Saturday, February 20, 2010

What Does it Take to Be an Olympic Athlete?

I really love the Winter Olympics. My favorite sports to watch are downhill skiing, snowboarding, speed skating, and ice skating.  I'll watch any winter sport that is fast, icy, and graceful.  Not that I want to try them myself, as I am a middling skier, have never tried snowboarding, and go ice skating about once a year with the kids. But I'm impressed with the skill and athletic prowess of the Winter Olympics athletes, and the joy they can take in their sport: J.R. Celski, Rachel Flatt, Apolo Anton Ohno, Hannah Kearney, the pairs skating winners Shen Xue and Zhao Hongbo.

Something seems different this year, though. I cringed as I watched three skiers crash in the women's final of the alpine downhill - one of them tossed into the air at one point like a rag doll - while navigating a course that the commentators admitted might be too difficult for them. In that event, Lindsey Vonn skied her final, gold-medal run in pain, favoring her injured right shin on the turns. I've seen the footage of J.R. Celski bleeding on the track after a serious injury during the Olympic trials in September far too many times. Already, of course, one Olympic athlete, the Georgian athlete Nodar Kumaritashvili has died on a luge training run.

The competition is not just about the participants' athletic abilities and their psychological skills in focusing on the task at hand. It's also about their ability to risk and recover from serious injuries, in order to win on courses that seem to be designed to be as dangerous as possible.

The NBC commentators recite a litany medical problems for each athlete (past knee surgeries, back injuries, concussions, severe lacerations), citing them as evidence of the athlete's triumph over obstacles. I don't see it that way. To me, it seems like reaching the level of an Olympic athlete sometimes requires the athlete to be willing to take inhuman risks in the name of winning. Grace, athleticism, and perseverance - what I enjoy watching - are secondary. Is that sport anymore? Or something else?

Friday, February 12, 2010

Is "Normal" Overrated?

I've been following the news around the draft proposal of the Diagnostic and Statistical Manual of Mental Disorders  revision (the DSM-V), the psychiatric "Bible" used to diagnose, classify, and (often) justify medicating mental health disorders. The draft of the fifth revision is open for public comment until April 2010; the final version will be released in 2013.

The Association of Health Care Journalists' Covering Health blog has a quick overview of the topic, with links to an in-depth article on the changes by Benedict Carey in the New York Times. Two big changes in the DSM-V include:
  • Describing Asperger's syndrome as a type of autism, instead of a separate diagnosis, under the umbrella term of autism spectrum disorder. Unlike people with severe autism, who have trouble with behavior, communication, and socialization, people with Asperger's syndrome, considered a high-functioning type of autism, have a much easier time functioning in society. People with Asperger's syndrome generally want to make social connections, but they have difficulty understanding social interactions.
  • Providing a different definition for bipolar-like behavior in children. Carey points out that children with a bipolar diagnosis are treated with sometimes-dangerous antipsychotic drugs. An alternative diagnosis, "temper dysregulation disorder with dysphoria," would be treated primarily with behavioral therapy.

Carey describes the DSM as "the guidebook that largely determines where society draws the line between normal and not normal." A person whose psychiatric problem creates a danger to himself or others certainly needs treatment. But the debate about how to classify Asperger's syndrome in particular brings up the larger question of how tolerant, or intolerant, we are of behavior that is simply different from the norm.

The blog, run by the mother of a teenager with an autism spectrum disorder, argues that diverse neurological conditions should be better understood and tolerated. Some people with autism spectrum disorders, irritated by how their conditions are misunderstood by the general public, call the rest of us "neurotypicals", bound by social conformity and a lack of creativity.

In an age that prizes - and benefits from - cultural diversity, shouldn't we allow for some neuro-diversity as well? A number of well-known people might have or have had Asperger's syndrome, including Albert Einstein, Bill Gates, and Isaac Newton. Certainly you can argue that they thought differently than the average person, but we have all benefited from their achievements.

Tuesday, February 9, 2010

Can Twitter Save Your Life?

I recently heard about a local 8-year-old girl with leukemia whose parents are looking for a bone marrow donor match for her. Because the girl, Natalie, is Asian, a match (i.e., someone whose cells are similar enough to the girl's cells for her immune system to accept the transplant) is most likely with an Asian donor.

There is an ongoing shortage of ethnic minority donors of bone marrow and stem cells for blood cancer patients (stem cells are extracted from the donor's blood in an outpatient procedure). As a result, Caucasian patients are about twice as likely to find a donor match as minority patients.

I looked at the site for the girl,, and looked at a related bone marrow donation site,, then tweeted the information to spread the word, because you never know who might be able to help. And perhaps Natalie's case will encourage more people to register as potential bone marrow donors so that patients with blood cancer will have a larger group of donors to search within the National Marrow Donor Program. Donating bone marrow, if you're the right match for a patient, is relatively simple and painless.

To spread the word and find a donor, Natalie's parents created a web page, Facebook page, and Twitter account, using social media to its fullest extent; I heard about Natalie on a Yahoo listserve. Natalie's website includes links to volunteer, register, and make donations, and a media contact number.

Thinking about Natalie's case, however, I am haunted by a  number of questions. First of all, I wonder about the families who need bone marrow or blood donors for their ill children but who don't have the tech savvy, access, or language skills to look for much-needed donors through social media.

These families can't cast a wide net looking for donors as Natalie's family has. They are less likely than Natalie's family to find a donor who can save their child. On the other hand, these families do benefit from the additional donors in the national registry who sign up when they hear about children such as Natalie. But to what degree does the surge of new registrants created by cases such as Natalie's mitigate this digital divide?

A while ago, when Twitter was quite new, I stopped to chat with the father of my daughter's classmate at pick-up time. He worked at Twitter, and I asked him what exactly Twitter was supposed to be used for - griping about your day? planning a night out with friends?

Now I know that Twitter is not just a tech toy. It played such a big role in documenting the Iranian election in 2009, for example, that the State Department asked Twitter to change its maintenance schedule in order to keep Twitter online during the protests. Twitter, Facebook, blogs, and other online media are, in fact, extremely powerful for spreading the word about any number of different causes -- political, medical, or personal. Powerful, that is, for people who have access to the technology.