EURJ Volume 13

Volume XIII Spring 2017

EURJ

Emory Undergraduate Research Journal

about EURJ

The Emory Undergraduate Research Journal (EURJ) is an annual print and online publication that accepts research manuscripts written by Emory undergraduates from all academic disciplines. EURJ provides a venue for students to showcase their high quality, original research while fostering interest in undergraduate research. Research can be submitted up until two years post-graduation. EURJ was founded through generous support by the Office of Undergraduate Education and is continuously supported by the Media Council.

Emory Undergraduate Research Journal Volume XIII Spring 2017

1655 North Decatur Road, Atlanta, Georgia 30322

A Letter from the Directors of Undergraduate Research Programs The College of Arts and Sciences at Emory has a long history of supporting undergraduate exploration, creativity, and experiential learning. As the co-directors of the recently restructured Undergraduate Research Programs, we are excited to support the university’s mission to foster an engaged community of undergraduate researchers. In our role as directors, we are committed to facilitating opportunities for students to explore their interests and passions through scholarly inquiry and experiential research.

As the faculty advisors of EURJ, we see our mission to promote and sustain a diverse and nuanced community researchers realized in the student profiles, articles, and features. This volume demonstrates the vibrancy of research occurring in the humanities, social sciences, arts, and sciences. In showcasing both the actual process of research and broadening the narrative of what research is and who conducts it, this issue of EURJ seeks to highlight a broader community of undergraduate researchers.

The editors have captured the zeitgeist of movement that the contributors to this volume of EURJ, energized by current events on a local, national and international scale, have drawn upon in their exploration and construction of knowledge. Through research, undergraduates are forming connections. The ways in which Emory undergraduate students’ access and contribute to the academic landscape, as seen in this journal, are numerous and varied as they pursue curiosity both in the classroom and beyond.

Along with the reimagining of EURJ, Emory is witnessing a bubbling of spaces of undergraduate intellectual dialogue such as the Researchers of Emory blog. These spaces in unison highlight and help to sustain a community of students engaged, drawn to inquiry, and fueled by the desire to discover, connect, and transform.

We are proud of the hard work of the editorial team and the contributors. We hope this issue sparks your curiosity, fuels conversation, and broadens your understanding of research at Emory.

Folashade Alao, PhD Associate Director, EmoryUndergraduate Research

Gillian Hue, PhD Associate Director, Emory Undergraduate Research

Editorial Board

Editors-in-Chief Kevin Ding Anqi Gao Managing Editor Josh Buksbaum Humanities Editors Angela Zaladonis Allison Irwin Ekaterina Koposova Natural Sciences Editors Shweta Sahu Ian George Jaewon Jeong Stellina Lee Martin Riu Social Sciences Editors Joan Shang Kenny Igarza Ashwin Ragupathi Matthew Ribel Treasurer Josh Buksbaum

Design and Layout Merry Chen Steven Chen Ursula Choi Miriam Lachs Website Editors Bahar Jalalian Ellen Kwon Ahbinav Nair Photographer Steven Chen Michelle Bermudez Copy Editor Merry Chen Special Features Natalia Brody Publicity Quentin Truncale Lucy Galvin Miriam Lachs

Photo by Steven Chen

Photo by Steven Chen

A Letter from the Editors: To our readers, We are excited to share with you the 13th volume of the Emory Undergraduate Research Journal (EURJ).

We continue our tradition of serving as an interdisciplinary journal that publishes undergraduate research from the natural sciences, social sciences, and humanities.

The articles you will find in this issue reflect the interdisciplinary nature of ongoing research at Emory that EURJ hopes to capture. This year, we present to you a diverse collection of articles, ranging from neuroscience research to critiques of philosophical theory. In addition, we proudly showcase an article that weaves together both medicine and literature, demonstrating the positive impact that fiction confers on the discovery and implementation of effective medical treatments. It is our hope that you join us in appreciating the variety of exciting work conducted by Emory undergraduates.

Another feature that we continued to implement this year is the presentation of the research process as opposed to simply showcasing the final product. In this issue, you will find articles featuring a student and faculty researcher who discuss their experiences and accomplishments in the field of cancer biology.

In closing, we want to express gratitude to everyone who contributed to EURJ’s success this issue. Specifically, we would like to thank Dr. Folashade Alao and Dr. Gillian Hue, our faculty advisors who have provided continuous support and constructive feedback. We would also like to recognize the undergraduate researchers whose original work and narratives we featured in this issue; many thanks to their research mentors as well for their guidance. Without their scholarship and enthusiasm, EURJ would not be possible. Last but not least, a huge thank you to all our staff members, many of whom joined the editing team this year and worked incredibly hard to produce the journal that is in your hands right now. We hope that you enjoy the Spring 2017 issue of EURJ! Sincerely,

Kevin Ding Editor-in-Chief

Anqi Gao Editor-in-Chief

Get involved with EURJ!

CONTACT

JOIN

SUBMIT

E-mail eurjstaff@gmail.com with any questions or comments about EURJ. E-mail f.alao@emory.edu or ghue@ emory.edu for questions or comments about undergraduate research.

Apply for a position on our staff as a section editor, photographer, treasurer, special features writer, design and layout editor, or publicity officer for the upcoming year.

Send in your research paper to EURJ for publication in the Spring 2017 issue. E-mail us for information regarding submission guidelines and deadlines.

Photo by Steven Chen

Table of Contents

Photo by Steven Chen

10

What Drives Us? Chasing Reward in a Dopaminergic Society

18

An Analysis of Liminality in “The Brief Wondrous Life of Oscar Wao”

24

Microfluidic Systems of High-Throughput Whole Ganglion Imaging in Caenorhabditis Elegans

32

The Socratic Solution: Resolving the Dilemma of the Crito

38

Fiction’s Power to Cure

46

Student Spotlight

48

An Interview with Dr. Gregg M. Orloff

What Drives Us? Chasing Reward in a

Dopaminergic Society

Solana Liu

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Introduction goal-directed movement and mesolimbic dopamine plays an invaluable role in executive functions like at An individual’s level of motivation is often heavily attributed as a personality trait-it’s a quality we tention which are important in learning (Korchounov group with self-control to embody the ideal achiever et al., 2010). Mesolimbic dopamine also invigorates action towards desired goals when triggered by euscapable of success in our society. However, seemingly discrete identification of personality traits understates tress-“good”, manageable levels of life stress encountered when we face mild challenges. Due to dopamine’s a major component of the motivational driving force which is the dopamine mesolimbic reward system, motivational effects through the behavioral explorative also commonly known as the reward circuit. Activaapproach response, the challenge is perceived as extion of this circuit triggers the projection of the neuciting (Ikemoto 2007). This could be characterized as rotransmitter dopamine to the nucleus accumbens concurrent occurrence of a sudden creative insight and and feelings of pleasure (Niehaus et al., 2009). Dopathe feeling of anticipation that precedes highly focused mine also plays a critical role in driving motivation in engagement in a task. Executive functions to maintain goal-directed behaviors by attention to the task at mediating feelings of mohand is coordinated by the “Pleasure can also be derived tivational desire which are prefrontal cortex and is important determinants mediated by proper dopafrom unnatural rewards, such of incentive drive, a submine functioning as well as alcohol, drugs, or other component of the complex (Hosenbocus et al., 2012). psychological concept of Furthermore, reaching the thrill-seeking behaviors-pleasure (Robinson et al., goal-directed outcome reall which fuel the rush of 2000; Palmer et al., 2008; sults in a sense of mastery Kringelbach & Berridge and accomplishment–feeldopamine...”

2010). This mechanism is ings highly dependent on also common to many of the release of dopamine our everyday activities-ex(Yau & Potenza, 2013). It ercising and listening to music, for instance, have been is nevertheless evident dopamine is highly involved in associated with increased levels of dopamine (Petzingall aspects of behavior from the creation of energizing er et al., 2015). The close involvement dopamine has incentive drive and maintenance of mental focus and with everything we do is further emphasized through concentration to the subsequent production of rewardits evolutionary involvement in our culture through ing pleasant feelings as behavioral reinforcement. noting behavioral manifestations of our predisposition

Reward seeking behavior facilitated by the reto chase reward. Disruption of dopamine-induced enlease of dopamine maintains a seductive dynamic as gagement underpins a variety of behavioral disorders the release of dopamine triggers the feeling of “wantwhich further supports the necessity of dopamine in ing”, an anticipatory craving for additional dopaproper functioning. Noting the reinforcing effects of mine-releasing behaviors. This subconsciously manicocaine, alcohol, nicotine, food, and music through fests in a behavioral bias towards dopamine releasing mediation of the mesolimbic circuit, we’re able to conbehaviors, which can comprise everyday activities such nect a variety of seemingly separate intrinsic and exas listening to music or indulging in your favorite comtrinsic factors to provide explanatory and predictive fort food. These small stress relieving activities serve as power for its increasing influence on the cultural develnatural rewards that satisfy physiological drives such as opment of the dopaminergic society we live in today. hunger and reproduction and activate the mesolimbic circuit (Blum et al., 2013). Pleasure can also be derived Functional Importance of Dopamine from unnatural rewards, such as alcohol, drugs, or oth Countless studies emphasize the importance er thrill-seeking behaviors-all which fuel the rush of of dopamine in a variety of life sustaining behaviors. dopamine (Michaelides et al., 2013).

Nigrostriatal dopamine regulates motor control and

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Evolution of a Dopaminergic Society

Dopamine not only plays a key role in our everyday functions, but is also attributed to as the key to the development of unique human cognitive skills such as abstract reasoning, temporal analysis, and working memory. These physiological adaptations to social, cultural, and environmental changes were enabled 80,000 years ago through dietary changes such as the inclusion of fish oils and increased meat consumption (Adams et al., 2011). Dietary changes overcame previous developmental constraints and resulted in increased development of dopamine receptors allowing increased dopamine processes or improved functioning at the receptor itself.

Interesting associations can be made to note the behavioral manifestation of these changes as hyperdopaminergic effects functionally manifest in masculine and less emotional behavior (Wersinger & Rissman 2000). Boldness and social risk taking, traits useful in obtaining positions of authority, are characterized by the “fearless dominance” trait used to characterize psychopaths. Interestingly, the number of psychopaths rises each year and furthermore, the general population’s perception on psychopaths intriguingly parallels these changes through increasingly glamorized and normal-

ized psychopathic portrayal in the media (Smith et al., 2013). In addition, the number of disorders correlated to excessive dopamine such as bipolar disorder, OCD, schizophrenia, and Tourette’s syndrome continuously and rapidly increases yearly, offering further evidence to suggest an increasingly hyperdopaminergic society (Healy 2006, Nestadt 2010).

A “hyped up” motivation system exaggerates dopaminergic effects and therefore encourages fast paced, driven, competitive, and novelty seeking behaviors-characteristic of our hyperdopaminergic society today. This evolutionary predisposition to seek rewards explains increasing obsession with achievements in a highly competitive environment in which we continuously set goals to chase the feeling of satisfaction and fulfillment. High dopamine individuals thrive in these societies and through their influence, shape and further encourage the hyperdopaminergic qualities of society.

The rush to seek rewards as well as the intense culture constructed by conquest and competition can fuel chronic restlessness within our high stress competitive hyperdopaminergic society. Countless neurochemical studies have demonstrated that in addition to relaxing activities and thrill seeking behaviors, stress-

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ful stimuli activate the dopamine system (Belujon & Grace, 2015, Piazza & Le Moal, 1998). Our homeostatic abilities to maintain a constant internal environment in response to environmental changes establishes a subconscious search for external dopamine releasing behaviors. The drive to fulfill immediate cravings may account for the presence of high risk, thrill-seeking activities which maintain a significant cultural presence today. Thrill seeking activities can behaviorally manifest as binge drinking, gambling, or substance use and all are able to fuel to the satisfying rush of dopamine (Michaelides et al., 2013, Avena et al., 2008, McHugh et al., 2014, Michaelides et al., 2013, Adinoff et al., 2004, Gosnell, 2005). Although societal standards intuitively categorize these activities as separate, this understates the common circuit activation between seemingly unrelated behaviors. Even sugar can be classified as addictive substance (Avena et al., 2008, Michaelides et al., 2013) and the cross-sensitization in movement from sugar to cocaine indicates some degree of potentiation between sucrose and psychostimulants (Gosnell, 2005). As dopamine additionally plays a role in stress relief, subconscious reward seeking behavior also suggests a neurobiological incentive for trending stress-relieving cultural practices such as yoga, meditation, and spiritual practices (Krishnakumar et al, 2015, Newberg 2014). Identifying the common mesolimbic dopamine activation in both everyday activities and thrill seeking clarifies how culturally encouraged stress behaviorally nurture the manifestation of a range of dopamine-releasing “self-medicating” behaviors. Whether it’s a response to acute cravings, as the body responds and maintains a homeostatic balance we naturally gravitate towards certain activities to fulfill those needs

Dopamine Deficiency

The proper functioning and processing of dopamine communicates a message of calm and wellbeing to the rest of the brain. However, it’s a delicate balance that the brain battles to maintain. Too much dopamine can lead to a false sense of euphoria and schizophrenic symptoms whereas not enough dopamine can result in Parkinson’s disease, depression, and propensities to addiction (Ducci & Goldman, 2012; Edenberg et al., 2006; Bevilacqua & Goldman, 2009, Korchounov et al., 2010). Because dopamine plays crucial roles as the pleasure and anti-stress molecule, inadequate do-

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paminergic activity stresses out other brain functions resulting in feelings of stress, pain, discomfort, and agitation (Zai et al., 2012). It also leads to physical changes in brain areas critical in judgement, decision making, learning, memory and behavior control which behaviorally manifest as motivational deficits, impulsivity, novelty seeking, substance and behavioral reward seeking, and a short attention span (Blum et al., 2015).

The altered functioning of dopamine also affects the brain’s resting state network connectivity (Cole et al., 2013), and is also suggested to impact the efficiency of functional network updates that occurs between tasks (Schultz & Cole 2016). This would explain how someone with attention deficit/hyperactivity disorder (ADHD), for example, would have trouble sustaining focus on a task.

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Problems in dopamine processing can stem from innate genetic differences, chronic drug use, or long term stress (Aschacher 2013, Weiss et al., 2001, Reist et al., 2007). A specific variant of the DRD2 receptor gene has been posited as the anomaly for resultant neurochemical issue and exists in 30% of the population today (Blum et al., 2008). Regardless of the source of dysfunction, a heightened reward threshold results in a chronically underexcited reward system.

Loss in ability to feel various dopaminergic effects in comparison to individuals with properly functioning dopamine processes manifests behaviorally in an inability to derive pleasure from everyday activities.

The brain attempts to adjust to the deficiency by searching for external dopamine releasing behaviors.

Thus, these individuals are more likely to self-medicate with thrill-seeking activities which would be able to trigger the release of supa-threshold dopamine. Cocaine, alcohol, nicotine, food, and music are all able to fulfill the reinforcing reward through the common mesolimbic mechanism (Blum et al., 2013). In addition to aberrant reward seeking behavior, the loss of dopamine-induced feelings of calm and well-being impacts the ability to respond to stressors, compounded by additional effects due to the disrupted cascade. The consequence dopamine functional deficiency automatically predisposes individuals to a higher risk for multiple impulsive, compulsive, and addictive behavioral tendencies ranging from mild anxiety and irritability to attention deficit hyperactivity disorder, alcoholism, eating disorders, and smoking (Blum et al., 2008). Evidence associating a certain variant of the DRD2 gene that results in deficient dopamine functioning with various substance use disorders, pathological gambling, sex addiction, eating disorders, alcoholism, attention deficit hyperactivity disorder, and smoking supports this hypothesis (Noble et al., 1993; Stice et al., 2012; Noble et al., 1991; Nisoli et al., 2007; Need et al., 2006. In fact, the umbrella term Reward Deficiency Syndrome (RDS) conceptually posits the A1 variant as the anomaly that results in the neurochemical inability to drive pleasure from normal, everyday activities (Blum et al., 2008). Additional studies propose other

“It questions the degree to which our civilization serves as an artificial construct nurtured by our natural human predisposition to chase reward.”

genetic polymorphisms that may predispose individuals to reward seeking behavior, but it’s imperative to note that any reduction in dopamine function can lead to reward deficiency and results in aberrant substance-seeking behavior and a lack of wellness, which can manifest in a variety of behaviors (Reist et al., 2007).

Conclusion

Recognizing the driving force of dopamine allows us to note the biological basis underlying our habits and conceptually redefines perceptions of reward seeking behavior within this dopaminergic society.

Predisposition for mesolimbic activation clarifies cultural novelty seeking as well as the lure of thrill seeking extrinsic factors. Connecting the biological basis within all reward seeking behaviors moves away from societal misconceptions of various compulsions attributed to problems in the dopaminergic cascade which predispose to unnatural rewards and explains comorbidity between seemingly separate disorders. It anticipates progression away from the social stigma attached to substance use disorders, ADHD, alcoholism, and the spectrum of reward-seeking behaviors that comprise RDS.

Understanding how strongly dopamine is interwoven into our actions can embody a raw perspective of the dopaminergic society we live in. It questions the degree to which our civilization serves as an artificial construct nurtured by our natural human predisposition to chase reward. Western moral values of efficiency, encouraged by dopaminergic projections, shapes many social pressures and expectations. For instance, the ideal of maximum efficiency contributes to shaping the social construction of insomnia and sleep disorders, which continuously increase in number each year (Nunn et al., 2016).

The fascinating implications of understanding our cognitive capabilities and motivational sources provides invaluable perceptual perspective on the complex interactions that influence our thoughts, feelings, and actions. Studies attribute happiness to finding the right hedonic balance-a state of pleasure without too much “wanting” (Kringelback & Berridge, 2010). And so despite individual differences, the right ideological views powerfully allow us to drive our own motivational mindset within this dopaminergic society.

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Solana Liu is a junior from Princeton, NJ studying Neuroscience and Behavioral Biology. She currently works at the Department of Anesthesiology at Emory University’s School of Medicine conducting research on treatments improving recovery after stroke. This summer, she plans to continue her research through the SURE fellowship program in preparation for her honors thesis next year as well as pursue an internship with Emory University’s Office of Technology Transfer.

In addition to research, Solana serves as Social Chair of the honor fraternity Phi Sigma Pi, peer reviewer for the IMPULSE Undergraduate Neuroscience Research Journal, and mentor for high school students in the Student Educational Experience Development.

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An Analysis of “The Brief Life of

Liminality in Wondrous Oscar Wao�

Iman Williams

The final lines of Derek Walcott’s Adios, Carenage from his epigraph, The Schooner Flight, considers a question that seems to follow the lives of all of the characters in The Brief Wondrous Life of Oscar Wao by Junot Diaz.

Walcott writes, “I have Dutch, nigger, and English in me, and either I’m nobody, or I’m a nation.” This scene offers a critique of the oppositional binary wherein the possibility of assuming personhood is either foreclosed or the subject is coerced into embodying a performance of a trope that does not, in fact, represent them. Walcott and Diaz are interested in imagining something that exists in an interstitial space between and beyond the borders that are generated by the conditions that the characters are situated within. That is to say that Walcott and Diaz propose a technology of reading that is an alternative to thinking about the cultural modalities and material architecture of state injunction that threatens to foreclose the possibility of movement and alternative modes of being.

The Fuku is described as an intergenerational curse carried by the screams of enslaved Black people from Africa to the Antilles. The narrator writes, “They say it came first from Africa, carried in the screams of the enslaved; that it was the death bane of the Tainos, uttered just as one world perished and another began; that it was a demon drawn into Creation through the nightmare door that was cracked open in the Antille” (1). The screams that are described in this scene are figured into the text as media of transport wherein a collective sonic force, presumably produced under the condition of confinement and domination, reproduces the violence that set it in motion. The Fuku is evidence that a world has “perished” and evidence of the emergence of new life, and therein undermines the notion of social death by presenting the Fuku as a condition of possibility for life. By making disaster the condition or site of possibility, Walcott’s epigraph apprehends Oscar’s final statement before he is killed in the canfields by Trujillo’s officials.

The final lines of Derek Walcott’s Adios, Carenage speak to the movement of Rafael Trujillo’s subject position in that Trujillo is, throughout the novel, a nobody or a nation. Trujillo is a nobody inasmuch as he is an elusive figure who is rarely ever seen and yet he is the progenitor of this intergenerational curse. Trujillo is, in a sense, a nation because he inculcates the mechanics of surveillance throughout the

island wherein everyone pays close attention to each other on behalf of Trujillo’s regime. The narrator comments, “For what Kennedy’s intelligence experts failed to tell him was what every single Dominican, from the richest jabao in Mao to the poorest guey in El Buey, from the oldest anciano sanmacorisano to the littlest carajito in San Francisco, knew: that whoever killed Trujillo, their family would suffer a fuku so dreadful it would make the one that attached itself to the Admiral jojote in comparison” (3). This scene suggests that Trujillo is the progenitor of Fuku because he has the capacity to traverse his body and transgress the interior subjectivity of every person in the nation. It is also important to note that Walcott’s epigraph, insofar as it illuminates the complexities of ethnicity in the Caribbean, performs a critique of Trujillo’s attempt to evade and problematize blackness in the Caribbean.

Oscar is unable to cede to a traditional symbolic of gender which is, partly, due to his blackness. There is, however, a brief period when Oscar embodies a normative mode or performance of masculinity — a kind of machismo that underlines the social order in the Dominican Republic. Not only does Oscar, who is seven years old at the time, actively court several different people at once, but he is also the object of desire who — is sought after by women who are more than twice his age. However, Oscar begins to get pathologized in such a way that it is impossible for him to inhabit his adolescence. The narrator writes, “Everybody else was going through the terror and joy of their first crushes, their first dates, their first kisses while Oscar sat in the back of the class, behind his DM’s and watched his adolescence stream by. Sucks to be left out of adolescence, sort of like getting locked in the closet on Venus when the sun appears for the first time in a hundred years” (23). Oscar, who desperately wants to receive and give love, does not have intimate or romantic relationships. After his Golden Age, Oscar, who stands as a figure for the nation, becomes a “nobody,” as Walcott apprehends in Schooners Flight, because Oscar is unable to refuse or assent to a temporal framework and mode of being that might have enabled him to assume personhood or manhood. While the isolation that Oscar endures threatens to disallow movement and alternative modes of being, there is still something generative about the interstitial space that Oscar is forced to inhabit. The narrator writes, “In these

“They say it came first from Africa, carried in the screams of the enslaved...”

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Noticias SC. “Discurso De Rafael Leonida Trujillo Molina En 1939.” Noticias SC, 28 Feb. 2015. Web. 18 Mar. 2017. pursuits alone Oscar showed the genius his grandmother insisted was part of the family patrimony. Could write in Elvish, could speak Chakobsa, could differentiate between a Slan, a Dorsai, and a Lensman in acute detail, knew more about the Marvel universe than Stan Lee, and was role playing game fanatic. Perhaps if like me he’d been able to hide his otakuness maybe shit would have been easier for him, but he couldnt” (21). However, Oscar’s dreamscape exceeds and animates life. The narrator continues, “You really want to know what being an X-man feels like? Just be a smart bookish boy of color in a contemporary U.S. ghetto. Mamma mia! Like having bat wings or a pair of tentacles growing out of your chest” (22). This scene suggests that the imaginative worlds produced by sci-fi novels, shows, and movies are passages to subjectivity that give Oscar the will to resist and live.

The romantic relationships that Oscar has throughout the novel seem to offer a critique of conventional modes of thinking about gender. The women that Oscar takes interest in, more often than not, run the risk of being misunderstood by the other characters as well as the readers. The

narrator writes, “His affection — that gravitational mass of love, fear, longing, desire, and lust that he directed any and every girl in the vicinity without regard to looks, age, or availability — broke his heart each and every day” (23).

The reader is urged to call into question the reliability of the narrator; it is suggested that Oscar’s reasoning is influenced by his desire for intimacy. Indeed, Oscar longs to have an erotic encounter with a woman and he is often met with disappointment as there are so few women that are interested in engaging with Oscar in this way. However, the narrator of this scene fails to account for the particularities of Oscar’s erotic relationships. For instance, Oscar, much like his mother, disarticulates oppressive figures and turns them into the objects of desire by pursuing people whose partners work closely with the Trujillo regime. It becomes clear that Oscar deliberately pursues women who refuse to be controlled by polarizing notions of what a female should be when he falls in love with Ana Obregon during his fifth SAT class. After she catches Oscar looking at her, Ana leans over to show him a passage in the book she is reading -- Sexus.

After she shows him the passage, Ana asks Oscar whether or

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not he think she is weird. Oscar himself believes that Ana existed in this liminal space, which is probably what attracted him to her. He writes, “She was this peculiar combination of badmash and little girl...and there was something in the seamlessness with which she switched between these aspects that convinced him that both were masks, that there existed a third Ana, a hidden Ana who determine what mast to throw up for what occasion but who was otherwise obscure and impossible to know” (35).

Oscar seems to be in conversation with Walcott throughout the novel up to the point at which his subjectivity is denied immediately prior to his death. Oscar is the subject of the aforementioned Walcott epigraph in that his life is marked by fragmentation and he endures social death throughout the text. But Oscar is not merely the subject of Walcott’s epigraph; rather, Oscar — an admitted fan of Octavia Butler and Alice Walker — is a writer who conceives himself in such a way that places him in conversation with an Afro-Caribbean writer — Walcott. While there is no mention of Oscar ever having read Walcott, his autobiographical voyage hinges on Walcott’s Adios, Carenage insofar as both

“The Brief Wondrous Life of Oscar Wao.” Literature to Life, 2016. Web.

writers conceive of themselves and the transatlantic slave trade as a site of disaster in which love is “[their] load”. It is important to note that Walcott’s epigraph precedes the text which tempts the reader tinterpreting the epigraph as separate from or prior to the narrative. This rhetorical technique leaves the reader to assume responsibility for the fragmentation that our reading imposes on the text. The question we must then ask ourselves is how does the text wants to be read? Like Walcott, OScar conceives of himself in relation to an event — his death in the canefields — prior to and after the event in such a way that indicates that Oscar

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not only has access to the interior subjectivity of the other characters, but he also has access to the interior subjectivity of the readers. Walcott writes, “I know these islands from Monos to Nassau,/ a rusty head sailor with sea-green eyes/ that they nickname Shabine, the patois for/ any red nigger, and I, Shabine, saw when these slums of empire was paradise.” Shabine, an epithet used against multiracial Caribbean people — though “the patois for any red nigger” indicates

“...if loving these islands must be my load, out of corruption my soul takes wings...” that this pejorative word has Haitian specificity, is the “nickname” that is given to the subject of Adios, Carenage. While Walcott uses the first person to refer to himself as Shabine — “I, Shabine — it is not clear that he is internalizing the racialized violence that is bound up with the epithet. He seems to be doing something else. Similarly, Oscar signs his letters with Oscar Wao, the pejorative “nickname” that he is given and although there are moments when Oscar seems to internalize self-hatred, it is not clear that his use of this “nickname” is an internalization of the violence that it is bound up with. This gesture seems to disavow and mock the denigration that the word insists upon. The writers disavowal and oblique use of irony indicates that Oscar and Walcott have access to the interior subjectivity of the people that foist these tropes onto them and, as Walcott apprehends in Adios, Carenage, Oscar and Walcott, like many other Afro-Caribbeans, are tasked with navigating oppositional binaries that either foreclose the possibility of assuming personhood or leave one to embody a form of subjectivity that disallows individuation. That the novel is an amalgamation of Oscar’s letters, in which he recounts events without speaking as someone who is trying to reconstruct said events, indicates that Oscar has access to multiple temporal frameworks. Oscar persists in the text as a transcendental figure whose subjectivity is affirmed through and after his death. Walcott anticipates this in Adios, Carenage when he writes, “Christ have mercy on all sleeping things!/ From that dog rotting down Wrightson Road/ to when I was a dog on these streets;/ if loving these islands must be my load, out of corruption my soul takes wings,”. Walcott, like Oscar, speaks from a temporal elsewhere in this scene. Walcott suggests that he was or is sleeping which may be an allusion to social

death and, like Oscar, Walcott does not seem to believe that the condition of social death can overdetermine love and the possibility of flight.

Oscar escapes in the literal and figurative sense towards the very end of the novel, which is when it becomes clear that Oscar not only orchestrates his own death but he also constructs his own autobiography in anticipation of the event of his death. This conscious stylistic gesture undermines conventional modes of thinking about personhood, movement and escape. Walcott continues, “I know these

Islands from Monos to Nassau, a rusty head sailor with seagreen eyes that they nickname Shabine, the patois for any red nigger, and I, Shabine, saw when these slums of empire was paradise.” Walcott, who states that he was once a “dog on the streets”, implies that he is transmuted into a sailor — an event which hinges on Oscar’s constant movement between and beyond subject positions that are imposed.

References:

Diaz, Junot. The Brief Wondrous Life of Oscar Wao. New

York: Riverhead, 2008. Print.

Iman Williams is a scholar and organizer from Baltimore Maryland.

She is currently pursuing her B.A. in Comparative Literature at Emory University. Her writing has been published by, or is forthcoming in, The Baltimore Sun, Entropy, Enclave, Moonsick Magazine, Acro Collective, Emory's Black Star Magazine, and The Volta. She is also the Founding Editor of the literary journal Subjugated Knowledge.

When she is not reading or writing, Iman spends much of her time studying performance art and cooking.

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Microfluidic Systems for Highthroughput Whole Ganglion Neural Imaging in Caenorhabditis elegans

Yun-Hsuan (Stellina) Lee

David Sherwood Labs, Duke University

Abstract

The relationship between neural structure and function at a systemic level garners significant research interest as insight into such implicate human health and diseases.

Caenorhabditis elegans is a powerful model organism as it is the only animal model with its complete nervous system anatomically mapped and well-characterized. Whole-ganglion neural imaging enables investigation of multiple neural features concurrently at the systemic level, thus presenting a unique opportunity for complete mapping of the relationship between neural structure and function. We interrogate whole ganglion neural properties from two fronts:1) static imaging of synapses and 2) dynamic imaging of neurons.

The use of microfluidic devices further expedited this process and increased throughput. For static imaging, we qualitatively visualized stereotypical features of synapses with developmental and genotypic variations, respectively. We aim to further correlate salient features to the formation of a mature functional nervous system. For dynamic imaging, we introduced efficiency at both the data acquisition and analysis level by acquiring large scale data and validating a developed 3D neuronal tracker. The parallel studies highlight the significance of whole ganglion neural imaging on C.elegans enabled by microfluidic systems.

Introduction

A major goal of neuroscience research is to examine the relationship between brain structure and function.

Brain-wide sampling examines both anatomical connectivity and the activity pattern in which neuronal populations function (Churchland et al, 2012). Caenorhabditis elegans’s optical transparency, compact nervous system, short life cycle, ease of genetic manipulation and homology to humans makes it an ideal model for various biological and neuroscience studies (Nguyen et al., 2015). This model organism is particularly suitable for whole ganglion neural imaging as it is the only animal in which a complete nervous system of 302 neurons and 8,000 synaptic connections has been anatomically mapped (White et al., 1986). The combination of whole ganglion neural imaging and C. elegans’s well-studied nervous system presents a unique opportunity to pioneer a complete mapping of how neural structure and function relate to one another (Schrödel, 2013). Traditional approaches remain manual and low-throughput, prompting this project to employ microfluidic systems for high-throughput imaging and analysis at subcellular resolution. Microfluidic devices, microchannels molded out of polydimethylsiloxane (PDMS), can be designed with specific features for large-scale, efficient genomic screening and data acquisition (Chung, 2008). Therefore, increased ability to conduct in vivo, in situ analysis on small multicellular organisms have been found within the lab-on-a-chip research community

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(Rohde, 2007;Yanik 2011; Wlodkowic, 2011).

This project is therefore motivated to characterize C. elegans neural structure and function in a high-throughput fashion by combining whole ganglion neural imaging with microfluidic systems. We interrogate C. elegan’s neural properties with two parallel studies: 1) Static imaging of a) synaptic morphology during development, and b) synaptic variation with genotypic differences. 2) Dynamic functional imaging of the head ganglion. This parallel approach will allow us to gain insight into both neural features and circuitry.

C. elegan’s well-understood nervous systems have commonly been described as possessing “stereotypical [positioning] of neurons” and “invariant connectivity (White et al, 1986). Nonetheless, little research has addressed how neural morphology and plasticity during development contribute to a functional adult nervous system (Kurup and Jin, 2015). White et al. (1978) described a synaptic re-wiring phenomenon seen in GABAergic Dorsal D (DD) motor neurons where neurons abolish pre-existing synapses and

“This project is therefore motivated to characterize C. elegans neural structure and function in a high-thoroughput fashion...” reform synapses on other sites without changing neuron morphology. Furthermore, synapse formation requires precise orchestration of many developmental events, such as cell migration, axon guidance, and synaptogenesis (Jüttner & Rathjen, 2005). The developmental timescale of synaptic morphology in C. elegans can thus be a useful tool in understanding neural plasticity and synapse development.

The study of synaptic morphology during development can be complemented by the study of synaptic variation due to mutations, which can provide insight into genomics and human health (Jaramillo-Lambert, 2015). Subtle synaptic variations have been shown to correlate with neurodevelopmental disorders such as autism spectrum disorder (ASD) and schizophrenia (Zoghbi, 2012). C. elegan’s genetic homology to humans thus introduces itself as a prime model for a linkage study relating genotypes to neural phenotypes.

Nonetheless, localization and regulation of synaptogenesis remain unclear (Goda and Davis, 2013). The advent of the targeted gene editing technique, CRISPR-CAS9, enables

precise, in-line protein expression, which troubleshoots overexpression of the head ganglion during imaging (Friedland et al, 2013). Thus, this study aims to qualitatively categorize, for the first time, stereotypical patterns of neural features at a whole ganglion level via a global pan-synaptic marker strain.

While static imaging enables detailed visualization of neural phenotypes, dynamic functional imaging of the entire head ganglion provides insight into neural dynamics. Previous studies have shown that most sensory functions and behavioral states are flexibly expressed across large neuronal networks, and that behavioral outputs are largely encoded through collective activity of neurons in dynamic coordination (Alivisatos et al., 2013; Kato, 2015).

To study structural and functional neural dynamics, genetically encoded calcium indicators are used for non-invasive functional imaging with fluorescent microscopes. The development of imaging technology such as light-sheet and light-field microscopy further allows simultaneous, volumetric recordings of large neural tissues for high-throughput and high-content imaging (Ahrens et al, 2013). Several publications have characterized C.elegans neuronal dynamics at a whole head ganglion level in both freely-behaving (Nguyen et al, 2015; Venkatachalam et al, 2015) and partially anesthetized animals (Schrรถdel et al, 2013; Prevedel et al, 2014; Kato et al, 2015), but no paper thus far has published data beyond a sampling size of five. However, variability in neural activity across subjects demands large sampling size; for example, large scale-questions such as neural populations involved for motor commands (Kato et al, 2015), and the microcircuits involved in response to sensory simulations (Venkatachalam et al, 2015).

The main bottleneck lies in the large scale data analysis required to extract and interpret data. This project therefore aims to further improve and validate an efficient and automated neuronal tracker, previously developed in the lab of Dr. Hang Lu by Charles Zhao. The tracker provides a similar analysis while significantly enhancing the efficiency to the order of 2 hours per subject in lieu of traditional manual annotations could take up to 1 week (Zhao et al, submitted, 2016). Along with validating the accuracy of the algorithm, this study aims to combine the developed neuronal tracker with microfluidic techniques to study the homogeneity and heterogeneity of whole ganglion functional imaging. By qualitatively comparing neural coordination and patterns between different videos, we will investigate invariant and differential neuronal activities across subjects. Overall, the two pipelines of this thesis propose high-throughput neural investigation via static and dynamic whole ganglion imaging, and the qualitative characterization of stereotypical neural features.

Methodology

Static Imaging

All worm strains contain a fusion of SYD-2::GFP, where syd-2 is a gene whose green fluorescence protein (GFP) marker expression is localized to presynaptic active zones. The wild type strain is used as a control group to study background presynaptic densities. For developmental variation, 20 worms were imaged at 5 developmental time points post-hatch: L1 (9 hrs), L2 (21hrs), L3 (29hrs), L4 (37hrs), and young adults (47hrs) using pad-imaging (White et al., 1978). The homogeneity and heterogeneity of synaptic morphology was subsequently qualitatively characterized. For the genotypic variation, 20 L4 worms were imaged. Two mutant strains with characterized differential expression of the presynaptic densities are used: one strain lacks the gene unc-104, which makes a protein responsible for anterograde axonal transport of synaptic vesicles across axonal microtubules, and is homologous to human kinesin motor protein. (Hall et al, 1991). The second mutant strain has a mutated syd-1 gene, which makes a protein that downregulates syd-2 presynaptic component recruitment (Patel et al, 2006).

All recordings occur within one hour of the tramisole rinse. Data was acquired using an inverted spinning disk microscope (PerkinElmer) equipped with an EMCCD camera (Hamamatsu). Images were taken under 100x magnification, where each Z stack was taken under green and red fluorescence. The neurons of interest for the whole ganglion neuronal analysis were the active neurons around the pharyngeal nerves, which are highlighted by GFP. The RFP was used to identify lipid droplets in order to exclude them from being classified as neurons. A brightfield image was also taken to serve as the reference frame.

Dynamic Imaging

To acquire whole brain functional imaging data in a high-throughput fashion, we employed a microfluidic device that controls for worm orientation (adapted from Cรกceres, 2013). All videos were generated with the strain ZIM 504, which expresses the Ca+2 sensor GCaMP5K pan-neuronally in the nucleus (Kato et al, 2015). Prior to loading, the worms were rinsed in 5mM tetramisole solutions for temporary immobilization. All recordings were taken within two hours of tetramisole rinses. Whole brain imaging videos were recorded under 40x magnification, where each Z stack was taken under green fluorescence for 10 minutes. Data was acquired using an inverted spinning disk microscope (PerkinElmer) equipped with an EMCCD camera (Hamamatsu). Videos were then compared across subjects qualitatively for stereotypical neural patterns and analyzed using the developed neuronal tracker for efficient data analysis.

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Figure 1: Worm Loading on Microfluidic Devices: Array Loading Scheme To efficiently image multiple worms while standardizing conditions, we employ microfluidic devices with 140 chambers to load the worms. Prior to loading, the worms are rinsed in solutions for temporary immobilization.

The microfluidic device is first rinsed with M9, then worms are loaded onto the device with a pressurizer.

Figure 2: Synaptic Morphology During Development Static imaging on the synapses show synaptic morphology throughout development, in which synapse formation requires precise orchestration of developmental events at each stage. Synapses appear around the nerve ring before the L1 stage and reaches full growth by L4. When the nematode reaches adulthood, synaptic pruning appears and suggest critical or sensitive period during development for a mature adult nervous system.

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Results

Figure 3: Synaptic Variation in Mutant Strains Genotypic variations result in differential neural phenotypes. The unc-104 KO strain shows an altered presynaptic density distribution, whereas the syd-1 strain shows lower intensity overall.

B

C

Imaging Valve

D

E

100 Îźm 20 Îźm

Figure 4: Dynamic Imaging Using a microfluidic device that controls for worm orientation (left), whole brain functional imaging can achieve efficiency at the data acquisition level. Dynamic functional imaging on four different time points for a specific video is shown (Right). Neurons exhibit differential activity over time, suggesting neural orchestration and dynamic coordination. Applying the neuronal tracker to the dynamic imaging videos, which shows comparable accuracy to previous manual hand curation data (Kato et al., 2015) efficiency can be achieved at the data analysis level as well.

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Discussion and Conclusion

Different microfluidic devices can be employed for different experimental measures. For example, a device that controls for worm orientation is ideal for dynamic imaging so that the calcium traces are recorded from the lateral side of the worms. The static imaging project on genotypic variation employs a worm array that holds up to 140 worms, which enables large sample size screenings of worms of the same age (L4). During imaging, however, one important consideration lies within the worm orientation (dorsal/ventral vs. lateral). Therefore, a device that controls for worm orientation might render more efficient. Additionally, the current device is designed only for the L4 age, therefore, devices that enable efficient feature phenotyping of all other life stages can be developed. The standardization of orientation and age could promote high-throughput investigation of the homogeneity and heterogeneity of static neural features and dynamic circuitry. Another concern during imaging is the varied intensity of each imaging session due to environmental factors. To address this issue, fluorescent microspheres can be used to calibrate the fluorescent intensities during each imaging session and between each imaging subject (Wu et al, 2007). For both static and dynamic imaging, combining microfluidic devices and whole ganglion neural imaging techniques facilitate high-throughput data acquisition, which in turn allow for the investigation of the homogeneity and heterogeneity of neural features and circuitry. For the static imaging project, we have found qualitative stereotypical patterns of quantifiable neural features through both developmental and genotypic variation.

We will identify characteristic features of each subtype in proposing insights into synapse formation and variation at a whole ganglion level. For the dynamic imaging project, combining the developed automated neuronal tracker with microfluidic systems achieves efficiency at both the data acquisition and analysis level. This invites further research into neural coordination and circuitry. Both projects reiterate the significance of the combined technique in presenting a high-throughput method for whole ganglion neural analysis.

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Alivisatos, A.P. et al. Neuron 74, 970–974 (2012).

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ica P. Colaiácovo, George M. Church, and John A. Calarco. “Heritable Genome Editing in C. Ele

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(2013): 741-43.

Goda, Y., and Davis, G.W. Mechanisms of synapse assembly

and disassembly. Neuron(2003): 40, 243–264.

Hall, D. H., & Hedgecock, E. M. Kinesin-related gene unc-104 is

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gans. Cell (1991): 65, 837-47.

Jaramillo-Lambert, A., Fuchsman, A. S., Fabritius, A. S., Smith, H.

E., & Golden, A. Rapid and Efficient Identification of

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Theodore H. Lindsay, Eviatar Yemini, Shawn Lockery, and

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I am a senior majoring in NBB and minoring in dance. Other than my research at the Lu Lab at GA Tech, I am an EPASS tutor in general chemistry and human physiology. In terms of extracurricular activities, I am an executive member of the co-ed service fraternity Alpha Phi Omega and am involved in Relay for Life. I am also a big foodie and enjoy exploring/traveling to new places, there’s so much in the world that I have yet to get a taste of!

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The Socratic Solution: Resolving the Dilemma of the Crito

Naman Gupta

lentina_x

The primacy of the many, despite its radical inclusivity, implies a fundamental tension between promoting the best interests of the wider community or state and overruling the interests of individual citizens. Classical political theorists such as Plato noted the morally questionable acts a form of government could force upon its citizens, especially where the execution of his mentor, Socrates, was concerned.

However, his Dialogues offer a seemingly contradictory answer to this question. The Apology offers a defense of a subversive ethical philosophy that runs counter to the political obedience Socrates counsels his friend to follow in the Crito.

Given his emphasis on developing a consistent ethical system that promotes arête, or virtue, what does Socrates view as a proper relationship between citizens and the state? This article argues that many contradictions can be resolved by developing the concept of the Demos, or the figurative representation of the Athenian people. The Demos must be understood as an idealized organ for rational decision-making fundamentally distinct from individual Athenians. The role of a Socratic citizen then becomes clear: to counterbalance the exuberant tendencies of democracy with traditional Athenian restraint lost after the Peloponnesian War.

Plato paints his teacher throughout the Apology as a profoundly anti-political philosopher who refused to engage with unjust political institutions. How, then, can this be squared with Socrates’ military service to his city throughout the Peloponnesian War, an act that required obeying the very organizations he later criticized as imperfect? The Apology makes clear that he considered it his duty to protect Athens during the war, and even viewed the conflict as justified. Besides a dearth of any proof for this view, it runs counter to Socrates’ philosophy of questioning even deeply-held views. The Crito provides a potent contradiction: Socrates elevates the nation above personal concerns yet seems to argue for disavowing the opinion of the majority.

Near the end of the dialogue, Socrates assumes the viewpoint of the “Laws” to argue that “your country is to be honored more than your mother, your father, and all your ancestors … you must worship it, yield to it, and placate its anger” (51a-b).

The idea that one’s country must be elevated before any immediate family responsibilities situates the nation as a larger family to be taken care of, rather than a separate entity. This

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characterization makes the wellbeing of the state the primary concern of its citizens, rather than arising naturally from the virtuous behavior of its citizens. Additionally, the use of the words “worship” and “placate” implies that the body politic should be treated like a god itself. As Anderson notes, this is preceded in the Attic political system by the concept of the “Demos”, a figurative representation of the Athenian people as a whole — a guise that members of the Council assumed in performing their office (Anderson 11-12).

Just as during Socrates’ trial, “when jurors took their seats in dikasteria, they too were thought to don the guise of Demos…When they voted, an indivisible corporate-self appeared to vote, with a single mind and a single will” (Anderson 12). However, in the Apology, Socrates justified his defiance of the jurors by arguing that the “the god” demands he continue questioning fellow citizens even if his life is not spared, seemingly opposing the supreme will of the Demos defended in the Crito. This contradiction grows in significance if we consider the basis of the conversation agreed upon between Socrates and Crito. While speaking with his friend, Plato’s teacher uses the example of an athletic trainer to suggest that “we should not then think so much of what the majority will say about us, but what he will say who understands justice and injustice” (48a). This metaphor is curious because it places a select few “who [understand] justice and injustice” above the purview of the majority, actively subverting the very democracy Socrates fought for.

How, then, should we resolve this?

The answer to this question may be found in extending the scope of our analysis to the technique that Plato uses in the Crito.

Like the cross-examination of Meletus within the Apology, Socrates leads his friend through a series of questions concerning his potential escape from jail. In this sequence, the Laws themselves, imbued by the will of the Demos, begin to question Plato’s mentor. Their exchange is fraught with tension, and Crito even argues that the time for discussion has passed and the two must flee the city while there is still time (46a).

Socrates’ response to this exhortation is crucial; he says: “My dear Crito, your eagerness is worth much if it should have some right aim; if not, then the greater your keenness the more difficult it is to deal with” (46b). This description introduces the idea that the “eagerness” of Crito, and other Athenians by extension, requires checks, lest they act rashly or without proper

consideration. As Dana Villa notes, “the Athenians posed the greatest possible challenge to Socrates not because they were more dogmatic… or more lawless…but because they were the most active of peoples, the most restless and driven” (Villa 4). Crito’s energetic and unrestrained spirit was a uniquely Athenian characteristic/personality trait, which not only formed a large part of her national ethos, but also presented difficulties to Socrates’ task of reconfiguring virtue.

Yet, this understanding offers an important insight into both the simplicity of Plato’s solution to his previous contradictions and the reason for the Crito’s structure. After establishing that the opinion of the enlightened matters more than that of the majority, Socrates gently chides his friend Crito for using trivial concerns to motivate flight.

Indeed, he advises that “as for those questions you raise about money, reputation, the upbringing of children, Crito, those considerations … belong to those people who easily put men to death … without thinking” (48c). Plato consciously lumps Crito’s reasoning in with the very “people who easily put men to death” i.e. the jurors themselves.

Thus, Crito is portrayed as a flawed character much like the Athenian majority, one who still has not internalized Socrates’ lessons of arête. However, because Crito has engaged with his mentor in aporetic dialogue, or a series of questions and answers, the flaws in his reasoning quickly become exposed. What Greek city might be more accepting of Socrates’ dangerous preaching, if not Athens? And what would be his philosophical legacy in Athens, if he fled after his trial? At the end, Crito is forced to admit defeat to the powerful logic advanced and acknowledge his own recklessness.

However, Socrates does not dismiss Crito’s objections about “money [and] reputation as unimportant or devalue the voice and input of the imperfect majority. While establishing a basis for conversation, he tells his friend that “if you can make any objection…make it and I will listen to you…I think it important to persuade you before I act, and not to act against your wishes” (48e). While Crito’s objections may be imperfect, Socrates still attempts to explain to him the most just course of action through aporetic dialogue. Plato’s mentor believes in dialogue — a notion crucial for democracy.

Additionally, in discussing the majority, Socrates argues that “[if only] the majority could inflict the great-

est evils, for they would then be capable of the greatest good … but now they cannot do either … they inflict things haphazardly” (44d). The idea that the majority “inflicts[s] things haphazardly” necessarily implies that their current discursive process lacks reason or logos behind it. As a result, for most citizens to have a sense of both “the greatest evils” and “the greatest good” and consequently imbue their deliberations with true justice, they must engage in the question-and-answer process that Socrates demonstrates so well to his friend. This is not an exclusionary path available to the few, however, but one that is accessible to anyone who is willing to learn.

The use of the word “now” introduces new concerns. If true, then was there a time in which Socrates believed that his emphasis on rational dialogue was widely held by the majority during his lifetime? This analysis must then look to the beginnings of his political engagement with the polis, during the Peloponnesian War. Contemporaneously, Pericles, in his Funeral Oration, argues that “we Athenians…take our decisions on policy or submit them to proper discussions…the worst thing is to rush into action before the consequences have been properly debated” (Villa 7). While her citizens may be more reckless than their peers in Sparta or Thebes, Athens countervails her rash tendencies through reasoned discussion and a “slowing-down” of the decision-making process. Pericles believes that a commitment to reasoned dialogue and restraint forms the foundation of Athenian democracy.

The majority seems to have forgotten this crucial lesson over the course of Athens’ ruinous war with her other Greek city-states. Cleon, Pericles’s successor, attacks this commitment to discussion as a ploy used by elite Athenians to deprive others of their rightful voice by halting action altogether (Villa 7, 12). The imposition of the Thirty after Spartan occupation undoubtedly did little to empower the voice of reason in Athenian policymaking. However, Greg Anderson notes that while supporters of radical democracy were exiled under the Thirty, they were considered to embody the Demos, even though separated from the city and people they governed (Anderson 15). Thus, we must consider the Demos to include, at some level, the values and indeed moral character of Pericles’ idealized Athens including a commitment to both her laws and democratic dialogue.

Consequently, Socrates’ simultaneous defense of the Laws within the Crito and disobedience of the Council in the

“Pericles believes that a commitment to reasoned dialogue and restraint forms the foundation of Athenian democracy.”

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Apology should be viewed through the lens of what he interprets to be the role of the Demos. Within the Athenian government, the dominant view held that “like a traditional Greek council of elders, its function was essentially to listen and decide between alternatives presented by others…[the] system was consciously designed to work through their personal motivations to produce impartial … decisions” (Anderson 16). In other words, the people — or the majority,

“Though the vicissitudes of Athens’ existence over his life surely challenged his faith in that democratic project...Socrates never truly lost faith in what the city’s project promised.” as Socrates understood it, — was socially distinct from the individuals themselves who made up the city’s population.

The Demos was supposed to represent the ideal of Athens as a wise, just decision-making body that would “listen and decide” between different courses of action and “produce impartial decisions” after careful deliberation. Thus, the latter portion of the Crito must be considered a defense, even though hostile to Socrates, of “deliberating and protecting such laws”, which has become absent following the resumption of democracy. Because aporetic dialogue necessarily involves both communication and listening in pursuit of an equitable solution, we must interpret the goal of the Socratic process as a fundamental reconnection with the will of the Demos.

This insight helps explain the rules by which Socrates determines whether or not to obey the government of the state. Although it may seem capricious and frankly anti-democratic to distance the will of the Demos from the people it purported to represent, aporetic dialogue placed a limit on what could reasonably be justified through the will of the people. In the Apology, the Athenians under Antiochis are presented as lawbreakers, while Socrates is shown as an upholder of justice: “you wanted to try …the ten generals… this was illegal, as you all recognized later…the orators were ready to prosecute me…but I thought I should run any risk on the side of law and justice” (32b). The indication that the citizens in question “realized later” only furthers the notion that Athenian justice had lost the virtue of reasoned dialogue, and now rushed into action without thought. Additionally, the assignment of blame to the orators in particular shows

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that Socrates places blame on sophistic training methods that have stripped public discourse of nuance and mediation.

He refuses, however, to accept the unlawful orders of the oligarchy, arguing that it would render him an impious citizen (32d). Finally, as mentioned in the Crito, the Laws define the role of an Athenian citizen as “one [who] must … persuade [one’s city] as to the nature of justice” (51c), which hints that Socrates is required to either accept punishment or convince the courts and government of his truth.

The Laws do not deny him the right to avoid impious action; they require only that Socrates forswear the right to avoid punishment for denying their power. Thus, as the personification of the Laws represents an actualized form of the Demos (Anderson 13), the Crito still maintains the right of the citizen to differentiate himself morally from the judgement of the Demos. However, it requires the citizen to forswear avoiding the logical discussion that follows in the law courts. As Klonoski writes, the literary structure of the latter part of the Crito mirrors a legal procedure in Athens known as graphē paranomion, or an ‘indictment against illegal procedures’ (Klonoski 17). As a result, it “portrays Socrates as an advocate…for the Athenian procedure for deliberating and protecting such laws’” (Klonoski 17). The usage of “obey” and “persuade” recalls the phrasing of Socrates’ quotation above that “I think it important to persuade you before I act, and not to act against your wishes” (48e). Just as Socrates considers it his duty to convince Crito fully before acting, Plato believes that the actions of any citizen must be preceded by either persuasion or acceptance regarding the will of the Demos.

Eric Gerlach

Upon reaching the age of eighteen, all Athenian men were required to repeat the Ephebic oath before enrolling in the Ephebic Academy, which trained them to defend the city. Socrates himself must have also made the vow, which pledged the new citizen to respecting the gods, defending the city’s democracy, and leaving the city-state a better place for future generations. Though the vicissitudes of Athens’ existence over his life surely challenged his faith in that democratic project, from the imposition of the Spartan Thirty to his own execution, Socrates never truly lost faith in what the city’s project promised. Indeed, he fulfilled the precepts of his oath like no other citizen, hoping to stave off Athens’ decline by reinvigorating its egalitarian and democratic spirit.

Socratic democracy, then, is an exercise in the purest form of democratic government because it not only acknowledges, but also embraces, the fundamental tension between reason and public discourse.

References: Anderson, Greg. “THE PERSONALITY OF THE GREEK STATE.”

The Journal of Hellenic Studies 129 (2009):1-22. Print.

Klonoski, Richard J. “Plato’s Invisible Hero Of Democracy: Socrates In

The Republic And Crito.” Journal Of Academic Emergency

Medicine Case Reports / Akademik Acil Tip Olgu Sunumlari Dergisi (Acil Tip Uzmanlari Dernegi)5.10 (2014): 7-20. Ac

ademic Search Complete. Web. 9 Feb. 2016.

Villa, Dana. Socratic Citizenship. Princeton: Princeton UP, 2001. Print.

Naman Gupta is a sophomore from Atlanta, Georgia. He entered the business school this semester, where he is planning to concentrate in finance. Additionally, he is pursuing an Applied Math and Stats major in the College, along with a Classics major. His research interests include Greek political philosophy, especially that of Plato and Aristotle, as well as classical military history. Naman is also involved in the Goizueta Investment Management Group, Emory Consult Your Community, Refugee Revive, and the Barkley Forum debate team. In the future, he hopes to receive the opportunity to go on an archaeological dig to a location in Greece.

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Fiction’s Power to Cure

Jessie Jiang

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The modern medical world has been challenged by patient dissatisfaction with detached doctor-patient relationships. The lack of personal connection between many doctors and their patients hinders productive diagnoses and treatments. To address this issue, the field of narrative medicine has emerged to foster stronger doctor-patient relationships. Narrative medicine, which will be limited to fictional patient stories in this paper, allows doctors to gain patient perspectives on diseases.

With this insight, doctors are pushed beyond their scientific objectivity to understand the symptoms exhibited in their patients and formulate more effective treatments (Kalitzkus). Since narrative medicine reveals the many unique, concrete problems that patients face, it may also provide doctors with innovative ideas for clinical treatments. Physicians may gain useful treatments to the physical and psychological ailments they are striving to cure by studying fictional narratives. Examining the benefits of narrative medicine and the potential for deriving general knowledge from fiction will provide a greater understanding for narrative medicine’s potential to provide real life clinical treatments.

Today, narrative-based medicine (NBM) is an indispensable component of quality healthcare. However, patient narratives were not always this valued. With the advent of modern medicine, the “classical objective biomedical scientific report” was preferred over patient narratives (Kalitzkus). This objective approach is known as “evidence-based medicine (EBM),” but healthcare professionals have come to recognize narrative-based medicine as a tool that “‘...provides meaning, context, perspective for the patient’s predicament...’” (Kalitzkus). EBM attempts to treat a patient based on the generalized knowledge of an illness and its accompanying prescription. In contrast, NBM analyzes the context of a specific medical case and provides a patient-centered approach in developing a treatment. It is often necessary for physicians to understand the suffering that their patients are going through. In John Davidson’s article on clinical empathy and narrative competence, a physician’s ability to empathize with his or her patient is of utmost importance. The article suggests “the ‘curative potential’ in the doctor-patient relationship is dependent on the physician’s ‘empathic observation, empathic listening, and introspective self-awareness’” (Davidson).

Rather than going through the motions of exam-

ining and diagnosing patients, physicians should actively listen to their patients’ stories and extract as much as they can about their personal situations. Narrative competence, a skill that supports the application of narrative medicine, is defined as the “capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness” (Charon). Research has shown that reading literary fiction improves narrative competence and therefore, peoples’ ability to “‘fill in gaps’ in the storylines” (Davidson). The “psychological processes” implemented when analyzing literary fiction, are “‘needed to gain access’ to ‘complicated individuals whose inner lives are rarely easily discerned’” (Davidson). These “complicated individuals” are the patients that doctors have the most difficulty treating, especially those with psychological disorders.

Since medicine has been a common theme in literature since its inception, there is a lot of narrative medicine available to physicians who want to gain access to their patients’ minds. Dr. Arnold Weinstein at Brown University explains why fictional literature has such a comprehensive collection of patient narratives. Weinstein claims “literature can be used to diagnose, explore, and treat diseases rather than traditional biology.” Whenever patients and doctors appear in literature, readers are able to see medicine and the role of the physician from a narrative point of view rather than a scientific view. This is significant because narrative medicine relies largely on the narrative point of view to help

“...literature reveals the “human experience of disease,” which is far more valuable to understand than the scientific concepts of the disease.”

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doctors perceive their patients’ struggles. Dr. Weinstein asserts that literature reveals the “human experience of disease,” which is far more valuable to understand than the scientific concepts of the disease. Reading the narratives of sick individuals often reveals the social and cultural ties of

disease as well. Science does not cover a disease’s emotional significance, which is a crucial element of the patient experience.

Some doctors still focus solely on translating symptoms into their medical meaning when communicating with their patients. Hemingway’s short story, “Indian Camp,” is a work of literature that provides an example of a poor doctor-patient relationship. At the same time, it reveals the mental agony experienced by the patient. An injured native man is bedridden in the same room in which his wife is having a difficult labor. He slits his own throat because he cannot bear to hear his wife in pain. This tragedy could have been prevented if the physician were more cognizant of the husband’s fragile emotional state. The physician’s focus on delivering the child and saving the wife is an example of the objective, science driven role of the doctor. On the other hand, his ignorance of the husband’s suffering represents the impersonal attitude he has towards his patients.

Research has shown that “medical mistakes result mainly from...a failure of empathic connection” (Davidson). Therefore the absence of emotional intelligence in physicians may

“Science does not cover a disease’s emotional significance, which is a crucial element of the patient experience.” be more detrimental towards patient care than inadequate medical knowledge or technology. While “Indian Camp” does not provide a narrative from the patient’s point of view, it effectively portrays the repercussions of having a weak doctor-patient relationship. It shows that doctors are not limited to narrative medicine when searching for fictional literature that may provide ideas on how to improve communication with patients.

There is significant evidence to suggest that information gained from reading fiction can be incorporated into one’s general knowledge. With this evidence, it is then possible to suggest that doctors may actually gain inspiration for treatments from their fictional readings. Studies have shown that people “integrate information from fictional sources with the rest of their world knowledge” (Marsh).

Since there are still limitations to the reliability of fiction, readers of fiction “avoid relying on low credibility sources” (Marsh). Thus, doctors can trust that their inclinations to read critically will allow them to gauge the reliability of

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information presented in fiction and recognize the applicability of fictional medical treatments. Scholars in Western societies may find the concept of extracting fact from fiction skeptical. However, they should learn to explore fiction’s potential contribution to academia. This concern is voiced in Neilsen’s article found in the Alberta Journal of Educational Research:

“...the issue...is about whether we will allow fiction

inside the door of this exclusive academic club...

part of the fear that grips the academy in these

circumstances has much to do with the impulse to

separate ourselves from the ordinary, the quotidian,

the everyday world where fiction informs, inspires,

connects, incites despair, and offers hope.” (Neilsen 211)

However, fiction’s ability to portray the quotidian is what makes it valuable to doctors. It provides realistic contexts for the illnesses that patients experience and even an abundance of realistic medical cases that doctors may be seeking to solve. Fiction is “serious business, and it can handle deeply personal terrain, tragedy, and despair,” which are elements that non-fictional medical texts cannot portray (Neilsen 212). This explains why fictional narrative medicine is so useful in improving doctors’ empathy for their patients. Doctors are able to perceive the pain their patients go through. The Western world could benefit by learning from other cultures, such as traditional Chinese culture, which often incorporates fiction into their factual understanding of the world.

“The lingering belief that knowledge is and must be

proof, proposition, muscle for prediction and con-

trol is bound inextricably with Western belief in the

individual as a separate, autonomous being...and

it is bound inextricably with our fear of the un

known.” (Neilsen 208) On the contrary, knowledge is not an independent entity and can be found beyond the realms of traditional proof.

“Fiction is knowledge. Poetry is knowledge. The arts are ways of knowing” because they provide a connection to the

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quotidian (Neilsen 208). Chinese culture relies heavily on integrating fact into art as a way of dispelling knowledge to laymen. People’s use of novel medicine, or “medicine found in novels,” during early modern China serves as a perfect example of how doctors in Western society could gain knowledge from fiction (Schonebaum 7).

During the late Ming and Qing dynasties, Chinese physicians would refer to fictional novels to find medical prescriptions for their patients. As an example, Andrew Schonebaum, the author of Novel Medicine, talks about “Ms. Zhou,” a fictional Chinese healer and the aunt of a medical expert. When called to treat a man with severe burns, Ms. Zhou consults “the novel Flowers in the Mirror by Li Ruzhen because she knew that it ‘used a great deal of well-documented and extensive evidence’ and because the ‘medical prescriptions work very well’” (Schonebaum 3). The prescription proves to be highly curative, and Ms. Zhou’s nephew, the medical expert, then incorporates this prescription into his knowledge and medical texts, thus starting the dissemination of a fictional treatment into the real world. Novels and medicine were highly integrated in early modern China because fictional plots “helped to sell, literally and figuratively, the useful knowledge included in these novels”

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(Schonebaum 4). Oftentimes, physicians sought help from novels more than strict medical texts such as the Systematic Materia Medica, which was familiar to all practitioners of elite medicine. Additionally during this time, well-educated people took interest in creating vernacular literature in China, a genre that provided “encyclopedic texts as much as it portrayed quotidian life, [and] entertained the reader with complex plots” (Shonebaum 5). It made medical content more accessible to laymen and amateur practitioners by using non-elite forms of writing. The popularity of vernacular literature in early modern China portrays fiction as a powerful medium capable of captivating all kinds of readers, from laymen to professionals. Vernacular literature also

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showed that fiction has the ability to help doctors discern the usefulness of the traditional medical practices implemented in stories and the real world.

“Fiction represented these actual practices, but also

critiqued, recommended, or explained them. In

doing so, fiction reveals its intrinsic interconnected

ness with the debates and concerns of its time. But

it is also an agent of its time, a vector of transmi-

ssion that entertains and affects its readers, condi

tions and instructs them. By capturing these robust

practices, fiction is one of the very few kinds of

sources that aid the historian of daily life.”

(Shonebaum 14) In the same way, fiction and narrative medicine in the 21st century may help doctors in the West understand the most appropriate fictional treatments they can administer to their patients. In addition, fiction can reveal the cultural implications on illness. In order to fully understand the effects of disease on a patient, doctors “cannot ignore the cultural beliefs about a disease” (Schonebaum 16). The way in which a disease or disorder is viewed by society largely affects the way patients cope with that disease. If doctors learn to understand how culture makes patients feel about their illness, they will be able to empathize with patients more and boost the doctor-patient relationship.

Doctors may benefit not only from the knowledge provided in the content of fiction, but also simply from the process of analyzing fiction. People in early modern China learned to analyze fiction and produce fiction commentary, which evaluates “the authenticity and meaning of fictional representation” (Schonebaum 23). “Commentators legitimized writing and reading novels” by connecting “the work at hand to those of the past” and correcting what was written (Schonebaum 23). This level of analysis was then applied across other genres such as medical texts:

“Readers treated medical texts in much the same

way they treated novels...They added commen tary, explained intertexts, and compiled, quoted,

and even followed up medical case histories and

materia medica with sequels.... now [Literati] were

subjecting fiction and medicine to the same kind of

scrutiny.” (Schonebaum 23) If modern doctors gain the skill to scrutinize the validity of fictional literature, they would be able to examine medical texts with more acumen. Furthermore, this level of scrutiny helps legitimize doctors’ incorporation of fictional ideas into real medical practices. Although Schonebaum’s Novel Medicine does not directly address narrative medicine, but rather the genre of fiction as a whole, the techniques for extracting knowledge from fiction can be applied to narrative medicine.

Narrative medicine effectively helps doctors under-

stand patients better because it is able to reveal the relationship between culture and disease. Culture encompasses the context of a disease: how the world defines a disease and how patients feel as a result of that definition. Bennet Kravitz’s book, Representations of Illness in Literature and Film, presents a number of fictional novels narrated by characters with serious disorders. The personal narratives found in these novels provide valuable insight into the minds of

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those suffering from illnesses. Kravitz asserts that “the diseases humankind experiences vary with the changes in culture,” and that “we cannot fully understand certain diseases unless we approach them holistically and allow for a cultural...explanation” (7). Therefore, doctors can analyze not only the personal thoughts of fictional characters and their physical symptoms, but also cultural elements to come up with creative treatments beyond those that only address the biomedical properties of a disease.

The first narrative that Kravitz presents is found in Jonathan Lethem’s novel, Motherless Brooklyn. In the novel, the narrator, Lionel Essrog, is a man suffering from Tourette’s syndrome, “a neurological disorder” causing “childhood-onset tics,” or “involuntary...movements or sounds,” “accompanied by uncontrollable noises and utterances” (Kravitz 9). Lionel suggests to the reader that there are “cultural connotations and origins” to his malady (Kravitz 11). First, he suggests that the setting of his entire life, New York, has led to the development of his Tourette’s because it is such a busy and clamorous city. Second, Lionel describes the experience of what it is like to have others label him as crazy. Lionel’s erratic behavior due to Tourette’s, causes people to brand him as a freak.

The more he hears himself being called a freak, the more he

behaves like one; Lionel “becomes a self-fulfilling prophecy” (Kravitz 13). Since “being crazy is a cultural determination,” readers can see that culture has an effect on Lionel’s health.

In Motherless Brooklyn, Lionel is a drummer, and he cannot envision living without his disorder because he believes that his tics from Tourette’s are what enable him to master the quick movements of drumming. Therefore, Lionel identifies “his very existence with the disease” (Kravitz 11). “Disease and art become intertwined” in Lionel’s life, allowing him to look past his illness and use it constructively to thrive in the world (Kravitz 14). From reading Lionel’s experience of Tourette’s, doctors should realize that treatment options for Tourette’s and other disorders may involve helping a patient find a passion they could focus on to transcend the cultural stigma and pain associated with their disease.

Tourette’s is one of the many disorders neglected by modern medicine because “conventional frameworks of modern medicine” cannot explain it (Kravtiz 10). Therefore, doctors need to become more competent at diagnosing and treating diseases like Tourette’s. They need to be aware of the cultural context of a disease and understand that oftentimes, treatments are not limited to pharmaceutical drugs.

Doctors should also change their approach when communicating with their patients about the disease. When a doctor tells his patients that they have “caused their disease,” they are also “made to feel that they have deserved it” (Kravitz 8).

However, what doctors learn from Lionel’s life is that they should encourage their patients to “engage their disease with a positive mindset, living life to the fullest” because those are the people who are “more likely to overcome their disease” (Kravitz 8).

Another valuable narrative presented by Kravitz is by a teenager with Asperger’s syndrome in Mark Haddon’s novel, The Curious Incident of the Dog in the Night-Time.

Haddon creates the character Christopher Boone and makes him the narrator to elucidate what it is like to have Asperger’s.

Asperger’s, like autism, causes people to have heightened sensory perception, which is overwhelming and causes anxiety.

Christopher intrinsically examines every bit of information he comes across, a process that can be exhausting and frustrating.

Asperger’s is different from autism however, in that it causes

“Culture encompasses the context of a disease: how the world defines a disease and how patients feel as a result of that definition.”

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“no significant delays in cognition or linguistic development;” it is primarily concerned with a “lack in social maturation” (Kravitz 44). “Christopher is a realistic portrayal of someone who suffers from Asperger’s syndrome” because he exhibits most of these symptoms (Kravitz 44). Christopher

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tells the reader that he cannot understand any jokes because he is unable to process “multiple meanings of language” (Kravitz 44). This seemingly insignificant piece of information is actually quite valuable in telling the reader why people who have Asperger’s in real life have difficulty communicating. Doctors can learn from “Christopher’s first person perspective...about how his syndrome affects his view of the world,” and use this insight to deal with their own patients (Kravitz 45). In the novel, Christopher focuses much of his narrative on his “confusion and uncertainty in the linguistic world” (Kravitz 50). What doctors can take away from this is the necessity to pay special attention to the way they are communicating with people with Asperger’s.

Treatments geared towards improving linguistic understanding could improve the social skills of patients who suffer from Asperger’s and help them live more normal lives.

Christopher also provides a list of his problematic behaviors such as “not liking being touched” and “screaming when [he is] angry or confused” (Kravitz 50). These behaviors are useful examples of behavioral problems that real life Asperger’s patients may display. Christopher is another character that is able to transcend the cultural stigma on his disease and “employ successfully the very thing that makes [him] odd” to thrive in the world (Kravitz 55). Christopher has both obsessive-compulsive disorder and a knack for numbers, so “to overcome the obstacles he faces he employs his counting strategy, which calms him because it is a compulsive as well as mathematical activity” (Kravitz 54).

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Finally, David Lodge’s novel, Therapy, provides another valuable patient narrative, this time on a man named Tubby Lawrence Passmore with chronic pain in his knee.

Chronic pain has become an “epidemic” in “the postmodern era” (Kravitz 84). “25% of the population in the west live with chronic pain,” so Tubby’s narrative is relevant to many medical cases today (Kravitz 86). “Conventional painkillers” are no longer effective because much of the pain from chronic illnesses can be attributed to depression (Kravitz 84). Novelist and cancer survivor Reynolds Price was able to “recognize the role the mind plays in experiencing pain,” and was able to control it (Kravitz 84). Similarly, Tubby is able to overcome his physical pain by talking to an existential philosopher to strengthen his control over his mind. At first, Tubby goes on a journey to find a medical solution for his pain. He visits a general practitioner, physical therapist, and surgeon named Mr. Nizar. Even after surgery, Tubby still experiences pain in his knee.

“Mr. Nizar has committed the typical postmodern

faux pas of the medical profession. He has treated

the disease, but cannot understand why the sub jective illness, the pain in Tubby’s knee, has re

mained...What Nizar has done is to promote a

clash between his patient’s narrative and his own

physician’s narrative. Patients discuss sickness in

terms of life narratives and the lived body while

many physicians deal with disease ahistorically.”

(Kravitz 86) What Mr. Nizar has done is exactly what some modern doctors are doing as a result of poor doctor-patient relationships and failure to analyze the context of the disease that patients are suffering from. In modern medicine, chronic pain has “become the diagnosis and not the symptom” (Kravitz 87). More often, pain is being recognized as a sign of depression, which suggests that “pain has assumed a cultural dimension and has become a new subject worthy of medical attention” (Kravitz 87). If studied correctly, fiction has the power to improve healthcare in tremendous ways.

Its ability to hold the interest of readers through entertaining plots makes it a good medium for communicating practical knowledge such as medical treatments. Fiction provides context for a disease, something doctors often overlook because they are trained to pinpoint the objective scientific problem in diseases rather than the subjective personal effect they have on patients. In order to fully understand the origin and catalysts of disease, doctors need to consider the impact culture has on disease. Doctors will then be able to create innovative treatments that work effectively on patients beyond the biomedical domain of diseases. Doctors who gain insight into the lives of their patients through narrative medicine will then be able to work at an optimal level of diagnosis and treatment.

References:

Charon, Rita. “What to Do with Stories: The Sciences of Narrative

Medicine.” Canadian Family Physician 53.8 (2007): 1265–

1267. Print.

Davidson, John H. “Clinical Empathy and Narrative Competence:

The Relevance of Reading Talmudic Legends as Literary

Fiction.” Rambam Maimonides Medical Journal 6.2 (2015).

Academic Search Complete. Web. 6 Oct. 2016.

Kravitz, Bennet. Representations of Illness in Literature and Film.

Newcastle Upon Tyne: Cambridge Scholars Publishing,

2010. Print.

Marsh, Elizabeth J., Michelle L. Meade, and Henry L. Roediger III.

“Learning Facts From Fiction.” Journal of Memory and

Language 49 (2003): 519-36. Web. 6 Oct. 2016.

Neilsen, Lorri. “Learning from the Liminal: Fiction as Knowledge.”

The Alberta Journal of Educational Research 48.3 (2001):

206-14. Web. 6 Oct. 2016.

Schonebaum, Andrew. Novel Medicine: Healing, Literature, and

Popular Knowledge in Early Modern China. Seattle: Univer

sity of Washington Press, 2016. Print.

Weinstein, Arnold. “Why Literature and Medicine.” Brown Alumni

Association. Providence. 21 Aug. 2010. Web. 5 Oct. 2016.

Jessie Jiang is a freshman considering a double major in Biology and Music Performance. Her research interests include patient psychology and the doctor-patient relationship, medical ethics, neurobiology, and English literature. She is currently working as a research assistant in Dr. Randy Hall’s neurobiology lab and intends to conduct independent research during her undergraduate years. She spends her time outside of class volunteering at Emory Clinic and playing the piano.

Jessie is on the service committee of Phi Delta Epsilon International Medical Fraternity, and she is also freshman representative of Global Medical Brigades on campus.

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STUDENT SPOTLIGHT: from which they are extracted, and can serve as “tumor ID cards.

After extraction, retrieved tumor antigens are packaged into a TMV vaccine and can be injected into an organism for treatment. The TMV vaccine then delivers its tumor antigens to specialized immune system cells that are responsible for fighting off pathogens like bacteria or viruses. Upon exposure to the TMV vaccine, however, these specialized cells can be trained to recognize and attack cancer cells-- a task the immune system typically struggles to accomplish.

Ultimately, exposing the immune system to tumor antigens via vaccination allows the immune system to acquire a refined ability to “see,� detect, and eliminate tumors growing within the body.

Menon said immunotherapies are an exciting development within the cancer research for a number of reasons.

Interviewed and written by Natalia Brody

The American Cancer Society predicts an estimated 1,688,780 people will be diagnosed with cancer this year. Emory 4+1 student Ashwathi Menon and her Principal Investigator, Dr. Periasamy Selvaraj, hope to lower this statistic through their work on a form of cancer treatment known as immunotherapy.

Immunotherapy is a form of treatment that trains and boosts the immune system to better fight diseases like cancer.

While some research has been done on immunotherapy, Menon said her lab is creating a special type of cancer immunotherapy that comes in the form of a Tumor Membrane Vesicle (TMV) vaccine and is made of tumor cell membranes. To create the TMV vaccine, pieces of a cancerous tumor are removed and tumor antigens are extracted from the sample. Tumor

antigens are biological molecules unique to the tumor

AJC1

Ashwathi Menon “...research is empowering.

Knowing that the work I do in lab and the knowledge I’ve gained through research can save a life, is serving humanity in a very special way.”

Firstly, immunotherapies provide novel approaches to fighting typically difficult-to-treat cancers like advanced stage melanoma (skin cancer) and lung cancer.

Immunotherapies also produce fewer side effects than traditional cancer therapies because they are a more cell specific drug. That is, immunotherapy allows for selective eradication of cancer cells while allowing healthy cells to persist. In killing more cancerous cells and fewer healthy cells, immunotherapy can lead to less harmful side effects than more standard treatments like chemotherapy, which kill many healthy cells in addition to cancer cells and cause harsher side effects like hair loss and decreased appetite. Menon said these fewer expected side effects could result in healthier patients and a better quality of life during cancer treatment.

Cancer is a disease genetically unique to every individual. Because of this, Menon said it is a challenge to design a vaccine that can work for everyone.

Ultimately, Menon classifies immunotherapies as a “hit-or-miss drug.” Although only a fraction of cancer patients respond to immunotherapies, patients who respond show promising results. Menon and her lab hope their work will progress into human clinical trials and, eventually, reach the pharmaceutical market.

Menon anticipates their immunotherapy treatment could act as either a standalone treatment or could be paired with other cancer drugs like chemotherapy.

In the end, however, Menon attributes her interest in cancer research to more than its compelling scientific nature-- “research is empowering. Knowing that the work I do in lab and the knowledge I’ve gained through research can save a life, is serving humanity in a very special way.”

As cancer incidents per year continue to rise, new treatment development like that of Menon and Dr. Selvaraj is imperative to both controlling and continuing to fight wide-spread diseases like cancer.

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Véronique Desaulniers

Interview with Dr. Gregg M. Orloff:

Almost 40% of men and women will be diagnosed with cancer in their lifetime. Given this statistic, it is a virtual certainty that everyone has or will have a connection to cancer; but thanks to Dr. Gregg Orloff, most people nowadays have an amazing resource on hand for all their questions: CancerQuest, a non-profit educational website designed to give patients the tools to aid and understand this disease.

“You don’t always have choices with cancer as to what you do, but can at least feel good about that you’re doing the right thing.”

Dr. Gregg M. Orloff Director of CancerQuest

Interviewed by Natalia Brody Written by Merry Chen

CancerQuest grew out of an idea that Dr. Gregg Orloff had in 1998, after his wife was diagnosed with breast cancer. “I went to my wife’s support group and the people didn’t know anything...how the drugs work, the treatments work,” he says. As a scientist, Orloff was in a position to understand and answer their questions, but as he did, he realized how uninformed other cancer patients were about the process, and how few resources were available to them. All the resources available at the time were either too technical for the average person, or too simplistic and with a “we’ll take care of you” mentality.

Thus, with the initial support of Emory College, CancerQuest began as a primarily an educational website that provided a resource for cancer patients to not only understand all the consequences and implications of different treatment options, but also to understand the biology behind cancer. “You can’t understand how to repair an automobile unless you know how they’re supposed to work…telling someone their muffler is broken is useless unless they know what a muffler does and how it works.” Even today, that is still

one of CancerQuest’s main goals. A simple foray into time to start spreading awareness about sun exposure, the website leads to numerous links, diagrams, and the dangers of smoking, and sexually transmitted disanimations all designed to help people understand the eases, which are the major risk factors for skin canbiological mechanisms of cancer. “My goal is to pro- cer, lung cancer, and cervical cancer respectively. In vide information that will empower cancer patients addition to prevention, CancerQuest also focuses on and their families and help them make informed med- the issues of “survivorship”—that is, the potential reical decisions as well as be comfortable with decisions percussions after treatment that often go overlooked. that they make,” says Orloff. “You don’t always have There are issues with reproductive health, sexuality choices with cancer as to what you do, but you can at and body image, anxiety about relapse, and financial least feel good about that you’re doing the right thing.” ramifications. His website also provides counseling

Since then, the website has expanded its reach on how to deal with psychosocial issues. “When your internationally—the website has been translated into chips are down, you find out who your friends are… multiple languages with ongoing partnerships be- people don’t support you the way you hoped they tween students and faculty at foreign universities in would,” he says, and these are just some of the things countries such as Mexico and China, to keep the site that are a part of a patient’s “cancer journey” that most updated. All of the work is done online, which helps people do not realize. coordination between the many people working on As to how this experience has changed Orloff this project. Citing funding as a main challenge to as a scientist: “[It] has burst, a little bit, the bubble the website, Orloff mentions that the website is main- that I live in;” like many other educated scientists, he tained mainly by student employees and volunteers. often used to surround himself with other similar inThe Spanish translation, for example, would have cost dividuals. Through the development of CancerQuest, almost $100,000; instead, it was done for free, thanks however, he realized that it is important to share his to the dedication and commitment of generous peo- biology knowledge. “It is incumbent upon us as the ple. Not only do the people involved with CancerQuest ‘experts’…to present it in a way that is palatable to the work with the website, they are also involved with average person; otherwise, we have failed.” His goal, outreach and fundraising. he says, is not to “dumb Orloff talks about the two things down”, but rather girls in Mexico who donatto elevate people. He real“Peace means that you made ed their hair to make wigs, izes that most people do and the woman who worked the best decision that you coud not have the same types with educating underserved of education that he was with the information that was African-American commufortunate enough to have, nities right here in Georgia. so his goal is to “try to get available.”

Orloff admits the the information and presinitial impetus was focused ent it in a way that we can on treatment; however, at least give as many peowhile education is still a main goal of the website, Or- ple as possible that confidence, that sense of peace”. loff says that there has also been a shift in focus to- And for him peace doesn’t always mean you have to wards prevention of the more preventable cancers, get better. “Peace means that you made the best desuch as skin cancer or lung cancer. Many risk factors cision that you could with the information that was are preventable, he says, and high school is the perfect available.”

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