The End of 2019
Well, here it is: the long-awaited update. So much for sticking with a monthly schedule. I know it's been entirely way too long since my last post. It's not been because I've been bored, I promise! Here are some of the more interesting things that have kept me quite busy this first semester of my second year.
October 2019 NYC - Champions of Brain Science
I was invited to participate in an event with some of the people who provide financial support for the PhD program's students for the first few years of our education. Sometimes graduates of the program who have made a significant amount of money or others who wish to support the research conducted here are generous enough to donate funds to the department. These donations are precisely how I have the ability to attend MIT without actually paying the full tuition out-of-pocket. There is certainly no possible way that I could afford the tuition here without their help. (~$25,000 per semester!) The event was geared to introducing the donors and the doctoral students they help support. This year the event was held at a sponsor's home in Manhattan. The view was absolutely breath-taking.
For just a moment as I was peering out above many of the skyscrapers of New York, I thought about how I had grown up, how poor my mother and I were at times, and how unlikely it would be that I'd ever be standing where I was at that moment. Of course, I wasn't in my own home, and I doubt I'd ever be able to afford such an abode as a scientist, but it was absolutely amazing to have such an experience. Often I am reminded of just how lucky I am to be a part of this community. This was certainly one of those times.
October 2019 Washington DC - AIMBE Conference
The Radiology Department at MGH had received an invitation to a public policy conference that was happening in DC which was looking for graduate students to attend. The event was geared to demonstrate the possibilities of influencing public policy through science, specifically in the area of biomedical research. There was a travel award being offered that could cover the costs of travel, so I gave it a shot and applied, and a few weeks later I was notified that I had won an award! That allowed me to go down to DC for a few days and hear from some interesting and amazing people in our government working towards providing better healthcare to our citizens through both research and policy.
It's important to know that there's a difference between policy for science, and science for policy. I hadn't quite known of this distinction prior to attending, but I think it makes intuitive sense. Policy for science includes appropriating funds for research programs like the BRAIN Initiative. This mechanism of the government funding research is the primary method our country uses to produce the knowledge needed to continually advance our society. However, science for policy can be thought of as using scientific investigations to inform good decisions in government. Arguably, most government decisions aren't made with scientific data to support those choices. At times, policy makers have actively dismissed the science and have made choices contrary to the evidence. Inevitably, this leads to essentially running an uncontrolled experiment on the population by implementing policies that are mis- or ill-informed. Terrible policies can and certainly have caused more harm to our citizens in the long-run. As an example, think about the terrible lead poisoning of poor communities in Flint, Michigan. At the conference, I was pleasantly surprised to find that there are many (in my opinion, heroic) people who are working to help guide our nation's leaders regardless of current political views. I left DC feeling quite inspired.
November 2019 NYC - Give an Hour
I ended up going back to NYC a few weeks later for another small conference, this time focused on mental health. It was hosted by Give An Hour, which is an amazing program where licensed psychologists around the country volunteer their time (hence the name, Give an Hour) to work with veterans outside of the VA system. This is a program model from which I have personally benefited, and felt quite honored to attend and contribute some ideas to making mental healthcare more available and socially acceptable to the general public.
There were some very interesting perspectives that were presented at the conference. One guest speaker was a person who had attempted suicide, while another few were people who had survived suicide, including the author of "Life After Suicide", Jennifer Ashton, MD. It was such a powerful experience to hear each of their stories, particularly given my own personal struggles. Take a look at some of the PTSD series of posts to learn more about what I mean.
One thing that I took from the conference is that simply putting information out to the general public is one of the greatest ways to inform the masses. It wasn't that long ago where the government's Ad Council used to broadcast public service announcements designed to teach the citizens of this country how to interact in healthy ways. Of course these ad campaigns have been mocked and ridiculed in the past (remember the commercial with eggs sizzling in a pan and the narrator stating, "this is your brain on drugs"), but the fact that I still remember the ad is a testament to its effectiveness. Perhaps partnering with media companies to use billboards or other media (radio, TV) to broadcast good messages about the normalcy of seeking mental health treatment is one way to reduce the stigma.
I had heard of a clinician in Zimbabwe who had looked at the overwhelming task of providing mental health treatment to a country of millions with only a few dozen psychologists. He chose to pay and train some of the grandmothers in each village to serve as first-line mental health providers. They were given a bench to place somewhere in the community and they sat and waited for people to come up and chat. It was called the Friendship Bench. They had run a small experiment and were able to show that many aspects of mental illness (depression, anxiety, etc.) could be reduced in a community if there's an outlet for talking about one's problems with another. It seems like such an easy way to reduce the stigma of mental health! I mentioned it at the conference and I think some of the other attendees just might have gone back home with the motivation to do something similar in their communities.
December 2019 MIT - Quantitative Methods for Neuroscience
While I was attending all of these out-of-state events, I did still have to maintain my performance in class. This particular course had been quite the challenging one this semester, but I've learned so much about statistical approaches to analyzing chaotic neural data. How can you sample neural activity and draw conclusions about its functional response to specific stimuli? I have to admit, it was a bit difficult to handle the homework (the last assignment was over 300 lines of code for me!), but I learned quite a bit more in about statistical functions in MATLAB and now have straightforward methods for analyzing neural activity. Let me just say that statistical analysis through general linear modeling (GLM) is virtually everywhere! While it was tough, I'm really glad I chose to take this course this semester. Here's a little excerpt from my notes:
Quite possibly the most important aspect of analysis is the development of a model to explain the data. If you have a mathematical model that can reproduce the output given the same neural input, then your model can be assumed to be an accurate way to explain whatever mechanism is being investigated. As an example, here's a figure from one of my models in the class:
December 2019 MIT - Functional MRI Methods
This was the other course I took this semester that really illuminated the intricacies and difficulties associated with functional brain imaging using MRI. As I entered the course, I felt like fMRI only produced results that could only be described as a shadow on the wall; the blood oxygenation changes that are observed in blood-oxygen level dependent (BOLD) fMRI only describe the changes in blood oxygen levels, not actual brain activity. However, I was pleasantly surprised to learn the history of the development of the technology, some of the controversies along the way, and the current supporting evidence of why fMRI is the best modality we have for functional brain imaging to date.
Perhaps the most innovative and exciting developments in fMRI analysis is that of functional connectivity analyses. What was commonly done in fMRI in the past was to design a task-based paradigm to see which areas of the brain are responsible for processing the particular task. This is a good method, but it won't be able to capture anything other than the activity associated with the task. For more general conclusions about the brain, another approach has used non-task-based, or resting-state scans to examine which parts of the brain are active when not engaged in a task. This had led to the discovery of the default-mode network, which is a collection of brain regions active during rest. The next level of analysis is to look at the time-course of activity and, see which areas fire at exactly the same time. The theory is that neurons that fire together are "wired together". This may not be entirely true since there could be small time delays along neural pathways, but since the technology can't sample the brain as fast as the actual brain activity, it's generally a good rule to follow. This type of analysis is known as functional connectivity MRI (fcMRI) and is really starting to shed light on some of the greater mysteries of the brain. Check out this fascinating paper on the analysis of criminal behavior in patients with brain tumors. You may find yourself questioning just how much control we may actually have over our own actions. Never forget, we ARE our brains.
December 2019 Fellowship Writing
I mentioned above how we graduate students are supported by funding from donors, but it is limited in time. The program guarantees support for the first three years, but we must find our own funding for the remainder of our education, however long that may be. Some students graduate in 5 years, but the average is 6, which means it is a significant amount of money to try to find. Luckily we have a system of government and private fellowships that students apply for to support our research and education costs.
I applied for a government fellowship with the hopes of conducting research to understand some of the risk factors associated with developing PTSD from combat experiences. The process of designing the fellowship application was fairly straightforward since I'm already working on aspects of the proposed project, but it was such a challenge to make it as clear and concise without sparing the details. Fellowship writing is essentially the same as grant writing. I spent so many hours revising the proposal to make it just right. Now I understand when researchers close themselves off for a week or so when a grant application is due. It's hard work, and it is always a competition, so making sure it's just right is a bit of a stressful challenge. Let's hope my first fellowship application isn't rejected!
The End of the Year, 2019
In my last post, I mentioned that I had been hit by a truck while riding my bicycle in early October which caused a bit of existential questioning afterwards. I think I still hadn't the time to process the events and to frame how I want to move forward into the future. An older friend of mine once said, "You're only alive for such a brief time. You'll be dead for practically forever. The chance to make a difference is now." That is certainly one way to look at it.
Maybe life is "engineered" to let us live just long enough to allow us all to forget just how short life really is. Perhaps the illusion of the stability of life gives enough of a foundation to allow the pursuit of life without constantly thinking about death. Certainly after my little bike accident last month, that illusion of stability has once again been shaken, but luckily I've had some really positive experiences to help put things into perspective. Recently, I have had quite a few very amazing opportunities present themselves that could really allow me to make my dreams of offering better treatment options for those with mental illness. Best of all, the opportunities are from many different aspects all pointing towards the same goal.
In an effort to frame my next year positively, I decided I wanted to take a break from New England and go for a bit of a road trip around the country to visit some of those people that have helped me along the way. So far it's been a great experience. I am writing this post while on the trip. Perhaps I'll post something on the road trip (with photos!) while I'm out on the road. Stay tuned!