A recent study found that higher parental and grandparental education and higher grades increases a person's risk for an eating disorder. This makes a whole lot of sense to me. And I'm not talking about how parents with higher levels of education might push their kids harder, etc. Or even how more educated parents have more money and therefore their kids experience more pressure to be thin. This could be true- I don't know. But I think the relationship is much more subtle than that.

One of the characteristics of an eating disorder is a drive for thinness. Considering that, through the ED, I defined "thinness" as "success" and/or "perfection," the drive for thinness in me (and in others I've spoken with) seems to be an offshoot of perfectionism. Indeed, even in non-ED university students, researchers found a relationship between stress, perfectionism, and drive for thinness.

Besides the eating disorder, my other main perfectionistic focus has been school. I skipped half of my brother's high school graduation party to study for an 8th grade history test. I worked until all hours of the night in high school, and usually through dawn in college. Driven by fear and anxiety, and fueled by pots of coffee, I stayed at the top of my class.

From the outside, I was a success. I sure looked the part. My parents were proud- why wouldn't they be? Over-achievement wasn't going to worry my parents, especially not after my brother! And this drive, this ineffable need to do more, do it better, was hauntingly familiar to both my parents, but especially my mother. It wasn't abnormal or pathological, right? It was familiar.

This post is not intended as any sort of mother-bashing (though several of my therapists have had a field day with what I am about to share), but my mom was pretty darn obsessive and perfectionistic about school and, instead of food/weight, her other obsession was cleaning. She skipped out on dates with my dad because she had to study. My dad, who had tickets to a concert/play/whatever, didn't want to waste the tickets, so he took my mom's mom instead.* And, also just like me, my mom excelled at school. She placed top in the state in her subject exams upon college graduation.

Both my parents graduated from college- my dad did so somewhat grudgingly, as school was never his "thing," but graduate he did. I know my mom's dad graduated from college, but I'm not sure about my dad's dad. I know neither of my grandmothers went to college, but everyone finished high school.

What I see in my family is not so much a legacy of high parental expectations, but a legacy of perfectionism and drive to succeed. Did my parents have high expectations? Maybe, but my freakishly higher expectations of myself were what drove me. So I fundamentally disagree with the authors' conclusions that:

"Thus, higher parental and grandparental education and higher school grades may increase risk of hospitalization for eating disorders in female offspring, possibly because of high internal and external demands."

Internal demands, yes. This is how the perfectionism manifests itself in myself, my mother, and many of my maternal relatives (of whom I know the most about). My dad is also a perfectionist, though in a very different way than my mother and I. So the link between higher grades and higher parental/grandparental education does make sense, but not in the way the authors might have assumed.

Anxiety can drive success. People have told me they wish their kids could have my GPA and "work ethic" and I have to tell them no, you really don't wish that. I love learning and enjoyed many of the aspects of school, but my high school and undergrad years were pretty hellish. I was lucky, in a sense, that the symptoms of my mental illness helped me succeed, but it also makes it harder for lots of people (myself included) to understand that these personality traits--the drivenness, the perfectionism--have downsides, too.

Note: I realized as I was blogging that the study seemed awfully familiar, and I remembered that Laura also posted about the study and its conclusions here.

*My grandmother, at that time, looked rather young and not unlike Doris Day, so they probably pulled off the whole "couple" routine. It's the epitome of putting the "fun" in "dysfunctional." She also appeared in the newspaper around this time to share the recipe for her "legendary" ham loaf. I have the picture somewhere- I should post it. It's a hoot.

I was reading the book "The Ancestor's Tale" by Richard Dawkins (an impressive tome in which the reader goes on a virtual time-travel back through evolution), and I stumbled across this little gem in the section known as "The Salamander's Tale," the excerpt of which has nothing to do with salamanders.*

"Many Western countries at present are suffering what is described as an epidemic of obesity. I seem to see evidence of this all around me, but I am not impressed by the preferred way of turning it into numbers. A percentage of the population is described as 'clinically obese.' Once again, the discontinuous mind insists on separating people out into the obese on one side of a line, the non-obese on the other. That is not the way real life works. Obesity is continuously distributed. You can measure how obese each individual is, and you can compute group statistics from such measurements. Counts of numbers of people who lie above some arbitrarily defined threshold of obesity are not illuminating, if only because they immediately prompt a demand for the threshold to be specified and maybe redefined...Nevertheless...our brains evolved in a world where most things do fall into discrete categories."

Dawkins' stance on size acceptance is really not the point here. Rather, it is the almost innate habit of humans to put essentially anything and everything into one of two categories.

Fat or thin.
Healthy or not.
Tall or short.
Dead or alive.
Rich or poor.
And so on.

Companies and advertising take advantage of this. One of the banner ads at the top of my emails sometimes read: Are you fat or healthy? As if you can't be both. Or neither. The irony is that most of us fall into some middle ground, neither rich nor poor, short nor tall, healthy nor unhealthy.

And not only do we want to categorize other people, we also want to categorize ourselves. We ask: am I normal weight, overweight, or obese?** I saw a book when I was browsing at Barnes and Noble yesterday that was titled, "Eat This, Not That." Very dichotomous. But frankly, I don't like either Big Macs or a Baconator, the two choices of burgers on the cover. I didn't look further in the book, but I got the basic premise.

Even more, one of the two categories is always more highly desired by society. It is also harder to achieve, which is perhaps why it is so highly valued. The harder it is to place yourself in a category, the more a company can sell you products to move yourself into said category. If you're not beautiful, you're ugly. It's very hard to be considered beautiful in our society. Your eyebrows must be perfectly plucked, no wrinkles on your skin, always wear makeup, style your hair, etc.

And how much money is made by selling products to de-wrinkle your skin, find the perfect foundation/mascara/eye shadow, hair dye, hair gel, curling irons?

A lot. A whole freaking lot.

Especially when we're younger, our brains are very black and white. We haven't yet mastered complexities and nuances of such things. Because this drivel is continuously driven into our heads by companies and culture, it gets harder and harder to break free.

This is where teaching kids about "healthy eating" and "healthy body weight" gets dangerous. A 5-year-old is not equipped to know that eating a slice of cake--even on a regular basis--is fine, but a steady diet of buttercream frosting isn't. Cake is bad. Cake is unhealthy. These two things are now considered exactly the same.

If you are either fat or thin, healthy or unhealthy, and thin=healthy and thin=desired, then you will want to be thin. Above all else. Kids aren't stupid. The pecking order on the playground is brutal. Fat is not looked upon favorably.

We could tell our children to eat a wide variety of foods, and to enjoy them. We could tell them that human beings come in an array of shapes and sizes. We could. But we also feel the need to pare information down to the most basic level, at the expense of the message itself. Healthy or not. Fat or thin. If teachers are always talking about dieting and weight loss, kids begin to think it's normal. And if "everyone is doing it," what's wrong with my thinking that?

The issue is first that this is taught at all. Good food/bad food is totally arbitrary. Margarine used to be thought of as "better" than butter because it had less saturated fat. Now "butter is better" because margarine has trans fats. In the 1980s and 90s, fat in general was the culprit of all of society's ills. In the 2000s, it's carbs. The second issue is that it is taught too soon, where your brain can't yet sort out all of the information properly (or that it's so diluted that you don't get all of the proper information). And the earlier kids are brainwashed into thinking this way, the more it is reinforced, and the harder it is to break free.

Even we as adults have a hard time breaking out of this mentality. It has been so reinforced that it seems almost instinctual. And because this dichotomous thinking has been honed by millions of years of evolution, the either/or concepts are quite natural. But if we have evolved speech and calculus, I think our brains are up to the challenge.

*The structure of the book is based on Chaucer's Canterbury Tales- an interesting choice for a hard-core atheist. But I digress...

**These online tests might tell you, after you plug in the numbers, that you are, in fact, underweight, but it never asks you that outright. Just the three choices above.

Is the name of my thesis that is done done DONE.

And here, for your reading pleasure, is the introduction.*

Out of Africa
The end of 2003 became the rainy season that wasn’t, plunging Kenya and other East African countries into drought. Crops were in danger. Drinking water was in danger. Where water used to be everywhere, women were now forced to walk long distances, often twice daily, to get fresh water. So they began to store the water in any kind of container they could find, to save their aching feet from the twice-daily walk to fetch water for drinking, cooking, and cleaning.

What they didn’t know—what they couldn’t have known—was that an invisible danger in those containers would set off a series of events whose effects would be felt thousands of miles away. The pools of water that collected in the nooks and crannies of the seemingly empty containers—as well as the stored water itself—was the perfect breeding ground for Aedes aegypti mosquitoes. These mosquitoes have evolved to live alongside humans, taking advantage of environmental quirks that come with Homo sapiens. They can breed in mere teacups of water, and their eggs can survive long after the water is gone. Aedes aegypti can spend their entire lives in houses and huts, never once venturing outside. Their meal of choice is human blood. “These are cosmopolitan animals,” said entomologist Kathleen Walker of the University of Arizona. “They’ve hooked [their] life styles on people.”

The close relationship between Aedes aegypti and humans was also utilized by viruses. They, too, have adapted and evolved. Diseases like dengue and yellow fever exist in a perpetual cycle between humans and mosquitoes. So, too, does an unusual disease with an even more unusual name: Chikungunya. Known in research circles as “Chik,” the virus has probably been around for centuries, transferred to person to person by Aedes aegypti. Most people in the US had never heard of the disease and it might have remained a tropical curiosity if not for the drought.

With plenty of containers and water for breeding, and ready access to human blood for food, the Aedes aegypti population skyrocketed. And at least one of these mosquitoes was infected with Chikungunya, buzzing from victim to unknowing victim and injecting the virus. In the beginning of 2004, hundreds of rural Kenyans reported headache, fever, and rash, as well as excruciating joint pain. This pain, the characteristic symptom of Chikungunya, is so severe that victims bend over, unable to stand. Indeed, it gives the disease its name: “Chikungunya” translates from Swahili as “that which bends over.” Fingers, wrists, knees and ankles swell, leaving limbs gnarled for weeks. The joint pain finally caught the attention of public health officials, who sent blood samples to advanced laboratories for more testing. Lab tests showed an outbreak of Chikungunya in Kenya.

An outbreak of Chikungunya in Kenya—indeed, anywhere in East Africa—is hardly a noteworthy event. This is the region where the virus likely evolved, so it makes sense that it would show up on its own front porch. Yet the outbreak that began in 2004 in Kenya soon left Africa and began a journey eastward, traveling in a large arc in the countries around the Indian Ocean. The total number of people infected with Chikungunya since 2004 is approaching four million, and cases have been reported in Malaysia, Taiwan, and Australia. And the virus shows no sign of stopping.

The Chikungunya virus was first discovered from a febrile woman in 1957, in modern-day Tanzania. By comparing the genes of the Chikungunya virus to those of closely related viruses, virologists knew that the virus had been circulating in east Africa for several hundred years. Perhaps it went unnoticed because the virus was confused with many of the other diseases circulating in tropical Africa. Indeed, the joint pain characteristic of Chikungunya can easily be mistaken as a symptom of dengue fever, another mosquito-borne disease endemic to Africa. And in impoverished countries such as Kenya, Uganda, and Tanzania, modern diagnostic equipment usually isn’t available to distinguish the different viruses causing the same symptoms.

For most of the virus’ history, Chikungunya would flicker in and out of sight, causing small, localized outbreaks. Once a person has been infected with Chikungunya, they are essentially immune for life. When the virus ran out of people to infect, it moved on to other remote areas of East Africa, leaving as suddenly as it had arrived. Up until 1962, Chikungunya had been known to exist only within Africa. Beginning in the 1960s, however, Chikungunya began to move, both around Africa and around the globe. India and Indonesia recorded outbreaks of Chikungunya in the 1960s and 1970s. Both Aedes aegypti and the closely related Asian tiger mosquito (Aedes albopictus) had always lived in those areas. As populations increased, and more of these people moved to urban areas, outbreaks grew larger. The virus could multiply rapidly with large numbers of people in very high concentrations, easily jumping from person to person. And the virus’s carrier, Aedes aegypti, could live just as easily in an apartment complex as in a hut in a dusty village.

Because Chikungunya infections require both mosquitoes and humans, treating both populations is necessary to stop current outbreaks and prevent future ones. Controlling mosquito populations has long been an effective way to combat infectious diseases such as yellow fever, dengue, and malaria, as well as Chikungunya. Given the cost-effective use of chemical insecticides, most countries combating Chikungunya have focused on reducing the number of both Aedes aegypti and Asian tiger mosquitoes.

This is so important because no medications exist to fight the virus once a person has become infected. Chikungunya is a virus, so antibiotics—which only kill bacteria—won’t help. And the development of antiviral medications is still in its infancy. Existing antiviral medications can only treat either the influenza virus or HIV. Treatment remains supportive: plenty of fluids, rest, and anti-inflammatory pain medications, such as Tylenol or Advil, as necessary. A person must then wait for the virus to run its course.

Currently, no vaccine exists to protect a person from becoming infected with Chikungunya. The US Army Medical Research Institute on Infectious Disease (USAMRIID) had been working on a vaccine back in the 1970s, but progress stalled and the project was abandoned. The gravity and scale of the current outbreaks has prompted scientists at USAMRIID to resume work on the project, though an effective vaccine is years in the future. The vaccine is still not ready for animal or human trials. If it passes this stage, then scientists must jump the hurdles of production. Many American pharmaceutical industries are not interested in developing treatments or vaccines for what they see as “Third World” diseases. To them, the Third World is a separate entity, a place far away that is dramatically different than the US. To Chikungunya, a person in Texas is the same as a person in Nairobi.

As the virus began traveling, it appeared in areas where no one was immune, and would strike again. Viruses like Chikungunya “replicate very quickly and spread through the population very fast,” said Ann Powers, director of the Alphavirus Labs at the Centers for Disease Control and Prevention. Because of this, she says, the virus rapidly runs out of people to infect, and the epidemic comes to a halt.

For example, Chikungunya existed in Kenya throughout 2004 and 2005 in cycles, striking and disappearing as groups of people became immune. But Chikungunya had no sooner burned through possible victims in Kenya that it began a slow trek eastward. Traveling east out of Africa, the virus first hit the idyllic Indian Ocean islands of the Comoros, the Seychelles, and Mauritius. The presence of Chikungunya in these French protectorates, popular vacation destinations made French virologists look closely at this disease. More than a full year after the first cases of Chikungunya were diagnosed in Kenya, the international community finally began fighting the disease in earnest. Why the delay? “Of course you have people dying of disease—that’s just what people do in Africa,” said Walker. “Any time you have tropical disease in developed country, it’s easier to get people’s attention.”

*This is copyright by ME, so don't go snatching it. The writing gods will give you bad juju for the rest of your life, and besides- it's not nice. Ask and ye shall receive. Take and I shall smite you.

I have finally decided on my thesis topic for my master's program: the effects of human environmental change (aka "athropogenic" environmental change) on mosquito borne diseases. I am going to be exploring such issues as globalization, climate change, and deforestation/reforestation through four different diseases: malaria, dengue fever, yellow fever, and an emerging virus: chikungunya.

It's fun to say, especially after a couple of glasses of wine. Researchers, however, refer to is as "chik." So I'm a Chik Chick.

I know. If it's too funny (and I know it is!), I will pause briefly while you compose yourself.

I've been working with Discover Magazine to do a short piece about new information on mutations in Chik that enable it to be transmitted much more easily. At any rate, the virus has been in the news after traveling to Italy.

And here, in a brief encapsulation of my thesis topic, is a story in today's New York Times:

As Earth Warms, Tropical Virus Travels to Italy

I will be campaigning in January for travel money. I don't expect a dime (money is, after all, short, and I don't think the reasoning of good food makes a good thesis will hold much water with the Graduate Student Organization), but it might be worth the effort.

Wish me luck!

Apparently, my immunology professor flunked math. You figure this out:

Mid-term: 70%

Final: 89%

Class grade? A

Say what?

I think this is one curve that I can start liking. Now I just need some way to glue it to my ass...

I'm realizing that in less than a week, I'm going to stand up in front of a room full of mostly 18-year-olds and be their professor. Teach them (I hope) how to write, or at least keep them marginally entertained for the semester.

My class is the most popular, the most requested, and has such a long wait list they would offer two sections if they could.

Yikes.

I was aware of that going in, that in a school that specializes in public health and medicine and course featuring these two subjects would likely attract a crowd. My write-up isn't bad, but it's not like the guy who's featuring Borat as a character study. Seriously. We're studying Typhoid Mary. Who is actually an interesting person, and it's a sad story at the end of things. She doesn't try to buy her way out of imprisonment with Khazakstani pubic hair a la Borat, however. It would have made for quite an interesting interlude, if nothing else.

I do think it's an interesting class. Sure, if I were dealing with students with a larger public health background, I might be able to do stuff that I personally would find more interesting. But all in all, I think I've actually created a good course.

I'm still scared shitless.

I know that's normal. Who wouldn't be nervous at starting something entirely new and foreign? I've never taught, never even taken a formal writing class until now. I suppose I'll have one writing class under my belt by the time I start teaching, so I'll be one class ahead of them. This class is also with the senior science editor for Time magazine, which in my opinion should count for two or so. At least.

Today was a good day. I took a preliminary class in rock climbing at the wall in the rec center with one of my classmates. It was so fun. I had mild vertigo at the top, but I didn't barf or panic. I take my final test tomorrow (or next Thursday). I got paperwork and annoying-ness out of the way. My apartment is still a pit, and I am going to take care of that now. I'm literally drowning in paper and cat hair.

Lovely.