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S. Lee Ware

S. Lee Ware has written 51 posts for Medical-Lee Speaking

But for the lottery of birth: Poverty, Racism, and the Permanent Underclass

In Rosa Lee: A Generational Tale of Poverty and Survival, Leon Dash documents the fascinating, disturbing experiences of an extended black urban family struggling to survive the nearly inescapable circumstances of poverty, racism, ignorance, violence and abuse, addiction, and crime in Washington, D.C. during the second half of the twentieth century. Dash, now a professor … Continue reading

Treatment of pediatric hearing loss with cochlear implantation

Lee Ware, Dasha Kenlan, John Penn, Kendra Campbell, Tara Shrout, Keith Albrektson, Jason Chisholm, Daniel Hudson Introduction Cochlear implants, approved for children by the FDA in 1990, are implantable, 2-component devices designed to transmit sound information from the external environment to a patient’s auditory processing circuitry. The external component (placed behind the ear) and internal … Continue reading

The Paradox of Manufactured Consent in the Information Age

The “information age” of instant communication and ubiquitous internet access has saturated all of us with information. Unfortunately, most of the information streaming along fibers and across airwaves is of low quality and dubious intention. The opinions and perspectives and agendas communicated, explicitly but especially implicitly, through the mainstream media channels are highly attuned to the … Continue reading

GDP’s relevance to well-being

GDP is a poor measure of a society’s well-being for several reasons. It potentially obscures gross inequality; it fails to reflect the externalities, the unpriced natural capital, and the social costs of classism inherent to the capitalist enterprise; and it reflects a fundamentally unsustainable economic system based on perpetual growth incompatible with the narrow conditional … Continue reading

The US is far behind peer nations in aligning policies with her public’s health.

The future of public health in the United States is difficult to predict, but the challenges public health has yet to overcome are much more certain. As Keck, Scutchfield, and Holsinger point out in their concluding chapter of Contemporary Public Health, “one of the few constants in public health practice is that change is ongoing … Continue reading

Fast Food Nation: How a Psychopathic Economic System Poisons for Profit.

In Fast Food Nation: The Dark Side of the American Meal, journalist and author Eric Schlosser explores the origin, evolution, ascendance, operation, impact, and exportation of the uniquely American (and extremely toxic) fast food industry. From its birth in the west coast post-war car culture to its capture of food markets around the planet, the fast food industry has succeeded in radically altering the human species’ relationship to food – its meaning, production, distribution, content, form and flavor, cost, acquisition, and consumption. Continue reading

Public Health Accreditation

As Keck, Scutchfield, and Holsinger phrase it, “public health is no longer in the position of being the only major health profession without a process to …. accredit its agencies.” But how and why has public health accreditation arisen, and how might it contribute to improving the public’s health? Continue reading

Health: to reform incentives or re-imagine a paradigm?

If any of mainstream economic theory’s assumptions are true, it is that incentives influence behavior (another is that for-profit firms that are legally mandated to maximize profits [see Ebay v. Newmark] will, in fact, maximize profits). If financial incentives under fee-for-service induce physicians to create demand (by prescribing un-valuable services), then realigning these financial incentives … Continue reading

Who gets sick and why?: the lense of Primordial Prevention

Primordial prevention targets the “causes of the causes” of ill-health and harm – the social and political determinants of health. In the US, these political and social environments are characterized by dramatic class-, gender-, and race-based inequalities in health, wealth, representation, agency, safety, rights, and opportunity. Continue reading

Core Functions of Public Health: Something’s Missing

Advocacy for social justice and health equity is necessary and essential towards fulfilling public health’s mission. Continue reading

Is the US Healthcare System “health care” or a “system”?

To use the word “system” to describe healthcare in the United States is to imply intentionality, coordination, and comprehensiveness, none of which can be appropriately applied here. Continue reading

Benefits and Challenges of PHSSR

Public health services and systems research (PHSSR) is, according to Mays, Halverson, and Riley in Holsinger’s Contemporary Public Health chapter 6, “the field of inquiry that examines the organization, financing, and delivery of public health at local, state, and national levels, and the impact of these services in population health.” Continue reading

Social Justice is the Smart Health Investment

Addressing the social determinants of health and well-being directly at the policy level may be both the most cost-effective and moral path forward. Though inequalities in power and wealth have been central to the critiques of western capitalist societies since the earliest days of the industrial revolution, and though industrial activity’s specific harms to human … Continue reading

Medicare’s Assessment of Brigham and Women’s Performance

Boston’s Brigham and Women’s Hospital (75 Francis Street; a subsidiary of Brigham and Women’s Healthcare) is a major teaching hospital of Harvard Medical School and among the best regarded acute care referral centers in the United States 1. In 1980, three separate hospitals were merged to constitute the present center 2. As of its 2012 … Continue reading

Human Hearing Loss

Hearing loss affects as much as 5% of the global human population and its negative consequences, often exacerbated by cultural bias or distributive injustice, include delayed cognitive and language development, learning deficits and poor academic performance, chronic unemployment and dependency, poverty, elevated risk of harm and poor health. I conducted a review of open access journals and other freely available resources to identify the principal causes of hearing loss; its consequences for individuals, communities, and states; and potential interventions most appropriate for developing and low-resource countries where hearing loss is currently most prevalent and its burdens most egregious. Continue reading

Incognito: an overview and critique

Neuroscientist David Eagleman begins his third book, Incognito: the secret lives of the brain, in panoramic Sagan-esque style, immediately striking a resonant harmony between lucidity and enthusiasm for the significance of his topic. The thesis? Human consciousness emerges from the physical attributes and activities of the brain, but is only a small part of the brain’s business; what else the brain is up to is normally inaccessible and mysterious, but our science, Eagleman asserts, is now uncovering its secrets. Continue reading

Summary and Critique of Cope et al.

BACKGROUND In Hemispheric Asymmetries during Processing of Immoral Stimuli 1, Cope et al. report the results of three fMRI studies consistent with the hypothesis that, among humans, the specialized circuitry involved in processing negative morally laden stimuli is lateralized in the left hemisphere. To contextualize their research, Cope et al. describe Broca’s early recognition of … Continue reading

The Fallibilities of Choice and Competition

Mill’s blacksmith example serves his argument well. But his argument for the sovereignty of free choice and competition in matters of social organization and production fails to account for the poor choices and biased competitive environments that often produce less than ideal results. In fact, socioeconomic prejudice remains as a potent and pernicious social ill long after the worst of codified sexism has been remediated, and the illness has been fueled as much by market forces and competition as by the inaction of government to meaningfully intervene in the disparities of wealth and opportunity that define a still openly classist society. Continue reading

CVS Modulates Moral Judgments

Few things feel more intuitive than our sense of right and wrong. How do agency, valence, and processing levels of moral stimuli influence this sense, and are the circuits involved lateralized in one or the other cerebral hemispheres? To address these questions, I used caloric vestibular stimulation (CVS) treatments followed by the Explicit Moral Judgment Test (EMJT) to probe the biological circuitry of moral judgments. Subjects’ moral evaluations were modulated by CVS treatments across agency, valence, and processing variables, providing evidence for the lateralization of newly identified moral modules concerned with positive-subtraction and self-positive processing. Continue reading

Burke was right: man is a religious animal

Burke’s arguments for why England, or any state, should keep its “church establishment” strongly foreshadows a great deal of modern science’s conclusions as to why religion exists in the first place, i.e., utility in the stability of social identity and political order. Burke’s only failure comes from the assumption that morality – that great social lubricant – is the exclusive domain of religion, and that moral behavior is derived from it. Continue reading

Medical Expertise

As an aspiring physician, medical expertise is something I hope to progressively develop during medical school, internship and residency, fellowship training, and eventually, clinical practice. The knowledge base upon which this expertise will be built has already begun to be established, though the process has often seemed disjointed and the information, to varying degrees, sometimes … Continue reading

Summary of Field’s Yoga: Clinical Research Review

Introduction Tiffany Field, of the Touch Research Institute, University of Miami School of Medicine and the Fielding Graduate University, reviewed recent empirical research of yoga’s impact on psychiatric and neurological conditions, cardiovascular health, immune conditions, and pregnancy. She then assessed yoga’s physiological effects, including decreased heart rate and blood pressure, and proposed mechanisms for its … Continue reading

Attention, Performance, and Memory

Summary of several chapters from Eysenck and Keane’s Cognitive Psychology, sixth edition (2010) Contrary to early interpretations of shadowing task results, it now appears that unattended stimuli receive considerable processing before being blocked by attentional filters. Theorists continue to debate the relative position of the attentional bottleneck, either early in the auditory processing circuit or … Continue reading

Neglect

Neglect is “a deficit in attention and awareness of one side of space”, usually the left side, contralateral to right-hemisphere damage (Wikipedia). It is caused by a problem in the brain, usually a lesion or damage from stroke, rather than a problem of sensation. That is, the eyes work fine, but the brain, because of … Continue reading

Quatrain to the Organs

Though I’ve observed dozens of surgeries and autopsies in the past, I am always astonished at the scale of our internal organs. In my imagination, the body is a TARDISian vessel, where the brain, heart, and digestive system, along with all the organs, are of an immense size, rightly proportional to their grand complexity. But … Continue reading