1. Rude doctors aren’t just annoying, they’re dangerous to patient health.

A substantial body of data attributes medical errors to interactions among hospital workers. Calls for improved patient safety gained traction from the late 1980s through the early ’90s, when Australian researchers reported a shocking find: the vast majority of medical errors, some 70‑80 per cent, are related to interactions within the health care team. In the early 2000s, a report by the Joint Commission that accredits health care organisations in the US studied adverse events over a 10‑year period and discovered that communication failure was the number-one cause for medication errors, delays in treatment, and surgeries at the wrong site. It was also the second leading cause of operative mishaps, postoperative events, and fatal falls.

The link between harsh words and medical errors was reignited in 2012 when Lucian Leape, professor of health policy at the Harvard School of Pub­lic Health, published a two-part series in Academic Medicine. ‘A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect,’ Leape and his co-authors asserted. ‘Disrespect is a threat to patient safety because it inhibits collegiality and co-operation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices.’

2. On the myth of ‘girls don’t count’

They were real. They were real and they counted. They’re not shadows among the men I saw. But I wanted them to be. I wanted to avoid the consequences, to avoid thinking, to avoid wondering what it meant. These men, they told me what it meant: it meant nothing.

3. This appears to be an evidence-based eating disorder app. [!!!!!!] (I’ve downloaded but not had a chance to play too much.) There’s also a version for clinicians!

E.E. Buckels et al, “Trolls just want to have fun,” Personality and Individual Differences, 2014.

4. Research into internet trolling: exactly as terrifying as reading the comments sections on your average news site would have you believe. Identified trolls scored high on psychopathy, sadism, narcissism (caveat: I’ve not been terribly impressed with previous measures of narcissism), Machiavellianism. You know, exactly the sorts of people you want clogging up the conversations.

I’m going to take a moment here to be thankful for first time comment moderation and you, thoughtful readers.

5. While I adored the Harry Potter books, I fell into a common pattern–I admired and identified with Hermione and saw Harry as the protagonist. Ron? The sidekick. This defense persuaded me that I’ve done a grievous wrong.

So what about Ron? He actually tends to a very clear gap in the ranks—providing a sense of family unity and street smarts. While Ron himself may often feel crushed by the burden of familial expectations, he extends the closeness of the Weasley clan to his friends both figuratively and literally. Harry and Hermione do both eventually become members of his family through marriage, but more importantly, Ron always treats them as blood. It’s there in every holiday Harry spends with the Weasley family, with that first sweater Harry receives on Christmas, and the unconditional love Harry and Hermione are both offered only because Ron’s family know how much these children mean to their son. I mean, he steals the family hover-car with the help of the twins because he’s worried that Harry is being held hostage by his abusive relatives. That knight parallel from their mega chess battle is looking more and more apt.

6. More of this, please.

Abortion opponents have been pushing the idea that abortion hurts women, that they feel regret. With 1.3 million women having an abortion every year, it’s likely that a certain number do feel regret. That’s the natural curve of any kind of big decision. What we want to know is: Who are those women and what do they need?

7. Ehlers-Danlos Syndrome is a disorder of collagen, making connective tissue or skin weak. These functional-but-decorative finger splints are gorgeous and creative. Too often, assistive devices are designed to hide, instead of taking advantage of their position as eye-catching accessories.

1. I may be occasionally gruntled or hinged, but I’ve got nothing on Robby’s wordplay.

I love discombobulating words; and recombobulating them; really, bobulating them in all sorts of ways. Though especially in ways that make new poetries possible, or lead to new insights about the world and its value.

I’m very fond of the approach of restricting myself to common words (Up-Goer Five), and of other systematic approaches. But I think my favorite of all is the artificial language Anglish: English using only native roots.

2. Phillip Seymour Hoffman died, sparking a discussion about addiction and recovery. Aaron Sorkin writes a tribute, and Mind Hacks has a wonderful wrap up:

Addiction has a massive effect on people’s choices but not so much by altering the control of actions but by changing the value and consequences of those actions.

If that’s not clear, try thinking of it like this. You probably have full mechanical control over your speech: you can talk when you want and you can stay silent when you want. Most people would say you have free will to speak or to not speak.

But try not speaking for a month and see what the consequences are. Strained relationship? Lost job maybe? Friends who ditch you? You are free to choose your actions but you are not free to choose your outcomes.

For heroin addicts, the situation is similar. As well as the pleasurable effects of taking it, not taking heroin has strong, negative and painful effects.

This is usually thought of as the effects of physical withdrawal but these are not the whole story. These are certainly important, but withdrawing from junk is like suffering a bad case of flu. Hardly something that would prevent most people from saving their lives from falling apart.

 3. Writing about research is important–and it matters who you use as the baseline.

4. Filed under: Hunh: The Difference Between “Significant” and “Not Significant” is not Itself Statistically Significant

5. I tried to make the appropriate skeptical response face to this, but my facial muscles weren’t up to it: is long term psychoanalysis better than other psychotherapies?

6. This post on empathy and being a standardized patient…yes. If you read nothing else, read this.

Empathy isn’t just something that happens to us—a meteor shower of synapses firing across the brain—it’s also a choice we make: to pay attention, to extend ourselves. It’s made of exertion, that dowdier cousin of impulse. Sometimes we care for another because we know we should, or because it’s asked for, but this doesn’t make our caring hollow. The act of choosing simply means we’ve committed ourselves to a set of behaviors greater than the sum of our individual inclinations: I will listen to his sadness, even when I’m deep in my own. To say “going through the motions”—this isn’t reduction so much as acknowledgment of the effort—the labor, the motions, the dance—of getting inside another person’s state of heart or mind.

This confession of effort chafes against the notion that empathy should always arise unbidden, that genuine means the same thing as unwilled, that intentionality is the enemy of love. But I believe in intention and I believe in work. I believe in waking up in the middle of the night and packing our bags and leaving our worst selves for our better ones.

7. …and now that you’ve read one thing this week, you should read another: Scott’s response on seeming and being empathetic.

One of my mentors taught me the important technique of having a tissue box near me at all times. If someone gets into an emotional situation, I unobtrusively place the tissue box closer to them, which signals that I suspect they’re upset and I’m okay with it, without bludgeoning them over the head with the fact. Sometimes questions work: “Are you okay?”, “Is there anything I can do to help?”, “Do you want to talk about this more, or do you want to move on?”

And part of what I had to do was unlearn my habits from communication classes and empathy exams. In the exams your goal is always very virtue-ethics-y: to demonstrate that you are The Kind Of Doctor Who Feels Empathy. In real life, your goal is consequentialist: there’s a person in pain in front of you, and you need to figure out how to help them. In what I think is C. S. Lewis’ phrase, you need to get out of your own head and do what’s best for the patient. Which sometimes involves reference to the content of my own head – all psychiatrists know that the therapeutic relationship is one of the most powerful weapons in medicine – but only if the patient cares what’s in there.

8. This is the Mental Elf blog. Say what you will about needing food and shelter, but I think I could subsist on puns and mental health research.

1. This week in results I can barely believe, gentrification appears to decrease the chances that longtime residents will leave. I’m slightly less skeptical given that the researcher himself didn’t anticipate getting these results–he expected the opposite. (h/t Scott)

Lance Freeman, the director of the Urban Planning program at Columbia University, says that’s what he believed was happening, too. He launched a study, first in Harlem and then nationally, calculating how many people were pushed out of their homes when wealthy people moved in.

“My intuition would be that people were being displaced,” Freeman explains, “so they’re going to be moving more quickly. I was really aiming to quantify how much displacement was occurring.”

Except that’s not what he found.

“To my surprise,” Freeman says, “it seemed to suggest that people in neighborhoods classified as gentrifying were moving less frequently.”

Freeman’s work found that low-income residents were no more likely to move out of their homes when a neighborhood gentrifies than when it doesn’t.

2. I used to think Allomancy was my favorite system of magic. I was so, so wrong. (Also, credit to Scott)

3. Mental health issues in hospitals and emergency rooms are a growing problem.

Nationally, more than 6.4 million visits to emergency rooms in 2010, or about 5 percent of total visits, involved patients whose primary diagnosis was a mental health condition or substance abuse. That is up 28 percent from just four years earlier, according to the latest figures available from the Agency for Healthcare Research and Quality in Rockville, Md.

By one federal estimate, spending by general hospitals to care for these patients is expected to nearly double to $38.5 billion in 2014, from $20.3 billion in 2003.

The problem has been building for decades as mental health systems have been largely decentralized, pushing oversight and responsibility for psychiatric care into overwhelmed communities and, often, to hospitals, like WakeMed.

In North Carolina, the problem is becoming particularly acute. A recent study said that the number of mental patients entering emergency rooms in the state was double the nation’s average in 2010.

More than 10 years after overhauling its own state mental health system, North Carolina is grappling with the consequences of a lost number of beds and a reduction in funding amid a growing outcry that the state’s mentally ill need more help.

4. So, uh, how does being a hitman work? Oh good, someone did quantitative research on that.

The results of their detailed search of British cases that matched this description in the period between 1974 and 2013 only turned up 27 contracted hits or attempted hits “committed by a total of 36 hitmen” (there was only a single “hitwoman”), but the researchers used the sample to tease out the details and profiles of typical killers-for-hire.

The main thrust of the paper, which will be published in the Howard Journal of Criminal Justice, is that hitmen do not operate with the drama, professionalism, or glamour that mob films and spy novels afford them. In actuality, the majority of killers select jejune settings for their crimes, have occasionally bumbling performances, and are often hired by contractors with lame motivations.

5. I once had a professor who offhandedly said “hah, he probably just cherrypicked whichever results looked pretty” when a student expressed shock at the results of some priming research from John Bargh.

(The example of priming I hear most often cited in popular conversation is that giving a stranger a cup of hot coffee, rather than iced, will make them think more positively of you.)

Not five minutes later, the professor praised Bargh for being the leading researcher in this growing new field. The ridiculousness of being known for squashing data into conclusions and being one of the most well known social psychologists didn’t seem to register.

That story makes this article investigating Bargh’s work even more compelling. (And because aaaah, what, Donellan has a blog?! </psychnerdery> I’m going to particularly note this in-blog link on Bargh as well.)

ETA: as I was scheduling this post, there was an update. It’s like a soap opera!*

6. Hunh. Discussing relationship movies decreased divorce rates. In retrospect, I suppose this makes sense. Instead of some awkward feeling counseling session, the movie couple can serve as a proxy. As long as everyone pretends they’re talking about Jack and Rose you can debate issues like differing family backgrounds or drawing one another naked. (link via Julia)

*Really, who can resist making bad shower puns? Not I. 

I was at a conference all weekend, and most of last week, so apologies for posting consistently, then disappearing. I’m going to crawl out from under this homework pile, and blogalogging shall resume!

1. I’m in a class about the Hebrew Bible this quarter, and we just covered the first two-thirds of Genesis. Which makes The Ride Back To Beersheba a timely link. (h/t Taylor)

2. “Hiroo Onoda, the Japanese soldier who refused to accept defeat in World War II until finally surrendering in 1974, died today. In thematically related news, Obamacare opponents have organized their latest campaign to repeal the “Obamacare bailout.”” That is a real opening to this article, and I think I love it.

3. Today in expensive things I want but shouldn’t buy, Durr watches. They vibrate every five minutes–no clock face, no readout–and make you attend to how much time is passing. Temporal orientation!

4. Wendy Davis Drops an Atomic Truth Bomb on Desperate Sexist Republicans. This headline is a real thing. On the other hand, this is a tumblr for kick-ass ledes.

5. On the other hand, Politico has a thoughtful article on Davis. Unlike many pieces of such style, it doesn’t pretend to know if it can answer whether she would make a good governor. Even more appealing to me–it doesn’t gloss over details in pursuit of a pretty picture. Yes, it’s possible that Davis’s ambition and work ethic might have resulted in the eventual divorce of the Davis family. Is it that surprising that a power shift within a relationship could be destabilizing? Journalists, take heed.

While she has been portrayed as the materialistic beneficiary of a duped husband, let me offer another plausible interpretation: At some point Jeff Davis astutely realized he had married a woman who aimed to do more than answer phones and serve salads. He saw that it would be not just in her interest, but his, if he facilitated her advance. He helped her go to law school not only out of the goodness of his heart but because he was betting on her economic prospects, as women have long bet on the prospects of men. How many hundreds of thousands of American women worked to put a husband through law or med school? Did we criticize the men who benefited? Jeff Davis did for his spouse what wives have long done for husbands: He invested in her—their—future.

6. I did not expect to find that a post titled “Why Scientific Papers Are Like Pop Music” would be an entirely apt metaphor, but here we are.

7. More snarky research papers.

8. Researchers have invented a bra that unhooks for ‘true love’. Yes, that is an actual claim they are making. I…..

…yeah, on that note, I think we’ll end. Happy Tuesday! If you live in the arctic tundra that is the Midwest, I hope you’re staying warm. Elsewhere, I am envying you. And I like winter.

1. The Edge Question is up: What scientific idea is ready for retirement? I haven’t made it through all of them (and every time I try, I lose hours to exploring past questions too). This response, Science as Self-Correcting, is one of the best thus far. It is a feel-good trope, it is a great way to make a fast and sloppy argument for science over religion, but it is simply not accurate. We’re not great at correcting ourselves in the best of circumstances, why would this mysteriously be true in science? (h/t Ed Yong)

But hiring, promotion, and grant committees typically don’t value the contributions made by individual researchers using these tools. As long as this continues, progress may be slow. As Max Planck observed, revolutions in science sometimes have to wait for funerals. Even after the defenders of old practices assume their final resting places, the antiquated traditions sometimes endure, in part from the support of institutional policies. A policy does not die until someone kills it. New reforms and innovations need our active support—only then can science live up to its self-correcting tagline.

2. I would really really like to see a psychotherapeutic treatment for anorexia succeed. Unfortunately, what I see is poor data collection,, treatments with little impact, and statistical handwavery. This is an excellent exploration of one such study, but contains photos of anorexia and discussion of weight.

3. And speaking of disordered eating, Andrea looks at eating disorder prevention, and what actually works. Using evidence!

4. Also at SED, misophonia in patients with eating disorders. File this under “…hunh”

5. 

A lot of people have a red handle installed deep in their person, where if somebody yanks on it, it hurts. For some people, it’s some terrible mistake they regret, and for some people, it’s something they’re always trying to get better at that hasn’t worked, or a relationship they can’t repair, or a weakness that makes them self-conscious, or a memory that’s sort of awful. I’m not any better or worse off than anybody else in having something like this in my nature/history; the only difference between mine and anybody else’s is that mine ison the outside.

I mean, let’s say your red handle is that you have a busted relationship with your parents. You’re a happy person, but there’s this one thing that’s really hard, that you haven’t really figured out, that’s just … a thing you haven’t overcome. Imagine if you had to walk around with a big sign around your neck that said, “Once called my mother a terrible name and we haven’t spoken in 10 years.” So that everybody knew – strangers, friends, nice people, mean people, salespeople, people on the train, people who drove by you in their cars while you were walking. Eeeeeeverybody. This is what it’s like to have your red handle on the outside. It can feel a bit like you are at the mercy of literally everyone.

In other words, stop with the fat jokes at Chris Christie. Actually, drop the proper noun there. People are fat, and sometimes this is their red handle, and perhaps you should stop pulling it.

6. Things West Wing taught me. Well, that and forever associating Andrew Jackson’s presidency with cheese.

7. SW friends in particular, you should be reading the whole sky, but this piece on book recommendations in jail ought to convince you. I’ve linked previously to Doing time.

8.  I might endorse switching to describing biases and heuristics as doing mental triage–there are all sorts of flaws with biases–people view them as universally negative, then don’t want to consider that they might have been caught in one, people use them to snipe at arguments rather than address substance, etc–and heuristic isn’t a sticky word that people are liable to recall and use. (h/t Peter Hurford)

Again, we all do this, but we are often reluctant to admit it because we want to present to the world a façade of rationality: I hold my views firmly because I have carefully examined the alternatives and have justifiably rejected them. And sometimes we have indeed carefully examined the alternatives; but usually we haven’t. We’ve undertaken intellectual triage and set a great many possibilities aside with limited or no scrutiny. This is what Dawkins has done with Christianity; he just thinks he hasn’t.

In general, practicing such triage is okay — indeed, it has to be okay because there’s no plausible alternative until we live much longer, eliminate sleep, and acquire faster internal processors — but it’s the sort of thing that can easily go wrong, primarily because, as a self-justifying defense mechanism, we try to fortify our position by attacking or dismissing all the people who believe the things that we’ve decided not to investigate.

9. I’m probably not going to get tired of analyses of the marshmallow test, but this one is from the NYT, and it’s excellent.