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“I Don’t Know Who I Am”

Question: Was it strange of having somebody else play you?

Jonathan Ames: Well, we would be filming – well he’s not playing me. I mean, it has my name, but it’s not me, so in the same way that I never feel like me. So, I’m watching him play this guy that has my name, but I don’t feel connected to my name. I don’t know who I am. I look in the mirror and I recognize myself, but I’m so confused as to my own identity that it certainly was fun to write things and to have it come alive, and to write a fight scene and see it play out, but I get more of a kick out of that then he’s playing Jonathan Ames. I feel divorced from that name especially because I know it’s not me.

Question: How are you confused about your own identity?

Jonathan Ames: Well, how am I confused about my own identity? I think we all struggle with self-loathing and our secret notions of ourselves, or feeling unlovable. I don’t know, I think it’s just a general confusion as to who I am and what I want in life. I feel very much like I’m tripping my way through darkness, but I think we all feel that way. It’s not easy to be alive and I have a very privileged life. I’ve always been lower, to now, upper middle class. So, these are luxurious struggles, you know? I’m not worried about food at the moment, or shelter, so for most of my career, my goal as an artist was to just simply pay the rent. Maybe a little bit of identity with having this TV show and people, for the moment, perceiving me as a success. And I never have perceived myself this way. And I’m not sure that people even do, so it doesn’t – I don’t know. I’m hanging in there. I want to pay attention and be loving to the people in my life and I guess on that sense I’m not confused about my identity.

Question: Do you feel that using your name for the character adds anything?

Jonathan Ames: But it adds something. I kept the name because when I wrote the short story, I wrote it in the style that I’ve written my essays. And I did that on purpose because whenever I would write my non-fiction, people would say to me, “Oh, you made that up, didn’t you?” And then when I write my fiction, they go, “That’s all true, right? Why’d you call it fiction?” You know, it’s like I couldn’t win. So, I thought, “ All right, I’m going to write a piece of fiction in the style that I write my essays and I’ll use my name as the character and then people would be like, “Wait, did this happen?” You know what I mean, it was almost like when you cross your fingers, and you go like that. You don’t know what finger is being touch, something like that.

And many writers have, of course, played with this idea of using their own name in fiction, or what have you and making themselves the character, it’s nothing new there. But it was my second stab at it really. In my graphic novel “The Alcoholic,” I named the character, Jonathan A., kind of a Kafka story, “A” could stand for alcoholic, or alone, or Ames. But then with this short story, which was the next thing I wrote, I named the character completely myself.

 So, I like what the TV show that it again creates that same **** of like, is this guy Is this an autobiography? Did this really happen to someone? People like to know about the artist behind the work as well. It’s part of their enjoyment of a piece of art usually, to feel like they’re communicating with someone, or someone is communicating with them. That’s why we’re drawn to art. I know for me, it’s like books are like friends. The book itself is a friend, or the story, or I’m connected to the characters. Then there’s also – that’s why we have author photos and bios. Who is this person that made this thing that is enchanting me?

 So, having the character have my name I think adds something for some viewers. Is this real? And it makes perhaps a little bit more pleasurable for them.

Recorded on: November 4, 2009

Fits of self-loathing, the challenge of being unlovable, and the general sense that you are tripping through darkness are part and parcel of the grand confusion of life—-Jonathan Ames explains.

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  • 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.

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