Book Review: Top Dog

A popular science writer has two choices: be vague when explaining the specific experiments behind their explanations, thus leaving themselves open to criticism about not sufficiently proving their supposition, or be exhaustive, which is boring.  It is impossible to be both truly rigorous and readable by mainstream publishing standards.

Reading Top Dog, I had an urge to make myself feel smart/assert dominance by criticizing their science.  Those of you who follow me on twitter got a taste of that.  But I stopped because I realized the criticism was a net drain on the universe.  While every study and experiment they cited could be criticized, that  is the nature of research: you can only prove so much in any given run.  You have to draw conclusions from the body of applicable research as a whole.  And in that context, I think it’s a pretty good book.  It explained  biochemistry in a way I found understandable but rigorous,* and I think their overall conclusions  are merited and well supported.  Some of them will be proven incorrect tomorrow, but that is the nature of science.

If you are looking for science writing for the sake of science writing, I would recommend the authors’ previous work, Nurture Shock.  But if you are looking for something specifically on the science of competition and, more broadly, stress, seriously consider Top Dog.

* This is a compliment.  I nearly ran on stage last week when a play’s key plot point depended on a faulty understanding of sickle cell anemia.

Systems vs. Goals

Scott Adams talks a lot about goals vs. systems.  I’m reading this in his latest book How to Fail at Almost Everything but he’s also blogged about it.  His main point is that if you have a goal, you’ve set yourself up to never feel successful.  You’re failing for the time between setting the goal and achieving it, and then once you’ve achieved it, it’s no longer a goal.  You have one, brief transition point to feel like a success.

We could get bogged down here in things like the definition of goal, system, and success, or the fact that meeting goals can pay dividends besides a vague feeling of success, but for now I want to accept this paradigm as useful and apply it to my work at the crisis chat.  Because it would be really, really easy to feel like a failure as a chat specialist.  People are constantly being sad at you, many of their problems are unsolvable and even if you know the solution you can’t make them do it, you never see your most successful chatters again, and you’re operating almost blind.*

If we had a personal goal of “this person feels X better” for each chat, we’d constantly feel like failures.  And the pressure to make them Feel Better would probably make us worse listeners and more proactive fixers.   Instead, we have a system of “listen, reflect, identify, give them space to identify their own solutions.”   I do go off book, and especially with teenagers I often end up giving specific ideas, but they’re presented as examples to provoke brain storming, not commands.

Obviously it’s dangerous to worship a system regardless of results.   But in this case, I think we’ve chosen a really great system that supports our desired results.  I was really worried crisis chat would be too stressful for me because I wouldn’t be allowed/able to fix people’s problems. **   Now I’m trying to figure how can I/should I hold onto this while practicing psychiatry.

*You would be amazing how many people mention that they’re in really great therapy for a diagnosed issue 30 minutes in.  This is why you ask about their current support network before offering suggestions.

**I feel really blessed that several friends very delicately brought up the same concern.  Because they knew me, and they wanted to make sure I had taken this into consideration before committing myself, but they didn’t push it when I said their concerns were valid and I wanted to do it anyway.

Reason #28348 to hate open offices

I’m going to discuss some gender-based psychology research.  Before I begin, I would like to give my standard disclaimer: any such research is measured at the aggregate level.  Individual variation is very high, so even very strong trends don’t tell you much about how any particular person will behave, or why.  I’m not going to speculate as to the relative importance of environment and biology, because it doesn’t matter for these purposes.

Top Dog talks about some very interesting research into group dynamics.  According to the studies they cite, working in dyads requires a very different set of skills than working in groups, to the point that techniques that are beneficial for one can be detrimental in the other.  The most productive way to interact with a group is as a team: with each person taking a specialized role, which includes letting some people be more valuable than others.  Dyads function best if both people are pretty equal.  Treating a group of 5 as 4 individual dyads and managing the relationships as such is exhausting and slows down the group considerably.

It turns out that women are better than men in dyads, and men are better than women in teams.  Men in dyads are more likely to waste energy competing with one another, women in groups are more likely to waste energy signalling a lack of competition.  The reasons for this are undoubtedly a complicated mix of biology and environment we do not possible have time to get into.  But assuming that it is true, in this culture, right now, what are some implications?
I work in an open office.  And I am acutely aware that one of the reasons it slows me down is that I can’t just have a 1:1 conversation.  I have to think about who might overhear us, and how this will sound to them, and prepare if they jump in… and it’s exhausting.  I wonder if this has the same underlying causes as women’s difficulties in groups.
The counter argument to this is that when I am in groups, I am all about specialization and hierarchy. But I am self conscious about that, and do hold back because I’m afraid of what other people will think of me.  Which is not necessarily irrational: it’s entirely possible the women reason react different in groups is that people (gender deliberately unspecified) react differently to them.
I would really love to see some hard data on whether men and women react to open offices differently.

Vestibular processing

My (new, good) sensory integration therapist’s current hypothesis is that the areas of the brain that coordinate between senses aren’t working properly in me.  In particular, she thinks my vestibulo-ocular reflex (the system that automatically adjusts your eyes to compensate for movement) is weak.  This seems plausible.  I get motion sick easily and am constantly running into things, which indicates a proprioception/kinesthesia problem.  But those are not the symptoms that drove me to seek treatment; my inability to filter out sound and especially conversation has a much larger impact on my life.

My first thought was “well, those are right next to each other and develop from similar precursors, it would make sense they’d fail together.”  But she’s not suggesting physical damage*, but miswired connections in the processing apparatus.  I say processing apparatus and not brain because the vestibular system has some extra-brain communication with the eyes, which is why the vestibulo-ocular reflex is so fast.  Some of the neurons that listen to the vestibular (motion/spatial) system run alongside the neurons that listen to the cochlear (hearing) system, which is why they’re grouped to together as the vestibulocochlear nerve, but that wiki article suggested and everything else I read confirmed that the vestibular and cochlear nerves reported to different areas of the brain.  It’s like having two roads run parallel to each other, but it’s impossible to jump from one to another and eventually branch to different locations.  Both will be affected by a snowstorm in their shared area, but a traffic jam at the destination for one won’t affect the other.

My neurology is weak, so I’m not sure what snow storm could be an analogy for.  “Pinched nerve” is a phrase that exists, or perhaps something in the fluid they both float in?  Except the whole point of neurons is to be heavily insulated against outside effects.  What about the destinations?  Were they really so separate?  That is a good question.  The brain does not break down into discrete little units.  It’s not quite true that everything connects to everything else, but it is true that tracking down everything affected by two particular sensory inputs and cross-referencing them is unlikely to be a good use of time.

Now, a digression. After writing down all the reasons The Fabric of Autism was stupid, I find myself reading it again.  Even though it is wrong, it is bringing up facts in the right area, which spurs me to do more research.  Faced with a dense, correct text it’s easy for my eyes to glaze over.  DNBHelp seems to have a pretty good grasp on otology without my help.  But given a light, fuzzy text with an occasional fact that I’m pretty sure is wrong or at least misleading but am unable to explain why, I will do lots of research so I can more accurately explain to it why it is wrong.  This probably won’t scale for the amount of reading I’ll have to do for nursing school, but it’s helpful for now.

I read another two chapters last night.  Mostly it was some nice, fuzzy work about the relationship between sensory input and safety, but there was a throwaway reference to the superior and inferior colliculus as the parts of the brain that process sensory input.  I looked that up, and what do you know:  the inferior colliculus is a processing center for integrating sensory input.  It handles auditory and somatic senses.  Somatic is a broad term, but it includes both proprioception and touch.  It’s involved in both the startle reflex, which means assessing stimulus for danger potential, and that vestibulo-ocular reflex thing we’ve spent so much time on**.  There is some evidence it’s responsible for filtering auditory signals, which is certainly weak in me.

The superior colliculus is just neat.  Say some part of your brain wants to interact with a specific object in the world.  E.g. you want to pick up that glass of water on the table.  How do you translate your sensory input into something your motor system can use to calculate what movements are necessary?  I don’t know, but apparently the superior colliculus does it.  In humans the primary input is visual, but it also handles echolocation and magnetolocation in animals that have them.

After all that, I have a non-exhaustive list of sections of the brain that do sensory integration, one which I find awesome and others of which I glare at with suspicion.  I still don’t have a good sense of what distinguishes a functioning system from a non-functioning one, and that is something I really want.

*Although it seems like something we should maybe check for</divp

**Interesting note:  vestibulo-ocular reflex appears on the inferior colliculus wiki page, but the reverse is not true.  This is probably because a lot of brain structures have their finger in the vestibulo-ocular pot, and we just don’t have time to list them all.

Quick Tip/Warning: Vibrating Toothbrushes

I’ve been using some form of electric toothbrush since I was 6.  This was a well intentioned call on my parents part, because I have terrible teeth, and the vibrating toothbrushes are significantly better at cleaning out plaque.  But it takes half an hour for a *normal* sensory system to calm down after that kind of stimulation (source: my OT, who didn’t say where she got that number from).  Who knows how long it takes children, or people with sensory issues.  That kind of stimulation right before bed is the worst possible thing for my sleep, and might explain why it’s always taken me forever to do so.

I’ve switched to no-vibration cleaning at night, and vibration cleaning in the morning, and I’m sleeping a lot better.

Book review: High Price

High Price is a really good book in ways that do not lend themselves to me writing a particularly good blog entry about it.  It is about a boy who grew up in the Miami ghetto, observing the effects of poverty and drug use first hand, and grew up to be a tenured neuropsych professor at Columbia studying the neurology of drug use.

I think there’s a few reasons I’m having trouble saying anything interesting about it.  One, it didn’t challenge any of my existing beliefs.  I already believed that drug wars were racist, that drugs weren’t as dangerous as the government told us, that a lot of the problems blamed on drugs were actually poverty or toxic social structures or institutional racism.  I also believed that academia is miserable to everyone and poor black men in particular.  I knew that gentrifying yourself led to alienation from family.  I’ve read about all of these in more detail elsewhere.  Which brings us to point two: this is a survey book.  It’s a very good survey book on a very important topic and I hope many people unfamiliar with the topic read it, but I’m not going to recommend it to any of my friends who already believe the things I listed above, or people with well researched opposition.  It’s not going to change their mind.

Three, despite my previous statement that the book didn’t change my beliefs, the author clearly has much more data on everything he talked about than I do, and I don’t think I have anything of value to add to the discussion.  More bluntly, I’m white, middle class, and have only an undergraduate degree: if I get air time on the topic of racism in academia, the correct thing for me to do is signal boost someone with a more informed opinion. *

Science wise, it’s pretty valid but not deep.  He mostly gives his conclusions, not an in depth explanation of the experiments.  On the other hand, he does a pretty good job explaining what makes the opposing research faulty, and I do love to see that.

So if you’re either looking for an introduction to this issue or share my very strange definition of light reading, I highly recommend this book.  Otherwise, it is probably not for you.

*High Price spends less than a chapter on institutional racism.  If you’re looking for information on that specifically, I’d recommend TressieMC

SAD and Inositol.

Over a month ago I mentioned I was treated for SIBO.   If it helped the digestive issues, it was subtle.  I am however pretty sure it gave me Seasonal Affective Disorder.

Let me give you some context.   I grew up in Rochester, NY (165 sunny days/year).  I went to college in Ithaca, NY (152 sunny days/year, but less snow than Rochester).  I’ve lived for Seattle (152 sunny days/year) for almost 8 years.    Winter weather might keep me indoors more, and I do need vitamin supplements year round, but that’s because wet socks are unpleasant and I’m bad at metabolism.  I didn’t have any SAD symptoms leading up to starting treatment for SIBO, which happened to be the day after winter solstice.

The treatment for SIBO for me was two antibiotics, erythromycin and xifaxan.   Two or three days after I started, I felt fine during the day, but as soon as the sun went down it felt like the world was ending.  It felt Late as soon as it was dark, which was 4:30 PM at the time.  As time went on, I got more and more emotionally distraught and depressed.  Everything felt awful.

1.5 weeks in, I noticed this, upped my vitamin D and started using a sun lamp, and that helped.  2 weeks in the treatment naturally ended, and I felt better still.  But not all the way better.

Finally, almost six weeks after I’d stopped antibiotics, I remembered a friend telling me about inositol, which is a carbohydrate used for intercellular communication.  The conventional wisdom is that your body can naturally manufacture enough inositol from glucose that nutritional sources are irrelevant: however, there’s some evidence that it’s either made or affected by your intestinal flora.*  I’d tried it when he suggested it and found it had no effect, but kept the bottle just in case.  I gave it another shot, and felt better the next day.  2 weeks in, I feel like the SAD is completely gone.

Right on the web page, there’s a warning that Xifaxan can cause an overgrowth of Clostridium difficile.  In the study my friend described but did not give me a proper citation for, he said the researchers had isolated six different bacteria that competed with C. difficile, one of which produced inositol.  I cannot find this study, or even a news article, anywhere.

It’s hardly proven, but I have a strong hypothesis that the antibiotics screwed up my intestinal flora (which is, in fact, what they were supposed to do, we were just hoping to localize the effects to the small intestine), leading to an inositol deficiency, leading to SAD.  In many ways my digestive system feels like it’s been bumped back to earlier stages of treatment (the HCl supplements and removing some food groups), which makes me think that some of the things I experienced were second order effects of changing intestinal flora, rather than my diet directly.