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Tracy Morgan's Recovery Speaks to Power of Science
A year after a near-fatal car accident, the comedian has rebounded from a traumatic brain injury.
Nearly a year after a car accident put him into a two-week coma, Saturday Night Live and 30 Rock actor Tracy Morgan spoke publicly about his recovery for the first time. With his attorney by his side, Morgan sat across from Matt Lauer during a live appearance on The Today Show. There were signs that he was not the man I had watched for seven years on one of my favorite sitcoms. A large metal cane sat at his feet. His voice was softer and his speech more tentative than fans of the notoriously boisterous comedian had grown accustomed to. He spoke of "good days and bad days," with the bad days involving short-term memory loss and irritability. He sounded hopeful about a return to comedy, but added, "I'm not 100 percent yet."
Still, for a man whose condition had been shrouded in secrecy for so long, he was impressively close to his usual self. When word got out that Morgan had suffered a traumatic brain injury, many feared the worst. The longer he stayed out of public view, the less likely it seemed that he would one day be able to get back to work in movies and TV. But in his brief return to television, Morgan has shown that his charisma and wit still remain, and that there's reason to be optimistic about his continued improvement.
Morgan's case is fascinating for those interested in the scientific and humanistic implications of traumatic brain injuries. When concern over the mental health of NFL players began to swell several years ago, societal awareness surrounding concussions and other head injuries greatly increased. Sports leagues around the country have devoted more attention and financial resources to helping athletes, both young and old, avoid and recover from TBIs.
Morgan's injury had nothing to do with athletics, and thus was not as well-documented as it might have been had it occurred on, say, a football field or hockey rink. But the excellent 2014 documentary The Crash Reel provides a window into the types of experiences that Morgan may be having as he continues to rehabilitate. The movie follows Kevin Pearce, an elite professional snowboarder who suffered a severe TBI following a half-pipe accident. In addition to Pearce, the film features various other TBI patients with varying levels of cognitive impairment. Bearing in mind the absolutely devastating effects that these injuries can have on their victims, it is encouraging to see Morgan in relatively good condition.
The news of Morgan's crash last summer offered an odd juxtaposition of comedy and tragedy. He had long been known as both a talented comic actor and a bit of a loose cannon, so it was startling to see someone who had hardly been associated with anything serious in his entire life suddenly facing questions about his mortality. The Tracy Morgan of The Today Show was one that hadn't been seen before. The man known as a bottomless well of non-sequiturs and oddball behavior was now moved to tears over the death of his friend and colleague James McNair, and lamenting the fact that his fiancee and daughter, who almost always traveled with him, could have very easily been in the vehicle, too.
Though he has more developmental and emotional hurdles to overcome, Morgan seems determined to make audiences laugh again. It's a credit to those who treated his TBI that he'll even be able to do so. Morgan repeatedly and effusively thanked the doctors and nurses who have overseen his recovery, leaving out any mention of miracles or divine intervention as the source of his healing. In giving Morgan a second lease on life, modern medicine and its practitioners have come up big for his family and his many fans.
Innovation in manufacturing has crawled since the 1950s. That's about to speed up.
Health officials in China reported that a man was infected with bubonic plague, the infectious disease that caused the Black Death.
- The case was reported in the city of Bayannur, which has issued a level-three plague prevention warning.
- Modern antibiotics can effectively treat bubonic plague, which spreads mainly by fleas.
- Chinese health officials are also monitoring a newly discovered type of swine flu that has the potential to develop into a pandemic virus.
Bacteria under microscope
needpix.com<p>Today, bubonic plague can be treated effectively with antibiotics.</p><p style="margin-left: 20px;">"Unlike in the 14th century, we now have an understanding of how this disease is transmitted," Dr. Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">Healthline</a>. "We know how to prevent it — avoid handling sick or dead animals in areas where there is transmission. We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria [and] prevent them [from] getting sick."</p>
This plague patient is displaying a swollen, ruptured inguinal lymph node, or buboe.
Centers for Disease Control and Prevention<p>Still, hundreds of people develop bubonic plague every year. In the U.S., a handful of cases occur annually, particularly in New Mexico, Arizona and Colorado, <a href="https://www.cdc.gov/plague/faq/index.html" target="_blank">where habitats allow the bacteria to spread more easily among wild rodent populations</a>. But these cases are very rare, mainly because you need to be in close contact with rodents in order to get infected. And though plague can spread from human to human, this <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">only occurs with pneumonic plague</a>, and transmission is also rare.</p>
A new swine flu in China<p>Last week, researchers in China also reported another public health concern: a new virus that has "all the essential hallmarks" of a pandemic virus.<br></p><p>In a paper published in the <a href="https://www.pnas.org/content/early/2020/06/23/1921186117" target="_blank">Proceedings of the National Academy of Sciences</a>, researchers say the virus was discovered in pigs in China, and it descended from the H1N1 virus, commonly called "swine flu." That virus was able to transmit from human to human, and it killed an estimated 151,700 to 575,400 people worldwide from 2009 to 2010, according to the Centers for Disease Control and Prevention.</p>There's no evidence showing that the new virus can spread from person to person. But the researchers did find that 10 percent of swine workers had been infected by the virus, called G4 reassortant EA H1N1. This level of infectivity raises concerns, because it "greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses," the researchers wrote.
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 NY Times editorial calling for mental healt</p><p>h disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>
Why Depression Isn't Just a Chemical Imbalance<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fbc027c9358dad4a6d9e2704fc9ddb04"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/GAC9ODvSxh0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Many years ago, my best friend tried to quit smoking. He asked for help. While I'm no addiction expert, I offered what I knew from my fitness toolkit: breathing exercises and cardiovascular training, methods for strengthening his body and mind that could, I hoped, inspire him to take better care of himself in general. He replied, "No, I meant something like a pill."</p><p>A few years later, he quit for good. After failing the cold turkey method a number of times, it finally stuck. Maybe it was watching his children grow up—the reason my parents quit when I was young. This method is not easy, however. It challenges you; it forces you to confront your demons; it drastically affects your brain chemistry. Yet, in the long run, it sometimes works. </p><p>Sometimes pills work, too. But often they do not. The journalist Robert Whitaker, author of "Anatomy of an Epidemic," discussed the clinical trial process <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">during our recent conversation</a>. While the FDA process appears thorough from the outside, pharmaceutical companies only need to prove that a drug works better than placebo, not that it works for the most amount of people. He continues, </p><p style="margin-left: 20px;">"Let's say you have a drug that provides a relief of symptoms in 20 percent of people. In placebo, it's 10 percent. How many people in that study do not benefit from the drug? Nine out of 10. How many people are exposed to the adverse effects of the drug? 100 percent."</p><p>Even though some pharmacological interventions show little efficacy, and even though Xanax, an addictive and destructive benzodiazepine that only showed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/" target="_blank">short-term (four weeks) efficacy</a> in clinical trials, is being prescribed for many months and years, doctors continue to use the language of clinical neuroscience to describe mental health issues. If chemistry is the problem, people will turn to chemistry for the solution. </p><p>Perhaps we should, as psychiatrist Dean Schuyler <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">writes</a> in a 1974 book, recognize that most depressive episodes "will run their course and terminate with virtually complete recovery without specific intervention." The problem is that idea isn't profitable. As long as the gatekeepers continue to use the language of chemical imbalances to describe what for many is just an episodic case of the "blahs," we'll continue creating more problems than we solve.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
SEAL training is the ultimate test of both mental and physical strength.
- The fact that U.S. Navy SEALs endure very rigorous training before entering the field is common knowledge, but just what happens at those facilities is less often discussed. In this video, former SEALs Brent Gleeson, David Goggins, and Eric Greitens (as well as authors Jesse Itzler and Jamie Wheal) talk about how the 18-month program is designed to build elite, disciplined operatives with immense mental toughness and resilience.
- Wheal dives into the cutting-edge technology and science that the navy uses to prepare these individuals. Itzler shares his experience meeting and briefly living with Goggins (who was also an Army Ranger) and the things he learned about pushing past perceived limits.
- Goggins dives into why you should leave your comfort zone, introduces the 40 percent rule, and explains why the biggest battle we all face is the one in our own minds. "Usually whatever's in front of you isn't as big as you make it out to be," says the SEAL turned motivational speaker. "We start to make these very small things enormous because we allow our minds to take control and go away from us. We have to regain control of our mind."