Saturday, February 23, 2013

A Provocative Lecture - Malcolm Gladwell at UCSF

Last night, we were privileged to have been invited to attend the Maurice Galante Lecture and Dinner, hosted by the UCSF Department of Surgery, and its chair, Dr. Nancy Ascher.  Obviously, this had nothing to do with yours truly, but was thanks to my wife, Amy Peele, who is the director of clinical operations for the UCSF transplant program.

Each year this lecture, named for Dr. Galante, a renowned general surgeon and professor at UCSF who just passed away this past month, brings a speaker from outside the specific practice of surgery to come give a lecture that they think will be of interest to the group.

This year's speaker was best-selling journalist and author, Malcolm Gladwell.  His books include the Tipping Point, Blink (which i'm in the middle of right now), and Outliers.  He is on the staff of the New Yorker magazine, and previously worked at the Washington Post.  It turns out that his cousin is the chair of the Opthalmology Department at UCSF, so he had a strong nudge to come speak to this group.

His talk was provocative to say the least.  The topic was Proof - scientific vs social.  He told two stories, one historical and one current, each of which depicted a conflict between these two forms of proof.

The historic section was about a guy named Frederick Hoffmann, who was an actuary for Prudential Life Insurance at the turn of the 20th century.  In this role, he wrote a series of books outlining why certain people posed greater insurance risks than others.  His first book, which is easily dismissed today, talked about how African Americans were going to die out early as a race due to poverty and lesser levels of intelligence.  Needless to say, this never happened, and Mr. Gladwell pointed out that he is proof of that.

However, in 1918, he wrote a book about the linkage between lung disease and the "dusty professions", specifically referring to black lung and coal mining.  This too was dismissed at the time, citing that he had no scientific proof to back up his assertions.  However, it was really an issue of money and politics.  No one wanted to acknowledge that coal mining posed a greater risk.  The actual affirmation of his theories didn't occur until more than 50 years later, after countless deaths.

It's easy for us to look back in hindsight and feel disbelief that this could ever happen.  However, then he cited a current issue that he feels is related.  I was expecting something about the current controversy over gun control, but to my surprise, his chosen issue was the game of football, at the high school, college, and professional levels.

He pointed out recent occurrences like the tragic suicide of Junior Seau, who was found in his autopsy to have suffered from a brain disease known as chronic traumatic encepelopothy or CTE.  This disease is known to be caused by repeated blows to the head, typical for what a linebacker or other position player could receive over time, especially if he started playing tackle football at a young age.  Seau's family is now suing the NFL for his wrongful death.

But Mr. Gladwell pointed out that this is not the first instance, and in fact, several other pro football players have committed suicide in recent years, and CTE showed up in all of their autopsies.  Just like with Hoffmann's case connecting lung disease and coal mining, these examples show a correlation, but there isn't firm scientific proof yet, and this is being used as an excuse for not taking action.  But again, there are bigger issues at play.

Gladwell pointed out that he, like me, and so many others of us, is a football fan.  I know I went to all of the games at Stanford while I was in college, and I continue to attend or watch the games still.  And I follow the 49ers too.  So the questions he raised really pose a tough dilemma.  The NFL and NCAA are taking steps like changing rules, and improving helmets, but this isn't enough.  What will it take before real action is taken.  Should we all become soccer fans?  I know baseball is still my favorite sport, but I can't say I wouldn't seriously miss watching college football if it were to suddenly go away, and i know other people, like my own Uncle Fred, who live for it.

Needless to say, after the talk, we were all provoked into thinking about ourselves, and our own feelings on this and so many related issues.  I appreciate being challenged like this, and was grateful to have had the opportunity to attend the lecture.

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