Hurry Up and Heal: the problem with pressuring athletes to get back in the game

Stephen Curry’s fall during last Sunday’s game resulted in a mild diagnosis and a heated discussion surrounding the treatment of injuries in professional sports. With only a medial collateral ligament sprain, Curry will be back on the court within a mere three weeks. The relatively positive prognosis still poses a challenge for both his team and the doctors treating the injury. Three weeks off the court could cause Curry to completely miss vital playoff games. With a key player out of commission, the NBA, his team, and Curry’s sponsors could potentially experience huge monetary losses. Therefore, the pressure is on doctors to get Curry back in the game. In addition to conventional treatment options, doctors often employ experimental healing methods such as plasma and bone marrow injections. It is common that unrelated injuries are often discovered in MRIs and X-rays while the injury the athlete came in for is being analyzed. For those who are not elite athletes, orthopedic surgeons would usually treat both the existing and new problems. However, when dealing with professional athletes, speed in recovery is paramount, so chronic injuries are often overlooked.

The pressure to get back in the game quickly isn’t unique to basketball— all high level athletes know that recovery time means lost money. Even in college athletics, students are pushed to get back in the game. A friend of mine was a top sprinter on the track team her freshmen and sophomore years until a knee injury took her out. The injury wasn’t severe, so she should have healed completely had she let it heal for the doctor-prescribed four weeks. Eager to get back to her sport and with pressure from her coach to represent at an upcoming meet, she convinced the doctor to allow her to compete after only three weeks of recovery. She re-injured her knee during a meet and the damage was irreparable. That extra week of lost healing time ended her running career. Similar instances of not allowing sufficient time for healing occur across all disciplines, leading to shortened player shelf life and lifelong health issues.

I completely understand why it continues to happen, however. Athletes feed on competition, and they often treat an injury like another opponent to defeat. Players bank on the same sheer grit and strength that make them exceptional athletes to overcome their injuries. True, playing through pain is a mark of dedication that earns athletes esteem from their teammates, but beneath its victorious facade, it flags players for expedited expiration. When a player prioritizes the immediate glory of playing through pain, they have to live with the consequences for the rest of their lives. Although many universities and professional sports teams have programs in place to educate athletes on the importance of caring for their personal health, they have not been effective. The influences of money and a sense of obligation to one’s teammates override the influence of a well-meaning athletic trainer telling a group of bored teenagers to take care of themselves. Or, in the case of professional sports, athletes feel pressured by their sponsors and teams to get back in the game. No bone marrow treatment or top orthopedic surgeon or plasma injection can heal an athlete fast enough by the professional sports industry standards.

There is no clear cut solution to this problem; there are always ways to circumnavigate and cheat regulations, and the highly individualized nature of medical problems makes it nearly impossible to standardize healing times and procedures. Athletes need to take responsibility for their own health. When elite athletes begin to prioritize thorough healing, their sponsors, teams, and peers will begin to prioritize it too. In the past ten years, ex-football players’ brain injuries have been brought into the spotlight, which has greatly raised awareness for the severity of head injuries and impacted the way concussions are treated in all sports. Similarly, if ex-athletes from other disciplines come forward to talk about the way poorly treated sports injuries negatively impact them long after they hang up their jerseys, then young athletes might take notice and become more aware of the potential gravity of a simple sprain or fracture.

What 7-Eleven CEO’s Resignation Can Teach U.S. Execs

On April 7th, 7-Eleven CEO Toshifumi Suzuki announced his resignation at a press conference. Suzuki created a stir due to his brutally honest statement explaining the reason for his resignation: “It is my lack of virtue and I am unbearably ashamed.” He even refused to choose a successor because he deemed himself unworthy of the task. His offense? Suzuki attempted to oust a subordinate exec that would likely become his successor. Board members disagreed with Suzuki, accusing him of nepotism—allegedly Suzuki wanted his son to inherit the position instead.

Suzuki’s unconventionally honest resignation is a refreshing foil to the usual CEO resignation speeches we hear from U.S. businesspeople. Even when the executive is obviously at fault, there seems to be a format for their resignation speeches: talk up the failing company, take no responsibility for the way their actions affected the company, and claim to be leaving in favor of better offers elsewhere. When Gerald Levin resigned in the wake of the infamously disastrous AOL-Time Warner merger, he talked up the company’s leadership team and bright future (a future he was well aware was non-existent since stock prices dropped 90% after the merger he solidified). When Volkswagon CEO Martin Winterkorn resigned in September of last year, he stated that he was “not aware of any wrongdoing on my part.” He resigned after it had been revealed that Volkswagon cars were equipped with filters before emissions tests that caused emission readings to be lower than true values. Raytheon CEO Dan Burnham resigned in 2003 because he wanted to ‘spend time with his family, teach, and possibly become a director on other company boards.’ Years later, the true reason for his resignation surfaced when he agreed to pay the SEC an almost 2 million dollar settlement on charges of accounting malpractice.

Resignation coverups such as these have unfortunately become almost ubiquitous in American business. Each resignation speech seems to be a carefully crafted PR dance of flashy optimism and denial of wrongdoing—a sharp contrast to the manner in which Japanese businessman Toshifumi Suzuki apologetically told the truth. Cultural ideals clearly come into play here—family honor is highly valued in traditional Japanese culture, whereas rebellion and success at any cost seems to be many American businesspeople’s twisted idea of the american dream.

It’s not like America is shameless. There is plenty of societal shame to go around—slut shaming, racial prejudice, and class-based hierarchy are all sources of shame. But somehow money laundering, intentionally manipulative commercial real estate deals, and blaming others for one’s own poor decisions are seen as parts of being a successful that are only problematic when people find out. The way high powered executives publicly handle their missteps sets the tone for how other businesspeople conduct themselves. When the CEO of a huge corporation makes a massive moral or legal misstep and proceeds to remorselessly deny responsibility for their actions, it perpetuates a cycle of dishonesty in the face of tumult. Perhaps if executives were culturally expected to own up to their wrongdoings rather than side stepping them with clever PR, people would be less likely to do those immoral things in the first place.

The Meditation Experiment

I love self-experiments. I have been both the researcher and the test rat for a myriad of health and wellness experiments over the years. Testing cod liver oil supplementation to increase retinol bioavailability, comparing endurance exercise performance on raw vegan 80/10/10 diet versus a high protein one, and scrutinizing the efficacy of antioxidant foods for treatment of chronic diseases have been a few of my recent studies. Although my studies usually focus on using food for wellness, I more recently became intrigued with the practice of meditation. I began to notice the ubiquity of alternative health practitioners and doctors’ high praises for the practice of meditation to promote both physical and mental wellbeing. Since I practice yoga daily and generally love any excuse to move, I thought meditation would be another unnecessarily sedentary burden. A good run or yoga class clears my head, so why should I have to sit still to get the same result? I challenged myself to meditate every day for 21 days.

I completed my 21 days yesterday, and I’m proud to say I missed only two days over the duration of the experiment. I was hoping for a grand transformation or awakening, but in reality, the effects were far subtler than I had hoped. I recently read an interview with ABC News anchor Dan Harris that echoed my experience with meditation: “meditation makes me ten percent happier.” Although this is definitely an oversimplification of the effects of meditation, it does make sense to me. Just like a test in which ten percent is the difference between an A and a B, meditation makes a small yet significant change. Meditation is a frustratingly subtle tool in our sensation-addicted society.

In a Zen Buddhist article entitled “You Are What You Download,” the author discusses how meditation brings up all the mindless media we assume we will forget. She talks about how meditating made her less inclined to engage in idle web surfing because she didn’t want to be haunted by it the next time she meditated. I definitely experienced what she was talking about. Especially the first two weeks of meditation, I would spend the majority of my time trying to fend off all the random thoughts I hadn’t ever really consciously considered before. I found myself thinking about the design on the bottom of my shoes, the side-by-side comparison of a Labradoodle and a chicken nugget that came up on my Facebook news feed, the thank you notes I need to write, the bothersome way my friend worded a text a few days ago, the National American University commercial song, and the list goes on. The meditation experiment has made me painfully cognizant of how my online habits affect my overall well-being. It’s difficult to separate from the deluge of pop culture clutter, but I took the first step by deleting Instagram and Facebook off of my phone. Since I made the change two weeks ago, I have become hyper aware of how much time my friends spend scrolling through their feeds instead of making eye contact.

This may sound hippie-dippy, but meditation really does create a shift in perspective. As you become more aware of the world around you, it will become more vibrant, and, best of all, you’ll realize that there is no separation between yourself and that vibrant, glowing world. Try meditating and you too can join the ranks of sober health freaks like me who sound like washed up rock stars reminiscing on acid trips of yore. 

The Human Test

Inspired by Ze Frank’s TED talk entitled “Are You Human?”, I started thinking about what defines humanness. The following list of questions is a sort of reverse Turing test; my goal in writing them is to get at the intangible morality, beauty, grittiness, and nuance that makes human experience so unique.

Have you ever noticed the little hairs that grow on your toes?

Have you ever walked into a pole while smiling at a text you were reading?

Have you ever thought about your to do list during sex?

Have you ever seen someone shoplift and not done anything about it and spent the rest of the day wondering if you should have?

Have you ever avoided smiling because you thought you had something in your teeth?

Have you ever had the nagging feeling that the people who look to you as an expert in a certain area will someday realize that you’re not smart enough or experienced enough to be telling them what to do?

Have you ever experienced a moment of awe when someone who you previously thought was so ordinary instantly  becomes strikingly beautiful? 

Have you ever flipped over a tails up penny and left it where you found it so someone else could find a lucky penny?

Have you ever woken up to a few seconds of happy floaty bliss before you remember that someone you love left you?

Have you ever been really proud of something and then pretended you weren’t because someone you respect gave you negative feedback on it?

Have you ever caught yourself changing your voice when you talk to different people?

Have you ever realized that you don’t have a favorite color anymore?

Have you ever gone an entire day without making eye contact with another person?

Have you ever avoided the people who love you because you thought your state of messiness would make you difficult to love?

Have you ever regretted telling the truth?

Have you ever used the excuse ‘sorry my phone died’ when you just didn’t want to talk to someone?

If you answered yes to one or more of these questions, congratulations, you’ve passed the human test. 

Disarming the Limbic Locksmith: the neuroscience of writer’s block

I used to be a good writer. Lately, though, my former writing prowess has been replaced by a skill set boasting about as much grace and finesse as a game of Mad Libs in a remedial second grade english class. Frustrated by my inability to write anything vaguely engaging, I took a deep dive into the neuroscience of writer’s block. Here’s what I learned:

The brain’s structures can be categorized into three major systems: the reptilian brain, the limbic brain, and the prefrontal cortex. The reptilian brain, comprised of the brainstem and the cerebellum, is responsible for regulating automatic survival functions (such as breathing and heart rate), relaying information from sensory organs, and coordinating muscular movement in response to sensory stimulation.The limbic brain’s main structures are the hippocampus, the amygdala, and the hypothalamus, which record value judgements on everything we experience and are responsible for basic human emotion. Evolutionarily newest and most complex, the prefrontal cortex is responsible for sensory perception, generation of motor commands, spatial reasoning, conscious thought, imagination, and language. The prefrontal cortex is the part of the brain that needs to be active for writing.  http://www.brainhq.com/brain-resources/brain-facts-myths/brain-101 Writer’s block occurs when emotional responses lock us out of that part of the brain.

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When ideas aren’t flowing and you start to get stressed, the prefrontal cortex cedes its control to the limbic system. This is meant to be energetically economical; the brain deems imagination and language unnecessary in the face of immediate danger (helpful when being eaten was our biggest fear, not so helpful in defending ourselves against teachers with red pens). The deactivation of the prefrontal cortex allows your inner critic to take control. The thalamus screens all stimuli and decides what gets relayed to the limbic system and what goes to the prefrontal cortex. The amygdala is the first to receive information perceived as a threat. It compares information about the present situation with the memories of similar past experiences stored in the hippocampus. The hypothalamus then sets off a chain of chemical messages to alert the body how to react to the threat based on precedent.  This creates a vicious cycle; if your limbic brain associates the experience of writer’s block with stress, it will prepare for trauma by blocking access to the prefrontal cortex, which in turn perpetuates the original source of stress. Your ability to effectively utilize language disintegrates while your self-loathing mounts.

Then, as the deadline approaches, a rush of dopamine and adrenaline floods the brain. These chemicals create the procrastinator’s high—the spike in focus and determination you get when you’re running out of time. The problem with adrenaline-fueled focus is that it only produces good results for mechanical tasks, not for highly creative tasks such as writing. I’ll take a closer look at the procrastination monster in another post, but for now, let’s break down how we can use neuroscience to overcome writer’s block.

1.  Satisfy the fight or flight urge. When the limbic system encounters  stress-inducing activities (such as uninspired paper writing), it prepares the body for combat with adrenaline and cortisol. Cortisol is often vilified as the obesity causing, sleep disrupting, age accelerating stress hormone. In reality, though, it’s just trying to help. Cortisol helps to shift blood flow towards muscles and away from systems that are non essential for a fight, such as the immune system, the skin, and the prefrontal cortex. Since cortisol is released in anticipation of confronting a threat, it is programmed to subside after physical exertion. Cortisol is released regardless of whether a threat is physical or psychological, so combating  writer’s block as if it were a hungry mountain lion may help you re-engage your writing brain. Short sessions (20-30 minutes) of vigorous exercise result in lower cortisol levels, which translates to a less stressed mind. When the limbic brain doesn’t detect an immediate threat, it reopens channels of communication to the prefrontal cortex, allowing you to think creatively and (hopefully) formulate some words. Additionally, the release of endorphins, serotonin, and dopamine during exercise help to break the cycle of creative blockage by numbing pain. These chemicals make the brain less likely to perceive the writing task at hand as an enemy. 

2. Use sensory shortcuts. The human brain thrives on tangible interaction with its surroundings. Typing is a minimally sensual activity by nature, but when writer’s block takes hold it becomes even more stagnant, making it easy to get caught in negative thought patterns. As I explained earlier, the brain defaults to already established neural connections when faced with stressful situations. Engaging the senses gives your brain novel information to make judgements about. If the limbic brain deems the stimuli non-threatening or pleasurable after comparing it the hippocampus’s records, it passes the information on to the prefrontal cortex, allowing the brain to think more creatively. While compiling research for this post, I noticed that almost every blog entry about the topic suggested using smells, tastes, sounds, and changes of scenery as antidotes to writer’s block: “Listen to calming music. Take a walk. Eat your favorite food. Light a candle.” Honestly, though, such advice often ends up reading like a trite and frilly self help book catering to a divorcee during a midlife crisis. So in the spirit of avoiding that trope, here are a few weirdly specific sensory shortcuts that have helped me:

  • Handstands: Part of what makes sitting to write so draining is that your brain isn’t getting very much oxygenated blood. At least once every hour while I’m working, I like to do a handstand up against a wall. I have even done this in the library—the increase in productivity definitely was worth the scornful yet mildly amused looks from other library patrons.
  • Rainy Mood + Bon Iver: Rainy Mood is a website that is refreshingly un-customizable. Its only feature is a home page that makes rain sounds. It helps to block out other sounds that easily distract me from my work. Bon Iver is my go to study music. It has lyrics but I can hardly understand them so it’s more soothing than it is singalong-inspiring.
  • Turmeric+ Ginger+ Lemon: Although junk food sounds way more appetizing when I’m stressed, I know that this combination will give me a better brain buzz. I make a vegetable juice that incorporates turmeric and ginger roots, lemon, apple, spinach, and celery. If you don’t have access to a juicer or blender, though, steep green tea and add a nub of ginger root and slice of lemon.
  • Zoom: When I am unhappy it is easy for me to get stuck in my own headspace, which only exacerbates writer’s block. To regain perspective, I like to either zoom way in on something infinitesimal or zoom way out to see the bigger picture. I especially love looking closely at leaves; the veins, textured edges, and color gradients provide a sort of meditative point of focus. Conversely, it is also helpful to zoom out by going to a crowded place and sitting down to people watch. Seeing people in such a hurry helps me to realize how ridiculous and unproductive stress is, helps me to recognize the universality of human emotion, and allows me to return to my work with less self-judgement and perfectionism.

Unfortunately, none of these things are guaranteed to work. If they did, I would have a lot more blog posts finished. However, now that I’m armed with a bit of an understanding of the neuroscience of writer’s block, I know that being hard on myself is the last thing that will help me get back to a place of creative flow. And hey, looks like I overcame my writer’s block (enough so to finish this post on writer’s block, anyway.)

New Drug Policy Fails to Address the Root of the Opioid Epidemic

On March 29th, President Obama announced a policy that will allocate increased funding to opioid abuse treatment programs and will make overdose reversal drugs more accessible. Although it is an important step in tackling America’s opioid epidemic, the policy fails to proactively address the root of the issue—the accessibility of painkillers to adolescents.

The 1.1 billion dollar initiative is a three-pronged plan that focuses on treatment and recovery plans for existing opioid abusers. Firstly, the plan’s funding will increase the accessibility of medication-assisted treatment, specifically the drug buprenorphine, which is the first opioid dependency treatment medication that can be prescribed and dispensed from a physician’s clinic. Additionally, the policy will fund wider distribution of naloxone, an opioid overdose reversal  drug that has already decreased the number of heroine overdose deaths in recent years. The policy’s final tenant calls for increased medicaid coverage of substance abuse treatment that will be on par with the coverage offered for other surgical and medical procedures.

I commend the initiative’s focus on aiding those who want to recover rather than criminalizing addiction, but the program’s scope is too narrow and will be ineffective in preventing new users from becoming addicted. True, as awareness of opioid dependency has increased in recent years, measures have been taken to better educate doctors on precautionary prescription practices for opioid medications such as oxycontin and morphine. These programs have led to a decrease in overall opioid prescriptions in the past two years, but they fail to specifically address the gravity of opioid use for adolescents. In fact, the FDA approved the use of oxycontin on for children as young as 11 in August of 2015.

Adolescents that use opioids, even if taken only as prescribed, are at an increased risk of developing an opioid addiction later in their lives. Since the brain’s prefrontal cortex, responsible for decision making and impulse control, does not fully develop until age 25, adolescents are at a higher risk of becoming addicted to drugs they try. According to the Drug Policy Alliance, 1 in 12 high school students reported non-medical prescription opioid use in the past year . Over sixty percent of the teens that have abused opioids were first exposed to the drug through a legal prescription. This suggests that after a teen uses a course of opioid pain management medication as prescribed, he/she is more likely to misuse opioids recreationally.

The obvious solution would be to teach doctors to be more judicious with the opioid prescriptions they write for young people—but the issue isn’t so simple. It is difficult to cut back because opioid painkillers are often the only drugs that will offer sufficient relief after surgeries, which teens often have due to sports injuries. Patients can become dependent on the medication during the 1-2 week course of post-op treatment. After the prescribed medication runs out, some adolescents cannot function normally without the medication. Parents hate to see their kids in pain and will sometimes offer them opioids leftover from other prescriptions. Even diligent parents can inadvertently put their child at greater risk for addiction. Opioids provide immediate relief, so family members and friends often provide the pills out of love. When a particularly rough week of ballet performances left me with severe back spasms, my well-meaning grandfather offered me a bottle of Vicodin he had leftover. Half a pill made the pain less severe, but it also made me loopy and numb—a feeling that I (thankfully) hated. I understand why so many adolescents are attracted to the escapist pleasure, though.If a call to a grandpa, friend, or parent is all it takes to get the drug, the reprieve from reality offered by opioids becomes that much more attractive.

In addition to the treatment-focused drug policy updates, government funding should be put towards making opioids less readily available to adolescents. Research funds should be put towards finding alternatives to opioids for treatment of chronic pain. Additionally, drugs should be concocted to have a shorter effective shelf life. If opioids became ineffective within a few months after being prescribed, at home medicine cabinets would no longer be a temptation for self-medication or intentional opioid misuse. The Drug Policy Alliance advises parents to dispose of or lock up leftover opioid medication, but few follow these guidelines. No parent assumes opioid abuse will affect their own child, and by the time they realize it does, it is often too late. If government funding is used to reformulate opioids to combat adolescent abuse of the drugs, there will be less need in the future for the government-funded overdose reversal drugs and treatment programs currently in place.