The Latest About Corlyss's Brain

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The Latest About Corlyss's Brain

Post by Ralph » Wed Jul 06, 2005 1:05 pm

Los Angeles Times June 16, 2005 Thursday


Copyright 2005 Los Angeles Times
All Rights Reserved
Los Angeles Times

June 16, 2005 Thursday
Home Edition

SECTION: MAIN NEWS; National Desk; Part A; Pg. 1

LENGTH: 3204 words

HEADLINE: The Nation;
COLUMN ONE | MAPPING THE MIND;
Deep, Dark Secrets of His and Her Brains;
Sandra Witelson had studied scores of brains looking for gender differences. Then she found one that made a difference: Einstein's.

BYLINE: Robert Lee Hotz, Times Staff Writer

DATELINE: HAMILTON, Canada

BODY:


The invitation curled from her fax machine, a courtly question scrawled above the signature of a man whose name she did not recognize.

"Would you be willing to collaborate with me on studying the brain of Albert Einstein?"

It was signed Thomas Harvey. Sandra Witelson did not hesitate.

She wrote "yes" on the piece of paper and faxed it back.

"It never occurred to me that it might be a joke," she recalled. "I knew that Albert Einstein's brain had been preserved and that it was somewhere where someone was looking after it."

For 40 years, Harvey, a retired pathologist from Princeton, N.J., had been the quixotic custodian of the 20th century's most famous brain.

In 1955, he had conducted a routine autopsy of Einstein after the 76-year-old physicist died at Princeton Hospital. The remains were to be cremated. Harvey, however, decided to preserve the organ responsible for the theory of relativity and the principle of the atomic bomb.

It was not such an unusual thing to do. Einstein's ophthalmologist had removed the scientist's eyeballs and put them in a safe-deposit box. Earlier acquisitive anatomists had preserved Galileo's finger, Haydn's head and Napoleon's penis.

For Harvey, however, more than morbid curiosity was at work. He believed that the slippery worms of Einstein's brain tissue, pickled in warm formalin, embodied some clue to the mystery of intelligence. He held on to that hope through 40 years of indecision.

Eventually, it led the soft-spoken Quaker to Witelson, a raven-haired Canadian psychologist with a taste for black leather and red showgirl nails.

She had brains, dozens of them -- the largest collection of normal brains in the world.

*

When Witelson began acquiring human brains, sex was the last thing on her mind.

Inside her walk-in refrigerator at McMaster University here in Ontario, her collection filled three walls of metal shelves. The 125 putty-colored specimens sat in frosted jars and snap-top plastic tubs like quarts of boiled shrimp and wedges of cheese.

Every one posed a riddle that had shaped her research for 30 years: How does the structure of the brain influence intelligence?

A professor of psychiatry and neuroscience, Witelson grappled with such a fundamental mystery by studying a somewhat smaller one: why certain abilities develop on one side of the brain rather than the other.

The two hemispheres of the brain are almost symmetrical physically but can seem to be separate minds when it comes to awareness and mental processing. They even have different problem-solving styles, researchers report. Yet they work together seamlessly to produce a single mind.

By 1977, Witelson was trying to learn why language skills developed on the left side of the brain for all right-handers but on the right side for many left-handers.

To compare the two sides, she needed normal brains -- more than anyone had gathered before.

For 10 years, she worked through a network of doctors and nurses, hoping to persuade terminal cancer patients to make a last contribution to medicine. Her research was funded by the U.S. National Institutes of Health.

By 1987, 120 men and women had agreed to donate their brains after death. They all submitted to thorough psychological and intelligence tests so that each brain would be accompanied by a detailed profile of the mind that had animated it.

In the prime of life, the cerebral cortex contains 25 billion neurons linked through 164 trillion synapses.

Thoughts thread through 7.4 million miles of dendrite fibers and 62,000 miles of axons so compacted that the entire neural network is no larger than a coconut.

No two brains are identical, nor are two minds ever the same.

With so many well-documented donors, however, Witelson could conduct comparative brain studies on an unprecedented scale.

She could confidently seek relationships between anatomical features and mental capacities. She could also compare right-handers and left-handers, and sort the organs by gender.

In an era when people probe the thought process with scanners, radioactive tracers and super-conducting sensors, Witelson's approach was deliberately old-fashioned.

She measured her brains.

She weighed them.

She cut them up and counted the cells.

She traced synapses, the junctures where impulses pass from one neuron to another in the hidden root cellars of the brain.

Wherever she looked, she discerned subtle patterns that only gender seemed to explain.

"We actually didn't set out to find sex differences," she said. "Sometimes as a scientist, you are doing one thing and you bump into something else."

Controversial Matters

The brains in Witelson's freezer are contested terrain in a controversy over gender equality and mental performance.

Her findings -- published in Science, the New England Journal of Medicine, the Lancet and other peer-reviewed journals -- buttress the proposition that basic mental differences between men and women stem in part from physical differences in the brain.

Witelson is convinced that gender shapes the anatomy of male and female brains in separate but equal ways beginning at birth.

On average, she said, the brains of women and men are neither better nor worse, but they are measurably different.

Men's brains, for instance, are typically bigger -- but on the whole, no smarter.

"What is astonishing to me," Witelson said, "is that it is so obvious that there are sex differences in the brain and these are likely to be translated into some cognitive differences, because the brain helps us think and feel and move and act.

"Yet there is a large segment of the population that wants to pretend this is not true."

No one knows how these neural differences between the sexes translate into thought and behavior -- whether they might influence the way men and women perceive reality, process information, form judgments and behave socially.

But even at this relatively early stage in exploration of the brain's microanatomy, battle lines between scientists, equal rights activists and educators have formed.

Some activists fear that research like Witelson's could be used to justify discrimination based on gender differences, just as ill-conceived notions of human genetics once influenced laws codifying racial stereotypes about blacks, Asians and Jews.

Other experts argue that the physical differences Witelson observed may result not from the brain's basic design but from conditioning that begins in infancy, when the brain produces neurons at a rate of half a million a minute and reaches out to make connections 2 million times a second.

Spurred by learning, neurons and synapses are ruthlessly pruned, a process that continues in fits and starts throughout adolescence, then picks up again in middle age.

"The brain is being sculpted gradually through sets of interactions," said Anne Fausto-Sterling, a gender studies expert at Brown University. "Even when something in the brain appears biological, it may have come to be that way because of how the body has experienced the world."

As Witelson's research helped establish, however, the mental divide between the sexes is more complex and more rooted in the fundamental biology of the brain than many scientists once suspected.

In the last decade, studies of perception, cognition, memory and neural function have found apparent gender differences that often buck conventional prejudices.

Women's brains, for instance, seem to be faster and more efficient than men's.

All in all, men appear to have more gray matter, made up of active neurons, and women more of the white matter responsible for communication between different areas of the brain.

Overall, women's brains seem to be more complexly corrugated, suggesting that more complicated neural structures lie within, researchers at UCLA found in August.

Men and women appear to use different parts of the brain to encode memories, sense emotions, recognize faces, solve certain problems and make decisions. Indeed, when men and women of similar intelligence and aptitude perform equally well, their brains appear to go about it differently, as if nature had separate blueprints, researchers at UC Irvine reported this year.

"If you find that men and women have fundamentally different brain architectures while still accomplishing the same things," said neuroscientist Richard Haier, who conducted the study, "this challenges the assumption that all human brains are fundamentally the same."

Yet, for the most part, scientists have been unable to document such patterns conclusively.

No one, however, had scrutinized as many brains as Witelson.

Detailing Differences

She began by studying the corpus callosum, the cable of nerves that channels all communication and cooperation between the brain's two hemispheres.

Examining tissue samples through a microscope, she discovered that the more left-handed a person was, the bigger the corpus callosum.

To her surprise, however, she found that this held true only for men. Among women there was no difference between right-handers and left-handers.

"Once you find this one difference," she remembered thinking, "it implies that there will be a cascade of differences."

As she systematically analyzed the brains in her refrigerator, she discovered that other neural structures seemed larger or smaller among men, depending on whether the man had been right-handed or left-handed.

They were relatively the same size in women. "The relationships that we were finding were always -- and I do mean always -- different for men and women," she said.

She narrowed her study to right-handed men and women, still looking for differences in microscopic anatomy between the left side of the brain and the right side. She meticulously counted the neurons in sets of tissue in which each sample measured 280 microns wide -- about twice the thickness of a human hair -- and 3 millimeters deep.

Staring through the microscope, she was baffled.

"I had the first two patients, and they were so very different," Witelson said. "I kept looking and looking at them, trying to see what the difference could be."

Then she consulted the donor documentation for each tissue sample. "Finally, I saw that one was a man, and one was a woman."

Among women, the neurons in the cortex were closer together. There were as many as 12% more neurons in the female brain.

That might explain how women could demonstrate the same levels of intelligence as men despite the difference in brain size.

"So among female brains, the cortex is constructed differently, with neurons packed more closely together," she said.

Witelson probed deeper. She knew that the human cortex was a sandwich of six layers, each packed with neurons.

She peeled away the sheets of the temporal lobe -- a region associated with perception and memory -- in several of her brain specimens. She discovered that the increased neural density occurred only on layers 2 and 4, which form the hard wiring for signals coming into the brain.

Then she analyzed the microscopic structure of the prefrontal cortex. There the crowding of neurons was evident only in layers 3, 5 and 6, which carry the wiring for outbound signals.

Just to be sure, she checked left-handed brains as well as right-handed brains. She found the same sex differences when she surveyed her left-handed brains.

Perhaps, she speculated, these neuron-rich layers in an area associated with perception and speech were the reason women scored more highly than men on tasks involving language and communication.

Slowly, she formed a theory: The brains of men and women are indeed different from birth. Yet the differences are subtle. They might be found only among the synapses in brain structures responsible for specific cognitive abilities.

For so long, scientists had championed the idea of larger brains as an indicator of intellect. Witelson, however, gradually became convinced that overall brain size didn't matter.

"One of the things that firmed it up for me," she recalled, "was the case of Einstein."

An Odd Pursuit

By taking Einstein's brain, Thomas Harvey had succumbed to an impulse older than medicine.

Since the days of Hippocrates, philosophers and scholars have been arguing over how the brain houses an intangible human spirit. St. Augustine was convinced that the soul lodged in the fluid-filled cavity of the organ's middle ventricle. Galen, the ancient pioneer of medicine, argued that vital spirits resided in the fourth ventricle.

When modern scientists discovered that intellect could be traced to neural tissues, brains became precious curios. Pathologists collected the brains of gifted musicians, scientists and other notables the way 18th century literary enthusiasts held onto the hearts of poets such as Percy Bysshe Shelley and Lord Byron.

Researchers at the Moscow Brain Institute measured dozens of the most brilliant brains. Vladimir Lenin, the leader of Russia's Soviet revolution, had a brain weighing about 3 pounds, they determined. The brain of writer Ivan Turgenev weighed 4.4 pounds. That of satirist Anatole France was 2.1 pounds.

At Princeton Hospital, Harvey weighed Einstein's brain on a grocer's scale. It was 2.7 pounds -- less than the average adult male brain.

He had the fragile organ infused with fixative and dissected it into 240 pieces, each containing about two teaspoons of cerebral tissue. He shaved off 1,000 hair-thin slivers to be mounted on microscope slides for study.

For years, Harvey agonized over how next to proceed. His odd pursuit inspired two books: "Possessing Genius" by Carolyn Abraham and "Driving Mr. Albert" by Michael Paterniti. Through the decades, however, he drifted in obscurity.

Finally in 1985, pioneering neuroanatomist Marion Diamond at UC Berkeley persuaded him to part with four small plugs of brain tissue. Diamond discovered that the physicist's brain had more cells servicing, supporting and nurturing each neuron than did 11 other brains she studied. These unusual cells were in a region associated with mathematical and language skills.

When they published their findings, the researchers speculated that these neurons might help explain Einstein's "unusual conceptual powers."

Critics contended the study was riddled with flaws, its findings meaningless.

Eventually, Harvey mailed bits of Einstein's motor cortex to a researcher at the University of Alabama, who reported that the cortex appeared to be thinner than normal but with more tightly packed neurons.

Had it simply been compacted by time and storage conditions?

DNA testing revealed nothing. The preservative fluids apparently had scrambled Einstein's genetic code.

Then in 1995, Harvey happened across Witelson's work. He read her research paper on gender differences and neuron density in the Journal of Neuroscience.

"It was impressive," he recalled. He was even more intrigued to learn about her collection of brains. He was 84, still hoping that his tissue samples had something to teach about the neural geography of genius. To make ends meet, he was working in a plastics factory. Worrying about Einstein's brain, like the years, had become a burden.

Harvey carefully packed it in the back of his battered Dodge and drove north to Witelson's laboratory. "I had the brain in a big jar," Harvey, now 94, recalled.

At midnight, he crossed over the Rainbow Bridge by Niagara Falls into Canada.

Customs officials asked if he had anything to declare. Just a brain in the trunk, he told them.

They waved him through.

Pieces Fall Into Place

Witelson could barely contain her curiosity.

Einstein's brain -- so far from ordinary in its intellectual achievement -- might reveal a telltale anatomical signature. Size alone certainly could not account for his brain power.

"Here was somebody who was clearly very clever; yet his overall brain size was average," Witelson said. "It certainly tells you that, in a man, sheer overall brain size can't be a crucial factor in brilliance."

For a moment, she was like a schoolchild picking candies from a Valentine's Day sampler. She judiciously selected 14 pieces of Einstein's brain. She took parts of his right and left temporal lobes, and the right and left parietal lobes.

Never had Harvey given away so much brain.

Witelson and her colleagues carefully compared the 40-year-old tissue samples with dozens of normal male and female brains in her collection. She also compared them with brains from eight elderly men to account for any changes due to Einstein's age at the time of his death.

She found that one portion of Einstein's brain perhaps related to mathematical reasoning -- the inferior parietal region -- was 15% wider than normal.

Witelson also found that it lacked a fissure that normally runs along the length of the brain. The average human brain has two distinct parietal lobe compartments; Einstein's had one.

Perhaps the synapses in this area were more densely interconnected.

"Maybe this was one of the underlying factors in his brilliance," she said. "Maybe that is how it works."

She took it as confirmation of her suspicions about the anatomy of intelligence. If there were differences affecting normal mental ability, they would show up in the arrangements of synapses at particular points in the brain.

Einstein, she was convinced, had been born with a one-in-a-billion brain.

"We suggest that the differences we see are present at birth," Witelson said. "It is not a consequence of environmental differences."

She turned again to the brains in her refrigerator. Wherever she looked, she began to see evidence of how microanatomy might underlie variations in mental abilities.

As she matched the brain specimens to the intellectual qualities of their owners, she discovered that differences in the size of the corpus callosum were linked to IQ scores for verbal ability, but only in women. She found that memory was linked to how tightly neurons were packed, but only in men.

Witelson determined that brain volume decreased with age among men, but hardly at all among women. Moreover, those anatomical changes appeared to be closely tied to a gradual decline in mental performance in men. "There is something going on in the male brain," she said, "that is not going on in the female brain."

Brain Conquers All

Last year, a worried farming couple brought their youngest child to McMaster University Medical Center.

They were no longer certain whether their child was a girl or a boy. The youngster had traits of both, as occurs in about one in 5,000 births. In this child, nature had devised a living test of gender and the brain.

The medical experts determined that the child's body was a composite of normal and abnormal cells. Some had a girl's usual complement of two female sex chromosomes. Many, perhaps due to a mutation, had only one female chromosome and consequently were almost male.

"Which cells got to the brain?" wondered Witelson, who was called in as a consultant. "You have to consider the sex of the brain."

The doctors all suspected the child's brain was masculine. There was no way to know for sure. They could not safely take a sample of neural tissue to biopsy.

Until recently, reconstructive surgery based on a doctor's best guess was the rule in such cases. But in Hamilton, they counseled patience, Witelson recalled.

"We said, 'Let the child's behavior tell us what sex the child is.' "

Given time, she believed, the brain would reveal itself.
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Ted

Post by Ted » Wed Jul 06, 2005 1:22 pm

the cerebral cortex contains 25 billion neurons linked through 164 trillion synapses.
Yep, that sounds like CD alright...

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Post by MaestroDJS » Wed Jul 06, 2005 1:53 pm

Mmm, brains. :D

Dave

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Post by Ralph » Wed Jul 06, 2005 3:42 pm

I'm waiting for Cor's response.
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Post by Corlyss_D » Thu Jul 07, 2005 1:15 am

Great article, Ralph. Thanks. I'm waiting for the political fall out, i.e., will womens groups allow this finding to persist.
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Post by Ralph » Thu Jul 07, 2005 6:35 am

Corlyss_D wrote:Great article, Ralph. Thanks. I'm waiting for the political fall out, i.e., will womens groups allow this finding to persist.
*****

No group will stop science. This is an interesting study but hardly the last word.

That there are differences in male and female brains doesn't surprise me. What the implications are is an open field for neuroscience.

But with three decades in the classroom and more than that practicing law I see most differences between men and women in my profession as reflective of nurture and culture, surely not nature. Actually, in law school women as a cohort outperform men, Corlyss being one sure example of that reality.
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Post by DavidRoss » Thu Jul 07, 2005 1:57 pm

This is not news--several books have been written over the past couple of decades summarizing research into gender differences in the brain. If it weren't for the current PC climate such differences would have been common knowledge since the late '80s. Without Einstein's buzz, would this story have been published in the Times?
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Post by karlhenning » Thu Jul 07, 2005 2:19 pm

Shhhh, David! Ours is a society anxious to believe that the sexes are absolutely the same, save for the minor matter of genitalia (as though that difference could be hermetically distinguished from all the body else).
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Post by Teresa B » Thu Jul 07, 2005 2:22 pm

Hi all,

Interesting. I don't know why anyone should be surprised by male/female brain differences, although some of the specific things are unexpected.

I've been a "feminist" in terms of goals like being viewed equally as human beings, and not being denied equal opportunity as far as education, employment, etc.

Since there is such a complex interaction between nature/nurture, with the brain actually physically changing from different experiences, I think the whole "biology is destiny" thing vs the "blank slate" thing tends to be a moot point.

One thing the more radical feminists keep getting upset over is the fact that there are still not equal numbers of women and men in certain professions. (Carol Tavris has written some excellent stuff on this subject.) I would agree that there is still discrimination around, but one reason for unequal distributions is probably unequal interest in that field. (Don't know whether that's nature or nurture.)

Women and men are now about equal in medical school classes. As far as I know there are many women in law now. But women airline pilots and engineers are still rare. For myself, a physician, I can say for certain, I simply did not find engineering appealing. (It wasn't "math anxiety," because I had no problem with it.) Could that be true of many women?

Having said that... I do think we need more women in the highest levels of government. For our own good. :)

All the best, Teresa
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Post by Ralph » Thu Jul 07, 2005 2:46 pm

Women airline pilots tend to be relatively few because the airlines like to hire from the Air Force and Navy. The number of female commercial pilots is steadily ascending.

My law school first-year entering class last summer was 61% female and we've been over 50% for a long time (many schools are at 50% or higher). My faculty has always had a high percentage of women over our nearly thirty-year history and that includes two women deans and more than a few women associate deans (law faculty select decanals candidates as being eligible for appointment-the university can't do that).

One female colleague my age remembers when there were few women at Harvard law School and some troglodyte professors held "Ladies Day" classes, the only day in the semester when women would be called on.

Many, many women are successful in law and as judges their visibility is nationwide. In New York, four of the seven judges on our highest court are female.

That said, in the private sector too few women make partner in major firms although promotion in government agencies is largely gender neutral. It's also true that more women are likely to leave law to raise families than are their male counterparts. And unlike Teresa's profession where a doctor can ably devote herself to part-time duties, that's very difficult in law, especially in litigation.
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Post by Teresa B » Thu Jul 07, 2005 4:12 pm

Ralph wrote:Women airline pilots tend to be relatively few because the airlines like to hire from the Air Force and Navy. The number of female commercial pilots is steadily ascending.


And unlike Teresa's profession where a doctor can ably devote herself to part-time duties, that's very difficult in law, especially in litigation.
Yes, BUT...

Why are there still relatively few women pilots in the Air Force and Navy to apply for the airline jobs? Is it discrimination, or lack of interest on the women's parts? (And hey, I'm all for more women pilots, if they're out there.)

Whether a woman can ably devote herself to part-time duties in medicine depends on the branch of medicine. Fields like general medicine, cardiology, pulmonology, general or various other types of surgery, and a number of other fields are very time-intensive, and patients have emergencies at all hours.

I think Medicine as a career is more appealing (say, than engineering) to many women because it is a "people" profession. Whether that's because women are predisposed genetically is a moot point. But the preference seems to be there.

Teresa
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Post by MaestroDJS » Thu Jul 07, 2005 6:33 pm

Teresa B wrote:I think Medicine as a career is more appealing (say, than engineering) to many women because it is a "people" profession. Whether that's because women are predisposed genetically is a moot point. But the preference seems to be there.
One thing that disappoints me about engineering is that there are so few women in this field. It's probably because engineering can be very impersonal -- although not the way I go about it! :D

It's not only my engineering firm, but almost all of our clients have predominantly male engineering departments. One notable exception was a project a few months ago at an industrial adhesives factory, which was owned and operated by a brother and sister. She did great work, and it was refreshing to exchange ideas about how this or that process should operate. Shortly before the end of my project, she paid me an odd compliment -- she really appreciated that I didn't talk down to her just because she was a woman. I said it would be great if more women were in engineering, simply because they'd bring different perspectives to bear.

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Post by Ralph » Thu Jul 07, 2005 7:44 pm

Teresa B wrote:
Ralph wrote:Women airline pilots tend to be relatively few because the airlines like to hire from the Air Force and Navy. The number of female commercial pilots is steadily ascending.


And unlike Teresa's profession where a doctor can ably devote herself to part-time duties, that's very difficult in law, especially in litigation.
Yes, BUT...

Why are there still relatively few women pilots in the Air Force and Navy to apply for the airline jobs? Is it discrimination, or lack of interest on the women's parts? (And hey, I'm all for more women pilots, if they're out there.)

Whether a woman can ably devote herself to part-time duties in medicine depends on the branch of medicine. Fields like general medicine, cardiology, pulmonology, general or various other types of surgery, and a number of other fields are very time-intensive, and patients have emergencies at all hours.

I think Medicine as a career is more appealing (say, than engineering) to many women because it is a "people" profession. Whether that's because women are predisposed genetically is a moot point. But the preference seems to be there.

Teresa
*****

It's discrimination in the sense that there are quotas for women in all branches of the military except for nursing. But that's legal. :(

Since the percentage of women who can serve in the military is limited it follows that relatively few can meet the exacting standards for pilot training (much more rigorous than for a commercial license).

And women who qualify - and we have carrier-based fighter pilots - are junior in rank and experience and aren't yet in the mid-career pipeline where male pilots often decide to change uniforms.

As for engineering, women have historically been discriminated against and medicine was a possible alternative for many. Fifty or more years ago some Jewish males who couldn't get into engineering schools because of a quota went for medicine (they weren't just satisfying mom).

When the law school was new I was reviewing applications when I came across a female applicant's file where the summary sheet showed she graduated college with less than a 2.0 GPA. I was about to reject her without even reading the file when I wondered how anyone could get a B.S. with less than a "C" cum. She had gone to a noted engineering school and to my amazement I read a dean's letter that admitted her grades had been rigged to make her fail. Not before or after have I ever seen a similar letter. The dean surely didn't have legal advice when he wrote it.

I admitted her and she graduated - she was a good student. No idea where she is today.
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Ted

Post by Ted » Thu Jul 07, 2005 8:52 pm

No idea where she is today.
Hopefully in the kitchen where she belongs :roll:

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Post by Corlyss_D » Fri Jul 08, 2005 12:04 am

Ralph wrote:
Corlyss_D wrote:Great article, Ralph. Thanks. I'm waiting for the political fall out, i.e., will womens groups allow this finding to persist.
*****

No group will stop science.
The Ecofactivists have come pretty close with all this human-caused climate change globaloney. They retaliate against scientists who dare speak out against their politically approved bull crap.


That there are differences in male and female brains doesn't surprise me.
Women have striven for so long to prove there are no meaningful differences that when someone, esp. a scientist, does speak out for meaningful differences, it is immediately discredited as attempting to force women out of the work place and into the burkha. Interesting petard. They have had that political position for 50 years and then get upset when scientists don't do heart studies on women and outraged when the male models prove wrong or misleading for women.
Actually, in law school women as a cohort outperform men, Corlyss being one sure example of that reality.
Highly unlikely in my case. I was already working 40-60 hours a week when I was going to law school. I had only so many hours of free time to devote to it. A lot of my fellow students didn't work even the 20 hrs a week, i.e., the minimum number for night division students. I didnt' want to be the best. I just wanted to do it at all to prove to myself I could. That has ever been the only reason I ever did anything remotely difficult.

Re: women in professions. It's all very nice but this I know and know full well: the minute women predominate in a profession, i.e., the profession becomes "feminized," the compensation begins to decline along with the respect of society. You can watch it happen to the medical profession even as we speak. In 30 years time, the profession will be almost exclusively female and their share of the medical costs crisis will have been resolved.
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Post by Ralph » Fri Jul 08, 2005 4:48 am

There are many reasons why physician compensation has relatively declined and the increased presence of women MDs isn't one of them. HMOs and pressure to do more for less is.

Women are way in the majority at vet schools and four of the five doctors at the office where I take my cats are female. Fees havenb't declined so I guess the vets are all doing okay.

Law isn't being "feminized" although there is a school of feminist jurisprudence that argues for that end.
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Post by Corlyss_D » Fri Jul 08, 2005 12:55 pm

Ralph wrote:There are many reasons why physician compensation has relatively declined and the increased presence of women MDs isn't one of them. HMOs and pressure to do more for less is.
I'm saying the pressure wouldn't be so great if women had stayed out.
Women are way in the majority at vet schools and four of the five doctors at the office where I take my cats are female. Fees havenb't declined so I guess the vets are all doing okay.
Its still growth industry. When it levels off, if women are still going into it to the point that more than 50% of the profession is women, you will see a decline in salaries. It will be attributed to something(s).
Law isn't being "feminized"
Hard to argue that when routinely women account for more than 50% of the law school classes. It's going to have an inevitable impact, if it hasn't already. Of course, a supply glut usually does have an impact on prices.
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Post by Teresa B » Sat Jul 09, 2005 6:38 am

Corlyss,
To what do you attribute the "feminization" of these professions? For one thing, is the drop in income a result, or the cause, of the increased percentage of women? (I mean, maybe the men just aren't as attracted knowing their income will not be as good.)

In medicine, for example, our income (except for cosmetic procedures, of course) is controlled by Medicare and managed care plans. This has been happening since the 70's, before which most doctors were paid fee-for-service up front and didn't have to accept the lower reimbursements. Now the vast majority of patients have to be on these plans, so we docs have no choice but to take the low reimbursement, or have no patients.

One could argue that we physicians have allowed this to happen, but it seems more complex than that. And most of the changes began to occur way before women made up half the work force. But could it be that "feminization" causes the public to respect the profession less? Women have surely not caused any drop in physician levels of competence! In fact, many people request female doctors.

But as a whole, is it the case that the profession commands less respect "automatically" because there are more women in it?

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Post by DavidRoss » Sat Jul 09, 2005 7:41 am

Teresa--I'm not Corlyss, but I'll offer a quick 2 cents worth of food for thought:

I would attribute the "feminization" of those professions, and others, to the expansion of opportunities to women that resulted directly from World War II and encouraged rather than discouraged women from pursuing careers in the professions, and to the sheer number of women who may already constitute the majority of the college-trained work force.

And I would attribute the ever-increasing cost of health care and the decline in physician compensation to the federal government's entry into health care with Medicare in the '60s, which created enormous new opportunities for corruption that unscrupulous profiteers hastened to take advantage of, and which transformed health care from a "noble calling" into a growth industry with high-profit margins guaranteed by government's ability to squeeze the taxpayer and regulate competition.
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Post by Corlyss_D » Sat Jul 09, 2005 12:19 pm

Teresa B wrote:Corlyss,
To what do you attribute the "feminization" of these professions? For one thing, is the drop in income a result, or the cause, of the increased percentage of women? (I mean, maybe the men just aren't as attracted knowing their income will not be as good.)
I don't recall that any of the reports I read some years ago on this phenomenon attributed it to a cause. It was being discussed in terms of cheerleading at first "New professional opportunities attract women in record numbers" sort of thing, followed a couple of years later with "Salaries decline in statistically significant amounts" sort of thing. I have a theory: it has to do with some ingrained prejudice against women in any profession. It happened with teaching and librarians first before it happened with law and medicine.
In medicine, for example, our income (except for cosmetic procedures, of course) is controlled by Medicare and managed care plans. This has been happening since the 70's, before which most doctors were paid fee-for-service up front and didn't have to accept the lower reimbursements. Now the vast majority of patients have to be on these plans, so we docs have no choice but to take the low reimbursement, or have no patients.
That was when women began going into medicine in large numbers. It wouldn't surprise me any to learn 10 years from now from sociological study that these managed care plans were made feasible by the entry of so many women into medicine. Right now I'm not claiming that because I don't have anything to back me up. I am just saying it wouldn't surprise me. (Without derailing the topic, let me say that I have been similarly surprised by the impact desegregation had on the public education system. I never would have seen it coming from how things were going in 1960. That's the kind of subsequently realized thing I'm talking about.)
One could argue that we physicians have allowed this to happen, but it seems more complex than that. And most of the changes began to occur way before women made up half the work force. But could it be that "feminization" causes the public to respect the profession less? Women have surely not caused any drop in physician levels of competence! In fact, many people request female doctors.
I realize that. It's an extremely mixed sociological bag. Without systematic facts and studies, which may never have been performed and may never be performed, I'm restricted to idle speculation. And don't forget the "informed consent" movement, which, if you ask my mother, she virtually single handedly started by being such a pain in the ass with my dad's doctors. That to my mind was a very "female" kind of mindset that has reduced the mystique once associated with doctoring. As professions generally are demystified, people are more comfortable with women performing them. But, also as professions are demystified, they command less in the way of salary. Again, no sociological study to support my hunch, but that's part of it I think. (BTW my mother was always leery of female doctors and shockingly considered them per se incompetent or ineffective, but she never felt that way about black male doctors, who were more widely-publicized to be the products of Affirmative Action - her experience until the late 80s was exclusively with military doctors. Go figure.)
But as a whole, is it the case that the profession commands less respect "automatically" because there are more women in it?
Yes. I will mention an anecdote from my own personal experience. When I was a GS 9 contracting officer, my boss got me appointed to the chairmanship of a highly publicized committee of professionals none of whom was lower than a GS 14 and most of whom were GS 15s. My boss literally swore me to secrecy about my grade level. Coincidentally I was the first woman to chair a committee in that DoD organization. Immediately my appointment was secure, the agencies represented on the committee began sending lower graded women to represent them. Now, I noted the phenomenon in my own small pond, but I was happy with the development because the program supported by the committee was a bunch of bull crap and suffered greatly from way too much highlevel attention. But I noted it none the less.
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Post by Corlyss_D » Sat Jul 09, 2005 12:38 pm

DavidRoss wrote:I would attribute the "feminization" of those professions, and others, to the expansion of opportunities to women that resulted directly from World War II and encouraged rather than discouraged women from pursuing careers in the professions, and to the sheer number of women who may already constitute the majority of the college-trained work force.
I agree both of these are contributing factors. I was never a feminist because I always knew who made "women's lib" possible: it was the women who went into the work force to fill the spaces left by men in WW2. What did we have? 16 million men under arms in WW2? That did more to pave the way for me to go to college than 100 Betty Friedans and Gloria Steinems ever could have done absent the predicate experience of the Rosies the Riveter.
And I would attribute the ever-increasing cost of health care and the decline in physician compensation to the federal government's entry into health care
I agree with you on the role of the Feds in creating the health cost nightmare - only I'd subsume it under the general category of "3rd party payers." If doctors had to rely on us individuals for compensation, health costs generally would be much much lower.

But you're going to have to make the case regarding the Feds causing lower salaries for doctors.
with Medicare in the '60s, which created enormous new opportunities for corruption that unscrupulous profiteers hastened to take advantage of, and which transformed health care from a "noble calling" into a growth industry with high-profit margins guaranteed by government's ability to squeeze the taxpayer and regulate competition.
Thanks to the strength of the doctors' unions, Medicare=free money. The graft and corruption in the program, which by law may not leverage it's numbers into lower costs is a f**king scandal.
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Post by Teresa B » Sun Jul 10, 2005 7:49 am

Corlyss, I think you have something there about the loss of the mystique of the male doctor being linked with the increase in women in the profession. This is not a bad thing in general, but it's bad for doctor's incomes! (The public has not much sympathy for that, of course.)

It isn't the income thing as much as the respect thing that bothers me. If more women = less respect for the profession, then it's a sad situation. I have read polls in which people have been asked about how they view their doctors (not male/female, but all doctors). They tended to have a somwhat negative view of the profession overall, but an extremely high percentage of them viewed their own doctor favorably.

So...How can some 89% of us be loved by our patients, but disliked as a group? Obviously, perception doesnt always follow facts! So I suppose the perception of women as less competent or less deserving of financial reward does not have to follow the fact that we are of equal competence.

By the way, if the AMA is in cahoots with Medicare as far as corruption, I, not an AMA member, have missed out on the profiteering. The only thing I've gotten from Medicare is a lot of very nice patients, but my reimbursements run about 66% of my charges. (And I have to write off the rest.) It's somebody other than us everyday practitioners who are getting all the profits. (I believe labs, medical supply people, and I hate to say it, but oncologists who give chemo, have profited quite a bit. The chemo centers have been reimbursed at very high rates for the drugs, so the doctors are not doing some shady deal. But recently Medicare has cracked down on the reimbursements.)

Basta, no more whining, :cry:

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Post by Corlyss_D » Sun Jul 10, 2005 4:28 pm

Teresa B wrote:Corlyss, I think you have something there about the loss of the mystique of the male doctor being linked with the increase in women in the profession. This is not a bad thing in general, but it's bad for doctor's incomes! (The public has not much sympathy for that, of course.)
Nobody ever talks about the mystique of the wise woman. If it's a shaman, whoooooa, big deal. Same advice from a wise woman, it just hasn't the same cachet.
I have read polls in which people have been asked about how they view their doctors (not male/female, but all doctors). They tended to have a somwhat negative view of the profession overall, but an extremely high percentage of them viewed their own doctor favorably. So...How can some 89% of us be loved by our patients, but disliked as a group?
It's the congressman phenomenon! I know my guy. He does alright for me. But your congressman stinks. In fact all 434 of the other congressmen are crooks in thrall to the special interests. We need to throw your bum out of office. But my bum is okay and I want to keep him.

So I suppose the perception of women as less competent or less deserving of financial reward does not have to follow the fact that we are of equal competence.
Well, if a woman can do it, it must not be very complex so it most certainly don't deserve the rate of pay Dr. Joe was getting for doing it.
By the way, if the AMA is in cahoots with Medicare as far as corruption, I, not an AMA member, have missed out on the profiteering. The only thing I've gotten from Medicare is a lot of very nice patients, but my reimbursements run about 66% of my charges.
It started off with doctors who had vehemently opposed medicare discovering that they could walk thru a ward of n patients in about 5 min. and charge Medicare for a "visit" with each patient.


I'm looking thru my stash of GAO reports and others to see if I can nail down the reports on drugs - Veteran's have probably the most sophisicated buyers of medical supplies in the government. They bargain for discounts on the basis of quantities purchased. HCFA (or whatever its successor acronym is) is prohibited by law from doing so. On top of that, audits rarely pick up the dummy corporations, phoney invoices, and insider corruption in the manipulation of billing and payment that is rife in the program. It's an insane operation. No sensible business would run that way.
It's somebody other than us everyday practitioners who are getting all the profits.
I don't doubt it.
(I believe labs, medical supply people, and I hate to say it, but oncologists who give chemo, have profited quite a bit. The chemo centers have been reimbursed at very high rates for the drugs, so the doctors are not doing some shady deal. But recently Medicare has cracked down on the reimbursements.)
And the dialysis guys, who managed to finagle their way into a dollar for dollar reimbursement from the government.

There were certainly some underreporting of the practice where doctors set up corporations that supplied other services, then prescribing those services from their own companies and billing exhorbitant rates for them. I think the government prohibits that by law now. As you can see I'm not as knowledgeable about this as I am, say, foreign affairs, but I think I can recover enough info shortly to at least limn the problem.
Last edited by Corlyss_D on Sun Jul 10, 2005 6:18 pm, edited 2 times in total.
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Post by Teresa B » Sun Jul 10, 2005 4:54 pm

Corlyss,

Good points! I do recall some crackdown on the practice of being invested in a lab or other ancillary business and then referring all your patients there, then billing exhorbitantly, etc.

There are individual practitioners who have been audited and caught. But more likely it takes a whistleblower. We just had a dermatologist in Sarasota, a Michael Rosin, who is a highly-qualified guy, get caught in about 20 or more counts of fraud. He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.

This is unconscionable, and luckily, I think this degree of fraud is rare. (at least I hope so.)

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Post by Corlyss_D » Sun Jul 10, 2005 6:22 pm

Teresa B wrote: He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.
Without wanting to start the death penalty debate all over again to no purpose, I hope they hang the guy by the balls until dead. Cancer is such a loaded word. To tell a perfectly healthy individual person they have cancer and wreak all that emotional havoc just to make a buck, the guy deserves no mercy.
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Post by Ralph » Sun Jul 10, 2005 8:19 pm

Teresa B wrote:Corlyss, I think you have something there about the loss of the mystique of the male doctor being linked with the increase in women in the profession. This is not a bad thing in general, but it's bad for doctor's incomes! (The public has not much sympathy for that, of course.)

It isn't the income thing as much as the respect thing that bothers me. If more women = less respect for the profession, then it's a sad situation. I have read polls in which people have been asked about how they view their doctors (not male/female, but all doctors). They tended to have a somwhat negative view of the profession overall, but an extremely high percentage of them viewed their own doctor favorably.

So...How can some 89% of us be loved by our patients, but disliked as a group? Obviously, perception doesnt always follow facts! So I suppose the perception of women as less competent or less deserving of financial reward does not have to follow the fact that we are of equal competence.

By the way, if the AMA is in cahoots with Medicare as far as corruption, I, not an AMA member, have missed out on the profiteering. The only thing I've gotten from Medicare is a lot of very nice patients, but my reimbursements run about 66% of my charges. (And I have to write off the rest.) It's somebody other than us everyday practitioners who are getting all the profits. (I believe labs, medical supply people, and I hate to say it, but oncologists who give chemo, have profited quite a bit. The chemo centers have been reimbursed at very high rates for the drugs, so the doctors are not doing some shady deal. But recently Medicare has cracked down on the reimbursements.)

Basta, no more whining, :cry:

Teresa :)
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The economic factors impact very heavily on patients' regard for their doctors and for the profession in general. No one feels good about being rushed and the American dependence on ordering tests often before a serious conversation between M.D. and patient ensues is corrosive of trust albeit often rational medicine.
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Post by Ralph » Sun Jul 10, 2005 8:23 pm

Teresa B wrote:Corlyss,

Good points! I do recall some crackdown on the practice of being invested in a lab or other ancillary business and then referring all your patients there, then billing exhorbitantly, etc.

There are individual practitioners who have been audited and caught. But more likely it takes a whistleblower. We just had a dermatologist in Sarasota, a Michael Rosin, who is a highly-qualified guy, get caught in about 20 or more counts of fraud. He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.

This is unconscionable, and luckily, I think this degree of fraud is rare. (at least I hope so.)

Teresa
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In New York it's illegal for a doctor to have an economic interest in any lab which does clinical testing. Ironically this has upped costs for patients while insuring a higher degree of ethics.

And it wasn't that long ago, maybe 30 years, when N.Y. first forbade M.D.s to write death certificates for family members after there was a little problem about a Great Neck doctor's wife's demise.
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Post by Ralph » Sun Jul 10, 2005 8:26 pm

Teresa B wrote:Corlyss,

Good points! I do recall some crackdown on the practice of being invested in a lab or other ancillary business and then referring all your patients there, then billing exhorbitantly, etc.

There are individual practitioners who have been audited and caught. But more likely it takes a whistleblower. We just had a dermatologist in Sarasota, a Michael Rosin, who is a highly-qualified guy, get caught in about 20 or more counts of fraud. He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.

This is unconscionable, and luckily, I think this degree of fraud is rare. (at least I hope so.)

Teresa
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It's relatively rare and inevitably recurrent just as there will always be lawyers who siphon off escrow accounts.
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Post by Teresa B » Tue Jul 12, 2005 6:03 am

Corlyss_D wrote:
Teresa B wrote: He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.
Without wanting to start the death penalty debate all over again to no purpose, I hope they hang the guy by the balls until dead. Cancer is such a loaded word. To tell a perfectly healthy individual person they have cancer and wreak all that emotional havoc just to make a buck, the guy deserves no mercy.
I have to agree with you on this one. And not only did this a--hole tell all these people they had cancer, but some of them he operated on multiple times, thus repeatedly putting them through the physical pain and scarring of surgery. Can you beat that? (I know you'd like to, to a pulp.)

And Ralph, I think you're right, this sort of thing is rare. But it does nothing for the reputations of us practitioners who try to do our best!

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Post by Ralph » Tue Jul 12, 2005 9:32 am

Teresa B wrote:
Corlyss_D wrote:
Teresa B wrote: He operated on scads of patients who never even had skin cancer. The trick was, he processed and read all his own biopsies. So he told the patients they had cancer and needed surgery, whether or not they had a mere zit.
Without wanting to start the death penalty debate all over again to no purpose, I hope they hang the guy by the balls until dead. Cancer is such a loaded word. To tell a perfectly healthy individual person they have cancer and wreak all that emotional havoc just to make a buck, the guy deserves no mercy.
I have to agree with you on this one. And not only did this a--hole tell all these people they had cancer, but some of them he operated on multiple times, thus repeatedly putting them through the physical pain and scarring of surgery. Can you beat that? (I know you'd like to, to a pulp.)

And Ralph, I think you're right, this sort of thing is rare. But it does nothing for the reputations of us practitioners who try to do our best!

Teresa
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Of course not and the legal profession gets hit more than doctors with true tales of incompetence and criminality because it's so easy for a dishonest lawyer to siphon off client money. Don't get me started on lazy and uncaring lawyers, a minority who wreak true havoc, sometimes with tragic results as in death penalty defense attorneys who just don't care.
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