The Human Condition

The Takeaway From 'The Takeaway': Five Easy Subject Changes to Avoid Thanksgiving Fights

2009-11-23T12:30:21Z

Today on Public Radio International's morning show, The Takeaway, host John Hockenberry, Detroit Free Press columnist Rochelle Riley, and I discussed how to avoid family fights during Thanksgiving. As I mentioned on the show, some amount of discord may be inevitable this year: from health care to climate change to gay rights, we're living in a particularly political time.

Like in War Games, the only way to win a political argument amongst relatives is not to play. But while you can head into Thanksgiving dinner determined to avoid any conversations about sensitive topics, you can't count on other members of your family to do the same. So if you want to keep the peace, you have a choice: you can either halfheartedly agree with whatever offensive (to you) nonsense (to you) that Aunt Sally is spewing, or you can try to artfully change the subject.

Of course, you could challenge Aunt Sally directly on her views about climate change, health-care reform, or whether or not H1N1 is a global conspiracy perpetrated by the pharmaceutical companies. Some families love nothing more than battling it out over turkey and mashed potatoes. For those who don't, we've provided a list of five all-important holiday dodges to get you from a dangerous topic to a less offensive one, still guaranteed to elicit a lot of opinions:

1) Health Care: Health care is not only incredibly complex and divisive, it can lead to discussions of an even more volatile topic, abortion. Instead, try to steer any medical conversations toward Charla Nash, the women who was brutally injured in a chimp attack. Nash's tragic story incorporates elements of health and medicine—she's currently living at the Cleveland Clinic full time, hoping for a face transplant; in the mean time she's relearning how to live without hands or a face. There's enough in her story to keep your family talking for hours.

2) Gay Rights: When someone starts to discuss the fight for gay marriage, talk about Adam Lambert: his humble beginnings on American Idol; his guy-on-guy kiss at the American Music Awards. By keeping the topic in the realm of pop culture, you may actually be able to have a low-stakes debate about gay rights. As Lambert himself pointed out, women have been performing similar stunts at award shows for years. Is this different? Discuss. And when things get too heated, switch to comparing the merits of Ellen vs. Paul a.

3) Sarah Palin: No matter how people feel about Palin, credulity that Levi Johnston is somehow still something of a celebrity is a point on which most Americans can unite. Bring up his Playgirl spread and watch the conversation go from politics to pornography.

Playgirl.com

4) Barack Obama: President Obama is a unique position to anger both liberals and conservatives, both of whom feel he's on the wrong path. Michelle Obama, with a 63 percent approval rating, is a much safer subject. And her initiatives as first lady are all family friendly: starting a garden, supporting military families, wearing Banana Republic and J. Crew on a public stage.

5) The wars in Iraq and Afghanistan: No matter how you feel about the war, you have to respect the service of the men and women serving overseas. Focus on that—then show your family the amazing online videos of soldiers reuniting with their dogs after serving a tour of duty:

6) Climate Change: Al Gore's recent appearance on 30 Rock will only lead to debates about whether Gore is an eco-savior or a false prophet and whether 30 Rock is still funny. Instead, bring up the meteorological styling of the tornado-chasing, Balloon-Boy-launching Henne family. Not only will everyone have something to say, chances are their family will make you appreciate how normal yours really is.

This is not how we recommend behaving every other day of the year. It's important to stand up for your beliefs and to be able to defend those beliefs articulately. But Thanksgiving is a different story: the level of discourse never gets beyond arguing over the very basic facts (Obama: Secret Muslim or not?), and very rarely will you change someone's mind over dinner.

Of course, if you are gay, or Sarah Palin, or a solider, it may be impossible not to get passionate—and personal—before the turkey is even out of the oven. But save for those situations, it's probably not worth taking on your sweet, frail, and totally sexist 86-year-old grandfather in a battle of oratory skill.

In other words: feel free to stand up for what you really believe in, but don't try to be a hero. Accept your family for the lovable, well-intentioned, ill-informed bunch that they are, pour another glass of wine, and try to make it through the night unscathed.

When all else fails? Mention Twilight and let your teenage cousin do the rest.

Mammograms, Pap Smears, and the PSA: How Other Screening Tests Measure Up

2009-11-20T20:14:09Z

Earlier this week the U.S. Preventive Services Task Force shocked legions of women when it recommended waiting until 50 for a first mammogram, despite previous recommendations that women begin mammograms at 40. Then today, the American College of Obstetricians and Gynecologists released new guidelines for Pap smears. Previously, all sexually active women were encouraged to get the test—which examines cells in the cervix to determine whether there are any abnormalities that could lead to cancer—every year. Now, the recommendations state that women begin the Pap test at 21, retest every other year, and then, once women hit their 30s, schedule a test every three years.

Quite often, new technology hits the market before long-term studies have been completed, says Ted Epperly, a family physician and past president of the American Academy of Family Physicians. Only after years of using the equipment can experts then gather statistics about their efficacy. And, Epperly suggests, there may be other tests once considered annual necessities that are now being reevaluated in light of new evidence. We asked Epperly to evaluate other preventative tests—once considered lifesavers—and relay what the evidence currently suggests. As always, be sure to check with your doctor about your individual risks and treatment plan.

COLONOSCOPY

Both men and women are advised to have their first colonoscopy at 50, the American Cancer Society reports. In some cases, testing for colon cancer can be delayed until age 55, Epperly says. He goes on to warn that testing should not be delayed in instances where there is a family history of colon cancer or where a person experiences symptoms including weight loss, bloody stool, or unexplained abdominal pain. Colonoscopies have one of the highest success rates: they can reduce a person's chances of dying from colon cancer by between 60 and 70 percent.

PROSTATE SCREENING

The American Cancer Society reports that screenings should begin for men at 50. But just like mammograms, the final results can be misleading. Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland, and a prostate screening test measures the level of this protein in a man’s blood. It’s possible for a man to have high levels of the protein in his system, but not actually have cancer. The National Cancer Institute reports that “only 25 to 35 percent of men who have a biopsy due to an elevated PSA level actually have prostate cancer.” It's also possible that the PSA can detect cancer so slow-moving that it likely would have gone undetected before the patient died of other causes.

The test is most useful for men who have a family history of prostate cancer or are experiencing symptoms like painful urination, weight loss, or pelvic pain. Black men are also encouraged to seek screening because they have a higher potential rate of prostate cancer. Evidence seems to indicate that men who don’t fall into any of these categories can forgo the prostate-cancer screening test, Epperly says.

CHEST X-RAY

As late as 2005, smokers were encouraged to get chest X-ray’s to detect any signs of lung cancer. But studies indicate the X-ray can produce misleading results. The U.S. National Cancer Institute conducted a study where 67,000 people received chest X-rays. The results showed abnormalities in nearly 6,000 cases, but after follow-up consultations with doctors, only 126 patients were actually diagnosed with lung cancer. Currently, no major professional organization, including the American Cancer Society, recommends routine screening because it hasn’t been shown to prevent people from dying of cancer.

FULL BODY SCAN

Total-body MRIs can also strain your wallet and cause unneeded anxiety. Popular in the past seven years as a general preventative tool, an MRI will produce images of anatomic abnormalities and is designed to help diagnose tumors, spinal-cord injuries, and problems with the lungs, kidneys, and uterus, the Mayo Clinic reports. However, MRIs often detect small irregularities that ultimately don’t require more testing or surgery. Epperly says patients often become more anxious when these irregularities are spotted and invest in costly medical exams to confirm that they are, in fact, healthy. Patients primarily need MRIs when a doctor is exploring a specific symptom, like whether excessive headaches might be the result of a tumor, Epperly says. Unless recommended by a doctor, total body images can be a serious financial burden, and may expose the patient to harmful radiation.

Is Motherhood Keeping Good Scientists Down? How to Fix Research's "Mommy Gap"

2009-11-19T16:01:29Z

by Jeneen Interlandi

Since Lawrence Summers’s ill-considered remarks at a 2005 economics conference (he blamed the lack of tenured female scientists on their biologically inferior intelligence and aptitude; he was president of Harvard University at the time), there has been a steady stream of books, reports, and panel discussions chronicling the woes of women who wear lab coats.

Last week, the Center for American Progress (CAP) reported that family obligations (read: child rearing) are still pushing young female researchers out of science. The findings build on a National Academy of Sciences (NAS) report from earlier this year that also dissected the biases against women in science, but concluded that much progress was being made. Taken together, the two studies suggest that the stumbling block for women researchers is not being a woman but being a mother.

The NAS study found that although women are still underrepresented in the applicant pool for faculty positions in math, science, and engineering, women who do apply are hired at rates equal to or higher than men. In mathematics, for example, women made up only 20 percent of the applicant pool but received 32 percent of the job offers. But according to the CAP study, which compared not only women to men, but parents to those without children, married women with children were 35 percent less likely to secure a tenure-track position than married men with children, and 33 percent less likely to do so than single women without children.

There's no dearth of suggestions on how to fix the problem. The National Association for Women in Science suggests that universities make a more concerted effort to recruit women for open faculty positions—by targeting their advertising toward women and being sure to include female faculty members on any search committee.

The CAP recommends providing financial support to labs to offset the productivity loss when a scientist takes family leave, and providing women who are pregnant or have newborns with special funds to hire a technician to help them out in the lab.

And the NAS and others have endorsed "stopping the tenure clock" for faculty members who want to start families. Tenure-track scientists have a certain number of years to establish themselves—which means publishing as many influential papers in as many prestigious journals as possible, usually over the first decade of their employment. Stopping the clock means adding an extra year or two to that time frame to allow for a less productive year after the birth of a child.

Those all sound like good ideas, and depending on which report you read, some of them are being implemented effectively and are indeed making a difference. But none of those solutions addresses the real problem. It’s not innate gender differences that hold women back (just look at this year’s Nobel Prize winners in science). It’s not even gender bias (OK, maybe a little, but that’s not the biggest problem). It’s that science is demanding and very, very competitive. No matter how family-friendly a given university is, a scientist who chooses to have a baby risks having her next big breakthrough scooped up by a competitor who chooses to spend 24/7 in the lab. Changing that will take more than a handful of policies; it will require changing the nature of the game itself. I don't think that's possible, and I'm not entirely convinced it's desirable. It’s competition, after all, that spurs innovation and advancement.

What should be possible is distributing those trade-offs more evenly between women and men. Instead of obsessing over mother-scientists, universities should strive to create an atmosphere that encourages their male scientists to be active fathers. Only then will both genders be equally compelled to confront the family-work balance issue that right now rests too squarely on the shoulders of women.

Some suggestions: Pay female scientists as much as their male counterparts, so that when scientist couples plan for a family, the woman isn’t automatically compelled to ditch her career simply because she earns less and he earns more. Have paternity leave on par with maternity leave; if you’re going to stop the tenure clock for child rearing, extend that offer to new fathers as well as new mothers.

The rest will be up to the mother-scientists themselves. After factoring out the nine months of pregnancy, women who want to be scientists and have families are faced with the same problem as men who want to do the same: time. Science and parenthood are two more-than-full-time jobs, and there are not enough hours in the day to do both. Men seem to have gotten around this problem easily enough by having their wives stay at home and take care of the whole parenting thing while they run their labs, publish their papers, and rise through the ranks of their respective disciplines. Women, I think, have four choices: choose a mate who will either stay at home with the kids or split the parenting responsibilities down the middle (I mean really split them, not just pretend to split them); accept a less ambitious career path (a smaller university, more teaching, less research or a less competitive area of research); or hire some help (and accept that you will not get to see your kids as much).

No matter what institutions or individuals do, having both a career—any career—and children requires making choices, and then making sacrifices. The more demanding the career and the more ambitious the individual, the more difficult those choices will be. But women shouldn’t be the only ones who have to choose.

Interlandi is a writer for NEWSWEEK.

There Is No Such Thing As Female Viagra: Flibanserin Can't Change Why Some Women Don't Want Sex

2009-11-18T15:42:06Z

by Barbara Kantrowitz

Back in the pre-Viagra age, men were actually impotent. Now, guys with a mechanical problem suffer from erectile dysfunction (E.D. in the ubiquitous TV ads), clearly one of Big Pharma’s most successful rebranding efforts. But women have been denied a similar makeover for their sexual problems because no one has yet figured out why some want it all the time and others hardly ever. If you’re too tired, you’re just plain frigid.

That could change with the announcement this week that a pill that appears to increase sexual desire in women with low libidos. This potential blockbuster, developed by the German drug manufacturer Boehringer Ingelheim, is called flibanserin and it was almost a nonstarter when it was first tested as an antidepressant. Flibanserin didn’t lift mood, but researchers noticed that it had one intriguing quality: it appeared to heighten sexual interest in laboratory animals and humans.

Could it be Big Pharma’s Holy Grail: a female Viagra? No doubt inspired by the tantalizing possibility of gazillions in worldwide sales, Boehringer paid for clinical trials of flibanserin in nearly 2,000 premenopausal European, American, and Canadian women suffering from hypoactive sexual desire disorder, a controversial diagnosis that reportedly affects as many as one in four women.

The results, presented earlier this week at the Congress of the European Society for Sexual Medicine in Lyon, France, showed that the women in the trial who took a daily dose of 100 milligrams of flibanserin for about six months increased the number of “sexually satisfying events” (not necessarily orgasm) to an average of 4.5 from 2.8 in the North American arm of the trial, compared to 3.7 in the placebo group.The women on flibanserin also said they were more interested in sex than those taking a placebo.

Flibanserin won’t be on sale any time soon. Boehringer still needs to get approval from the FDA and other regulatory bodies around the world, a process which could take years.

Still, the announcement has already ignited the smoldering debate about the causes and even the definition of sexual dysfunction in women. Sex researchers (mostly men) used to believe that healthy women were just like them, always on the prowl for the right moment. Women who didn’t experience a constant undercurrent of sexual desire were considered abnormal.

But in recent years, female researchers (most notably University of British Columbia psychiatrist Rosemary Basson) have come to a very different conclusion. Basson and her colleagues have found that while men’s sexual progression is essentially linear─from desire to arousal to orgasm─women’s sexuality is more accurately circular, with one positive factor (such as emotional satisfaction or intimacy) reinforcing others and eventually leading to desire and arousal.

A woman is most like a man early in a relationship, when she is full of sexual excitement over a new lover. But women in long-term relationships tend to need more stimuli, and that means a guy who satisfies them emotionally (doing the dishes always helps) as well as physically. Women may also steer away from sex because of a large number of nonsexual disorders, including depression, alcoholism, hormonal problems, and even vaginal pain with penetration.

According to Boehringer, the women in the flibanserin study were only suffering from hypoactive sexual desire disorder, not any other condition that could have hampered their sex drive. But that diagnosis is highly controversial. In order to figure out what it means, you have to define a normal sex drive. No one really knows whether normal means wanting sex once a day, once a month or once a year. Sex researchers currently say that a woman’s sex drive is dysfunctional only if she’s unhappy about it, if it causes her personal distress. That’s why the estimate of how many women suffer from sexual dysfunction ranges from 9 percent to as high as 26 percent.

Such nuance could vanish if Boehringer eventually wins approval for flibanserin. It’s a good bet that right now there are marketers already testing out brand names and a catchy new label for the old frigid. Any ideas?

Barbara Kantrowitz writes the "Her Body" column for Newsweek.com

The Real Problem With Mammograms: They're Too Good at Finding Things We Don't Understand

2009-11-17T22:32:34Z

This week, the United States Preventive Services Task Force revised their guidelines for breast cancer screening based on a comprehensive review of evidence published in the most recent issue of the Annals of Internal Medicine. Previously, women over 40 were encouraged to schedule a mammogram every year. Now, USPSTF says that women can wait until 50. Though other groups, like Susan G. Komen for the Cure and the American Cancer Society have not changed their recommendations, it's the USPSTF that helps insurers decide what procedures are covered and which aren't.

According to the New York Times,

While many women do not think a screening test can be harmful, medical experts say the risks are real. A test can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. And mammograms can find cancers that grow so slowly that they never would be noticed in a woman’s lifetime, resulting in unnecessary treatment.

Overall, the report says, the modest benefit of mammograms—reducing the breast cancer death rate by 15 percent—must be weighed against the harms. And those harms loom larger for women in their 40s, who are 60 percent more likely to experience them than women 50 and older but are less likely to have breast cancer, skewing the risk-benefit equation. The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 74, and one death for every 377 women age 60 to 69.

Many cancer groups opposed the decision, and it's easy to see why: their job is to ensure that no one, no matter how slim the odds, dies of cancer that could have been prevented. Proponents of evidence-based medicine say that mammograms lead to too many unnecessary tests and the detection of too many tumors that may not really need treatment. But as it turns out, mammograms themselves aren’t the problem.

Mammograms, says Dr. Heidi Nelson, are very good at detecting abnormalities in breast tissue. The problem is that we're not yet good at understanding what those abnormalities mean. Dr. Nelson, a research professor in the Departments of Medical Informatics and Clinical Epidemiology and Medicine at Oregon Health Sciences University, lead the comprehensive review upon which the USPSTF's data was based, though she is not affiliated with the group and made no recommendations for how the data should be interpreted. The evidence she’s collected has shown a clear trend.

We’ve come to a point where the ability to detect precancerous cells has outpaced our ability to understand how these cells operate. In many cases women are treated for breast cancer based on precancerous lumps that are only rarely deadly. A better test for certain genetic markers might help researchers understand which precancerous lumps are most likely to turn into a fast-moving cancer, says Nelson, but no test like that exists. For now, doctors treat lots of tumors that may not kill anyone, and women are subjected to a battery of tests that don’t provide many answers. “We can’t advise people at this stage,” says Nelson. “We can only find things.”

And we’re finding more than ever. “Each year we’re picking up more and more lesions that aren’t quite cancers,” says Dr. Christine Pelligrino, head of the breast health clinic at the Montefiore-Einstein Center for Cancer Care. “We’ve ID’d lesions over the last 5-10 years that we know are associated with an increase relative risk of developing an invasive breast cancer. For the majority of women, they’re not going to actualize that risk,” she says. But some will, and it’s difficult to tell in whom. “What do you do about it in those women?” Pelligrino asks. In some cases, you watch and wait. In some cases, you treat it, either with chemotherapy or cancer-preventing medications. In all cases, women have to go through a battery of tests, and have to live with the knowledge that there may be a time bomb living inside their bodies—even if the odds are slim.

The debate over whether the benefits of mammograms for women in their 40s outweigh the risk is nothing new. In 1997, Sharon Begley wrote in NEWSWEEK about the mammogram debate, just after the National Institute for Health recommended that women in their 40s not receive annual mammograms (a position they since revised). She noted then, as now, we have minimal answers about the types of tumors we find in younger women.

Confined to the ducts of the breast, [ductal carcinoma in situ, or DCIS] accounts for about 10 percent in all women, and from 15 to 60 percent in women in their 40s.…"It may stay there a woman's whole life and never invade surrounding tissue,'' says Dr. Michael Cohen of Sloan-Kettering, "but we don't know how to tell the one that won't spread from one that will.”

Twelve years and a few flip-flopping recommendations later, the research is still unclear. "We find so many [DCIS tumors] on mammography, and we don’t know what proportion would ever cause trouble in progressing on to cancer. We don’t have good historic information on that," says Nelson. "We treat them like cancer, but a lot would not progress to that point."

Mammograms have long been a source of small comfort for women who fear breast cancer. They're proactive. They're responsible. They feel like positive steps to safeguard one's health. But the truth is, there’s only so much a woman can do to protect herself against breast cancer. Perhaps it’s time to put the onus not on women to detect breast cancer, but on science and medicine to figure out why some cancerous lesions kill women, and some don’t. Until then, we’re left with the new guidelines, a lot of controversy, and not much else to help us keep our breasts healthy.

"It’s dissatisfying that today we don’t have a list of five other things we can do," says Nelson. "We need a lot of research on other fronts, and we just don't have that yet."

Brooke Magnanti's Surprisingly Logical Call Girl Confession: That's DR. Belle Du Jour To You

2009-11-17T18:25:27Z

Unless you’ve been in solitary confinement, you’re aware of the fact that Belle de Jour, blogger, former prostitute, and head of the Diary of a London Call Girl publishing empire has revealed herself to be Dr. Brooke Magnanti, research scientist at the Bristol Initiative for Research of Child Health.

When she’s not blogging about her past sexploits, she using her Ph.D. in informatics, epidemiology, and forensic science to research the effects of pesticides on children. How’s that for an unexpected spin on the whore-with-the-heart-of-gold theme? I’m kinda jealous of her, I have to admit. Magnanti is like a year of feminist studies rolled into one. I would have loved to be the first credible candidate for one of feminism’s holy grails: the empowered sex worker—able to expose herself to patriarchal fantasies of male domination without becoming damaged goods.

We may have to add her to our pantheon of saints right up there with Susan Faludi and Katha Pollitt. I don’t think I’ve ever heard a more level-headed and reasonable explanation for becoming a call-girl than this one by Magnanti:

“I couldn’t find a professional job in my chosen field because I didn’t have my Ph.D. yet. I didn’t have a lot of spare time on my hands because I was still making corrections and preparing for the viva; and I got through my savings a lot faster than I thought I would. … What can I do that I can start doing straightaway, that doesn’t require a great deal of training or investment to get started, that’s cash in hand and that leaves me spare time to do my work in?”

Is this woman a scientist or what? Now before you go all ballistic and chastise either myself or Dr. Magnanti for our lack of moral fiber, let me add two things: working as an escort is not illegal in the United Kingdom. Yup, prostitution is above board in England—it’s the activities that make sex work a nasty dangerous enterprise that are illegal—no streetwalking, no pimps, no brothels. Secondly, the idea that prostitution is the only commodified form of erotic activity is crazy. Consider the Sports Illustrated swimsuit edition for a moment—$6.99 and all you get is the illusion of female sexuality. Magnanti may well be the rare woman who can, as Gloria Steinem put it to Vermont Woman, “experience sexuality as power.…It’s not sexuality that’s the problem, it’s whose sexuality and why?” That’s also why I can love Belle de Jour and still condemn human trafficking, the prostitution of children, and pimping without appearing hypocritical or naive.

And lest you think I dodged the whole morality question, let me answer in more detail by punting to a smarter mind. In Feminist Issues in Prostitution, Sarah Bromberg asserts that our stern disapproval of call girls stems “from an underlying assumption in conventional morality that involvement in prostitution will “necessarily” have degenerative effects on a person leading her to other criminal activities.…Prostitution is not a profound condition of degeneracy and in many instances it may be a self-regarding expression of a person surviving in the best way given their skills and opportunities.” Take that, you Puritans!

So, I’m a big fan of Dr. Magnanti now; I might even buy her new book, Belle de Jour’s Guide to Men. ~~I have a feeling her point of view might be more interesting than the play-hard-to-get, treat-men-like-untrainable-dogs claptrap we women usually get.~~ [As it turns out, the start of chapter one hits the "men are like untrainable dogs" metaphor pretty hard. I guess some stereotypes are hard to break, even if you're a pioneering scientist/call girl.]

New Report Claims That Many Probiotics Provide Fewer Live Cells Than Listed on Labels

2009-11-16T20:27:49Z

Americans are spending more and more dollars each year on probiotic supplements, or so-called “friendly” bacteria. Studies have shown that probiotics—which you might purchase in the form of yogurt, capsules, miso, beverages, or powders—can treat a host of conditions, including irritable bowel syndrome, diarrhea caused by viral infection or antibiotics, vaginal yeast infections, hypertension, the common cold, and even acne. Over the past decade, consumer sales of probiotics in the U.S. have nearly quadrupled (growing from $115 million in 1998 to $425 million in 2008), according to Nutrition Business Journal.

But, according to a report released today, many of the most popular probiotic supplements don’t contain the amount of live bacteria listed on their labels. ConsumerLab, a private company that tests health and nutritional products at independent labs across the country, found that at the time a consumer buys a probiotic, it may contain as little as 10 to 58 percent of the amount of viable organisms listed on the label. “It’s shocking how many products really don’t have what they claim on their labels,” says Tod Cooperman, the president of ConsumerLab. “The buyer has to be careful.”

ConsumerLab purchased the probiotics as a consumer would, cultured the products to determine the number of viable cells in them, and compared the results to the amounts listed on the product labels. The company sent any product that did not contain the amount of live cells listed on the label to a second lab for additional testing. “We’re absolutely certain about what we found,” Cooperman says. Despite the misleading numbers, most products contained at least one billion organisms, which is probably enough to provide some—although not necessarily optimal—benefit, according to Cooperman.

In that sense, The ConsumerLab report reveals false marketing rather than ineffective products. Mary Ellen Sanders, a probiotics expert and microbiologist unaffiliated with ConsumerLab, says that although the majority of products on the market need between 1 and 10 billion live cells to work, there’s no benchmark number that researchers can use. “If you do a study that shows that 100 million causes a health effect, then that’s an adequate dose,” she says.

Consumers should therefore consider more than just the number of live cells in a given product. What really matters is whether or not there’s evidence that a probiotic supplement can actually reduce or treat the buyer’s specific symptoms. “The best products on the market are the ones that have been tested in human studies and have been shown to have a benefit,” Sanders says. Still, she adds, even if people only need a small percentage of the live cells listed on a label to see a health benefit, companies should be forthcoming about what’s actually in their products.

And numerous products that ConsumerLab tested contained misleading labels. Nature’s Secret Ultimate Probiotics claimed to contain 4 billion cells from 17 different strains per tablet at the time of manufacture, but testing found 520 million viable cells, just 13 percent of the original amount. Swiss Natural Sources “5” Strain Dophilus claimed to contain 6 billion cells from five different strains per capsule at the time of manufacture, but testing found just 0.8 billion viable cells, or 13 percent of that amount.

Mary Jane Kordahi, the vice president of marketing at Irwin Naturals (which makes Nature’s Secret Ultimate Probiotics), says that since her company specifies on its label that the product contains 4 billion cells only at the time of manufacture, the marketing is “not deceptive.” She says that during the first six months of shelf life, a large percentage of the live cultures begin to die (although she admits that far more than 13 percent should survive). Shipping and storage conditions might have contributed to the high death rate in the particular bottles that ConsumerLab chose for testing, she says. Swiss Herbal Remedies did not respond to a request for comment about its “5” Strain Dophilus.

The number of live cells in Dr. D Chocolate-Flavored Probiotics was particularly low. The pediatric product claimed to provide 1.3 billion cells per chocolate “bear,” but testing found only 91 million viable cells—or a mere 7 percent of that amount. Stefan Friedman, a spokesman for Dr. D, said in a written statement that typical tests wouldn’t take into account that the live cultures in this particular product were encapsulated “to ensure safe delivery of the bacteria to the intestine.” Tests need to “break” the encapsulation, says Friedman, in order to find the live bacteria. He claims that the 7 percent of bacteria found by the two independent laboratories was actually “extra bacteria that was not encapsulated completely and was visible during the test.”

But Cooperman says that ConsumerLab took encapsulation methods into account. “Prior to culturing each product, each was put through a device in which it was mixed for approximately an hour in warm agar, activating any bacteria, whether or not encapsulated,” he says. Indeed, other encapsulated products, such as Jarrow femdophilus, were found to contain 100 percent of their listed bacteria. “We would not have had such results if encapsulation caused a problem,” Cooperman says.

Sanders says that it can sometimes be difficult to get accurate results when testing probiotics. “There are a variety of different types of microbes that are used in probiotics, and different ones grow up better under different conditions,” she says. “You need to know the microbes you’re working with in order to know the best way to count what’s there.”

Unfortunately, it’s not easy for consumers to determine which products they can trust. Sanders says that companies use the term “probiotics,” which doesn’t have a legal definition, quite loosely. For now, Sanders recommends that buyers call the manufacturer (or visit the company’s Web sites) to make sure there’s scientific evidence that a given product actually works.

The highest quality probiotics that ConsumerLab tested included Advocare Probiotic Restore, GNC Nature Brand Best Super Acidophilus, and Jarrow Formulas Jarro-Dophilus. For the full report, click here.

Research Determines Exactly What All Women Want, All The Time, In Every Scenario...Except Not.

2009-11-16T18:07:59Z

by Leigh Bond

Who says that women only like jerks? A new study published in the journal Science from Binghamton University and the University of Arizona adds yet another clue to the mystery that is female sexual selection. "Nice guys don't always finish last," says the press release.

Of course, the nice guys in question happened to be insects. Researchers in this study observed the effects of a controlled group of male water striders – both aggressive and low-key, and their sexual relations with the females in the group. According to the study led by Omar Tonsi Eldakar of the University of Arizona’s Arizona Research Laboratories, groups of “gentlemen” water striders mated with more females than did groups of the “psychopath” suitors. The research contradicts previous laboratory studies finding sexually aggressive males more successful at reproducing, said Eldakar. In previous studies, the females were blocked from leaving the areas populated by the sexually aggressive males; this study showed that actually given a choice, the females would leave whenever the jerk bugs came around - the nice bugs got the girls.

A lesson, according to Scientific Blogging, for all women. Their article based on the study approvingly notes that, "Female water striders don't like the bad boys and they don't even have to reach the age of 30 before they wise up about choices in males." Of course, most water striders die off before their second birthday. But still: human ladies could learn a thing or two!

This is not the first time a news release or article has claimed that the key to human sexuality lies in understanding our animal friends. Nor is it the first time that the evidence contradicts previous research. To wit: Seahorses want their ladies large and pushy, capable of producing bigger, better eggs; the fickle female katydids change their type by the season – in winter, they like the ‘cool guys’ and in summer, they ‘like them hot.’ Peahens may play it shallow and like their peacock flashy , but redback spiders swear that smaller mates make better lovers and like them fast and frisky. High balling isn’t for all species however - male sand gobies play a different game and pull their ‘Mr. Mom’ card to snare their lady’s heart and nest; female beetles show that swimming the low tides of the gene pool bodes for superior egg fertility – studies have shown that higher paternity shares go to males with lower genetic quality. Bowerbirds apparently don’t care one way or another - they’d really just like their nest to be blue.

Of course, the human evidence is just as contrarian. In the battle between dads versus cads, a study by the University of Michigan shows that women prefer dads – “men who are kind, compassionate and monogamous” over classic Byronic heroes, dominant, dark and daring – or at least for the long term. Counter this with a Cornell University study that swears women in cities really just want men with money, and suddenly “nice” isn’t quite enough. Rich jerks won’t cut it either though, according to a UCLA study published in the journal Personal Relationships that shows women prefer prestige, true, but will still shy away from coercive encounters. And being rich won’t save a marriage either, according to John Gottmann at the University of Washington, who says despite any superficial qualities, happiness lays rooted in friendship .

All this information might lead one to believe that the idea of "what women want" – a neatly packaged biological urge all women are evolutionarily compelled to follow – is a bunch of crap.

Daphne J. Fairbairn, Professor of Biology at the University of California: Riverside, and editor of “Sex, Size and Gender Roles: Evolutionary Studies of Sexual Size Dimorphism” warns about not approaching these studies-- or their sexed up press releases--with a critical eye. “It would be nice if societies work this way, but they don’t,” she says, of the environments created by scientific research.

The real world is not a controlled environment – it’s messy, cut-throat, and competitive. Scientific studies typically generate an idea of something that could work, but are less successful at demonstrating something that already does. Water striders case marks a classic example: different experiments setting up different artificial environments, and coming away with different results. Moreover, we should note, women and water striders are not the same thing. Not even close. And the idea that our behaviors and actions can be determined by evolutionary or biological drives we inherited from either caveman ancestors or our animal antecedents is reductive at best, lazy and offensive at worst.

In other words: all this talk about scientists proving what ladies REALLY want? It's about PR departments of hospitals and research institutions marketing their fascinating-to-few-but-other-scientists breakthroughs by making a journal in Nature sound like Cosmo. It's about media outlets looking to fill a slow news day with stories that sound like sex advice instead of scientific advancements. What's it's not about is any resonating truth about female sexuality.

Sex sells, as they say. But when it comes to research "proving" what women want, we're not buying it

The American Medical Association Reconsiders Marijuana. Will the Justice Department Follow?

2009-11-13T19:44:56Z

More than 100 million Americans have smoked pot. Thirteen states have medical marijuana laws on the books, and a dozen more are considering legislation. Studies have shown that the substance can stimulate appetite, ease muscle spasms and numb pain.

Yet since 1970, when Richard Nixon signed the Controlled Substance Act into law, the time-slowing green plant known as marijuana has been a Schedule 1 controlled substance: classified alongside drugs like heroin and PCP—and deemed more harmful than cocaine, meth, and Ketamine. Pot advocates call that reality the “Schedule I Lie” —referring to the drug’s federal classification as the most potent of drugs, considered, by law, to have “no accepted medical use.”

The idea that a few tokes every now and then is more harmful than the recreational use of dog tranquilizer seems a bit, well, bogus, considering its mainstream acceptance. Barack Obama has openly admitted to smoking pot; Michael Phelps has tried it (and still managed to bring home eight gold medals); and earlier this year, attorney general Eric Holder discouraged U.S. attorneys from prosecuting retailers in medical marijuana states. There are pot TV shows and cities (like Oakland) that are now taxing the drug’s medicinal use to bring in extra revenue.

Yet despite how the culture around pot has changed, defenders of the current federal policy have clung to a prominent, and trusted, ally to back them: the American Medical Association, which the justice department often cites when enforcing marijuana policy.

So it it might have come as a surprise on Tuesday when the AMA announced that, after 72 years, it was reversing its pot policy—and urged the federal government to do the same. Precipitated by a similar decision by the group’s Medical Student Section, the AMA resolved that “that marijuana’s status as a federal Schedule 1 controlled substance be reviewed,” with the goal of facilitating clinical research, and presented a new medical report, conducted by its Council on Science and Public Health, laying out the drug’s various medical benefits.

The AMA hopes the resolution will make clinical research on cannabis—long a roadblock in proving that the substance was ill-classified—a more-easily obtained reality. At present, getting the necessary clearance to study a Schedule 1 drug is a near-impossible bureaucratic nightmare that involves multiple government agencies, and purchase of notoriously low-potency pot from the government’s only legal growth facility, at the University of Mississippi. As a result, “only a small number of randomized, controlled trials have been conducted on smoked cannabis,” physician (and AMA board member) Edward Langston told the Los Angeles Times earlier this week.

Tthe AMA move is a powerful symbolic gesture—"a huge shift in medical ideology," says the medical student who spearheaded the resolution—and demolishes the long-held pot prohibitionist claim that "no sound scientific studies have supported medical use of smoked marijuana.”

Realistically, however, the future looks hazy. “This is symbolic if nothing else because the AMA is abandoning this flat-earth policy it's held for decades," says Paul Armentano, the deputy director of the National Organization for Reform of the Marijuana Laws and the coauthor of Marijuana Is Safer; So Why Are We Driving People to Drink?. “But does the AMA have the power to reschedule marijuana, or even get the ball rolling so that those who have the power will do it? I highly doubt it.”

As of Friday, the Justice Department was still touting the AMA's outdated stance, on a Web page devoted to debunking the "myth" of medical marijuana.

Jessica Bennett is a staff writer at NEWSWEEK, where she covers women's issues and cultural affairs. Read NEWSWEEK's full coverage of the medical marijuana debate.

Charla Nash on Oprah: What Happened to Winfrey's "Chimp Lady" Gaffe?

2009-11-13T17:41:19Z

...

I was among the 7.4 million Americans who tuned in on Wednesday to watch Oprah Winfrey interview Charla Nash, the woman tragically attacked by her friend’s pet chimpanzee back in February. If you were among us, you witnessed the deeply awkward moment just after Oprah removed Nash’s veil and, confronted with her horribly mangled face, asked her how she is able to eat. Nash, who lost her eyes, nose, lips, and hands because of the attack, explained that she can’t eat solid foods and instead consumes everything in liquid form through a straw. Oprah, in a cringe-inducing response, said something like, “Well, at least it helps you keep your weight down.” What the what?

At the time, I was gchatting with a friend who was also watching the episode (and, Newsweek overlords, I was also hard at work, I swear!), and I typed into the chat window: “OMG. Did Oprah really just say at least you keep your weight down?”

“SERIOUSLY.” He replied. “Had the same thought.”

“Oh, Oprah.”

To be fair, I don’t entirely blame her. If I were in Oprah’s shoes, interviewing a woman so tragically disfigured, and confronted, suddenly, by the terrifying sight of oozing sores where a face used to be, I can easily imagine myself tripping up, saying something awkward and inappropriate, something that I would curse myself for and cringe at the thought of for weeks or months thereafter. And given Oprah’s very public battles with her weight, it’s not wholly surprising that at the moment she felt disarmed, she would come up with a bad joke having to do with dietary struggles.

But the next day, it occurred to me that the comment made Oprah ripe for inclusion in our weekly indignity index, our “unscientific appraisal of dubious public behavior.” So I mentioned it to my boss, who asked to see a clip of the gaffe, or at least a reference to it from a reputable news organization. So I looked. And looked and looked and looked. And …. there was nothing. Absolutely nothing. It was as if it had never happened.

It’s not entirely surprising that no papers mentioned the moment. In today’s media climate, it’s unlikely that many reporters were freed up enough to watch the episode and pay full attention. They were probably, as I was, multitasking, and based a good deal of their coverage on whatever talking points the show released. Plus, the bigger point of the story, the headline, was Nash as a survivor. Her spirit, as Oprah pointed out again and again, is absolutely phenomenal. I don’t think anyone watching the episode wasn’t moved by how upbeat and positive Nash was given what had happened to her. And to Oprah’s credit, she handled the rest of the interview with her characteristic unflappability and poise.

But still, it was a deeply cringe-worthy moment. Surely someone must have caught it. Some blogger somewhere must have posted a clip. So I kept searching—I clicked through every YouTube video from the show, but all of the ones that included that particular moment had been taken down for copyright infringement. Other clips from the same episode are live. And clips from earlier shows this week are up as well. But that part of Wednesday’s episode, arguably the most fascinating segment of Oprah’s show all week, was posted, multiple times, by multiple people, then removed. And only an earlier segment, about Nash’s day-to-day life at the Cleveland Clinic, was posted on Oprah’s site. It was confounding—almost as if it had never happened. My boss thought I’d made the whole thing up.

After three or four hours Googling, finally I found a handful of tweets from viewers expressing the stunned, did she really just say that sentiment as I had. Some commenters on Oprah.com mentioned it as well. Plus, I had the transcript of my gchat. Together, it was enough to redeem myself to my boss. But still, what the what?

The official statement, from Harpo spokesperson Angela DePaul is that, aside from some selected clips on the official website, “We don’t stream our show online or maintain an online media archive. Our footage is copyrighted material.” I still didn’t understand why other segments from this week’s shows were still up on YouTube while that one had disappeared, so I asked whether Harpo had specifically gone after copyright violations of that particular segment of the show. “Unable to confirm,” she told me.

It’s too bad, though, that for whatever reason, this clip has disappeared from the internet. Oprah’s success lies, in part, in the fact that she is an everywoman who struggles with weight, relationships, family, and everything else just like the rest of us. We all say the wrong thing from time to time—it’s just part of being human. Oprah, I hope, would know that better than anyone, and be able to laugh at herself. And maybe also cringe, just a little.

Jesse Ellison is a NEWSWEEK reporter.

Helping a Fort Hood Victim: Friends Start Fund to Sponsor Wounded Soldier's Family Visit

2009-11-12T23:45:55Z

Alan Carrol at training in Fort Hood (courtesy of Alan Carrol).

by Jeneen Interlandi

In the wake of the Fort Hood shootings, many soldiers—including Alan Carrol, who I profiled earlier this week—are still struggling to reunite with loved ones. According to some of the soldiers I've spoken with, the U.S. Army has done an incredible job of flying parents and siblings to Fort Hood from all over the country to visit the wounded, attend memorial services, and comfort one another. But for one reason or another, some family members have slipped through the cracks.

Alan's sister, for one, needs a plane ticket from Colorado to visit her brother, who took four bullets and lost three close friends in the tragedy. A fund has been established to cover the $900 in travel expenses. I never knew Alan personally, but we grew up in the same town: Bridgewater, N.J. Members of the community will be chipping in to help pay these expenses. Anyone else who feels motivated to do so can visit the site.

More information about how to help the victims of Fort Hood is detailed in our gallery on the shooting's aftermath.

Jeneen Interlandi is a NEWSWEEK staff writer.

Emma Thompson's Polanski Reversal: Even Celebs Get Peer Pressured

2009-11-10T17:03:33Z

By now, news has reached the blogosphere that Emma Thompson has asked to remove her name from the online petition in support of Roman Polanski. (Remember him? He’s the famous director who was convicted of unlawful sexual contact with a minor.)

Turns out that one of her fans had the courage to ask her to reconsider her support of Polanski. Well now, I feel stupid. I too was heartbroken that Thompson had signed the petition. But I didn't do anything about it. I just complained to my friends and sulked. Thompson, through the roles she has played, and her good works on an array of worthwhile causes she's devoted herself to, is a role model for us women who don't want to play cute to get ahead. But when she signed the petition, I just felt that she was another insular superstar whose strength and cool was just for show. I am so glad I was wrong.

But isn’t it amazing that one of the reasons Thompson says she signed in the first place was because she was getting tons and tons of calls from her film friends pressuring to sign? You see, peer pressure doesn’t go away when you grow up and graduate from high school; it follows you wherever you go. (Sigh.) So, I’m hoping (without hope) that Thompson’s act becomes a cause célèbre and peer pressure will force all the other boldface names that I admire to also get their names removed (um, Wes Anderson, it’s your turn). Should you be a celebrity who’s dying to take her name off and are too frightened—Emma just gave you cover. Here, I’ll even spin it for you, free of charge. Simply say something like this: “Emma’s courageous act has made me realize that I just didn’t know what I was signing. A crime is a crime and nobody deserves special treatment.”

Oh and just so you don’t seem like a pushover you can also add something like: “But I also have serious concerns that Polanski didn’t get a fair trial last time around and we have to be careful that we’re punishing him for the right things.” That way, you can get your famous friends off your back and do the right thing.

So far Thompson has denied our request for an interview but if we do get her on the line, we’ll thank her.

Making a Digital First Impression: Why You Can't Fake Your Facebook Profile

2009-11-10T16:02:19Z

by Johannah Cornblatt

The photo showed a man in a T shirt and baseball cap standing on top of a mountain. Tien-Yi Lee, a Web-site designer who had joined Nerve.com’s online dating service, says she felt an instant connection. “I saw his picture, and he had a very kind of friendly, sparkly vibe,” she says. “He had a great smile.” A few days later, Lee met the man at a bar in Cambridge, Mass. Lee remembers thinking that the photo on Nerve provided a “very accurate” reflection of her date’s personality in real life. A year after marrying the man from the photo, Lee’s first impressions of her future husband still largely hold true. “The picture was in sync with who he is,” she says.

Lee’s experience is common among those who meet on the Internet, according to a new study on the role of physical appearance in creating first impressions. The study, which will be published in next month’s issue of Personality and Social Psychology Bulletin, found that you can actually learn a great deal about a stranger’s personality from appearance alone.

More than 700 million people worldwide are now using online social networking sites that showcase personal photographs, but few realize just how accurate first impressions online can be. The findings from this study and other research on personality suggest that the photos you post online provide a wealth of information about who you are—whether you like it or not.

In the study, observers looked at full-body photos of 123 people they had never met. The observers viewed the people either in a controlled pose with a neutral facial expression or in a natural pose and then rated them on 10 personality characteristics. The authors of the study combined self-reported ratings from the people photographed with evaluations from close acquaintances to determine how well the observers were able to guess the traits. Even when people stood in the controlled pose, the observers accurately judged some major personality traits, including extroversion, self-esteem, and even religiosity. When people stood in a natural position, the judgments were accurate for nine of the 10 personality traits: extroversion, agreeableness, conscientiousness, emotional stability, openness, likability, self-esteem, loneliness, religiosity, and political orientation.

“A lot of people don’t like to admit that they make judgments based on appearance, but it’s inherent in everything that we do,” says Laura Naumann, director of the Personality Lab at the University of California, Berkeley, and an author of the study. “Anywhere you have a profile and pictures are being posted, people are using that information.” (Accuracy was lowest for neuroticism, a finding consistent with research demonstrating that neuroticism is extremely difficult to detect on first impression in real life.)

How participants stood and whether or not they smiled provided the biggest clues about personality. Extroverts apparently smile more, stand in energetic and less tense poses, and appear healthy, neat, and stylish. While more obvious cues—like wearing a cross or a Star of David—gave viewers information about religiosity, there was also a strange correlation in this study between standing in a relaxed position and being more devout. “I think a lot of people forget that our posture says a lot of things about us,” Naumann says. “Even if we were to put everyone in the same white jump suit, people’s inherent personalities might still come through in how they stand.”

Clothes and accessories can be misleading. While men who dressed more neatly and formally were accurately judged as more conscientious, assessing conscientiousness in women was much more difficult. “Some women might not do their homework on time or show up to a meeting on time but still have a conscientious appearance,” Naumann says. The report suggests that this gender disparity might stem from the fact that society places more pressure on women to look their best.

Research has shown that people are often clueless about how they’re viewed on the basis of their online profiles. “A lot of the time we think we come across a certain way, but we don’t,” says Simine Vazire, an assistant professor of psychology who runs Washington University’s Personality and Self-Knowledge Lab and an author of the study. “On the Internet, that’s multiplied by a million, so we should be careful about how we broadcast ourselves.”

A forthcoming study on Facebook, which will be published in Psychological Science next year, found that online social networking sites are not effective for promoting “idealized” identity. Instead, such sites often portray personality quite accurately, a finding that might help explain their popularity. As with the study on personality based on physical appearance, the Facebook study found that accuracy was strongest for judging extroversion and openness.

While it’s difficult to influence the way strangers judge you from a photograph, it’s even harder to control your overall online persona when other features like friend lists and Facebook message walls come into play. “If I want to appear extroverted, I can’t just suddenly create 450 friends and have them post on my wall and have photos of me yelling drunkenly at the camera at yet another party,” says Samuel Gosling, an associate professor of psychology at the University of Texas and an author of both personality studies. “You can’t just fabricate those.”

Vazire says the research suggests that strangers can know as much about your personality as acquaintances just by looking you up on the Internet. “It’s another example of how pervasive personality is,” she says. “You can’t outrun your personality. It’s going to follow you everywhere.”

Vazire warns against putting too much stock in a single profile photo, though. And Tien-Yi Lee should know. Although she instantly fell for her future husband’s smile on Nerve.com, he was the fourth date she found on the Internet that week—and number 97 overall.

From Ft. Hood to Florida: Lots of Questions, Few Answers on the Psyche of Shooters

2009-11-06T22:35:15Z

by Rabeika Messina

We don’t know much about suspected Ft. Hood killer Nidal Malik Hasan: there are reports he gave away his possessions. There are reports he was terrified of being deployed. And there’s the fact that prior to his killing spree, Hasan worked as a psychiatrist, treating war-affected patients at both Walter Reed and Ft. Hood. Shouldn’t a psychiatrist have seen his own unraveling coming? Or are psychiatrists more likely to unravel than anyone else? What turns a man professionally endowed to treat the mental ailments of others into one who goes mental himself? And in his addled state, what did he think he’d achieve by opening fire into a crowd?

We may never fully know what Hasan was thinking the morning before his alleged killing spree, but we do know that some of his professional colleagues frustrated that this attack may be perceived as yet another black mark against their industry. Psychiatrists have long been plagued by jokes about instability, and while most are quite sane, there's some truth to the rumors: studies show that these doctors have the highest suicide rate among physicians. They are most likely to suffer from depression compared to surgeons and GPs, and they’re more likely to be critical of themselves and others. It makes sense: unlike an orthopedic surgeon, treats a broken bone, fixes it, and moves on, a psychiatrist, working to help people make peace with themselves and their troubled psyche, doesn’t get that same closure, the same sense of accomplishment, may feel helpless and frustrated as a result.

Being a psychiatrist doesn’t mean one holds all the keys to mental stability. While the majority of psychiatrists are well-balanced individuals, and according to an article in Psychology Today, an American Psychiatric Association study stated that those with emotional disorders are more drawn to the field than other types of medicine.

“Just because someone is a psychiatrist [does not mean] they’re not prone to the same evolvement of a mental illness,” said Dr. Kathryn Moss, a psychiatrist from the New York Presbyterian Hospital and the Weill Cornell Medical Center. Especially if Hasan was suffering from a something like a Pre-Post-Traumatic Stress Disorder. By routinely treating troops with disturbing experiences, he could have experienced enough strain and trauma to cause PTSD, even without deploying. “Exposure is not just to visceral traumas, but also to constant, ongoing stress,” explains Dr. Nancy Sherman, a Georgetown University professor with expertise on PTSD and the emotional and mental health of soldiers. “The mental health workers who are dealing with the current wars are under enormous stress, and it simply isn’t often recognized. Their needs must be addressed as much as those of the troops up for deployment,” she states.

But while PTSD can lead to violent outbursts in many returning troops, it has yet to result in such a gruesome, public crime. And there are plenty of depressed and dejected docs who don’t go on shooting rampages.

That’s because mass killers aren’t likely to be driven by conditions like anxiety, depression or bipolar disorder, which aren’t normally characterized by violent fits. Instead, says Moss, someone who inflicts this type of harm on other humans is under a much greater, more troubling psychosis. “They are delusional about what is going on in their environment,” says Moss. “They don’t share a view the reality that other people share, so they act in ways that other people wouldn’t act,” she says.

Nothing made that point more tragically clear than the shooting that occurred almost 24 hours later in Orlando, Florida. There, Jason Rodriguez turned himself in after cops surrounded his home, accusing him of shooting six people, killing one, in a Florida high rise. Rodriguez had no military background. He worked in at an engineering firm, not as a mental health profession. But he, like Hasan, was purportedly compelled to pull the trigger and shoot into a crowd. The only thing they likely had in common was a deep, troubling mental illness. “Mass shooters are impelled by a mental disorder, revenge, some type of ideological motivation or even perversion,” says Dr. Jeffrey Lieberman, chairman and professor at the Department of Psychiatry at Columbia University.

But to what end? What satisfaction do these killers get from attacking people in a public setting? “Sometimes, if they have some kind of delusion, these people feel that the group is a person,” explains Dr. Moss. “They see everyone as part of a conspiracy, out to get them. In the shooter’s mind, it is specific, because he chose that group.”

If these two men really are guilty of such crimes, could Hasan’s actions have impacted Rodriguez? Perhaps, says Lieberman. For those unstable enough to be considering such a thing, recent attacks can be triggering. “There is a contagion effect; there’s enough people out there who are mentally unstable and emotionally fragile that they can be influenced by the cultural environment,” he says.

A scary thought in a country that's seen more than ten mass killings in the past ten years. Something is triggering these killers, whether it's internal conflict, external stimulus, or a combination of both. Either way, the challenge is to discover what's motivating the shooters ahead of time, instead of wondering why after tragedy strikes.

"This Is a Betrayal": A Chaplain Discusses the Long Recovery From Fort Hood and the Lasting Legacy of PTSD

2009-11-06T19:12:11Z

An ordained Baptist chaplain and army captain, Roger Benimoff spent two tours of duty in Iraq and months between deployments counseling soldiers in the U.S. During his career, he provided spiritual guidance to American soldiers through crises of faith, bereavement, and trauma until he himself broke down. While training and working as a chaplain at Walter Reed during the height of its crisis, Benimoff was diagnosed with chronic PTSD and spent months of treatment at some of the facilities where he trained as a caretaker. NEWSWEEK's Eve Conant has tracked Benimoff's experiences over the years, starting with his time at Walter Reed, and recently in a book about his experiences, Faith Under Fire. Benimoff retired from the army earlier this year. He spoke with Conant from Dallas, where he is a hospital chaplain, about what might have happened in Fort Hood, how the military families will cope with tragedy on the homefront, and why the army pushed him so far he had to leave.

Is "contact" or "secondary" PTSD a genuine problem?

Oh yes, definitely. I didn't have much time to counsel before I was deployed—I had only three weeks active duty before going over—but I would debrief my soldiers in Iraq all the time about events I was not present at. I remember when Eagle Troop had lost a soldier to a sniper and I did the CISD [Critical Incident Stress Debriefing]. I still have those images in my head. Or when one of Fox Troop's tanks went over a land mine. The soldiers told me about how the IED blew through their tank, how the driver's body was completely destroyed, how it was like spaghetti, and they were desperately trying to pull him out of the driver's seat while their command told them to leave the scene. They didn't leave him behind. But the tension of that, and their descriptions of that moment stay with me. When Eagle Troop lost a sergeant to an RPG, they told me about running into the hospital, seeing Iraq soldiers vomiting on the stairs after what they had just seen—walls covered in blood, brain matter on the floor. These images don't go away and I wasn't even there that day.

Besides the images, what does it feel like when you remember what the soldiers told you about, and how long did the feelings last?

Scared. It was haunting. People I cared about were suffering, which causes stress, but then you also get scared and depressed yourself. You are constantly having to respond and help even when you are feeling helpless. I remember just an overwhelming sense of all my feelings colliding at once, of not being able to compartmentalize. And when you are surrounded by tanks and equipment, whether in Iraq or at a base at home, it's even harder to compartmentalize.

Were you diagnosed with secondary PTSD as well as chronic PTSD? How does something like Fort Hood affect you?

I know that my psychologist at Walter Reed talked to me about it, but I don't think it ever made it into the paperwork. But absolutely it was part of it. It's constantly being in that environment that is so hard. Even now, thinking about Fort Hood I'm depressed today. I can just picture people in the Readiness Center, because I've been in so many myself. I've led sessions. I know there was a chaplain there who must have responded to this. I'm 100 miles away from Fort Hood right now, but I'm depressed and worried. I feel the same way today as I did back in the desert. I heard a soldier's wife talking on the radio about how they were supposed to be safe at home. This is such a betrayal.

Is it harder for army families—already so strained—to bounce back from something like this?

Military families have more resources than other families in a tragedy. But at the same time they are back in the U.S., and this is not supposed to happen here. Even in Iraq you don't often have 12 soldiers killed at once and here it's happened on our own soil. I don't think the families can bounce back from this. This shatters the paradigm that—wow—my loved one is back and finally safe.

How do you feel now, as a chaplain at a hospital?

I'm still in the healing process. But I'm reframing my experience—it's not that God abandoned me but that God provided space for me. My family stayed with me, my mentors and friends, even when I was lashing out.

Is it hard for caretakers to get help for themselves?

Yes. I didn't want to be judged. When people tried to help me I would study how they would engage me—if I sensed any canned statements or if I felt they were uncomfortable with me I would back off and close up.

What do you think was in the shooter's mind at Fort Hood? Were you both at Walter Reed at the same time, since you both studied there?

I didn't know him, am not sure if we were at Walter Reed at the same time. But I know anyone there would have experienced a lot of secondary stress. After all, I became an inpatient soon after starting work at Walter Reed. But I can't imagine shooting anyone. I also don't know what role his religion played, if any.

Why did you leave the army?

I could not stay in the army any longer and do good. There was a part of me who hated all of humanity because I could not understand the atrocities that people would commit, the horrors that people are capable of. I hated humanity and I hated God and I hated myself. I was so burned out, so angry with God and with the army I knew I had to get away from that culture. I could not be an army chaplain any longer without doing harm to others. But I can't imagine how someone would shoot their own soldiers. When I say I would do harm I mean emotionally—I was closed off and cold. I could not give the spiritual and emotional care that soldiers needed.