Student Essays

“Untitled” Three poems

You plucked a rose from my garden
So fast
So hard
You said you’d never seen such beauty
You’ve never felt such emotion
You admired it I thought
Plucking the petals off
Gently...
Into the wind
Until there was nothing left of it
You were then the thorn on my rose
Gave me pain that I will always carry
Invisible wounds that I always feel
From the rose you buried
I never got to keep in a vase
The fragrance you claimed
That never belonged to you
You took this single red, red rose 

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Save me
Not from myself, but
From the other side
Trying to reach in
Tear everything down
And leave
If I don’t survive
I go down with it
That means for you to get a hold of me
You would need to reach
In the deepest parts of your memories
To see me
To hear me
To embrace me
I urge you, to hold on to me for dear life

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I was an empty canvas
You painted me with the brightest of colors
Not in a form of expression
But as a hobby
You then stained the canvas
And painted over it with the darkest of colors
You never saw the mess you made
Just admired your work

From Sandcastles to Brick Houses

Last year, I threated God with my life. As a child, I always viewed my life as a sandcastle, strategically placing layer after layer, forming a fortified fortress of hope for the future. Naively, I managed to always build my castles close to the edge of the water, helplessly watching waves whip into them, leaving behind a small mound of muddied serendipity and seashells. No matter how many times the waves came crashing, I always managed to gather the remains and rebuild, until the tsunami.

As a child, I woke to the melody of bracelets making their way through the halls. I’d rub my eyes awake, tiptoeing toward the door as I peered out to see my mom’s laboratory coat as it glided through the air, as she gently opened the door, ready for work. The tune of her bracelets would jolt me awake as I scurried towards her warm embrace. I often rushed to explain the various adventures of my day - it was rough being a ten-year-old with such an active imagination with so little time. I never got to finish any of my stories before she was whisked away to entertain my three other siblings or getting called away to work. But our small moments, when she caressed my head, or her soft smile was enough for me; or so I thought.

After she stopped wearing her bracelets, I stopped recognizing her when she came to and from work. She became a stranger who frequented the house even less. When she smiled at me, my heart coiled and ached, as I was unable to reciprocate her gaze. But I did love her—I do love her. I loved her more than my own sanity would allow. So, I strived to earn her love, or at least convince myself that I deserved it. Had I known she was working as a pharmacist illegally until her certification transferred from Egypt, I would’ve never resented her work for the time I lost with her. Had I known then that my older brother was used as evidence against immigration, the prized firstborn American citizen, I would have never envied the attention he received.

So, in high school, I took a step forward. I worked to be the daughter and sister that could live up to the sacrifices my loved ones made for my future. From bumping up in class rank to adhering to my religious teachings, I became the daughter deserving of my mother. I cultivated our relationship through a garden of memories adorned with her favorite flowers, roses. When we returned home, I smiled at my mother, as she took a seat beside me. I looked up at her warmly before quickly shifting my gaze away from her pale hollowed-out cheeks and thin stature. How stupid of me. It’s been months since that damned tsunami hit, and I keep pretending my sandcastle never crumbled.

I’m immature in that way. Denial is the only way I know how to deal with pain, but when those damn nurses came into our home, it made denial hard. I hated seeing her like that. Those red roses fading into the wilting blue and black color of her IV bruises, that damn scar on her chest from chemotherapy, I hated it all. Everything I was, and everything I thought I was--shattered the second I heard: “stage four cancer.”

God wouldn't do this to me. Not after all the miserable years I endured on this planet, just to have the woman I love most in the world be taken from me. If my mother died, I swore I would follow her. And I know God is too generous, too forgiving to allow my mother, a devote Muslim, to know the heartbreak of her child choosing damnation over a life without her. Unsurprisingly, threats don’t work on the Almighty, so I went with plan B: complete and utter denial.

I often found myself frantically running through the house and the garden in search of my mother. She’d been in and out of the hospital so much that I never knew when she’d be home or when she’d be gone. I was lost without her, left to seek comfort on those nights where I’d find myself falling asleep in my mother’s arms, just to open my eyes to the old black hijab she always used to wear hugging me back. I wiped my tears and buried myself in the cardamom oak fragrance, ready to pretend again.

God must’ve found my threat amusing enough for my mother to be one of the eighteen people who received a successful clinical trial. After months of hopelessness, I regained nefesi, my life and breath, with a single embrace. She was finally home for good, and, in that moment, I made a commitment to rebuild my life, brick by brick, into one that honors my mother, her sacrifices, and beliefs. I now thrive in a brick house, proudly adorning talismans from the beach, ready to expand to the various possibilities that my future will bring. I have learned to embrace my life and all its challenges, chiming my mother's bracelet tune as I follow her into pharmacy and womanhood.

Review of Thomas A. Guglielmo “’Red Cross, Double Cross’: Race and America’s World War II-Era Blood Donor Service.” The Journal of American History, Jun 2010. Pg. 63.

The image of the Red Cross often evokes feelings of compassion, with individuals visualizing the life-saving aid the organization provides in critical times, completely oblivious to its dark and racist history. In his article, “’Red Cross, Double Cross’: Race and America’s World War II-Era Blood Donor Service” (2010), Thomas A. Guglielmo directly challenges this idealized image. He argues that despite its external humanitarian image, the organization’s history is marred with racism and discrimination against African Americans, who had to protest and publicly argue in hopes of abolishing the practice. He does so in a comprehensive way, providing a thorough examination of the Red Cross’s blood donor program during World War II in relation to racial prejudices, all while using clear and concise language so that a general audience could understand his message. However, Guglielmo is limited in his exploration of the long-term consequences of this segregation, and his discussion of internal conflict within the Red Cross about these discriminatory practices.

From the start of the Red Cross’s efforts in World War II, the organization was centrally focused on providing blood for soldiers in combat, stating that “thousands of men [were] alive” thanks to the donations (Guglielmo, 63). However, their practices for obtaining such blood reflected the attitudes of society rather than those of science: the blood of African Americans was inferior to those of white Americans. For instance, the Red Cross would label collected blood as “white” or “colored” to ensure these collections remained separated (Guglielmo, 66). The Red Cross attempted to downplay this discrimination by “avoiding talk of races as fundamentally and immutably distinct, but Guglielmo argues that this practice “maintained a deeply unequal racial order” (Guglielmo, 66). An organization whose goal was to save lives was contrarily risking them by not receiving blood donations from black Americans. Even when they started accepting blood, the donations were segregated, as most white soldiers refused to be treated with the blood of a black person. This practice needlessly endangered the lives of soldiers, especially as the war raged on, bloodshed increased, but blood donations remained stagnant. Thus, Guglielmo effectively portrays how the Red Cross’s discriminatory practices fully opposed its public mission.

African Americans were forced to argue and protest against the Red Cross to eliminate these racist policies. In 1941, an African American named Wanda Douglas was turned away at a donation center, leading to much controversy surrounding the Red Cross. Nonetheless, Surgeon General of the Navy Ross T. McIntire stated “…regarding the use of negro blood… At this time, there is no need for such a procedure and I can not visualize one in the near future” (Guglielmo, 69). Supporting the opinions of the military, Red Cross director G. Candy Robinson added, “…about ninety-five percent of those serving in the armed forces are white men, who… prefer plasma from white donors” (Guglielmo, 70). Early protests and publicity against the Red Cross were unsuccessful, as the organization remained firm on excluding African Americans entirely. However, these efforts did not remain unnoticed, but instead set the precedent for similar activism in the coming years. Through “impassioned protest letters and telegrams” to the President, increased attention in newspapers and tabloids, and involvement from civil rights groups such as the NAACP, the Red Cross finally decided to accept blood from black donors on a segregated basis in 1942 (Guglielmo, 71). While the practice of blood being segregated and only being given to members of the same race remained in place until 1947, Guglielmo shows the power of activism in addressing inequitable health policies.

A strength of Guglielmo’s literary work is the context in which he presents his argument. It was clear that by the time of World War II, members of the military and Red Cross were aware that there was no scientific basis to segregate blood. For instance, Surgeon General of the Army James C. Magee expressed that he did not wish to mix white and black blood “for reasons not biologically convincing but which are commonly recognized as psychologically important in America” (Guglielmo, 70). Guglielmo strengthens this position by including an argument from historian David Freund, who explains how Americans at the time “downplayed essentialist racial hierarchies and highlighted… ‘nonracial variables’” (Guglielmo, 66). By including these components in his writing, the author alludes to the overarching racist attitudes of Americans in the 1940s. While different from the belief that African Americans were biologically different, white Americans perceived black people as socially inferior and outright did not wish to be associated with them. This attitude extended into the military, where soldiers refused to have their own blood mixed with that of African Americans. Guglielmo’s context surrounding racism in America sets the perfect platform for the presentation of his argument.

The author’s use of clear and concise language allows his writing to be easily understood. By including quotes from primary sources in a chronological progression, Guglielmo establishes evidence for his argument. He further enhances these examples by thoroughly explaining the importance of them, in a way that any interested readers could follow. Thus, he reaches an audience of not only historians and public health professionals to whom this work may directly impact, but also the general public who may be familiar with the work of the Red Cross but unfamiliar with its dark past. Reaching a large audience allows Guglielmo’s argument to be amplified, allowing more readers to discover the discriminatory practices of the Red Cross and the power of activism in bringing about change.

However, Guglielmo’s exploration of the Red Cross’s history is not as thorough as it could be. While he focuses on the efforts of African Americans in forcing the Red Cross to switch from exclusion to segregation and eventually to full inclusion, he halts there, failing to explore the long-term consequences such policies had on the black community. This episode eroded the trust of many black people in the American healthcare system, who felt a sense of betrayal and hypocrisy, comparing the Red Cross’s policies to “Hitler’s ideas of race and blood” (Guglielmo, 71). This lack of trust has led the African American population to question the quality of care they would receive in hospitals, as well as from white medical professionals. Furthermore, the damage dealt by these policies is present to this day; for example, the increased hesitancy of black Americans to receive the COVID-19 vaccine is evidence of distrust in the system. Thus, Guglielmo’s argument is partially incomplete, as the problems from the Red Cross’s discrimination and racial prejudice in the medical field did not end in 1947.

Another weakness lies in Guglielmo’s limited discussion of internal conflict within the Red Cross.  While he emphasizes the overall stance of the organization in excluding and segregating blood from black donors, exploring potential internal debates on the issue could provide a better understanding of the decision-making process in establishing these policies. Examining whether there were individuals within the Red Cross who challenged the racist attitudes could shed light on the power dynamics in the organization and offer a more complete historical picture.  Did any voices within the Red Cross argue for inclusivity based on medical science or humanitarian principles?  Understanding these internal factors could strengthen Guglielmo’s analysis.

“Red Cross, Double Cross” portrays the racist practices of an organization that seems perfectly benevolent on the outside. By placing his argument in a larger historical context and by using clear and concise language, Guglielmo shows how social activism can foster good change. While he does not explore the eventual consequences of the Red Cross’s policies or the potential internal debate within the organization, Guglielmo’s work encourages readers to holistically analyze other healthcare organizations as well. Are their actions as idealistic as their image, or is there something more immoral happening behind the public’s watch?

Guglielmo, T. A.  “’Red Cross, Double Cross’: Race and America’s World War II-Era Blood Donor Service.” The Journal of American History, Jun 2010. Pg. 63.

Breast Cancer Can Leave Legacies Too

The reason I majored in Doctor of Pharmacy at ACPHS was to contribute to the bigger picture of health care, one patient at a time. I see my occupation as an opportunity to leave my mark, even if the impact is only felt by a few. The word “legacy” is often seen in a large-world perspective with the thinking that to leave one, we must do something huge and world-changing. However, The Bright Hour by Nina Riggs challenges this belief, showing that leaving a legacy can be as simple as writing a book to share our experiences, like her life with cancer, and recognizing the importance of the times we share with others. Through her book The Bright Hour, I believe Nina Riggs’ theme of legacy, through the lens of her breast cancer journey, helps us elucidate the human experience of breast cancer by showing a new side to life in terms of death and her experience with learning to let go.

In her book, Nina Riggs frequently mentions her mother, who also passed away from cancer. In “Mother and Daughter Tour Italy,” Riggs recounts they constantly argued throughout their trip and says her mother “desperately [needed] to still be [her] mom,” and Riggs “desperately [needed] to prove to her how much [she] didn’t need a mom” (Riggs 78). This seems like typical mother-daughter banter, but on page 79, there comes a deeper meaning to their exchanges. Riggs tells she and her mother were reading Atul Gawande’s Being Mortal and came to a new “clarity” on death she faced with her mother. Riggs found “beauty” in Gawande’s exploration of “how to distill what matters most to each of us in life in order to navigate our way toward the edge of it in a meaningful and satisfying way” (Riggs 79). To Riggs, this was “mind-blowing”; however, it wasn’t for her mother who said, “This is what I’ve been saying all along; you just haven’t been ready to listen” (Riggs 79). I believe this marked a shift for Riggs in her understanding of death. She begins to see it as something that makes life more valuable and realizes her mother “bothering” her on this trip was her mother’s way of finding “comfort at the edge” of her life. Her mother’s need to still be her mother was her way of leaving her “legacy” behind, her way of confronting death with meaning. This motivates Riggs to do the same with her children, leaving her legacy of meaning and impact for them. Additionally, I took her mother saying she wasn’t ready to listen as a comforting reminder, as Riggs will eventually face the same reality because of her own cancer diagnosis. Riggs may not be ready to face “the edge,” but her mother is encouraging her to find her lasting purpose with her children and leave a mark they can keep with them. I found this passage humanizing in that we all will face death, and describing it as something that can motivate us to find meaning before “the edge” help cancer patients feel more human.

Nina Riggs not only explores the idea of leaving a legacy for her children, but also reflects on how her children are shaping her own legacy. This opened my eyes to how different ages influence our outlook on life, and how simple perspectives of youth can impact adults just as much as adult lessons can influence youth. This is discussed in the chapter “Not Men-O’-War,” about when Riggs and her children observed jellyfish at a beach house during a holiday. Although the jellyfish had dangerous stingers, her children were captivated by them and their hearts. Riggs said their captivation, rather than being afraid, helped her come “closer to [understanding] that openness to fear” (Riggs 181). For those with cancer, they come to see life from a different “lens” and learn more from the people around them than they did before, which I think is captured by Riggs in this chapter. While Riggs is still tackling the fear surrounding her breast cancer and possible death, her children unknowingly teach her not to fear it, which echoes the lessons her mother shared with her during her own cancer journey. She and Freddy (one of her sons) also wrote in the sand something that made them stronger but that they are ready to let go of. Riggs writes CANCER, and Freddy writes DIABETES (Riggs 182). This may symbolize the belief that Riggs does not want her legacy to be defined by her cancer and hopes to be remembered by the impact she left on the people she loved and the fearlessness she has learned from her children. Riggs’ book sheds light on the human experience of cancer by allowing us to see how it changes our perspective on life, especially with regards to fear, through family and those we love. In this chapter, we see the impact her children and family had on her, which has also impacted the definition of legacy and its theme in the book. Riggs leaves her legacy shaped by not only her experiences, but also by her children, humanizing the experience of her cancer. This reoccurring theme of legacy underscores her journey of letting go of her family, offering readers the raw side of confronting cancer, life, and death.

Towards the end of her memoir, Riggs comes face-to-face with death as her treatments are no longer working. In “Momento Mori,” she reiterates the phrase “Remember, you must die” during her trip to Florida with her kids and husband, which also reminds her of her trip to Italy with her mother. In the end, she comes to terms with death and acknowledges that as parents, “we follow our children down manicured paths through an overdeveloped inland swamp, whispering remember you must- we all must- die in [our children’s] ears as they find their way through world rebuilt and worlds that never were” (Riggs 299). This final quote portrays how much Nina Riggs’ character has developed through her cancer journey. She first saw death in a new light through her mother, learned to not fear it from her children, and now finally accepts it and lets go. From her book, it becomes clear that she has left her children the legacy of her story and the lesson of not dwelling on the “worlds that never were” and focusing on the “world rebuilt” from their time together and the future that lays ahead, ultimately symbolizing the nature of life and death. For me, this chapter was hard to read emotionally, and I thought this chapter served as a reminder of the human soul and the pain and joy it goes through during life, and even more so for cancer patients when they face death.

The Bright Hour by Nina Riggs fully encompasses the theme of legacy through elucidating the human experience of cancer by showing the development of letting go and coming to terms with death. However, the truly humanizing part of Riggs’ book lies in the understanding of this and continuing to live life to the fullest. As I prepare to become a doctor someday, I aspire to support my patients not only physically, but emotionally through the rollercoaster of cancer and life. Because of Nina Riggs, I want to create my legacy not only by my contributions to society, but also by the impact I had on the people I met and the souls I touched.

Works Cited

Riggs, Nina. The Bright Hour: A Memoir of Living and Dying. Simon & Schuster Paperback, 2018.

Child of The Moon

It began with a humble lunch box. Though it was crafted with ordinary plastic, it held immeasurable value. The contents of the ordinary plastic were far from plain; each spice and herb sang to me fondly in my mother’s voice. However, as I opened it, I stumbled upon a lingering bitter sensation. The task of placing my lunchbox on the table that was scattered with Lunchables and Fruit Roll-ups seemed impossible. It didn’t belong on the table, but rather hidden away in my backpack where only I could see it. The unusual bitterness ran circles around my mind, casting a shadow on my reflection. “Why is my hair like this? Why is my nose shaped this way?” A small memory of dread had grown into a tree with stubborn roots. Just what would it take for the bitterness to dissipate?

My cultural roots weighed down my shoulders with burden and shame, rather than uplifting them with identity and pride. Shame stung my face when I dared to wear my traditional cultural attire in public. The cloth was reminiscent of the vivid patterns seen through the lens of a kaleidoscope, yet it felt criminal to be seen wearing it. My routine was the flip of a switch, in my home rhythmic words of Urdu rolled off my tongue. At school, every word would be manually translated into English. Each thought meticulously crafted into a sentence that I hoped would get my point across. One morning during attendance, I answered to my name in Urdu out of habit in front of my entire 4th grade class. My teachers face contorted, and I sunk into myself as the room filled with laughter. It wasn’t until I was handed a box of tissues that I realized I was crying. I felt stupid, as if the knowledge of my native language was nothing but a burden.

It had been 8 years since I visited my home country, and ironically the 18-hour plane ride only worked to stray me even further from the familiar warmth of home. Through my eyes a Pakistani household was an empty building, devoid of any furniture, with stark white walls. It taunted me, because it was my own creation, I had witnessed the kaleidoscopic colors of my culture fade out of my life.

On the 3rd day of my trip, I noticed that the Pakistani sun would relent only when the moon was there to take its place. It made me appreciate the moon in a new light. I’d climb the infinite stairs up to the rooftop of my mother’s childhood home where I could admire the moon and count the canopy of stars. It became a ritual that I’d look forward to nightly, and eventually my cousins joined me. We climbed the stairs quickly, panting by the time we reached the last one; yet we’d still find words to share the stories that had been buried under the blanket of time. Though every word was lined with precious silver, there was a handful of words that were pure gold. “You’re a child of the moon you know.” My cousin whispered for only me to hear. “If you feel out of place in America, just look up. We’ll both see the same one.” She said as she pointed at the moon. I felt overwhelmingly blissful, the corners of my mouth soared up as cold tears streamed down my face. I loved the moon, and everything it represented for my culture. I deeply regretted neglecting it for the better half of my life. Each night, every story that was shared helped to slowly paint the stark white walls with the kaleidoscopic colors that I had finally learned to adore. By the end of my trip, the house was adorned with moonlit memories, each one worth its weight in gold. It was when I accepted my culture with open arms that a Pakistani household became a home; surrounding me with warmth and a sense of belonging that I had craved my entire life.

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Unconditional

Aytin Shariq, a name to be earned. Surely, I was not deserving of it at my very first word, or my very first step. Surely, I would have to reach my very first miracle, or anything more meaningful than my mere existence. To truly claim such a name, it would take my weight in gold. But of course, that was solely my burden. What tasted sweet to others settled bitterly on my tongue. Unconditional was a word as meaningless as my own name, only to me of course. I have had to learn that it could never be one of my possessions.

My brothers, 10 and 14, were once 5 and 9. It was during this time that it occurred to me, something was new. Not the kind of new that was shiny and rewarding, but the kind that made the bitter taste on my tongue unbearable, worse than it had ever been. The kind of new that mocked me, even with my tireless attempts to look past it, it made my bronze resemble clay. They had deserved their names the moment they were born. Shahmir Qureshi, the king of kings, Shahwaiz Qureshi, noble like no other. Aytin Shariq, bright as the moon, or rather, one day to be as bright as the moon. Though, that day will never come. The day that the moon shines like the sun will not come either. The moon will not be unconditionally loved like the sun, nor will it give life to the flowers that bask underneath. Even the tides under its reign go unnoticed until a ship is beached upon a shore; when the tides are finally noticed, it is nearly always when they draw the ire of man.

I carry my father’s first name as my last, heavy as it is, it’s the way of the tribe. Muslim girls are proud to carry their fathers name, some even take it to their last day. I would do the same if I deserved it, if I weren’t obligated to give my life a meaning, other than just living. If my value did not exist at the very peak of a mountain, or at the end of dark tunnel, where then am I to find it? While it feels as though my value is linked to achievement, some unattainable summit to climb, I yearn for my clay be refined to bronze, and soon the bronze to gold.

My first name, the only name in the family to start with the letter A, is a mighty bluff. The letter S was the sun; it did not matter that the letter A came first in the alphabet. Of course, I love the sun. The sun deserves all that he has, he’s dear to me. He’s the very reason flowers grow, and the world lives to bask in his warmth. Yet still I wonder; when will the bitterness fade, when will the moon be loved as unconditionally?

I cannot say I love the moon. Though, that is where it must start. To love the moon would be to love her for who she is, not how brightly she shines, not if she helps the flowers to grow. Love her as she comes, tides and all. To speak of her the same way the sun is spoken of. Is that what I am to do? Love the moon myself, with a glint of hope that one day, others will too? So be it. If that is what it takes to deserve my name, to be loved unconditionally regardless of silly titles or numbers. I love the tides. I love the moon.

The Downward Cycle

Yet again, I am trapped in thoughts whose origins I do not know. Thoughts that stab other thoughts. Thoughts that spiral off the clock tower and fall through the gears until the clock strikes three. Chime, down goes the clock tower. Chime, down goes my anatomy. Chime, down goes the rain. This rain, coursing along and through thy skin and veins. Puddles he steeped in, distorted, no-name, anonymous reflections. This red-blooded thief, that is not me, not anymore. Rain became tears, tears became thoughts, thoughts became rain. Rain became tears, tears became thoughts, thoughts became rain. This is the cycle we forever live in. His mind, one I am acquainted with, is a tomb for which we cannot escape. Trapped, darkness, sorrow, pain, pain, pain, until an unlucky foe frees us from these walls. When they shall find us, I hope they look past the jewels and gold which circumnavigates these two hands, and se the piercing rays emitting from the sun, which stab the drops of rain, evaporating the leftover distortions from my mind. Chime, up goes the rain, for now I shall not experience anymore pain.

Zeyad Elkaffash

I'm a commuter student from Schenectady, New York. This is my first year as a pre-pharmacy major in the PharmD program. Conveying meaning efficiently has always fascinated me. Consequently, reading is a passion of mine. This passion developed into hours of reading novels, webnovels, and all manner of stories. This reading grew my love for writing and wordplay, which brought about my hobby writing. This essay was written for Principles of Communication taught by Dr. Anna Eyre. The assignment was to write a summary and response essay to “Corn-pone Opinions” by Mark Twain.

A Call to Action

A man is walking to his car, groceries in hand. Suddenly, he sees a protest for animal rights pass by. The eggs in his bag smash against the asphalt. He joins the protesters. This is what would happen in a world where people cannot form their own opinions and always conform to the crowd. Mark Twain paints this picture of humanity in his initially unpublished writing "Corn-prone Opinions.” Twain paints a picture where all self-approval is derived from the populous and polarized social silos are inevitable. I will concede that band wagoning and similar behaviors are prevalent in modern society; however, these behaviors are not the rule. Even though many people are conforming to their respective crowds, humans still form their own unique thoughts and opinions, or as Twain puts it “coldly-thought-out and independent verdict”1(p.1) .

I do not believe Twain believes in the narrative about conformity he shares in “Corn-pone Opinion”. Twain begins with a description of a slave, a man without power or voice in society. Jerry, the slave, would stand on top of his master’s wood pile and give sermons every day. Society silenced Jerry; he was over-looked in the distribution of rewards. Despite this, Jerry, armed with his inherently human ability to reason and think, went against societal expectations to share with his audience, no one he knew, what he thought. It was Jerry’s belief that people in society would intentionally conform to the standards applied to them by society and for their own social and monetary gain1(p.1). In this passage, Jerry, and by extension Twain, are referring to the practice of slavery, which was a practice perpetuated by men in power who conformed to, as Twain states, “ the majority view of his locality by calculation and intention”1(p.1).

A devoted abolitionist, Twain intentionally started “Corn-pone Opinions” with a slave who indirectly called out the practice of slavery. Twain deliberately demonstrates society’s reality, which has people of all different walks of life forming their own unique thoughts and ideas no matter the circumstances, a reality exemplified by Jerry.1(p.2). Twain later explains that members of a society will conform to the fashion of those they perceive as wielders of authority by the human instinct to yield to authority, and secondly the instinct to conform to the majority.1(p.2) This, to me, shows how the practice of conforming to the crowd is widespread throughout portions of society, and is often not directly related to monetary value. Twain mentions this to reinforce his idea that humans will choose to conform to the crowd, not with “calculation and intention”1(p.1), but instead out of their own desire for self-approval derived from the approval of others.

Validating yourself via the approval of others is a familiar experience of many of us today. I believe this idea is rooted in fact. However, I strongly disagree with Twain’s implication that the approval of others is the primary source of self-approval. One of the most crucial pieces of advice given to modern youth in this social media driven world is to seek to accept yourself before seeking acceptance from others. It is apparent that Twain saw in his world the beginning of crowd mentalities and social silos that divided the populous into groups, key characteristics of our world today, and wrote “Corn-pone Opinions” as a wakeup call.

In effect, “Corn-pone Opinions” is a call to action, as is further elaborated on in his conclusion when he strongly, ironically, states how public opinion is treated in a society without original thinkers. “Its name is public opinion. It is held in reverence. It settles everything. Some think it the voice of God.”1(p.3) Using the example of wine consumption in Europe, Twain concludes the paragraph by explaining that “We get our notions and habits and opinions from outside influences; we do not have to study them out.”1(p.2) Contrary to what Twain says, people naturally collect the opinions of others to form their own unique collage. Twain, like everyone else, takes inspiration from already existing opinions--Jerry’s--and develops them into his own.

Despite Mark Twain saying that a “coldly-thought-out and independent verdict”1(p.1) doesn’t exist he demonstrates how a “coldly-thought-out and independent verdict”1(p.1) is formed. By writing about a situation wherein society throws away the inherently human ability to reason out opinions, he is asking his audience to draw their own opinions and speak up. In some way, he encourages using your voice when he talks about how even a nobody could start a trend1(p.2). Much of what Twain says in “Corn-pone Opinions” is meant to be refuted, like the fact that Jerry was wrong that humans can form opinions. It is clear to me that through writing “Corn-pone Opinions”, Twain was attempting to call out an unfortunate practice in society, this practice being conformity without thought. It is incredibly important that we, as members of society, attempt to remedy this by educating ourselves and forming our own opinions.

References

Corn-pone* Opinions by Mark Twain - Havlicek's classroom [Internet]. [cited 2022 Oct 17].

Kayleigh Early

My name is Kayleigh Early, and I’m from Williamsport, PA. I’m a P2 student in the PharmD program with a minor in public health. Writing is important to me because it helps me express what I’m thinking to myself and others. I personally find it much easier to articulate my thoughts via writing. When speaking, I feel like important ideas are left unsaid. Outside of school, I enjoy spending time with my dog, Flynn, and going for hikes and runs. This essay was written for Global Health taught by Dr. Kevin Hickey.

Bending the Arc of Oral Health Care

Many believe that President Biden has restored routine to the White House, habitually beginning his day in the Oval Office at 9 am and ending at 7 pm with dinner.1 Ideal morning and evening routines typically consist of exercise, meditation, affirmations, journaling, and reading, but they fail to mention a task that many educated people (with the proper access) accept as given—teeth brushing. Oral health is often considered a separate entity from physical and mental health, when in fact it is a crucial, unseen aspect of daily living. In fact, in 1948, the World Health Organization (WHO) defined oral health “as the general wellbeing that allows individuals to accomplish daily activities such as eating, talking, smiling, and performing social roles, rather than merely the absence of disease.”2 The numerous opportunities available in the contemporary world would suggest that education and access to proper care is widespread, but this is rarely the case. For many people, especially those living in Southeast Asia and Brazil (although also seen in underserved communities in the United States), oral health is not given the proper attention, ultimately introducing the flawed argument that not all people are worthy of this essential element of life.2,3,4,5,6,7,8,9.

For the Karen ethnic group living along the Thai-Myanmar border in Thailand, the importance of oral health is recognized but not properly pursued.3 A 30-45-year-old woman living in the Mae Tan Village stated, “After losing baby teeth, we simply throw them away. But adult teeth, we cannot lose them, as they are more important and necessary. We use them throughout our lives.”3 The priority placed on oral health is contradictory to the culture’s oral health routines. Although the Karen ethnic group practices teeth brushing, it is not completed logically. A 30-45-year-old woman living in the Khun Houy Village explained, “I take a shower once a day in the evening, and I also brush my teeth at the same time…We rinse our mouths after dinner, and that is enough.”3 The issue is not that the Karen people disregard oral health but that they are uneducated about the best practices to prevent issues such as gingivitis, toothaches, or severe dental caries.3 Many people in this culture brush their teeth with a toothbrush and salt, and they perceive toothbrushing as a sign of hygiene rather than a preventative measure to reduce risks associated with poor oral health.3 With nobody informing the Karen ethnic group about correct oral care practices, achieving optimal oral health, an aspect of life that these people appreciate but do not fully understand, is not a likely possibility.

Even if professional dental care is made available (currently a general lack thereof), the Karen people prefer to self-treat.3 Members in the Mae Tan Village have resolved numerous oral health issues on their own, working through dental pain with more frequent tooth brushing and reduced consumption of sweet foods, settling gum bleeding with warm salt water rinses, and dealing with tooth mobility by eating a soft food diet or chewing on the other side of the mouth.3In a culture that lacks timely dental care and fears dental procedures and equipment, increasing access and trust in professional resources is imperative.3 However, understanding the appropriate measures to prevent dental issues (via education) is just as critical. The Karen ethnic group’s lack of access to oral health resources and education suggests that those with the means to help do not value this society’s overall wellbeing.

The Karen people are not alone in their preference to self-treat oral health problems.2 Two Brazilian indigenous groups, specifically the Kaingang and Guarana people, distrust dental health care practices.2 They associate oral health care with white people and believe that “white food causes white disease.”2 In other words, “white” treatment has only become necessary because “white” food exists. The Kaingan and Guarana people appear to sense a level of hypocrisy among the “white” dental health care practices. Why should they accept help from the same people that instigated their issue? In truth, “the adoption of Western dietary habits, although often naturalized, was understood as a threat to the health of individuals, with important impacts on the oral status.”2 Many foods in the Western diet are high in sugar, which ultimately has a decaying effect on teeth, especially when teeth are not properly maintained. Part of the Brazilian indigenous groups’ distrust of dental health care also has to do with lack of access, high dentist turnover in the villages, and inefficiency at dental care practices.2 Dental care workers may build rapport and establish trust within the communities by making home visits, but in an already failing system, such prospects are slim.2 The “white” people’s failure to make oral health care accommodations for people that need help implies that such an issue is, in their minds, insignificant.

​The Karen, Kaingang, and Guarana people prefer to self-treat and utilize traditional dental practices, but is this harmful? According to the American Dental Association (ADA) and other public health agencies, it is recommended to brush teeth with fluoridated toothpaste twice daily while also flossing daily.4 Despite this recommendation, a traditional form of toothbrush, called the miswak (originated from the stem of the Arak tree), displays antimicrobial activity against Streptococcus mutans (a bacteria that contributes to tooth decay) and is commonly used among indigenous people.4 Although it was found that the use of miswak chewing sticks along with toothbrushing can improve oral hygiene and gingival health, there are many limitations that must be considered, including poor quality due to lack of standardization, irritation and sensitivity, instability in the gastrointestinal tract, poor absorption, and low bioavailability.5 For many, traditional dental practices instill the “illusion that these products are safe for daily or long-term use, which may not be the case.”6 While it would be ideal that all people resort to evidence-based dental practices, especially the utilization of fluoridated toothpaste, lack of education and access to appropriate resources makes this unrealistic. Actions to improve access and education have been initiated, but they are frequently flawed. Apparently, the lack of effective initiative suggests that it is not believed that all people deserve these services.

​In Brazil, many of the issues association with dental care revolve around the dentists’ approach to treatment. It is commonplace for dentists to focus on the patient’s condition rather than the story behind the person’s dental problems.7 In fact, “the focus is on the disease, or more specifically, the damaged tooth, as if it were an entity separate from the general physiology of body and society.”7 This is problematic because patients’ conditions are blamed as the result of poor oral hygiene habits, when in reality the problem might be lack of access to water, toothbrushes, toothpaste, or other means to maintain adequate health.7 The dentists also tend to lack empathy, explaining, “Sometimes I lose my patience with that person that I’ve already told ten times, yet they come back without brushing their teeth, full of plaque.”7 It is not a health care professional’s place to judge a patient for their health condition, even if the solution, such as teeth brushing, appears simple. Judgment impedes proper care, and it ultimately reduces the likelihood that patients’ conditions will improve. Not only are dentists frequently unsympathetic, but they are also unable to devote necessary time to their patients. One dentist said, “If I stop everyone and say, look, let’s learn about tooth brushing, and demonstrate it, I won’t have time to see everyone.”7 The most efficient approach to dental care would be to stop the problem before it begins, but, evidently, dentists in Brazil do not have the time to practice logically. With time limitations as a prominent barrier to improve dental access and education, perhaps a solution would include increasing the number of facilities and dentists available, so each dentist would be responsible for fewer patients. Until this is achieved, however, the lack of time and resource allocation signifies that oral health care is not at the forefront for all populations. 

​Efforts to promote oral health have been more successful in India. While India experiences unequal distribution of dentists in rural and urban areas (limiting access for some individuals) as well as pricey dental treatments, the country has trained AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) professionals to offer dental advice to those who cannot seek direct care.8 In just one day of training, AYUSH professionals significantly increased their knowledge of dental care, thereby making them valuable assets to the Indian population.8 Beyond the utilization of AYUSH professionals, India has also implemented the National Oral Health Programme (NOHP), which includes objectives such as “enhancement of oral health care delivery system, improvement of access to services to oral health care, and reduction in disparities in the oral health status of people across different geographic locations, age groups, gender, and socioeconomic status.”8 In this way, whereas Brazil appears reluctant to account for determinants of health, India acknowledges that they exist and is working to adapt to different populations’ needs.8 Despite these efforts, the fact that improvements in oral health care and education are still a work in progress implies that, at the moment, all individuals are not believed worthy of the human right to sufficient oral health.

Inadequate access to dental care is not an issue reserved to Southeast Asia and Brazil. In underserved communities in America, especially those comprised of immigrants, people refrain from seeking medical and dental care because they fear interacting with public and private agencies that may question their immigration status. If these people do seek help, their last resort is hospital emergency rooms rather than dental health care practices.9 This is problematic because “hospital emergency departments are ill-equipped to handle dental problems, so many patients receive only antibiotics or pain medication, leaving their fundamental oral conditions untreated and thus likely to become exacerbated over time.”9At this point, the dental care received is no longer preventative but a band-aid solution. Determinants of health limit health equity. Initiatives to improve access to dental care should consider “complex and controversial issues of racism, income inequality, food insecurity, and inequities in education, taxation, and housing.”9 At the moment, the health care system does not prioritize those born into unforgiving circumstances. Until all people are treated as human beings deserving of care, oral health (or truly any facet of health) cannot be given the proper attention, and people will continue to suffer the unfair consequences.

In President Biden’s first speech to Congress, he, recalling a famous Martin Luther King Jr. speech, declared, “We have a giant opportunity to bend the arc of the moral universe toward justice. Real justice.”10 Moral injustice spans vast numbers of issues, and, as a pervasive issue, it is not specific to any one geographical area. In the oral health sphere, the lack of education and access, distrust in health care professionals, reliance on traditional practices, and recognition of dental professionals’ lack of empathy and time, are not issues restricted to Southeast Asia, Brazil, and underserved communities in America.2,3,4,5,6,7,8,9 Wherever social, economic, and environmental influences limit adequate health care (but, in truth, limit equity in almost all aspects of life), oral health will not be prioritized. Every person with sufficient means has a responsibility to advocate for equity, but not just for oral health. If not now, then when?

References

Parker, Ashley. Weightlifting, Gatorade, birthday calls: Inside Biden’s day [Internet]. Washington Post; 24 May 2021 [cited 2022 Dec 10]. Available from: https://www.washingtonpost.com/politics/biden-daily-routine-gatorade/2021/05/23/b6f608c2-b40e-11eb-a3b5-f994536fe84a_story.html

Soares GH, Carrer FCA, Biazevic MGH, Michel-Crosato E. Food Transition and Oral Health in Two Brazilian Indigenous Peoples: A Grounded Theory Model. Journal of Health Care for the Poor and Underserved. 2019 Aug;30(3):1037-1052.

Thu SWYM, Negeonwiwatkul Y, Maneekan P, Phuanukoonnon S. Perception and belief in oral health among Karen ethnic group living along Thai-Myanmar border, Thailand. BMC Oral Health. 2020 Nov 11;20(1):322-332.

Rifaey N, AlAdwani M, Karched M, Baskaradoss JK. A clinical investigation into the efficacy of miswak chewing sticks as an oral hygiene aid: A crossover randomized trial. International Journal of Dental Hygiene. 2020 Dec 20;19(2):223-230.

Kumar R, Mirza mA, Naseef PP, Kuruniyan MS, Zakir F, Aggarwal G. Exploring the Potential of Natural Product-Based Nanomedicine for Maintaining Oral Health. Molecules. 2022 Mar 7;27(5):1725.

Reddington AR. Patient Education: Holistic Oral Health Care Trends. The Dental Assistant. 2018 May/Jun;87(3):12-15.

Soares GH, Carrer FCA, Biazevic MGH, Michel-Crosato E. Food Transition and Oral Health in Two Brazilian Indigenous Peoples: A Grounded Theory Model. Journal of Health Care for the Poor and Underserved. 2019 Aug;30(3):1037-1052.

Kharbanda OP, Priya H, Bhadauria US, Khurana C, Das D, Dev M, et al. Empowering AYUSH health professionals on oral health promotion in a tertiary care dental hospital in India: An interventional study. Journal of Ayurveda and Integrative Medicine. 2020 Jun 30;12(1):75-79.

Demby N, Northridge ME. Delivering Equitable Care to Underserved Communities. American Journal of Public Health. 2018 Nov;108(11):1446-1447.

McCarthy, Joe. 13 Key Quotes from President Joe Biden’s First Speech to Congress [Internet]. Global Citizen; 29 Apr 2021 [cited 2022 Dec 12]. Available from: https://www.globalcitizen.org/en/content/joe-biden-address-to-congress-quotes/

Maung Ka

I was born in a refugee camp between the borders of Thailand and Myanmar. My family immigrated to the United States in 2009. For most of my childhood, I grew up in Albany. I wanted to be able to help my Karen refugee community with their misconceptions about medicine so I chose the PharmD major, class of 2027. Writing is important to me because it's easier for me to get my points across. I'm not a good speaker so my words may miss their intention but writing allows me to organize my thoughts and be more concise. When I'm not in school, I like to work out at the gym and play pick-up basketball with my friends. This essay was written for Humanities 201 taught by Dr. Kevin Hickey.

When Refugees Resettle

When refugees resettle to a new, stable country to make their new life, all their problems don’t just go away. Although it is common sense that adaptation to a new country with a new language, culture, weather, etc. will have it’s challenges, there are unique difficulties for the resettled refugee. It is important to be aware of these problems as it is projected that there could be an increase in refugees with ongoing world conflicts and the problems associated with global warming. In the film, I Am Not Your Negro, by Raoul Peck, James Baldwin says, “part of my responsibility, as a witness, was to move as largely and as freely as possible. To write the story, and to get it out.” This quote details how, as a witness, it is your responsibility to give a voice to those unseen and unheard.  As an ethnic Karen refugee myself, although my perspective may be limited, I will be using my personal experiences and the things learned from Humanities 201 to give a voice to my people and their problems and raise awareness of them because I believe Karen refugees are unseen and unheard. 

The poem, Some People, by Wislawa Szymborska, says, “They leave behind some of their everything, sown fields, some chickens, dogs, mirrors in which fire now sees itself reflected.” Refugees are people who must leave things behind as their homes are often in ruins and as they are forced to flee. In addition to leaving physical possessions behind, they also must leave parts of their identity behind. 

My parents had to flee from their homeland of Myanmar to the outskirts of Thailand in fear for their lives as they fled from the ethnic cleansing perpetrated by the Burmese military Junta. My mother would tell me stories of having to hide in the forest as the village that she was born in was burned to the ground by Burmese soldiers. Not knowing if their relatives in different villages were safe, they had no choice but to flee deeper into the jungle. When they were repeatedly displaced, they had no choice but to flee to a refugee camp along the Thai-Burma border. My siblings and I were raised in one of these camps, named the Umpiem refugee camp in Thailand. I knew no other life than that of being “warehoused” in a refugee camp. It was my norm. It was all I knew. However, that wasn’t the case for my parents. They were aware that life beyond the confines of the camp offered better opportunities. They applied for resettlement and in a lottery-style system, luckily had their names drawn in 2009, which meant our family could resettle in Albany, New York. 

In the Great Migration series by Jacob Lawrence, many African Americans move to the north from the south searching for better opportunities and equality. However, they were faced with segregation, discrimination, and overcrowded living conditions. This is like the immigration of refugees. Refugees arrive in new countries with the prospect of stability, freedom, and opportunities however they also face problems such as language barriers, culture shock, discrimination, loss of identity, etc. Like the African Americans who migrated from the south to the north, refugees also must work high demand jobs that pay low wages. This is compounded by the fact that since the Karen have endured over 60 years of civil unrest, it has made schooling a rarity. My parent’s elementary education was continually disrupted. I began my education in a refugee camp school: a bamboo and thatch structure with nothing more than a few benches and a teacher. A lack of education and opportunity makes it difficult for newly arrived refugees to work anything more than manual labor jobs. 

The loss of identity is a big problem that refugees face and this is something that I have noticed among my own Karen resettled community here in Albany. In her work, Mother Tongue, Zineb Sedira documents how hard it was for her mother and daughter to communicate with each other because Sedira’s mom spoke Arabic and could understand French, but the granddaughter was able to understand French but only speak English. The video is great to showcase how being raised in a different country from their native country causes the loss of one of the most important aspects of identity and that is the mother tongue. Arriving in Albany at the age of six, I can communicate with my parents but am unable to speak at a high proficiency in their native Karen or Burmese tongue. They, in turn, are not proficient in the language I am most proficient in: English. The fact that I’m able to speak their native tongue at all is only because I was born and raised in a refugee camp for the first six years of my life. What I have noticed, however, is that most Karen kids born and raised in America are not able to speak Karen or understand Karen. Almost all the Karen kids I see at church are unable to communicate in Karen. Instead, they communicate in English. This proves problematic for parent-child relationships. In addition to a loss of language, many Karen kids are routinely exposed to American food since they are given free breakfast and lunch at school. Consequently, they develop a taste for American food and fast food like McDonald’s instead of eating traditional Korean food like fish paste with rice. This further adds stress to the parent-child relationship, as parents can’t afford fast food every day and they don’t know how to cook American food.  

Another way Karen people lose parts of their identity in the resettlement process is with the loss of childhood. This is especially the case for older siblings. In the Karen community in Albany, when families first arrive, parents are not able to speak, read or write English, so they rely on their eldest children to do so. Resettled refugee children do things that normally a parent would do. These older siblings have responsibilities that an adult should have. The eldest child (like my sister, for example), has to fill out forms that decide whether the family gets aid from the government for Food stamps, sorts mail, deals with the landlord, calls and makes doctor appointments, etc. etc. The eldest child is expected to pave the way for their younger siblings and teach them about the new country and to take care of them for everything the parents are not able to. 

Immigrating to a new country also goes hand-in-hand with enduring discrimination, especially when you look, dress and talk differently from your American and African American classmates. Growing up in Albany public schools, I was often made fun of for my small eyes, and people called me Jackie Chan or Bruce Lee. However, the bullying that I had to endure was not as bad as some other Karen kids. A Karen girl in middle school was bullied and had her hair set on fire, another girl had gum shoved in her hair and yet another child had her classmate cut off her pony tail. I routinely heard racial slurs against female Asian students. As a child, it was confusing why we were so hated when all we did was to look different. The bullying and discrimination doesn’t just happen to kids. A Karen man who was walking in the city by himself was brutally assaulted by some African American men. Because the majority of resettled Karen refugees arrive with trauma from what they endured at the hands of the Burmese military and while refugees, the community as a whole, lacks confidence and perhaps lends itself to being picked on and targeted by inner-city folks in Albany.  

Kara Walker’s sculpture, A Subtlety, shows us how America as a country has profited off of African Americans, especially in the sugar business. African Americans often work hard labor jobs while not getting paid much and being profited off of. People who don’t have much education or literacy skills are often subjected to hard manual labor jobs. This is especially true for the adult resettled Karens living in Albany. Most Karen people in Albany work in factories such as mattress companies, bottle factories or other processing plants. A few work at Walmart, and as room cleaners at hotels. My dad worked as a pizza hut dishwasher and also washed dishes at a college, until he couldn’t anymore. 

In Ages of Consequences by Jared P. Scott, Bangladesh was labeled as “ground zero” for the devastating effects of Climate change with its rising sea levels and cyclones. Finding out more about Bangladesh, I learned that Myanmar was 2nd among the countries most affected by climate change based on the Global Climate Risk Index by German Watch from 2000 to 2019. Like Bangladesh, Myanmar will have to deal with more natural disasters such as droughts, flooding, and cyclones. Karen refugees will even have more to worry about, especially since most of our relatives are in bamboo hut villages that rely on farming to survive and because of global warming precipitation patterns are unpredictable. 

In the story, To the Insects, by W.S. Merwin, it’s stated that “we kill you again and again and we turn into you eating the forests eating the earth and the water.” Humans have become pests like how we see ants by destroying the earth through deforestation and burning of fossil fuel making global warming worse. However, Myanmar and Bangladesh are not countries that play a large part in global warming like northern, more developed countries, yet they are the most affected. Especially with climate change, there will be more climate refugees. Refugees are unseen and unheard. As a Karen refugee and as a witness, it was important to raise awareness of the problems associated with resettlement that refugees when they come to a new country. Displacement and genocide forces refugees from their home, making them a unique “breed” of immigrant to this country, with a unique set of challenges they face.

Britney Mbeng

My name is Britney Mbeng and I am a P3 PharmD student with a passion for public health. Writing is important to me because it has always been a way for me to immerse myself into new worlds and to expand the limits of my imagination! Besides writing, I spend my free time reading science fiction novels, cooking, baking, and watching anime. This piece was written for Health Care and Human Values taught by Dr. Kevin Brosnan. The assignment was to choose one of two different cases and defend an ethical judgement (either morally permissible, morally obligatory, or morally wrong).

An Ethical Analysis of Case #2 – The Prisoner Study

The Prisoner Study posits an ethical dilemma in which 100 death row inmates are to be used as subjects in a life-saving clinical trial that is likely to kill or severely harm the participants involved. In order to determine the moral justifications of this case, two moral theories come to mind: (1) the ethical principles in clinical research and (2) utilitarianism. In this analysis, I will argue that conducting this trial is not morally justifiable and lays the ground for significant societal harm.

The Belmont Report outlines basic ethical principles all medical research must follow: respect for persons, beneficence, and justice. The prisoners were not able to make an informed decision about their role in the study (essentially coerced), infringing on their autonomy entirely. Despite the benefits society would reap from their sacrifice, the death/harm brought to the prisoners is contradictory to the principle of beneficence—to act in the best interest of the patient. Lastly, in a just world, all people must shoulder equal benefits and harms of an intervention. In this case, the prisoners shoulder all the harm, while the rest of society shoulder all the benefits. These outcomes are not equally allocated among all those impacted by the study, therefore unjust. From a clinical research lens, I believe this case is not morally justified.

Utilitarianism is a theory that favors the action whose consequences benefit the most amount of people. Despite the morbid act of sacrificing 100 prisoners, their deaths would benefit an entire society. To a utilitarian, the action of their sacrifice would be morally permissible. However, I would argue that a utilitarian approach calls into question how mankind has historically taken advantage of vulnerable populations to advance humanity. If we kill 100 prisoners today, how many will we kill tomorrow or the day after that? I strongly believe that the repercussions of this sacrifice extend beyond its immediate “benefits”. The harm and death of prisoners may exponentially increase as more sacrifices may need to be made in the name of science and medicine. The lines of clinical ethics would continue to blur across different types of ethical dilemmas. Legal reparations may be pursued by the prisoners’ families, and trust in the medical community may be lost. Even under a utilitarian stance, the moral justification of this action seems to crumble entirely.

In summary, a case surrounding the involuntary participation of death row inmates in a clinical trial guaranteed to bring them harm and death (but, of course, benefit all of society) is neither morally permissible, obligatory, nor right. Regardless of the good the trial would bring, the utter disregard for human life and autonomy, the negative precedence it sets for the medical community, and the debate of utility, this case is not morally justifiable.

Beau Morrell

Hi! I'm Beau Morrell. I'm from Vermont. I'm a first year Public Health major interested in the PA track. Writing is important to me because it's a key part of self-expression. I also find meaning in writing for advocacy and to uplift the voices of others.

Sunday Best

I felt so pretty that day, sitting on the musty stairwell that smelled of old books. My abuela sat in front of me, focusing on tying up my new boots. Her curly gray hair was done up, held in place by a large, bejeweled barrette. 

Abuela finished the knot with a neat bow and patted my leg. I smiled at my feet. The boots were dark brown and reached up just past my ankle. They had a slight heel, making them feel mature. I had just turned 8, so I was thrilled to get my own fancy grown up shoes.

​“These are church boots, only wear them for very holy occasions.” She told me. I agreed, despite knowing I would never take them off.

​“Up!” She announced. I stood and let her fuss over my outfit. Typically, she smelled of earth and fish from tending to the garden and cooking. This time, she smelled as if every floral scent was mixed into one, and it made my eyes water.

​My grandparents and myself all got into their old beat up pickup truck, so caked in mud on the sides you could barely tell that it used to be white. I settled into the back seat, shoving clutter out of my way. It stunk of chemicals l from the several old air fresheners hanging off the dash. 

​“You excited pumpkin?” My abuelo asked, making eye contact with me through the rearview mirror. 

​I just smiled and he turned back to face the road. I was terrified. My mom is pagan, and I was raised surrounded by a coven of witches. I loved every part of it, especially the nights spent playing drums around a fire, and our feasts where I could have as many deserts as I wanted.

​My mom told me that I could go to church, and that plenty of people go. She was always more than happy to let me learn more about their religion, but only if I was comfortable. Still, I feared I would seem out of place.

​Next thing I knew, I was being lead through big wooden doors. Inside, the wooden walls seemed to continue upwards impossibly high before meeting the ceiling. I looked in awe at the designs in the glass embedded within the walls. The sun shone through them, illuminating endless rows of wooden benches in faint multicolor hues of red, blue and yellow.

​I noticed several other children grouping together. When abuela saw me looking, she shoved me towards them.

​“Vamos, vamos!” she chirped, ushering me into the crowd of kids. Suddenly, her hand vanished from my back. I moved out of the crowd and looked for her, but she was gone. 

​The group started moving, led by a tall woman in a long skirt. I followed them hesitantly until we got to a smaller room down the hall.

​It was colorful; several posters hung on just about every wall. Many contained images of animals, with bolded quotes written overtop. In the front of the room was a large whiteboard, and above it a banner displaying the letters of the alphabet.

I sat down and the tall lady moved to the front of the class. She began talking, but I was distracted by studying the chunky jewelry that hung from her neck.

​“… and today we have someone new!” I was drawn back to the conversation as all the students turned to face me, some smiling, others looking annoyed by my presence. I sunk into my chair even more.

​She approached me and handed me a sheet of paper. “Just follow along,” she whispered. “You can skip any word you don’t know.”

​I looked at the paper she gave me with determination. I read a lot; I could impress them by knowing all the words.

​I was so focused on reading and pronouncing each word perfectly that I didn’t digest most of it. The teacher kept her eyes glued to me as she stood over my shoulder.

​When we finished the class began clapping, and I felt proud of myself. The rest of the day was a lot of crafting. Luckily, I was happy to quietly color until class ended.

​I ran out as soon as we were dismissed, excited to rejoin my grandparents and tell them how well I read. I spotted my abuela and rushed to her.

​“abue-“she cut me off, grabbing my hands forcefully. 

“Did you say it? Did you promise yourself to Jesus?” she asked, still holding me. My confidence and excitement from before vanished. I had no clue what she was talking about. Just then the teacher came over, and my abuela quickly released me. 

​“He did!” she said to my abuela, beaming proudly. “Don’t you remember?” she asked.

​I suddenly remembered the paper she handed me in class, with all those big words. I perked back up with new confidence.

“Oh yeah, I was able to read all of it!” I exclaimed, relaxing as I saw them both smile proudly at me.

​“You know this means you’re Christian now!” she exclaimed. I looked around and saw a few heads turn our way.

I was overwhelmed with a guilt that made my entire body feel heavy. That’s not what I meant. I tried to backtrack but my abuela continued, leaving me no room to speak.

​She cupped my face with her hands. The smell of perfume that was merely an irritant was suddenly nauseating.

​“Ah, mi pollito, I’m so proud!” She let go of my face and ruffled my hair. I searched for a way out. Despite the high ceilings, I had never felt more trapped. 

​By this time, other women of the church had started to notice us, and they began riffling through bags and purses. 

​One pulled out a pocket mirror and wrote the date on it before handing it to me. Others gave me bibles. Some even gave me their jewelry.

“May you never forget this day.”—“You made the right decision.”—“We’re so proud of you.”

​My hands shook as I took each gift. I felt like a scam artist, taking praise for being something that I wasn’t. I politely thanked them as I held back tears. 

​On the ride home, Abuela bought McDonalds to celebrate. I picked at my fries as I stared at the floor of the truck, examining the trash and dirt that lay there. Seeing all the crumpled receipts, old take out boxes, dirty clothes, and fur, all made the truck felt dirtier than it did that morning. Distantly, I could hear my abuela in the front seat singing along to a hymn on the radio. I curled in on myself and cried quietly until I fell asleep.

​At home, I hid in my room. I could hear my mom speaking with abuela on the phone down the hall from me. She didn’t sound very happy.

I studied my church boots, noticing each imperfection that I hadn’t seen before. There was a loose string on the inside of the sole, and a small part of the leather that was already peeling. The heel it had made my feet ache, even after I took them off. I had blisters on both heals, that made it sore to even wear socks. Maybe I would be able to keep my promise to abuela, they didn’t feel pretty anymore anyways.

Sophia Otterstedt

My name is Sophia Otterstedt, and I’m from Eastvale, California. As of 2023, I am a second-year student in the Microbiology program. I love to read, find new music, and hang out with my friends in my spare time! Writing is important because it can be a healthy, creative outlet for just about any aspect of your life. It is also subjective, with different meanings extrapolated from the same words, which can make writing a wonderful thing. This essay was written for Contemporary World History taught by Dr. Kevin Hickey.

Non-White Women: Disregarded by White Women, Mistreated by Non-White Men

Representation of minority groups throughout history has always been a cycle of progression and regression. Ignorance, whether willful or not, will affect those who are overlooked. Along with ignorance, the representation of such minorities causes unintentional side effects such as negative stereotypes, fetishization, and misogyny. The most efficient way to counteract the adverse effects of a one-sided story is to provide an open space for a more diverse group to open a dialogue. A dialogue that can add more sides to a single story can give a more accurate perspective on the world. While open dialogue and representation vary in every social circumstance, non-white women are usually the most overlooked. Non-white women will face the brunt of these negative stereotypes, hyper-sexualization, racism, and misogyny. White women and non-white men can also face such struggles. However, these groups can play a hand in the oppression of non-white women, whereas non-white women have no power in many scenarios compared to their white women and non-white men counterparts.

One of the most significant problems minorities face sometime in their lives is a form of racism. It can sometimes appear as a subtle passing comment or be as blatant as acts of violence against those who are discriminated against. Fetishization, and stereotyping are ways racism is implemented in everyday life. Stereotypes are a way to make a sweeping generalization of groups of people. Fetishization may seem like a compliment on the surface; however, with a deeper understanding, it has much deeper roots in racism and misogyny. The hypersexualization of non-white women is also a form of stereotyping that contributes to racism. It may seem like a compliment or even a simple dating preference to say, for example, Asian women are submissive for their partners. However, what this does is perpetuate different stereotypes that cause non-white women to be affected more by sexual violence. Fetishization reduces people to their racial stereotypes and dehumanizes its victims. In Rafeef Ziadah's moving spoken poetry, Shades of Anger, she describes the so-called shades of anger Arab women come in during Israel's ongoing occupation of Palestine. Ziadah mocks the U.S.'s aid for Israel by stating, "Should I not scream? / I forgot to be your every orientalist dream / Genie in a bottle, belly dancer, harem girl, soft spoken Arab woman." (2:46-2:54). While critiquing a more significant issue of the violent occupation, she lists the typical stereotype of the tantalizing and submissive Arab woman that some Americans hold. The critique of the fetishization of Middle Eastern women shows the grotesque image that’s shoved onto innocent women trying to live through a violent conflict, thus removing any urgency to their oppression, just as long as they are pretty and submissive. The dehumanization of non-white men can also distance them from their oppression. Renowned photographer, Robert Mapplethorpe, was incredibly guilty of his near-blatant fetishization of black men. His main subjects were muscular black men, who were almost always nude. They posed in suggestive manners, as was his style, but these photos contributed to a significant problem of black fetishization. Black people were primarily seen as hypersexual beings, with these myths being used to justify the enslavement and torture of black people for centuries. Thus, Robert Mapplethorpe's portrayal of black men added to the hypersexual stereotype Americans associate them with today.

With this argument in mind, it is evident that women are at the center of these issues. Misogyny, inward and out, plays a considerable role in treating non-white women. Referring back to Robert Mapplethorpe, he photographed black women rarely, if ever. The one instance where he did photograph a black woman was the well-established Grace Jones. Jones was considered very masculine because of how she, like Mapplethorpe, explored gender expression. The only difference is that Mapplethorpe was seen as groundbreaking and Jones as ugly. The masculinization of black women is misogynoir, a combination of racism and misogyny often targeted towards black women. Misogynoir, a separate misogyny, is proof enough that non-white women are more disregarded; however, black people are working to tear this down. Photographer, Zanele Muholi, is one of these people. In Muholi's Homage to Black Women, they display themself in an unapologetic series of photographs where their black features are the main focus. They’re beautiful photos that demonstrate the black body in a way that isn't inherently sexual or serves some ulterior motive, like the salacious catalog of Robert Mapplethorpe. Muholi continues the motif of black beauty with the brave series, Faces and Phases. In this series, black people, more specifically black lesbians, were featured front and center as a form of preserving LGBTQ history as well as humanizing people that suffer disproportionally from sexual and hateful violence in South Africa and across the world. Misogyny is also highlighted in the film Women Without Men (1990), four women are followed as they navigate their way through their everyday oppression, with political turmoil in the background. This movie illustrates how misogyny affects women by keeping them distracted from directly participating in politics. The women featured in this movie are more worried about their different, oppressive problems are society's way to, either intentionally or unintentionally, keep women from participating in politics. Without women contributing to politics, they will be left complacent and subservient in a society that seeks to prevent women from improving their living conditions.

However, an essential factor of misogyny often overlooked is how women can perpetuate these problems. Though women don’t hold the same status as men, there are aspects that divide women further apart. White women are the closest to the power of white men because of their proximity to whiteness. White women, by extension white people, will never experience racism the way non-white people do, since there is no system of power behind non-white people to oppress white people. There are, however, centuries of domination behind the racism targeted at non-white people by white people. White women sometimes weaponize stereotypes of weakness and submissiveness to project stereotypes on non-white people. The hard-hitting documentary, The Central Park 5, detailed a case of a white woman who wrongfully accused 5 black and Latino teenage boys of brutal sexual assault. The largely white-dominated media painted these children as animals and savages, where their race no doubt played a part in their prosecution and demonization in the media. The actual perpetrator was discovered after the boys had already served 7 years in prison. The boys, who were men upon release, received financial compensation, but what good is monetary compensation for over 7 years of trauma? While white women can use those stereotypes to inflict harm on others, women, in general, can also internalize these stereotypes to enact meaningless competition between women, just as men do. Jumping Monkey Hill, by Chimamanda Ngozi Adichie, demonstrates the concept of internalized misogyny when Ujunwa became jealous of the Senegalese woman when she became the object of sexual harassment for the white African expert, Edward. Throughout the story, Ujunwa was sexually harassed by Edward and expressed her distaste for his actions; however, when he decided to fetishize the Senegalese lesbian, Ujunwa felt an odd sense of jealousy.. This is a form of internalized misogyny where the woman, Ujunwa, almost missed being the center of attention of the white man. She accepted the gross stereotypes of being a woman on top of the racial fetishization as she believed the “ogling as her due” (Adichie).

To summarize, racism and misogyny often stem from ignorance and a lack of dialogue between non-white and white people. Depending on the context of social situations, various underlying power dynamics will change how people act around one another. The most disadvantaged people based on gender and racial hierarchies are non-white women. Racial stereotypes and fetishization play a part in these power dynamics because they seek to dehumanize women so they are unable to interact with the world on the same level as men. It inhibits women from political input and social or economic growth. However, misogyny can also be internalized and allows women to oppress other women. All these factors combined contribute to the fact that non-white women would remain powerless in social situations. However, if the dialogue and representation were opened to include more people in all aspects of life, there would be less prejudice and systemic oppression of minority groups and would create a more egalitarian society.

References

Zanele Munholi, self portraits and faces and phases

Adichie, Chimamanda N. Jumping Monkey Hill. Granta, 2006.

Burns, Sarah, et al., directors. Central Park Five. Sundance Selects, 2012.

Mapplethorpe, Robert. Self Portraits. 1980.

Muholi, Zanele. Homage to Black Women. 2016

Muholi, Zanele. Faces and Phases. 2010

Neshat, Shirin, director. Women Without Men. 2010. 

“Rafeef Ziadah - 'Shades of Anger', London, 12.11.11.” Youtube, Sternchen Productions, 2011.

Morgan Scarsavafa

My name is Morgan and I am from Montgomery, NY (Orange County). I’m a fourth year public health student also looking to get a minor in microbiology. I just recently was accepted into the UAlbany MPH program as well! I have used writing my entire life as a tool for expression, and this tool has seen me through all of my highs and lows. Whether it’s formal writing or freewriting, I have always found a way to fit my own perspective in. At ACPHS, I have been given a lot of opportunities to fine tune this skill; it has served me well! Some of my other hobbies include running, lifting, and making/listening to music; I’m currently in my final seasons for the ACPHS XCTF team! This research essay was written for Global Health taught by Dr. Kevin Hickey.

Painting a Picture with Patterns: The Construction of the Culture of Woman

We often define culture as a set of traditions and behaviors common among people living within a specified geographic area. While this definition has served us well, it may be time to expand it past physical boundaries. The structure of culture provided by the Process Iceberg1 as well as the practice of pattern naming2 can both be utilized to expand this definition of culture. It would be productive to use these tools to construct a comprehensive understanding of what it means to be female. In a way this could be considered the global female culture. The concept of pattern naming, as detailed in The Willful Virgin, is a tool that can be utilized to formulate the definition of female culture. In order to accomplish this, we must first investigate exactly what ‘culture’ means.

Culture encompasses so much more than just traditions and behaviors. Think about where these traditions and behaviors come from; often times there are shared experiences or shared forces among people that consider themselves to be within the same culture. As written by Tony Mann, “the notion of culture being ‘behaviour’ is too simplistic because behaviour is driven and influenced by forces that exert control over it.”1 By viewing culture at this angle, we are allowing the ability to approach culture at its base. This angle approaches culture from its causes rather than its effects. To consider a wholistic understanding of what culture is, considering its causes appears to be essential. We cannot enjoy a meal without also appreciating its ingredients.

In almost all cases for all individuals, it is rare to find that only one culture is acting on each individual’s experience. In many cases, “there is a ‘hidden’/shadow Iceberg [culture] that operates counter to the formal strategy, structure, systems and roles.”1 This is a phenomenon that will be established several times in this paper; while female culture is fairly consistent, this does not mean that each woman is experiencing the same exact things. Being a woman means being subjected and presented to the world in a way that is uniquely female. This presentation wears a different mask in different places, but this does not mean that the mask is made of completely different materials.

Why is this relevant? Tony Mann goes on to describe the importance of recognizing these behind the scene cultures, detailing that, “It operates behind, alongside and sometimes in competition with the formal Iceberg [culture], in which case management has to acknowledge its existence and seek to understand why.”1 Recognizing cultures that lie under and synergize with others is essential to understanding the individual experience of any one person as well as understanding the overall experience of groups that may identify with several common cultures. Being female and presenting oneself to the world as such has a degree of nuance that comes with doing so, and these nuances do work to influence the cultures that lie on top of them. These nuances are built by shared and/or parallel experiences (more to come on this). To close off the argument that culture is not always defined by geographic bounds, “The culture of an organization [or group] is more than behavior… It is reflected in the structure and processes and made possible by the systems… lived out by everyone through their skills, attributes and knowledge.”1 The idea of culture needs to encompass the overarching forces working on the group of people in question. The world influences women in such stark ways that are hard to ignore; the collection of these common influences have the potential to add up to what could be considered the global female culture.

How exactly do we pinpoint the pieces of these stories that qualify them to be included in any one collection? This is where the concept of pattern naming2 comes in. This process is carried out through the collecting of stories and the highlighting of common themes and experiences within those stories. Marilyn Frye describes the importance of the process through detailing that, “The experiences of each woman and of the women collectively generate a new web of meaning.”2 The web that Frye speaks of is the web that creates the picture of the culture of being woman. According to Frye, “Our process has been one of discovering, recognizing, and creating patterns – patterns within which experience made a new kind of sense, or in many instances, for the first time made any sense at all.” These patterns create a new understanding of what it means to be a woman. Understanding this allows us to put together a comprehensive list of common themes, experiences, and forces that women around the world encounter either daily or at some point in their lives. These pinpointed commonalities are the workings of the female culture. According to Frye, “What we want to do is to speak of and to and from the circumstances, experience and perception of those who are historically, materially, culturally constructed by or through the concept woman.”2 While women all exist within their own cultures, we must also be aware of the fact that being a woman is unique in itself. Women do not experience the world in the same way as men; girls do not experience the world in the same way as boys. We see this in our own lives in so many forms. Using this logic, it is only reasonable to try to define what it means to be a woman in the same way we define being American or just about any other geographically bounded culture.

The unique part about the female culture being constructed here is that, unlike many cultural traditions and behaviors, women do not experience their own culture in the exact same ways. In many cases, women will have experiences that have little to nothing in common other than one overarching theme. Frye comments on this to say, “the differences among women across cultures, locales and generations make it clear that although all female humans may live lives shaped by concepts of Woman, they are not all shaped by the same concept of Woman.”2 This goes to say that the specifics of each situation may not be the same, but the forces creating the experience usually are. A pattern that sticks out in a particularly glaring way is the pattern of male dominance that is undeniably visible worldwide. Frye incorporates this into her writing to say, “Women's lives are full and overflowing with the evidence of the imbalanced distribution of woes and wealth as between the women and the men of each class, race and circumstance.”2 There is a clear discrepancy between the experiences of women and men globally, and this discrepancy is widely accepted to be crafted by men. Frye describes this acknowledgement as the process of obtaining, “knowledge of the oppression of women by men.”2 That being said, the pattern of male dominance is a uniquely female experience, as men do not experience this in the same stratifying way that women do. This pattern is one of the most prevalent patterns across all geographic and societal cultures.

An essential theory that helps develop the importance of recognizing male dominance is that of feminist care ethics. A part of this theory establishes women as the primary caretakers in the household, and the theory builds to suggest that this role carries over into their lives outside of the home (given that they have the opportunity to have a life outside of their households). This can manifest as women holding jobs that are primarily nurture-based, such as becoming a teacher, nurse, secretary/receptionist, and others. While there is an acknowledged biological component to this phenomenon, the societal structure of this adoption of the caretaker role does have a touch of male dominance to it. Women are often not given or allowed to have the same opportunities as men both inside and outside of the household due to the domination of the male perspective in societies across the globe.

Constructing this collection of patterns to create an idea of what the female culture might look like requires building a compilation of stories. These stories can come from several different angles, but for the purpose of this paper just two will be focused on. The first angle is location based. Women from different locations clearly have different experiences; sometimes these experiences cannot even be directly compared because the nature of each has the potential to be so different. However, there are overarching themes that can be pulled from each experience at both locations. The second angle is situation based. Even for women that are from the same place, there are different situations that they will or will not find themselves in. Even though the situations could have nothing to do with one another, it is still possible to draw conclusions about common themes. To reiterate: male dominance is a very strong theme in just about every location and almost every situation. There is some sort of touch of this theme in almost every interaction that a woman could find herself in.

In terms of location, it will be beneficial to compare two. In Iraqi Kurdistan, the concepts provided through feminist care ethics are heavily visible. The article provides that, “Even in the best of circumstances for immigrant women workers, being required to leave one’s children behind is a serious human rights issue and, in particular, a women’s rights problem and a children’s rights crisis.”3 Considering this phenomenon to be both a women’s rights issue and a children’s rights issue poses two issues. The life of the child should be able to be supplemented by their father’s presence; the outcome of childhood should not solely ride on the back of their mothers staying at home. The second problem posed by this situation is the language itself: if the need for the mother to work is really a problem for the child, then would this not be an issue for the whole family? This problem, which certainly affects the child, is shoved onto the mother. However, the father is typically not considered in these instances. This is an example of male dominance, where the mother is handed a problem that really concerns the entire family.

The pattern of male dominance through the use of the caretaker role is also seen in Africa, where it has been admitted that “women migrants would be key asset to the financial sector in addition to the development of their home countries because of assumption that ‘women are motivated by a higher sense of commitment to family well-being and thus are more likely to remit.’”4 This assumption is purely based in the idea that women live, breathe, and die for their families, which plays into the caretaker role described by feminist care ethics.

But why do we make this assumption? While the situation described in Kurdistan makes the argument that women working can be detrimental to the family structure, the situation described in Africa describes giving women a specific role based in the same characteristic needed to nurture a family: softness. In simplistic terms, women have historically been placed into softer roles, allowing men to be placed into roles that require them to be harder. This gender-based stratification between soft and hard builds up the presence of male dominance, and it is common to find this stratification in any corner of the world.

Approaching this topic from a location based angle is certainly productive, but there is also value in approaching the topic from the basis of situations. Location establishes the vastness of the patterns while situations establish the degree of integration of the patterns. Male dominance in the workplace is a problem that has existed for as long as the workplace has existed. This pattern is very strong, as explained in a study where, “Analyses revealed that applicants were more often selected for a position in which the occupation stereotype matched their gender suggesting an effect of an evaluator’s gender role traditionalism.”5 Based off of the current understanding of gender stereotypes, and considering the characterization of women as provided by feminist care ethics, it is easy to assert which gender roles women are often shoved into. The steadiness of this practice of enforcing male dominance in the workplace is further established in the same study where, “those participants indicating that they held more traditional gender role beliefs tended to favor male applicants in their evaluations.” Not only did this study formulate the role male dominance plays in role selection in the workplace, but it also established the idea that this presence of male dominance is heavy and unchanging.

The issue previously established is particularly glaring in STEM fields. In the same study, it is shown that “Once women enter a STEM or other traditionally masculine career field, they are subject to different evaluative standards, and thus have a harder time pursuing employment and promotion in these fields.”5 This difference in treatment is part of the female experience and can likely lead to actions and reactions that are based in the knowledge of these differences.

In another study regarding managerial decisions, the “Results suggested that both gender and organizational context contributed to shaping the managers’ understandings and decisions regarding the ethical dilemmas in their work.”6 Within the same study, “women and men managers acknowledged similar ethical dilemmas, [but] the moral reasoning they used was, at times, different.”6 While this does not necessarily establish a pattern of dominance, the idea that the difference in decisions made by managers was able to be stratified by gender says a lot about how female experiences and male experiences play a role in how an individual interacts with the world around them. “[The] results provide support for a more complex understanding of how women and men managers experience ethical issues and make decisions when they confront salient moral dilemmas in their natural work setting.”6 The fact that there is a difference between male and female decision-making in the workplace warrants an investigation as to why, and the reasons why relate back to the forces previously mentioned that encompass the culture of being woman.

Why is the investigation of the global female culture important? The investigation of any culture is important for the understanding each culture provides towards the grand scheme of being human. While all cultures are important, it is important to specifically highlight differences between people that have the potential to stratify the human experience as a whole. Biological sex as well as societal presentation of gender make up one (two really, but one for the purposes of this paper) of those differences. As expressed previously, being a man and being a woman in today’s world are two extremely different experiences. Having a comprehensive understanding of the differences within the human condition creates a better understanding of what it means and what it could mean to be human altogether.

Understanding women and what their experiences are/could be is important in a healthcare sense because providers have to be able to respond to the unspoken parts of their patients’ stories in order to provide more comprehensive care. Patients are not always eager to share every bit of their lives with providers, and this can be accidental or purposeful. Although it is a drop in the bucket of what makes up an individual, having an idea of how biological sex and gender identity affect the experience of the patient gives more of an insight as to how to interact with and respond to that patient. Falling into the demographic of “female” provides a degree of insight that most patients wouldn’t cover during a routine fill-in with a provider, so having some sort of framework of the culture of woman to work with is incredibly useful in these situations.

Going into the future, it is important to understand the current state of the female culture and experiences in order to decide what changes are desired and/or needed. Although only one pattern contributing to the culture of woman was highlighted in previous statements, there are so many other forces contributing to this concept. Feminism is a driving force for change regarding the female experience. “This is because feminism whether in migrating or sedentary life involves the creation of new social dynamics, concepts and lifestyles at the expense of well-established pre-existing social norms and worldviews, some of which are almost universal.”4 It is common practice for artists to take a step back and ask their pieces “what do you need from me?” If we consider the female culture to be the picture and feminists (and the rest of the world) to be the artists, the concept of understanding the female culture in order to further shape it makes a lot of sense.

Being a woman in today’s world has a specific set of qualities that are not inherently understood by anyone looking from the outside in. That is the value in attempting to put these collections of patterns and stories down on paper. Human beings are brilliantly complex, and that is one virtue that mankind can lean into. A researcher described the complexity of women through the following: “the women in our study are aware of the various systems that have enslaved them. They speak critically of masculinities, bosses, the police, immigration authorities, and governments. They also speak of hope. At the same time, they tell their difficult stories, the women also tell a story of risk, courage, and taking care of one another and of their children and families back home. Their journeys are remarkably filled with their belief in justice and their commitment to achieving it.”3 Where there is darkness, there is also light; it is imperative to understand how a group of people perceives those contrasts in order to understand how that group thinks. We will always have an endless amount of data to decipher, and that data exists in the form of the stories we tell and the experiences we share.

References

Mann T. What is culture? Training Journal. 2010:47-51.

Frye M. p. 60-65. In: Willful Virgin: Essays in Feminism, 1976-1992. Freedom, CA: Crossing Press; 1992.

Carter K, Aulette J. The domestic workers convention is not enough: A postcolonial feminist view of ethiopian and filipino domestic workers in iraqi kurdistan. Frontiers. 2016;37(3):175-203.

Ojong VB. The social dynamics of feminism in the context of african migration. Gender & Behaviour. 2019;17(3):13920-13931.

Rice L, Barth JM. A tale of two gender roles: The effects of implicit and explicit gender role traditionalism and occupational stereotype on hiring decisions. Gender Issues. 2017;34(1):86-102.

Miller, Y., Kark, R. & Zohar, N. Her/His Ethics? Managerial Ethics in Moral Decision-Making from a Contextual, Gendered, and Relational Perspective. Sex Roles 80, 218–233 (2019).

Sarah Richter

I am from Rockland County, New York, and am a PharmD major in my first year. Writing is extremely valuable to me because it allows me to connect with others through my culture and beliefs. In my free time I enjoy spending time with my family, working with horses, and studying. This narrative essay was written for Principles of Communication taught by Professor Amanda Ruschack.

My Mother is My Culture

My culture resides within my mother's footprints. With every step she took, the indents left behind were too shallow for mine to follow. Her footprint was too big for mine to mold perfectly with, and they lacked the depth that would hold the water of her culture. The rain in Colombia is heavy during May, however, my mother carried a bucket with holes, refusing to bring her culture to the United States. I grew up missing an essential part of my identity, my Hispanic heritage. As I continue trying to fill my bucket, I still struggle to patch the holes that let my culture seep away; I struggle to understand why my mother left her culture behind in Colombia, instead of sharing it with her daughter.

In the beginning, I lacked the understanding of why my mother would be so hesitant to share her life with her children. Throughout the years of stories from her childhood, the resentment that built up had gone away. Originally, I felt pressured by others to fit into the stereotype of a Latina. My mother never taught me Spanish and would speak to me in broken English, in a hopeless attempt to assimilate into a more 'authentic' American lifestyle. To my mom, being in the United States as a citizen meant you should adopt their customs, language, and culture while disowning your own. Whenever my ethnicity was brought up, remarks from other Hispanics surrounded me. I even began to question my upbringing - why was I not able to speak Spanish, partake in holidays and celebrations, or share food from my mother's hometown? I couldn't find an answer to supply them with, let alone an answer to tell myself to ease the disappointment I had. I was embarrassed to mention that I was Colombian, afraid of the overbearing questions I'd face.

For years I avoided any idea that I had any other part in my culture other than being American and European, since to most, there was an absence of culture. I felt disconnected from other classmates, especially those who were involved in their cultures. Kids with immigrant parents often packed native foods for lunch, styled their hair into protective styles from their countries, and even went on trips to engage more in their culture. I was jealous of those kids - the ones who smelled of spices their mothers used to cook with, those who spoke their native language with ease to their parents, and those who felt a close connection to their culture. My mother sent me to school with money for school lunch, or if I was lucky, a brown paper bag with a sandwich inside. Nothing I brought out of my house resembled my culture. My mom brushed my natural curls into a straight poofy style, putting my hair into a tight ponytail that others made fun of. I was inherently jealous of not being able to embrace my culture.

As time went on, instead of others trying to welcome different cultures, they began to use it against us. Even though my mother still refused to teach me Spanish, or feed us Colombian empanadas con chorizo, I declined the idea of letting it go. Other children, especially those without their own culture, began to judge those who had one. Comments circulated about the way food smelled or looked, or the way children replicated accents that their parents' tongues had. Students often made remarks about the hair on my arm, referring to me as a boy. They were unaware that being Latina meant having more hair on my arm, or even if they were aware, they didn't care.

I started to dislike my culture and the plethora of judgement it brought to me. I felt unincluded in either group; neither the Hispanics nor the Americans wished to have me a part of them. To other Hispanics, I wasn't Hispanic enough. I did not speak much Spanish, nor did I share the same holidays, traditions, or food. To them, I was a disgrace to their culture and whitewashed. To the Americans, I lacked what they wished was more prevalent in their expectations. I didn't have blonde hair or blue eyes, nor did I have two white parents. I ate food combinations they saw as weird, and they viewed my mom as an alien. There was no group I felt comfortable associating with.

After countless stories, my mom eventually shared the hardships she endured in Colombia. Ranging from guerillas going onto her family's farm, or living in a convent, I finally understood why she neglected to share about her culture. My mother no longer wanted to be a part of her culture and wished to push it into the past. She wished to embody American society in hopes of protecting my brother and me from the potential trauma that she faced, living in a poor country. As much as it angered a younger me for lacking my Colombian side, and still causes me to feel like a part of myself is missing, I couldn't blame my mother for struggling to share that piece of her life. So instead of fully embracing being Colombian as part of my culture, I made my mother my culture instead.

Sopheary Te

My name is Sopheary Te, and I am a PharmD candidate for the class of 2028 from Norristown, Pennsylvania. I love to write because it challenges me to combine creativity with intellect, but my other hobbies include drawing and photography. This essay was written for Humanities 115 taught by Dr. Ray Chandrasekara.

This is Not a “Negro Problem”

Raoul Peck’s documentary, I Am Not Your Negro, based on one of James Baldwin’s incomplete works, expresses the late author’s views on racism in America. The film discusses some of the major obstacles that black Americans face, namely the widespread apathy towards racism.  Moreover, the major theme of the film is that these obstacles are not a “Negro problem” that black Americans can defeat alone. These themes are similarly addressed in Jacob Lawrence’s Migration Series, a series of artworks depicting the incessant challenges black Americans faced during the Great Migration out of the South. Both works illuminate the idea that change is in the hands of everyone, from those who remain complicit in America’s systemic racism, to those who suffer because of it. Every American must be actively antiracist if this country is to truly move forward beyond its deeply racist history.

As stated above, many white Americans don’t consider racism a problem they have to personally address; in truth, many only view it as an unfortunate occurrence that some racist whites—not them—inflict on black people. With this mindset, they fail to realize how their complicity with the current system is also racist. One of the resounding themes of the documentary is that white Americans are afraid of acknowledging their own guilt, so they refuse to address the current and historic issues with race. Those who are privileged, after all, have no desire to change the status quo; consequently, they choose to ignore racism and the glaring fact that their wealth and privilege are results of the oppression and exploitation of minorities. Addressing racism is neither easy nor comfortable, but, as stated in the documentary, “nothing can be changed until it is faced.” With this statement, Baldwin reminds us that complicity in racism by anyone, regardless of race, prevents the achievement of real progress.

Weaponized apathy is also addressed in Jacob Lawrence’s Migration Series. For example, white privilege juxtaposes black subordination in Panel 49, titled “They found discrimination in the North. It was a different kind.” This painting features a segregated restaurant in which white diners possess far superior cutlery to that of black diners, illustrating the unequal conditions of segregated institutions. During the time of the Great Migration, white people justified this widespread segregation through the “separate but equal” clause, but they ignored the clear inequality between the treatment of black and white patrons. This disregard is reflected in the white diners’ blatant unaffectedness regarding their superior treatment. Lawrence’s art thus reflects the film’s notion that those who are not suffering from racism choose to renounce issues of inequality, because to see them as problems would force white Americans to relinquish their power over black Americans. Essentially, the Migration Series demonstrates that even if people are not directly abusing black Americans, their complicity contributes to stagnation, thereby preventing the progress that can only be achieved through anti-racism.

Both Peck’s documentary and Lawrence’s paintings illustrate how black Americans face dehumanizing discrimination simply for existing. An overarching theme in both the film and the artwork is that the U.S., as a whole, has a racist history: the film’s ending lines state that the only difference between the North and the South is in “the way they castrate you,” which is echoed by the Migration Series’ depiction of the horrors black Americans faced no matter where they went. In this sense, both works condemn the way we view racism as a pinpointed, rather than nationwide, issue; this perspective only shifts blame and avoids the accountability required for change. Again, all Americans must cease the apathy towards racism, for it is a problem that cannot be solved until it is recognized and addressed by everyone.

References

I Am Not Your Negro. Directed by Raoul Peck, performances by James Baldwin. Magnolia Pictures, 2016.

"Jacob Lawrence: The Migration Series." The Phillips Collection, lawrencemigration.phillipscollection.org/the-migration-series. Accessed 29 Sept. 2022.

Rayne Valentine

Rayne Valentine is a first-year student in the Population Health program. This research-based argument was written for Academic Reading and Writing taught by Dr. Anna Eyre.

The Efficacy of Plant-Based Diets in Reducing Type 2 Diabetes and Cardiovascular Disease

With chronic diseases taking the spot of leading causes of death in the United States, counteracting and preventing these diseases is becoming a priority. For many conditions, especially cardiovascular disease and type 2 diabetes, diets with the inclusion of animal products are a contributing factor leading to both the progression and increased severity of the diseases. A solution to this problem is plant-based eating, which has been shown in numerous studies to be effective in the prevention and management of type 2 diabetes and cardiovascular disease. Plant-based eating is an alternative diet excluding animal products. Plant-based eating patterns emphasize the consumption of legumes, whole grains, nuts, fruits, vegetables, and seeds.4 Those who choose to follow this diet may do so for varying reasons including health benefits, lighter environmental impact, and ethical concerns. Recent studies have been conducted that demonstrate the inclusion of animal products in a diet significantly increases the likelihood of obtaining specific diseases, making plant-based diets a valid option to improve health. The evidence conducted to support this proves that plant-based eating is effective in reducing the risk of type 2 diabetes and cardiovascular disease.

The Diabetes Federation estimated that 463 million people had diabetes in 2019 and is expecting prevalence to grow to 578 million, or 10.4% of the global population, by 2030.1 Of the 463 million, type 2 diabetes made up 422 million, and case numbers are exponentially increasing in middle and low-income countries.4 This is a problem that we need to address and remedy promptly. Plant-based diets have been shown repeatedly to improve glycemic control and ameliorate insulin sensitivity. Several Adventist Health Studies are exemplary reports on the effects of plant-based eating on health relative to type 2 diabetes. In one Adventist Health Study, men and women who consumed meat reported a greater risk of diabetes by 93% and 97% as compared to their vegetarian participants.1 In Study 2, in which 61,000 individuals partook, prevalence decreased with each reduction of consumed animal products. Prevalence was reported at “7.6% in non-vegetarian diets, 6.1% in semi-vegetarians, 4.8% in pesco-vegetarians, 3.2% in lacto-ovo vegetarians, and 2.9% in vegans”.4 The non-vegetarians in this study only ate meat occasionally, with non-vegetarians at once a week or more and semi-vegetarians at less than once a week.4 This suggests that even semi-regular inclusion of red meat and poultry in the diet escalates the risk of type 2 diabetes. Following 8,401 members of the Adventist Mortality Study and Adventist Health Study, it was observed that adhering long-term (seventeen years) to a diet including meat consumption at least once a week was associated with a 74% increase in the odds of developing diabetes as opposed to those who ate plant-based.4

Two biological components of the body interact with diet and influence cardiovascular disease. Many observational studies have demonstrated a relationship between risk of cardiovascular disease and poor glucose control. HbA1c is a form of hemoglobin linked to a monosaccharide, or sugar, and is linked with cardiovascular disease and type 2 diabetes. Studies establish that glycated hemoglobin concentrations of 6.0-6.9% had a lower risk of fatal/nonfatal coronary artery disease by 20% than those with levels of 7.0-7.9%.2 This is significant as analysis of six randomized control trials showed a significant reduction of HbA1c in vegetarian diets as compared to the typical diet of patients with type 2 diabetes.2

Another serious chemical compound is TMAO (trimethylamine N oxide). When consumed, the nutrients choline and L-carnitine are processed by gut microbes, resulting in trimethylamine being released into the blood. It is then transported to the liver and converted into trimethylamine N-oxide. TMAO is affiliated with a higher risk of cardiovascular events independent of traditional risk factors by affecting cholesterol, sterol metabolism, and atherosclerotic pathways.5 This is especially dangerous as the effects on atherosclerotic pathways may lead to stroke, heart attack, and death. L-carnitine and choline are found in abundance in red meat, full-fat dairy, and eggs. TMAO levels may be reduced through diet modifications and elimination of TMAO precursors.

Even more so than diabetes, plant-based eating patterns have a significant impact on preventing cardiovascular disease. It is reported that almost one half of cardio-metabolic deaths in the United States could be prevented through proper nutrition.2 Evidence suggests “plant-based diets may reduce risk of coronary heart disease events by an estimated 40%”.2 Regarding ischemic heart disease incidence and mortality, vegetarian diets have been associated with reductions of 24-32% relative to omnivorous diets and even the clinical reversal of coronary heart disease.3 Many cohort studies have provided evidence and backed claims of the efficacy of plant-based eating in cardiovascular health. Coronary artery stenosis, the narrowing of arteries in the heart, and atherosclerosis, the thickening or hardening of arteries, are both due to buildup of fatty plaque in the arteries and are a contributing factor of disease events and mortality. Among patients with moderate to severe coronary artery disease, one study demonstrated significant reduction of coronary artery stenosis and atherosclerotic stenosis after five years on a vegetarian diet- a risk reduction of 13%.1Those in the control group who remained eating an omnivorous diet experienced a progression in atherosclerosis. To date, a low-fat, vegetarian diet is the only dietary pattern to have shown cessation and reversal of arterial plaque.2

Several studies have been conducted on the efficacy of plant-based diets in relation to coronary artery disease and cardiovascular event rates. Authors of one study following patients with severe coronary artery disease reported that of those who adhered to a low-fat, plant-based diet, 73% were documented to have a regression of the disease during repeat testing after five years on the diet.4 One study, the Esselstyn program, produced significant findings. 89% of the participants followed the whole-food, vegan diet assigned. The results found the cardiovascular event rate to be remarkably low- 0.6% among those who adhered to the diet compared to the 62% of the non-adherent group.4 Such a significant difference of event rates indicates that plant-based diets have a substantial effect on our bodies, more so than we currently know.

Recently, a cohort study comprised of 131,342 adults measured the efficacy of plant-based eating despite lifestyle factors. In participants with at least one unhealthy lifestyle factor, substituting just 3% of an animal protein with a plant protein resulted in a 10% decrease in all-cause mortality and a 12% decrease in cardiovascular mortality.4 Such results from a minute change suggest that drastic changes in diet yield more extensive results.

In addition, heme iron, a type of iron found primarily in animal foods such as red meat, poultry, and seafood, is observed to have a positive association between intake and risk of stroke.3,5 A study was done by the American Heart Association measuring relationships between risk of stroke and heme iron intake with consideration of factors such as BMI, smoking status, physical activity, and alcohol consumption. Findings showed that among men with normal weight, those in the highest quintile of heme iron intake had a 40% higher risk of stroke than those in the lowest quintile.3 Aside from risk, incidence of stroke among the men in the highest quintile was 16% higher. This is significant as the Association reported no interactions observed between heme iron intake and smoking status, physical activity, and alcohol consumption.3 This implies that consumption of animal products containing heme iron increases the risk of stroke independent of other lifestyle components and may be one contributing factor of the difference in coronary heart disease events between vegetarian and omnivorous diets.

It should be noted that the relationship between plant-based eating patterns and prevalence and risk of both diabetes and cardiovascular disease is due to the absence of saturated fats and cholesterol along with the addition of monounsaturated and polyunsaturated fats. When compared to saturated fats, monosaturated and polysaturated fats have supportive effects on glycemia, insulin resistance, and secretion.4 Inversely, saturated fats elevate the risk of diabetes and are associated with increased mortality in diabetic patients.4 There is also evidence that polyunsaturated fatty acids activate anti-inflammatory pathways in the heart.5 It is possible this is due to “altering cell membrane fatty composition and hence cell membrane function, moderating gene expression and enzyme activity, and mediating the inflammatory response”.5 Saturated fats, the harmful fat, are found in products such as butter, milk, red meat, poultry, eggs, and cheese.6 Unsaturated fats, both monounsaturated and polyunsaturated, are the ‘good’ fats with beneficial effects on the body. Monosaturated fats are considered most healthy and are present in nuts, avocados, and seeds. Polyunsaturated fats are especially significant in diets in that they are excellent plant-sources of Omega-3 fatty acids and they appear in vegetable oils, nuts, and leafy greens. Polyunsaturated fats appear in high concentration in sunflower, corn, and soybean oils, flax seeds, and walnuts. These healthy fats are present in plant-based diets and contribute to the preventative effects relative to type 2 diabetes and cardiovascular disease.6

Arguments have been made against the health of relying on plant-based diets for nutrition, particularly that of the vegan diet, claiming that these diets may not supply essential nutrients. Contrary to this belief, manifestations of deficiencies have not been found to be more common among vegetarian populations than omnivorous populations.2 The American Heart Association as well as the Academy of Nutrition and Dietetics recommend plant-based eating for improved health, with the latter stating, “...appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases.”2 Nutrients that may be difficult to obtain are protein, zinc, vitamin D, and vitamin B-12.2 While the bioavailability of some of these are lower in plants, well-balanced and planned eating patterns can easily prevent deficiencies. One essential vitamin, B-12, is made by neither plants nor animals but by microbes.1 B-12 can be found in foods such as nutritional yeast, plant milks, vegan yogurts, and mushrooms. Supplements are easily accessible, affordable, and found in most grocery stores. Adequate vitamin D levels can be ensured by sunlight exposure, and other essential vitamins can be easily obtained through supplements and/or consuming fortified foods.5

All the compiled statistics and figures point to the indisputable fact that plant-based diets improve health as well as reduce the risk of developing and mitigating the severity of type 2 diabetes and cardiovascular disease. Several compounds and components of animal products result in negative reactions in the body and have long-term detrimental effects. Even removing some animal products such as dairy or eggs reduces incidence and prevalence of these diseases, making plant-based diets a justifiable solution. In the case of cardiovascular disease, even modifying the diet to be more plant-based may reverse the effects of plaque and narrowing of arteries in the heart. Plant-based diets are also shown to improve glycemic control and insulin sensitivity, thus reducing prevalence and risk of obtaining type 2 diabetes. Patients who suffer from these diseases should consider altering their diet to be more plant-based as it very well may result in reduced health issues and increased longevity.

References

Jardine, M. Kahleova, H. Levin, S. Ali, Z. Trapp, C. Barnard, N. Perspective: Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations. Adv Nutr. 2021 Jun; 12(6):2045-55.

Kahleova, H. Levin, S. Barnard, N. Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients. 2017 Aug; 9(8):848.

Kaluza, J. Wolk, A. Larsson, S.C. Heme Iron Intake and Risk of Stroke: A Prospective Study of Men. Am Heart J. 2013;44[2]

McMacken, M. Shah, S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017 May; 14(5):342-54.

Satija, A. Hu, F. Plant-based diets and cardiovascular health. Trends Cardiovasc Med. 2018 Oct; 28(7):437-41.

Types of Fat. [Internet]. Harvard. [cited 2022 Dec 3]. Available from: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/

Reyna Woo

My name is Reyna Woo, and I am currently a first-year student in the PharmD program. I was born and raised in Southern California, though I attended high school in South Korea. Writing is my means of self-expression and creativity – it allows me to communicate my thoughts and ideas and feelings to others effectively. Writing is an outlet for me to convey my personal experiences and perspectives that I sometimes find difficult to articulate verbally, which is why it is so important to me. This narrative essay was written for Principles of Communication taught by Professor Amanda Ruschack.

The Need for Speed

“Unstoppable taste for haste” is what the BBC coined as the expeditiousness embedded in South Korean culture and lifestyle. Everything is fast: the internet, food, and even people are in a constant rush, no matter the situation. And perhaps, owing to this Korean characteristic of urgency, my mind is always centered on being fast; a sense of uneasiness would crawl up my neck whenever someone else had a head start, and as I became older, this anxiety began to eat at me. Though, through my struggles, I was able to gain a better understanding of what it means to take things slow and become more accustomed to being at a different pace than everybody else.

Having lived a substantial amount of time in both Korea and America, I have experienced two strikingly disparate cultures and know the struggles of being caught between the different speeds of the two societies while trying to fit into the different social norms of the two countries. There were times when I was unable to overcome the language barrier and had difficulties communicating with others. I would constantly struggle to maintain a conversation for long periods without stuttering or hesitating, which led me to have trouble making friends. I remember feeling extremely self-conscious about how words would stumble out of my mouth; it seemed as if so many sets of eyes were on me, staring at me, judging me. I have always labored through oral presentations and such where I have had to talk in front of a group of people with all their attention focused on me. While the reality was that I was not presenting anything to anyone, every time I spoke in Korean, I felt that everyone’s focus would shift to me, and it became even harder to continue. And the fact that Korea was such a fast-paced society did nothing to help me overcome my internal struggles. I was constantly overwhelmed by the fact that I felt I was behind in everything – like behind in overcoming language barriers.

One of the most striking experiences I had regarding my struggles with keeping up with the rapid flow in Korea was with school. Of course, all students face difficulties when transferring schools. But attending a new school in a whole other country is on a different note. After I graduated from middle school in America, I had to attend an extra year of middle school in Korea because of the difference in the academic calendar. That meant that I would be an entire year behind all my friends and former classmates back in the States: I would still be in high school while everyone else moved on to college. People around me, especially my parents, told me that one year behind would be insignificant in the long run, and it would impact my life much less than I imagined it would. But no words could reassure me. I thought that I had to stay at the same pace as everyone else to succeed. I had unknowingly confined myself to a mindset that required me to function at the same speed, same time as everyone else.

I attempted to make amends with myself – after all, it was but one year. But whenever I received news of the end of another academic year back in America while I was attending school, I was reminded of how I would always be a few steps behind everyone. Although I faced inner conflicts in this unusual circumstance in my life, I put the situation at the back of my head and shut my eyes and ears tight so that I could focus on more urgent matters I had to deal with, such as academics. My parents advised me that I may be overthinking the seemingly unreconcilable one-year discrepancy and told me that as years go by, there will be several obstacles that will slow me down. Through their advice, I was able to grab a foothold and came to realize that similar situations would likely be repeated many times in the years ahead. Gradually, I was able to fully comprehend that people go at their own pace and accomplish their goals at different times. The problem was not me being slow—it was about me being so desperate about it and doing nothing to compensate for it. 

There will be unexpected situations that might arise in the future: I might take a gap year that delays my education and seeing other students driving forward ahead of me while I am at a standstill could once again make me anxious about being behind. Or perhaps, after graduating college, a gap between graduates who have a steady career and those who have not might spark a sense of hurry. But I am positive that my past experiences have prepared me for such instances. The impatient, rigid person who disliked being behind everyone had transformed into a calm, flexible person who now goes at her own pace without any distress.