays by Kathleen Jamie. Her book inspired this post, because of how present she is in the world of each essay. From “The Gannetry,” on a colony of gannets in Scotland:

The cliffs were south-facing, full in the sun, and five hundred foot high. They formed promontories and bowls, so we walked out onto the broadest promontory and from there looked back into the cauldron the birds had commandeered for themselves.

And from “Moon,” an observation of an eclipse:

The moon does us a great service, metaphorically and literally, and this is part of it – occasionally she allows us to appreciate the shadow cast by our own planet. She shows us that the earth, for all the cacophony of life on its surface, is firstly an object, bigger than we are, magisterial enough to cast a shadow thousands and thousands of miles into space.

In this piece, she describes the moon ripening like fruit, even as the Earth becomes more strikingly rock-like. Although people have compared the moon to food before, she constructs the imagery with delicacy and care, and in a way that’s unique to her. She doesn’t make a lazy comparison. It’s borne of observation and imagination.

Before describing people as having nerves of steel or being weak as a kitten, study them. Reflect on who they are in a specific moment. Do you want to say something about emotions or economics or how beautiful your backyard looks at dawn? Don’t lean too hard on the readymade phrases. What are you really trying to say?

Reading good writing reminds you to observe the world more carefully. So does being present in the moment as you write or edit your work. Think about what you’re trying to write and how to write it precisely and memorably.

On Drug Fumes and Public Transit

by hkatz, posted in Struggling Striving Healing

There needs to be some balance, an approach that finds middle ground between: a) draconian punishments for the non-violent possession of small amounts of drugs, and b) a hands-off, free-for-all, disregard-for-public-safety version of decriminalization.

From the Seattle Times:

Bus and train operators say so many people are smoking drugs on Seattle-area transit that the fumes, and volatile behavior, create a hazardous work environment that discourages ridership.

and

Narcotics smoking aboard transit took hold last summer, and now surpasses needles and marijuana in driver complaints. Since then, at least six operators asked to stop driving midshift, and 14 specifically mentioned feeling headaches, dizziness or irritated breathing.

These are fumes from heating fentanyl, meth, and/or heroin.

In 2019, the Washington Post wrote about Seattle decriminalizing personal drug possession. While the article shares stories of people getting the help they need, it also points out pitfalls – how the city’s decriminalization policy doesn’t consistently lead to meaningful help, but often translates to a hands-off approach that lets problems fester – particularly a mix of hard drug use, untreated mental illness, homelessness, and violence. With the pandemic shutdowns, these problems have gotten worse.

Can We Talk About Modesty in a Secular Society?

by hkatz, posted in Self-Development

Outside of religious circles, it’s not at all popular to talk about modesty. And in religious circles, modesty often gets reduced to how short a woman’s skirt is or whether you can see her hair or bare shoulders.

I don’t often come across discussions of modesty as a way of living with dignity and restraint, especially in a world that constantly encourages excess. Whether or not you’re religious, the concept of modesty is worth exploring. And not just for women.

(Do I feel a little like Mary Bennet bringing this up? A little, yeah, but I’m also laughing at that thought.)

So, what does modesty look like?

  • Not flaunting wealth or expensive possessions, in a world where displays of luxurious excess are everywhere.
  • Holding back on gloating or on glorying over another person’s problems.
  • Being moderate in how you drink, eat, or enjoy other pleasures. Basically, enjoying yourself without overdoing it or indulging in out-of-control behavior.
  • Not wanting to “bare it all.” Being more selective about what you share and with whom. I’m not just talking about your body, but your secrets, your children’s secrets, lots of personal details shared for no helpful reason. (Sometimes there’s a good reason to share a secret, especially when you’re trying to protect yourself or others from danger, but in other cases it’s just TMI, 24/7, on social media and elsewhere.)
  • Preserving important boundaries. Not thinking that you’re entitled to control people and violate their privacy, dignity, and trust. Not treating your own worth with carelessness, as if it doesn’t matter who you let into your life or which violations you perpetrate or endure.
  • Stopping yourself from acting like a loud and aggressive ass.

Modesty is an antidote to excess, to a lack of thoughtfulness and judicious restraint. It’s connected to humility, another unpopular concept that often gets misunderstood as humiliation or needing to act like a doormat – when instead, it’s about being aware of your limitations as a human, which means you’re curbing arrogance and acting with greater care and healthy doubt.

For many people, the concept of modesty is steeped in unpleasant connotations. It has been frequently misused as a weapon to silence and hurt people, particularly women and girls. Its misuse doesn’t make it useless though. It’s still an important value and can be discussed meaningfully and helpfully in different contexts.

It should be possible to talk about modesty without self-righteous hectoring and preening. Also, without the hyper-focus on women (or rather, certain aspects of women) and the mere lip service paid to the idea that men should be modest too.

People don’t have to be religious to appreciate modesty and its possible expressions. They can consider how to bring it more into their lives and what may change for the better as a result.

Perpetually Isolated Seniors

by hkatz, posted in Struggling Striving Healing

I was reading an article about the effects of pandemic isolation on seniors, when this part jumped out at me:

After the pandemic hit, some seniors felt a dramatic worsening of loneliness and mental health problems such as anxiety and depression, after which things perhaps stabilized a bit as the pandemic progressed. Others — probably those who were already very isolated, Perissinotto notes — weren’t very affected, likely because the pandemic didn’t change much about their level of social contact.

The seniors who “weren’t very affected,” because they were already very isolated before the pandemic – yes, the pandemic may not have affected them as much, because you can’t make a rock-bottom situation worse. The deep levels of loneliness, anxiety, or depression predate the social distancing measures.

Living alone, sometimes with only a T.V. to listen to, day in and day out, is a way of life for many people. A tiny number may relish it (you’d have to ask them), but the vast majority of people would never choose such unrelenting isolation.

A bunch of articles came out early in the pandemic (like this one) about the need to reach out to isolated older adults. I hope more people realize that this is a long-standing problem, and it continues now.

Five Tricks Food Companies Use to Make You Think You’re Eating Healthy

by hkatz, posted in Struggling Striving Healing

When people become more health conscious, food companies try to make products sound more healthy. It’s important to not be caught off-guard by the tricks they use.

The following are five to watch out for:

“Contains natural ingredients!”

On food packaging, companies will proudly display this statement or a variation of it, like “all natural” and – my favorite – “made with real fruit.” (“There’s real fruit in our fruit juice. How unexpected!”)

But is a product with “natural ingredients” actually healthy? Maybe, maybe not. If I bake an apple pie, it will contain real apples. It will also have plenty of sugar. All-natural sugar.

“Organic!”

Organic is a healthy-sounding word, and some foods described as organic are in fact healthy. Other times, not so much. I’ve seen organic candies and chocolate bars. I may be using organic apples for my sugary apple pie.

“Only 70 calories per serving!”

That doesn’t sound too bad. It’s only 70 calories. But be sure to check the serving size. If the serving size is a teaspoon, and you just ate 10 teaspoons…

The same warning applies to other nutritional claims, like, “Only 4 grams of sugar per serving!” Always check the serving size.

“Low fat!”

Many foods are low in fat. But when you check the nutrition label, you may discover that they’re high in sugar or salt or that they contain undesirable additives, like unhealthy oils.

“It’s yogurt, so it’s healthy!”

Companies love to take advantage of the fact that you associate certain foods with health. Yogurt is one example. Many people automatically assume that a yogurt product is a healthy choice. But this isn’t always true. For certain brands, a small yogurt cup will contain a lot of sugar, especially if it’s flavored yogurt. Always check the nutrition label.

Another example is salad. Salads can be a healthy choice, but not if you bury the vegetables in heavy dressings and croutons. In some restaurants, salads are hundreds of calories because of the excessive use of oily, salty, or sugary additives. The word ‘salad’ still gives these dishes a vaguely healthy aura.