VOLUME 11, ISSUE 1. AUTUMN 2024
FROM THE EDITORS-IN-CHIEF
Dear Readers,
Welcome to 2025! We hope you all have had a splendid holiday season and are ready to get your gears turning this Winter Quarter. These past few months, our team –– full of returning and new faces –– was hard at work on our newest issue. Now, we’re proud to finally present to you the Autumn ‘24 Edition of PULSE magazine! In this issue, our writers and editors tackle a wide breadth of topics in medical journalism. We first feature one of our very own UChicago Medicine faculty, Dr. Thomas Fisher. A few pieces chronicle the variety of roles doctors have played in shaping healthcare, ranging from accounts of a wartime physician who pioneered skin grafting in the early 20th century to “medical influencers” in our modern age. This issue also digs deep into social determinants of health, such as cultural relativity in healthcare and the importance of parenting on childrens’ behavioral development.
All that said, the sciences of medicine aren’t lost on us; PULSE wouldn’t be what it is without its penchant for scientific journalism. As many of us commence down the pre-medical journey at UChicago, we find a knack for reporting on novel treatments in pediatrics and psychiatry, as well as the neurological foundations of love.
Finally, we want to address the future of this magazine, as both of us are graduating in a few months. It is PULSE tradition for EICs to pass down the mantle when entering the new calendar year and begin the transition into a new board and era of the magazine. As such, this will be our last issue as Co-EICs. We first want to thank our board for supporting us in leading this initiative for over a year. Furthermore, we can’t thank enough all the writers, editors, and designers who have worked with us and carried out the bulk of journalistic work. Finally, we want to thank you, our reader, for enjoying the work that we put so much passion into, and encouraging us to keep improving this publication. Happy reading, and we wish every single one of you a strong start to the new year!
Sincerely,
Fareen Dhuka and Ayman Lone
Farewell.
Writers
Francisca Anazco
MacKenzie Brogan
Emnet Djibrila
Amiti Goel
Alexandra Hannett
Franziska Kungys
Mia Mahon
Chioma Okegbuson
Alexander von Kumberg
Sienna Yamini
Winni Zhao
Editors
Hunter Bershtein
Fareen Dhuka
Roxanna Fahid
Sophia Falk
Sophie Feng
Chantel Johnson
Michelle Mejia
Shannon Meng
Kim Mercado
Alexis Truta
Editorial EIC
Fareen Dhuka
Ayman Lone
Layout EIC
MacKenzie Brogan
Senior Editors
Sanaa Imami
Michelle Lu
Production
MacKenzie Brogan
Rina Iwata
Cover Design
Kim Mercado
Faculty Spotlight: Dr. Thomas Fisher, Jr., MD, MPH
Written by: MacKenzie Brogan
Edited by: Fareen Dhuka
Dr. Thomas Fisher is a board-certified emergency medicine physician and has served as an attending physician at the University of Chicago Medicine since 2011. His work with UChicago began as a medical student at the University of Chicago Pritzker School of Medicine from 1996 to 2001, where he also earned a Master of Health Care Policy and Management from the Harvard T.H. School of Public Health. He remained at UChicago Medicine for his emergency medicine residency from 2001 to 2004 where he was selected as Chief Resident.
Beyond clinical and administrative roles, Dr. Fisher has been actively involved in health policy. He previously worked as a White House Fellow under the Obama administration from 2010 to 2011, advising on national healthcare policy initiatives. In addition, his healthcare entrepreneurial work earned him recognition as one of Crain’s Chicago Business 40 Under 40 in 2013, Chicago United’s Business Leader of Color in 2015, and the Aspen Institute’s Health Innovator Fellow in 2017. Also an accomplished writer, Dr. Fisher authored “The Emergency: A Year of Healing and Heartbreak in a Chicago ER,” which explores the intersections of medicine, policy, and social justice during the COVID-19 pandemic.
Recently, members of the PULSE Board had the opportunity to listen
to Dr. Fisher’s “Systems vs Humans in Healthcare” as part of the MacLean Center for Clinical Medical Ethics
43rd Annual Interdisciplinary Lecture Series. Dr. Fisher’s lecture centered on a powerful exploration of the role of caregivers within the systemic challenges in healthcare and the broader social factors affecting health outcomes. He began by emphasizing the critical role caregivers like nurses, doctors, and pharmacists play in society, noting that larger societal decisions are often large determining factors of their patients’ stories. Listening to patients, he argued, provides crucial insights into the health systems and societal structures that shape their experiences.
To illustrate the deep-rooted challenges within emergency care, Dr. Fisher shared two patient stories which illustrated systemic failures: one of mental health issues and one of surgical subspecialty needs, highlighting the struggle to access scarce clinical resources hidden behind paywalls, if they exist at all. These stories underscored the broader issue of how healthcare systems can entrap both patients and caregivers, leading to moral injury and burnout among healthcare providers. While caregivers strive to deliver excellent care, they are often confronted with the distressing reality of systemic failures. On an average day, ER caregivers are managing too many patients to dedicate sufficient time to fighting the system for one patient. Their shift often ends before they can see the patient through their admission or
treatment, and it’s easy to transfer the responsibility to the next shift. These caregivers are often too tired or burnt out to fight the system every day, for each patient. These systems conspire to leave patients trapped, and they trap caregivers alongside their patients. Social determinant factors such as poverty and systemic inequities shape health outcomes beyond general healthcare access. Concentrated poverty and institutional injustices create a predictable cycle of disadvantage that perpetuates poor health outcomes. This cycle is deeply embedded in the history of segregation and discriminatory policies in Chicago, including redlining policies, NAFTA, and the War on Drugs which disproportionately affected and targeted minority communities. Dr. Fisher urged attendees to reflect on their roles in addressing these systemic issues. Drawing on Dr. Martin Luther King, Jr.’s call to disobey unjust laws in Letter from a Birmingham Jail, he advocated for caregivers and citizens to oppose the unjust healthcare systems that work against the humans within them. Specifically, Dr. Fisher encouraged individuals to engage in moral leadership that challenges rather than conforms to unjust systems, the creation of new systems that prioritize shared humanity over profit, and the use of existing quality improvement tools to address inequities in healthcare delivery. He then left listeners with a reading of Audre Lorde’s poem “A Litany for Survival,” emphasizing the importance of speaking out against injustices and the fear that accompanies silence.
Following the lecture, Dr. Fisher was kind enough to answer some questions for us.
Q: What made you decide to become a doctor and specialize in emergency medicine?
A: I chose emergency medicine after starting medical school. This was the only specialty that allowed for certain things that were important to me. Before the ACA, emergency medicine was the only place where everyone can be seen regardless of their ability to pay. I wanted to pursue medicine out of desire to serve the least among us without barriers.
Other specialties have boundaries: cardiologists only work with the heart, pediatricians only work with kids, and some specialties might have to treat patients based on their insurance or ability to pay. Emergency medicine also allows me to work with my hands and use problem solving. When someone comes to you as a pulmonologist, you already know that the problem is in the patient’s lungs as opposed to anxiety or something else. Emergency medicine allows for more unfiltered problem solving. The emergency department is also an interface between the hospital and the community. It can be a laboratory for understanding society. The ER reflects what’s going on in America.
I went into medicine for a lot of the same reasons: taking care of people, touching society, using science both to understand and to cure in real life with real people and pressing problems today. Medicine exists
on a spectrum from the molecule to society, and all of the places that exist in between are important and good and valid.
Q: What have you found most rewarding about being a doctor? What has been the most challenging?
A: What I’ve found most rewarding is the flexibility to work on healthcare from different perspectives, as a clinician, with the government, and in the nationwide health system. I’ve also had the opportunity to work in large systems and to work in and build small ones. All of this helps to understand the things at play at the patient bedside and with the continual growth of knowledge. Throughout my practice, medicine has evolved, and I’ve evolved within medicine. The biggest difficulty is patients being trapped in systems and being trapped in them as well. This gets no less frequent despite growing knowledge, skill, and experience. It’s something that everyone experiences, so there’s some comfort in commiseration, but there’s frustration there as well.
Q: What motivated you to pursue an MPH, and how has that impacted your perspective/approach to medicine?
A: In med school there are a lot of career choices. I chose to pursue community health more than research. I worked in a clinic in Woodlawn, and it broadened my perspective on how healthcare fits into society, from employment to the environment. When I was in medical school, classes skewed towards the molecule, organ system. Public health
fits this into a larger society. I got a glimpse of this from working in the clinic, and public health school really gave me the tools to see and to understand this.
Q: If you could give any advice to an aspiring doctor, what would it be?
A: I have three. First, find a professional peer group that you can rely on for help, support, and mutual accountability, and go beyond just other doctors to find it.
Second, medical education teaches you to avoid risk. Buck that impulse. Some risk is okay – sometimes you may have some weird opportunities, but you should pursue them and have faith in yourself.
Third, maintain balance while committing to excellence. Self care is important, but when you’re at work go hard. Be fully present at work, doing the best work that you can. Don’t let self care become an excuse to do lazy work. Experience life outside of work, and commit to building a three-dimensional life outside of work that you love and can love you back, because medicine won’t love you back.
Q: What was the most important or your favorite thing that you do/ have done outside of medicine?
A: I have a strong meditation game, and I can still run a seven-minute mile. Maintaining health is definitely important. But what’s most important is that I have a life full of love, full of family and friends who are like family. That’s what creates meaning in your life.
Mending the Wounds of War: Sir Harold
Gilies’ Facial Reconstruction Revolution
Written by: Alexander von Kumberg
Edited by: Fareen Dhuka and Michelle Lu
Although an undesirable truth, it is evidently the case that wars fuel scientific innovation. Medicine is certainly not immune to this phenomenon; indeed, it may very well be the field which has developed most in times of conflict. In such dire circumstances, we often see the rise of brilliant physicians – such as Sir Harold Delf Gillies – who selflessly promoted human dignity regardless of the patient’s uniform and who fostered medical innovation. Gillies was born 1882, in Dunedin, New Zealand, a city defined by its Victorian and Edwardian architecture and large Scottish patrimony. As a schoolboy, Gillies attended Wanganui Collegiate School on the North Island. His first encounter with medicine may have been a childhood accident, in which he stumbled while sliding down his home’s banisters and was left with a stiff elbow. Nonetheless, he was a prestigious athlete – receiving golf blue thrice (1903, 1904, and 1905) as well as a rowing blue in 1904 (blue being a recognition of sporting excellence). A scholar and student of science, he left ‘the Britain of the Pacific’ for Gonville and Caius College, Cambridge to study medicine. In 1910, Gillies continued his medical studies at St. Bartholomew’s Hospital – the primary teaching hospital of London - and began working as an
Ear Nose and Throat (ENT) doctor under the head of the newly created ENT Department, Douglas Harmer.
In August of 1914, Great Britain declared war on the German Empire following their refusal to remove troops from neutral Belgium. Aged 32, Gillies, in line with the trend amongst all young Britons, hurriedly joined the British Army, specifically the Royal Army Medical Corps. His first posting was in Boulogne, France and later Belgium where he worked with Franco-American dentist Auguste Charles Valadier. Valadier developed jaw repair systems, and it is clear that Gillies’ experience as an ENT, paired with his time with Valadier, prompted Gillies’
experiments with facial reconstruction and nascent skin grafts. Skin grafting is a transplantation surgery in which surgeons use healthy skin tissue to promote healing and treat extensive trauma, burns, and some cancers on the skin. Modern skin grafts were developed in the mid to late 19th century by Swiss surgeon Jacques-Louis Reverdin who introduced the “pinch graft,” also called the “Reverdin graft,” but the technique was not prevalent and remained in its early forms until the 20th century. A contemporary pioneer of the technique was the oral surgeon, Hippolyte Morestin, whom Gillies enthusias-
tically shadowed in the early war period. In one particularly inspiring instance, Morestin used jaw skin to cover the excision wound of a facial tumor. It was this experience which invigorated Gillies’ zeal to pioneer facial injury reconstruction.
The very nature of the conflict, namely raining shrapnel, machine gun fire, soldiers peering over parapets and trench warfare, meant that wounded with facial injuries were abundant. Shrapnel in particular resulted in jagged wounds and often carried soil with it when penetrating the body, promoting infection and increasing mortality. Surviving often meant lifelong social and functional disabilities. Gillies was reacting to this historical circumstance with his medical experience as an ENT. A noteworthy example of Gillies’ innovation is his treatment of Willie Vicarage – a sailor who was wounded at the pivotal Battle of Jutland in 1916. A fire had caused the development of a scar tissue mask which prevented him from closing his mouth or eyes. The trouble with Willie’s case was that
it demanded a larger than normal skin graft, and thus necessitated skin from Willie’s chest. The living skin tissue curled up at the edges under tension, which prompted Gillies and his team to sew it into a tube-like shape. This allowed for controlling the curling and decreasing the risk of infection. This tubed skin pedicle was then attached to the face, and cut open, allowing for peeling and extension of the skin over the wide site of injury. Willie’s surgery is an example of the ingenious and novel operations that Gillies created and promulgated.
In 1916, Gillies convinced Chief Surgeon William Arbuthnot-Lane to establish a facial injury ward at Aldershot, the Cambridge Military Hospital. While the ward was extremely successful, the war brought with it endless supplies of patients. New hospital wings around France and England had to be devoted to facial repairs. In 1917, he established the Queen’s Hospital at Frognal House, which became his base of operations. These developments were overseen by Gillies while he simultaneously developed many innovative plastic surgery techniques. Captain
Budd, an infantryman wounded by a shell blast, recounts Gillies’ treatment plan for a nose reconstruction; “It was Gillies’ intention to take a strip of skin from my forehead and after lifting it to twist it downwards over the site of my nose to be, and at the same time to get some cartilage from me elsewhere to from the bridge of my nose.” Between 1916 and 1925, Gillies performed over 11,000 surgeries on over 5,000 military personnel. For his wartime endeavors, he was knighted. His interwar life was defined by extensive lecturing, teaching, and the promotion of novel surgical techniques. With the outbreak of the Second World War, Gillies mobilized once again, organizing plastic surgery units in Britain and training other surgeons. He suffered from sudden cerebral thrombosis while performing surgery and died shortly afterwards in 1960.
Certainly, Gillies’ novel methods of posttraumatic reconstruction were only made possible by his wartime experiences. Indeed, for most of human history, surviving major war-related facial injuries was a rarity – if sustained and survived, one was found to be immensely fortunate with the concern for reconstruction virtually nonexistent. Yet, medical innovations developed during the Great War by surgeons like Gillies meant that the wounded could survive the unsurvivable, and better, present patients with a chance to resume living with a degree of normalcy.
Doctors in the Digital Age: The Rise of Medical Influencers
Written by: Alexandra Hannett
Edited by: Shannon Meng
In this day and age, countless professionals have taken to TikTok, Instagram, Youtube, and other social media platforms to advertise their companies, share their knowledge, and provide insight to what their daily lives are like. Doctors and healthcare professionals are no exception. Despite the demanding nature of their work, these professionals continue to embrace their role as trusted advisors, prepared to engage with concerned online followers after long hospital shifts. From educating the public on essential health topics, to connecting with a network of fellow professionals, more and more healthcare providers are using the internet to extend their impact. For some, online engagement has become a secondary career, producing content at a volume comparable to a full-time job alongside their clinical commitments. This article explores the benefits and potential pitfalls of broadcasting a career in medicine on the internet,
focusing on popular medical influencers like Doctor Mike and Dr. Miami as primary examples. The goal is to highlight the immense opportunities for healthcare professionals to educate, inspire, and connect with others through a digital presence while also addressing the professional, legal, and ethical challenges that come with it. Ultimately, this complex endeavor requires careful consideration of both the pros and cons, as navigating a digital platform in medicine is a path filled with rewarding possibilities and significant responsibilities.
Two practicing doctors serve as examples of medical influencers who have amassed significant followings, yet remain distinct in the tones and intentions of their content. Firstly, Dr. Mikhail Varshavski, D.O., commonly known as “Doctor Mike,” is a board certified family medicine physician who began creating medical content on YouTube in April 2017. Since then, he has accumulated over 12 million
subscribers on YouTube and expanded his platform to all forms of social media, including TikTok, Instagram, and X. Doctor Mike’s content heavily consists of reaction videos where, as a credible physician, he comments on medical drama television shows, trending medical topics, and healthcare current events. Additionally, he produces informative content on topics that are widely relatable to the younger generation through podcasts with other medical professionals and videos such as “Why We’ve Become the ANXIOUS Generation & How we can fix it” and “Worst Health Mistakes Young People Make.” Known for his objective stance, Doctor Mike protects the privacy of his patients by not discussing them, and focuses on educating viewers through thoughtful, sit-down videos. An interesting contrast to Doctor Mike’s content is that of Dr. Michael Salzhauer, MD, more commonly known as “Dr. Miami,” a plastic surgeon based in Bay Harbor Islands, FL. Dr. Miami first built his following by livestreaming plastic surgeries he was performing on Snapchat, providing viewers with an up-close and unfiltered look at his procedures. While he has been engaged with social media for some time, he has increased his following through his candid, relatable, and humorous approach to medical content creation. He offers a very transparent view into his lifestyle, even starring in a one-sea-
son reality show titled Dr. Miami, which featured many patients as they underwent consultations and surgeries. Today, his primary audience is on TikTok, where he posts short, often playful and satirical videos, participating in trends, lip-syncing to popular audio clips, and even poking fun at his patients rather than focusing on original educational content. His content is intentionally unserious, blending elements of humor and satire that make his account feel more like a comedy channel than a medical one. However, he frequently continues to post content of surgical work he has done on patients with their consent, perhaps to market his capabilities to potential clients interested in plastic surgery. Overall, Dr. Miami’s tone is lighthearted and occasionally facetious or juvenile, presenting a stark contrast to the more traditional and educational approach of Doctor Mike. Nonetheless, the ability to connect and relate to others online is an invaluable benefit for medical professionals, aspiring practitioners, and anyone interested in learning more about healthcare. One of the most significant advantages of engaging on social media as a healthcare professional is the chance to foster a vast, supportive, and global medical community. By sharing their experiences, doctors and other medical professionals help build a space where those in similar fields can feel understood and validated. For young professionals just starting out, this network provides access to seasoned experts who share genuine advice and insights developed over years of practice. Such connections bridge the knowledge gap between generations, offering mentorship and support that may be otherwise inaccessible in their
immediate environments. Additionally, hearing stories about the personal challenges of burnout, struggles with work-life balance, and mental health issues can foster a sense of solidarity. Many healthcare influencers share these stories openly, helping others in the profession feel less isolated in their struggles. For example, Doctor Mike’s videos often touch on challenges in medicine, such as dealing with anxiety, the pressures of medical school, or his own experience in navigating his career. Similarly, various medical vloggers detail their application processes, residency journeys, or the highs and lows of their daily lives in healthcare. This transparency provides not only guidance for those navigating similar paths,
but also a sense of camaraderie across the online healthcare community. Moreover, even for those not working in or aspiring to a career in medicine, following medical influencers offers an engaging way to learn about health topics and gain insight into the lives of healthcare professionals. At the very least, content from medical influencers provides entertainment and a unique perspective for viewers. While
it’s unlikely that Dr. Miami’s humorous and satirical approach inspires viewers to pursue a career in plastic surgery, his engaging persona attracts audiences who enjoy his personality and style. This blend of entertainment and education, common among medical influencers, helps make medical information more relatable and digestible. Social media, after all, can serve as a powerful educational tool, allowing the public to access simplified explanations of complex medical concepts that might otherwise feel overwhelming. Doctor Mike, for instance, frequently uses his platform to break down complicated health issues and offer practical advice, making important health information accessible to a wide audience. Influencers like Doctor Mike also play a crucial role in debunking health myths, delivering accurate information, and positively impacting public health behaviors. In a digital world where medical misinformation is prevalent, these credible voices build trust with viewers and provide a reliable source of factual health information.
However, there are significant concerns that arise when professional medical care intersects with something as public as social media. One of the primary issues is the potential for ethical and legal breaches, especially regarding patient privacy laws like HIPAA, a federal law that protects patients’ private health information from being shared without their consent. When doctors share details about their work online– even with the best intentions–there is a risk revealing sensitive information or inadvertently violating privacy regulations, which could have serious legal consequences. For instance, Dr. Miami grew his platform by live-stream-
ing plastic surgeries on Snapchat, offering an unfiltered view of procedures. Although these streams were shared with patient consent, they illustrate how easily privacy boundaries can blur on social media. In other cases, being on social media may result in a doctor inadvertently revealing identifiable patient information through photos, descriptions, or even casual anecdotes, risking a breach of confidentiality. Beyond legal ramifications, such as fines or lawsuits, violations of privacy policies can severely damage a healthcare provider’s professional reputation. Doctors on social media often face the difficult task of balancing transparency about their work with the obligation to protect patient confidentiality. Beyond privacy, the logistics and ethics of providing medical advice over social media are complicated. It is difficult to tread the fine line between general education and personalized medical advice, which raises questions about doctor-patient boundaries. While Dr. Mike uses his platform to debunk health myths and provide practical tips, he must carefully avoid offering personalized
advice to viewers he has never met. An online presence raises many questions for medical influencers: Is it ethical for a doctor to provide guidance to an unknown online audience? What are the potential consequences if such advice is misinterpreted or misapplied? Unfortunately, these questions lack clear answers, as no formal governing body currently oversees the conduct of healthcare professionals who share content about their work online. This absence of regulatory guidance leaves healthcare influencers largely responsible for determining appropriate boundaries, adding another layer of complexity to the ethical standards of medical content on social media.
Unfortunately, as influencers, medical influencers may feel pressure to create content that maximizes likes and engagement, which could lead to prioritizing entertainment over education. In striving for popularity, there is a risk of oversimplifying complex issues or posting content that appeals to viewers but lacks educational substance, like in the case of Dr. Miami, when he often participates in TikTok trends that amass millions of likes. Moreover, putting one’s opinions or personal content
on such a public platform can be a double-edged sword. While it may boost a doctor’s visibility or even attract more patients, it also opens the door to scrutiny that can harm their reputation or even discredit their professionalism.
In the end, the presence of healthcare professionals on social media offers both significant opportunities and notable challenges. On one hand, medical influencers have created a valuable bridge between the public and the world of healthcare, educating and inspiring while fostering a sense of community and transparency. Doctor Mike, for instance, uses his platform to simplify complex health topics, helping to combat misinformation and build trust with his audience. Dr. Miami, with his humorous, unfiltered, and candid approach, provides a different kind of insight into the realities of plastic surgery, making the field more relatable to the general public. However, as these professionals navigate the demands of social media, they must also contend with ethical and legal risks that accompany this exposure. The line between education and entertainment can blur, and without clear regulatory guidance, healthcare influencers face difficult questions about the boundaries of their role online. Ultimately, as medical influencers continue to grow in popularity, they must tread carefully in balancing the benefits of public engagement with the responsibilities and standards expected within the healthcare field.
Reimagining U.S. Healthcare with a Culturally Competent Approach
Written by: Francisca Anazco
Edited by: Michelle Mejia
For over two millennia, newly initiated physicians have declared, “I will do no harm or injustice,” as one of the professional ethical standards outlined by the Hippocratic Oath [1]. In light of today’s rapidly diversifying environment, obstacles have emerged in providing equal, quality healthcare across cultures and languages.
According to the U.S. Census Bureau, Hispanic individuals comprised 19% of the U.S. population in 2019, with nearly 70% of them—about 42 million people—speaking Spanish at home [2]. However, despite being the largest ethnic minority in the nation, it has become well recognized that they receive less and lower-quality care than the white majority of Americans.
Multiple studies in the Journal of General Internal Medicine attest that language differences explain ethnic disparities in healthcare. For example, Cheng et al. utilized evidence-based healthcare services to discern discrepancies between white Americans and Hispanic/Latinos. Using this analytic approach, the study observed that white Americans are generally more likely to receive all recommended services for prevention and chronic disease management compared to Latinos. However, when grouping individuals by language—meaning white Americans and English-speak-
ing Latinos compared to Spanish-speaking Latinos, English-speaking Latinos were not significantly less likely to receive these services. It turns out that those with limited English proficiency were severely disadvantaged compared to their English-speaking counterparts [3]. At first glance, the apparent ethnic disparity seems to conceal a deeper language disparity among various communities in the U.S.
Further analyses, however, revealed that Spanish-speaking patients who were also comfortable conversing in English received fewer services, even when they were able to communicate with their doctors in English [3]. Ongoing research in this area has begun to reveal a complex tangle of explanatory factors that result in unfair and adverse health outcomes—a reality for millions that the U.S. healthcare system has disavowed, despite physician’s ethical contract to the
Hippocratic Oath.
The discourse surrounding healthcare disparities among ethnic groups, primarily contrasting white Americans with immigrant, non-English speaking communities, gives room for an ethnocentric rhetoric that raises the question: should the healthcare system adapt to accommodate the growing non-English speaking population, or should these individuals learn English to access existing resources?
The U.S. was built on the tenets of equality, justice, and unity. Modern demographic changes don’t negate the fact that immigrants— voluntary or forced—built the foundations of this nation, transforming it into a cultural melting pot. There are many ethical, legal, and practical reasons to serve the
health needs of all groups, regardless of the culture or language with which they associate.
However, the reality is that while immigrants are expected to learn English, there is no well-coordinated system to accomplish this goal [4]. While assimilation to American culture is expected, immigrant communities are marginalized and segregated. The overall cultural separation in communes allows immigrants to continue speaking their native language, not creating a real necessity to speak English [4]. That is, until they fall ill.
Thus, while Title VI of the Civil Rights Act of 1964 mandates that healthcare systems receiving federal assistance provide equal, language-appropriate care, disparities continue to persist [5]. So what’s the solution?
Experts call for a multidimensional approach to deliver equitable care to minority communities. “With all the complexity of this issue, it’s not enough to tackle this just from the educational angle, it’s not enough just to do policy, it’s not enough to do research alone,” says Pilar Ortega, MD, MGM, vice president of diversity, equity, and inclusion for the Accreditation Council for Graduate Medical Education.
A promising beginning to address this reality calls for initiatives to empower and grow the Hispanic representation in the healthcare workforce. While Hispanics make up 20% of the U.S. population, only 6% of physicians identify as Hispanic, and only 2% of non-Hispanic physicians are Spanish-speaking [6]. This stands in stark contrast to the resounding 66% of non-Hispanic white physicians in the U.S. [7].
A policy brief written for the UCLA Latino Policy and Politics Initiative in 2018 recommended “increasing medical school admissions for Latino students, recruiting Latino out-of-state physicians, expanding opportunities for Latino international medical graduates, and creating a state-funded, Spanish-language residency pilot program” [6]. Emphasizing the need for Spanish language skills, representation, and educational opportunities would improve discordance in patient-physician interactions and enhance the potential for culturally competent care.
A sizable body of research has shown that patient-physician interactions and practice patterns are influenced by the race, ethnicity, gender, and socioeconomic status of both parties [7]. Studies have shown that Hispanics are less likely to seek
medical care for a present illness and less likely to say that they have seen a professional in the past year [8].
Although the reasons why Hispanics resort less to healthcare services are complex, factors such as lack of insurance and cost of healthcare shed light on marked socioeconomic differences, but factors such as biases, lack of cultural relativism and understanding show a sense of mistrust between Latino and non-Latino physicians [6]. This can have devastating implications on healthcare outcomes: communication challenges and mistrust result in a decrease of adherence to medication and treatment, as well as lower rates of hospital admissions or interventions [9]. Language discordance, coupled with racial and ethnic discordance, introduced additional hurdles to providing equitable healthcare.
Another resource that supports patient-physician interactions is the use of trained medical interpreters. Such is the case at CommunityHealth, a free clinic for low-income, uninsured adults located in Ukrainian Village, Chicago, IL, where most of the patient population is of Hispanic
heritage and primarily Spanish- and Polish- speaking. As one of the largest volunteer centers in the nation, CommunityHealth utilizes on-call and onsite volunteer interpreters trained by the organization to support physicians in facilitating effective communication between patient and physician.
Other studies suggest incorporating AI tools for interpreting alongside English-Spanish translators; however, these resources require physicians to be trained and competent in their use. Educational interventions such as Spanish medical courses or training on utilizing interpreter services positively impact patient outcomes and strengthen patient-physician relationships [5].
When discussing the need for Spanish language instruction in medical training, Richard Brower, MD, assistant vice president for academic affairs in El Paso, TX, emphasizes the importance of language concordance, where more than 80% of residents are Hispanic. “I think the clinical effects extend beyond translation or formal interpretation,” he says. “Most students don’t reach independence, but it’s about building on existing skills and the ability to establish rapport and trust… Even just introduc-
ing themselves, asking questions, picking up on humor or distress… It’s a big plus” [6].
Language identity—often intersectional with cultural and ethnic characteristics, as well as immigrant status—plays a significant and influential role in patient-physician interactions across the nation. Since the U.S. population is expected to remain multilingual in the foreseeable future, a healthcare system transformation is needed to deliver culturally competent care efficiently and equitably. A multidimensional approach, drawing from policy and education initiatives, will be necessary to uphold the Hippocratic Oath’s professional standards and reduce harmful, nationwide health disparities.
Growing Up Alone: The Hidden Consequences of Absent Working Parents and Child Development
Written by: Winni Zhao
Edited by: Roxanna Fahid
The exasperated sighs from consumers in grocery store aisles as they confront the startling price tags of fresh deli bread and chicken breast are all too familiar. Stagnant wages and minimal government regulation—which allows large corporations to drive up the prices of productions with little accountability—insufficiently compensate for the inflating prices of basic daily necessities. These consequences wreak havoc on household budgets, especially for low-income families. More and more working parents are finding themselves taking on extra jobs to put food on the table at the expense of quality time with their children, taking a physical and psychological toll on the next generation of young Americans. The extra work responsibilities these parents and guardians take on influence children’s overall development, including emotional and psychosocial health, academic life, and physical growth.
Emotional and Psychosocial Development
Parental presence is critical in childhood development, especially in achieving early developmental milestones. For instance, a parent’s involvement with a hobby their child is interested in helps them become
more self-aware, confident, and assertive in their choices as young children often look up to their parents for validation. The presence of encouraging parents and guardians boosts children’s self-esteem which has a positive impact beyond just childhood, carrying these traits throughout their lives. Such parental presence is an example of attachment theory. According to The Impact of Parental Absence on Early Childhood Development in the Context of Thailand (Jampaklay 2013), a study on children of migrant parents, such attachment allows brain stimulations that play a role in establishing emotional development. The emotional “attachment” formed by the child provides them a sense of stability and confidence to take risks during their growth. Without this security, the child consequently becomes more fearful of learning the environment around them, hindering their emotional growth. They are more withdrawn and have difficulty forming healthy relationships as they distrust others. These characteristics developed early on play a key factor in later challenges, including substance
abuse and temper problems.
Parental Stress: How Contagious is it?
The development of healthy parental attachment can be more difficult in the presence of stress. The pressure of work environments is inevitable—and keeping up with multiple jobs only worsens it. Stress spillover in home environments is common in this case, and raising toddlers could only add to the strain. These stressful environments negatively affect family dynamics: they worsen the quality of time spent together, interfere with parental judgment, and disable their awareness of their children’s whereabouts and emotional states. Waters (2014) notes in her study Stress Contagion: Physiological Covariation Between Mothers and Infants that a child learns to handle stress and strong emotions through a parent-child relationship; without parent-child quality time, the process of managing and gaining awareness of their emotions becomes stunted. Over time, the
child picks up the strained attitude and develops emotional difficulties. Emotional challenges, such as anxiety, often arise due to the inability to control new feelings—they are left to experience and process new emotions without a parent’s guiding hand.
Emotional management deficiencies can translate into the academic and social dimensions of school life. Pressure in an educational environment is common, but stress regulation requires emotional control that is often honed through parental guidance since early childhood. Poor grades are the consequence of procrastination and difficulty concentrating due to a lack of such guidance. Additionally, in the study The Effects of Parental Absence on Children Development: Evidence from Left-Behind Children in China (Mao 2015), the author emphasizes that the separation from parents deprives these “left-behind children”—those whose parents left behind to seek financial stability—of care, protection, and education. In turn, these children become more vulnerable to psychological problems, including depression, loneliness, and anxiety. The inability to regulate emotions may lead to unhealthy coping mechanisms such as emotional outbursts or even bullying. These consequences prevent the children from developing socially Food for Thought
Learning to manage emotions requires a good parent-child relationship and quality time—this also applies to eating responsibly. Paradoxically, taking on second or third jobs to put food on the table can lead to physical consequences for their child’s wellbeing. Quick meals become the simpler choice after draining their energy in high-stress environments,
but the adverse effects accumulate over time. In a similar study on the left-behind children in Health Seeking Behavior Among Rural Left-Behind Children: Evidence from Shaanxi and Gansu Provinces in China (Guan 2018), those left by their parents showed lower levels of physical health than their peers, including poor vision and lower in average height and weight. Temporary caregivers who fill in the roles of parents lack proper experience and can neglect the children’s health, leading to malnutrition, missed vaccinations, and ignored signs of disease. These children are at risk for stunted growth, low physical activity, and unhealthy food preferences. This phenomenon is like a double-edged sword: having a
quality life is difficult without taking on extra jobs, but these longer work hours to provide the children with food take a toll on their emotional and physical health.
Macronutrient and micronutrient intake is vital in child development. Protein is crucial to meet growth needs and should be one of the top priorities, lipids are a source of essential fatty acids that support brain and heart
growth, and carbohydrates are indispensable for vital organs such as the kidneys and brain along with metabolism. Additionally, minerals and vitamins are vital for bone growth, regulation of the immune system, and overall development. These are essential nutrients to stay healthy, requiring attention and care from parents to supervise the proper intake amounts. However, without parental attention, these habits can be permanently “ossified” when young, carrying poor habits into adulthood. In the study Tracking Dietary Patterns over 20 Years from Childhood through Adolescence into Young Adulthood: The Saskatchewan Pediatric Bone Mineral Accrual Study (Movassagh 2017), the author reveals that “western-like” diets high in refined grain, processed meats, and surgery foods showed a high likelihood of continuing into adulthood. Thus, when unhealthy dietary habits are established at a young age, they become challenging to break. Fast and easy meals are time efficient but are hardly sufficient for a balanced diet, creating risks for inadequate physical development and habits that create further health problems during adulthood.
With impacts ranging from emotional instability to insufficient nutrition, parental presence in a child’s life is as equally important as basic physiological needs. Given how easily early childhood experiences can influence the development of personality, economic challenges play a notable role in not only the current working parents but also in shaping future generations. The future of our youngest generations depends on our ability to address these underlying issues.
From Diagnosis to Discovery: AI’s Impact on Pediatric Cancer Care
Written by: Amiti Goel
Edited by: Chantel Johnson
Advancements in artificial intelligence (AI) are advancing various industries by the development of new modeling systems in healthcare. AI in medicine involves the use of algorithms, machine learning, and predictive models to enhance patient care, diagnosis, and treatment. As technology evolves, AI has the potential to revolutionize pediatric cancer treatment and expand applications in oncology practice in the near future. Pediatric cancer, with its unique challenges—such as early detection, treatment side effects, and long-term prognosis—can particularly benefit from AI tools to support healthcare professionals with delivering earlier diagnoses and personalized care. These challenges are amplified in pediatrics due to the not fully developed anatomy and physiology of children, which makes diagnosing and treating diseases inherently more complex than in adults. However, the recent developments in AI applications to healthcare has caused a raise in important questions that have yet to be answered. How do we ensure AI furthers, rather than replaces, the human touch in medicine? Could parents rely on AI models to be a significant aspect of their child’s care? Let’s explore how AI is transforming pediatric oncology, while highlighting both the potential and the limitations
with an overall focus on the future of healthcare.
Early detection is critical in improving cancer outcomes for pediatric patients who have limited detection capabilities and larger potential for relapse in the future. AI-based diagnostics have already made significant breakthroughs. For example, Google Health’s breast cancer detection model reduced false negatives by 9.4% compared to radiologists, showing how AI can identify subtle patterns that might otherwise go unnoticed by medical professionals (McKinney et al., 2020). Similar advances are being made in brain tumor diagnostics, with MIT’s AI system aiding in the analysis of glioblastomas which helps clinicians make quicker, more accurate decisions (Chang et al., 2019). In addition to imaging, AI tools analyze genetic markers to identify high-risk individuals even before birth. DeepGestalt, an AI platform profiled in Nature (Gurovich, Y., et al., 2019) , demonstrated remarkable accuracy in detecting rare genetic conditions, outperforming many specialists. Such predictive tools are invaluable
for early screening, potentially altering the course of a child’s treatment before symptoms develop. By integrating advanced technologies into pediatric oncology, healthcare professionals can provide earlier and more precise care for children at risk.
AI is also transforming how clinical trials are conducted in pediatric oncology, where pre-screening participants is complex and time-consuming. PathAI (2024), a platform specializing in AI-based pathology, has improved clinical trial enrollment times by 30% by quickly identifying eligible participants from patient records (PathAI, n.d.). The technology ensures that clinical trials reach full enrollment faster, bringing new treatments to children more efficiently. AI models also play a critical role in drug discovery because of the significant reduction in time it takes to develop new therapies. DeepMind’s AlphaFold (Jumper, J., et al., 2021), for example, has transformed biology by predicting the
structures of proteins which accelerate the discovery of new drug targets. With AI-powered simulations modeling drug interactions before clinical trials begin, the process of developing breakthrough therapies becomes both faster and more cost-effective. While AI can make processes like clinical trials and drug discovery faster and more precise, it’s important to consider how these advancements might influence the cost of healthcare. The initial investment in AI technology and infrastructure could drive up costs for consumers, even as the outcomes of treatment become more effective and potentially curative in the long term. Regardless, for pediatric oncology and beyond, these advances offer hope for new treatments to be available sooner with more options and better outcomes in the long run.
One of AI’s most impactful applications is the creation of personalized treatment plans. Each child’s response to cancer therapy varies, therefore doctors need tools that can tailor treatments to individual patients. Platforms like Tempus and OncoKB are already being used to analyze vast oncology datasets and recommend personalized treatment plans based on a patient’s specific genetic profile and medical history. By harnessing patient-specific data, AI can suggest optimal drug combinations and dosing regimens to maximize efficacy while minimizing side effects. This particular approach of precision medicine ensures that treatment decisions are not only evidence-based, but also centered on maintaining the best possible quality of life for young patients and their families.
Another developing aspect of AI in medicine is offering new techniques to monitor children during
and after treatment. Wearable devices such as the Oura ring or Apple Watch, incorporating AI algorithms, allow doctors to remotely track vital signs in real time which alert them of any concerning trends without requiring in-person visits. For families managing complex treatment schedules, the technology provides reassurance in knowing that their child’s condition is being monitored continuously. In addition, AI-powered chatbots and virtual assistants are becoming essential tools in pediatric care. Sensely (Sensely, 2021), it is already in use in hospitals by helping patients and caregivers with appointment scheduling and answering routine medical questions. These AI tools ensure that families stay connected to their child’s medical conditions while facilitating smoother care coordination throughout their treatment journey.
Despite AI’s benefits on medicine, it does come with limitations. AI-driven oncology tools can perpetuate biases with racial and socioeconomic factors that can influence treatment recommendations. This highlights the need for diverse datasets and careful oversight to ensure equitable care for all patients. Additionally, while AI can streamline research and development, the high cost of developing and implementing these advanced technologies could still drive up healthcare costs in the short-term. Increase in healthcare costs because of the new AI models would cause these helpful innovations to be less accessible to certain patient demographics.
Although, it is important to consider that while these treatments may be more expensive, they could ultimately lead to better outcomes, reducing the need for costly interventions later on. The arrangement for a child to receive a
higher-cost, effective treatment would be more beneficial in contrast to a less expensive treatment currently offered that does not propose the same chance of success. Moreover, trust between doctors and families is extremely vital, distinctly when parents are asked to rely on AI-driven recommendations for their child’s care. But, it is important to understand that AI is being utilized to enhance, not replace, the expertise of healthcare professionals to ensure that treatment decisions align with the child’s specific needs and values to improve patient quality of care.
AI is revolutionizing pediatric oncology by enabling earlier diagnoses, creating personalized treatment plans, improving long-term prognosis, and accelerating drug development. These advancements bring hope for better outcomes that reduce treatment burdens and provide more effective therapies tailored to each child’s needs. Nevertheless, the integration of AI into pediatric oncology care must be thoughtful and balanced. By combining the best of human expertise with the power of AI models, healthcare providers can offer more precise, compassionate care to young patients and their families. As the advancement of innovations in healthcare evolves, it is still critical to have clinical judgment, empathy, and human insight remaining indispensable. AI will play a pivotal role in the future of medicine by guiding healthcare professionals, empowering patients, and enhancing everyone’s understanding of cancer and other common health complications in ways we are only beginning to understand.
UV Blood Irradiation: Hack or Hoax?
Written by: Franziska Kungys
Edited by: Sophie Feng
Everyone’s heard that sun exposure can be good, but how good? Is it possible that Ultraviolet Blood Irradiation–a treatment in which small amounts of blood are drawn out, exposed to UV light, and reintroduced into the circulatory system– could be some kind of miracle treatment? It has a brief, but rich history. In about thirty years of popularity it was found to treat a variety of ailments, but some research suggests it might do the opposite.
The germicidal effects of UV light were first observed in 1877 by two scientists, Downes and Blunt, when they noticed that sunlight prevented the growth of microorganisms in their test tubes. About twenty years later, physicist Niels Finsen won a Nobel prize for his research using concentrated beams of UV light to treat Lupus Vulgaris, a cutaneous form of tuberculosis. This treatment became widespread for many skin conditions, and eventually led American scientists Emmet Knott to hypothesize that its effectiveness was due to UV absorption by subcutaneous capillaries. Knott and his partner, Lester Edblom, created the first UV blood irradiation machine, patented in 1928.
The purpose of the device was to draw, expose a small amount of blood to concentrated UV light, and reintroduce it into the patient’s circulatory system. The light exposure kills bacteria and deactivates toxins, effectively treating diseases. With further experimentation, Knott found that a shorter exposure time, insufficient for
killing bacteria, resulted in similar if not better results; the harmed bacteria created a similar result to a modern vaccine when reintroduced into the bloodstream by increasing the immune response to the remaining, unharmed bacteria.
The first use of Knott’s device on a human was in 1928 as a last resort on a woman dying in the aftermath of a septic abortion and ailed by hemolytic streptococcus septicemia. It led to a quick and complete recovery. Knott’s device was then used for a series of 75 cases of pneumonia, all resulting in lessening of symptoms and quicker recovery times. After these initial successes, the irradiation device was redesigned to increase irradiation efficiency and uniformity and a couple were distributed to doctors for further experimentation.
For a while, blood irradiation became a relatively common treatment
for a number of diseases, including
• Infectious arthritis
• Osteoarthritis
• Mastoiditis
• Furunculosis
• Escherichia coli
• Septicemia
• Post-abortion sepsis
• Puerperal sepsis
• Peritonitis
• Typhoid fever
• Tuberculosis glands
• Chronic blepharitis
• Uveitis
• Chronic paranasal sinusitis
• Acne vulgaris
• Secondary anemia
Beyond the bactericidal and inflammation reduction abilities that allow for the treatment of the above conditions, UBI has been found to potentially have more general benefits worth further exploration. Among these are
improved circulation, increased red blood cell count, and pain relief, likely an effect of reducing inflammation.
Another possible use of UBI is immunity building because a short exposure time, as Knott discovered, results in harmed but not dead bacteria. In his experiments, the resulting viral fragments created a vaccine-like response, strengthening the immune response to the virus. This merits further research because successful immunomodulation through this method would, in theory, not create viral resistance or super pathogens, unlike antibiotics.
Despite the observed effectiveness, the treatment faded out after the 1950s as pharmaceutical antibiotics rose in popularity and is not commonly used in medicine today because it is not properly understood, and there are many questions
surrounding potential negative side effects. Most of the research that has been done on UBI has revealed results opposing the observed effectiveness of the treatment; yet, it is worth noting that most experiments were done at high or extended UV exposures that did not reflect the actual treatment.
Still, these studies have shown that extended, intense UV irradiation actually reverses production of cytokine–an essential messenger protein of the immune system–and blocks its release, which seems to contradict observations of increased immunity. With the more extreme and extended exposure, UV radiation also has the potential to affect the membranes and submicroscopic structure of red blood cells.
These studies raise real concerns, but further research needs to be done with more varied parameters to find if there are in fact ranges and intensities
of exposure that can create positive results such as those first observed by Knott. The presence of modern UBI clinics in the United States and globally that still observe positive treatment results suggests there was and still is such a range, and its historical applications and diverse health benefits highlight that it is worth finding.
What’s on the Horizon for Alzheimer’s and Dementia?
Written by: Emnet Djibrila
Edited by: Alexis Truta
While many individuals and families are personally affected by Alzheimer’s and dementia worldwide, public knowledge about these neurodegenerative diseases is generally low. Despite the two conditions having different clinical definitions, people often use the terms interchangeably. According to the Alzheimer’s Association, dementia is an umbrella term that describes the symptoms associated with a decline in memory, reasoning, and cognitive function. While dementia can be caused by Alzheimer’s disease, this only accounts for 60-80% of cases with the remainder of cases being attributed to a variety of conditions.
Given that a majority of patients with dementia have Alzheimer’s, there has been a significant push to understand the determining factors of this condition, biochemical, genetic, or otherwise, in order to effectively treat or prevent it. According to the Alzheimer’s Association, “an estimated 6.9 million Americans age 65 and older are living with Alzheimer’s in 2024.” Causes for Alzheimer’s are still not entirely understood by scientists; however, significant progress has been made in understanding determinants for the disease. Most people are aware of the main risk factors for the disease—genetics and aging. There are various age-related changes that are thought to contribute to Alzheimer’s damage, including the shrinking of certain brain regions, inflammation
in the brain, decreased energy production in cells, damaged blood vessels in the brain, and production of unstable molecules called free radicals leading to oxidative stress in the brain. There are also genetic risk factors that contribute to the development of Alzheimer’s disease. The apolipoprotein E (APOE) gene, specifically inheritance of the APOE4 allele, is associated with increased risk for disease development, as well as for an earlier age of onset. Specific demographic factors can also contribute to how likely one is to present with Alzheimer’s. Black Americans that are a part of the aging population are approximately twice as likely to develop Alzheimer’s compared to their White counterparts. Aging Hispanic Americans are 1.5 times more likely to develop the disease compared to aging White Americans.
While scientists pursue research to identify the risk factors of this disease
to develop more effective preventative measures, public health and patient advocacy organizations must strive to support the communities disproportionately affected by this disease. Many of the aforementioned demographic factors also intersect with social factors that impact how families care for patients affected by Alzheimer’s and dementia. Individuals with dementia require more and more care as their disease progresses. It is difficult to quantify exactly how much assistance a patient with progressing Alzheimer’s might need, but with a sharp decline in cognitive abilities that can make it increasingly difficult to dress, eat, and maintain personal hygiene, it becomes clear that a caregiver is necessary to maintain both the patient’s well-being, and their personal safety as well. Later-stage
dementia requires support with mobility and personal care around the clock. While dementia is blind to socioeconomic status, those in lower income groups may lack the resources to place the patient into a long-term care facility, often being forced to find a caretaker or take on the roles of a caregiver themselves while balancing other obligations. Caregiving for an aging individual with dementia can take an emotional, physical, and financial toll. A large population of caregivers are women, with ⅓ of caregivers being daughters of the affected individual. They also tend to fall within a category called the “sandwich generation,” where they care for an aging parent in addition to one or more children. The financial burden of caring for someone with dementia can also create long-term expenses that severely inconvenience families. The impact of dementia is not just limited to the individual who suffers from the condition, which is why it is so important to work towards finding effective avenues of care and treat-
ment for dementia patients that will be beneficial for the patient and caretaker as well.
The growing population of individuals and families affected by dementia has created an equally rapidly growing field of clinical research with the hopes of finding treatments and preventative care for the disease. Scientists have made great progress in their investigations of the causes of Alzheimer’s and dementia, as well as in potential treatments and preventative measures. Preventative care for Alzheimer’s was functionally equivalent to maintaining a good bill of health until the early 2000s, with physicians and public health officials encouraging aging individuals to maintain good health practices, avoid smoking, and continue exercising their brains, when researchers conducting evidence-based trials have begun to study the positive effects of various vitamins and drug treatments on Alzheimer’s and dementia. One recent development is the FDA approval of two promising drug treatments, Lecanemab and Donanemab. This approval
means that these drugs have been determined to be safe and effective for their intended use. Lecanemab and Donanemab are now openly available in the US and were approved, in 2023 and 2024 respectively, for patients with early stage Alzheimer’s and dementia experiencing mild symptoms. These drugs are intravenous (IV) therapy treatments that have shown to clear amyloid plaques from the brain. This is extremely relevant research because a feature of Alzheimer’s disease that has long puzzled scientists is the irregular accumulation of beta-amyloid plaques and how these plaques specifically relate to the development of conditions like Alzheimer’s. Scientists have supposed a strong positive correlation between the accumulation of these plaques and the development of Alzheimer’s. Ideally, in earlier-stage dementia patients, clearing this amyloid plaques would stop or slow the progression of the disease.These treatments are newly implemented, so there is not yet much longitudinal research on the long-term effects of these drugs; however, affected patients and their families have agreed to participate in this cutting-edge research that will hopefully, one day, minimize symptoms of Alzheimer’s and dementia in all patients regardless of the progression of their condition.
Ultimately, as the US population continues to grow and the aging population becomes larger, Alzheimer’s research becomes even more medically relevant than ever. With many medical innovations to treat dementia on the horizon, caretakers and medical professionals alike are increasingly confident that dementia’s impact on the aging population will eventually diminish.
The Chemistry of Love: How Neurotransmitters Shape Our Emotions
Written by: Chioma Okegbuson
Edited by: Sophia Falk
When people fall in love, many chemicals are involved in producing physical and emotional responses like sweaty palms or a hint of blush on their cheeks. Dopamine, norepinephrine, serotonin, oxytocin, and cortisol are some of the most important neurotransmitters that play a role in such a strong feeling. Without them, love wouldn’t be possible. Neurotransmitters are vital for carrying out important messages from one neuron to the next, making it necessary to think about your loved one, feel love for
your significant other, and act the way you do around your crush.
Dopamine is often associated with pleasure and satisfaction, a core feeling that cannot go unpaired with love. It controls memory, motivation, and especially, mood—the three M’s. In the beginning stages of love, dopamine activates the reward “circuit”, allowing love to be a pleasurable experience. In 2005, Fisher experimented with dopamine’s association with love. She gathered college students ages 18 to 26 and showed pictures of their loved
ones for 30 seconds. When shown these pictures, two areas of the brain with dopamine abundance, also known as the “feel-good” neurotransmitter were activated: the caudate nucleus, which is linked with detected rewards/ expectations, and the right ventral tegmental area (VTA), which is a dopamine-abundant area associated with focussed attention and the three M’s. However, when shown pictures of regular friends, Fisher noticed from fMRI scans, that
parts of the brain not associated with dopamine were activated.
Norepinephrine, similar to adrenaline, heightens arousal and increases blood pressure. This neurotransmitter is the cause of one feeling their “heart racing,”. It brings people the feeling of exhilaration and excitement when seeing their “crush” or the burst of relief when they see their loved one. Norepinephrine also plays a role in our stress response, which is why some people experience the nervousness and intensity that come with the beginning of a new relationship. However, the stress people experience in their initial stage of romance is caused by cortisol secreted by HPA, an endocrine system organ. As cortisol levels rise, the neurotransmitter, serotonin, is depleted, leading to obsessive-compulsive behavior associated with infatuation. In an experiment run by Donatella Marazziti and Domenico Canale, they discovered that plasma cortisol levels were higher during the first 6 months of a romantic relationship than in their control group of singles and those in long-term relationships. Cortisol levels aren’t just high in newly forged relationships, but higher in women by merely thinking about their significant other. In contrast, people in long-term relationships have lower cortisol levels. This is because of the consistent social support and happiness that buffer that feeling of anxiety and reduce HPA axis activity. Last but not least, the two main, and widely known neurotransmitters associated with love, are serotonin and oxytocin. Serotonin helps regulate mood and overall well-being, bringing couples a sense of happiness and contentment with their partners, which can stabilize the highs and lows
associated with being in a committed relationship. While dopamine and norepinephrine might heighten during the early stages of a relationship, serotonin levels tend to be lower, contributing to obsessive thoughts, like norepinephrine, about their partner. But over time, as serotonin levels increase, people begin to familiarize themselves with their partners, promoting a sense of calmness and contempt. Oxytocin, known as the “cuddle hormone” or “love hormone”, is released mainly when physical touch and affectionate interactions are involved. It promotes a sense of bonding, solidifying trust and security. When engaging in something as simple as holding hands or hugging, the body releases oxytocin, building a stronger connection while regulating the nervous system. This is because touch can trigger a pressure-sensitive
sensory nerve called Pacinian corpuscles, which sends signals to the vagus nerve that conducts signals to the hypothalamus, lowering their heart rate and blood pressure which can contribute to managing stress. Love is beautiful, so thank the brain and the many neurotransmitters at work for helping you experience such an exciting emotion.
Postural Orthostatic Tachycardia Syndrome in the Post-COVID Era
Written by: Mia Mahon
Edited by: Sophia Falk
Postural Tachycardia Syndrome (POTS) is an autonomic disorder characterized by lightheadedness, a rapid heartbeat (specifically an increase by over 30 bpm when standing), and fainting. POTS “mainly affects women between the ages of 15 to 50 years of age” and can come and go for years (Postural tachycardia syndrome (POTS), n.d.). There are many causes for the development of POTS, and newfound research has related COVID-19 to a POTS diagnosis.
Post-COVID-19 POTS has become a topic of interest following the many accounts of patients experiencing long-term POTS symptoms after COVID. Research has shown that POTS can be triggered by viruses or bacterial infections, and COVID-19 has been identified as a possible trigger. Many people recovering from COVID-19 have symptoms similar to POTS, such as “brain fog, tachycardia (increased heart rate) and severe chronic fatigue,” which has led to these patients being tested for POTS (Covid-19 and pots: Is there a link?, 2024). However, a POTS diagnosis is often overlooked and difficult to obtain, as not many doctors are familiar with the disorder. POTS symptoms are often easily dismissed, which could be prevented with more research and educational outreach.
One study found “that 2%–14% of coronavirus disease 2019 (COVID-19) survivors develop POTS,” and even more survivors showed long-term POTS symptoms (Ormiston et al., 2022). While these case numbers grow, so does the research on why COVID-19 is linked to POTS. Autoimmunity is one possible cause, as COVID may cause the production of autoantibodies that attack autonomic nerve fibers. Another cause may be spike proteins, which can cause toxic action. This occurs when “a spike protein of the COVID-19 virus attached to ACE2 receptors enters the cell and causes multisystem damage,” leading to POTS symptoms (Mallick et al., 2023). Lastly, COVID can cause hypovolemia, leading to decreased cardiac output, and potentially POTS (Mallick et al., 2023). These are all just theories, and more research needs to be done to find a definitive answer as to why POTS and COVID have an apparent association. In order to better understand Post-COVID POTS, it is important to understand the leading symptoms of the disorder. One study found that “The most common high-impact symptoms
were palpitations (68.75%), fatigue (62.5%), and dyspnea (37.5%)” with headaches and syncope/ presyncope being the next most common (Cantrell et al., 2024). It is important to note that symptoms vary for patients with POTS, and this same variation is seen in the Post-COVID POTS group. In fact, Post-COVID POTS was observed to accurately reflect the POTS population (Cantrell et al., 2024). Since the presentation of POTS and PostCOVID POTS can be variable, it can be harder to obtain a diagnosis. Post-COVID POTS is diagnosed as POTS, so the treatment and management processes of both are the same. One of the most common treatments is increasing water and salt in a patient’s diet. In addition, “compressive garments significantly reduce venous pooling and improve POTS symptoms,” and are key parts of a typical POTS treatment plan (Mallick et al., 2023). Medications are also available to help reduce symptoms caused by POTS. It is important to be aware of the many treatment methods, as different POTS symptoms require different treatments. As scientists continue their research, more treatment options for POTS will be found and an understanding of the connections between COVID-19 and POTS will be obtained.
From Chaos to Cure: The Evolution and Impact of COVID-19 Vaccines in Ending the Pandemic
Written by: Sienna Yamini
Edited by: Hunter Bershtein
For over three years, the world was in chaos. The spread of the virus was rampant, and businesses around the world shut down. However, on May 5th, 2023, the big announcement was made: the World Health Organization declared the end of COVID-19 Pandemic. A critical development leading to this declaration was the invention and use of vaccines worldwide. When the world stopped, innovation flourished, leading many different vaccines to be developed throughout the pandemic years. Vaccination was a key factor in reducing COVID-19 infection rates and the pandemic death toll (McLaughlin, 2022). However, with many vaccines in circulation, it is important to understand their differences, as not all vaccines are built the same. Each comes with its own unique biological mechanism, efficacy, and side effect profile. Though each vaccine has distinct characteristics, they all have one important commonality: bringing about the end of the pandemic.
The COVID-19 mRNA vaccines were the first FDA approved mRNA vaccines (CareFirst). mRNA vaccines carry viral mRNA, which causes the recipient to produce viral protein. When the body’s immune system comes into contact with the viral
protein, it triggers an immune response in the form of antibodies that target the viral protein encoded by the mRNA from the vaccine. Since these antibodies are specific to the viral protein, they can recognize and mark the specific virus in the body for attack by the immune system. As such, when someone who is vaccinated with an mRNA vaccine is infected, they are already equipped with antibodies to recognize the virus, and they can more quickly evoke a strong virus-specific immune response. This heightened immune response leads to more efficient clearance of the virus, hopefully, before it can spread (Carefirst). Both Pfizer-BioNTech and Moderna are examples of mRNA vaccines against COVID-19. These vaccines use mRNA to make copies of the spike protein on the outer membrane of the COVID-19 virus, which then triggers the body’s immune system to produce antibodies specific for these spike proteins. When someone contracts COVID-19, these antibodies bind the spike protein and mark the virus for clearance by the immune system, helping fight off infection. The Pfizer
and Moderna vaccines have a 95% efficacy for preventing COVID-19, a measure of how well the vaccines can protect people against the virus. Additionally, one study found that overall vaccinations in the U.S. (2020 to 2022) were able to stop around 18.5 million hospitalizations and 3.2 million deaths (Fitzpatrick et al., 2022). It’s clear the COVID-19 vaccines were extremely effective in reducing the severity of the disease (Center for Disease Control, 2024).
The Pfizer vaccine began development in January 2020, and clinical trials in March 2020. The first doses were released December 14th, 2020. The Moderna vaccine began development in January 2020 as well, and clinical trials started in February 2020. Shortly after the Pfizer vaccine, Moderna was released for use December 18th, 2020. While these are both mRNA vaccines, they have slight differences. For example, the Pfizer vaccine contains 30 mg of mRNA in a dose, while the Moderna
vaccine contains 100 mg of mRNA in a dose. Additionally, the Pfizer vaccine is commonly stored at -70˚C, while the Moderna vaccine is stored at -20˚C. However, these vaccines do have similar side effects, including pain at the injection site, fatigue, and muscle pain.
Another type of vaccine is the viral-vector vaccine, which uses a modified version of a different virus to send information about the virus in question (OIDP, 2024). For COVID-19, viral-vector vaccines take material from Covid-19 virus and put it in a different viral vector, which then sends the information to your cells. Your cells use this viral information to make copies of the COVID-19 spike protein, and display it, mimicking the actual virus. This prompts the body’s immune response and creates antibodies against the virus for future use. An outdated example of a viral-vector vaccine is the Johnson and Johnson vaccine, which is not available in the U.S. anymore due to side effects issues. The Johnson and Johnson vaccine began development in January 2020, and was released for use in February 2020. The efficacy of this vaccine was around 85% for severe cases, and side effects includ-
ed fatigue, muscle and joint pain, and nausea. Another example of a recalled vaccine is the AstraZeneca viral-vector vaccine, which used modified chimpanzee adenovirus as its viral vector. It began development in April 2020, and was released for use December 30, 2020. The side effects were mild, such as fever or fatigue. However, some rare side effects include blood clots (Vanaparthy et al., 2021) (Katella, 2024). As a general consensus, mRNA vaccines have been shown to be more effective at reducing the spread of the virus, especially due to their high efficacy.
Protein subunit vaccines use harmless parts of the virus that will most effectively trigger an immune response. The body recognizes the harmless spike proteins the vaccine carries, and creates antibodies. They do not carry live viruses, and usually have less side effects. The Novavax vaccine contains a modified spike protein that cannot cause disease. When used, the vaccine triggers an immune response and antibodies are released. The Novavax vaccine is the only non-mRNA vaccine that was approved for use in the U.S., released in 2021. It had around 90% efficacy. Side effects include pain at the injection site, fatigue, and muscle pain (Katella, 2024). However, since this
vaccine was developed later and there is a high demand for mRNA vaccines, the Novavax vaccine is not as widely used.
Inactivated vaccines take a live virus and kill it. The inactivated virus in a vaccine can create an immune response. Live Attenuated Vaccines use a live but weaker form of a virus. They directly target the immune system and trigger immune responses without causing disease (Pfizer). There is currently no live attenuated COVID-19 vaccine, but there was one in clinical stages in 2023 (IDSA). A live attenuated COVID-19 vaccine would mean easier storage and administration, making it more widely available to certain communities. However, these vaccines require extensive testing before they could be released to the public. An example of an inactivated covid vaccine is the Sinovac vaccine (OIDP, 2024). It was released for emergency use in China in July 2020, and had a 50-83% efficacy. Side effects also include pain at the injection site and fatigue.
These are some of the major vaccines that were used during the pandemic and are still currently in use. In terms of numbers, around 80% of Americans have been vaccinated at least once against COVID-19, and about 70% have had two doses (USAFacts, 2024) (CDC Covid Data). 60% of fully vaccinated people received the Pfizer vaccine, while 37.5% of vaccinations were from Moderna. Although the pandemic brought about chaos and death, it ultimately demonstrates the power of scientific innovation in fighting against such crises. Each COVID-19 vaccine differs in its usage and efficacy, but we nonetheless must attribute our departure from the pandemic to their development.
References
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What’s on the Horizon for Alzheimer’s and Dementia?
By Emnet Djibrila
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The Chemistry of Love: How Neurotransmitters Shape Our Emotions and Connections By Chioma Okegbuson
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Postural Tachycardia Syndrome in the Post-COVID Era
By Mia Mahon
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From Chaos to Cure: The Evolution and Impact of COVID-19 Vaccines in Ending the Pandemic
By Sienna Yamini
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