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Like Father, Like Son

Question: Do you remember liking the stories your father wrote?

Andre Dubus III: Well, like a lot of people, like a lot of kids, I didn't know what my dad did. Or I vaguely knew that he wrote stories but I didn't think about it. I was probably-- I was 15 the first time I read anything of his and it was his first book and his only novel, The Lieutenant, and I really loved it, and I couldn't believe my father wrote something that good, because, you know, he's just "that guy." And then the first short story I read of his, I was probably 18, and it was the story, "Killings," which was ultimately adapted into the film "In the Bedroom," and I couldn’t believe the power of that story. And so, yeah, I loved his work. I still love his work. He's one of my favorite writers. I think he's a really honest, passionate, compassionate writer. I don't-- Catholicism is always, that's foreign to me. You know, I don't practice a particular faith and that's all. But I love his work. I think he was an artist.

Question: He knew Kurt Vonnegut?

 

Andre Dubus III: Yeah, Vonnegut actually-- when my father left the Marines, moved to-- went to the Iowa Writers Workshop in the sixties, some of my earliest memories were our grandmother bought us a TV and this guy Kurt would come down every day at three o'clock and watch Batman, and he'd chain smoke and had curly hair and he'd look down at me and I'd look up at him and he's say, "I like the Riddler, who's your favorite character?" and he'd smoke, and I'd say, "I like False Face." "Yeah, Kapow, Kazowi." And it was Kurt Vonnegut. I had no idea. Years later, "I watched Batman with Kurt Vonnegut?" Yes, you did. I wouldn't say-- well, I would say my father's life was tumultuous in that he was what sociologists would call a serial monogamist, you know, he was married three times, divorced three times and I think if he'd lived, he'd have been married again. He and I talked about some of this later in his life, and I know that with each marriage, he meant to stay married, it just wasn't in the cards for him. So the tumultuous part was really just the homefront, you know, the nest. It was never quite stable for him.

Question: Do you see his writing in yours?

Andre Dubus III: I really-- do I see any of his writing in mine? Not really. Well, only in that we both, you know, he wrote really deep, lovely character-driven fiction, I try to write character-driven fiction. But I think we have such a different vision of the world, and I think his sentences were actually more lyrical and beautiful. He was a real stylist, and he's from the South. That's a distinction, he's a Southern writer, at least in voice, I think, and in cadence. He's got a lot of Faulkner and St. James Bible in him, I think. And I'm from New England, it's a whole different vibe. No, I don't think so. I think if we didn't have the same name, no one would ever think of us two together. But I might be wrong. I'm just the writer of one of these things, so I might be wrong about that.

Question: Is there a difference between Northern and Southern fiction writing?

Andre Dubus III: I read a lot of Southern fiction. And I think what I love about it is what I love about-- all my relatives were from Louisiana, my mother and father, every grandparent, aunt, uncle and cousin, everybody's from Louisiana and Texas, too. So I feel sort of a soulful connection to that region, although I'm an East Coast kid. You know, I'm a mill town kid from north of Boston. I think that there's a certain lyricism in Southern writing that is not in Northern writing. I'm making broad generalizations here, but there's a certain lyrical quality, that I think might come from the St. James Bible in some ways. It comes from-- I don't know. it's frankly a mystery, but what I love-- and there's also a deep, sensual quality to a lot of-- you know, in so much Southern writing, everybody's got a body, you know, there's bourbon and crawfish and hot sun on your face and the squeal of a car over gravel. I'm a sucker for all that. I love all that. And I'm making broad generalizations, but one could argue that a lot of writing from the North tends to be a little bit more cerebral and urban, fast-clipped, more of an interior sort of life. A little edgier. And I like both. I mean, both are delicious, really. And I don't know, man, I haven't really thought about this with me, I may kind of fall somewhere in-between. I don't know. I think they're equally powerful. I don't believe Southern fiction is superior to Northern fiction, at all. And I'm not even comfortable with these broad generalizations, because there are so many exceptions. But there are some broad truths there, I think.

Recorded on: 6/11/08

 

 

Author Andre Dubus grew up in the shadow of writers, from his famous father to Kurt Vonnegut.

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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

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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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