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Periods, miscarriage, and menopause: Why is animalistic womanhood taboo?

“For ten minutes I was somebody’s mother,” says Ariel Levy, as she discusses the silent but universal animal lives of women.

Ariel Levy: When I was 38 I accepted an assignment in Mongolia and I had been writing stories for The New Yorker, and before that New York magazine, for 20 years and this was going to be the last adventure like this for a while because I was about to start on another kind of adventure: I was five months pregnant and I was about to have a new kind of life. And I wasn't worried about it. My doctor had said it was fine to fly until the third trimester and I was not concerned. But the second night I was in Mongolia I went into labor in my hotel room and I gave birth and for ten minutes I was somebody's mother. And when I got home from Mongolia I was so sad I could barely breathe and friends or women who knew what had happened to me would take one look at me and literally burst into tears. And I actually understand how that felt for them now because now women come to my readings and things and I see them and I look at them and I immediately know what they're going to tell me. They have a particular kind of look; they just look blown apart.

The reason I wrote about it in this essay for The New Yorker called 'Thanksgiving In Mongolia' was that I felt like: why doesn't anybody talk about this? This is an incredibly intense experience that a lot of women have. And when it happens to you there's no literature about it, there's very little, so you feel insane, you feel like a crazy person that you're having that level of grief for a baby who wasn't even quite a baby, and are you the only person who's having this reaction to this experience? The answer is no. At this reading that I gave for my book The Rules Do Not Apply last week in San Francisco this lady raised her hand and she was like, "I have three children who are alive; I've lost four babies; I'm at 77 years old and I miss every one of them." And that was amazing to me. I mean, more and more I'm meeting women who are older who are like, "Oh yeah, it's never stopped hurting." I mean it goes away. At first you sort of live in grief, like in a tunnel of grief, and then eventually grief lives in you and it's just something you take with you and you're not walking around about to cry. But it is a big thing and I think that in more general terms things that have to do with this business, with this animal experience of being a woman—you know, not everywoman is going to have a child, not every woman is going to lose a child, god knows, but every woman at some point in her life is going to have some kind of intense experience around menstruation, fertility, childbirth, child loss, menopause, all this stuff, all this animal stuff about being a woman, we don't talk about. And it's an enormous part of the lives of half the human population. We should talk about it, I think.

So when I got back from Mongolia I wrote this essay about the experience of losing my baby there. And the reason I did that—well, there was no reason, it just happened; it sort of came out of my fingers and I didn't think about it. But if I were to think about it subsequently part of the reason I did it was because just like anyone else is proud of their offspring, I was proud of mine. I mean I think if you have children who are alive—most people I know who have kids spend a certain amount of time looking at them and being like, "Oh my god, I made you. You're a person. Like, look at you, you're beautiful!" And I did that. Only for ten minutes, but I did do it and I was proud. I was like, 'World, I made a person! No one knows but me, no one met him alive but me. I'm going to write about this because I feel compelled to, for whatever it's worth, I want to proclaim this person's life happened.' And that was why I wrote it. Now why I published it was that I thought it was a matter of feminism that that should be a legitimate subject for writing, for literature, for publication. And the response I got to that made me realize I should write about it more.

In 2013, Ariel Levy published her critically acclaimed essay Thanksgiving in Mongolia in The New Yorker, recounting the experience of giving birth to her baby at five months, alone in a hotel room in Mongolia, and ultimately losing him. "For ten minutes I was somebody's mother," she says. That feeling was impossible to come to terms with when she returned home, and the culture of silence surrounding miscarriage rocked her. "I felt like: why doesn't anybody talk about this? This is an incredibly intense experience that a lot of women have. And when it happens to you there's no literature about it, there's very little, so you feel insane." For Levy, this taboo extends to the entire animal experience of being a woman: menstruation, fertility, childbirth, child loss, menopause—all things to be whispered, not discussed. Listening to Levy make this broad experience of loss deeply personal and public is incredibly moving. Ariel Levy's memoir The Rules Do Not Apply, is out now.

A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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How often do vaccine trials hit paydirt?

Vaccines find more success in development than any other kind of drug, but have been relatively neglected in recent decades.

Pedro Vilela/Getty Images
Surprising Science

Vaccines are more likely to get through clinical trials than any other type of drug — but have been given relatively little pharmaceutical industry support during the last two decades, according to a new study by MIT scholars.

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