Author: Olivia Ares Page 1 of 2

How to be a Global Inventor

On November 29, 2023

In Biomedical Engineering, Business/Economics, Climate/Global Change, Engineering, Entrepreneurship, Faculty, Global Health

Gadgets, devices, doo-dads, oh my! The Duke Global Health Institute (DGHI) recently hosted three of its members to lead a panel on creating medical devices for low- and middle-income countries. The event was called “Global Medical Device Innovation: Three Models for Creation and Commercialization.”

Each sought to decrease costs and increase scalability for medical procedures. In short, they are expert inventors who are doing good in the world.

*Two of the most prominent inventors of our era. Image courtesy of Disney.*

We’ll go step-by-step in a moment, but to start you on your journey to being just like our panelists, here’s a short glossary:

Standard-of-care: a public health term for the way things are usually done.

IRB: institutional review board, a group of people, usually based in universities, that protect human subjects in research studies.

Screening: when doctors look at signs your body might show to determine
whether you need to be tested for certain conditions.

Supply-chain: the movement of materials your product goes through before, during, and after manufacturing. It is a general term for a group of different suppliers, factories, vendors, advertisers, researchers, and others that work separately.

Regulatory pathways: supply-chain for government approvals and other paperwork you need to have before introducing your product to the public.

Step 1: Meet your Mentors

Walter Lee is Chief of Staff of the Department of Head and Neck Surgery & Communication Sciences, Co-Director of the Head and Neck Program, and an affiliate faculty member at the Duke Global Health Institute. He presented ENlyT (pronounced like en-light), a newfangled nasopharyngoscope – a camera that goes down your nose and down your throat to screen for cancer. He wants to expand with partners in Vietnam and Singapore.

Marlee Kreiger helped found the Center for Global Women’s Health Technologies at Duke in 2007. Since then, she has led the Center in many interdisciplinary and international ventures. In fact, the Center for Global Women’s Health Technologies spans both the Pratt School of Engineering and the Trinity College of Arts and Sciences. She presented on the Callascope, a pocket-sized colposcope – a camera device for cervical cancer screening.

Julias Mugaga will soon be a visiting scholar at Duke – until then, he heads Design Cube at Makerere University in Uganda. He presented his KeyScope, a plug-and-play surgical camera with 0.3% of the cost of standard-of-care cameras.

Step 2: Name your Audience

DGHI has “global” in the name, so it is no surprise that these presenters serve communities around the world. Perhaps something that inventors like Dr. Doofenshmirtz often get wrong is that new innovation should come at the benefit of underserved communities, not at the cost of them. For Lee, that focus would be in his collaborations in Vietnam; for Mugaga it was his community in Uganda; and for Kreiger, it was the many studies conducted in Zambia, Tanzania, Kenya, Costa Rica, Honduras, and India.

Each of the presenters could agree that the main strategy is simple: find partners. Community members on the ground. Organizations that can benefit from your presence.

*Another prominent–albeit villainous–inventor, Dr. Doofenshmirtz. Image courtesy of Disney.*

Another notable aspect of your audience will be the certification you vie for. Depending on your location, you may need different permissions to distribute your product, or even begin on the journey to secure funding from certain sources.

In the United States, the most relevant regulatory pathway is FDA clearance, which is notably less restrictive than the CE mark distributed in the European Union. Both certifications are accepted in other countries, but many of the inventors on the panel opted to secure a CE mark to potentially appeal to a wider variety of governments around the world.

ISO is an international organization that is also necessary for certification, particularly if you are looking to test a medical product. No reason to be dragged down by the paperwork, though! When asked about securing Ugandan product certification, Mugaga declared, “This is one of the most exciting journeys I have taken.” His path to clearance was even more wrought with uncertainty – without steady sources of material in the Ugandan economy, it is harder to earn FDA or CE approval, two of the most widely-acknowledged certifications in the world.

Step 3: Test

Now that you have permission, you can start changing lives. Many participants in our panelists’ studies were patients in community health clinics across the globe. Their partners in these clinics also had the opportunity to save tens to hundreds of thousands of dollars in equipment. While it seems like a no-brainer, there are ethical concerns that need to be addressed first. For that, you need to fill out…. You guessed it: more paperwork. IRB approval is usually granted by educational institutions (as you should recall from my handy glossary), and is crucial to secure before any testing with humans is started. In fact, the government (and most private investors) won’t even give you a second glance if you ask them for money without IRB approval.

One big hurdle many of the panelists noted was a distrust of the technology and institution it came from – a foreign entity testing their products on you does not always invoke fear, but it certainly does not always promote trust. Kreiger noted that the work of their community health partners does the heavy lifting on that front; not only are they known community pillars, but they have authority to promote health technology through their existing relationships. If you run into trouble identifying partners in your inventorship journey–never fear. Lee has a message for you: “Ask around. At Duke, there’s always an expert around who’s willing to lend you their time.”

Step 4: Distribute

Now that you are an expert, your invention works, and you’re saving lives, you can attempt to cement your design as standard-of-care. This may look different depending on where in the world you want to distribute, but the next step is to contract a large-scale manufacturer. Your materials have been sourced by now (FDA says they better be) — so finding someone to put them together at an industrial scale should be easy! Your cost may fluctuate at this scale with the increased labor costs, but bulk production and distribution altogether should provide you, your institution, and your clients the best possible chance at changing the world.

Lee did not receive NIH funding until his fourth attempt at applying. Kreiger did not settle on the first manufacturer contracted. Mugaga is still in the process of securing a CE mark. And yet, all of them are success stories. You can see the ENlyT saving lives in hospitals in Vietnam; you can track the reallocation of $18,000 in savings from purchasing a Calloscope; and if you’re lucky, you’ll catch Mulgaga on campus next year as a visiting scholar at Duke!

Post by Olivia Ares, Class of 2025

How to Vaccinate Your Kids Against Racist Misinformation

By Olivia Ares

On October 1, 2023

In Behavior/Psychology, Biology, Lecture, Students

Raise your hand if you learned about Mendel and his peas in high school biology.

It is a common misconception that this model of simple genetic traits applies for all traits. As a result, many students adhere to the idea of genetic essentialism, which concludes that even complex traits like skin color and intelligence are determined solely by someone’s genetics.

This is a notion that has been widely disproven in the scientific community for the past 20 years. However, there is a clear, historical roadblock in the community’s ability to translate this to the public — in a study to be published next month in Science, this group of scientists thinks they found a way.

Brian Donovan is a senior research scientist at BSCS Science Learning, and the principal investigator for a $1.29 million NSF project studying the effects of changing genetics education in American high schools.

On Wednesday evening, he gave a special talk at Duke to a standing-room-only crowd filled with the Biology and Evolutionary Anthropology departments, as well as about 50 assorted undergrads who were scribbling notes like they were going to be tested (myself included).

This talk is especially salient for the crowd in attendance: Duke has one of the most innovative introductory Biology courses in the nation (as anyone who has taken BIO202 with Dr. Willis will tell you), aimed specifically at combatting prejudice from misconceptions in genetic education.

*Biological Sciences, Room 141, packed to the brim.*

Donovan’s grandparents were Holocaust survivors from Poland who experienced ethnic persecution at its highest, and he was inspired to combat these prejudices. Many people don’t realize that Nazism borrowed many of their tenets from Jim Crow laws, he discussed in the presentation. Not to mention the basic genetic model used in classrooms across the country — the Punnett Square — was developed in accordance with eugenics.

Donovan’s pitch was simple: a vaccine against racism.

According to numbers calculated in the study based on teenagers’ social media use and content, 13% of high school students in the U.S. could be exposed to racist manifestation during their high school career. And 98% of these kids take high school biology. Combatting racism with proper, well-rounded education on common misconceptions about genetics and race could be part of the solution.

But this doesn’t mean we need to nix Mendel altogether, Donovan says — we just need to restructure the narrative.

*Dr. Brian Donovan giving a lecture on Wednesday in the Biological Sciences building.*

The new-and-improved curriculum (called “human(e) genetics,” which is very clever, if you ask me) focused on facets of genetics that are commonly considered fact by the scientific community.

0.1% of the human genome is variable between people.
There is statistically more genetic variation within human populations than between them.
Complex traits, like skin color and height, have very weak association with genetics alone.
The relationship between environment and genetics is hard to quantify exactly. Studies in humans would be very unethical.

Height is a complex trait, just like skin color, says Donovan. These traits exist on a continuum. But you don’t make assumptions about people’s background based on their relative heights, yet the continuum of height variety is just as discrete as the continuum of skin color variety.

So, if all of this is such common knowledge, why is it not taught in classrooms already? Take this quote from a 1941 textbook called Biological and Human Affairs:

“There are no studies on how that impacted kids.” Donovan declared. “But I don’t think we need one after reading that. I think we can tell.”

After crunching a lot of numbers, Donovan’s team calculated that, considering the success rate of their humane genetics curriculum in experimental groups (the number of students who changed from agreeing with genetic essentialism to disagreeing with it), 52% of the original 13% exposed to racist ideals online would be protected from following them after this new education model.

Of course, this model can be expanded to address more issues than just racial prejudices. Donovan’s team has also conducted studies on the effects of humane genetics education on gender perception.

These studies have even more relevance today in the age of controversy in history and biology education in Florida and the CRT controversy across the nation. In the question-and-answer session, students critiqued the feasibility of instituting humane genetics education in these states as a result.

The best way to educate adults, Donovan answered, is to educate the masses. “I have to ask you all,” he gestured to the room, “to publish. We need to publish papers that confirm we have a scientific consensus.”

Post by Olivia Ares, Class of 2025

One Man’s Death Is Not Another Man’s Science

By Olivia Ares

On April 11, 2023

In Anthropology, Biology, Faculty, Field Research, Fossils, Genetics/Genomics, History, Lecture, Responsible Conduct

Geer Cemetary in Durham is one of many burial grounds in America that hold the remains of thousands of Black Americans from the 19th century. There are no records of the people buried there. The process of researching grounds like these as a form of reparations to descendent communities was pioneered by Michael Blakey in the African Burial Ground Project in Lower Manhattan, New York. He is currently the Director of the Institute for Historical Biology at the College of William and Mary.

Dr. Michael Blakey. Image courtesy of Library of Virginia Education

On April 4, Blakey visited Duke as a guest of the Franklin Institute of Humanities, the Department of Classical Studies, the Department of International Comparative Studies, and Trinity College. In attendance to his lecture were students of Classical Studies 144: Principles of Archaeology with Alicia Jimenez, International Comparative Studies 283: Death, Burial, and Justice in the Americas with Adam Rosenblatt, and several graduate students by invitation (and me). His presence was clearly highly anticipated.

I initially approached Dr. Jimenez with my interest in bioarchaeology in January as I was planning my Program II application. She invited me to this seminar, and to lunch with Blakey and the graduate students beforehand. I came prepped with questions on osteopenia and hypertrophy, as well as a map of Brightleaf Square so I wouldn’t get lost (I still got lost) and a few dollars cash for parking (they only took card).

Geer Cemetery, Durham, NC. Image Courtesy of Durham in Plain Sight

For those of you who have ever loved the detective fiction heroine Temperance Brennan, Blakey’s work is for you. He is co-chair of the Commission for the Ethical Treatment of Human Remains through the American Anthropological Association. He was claiming the title of bioanthropologist before it was cool. He wrote a guide for the profession called Engaging Descendant Communities, or, more lovingly, The Rubric. Blakey encourages allowing those descendant communities to guide scientists’ research on human remains. He calls us Homo reminiscens, because what makes us “human” may be our affinity for memorializing our dead as much as it may be our large brains (á la Homo sapiens). “Burial is human dignity,” Blakey announced during the seminar, “Dignity is what we do.”

“Ethical code is not law. It is our greatest responsibility.”
Michael Blakey

After all, science has historically been used to justify the unjust. Bioarchaeology is a famous contributor to the field; the pseudoscience of phrenology was upheld until well into the 20th century, and was originally used as “scientific proof” that people of African descent were lesser than Europeans. It was also cited as a justification for displacing Native Americans from their lands.

During lunch, I was struck by Blakey’s cadence. He had a deep, slow voice and spoke with intention. He ordered the giant pretzel. I never asked my questions; instead, I was swept away by the group’s discussion on ethics–a topic I had no open Safari tabs on. I asked instead why a scientist would choose to guide themselves entirely by a non-expert opinion rather than scientific inquiry; would that not hinder discovery?

The scientific method, as you may recall, starts with asking a question. Rather than gracefully including descendent communities after the paper has been written, Blakey urges scientists to only pursue questions about remains that the descendants wish to answer. The science of death should never be self-serving, he noted. There is no purpose to publishing a paper if it is not in the service of the community that provided the subject. A critical reader may notice that The Rubric is not called The Gospel or The Constitution. Rather than a rule of law, it is a guideline. That’s because ethics is based on the respect of self, of craft, and of others. “Ethical code is not law,” Blakey reminds scientists. “It is our greatest responsibility.”

Geer Cemetary has been the subject of Duke research for years now, from a Story+ program to class field trips. Members of ICS, CLST, and FHHI have been in cooperation with Friends of Geer Cemetary to answer such questions about burial conditions–the attempt at dignity granted to Black residents of Durham by their descendants.

Edit: a previous version of this article had incorrectly stated that the Department of African and African American Studies sponsored Michael Blakey’s lecture.

Post by Olivia Ares, Class of 2025

On being MIXED

By Olivia Ares

On February 28, 2023

In Anthropology, Behavior/Psychology, Faculty, Genetics/Genomics

Chances are, you have not felt betrayed by a Google form. But if you’re part of the 8% of multiracial students at Duke, perhaps you’re familiar.

If you check one box, it feels like you deny your identity as another. It is a constant battle of representation, of feeling a responsibility towards all of your communities while simultaneously feeling an imposter in all of them. There is always the issue of being too white for one group, too brown for another.

Since 2012, every county in the United States has reported a multiracial population. Dr. Sarah Gaither, an assistant professor of psychology & neuroscience at Duke, studies the identity crisis multiracial students face. In 2015, she published “‘Mixed’ Results: Multiracial Research and Identity Explorations” in Current Directions in Psychological Science. And on February 10, she organized a screening of MIXED, a documentary following the struggles and backlash facing mixed-race families. The film’s directors, Caty Borum and Leena Jayaswal of American University, joined the screening and provided a Q&A session for the audience.

Gaither’s research is featured in the film, as well as Duke SWIRL (Students With Interracial Legacies), a former student organization.

“Multiracials who identify as multiracial actually experience decreased self-esteem when asked to choose only one racial identity,” Gaither notes in her article. Sure enough, the documentary follows America’s slow response to progress. Despite being in the aftermath of our first biracial president, despite it being over 50 years since Loving v. Virginia, which legalized interracial marriage nationwide, there have only been two U.S. Censuses taken since the Census Bureau allowed more than one race to be checked on official forms. This caused a notable shift; between 2000 and 2010, the number of reported interracial people increased by 32%, likely because of the ability to “claim more than one race” as a legal identity.

Duke’s Undergraduate Student Body, Fall 2022 (Source: https://facts.duke.edu/)

Gaither’s research in the Duke Identity and Diversity Lab pledges to continue this research. She notes interesting extensions of multiracial identities, such as Latinx students and families who are subject to even more confusing checkboxes on aforementioned Google forms (What is your race and ethnicity? Because “Hispanic/Latino” is its own category).

“The process of racial self-identification can be more challenging as racial categories can be complex and/or ambiguous,” Gaither says. She also notes the identity crises genderqueer people face, and how restricting checkboxes can really be.

The documentary provides the viewer an opportunity to experience the inequities and bigotries that still exist toward multiracial families. Race, after all, is genetically irrelevant. The documentary team gives examples of questions they are often asked:

“Are you the nanny?”
“What is she?”
“Did you adopt those children?”
“Where did they come from?”

And I’ll add a few more, from experience:

“It’ll be two separate checks today?”
“Where do you get that hair from?”
“Is this your aunt?”

The point is: racial divides are projected by outsiders onto mixed families, and it creates a crisis of identity for mixed-race individuals. It is a phenomenon well documented by Gaither, Borum, Jayaswal, and others who have lived it.

Post by Olivia Ares, Class of 2025

Inside Biblical Research with Duke’s Mark Goodacre

By Olivia Ares

On November 3, 2022

In Faculty, Humanities, Religion

This is part two of a two-part series; last week we looked at what biblical research is and why it matters—this week we’re looking at how it’s conducted.

“Sometimes I have to take a running start to the word ‘religion,'” says Mark Goodacre, chair of the religious studies department at Duke.

A beautiful sentiment.

He corrects himself: “That is, I have trouble saying the word itself. I often have to stop and think so I don’t stumble over it.”

A considerate pause: “Department of…Re-lig-ious Studies*.* There we go.”

Goodacre has a podcast about the New Testament. His students have admitted to using his calming British timbre to lull themselves into a sense of peace. When I met with him over Zoom, he was back in Cambridge visiting his brand-new granddaughter. Other than being one of the world’s most forefront New Testament scholars, he is also an ABBA superfan.

Goodacre consulted on the Gospel of Matthew for the New Revised Standard Version Updated Edition—the most modern scholarly edition of the Bible. He argued to the board that the commonly translated “leper” should be considered “person with leprosy” and “deaf-mute” as “person who could neither see nor hear.”

Goodacre is one of hundreds of New Testament scholars around the world who are working towards a greater understanding of historical and theological Christianity.

Coming from outside the world of biblical research, it may be difficult to understand the relationship between religious texts and academia. You can think of it like this: in an academic setting, the Bible is heavily seasoned with nuance, slow-roasted for decades at a time, pulled apart, chopped into little chunks of knowledge, placed in boiling vats of outside context, and served objectively with a fresh garnish of analysis.

“You’re taking the tools you have in the arts and sciences, and you’re not treating religious texts any differently,” Goodacre says. “People often think you have to treat sacred things differently, but they are still the product of human beings in specific contexts at specific points in history. Subject them to proper scrutiny— like you would to any modern writer.”

Last week, we looked at why biblical research matters. But perhaps that relationship goes both ways; researchers are constantly inspired by the world of arts and sciences, the conversations they have with students—and more than that, current events. Today, as much as in any decade, the Bible is a central topic of debate in public policy and ethical issues that affect people all over the world. Goodacre gives us some examples:

“For example, take slavery in America; sometimes the same passage in the Bible would be referred to by both abolitionists and slave owners. Modern scholars are able to provide context to those passages and truly defend the arguments of abolitionists.”

As a Brit, Goodacre finds the American separation of church and state an interesting concept. As a scholar, he is able to provide context and voice to arguments made on both sides.

“It is healthy for our politics and culture to have people who can have intelligent discussions about the Bible in issues in our courts like marriage, divorce, sexuality, abortion.”

Goodacre makes sure to teach historical analysis tools in his classes. Among those tools include the ability to view texts from different perspectives; beyond being able to step away from politics to provide an outside view, scholars also need to be able to get even closer to the text. Different views on the text have been the consensus at different points in history, and often scholars find reasons to visit and revisit translations and interpretations for different analyses.

*Some books written by Goodacre, images courtesy of Google Books.*

For example, Goodacre teaches a class at Duke called Jesus and Film, and in the class he repeatedly revisits the issue of the persistent white, European Jesus depiction in even modern art. Since graduating from Oxford years ago, he has revisited the same material he once studied with a feminist perspective despite being taught it in a male-dominated space.

“For someone like me who went to grad school a few decades ago,” he says, “it’s a liberating thing to take feminist and racial perspectives with the weight they deserve.”

What does this have to do with us non-religious studies folks? Perhaps some of us follow the scientific method to conduct our experiments, others the engineering method and even others use literary analysis or investigation methods or whatever we need to get to the root of a problem. All of these methods and more are encompassed within the realm of religious studies and biblical research; by looking at a problem from all angles, and without treating sanctity as an exception to scrutiny, scholars are able to work.

What is Biblical Research, Anyway? The Answer Might Surprise You

By Olivia Ares

On October 26, 2022

In Anthropology, Art, Faculty, History, Lecture, Students

This is part one of a two-part series; next week we will dive into the nitty-gritty of biblical research, but for now, we’re focusing on what biblical research is and why it matters.

*Image courtesy of Duke Divinity School*

To the uninitiated, “biblical research” might not conjure up images of dancing, or analyzing films, or studying engineering. But meet Maximillion Whelan. A third-year M.Div. student at Duke, Whelan runs a website for film aficionados focusing on analyzing movie scenes and was recently published in Quarterly Review of Film and Video for an article on theology and film. He notes: “Biblical research sheds light on how everyday activities effectively shape history and are also shaped by history. By “zooming in,” delving into the details and contexts, biblical research enables us to simultaneously “zoom out” – to see what things we are taking for granted, where our readings have led us, and how we take our readings into other spheres of life.”

*Image courtesy of Nicole Kallson (as part of her course Introduction to Theology and the Arts*)

Or take Divinity School student Nicole Kallson. She is pursuing a Master’s of Theological Studies with a Certificate in Theology and the Arts.

“As a theologian and dancer, I use my background in dance to assist my understanding of the Bible.” Kallson explains. “I tend to focus on ideas of embodiment, beauty, and inter- and intra- personal relationships.”

Both students—along with countless other Blue Devils and other mascot identities—use their studies as a lens through which to examine themselves and their passions. And isn’t that what we emphasize so clearly at Duke—the interdisciplinary, interpersonal, interfaith, international, interwoven identities of people, places, and things? Is that not what research is all about in the end? Perhaps the purpose of biblical research is not as foreign to us as we may think at first.

Degree-seekers may come from expertise in literature, classical studies, practical faith, or other backgrounds that may easily come to mind. But they also come from natural sciences, physical sciences, political science, art and media studies, creative writing, engineering, medicine, sociology, public policy, economics, and so much more. And each of these students is applying their research and understanding of the Bible to their understanding of the world at large, seeking to become better, more intentional academics in the process.

The new Dean of Duke Divinity School was born and raised in Puerto Rico; he has prayed with Pope Francis and presented him with writings on interfaith dialogues. He also has Bachelor’s and Master’s degrees in mechanical engineering.

Dean Edgardo Colon-Emeric moderated a symposium on the Bible last Friday, October 11, 2022 through the Karsh Alumni Center Forever Learning Institute (part of the Policing Pages series, which Jakaiyah Franklin also wrote about for the Blog!).

“It might seem odd to have a series focused on the Bible as a banned book, given that it’s the most polished book in history,” he opened. He gave an example further; for a time in recent Guatemalan history, possession of the Bible was persecuted as a means of targeting perceived Communist empathizers. Even within Christain communities, he explains, there has been discourse among devotees of certain translations and versions—not all of them amenable.

The event also featured Brent Strawn of the Duke Divinity School and Jennifer Knust from Trinity College of Arts & Sciences Department of Religious Studies.

*Jennifer Knust during the Forever Learning Institute’s* Policing Pages presentation on the Bible

“The survival of the New Testament as a text and a collection is a theological and practical achievement,” noted Knust. “It is repeatedly refreshed in response to new circumstances, even as remains of past approaches continue to shape what can happen next.”

It is because of the differing opinions of so many people over such a long time that we have different faiths, and biblical research uses the lens of Christianity to evaluate that phenomenon.

Knust continues: “Today we know that there are over 5,000 manuscript copies of the New Testament, none of which are identical in every particular.”

She herself was a member of the board of the New Revised Standard Version Updated Edition—the most recent scholarly translation of the Bible, published in 2021. She elaborated on her feelings on the dynamics and fluidity of the text, describing a constant push and pull of desire and tradition. Perhaps researchers, in the present, past, or future, may desire to change words, meanings, or uses of the Bible, but they are contradicted by a tradition dictated by the populous.

Biblical research seeks to answer questions about the Bible— and by extension, the fruitfulness of humanity. The sustainability of religious texts of all kinds is a testament (pun intended) to the success of human minds compounded over thousands of years.

*A 1611 copy of the Authorized Version Knust* *uses as an example of different Protestant translations.*

On this PeopleMover-style tour of biblical research, I hope we’ve taken away some key points:

Firstly, the work of many biblical researchers is deeply personal. We’ve discovered through this that the work of any researcher in any field has the potential to be deeply personal.

Additionally, we learned that the interdisciplinary reach of biblical studies works inversely; students may turn to biblical research from other subjects to enhance their work, or they may even turn to other subjects to enhance their work in biblical research.

And finally, we arrive at our destination; next week we’ll talk more in-depth about what biblical research entails and meet some key players in those conversations.

Expanding the SCOPE of Medical Education

By Olivia Ares

On September 15, 2022

In Anthropology, Art, Biology, Global Health, Medicine, Students, Visualization

It may be hard to put your finger on it, but Duke often allows students to connect their classes to something more personal.

The university’s emphasis on interdisciplinary education is a major initiative that colors students’ academic experiences. While there are many examples of these connections between people, classes, fields, and departments, few so tangibly represent those connections like The SCOPES Project, which connects arts and humanities to medical education at Duke.

*Beneath the Surface* by Mihir Patel, 2022. Image Courtesy of SCOPES.

Art and medicine can exist in entirely different worlds. They can appeal to different people and tell different stories. But why be simple when you can be, well… stunning? They can be integrated to form something powerful, and that’s precisely what SCOPES leadership members Isa DeLaura, Raluca Gosman, Mason Seely, David Stevens, and Lindsay Olson aimed to do.

“It is encouraging as an upperclassman who previously participated in this program to see rising students continue the tradition of incorporating the humanities into medical practice,” Mason Seeley says. The generational aspect of the project seems to contribute to its personality; participants bring their own perspectives to their work only to walk away with dozens more.

“Having a creative outlet has helped me process interactions with patients and the difficulties of the profession, and celebrate happy moments as well,” says Isa DeLaura.

“The goal is to give artists creative freedom to explore their relationships with their patients with whatever medium and in whatever style works best for them. As such, every year the feel is entirely based on the decisions of the artists.”
Isa DeLaura, MS3+

David Stevens insists that the artists “resist… forces of depersonalization in compelling and beautiful ways.”

The project is inspired and supported by yet another interdisciplinary Duke initiative called APPLE (Appreciating Patient Perspectives through Longitudinal Encounters), which connects medical students with patients living with chronic illnesses. The artists/medical students/empaths-in-training then attended multiple creative workshops and developed art pieces to reflect their patients’ personal experiences. But this year’s 6th annual SCOPES exhibition looks a bit different from past years’ (which are conveniently available online for your viewing pleasure).

Having attended many an art opening myself, I am unashamed to say that much of my enjoyment comes from the cheeseplates (and the excitement in the air, but that’s besides the point). Some exhibitions opt for a traditional charcuterie, some marked Kirkland Signature and others displayed on a handmade butcherblock. The point of fingerfoods is to encourage the attendees to stand up, walk around, and interact with the masses. But it also encourages attendees to “just stop by,” making the affair all the less intimate.

Following limitations on group gatherings Duke enforced during COVID, the SCOPES team decided to apply their newfangled interdisciplinary/revolutionary/innovative thinking to the art opening itself: They held a banquet.

“I loved the way this turned out,” says DeLaura. “It was very personal and made for great discussion and comradery.”

*Fences, Rivers, Walls* by Taylor Yoder, 2022. Image Courtesy of SCOPES.

“SCOPES has provided an opportunity to reflect on my experiences as a first-year medical student while also exploring new ways to combine various art forms to create my vision,” says Taylor Yoder, who created Fences, Rivers, Walls, pictured above. “I hope to continue shooting film throughout my medical education and career.”

I was particularly (although wrongfully) surprised about the variety in the exhibit. While the artists attended the same workshops and worked with patients through the same program, they took radically different approaches to their creations. Esme Trahair, a second-year medical student, was a humanities major in undergrad. Her piece combines historical perspectives with modern (although antiquated) mechanisms, emphasizing “the importance of remembering and learning from historical, outdated medical teachings.”

*For the Record* by Esme Trahair, 2022. Image Courtesy of SCOPES.

The work features a variety of perspectives, but also some clear motifs that could be key takeaways for future medical providers. Like Yoder, artist Kreager Taber explores the patient’s value of “home.” Exploring these motifs could allow for more personal, “upstream” healthcare.

This year’s SCOPES exhibition is held in the Mars Gallery in the Duke University Hospital Concourse. It is an initiative of the Trent Center for Bioethics, Humanities & History of Medicine at the Duke University School of Medicine. It will be on display August 9-September 29, and available for viewing online at this link.

P.S. If you are an MS1 student interested in participating in SCOPES, I have a link for you!

Post by Olivia Ares, Class of 2025

Medicine Under a Microscope

By Olivia Ares

On February 15, 2022

In Biology, Genetics/Genomics, Global Health, Immunology, Lecture, Science Communication & Education

Duke Research Week 2022 featured a range of speakers from across all disciplines. The Lefkowitz Distinguished Lecture on January 31st highlighted some of our favorite things here at Duke Research Blog: ingenuity and perspective.

Dr. Huda Yahya Zoghbi’s career spans decades; her Wikipedia page sports an “Awards and Honors” section that takes up my entire computer screen. She is a geneticist, neuroscientist, pediatric neurologist, pharmaceutical executive, and literature lover. Her presentation kicked off 2022 Research Week with a discussion of her work on Rett Syndrome. (View the session)

Rett Syndrome is a rare genetic disorder. The gene that researchers identified as the driver of the syndrome is MeCP2, which is especially active in brain cells. Certain mutations of this one gene can be responsible for a loss of speech, development issues, and persistent fidgeting.

This image has an empty alt attribute; its file name is _Sk5Y-Q39YYuBd_Ntz_77pXwX8uwtEhTnl4yokbul2AdWHu0xpP_mTKi8mQQHlG7GjmP32Nc4xb1oq-InXReJVfbBai5DF8Enf6LvkuPNZlPou9rc5RCjjjc6B_fRj1oCaVMGWCS — The MeCP2 protein. Image: Wikipedia Commons

Children with Rett Syndrome faced chronic misdiagnosis, and even with proper care were limited by a lack of research.

Duke’s Dr. Robert Lefkowitz introduced Zoghbi at the beginning of the seminar and explained how she came to become the leading expert on this relatively unknown disorder. After completing medical school in Beirut in the midst of the ravaging Lebanese Civil War, she came to Texas Children’s Hospital, where she was able to observe and diagnose her first case of the syndrome, a process spurred by a simple interest in a newly-published journal article.

Holistic knowledge of Rett Syndrome is completely dependent on genetic research. A mutation on the MeCP2 gene causes errors in transcription, the reading out of DNA in your cells which leads to the production of proteins.

The mutated gene’s MeCP2 protein is then lacking the ability to do its job, which is helping other genes be expressed, or actively transcribed.

It’s a vicious cycle; like when you go to sleep late one night, so you sleep in the next day, then go to sleep late the next night, then sleep in the next day, and so forth.

In order to simulate and measure the effect of different kind of mutations on the MeCP2 gene, Zoghbi and her team studied genetically modified mice. While Rett Syndrome is caused by a lack of MeCP2 function, an overactive MeCP2 gene causes MeCP2 duplication syndrome. Varying degrees of gene efficiency then produce varying degrees of severity in the syndrome’s traits, with fatality at either end of the curve.

Zoghbi’s talk focused mainly on the mechanics of the disorder on a genetic level, familiar territory to both Nobel Laureate Lefkowitz and Duke Medicine Dean Mary Klotman, who shared some discussion with Zoghbi.

This medicine on a microscale is applicable to treating genetic disorders, not just identifying them. Zoghbi has been able to experimentally correct MeCP2 duplication disorder in mice by modifying receptors in a way that reverses the effects of the disorder.

The symptoms of Rett Syndrome are physical; they present themselves as distinct phenotypes of a subtle difference in genotype that’s too small to see. The field of genetics in medicine is responsible for making that connection.

Post by Olivia Ares, Class 2025

This image has an empty alt attribute; its file name is ARES_Olivia.jpg

How is Universal Healthcare Like the Waterboarding Debate?

By Olivia Ares

On November 10, 2021

In Behavior/Psychology, Global Health, Lecture, Medicine, Policy, Science Communication & Education

The Duke Medical Ethics Journal (DMEJ) is an undergraduate publication started in Spring of 2020 that examines conversations around universal patient-doctor responsibility. In other words, they’re training the next generation of healthcare providers to ask big questions and make informed decisions. So, we owe them a huge thank-you in advance.

On Sunday, October 24th, DMEJ hosted Dr. Gopal Sreenivasan to speak with current members. The event was open to the public as part of the club’s mission to promote ethical practices across all fields. Dr. Sreenivasan is a moral philosopher, but he is also a professor of medicine at Duke Medical School. His position as the “Crown Professor of Ethics at the Trent Center for Bioethics, Humanities & History of Medicine,” is part of an initiative to connect societal arts and sciences aspects of Duke University to the Medical School.

“Today, I want to talk to you all about the human right to health,” he opened.

Sreenivasan’s talk was focused on the question of how individual countries can provide healthcare or insure health. “One division within the human right to health is the division between health and healthcare,” he clarified. “Another is the difference between a regular right and a human right.”

As a philosopher, Sreenivasan took the issue of access to health and placed it on a universal scale. He addressed the social determinants of health (callback time!) as part of the solution, alongside more direct-but-still-indirect healthcare actions like vaccinations. His conclusion? We are ultimately moving away from the narrative that we have a right to healthcare and towards the narrative that we have a human right to health.

“You have a right to health, but that does not necessarily mean you are going to be healthy. There are still factors that affect this which are under no one’s control. It doesn’t mean that if you don’t live to be 80 or 85 that your right has been violated. But you’re still entitled to a broader range of things than just health.”

To help illustrate this for my fellow visual learners, I’ve made a fun little visual aid.

Sreenivasan laid out a verbal map to demonstrate the confusion policy makers face about addressing the wellbeing of their constituents. If you believe healthcare is a right, you believe the government has a different role to play than if you believe health is a right. You may expect less of them in terms of handling indirect factors like social determinants and vaccines. If you believe healthcare is a human right, you expect all governments to provide healthcare access universally. This is different from Sreenivasan’s preferred view: health is a human right. All people are entitled to all aspects of their health being addressed all the time in every way in every place.

The word human in “human right” indicates universality the same way removing the care from “healthcare” does; they both broaden the scope.

After that lovely philosophical grammatical discussion (Do colorless green ideas sleep furiously?) as our foundation, Sreenivasan moved on to a challenging analogy: waterboarding.

“It does not belong to the nature of a right that everyone has to have it. But it does seem to belong to the nature of a human right that everyone has to have it. Take the human right to not be tortured, for example.”

Your moral view may differ on whether or not it is a human right not to be tortured. You may think the right should apply to all people, or no people, or only some people. But you also may think that the right should apply to only certain aspects of torture; maybe you think that specifically waterboarding doesn’t count.

(The debate around whether or not waterboarding counts as torture and whether or not it is prohibited under human rights legislation is one that has been around for a long time. Torture has been banned by multiple American presidents in multiple environments, but the language around waterboarding in particular is highly controversial. You can read more about the debate here.)

“It’s not that some people have a human right not to be tortured which protects them from waterboarding, and other people have a human right not to be tortured but it is somehow lesser and does not protect them from waterboarding. You can’t pick and choose the content based on the person for whom the right belongs.”

So, how is the waterboarding debate like universal healthcare?

For one, it’s a matter of exclusion. It’s a matter of moral philosophy. It’s a matter of definition.

The question of whether there should be universal healthcare goes far beyond the question of whether healthcare is a right.

How do we improve access? Who is at fault for rising drug prices? How is America’s healthcare system different than other countries? These questions must start with questions of definition. Who is our target audience? Who is included? Who is excluded? What is included? What is excluded?

“It seems intuitive that human rights are all or nothing.” Sreenivasan explained. “Either everyone has them or no one has them. But then you must say that their content also has to be the same.”

Post by Olivia Ares, Class 2025

If Homer Had a Guitar

By Olivia Ares

On November 3, 2021

In Art, Visualization

Most ninth-graders in the U.S. read The Odyssey for English class. Not that many sing it, though.

Since 2001, Joe Goodkin has traveled the U.S. performing his retelling of The Odyssey. “These poems were meant to be felt, not studied, and I think my work can add that element back into how we encounter them today,” he says.

Last week, he premiered his new work: an American Blues re-telling of The Iliad.

The Duke Classical Studies Department hosted Goodkin to perform this piece on Friday, October 22nd in the Sarah P. Duke Gardens (The weather being lovely, he remarked: “Thank you, Zeus. I must have performed the right number of hecatombs”).

The Blues of Achilles re-tells The Iliad from eleven different perspectives. “This is what I envisioned these songs being,” Goodkin confessed to his audience. “Us doing exactly what they did 3,000 years ago— sitting around, listening to stories of the Trojan War.”

He’s referring to the fact that epic poems were written to be sung as performances rather than read as stories (Although if you’re like me and your only prior knowledge of the Trojan War came from Madeline Miller, you might be confused). Homer’s The Odyssey and The Iliad lose some of their musicality when translated into English and read off of a page, but Goodkin aims to re-invigorate those stories.

Goodkin’s work is a form of artistic research used to better understand Greek culture. He gives the example of The Singer of Tales, a book about the importance of oral tradition as a form of research. Written in 1960 by Harvard professor Albert Lord, The Singer of Tales focuses on illiterate oral poets of former Yugoslavia and compares their methods to Homeric epic. Cool, right? While it seems a bit far-fetched, Goodkin is actually doing something similar.

“While I don’t expect my work to be as important or scholarly as that book,” Goodkin notes, “I think [my work] can be a way for modern audiences to treat the epic poems as experiences rather than just artifacts.”

Joe Goodkin performed in the Sarah P. Duke Gardens on Friday, Oct. 22.

Homer’s works were integral to Greek life and values. Storytelling, to the Greeks, was the main form of broad communication and cultural unity. Modern organizations like the International Storytelling Center recognize the importance of oral literature and its effect on our cultural understanding.

We tell stories all day every day (heck, you’re even reading one right now!); Goodkin, and other storytellers, use this link to connect with their audience and convey an understanding of other cultures and viewpoints. Goodkin’s The Blues of Achilles reflects many attributes of the original, as well. For one, the chronology of the story is reversed. “I wanted my audience to have the same sort of idea a Greek audience would have about the end of the story. You have different things in play when the audience knows the end of the story. Even thinking about time in The Iliad, it’s very elastic and funky. So I wanted to recreate some of that disorientation,” he explained.

The Blues of Achilles is a blues composition— and blues music, like epic poems, is a culture-specific art form. In explaining his interpretations, Goodkin said: “I thought, ‘If Homer’s Iliad is “The Wrath of Achilles”, I have to interpret that line in a different way, like a poet would.’” (Author’s note: Remind you of anything?) “For one, ‘blues’ is in his name— áchos laós means the grief of the people.”

In re-telling these epics, Goodkin is not only bringing another perspective to the classics scene, but connecting it to American culture. “Blues music is our oral tradition. It was composed and came to be as an art form largely the same way the Greek epic did, by these bards-slash-singer-songwriters,” he explains.

Homer retellings, interpretations, and translations differ across time and perspective, but they all intend to revive the poems for their audience. Whether or not we see the connections to our lives, these myths originated many archetypes we are familiar with (Just ask Meg Ryan). In the end, Greek myths are all human stories about tragedy, war, love, loss, and morality, and they are as relevant today as they were 3,000 years ago.

If you’re interested in working with the Gardens for your class or research, contact kati.henderson@duke.edu or visit this link.

Post by Olivia Ares, Class 2025